Reliability and measurement error of tensiomyography to assess mechanical muscle function: A systematic review

Interest in studying mechanical skeletal muscle function through tensiomyography (TMG) has increased in recent years. This systematic review aimed to (a) report the reliability and measurement error of all TMG parameters [i.e., maximum radial displacement of the muscle belly (Dm), contraction time (Tc), delay time (Td), half-relaxation time (1/2 Tr), and sustained contraction time (Ts)] and (b) to provide critical reflection on how to perform accurate and appropriate measurements for informing clinicians, exercise professionals, and researchers. A comprehensive literature search was performed of the Pubmed, Scopus, Science Direct and Cochrane databases up to July 2017. Eight studies were included in this systematic review. Meta-analysis could not be carried out due to the low quality of the evidence of some studies evaluated. Overall, the review of the nine studies involving 158 participants revealed high relative reliability [intra-class correlation (ICC)] for Dm (0.91-0.99); moderate to high ICC for Ts (0.80-0.96), Tc (0.70-0.98), and 1/2 Tr (0.77-0.93); and low to high ICC for Td (0.60-0.98), independently of the evaluated muscles. Additionally, absolute reliability [coefficient of variation (CV)] was low for all TMG parameters except for 1/2 Tr (CV = >20%) while measurement error indexes were high for this parameter. In conclusion, this study indicates that three of the TMG parameters (Dm, Td and Tc) are highly reliable, whereas 1/2 Tr demonstrate insufficient reliability, and thus should not be used in future studies

Adicción al ejercicio en ciclistas

A pesar de que existe múltiple evidencia científica acerca de los beneficios del ejercicio físico sobre la salud física y mental, se ha sugerido que puede existir un límite en el volumen de ejercicio que puede ser perjudicial para la salud y crear un riesgo de adicción al ejercicio (RAE). La adicción al ejercicio (AE) ha sido descrita como un patrón mórbido de comportamiento en el que el individuo que se ejercita pierde el control sobre sus hábitos de ejercicio, exhibe dependencia y experimenta consecuencias negativas para la salud, así como en su vida social y profesional. El campo de la AE es relativamente nuevo y los resultados y conclusiones no estan claros. Una limitación significativa es el uso de múltiples terminologías para describir el mismo fenómeno (dependencia al ejercicio, ejercicio compulsivo, etc.). La investigación se basa principalmente en autoinformes obtenidos a partir de cuestionarios, como el Exercise Addiction Inventory (EAI), el cual evalúa el RAE, ya que este término incluye tanto la dependencia como la compulsión. La AE se sitúa dentro del campo de las adicciones conductuales, pero debido a la falta de evidencia sólida y metodológicamente rigurosa sobre la AE como una morbilidad, el trastorno no aparece como una disfunción mental en la última (quinta) edición del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM-5). Existe una gran variabilidad entre estudios sobre la prevalencia de RAE. Aunque la prevalencia de REA establecida por el EAI obtenida en un estudio en población deportista general fue 3.2%, otros estudios muestran valores mucho más altos en atletas de resistencia (triatletas, corredores, etc.). El volumen excesivo de entrenamiento ha sido destacado como uno de los factores que podrían explicar esta variabilidad. A pesar de que el ciclismo es uno de los deportes de resistencia más comunes y practicados y esta asociado con una reducción de mortalidad por todas las causas, hasta la fecha, la literatura no ha valorado el REA en la población ciclista amateur y su asociación con la salud psicosocial (calidad de vida, calidad de sueño, ansiedad, etc.). Por lo tanto, el objetivo de este estudio fue obtener la prevalencia de RAE en una muestra de ciclistas amateur, analizar su asociación con factores de riesgo y, valorar su influencia en parámetros asociados con la salud física y mental de ciclistas.ConclusionesLa prevalencia del REA en los ciclistas amateur es del 17%. La práctica del ciclismo de resistencia amateur tiene efectos beneficiosos para la salud. Los beneficios en la calidad del sueño y la salud mental están limitados en aproximadamente el 20% de sujetos con RAE. Nuestros resultados también sugieren que el RAE en ciclistas de resistencia amateur no se ve significativamente influenciado por factores extrínsecos como edad, sexo, factores sociodemográficos y entrenamiento, lo que sugiere que para diagnosticar con precisión y establecer el tratamiento apropiado, psicólogos deportivos clínicos deben centrar su atención en los factores intrínsecos en cada sujeto que puede inducir la AE.<br /

Optimizing Field Body Fat Percentage Assessment in Professional Soccer Players

Body composition is a determinant of performance in soccer. To estimate the body fat percentage (%BF), dual energy X-ray absorptiometry (DXA) is effective though this method is expensive and not readily accessible. This study examines the validity of widely used field methods based on anthropometric data and bioelectrical impedance analysis (BIA). Participants were 21 male Spanish First Division soccer players aged between 22 and 35 years. In each participant, body fat mass was determined by BIA and using 18 anthropometric equations including skinfold (SKF) measurements. DXA was used as reference. Correlation with DXA measurements was excellent for all equations and separate SKF measurements yet only moderate for BIA. However, only the equation recently developed for use in soccer players based on iliac crest and triceps SKFs showed no significant or standardized differences with DXA-derived %BF and these measurements also had the lowest bias. Our findings suggest that when DXA is not available, the best field method for %BF assessment in footballers is the equation based on iliac crest and triceps SKF. As another good option, we propose the sum of triceps, subscapular, supraspinal, and abdominal SKFs, as this combination also showed good correlation with DXA

Cardiac troponin I release after a basketball match in elite, amateur and junior players

BACKGROUND: Available scientific data related to cardiac troponin I (cTnI) release after intermittent exercise is limited. It is also of interest to determine what personal or environmental factors mediate the exercise-induced release of cTnI. This study had two objectives: 1) to examine the individual release of cTnI to a basketball match; and 2) to establish the influence of athlete status as well as biological age on cTnI release. METHODS: Thirty-six basketball players (12 adult elite [PBA]: 27.3±4.1 years, 12 adult amateur [ABA]: 29.6±2.9 years, and 12 junior elite [JBA]: 16.6±0.9 years) participated in a simulated basketball match with serial assessment of cTnI at rest, immediately post- and at 1, 3, 6, 12, and 24 h post-exercise. RESULTS: The basketball match increased cTnI levels (pre: median [range]; 0.006 [0.001-0.026]; peak post: 0.024 [0.004-0.244] μg/L; p=0.000), with substantial individual variability in peak values. PBA and JBA players showed higher baseline and post-exercise cTnI values than ABA (all p<0.05). Peak cTnI exceeded the upper reference limit (URL) in the 26% of players (3 PBA; 6 JBA). CONCLUSIONS: The current results suggest that intermittent exercise can promote the appearance of cTnI and that this is potentially mediated by athlete status

Are Fibromyalgia patients cognitively impaired? Objective and subjective neuropsychological evidence.

9nonemixedTESIO, VALENTINA; TORTA, Diana; Colonna F; LEOMBRUNI, Paolo; GHIGGIA, ADA; Fusaro E; GEMINIANI, Giuliano Carlo; TORTA, Riccardo; CASTELLI, LorysTesio, Valentina; Torta, Diana; Colonna, F; Leombruni, Paolo; Ghiggia, Ada; Fusaro, E; Geminiani, Giuliano Carlo; Torta, Riccardo; Castelli, Lory

Adherencia a la dieta mediterránea en adultos inactivos, practicantes de ciclo indoor y ciclistas aficionados

Introducción: existe información limitada sobre la relación entre la adherencia a la dieta mediterránea (ADM) y la práctica deportiva. Objetivo: determinar la posible asociación de la práctica deportiva y el volumen de entrenamiento en bicicleta con la ADM y la influencia de la proximidad de una prueba ciclodeportiva sobre la ADM. Material y métodos: una primera evaluación de la ADM en 785 (84 mujeres) ciclistas aficionados (volumen = 7 horas/semana), 514 (224 mujeres) practicantes de ciclo indoor (volumen: 2-6 horas/semana) y 718 (411 mujeres) adultos inactivos fue desarrollada en mayo, coincidiendo con la participación de los ciclistas en una prueba ciclodeportiva. Una submuestra de 359 ciclistas y 148 inactivos fueron evaluados nuevamente en noviembre, en fecha alejada de la prueba ciclodeportiva. Se utilizó el cuestionario MEDAS-14 para valorar la ADM y un cuestionario autodiseñado para evaluar el volumen de entrenamiento. Resultados: un 40% de los sujetos evidenció alta ADM. En ambos sexos, los deportistas mostraron mayor ADM que los inactivos, con los mejores índices para los grupos de ciclistas (p < 0, 001). La relación entre la ADM y el volumen de entrenamiento fue débil (hombres: r = 0, 137, mujeres: r = 0, 173; p < 0, 001). La ADM de los ciclistas disminuyó de mayo a noviembre (p < 0, 001) sin cambios en los sujetos inactivos (p = 0, 535). Conclusiones: la práctica deportiva en bicicleta se asocia con una mayor ADM con limitada influencia del volumen de entrenamiento y con efectos positivos transitorios de la participación en una prueba ciclodeportiva. Introduction: There is limited information referred to the relationship between adherence to the Mediterranean Diet (AMD) and sports practice. Objective: To determinate the association of cycling practice and cycling training volume with the AMD and the influence of the participation in a high-demand cyclist event on the AMD. Material and methods: A first evaluation of AMD in 785 (84 women) amateur cyclists (volume: = 7 hours/week), 514 (224 women) indoor cycling practitioners (volume: 2-6 hours/week) and 718 (411 women) inactive adults was conducted in May coinciding with the participation of cyclists in a cycling event. A subsample of 359 cyclists and 148 inactive subjects agreed to be retested in November, far from the cycling event date. The MEDAS-14 questionnaire was used to assess the AMD and a self-designed questionnaire was used to assess the volume of training. Results: 40% of subjects showed high AMD. In both sexes, athletes showed higher AMD than inactive subjects, with the highest indexes for groups of cyclists (p < 0.001). The relationship between AMD and training volume was weak (men: r = 0.137, women: r = 0.173; p < 0.001). The AMD of cyclists decreased from May to November (p < 0.001) with no significant changes in inactive subjects (p = 0.535). Conclusions: Cycling is associated to higher values of AMD with a limited influence of training volume and transient positive effects of participation in a cycling endurance event

Land- and water-based exercise intervention in women with fibromyalgia: the al-andalus physical activity randomised controlled trial

Background The al-Andalus physical activity intervention study is a randomised control trial to investigate the effectiveness of a land- and water-based exercise intervention for reducing the overall impact of fibromyalgia (primary outcome), and for improving tenderness and pain-related measures, body composition, functional capacity, physical activity and sedentary behaviour, fatigue, sleep quality, health-related quality of life, and cognitive function (secondary outcomes) in women with fibromyalgia. Methods/Design One hundred eighty women with fibromyalgia (age range: 35-65 years) will be recruited from local associations of fibromyalgia patients in Andalucía (Southern Spain). Patients will be randomly assigned to a usual care (control) group (n = 60), a water-based exercise intervention group (n = 60) or a land-based exercise intervention group (n = 60). Participants in the usual care group will receive general physical activity guidelines and participants allocated in the intervention groups will attend three non-consecutive training sessions (60 min each) per week during 24 weeks. Both exercise interventions will consist of aerobic, muscular strength and flexibility exercises. We will also study the effect of a detraining period (i.e., 12 weeks with no exercise intervention) on the studied variables. Discussion Our study attempts to reduce the impact of fibromyalgia and improve patients' health status by implementing two types of exercise interventions. Results from this study will help to assess the efficacy of exercise interventions for the treatment of fibromyalgia. If the interventions would be effective, this study will provide low-cost and feasible alternatives for health professionals in the management of fibromyalgia. Results from the al-Andalus physical activity intervention will help to better understand the potential of regular physical activity for improving the well-being of women with fibromyalgia.This study was supported by the Consejeria de Turismo, Comercio y Deporte (CTCD-201000019242-TRA), the Spanish Ministry of Science and Innovation (I + D + I DEP2010-15639, grants: BES-2009-013442, BES-2011-047133, RYC-2010-05957, RYC-2011-09011), the Swedish Heart-Lung Foundation (20090635), the Spanish Ministry of Education (AP-2009-3173), Granada Research of Excelence Initiative on Biohealth (GREIB), Campus BioTic, University of Granada, Spain and European University of Madrid. Escuela de Estudios Universitarios Real Madrid. 2010/04RM

The placebo effect and its determinants in fibromyalgia: meta-analysis of randomized controlled trials

The aims of this study were to determine whether placebo treatment in randomised controlled trials (RCTs) is effective for fibromyalgia and to identify possible determinants of the magnitude of any such placebo effect. A systematic literature search was undertaken for RCTs in people with fibromyalgia that included a placebo and/or a no-treatment (observation only or waiting list) control group. Placebo effect size (ES) for pain and other outcomes was measured as the improvement of each outcome from baseline divided by the standard deviation of the change from baseline. This effect was compared with changes in the no-treatment control groups. Meta-analysis was undertaken to combine data from different studies. Subgroup analysis was conducted to identify possible determinants of the placebo ES. A total of 3912 studies were identified from the literature search. After scrutiny, 229 trials met the inclusion criteria. Participants who received placebo in the RCTs experienced significantly better improvements in pain, fatigue, sleep quality, physical function, and other main outcomes than those receiving no treatment. The ES of placebo for pain relief was clinically moderate (0.53, 95%CI 0.48 to 0.57). The ES increased with increasing strength of the active treatment, increasing participant age and higher baseline pain severity, but decreased in RCTS with more women and with longer duration of fibromyalgia. In addition, placebo treatment in RCTs is effective in fibromyalgia. A number of factors (expected strength of treatment, age, gender, disease duration) appear to influence the magnitude of the placebo effect in this condition

Exercise and global well-being in community-dwelling adults with fibromyalgia: a systematic review with meta-analysis

<p>Abstract</p> <p>Background</p> <p>Exercise has been recommended for improving global-well being in adults with fibromyalgia. However, no meta-analysis has determined the effects of exercise on global well-being using a single instrument and when analyzed separately according to intention-to-treat and per-protocol analyses. The purpose of this study was to fill that gap.</p> <p>Methods</p> <p>Studies were derived from six electronic sources, cross-referencing from retrieved studies and expert review. Dual selection of randomized controlled exercise training studies published between January 1, 1980 and January 1, 2008 and in which global well-being was assessed using the Fibromyalgia Impact Questionnaire (FIQ) were included. Dual abstraction of data for study, subject and exercise program characteristics as well as assessment of changes in global well-being using the total score from the FIQ was conducted. Risk of bias was assessed using the Cochrane bias assessment tool. Random-effects models and Hedge's standardized effect size (<it>g</it>) were used to pool results according to per-protocol and intention-to-treat analyses.</p> <p>Results</p> <p>Of 1,025 studies screened, 7 representing 5 per-protocol and 5 intention-to-treat outcomes in 473 (280 exercise, 193 control) primarily female (99%) participants 18-73 years of age were included. Small, statistically significant improvements in global well-being were observed for per-protocol (<it>g </it>and 95% confidence interval, -0.39, -0.69 to -0.08) and intention-to-treat (-0.34, -0.53 to -0.14) analyses. No statistically significant within-group heterogeneity was found (per-protocol, Q_w= 6.04, <it>p </it>= 0.20, <it>I</it>²= 33.8%; intention-to-treat, Q_w= 3.19, <it>p </it>= 0.53, <it>I</it>²= 0%) and no between-group differences for per-protocol and intention-to-treat outcomes were observed (Q_b= 0.07, <it>p </it>= 0.80). Changes were equivalent to improvements of 8.2% for per-protocol analyses and 7.3% for intention-to-treat analyses.</p> <p>Conclusions</p> <p>The results of this study suggest that exercise improves global well-being in community-dwelling women with fibromyalgia. However, additional research on this topic is needed, including research in men as well as optimal exercise programs for improving global well-being in adults.</p

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)