Pengaruh Senam Terhadap Keluhan Muskuloskeletal Pada Lansia

Background: The elderly group is a high risk group that experiences various health problems, especially degenerative diseases. Elderly people tend to experience a decrease in the musculoskeletal system. Decreases in the musculoskeletal system can cause disruption to physical mobility in the elderly. Methods: The purpose of this study was to determine the effect of gymnastic on musculoskeletal disorders.  The study was quantitative research with experimental one group pre-test post-test design. It was conducted at  the Posyandu in Nggaren, Pandeyan Village, Ngemplak, Boyolali. Sampling was done by total sampling technique with a total of 48 respondents . Analysis of data using Wilcoxon. Results: p-value = 0.001 (p <0.005). Conclusion: there is an effect of gymnastic on musculoskeletal disorders in the elderly at the Posyandu in Nggaren, Pandeyan Village, Ngemplak, Boyolali

Are patients satisfied? A systematic review and meta-analysis of patient ratings in exercise therapy for the management of tendinopathy.

Outcomes measuring patient rating of overall condition, including patient satisfaction, are associated with improved general health and higher quality of life. However, this outcome domain is under-explored in the management of tendinopathy. The purpose of this systematic review and meta-analysis was to synthesise intervention data investigating patient satisfaction and perceived improvement or deterioration following engagement in exercise therapy for the management of tendinopathy. A search of randomised controlled trials investigating exercise therapy interventions across all tendinopathies was conducted, extracting data assessing patient rating of overall condition. Outcomes were split into those measuring satisfaction (binary) and those measuring global rating of change (GROC). Bayesian hierarchical models were used to meta-analyse proportions and mean effect size (percentage of maximum) for the two outcome categories. From a total of 124 exercise therapy studies, 34 (Achilles: 41%, rotator cuff: 32%, patellar: 15%, elbow: 9% and gluteal: 3%) provided sufficient information to be meta-analysed. The data were obtained across 48 treatment arms and 1246 participants. The pooled estimate for proportion of satisfaction was 0.63 [95% CrI: 0.53 to 0.73], and the pooled estimate for percentage of maximum GROC was 53 [95% CrI: 38 to 69%]. Evidence was also obtained that the proportion of patients reporting positive satisfaction and perception of change increased with longer durations relative to treatment onset. The study concluded that patient satisfaction is not commonly reported in tendinopathy research and, in those studies where it is reported, satisfaction and GROC appear similar and are ranked moderately high, demonstrating that patients generally perceive exercise therapy for tendinopathy management positively. Further research including greater consistency in measurement tools is required to explore, and where possible identify patient and exercise moderating factors that can be used to improve person-centred care

What are small, medium and large effect sizes for exercise treatments of tendinopathy? A systematic review and meta-analysis.

The objective of this study was to quantify and describe effect size distributions from exercise therapies across a range of tendinopathies and outcome domains, to inform future research and clinical practice through conducting a systematic review with meta-analysis. The review and meta-analysis explored moderating effects and context specific small, medium, and large thresholds. The study looked specifically at randomised and quasi-randomised controlled trials involving any persons with a diagnosis of rotator cuff, lateral elbow, patellar, Achilles or gluteal tendinopathy of any severity or duration. The study was conducted using common databases, six trial registries and six grey literature databases, which were searched on 18/01/21 (PROSPERO: CRD42020168187). Standardised mean difference (SMDpre) effect sizes were used with Bayesian hierarchical meta-analysis models to calculate the 0.25- (small), 0.5- (medium) and 0.75-quantiles (large), and to compare pooled means across potential moderators. Risk of bias was assessed with Cochrane's Risk of Bias tool. Data were obtained from 114 studies comprising 171 treatments and 4104 participants. SMDpre effect sizes were similar across tendinopathies but varied across outcome domains. Greater threshold values were obtained for self-reported measures of pain (small = 0.5; medium = 0.9; large = 1.4), disability (small = 0.6; medium = 1.0; large = 1.5) and function (small = 0.6; medium = 1.1; large = 1.8); and lower threshold values obtained for quality of life (small = -0.2; medium = 0.3; large = 0.7), and objective measures of physical function (small = 0.2; medium = 0.4; large = 0.7). Potential moderating effects of assessment duration, exercise supervision and symptom duration were also identified, with greater pooled mean effect sizes estimated for longer assessment durations, supervised therapies and studies comprising patients with shorter symptom durations. The study found that the effect size of exercise on tendinopathy is dependent on the type of outcome measure assessed. Threshold values presented here can be used to guide interpretation and assist with further research better establishing minimal important change

Exercise therapy for tendinopathy: a mixed-methods evidence synthesis exploring feasibility, acceptability and effectiveness.

Tendons are cords of strong, flexible tissue that attach muscles to bones, allowing joints to move. Tendinopathy is a common condition that can affect any tendon in the body, causing pain and limiting function. Exercise is often used to treat tendinopathy. We examined over 500 research papers on exercise for tendinopathy. The most common tendons to be studied were the calf (Achilles), knee (patellar), elbow, and shoulder. Strengthening exercise was studied most often, especially in lower limb tendinopathy. Other types of exercise such as stretching, balance and aerobic activity were less common, but were used to some extent in the upper and lower limbs. We found that exercise therapy is safe and beneficial for the tendinopathies that have been studied to date. Exercise may be most beneficial when combined with another intervention such as injection or electrotherapy. Strengthening exercise may be most beneficial for lower limb tendinopathies. However, more research is needed on the type of strengthening and the dosage, such as how many exercises and how much resistance to use. Shoulder tendinopathies may benefit from exercise that targets joint flexibility and position more than strengthening. We also found that people who receive exercise therapy for tendinopathy are generally satisfied with the effect it has on their symptoms. Finally, we found that an individualised, person-centred approach to delivering exercise therapy is valued by people with tendinopathy. They also believe that the patient-healthcare provider relationship is important for promoting the confidence and motivation people need to continue with exercise programmes, especially when they complete them independently. Although we examined a lot of papers, many of the studies were low quality. This means there is still a need for high-quality studies to tell us how effective specific types of exercise are for specific tendinopathies. There is also a need for more studies on patients' and professionals' experiences of receiving or providing exercise for tendinopathy.This project is registered as www.osf.io/a8ewy/ (scoping review); PROSPERO CRD 42020168187 (efficacy reviews); https://osf.io/preprints/sportrxiv/y7sk6/ (efficacy review 1); https://osf.io/preprints/sportrxiv/eyxgk/ (efficacy review 2); https://osf.io/preprints/sportrxiv/mx5pv/ (efficacy review 3); PROSPERO CRD42020164641 (mixed method review)

Effects ot stretching on the extracellular matrix on the calcaneal tendon of rats

Orientador: Edson Rosa PimentelDissertação (mestrado) - Universidade Estadual de Campinas, Instituto de BiologiaResumo: Os tendões servem para realizar a transferência de força dos músculos para os ossos, sendo capazes de suportar altas forças de tensão. Muitos trabalhos descreveram alterações nas propriedades estruturais, bioquímicas e biomecânicas dos tendões de animais que foram submetidos a exercícios prolongados, porém pouco se sabe sobre o que ocorre no tendão que passa por um processo de alongamento, um procedimento bastante comum em academias e clínicas de Fisioterapia. Assim, nosso trabalho teve como objetivo avaliar os aspectos morfológicos e bioquímicos dos tendões de ratos submetidos ao alongamento três e cinco vezes por semana. Os ratos tiveram seus músculos alongados por um período de 30 segundos intercalados com 30 segundos de relaxamento, com 10 repetições, 3 e 5 vezes por semana durante 21 dias. Os tendões foram removidos e utilizados para os procedimentos de morfologia e de bioquímica. Os tendões também foram submetidos ao ensaio mecânico sob tração a fim de avaliar suas propriedades biomecânicas. Nos cortes corados com AT, na entese dos tendões dos grupos alongados, observou-se um aumento na quantidade de células com morfologia arredondada. Já na região próxima à entese pode ser observado metacromasia mais intensa nos grupos alongados. Observações feitas nos cortes corados com HE, nas regiões de tensão, mostraram que as células apresentaram-se mais alinhadas. Nos grupos alongados, em ambas regiões ocorreu aumento na quantidade de células. Nos cortes que foram submetidos à Reação de Von Kossa, observou-se uma região calcificada em todos os grupos, porém esta apresentou uma MEC mais densa nos tendões dos grupos alongados três e cinco vezes. Análise do gel de SDS-PAGE revelou uma maior quantidade de colágeno nos grupos alongados e a presença do componente de 65 kDa nas regiões de tensão e compressão em todos os grupos. A quantidade de proteínas, de glicosaminoglicanos e de hidroxiprolina também foi superior nos animais alongados. O gel de agarose revelou a presença de dermatam sulfato nas regiões de tensão e de compressão e de condroitim sulfato somente nesta última. Durante o ensaio mecânico, os tendões dos grupos alongados suportaram valores de tensão máxima superiores, com deslocamentos semelhantes, sugerindo que estes tendões são mais resistentes à ruptura. Esses resultados mostraram que o estímulo do alongamento acarretou modificações nas características estruturais, bioquímicas e biomecânicas, confirmando o caráter adaptativo do tendão em resposta à aplicação dos procedimentos de alongamentoAbstract: The tendons are structures that transmit forces from the muscles to the bone, and are capable of supporting high tensile strenghts. Many studies have shown alterations in tendons of animals submitted to strenuous exercises, however, just a little is known about what happens in tendons when they are under a stretching program, a common procedure in academies and phisiotherapy institutes. So our objective was to evaluate the morphological, biochemical and biomechanical aspects of tendons submitted to stretching exercises. Rats had their muscles stretched for a period of 30 seconds with 30 seconds of resting, with 10 repetitions, three and five times a week during 21 days. The tendons were used for morphological and biochemical procedures. They were also submitted to mechanical tensile strain test and their mechanical properties were evaluated. Analysis of AT stained sections of enthesis from stretched tendons, showed a high amount of rounded cells. In the region next to enthesis, which passes close to the calcaneous, the metachromasy was more intense in stretched groups. In the tension region, in the HE stained sections, it was found a larger alignment of the cells in the stretched group. In both regions occurred an increase on the amount of cells. In the sections submitted to Von Kossa reaction, was observed, a calcified region in all groups, but the extracellular matrix were denser in stretched ones. Analysis of SDS-Page showed a high amount of collagen and the presence of a polidisperse component of 65 kDa in the tension and compression regions in all groups. The amount of proteins, glycosaminoglycans and hydroxiproline was higher in the tendons of three and five times stretched groups. The agarose gel revealed the presence of dermatan sulfate in the tension and compression regions and chondroitin sulfate only in this last one. During the mechanical tensile strain test, the stretched tendon supported high values of maximum stress with the same strain, when compared to the control group, suggesting that the stretched tendons were more resistant to the failure. These results show that the stimulus of stretching leads to alterations in the structural, biochemical and biomechanical characteristics, confirming the adaptative character of tendons, in response to the application of stretching exercisesMestradoBiologia CelularMestre em Biologia Celular e Estrutura

Efetividade das técnicas de recuperação após a corrida: revisão sistemática

Insufficient recovery from running-induced muscle damage impairs performance and affects training attendance. The aim of this systematic review (CRD42021253538) was to evaluate the effectiveness of recovery strategies after running on clinical signs and blood biomarkers. Searches were carried out in PUBMED, EMBASE, SportDISCUS, CINAHL, Web of Science, CENTRAL, PEDro, LILACS and SCIelo databases until October 2022. Randomized clinical trials were included that evaluated the effectiveness of massage, cryotherapy, electrotherapy, phototherapy, cupping therapy, therapy by vibration, compression garments, pneumatic compression, instrumental myofascial release, and post-run stretching. Primary outcomes were pain, fatigue, isometric contraction, jumping, torque and secondary biomarkers lactate dehydrogenase, creatine kinase and C-reactive protein. The results were analyzed immediately, 24, 48h, 72h and 96h after the intervention. Two researchers selected the studies, extracted the data, independently assessed the risk of bias (Risk of Bias II) and the certainty of the evidence (GRADE). Disagreements were resolved by a third researcher. The meta-analysis was performed when at least two studies were comparable and reported as standardized mean difference and 95% confidence interval. The Sidik-Jonkman random effect model was used. Analyzes were processed using StataMP 16. A total of 20,314 studies were found, 25 of which 13 were pooled for meta-analysis. The main results of this review indicate that cryotherapy had a great effect in reducing pain 24h and 48h after using the technique. The quality of the evidence is very low, the data are incipient, and future studies are likely to have an impact on the effect estimate.A recuperação insuficiente do dano muscular induzido pela corrida gera prejuízos ao desempenho e repercute na assiduidade do treinamento. O objetivo dessa revisão sistemática (CRD42021253538) foi avaliar a efetividade de estratégias de recuperação após a corrida nos sinais clínicos e biomarcadores sanguíneos. Foram realizadas buscas nas bases PUBMED, EMBASE, SportDISCUS, CINAHL, Web of Science, CENTRAL, PEDro, LILACS e SCIelo até outubro de 2022. Foram incluídos ensaios clínicos randomizados que avaliaram a efetividade da massagem, crioterapia, eletroterapia, fototerapia, ventosaterapia, terapia por vibração, roupas de compressão, compressão pneumática, liberação miofascial instrumental e alongamento após a corrida. Foram considerados desfechos primários a dor, fadiga, contração isométrica, salto, torque e secundários os biomarcadores lactato desidrogenase, creatina quinase e proteina C-reativa. Os resultados foram analisados imediatamente, 24h, 48h, 72h e 96h após a intervenção. Dois pesquisadores selecionaram os estudos, extraíram os dados, avaliaram o risco de viés (Risk of Bias II) e a certeza da evidência (GRADE) de forma independente. Divergências foram equacionadas por um terceiro pesquisador A metaanálise foi realizada quando pelo menos dois estudos eram comparáveis e reportados como diferença de média padronizada e intervalo de confiança de 95%. Foi utilizado o modelo de efeito aleatório Sidik-Jonkman. As análises foram processadas no StataMP 16. Foram encontrados 20.314 estudos, foram incluídos 25 dos quais 13 foram agrupados para metanálise. Os principais resultados dessa revisão sinalizam que a crioterapia apresentou um efeito grande na redução da dor 24h e 48h após a utilização da técnica. A qualidade da evidência é muito baixa, os dados são incipientes e estudos futuros provavelmente terão impacto na estimativa do efeito.FAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas Gerai