Cardiorespiratory fitness, balance and walking improvements in an adolescent with cerebral palsy (GMFCS II) and autism after motor-assisted elliptical training

Purpose: To quantify the impact of motor-assisted elliptical (ICARE) training on cardiorespiratory fitness, balance and walking function of an adolescent with walking limitations due to cerebral palsy. Materials and methods: A thirteen-year-old boy with hemiplegic cerebral palsy (Gross Motor Function Classification System II) and autism participated. Peak oxygen consumption (peak VO2, primary outcome measure), oxygen cost of walking, Pediatric Balance Scale (PBS), modified Timed Up and Go (mTUG), 2-Minute Walk Test (2MWT), and gait characteristics (speed, cadence, step length, single support time) were assessed prior to and after completion of 24 sessions of moderate- to vigorous- intensity ICARE training. The goal was to engage the participant in 3 weekly sessions for 8 weeks with progressively challenging training parameters (speed, time overriding the motor’s assistance, step length). Results: From pre- to post-intervention, improvements were detected for peak VO2 (27.2 vs. 40.2 ml/ kg/min), oxygen cost (0.24 vs. 0.17 ml/kg/m at 1.52 m/s), PBS (47 vs. 55), mTUG (8.5 vs. 7.1 seconds), 2MWT (76.8 vs. 128.3 meters). Though not all displayed clinically significant changes, self-selected and fast walking speeds improved. Conclusions: Fitness, balance and walking improvements were achieved by an adolescent with cerebral palsy and autism after participating in a moderate- to vigorous-intensity exercise

Estudo dinamométrico da marcha de idosas ultrapassando obstáculos

The present study aimed to investigate the gait during obstacle negotiation in physically active and in sedentary elderly women with the purpose of identifying adaptations performed by both groups when facing a more complex gait task. Twenty healthy participants were divided into active and sedentary groups. A force plate was used to assess the vertical orthogonal component of ground reaction forces during gait: peak and minimum forces, vertical impulse and foot support time. Such variables were analyzed during two distinct gait protocols: unobstructed gait and gait with obstacles positioned at 10%, 20%, and 30% of the participants lower limb height. The obstacle was also positioned prior to and after the force plate, so two different functions of the same lower limb were assessed. The results are presented in three sections: the first one describeed the two groups (no statistical difference observed), the second reported the effect of obstacle height (where the 10% height was already a challenging obstacle for the sedentary group), and the third compared the lower limb functions of primary and secondary support (no statistical difference observed). It was concluded that physical activity assisted on obstacle negotiation during gait. The sedentary elders opted to engage in a safer strategy of obstacle negotiation, observed by lesser magnitudes of the dynamometric variables along with the foot support time.O presente estudo teve como objetivo investigar a marcha durante a negociação de obstáculos de mulheres idosas fisicamente ativas e sedentárias para identificar as adaptações realizadas pelos dois grupos diante de uma tarefa de marcha mais complexa. Participaram do estudo 20 idosas sadias, divididas entre grupo ativo e grupo sedentário. Foi utilizada uma plataforma de força para avaliar a componente ortogonal vertical das forças de reação do solo: forças máxima e mínima, impulso vertical e tempo de apoio. Essas variáveis foram analisadas durante dois protocolos distintos: marcha livre e marcha com obstáculo com alturas de 10%, 20% e 30% do comprimento do membro inferior das voluntárias. O obstáculo foi posicionado previamente e após a plataforma para que duas funções diferentes do mesmo membro inferior fossem investigadas. Os resultados estão apresentados em três seções: a primeira avalia os dois grupos (não houve diferença significativa), a segunda avalia o efeito da altura do obstáculo (onde a altura de 10% já se apresenta como um obstáculo desafiante para as idosas sedentárias) e a terceira compara as funções de suporte primário e secundário (não houve diferença significativa). Conclui-se, para a amostra utilizada, que a atividade física auxiliou na negociação de obstáculos durante a marcha. As idosas sedentárias optaram por uma estratégia mais segura na negociação de obstáculos, observada pelas menores magnitudes das variáveis dinamométricas juntamente com um maior tempo de apoio

Preliminary results on organization on the court, physical and technical performance of Brazilian professional futsal players: comparison between friendly pre-season and official match

The main aim of this study was to verify possible differences between a friendly pre-season match (FM) and an official in-season match (OM) regarding physical, technical, and organizational performances of a professional Brazilian futsal team. Ten professional futsal athletes participated in this study. The matches were monitored with video cameras (30 Hz) and athlete trajectories obtained with automatic tracking. The values obtained for distance covered per minute, percentage of distance covered at moderate intensity, team coverage area, spread, passes, possessions, ball touches and successful passes per minute were greater for the OM than FM. On the contrary, percentage of distance covered, standing and walking was greater for the FM than OM. We concluded that physical, technical, and tactical performances are different between a FM and an OM in futsal and also these parameters mutually influenced each other distinctly. Future studies should verify whether pre-season tournaments reproduce similar demands to a regular season official match

Influência do ciclo menstrual na atividade eletromiográfica e na cinemática do joelho durante a aterrissagem do salto

Universidade Federal de Minas GeraisEstudos epidemiológicos indicam que as mulheres são de duas a oito vezes mais propensas à ruptura do ligamento cruzado anterior (LCA) que os homens quando participam de uma mesma atividade. Dentre os fatores utilizados para explicar tal discrepância, a relação entre picos dos hormônios sexuais femininos e o aumento da frouxidão ligamentar têm sido recentemente abordada com resultados ainda controversos. Diante disso, o objetivo deste estudo foi realizar uma revisão sobre a influência da oscilação dos hormônios sexuais femininos na frouxidão e lesão do LCA. Para tanto, foi realizada uma revisão na literatura com consulta às bases de dados eletrônicas (MEDLINE, PubMed, PEDro, EMBASE, CINAHL, COCHRANE, LILACS e SciELO) do ano de 1966 até 2008. Neste período nenhum estudo foi encontrado em língua portuguesa, sendo destacados 19 estudos em língua inglesa. Destes estudos, apenas dois realizaram a mensuração da frouxidão do LCA de maneira dinâmica, enquanto que os outros estudos realizaram de forma estática por meio do instrumento KT. A frouxidão do LCA foi observada com maior freqüência nas fases folicular tardia e lútea. Estes resultados foram obtidos em sua grande maioria por meio de uma avaliação estática, portanto não inteiramente reprodutível dos mecanismos de lesão do LCA que usualmente ocorrem em situações dinâmicas. Já nos resultados dos estudos que realizaram questionários pós-lesão e levantamento de dados a fase folicular inicial foi indicada, no entanto, esse achado foi baseado em dados subjetivos, limitando sua fidedignidade

Frontal plane comparison between drop jump and vertical jump: Implications for the assessment of ACL risk of injury

The potential to use the vertical jump (VJ) to assess both athletic performance and risk of anterior cruciate ligament (ACL) injury could have widespread clinical implications since VJ is broadly used in high school, university, and professional sport settings. Although drop jump (DJ) and VJ observationally exhibit similar lower extremity mechanics, the extent to which VJ can also be used as screening tool for ACL injury risk has not been assessed. This study evaluated whether individuals exhibit similar knee joint frontal plane kinematic and kinetic patterns when performing VJs compared with DJs. Twenty-eight female collegiate athletes performed DJs and VJs. Paired t-tests indicated that peak knee valgus angles did not differ significantly between tasks (p = 0.419); however, peak knee internal adductor moments were significantly larger during the DJ vs. VJ (p \u3c 0.001). Pearson correlations between the DJ and VJ revealed strong correlations for knee valgus angles (r = 0.93, p \u3c 0.001) and for internal knee adductor moments (r = 0.82, p \u3c 0.001). Our results provide grounds for investigating whether frontal plane knee mechanics during VJ can predict ACL injuries and thus can be used as an effective tool for the assessment of risk of ACL injury in female athletes

Feasibility of motor-assisted elliptical to improve walking, fitness and balance following pediatric acquired brain injury: A case series

Purpose: Walking, fitness, and balance deficits are common following acquired brain injury (ABI). This study assessed feasibility, acceptability, and usefulness of a modified motor-assisted elliptical (ICARE) in addressing walking, fitness, and balance deficits in children with chronic ABIs. Methods: Three children (\u3e 5 years post-ABI) completed 24 ICARE exercise sessions (exercise time, speed, and time overriding motor-assistance gradually increased) to promote mass repetition of gait-like movements and challenge cardiorespiratory fitness. Parents’ and children’s perceptions of ICARE’s safety, comfort, workout, and usability were assessed. Cardiovascular response, gait and balance outcomes were assessed. Results: No adverse events occurred. Parent’s Visual Analogue Scale (VAS) scores of perceived device safety (range 80–99), workout (range 99–100), and usability (range 75–100) were high, while comfort were 76–80 given commercial harness fit and arm support. Children’s VAS scores all exceeded 89. Comfortable walking velocity, 2-Minute Walk Test, fitness, and Pediatric Balance Scale scores improved post-training, with many outcomes surpassing established minimal clinically important differences. Conclusion: Following engagement in moderate- to vigorous-intensity exercise promoting repetitive step-like movements on a specially adapted motor-assisted elliptical, three children with chronic ABI demonstrated improvements in walking, fitness and balance. Future research in community-based environments with a larger cohort of children with ABI is needed

Comparison of plantar pressure profile of young adults during training on elliptical devices and overground walking: A pilot study

Background: Elliptical training may offer advantages over other cardiorespiratory exercises for those requiring podiatric care, since its constant double-limb support diminishes recurring high-impact plantar forces while allowing exercise in a functional, upright posture. Unknown is the impact of distinct elliptical models, that can alter user’s body mechanics, on potential variations in plantar pressure patterns. Purpose: To compare plantar pressure variables while exercising on four ellipticals and walking. Methods: For this cross-sectional pilot study, plantar pressure data were recorded from ten young adults while exercising on four ellipticals (True, Octane, Life Fitness, SportsArt) and walking overground. One-way repeated measures ANOVA identified differences in heel, arch, and forefoot maximum force (MF), peak pressure (PP), and pressure-time integral (PTI). Results: MF was lower under the heel when exercising on all ellipticals compared with walking, with further differences detected between models. PP was lower on all three foot regions when exercising on all ellipticals compared with walking, except Octane under the arch, with differences detected between ellipticals under the heel. PTI was lower under the heel and arch when exercising on some of the ellipticals compared with walking, with differences again detected under the heel between models. Conclusion: Plantar pressures were lower when exercising on the ellipticals compared with walking for most variables. Caution is recommended to which elliptical could be incorporated into therapeutic programs given that differences among models were detected under the heel

Test-retest reliability and minimal detectable change of the computerized dynamic posturography PROPRIO for adults with chronic traumatic brain injury

Purpose: Balance deficits after brain injury, including reactive recovery from unexpected perturbations, can persist well after rehabilitation is concluded. While traditional clinical assessments are practical, the anticipatory nature of the tasks may mask perceptible balance control. Computerized dynamic posturography can directly quantify capacity to respond to unexpected, external perturbations. This study examined the reliability of the computerized dynamic posturography assessment with the device PROPRIO® 4000 in adults with traumatic brain injury and created the minimal detectable change for its standardized test. Methods: Ten adults (ages 21–55 years) with chronic (average 10 ± 6 years post-injury) severe (loss of consciousness 2–75 days) brain injury performed three trials of the Propriotest® on two separate days. The average of three trials and the best scores were used separately for analysis. Test-retest reliability was verified using Intraclass Correlation Coefficients with 95% confidence interval and standard error of measurement in relation to the Intraclass Correlation Coefficients at 95%. The minimal detectable change was calculated at 95% confidence level (minimal detectable change95) and Bland-Altman plots were created to express agreement between measurement days. Results: The results exhibited excellent reliability for both average (Intraclass Correlation Coefficient of 0.969, standard error of measurement 50.9 points) and best (Intraclass Correlation Coefficient of 0.985, standard error of measurement 31.3 points) scores, with average and best minimal detectable change95 of 141.0 and 86.7 points, respectively. Conclusions: Clinicians and rehabilitation researchers can use these findings to determine if a Propriotest® change score represents a true post-treatment effect with adults with chronic brain injury. Implications for rehabilitation • After brain injury, balance deficits are common and can persist well after completion of rehabilitation programs. • Computerized dynamic posturography allows for objective quantification of one’s capacity to respond to external perturbations. • The device PROPRIO® 4000 provides reliable quantification of balance deficits of community dwelling individuals who have experienced a severe traumatic brain injury. • The minimal detectable change scores created can assist clinicians and rehabilitation researchers detect whether a change in balance score represents a true effect of an intervention at posttreatment

Variations in plantar pressure variables across elliptical trainers in older adults

Background: Ellipticals are used to address walking and cardiorespiratory training goals of older adults, some of whom are at risk for foot injuries. Variations in joint kinematics and muscle demands when using different ellipticals could lead to plantar pressure differences. This study explored plantar pressure variables during gait and use of four ellipticals. Methods: Plantar pressures were recorded while 10 adults [68.1 (4.5) years] walked and used the True, Octane, Life Fitness, and SportsArt ellipticals. Repeated-measures ANOVAs (5 × 1) identified forefoot and heel differences across conditions. Findings: Maximum forefoot forces and peak pressures were significantly lower than walking for each elliptical condition with one exception (Life Fitness peak pressure). However, sustained elliptical pedal contact time contributed to forefoot pressure-time integrals and dosages (i.e., cumulative pressure during one minute of activity) not varying significantly amongst elliptical and walking conditions. Heel maximum forces and peak pressures were significantly lower than walking during all elliptical conditions except SportsArt. Heel contact time on SportsArt and Octane exceeded walking, and SportsArt heel contact time exceeded Life Fitness. Heel pressure-time integral was greater on SportsArt compared to walking, Life Fitness, and True. Sports Art heel dosage exceeded Life Fitness and True. Interpretation: While elliptical training\u27s sustained double limb support diminished maximal forces and peak pressures under the forefoot and heel compared to walking, each ellipticals\u27 pressure-time integral and dosage were not significantly lower than walking. These findings point to the importance of carefully initiating elliptical training programs to minimize tissue injury, particularly if sensory neuropathy is present