BIOMECHANICAL ISSUES IN SPORTS PHYSIOTHERAPY AND REHABILITATION

In the last decades the number of people participating in sports and leisure time exercise activity has increased tremendously (Westerstahl et al., 2003). Due to this raise in participation the incidence of sports injuries increased, which resulted in a boost for medical interventions. For example, in the Netherlands with a population of about 15 million, there is an allover incidence of 3 injuries per 1000 hours spent on sports. One of these 3 injuries needed medical care (van Mechelen et al., 1992). Many injured athletes or leisure time sporting persons not only consult their sports physician (team physician), but also rely on the professionalism of the sports physiotherapists to increase the speed of their recovery and reduce time off of their sports and training (either competitive or a lower level of exercising). Sports physiotherapy is a specialty widely recognized as a profession with its own body of knowledge and as such represented in the World Confederation of Physical Therapy (WCPT) by the International Federation of Sports Physiotherapy (IFSP). As members of the sports medical team, sports physiotherapists are active in the prevention and rehabilitation of sports related lesions. Sports physiotherapists work with athletes of all ages and abilities, at individual and group levels, to prevent injury, restore optimal function and contribute to the enhancement of sports performance after injury, using sports-specific knowledge, skills and attitudes to achieve best clinical practice (Bulley &. Donaghy, 2005). Furthermore, sports physiotherapists are pioneers in their field, critically challenging, evaluating practice and developing new knowledge through research. However, for many years, sports physiotherapists have been relying too much on authority and non-scientific methods rather than on hard evidence for their clinical decision-making. With the risk of oversimplifying, it can be stated that many injuries are the result of a biomechanical “overuse” of the musculoskeletal system, either in an acute (trauma) or a chronic (fatigue) state. The rehabilitation of injured athletes to their functional pre-injury status is confronted with the loading capability of the injured tissue and its interaction with the known training principles (variation, overloading, specificity and recovery). Depending on the progression of the wound healing, the injured tissue may (and must) receive more and more loading in order to heal and regain functionality. Therefore, restoration of function will depend merely on the phases in which the immunological system is restoring the injured tissue (Cabri & Gomes-Pereira in E. Müller et al., 1998). For example, in muscle injuries, it is known that these phases of repair are linked with the amount of loading the injured tissue can bear (loading capability) and that early mobilization will contribute to increased efficacy of repair (Järvinen et al., 2005). In this context, biomechanical studies contribute much to the knowledge of loading on the musculoskeletal tissues during (rehabilitation) exercises, both quantitatively and qualitatively

Low back pain in young people : cross-sectional study in Lisbon

FCT (Fundação para a Ciência e a Tecnologia), IDP (Instituto do Desporto de Portugal), AIESEP World Congres

Relationship between stability and variability of the core in dynamic reaching tasks

Core stability is important to many functional and athletic tasks. Motion variability has been proposed as a measure to characterize core stability. Based on motor learning theories, the current study hypothesized  that variability and stability of core movements show a U-shaped relationship and further investigated whether functional range of motion (“mobility”) or speed of motion affect this relationship.  Twenty-four healthy subjects performed 20 cycles of two different unilateral hand reaching tasks for both the left and right hand under stable and unstable conditions. Reach targets were positioned to trigger large core movements. Specifically, the anterior target was positioned midsagittal at arm length´s distance and hip height. Two posterior targets (60 degrees posterior to neutral stance frontal plane) on both the left and right side were high (at arm length distance and height with accrued 10 cm) and low (arm length distance at hip height). Kinematic data were recorded and three-dimensional angles between pelvis and thorax (core) were calculated. Pearson correlation coefficients and paired T-tests were calculated to assess variability, mobility and speed of the core movements. A parabolic function was fitted to the variability data and the quality of the fit was assessed by calculating adjusted R-squared values.  In the sagittal plane, variability could be modeled with a U-shaped distribution; in the other planes of motion this was the case in 2 of 4 reaching tests. In two tests, movement speed changed between the stable and unstable conditions. Mobility did not appear to affect variability in the stable condition, but some correlations were observed in the unstable condition. The relationship between mobility and variability, and the change in variability were task-specific

COMPARATION OF ABDOMINAL WALL ACTIVATION DURING SIT- UP AND CURL- UP EXERCISES IN WOMEN

In order to carry out this study, fourteen healthy females performed series of sit-up and curl-up exercises, with and without fixation for the legs. Electrogoniometers were placed on the hip and dorsal spine. Surface EMG was recorded from the superior and inferior portions of the rectus abdominis, external oblique, internal oblique, and rectus femoris of both sides. Muscle patterns were compared to norrr.alized values of integrated EMG. The results showed that the sit-up exercise required higher activity of the abdominal muscles than the curl-up, when the exercises were performed with or without fixation of the legs. In the same way, the sit-up exercise required high activity of the rectus femoris, mainly with fixation for the legs

The influence on peroneal reaction time after five days of ankle taping

Objectives: To study the influence of ankle taping on proprioception and active mechanism of joint protection by indirectly measuring of the proprioception. Methods: The sample was constituted by 32 healthy subjects randomly assigned to either an experimental group (n=17) or a control group (n=15). Subjects had a mean age of 19 years (min=17-max=24), a mean height of 1,67 m (min=1,48-mix=1,80) and a mean weight of 62,5 kg (min=47,5- max=80,5). The experimental group subjects wore an ankle tape for 5 days. No intervention was done on the control group. Several measurements of the peroneal reaction time (PRT) were done before tape immobilization and after removing it. Measurements were done with a trapdoor and surface EMG. The PRT was calculated with a specific computer algorithm. Results: The wearing of ankle tape during five days did not influence the peroneal reaction time (p>0,05). Conclusions: It seems the ankle tape does not influence the active mechanism of joint protection of healthy subjects, however the decision to administer it should be thoughtful.N/

Cross-cultural adaptation and validation of the Portuguese version of the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS)

Abstract The objective of this study was to cross-culturally adapt and validate the Portuguese version of the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS). This version was obtained with forward/backward translations, consensus panels and pre-testing. The Portuguese KOS-ADLS and Medical Outcomes Study, 36-item Short Form (SF-36) questionnaires, visual analogue scales (VAS) of pain, disability and discomfort, and a form for patient’s characteristics were administered to 168 subjects with knee osteoarthritis (OA). Reliability was acceptable (Cronbach’s alpha?=?0.91; ICC?=?0.97). There were significant correlations with SF-36 physical component subscales, all VAS, and duration of knee OA. The subjects with bilateral knee OA and that need walking aids obtained lower scores (p?<?0.001). No floor/ceiling effects were detected. Responsiveness to physical therapy was showed (standardized effect size?=?0.62; standardized response mean?=?1.02). The Portuguese KOS-ADLS evidenced acceptable reliability, validity, floor/ceiling effects, and responsiveness

O efeito das ligaduras funcionais da articulação tíbio-társica na propriocepção: revisão da literatura

Introdução: A ligadura funcional na articulação tíbio-társica é utilizada com fins terapêuticos ou preventivos. A sua eficácia pode ser atribuída à limitação mecânica que implica, mas também pode envolver processos neurofisiológicos relacionados com o feedback proprioceptivo. Existem instrumentos de medida que avaliam objectivamente algumas componentes da propriocepção. Objectivos: Realizar uma revisão da literatura sobre o efeito das ligaduras funcionais da articulação tíbio-társica na propriocepção. Relevância: O conhecimento sobre o tema pode constituir mais uma informação que contribui para decisão dos fisioterapeutas ou outros profissionais de saúde quanto à aplicação da ligadura funcional na articulação tíbio-társica. Metodologia: Com base numa metodologia sistemática, foi realizada uma revisão dos artigos publicados entre 1987 e 2007, pesquisados nas bases de dados referenciais PubMed e PEDro. Foram seleccionados os artigos que cumpriam com os critérios de selecção e eliminados os restantes. Resultados e discussão: Dos 66 artigos provenientes das pesquisas, foram seleccionados 10 artigos. Constatou-se que cinco artigos referem que as ligaduras funcionais não apresentam qualquer efeito sobre a propriocepção. Um estudo verificou alterações benéficas que desapareciam após o exercício físico. Dois estudos referem que a ligadura funcional poderá intervir positivamente nos sistemas proprioceptivos implicados na estabilidade dinâmica. Apenas um estudo refere que a ligadura poderá ter um efeito prejudicial sobre a propriocepção. Conclusão: Os resultados dos estudos não são unânimes quanto aos efeitos da ligadura funcional da articulação tíbio-társica na propriocepção. É necessária a realização de mais estudos com desenhos experimentais de maior qualidade metodológica

Adaptação e validação intercultural da versão portuguesa do Physical Therapy Outpatient Satisfaction Survey

ABSTRACT - The aim of this study was to adapt and validate the Physical Therapy Outpatient Satisfaction Survey (PTOPS) for the Portuguese culture. This version was obtained by a forward/ backward translation, consensus panels, and pre-test. The Portuguese PTOPS was administered to 76 physical therapy outpatients in 10 health services. The content analysis (panels of experts and lay people) and the factor analysis resulted in a reduction of the original 34 items to 28 items that validly identify 3 constructs. The reliability was acceptable for both internal consistency (Cronbach’s alpha = 0.73) and reproducibility (ICC between 0.84 and 0.87), which represent acceptable levels of validity and reliability.RESUMO - Foi objetivo deste estudo adaptar e validar para a cultura portuguesa o Physical Therapy Outpatient Satisfaction Survey (PTOPS). Esta versão resultou do processo de tradução, retroversão, painéis de consenso e pré teste. A PTOPS foi administrada a 76 doentes ambulatórios de fisioterapia, em 10 instituições de saúde. Da análise de conteúdo (painéis de peritos e gente comum) e da análise fatorial resultou uma redução dos 34 itens da versão original para 28 itens, que identificam validamente 3 constructos. A fiabilidade foi aceitável quer na coerência interna (α de Cronbach = 0,73), quer na reprodutibilidade (ICC entre 0,84 e 0,87). Evidenciando níveis aceitáveis de validade e fiabilidade.info:eu-repo/semantics/publishedVersio

SEMG MEASUREMENTS ON LAND AND IN WATER PRIOR TO AND AFTER 60- 90 MINUTES OF SUBMERSION (SWIMMING) ARE HIGHLY RELIABLE

The purpose of this study was to investigate the reliability of surface electromyography (sEMG) measurements after being submerged (swimming) for 60-90 minutes. Isometric maximal voluntary contractions (MVC) on land and in water were collected of eight muscles in three males and three females (mean age 22.5±4.5 years). A paired samples t-test showed no significant differences in the mean MVC signal between pre and post test after prolonged water submersion (

Influence of Anthropometry, Age, Sex, and Activity Level on the Hand Reach Star Excursion Balance Test

The influence of anthropometric measurements, age, sex, and activity level have been found to influence tests of dynamic postural control such as the star excursion balance test (SEBT). The hand reach star excursion balance test (HSEBT) measures different aspects of dynamic postural control. The purpose of the present study was to explore the influence of these factors on the HSEBT. A convenience sample of 223 subjects performed four horizontal (L45, R45, L135, and R135) and two rotational (LROT and RROT) reaches. The influence of anthropometric measurements (height, arm length, leg length, and wingspan) on reach measurements were assessed using stepwise multiple linear regression. Influence of age (young: &lt;20 years; adult: &gt;20 years), sex (male; female) and activity level (athletes; recreational) on reach measurements were analyzed using independent samples t-test (p &lt; 0.05) and interpreted using effect size (Cohens d) and established values of minimal detectable change (MDC). Wingspan explained a significant portion of the variance of only R45 (34.6%) and L45 (11.7%) reach measurements and normalized (percentage of wingspan). A medium effect of age, sex, and activity level was observed for normalized L45 and R45 reaches (d = 0.50–72). Group differences greater than MDC values and a medium effect for age (d = 0.55) and activity level (d = 0.75) were observed for the R135 reach. L45 and R45 reaches should be normalized to wingspan, but not the other reaches. Between individual or group comparisons should consider age, activity level and sex as potential covariates