Evaluación de cambios fisiológicos y tisulares producidos tras la punción seca en puntos gatillo de la musculatura extrínseca del pie

Los puntos gatillo miofasciales (PGM) son puntos hiperirritables dentro de bandas tensas en el músculo, que provocan dolor local y referido cuando se estimulan. Entre la variedad de técnicas utilizadas para tratar los PG, la punción seca (PS) es la intervención más comúnmente aplicada. Los mecanismos fisiológicos subyacentes a los efectos de la PS permanecen sin estar aclarados. Examinar los cambios fisiológicos y de contractibilidad que se producen en el músculo esquelético después de realizar PS en el área donde se encuentra el PGM, medidos con resonancia magnética (RMN) y tensiomiografía (TMG). Material y Métodos Se ha realizado una medición de los cambios que se producen en el músculo una hora después de la PS sobre un PGM, con imágenes de RMI y TMG. El estudio incluyó 18 sujetos asintomáticos con PGM latente en un músculo gastrocnemio medial, y la pierna contralateral se utilizó como control. Los resultados mostraron que la intensidad de la señal de RMN aumentó significativamente una hora después de la intervención con PS, lo que sugiere la presencia de edema intramuscular. Los parámetros tensomiográficos mostraron una mayor rigidez muscular con una mejora en el tiempo de contracción después de la PS. Este es el primer estudio que muestra edema intramuscular después de realizar PS en humanos. Las investigaciones futuras deberían centrarse en el uso de la terapia de la PS en sujetos con PG activos y en el seguimiento de los cambios en las horas posteriores medidos con RMN.Myofascial trigger points (MTPs) are hyperirritable points within strained bands of muscles that cause local and referred pain when stimulated. Among the variety of techniques used to treat, dry needling (DN) is the most commonly applied intervention. The physiological mechanisms underlying the effects of DN remain unclear. Objectives To examine the physiological and contractibility changes that occur in the skeletal muscle after performing DN in the area where the MTPs are located, measured with magnetic resonance imaging (MRI) and tensiomyography (TMG). Methods A measurement of the changes that occur in the muscle one hour after DN on a MTPs, with images of MRI and TMG has been made. The study included 18 asymptomatic subjects with a latent MTPs in a gastrocnemius medial muscle, and the contralateral leg was used as control. Results The results showed the intensity of the MRI signal increased significantly one hour after the DN intervention, suggesting the presence of intramuscular edema. The tensomiographyc parameters showed greater muscular rigidity with an improvement in the contraction time after PS. Conclusions This is the first study to show intramuscular edema after performing PS in humans. Future research should focus on the use of SP therapy in patients with active PG and on the follow-up of changes in the subsequent hours measured with NMR.PodologíaCiencias de la Salu

The effects of the Nordic hamstring exercise on sprint performance and eccentric knee flexor strength: A systematic review and meta-analysis of intervention studies among team sport players

The primary aim of this study was to investigate the effects of the Nordic hamstring exercise (NH E ) on sprint performance (i.e., 5, 10 and 20 m) and explore associations between study characteristics and sprint outcomes in team sport players. Secondary aims were to (1) investigate the effects of the NH E on eccentric strength of the knee flexors (ES KF ) with categorical subgroup analysis to determine differences between recreationally, well-trained individuals and young athletes, (2) determine the relation between ES KF and sprint performance in team sport players, and (3) explore the effect of study characteristics (i.e., weekly volume, time duration and body mass) on ES KF .Medicin

Effects of ankle position during the Nordic Hamstring exercise on range of motion, heel contact force and hamstring muscle activation

One of the main benefits of the Nordic Hamstring Exercise (NHE) is that it can be performed without the need of any extra material. However, numerous technical execution variables such as the ankle and pelvis position can influence the performance. The primary aims of this study were to investigate the effects of ankle position (i.e., plantar or dorsal flexion) on Nordic Hamstring Break Point (NHBP), repetition time and heel contact force. A secondary aim was to investigate differences in biceps femoris long head and semitendinosus muscle activation. Male professional field hockey players (n = 12) volunteered for the study. Paired t-tests were used to analyse the effect of ankle position on muscle NHBP, eccentric peak torque and repetition time. Ankle dorsal flexion resulted in a higher NHBP (p = 0.002, effect size [ES] = 1.48 [0.57 to 2.38]), repetition time (p = 0.004, ES = 0.98 [0.24 to 1.72]) and both absolute and relative heel contact force (p = 0.028, ES = 0.67 [0.01 to 1.34], p = 0.017, ES = 0.76 [0.07 to 1.44], respectively) compared to plantar flexion. Muscle activation was not significant different. This study showed a higher NHBP, absolute and relative heel contact force and repetition time with a dorsal flexed ankle vs. a plantar flexed ankle in the NHE, without changes in hamstrings muscle activation.Medicin

Relación entre la potencia y velocidad en press de banca y la velocidad de lanzamiento de balón en jugadores profesionales de balonmano = Relationship between barbell power and velocity in bench press exercise and ball throwing velocity in professional handball players

p. 53-59Los objetivos de este estudio fueron (a) analizar la relación existente entre la una repetición máxima (1-RM) en press de banca y la velocidad de lanzamiento en jugadores de balonmano U18 de nivel internacional y, (b) analizar qué variables del ejercicio del press de banca son más relevantes en el rendimiento específico (velocidad de lanzamiento del balón) durante el test de velocidad de lanzamiento (T3-Step). Dieciséis jugadores de la Selección Española de Balonmano Juvenil participaron en la presente investigación. Todos los sujetos realizaron un protocolo incremental en el ejercicio del press de banca, además delT3-Step de velocidad de lanzamiento del balón. Por un lado, se analizó la relación existente entre la velocidad media (Velmedia), velocidad media de la fase propulsiva (VelMFP), velocidad pico (Velpico), potencia media (Potmedia), potencia media de la fase propulsiva (PotMFP), y potencia pico (Potpico)en todo el espectro de cargas en relación con la velocidad de lanzamiento. También se realizaron los mismos análisis con la carga en donde se obtuvo la máxima potencia media (CargaMP). Los resultados mostraron, por un lado que el rango de correlación de la CargaMP, PotmediaMP, PotMFPMP y PotpicoMP y la velocidad de lanzamiento fueron de .61 (p= .012), .702 (p< .01), .734 (p< .01) y .63 (p< .01), respectivamente. El coeficiente de correlación de Pearson entre la 1-RMy la velocidad de lanzamiento fue de r = .61 (p < .01). En conclusión, las variables relevantes a nivel de rendimiento específico con la velocidad de lanzamiento fueron la 1RM, la CargaMP, la PotMFPMP y la VelMFPMP. Todas estas analizadas en función del 60% de la 1-RM.S

Mechanomyographic measures of muscle contractile properties are influenced by electrode size and stimulation pulse duration

The aim was to determine the effects of changing pulse duration and electrode size on muscle contractile properties. Thirty-six healthy young male participated in the study (age 24.8 ± 5.8 years; height 178.2 ± 0.6 cm; body mass 71.8 ± 7.3 kg; self-reported weekly moderate intensity activity 3.5 ± 1.2 h·week−1). Tensiomyography was used to assess rectus femoris (RF) and vastus medialis (VM) muscles neuromuscular properties of the dominant leg according to the electrode size (3.2–5 cm) and the stimulus length (0.2, 0.5, and 1 ms). Maximal radial displacement (Dm); Contraction time (Tc); Delay time (Td); Sustained time (Ts) and Half relaxation time (Tr) were measured. Relative and absolute reliability was quantified. To analyze the effects of the electrode and the stimulus length, a repeated-measures analysis of variance was used. Dm and Tc parameters showed for both muscles an excellent relative (0.95–0.99) and absolute reliability (1.6–4.2%). However, Ts and Tr showed low values of absolute reliability (4.4–40.9%). The duration of the stimulus length applied to the RF and VM and electrode size significantly influences muscle’s contractile properties (p < 0.05; η2p = 0.09–0.60). The Dm increases substantially as the duration of the stimulus increases and with the use of the larger electrode in both muscles. However, Tc and Td are less affected by both conditions and not entirely clear. Practically, our study suggests that a stimulus pulse duration of 1 ms together with a 5 × 5 cm electrode is necessary to reach a reliable and reproducible assessment of both RF and VM muscles contractile properti

Mechanomyographic Measures of Muscle Contractile Properties are Infuenced by Electrode Size and Stimulation Pulse Duration

The aim was to determine the efects of changing pulse duration and electrode size on muscle contractile properties. Thirty-six healthy young male participated in the study (age 24.8±5.8 years; height 178.2±0.6cm; body mass 71.8±7.3kg; self-reported weekly moderate intensity activity 3.5±1.2h·week−1). Tensiomyography was used to assess rectus femoris (RF) and vastus medialis (VM) muscles neuromuscular properties of the dominant leg according to the electrode size (3.2–5cm) and the stimulus length (0.2, 0.5, and 1ms). Maximal radial displacement (Dm); Contraction time (Tc); Delay time (Td); Sustained time (Ts) and Half relaxation time (Tr) were measured. Relative and absolute reliability was quantifed. To analyze the efects of the electrode and the stimulus length, a repeated-measures analysis of variance was used. Dm and Tc parameters showed for both muscles an excellent relative (0.95–0.99) and absolute reliability (1.6–4.2%). However, Ts and Tr showed low values of absolute reliability (4.4–40.9%). The duration of the stimulus length applied to the RF and VM and electrode size signifcantly infuences muscle’s contractile properties (p<0.05; η2 p=0.09–0.60). The Dm increases substantially as the duration of the stimulus increases and with the use of the larger electrode in both muscles. However, Tc and Td are less afected by both conditions and not entirely clear. Practically, our study suggests that a stimulus pulse duration of 1ms together with a 5 × 5cm electrode is necessary to reach a reliable and reproducible assessment of both RF and VM muscles contractile properties.Ciencias de la Actividad Física y del Deport

Electromyographic Activity Evolution of Local Twitch Responses During Dry Needling of Latent Trigger Points in the Gastrocnemius Muscle: A Cross-Sectional Study

Trigger points (TrPs) are hypersensitive spots within taut bands of skeletal muscles that elicit referred pain and motor changes. Among the variety of techniques used for treating TrPs, dry needling is one of the most commonly applied interventions. The question of eliciting local twitch responses (LTRs) during TrP dry needling is unclear. Our main aim was to investigate the evolution of the electromyographic (EMG) peak activity of each LTR elicited during dry needling into latent TrPs of the gastrocnemius medialis muscle. Methods. Twenty asymptomatic subjects with latent TrPs in the gastrocnemius medialis muscle participated in this cross-sectional study. Changes in EMG signal amplitude (root mean square [RMS]) with superficial EMG were assessed five minutes before, during, and five minutes after dry needling. The peak RMS score of each LTR was calculated (every 0.5 sec). Results. Analysis of variance revealed a significant effect (F ¼ 29.069, P <0.001) showing a significant decrease of RMS peak amplitude after each subsequent LTR. Differences were significant (P <0.001) during the first three LTRs, and stable until the end of the procedure. No changes (P ¼0.958) were found for mean RMS data at rest before (mean ¼ 65.2 mv, 95% confidence interval [CI] ¼ 47.3–83.1) and after (61.0 mv, 95% CI ¼ 42.3–79.7) dry needling. Conclusions. We found that, in a series of LTRs elicited during the application of dry needling over latent TrPs in the medial gastrocnemius muscle, the RMS peak amplitude of each subsequent LTR decreased as compared with the initial RMS peak amplitude of previous LTRs. No changes in superficial EMG activity at rest were observed after dry needling of latent TrPs of the gastrocnemius medialis muscle.Ciencias de la Actividad Física y del Deport

Localization of Muscle Edema and Changes on Muscle Contractility After Dry Needling of Latent Trigger Points in the Gastrocnemius Muscle

Background. Myofascial trigger points (TrPs) are hyperirritable spots within taut bands of skeletal muscles that elicit local and referred pain when stimulated. Among the variety of techniques used for treating TrPs, dry needling (DN) is the most commonly applied intervention. The physiological mechanisms underlying the effects of DN remain to be elucidated. Objective. To examine changes in skeletal muscle after DN in the area where the TrP is located. Methods. We measured in vivo changes that occur in human skeletal muscle one hour after DN over a TrP with magnetic resonance imaging (MRI) and tensiomyography. The study included 18 asymptomatic subjects with a latent TrP in one medial gastrocnemius muscle, and the contralateral leg was used as control. Results. The results showed that MRI signal intensity significantly increased one hour after the DN intervention, suggesting the presence of intramuscular edema. Tensiomyographic parameters showed higher muscle stiffness with an improvement in contraction time after DN. Conclusions. This is the first study showing intramuscular edema after TrP DN in human skeletal muscle. Future research should focus on using DN therapy in patients with active TrPs and on monitoring changes occurring at longer follow-up with imaging techniques.Fisioterapi

Impact of Pain Neuroscience Education Program in Community Physiotherapy Context on Pain Perception and Psychosocial Variables Associated with It in Elderly Persons: A Ranzomized Controlled Trial

This study investigated the long-term effect (six-months) of a Pain Neuroscience Education (PNE) program on pain perception, quality of life, kinesiophobia and catastrophism in older adults with multimorbidity and chronic pain. Fifty participants (n = 50) were randomly assigned to the pain education therapy group (PET; n = 24) and control group (CG; n = 26). The PET group received six sessions (i.e., once a week, 50 min) about neurophysiology of pain while the CG carried on with their usual life. Perception of pain through the visual analogue scale (VAS), quality of life (EQ-5D questionnaire), kinesiophobia (TSK-11) and catastrophism (PCS) were assessed after six months since the last PNE session. Statistically significant differences on VAS (t(48) = 44, p = 0.01, ES = 0.42 [0.13, 0.65]) was found in favor to PET group. No other statistically significant differences were found. This study found that the application of a PNE intervention in an isolated form was able to significantly reduce pain perception with low effect size in the long-term (six months after intervention) in elderly people with chronic pain.Medicin

Hip adduction and abduction strength profiles in elite and sub-elite female soccer players according to players level and leg limb-dominance

Background: Understanding the hip adduction and abduction strength in female soccer players is crucial for performance enhancement and injury prevention. This study compares the strength profiles in these muscle groups between elite and sub-elite female soccer players and assesses the impact of leg limb-dominance. Methods: A descriptive-comparative study was employed. Eighty-two female soccer players were evaluated. Isometric hip-adduction and abduction strength were measured using a handheld dynamometer. Results: Female elite and sub-elite soccer players displayed a mean and standard deviation (SD) on isometric hip-adductor strength for dominant (3.19 Nm/kg ± 0.69 vs. 2.40 Nm/kg ± 0.67) and non-dominant leg (3.32 Nm/kg ± 0.76 versus 2.42 Nm/kg ± 0.70), respectively. For isometric hip-abductor strength in elite and sub-elite players, a mean and SD of dominant (2.86 Nm/kg ± 0.56 vs. 2.07 Nm/kg ± 0.50) and non-dominant (2.80 Nm/kg ± 0.59 vs. 2.04 Nm/kg ± 0.43). In essence, elite players were stronger than sub-elite players on isometric hip-adduction (mean difference [MD] = 0.82 Nm/kg, CI95% = 0.42–1.12) and abduction (MD = 0.83 Nm/kg, CI95% = 0.54- 1.12) both in dominant and non-dominant, leg, whereas no differences existed for hip adduction:abduction ratios between groups and legs. Conclusions: Elite female athletes exhibited greater strength than sub-elite female players in both hip adduction and abduction, whereas adduction:abduction ratio values did not differ between the two groups or between different legs