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INTRODUCTION: Helicopter pilots may present chronic low back pain due to vibration exposure and asymmetric posture during flight. OBJECTIVES: To analyze the effects of a Pilates-based exercise program on low back pain of helicopter pilots of the Brazilian Air Force. METHODS: This is a randomized controlled trial with fifteen helicopter pilots of the Brazilian Air Force, who were assessed for pain intensity (Numerical Pain Rating Scale), disability associated with low back pain, and spine muscle endurance in three positions: trunk extension (Ito test) and left and right lateral bridge. Individuals were randomly distributed into the regular exercises group (REG) (n = 7), oriented to maintain their exercise routine, and Pilates group (PG) (n = 8), which performed an exercise program based on Pilates method twice a week for 12 weeks. Reassessments occurred after 6 and 12 weeks. Data were analyzed on SPSS 20.0 software using a significance level of 5%. RESULTS: PG showed a significant reduction in low back pain after 12 weeks of training compared with REG (mean difference of 3.5 points, p < 0.0001). We also observed increased endurance of trunk extensors (p = 0.002) and right (p = 0.001) and left lateral muscles (p = 0.001) in the PG compared with REG. However, the indexes of disability did not change between groups. CONCLUSION: Pain intensity was significantly reduced while spine muscle endurance increased in PG compared with REG after intervention; thus, Pilates-based exercises should be considered in physical conditioning programs for helicopter pilots.

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INTRODUCTION: Chronic low back pain may be associated with pathoanatomical, neurophysiological, physical, psychological and social factors; thus, treatments to reduce symptoms are important to improve the quality of life of this population. We aimed to evaluate the effects of transcranial direct current stimulation (tDCS) combined with Pilates-based exercises compared with sham stimulation on pain, quality of life and disability in patients with chronic non-specific low back pain. METHODS AND ANALYSIS: This is a protocol for a double-blind randomised controlled trial with participants, outcome assessor and statistician blinded. We will include 36 individuals with a history of non-specific chronic low back pain for more than 12 weeks and minimum pain intensity of 3 points on the Numerical Pain Rating Scale. Individuals will be randomised into two groups: (1) active tDCS combined with Pilates-based exercises and (2) sham tDCS combined with Pilates-based exercises. Three weekly sessions of the protocol will be provided for 4 weeks, and individuals will be submitted to three assessments: the first (T0) will be performed before the intervention protocol, the second (T1) immediately after the intervention protocol and the third (T2) will be a follow-up 1 month after the end of the intervention. We will assess pain, disability, central sensitisation, quality of life, pressure pain threshold, global impression of change, adverse events and medication use. The Numerical Pain Rating Scale and the Roland-Morris Disability Questionnaire will be used at T1 to assess pain and disability, respectively, as primary outcome measures. ETHICS AND DISSEMINATION: This trial was prospectively registered in ClinicalTrials.gov website and ethically approved by the Ethics and Research Committee of the Faculty of Health Sciences of Trairi (report number: 5.411.244) before data collection. We will publish the results in a peer-reviewed medical journal and on institution websites. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov (NCT05467566).

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Patellofemoral pain (PFP) is one of the most frequent musculoskeletal dysfunctions in the knee and its treatment is controversial. This study analyzed the effects of Kinesio Taping (KT) immediately and 72 hours after its application on the electromyographic (EMG) activity of the vastus medialis oblique (VMO) muscle, on the isokinetic performance of the quadriceps femoris and on the pain of subjects with PFP. Fifty-four participants were divided into three groups and performed one of the following protocols: (1) control group (CG)-remained at rest; (2) KT tension group (TG)-KT application with tension in the VMO region; and (3) KT without tension group (WTG)-KT application without tension in the same region. VMO and vastus lateralis (VL) EMG activity (RMS and onset), isokinetic performance and pain intensity were evaluated at three moments: before KT application, immediately after and 72 hours after. A mixed model ANOVA was used for statistical analysis with a significance level of 5% (p ≤ 0.05). No differences between the evaluated groups were found in relation to EMG variables and isokinetic performance. A reduction in pain intensity was found in the WTG in comparison to CG, after 72 hours. KT does not alter EMG parameters nor the isokinetic performance of subjects with PFP. However, we noticed reduced pain in the group submitted to the technique without tension 72 hours after its application.

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ABSTRACT Introduction: Soccer is the most popular and practiced sport in the world and is characterized by high intensity movements. This high demand induces several types of locomotor system injury, and one of the intrinsic factors responsible for triggering these injuries is muscle imbalances, which can occur between limbs or between muscles groups of the same limb. Objective: To evaluate the muscular performance between knee flexor/extensor groups of both limbs in professional soccer athletes.: Methods: Isokinetic assessments were performed in 18 professional soccer athletes, with mean age of 26.9 ± 3.6 years and mean body mass index (BMI) of 23.9 ± 1.7 kg/m2.. The test protocol consisted of five concentric contractions of knee flexion and extension at angular velocity of 60o/sec, 15 contractions at 180o/sec and 30 contractions at 300o/sec in both limbs. Test paired t-test was used to verify the torque, power, and fatigue ratio of flexors and extensors of the dominant and non-dominant knee. Results: There was no significant difference between the evaluated members related to dominance (p>0.05). Regarding the torque ratio between flexors and extensors, we observed values below what is considered normal for this population, besides a higher fatigue index in knee flexor group when compared with the extensor group. Conclusion: No better performance was observed in the dominant limb, suggesting that, although this limb is preferred, this does not necessarily characterizes the better performance. The data also revealed an imbalance in the torque production capacity between the knee flexor and extensor groups, with an unfavorable ratio for the hamstrings, as well as a higher fatigue index in this group, which would make these muscles more susceptible to injures. Level of Evidence II; Diagnostic studies - Investigating a diagnostic test.

RESUMO Introdução: O futebol é o esporte mais popular e mais praticado no mundo e caracteriza-se por movimentos de alta intensidade. Essa alta demanda induz diversos tipos de lesões do aparelho locomotor, e um dos fatores intrínsecos responsável por desencadear essas lesões é o desequilíbrio muscular, que pode ocorrer entre os membros ou entre grupos musculares de um mesmo membro. Objetivo: Avaliar o desempenho muscular entre os grupos flexores/extensores do joelho de ambos os membros em atletas profissionais de futebol. Métodos: Foram realizadas avaliações isocinéticas em 18 atletas profissionais de futebol, com média de idade de 26,9 ± 3,6 anos e índice de massa corporal (IMC) médio de 23,9 ± 1,7 kg/m2. O protocolo do teste consistiu em cinco contrações concêntricas de flexão e extensão do joelho na velocidade angular de 60º/s, 15 contrações a 180º/s e 30 contrações a 300º/s, em ambos os membros. O teste t pareado foi utilizado para verificar a razão do torque, potência e fadiga de flexores e extensores do joelho dominante e do não dominante. Resultados: Não houve diferença significativa entre os membros avaliados no que se refere à dominância (p>0,05). Com relação à razão de torque entre flexores e extensores, observaram-se valores abaixo do que se considera normal para essa população, além de um maior índice de fadiga no grupo flexor quando comparado com o grupo extensor do joelho. Conclusão: Não foi observado desempenho melhor no membro dominante, sugerindo que, embora haja preferência do uso desse membro, isso não caracteriza necessariamente a melhor performance. Os dados também revelaram um desequilíbrio na capacidade de produção de torque entre o grupo flexor e extensor do joelho, com razão desfavorável para os isquiotibiais, além de maior índice de fadiga nesse grupo, o que tornaria esses músculos mais suscetíveis a lesões. Nível de Evidência II; Estudos diagnósticos - Investigação de um exame para diagnóstico.

RESUMEN Introducción: El fútbol es el deporte más popular y más practicado en el mundo y se caracteriza por movimientos de alta intensidad. Esta alta demanda induce diversos tipos de lesiones del aparato locomotor y uno de los factores intrínsecos responsables de desencadenar esas lesiones es el desequilibrio muscular, que puede ocurrir entre los miembros o entre grupos musculares de una misma extremidad. Objetivo: Evaluar el rendimiento muscular entre los grupos flexores y extensores de la rodilla de ambas extremidades en atletas profesionales de fútbol. Métodos: Se realizaron evaluaciones isocinéticas en 18 atletas profesionales de fútbol, con promedio de edad de 26,9 ± 3,6 años e índice de masa corporal (IMC) promedio de 23,9 ± 1,7 kg/m2. El protocolo del ensayo consistió en cinco contracciones concéntricas de flexión y extensión de la rodilla a la velocidad angular de 60º/s, 15 contracciones a 180º/s y 30 contracciones a 300º/s, en ambas extremidades. La prueba t pareada se utilizó para verificar la razón del par de torsión, potencia y fatiga de flexores y extensores de la rodilla dominante y no dominante. Resultados: No hubo diferencia significativa entre las extremidades evaluadas en lo que se refiere a la dominancia (p > 0,05). Con respecto a la razón de par entre flexores y extensores, se observaron valores por debajo de lo que se considera normal para esta población, además de un mayor índice de fatiga en el grupo flexor cuando se compara con el grupo extensor de la rodilla. Conclusión: No se observó un mejor desempeño en la extremidad dominante, sugiriendo que, aunque hay preferencia del uso de esa extremidad, esto no caracteriza necesariamente un mejor rendimiento. Los datos también revelaron un desequilibrio en la capacidad de producción de par de torsión entre el grupo flexor y extensor de la rodilla, con una razón desfavorable para los isquiotibiales, además de un mayor índice de fatiga en ese grupo, lo que haría que esos músculos fueran más susceptibles a las lesiones. Nivel de evidencia II; Estudios diagnósticos - Investigación de un examen para diagnóstico.

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The aim of this study was to analyze the immediate effects of applying Kinesio Taping(®) (KT) on the neuromuscular performance of femoral quadriceps, postural balance and lower limb function in healthy subjects. This is a randomized, blind, controlled, clinical trial, where sixty female volunteers (age: 23.3 ± 2.5 years; BMI: 22.2 ± 2.1 kg/m(2)) were randomly assigned to three groups of 20 subjects each: control (10 min at rest); nonelastic adhesive tape (application over the rectus femoris, vastus lateralis and vastus medialis muscles); and KT (KT application over the same muscles). All individuals were assessed for single and triple hops, postural balance (by baropodometry), peak concentric and eccentric torque and electromyographic activity of vastus lateralis, before and after interventions. No significant differences in electromyographic activity of the VL or concentric and eccentric knee peak torque were recorded, between groups and initial and final assessment in any of the three groups. We also observed no significant alteration in single and triple-hop distance and one-footed static balance between the three groups. Application of KT to RF, VL and VM muscles did not significantly change lower limb function, postural balance, knee extensor peak torque or electromyographic activity of VL muscle in healthy women.

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