Search

Knee osteoarthritis is a prevalent joint disease affecting millions of individuals globally. While total knee arthroplasty is an effective treatment for advanced stages of KOA, it may not be suitable for earlier stages or younger patients. Supervised exercise therapy has proven to be the first-line treatment of preference in tackling pain and disability caused by KOA. However, the high intensities required to induce positive muscle adaptations are not indicated in this population, as this is often accompanied by pain, discomfort, and frustration, leaving low-load resistance training as the only feasible method of treatment. Recently, the use of blood flow restriction training has begun to emerge as a substitute for high-load resistance training. With BFRT, a cuff is applied around the proximal aspect of the affected limb, causing partial arterial and full venous occlusion, thereby inducing localized hypoxia and the accumulation of metabolites, mimicking the effects of high-load resistance training, albeit with low loads. Consequently, BFRT might offer a suitable and more effective alternative for KOA patients who are not (yet) eligible for TKA compared to traditional exercise therapy. This review aims to summarize the current evidence as regards the application of Blood Flow Restriction in exercise therapy for knee osteoarthritis patients, with particular consideration of the underlying mechanisms and its safety, as well as general guidelines for practical implementation in clinical practice. In doing so, this narrative review aims to create a framework for translating from theory into practice. [ABSTRACT FROM AUTHOR]

Sports injuries are a considerable problem in physical education teacher education (PETE) students. They have important consequences and might affect the attitude that PETE students have towards sports and physical activity. Up to now, several efficacious injury prevention programmes have been developed for various sports disciplines. There is a high probability that several components of those prevention programmes are transferable to the PETE environment. A systematic review was conducted to identify intrinsic components that are potentially applicable in PETE programmes. The databases PubMed and Web of Science were searched for articles published between 1974 and 1 February 2015. The systematic study selection resulted in the inclusion of 59 studies. Seventeen studies were rated as having a low risk of bias. Efficacy of the applied programme was proven in 11 of these. Analysis led to guidelines for an injury prevention programme for PETE students. A multiple preventive intervention should include an awareness programme, functional strength training, stretching, warm-up, core stability and dynamic stability exercises of the lower limbs. This multiple preventive intervention preferably has a gradual build-up, makes use of no or only simple materials and is executed around three times per week.

Maintaining the range of motion in repetitive movement tasks is a crucial point since it directly influences the movement rate. Ensuring the movement amplitude can be reliably maintained when motor function is assessed by measuring the maximum movement rate is therefore a key consideration. However, the performed range of motion during such tasks is often not reported. This study aimed to determine whether individuals are able to maintain an intended range of motion during a knee flexion/extension maximum movement rate task in the absence of tactile and visual feedback. Twelve healthy male individuals performed knee flexion/extension at maximum speed for eight 10-s blocks in a 45° arc between 45° and 90°. The range of motion was monitored using a marker system and the movement rate was measured. The performed range of motion was not significantly different from the 45° arc during the task despite a 13.47% decrease in movement rate from the start to the end of the task. Nevertheless, there was only anecdotal evidence of no difference from 45° in most blocks, while on the second and seventh blocks, there was anecdotal evidence of differences in the Bayesian one-sample test. There was also no significant shift in the maximum flexion/extension angles throughout the task. Healthy male individuals were thus able to perform a consistent average predefined knee range of motion in a maximum movement rate task despite decreases in movement rate. This was achieved without constraint-inducing devices during the task, using only basic equipment and verbal feedback. [ABSTRACT FROM AUTHOR]

Although the underlying mechanisms behind upper limb (e.g., finger) motor slowing during movements performed at the maximum voluntary rate have been explored, the same cannot be said for the lower limb. This is especially relevant considering the lower limb's larger joints and different functional patterns. Despite the similar motor control base, previously found differences in movement patterns and segment inertia may lead to distinct central and peripheral manifestations of fatigue in larger joint movement. Therefore, we aimed to explore these manifestations in a fatiguing knee maximum movement rate task by measuring brain and muscle activity, as well as brain-muscle coupling using corticomuscular coherence, during this task. A significant decrease in knee movement rate up to half the task duration was observed. After an early peak, brain activity showed a generalized decrease during the first half of the task, followed by a plateau, whereas knee flexor muscle activity showed a continuous decline. A similar decline was also seen in corticomuscular coherence but for both flexor and extensor muscles. The electrophysiological manifestations associated with knee motor slowing therefore showed some common and some distinct aspects compared with smaller joint tasks. Both central and peripheral manifestations of fatigue were observed; the changes seen in both EEG and electromyographic (EMG) variables suggest that multiple mechanisms were involved in exercise regulation and fatigue development. [ABSTRACT FROM AUTHOR]

Context: Although training with an aquabag (AB) has gained popularity, there is a lack of evidence of its effect. This study wanted to evaluate the effect of AB implementation on muscle activity of core and lower limb muscles during 3 functional exercises. Design: Cross-sectional observational study. Methods: Twenty healthy subjects performed a squat, lunge, and step-up, while using a stick and an AB. Surface electromyography signals were recorded from the trunk, pelvis, and thigh muscles in the dominant leg. Linear-mixed models were used to analyze the normalized surface electromyography signals. Results: Results demonstrated a significant increase in muscle activity of the back muscles during all 3 exercises (P<.00l to P=.003), abdominals during squat (P = .034) and step-up (P = .046), hamstrings during lunge (P = .008) and step-up (P = .008), and gluteal muscles during lunge (P < .001 and P = .010, respectively). Conclusions: These results indicate that an AB promotes functional strength training by demanding compensatory/additional activity of both stabilizing muscles (specifically in the core and pelvis regions) and prime movers of the lower limb. The authors recommend the use of an AB to enhance training and rehabilitation effects. [ABSTRACT FROM AUTHOR]

Hamstring strain injuries (HSI) are still the most common injuries in soccer. Recent research has been focusing on the role of hamstring muscle morphology and architecture. The hamstring's fibre type composition might play a role as well, but this has never been investigated in the light of HSI risk in an athletic population. The purpose of this study was to investigate the association between hamstring muscle fibre type, hamstring strain injury history (HSIH), performance and isokinetic strength in a population of amateur male soccer players. In this cross-sectional observational study, 44 male soccer players (22 with and 22 without HSIH) participated. The research consisted of a non-invasive fibre composition evaluation using proton magnetic resonance spectroscopy (1H-MRS), functional performance (evaluated by means of maximal jumping height, maximal sprinting speed and hamstring muscle strength endurance (single leg hamstring bridge testing)), and isokinetic strength testing. The results revealed that hamstring carnosine concentration demonstrated a high inter-individual variability within this soccer population and was not significantly associated with either HSIH or with any of the functional performance parameters. The only secondary outcome measure presenting a significant association with the intramuscular carnosine content was the hamstrings' explosive strength production capacity, objectified by means of the time to peak torque (TPT), measured concentrically at an angular velocity of 240 degrees/second (°/s) during isokinetic strength testing. This TPT was significantly shorter in players presenting higher carnosine concentrations (p = 0.044). The findings indicate that in male amateur soccer players (1) the hamstrings have no distinct fibre type dominance and (2) fibre typology in this population does not relate to HSIH or performance. [ABSTRACT FROM AUTHOR]

Despite the high prevalence of tendon pathology in athletes, the underlying pathogenesis is still poorly understood. Various aetiological theories have been presented and rejected in the past, but the tendon cell response model still holds true. This model describes how the tendon cell is the key regulator of the extracellular matrix and how pathology is induced by a failed adaptation to a disturbance of tissue homeostasis. Such failure has been attributed to various kinds of stressors (eg, mechanical, thermal and ischaemic), but crucial elements seem to be missing to fully understand the pathogenesis. Importantly, a disturbance of tissue pressure homeostasis has not yet been considered a possible factor, despite it being associated with numerous pathologies. Therefore, we conducted an extensive narrative literature review on the possible role of intratendinous pressure in the pathogenesis of tendon pathology. This review explores the current understanding of pressure dynamics and the role of tissue pressure in the pathogenesis of other disorders with structural similarities to tendons. By bridging these insights with known structural changes that occur in tendon pathology, a conceptual model was constituted. This model provides an overview of the possible mechanism of how an increase in intratendinous pressure might be involved in the development and progression of tendon pathology and contribute to tendon pain. In addition, some therapies that could reduce intratendinous pressure and accelerate tendon healing are proposed. Further experimental research is encouraged to investigate our hypotheses and to initiate debate on the relevance of intratendinous pressure in tendon pathology. [ABSTRACT FROM AUTHOR]

Introduction: Injuries may limit para athletes' training and daily activities, affecting their sports performance and social participation. Objectives: To assess injury occurrence and associated burdens in Brazilian para athletes throughout a season. Study design: Prospective longitudinal study. Methods: Data were collected between January and December 2022 at two Brazilian Paralympic Reference Centers. Para athletes from athletics, swimming, powerlifting, and taekwondo were included. A total of 102 athletes (25 females, 77 males) were studied using the Oslo Sports Trauma Research Center Questionnaire to record injuries, on a weekly basis, for 50 weeks. Incidence was calculated as the number of new cases divided by the time at risk in hours. The result was multiplied by 1000 to obtain the rate per 1000 hours of sport participation. Weekly prevalence was calculated by dividing the number of para athletes reporting an injury by the number of questionnaire respondents each week. A risk matrix graph was used to estimate burden. Results: The majority of injuries were located in the shoulder (306;24.0%), ankle (217;17.1%), knee (187; 14.7%), and thigh (117;9.2%). The injury incidence rate was 24.2 per 1000 athlete hours (95%CI 23.4-25), and the mean weekly injury prevalence was 44.5% (95%CI 42.1-46.9). Injuries with a gradual onset were most common, with an incidence of 9.2 injuries per 1000 athlete hours (95%CI 8.9-9.5), while sudden onset injuries had an incidence of 8.2 injuries per 1000 athlete hours (95%CI 7.7-8.7). Twenty-three percent of all injuries caused at least one day of time-loss, with gradual onset injuries in the shoulder, knee, ankle, and thigh presenting the highest burdens. Conclusions: Brazilian para athletes experienced a high incidence, prevalence and burden of injuries through- out the season. Practitioners working with para athletes should carefully monitor the occurrence and burden of shoulder injuries in non-ambulant athletes and ankle/knee/thigh injuries in ambulant athletes. [ABSTRACT FROM AUTHOR]

Pieters, D, Wezenbeek, E, De Ridder, R, Witvrouw, E, and Willems, T. Acute effects of warming up on Achilles tendon blood flow and stiffness. J Strength Cond Res 36(10): 2717–2724, 2022—The aim of this study was to investigate the acute effect of frequently used warm-up exercises on the Achilles tendon blood flow and stiffness. In doing so, we want to explore which exercises are suitable to properly prepare the athlete's Achilles tendon in withstanding high amounts of loading during sport activities. This knowledge could help sport physicians and physiotherapists when recommending warm-up exercises that are able to improve sport performance while reducing the injury susceptibility. Achilles tendon blood flow and stiffness measurements of 40 healthy subjects (20 men and 20 women) aged between 18 and 25 years were obtained before and immediately after 4 different warm-up exercises: running, plyometrics, eccentric heel drops, and static stretching. The effect of these warm-up exercises and possible covariates (sex, age, body mass index, rate of perceived exertion, and sports participation) on the Achilles tendon blood flow and stiffness was investigated with linear mixed models. The level of significance was set at α = 0.05. The results of this study showed a significant increase in Achilles tendon blood flow and stiffness after 10 minutes of running (p < 0.001 and p < 0.001) and plyometrics (p < 0.001 and p = 0.039). Static stretching and eccentric exercises elicited no significant changes. From these results, it could be suggested that warm-up exercises should be intensive enough to properly prepare the Achilles tendon for subsequent sport activities. When looking at Achilles tendon blood flow and stiffness, we advise the incorporation of highly intensive exercises such as running and plyometrics within warm-up programs. [ABSTRACT FROM AUTHOR]