Do Fitflops™ increase lower limb muscle activity?

Fitness toning shoes are becoming increasingly popular, they aim to increase muscle activity, raise energy expenditure and improve overall health while wearing them. Yet there is a lack of consensus in the literature regarding their effectiveness. One such shoe on the market is the Fitflop™ designed to activate leg muscles through density shifts in the shoe's sole. The purpose of this study was to investigate the effect of wearing Fitflops TM on the muscle activity of the lower limb. Twenty three females (age 20.8 (1.3)years, mass 62.9 (11.9)kg, height 165.4 (5.6)cm) participated in the study. Muscle activity of the medial gastrocnemius, biceps femoris, rectus femoris and gluteus maximus of the participants' right limb were recorded using surface electromyography during participation in three different tasks to simulate daily living activities. These were a) treadmill walking b) stair climbing and c) zigzag walking around cones. The participants completed the tasks barefoot, while wearing Fitflops™ and while wearing regular flip flops so that comparisons between muscle activity in the different shoe conditions could be made. The results show that there was no significant difference in the activity of the medial gastrocnemius, biceps femoris, rectus femoris and gluteus maximus muscles across all shoe conditions and simulated daily activities (P > 0.05). Based on these results, the use of Fitflops™ is not recommended as a means of increasing muscle activity of the medial gastrocnemius, biceps femoris, rectus femoris and gluteus maximus during activities of daily living in a healthy recreationally active female population

Per-protocol investigation of a best practice exercise referral scheme.

Objectives: To investigate the effects of an exercise referral scheme (ERS) aligned to the UK best practice guidelines on a range of outcomes including those associated with key health concerns of the Scottish population. Study design A longitudinal design with data collection at three time points (baseline, midway and post) during a 12-week ERS intervention was employed. Methods: Health-related physical fitness was assessed through measurement of resting heart rate, blood pressure, FEV1:FEV6 (ratio of forced expiratory volume over one [FEV1] and six [FEV6] seconds), body mass and peak oxygen uptake (VO2 peak), whilst functional capacity was assessed through the five times sit to stand test. Psychosocial well-being and quality of life were measured using the World Health Organization Quality of Life questionnaire (WHOQOL-BREF) and the Profile of Mood State questionnaires. Growth curve analyses were used to model each outcome variable across the three time periods. Results: A range of effects were obtained with significant linear improvements in physical performance tests (P < 0.001) and psychosocial assessments (P ≤ 0.002). Additionally, significant quadratic effects of time were obtained for body composition variables and physical activity levels (P < 0.001) with the greatest improvements obtained between baseline and midway assessments. Conclusions: An ERS aligned to the UK best practice guidelines can positively influence a range of health outcomes including those associated with lung function and cardiovascular fitness which are prevalent medical conditions in Scotland. In addition, results indicate that ERS can positively affect outcomes related to functional capacity as well as mental well-being and perceptions of health. The findings of the study identify the need for further investigation including consideration of the initial health status of referred clients

The effectiveness of multifactorial and multicomponent interventions for the prevention of falls for adults in hospital settings: a systematic review and meta-analysis.

The objective of this systematic review and meta-analysis was to evaluate the effectiveness of multicomponent and multifactorial interventions for reducing falls in adult in-patients. Falls are the most common cause of accidental injury in hospitals worldwide, resulting in high human and economic costs. In attempts to reduce the number of falls, a wide range of interventions have been employed, often in combination, either as a package (multicomponent) or tailored to the individual (multifactorial). There is a need to synthesise the findings from primary studies and assess which approach may be more effective. The systematic review included studies comprising adult inpatients aged 18 years and over from any hospital setting including elective, non-elective, day-case and secondary care. Randomized controlled trials (RCT), cluster-randomised trials, quasi-experimental controlled trials and historical controlled trials were included that presented sufficient information regarding the rate or number of falls. This effectiveness review was conducted in accordance with JBI methodology and was guided by an a priori protocol. A comprehensive 3-step search strategy was employed across 14 databases. Screening was conducted by two independent reviewers, and data was extracted using a bespoke data extraction tool designed for this review. Methodological quality was assessed using adapted versions of JBI critical appraisal checklists. Meta-analyses were conducted within a Bayesian framework to interpret results probabilistically and account for covariance in multiple sets of falls data reported in the same study. Effect sizes were calculated by comparing the rate or number of falls in the intervention group compared with usual care. Narrative syntheses were conducted on studies that met the inclusion criteria but did not provide sufficient data for inclusion in meta-analyses. A total of 9,637 records were obtained and following screening 24 studies were included in this review, 21 of which presented sufficient information to be included in meta-analyses. Most studies (n=16) comprised a weaker historical control design with 6 quasi-experimental and only 5 RCT studies. Multifactorial interventions were more common (n=18) than multicomponent (n=6), with the most frequent components including environmental adaptations and assistive aids (75% of studies). Meta-analyses provided evidence that both intervention types were effective at reducing the rate and risk of falls compared to usual care. Evidence was also obtained of greater reductions in rate and risk of falls with multicomponent interventions, however, analyses were potentially confounded by an association between intervention type and study design. Falls interventions routinely employed in hospitals can substantially reduce falls, however, no evidence was obtained in support of tailoring interventions to individual risk factors. Future high-quality RCTs are required that directly compare multicomponent and multifactorial interventions

Kinetic and kinematic changes during a 30-repetition bout of the barbell clean.

The purpose of this stduy was to investigate the biomechanical effects of performing a large number of repetitions with a technically demanding exercise, as is recommended in many extreme conditioning programs. Sixteen trained male participants (age: 24.1 [± 4.1] years; stature: 180.1 [± 3.6] cm; mass: 94.6 [± 10.4] kg; resistance training experience: 6.0 [± 3.4] years) performed 30 repetitions of the barbell clean in as short a duration as possible using the same absolute load of 62 kg. The participants also performed a baseline assessment comprising 6 repetitions with the same absolute load to provide a non-fatigued comparison. Discrete and continuous kinematic variables were quantified using 2D video analysis, whilst kinetics were quantified using force values collected from a force platform. Statistically significant differences in kinematic and kinetic values were observed between the baseline assessment and fatiguing protocol. However, the magnitude of these differences was classified as low to moderate. Knee flexion at the beginning of the movement was significantly lower during the 30 repetition protocol compared with baseline and decreased as fatigue accrued (p < 0.001, eta square=0.045). Accumulation of fatigue resulted in decreased hip flexion and increased ankle dorsiflexion at the catch phase (p < 0.001, eta square=0.040; p=0.036, eta square=0.044, respectively). In contrast, continuous kinematic variables demonstrated that participants were able to maintain coordinated action between the hip and knee throughout the 30 repetitions. Collectively, the results demonstrate that, despite relatively small changes to technique observed at the beginning and end of the barbell clean, the more important coordinative features of the movement can be maintained despite accruing substantial fatigue. It is recommended that if extreme conditioning programs are used with technically demanding resistance exercises then technique should be monitored and the session terminated if improper movement patterns emerge

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial

Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a centralised computer system to receive a single large-diameter screw with a side-plate (sliding hip screw) or the present standard of care, multiple small-diameter cancellous screws. Surgeons and patients were not blinded but the data analyst, while doing the analyses, remained blinded to treatment groups. The primary outcome was hip reoperation within 24 months after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function. Analyses followed the intention-to-treat principle. This study was registered with ClinicalTrials.gov, number NCT00761813. Findings Between Mar