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Background: There is evidence that core stabilisation, strength and endurance training contribute to reduce low back pain in the general population. However, we are not aware of the effect of these exercises on fighter aviation pilots. Therefore, the present study aims to investigate the effects of an exercise protocol on chronic low back pain in Brazilian Air Force fighter pilots. Changes in neck pain, lumbar disability, range of motion, strength and resistance were also investigated., Methods: Fourteen participants with chronic low back pain were randomised into two groups: stabilisation exercise group (SEG-n=7), exercise protocol twice a week for 12 weeks) and the regular exercise group (REG-n=7), which performed their own usual exercise routine. The evaluations were carried out before and after the training period. The primary outcome was the intensity of low back pain and the secondary outcomes were cervical pain, functional disability, range of motion, maximum isometric strength and trunk muscle resistance., Results: The SEG had a significant reduction in low back pain compared with the REG (difference of 2.3 points, p=0.04) and a lower rate of cervical pain (difference of 2.5 points, p=0.01) at the end of the protocol. Maintenance of trunk muscle strength was also observed in the SEG over the period, while the REG presented a decrease in flexural strength to the right side (difference between groups: -3.7%, p=0.04). There were no differences in the rates of disability, range of motion or resistance to fatigue between groups., Conclusions: The stabilisation exercise programme focused on the core muscles was successful in decreasing the fighter pilots' chronic lumbar pain. Pilots are normally active; however, our results indicate that specific trunk training programmes should be offered considering the work needs of these subjects., Clinical Trials: 'Exercise protocol for pilots with back pain' (registered: 09 October 2018)-NCT03713814 (https://clinicaltrials.gov/ct2/show/NCT03713814)., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: To assess the immediate effect of conventional and burst transcutaneous electrical nerve stimulation (TENS) in combination with cryotherapy on pain threshold and tolerance in healthy individuals., Design: Randomised, controlled trial., Setting: University laboratory., Participants: One hundred and twelve healthy women., Interventions: Volunteers were allocated at random to seven groups (n=16): (1) control, (2) placebo TENS, (3) conventional TENS, (4) burst TENS, (5) cryotherapy, (6) cryotherapy in combination with burst TENS, and (7) cryotherapy in combination with conventional TENS. Pain threshold and tolerance were measured by applying a pressure algometer at the lateral epicondyle of the humerus, before and after each intervention., Main Outcome Measures: The primary outcome measure was pressure pain threshold., Results: A significant increase in pain threshold and tolerance at the 5% level of significance was recorded as follows: burst TENS {pain threshold: mean difference 1.3 [95% confidence interval (CI) 1.4 to 1.2]; pain tolerance: mean difference 3.8 (95% CI 3.9 to 3.7)}, cryotherapy [pain threshold: mean difference 1.3 (95% CI 1.4 to 1.2); pain tolerance: mean difference 1.9 (95% CI 1.8 to 2.0)] and cryotherapy in combination with burst TENS [pain threshold: mean difference 2.6 (95% CI 2.4 to 2.8); pain tolerance: mean difference 4.9 (95% CI 5.0 to 4.8)]. Cryotherapy in combination with burst TENS provided greater analgesia compared with the other groups (P<0.001)., Conclusion: These results support the use of cryotherapy in combination with burst TENS to reduce induced pain, and suggest a potentiating effect when these techniques are combined. No such association was found between cryotherapy and conventional TENS., (Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.)

Knee kinematics after anterior cruciate ligament (ACL) reconstruction is of interest in studies evaluating the effect of training programs. Many studies have addressed knee flexion/extension but not valgus/varus movements. Considering that joint stability is a major concern in ACL reconstruction surgery, movements occurring in the frontal plane of the knee also deserve attention. Knee extensor torque was analyzed by an isokinetic dynamometer and the angular amplitudes and velocities of flexion/extension and valgus/varus movements were analyzed by goniometry during gait 9 months after ACL reconstruction. The analysis was repeated after 3 months of eccentric isokinetic training of the quadriceps in five patients. The gait pattern was also recorded for 10 healthy controls. The knee extensor torque and flexion/extension range of movement during gait increased significantly after training. However, an unexpectedly increased valgus, most pronounced during the swing phase, which may imply adverse effects on the knee, was also observed in the ACL reconstructed knee. The recorded valgus angles may however be overestimated due to crosstalk. Thus, the extent of the increased valgus, as well as the mechanisms involved and the functional and clinical implications, need clarification before eccentric training after ACL reconstruction can be generally recommended.