The relationship between hip abductor muscle strength and magnitude of pelvic drop following a 3 week strengthening protocol in non-specific low back pain patients.

Purpose: To examine the relationship between hip abductor muscle (HABD) strength and the magnitude of pelvic drop (MPD) for patients with non-specific low back pain (NSLBP) and controls (CON) prior to and following a 3-week HABD strengthening protocol. At baseline, we hypothesized that NSLBP patients would exhibit reduced HABD strength and greater MPD compared to CON. Following the protocol, we hypothesized that strength would increase and MPD would decrease. Relevance: The Trendelenburg test (TT) is a common clinical test used to examine the ability of the HABD to maintain horizontal pelvic position during single limb stance. However, no study has specifically tested this theory. Moreover, no study has investigated the relationship between HABD strength and pelvic motion during walking or tested whether increased HABD strength would reduce the MPD. Methods: Quasi-experimental with 3-week exercise intervention. Fifteen NSLBP patients (32.5yrs,range 21-51yrs; VAS baseline: 5.3cm) and 10 CON (29.5yrs,range 22-47yrs) were recruited. Isometric HABD strength was measured using a force dynamometer and the average of three maximal voluntary contractions were normalized to body mass (N/kg). Two-dimensional MPD (degrees) was measured using a 60 Hz camera and was derived from two retroreflective-markers placed on the posterior superior iliac spines. MPD was measured while performing the static TT and while walking and averaged over 10 consecutive footfalls. NSLBP patients completed a 3-week HABD strengthening protocol consisting of 2 open-kinetic-chain exercises then all measures were repeated. Non-parametric analysis was used for group comparisons and correlation analysis. Results: At baseline, the NSLBP patients demonstrated 31% reduced HABD strength (mean=6.6 N/kg) compared to CON (mean=9.5 N/kg: p=0.03) and no significant differences in maximal pelvic frontal plane excursion while walking (NSLBP:mean=8.1°, CON:mean=7.1°: p=0.72). No significant correlations were measured between left HABD strength and right MPD (r=-0.37, p=0.11), or between right HABD strength and left MPD (r=-0.04, p=0.84) while performing the static TT. Following the 3-week strengthening protocol, NSLBP patients demonstrated a 12% improvement in strength (Post:mean=7.4 N/kg: p=0.02), a reduction in pain (VAS followup: 2.8cm), but no significant decreases in MPD while walking (p=0.92). Conclusions: NSLBP patients demonstrated reduced HABD strength at baseline and were able to increase strength and reduce pain in a 3-week period. However, despite increases in HABD strength, the NSLBP group exhibited similar MPD motion during the static TT and while walking compared to baseline and controls. Implications: The results suggest that the HABD alone may not be primarily responsible for controlling a horizontal pelvic position during static and dynamic conditions. Increasing the strength of the hip abductors resulted in a reduction of pain in NSLBP patients providing evidence for further research to identify specific musculature responsible for controlling pelvic motion.

Improving muscular endurance with the MVe Fitness ChairTM in breast cancer survivors: A feasibility and efficacy study

Objectives To assess the feasibility and efficacy of delivering Pilates exercises for resistance training to breast cancer survivors using the MVe Fitness Chair™. Design Pilot randomized controlled trial. Methods Twenty-six female breast cancer survivors were randomized to use the MVe Fitness Chair™ (n = 8), traditional resistance training (n = 8), or a control group (no exercise) (CO) (n = 10). The MVe Fitness Chair™ and traditional resistance training groups completed 8 weeks of exercise. Muscular endurance was assessed pre and post-test for comparisons within and between groups using push ups, curl ups, and the Dynamic Muscular Endurance Test Battery for Cancer Patients of Various Ages. Results Feasibility of the MVe Fitness Chair™ was good, evidenced by over 80% adherence for both exercise groups and positive narrative feedback. Significant improvements in muscular endurance were observed in the MVe Fitness Chair™ (p < 0.002) and traditional resistance training groups (p < 0.001), but there were no differences in improvement between the MVe Fitness Chair™ and traditional resistance training groups (p < 0.711) indicating that Pilates and traditional resistance training may be equally effective at improving muscular endurance in this population. Conclusions The MVe Fitness Chair™ is feasible for use in breast cancer survivors. It appears to promote similar improvements in muscular endurance when compared to traditional resistance training, but has several advantages over traditional resistance training, including cost, logistics, enjoyment, and ease of learning.

Efeito da vibração gerada em plataforma oscilante/vibratória em indivíduos com síndrome metabólica ou paralisia cerebral

A realização de atividade física regular é uma intervenção não farmacológica com grandes benefícios para melhora da qualidade de vida, redução da morbidade e da mortalidade de disfunções cardiorrespiratórias, controle da síndrome metabólica (SM), bem como no manejo de portadores de distúrbios neurológicos como na paralisia cerebral (PC). Os exercícios de vibração de corpo inteiro (EVCI) são produzidos quando o indivíduo está em contato com a base de uma plataforma oscilante/vibratória (POV) ligada devido a efeitos de vibrações sinusoidais e deterministas produzidas por essas plataformas. Os EVCI têm sido utilizados por pessoas treinadas e não treinadas e no tratamento de pacientes com diferentes desordens clínicas. Efeitos biológicos como aumento da flexibilidade e da força muscular são relatados através da realização destes exercícios. O objetivo deste estudo foi investigar os efeitos das vibrações geradas em POV em pacientes com SM ou com PC. Em relação aos estudos com SM, foi realizada uma busca no banco de dados PubMed para a palavra-chave flexibilidade e sua relação com os EVCI, bem como um estudo de caso sobre o efeito dos EVCI na flexibilidade de paciente com SM. Em relação à investigação com PC, revisão sistemática foi realizada sobre os efeitos dos EVCI em portadores de PC através de pesquisas nas bases de dados PubMed, Cochrane Library, Cinahl (Ebsco Host), PEDro, Science Direct and Scopus. Os resultados obtidos através do uso de protocolo de EVCI com baixa frequência (5 a 14 Hz) foi verificado aumento da flexibilidade anterior de tronco em paciente com SM e parece haver uma estabilização desta medida ao longo do protocolo proposto de onze sessões. Um importante número de publicações é encontrado no PubMed para a palavra-chave flexibilidade e os achados de nossa investigação revelam que há interesse em avaliar o efeito dos EVCI na flexibilidade dos indivíduos. Os efeitos pesquisados em pacientes com PC incluem fortalecimento muscular, redução da espasticidade, aumento na flexibilidade, aumento de densidade mineral óssea e melhora do controle postural. Em conclusão, a análise dos estudos apresentados permite sugerir que os EVCI podem ser uma modalidade de intervenção segura para portadores de SM, melhorando a flexibilidade anterior de tronco. Além disso, a revisão realizada mostra melhora da flexibilidade em vários grupos estudados. Para portadores de PC, foi verificado que os EVCI melhoram vários parâmetros clínicos de portadores, porém, como os protocolos não são descritos com detalhes, as evidências para uma definição de melhores parâmetros para esta população permanecem inconclusiva.

Método DeLorme versus Electroestimulação no fortalecimento muscular do quadricípete

Monografia apresentada à Universidade Fernando Pessoa para obtenção do grau de Licenciada em Fisioterapia

Effect of neuromuscular electrical stimulation and isotonic exercises in flexor and extensor muscles of knee of hemiplegic patients

Aim. To verify the muscular force and resistance to the movement of the flexor and extensor muscles of the knee of patients with spasticity after treatment with neuromuscular electrical stimulation (NMES) and isotonic exercises. Patients and methods. The patients this study were divided into group I (NMES) and group 2 (isotonic exercises). Their muscular torque and resistance to the movement of the flexor and extensor knee muscles were measured by the isokinetic dynamometer and the degree of spasticity by the modified Ashworth scale before and after ten sessions. Results. Alterations in the scores of the modified Ashworth scale were not observed. An increase in the flexor torque in group 1 (p = 0.041) and in group 2 (p = 0.001) was verified. In the passive mode, group 1 presented a reduction of resistance to the flexion movement (p = 0.026), while in group 2, a reduction of resistance to both the flexion (p = 0,029) and extension movements (p = 0.019) was verified. Conclusions. The two therapeutical resources had their efficiency proven only for the increase of the force of the flexor muscles. The resistance to movement, the isotonic exercises were more effective because they promoted a reduction in the resistance of the flexor and extensor knee muscles.

Efeito do exercício físico e estatinas na função muscular em animais com dislipidemia

As estatinas são utilizadas no tratamento das dislipidemias, com grande tolerância; no entanto, vários efeitos colaterais podem surgir, destacando-se miopatia. A prática regular do exercício físico (EF) produz modificações favoráveis no perfil lipídico; entretanto, pode gerar lesões musculares. OBJETIVO: Avaliar o efeito da associação entre exercício físico e estatinas na função muscular, pela análise histológica, em modelo experimental animal com dislipidemia. MÉTODOS: Foram utilizados 80 ratos machos Wistar, distribuídos em oito grupos, incluindo animais submetidos à dieta hipercolesterolêmica (DH), sinvastatina com (G1) e sem (G2) EF; DH e fluvastatina, com (G3) e sem EF (G4); alimentados com ração comercial (RC) na presença (G5) e ausência de (G6) EF; DH submetidos (G7) ou não (G8) a EF. A DH foi administrada por 90 dias, as estatinas e prática de EF em esteira rolante por oito semanas. Os animais foram sacrificados, e o músculo sóleo retirado para análise histológica. Aplicaram-se os testes t de Student pareado e análise multivariada, com nível significante para p < 0,05. RESULTADOS: As principais alterações histológicas encontradas foram fibras de diferentes diâmetros, atróficas, em degeneração, splitting, edema, infiltrado inflamatório. Essas alterações foram observadas em 90% dos animais do grupo G1, 80% do G2, 70% do G3, 30% do G4, 40% do G5 e 30% do G7. Nos grupos G6 e G8 identificaram-se fibras musculares com morfologia preservada. CONCLUSÕES: Na avaliação histológica muscular, a associação entre fluvastatina, sinvastatina e exercício físico acarreta alterações morfológicas com predomínio no uso da sinvastatina, variando de grau leve a grave, no músculo sóleo de ratos, induzidos pelos inibidores da HMG-CoA redutase.

Efeito de três tecnicas de alongamento muscular sobre o torque e atividade eletromiográfica

PURPOSE: To examine the acute effects caused by three techniques for stretching the hamstrings muscle on the active concentric peak torque (PT), passive PT and electromyographic activity (EMG). METHODS: Sixty volunteers (mean ± SD age, 22.6 ± 3 years), height 1.64 ± 0.07m and body weight of 58 ± 8.6kg, were randomly allocated into 4 groups of 15 subjects: Control Group (CG) - 5 minutes at rest, Static Stretching Group (SG) - 2 x 30s; Hold-Relax Group (HRG) - 3 x 6s of isometric contraction of hamstrings interspersed by 10s of hamstrings stretching and agonist Hold-Relax Group (AHRG) - 3 x 6s of isometric contraction of the quadriceps interspersed by 10s of hamstrings stretching. Evaluation has been conducted preand post-intervention, which verified the active concentric PT, passive PT EMG activity of IT. The statistical inference was performed by testing intra and inter, significance level at 5%. RESULTS: After intervention, there was a reduction in passive PT on CG, accompanied by a reduction of EMG activity, and an increase in passive PT on SG and AHRG. There was no change in the active concentric PT, or change in EMG activity. CG showed an increase in angle of the PT active, while the other groups showed no change. CONCLUSION: The results suggest that the shortterm stretching: 1) causes acute increase in passive torque, since the muscle does not perform sub-maximal contraction, 2) does not change in electromyographic activity and active torque, ind ependent of the technique

Efeito do método pilates no desempenho muscular e no equilíbrio corporal de mulheres idosas: ensaio clínico controlado randomizado

Background: The Pilates Method is a modality of exercise that has been growing in recent decades, but few researches has been conducted with elderly and little is known about its benefits in this population. Objective: To evaluate the effect of a program of Mat Pilates exercises in muscle performance and postural balance in elderly women. Materials and Method: This is a randomized controlled trial that evaluated the muscle performance (isokinetic dynamometer Biodex System 3 Pro®) and postural balance (Balance Master System®) of 33 women aged 65-80 years. The experimental group (EG) participated of a 12-week program of Mat Pilates exercises with two weekly sessions. Data normality was verified by the Shapiro - Wilk test and were adopted p value < 0.05 as significance level. Results: There were no differences between groups after training. However, the EG showed an increase in the values of extension and flexion average power to 60 ° / s after training (32.19 W to 37.04 W and 14.48 W to 17.56 W, respectively). Conclusion: The proposed exercise program was not effective in the total work and average power of flexor and extensor of the knee, as well as static and dynamic balance of participants

Efeitos do treinamento muscular inspiratório domiciliar sobre a atividade eletromiográfica dos músculos respiratórios em asmáticos: estudo piloto

Asthma treatment aims to achieve and maintain the control of the disease for prolonged periods. Inspiratory muscle training (IMT) may be an alternative in the care of patients with asthma, and it is used as a complementary therapy to the pharmacological treatment. Thus, the aim of this study was to investigate the effects of a domiciliary program of IMT on the electromyographic activity of the respiratory muscles in adults with asthma. This is a clinical trial in which ten adults with asthma and ten healthy adults were randomized into two groups (control and training). The electrical activity of inspiratory muscles (sternocleidomastoid (ECM) and diaphragm) was obtained by a surface electromyography. Furthermore, we assessed lung function (spirometry), maximal inspiratory pressure - MIP - (manometer). The functional capacity was evaluated by six minute walk test. Participants were assessed before and after the IMT protocol of 6 weeks with POWERbreathe® device. The training and the control groups underwent IMT with 50% and 15 % of MIP, respectively. The sample data were analyzed using SPSS 20.0, attributing significance of 5 %. Were used t test, ANOVA one way and Pearson correlation. It was observed an increase in MIP, after IMT, in both training groups and in healthy sham group (P < 0.05), which was accompanied by a significant increase in ECM activity during MIP in healthy training group (1488 %) and in asthma training group (ATG) (1186.4%). The ATG also showed a significant increase in diaphragm activity in basal respiration (48.5%). Functional capacity increased significantly in the asthma sham group (26.5 m) and in the asthma training group (45.2 m). These findings suggest that IMT promoted clinical improvements in all groups, especially the ATG, which makes it an important complementary treatment for patients with asthma

Torque, myoeletric sygnal and heart rate responses during concentric and eccentric exercises in older men

Background: The literature reports that the eccentric muscular action produces greater force and lower myoelectric activity than the concentric muscular action, while the heart rate (HR) responses are bigger during concentric contraction. Objectives: To investigate the maximum average torque (MAT), surface electromyographic (SEMG) and the heart rate (HR) responses during different types of muscular contraction and angular velocities in older men. Methods: Twelve healthy men (61.7 +/- 1.6years) performed concentric (C) and eccentric (E) isokinetic knee extension-flexion at 60 degrees/s and 120 degrees/s. SEMG activity was recorded from vastus lateralis muscle and normalized by Root Mean Square-RMS (mu V) of maximal isometric knee extension at 60 degrees. HR (beats/min) and was recorded at rest and throughout each contraction. The data were analyzed by the Friedman test for repeated measures with post hoc Dunn's test (p<0.05). Results: The median values of MAT (N.m/kg) was smaller and the RMS (mu V) was larger during concentric contraction (C60 degrees/s=2.80 and 0.99; C120 degrees/s=2.46 and 1.0) than eccentric (E60 degrees/s=3.94 and 0.85; E120 degrees/s=4.08 and 0.89), respectively. The HR variation was similar in the four conditions studied. Conclusion: The magnitude of MAT and RMS responses in older men were dependent of the nature of the muscular action and independent of the angular velocity, whereas HR response was not influenced by these factors.

Recondicionamento muscular na DPOC: principais intervenções e novas tendências

Há algum tempo o condicionamento físico vem sendo parte obrigatória no tratamento de portadores de DPOC. Estes pacientes apresentam comumente intolerância ao exercício de intensidade variável e relacionada à disfunção muscular esquelética. Neste sentido, o exercício físico apresenta-se como ramo mais importante no processo de reabilitação pulmonar. O exercício aeróbio e o treino de força com pesos são fundamentais no incremento de capacidade física e qualidade de vida, principalmente naqueles indivíduos que apresentam as formas moderada ou grave da DPOC. Além disso, espera-se atualmente maior desenvolvimento nas pesquisas em relação à aplicação de estimulação elétrica neuromuscular (EENM) e ao uso criterioso de substâncias ergogênicas tais como esteróides anabolizantes e creatina oral. Tendo em vista as repercussões negativas da disfunção muscular e a importância da reabilitação pulmonar no tratamento da DPOC, esta revisão tem como objetivo reunir informações de estudos relevantes acerca das principais estratégias para o recondicionamento muscular esquelético nestes pacientes nos últimos 15 anos.

Temporomandibular Joint Vibration Before and After Exercises and Occlusal Splints

Temporomandibular joint (TMJ) sounds are frequent in patients. The aim of this study was to analyze patients with clicking at the end of opening and at the beginning of closing their mouths treated by muscular exercises through chewing and by occlusal splints. Fifteen patients with clinically verified clicking and TMJ and 15 patients without sounds were selected by the Research Diagnostic Criteria for Temporomandibular Disorders. They were submitted to electrovibratography at consultation and 60 and 120 days of treatment by occlusal splints and exercises. Patients demonstrated significant reduction of TMJ sounds after treatment, but vibration intensity was not similar with that of the control group after 120 days.

Participation of the deltoid (anterior portion) and pectoralis major (clavicular portion) muscles in different modalities of supine and frontal elevation exercises with different grips

The muscles deltoid-anterior portion (DA) and pectoralis major-clavicular portion (PMC) were analysed to establish the muscular behavior and intensity patterns, as well to evaluate the connected participation of these muscles during supine and frontal elevation exercises. Twenty-four male volunteers were examined using a 2-channel TECA TE4 electromyograph and Hewlett Packard surface electrodes. Our results showed low levels of activity to PMC in frontal elevation exercises, whereas to DA the levels were very high. In the supine exercise, the action potential levels developed by the PMC were always lower than those presented by DA, however, with action simultaneity. Some suggestions to the use of the tested exercises are presented.

Muscular strength, bone density and body composition of a woman with systemic lupus erythematosus submitted to a resistance training program: A case report

Introduction. Physical activity can provide long-term benefits for systemic lupus erythematosus (SLE). Objective. This study sought to demonstrate the effects of progressive resistance training on the muscular strength, bone mineral density (BMD) and body composition of pre-menopausal women with SLE undergoing glucocorticoid (GC) treatment. Materials and Methods. This is the case report of a 43-year-old African-South American premenopausal woman with non-extensive SLE and low bone density. A six-month program with three bimonthly cycles of 70%, 80%, and 90% intensity according to the 10 maximum-repetition test was used. Dual-energy X-ray absorptiometry (DXA) was used to measure the BMD, T-scores and body composition, and indirect fluorescence was used to measure the levels of antinuclear antibodies. Student's t-test was used. Results. Statistical improvement was noted in all strength exercises, including the 45° leg press (Δ%=+50%, p<0.001) and knee extension (Δ%=+15%, p=0.003) to maintain the BMD of the L2-L4 lumbar (Δ%=+0.031%; p=0.46) as well as the trochanter (Δ%=+0.037%; p=0.31) and BMI (Δ%=-0.8, p=0.54). Conclusion. In this case study, the presented methodology had a positive effect on strength and contributed to the maintenance of BMD and body composition in a woman with SLE undergoing GC treatment. © 2012 Revista Andaluza de Medicina del Deporte.

A eletromiografia em treinamento resistido: avaliação da fadiga muscular, adaptações e relações com parâmetros subjetivos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)