Joint damage and motor learning during unipedal stance in haemophilia arthropathy: report of two cases
Effectiveness of a Group-Based Progressive Strength Training in Primary Care to Improve the Recurrence of Low Back Pain Exacerbations and Function: A Randomised Trial
Low back pain (LBP) is the leading cause of disability and one of the most common reasons for physician visits in primary care, with a 33% rate of recurrence during the first year. However, the most optimal exercise program in this context remains unknown. The objective was to evaluate the effectiveness of a group-based progressive strength training program in non-specific chronic LBP (CLBP) patients in primary care on pain recurrence and physical function. Eighty-five patients with non-specific CLBP were separated into two groups (Intervention group: completed a progressive strength training program 3 days per week for 8 weeks
Safety, Fear and Neuromuscular Responses after a Resisted Knee Extension Performed to Failure in Patients with Severe Haemophilia
BACKGROUND: low-moderate intensity strength training to failure increases strength and muscle hypertrophy in healthy people. However, no study assessed the safety and neuromuscular response of training to failure in people with severe haemophilia (PWH). The purpose of the study was to analyse neuromuscular responses, fear of movement, and possible adverse effects in PWH, after knee extensions to failure.METHODS: twelve severe PWH in prophylactic treatment performed knee extensions until failure at an intensity of five on the Borg CR10 scale. Normalised values of amplitude (nRMS) and neuromuscular fatigue were determined using surface electromyography for the rectus femoris, vastus medialis,…
Electromyographic and Safety Comparisons of Common Lower Limb Rehabilitation Exercises for People With Hemophilia.
Abstract Background Ankles and knees are commonly affected in people with hemophilia and thus are targets for prevention or rehabilitation. However, to our knowledge, no studies have evaluated muscle activity and safety during exercises targeting the lower limbs in people with hemophilia; this lack of information hinders clinical decision-making. Objective The aim of this study was to compare the tolerability of, safety of, and muscle activity levels obtained with external resistance (elastic or machine)-based and non–external resistance-based lower limb exercises in people with hemophilia. Design This was a cross-sectional study. Methods Eleven people who had severe hemophilia and were und…
Tolerability and Muscle Activity of Core Muscle Exercises in Chronic Low-back Pain
Most of the studies evaluating core muscle activity during exercises have been conducted with healthy participants. The objective of this study was to compare core muscle activity and tolerability of a variety of dynamic and isometric exercises in patients with non-specific low back pain (NSLBP). 13 outpatients (average age 52 years
Dry needling technique decreases spasticity and improves general functioning in incomplete spinal cord injury: A case report
Context: Spasticity in neurological disorders (i.e. stroke patients and cerebral palsy) is positively improved by dry needling. However, reports are scarce regarding the potential effects of dry needling in reducing spasticity and improving functionality in patients with an incomplete spinal cord injury. The aim of this case report was to study the immediate, short-term effects of dry needling treatment (10 weeks) on spasticity, dynamic stability, walking velocity, self-independence, and pain in a single patient with an incomplete spinal cord injury. Findings: The dry needling treatment resulted in immediate, short-time effects on basal spasticity in the upper (reduction from 2 to 0 point m…
Does the educational level of women influence hand grip and pinch strength in carpal tunnel syndrome?
Abstract Background Grip and pinch strength are relevant functional variables for various activities of daily life and are related to the quality of life of patients with carpal tunnel syndrome (CTS). Objective The main aim was to analyze the relationship between grip and pinch strength and the educational level in women with CTS. Study design Cross-sectional study. Methods Thirty-one female patients with CTS awaiting surgery were assigned to the low education group if they only had primary education level (completed or not) and the high education group for those having higher education level. The assessments included: grip strength, pinch strength, Visual Analogue Scale, Quick DASH Questio…
Impact of Visual Biofeedback of Trunk Sway Smoothness on Motor Learning during Unipedal Stance.
The assessment of trunk sway smoothness using an accelerometer sensor embedded in a smartphone could be a biomarker for tracking motor learning. This study aimed to determine the reliability of trunk sway smoothness and the effect of visual biofeedback of sway smoothness on motor learning in healthy people during unipedal stance training using an iPhone 5 measurement system. In the first experiment, trunk sway smoothness in the reliability group (n = 11) was assessed on two days, separated by one week. In the second, the biofeedback group (n = 12) and no-biofeedback group (n = 12) were compared during 7 days of unipedal stance test training and one more day of retention (without biofeedback…
Feasibility, safety and muscle activity during flywheel vs traditional strength training in adult patients with severe haemophilia
INTRODUCTION: Eccentric training has been associated with several specific physiological adaptations. The flywheel machine is one of the easiest ways of performing eccentric overload training. However, no studies evaluated its feasibility, safety and muscle activity in patients with haemophilia (PWH).AIM: To evaluate feasibility and safety and compare muscle activity during flywheel vs weight machine knee extension exercise in severe PWH.METHODS: Eleven severe PWH [mean age of 33.5 (8.1) years] participated in this cross-sectional study after receiving prophylactic treatment. Surface electromyography (EMG) signals were recorded for the rectus femoris during the knee extension exercise perfo…
Effects of performing dual tasks on postural sway and postural control complexity in people with haemophilic arthropathy
Introduction People with haemophilic arthropathy (PWHA) have impairments in postural control. However, little is known about the effects of demanding conditions, including the unipedal stance and dual tasks, on postural control in PWHA. Aim Determine the effects of performing dual tasks while in the one-leg stance on postural sway and postural control complexity in PWHA vs. healthy active (HAG) and non-active (HNAG) groups of individuals. Methods Fifteen PWHA and 34 healthy subjects (18 active and 16 non-active) were recruited. Vertical (V), mediolateral (ML) and anteroposterior (AP) centre of mass signals were acquired using a 3-axis accelerometer placed at the L3/L4 vertebrae of subjects …
EMG, Rate of Perceived Exertion, Pain, Tolerability and Possible Adverse Effects of a Knee Extensor Exercise with Progressive Elastic Resistance in Patients with Severe Haemophilia
In people with haemophilia (PWH), elastic band training is considered an optimal option, even though the literature is scarce. The aim was to evaluate normalized electromyographic amplitude (nEMG), rate of perceived exertion (RPE), pain, tolerability, and possible adverse effects during the knee extension exercise using multiple elastic resistance intensities in PWH. During a single session, 14 severe PWH undergoing prophylactic treatment performed knee extensions without resistance and with different intensity levels of elastic resistance. nEMG was measured for the knee extensors and participants rated their RPE, tolerability and pain intensity after each condition. Patients had to report …
Effects of A Dual-Task Intervention in Postural Control and Cognitive Performance in Adolescents.
The aim was to assess dual- versus single-task training for motor performance and cognitive performance in adolescents. Two experiments were performed. In the first, 30 adolescents were randomized to three groups to determine the effect of dual-task difficulty on postural control: α-scaling and root mean square (RMS). In the second, 20 adolescents were randomized to two groups to determine the effect of dual-task practice to improve working memory. RMS in the post-test was lower than the pre-test in both dual-task groups, while α-scaling was lower in post-test than pre-test only in the high-difficulty dual-task group. A practice effect was observed on the percentage of correct answers only …
Changes in Muscle Activity Patterns and Joint Kinematics During Gait in Hemophilic Arthropathy
Hemophilic arthropathy is the result of repetitive intra-articular bleeding and synovial inflammation. In people with hemophilic arthropathy (PWHA), very little is known about the neural control of individual muscles during movement. The aim of the present study was to assess if the neural control of individual muscles and coordination between antagonistic muscle pairs and joint kinematics during gait are affected in PWHA. Thirteen control subjects (CG) walked overground at their preferred and slow velocity (1 m/s), and 14 PWHA walked overground at the preferred velocity (1 m/s). Joint kinematics and temporal gait parameters were assessed using four inertial sensors. Surface electromyograph…
Effect of neuromuscular electrical stimulation frequency on postprandial glycemia, current-related discomfort, and muscle soreness. A crossover study
Consensus is lacking regarding optimal neuromuscular electrical stimulation (NMES) parameters for postprandial glycemic control. Therefore, the aim of this study was to determine the NMES frequency inducing the greatest hypoglycemic effect in healthy individuals. The secondary aim was to compare current-related discomfort and muscle soreness between different frequencies. We conducted an experimental clinical study with a randomized crossover design. Sixteen healthy and sedentary participants received NMES for 20 min at 5, 10, or 50 Hz (pulse duration: 400 μs, on-off ratio: 4:12 s) following a standardized meal. Glycemia, discomfort, and muscle soreness during and after NMES were compared …
Modular reorganization of gait in chronic but not in artificial knee joint constraint
It is currently unknown if modular reorganization does occur if not the central nervous system, but the musculoskeletal system is affected. The aims of this study were to investigate 1) the effects of an artificial knee joint constraint on the modular organization of gait in healthy subjects; and 2) the differences in modular organization between healthy subjects with an artificial knee joint constraint and people with a similar but chronic knee joint constraint. Eleven healthy subjects and eight people with a chronic knee joint constraint walked overground at 1 m/s. The healthy subjects also walked with a constraint limiting knee joint movement to 20_. The total variance accounted (tVAF) f…
The Relevance of Dual Tasking for Improving Trunk Muscle Endurance After Back Surgery
Abstract Objective To determine the effect of dual tasking on trunk muscle endurance in patients after lumbar diskectomy. Design Cross-sectional study. Setting Rehabilitation hospital setting. Participants Individuals (N=14) undergoing primary lumbar diskectomy. Intervention Using a randomized design on 2 separate days, muscle endurance was evaluated during prone bridging and Biering-Sorensen tests. Each test was randomly performed under 2 cognitive conditions: single task without cognitive condition and self-regulated dual task (ie, mathematical task). Main Outcome Measures The primary outcomes were time to failure and pain assessed by the visual analog scale from 0 to 100 mm. The secondar…
Neuromuscular control during gait in people with haemophilic arthropathy
Introduction: Effects of haemophilic arthropathy on neuromuscular control during gait are currently unknown. Aims: (a) To assess how haemophilic arthropathy affects the complexity of neuromuscular control during gait; (b) To investigate the relationship between complexity of neuromuscular control and joint impairment. Methods: Thirteen control subjects (CG) walked overground at their preferred and a slow velocity and thirteen people with haemophilic arthropathy (PWHA) walking at their preferred velocity. Surface electromyography (EMG) was collected from eleven leg muscles. Electromyography variance explained by muscle synergies (sets of co-activated muscles that can be recruited by a single…
Sensory strategies of postural sway during quiet stance in patients with haemophilic arthropathy.
Introduction: The sensory strategies of postural control in adult haemophilic arthropathy patients are still poorly understood. Aim: To determine sensorial posture-control strategies through postural sway frequency analysis when in a bipedal quiet stance with and without visual stimulus deprivation in healthy subjects and patients with haemophilic arthropathy. Secondarily, to determine the irregularity of postural balance control through sample entropy (SampEn). Methods: A triaxial accelerometer attached at the L3 level determined the displacement and acceleration of the centre of mass (DCoM and ACoM, respectively) under open-and closed-eyes conditions. Sensorial strategies were studied by …
Carpal tunnel syndrome and pain
Abstract Carpal tunnel syndrome (CTS) is a compressive peripheral neuropathy characterized by pain, tingling sensation, and paresthesia in the region of the median nerve. The patient’s medical history, the presence of risk factors, and the characteristics of the symptoms are key aspects for establishing a suitable differential diagnosis. Conservative or surgical treatment of CTS may be indicated depending on both the severity and temporality of the condition. The conservative treatment of mild and moderate CTS includes, among the most common treatments in physiotherapy and occupational therapy, the use of orthoses, physical agents, manual therapy, therapeutic exercises, education, ergonomic…
Safety and Effectiveness of Progressive Moderate-to-Vigorous Intensity Elastic Resistance Training on Physical Function and Pain in People With Hemophilia.
Abstract Objective Strength training is recommended for people with hemophilia; however, published data are anecdotal and have methodological limitations. The purpose of this study was to evaluate the safety and effectiveness of progressive moderate-to-vigorous intensity elastic resistance training on physical function and pain in this patient population. Methods A randomized controlled trial was conducted in a university laboratory setting where 20 patients (17 with severe, 1 with moderate, and 2 with mild hemophilia) aged 21 to 53 years received evaluations at baseline and 8-week follow-up. Participants were allocated to intervention (progressive strength training) or control (usual daily…
Effectiveness of Dry Needling in the Management of Spasticity in Patients Post Stroke.
Abstract Objective: To determine the effectiveness of the dry needling technique (DNT) in the treatment of spasticity for individuals with stroke. Design: We reviewed the Embase, Pubmed/MEDLINE, Web of Science and Cochrane Central Register of Controlled Trials (CENTRAL) databases. We also performed a manual search of the references that are included in the selected articles. Studies included were: i) randomized clinical trials (RCTs); ii) involving patients with a diagnosis of stroke; and iii) using DNT alone or in a multimodal treatment. Muscular spasticity was the primary outcome of the study. The additional outcomes included were: pressure pain sensitivity, range of motion and perception…
Perceived physical exertion is a good indicator of neuromuscular fatigue for the core muscles
Although several studies have assessed core training, specific prescription recommendations remain lacking. The purpose of the present study was to determine the association between the rate of perceived exertion (RPE) and neuromuscular fatigue of the core muscles during the prone bridging endurance test. Fifteen healthy and moderately active subjects participated. Neuromuscular fatigue was assessed with surface electromyography on the rectus abdominis (RA), external oblique, internal oblique, and lumbar erector spinae. Participants rated the RPE (Borg CR 10) every 5 s. The time to failure was 123.7 ± 58.1 s. From the midpoint of the time to failure, the RPE significantly increased (p 0.05…
Effects of Cognitive and Mental Health Factors on the Outcomes Following Carpal Tunnel Release: A Systematic Review and Meta-analysis.
OBJECTIVE To determine the effects of the cognitive and mental health factors on the outcomes following carpal tunnel release (CTR). DATA SOURCES Embase, Pubmed/MEDLINE, Web of Science, CINAHL and Cochrane Central Register of Controlled Trials (CENTRAL) databases from inception to August 14, 2021. STUDY SELECTION Randomized controlled trials and observational studies of patients with CTR were included. The included studies aimed to determine the effect of the cognitive (catastrophic thinking, kinesiophobia and self-efficacy) or mental health factors (symptoms of anxiety and depression) on the outcomes at least three months post-CTR. DATA EXTRACTION Two independent reviewers performed data e…
Estimation of tensile properties of the Achilles tendon in haemophilic arthropathy of the ankle: case study
Assessment of tensile mechanical properties of the Achilles tendon in adult patients with haemophilic arthropathy.
A single preoperative pain neuroscience education: Is it an effective strategy for patients with carpal tunnel syndrome?
Patients undergoing carpal tunnel release surgery may continue to experience pain despite the intervention. This symptom may be modulated by psychosocial factors including depression, catastrophic thinking, and kinesiophobia. Pain neuroscience education (PNE) has been found to be effective when combined with therapeutic exercise in patients with chronic pain, but this strategy has not been evaluated in patients with persistent hand pain. The findings of this study indicate that a single preoperative PNE session in combination with therapeutic exercise does not provide added benefits in comparison to standard preoperative care plus therapeutic exercise. Future studies should evaluate if pati…
Upper-Body Exercises With External Resistance Are Well Tolerated and Enhance Muscle Activity in People With Hemophilia
Abstract Background Conventional nonresisted therapeutic exercises for people with hemophilia involve a careful, low-intensity approach to avoid injuries. Externally resisted exercise is highly efficient for increasing muscle strength in healthy adults but its feasibility for people with hemophilia remains unknown. Objective The purpose of this study was to evaluate muscle activity during upper-body rehabilitation exercises with 2 types of external resistance and without external resistance (conventional) and to examine tolerability, kinesiophobia, and possible adverse effects derived from the session. Design This was a cross-sectional study. Methods Twelve people with hemophilia A/B (11 wi…