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Background: Ankylosing spondylitis (AS) is characterised as a chronic inflammatory disease of the axial skeleton. The force platform is an option for performing the postural assessment of these individuals. Objectives: To review and evaluate the behaviour of the centre of pressure (CoP) variables during the postural control examination in patients with AS compared to a control group. Method: A systematic review, registered in PROSPERO, that followed the PRISMA Statement. A search was carried out in the following databases: Medline, Web of Science, Embase, Scopus, and Scielo, from 1945 to 2023. Studies were selected that aimed to understand the use of the force platform for the assessment of postural control. The risk of bias assessment was performed using the AXIS tool. Results: Five studies were included, with a total of 247 participants. The assessment of risk of bias presented high scores in the AXIS tool. Patients with a diagnosis of AS presented increased thoracic kyphosis in most of the studies, as well as large displacements in the anteroposterior (AP) and mediolateral (ML) directions, and altered total mean velocity (TMV) and frequency, indicating worse postural stability. Regarding the functional status, the most used questionnaires were the Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI) and Bath Ankylosing Disease Activity Index (BASDAI). Conclusion: Patients with ankylosing spondylitis present postural instability, verified by means of higher values of centre of posture variables. Clinical implications: Individuals with ankylosing spondylitis presented postural instability and balance deficit. Therefore, exercises for balance training and postural control are essential in the clinical management of these patients.

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BACKGROUND: Total hip arthroplasty (THA) is a surgical procedure that can alter physical function and quality of life. OBJECTIVES: The aim was to verify the effects of aquatic exercises compared with exercises on land, control or other modalities, in patients undergoing THA on the primary outcomes: self-reported physical function, quality of life and pain; and secondary outcomes: muscle strength, functional capacity and gait. DESIGN: Systematic review that followed the PRISMA Statement and PROSPERO registered. The search was performed in the following databases: Web of Science, Embase, Medline, Cinahl, Lilacs, SPORTDiscus, Cochrane Library, Scopus, SciELO, and PEDro, from 1945 to 2022. The risk of bias assessment was performed using the Risk of Bias 2 (RoB2) from the Cochrane Collaboration. RESULTS: Three randomized controlled trials (RCTs) were included, with a total of 364 participants. In the selection process, two publications from the same study were found. The RoB2 assessment classified one RCT as "high risk of bias" and the others as "low risk of bias". Therefore, the analysis of the results considered only studies with a low risk of bias. For the self-reported physical function outcome, evaluated by WOMAC, improvement was observed in favor of aquatic exercises, when started on the 14th postoperative day. Pain improved after 24th week postoperative, in favor of exercise (effect size between 0.2 and 0.4). Quality of life, verified only by one RCT, improved at each time point evaluated (effect size between 0.01 and 0.10). The functional capacity showed no difference between the groups. This was the first systematic review to assess the benefits of aquatic exercises specifically in THA and it was possible to infer that the exercises initiated after 14 days of postoperative are safer. The protocol should include proprioceptive, coordination, and resistance exercises. The session can last around 30 min and is held three times a week. CONCLUSION: Decision making for treatment in the postoperative of THA may include aquatic exercises as a safe and efficacious alternative to improve self-reported physical function, pain, quality of life, and muscle resistance.

Assuntos

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BACKGROUND: Osteoarthritis (OA) is characterised by joint degeneration and represents the leading cause of disability in old age. OA entails a personal burden, with suffering and reduced quality of life (QoL). OBJECTIVE: To compare the QoL of individuals with OA to that of asymptomatic individuals in order to determine the actual impact of OA on the affected population. METHOD: Cross-sectional study with a sample of 140 patients diagnosed with OA. Another 51 sex- and age-matched asymptomatic individuals with no clinical signs of knee OA or lower limb osteoarticular symptoms for at least the preceding six months were recruited. Knee OA was stratified radiologically according to the Ahlbäck classification (1968). QoL was measured using the SF-36 questionnaire (Medical Outcomes Study 36-Item Short-Form Health Survey). The participants were assigned to "osteoarthritis" (OG) or "asymptomatic" (AG) groups. RESULTS: The OG presented greater body mass and BMI than the AG. Perceived QoL was worse for the OG than the AG across SF-36 domains. In the comparison of the grades of OA degeneration, the group with Ahlbäck grades 4 and 5 (severe) perceived their QoL as poorer than those with grades 1, 2, and 3 (moderate). The grade of OA, older age, and BMI were shown to be strong independent predictors of poor perceived quality of life. CONCLUSION: Individuals with knee OA showed worse perceived QoL compared with asymptomatic individuals. The domains with the lowest scores were physical functioning and functional limitation. Quality of life was influenced by BMI, age, sex, and grade of osteoarthritis.

Assuntos

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The purpose of this systematic review was to analyze the effects of concurrent training on one repetition maximum (1RM), maximum oxygen consumption (VO2max), and peak oxygen consumption (VO2peak) in healthy adults. The review followed PRISMA recommendations using randomized controlled trials in nine databases. Twenty-one studies met the inclusion criteria, totaling a sample of 796 subjects to perform the meta-analysis. As result, concurrent training provides similar increases in 1RM as strength training for upper limbs (standardized mean difference [SMD]: 0.12; 95% IC: [-0.18; 0.41]; p=0.43) and for the lower limbs (SMD: -0.32; 95% IC: [-0.79; 0.15]; p=0.19). Similarly, no difference was found in the aerobic capacity between the concurrent training vs. aerobic training groups ([SMD - VO2max]: -0.19; 95% IC: [-0.71; 0.33]; p=0.48 and [SMD - VO2peak]: -0.24; 95% IC: [-0.57; 0.08]; p=0.14). Based on the results found, we can affirm that a) similar to strength training, concurrent training provides maximum strength development for upper and lower limbs; and b) cardiorespiratory capacity is not impaired by concurrent training in relation to aerobic training, demonstrating the compatibility of the two training sessions.

Assuntos

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BACKGROUND: Foot type classification is well recognized in clinical practice and orthopedic literature, a universally accepted classification or standardized measures to determine foot types are lacking. The objective of this study was to identify which non-radiographic assessment methods are considered valid and/or reliable for the classification of foot types. METHOD: A systematic database search was performed. Only cross-sectional studies that performed reliability and/or validity analysis of non-radiographic methods were included. To evaluate the risk of bias, the Critical Appraisal Tool (CAT) was used to evaluate the measurement properties of objective clinical methods. RESULTS: Twenty-six studies were included. The results of reliability and validity, in general, demonstrated high scores, but, inconsistencies were related to the variability of the measurements, heterogeneity of the methods used to determine reliability and validity, and lack of parameters for classifying foot types, which resulted in few elements to determine which method of foot type evaluation is valid and reliable. CONCLUSION: Given the Intraclass Correlation Coefficient and CAT results and the presence of normative values, the static measurements of the "Arch Height Index", "Foot Posture Index", and "Staheli Arch Index" can be suggested to classify foot types.

Assuntos

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BACKGROUND: The prevalence of low back pain is lower when physical fitness (aerobic and muscular) is higher. Strength exercises are important for subjects with low back pain, but there are few studies on the inclusion of aerobic exercise in low back pain programs. The aim of this study was to compare the effects of aquatic exercises with or without high-intensity component on the functional status, lumbar and abdominal muscle endurance, and performance of subjects with chronic low back pain. METHODS: Forty-eight volunteers between 20 and 60 years old were randomly allocated to an experimental group AEDWR (aquatic exercises plus deep-water running group, N.=25) or to a control group AE (aquatic exercises only group, N.=23). The dependent variables included functional status (Repeated Sit-to-Stand test), lumbar (Sorensen test) and abdominal (One Minute Abdominal test) muscle endurance, and physical performance (Maximum Physical Fitness test), which were measured before and after the 9-week intervention and at 21 weeks of follow-up. RESULTS: Lumbar endurance was higher in the AEDWR group at the end of the treatment, with a mean difference (MD) of 43.2 seconds, 95% confidence intervals (CI) (9.6; 76.7), P=0.01, d̅=0.74, and better in the follow-up with MD=40.2 seconds, 95% CI (7.1; 73.3), P=0.02, d̅=0.71, than in the AE group. Participant performance also improved on the 9th week in the AEDWR group, with an MD=0.53 kgf, 95% CI (0.008; 0.98), P=0.02, d̅=0.60. CONCLUSIONS: The addition of deep-water running exercise to aquatic exercises improved lumbar muscle endurance and performance when compared with aquatic exercises only, and this effect was maintained during the follow-up to lumbar muscle endurance.

Assuntos

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The tools used to evaluate foot types are divergent since they adopt classic linear analyzes, based on anthropometric or image measurements, which do not dynamically contemplate the variability of foot shape. The use of newer techniques such as multiscale fractal dimension (MFD) may be a key to this type of problem. However, for these measures to be used safely and consistently, it is essential to evaluate their reliability. The aim of this study was to evaluate the test-retest reliability of MFD measurements of adult plantar pressure maps during gait, as well as the standard error of measurement (SEM), and minimal detectable change (MDC90). Seventy-two subjects were included in the test-retest, with a one week interval. The plantar pressure maps were constructed using a pressure platform. The data were processed in a routine for extracting the MFD curve measurements (maximum and integral values). The Intraclass Correlation Coefficient results (ICC3,k) were excellent for both measurements (maximum value 0.96, 95% confidence interval [0.93-0.97], and integral 0.95 [0.92-0.97]) with low SEM and MDC90 values below 10% of the mean. The application of MFD to the plantar pressure data generated by the pressure platform is reliable and could allow exploration of the complexity of foot shapes, enabling their classification.

Assuntos

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This study aimed to analyze the coordination and variability between the thorax, lumbar, and pelvis segments in runners with chronic low back pain group (LBPG) and matched control group (CG). Twenty-six recreational runners were evaluated on a treadmill at 3.3 m/s. The coordination of the pelvis-lumbar and lumbar-thorax in all three planes and between the transverse and frontal plane of the lumbar segment were evaluated using the vector coding technique. Coordination was analyzed via histograms with the percentage of each pattern and the coupling angle during the cycle. The variability coordination was calculated from the angular deviation between the cycles. Differences were observed in the coordination patterns and in the coupling angle during the cycle. Between the pelvis-lumbar in the frontal plane, the LBPG (x¯ = 50.6% (SD = 10.7)) presented more in-phase pattern than the CG (38.6% (8.7; P = 0.05). For the lumbar-thorax, differences occurred in all planes. Between the frontal-transverse plane of the lumbar segment, the LBPG (27.6% (7.9)) presented more in-phase pattern than the CG (38.6% (8.7); P = 0.02). The variability did not demonstrate the differences between the groups; these differences were observed in coordination between the lumbar and adjacent segments in all planes. The model of rigid segments and the coordination analyses were sensitive to detect these differences, and the presence of more in-phase patterns could be related to the protection mechanism in order to avoid painful movements.

Assuntos

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BACKGROUND: Many studies have investigated isokinetic performance in volleyball players but not through surface maps. OBJECTIVES: The goals of this study were to assess velocity-specific isokinetic knee extensor-flexor muscle strength and to compare the isokinetic knee extensor-flexor muscles between professional (PRO) and under-17 (U17) female volleyball players. METHOD: This cross-sectional laboratory study was developed with two groups: PRO (n = 12), medianage = 21.3 years, and U17 (n = 9), medianage = 15 years. Peak torque, total work, mean power, angle of peak torque, hamstring-quadriceps torque ratio (H-Q ratio) and torque-angle-velocity surface maps were analysed from knee extension-flexion at 60, 120 and 300 degrees per second (°/s). RESULTS: Significant differences were identified for extensor peak torque between PRO x = 202.3 Newton metre (N·m) (standard deviation [SD] = 24.4) and U17 x = 141.6 N·m (30.1) at 60 °/s (p < 0.001; d = 2.21) as well as flexor peak torque (PRO x = 75.7 N·m [10.3] and U17 x = 57.7 N·m [11.4]) at 120 °/s (p < 0.001; d = 1.65) for the dominant limb. There were also significant group differences for total work and mean power at all velocities for extension and flexion. Surface maps demonstrated higher torque at lower speeds for both groups with smaller torque changes across velocities for flexion. CONCLUSION: Different groups of female volleyball players showed contrasting concentric knee muscle strength across isokinetic velocities. CLINICAL IMPLICATIONS: These results demonstrate the importance of specific strength training for different age groups, even within the same sport, and provide insight into muscle strength.

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BACKGROUND: and Purpose: Knee muscle strength deficits have been reported in individuals who have undergone anterior cruciate ligament reconstruction (ACLR). Isokinetic testing is a valid way to assess muscle strength. Some isokinetic variables, including the range of motion in the phases to attain a specific velocity, load range (sustained specific velocity), time to achieve deceleration, and qualitative analysis of the torque-angle velocity relationship, may contribute to understanding recovery of these individuals after surgery. Thus, the purpose of this study was to compare the load range (LR), time to attain velocity (TTAV), deceleration time (DT) phases, total range of motion (ROM), peak torque/body mass (PT/BM), angle of peak torque (AngPT) during LR and torque-angle-velocity relationships (TAV3D) between post ACLR and matched control subjects.Study design: Case-control. METHODS: Seven men who underwent ACLR and seven matched controls were evaluated from four to six months after surgery. Testing was performed on a Biodex System 4 isokinetic dynamometer in concentric mode at 60, 120 and 300 °/s, for knee flexion and extension. RESULTS: Statistically significant differences were seen for extension ROM at 60 °/s where ROM was greater in the control group. PT/BM for extensors was also significantly greater in controls by 20 % compared to ACLR at 60 and 120 °/s. PT/BM for flexors was significantly greater for controls at 60 °/s (∼15 %). TAV3D showed differences in torque and, specifically, the control group sustained knee flexion torque for a greater range of motion when compared to the ACLR group. CONCLUSION: The ACL group presented with lower ROM and PT/BM, therefore exhibiting worse muscle performance in comparison to the control group.Level of Evidence: 3.