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Introduction and hypothesis Although involuntary reflexive pelvic floor muscle contractions seem crucial during stress urinary incontinence-provoking situations, hitherto existing guidelines feature voluntary pelvic floor muscle training only. Two pelvic floor muscle protocols were compared regarding their effect on stress urinary incontinence in women: one focusing on standard physiotherapy with voluntary pelvic floor muscle training, the other additionally including involuntary reflexive pelvic floor muscle training. Methods This study was designed as a triple-blind prospective randomized controlled trial with women suffering from stress urinary incontinence with two physiotherapy intervention groups (control group: standard physiotherapy, n = 48, experimental group: standard physiotherapy plus involuntary reflexive pelvic floor muscle training triggered by whole-body movements such as jumps n = 48). Both interventions lasted 16 weeks (9 personal physiotherapy consultations and 78 home training sessions). Group differences and development over time were analyzed concerning the primary outcome International Consultation on Incontinence Modular Questionnaire Urinary Incontinence short form (ICIQ-UIsf) by mixed effect regression models. Results The ICIQ-UIsf score decreased significantly over time for both groups by about 3 points from about 10 to about 7 points with no group differences at any point in time. Discussion This trial did not find any additional benefit for stress urinary incontinence by adding involuntary reflexive pelvic floor muscle training to standard training. Both training protocols showed similar clinically relevant improvements; however, there was still moderate incontinence after interventions. Future studies should test and apply pelvic floor muscle function- oriented training methods for pelvic floor muscle hypertrophy, intramuscular coordination, and power, which are more in line with conventional skeletal muscle training, i.e., performed with higher intensities and workout.

Die Hochschule der Künste Bern erforscht zusammen mit der Berner Fachhochschule für Gesundheit die Belastungen beim Tubaspielen. Im Labor untersuchten die Forschenden die Kräfte auf Muskeln und Skelezz. Weiter befragten sie Musikerinnen und Musiker zu Beschwerden und Prävention. Schliesslich stellten sie eine Übungsreihe zusammen, mit denen sich Verspannungen lösen und Belastungen ausgleichen lassen., La Haute école des arts de Berne, en collaboration avec la Haute école spécialisée de santé de la même ville, mène des recherches sur les charges liées à la pratique du tuba. Les chercheurs ont ainsi étudié en laboratoire les tensions qui s'exercent sur la musculature et le squelette. Ils ont également interrogé des instrumentistes sur leurs douleurs et la prévention. Enfin, ils ont mis au point une série d'exercices censés faire relâcher la tension et équilibrer les charges., Due instituti di Berna, la Scuola universitaria delle arti e la Scuola universitaria professionale per la salute, stanno portando avanti una ricerca sul logorio fisico provocato dal suonare la tuba. I ricercatori hanno indagato il carico esercitato su muscoli e scheletro in laboratorio. Hanno anche fatto un'inchiesta su disturbi e prevenzione tra chi suona questo strumento. Infine hanno compilato una lista di esercizi che permettono di allentare le tensioni ed equilibrare i carichi sopportati.

Playing a musical instrument involves complex motor skills. The daily training loads on the musculoskeletal systems of the body from playing the tuba at an elite level can be compared with those of elite athletes[1]. Complaints that result from playing an instrument are called performance-related musculoskeletal disorders (PRMDs)[2, 3]. Not many of those are known in tuba players. Yet, a high percentage (84%) of professional orchestral musicians experience performance-impairing pain [3]. In tuba playing, it is not only the challenge of holding and stabilizing the heavy instrument, it is also awkward postures, the duration of the many daily hours of practicing time and the repetitive physical loads that might increase the risk for those complaints. Although these aspects sound similar to sports related complaints/injuries, the perspectives of prevention, health promotion and therapy management are [...]

INTRODUCTION Two thirds of women suffering from stress urinary incontinence (SUI) reported a negative impact on quality of life (QoL). SUI can also lead to less physical activity and more comorbidities. SUI may result in a substantial economic burden on health care services but numbers are not clear. Therefore, the aim of this study was to estimate the health status, the comorbidities and the health costs of women with SUI living in the Canton of Bern (Switzerland). METHODS This cost-of-illness (COI) study was embedded in an RCT (n=96) exploring the effect of two pelvic floor muscle training protocols in women with SUI. A prevalence-based COI study with a societal perspective and a bottom-up approach was applied. Baseline demographics, comorbidities and cost data were collected prospectively during 16 weeks. Descriptive statistics, a frequency and a one-way sensitivity analysis were performed. RESULTS Thirty-seven participants volunteered in this COI study. About 95 % had at least one comorbidity. The most commonly reported problem was back pain (47.6 %). Fifty-one percent consulted a medical doctor, the prevalence of drug consumption was 70 %, 11 % reported less efficiency whilst working and 30 % less physical activity. Mental stress was mentioned by 59.5 % of the participants. The average health costs were CHF 2256. DISCUSSION This COI study provided data on health status, comorbidities, QoL, health care use, productivity losses and costs of SUI. The high prevalence of comorbidities observed in this study was comparable to obese females of a similar age group. The high economic burden of SUI requires cost-effective preventive actions and clinical treatment concepts.

Surface electromyography is often used to assess muscle activity and muscle function. A wavelet approach provides information about the intensity of muscle activity and motor unit recruitment strategies at every time point of the gait cycle. The aim was to review papers that employed wavelet analyses to investigate electromyograms of lower extremity muscles during walking and running. Eleven databases were searched up until June 1st 2017. The composition was based on the PICO model and the PRISMA checklist. First author, year, subject characteristics, intervention, outcome measures & variables, results and wavelet specification were extracted. Eighteen studies included the use of wavelets to investigate electromyograms of lower extremity muscles. Three main topics were discussed: 1.) The capability of the method to correctly assign participants to a specific group (recognition rate) varied between 68.4%-100%. 2.) Patients with ankle osteoarthritis or total knee arthroplasty presented a delayed muscle activation in the early stance phase but a prolonged activation in mid stance. 3.) Atrophic muscles did not contain type II muscle fiber components but more energy in their lower frequencies. The simultaneous information of time, frequency and intensity is of high clinical relevance because it offers valuable information about pre-and reflex activation behavior on different walking and running speeds as well as spectral changes towards high or low frequencies at every time point of the gait cycle.

Objective: Generalized Joint Hypermobility (GJH) is defined as a condition in which several joints move beyond their normal limits. It seems to be associated with musculoskeletal disorders, pain, reduced activity level in sports and reduced strength. The aim of the current study was to record specific problems and disorders of hypermobile women and to build subgroups based on these results. As a second objective, the study aimed to identify differences in activity level between these subgroups. Methods: A total of 195 women were included in this exploratory study: 67 normomobile (NM) and 128 hypermobile. Of these, 56 were classified as hypermobile with symptoms and 47 as hypermobile without symptoms. Symptoms were first recorded with the Canadian Occupational Performance Measure (COPM) and then monthly over a period of 6 months with a face validated questionnaire including general impairment, localization, type, intensity and frequency of problems. Activity level was determined by the International Physical Activity Questionnaire. Results: On the COPM there was no significant difference between patients in the NM and HM groups. The face validated questionnaire identified the most important problem to be pain in different localizations after remaining in one position for too long. The highest activity level was found in the HM group (p=0.021). Conclusion: Hypermobile women are active for longer during the day than women with normal mobility, but the type and degree of activity needs further evaluation. More detailed recording of symptoms in women with GJH is required to identify the discrete differences between the groups. To build subgroups in GJH the procedure of screening has to be more comprehensive. Widespread pain and level of activity are aspects that have to be included in the holistic approach to the management of patients with GJH.