Electromyographic evaluation of spine and lower extremity muscles during repeated and sustained bodyweight deep-squat

Introduction. Squat is a preferred exercise included in strengthening and rehabilitation protocols due to its ability to recruit large muscles of the spine and lower extremities. Speed of performing movement and regular practice are known to influence muscle activation. However, muscle activation during fast-repeated bodyweight deep-squat and sustained deep squat remains less explored. Aim of Study. This study aimed at exploring muscle activation during fast and sustained bodyweight squat and observing the effect of habitual squat exposure on spine and lower extremity muscle strength and activation. Material and Methods. Forty healthy adults (30-45 years), with varying daily squat exposure, were recruited for this cross-sectional study following an institutional ethical approval. Superficial electromyography of the erector spinae, rectus abdominis, gluteus maximus, gluteus medius, vastus lateralis, biceps femoris and the gastrocnemius was recorded during a single controlled squat, repeated fast squat and sustained squat. Muscle strength was evaluated using a trunk-leg dynamometer. Results. Higher muscle activity was observed during the ascent phase (81-240% MVC) and the descent phase (76-292% MVC) ofa single squat, whereas the sustaining squat demanded low muscle activity (27-58% MVC). Repeated fast squatting elicited 2.5--10 times greater muscle activation than sustained squat. Muscle activity did not vary significantly among people with varying squat exposure. A moderately strong negative correlation was observed between deep squat repetitions and age (r = –0.710,p ≤ 0.001), whereas a moderate positive correlation was observed between deep squat repetitions and force developed during trunk and leg dynamometry (r = 0.610, p < 0.001, r = 0.654, p < 0.001, respectively). Substantial co-activation of the erector spinae–rectus abdominis, biceps femoris–vastus lateralis and gluteus maximus–gluteus medius was observed during fast repeated squat. Conclusions. Repeated, dynamic, bodyweightdeep-squatting exercises elicited greater muscle activation compared to sustained squat. Exercises over and above habitual activities of daily living involving sustained squatting are essential to obtain greater benefits in muscle strength

SPINE20 recommendations 2021: spine care for people's health and prosperity

PURPOSE: The focus of SPINE20 is to develop evidence-based policy recommendations for the G20 countries to work with governments to reduce the burden of spine disease, and disability. METHODS: On September 17-18, 2021, SPINE20 held its annual meeting in Rome, Italy. Prior to the meeting, the SPINE20 created six proposed recommendations. These recommendations were uploaded to the SPINE20 website 10 days before the meeting and opened to the public for comments. The recommendations were discussed at the meeting allowing the participants to object and provide comments. RESULTS: In total, 27 societies endorsed the following recommendations. SPINE20 calls upon the G20 countries: (1) to expand telehealth for the access to spine care, especially in light of the current situation with COVID-19. (2) To adopt value-based interprofessional spine care as an approach to improve patient outcomes and reduce disability. (3) To facilitate access and invest in the development of a competent rehabilitation workforce to reduce the burden of disability related to spine disorders. (4) To adopt a strategy to promote daily physical activity and exercises among the elderly population to maintain an active and independent life with a healthy spine, particularly after COVID-19 pandemic. (5) To engage in capacity building with emerging countries and underserved communities for the benefit of spine patients. (6) To promote strategies to transfer evidence-based advances into patient benefit through effective implementation processes. CONCLUSIONS: SPINE20's initiatives will make governments and decision makers aware of efforts to reduce needless suffering from disabling spine pain through education that can be instituted across the globe

Incremental shuttle walk test: Reference values and predictive equation for healthy Indian adults

Purpose: Physical inactivity in Indians is leading to an increase in noncommunicable disorders at an early age in life. Early identification and quantification of the lack of physical activity using simple and reliable exercise testing is the need of the hour. The incremental shuttle walk test (ISWT) is an externally paced walk test widely used for the evaluation of exercise capacity. Currently the normative values available for clinical reference are generated from Western populations. Hence, the study was conducted to find normative values for the ISWT in healthy Indian adults (17-75 years). Materials and Methods: A convenience sample of 862 subjects was recruited after ethical approval was obtained. All subjects were divided into groups as per age and gender. For age, the grouping was as follows: Group 1: Young adulthood (17-40 years), group 2: Middle adulthood (40-65 years), and group 3: Old adulthood (>65 years). The ISWT was performed as per standard protocol by Sally Singh. Results: The average distance walked were 709.2m,556.4m and 441.3m in females and 807.9 m, 639.6 m and 478.2 m in males in the three respective age groups. Stepwise regression analysis revealed age and gender as key variables correlating with incremental shuttle walk distance (ISWD). The derived predictive equations for males and females may be given as follows: 740.351 - (5.676 × age) + (99.007 × gender). Conclusion: Reference values were generated for healthy Indian adults. Physiological response to the ISWT was shown to be affected by gender and increasing age. Easily measurable variables explained 68% of the variance seen in the test, making the reference equation a relevant part of the evaluation of the ISWT