Search

Objective: To evaluate the evidence from randomised controlled trials (RCTs) on the effectiveness of prevention strategies to reduce future impact of low back pain (LBP), where impact is measured by LBP intensity and associated disability., Design: Systematic review with meta-analysis., Data Sources: MEDLINE, Embase, CINAHL, PEDro and The Cochrane (CENTRAL) databases from inception to 22 October 2018., Eligibility Criteria: RCTs evaluating any intervention aiming to prevent future impact of LBP, reporting an outcome measure of LBP intensity and/or disability measured at least 3 months post-randomisation, and the intervention group must be compared with a group that received no intervention/placebo or minimal intervention. Trials restricting recruitment to participants with current LBP were excluded., Results: 27 published reports of 25 different trials including a total of 8341 participants fulfilled the inclusion criteria. The pooled results, from three RCTs (612 participants), found moderate-quality evidence that an exercise programme can prevent future LBP intensity (mean difference (MD) -4.50; 95% CI -7.26 to -1.74), and from 4 RCTs (471 participants) that an exercise and education programme can prevent future disability due to LBP (MD -6.28; 95% CI -9.51 to -3.06). It is uncertain whether prevention programmes improve future quality of life (QoL) and workability due to the overall low-quality and very low-quality available evidence., Conclusions: This review provides moderate-quality evidence that an exercise programme, and a programme combining exercise and education, are effective to reduce future LBP intensity and associated disability. It is uncertain whether prevention programmes can improve future QoL and workability. Further high-quality RCTs evaluating prevention programmes aiming to reduce future impact of LBP are needed., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Stereotactic Ablative Radiotherapy (SABR) is increasingly replacing thoracotomy for resection of lung cancers and oligometastatic lung lesions but it is not known whether exercise can be maintained during SABR, the major side-effect of which is fatigue. This case study describes a 57-year-old male who exercised regularly (above American College of Sports Medicine minimum weekly exercise guidelines) and continued to exercise during SABR for a renal cell metastasis in his left lung. His exercise program included 5x60-minute moderate intensity aerobic exercise sessions and 3x45-minute resistance exercise sessions per week for 12 weeks post-treatment. Cardiorespiratory fitness and strength, as well as self-reported fatigue, depression, anxiety, physical wellbeing and sleep quality were assessed at baseline and fortnightly. Exercise adherence was 98% and no adverse events occurred. Fatigue was elevated from Weeks 2-8, which adversely impacted exercise intensity perception. Minimal changes were observed in cardiorespiratory fitness, depression, anxiety and sleep quality, but strength decreased, and physical wellbeing was improved above baseline levels. This is the first reported clinical case of exercise during SABR for a lung carcinoma. The data suggest that exercise may be feasible for patients undergoing SABR and may improve physical wellbeing. Larger controlled studies are needed to confirm these findings.

Question: What is the effectiveness of interventions that aim to prevent a new episode of neck pain?, Design: Systematic review and meta-analysis of randomised, controlled trials., Participants: People without neck pain at study entry., Intervention: Any intervention aiming to prevent a future episode of neck pain., Outcome Measures: New episode of neck pain., Results: Five trials including a total of 3852 individuals met the inclusion criteria. The pooled results from two randomised, controlled trials (500 participants) found moderate-quality evidence that exercise reduces the risk of a new episode of neck pain (OR 0.32, 95% CI 0.12 to 0.86). One of the meta-analysed trials included some co-interventions with the exercise. There was low-quality evidence from three randomised, controlled trials (3352 participants) that ergonomic programs do not reduce the risk of a new neck pain episode (OR 1.00, 95% CI 0.74 to 1.35)., Conclusion: This review found moderate-quality evidence supporting the effectiveness of an exercise program for reducing the risk of a new episode of neck pain. There is a need for high-quality randomised, controlled trials evaluating interventions to prevent new episodes of neck pain., Registration: PROSPERO CRD42017055174. [de Campos TF, Maher CG, Steffens D, Fuller JT, Hancock MJ (2018) Exercise programs may be effective in preventing a new episode of neck pain: a systematic review. Journal of Physiotherapy 64: 159-165]., (Copyright © 2018 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.)

Purpose: Knowledge of aerobic performance capacity allows for the optimisation of training programs in aerobically dominant sports. Maximal aerobic speed (MAS) is a measure of aerobic performance; however, the time and personnel demands of establishing MAS are considerable. This study aimed to determine whether time-trials (TT), which are shorter and less onerous than traditional MAS protocols, may be used to predict MAS., Methods: 28 Australian Rules football players completed a test of MAS, followed by TTs of six different distances in random order, each separated by at least 48 h. Half of the participants completed TT distances of 1200, 1600 and 2000 m, and the others completed distances of 1400, 1800 and 2200 m., Results: Average speed for the 1200 and 1400 m TTs were greater than MAS (P < 0.01). Average speed for 1600, 1800, 2000 and 2200 m TTs were not different from MAS (P > 0.08). Average speed for all TT distances correlated with MAS (r = 0.69-0.84; P < 0.02), but there was a negative association between the difference in average TT speed and MAS with increasing TT distance (r = -0.79; P < 0.01). Average TT speed over the 2000 m distance exhibited the best agreement with MAS., Conclusions: MAS may be predicted from the average speed during a TT for any distance between 1200 and 2200 m, with 2000 m being optimal. Performance of a TT may provide a simple alternative to traditional MAS testing.

Objective: The purpose of this study was to determine if vibration therapy is more effective than the standard treatment of stretching and massage for improving recovery of muscle strength and reducing muscle soreness after muscle damage induced by eccentric exercise., Design: A randomized, single-blinded parallel intervention trial design was used., Setting: Research laboratory., Participants: Fifty untrained men aged 18 to 30 years completed the study., Interventions: Participants performed 100 maximal eccentric muscle actions (ECCmax) of the right knee extensor muscles. For the next 7 days, 25 participants applied cycloidal vibration therapy to the knee extensors twice daily and 25 participants performed stretching and sports massage (SSM) twice daily., Main Outcome Measures: Changes in markers of muscle damage [peak isometric torque (PIT), serum creatine kinase (CK), and serum myoglobin (Mb)], muscle soreness (visual analog scale), and inflammation [serum C-reactive protein (CRP)] were assessed., Results: After ECCmax, there was no difference in recovery of PIT and muscle soreness or serum CK, Mb, and CRP levels between vibration and SSM groups (P > 0.28)., Conclusions: Cycloidal vibration therapy is no more effective than the standard practice of stretching and massage to promote muscle recovery after the performance of muscle-damaging exercise., Clinical Relevance: Prescription of vibration therapy after maximal exercise involving eccentric muscle damage did not alleviate signs and symptoms of muscle damage faster than the standard prescription of stretching and massage.

• Exercise relative motion orthoses are used during exercise and function to improve PIPJ motion. • The affected finger's MCPJ is typically positioned in 11-30° relative extension or flexion. • A 4-finger design is more commonly used for border digits than a 3-finger design. • Exercise RM orthoses are prescribed more for active/passive PIPJ extension rather than flexion deficits. • Exercise RM orthoses are prescribed more for active PIPJ extension/flexion deficits than passive deficits. Cross-sectional online survey. Exercise relative motion (RM) orthoses are prescribed by hand therapists to improve finger motion but there is limited scientific evidence to guide practice. To describe Australian hand therapists' use of exercise RM orthoses to improve PIPJ motion, including trends in orthosis design, prescription, clinical conditions, and their opinions on orthosis benefits and limitations. 870 Australian Hand Therapy Association members were sent an electronic survey that included multiple choice, Likert scale and open-ended questions under four subgroups: demographics, design trends, prescription, and therapist opinions. Data analysis consisted of predominantly descriptive statistics and verbatim transcription. 108 Australian therapists completed the survey, over a third with ≥ 20 years of clinical experience. Exercise RM orthoses were prescribed weekly to monthly (82%) for between 2-6 weeks duration (81%) and used during exercise and function (87%). The most common differential MCPJ position was 11-30° extension (98%) or flexion (92%). Four-finger designs were most common for border digits (OR ≥3.4). Exercise RM orthoses were more commonly used for active and extension deficits compared to passive (OR ≥3.7) and flexion deficits (OR ≥1.4), respectively. Clinicians agreed that the orthosis allowed functional hand use (94%), increased non-intentional exercise (98%), and was challenging to use with fluctuating oedema (60%). This survey highlights notable clinical trends despite only reaching a small sample of Australian hand therapists. Exercise RM orthoses were frequently being used for active PIPJ extension and flexion deficits. A common MCPJ differential angle was reported, while the number of fingers incorporated into the design depended on the digit involved. Therapists' preferences mostly agreed with the limited available evidence. This limited survey identified common exercise RM orthosis fabrication and prescription trends amongst Australian therapists. These insights may inform future biomechanical and clinical research on this underexplored topic. [ABSTRACT FROM AUTHOR]

Background: Studies investigating the effects of cold-water immersion (CWI) on the recovery of athletic performance, perceptual measures and creatine kinase (CK) have reported mixed results in physically active populations. Objectives: The purpose of this systematic review was to investigate the effects of CWI on recovery of athletic performance, perceptual measures and CK following an acute bout of exercise in physically active populations. Study Design: Systematic review with meta-analysis and meta-regression. Methods: A systematic search was conducted in September 2021 using Medline, SPORTDiscus, Scopus, Web of Science, Cochrane Library, EmCare and Embase databases. Studies were included if they were peer reviewed and published in English, included participants who were involved in sport or deemed physically active, compared CWI with passive recovery methods following an acute bout of strenuous exercise and included athletic performance, athlete perception and CK outcome measures. Studies were divided into two strenuous exercise subgroups: eccentric exercise and high-intensity exercise. Random effects meta-analyses were used to determine standardised mean differences (SMD) with 95% confidence intervals. Meta-regression analyses were completed with water temperature and exposure durations as continuous moderator variables. Results: Fifty-two studies were included in the meta-analyses. CWI improved the recovery of muscular power 24 h after eccentric exercise (SMD 0.34 [95% CI 0.06–0.62]) and after high-intensity exercise (SMD 0.22 [95% CI 0.004–0.43]), and reduced serum CK (SMD − 0.85 [95% CI − 1.61 to − 0.08]) 24 h after high-intensity exercise. CWI also improved muscle soreness (SMD − 0.89 [95% CI − 1.48 to − 0.29]) and perceived feelings of recovery (SMD 0.66 [95% CI 0.29–1.03]) 24 h after high-intensity exercise. There was no significant influence on the recovery of strength performance following either eccentric or high-intensity exercise. Meta-regression indicated that shorter time and lower temperatures were related to the largest beneficial effects on serum CK (duration and temperature dose effects) and endurance performance (duration dose effects only) after high-intensity exercise. Conclusion: CWI was an effective recovery tool after high-intensity exercise, with positive outcomes occurring for muscular power, muscle soreness, CK, and perceived recovery 24 h after exercise. However, after eccentric exercise, CWI was only effective for positively influencing muscular power 24 h after exercise. Dose–response relationships emerged for positively influencing endurance performance and reducing serum CK, indicating that shorter durations and lower temperatures may improve the efficacy of CWI if used after high-intensity exercise. Funding: Emma Moore is supported by a Research Training Program (Domestic) Scholarship from the Australian Commonwealth Department of Education and Training. Protocol registration: Open Science Framework: 10.17605/OSF.IO/SRB9D. [ABSTRACT FROM AUTHOR]

Wade, JA, Fuller, JT, Devlin, PJ, and Doyle, TLA. Senior and junior rugby league players improve lower-body strength and power differently during a rugby league season. J Strength Cond Res 36(5): 1367–1372, 2022—This investigation evaluated lower-body strength and power changes across a rugby league season in elite junior and senior athletes. Twenty-five senior and 20 junior rugby league players performed an isometric midthigh pull and countermovement jump at 3 time points in a National Rugby League training season (mid-preseason, end-preseason, and in-season). Linear fixed-effects models were used to compare isometric midthigh pull force and countermovement jump power between player experience groups (senior vs. junior) across the season phases (mid-preseason vs. end-preseason vs. and in-season). Cohen's effect sizes (ES) with 95% confidence intervals were calculated for pairwise comparisons. For senior players, absolute and relative strength (ES = 0.38, p < 0.007) and power (ES = 0.64, p < 0.008) increases were observed at end-preseason compared with mid-preseason, but there were no changes in-season (ES = 0.02, p > 0.571). For junior players, strength did not change (ES < 0.01, p > 0.738) and absolute power decreased (ES = 0.29, p < 0.014) at end-preseason compared with mid-preseason; large increases were evident for absolute and relative strength (ES = 1.43, p < 0.001) and power (ES = 0.62, p < 0.001) in-season. This research demonstrates senior and junior rugby league players exhibit unique patterns of improvements in lower-body strength and power across different phases of the season. This highlights the importance for training programs to differ between junior and senior athletes and target different physical qualities for both groups at different times of the season, thus providing guidance for strength and conditioning coaches. [ABSTRACT FROM AUTHOR]

Running is a popular form of physical activity yet discontinuation is common. Interventions targeting physical activity adoption have shown modest effects, often with little translation into long-term participation, which may limit the health benefits available to the wider community. This paper details the development of a new online running intervention (Just Run) aimed at improving continuation of running activity in new runners through a motivational and psychological lens, including aspects of design, content, refinement, and usability testing. A six-step intervention mapping process was used to develop a theory-based online intervention using a mix of research designs. Key stakeholders including runners, coaches and relevant experts in physical activity and behavior change provided valuable insight, feedback and refinement of the education to be delivered. The final Just Run intervention included ten modules delivered online over twelve weeks to promote ongoing running participation through videos, testimonials, and activities. Key themes identified through the literature and stakeholder engagement process related to goal setting, self-efficacy, intrinsic motivation, social support and overcoming barriers to running participation. Usability testing confirmed the quality and suitability of the education to the target population. Just Run has been developed with a range of stakeholders to address an area of unmet need in the adoption and promotion of running. Just Run is a robust online intervention that has been designed and pre-tested with positive feedback and unique insights from key stakeholders. Further investigation is required to support its implementation to the wider community. • A six-step intervention mapping process informed the design of Just Run. • Key stakeholders contributed to the design of this motivational running intervention. • Goal setting and social support were key topics included in the designed material. • Positive usability testing confirmed the aptness of the education to runners. [ABSTRACT FROM AUTHOR]