RESUMEN
BACKGROUND: Strong evidence supports the proximal combined with quadriceps strengthening for patellofemoral pain (PFP) rehabilitation. However, most reported rehabilitation programs do not follow specific exercise prescription recommendations or do not provide adequate details for replication in clinical practice. Furthermore, people with PFP have power deficits in hip and knee muscles and it remains unknown whether the addition of power exercises would result in superior or more consistent outcomes. Therefore, this study is designed to verify whether the benefits of a rehabilitation program addressing proximal and knee muscles comprising power and strength exercises are greater than those of a program consisting of strength exercises only. METHOD: This study will be a randomized controlled trial that will be conducted at university facilities. A minimum of 74 people with PFP between the ages of 18 and 45 years will be included. The experimental group will engage in a 12-week resistance training program focusing on proximal and knee muscles using power and strength exercises. The control group will engage in a 12-week resistance training program focusing on proximal and knee muscles using strength exercises only. Primary outcomes will be pain intensity and physical function; and secondary outcomes will be kinesiophobia, self-reported improvement, quality of life, peak hip and knee torque, and hip and knee rate of force development. The primary outcomes will be evaluated at baseline, and after 6 weeks, 12 weeks, 3 months, 6 months, and 1 year. The secondary outcomes will be evaluated at baseline and immediately after the interventions. Therapists and participants will not be blinded to group allocation. DISCUSSION: This randomized clinical trial will investigate if adding power exercises to a progressive resistance training may lead to more consistent outcomes for PFP rehabilitation. The study will provide additional knowledge to support rehabilitation programs for people with PFP. TRIAL REGISTRATION: ClinicalTrials.gov NCT03985254. Registered on 26 August 2019.
Asunto(s)
Síndrome de Dolor Patelofemoral , Entrenamiento de Fuerza , Adolescente , Adulto , Terapia por Ejercicio , Humanos , Persona de Mediana Edad , Fuerza Muscular , Síndrome de Dolor Patelofemoral/diagnóstico , Síndrome de Dolor Patelofemoral/terapia , Músculo Cuádriceps , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento , Adulto JovenRESUMEN
CONTEXT: Fencing is a sport of agility, with a higher incidence of lower-limb injuries, of which the ankle sprain is the most prevalent. Injury prevention is very important to improve performance and decrease the withdrawal time of athletes. Proprioceptive training programs can be added to the training of athletes, since, in addition to easy application and low cost, proprioception has the function of stabilizing the ankle joint to prevent injuries. OBJECTIVE: To verify the influence of a 12-week proprioceptive training program on dynamic neuromuscular control in fencing athletes. DESIGN: The study was a clinical trial, and the athletes were allocated, for convenience, in the intervention group or in the control group. SETTING: The study was developed in 4 stages (preintervention, intervention, postintervention, and follow-up of 3). The neuromuscular control during the star excursion balance test was evaluated. PARTICIPANTS: The participants were 19 fencing athletes (intervention group: 10, and control group: 9), aged 14-35 years, from a multisport club. INTERVENTIONS: The athletes performed the proprioceptive training during 12 weeks, 3 times a week, with a duration of 30 minutes. MAIN OUTCOME MEASURES: Dynamic neuromuscular control. RESULTS: The data and SE were considered for statistical analysis, submitted to the generalized estimates equations test with Bonferroni post hoc. The level of significance was .05. The distance reached in the star excursion balance test increased significantly in all 8 directions evaluated in the 2 legs of the intervention group. CONCLUSIONS: The proprioceptive training program was able to improve dynamic neuromuscular control in fencing athletes.
Asunto(s)
Terapia por Ejercicio/métodos , Equilibrio Postural/fisiología , Propiocepción/fisiología , Deportes/fisiología , Adolescente , Adulto , Articulación del Tobillo/fisiología , Femenino , Humanos , Masculino , Adulto JovenRESUMEN
OBJECTIVE:: To investigate how dynamic neuromuscular control, postural sway, joint position sense, and incidence of ankle sprain are influenced by balance training in athletes compared with the control group in randomized clinical trials. DATA SOURCES:: The search strategy included MEDLINE, Physical Therapy Evidence Database, Cochrane Central Register of Controlled Trials, and Latin American and Caribbean Center on Health Sciences Information. Randomized controlled trials (RCTs) were published by June of 2018. METHODS:: RCTs that evaluate the effectiveness of proprioception in these outcomes: dynamic neuromuscular control, postural sway, joint position, and the incidence of ankle sprains in athletes aged between 18 and 35 years. Two reviewers independently screened the searched records, extracted the data, and assessed risk of bias. The treatment effect sizes were pooled in a meta-analysis using the RevMan 5.2 software. Internal validity was assessed through topics suggested by Cochrane Collaborations. RESULTS:: Of the 12 articles included ( n = 1817), eight were in the meta-analysis ( n = 1722). The balance training reduced the incidence of ankle sprains in 38% compared with the control group ( RR: 0.62; 95% CI: 0.43-0.90). In relation to the dynamic neuromuscular control, the training showed increase in the distance of reach in the anterior (0.62 cm, 95% CI: 0.13-1.11), posterolateral (4.22 cm, 95% CI: 1.76-6.68), and posteromedial (3.65 cm, 95% CI: 1.03-6.26) through the Star Excursion Balance test. Furthermore, training seems to improve postural sway and joint position sense. CONCLUSION:: Balance training reduces the incidence of ankle sprains and increases dynamic neuromuscular control, postural sway, and the joint position sense in athletes.
Asunto(s)
Traumatismos del Tobillo/epidemiología , Traumatismos en Atletas/epidemiología , Modalidades de Fisioterapia , Propiocepción/fisiología , Esguinces y Distensiones/epidemiología , Traumatismos del Tobillo/prevención & control , Traumatismos en Atletas/prevención & control , Humanos , Incidencia , Esguinces y Distensiones/prevención & controlRESUMEN
BACKGROUND: Several factors are associated with the presence of chronic low back pain; one of them is the flexibility of the hamstring muscles that influences the posture of the pelvic spine. OBJECTIVE: Investigate the influence of two different time periods of passive static stretching on the flexibility of the hamstring. METHODS: Forty-six physiotherapy students were divided into two groups performing stretching exercises: 30 s and 60 s duration. The collections consisted of: (1) pre-test: evaluation of the flexibility of the hip and knee, using a manual goniometer by means of the following tests: Straight Leg Raise Test (SLR), Passive Hip Flexion Test (PHFT) and Modified Knee Extension Test (MKET), (2) intervention: stretching with different runtimes, (3) post-test: reappraisal of flexibility, conducted immediately after the intervention. RESULTS: Significant difference was observed intra groups, group that did stretching exercises lasting 30 seconds (G30) (SLR p = 0.000. PHFT p = 0.003 and MKET p = 0.000) and group that did stretching exercises lasting 60 seconds (G60) (SLR p = 0.000. PHFT p = 0.001 and MKET p = 0.002). Comparing the groups, no significant difference was found (SLR p = 0.307; PHFT p = 0.904; MKET p = 0.132). CONCLUSION: Thus it can be inferred that 30 seconds are sufficient for increased flexibility of young women. Therefore the time-treatment sessions can be optimized. Only the acute effect of stretching was observed; further investigation of the long-term effect is required.