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5. Isokinetic Eccentric Quadriceps Muscle Performance Assessment in Patellofemoral Joint Primary and Secondary Injury Prevention: An Intra-Rater Reliability and Standard Error of Measurement Pilot Study.

Author

Llurda-Almuzara, Luis, Lewis, Courtney, Taylor, Matthew J. D., Neal, Bradley S., and Clark, Nicholas C.

Subjects
QUADRICEPS muscle physiology, BIOMECHANICS, RESEARCH evaluation, CONFERENCES & conventions, KNEE joint, PSYCHOMETRICS, KNEE injuries
Abstract

Introduction: Quadriceps muscle weakness is implicated in the onset and persistence of patellofemoral joint (PFJ) pain, which commonly manifests during the early stance-phase of gait when eccentric quadriceps muscle performance (ecc- QMP) is required to decelerate momentum and shock-absorb forces away from articular tissues. Therefore, assessment of eccQMP is prudent in PFJ primary and secondary injury prevention, but reliable measurement procedures are scarce in the literature. Objective: To assess critical psychometric properties of a new isokinetic eccQMP assessment procedure linked closely to the biomechanics of gait during stair and hill descent, using a specific knee range-of-motion and velocity-of-motion (specificity of testing1). It was hypothesised that procedures would demonstrate good intra-rater reliability (intraclass correlation coefficient [ICC] ≥0.75). Study design: Between-day (D1/D2) repeated measures. Setting: biomechanics laboratory. Study population: eight athletes volunteered (male n=6, female n=2, age 23.0±3.6yr; height 157.0±35.8cm; mass 86.0±36.4kg). Assessment: athletes were seated on an isokinetic dynamometer set to eccentric mode. For specificity of testing, dynamometer configuration was knee flexion/extension range-of-motion 10-80° and velocity-of-motion 60°/s then 120°/s. Three maximal-effort knee flexion (eccQMP) trials were performed for both velocities. Peak torque (PT; Newton-metres [Nm]) and time-to-peak torque (TTPT; milliseconds [ms]) were measured. Limb order was ran- domised for D1 then repeated D2. Main outcome measurements: relative reliability (ICC 2,1) and absolute reliability (standard error of measurement (SEM)). Results: For 60°/s: PT ICC/SEM, right 0.95/13.5Nm, left 0.98/10.2Nm; TTPT ICC/SEM, right 0.12/1121.0ms, left 0.12/666.3ms. For 120°/s: PT ICC/SEM, right 0.85/23.8Nm, left 0.96/15.1Nm; TTPT ICC/SEM, right 0.76/174.4ms, left 0.05/694.7ms. Conclusion: For both 60°/s and 120°/s, eccentric PT consistently demonstrated good relative reliability (ICC>0.75) but TTPT did not (ICC<0.75). The SEM was consistently lowest when the highest ICCs were evident. The new isokinetic eccentric quadriceps PT assessment procedures demonstrate psychometric properties that qualify them for potential use in PFJ primary and secondary injury prevention. [ABSTRACT FROM AUTHOR]

Published
2024

6. Intra-Rater Reliability and Error of Measurement of Knee Isokinetic Eccentric Muscle Performance Assessment Procedures in Anterior Cruciate Ligament Injury Prevention Screening for Adult Agility-Sport Athletes.

Author

Llurda-Almuzara, Luis, Lewis, Courtney, and Clark, Nicholas C.

Subjects
KNEE physiology, ANTERIOR cruciate ligament injury prevention, MOTOR ability, RESEARCH evaluation, MUSCLE strength testing, CONFERENCES & conventions, ATHLETES, MEASUREMENT errors, PSYCHOMETRICS, MEDICAL screening, ATHLETIC ability, ISOKINETIC exercise, RANGE of motion of joints, ADULTS
Abstract

Introduction: Noncontact anterior cruciate ligament (ACL) injuries occur frequently during change-of-direction/landing tasks when eccentric muscle performance is required to decelerate momentum and shock-absorb forces away from noncontractile tissues. Therefore, assessment of knee eccentric muscle performance is prudent in noncontact ACL injury prevention screening, but reliable measurement procedures are scarce in the literature. Objective: To assess critical psychometric properties of a new knee isokinetic eccentric muscle performance assessment procedure linked closely to noncontact ACL injury mechanisms and using a specific knee range-of-motion and velocity-of-motion (specificity of testing.1,2 It was hypothesised that procedures would demonstrate good intra-rater reliability (intraclass correlation coefficient [ICC] ≥0.75). Study design: Between-day (D1/D2) repeated measures. Setting: biomechanics laboratory. Study population: 12 agility-sport athletes volunteered (male n=7, female n=5, age 23.5±4.6yr; height 170.0±10.1cm; mass 75.7±12.3kg). Assessment: athletes were seated on an isokinetic dynamometer set to eccentric mode. For specificity of testing, dynamometer configuration was knee flexion/extension range-of-motion 0-60° and velocity-of-motion 240°/second. Five maximal-effort knee flexion (eccentric quadriceps) and extension (eccentric hamstrings) trials were performed. Peak torque (PT; Newton-metres [Nm]) and time-to-peak torque (TTPT; milliseconds [ms]) were measured. Limb order was randomised for D1, the order repeated for D2. Main outcome measurements: relative reliability (ICC 2,1), absolute reliability (standard error of measurement [SEM]). Results: For eccentric quadriceps PT ICC/SEM: right 0.76/22.8Nm, left 0.78/19.0Nm. For eccentric quadriceps TTPT ICC/SEM: right 0.07/213.0ms, left 0.13/316.3ms. For eccentric hamstrings PT ICC/SEM: right 0.92/13.7Nm, left 0.96/8.0Nm. For eccentric hamstrings TTPT ICC/SEM: right 0.74/12.5ms, left 0.41/16.6ms. Conclusion: For both eccentric quadriceps and hamstrings, PT consistently demonstrated good relative reliability (ICC>0.75) but TTPT did not (ICC<0.75). Interestingly, right and left eccentric hamstring TTPT absolute reliability (SEM) were <17.0ms. These new knee isokinetic eccentric PT assessment procedures possess critical psychometric properties that qualify them for use in ACL injury prevention screening systems with adult agility-sport athletes. [ABSTRACT FROM AUTHOR]

Published
2024

7. Effects of Adding an Online Exercise Program on Physical Function in Individuals Hospitalized by COVID-19: A Randomized Controlled Trial

Author

Llurda-Almuzara, Luis, primary, Rodríguez-Sanz, Jacobo, additional, López-de-Celis, Carlos, additional, Aiguadé-Aiguadé, Ramón, additional, Arán-Jové, Raúl, additional, Labata-Lezaun, Noé, additional, Fernández-de-las-Peñas, César, additional, Bosch, Joan, additional, and Pérez-Bellmunt, Albert, additional

Published
2022
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10. Effect of respiratory muscle training in asthma: a systematic review and meta-analysis

Author

Lista-Paz, Ana, Bouza Cousillas, Lucía, Jácome, Cristina, Fregonezi, Guilherme, Labata-Lezaun, Noé, Llurda-Almuzara, Luis, Pérez-Bellmunt, Albert, Lista-Paz, Ana, Bouza Cousillas, Lucía, Jácome, Cristina, Fregonezi, Guilherme, Labata-Lezaun, Noé, Llurda-Almuzara, Luis, and Pérez-Bellmunt, Albert

Abstract

[Abstract] Background: The last systematic review about respiratory muscle training (RMT) in people with asthma was published almost 10 years ago. Since then, several works have been published. Objective: To review the effect of RMT in people with asthma. Methods: We conducted a systematic review of research included up to September 2021 in PubMed/MEDLINE, PEDro, Scopus, Web of Science, CINAHL, LILACS, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov. We included randomized controlled trials and quasi-experimental studies assessing the effect of RMT on respiratory muscle function, rescue medication, asthma-related symptoms, lung function, exercise capacity, healthcare use, health-related quality of life (HRQoL) and adverse effects in people with asthma. Risk of bias and methodological quality were assessed with the Cochrane Risk of Bias assessment tool and the PEDro scale. Meta-analysis was performed whenever possible; otherwise a qualitative approach was followed. Results: Eleven studies (270 participants) were included, 10 with only adults and were included in the meta-analysis. Inspiratory muscle training (IMT) had beneficial effects on maximal inspiratory pressure (PImax: mean difference [MD] 21.95 cmH2O [95% confidence interval [CI] 15.05; 28.85]), with no changes in maximal expiratory pressure (MD 14.97 cmH2O [95%CI -5.65; 35.59]), lung function (forced expiratory volume in 1 sec: MD 0.06 [95%CI -0.14; 0.26] L; force vital capacity: MD 0.39 [95%CI -0.24; 1.02] L) and exercise capacity (standard mean difference [SMD] 1.73 [95%CI -0.61; 4.08]). Subgroup analysis revealed that IMT load >50% PImax and duration >6 weeks were beneficial for exercise capacity. The qualitative analysis suggested that IMT may have benefits on respiratory muscle endurance, rescue medication and exertional dyspnoea, with no adverse effects. Conclusions: This systematic review and meta-analysis showed a significant increase in PImax after IMT in adults with asthma and

Published
2022

12. Análisis de la respuesta neuromuscular y la proyección del ángulo de la rodilla en el plano frontal en sujetos físicamente activos: implicaciones para la lesión de ligamento cruzado anterior

Author

Llurda Almuzara, Luis, Pérez Bellmunt, Albert, Aiguadé-Aiguadé, Ramón, and Universitat Internacional de Catalunya. Departament de Ciències Bàsiques

Subjects
Valgo de rodilla, Ligamento cruzado anterior, Función neuromuscular, Fisioterapia
Abstract

La lesión de ligamento cruzado anterior es una de las lesiones más devastadoras en el ámbito deportivo. El valgo dinámico de rodilla durante el gesto deportivo puede ser uno de los mecanismos más comunes en la lesión del ligamento cruzado anterior. Entender el valgo dinámico de rodilla puede resultar fundamental para actuar adecuadamente en la prevención de dicha lesión o en su posterior rehabilitación. El objetivo principal de la presente tesis doctoral es analizar si existe una correlación entre diferentes parámetros de la respuesta neuromuscular de la musculatura de la extremidad inferior y el máximo ángulo de proyección de la rodilla en el plano frontal durante un aterrizaje unipodal. Esta tesis doctoral se divide en tres estudios con un diseño observacional con carácter transversal en participantes hombres, sanos y físicamente activos. El primer estudio evaluó la correlación entre el máximo ángulo de proyección de la rodilla en el plano frontal durante un salto con aterrizaje unipodal y el tono y la rigidez de la musculatura posterior de la extremidad inferior en 50 hombres. El máximo ángulo de proyección de la rodilla en el plano frontal fue evaluado mediante el programa de análisis de movimiento en dos dimensiones Kinovea® software. El tono y la rigidez muscular fueron evaluados mediante la tensiomiografía y la miotonometría. El segundo estudio evaluó la correlación entre el máximo ángulo de proyección de la rodilla en el plano frontal durante un salto con aterrizaje unipodal y la actividad muscular de la musculatura posterior de la extremidad inferior y del cuádriceps durante la realización del salto en 35 hombres. Se utilizó el software Kinovea® para el análisis del máximo ángulo de proyección de la rodilla en el plano frontal y el electromiógrafo de superficie mDurance® para analizar la actividad muscular. El tercer estudio evaluó la validez y fiabilidad de una aplicación móvil desarrollada para medir el máximo ángulo de proyección de la rodilla en el plano frontal durante acciones estáticas y dinámicas en 35 hombres. Se utilizó el software Kinovea® y la aplicación MyMocap® para evaluar el máximo ángulo de proyección de la rodilla en el plano frontal. En el primer estudio no se encontraron correlaciones significativas entre el máximo ángulo de proyección de la rodilla en el plano frontal y el tono muscular o la rigidez de la musculatura posterior de la extremidad inferior. En el segundo estudio se encontraron correlaciones significativas entre el máximo ángulo de proyección de la rodilla en el plano frontal y la actividad muscular del glúteo mayor, glúteo medio, bíceps femoral y semitendinoso tanto para la extremidad dominante como para extremidad no dominante. Es decir, cuanta más actividad muscular, el máximo ángulo de proyección de la rodilla era mayor. Se encontraron correlaciones significativas entre el máximo ángulo de proyección de la rodilla en el plano frontal y la actividad muscular de los gastrocnemios únicamente para la extremidad no dominante. No se encontraron correlaciones significativas entre el máximo ángulo de proyección de la rodilla en el plano frontal y la actividad muscular del cuádriceps. El tercer estudio demostró la validez de la aplicación MyMocap para medir el ángulo de proyección de la rodilla en el plano frontal durante una posición estática de sentadilla. La validez de la aplicación para medir el máximo ángulo de proyección de la rodilla en el plano frontal durante acciones dinámicas fue entre justa y moderada. La fiabilidad interna de la aplicación obtuvo buenos resultados test-retest.

Published
2022

17. Relación de la función neuromuscular con el control del valgo en sujetos sanos y físicamente activos: implicaciones para la lesión de ligamento cruzado anterior. estudio observacional

Author

Llurda Almuzara, Luis

Subjects
ligamento cruzado anterior, 616.8, prevención, Valgo dinámico de rodilla, 616.7, fuerza, respuesta neuromuscular
Abstract

Tutor: Dr. Albert Pérez Bellmunt. Curso 2019-2020 El valgo dinámico de rodilla (DKV) durante diferentes gestos deportivos es una alteración biomecánica que ha sido descrita como un gran factor de riesgo para sufrir una lesión de ligamento cruzado anterior. La musculatura de la rodilla y de la cadera parece tener un rol crucial en la prevención de esta alteración. El objetivo de este estudio es analizar una posible correlación entre el DKV y la respuesta neuromuscular (RNM) de la musculatura de la cadera y rodilla en sujetos sanos y físicamente activos. ----Métodos. Estudio observacional con carácter transversal realizado en 50 sujetos. Se analizaron las variables “valgo dinámico de rodilla” durante un test de salto a una pierna, la respuesta neuromuscular de la musculatura posterior de la pierna y la fuerza de la extremidad inferior. -----Resultados: No se encontraron correlaciones significativas entre el DKV y la respuesta neuromuscular y/o la fuerza de la extremidad inferior (p>0.05). -----Conclusión. El control del valgo dinámico de rodilla parece no estar correlacionado con la respuesta neuromuscular aislada de la musculatura posterior de la extremidad inferior. Lo anterior sugiere que el control del DKV depende fundamentalmente de la actividad del sistema nervioso central y no de la respuesta neuromuscular de músculos aislados. Por tanto, la prevención de lesiones de ligamento cruzado anterior debería centrarse en la actividad del sistema nervioso central y no en mejorar la respuesta neuromuscular aislada de determinados músculos. info:eu-repo/semantics/submittedVersion

Published
2020

22. Effectiveness of Protein Supplementation Combined with Resistance Training on Muscle Strength and Physical Performance in Elderly: A Systematic Review and Meta-Analysis

Author

Labata-Lezaun, Noé, primary, Llurda-Almuzara, Luis, additional, López-de-Celis, Carlos, additional, Rodríguez-Sanz, Jacobo, additional, González-Rueda, Vanessa, additional, Hidalgo-García, César, additional, Muniz-Pardos, Borja, additional, and Pérez-Bellmunt, Albert, additional

Published
2020
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23. Neuromuscular response what is it and how to measure it?

Author

Pérez Bellmunt, Albert, Llurda-Almuzara, Luis, Simon, Mathias, Navarro, Raul, Casasayas Cos, Oriol, López-de-Celis, Carlos, Seijas, Roberto, and Alavarez, Pedro

Subjects
Neuromuscular response, Resposta neuromuscular, Tejido muscular, 616.7, Sports medicine, Medicina deportiva, Teixit muscular, Medicina esportiva, Respuesta neuromuscular, Muscle tissue
Abstract

The neuromuscular response or neuromuscular function is a set of biomechanical and viscoelastic properties about the muscular and fascia tissue. These characteristics are fundamental for the rehabilitation and sport medicine. This is a review of how to measure neuromuscular response and to define this concept, its parameters and present different tools (myometry and tensiomyography) to measure it. info:eu-repo/semantics/publishedVersion

Published
2019

24. Effectiveness of fibrolysis diacutaneous in the management of musculoskeletal diseases. A systematic review

Author

Aiguadé Aiguadé, Ramon, Labata Lezaun, Noé, Moure Romero, Lourdes, Calvo Estelrich, Xavier, Pampín, P., and Llurda Almuzara, Luis

Subjects
business.industry, Medicine, Revisión Sistemática, Sistema musculesquelètic, business, Fisioterapia
Abstract

Purpose: The principal aim of the review is to study the evidence regarding the effectiveness of diacutaneous Fibrolysis (DF) in musculoskeletal diseases and getting some recommendations evidences based. Methods: An electronic literature search was conducted utilizing PubMed, ScienceDirect, PEDRO, Cochrane and Mendeley. All titles and abstracts were reviewed, and full text articles meeting eligibility criteria were assessed in detail to determine inclusion or exclusion. Articles were reviewed by two different investigators. Results: Principal findings of this review shows an improvement in functional capacity and a significant reduction of symptoms in the FD groups, immediately after intervention and at least, three months follow up. Conclusions: There is limited evidence and more studies are needed to assess the effectiveness of DF to improve the function or the symptomatology.

Published
2019
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25. Is Dry Needling Effective for the Management of Spasticity, Pain, and Motor Function in Post-Stroke Patients? A Systematic Review and Meta-Analysis.

Author

Fernández-de-las-Peñas, César, Pérez-Bellmunt, Albert, Llurda-Almuzara, Luis, Plaza-Manzano, Gustavo, De-la-Llave-Rincón, Ana I, and Navarro-Santana, Marcos J

Subjects
PAIN management, CONFIDENCE intervals, INFORMATION storage & retrieval systems, MEDICAL databases, META-analysis, MYOFASCIAL pain syndrome treatment, NONPARAMETRIC statistics, SPASTICITY, SYSTEMATIC reviews, STROKE patients, DESCRIPTIVE statistics, ODDS ratio
Abstract

Objective To evaluate the effects of muscle dry needling alone or combined with other interventions on post-stroke spasticity (muscle tone), related pain, motor function, and pressure sensitivity. Databases and Data Treatment Electronic databases were searched for randomized controlled trials including post-stroke patients where at least one group received dry needling and outcomes were collected on spasticity and related pain. Secondary outcomes included motor function and pressure pain sensitivity. Data were extracted by two reviewers. The risk of bias was assessed with the Cochrane Risk of Bias tool, methodological quality was assessed with the Physiotherapy Evidence Database score, and the quality of evidence was assessed by the Grading of Recommendations Assessment, Development, and Evaluation approach. Between-groups mean differences (MDs) and standardized mean differences (SMDs) were calculated. Results Seven studies (three within the lower extremity, four in the upper extremity) were included. The meta-analysis found significantly large effect sizes of dry needling for reducing spasticity (SMD: -1.01, 95%confidence interval [CI] -1.68 to -0.34), post-stroke pain (SMD -1.01, 95%CI -1.73 to -0.30), and pressure pain sensitivity (SMD 1.21, 95% CI: 0.62 to 1.80) as compared with a comparative group at short-term follow-up. The effect on spasticity was found mainly in the lower extremity (MD -1.05, 95% CI: -1.32 to -0.78) at short-term follow-up. No effect on spasticity was seen at 4 weeks. No significant effect on motor function (SMD 0.16, 95% CI: -0.13 to 0.44) was observed. The risk of bias was generally low, but the imprecision of the results downgraded the level of evidence. Conclusion Moderate evidence suggests a positive effect of dry needling on spasticity (muscle tone) in the lower extremity in post-stroke patients. The effects on related pain and motor function are inconclusive. [ABSTRACT FROM AUTHOR]

Published
2021
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26. Influencia del tipo de ejercicios de fuerza excéntrica en la prevención de lesiones musculares de bíceps femoral en futbolistas profesionales. Proyecto de investigación

Author

Llurda Almuzara, Luis, Renovell Romero, Diana, and Universitat de Lleida. Facultat d'Infermeria i Fisioteràpia

Subjects
Exercici terapèutic, Lesión isquiosural, Ejercicio excéntrico, Cuixa -- Ferides i lesions, Bíceps femoral
Abstract

PREGUNTA DE INVESTIGACIÓN ¿Es más efectiva la prevención de lesiones musculares de bíceps femoral mediante ejercicios que se asemejen al mecanismo lesional en comparación con ejercicios que no tengan en cuenta este aspecto en futbolistas profesionales? OBJETIVOS El objetivo general de este proyecto de investigación es valorar si la elección de unos ejercicios u otros influye o no en el número de lesiones musculares de bíceps femoral registradas durante una temporada en futbolistas profesionales de primera y segunda división española. METODOLOGÍA Se propone un proyecto de investigación con dos grupos y dos protocolos de prevención. - Grupo específico: el grupo intervención realizará un protocolo basado en ejercicios que hayan demostrado ser óptimos para el bíceps femoral y se asemejen lo máximo posible al mecanismo lesional. - Grupo inespecífico: el grupo control realizará un protocolo basado en ejercicios que están descritos en la bibliografía como ejercicios de fuerza excéntrica de isquiosurales pero que no obtienen una gran activación de bíceps femoral ni se asemejan al mecanismo lesional. El protocolo tendrá una duración de 10 semanas (6 semanas pretemporada y 4 de temporada). Los sujetos serán futbolistas profesionales de primera y segunda división española que no vayan a participar en competición europea el próximo año (n = 864). Se distribuirán aleatoriamente los 36 equipos que van a participar en el estudio en dos grupos, un grupo que realizará el programa específico y un grupo que realizará el programa inespecífico.

Published
2017

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