Return to training in soccer players after anterior cruciate ligament reconstruction: reflections and considerations

This clinical and rehabilitative overview focuses on the return to unrestricted sporting activity, aiming to consolidate the scientific evidence surrounding the structural progression of athletes, particularly footballers, undergoing anterior cruciate ligament reconstruction (ACLR). A multidisciplinary approach necessitates a shared language and standardized methodologies. Unfortunately, significant disparities persist in the structural strategies guiding the decision-making process for returning to on-field activities, the latter stages of rehabilitation, and subsequent restoration of technical and tactical football abilities. Divergences in definitions, terminologies, and rehabilitation protocols can substantially influence final outcomes. Presently, scientific consensus studies regarding the decision-making process during the final stages of on-field rehabilitation are lacking. Nevertheless, this overview outlines and defines pivotal language parameters crucial for effective communication and the seamless integration of clinical and rehabilitative data among the diverse professionals involved in facilitating the athlete's return to peak performance. In conclusion, the successful resumption of competitive sporting activities for footballer's post ACLR demands a collaborative decision-making approach encompassing various professionals. Additionally, it necessitates a cohesive transition from rehabilitation to on-field work, aiming at reinstating athleticism, technical prowess, and tactical acumen.

Noninvasive brain stimulation for cognitive rehabilitation following traumatic brain injury: A systematic review

Traumatic brain injury (TBI) can cause numerous cognitive deficits. These deficits are associated with disability and reduction in quality of life. Noninvasive brain stimulation (NIBS) provides excitatory or inhibitory stimuli to the cerebral cortex. This review aimed to examine the effectiveness of NIBS (i.e., rTMS and tDCS) on cognitive functions in patients with TBI. PubMed, SCOPUS, PEDro, CINAHL, MEDLINE, REHABDATA, and Web of Science were searched from inception to May 2021. The risk of bias in the randomized controlled trials was assessed using the Cochrane Collaboration's instrument. The Physiotherapy Evidence Database (PEDro) scale was applied to evaluate the risk of bias in the non-randomized controlled trials. Ten studies met our inclusion criteria. Six studies used repetitive Transcranial Magnetic Stimulation (rTMS), and four used transcranial Direct Current Stimulation (tDCS) as cognitive rehabilitation interventions. The results showed heterogenous evidence for the effects of rTMS and tDCS on cognitive function outcomes in individuals with TBI. The evidence for the effects of NIBS on cognition following TBI was limited. TDCS and rTMS are safe and well-tolerated interventions post-TBI. The optimal stimulation sites and stimulation parameters remain unknown. Combining NIBS with traditional rehabilitation interventions may contribute to greater enhancements in cognitive functions post-TBI.

Exploring the interplay between metabolic power and equivalent distance in training games and official matches in soccer: a machine learning approach

Introduction: This study aimed to explore the interplay between metabolic power (MP) and equivalent distance (ED) and their respective roles in training games (TGs) and official soccer matches. Furthermore, the secondary objective was to investigate the connection between external training load (ETL), determined by the interplay of metabolic power and equivalent distance, and internal training load (ITL) assessed through HR-based methods, serving as a measure of criterion validity. Methods: Twenty-one elite professional male soccer players participated in the study. Players were monitored during 11 months of full training and overall official matches. The study used a dataset of 4269 training games and 380 official matches split into training and test sets. In terms of machine learning methods, the study applied several techniques, including K-Nearest Neighbors, Decision Tree, Random Forest, and Support-Vector Machine classifiers. The dataset was divided into two subsets: a training set used for model training and a test set used for evaluation. Results: Based on metabolic power and equivalent distance, the study successfully employed four machine learning methods to accurately distinguish between the two types of soccer activities: TGs and official matches. The area under the curve (AUC) values ranged from 0.90 to 0.96, demonstrating high discriminatory power, with accuracy levels ranging from 0.89 to 0.98. Furthermore, the significant correlations observed between Edwards' training load (TL) and TL calculated from metabolic power metrics confirm the validity of these variables in assessing external training load in soccer. The correlation coefficients (r values) ranged from 0.59 to 0.87, all reaching statistical significance at p < 0.001. Discussion: These results underscore the critical importance of investigating the interaction between metabolic power and equivalent distance in soccer. While the overall intensity may appear similar between TGs and official matches, it is evident that underlying factors contributing to this intensity differ significantly. This highlights the necessity for more comprehensive analyses of the specific elements influencing physical effort during these activities. By addressing this fundamental aspect, this study contributes valuable insights to the field of sports science, aiding in the development of tailored training programs and strategies that can optimize player performance and reduce the risk of injuries in elite soccer.

Golden ratio and self-similarity in swimming: breast-stroke and the back-stroke

INTRODUCTION

Dynamics-on-graph concepts and generalized finite-length Fibonacci sequences have been used to characterize, from a temporal point of view, both human walking & running at a comfortable speed and front-crawl & butterfly swimming strokes at a middle/long distance pace. Such sequences, in which the golden ratio plays a crucial role to describe self-similar patterns, have been found to be subtly experimentally exhibited by healthy (but not pathological) walking subjects and elite swimmers, in terms of durations of gait/stroke-subphases with a clear physical meaning. Corresponding quantitative indices have been able to unveil the resulting hidden time-harmonic and self-similar structures.

RESULTS

In this study, we meaningfully extend such latest findings to the remaining two swimming strokes, namely, the breast-stroke and the back-stroke: breast-stroke, just like butterfly swimming, is highly technical and involves the complex coordination of the arm and leg actions, while back-stroke is definitely similar to front-crawl swimming. An experimental validation with reference to international-level swimmers is included.

Role of music therapy in improving cognitive function post-traumatic brain injury: A systematic review

Cognitive deficits are one of the most prevalent impairments in patients with traumatic brain injury (TBI). Music therapy has the potential to be a valuable intervention for improving cognitive function. This review aimed to investigate the effects of music therapy on cognitive function in patients with TBI. Scopus, PubMed, REHABDATA, PEDro, EMBASE, and web of science were searched for experimental trials examining the impacts of music therapy on cognition in patients with TBI from inception until December 2022. Physiotherapy Evidence Database (PEDro) scale was used to evaluate the methodological quality of the included studies. Five studies met the inclusion criteria. A total of 122 patients with TBI were included in this review, 32% of whom were females. The PEDro scores ranged from four to seven, with a median of five. The findings showed that music therapy could be effective in improving executive function post-TBI, with limited evidence for the effects on memory and attention. Music therapy might be safe in patients with TBI. The evidence for the effect of music therapy on executive function in patients with TBI is promising. Further studies with larger sample sizes and long-term follow-ups are strongly needed.

Effects of long-term detraining on muscle performance in young soccer players

BACKGROUND

Long-term detraining consists of a physiological partial or total reduction of the adaptations induced by training caused by a suspension period of the training itself longer than 4 weeks. The aim of this study was to analyze a group of young soccer players by assessing the effects of long-term detraining on neuromuscular performance.

METHODS

A study sample of 35 young soccer players of subelite level (age: 14.5±0.5 years) was recruited. The subjects were tested 7 days before the interruption of training for the summer break (T0), and at the end of the 7-week detraining period (T1).

RESULTS

No statistically significant differences were found for BMI (P=0.283) and percentage of fat mass (P=0.273) between T0 and T1. PUSH UP (P=0.016; ES [effect size]=0.2) and SIT UP (P=0.001; ES=1.2) test values show statistically significant increase, those of CHIN UP (P=0.05; ES=-0.2), instead, a statistically significant worsening. Statistically significant but moderate differences on speed running test 30 meters (P=0.001; ES=0.3) are observed as well as trivial differences on 50 meters (P=0.001; ES=0.2), while differences on 10, 15 and 20 meters are irrelevant. As for the jump tests, values show a slight worsening (P=0.135; ES=0.2) in Squat Jump and Counter Movement Jump (P=0.153; ES=0.2) without statistical significance.

CONCLUSIONS

A 7-week-long detraining period does not seem to produce any appreciable changes on neuromuscular performance of the lower limb (trained muscle) in young soccer players. As regards the analyzed age group, coaches should not focus their attention on neuromuscular efficiency maintenance exercises in the off-season period.

A Novel Neurorehabilitation Approach for Neural Plasticity Overstimulation and Reorganization in Patients with Neurological Disorders

Neurological disorders are those that are associated with impairments in the nervous system. These impairments affect the patient’s activities of daily living. Recently, many advanced modalities have been used in the rehabilitation field to treat various neurological impairments. However, many of these modalities are available only in clinics, and some are expensive. Most patients with neurological disorders have difficulty reaching clinics. This review was designed to establish a new neurorehabilitation approach based on the scientific way to improve patients’ functional recovery following neurological disorders in clinics or at home. The human brain is a network, an intricate, integrated system that coordinates operations among billions of units. In fact, grey matter contains most of the neuronal cell bodies. It includes the brain and the spinal cord areas involved in muscle control, sensory perception, memory, emotions, decision-making, and self-control. Consequently, patients’ functional ability results from complex interactions among various brain and spinal cord areas and neuromuscular systems. While white matter fibers connect numerous brain areas, stimulating or improving non-motor symptoms, such as motivation, cognitive, and sensory symptoms besides motor symptoms may enhance functional recovery in patients with neurological disorders. The basic principles of the current treatment approach are established based on brain connectivity. Using motor, sensory, motivation, and cognitive (MSMC) interventions during rehabilitation may promote neural plasticity and maximize functional recovery in patients with neurological disorders. Experimental studies are strongly needed to verify our theories and hypothesis.

Prevention of Secondary Injury after Anterior Cruciate Ligament Reconstruction: Relationship between Pelvic-Drop and Dynamic Knee Valgus

(1) Background: Optimal neuromuscular, Lumbo-Pelvic-Hip Complex, and lower extremity control are associated with decreased risk factors for secondary anterior cruciate ligament (ACL) injury. This study aimed to analyze any asymmetries and malalignments in the Lumbo-Pelvic-Hip Complex and the lower limbs at 6 months after ACL reconstruction (ACLR). (2) Methods: We conducted an exploratory retrospective observational single-center study in patients during the outpatient postoperative rehabilitation program at ICOT (Latina, Italy). From January 2014 to June 2020, 181 patients were recruited, but only 100 patients (86 male 28 ± 0.6 years, 178 ± 0.5 height; 14 female 24 ± 2.0 years, 178 ± 3.0 height) were eligible for the inclusion criteria and studied 6 months after ACL reconstruction surgery. (3) Statistical analysis: Student's t-tests and Pearson's product-moment correlation coefficient were used to determine significant differences between affected and non-affected limbs and variables' association. (4) Results: The study shows a decrease in neuromuscular control of the Lumbo-Pelvic-Hip Complex and dynamic adaptive valgus of the knee at 6 months after ACLR (mean difference between pathological and healthy limb of dynamic adaptive valgus was -10.11 ± 8.19° 95% CI -14.84 to -9.34; mean value was 16.3 ± 6.8° 95% CI 14.04 to 18.55 for healthy limb and 4.2 ± 3.1° 95% CI 3.15 to 5.21 for pathological limb, p < 0.0001). The results also showed a relationship between dynamic adaptive valgus and contralateral pelvic drop (r = 0.78, 95% CI 0.62 to 0.88, magnitude of correlation very large). (5) Conclusions: The analysis showed an associative correlation between decreased postural control of the pelvic girdle and dynamic adaptive valgus of the knee in 38% of patients; this study highlights the usefulness of the Single-Leg Squat Test (SLST) as a clinical/functional assessment to evaluate the rehabilitation process and as a preventive tool to reduce the risk of second ACL injuries during the return to sport.

Proprioceptive Focal Stimulation (Equistasi®) for gait and postural balance rehabilitation in patients with Parkinson's disease: A systematic review

Gait and postural deficits are the most common impairments in patients with Parkinson's Disease (PD). These impairments often reduce patients' quality of life. Equistasi^® is a wearable proprioceptive stabilizer that converts body thermic energy into mechanical vibration. No systematic reviews have been published investigating the influences of Equistasi^® on gait and postural control in patients with PD. This review aimed to examine the effects of proprioceptive focal stimulation (Equistasi^®) on gait deficits and postural instability in patients with PD. PubMed, Scopus, PEDro, REHABDATA, web of science, CHAINAL, EMBASE, and MEDLINE were searched from inception to July 2021. The methodological quality of the selected studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. Five studies met the eligibility criteria. The scores on the PEDro scale ranged from 3 to 8, with a median score of 8. The results showed evidence for the benefits of the proprioceptive focal stimulation (Equistasi^®) on gait and postural stability in individuals with PD. Proprioceptive focal stimulation (Equistasi^®) appears to be safe and well-tolerated in patients with PD. Proprioceptive focal stimulation (Equistasi^®) may improve gait ability and postural stability in patients with PD. Further high-quality studies with long-term follow-ups are strongly needed to clarify the long-term effects of proprioceptive focal stimulation (Equistasi^®) in patients with PD.

Transcranial direct current stimulation for upper extremity spasticity rehabilitation in stroke survivors: A systematic review of randomized controlled trials

OBJECTIVES

To examine the effects of transcranial direct current stimulation (tDCS) on upper extremity spasticity after stroke and to define the most effective tDCS parameters.

LITERATURE SURVEY

Systematic review in the following databases: PubMed, SCOPUS, PEDro, CINAHL, MEDLINE, REHABDATA, AMED, and Web of Science databases. Studies up to June 2020 were included.

METHODOLOGY

Studies were included if the sample was composed of individuals with stroke, the intervention followed a tDCS intervention (alone or combined with another intervention), and the study was a randomized controlled trial including at least one measurement assessing upper extremity spasticity. Two authors independently screened the included studies. Conflicting decisions between authors were resolved by discussion with the third author. The methodological quality was assessed using the Cochrane Collaboration's tool. The authors determined that the meta-analysis was not feasible due to the heterogeneity in the protocols among the included studies.

SYNTHESIS

After the screening of 1204 records, a total of seven studies met the specified inclusion criteria and involved 320 participants (mean age = 60.3), 31.1% of whom were females. Patients with ischemic stroke comprised 77.2% of the total patients, and 42.2% were with right hemispheric stroke. Six studies exhibited "high" quality and one exhibited "moderate" quality. Five of the selected studies that combined the tDCS intervention and other traditional interventions showed a significant reduction in upper extremity spasticity after stroke following tDCS intervention. The other two studies that delivered tDCs alone did not show a significant difference.

CONCLUSIONS

The evidence for the effect of tDCS on upper extremity spasticity after stroke was limited. The optimal tDCS treatment dosage remains unclear. Additional studies with large sample sizes and long-term follow-up are strongly warranted.

Acute Effects of Kinesio Taping on Functional Performance in Healthy Soccer Players: A Randomized, Controlled Crossover Trial

This study aimed to investigate the acute effects of the Kinesio tape (KT) application on functional performance in healthy athletes. In this randomized, controlled crossover trial, a total of sixteen healthy soccer players (male = 14; age = 23.28 ± 3.13 years old) were assigned randomly into either KT over quadriceps, KT over hamstring, KT over quadriceps plus hamstring, or no intervention control condition. Four conditions were applied in a crossover design through three consecutive test sessions for each condition with a washout period of 2 days between the trials. Afterwards, all participants performed a 5-min warm-up routine and four sets of 30-s static stretching exercises for the hamstring and gluteal muscles for three consecutive treatment sessions. The running, jump, and flexibility tests were used to assess the functional performance of healthy athletes. A total of sixteen participants completed the study. No significant differences in the jump, flexibility, and running tests among the conditions were reported (p > 0.05). These findings suggest that KT application has no acute effects in improving functional performance in healthy athletes. However, further studies with larger sample sizes are needed to verify our results.

Whole Body Vibration: A Valid Alternative Strategy to Exercise?

Several studies agree that mechanical vibration can induce physiological changes at different levels, improving neuromuscular function through postural control strategies, muscle tuning mechanisms and tonic vibration reflexes. Whole-body vibration has also been reported to increase bone mineral density and muscle mass and strength, as well as to relieve pain and modulate proprioceptive function in patients with osteoarthritis or lower back pain. Furthermore, vibratory training was found to be an effective strategy for improving the physical performance of healthy athletes in terms of muscle strength, agility, flexibility, and vertical jump height. Notably, several benefits have also been observed at the brain level, proving to be an important factor in protecting and/or preventing the development of age-related cognitive disorders. Although research in this field is still debated, certain molecular mechanisms responsible for the response to whole-body vibration also appear to be involved in physiological adaptations to exercise, suggesting the possibility of using it as an alternative or reinforcing strategy to canonical training. Understanding these mechanisms is crucial for the development of whole body vibration protocols appropriately designed based on individual needs to optimize these effects. Therefore, we performed a narrative review of the literature, consulting the bibliographic databases MEDLINE and Google Scholar, to i) summarize the most recent scientific evidence on the effects of whole-body vibration and the molecular mechanisms proposed so far to provide a useful state of the art and ii) assess the potential of whole-body vibration as a form of passive training in place of or in association with exercise.

Rehabilitation interventions for cognitive deficits in stroke survivors: A systematic review of randomized controlled trials

Cognitive deficits are one of the most common impairments after stroke. It negatively affects physical and social functioning. Rehabilitation interventions for cognitive deficits post-stroke have taken less consideration. The present study aimed to provide an overview of the effects of various rehabilitation interventions on cognitive functions in patients with stroke. PUBMED, SCOPUS, PEDro, EMBASE, MEDLINE, and REHABDATA were searched for randomized controlled trials (RCTs) investigating the effects of rehabilitation interventions on cognitive domains poststroke until August 2021. The methodological quality of the selected studies was evaluated using the Cochrane Collaboration tool, and the effect sizes were calculated. Forty-four studies met the inclusion criteria. A total of 3561 individuals with stroke, 57.60% of whom were males. The mean age for all participants was 65.48 years. Eighteen RCTs were high, moderate (n = 17), and low methodological quality (n = 9). The results showed evidence for the beneficial effects of many rehabilitation interventions on cognition in individuals with stroke. Rehabilitation plays a crucial role in improving cognitive functions in stroke patients with mild cognitive deficits. Virtual reality (VR), computer-based cognitive rehabilitation (CBCR), and non-aerobic exercises may promote cognitive functions in patients with stroke.

Virtual reality for balance and mobility rehabilitation following traumatic brain injury: A systematic review of randomized controlled trials

BACKGROUND

Balance and mobility deficits are most prevalent impairments in patients with traumatic brain injury (TBI). The evidence has proposed that rehabilitation plays an important role in improving balance and mobility post-TBI. Virtual reality (VR) is a computer technology that provides immersed users to generate feedback such as visual, audio, and haptic.

OBJECTIVE

This review aimed to examine the effects of the VR treatment intervention on balance and mobility in patients with TBI and to define the most effective VR treatment protocol.

METHODS

SCOPUS, PEDro, PubMed, REHABDATA, EMBASE, and the web of science were searched for experimental trials examining the impacts of VR training on balance and mobility in patients with TBI from inception until July 2022. Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the selected studies.

RESULTS

Five randomized controlled trials (RCTs) met the inclusion criteria. The PEDro scores ranged from 6 to 8, with a median of 6. A total of 157 patients with TBI were included in this review, 31.2% of whom were females. The findings showed that VR intervention is not superior to traditional physiotherapy interventions in improving balance and mobility post- TBI.

CONCLUSIONS

The preliminary findings showed that the influence of VR on the balance and mobility ability in patients with TBI is promising. Combining VR with other concurrent rehabilitation interventions may show more significant improvements in balance and mobility compared to VR interventions alone. The optimal VR treatment protocol remains unclear. Further randomized controlled trials are strongly needed.

Whole Body Vibration Improves Brain and Musculoskeletal Health by Modulating the Expression of Tissue-Specific Markers: FNDC5 as a Key Regulator of Vibration Adaptations

Whole body vibration (WBV) is well known to exert beneficial effects on multiple tissues, improving synaptic transmission, muscle mass, bone quality, and reducing anxiety and depressive behavior. However, the underlying molecular mechanisms are not yet fully understood, and organs and tissues may respond differently to the vibratory stimulus depending on multiple factors. Therefore, we investigated the WBV effects on the brain and musculoskeletal tissue of 4-month-old young mice, evaluating synaptic plasticity by electrophysiological recordings and tissue organization by histology and histomorphometric analysis. Specifically, WBV protocols were characterized by the same vibration frequency (45 Hz), but different in vibration exposure time (five series of 3 min for the B protocol and three series of 2 min and 30 s for the C protocol) and recovery time between two vibration sessions (1 min for the B protocol and 2 min and 30 s for the C protocol). In addition, immunohistochemistry was conducted to evaluate the expression of fibronectin type III domain-containing protein 5 (FNDC5), as well as that of tissue-specific markers, such as brain-derived neurotrophic factor (BDNF) in brain, myostatin in muscle and collagen I (COL-1) in bone. Our results suggest that the WBV effects depend closely on the type of protocol used and support the hypothesis that different organs or tissues have different susceptibility to vibration. Further studies will be needed to deepen our knowledge of physiological adaptations to vibration and develop customized WBV protocols to improve and preserve cognitive and motor functions.

COVID-19 as a Potential Cause of Muscle Injuries in Professional Italian Serie A Soccer Players: A Retrospective Observational Study

The COVID-19 pandemic has shocked the entire planet. The soccer world has also suffered major upheavals, and many professional soccer players have been infected with the virus. The aim of this study was to evaluate the incidence of injuries in Italian Serie A professional soccer players before and during the COVID-19 pandemic. Methods: We evaluated the incidence of muscle injuries between four competitive seasons of the Italian Serie A (2016-2017, 2017-2018, and 2018-2019 pre-COVID-19 vs. 2020/2021 post-COVID-19) in professional soccer players. Results: Significant differences were found in muscular injuries between the post-COVID-19 season and the previous seasons (p < 0.001). The median split of the players' positivity duration was of 15 days. The players' long positivity (PLP) group showed a significant number of muscular injuries compared to the players' short positivity (PSP) group (p < 0.0014, ES = 0.81, Large). The total teams' days of positivity were significantly related to the total team number of muscular injuries (r = 0.86; CI 95% 0.66 to 0.94; p < 0.0001). In conclusion, this data showed that the competitive season post-COVID-19 lockdown has a higher incidence of muscle injuries in Italian Serie A soccer players compared to the pre-pandemic competitive season.

Paddle propulsive force and power balance: a new approach to performance assessment in flatwater kayaking

This study aims to determine the propulsive force (Fp) and its timing of application during the paddle stroke confirming the dynamic balance between propulsive and drag powers (Pp = Pd) in kayaking performance. Ten male sub-elite paddlers participated in the study. The athletes carried out three trials of 50 m at three different velocity ranges: 2.70 - 3.00 m/ s; 3.01 - 3.50 m/s and 3.51 - 4.00 m/ s. A constant velocity during each trial was maintained and the section between 15 and 40 m of the total pool length was considered for further analysis. Data were collected using the E-kayak system provided of an instrumented paddle and 2D video analysis. It was observed that the propulsive force increases in intensity (up to 90% of the peak force) as the velocity increases. The dynamic balance between Pd and Pp was confirmed with a Bland and Altman plot (estimated bias: 0.2; LoA: 12.8 and 13.3 W). The related comparisons between the power parameters showed no significant difference (p > 0.050) in each of the considered velocity. By applying the dynamic balance theory between Pp = Pd on the data obtained from the interaction among GPS, force on the paddle and 2D video analysis, it is possible to acquire essential information (Fp, Pp) to monitor the flatwater kayaking performance.

Specificity of weightlifting bench exercises in kayaking sprint performance: A perspective for neuromuscular training

Several studies showed significant differences between bench lift exercises without investigating which is more related, in biomechanical and neuromuscular terms, to improve the sprint flatwater kayak performance. This study aims to compare the power-load and velocity-load neuromuscular parameters performed in prone bench pull (PBP), and bench press (BP) exercises to identify which of them meet the gesture specificity in sprint flatwater kayak performance. Ten elite kayakers participated in this study. Power-load, velocity-load relationships, the maximum dynamic strength, and the kayak sprint performance test were assessed. The power-load and velocity-load relationships showed significant differences between the PBP and BP for each considered load. The kayakers showed a significant correlation between maximum power performed on the PBP and the maximum velocity reached in the kayak sprint (r = 0.80, p &lt; 0.01) and the stroke frequency (r = 0.61, p &lt; 0.05). Conversely, the maximum power performed on the BP did not correlate with the kinematic parameters analyzed. In addition, the maximum dynamic strength in the PBP and BP did not correlate with the maximum velocity and stroke frequency. Furthermore, no significant difference was observed in both the bench exercises for the maximum dynamic strength (p &gt; 0.05). The results of this study suggest that the maximal muscular power expressed in PBP exercise only seems to be more specific in kayak velocity performance compared with maximal dynamic strength and with all dynamic parameters recorded in the BP. This will allow coaches and trainers to use specific bench exercises for specific neuromuscular kayakers’ adaptations during the whole competitive season.

Neuromuscular response to the stimulation of plantar cutaneous during walking at different speeds

BACKGROUND

A lot of authors have been studied the consequence of postural control strategies through investigating the effects of foot-surface contact. In this context an important variable of textured surfaces or insoles could be related to material stiffness. We apply a particular textured insoles to evaluate neuromuscular response of plantar stimulation during walking.

RESEARCH QUESTION

Could textured insoles alter the human locomotion during walking at different speeds?

METHODS

Ten adults (age: 27 ± 5 years) completed three trials on the multifunction treadmill at 0.42 ms^-1, 0.89 ms^-1, and 1.5 ms^-1 walking speed. Temporal-spatial parameters, gait line, and kinetic parameters were analyzed. The Co-Contraction Index (CCI) and electromyography (EMG) of the right leg muscles were assessed during four phases of gait: first half stance (FHS), half stance (HS), second half stance (SHS), swing phase (SP). Textured insole and soft control insole were worn while walking.

RESULTS

Plantar stimulation improved cadence, stride time, stride length and gait line parameters with increasing speed. First force peaks and maximum force forefoot were always significant. The maximum force midfoot was significant at 0.42 and 0.89 ms^-1. The maximum force heel only was significant in lower velocity. The maximum pressure showed different significant values except for the heel. Significant differences in the CCI were always found in the FHS and SHS for the plantar muscles, and in the FHS and HS for the knee muscles. The differences in gait analysis in biomechanical and in electromyographic parameters were more significant in the higher speed tested.

SIGNIFICANCE

The perception of shape and texture through its linear response to skin deformation over a wide range of deformations could be the reason why the significant differences increase in the higher speed. In conclusion, sensory interventions fallowing appropriate insoles can influence significantly gait. Walking strategy positively adjusts locomotion with high efficiency.

Clinical effectiveness of focal muscle vibration on gait and postural stability in individuals with neurological disorders: A systematic review

BACKGROUND

Gait deficits and postural instability are common impairments among patients with neurological disorders. These impairments limit function independence and decrease activities of daily living. Focal muscle vibration (FMV) produces vibration signals affecting the nervous system. No systematic review has been published examining the influence of FMV on gait ability and postural stability in individuals with neurological disorders.

OBJECTIVES

This study aimed to investigate the effects of FMV on gait and postural stability parameters in individuals with neurological disorders.

METHODS

PubMed, Scopus, PEDro, REHABDATA, web of science, CHAINAL, EMBASE, and MEDLINE were searched from inception to July 2021. The methodological quality of the selected studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale.

RESULTS

Five randomized controlled trials (RCTs) met the eligibility criteria. The scores on the PEDro scale ranged from seven to nine, with a median score of eight. The results showed evidence for the benefits and non-benefits of the FMV intervention on gait and postural stability in individuals with neurological disorders.

CONCLUSIONS

The FMV intervention is safe and well-tolerated in individuals with neurological disorders. The evidence for the effects of FMV on individuals with neurological disorders was limited. Further high-quality studies with long-term follow-up are strongly needed.

Hyperbaric oxygen therapy for cognitive impairments in patients with traumatic brain injury: A systematic review

Cognitive deficits are the most common impairments after traumatic brain injury (TBI). It can be linked with poor physical function. Hyperbaric oxygen therapy (HBOT) increases blood flow and oxygen supply to the brain. This review aimed to summarize and evaluate the available literature on the influences of HBOT on cognitive deficits in patients with TBI. PubMed, SCOPUS, PEDro, REHABDATA, MIDLINE, CHINAL, EMBASE, and Web of Science were searched from inception until June 2021. The methodological quality was measured using the physiotherapy evidence database (PEDro) scale. Ten studies met the eligibility criteria. Six studies were randomized controlled trials, and four were pilot studies. The scores on the PEDro scale ranged from two to nine, with a median score of seven. The included studies showed heterogeneity results for the beneficial effects of HBOT on improving cognitive functions in patients with TBI. The evidence for the beneficial effects of HBOT on cognitive functions post-TBI was limited. Further randomized controlled trials with large sample sizes are strongly needed to understand the effects of HBOT on cognitive functions in patients with TBI.

Changes in spasticity following functional electrical stimulation cycling in patients with spinal cord injury: A systematic review

Spasticity is one of the most common secondary impairment after spinal cord injury (SCI). It can lead to an increase in the level of disability. The functional electrical stimulation cycling (FES-cycling) promotes recovery in patients with SCI. No systematic review has been published examining the influence of FES-cycling on the spasticity of lower extremities post-SCI.Objective: This review aimed to investigate the effects of the FES-cycling on the lower extremities spasticity in patients with SCI.Methods: PubMed, Scopus, PEDro, REHABDATA, Web of Science, and MEDLINE were searched until December 2019. The methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale.Results: Ten studies were met the inclusion criteria. Two were randomized clinical trials, cohort study (n = 2), and pilot study (n=6). The scores on the PEDro scale ranged from one to nine, with a median score of three. The results showed evidence for the beneficial effects of FES-cycling on the spasticity of lower extremities in individuals with SCI.Conclusion: The FES-cycling intervention may reduce the lower extremities spasticity in patients with various injury levels of SCI. It is not a suitable intervention for medically unstable patients or with contraindication for lower extremities movement. Further randomized controlled trials with a large sample size strongly warranted to confirm our findings.

Transcutaneous spinal cord stimulation effects on spasticity in patients with spinal cord injury: A systematic review

CONTEXT

Spasticity is one of the most prevalent impairments following spinal cord injury (SCI). It can lead to a decrease in the patient's functional level. Transcutaneous spinal cord stimulation (tSCS) has demonstrated motor function improvements following SCI. No systematic reviews were published examining the influences of tSCS on spasticity post-SCI.

OBJECTIVES

This review aimed to investigate the effects of tSCS on spasticity in patients with SCI.

METHODS

PubMed, SCOPUS, PEDro, CINAHL, MEDLINE, REHABDATA, AMED, and Web of Science databases were searched until June 2021. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the selected studies.

RESULTS

Six studies met the inclusion criteria. Five studies were pilot studies, and one was a case series. The scores on the PEDro scale ranged from two to four, with a median score of four. The results showed heterogenous evidence for the effects of tSCS on spasticity reduction post-SCI.

CONCLUSIONS

TSCS appears safe and well-tolerated intervention in patients with SCI. The evidence for the effectiveness of tSCS on spasticity in chronic SCI patients is limited. Further randomized controlled studies are strongly needed to study the effects of tSCS on patients with SCI.

Robot-assisted gait training in individuals with spinal cord injury: A systematic review for the clinical effectiveness of Lokomat

BACKGROUND

Spinal cord injury (SCI) is a critical medical condition that causes numerous impairments leading to accompanying disability. Robotic-assisted gait training (RAGT) offers many advantages, including the capability to increase the intensity and total duration of training while maintaining a physiological gait pattern. The effects of the RAGT 'Lokomat' on various impairments following SCI remain unclear.

OBJECTIVES

This review was conducted to examine the impacts of the RAGT 'Lokomat' on the impairments following SCI.

METHODS

We searched PubMed, SCOPUS, PEDro, REHABDATA, MEDLINE, EMBASE, and web of science from inception to January 2021. Experimental studies examining the effects of the Lokomat on the impairments following incomplete SCI were selected. The methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale.

RESULTS

Sixteen studies were met the inclusion criteria. Thirteen were randomized controlled trials, two were clinical trials, and one was a pilot study. The scores on the PEDro scale ranged from two to eight, with a median score of six. The results showed evidence for the beneficial effects of the Lokomat on many motor impairments following incomplete SCI.

CONCLUSIONS

The Lokomat may improve gait speed, walking distance, strength, range of motion, and mobility after incomplete SCI. There is insufficient evidence for the effect of the Lokomat on balance, depression, cardiorespiratory fitness, and quality of life. The effects of the Lokomat on the lower extremity spasticity were limited.

Acute effects of whole-body vibrations on the fatigue induced by multiple repeated sprint ability test in soccer players

BACKGROUND

We tested the hypothesis that Whole Body Vibration (WBV) positively affects the fatigue process ensuing from repeated bouts of maximal efforts, as induced by repeated sprints ability (RSA). Eleven male soccer players performed three sets of six repeated shuttle sprints (40 metres).

METHODS

Eleven male soccer players (age 23,6±4,5 years) were cross-randomized to perform WBW before RSA and during the recovery between sets (WBV-with) or to warm-up and passive recovery between sets (WBV-without). The effects of WBV were quantified by sprint time (ST) and blood lactate concentration (LA), collected up to 15th min after completion of tests.

RESULTS

ST during RSA showed a better maintenance of performance in the WBV-with compared to WBV-without condition in all three sets, reaching a statistical significance between-groups during the 2nd and 3rd set (P< 0.05). No significant differences in ST over the sets were detected in WBVwith, whereas a significant decrease was observed in the WBV-without condition (P<0.001). LA recovered significantly faster from the 9th to 15th minute of recovery in WBV-with as compared to WBV-without (P<0.05).

CONCLUSIONS

These findings would indicate that WBV performed during recovery between RSA sets is capable of delaying the onset of muscle fatigue resulting in a better maintenance of sprint performance.

Dose-Response Effect of Vibratory Stimulus on Synaptic and Muscle Plasticity in a Middle-Aged Murine Model

Whole body vibration plays a central role in many work categories and can represent a health risk to the musculoskeletal system and peripheral nervous system. However, studies in animal and human models have shown that vibratory training, experimentally and/or therapeutically induced, can exert beneficial effects on the whole body, as well as improve brain functioning and reduce cognitive decline related to the aging process. Since the effects of vibratory training depend on several factors, such as vibration frequency and vibration exposure time, in this work, we investigated whether the application of three different vibratory protocols could modulate synaptic and muscle plasticity in a middle-aged murine model, counteracting the onset of early symptoms linked to the aging process. To this end, we performed in vitro electrophysiological recordings of the field potential in the CA1 region of mouse hippocampal slices, as well as histomorphometric and ultrastructural analysis of muscle tissue by optic and transmission electron microscopy, respectively. Our results showed that protocols characterized by a low vibration frequency and/or a longer recovery time exert positive effects at both hippocampal and muscular level, and that these effects improve significantly by varying both parameters, with an action comparable with a dose-response effect. Thus, we suggested that vibratory training may be an effective strategy to counteract cognitive impairment, which is already present in the early stages of the aging process, and the onset of sarcopenia, which is closely related to a sedentary lifestyle. Future studies are needed to understand the underlying molecular mechanisms and to determine an optimal vibratory training protocol.

The effect of age, sex and a firm-textured surface on postural control

In previous studies, the influence of plantar sensation has been examined using various textured surfaces with different stiffness materials to assess static balance. This study investigated the effects of a Firm Textured Surface (FTS) along with age and sex-related influences on postural control under different visual conditions. Forty subjects (20 elderly, 10 males, mean age 68.30, 10 females, mean age 68.00, and 20 young people, 10 males, mean age 25.45, 10 females, mean age 27.30) participated in this study maintained a quiet standing on FTS, foam and firm surfaces with eyes open and closed. The center of pressure displacement (CoP_DISP), CoP velocity (CoP_VEL), and sway velocity of the CoP in anteroposterior (AP) and mediolateral (ML) direction (V_A/P and V_M/L) were measured. FTS was associated with lower postural sway measures in both the groups with eyes open and closed. However, the foam surface showed the worst results in all postural parameters under all experimental conditions. Separate four-way ANOVAs were applied to each dependent variable. The main effects of surface (p < 0.0001), vision (p < 0.0001) and age (p < 0.0001 for CoP_DISP, CoP_VEL and V_A/P; p = 0.0003 for V_M/L) were significant in each of the four fitted models. Sex was never significant, either as a main effect or an interaction with other experimental factors. Eyes open were able to reduce the negative effects of the foam surfaces but without vision the proprioceptive sensory system cues of the body state become more important for maintaining balance. A good stimulation with rigid texture should be considered as relief to reduce the physiological-related decline of afferent information with age.

Rehabilitation of limb apraxia in patients following stroke: a systematic review

Apraxia is widely used to describe one of the more disabling deficits following left strokes. The role of rehabilitation in treating apraxic stroke patients remains unclear. This systematic review was conducted to study the impacts of various rehabilitation interventions on the limb apraxia post-stroke. PubMed, SCOPUS, PEDro, CINAHL, MEDLINE, REHABDATA, and Web of Science were searched for the experimental studies that investigated the effects of the rehabilitation interventions on apraxia in patients with stroke. The methodological quality was rated using the Physiotherapy Evidence Database scale (PEDro). Six studies met our inclusion criteria in this systematic review. Four were randomized controlled trials, pilot (n = 1), and case study (n = 1). The scores on the PEDro scale ranged from two to eight, with a median of seven. The results showed some evidence for the effects of strategy training and gesture training interventions on the cognitive functions, motor activities, and activities of daily livings outcomes poststroke. The preliminary findings showed that the effects of the strategy training and the gesture training on apraxia in patients with stroke are promising. Further randomized controlled trials with long-term follow-ups are strongly needed.

Kinematic Analysis of Water Polo Player in the Vertical Thrust Performance to Determine the Force-Velocity and Power-Velocity Relationships in Water: A Preliminary Study

BACKGROUND

To date, studies on muscle force and power-velocity (F-v and P-v) relationships performed in water are absent.

AIM

The goal of this study is to derive the F-v and P-v regression models of water polo players in water vertical thrust performance at increasing load.

METHODS

After use of a control object for direct linear transformation, displacement over the water and elapsed time was measured, by using a high-speed 2D-videoanalysis system, on 14 players involved in the study.

RESULTS

Intra-operator and player's performance interclass correlation coefficient (ICC) reliability showed an excellent level of reproducibility for all kinematic and dynamic measurements considered in this study with a coefficient of variation (CV) of less than 4.5%. Results of this study have shown that an exponential force-velocity relationship seems to explain better the propulsive force exerted in the water in lifting increasing loads compared to the linear one, while the power and velocity have been shown to follow a second-order polynomial regression model.

CONCLUSION

Given the accuracy of the video analysis, the high reliability and the specificity of the results, it is pointed out that video analysis can be a valid method to determine force-velocity and power-velocity curves in a specific environment to evaluate the neuromuscular profile of each water polo player.

Front crawl stroke in swimming: Phase durations and self-similarity

Human movements, such as walking and running, are able to generate rhythmic motor patterns, with the consequent appearance of hidden time-harmonic structures. Such harmonic structures are represented (at comfortable speed) by the occurrence of the golden ratio as ratio of durations of specific walking and running gait sub-phases. Preliminary experimental evidences suggest that front crawl swimming may behave, under this point of view, like walking and running. This paper aims to demonstrate that a mathematical connection between the golden ratio and the front crawl swimming stroke actually exists, at a pace that plays the role of the comfortable speed in walking and running. Generalized Fibonacci sequences are used to this purpose. They rely on the durations of aggregate phases of the front crawl swimming stroke with a clear physical meaning, while characterizing self-similarity of front crawl strokes in its simple nature and enhanced (stronger) variant. Experimental data on front crawl swimmers illustrate the theoretical derivations, suggesting that the pace playing the role of the comfortable speed in walking and running is the middle/long-distance one, while showing that the self-similarity level increases with the swimming technique and the enhanced self-similarity is associated with the performance of top-level swimmers.

Relative handgrip strength is inversely associated with the presence of type 2 diabetes in overweight elderly women with varying nutritional status

BACKGROUND AND AIMS

To describe cross-sectional associations of BMI-adjusted handgrip strength with the presence of diabetes and hypertension in a community setting.

METHODS AND RESULTS

Between 2016 and 2018, 601 consecutive elderly active women (70.7 ± 6.9 years) were enrolled. Nutritional status was evaluated by the Mini Nutritional Assessment (MNA) score. Muscle strength and level of fitness were assessed by standardized physical functional tests and handgrip strength (HGS). The majority of participants were overweight or obese (80% with BMI > 25). Prevalence of diabetes and hypertension was 13 and 60%, respectively. Participants in the lowest quartile of BMI-adjusted HGS (RHGS) had significantly higher prevalence of diabetes and hypertension compared with those in the top quartile (20.7 vs 5.3% and 49.3 vs 39.3%, respectively, p < 0.01 for both), without significant differences in nutritional status. Association with the presence of diabetes was significantly weaker in women with higher vs lower RHGS values (OR 0.77; 0.59-0.86 CI95%; p = 0.002), independent of age, abdominal adiposity, and presence of hypertension. RHGS was positively correlated with most of the physical functional tests performed.

CONCLUSION

RHGS is an easy-to-obtain measure of muscular strength, independently associated with the presence of diabetes in overweight active elderly women. Prospective studies are required to assess its predictive value to identify adults at risk of developing diabetes.

Rethinking training in elite soccer players: comparative evidence of small-sided games and official match play in kinematic parameters

BACKGROUND

The aim of this study was to compare kinematics parameters among official matches and SSGs of an Italian premier league soccer team.

METHODS

Eighteen elite professional male soccer players (4 central defenders, 4 wide defenders, 3 central midfielders, 3 box-to-box midfielders, 2 wingers and 2 strikers) took part in the study. Players were monitored during four months of full training (including preseason and in-season) and over 26 matches (14 Serie A matches, 9 Europa League matches, and 3 friendly matches), from July 2017 until November 2017. The kinematic parameters during official matches and SSGs were evaluated through video match analysis.

RESULTS

The kinematic data analysis shows that the metabolic power, that constitutes an integrated measure of acceleration and velocity, fails to reflect what occurs during actual match-play.

CONCLUSIONS

An increased attention should be place in planning SSGs during training to better reproduce actual match situations.

Effects of three different stretching protocols on hamstring muscle flexibility in professional soccer players: a randomized study

BACKGROUND

The current study aimed to investigate and compare the influences of global postural rieducation techniques (GPR), stretching exercises on a whole-body vibration platform (WBV), and static stretching exercises on hamstrings flexibility in elite soccer players.

METHODS

24 professional soccer players were randomly assigned to either global postural re-education (N.=8), stretching on whole-body vibration group (N.=8) or static stretching (N.=8), during the first 4 weeks of the precompetitive season. Assessment of hamstring muscle flexibility was performed using a straight leg raise test. All participants were assessed three times: at baseline, at the end of the study protocol and 14 days after the end of the study protocol.

RESULTS

The short-term increase in hamstring muscle flexibility was observed in all 3 groups, without significant differences among groups. However, after 14 days from the end of the interventions only the WBV group maintained the flexibility level achieved just at the end of the protocol with no significant changes in both legs whereas a significant decrease in the SLRT in GPR and SS groups, in right and left legs (GPR, P=0.002; P=0.015; SS, P=0.0001; P=0.0001), was observed.

CONCLUSIONS

These results would suggest that GPR, static stretching on whole-body vibration and static stretching techniques all improve hamstring muscle flexibility, but only stretching on WBV maintains the effect over time in professional soccer players.

Effects of physical therapy interventions on balance ability in people with traumatic brain injury: A systematic review

BACKGROUND

Balance deficits are common impairments in individuals with post-traumatic brain injury (TBI). Balance deficits can restrict the activities of daily living and productive participation in social life. To date, no systematic reviews have examined the impact of physical therapy intervention on balance post-TBI.

OBJECTIVE

To examine the effects of physical therapy interventions on balance impairments in individuals with TBI.

METHODS

We systematically searched in PubMed, EMBASE, Scopus, PEDro, MEDLINE, REHABDATA, and Web of Science for randomized controlled trials (RCTs), clinical control trials, and pilot studies that examined the effects of physical therapy interventions on balance deficits in individuals post-TBI. The methodological quality was estimated using the Physiotherapy Evidence Database (PEDro) scale.

RESULTS

Eight studies published from 2003 to 2019 were included in this study. A total of 259 TBI participants post-TBI were included in this review, 71 (27.41%) of which were females. The methodological quality of the selected studies ranged from low to high. There were no significant differences between experimental interventions, virtual reality (VR), vestibular rehabilitation therapy (VRT), control group interventions, and other traditional physical therapy interventions.

CONCLUSIONS

The evidence about the effects of the physical therapy interventions in improving the balance ability post-TBI was limited. Further randomized controlled trials are strongly warranted to understand the role of physical therapy in patients with TBI who complain about balance deficits.

Diet high in protein-rich foods with structured sport activity may be useless to lose fat mass and maintain fat-free mass

BACKGROUND

The aim of this study was to demonstrate that a normal protein diet along with minimal sports activity can be enough to lose fat mass and maintain muscle mass.

METHODS

All participants were prescribed a hypocaloric nutritionally balanced Mediterranean-style diet tailored to the individual for 8 weeks. Body composition and energy expenditure were measured. Sedentary patients (G1) were only recommended to perform minimal aerobic training, while sport subjects (G2) were prescribed structured physical activity and higher calorie and protein contents in the diet.

RESULTS

There were no significant differences between the two groups for any of the measured parameters.

CONCLUSIONS

The models of lifestyle changes that are currently circulating were for the most part ineffective. It does not appear to be necessary to increase the protein content of the diet above that recommended by guidelines in order to lose weight. Even prescribing specific physical activity is not necessary to maintain muscle mass.

Effectiveness of Warm-Up Routine on the Ankle Injuries Prevention in Young Female Basketball Players: A Randomized Controlled Trial

Background and Objectives: Ankle joint is the most common site of injury for basketball athletes. An effective warm-up (WU) is a period of preparatory exercise to improve training performance and reduce sports injuries. Continuous examination of effective WU routines in basketball players is a necessity. The aim of this study was to investigate the effects of general and combined warm up on ankle injury range of motion (ROM) and balance in young female basketball players. Materials and Methods: A sample of 28 young female basketball players were randomly allocated to either global warm up control group (GWU) (n = 11) or combined warm up experimental group (CWU) (n = 17). All participants performed 7-min of run. The CWU group performed a single leg stance barefoot with eyes closed, plank forearm position and triceps sural stretching. Participants in GWU performed walking ball handling and core stability using a Swiss ball. Both WU routines were conducted 3 times per week for 10 weeks. Outcome measurements were the Stabilometric platform and dorsiflexion lunge test. Results: Twenty-eight young female basketball players completed the study. Participants in the experimental group improved significantly in the range of motion (ROM) in right and left ankle and the center of pressure displacement (CoP). The control group did not show any changes in ankle dorsiflexion and a significant reduction in all body balance parameters. Conclusions: An 8-min combined warm-up routine for 10 weeks improves the ankle dorsiflexion ROM and CoP displacement that plays a key role in ankle injuries prevention in basketball players. Further studies are strongly needed to verify our findings.

Sarcopenic obesity: etiology and lifestyle therapy

OBJECTIVE

Sarcopenic obesity (OS) is a multifactorial condition characterized by the simultaneous presences of sarcopenia and obesity. The prevalence of OS is increasing in adults over 65 years of age; people with OS present greater health risks than people who are only sarcopenic or obese. Therefore, the study of OS and the search for effective treatment are important due to the constant increase of the elderly population.

MATERIALS AND METHODS

This review discusses the etiology and evolutionary mechanisms of OS while exploring its molecular, metabolic, oxidative, inflammatory, hormonal, and nutritional stresses. Studies have tried to unravel the causes related to the onset of sarcopenia, which is responsible for the decrease of muscle mass and strength in elderly subjects. The diagnostic criteria and the methods of evaluation of OS are described in these research studies, although there is no univocal definition for these parameters. The most studied treatments in OS are illustrated and highlight how the physical activity performed through both aerobic and resistance exercises, as well as a correct nutritional treatment, prove to be the most effective interventions in the regression of the pathology and in the improvement of physical function.

RESULTS

New therapies for OS are hypothesized that will open the way to other possible types of intervention in the future.

CONCLUSIONS

The deficiency of muscle mass in obese elderly subjects will be one of the health challenges of the future to reduce the risk of chronic diseases.

Task-oriented Motor Learning in Upper Extremity Rehabilitation Post Stroke

Background: Upper extremity deficits are the most popular symptoms following stroke. Task-oriented training has the ability to increase motor area excitability in the brain, which can stimulate the recovery of motor control.

Objective: This study was aimed to examine the efficiency of the task-oriented approach on paretic upper extremity following a stroke, and to identify efficient treatment dosage in those populations.

Method: We searched through PubMed, Scopus, Physiotherapy Evidence Database (PEDro), National Rehabilitation Information (REHABDATA), and Web of Science databases. Randomized clinical trials (RCTs) and pseudo-RCTs those investigating upper extremity in patients with stroke published in English language were selected. Different scales and measurement methods to assess range of motion, strength, spasticity, and upper extremity function were considered. The quality assessment of included articles was evaluated utilizing the PEDro scale. Effect sizes were calculated.

Results: Six RCTs were included in the present study. The quality assessment for included studies ranged from 6 to 8 with 6.5 as a median. A total of 456 post-stroke patients, 41.66% of which were women, were included in all studies. The included studies demonstrated a meaningful influence of task-oriented training intervention on the hemiplegic upper limb motor functions but not spasticity post-stroke.

Conclusion: Task-oriented training does not produce a superior effect than other conventional physical therapy interventions in treating upper extremity in patients with stroke. There is no evidence supporting the beneficial effect of task-oriented on spasticity. Task-oriented training with the following dosage 30 to 90 minutes/session, 2 to 3 sessions weekly for 6 to 10 weeks may improve motor function and strength of paretic upper extremity post-stroke.

Gender differences in taste and foods habits

Purpose

The purpose of this paper is to examine gender differences in food habits and food choices, including decisions in healthy eating, to personalize diet therapies to be as effective possible for long-term weight loss.

Design/methodology/approach

In this cross-sectional study, eating behaviours were assessed using a questionnaire composed of 12 questions concerning food habits, 17 concerning food taste, and four about healthy eating. There were 2,021 (1,276 women) Caucasian adults enrolled in the study.

Findings

Statistically significant differences in women compared to men occurred for the following questionnaire entries reading eating habits: whole grain food (10.0 per cent higher in women; p < 0.001); cereals such as barley (8.3 per cent higher in women, p < 0.001); cooked vegetables (6.6 per cent higher in women, p < 0.001); eggs (5.0 per cent lower in women, p = 0.03); meat (9.3 per cent lower in women, p < 0.001); and processed meat (7.1 per cent lower in women, p < 0.001). Women consume more water, sugar-sweetened beverages and alcoholic drinks than males, and liked salty foods more than sweet foods. Men ate faster, ate more during the night and slept worse than women. Men ate meals out more often and tended to be hungrier later in the day. Women missed more meals and ate more times during the day and were also more likely to eat uncontrollably.

Research limitations/implications

The authors observed strong evidence of profound gender-specific differences between men and women in terms of dietary habits, the taste of food and in the relationship with meals.

Practical implications

The findings suggest a need for the creation of gender-specific programs for promoting a healthy lifestyle.

Social implications

A need for the creation of gender-related programs for promoting healthy lifestyle has been demonstrated.

Originality/value

Reasons for the different eating behaviours among men and women have been found. Western society’s perception of the ideal body weight is much lower for women than for men. In general, social perceptions influence nutritional behaviour to a great extent. Women’s greater nutritional knowledge and sex-specific taste preferences also account for the differences in eating behaviour.

Cognitive rehabilitation post traumatic brain injury: A systematic review for emerging use of virtual reality technology

BACKGROUND

Traumatic brain injury (TBI) can causes numerous cognitive impairments usually in the aspects of problem-solving, executive function, memory, and attention. Several studies has suggested that rehabilitation treatment interventions can be effective in treating cognitive symptoms of brain injury. Virtual reality (VR) technology potential as a useful tool for the assessment and rehabilitation of cognitive processes.

OBJECTIVES

The aims of present systematic review are to examine effects of VR training intervention on cognitive function, and to identify effective VR treatment protocol in patients with TBI.

METHODS

PubMed, Scopus, PEDro, REHABDATA, EMBASE, web of science, and MEDLINE were searched for studies investigated effect of VR on cognitive functions post TBI. The methodological quality were evaluated using PEDro scale. The results of selected studies were summarized.

RESULTS

Nine studies were included in present study. Four were randomized clinical trials, case studies (n = 3), prospective study (n = 1), and pilot study (n = 1). The scores on the PEDro ranged from 0 to 7 with a mean score of 3. The results showed improvement in various cognitive function aspects such as; memory, executive function, and attention in patients with TBI after VR training.

CONCLUSION

Using different VR tools with following treatment protocol; 10-12 sessions, 20-40 min in duration with 2-4 sessions per week may improves cognitive function in patients with TBI. There was weak evidence for effects of VR training on attention post TBI.

Electric field modulation of magnetic exchange in molecular helices

The possibility to operate on magnetic materials through the application of electric rather than magnetic fields-promising faster, more compact and energy efficient circuits-continues to spur the investigation of magnetoelectric effects. Symmetry considerations, in particular the lack of an inversion centre, characterize the magnetoelectric effect. In addition, spin-orbit coupling is generally considered necessary to make a spin system sensitive to a charge distribution. However, a magnetoelectric effect not relying on spin-orbit coupling is appealing for spin-based quantum technologies. Here, we report the detection of a magnetoelectric effect that we attribute to an electric field modulation of the magnetic exchange interaction without atomic displacement. The effect is visible in electron paramagnetic resonance absorption of molecular helices under electric field modulation and confirmed by specific symmetry properties and spectral simulation.

Effect of segmental muscle vibration on upper extremity functional ability poststroke: A randomized controlled trial

BACKGROUND

Upper extremity functional impairments are common consequences of stroke. Therefore, continuous investigation of effective interventions for upper extremity functions after stroke is a necessity. Segmental muscle vibration (SMV) is one of the interventions that incorporate sensory stimulation to improve motor cortical excitability. The aim of this study was to investigate the influence of 5-minute SMV application along with supervised physical therapy (SPT) on improving activities of daily living and motor recovery on the hemiparetic upper extremity in patients with stroke.

METHODS

A sample of 37 patients poststroke (29 males) was randomly allocated to either SPT control group (n = 18) or SPT and SMV (SPT-SMV) experimental group (n = 19). All patients received 3 sessions per week of SPT for 8 weeks. The SPT-SMV experimental group received SMV at the end of each SPT session. Outcome measures used were Barthel index (BI), modified Ashworth scale, manual muscle testing, and goniometry for range of motion (ROM) assessment.

RESULTS

Thirty-four patients completed the study. Patients in both groups improved significantly after treatment in BI, elbow ROM, and elbow muscles strength. However, muscle tone in elbow joint of the hemiplegic upper extremity improved significantly after SMV only in the experimental group (SPT-SMV).

CONCLUSION

The SPT intervention can improve functional outcomes of upper extremity in people after stroke. However, using SMV may have superior effect on improving muscle tone after stroke.

Acute changes in neuromuscular activity in vertical jump and flexibility after exposure to whole body vibration

This study was aimed to investigate the neuromuscular activity after 10 minutes of exposure to a whole body vibration (WBV) session.Twenty male young adults (24.8 ± 2.5 year olds) were randomized and divided into 2 groups: the vibration group (VG) was exposed to 10 minutes of WBV at 35 Hz; performed 10 minutes of WBV at 35 Hz (displacement = 5 mm; magnitude = 5 g); the nonvibrated group (NVG) was the placebo group that maintained the same position on the plate but without exposure to any type of vibration. Subjects were evaluated with counter movement jump (CMJ) and muscular flexibility by means of electromyographic (EMG) analysis recorded on the vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), and gastrocnemius lateralis (LG).The 10 minutes of WBV showed an increase in muscular flexibility, associated with a decrease of EMG activity in BF (P < .01) and jump height. The latter was associated with a reduction of EMGs activity in BF (P < .01). The control group did not show any significant difference in all considered parameters.These results support the hypothesis that 10 minutes of WBV had effects on flexibility and explosive strength performance influencing neuromuscular behavior through inhibitor effects on antagonist muscles more than the stretch reflex activity on agonist muscles.