Does COVID-19 affect the exercise capacity of non-hospitalized patients?

[Abstract] Objective. To determine whether non-hospitalized adults post COVID-19 have impaired exercise capacity. Design. Retrospective analysis. Setting. Cardiovascular outpatients unit in Instituto Cardiovascular de Rosario, Argentina. Patients. Eighty non-hospitalized patients post-infection by COVID-19. Interventions. Participants completed an ergometry pre and post COVID-19 infection. Main outcome measures. The study's main variables were the metabolic equivalents of task (METs) and the indirect peak oxygen consumption (VO2 peak). Results. The median of METs was 11.7 (9.4-14.8) and 11.7 (11-11.7) in pre and post ergometry, respectively, (p = 0.022). The median VO2 (mL/Kg/min) was 21857 (16938-32761) and 21699 (17004-26467) in pre and post ergometry, respectively, without significant differences. Conclusions. We found slight differences in maximal physical capacity evaluated through exercise testing in non-hospitalized patients by COVID-19

Test–Retest Reliability of Functional Electromechanical Dynamometer on Five Sit-to-Stand Measures in Healthy Young Adults

Background: The purpose of this study was to determine the reliability for the strength and movement velocity of the concentric phase from the five Sit-to-Stand (5STS), using three incremental loads measured by a functional electromechanical dynamometer (FEMD) in healthy young adults. Methods: The average and peak strength and velocity values of sixteen healthy adults (mean ± standard deviation (SD): age = 22.81 ± 2.13 years) were recorded at 5, 10 and 15 kg. To evaluate the reliability of FEMD, the intraclass correlation coefficient (ICC), standard error of measurement (SEM) and coefficient of variation (CV) were obtained. Results: Reliability was high for the 10 kg (CV range: 3.70–4.18%, ICC range: 0.95–0.98) and 15 kg conditions (CV range: 1.64–3.02%, ICC: 0.99) at average and peak strength, and reliability was high for the 5 kg (CV range: 1.71–2.84%, ICC range: 0.96–0.99), 10 kg (CV range: 0.74–1.84%, ICC range: 0.99–1.00) and 15 kg conditions (CV range: 0.79–3.11%, ICC range: 0.99–1.00) at average and peak velocity. Conclusions: The findings of this study demonstrate that FEMD is a reliable instrument to measure the average and peak strength and velocity values during the five STS in healthy young adults.FEDER/Ministry of Science, Innovation and Universities—State Research Agency (Dossier number: RTI2018-099723-B-I00

Personalized pain management:The relationship between clinical relevance and reliability of measurements

Reliability is a topic in health science in which a critical appraisal of the magnitudes of the measurements is often left aside to favour a formulaic analysis. Furthermore, the relationship between clinical relevance and reliability of measurements is often overlooked. In this context, the aim of the present article is to provide an overview of the design and analysis of reliability studies, the interpretation of the reliability of measurements and its relationship to clinical significance in the context of pain research and management. The article is divided in two sections: the first section contains a step-by-step guide with simple and straightforward recommendations for the design and analysis of a reliability study, with a relevant example involving a commonly used assessment measure in pain research. The second section provides deeper insight about the interpretation of the results of a reliability study and the association between the reliability of measurements and their experimental and clinical relevance. Significance: Reliability studies quantify the measurement error in experimental or clinical setups and should be interpreted as a continuous outcome. The assessment of measurement error is useful to design and interpret future experimental studies and clinical interventions. Reliability and clinical relevance are inextricably linked, as measurement error should be considered in the interpretation of minimal detectable change and minimal clinically important differences.Fil: Mista, Christian Ariel. Universidad Nacional de Entre Ríos. Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática; ArgentinaFil: Intelangelo, Leonardo. Instituto Universidad del Gran Rosario; ArgentinaFil: Biurrun Manresa, José Alberto. Universidad Nacional de Entre Ríos. Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática; Argentin

Movilización pasiva continua en pacientes con artroplastia de rodilla

Introduction: Total knee arthroplasty (TKA) is a valid therapeutic option for patients with severe arthritis and physical disability. However, many TKA patients develop pain and functional impairment. In our study, we used a continuous passive motion (CPM) device for exercise starting 10 days after surgery. materials and methods: The study population consisted of 60 patients, who were randomized into 2 groups. Group I (GI: 30 patients, 23 females) underwent the standard treatment and group II (GII, 30 patients, 17 females) underwent the standard treatment plus CPM starting 10 days after surgery. We evaluated pain, range of motion (ROM), extension muscle strength, and function (WOMAC and TUG tests). Results: All compared parameters yielded no statistically significant differences. A greater trend toward improvement was observed in GII regarding some parameters: greater extension muscle strength and a baseline correlation between flexion strength and the TUG test. Conclusions: The use of CPM starting 10 days after of surgery improved the extension muscle strength and produced better TUG test results, although without any statistically significant difference with the standard procedure. No adverse effects were observedIntroducción: La artroplastia total de rodilla es el recurso terapéutico para pacientes con artrosis severa y gran incapacidad física. Sin embargo, muchos evolucionan con dolor y déficit funcional. En este estudio, se utiliza un tratamiento con movilización pasiva continua a partir de los 10 días de la cirugía. materiales y métodos: Se incluyó a 60 pacientes que fueron asignados, en forma aleatoria, a 2 grupos (30 en cada grupo). Al grupo 1 (G1, 23 mujeres) se le aplicó un protocolo de tratamiento convencional y, al grupo 2 (G2, 17 mujeres), el mismo programa y la adicción de un equipo de movimiento pasivo continuo a los 10 días de la inter-vención. Se evaluaron el dolor, la movilidad articular, la fuerza muscular y la función (WOMAC y prueba TUG). Resultados: No se observaron diferencias estadísticamente significativas en los parámetros estudiados, aunque sí una tendencia a la mejoría en el G2. En este grupo, la fuerza de extensión de la rodilla fue mayor y también hubo una correlación basal entre la fuerza y la prueba TUG. Conclusiones: El uso diferido de la movilización pasiva continua mejoró la fuerza de extensión de la rodilla y el rendimiento en la prueba TUG, aunque sin diferencias significativas entre ambos grupos. No se observaron efectos adverso

Effect of confinement by covid-19 on the lifestyle of the university population of Argentina: Evaluation of physical activity, food and sleep.

Objective: to determine lifestyle changes, such as physical activity, nutrition, and sleep in an Argentinean university population, caused by confinement during the COVID-19 pandemic. Methods: Cross-sectional study via web survey. 1021 the Argentinean university population (women, n = 645 and men, n = 376) aged between 18–70 years old was participate. Survey was utilized to measure participant physical activity behavior, nutrition, and sleep April to May 2020. Results: the main findings revealed that 4.3% of the sample showed obesity; the highest proportion of the sample stayed more than 6 hours in a sedentary status; 21.74% reported bad sleep quality; a reduction in good feeding pattern; and an increase in subjects who do not perform physical activity. According to socio-demographic and anthropometric factors, being a student (OR 2.19, CI95% 1.18 - 4, p= .012), overweight (OR 1.71, CI95% 1.19 – 2.44, p= .003), obesity (OR 4.45, CI95% 2.27 – 8.7, p< .001), and have been confined more than 45 days was associated with bad feeding. Likewise, low physical activity levels were associated with obesity (OR 3.2 CI95% 1.66 – 6.18, p= .001), being female (OR 1.61, CI95% 1.14 –2.28, p= .006) and get married (OR 1.72, CI95% 1.14 – 2.61, p= .009). Moreover, being a student was associated with poor sleep quality (OR 43.6, CI95%5.4 – 350, p< .001). Conclusion: This study suggests that confinement decreased healthy living habits such as good nutrition and physical activity and affected the quality of sleep in young subjects.Objetivo: determinar los cambios en el estilo de vida, como la actividad física, la nutrición y el sueño en una población universitaria argentina, causados por el confinamiento durante la pandemia de COVID-19. Métodos: Estudio transversal mediante encuesta por Internet. Participaron 1021 personas de la población universitaria argentina (mujeres, n = 645 y hombres, n = 376) de entre 18 y 70 años de edad. La encuesta fue utilizada para medir el comportamiento de la actividad física, la nutrición y el sueño de los participantes de abril a mayo de 2020.Resultados: los principales hallazgos mostraron que el 4,3% de la muestra presentaba obesidad; la mayor proporción de la muestra permaneció más de 6 horas en estado sedentario; el 21,74% informó sobre la mala calidad del sueño; una reducción de los hábitos correctos de alimentación; y un aumento de los participantes que no realizan actividad física. De acuerdo con factores socio-demográficos y antropométricos, ser estudiante (OR 2.19, CI95% 1.18 - 4, p= .012), el sobrepeso (OR 1.71, CI95% 1.19 - 2.44, p= .003), la obesidad (OR 4.45, CI95% 2.27 - 8.7, p< .001), y haber estado confinado más de 45 días se asoció con una mala alimentación. Asimismo, los bajos niveles de actividad física se asociaron con la obesidad (OR 3,2; IC95% 1,66 - 6,18, p= .001), ser mujer (OR 1,61; IC95% 1,14 -2,28, p= .006) y estar casado (OR 1,72; IC95% 1,14 - 2,61, p= .009). Además, ser estudiante se asoció con una mala calidad de sueño (OR 43,6, CI95% 5,4 - 350, p< .001). Conclusión: Este estudio sugiere que el confinamiento disminuyó los hábitos de vida saludables como la buena nutrición, la actividad física, y afectó la calidad del sueño en sujetos jóvenes

No Evidence of Short-term Changes in Muscle Activity Elicited by Dry Needling in Chronic Unilateral Shoulder Pain Patients

Objective: The aim of the study was to assess short-term changes in shoulder muscle activity elicited by dry needling in chronic unilateral shoulder pain (USP) patients. Methods: A randomized, double-blind, placebo-controlled clinical trial was conducted, in which 30 volunteers with USP were recruited and randomly assigned to either real or sham dry needling conditions. Pain intensity scores, pressure pain threshold, glenohumeral internal rotation angles, and electromyographic activity during isotonic shoulder tasks (shoulder flexion and extension) were assessed before, immediately, and 72 hours after the intervention in the infraspinatus and deltoid muscles. Results: A single application of real dry needling resulted in lower pain intensity scores and a larger range in glenohumeral internal rotation 72 hours after the intervention in comparison with sham dry needling. No differences in pressure pain threshold or muscle activity were observed due to the intervention. Discussion: A single application of real dry needling resulted in clinically significant changes in the short term. No differences were detected in muscle activation in the infraspinatus or deltoid muscles. Complementary interventions and longer follow-up times may be required to observe changes in muscle activity.Fil: Intelangelo, Leonardo. Instituto Universidad del Gran Rosario; ArgentinaFil: Mendoza, Cristian. Instituto Universidad del Gran Rosario; ArgentinaFil: Lassaga, Ignacio. Instituto Universidad del Gran Rosario; ArgentinaFil: Barbosa, Alexandre C.. Universidade Federal de Juiz de Fora; BrasilFil: Biurrun Manresa, José Alberto. Universidad Nacional de Entre Ríos. Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática; ArgentinaFil: Mista, Christian Ariel. Universidad Nacional de Entre Ríos. Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática; Argentin

Reliability of Isokinetic Hip Flexor and Extensor Strength Measurements in Healthy Subjects and Athletes: A Systematic Review and Meta-Analysis

Background: The objective of this systematic review and meta-analysis was to examine the reliability of isokinetic measurements of hip strength in flexion and extension in healthy subjects and athletes. Methods: The databases used were Web of Science, SCOPUS, Medline and PubMed. R was used for all statistical analyses. Results: Hip flexion shows moderate reliability in the supine position (ICC = 0.72; 95% CI: 0.46–0.99) and good reliability in the standing position (ICC = 0.79; 95% CI: 0.54–1.04). Hip extension shows excellent reliability in the supine position (ICC = 0.90; 95% CI: 0.85–0.96) and moderate reliability in the standing position (ICC = 0.72; 95% CI: 0.48–0.96). Flexion of 120°/s and 180°/s showed excellent reliability (ICC = 0.93; 95% CI: 0.85–1.00), (ICC = 0.96; 95% CI: 0.92–1.01). The 60°/s and 120°/s extension showed good reliability (ICC = 0.90; 95% CI: 0.82–0.98), (ICC = 0.87; 95% CI: 0.75–0.99). The 180°/s extension presented excellent reliability (ICC = 0.93; 95% CI: 0.82–1.03). Conclusions: The standing position shows good reliability for hip flexion and the supine position shows excellent reliability for hip extension, both movements have excellent reliability at velocities between 120°/s to 180°/s

Pressure pain threshold mappings of the infraspinatus muscle in chronic unilateral shoulder pain patients do not reflect generalized hypersensitivity

Objectives: Increased mechanical sensitivity has been observed on the unaffected side in chronic pain conditions, suggesting generalized or widespread hypersensitivity. However, this cannot be considered as a universal response since this hypersensitivity is inconsistent across muscle pain pathologies. The aim of this study was to assess generalized hypersensitivity in chronic unilateral shoulder pain, using pressure pain threshold (PPT) mappings of the infraspinatus muscle. The proposed evaluation is based on the assessment of PPT on a limited subset of sites, reducing potential habituation or sensitization effects. Methods: Twenty-nine patients with unilateral shoulder pain (USP) and twenty-seven healthy volunteers were recruited. PPT was assessed using a manual pressure algometer. Six sites distributed over the infraspinatus muscle were assessed, and three repetitions were performed at each site. Mappings were derived using two-dimensional interpolation. Results: Lower PPT values were found in the symptomatic side in comparison with the asymptomatic side at all assessment sites (estimated difference: 1.42 ± 0.10 kgf/cm2, p < 0.001), but there were no differences among the asymptomatic side of USP patients and any of the sides in healthy volunteers (largest estimated difference: 0.17 ± 0.28 kgf/cm2, p = 0.927). Furthermore, the medial region of the infraspinatus muscle showed higher mechanical sensitivity in both healthy volunteers and USP patients. Conclusions: These results suggest that USP does not induce generalized hypersensitivity, in contrast with previously reported findings. Physiotherapists could take these results into account for the assessment and treatment of patients with USP.Fil: Intelangelo, Leonardo. Instituto Universidad del Gran Rosario; ArgentinaFil: Bordachar, Diego José. Instituto Universidad del Gran Rosario; ArgentinaFil: Mendoza, Cristian. Instituto Universidad del Gran Rosario; ArgentinaFil: Lassaga, Ignacio. Instituto Universidad del Gran Rosario; ArgentinaFil: Carvalho Barbosa, Alexandre. Universidade Federal de Juiz de Fora; BrasilFil: Biurrun Manresa, José Alberto. Universidad Nacional de Entre Ríos. Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática; ArgentinaFil: Mista, Christian Ariel. Universidad Nacional de Entre Ríos. Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática; Argentin

Balance Differences between North and South American Older Adults: A Cross-Sectional, Age and Sex Matched Study

This study aimed to characterize the risk of falling in low-, moderate- and high-risk participants from two different geographical locations using a portable force-plate. A sample of 390 older adults from South and North America were matched for age, sex, height and weight. All participants performed a standardized balance assessment using a force plate. Participants were classified in low, moderate and high risk of falling. No differences were observed between South and North American men, nor comparing North American men and women. South American women showed the significantly shorter center of pressure path length compared to other groups. The majority of the sample was categorized as having low risk of falling (male: 65.69% and female: 61.87%), with no differences between men and women. Moreover, no differences were found between North vs. South Americans, nor between male and female groups compared separately. In conclusion, South American women had better balance compatible with the status of the 50&ndash;59 years&rsquo; normative age-range. The prevalence of low falls risk was~61&ndash;65%; the prevalence of moderate to high risk was~16&ndash;19%. The frequency of fall risk did not differ significantly between North and South Americans, nor between males and females