Modelling and in vivo evaluation of tendon forces and strain in dynamic rehabilitation exercises: a scoping review

Objectives Although exercise is considered the preferred approach for tendinopathies, the actual load that acts on the tendon in loading programmes is usually unknown. The objective of this study was to review the techniques that have been applied in vivo to estimate the forces and strain that act on the human tendon in dynamic exercises used during rehabilitation. Design Scoping review. Data sources Embase, PubMed, Web of Science and Google Scholar were searched from database inception to February 2021. Eligibility criteria Cross-sectional studies available in English or Spanish language were included if they focused on evaluating the forces or strain of human tendons in vivo during dynamic exercises. Studies were excluded if they did not evaluate tendon forces or strain; if they evaluated running, walking, jumping, landing or no dynamic exercise at all; and if they were conference proceedings or book chapters. Data extraction and synthesis Data extracted included year of publication, study setting, study population characteristics, technique used and exercises evaluated. The studies were grouped by the types of techniques and the tendon location. Results Twenty-one studies were included. Fourteen studies used an indirect methodology based on inverse dynamics, nine of them in the Achilles and five in the patellar tendon. Six studies implemented force transducers for measuring tendon forces in open carpal tunnel release surgery patients. One study applied an optic fibre technique to detect forces in the patellar tendon. Four studies measured strain using ultrasound-based techniques. Conclusions There is a predominant use of inverse dynamics, but force transducers, optic fibre and estimations from strain data are also used. Although these tools may be used to make general estimates of tendon forces and strains, the invasiveness of some methods and the loss of immediacy of others make it difficult to provide immediate feedback to the individuals.This work is part of a government-funded project supported by the University Teaching Training Programme (FPU) of the Ministry of Science, Innovation and Universities of Spain. Grant number: FPU17/00161. The University of Malaga has supported this study with the contribution of funds to support its publication in open access

The Importance of Lifestyle Factors for Work Ability among Physical Therapists:A Cross-Sectional Study

Lifestyle factors such as smoking, sedentarism, low physical activity levels, and overweight are associated with poor health, and they can potentially influence work ability. However, it remains unknown which lifestyle habits are associated with work ability among physical therapists (PTs). The aim of this study was to examine the associations between smoking, alcohol consumption, BMI, sitting time, and physical activity levels with work ability among PTs utilizing a nationwide questionnaire. Associations were modeled using logistic regression controlled for various confounders. Overweight, sitting >150 min/day, and <75 min/week of leisure-time vigorous physical activity were associated with lower work ability among PTs. Further, the existence of two unhealthy habits showed a weak-to-moderate positive association with lower work ability scores (Model 1: OR, 2.21, 95% CI = 1.16–4.22; Model 2: OR, 2.32, 95% CI, 1.18–4.54), with even stronger associations when three unhealthy habits (Model 1: OR = 3.30, 95% CI, 1.58–6.86; Model 2: OR, 3.34, 95% CI, 1.54–7.26) or four unhealthy habits (Model 1: OR = 8.91, 95% CI, 2.55–31.1; Model 2: OR = 8.20, 95% CI, 2.15–31.2) were present. In conclusion, overweight, low physical activity, and sedentarism were associated with lower levels of work ability, especially when ≥2 unhealthy lifestyle factors were present

Effect of a brief progressive resistance training program in hospital porters on pain, work ability, and physical function

Background Hospital porters are possibly exposed to the greatest mechanical loads within the hospital environment. However, the evidence about preventive strategies in this population is scarce. Objective To investigate the effect of a workplace-based progressive resistance-training program on musculoskeletal pain among hospital porters. Method A total of 37 hospital porters (27 women, 10 men) participated. Participants allocated to the intervention group performed five brief resistance training sessions/week, for 9 weeks during working hours at the hospital. Intensity was progressively increased. Participants allocated to the control group maintained their usual physical activity. The primary outcome was pain assessed with the patient global impression of pain change scale. Secondary outcome measures were average pain intensity, work ability, use of analgesics, and physical function. Additionally, perceived general changes were evaluated at follow-up: wellness, satisfaction at work, desire to exercise, motivation to eat healthy, energy to be with family and friends, and socialization with colleagues. Results For the primary outcome, the intervention group showed lower general pain (p < 0.0001) and greater wellbeing (p < 0.0001), work satisfaction (p = 0.0048), desire for practicing exercise (p = 0.0007), and energy (p = 0.0474) compared with the control group. Significant between-group interactions were found for work impairment due to diseases (d = -1.2), hips/thighs pain (d = 0.7), ankles/feet pain (d = 0.4), the Biering-Sorensen test (d = -0.6) and the push-ups test (d = -2.3) favoring the intervention group. All between-group differences were clinically important. Conclusion A progressive resistance training program performed at the workplace is feasible and effective in reducing musculoskeletal pain and improving work ability and physical function among hospital porters.This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Escriche-Escuder is supported by a predoctoral grant of the University Teaching Training Programme (FPU) of the Ministry of Science, Innovation and Universities of Spain. Grant number: FPU17/00161

Fear Avoidance Beliefs and Risk of Long-Term Sickness Absence: Prospective Cohort Study among Workers with Musculoskeletal Pain

Background and Objective. Musculoskeletal pain is common in the population. Negative beliefs about musculoskeletal pain and physical activity may lead to avoidance behavior resulting in absence from work. The present study investigates the influence of fear avoidance beliefs on long-term sickness absence. Methods. Workers of the general working population with musculoskeletal pain (low back, neck/shoulder, and/or arm/hand pain; n = 8319) from the Danish Work Environment Cohort Study were included. Long-term sickness absence data were obtained from the Danish Register for Evaluation and Marginalization (DREAM). Time-to-event analyses (cox regression) controlled for various confounders estimated the association between fear avoidance beliefs (very low, low, moderate [reference category], high, and very high) at baseline and long-term sickness absence (LTSA; ≥6 consecutive weeks) during a 2-year follow-up. Results. During the 2-year follow-up, 10.2% of the workers experienced long-term sickness absence. In the fully adjusted model, very high-level fear avoidance increased the risk of LTSA with hazard ratio (HR) of 1.48 (95% CI 1.15-1.90). Similar results were seen analyses stratified for occupational physical activity, i.e., sedentary workers (HR 1.72 (95% CI 1.04-2.83)) and physically active workers (HR 1.48 (95% CI 1.10-2.01)). Conclusion. A very high level of fear avoidance is a risk factor for long-term sickness absence among workers with musculoskeletal pain regardless of the level of occupational physical activity. Future interventions should target fear avoidance beliefs through information and campaigns about the benefits of staying active when having musculoskeletal pain

Tolerability and Muscle Activity of Core Muscle Exercises in Chronic Low-back Pain

Most of the studies evaluating core muscle activity during exercises have been conducted with healthy participants. The objective of this study was to compare core muscle activity and tolerability of a variety of dynamic and isometric exercises in patients with nonspecific low back pain (NSLBP). 13 outpatients (average age 52 years; all with standing or walking work in their current or latest job) performed 3 consecutive repetitions at 15-repetition maximum during different exercises in random order. Surface electromyography was recorded for the rectus abdominis; external oblique and lumbar erector spinae. Patients rated tolerability of each exercise on a 5-point scale. The front plank with brace; front plank and modified curl-up can be considered the most effective exercises in activating the rectus abdominis; with a median normalized EMG (nEMG) value of 48% (34-61%), 46% (26-61%) and 50% (28-65%), respectively. The front plank with brace can be considered the most effective exercise in activating the external oblique; with a nEMG of 77% (60-97%). The squat and bird-dog exercises are especially effective in activing the lumbar erector spinae; with nEMG of 40% (24-87%) and 29% (27-46%), respectively. All the exercises were well tolerated; except for the lateral plank that was mostly non-tolerated. In conclusion; the present study provides a variety of dynamic and isometric exercises; where muscle activity values and tolerability can be used as guide to design evidence-based exercise programs for outpatients with NSCLBP

Impact of hip abductor and adductor strength on dynamic balance and ankle biomechanics in young elite female Basketball players

This study aimed to evaluate, in an isolated and relative manner, hip abductor (ABD) and adductor (AD) strength and to study the extent to which these factors are related to balance and ankle dorsiflexion mobility in young elite female basketball players. Sixty trainee-level elite female basketball players (13-18 years old), who voluntarily agreed to participate in the study, were divided into three subgroups based on competition age divisions (U14, U16, U18). Isometric hip ABD and AD strength in each leg was evaluated using the ForceFrame Strength Testing System, also calculating the strength ratio and imbalance between legs. Y Balance Test (YBT) and ankle dorsiflexion mobility were also assessed. ANOVA was used for between-group differences analysis. Likewise, the impact of hip strength on balance and ankle mobility was analyzed using Pearson's correlation coefficient. A linear regression model for dependent variables was created with all variables that exhibited significant correlations. A between-group comparison analysis for the three competition age subgroups (U14, U16, U18) revealed non-significant differences (p > 0.005) for the hip strength variables except for hip ABD strength. The correlation study showed low-moderate effect sizes for hip ABD (in both the contralateral and homolateral limb) and AD strength (only the homolateral limb) with YBT and ankle dorsiflexion. However, when performing a regression model, only right hip ABD significantly predicted right limb YBT scores (β = 0.592, p = 0.048). The present study indicated that, although both hip ABD and AD strength correlate with balance and ankle mobility with low-moderate effect sizes, only hip ABD strength was found to significantly predict YBT scores. Therefore, the potential role of hip ABD strength in particular, but also hip AD strength, for monitoring and enhancing balance and ankle mobility outcomes, should be taken into consideration when designing and implementing preventive strategies for lower-limb injuries

Implantación de nuevas metodologías para la impartición de los contenidos teóricos en le Grado de Fisioterapia. Póster

[SPA]La metodología didáctica que se expone se está implantando en del Grado en Fisioterapia en la Universidad de Valencia (UV) y son herramientas que se adaptan a los postulados constructivistas del EEES Analizar la implantación metodológica para los contenidos teóricos en el Grado en Fisioterapia de la UV. Se han implantado los métodos de lección magistral participativa, los mapas conceptuales y el estudio de casos enseñanza-aprendizaje durante las clases teóricas del presente curso académico, con el fin de desarrollar las competencias de la propuesta educativa de los estudiantes de segundo curso del Grado en Fisioterapia. La lección magistral participativa ha permitido mejorar la comunicación del profesor con el estudiante alternando con otras técnicas didácticas potenciando sus ventajas. Los mapas conceptuales han mostrado resultados positivos para establecer las relaciones que parten de un concepto, así como para interrelacionar los contenidos. El estudio de casos ha permitido realizar análisis completos de casos o problemas reales clínicos, acercando a la realidad asistencial al estudiante. Estos métodos has sido muy eficaces en el proceso de aprendizaje promoviendo la motivación por parte del estudiante y del profesor, así como el análisis crítico de la información. [ENG]This article presents the teaching methodology that is being introduced in the Degree in Physiotherapy of the University of Valencia (UV). It consists of teaching tools adapted to the EHEA constructivist postulates. To analyse the introduction of new teaching methodologies for the theoretical aspects of the Degree course in Physiotherapy of the UV. The teaching-learning methods of participative lecture, concept maps and case studies have been incorporated to the theory classes during the current academic year, with the aim of developing the competences of the education proposal for Year 2 of the Degree in Physiotherapy. Participative lecture has achieved to improve the teacher-student communication, alternating with other teaching techniques that amplify its strengths. - Concept maps have reported positive results for establishing connections from a particular concept, as well as for interconnecting contents. - Case studies have made possible to carry out comprehensive analyses of clinical cases or “real word” problems, drawing clinical reality up to the student. These methods have proved to be very effective in the teaching-learning process, encouraging the student’s and the teacher’s motivation, as well as the critical analysis of information.Campus Mare Nostrum, Universidad Politécnica de Cartagena, Universidad de Murcia, Región de Murci

High-Intensity Interval Training (HIIT) on Biological and Body Composition Variables in Patients with Musculoskeletal Disorders: A Systematic Review and Meta-Analysis

In order to assess the impact of high-intensity interval training (HIIT) on biological and body composition variables in patients with musculoskeletal disorders (MSKD), a systematic search on PubMed (Medline), CENTRAL, CINAHL, Web of Science, SPORTDiscus, and Scopus was conducted. Standardized mean differences (SMD) and 95% confidence intervals were calculated and pooled in a meta-analysis using the random-effects model. The effectiveness of HIIT on waist circumference, muscle mass, resting heart rate, resting systolic and diastolic blood pressure, C-reactive protein, body weight, and body fat were determined. GRADE, risk of bias 2, and PEDro scales were employed. HIIT compared to no intervention, minimal intervention, or usual care did not show significant results in its favor on any of the variables studied, except for the resting heart rate when compared with no intervention (SMD = −0.33; 95% CI: −0.63, −0.04; heterogeneity Q value: 0.14; p = 0.93; I2 = 0%). In addition, HIIT also does not seem to be more effective than moderate-intensity continuous training. Based on the results, it seems that HIIT has almost no significant effects on biological and body composition variables, except for resting heart rate, in patients with MSKD

Modelling and in vivo evaluation of tendon forces and strain in dynamic rehabilitation exercises: a scoping review

Objectives Although exercise is considered the preferred approach for tendinopathies, the actual load that acts on the tendon in loading programmes is usually unknown. The objective of this study was to review the techniques that have been applied in vivo to estimate the forces and strain that act on the human tendon in dynamic exercises used during rehabilitation.Design Scoping review.Data sources Embase, PubMed, Web of Science and Google Scholar were searched from database inception to February 2021.Eligibility criteria Cross-sectional studies available in English or Spanish language were included if they focused on evaluating the forces or strain of human tendons in vivo during dynamic exercises. Studies were excluded if they did not evaluate tendon forces or strain; if they evaluated running, walking, jumping, landing or no dynamic exercise at all; and if they were conference proceedings or book chapters.Data extraction and synthesis Data extracted included year of publication, study setting, study population characteristics, technique used and exercises evaluated. The studies were grouped by the types of techniques and the tendon location.Results Twenty-one studies were included. Fourteen studies used an indirect methodology based on inverse dynamics, nine of them in the Achilles and five in the patellar tendon. Six studies implemented force transducers for measuring tendon forces in open carpal tunnel release surgery patients. One study applied an optic fibre technique to detect forces in the patellar tendon. Four studies measured strain using ultrasound-based techniques.Conclusions There is a predominant use of inverse dynamics, but force transducers, optic fibre and estimations from strain data are also used. Although these tools may be used to make general estimates of tendon forces and strains, the invasiveness of some methods and the loss of immediacy of others make it difficult to provide immediate feedback to the individuals