Sports Medicine and Rehabilitation

  • PROGRESSIVE EXERCISE THERAPY IN MUSCLE DYSTROPHY: TWO CASE STUDIES IN ADULT PATIENTS WITH DM2 AND LGMD2D

    These two case studies aimed to investigate the effect and acceptance of progressive strength training in patients with muscular dystrophy. Case 1 completed a progressive resistance exercise over 12 weeks. The results showed increases in leg extensor strength, hand strength and balance. Furthermore, the anaerobic test showed an increase in the maximum glycolysis rate. Creatine kinase levels were reduced while maintaining low muscle soreness. Case 2 conducted seven weeks of electronically assisted strength training and electromyostimulation. In the course of the training, an increase in the self-contribution of the performance in the execution of movement was observed in the assisted strength training. Furthermore, an increase in the intensity of external stimuli was observed. The creatine kinase showed a reduction with physiological behavior of muscle soreness. The results demonstrate the acceptance and feasibility of progressive exercise protocols used to increase performance in two cases of muscular dystrophy.

  • MEDIAL TIBIAL STRESS SYNDROME: THE RELATIONSHIP BETWEEN GENDER AND LOWER-EXTREMITY FUNCTIONAL PERFORMANCE AMONG COLLEGIATE TRACK AND FIELD ATHLETES

    Medial tibial stress syndrome (MTSS) is a common lower extremity injury in track and field athletes. Many risk factors are associated with MTSS, and lower extremity performance may become altered in athletes suffering from prior symptoms, potentially increasing risk of future injury. The purpose of this study was to first examine the effect a prior history of MTSS has on lower-extremity measures, per gender, in collegiate level track and field athletes, and then determine if such measures predict future injury. Fifty-three healthy Division III collegiate track and field athletes (mean age = 19.40 ± 1.13 years) completed an injury history questionnaire along with five preseason lower-extremity functional tests including: ankle dorsiflexion (DF), single-leg anterior reach (SLAR), two timed single-leg balance (SLBAL) tests on a force plate, and single-leg hop for distance (SLH). Performance data were compared across gender and questionnaire data regarding injury history and occurrence of MTSS. Fifteen subjects (28%) reported previous MTSS symptoms within the last 2 years. Chi-square analyses revealed females experienced more diagnoses compared to males (p = .03). Independent t-tests revealed differences between gender on all SLBAL tests, as males performed better on all recorded measures (p < .001 – p = .003). No significant differences were noted in lower-extremity performance tests between subjects with and without prior MTSS injuries. Regression analyses using postseason injury questionnaire data revealed prior MTSS injuries had 17.3 higher odds of experiencing MTSS during the season (adjusted odds ratio [AOR] = 17.33, 95% CI: 3.5 – 86.4; p = .001).

  • PHYSIOTHERAPISTS AND PHYSICAL ACTIVITY AT WORK AMONG IN BENIN AND FRANCE

    Physical activity at work is an important indicator of the level of activity. Physiotherapists are one of professionals for the prevention against sedentary lifestyle. Objective: To assess the level of physical activity at work among physiotherapists in Benin and France. Method: Descriptive and analytical cross-sectional study, conducted from July 2017 to July 2018. With physiotherapists who consent to participate to this study we use a pedometer. They wear it at work for five consecutive days. The average number of daily steps at work was determined. Physiotherapist’s level of inactivity was assessed using the Baecke questionnaire. Data was analyzed using Epi Info 13.0. X2 of Pearson’s and ANOVA tests. They were used for the comparison of qualitative and quantitative variables respectively. Significance level was set at 0.05. Results: Among fifty-four physiotherapists evaluated, forty-four (81.5%) were sedentary, with a significant level of sedentary lifestyle in twenty-six cases (48.11%). This limitation of physical activity at the workplace and the level of sedentary lifestyle of the subjects were comparable among Beninese and French physiotherapists and they were not associated with any of the factors studied. Conclusion: The level of physical activity of physiotherapists at work is limited. Raising the awareness of these actors seems essential.

  • THE COMPARISON OF THE SHOULDER MUSCLE ACTIVATION IN PATIENTS WITH ROTATOR CUFF TEAR UNDER AN ABDUCTION BRACE AMONG THE THREE POSTURES

    Background: Immobilization using an abduction brace is essential for the relaxation of the rotator cuff and scapular muscles and the prevention of a retear in patients with rotator cuff tear after arthroscopic rotator cuff repair (ARCR). However, thus far, the comparison of the scapular muscle activities has not been compared among different postures under an abduction brace in patients after ARCR. Objectives: The purpose of our study was to compare the scapular muscle activities among the supine position, sitting position, and walking under an abduction brace before and after ARCR Study Design: Observational, repeated measures study. Methods: Twelve patients with full-thickness rotator cuff tears were studied. The mean patient age was 64.7 years. The scapular muscle activations of the ipsilateral limbs were measured using surface electromyography in three postures: supine position, sitting position, and walking. The integrated electromyography relative values of the upper trapezius, anterior deltoid, middle deltoid, and biceps brachii were compared preoperatively and at two weeks after ARCR. Results: The trapezius, biceps brachii, and middle deltoid in the walking showed significantly higher integrated electromyography relative values than those in the supine position, preoperatively and at two weeks after surgery. The anterior deltoid in the sitting position had significantly higher integrated electromyography relative values than those in the supine position. Conclusions: Postures affected the scapular muscle activities in ARCR patients under an abduction brace. Understanding the influence of posture on the scapular muscle activity after ARCR will help rehabilitation accurately and appropriately.

  • THE BICEPS BRACHII ROLE IN THE STABILIZATION OF THE CROSS PUNCH

    Purpose: starting from an injury background, we assumed that the biceps brachii’s activations could have an important role in upper limbs injury. In this work we analyzed whether different activations of the biceps brachii impact on the power transfer of the punch and how boxers of different skill levels activate the biceps brachii when deliver a punch according to their skill level and efficacy. Methods: we enrolled, basing on official rankings, 23 skilled (n=6) and unskilled boxers. Subjects were instructed to perform three cross punches directed to a fixed elastic target triggered by the coach whistling, and were monitored through a surface electromyography sensor (EMG) on the biceps brachii to estimate the muscular activation during the performance, and through an accelerometer placed inside the elastic impact target to estimate the impact energy. We analyzed the oscillatory content of the EMG signal in order to assess the muscular activation between skilled and unskilled boxers, and between weak and strong punches. Results: both skilled and unskilled boxers threw strong, medium and weak strikes. Skilled boxers performed better than unskilled boxers (47% vs 25% in the “strong punch” category).The EMG analysis revealed a significant increase of lower and higher frequencies (2-4 Hz and 15-17 Hz) and a decrease on the medium frequencies (7-9 Hz) in the skilled boxers compared to the unskilled boxers in strong punches. Weak punches had a similar activation patterns in the two groups. Conclusions: our results support the hypothesis that skilled boxers adapt their activation pattern of the biceps to better stabilize the punch delivery (and thus increasing the transfer of force).

  • EFFECTS OF GROUP EXERCISE PROGRAM ON MORPHOLOGICAL STATUS OF FEMALE UNIVERSITY STUDENTS

    The objective of the research was to determine the effects of the “Body Workout” aerobic exercises on morphological characteristics of female university students after a period of 2 months with training sessions in the duration of three hours per week. The sample of research participants was made up of female university students from the Faculty of Sports and Physical Education in Novi Sad (AGE = 22.13±0.98 years) that were actively included in the workout program. The total sample participating in the research comprised of 52 participants, 25 of which comprised the experimental group (AGE=22.11±0.89; TV=166.11±5.01) while the remaining 27 of them comprised the control group (AGE=22.45±0.78 years, TV=169.51±5.04). The experimental group followed the “Body Workout” aerobic exercises model and the control group followed the regular curriculum for the university course of Fitness (Rekreacija in Serbian) at the Faculty of Sports and Physical Education in Novi Sad. At the initial measuring, there were no statistically significant differences among the participants (P=0.41). Physical changes that occurred in the participants’ bodies during the research period of two months were followed by means of monitoring of twelve morphological characteristics. According to the research results, significant effects were determined in transformation of morphological characteristics among the members of the experimental group on the level of the entire system (P=0.00) and the individual differences could be perceived in the final measuring in variables Circumference of the lower leg (p=0.05), Skinfold of biceps brachii (p=0.00), Skinfold of triceps brachii (p=0.00), Skinfold of the forearm (p=0.00), Subscapula skinfold (p=0.02) and Abdominal skinfold (p=0.00) among the members of the experimental group. That is an indication that the experimental Body Workout program had a significant impact on the above mentioned characteristics. At the same time, it was determined that the experimental program of aerobic exercises produced the greatest effects on…

  • PHYSIOTHERAPY APPROACH IN MICROCEPHALY PATIENTS

    INDRODUCTION: Microcephaly is a neurological condition with a craniofacial anomaly where it has a reduced cephalic perimeter, resulting in malformation of the central nervous system. In 2015, Brazil registered an outbreak of the disease, mainly in the states of northeastern Brazil, causing a state of alert in the entire population and a problem for public health that after investigative studies, concluded that the responsible for the outbreak would be the Zika virus. In general, the disease may present a delay in the neuropsychomotor development, the application of an early intervention program should be done in a systematic and individual way, respecting the various changes in each case. With the physiotherapist applicability occurs the contribution with the physical and psychic benefits, creating more possibilities for psychosocial rehabilitation. OBJECTIVE: To show the approach of physiotherapy to minimize the impairment caused by microcephaly, through appropriate treatments mediating the disability of each individual. METHODOLOGY: For this summary, a study was made on the need for physiotherapy in patients with microcephaly. It was conducted by electronic research in the databases Scielo, Pubmed and Bireme RESULTS: Microcephaly is a pathology that causes severe functional and cognitive alterations, being important the rehabilitation with purpose the stimulation of the child according to the neuropsychomotor age. The conduct of any technique in the first years of life helps in the process of maturation of the central nervous system, being considered important for the development of motor, cognitive and sensory skills. The study demonstrated that in addition to early interventions, the care with an interdisciplinary health team and the support of the family environment favors the development and functionality leading to the autonomy and independence of the child. CONCLUSION: Microcephaly is a pathology that requires continuous treatment for the rest of life. The early stimulation through a conduct with kinesiotherapeutic…

  • THE IMPORTANCE OF THE MULTIPROFESSIONAL APPROACH IN SOTOS SYNDROME

    Introduction: Sotos syndrome or cerebral gigantism is a rare genetic disorder characterized by excessive physical growth in early childhood, being associated with the NSD1 gene, located on chromosome 5. The Individuals show as physical changes macrocephaly, neuropsychomotor retardation, stomatoglossognathic system alteration, delay in language acquisition and development, and cognitive deficit. Objectives: To report the importance of the approach of Occupational Therapy, Speech Therapy, Physiotherapy and Psychology professional regarding intervention in a patient with Sotos syndrome. Local: Unit of Neuropsychomotor rehabilitation of the Specialized Center for Rehabilitation of a region of the Alagoas backwood. Methodology: Patient attended the aforementioned institution with medical diagnosis of Sotos Syndrome and with complaints of motor deficit, delay in acquisition, development and use of oral language, difficulty in oral control, and cognitive and behavioral changes. Initially, the basic script for multiprofessional institutional evaluation was applied, as a way to gather more information about the general complaint of the patient, made the anamneses and specific evaluations of occupational therapy, phonoaudiology physiotherapy and psychology, looking to promote the rescue of specific complaints. Was also performed the application of the UTP- Unique Therapeutic Project, seeking to list the CIF of the patient and the objectives to be drawn in the short, medium and long term. The multiprofessional rehabilitation regarding of this patient was performed from preselected play resources, where she also had guidelines regarding early stimulation. Results: After 1 year in the unit of neuropsychomotor rehabilitation, it was observed that there was significant improvement in all aspects evaluated. With regard physiotherapeutic rehabilitation and occupational therapy, the patient shows improvement in gait resulting from lower limb strengthening and balance development. Regarding the speech-language complaints, the patient improved communicative intention, social interaction, linguistic structuring and oral control. It also presented a linear change in the psychological patterns of cognitive and behavioral…

  • THE USE OF ELASTIC BANDAGE IN TREATMENT OF SPEECH THERAPY IN PATIENTS POST ORTHOGNATHIC SURGERY

    Introduction: The orthognathic surgery is realized for the correction of maxillo-mandibular disproportions, providing improvement in aesthetics and setting a harmony between anatomical structures. As it is a readjustment of these structures, these patients may present a demand for speech therapists interventions, either in pre or post-operative with the objective of set a new functional pattern suitable to the new form. Objectives: To describe the experience regarding the effectiveness of patients post orthognathic surgery with the use of elastic bandage associated with speech therapy. Local: Specialized Center in Rehabilitation of the municipality of Maceió. Methods: A descriptive study of the experience in patients submitted to the orthognathic surgery. Interventions and lectures were realized in order to solve the doubts regarding speech therapy. The purpose of the action is to realize anamnesis, evaluation and speech-language intervention, focused on the area of orofacial motricity, in patients who entered the rehabilitation center and looked for phonoaudiological demand after orthognathic surgery. Results: Five patients who had realize orthognathic surgery to correct maxillo-mandibular disproportion were observed. Initially, a anamnesis speech-language pathology was realized, with the objective of knowing the clinical history and demand of each patient. Then, evaluations were carried out based on validated protocols, in order to analyze how was the structures and functions related to orofacial motricity, in order to draw up the therapeutic plan of these patients. Of the five patients initially mentioned, four presented a demand to apply for elastic bandage associated with the performance of speech therapy. The sessions were performed once a week, where orofacial myofunctional exercises were performed during therapy and finished with the application of elastic bandage. At the end of one year of observation, it was possible to verify that patients who used elastic bandage presented a faster rehabilitation process, when compared to those who did not,…

  • Supplements and Enhancement Drugs: Athletes Torment Themselves with Potential Risks

    An individual’s dietary and supplement strategies can influence markedly their physical performance. Issues related to knowledge of nutrition and dietary supplementation (DS) are understudied in professional athletes. Supplements nowadays are used with the aim of improve body composition, of which the origins are multiplex in structure. Many approaches to improve the response to resistance training are the use of pre-/post-/in between workout nutritional interventions; with beverages garnering significant interest. The health benefits and risks of dietary supplement use are controversial as there is no visible immediate benefits observed. Sports nutrition recommendations for endurance exercise however remains a complex issue with often opposing views and advice by various health care professionals. Many athletes, at all levels of competition, place great emphasis on the use of dietary supplements, but of all the factors that determine athletic performance, supplements can play only a very small role. Compared with factors such as talent, training, tactics, and motivation, nutrition has a small effect on performance, and supplements can be no more than a minor part of the athlete’s nutrition strategy.