Long-Term Effects of Specific Stabilizing Exercises for First-Episode Low Back Pain

Study Design. A randomized clinical trial with 1-year and 3-year telephone questionnaire follow-ups. Objective. To report a specific exercise intervention’s long-term effects on recurrence rates in acute, first-episode low back pain patients. Summary of Background Data. The pain and disability associated with an initial episode of acute low back pain (LBP) is known to resolve spontaneously in the short-term in the majority of cases. However, the recurrence rate is high, and recurrent disabling episodes remain one of the most costly problems in LBP. A deficit in the multifidus muscle has been identified in acute LBP patients, and does not resolve spontaneously on resolution of painful symptoms and resumption of normal activity. Any relation between this deficit and recurrence rate was investigated in the long-term. Methods. Thirty-nine patients with acute, first-episode LBP were medically managed and randomly allocated to either a control group or specific exercise group. Medical management included advice and use of medications. Intervention consisted of exercises aimed at rehabilitating the multifidus in cocontraction with the transversus abdominis muscle. One year and three years after treatment, telephone questionnaires were conducted with patients. Results. Questionnaire results revealed that patients from the specific exercise group experienced fewer recurrences of LBP than patients from the control group. One year after treatment, specific exercise group recurrence was 30%, and control group recurrence was 84% (P , 0.001). Two to three years after treatment, specific exercise group recurrence was 35%, and control group recurrence was 75% (P , 0.01). Conclusion. Long-term results suggest that specific exercise therapy in addition to medical management and resumption of normal activity may be more effective in reducing low back pain recurrences than medical management and normal activity alone. [Key Words: multifidus, low back pain, rehabilitation]

The use of perineal ultrasound to quantify levator activity and teach pelvic floor muscle exercises

Perineal ultrasound was used to detect and quantify levator activity by measuring the displacement of the internal urethral meatus against the inferoposterior margin of the symphysis pubis, Women who had previously been instructed in pelvic floor muscle exercises were more likely to contract the levator muscle when asked to do so than were those without previous instruction (P

Co-activation of the abdominal and pelvic floor muscles during voluntary exercises

The response of the abdominal muscles to voluntary contraction of the pelvic floor (PF) muscles was investigated in women with no history of symptoms of stress urinary incontinence to determine whether there is co-activation of the muscles surrounding the abdominal cavity during exercises for the PF muscles. Electromyographic (EMG) activity of each of the abdominal muscles was recorded with fine-wire electrodes in seven parous females. Subjects contracted the PF muscles maximally in three lumbar spine positions while lying supine. In all subjects. the EMG activity of the abdominal muscles was increased above the baseline level during contractions of the PF muscles in at least one of the spinal positions. The amplitude of the increase in EMG activity of obliquus externus abdominis was greatest when the spine was positioned in flexion and the increase in activity of transversus abdominis was greater than that of rectus abdominis and obliquus externus abdominis when the spine was positioned in extension. In an additional pilot experiment. EMG recordings were made from the pubococcygeus and the abdominal muscles with fine-wire electrodes in two subjects during the performance of three different sub-maximal isometric abdominal muscle maneuvers. Both subjects showed an increase in EMG activity of the pubococcygeus with each abdominal muscle contraction. The results of these experiments indicate that abdominal muscle activity is a normal response to PF exercise in subjects with no symptoms of PF muscle dysfunction and provide preliminary evidence that specific abdominal exercises activate the PF muscles. Neurourol. Urodynam. 20:31-42, 2001. (C) 2001 Wiley-Liss, Inc.

Effect of the movement speed of resistance training exercises on sprint and strength performance in concurrently training elite junior sprinters

The aim of this study was to determine the effects of 7 weeks of high- and low-velocity resistance training on strength and sprint running performance in nine male elite junior sprint runners (age 19.0 +/- 1.4 years, best 100 m times 10.89 +/- 0.21 s; mean +/- s). The athletes continued their sprint training throughout the study, but their resistance training programme was replaced by one in which the movement velocities of hip extension and flexion, knee extension and flexion and squat exercises varied according to the loads lifted (i.e. 30-50% and 70-90% of 1-RM in the high- and low-velocity training groups, respectively). There were no between-group differences in hip flexion or extension torque produced at 1.05, 4.74 or 8.42 rad . s(-1), 20 m acceleration or 20 m 'flying' running times, or 1-RM squat lift strength either before or after training. This was despite significant improvements in 20 m acceleration time (P < 0.01), squat strength (P< 0.05), isokinetic hip flexion torque at 4.74 rad . s(-1) and hip extension torque at 1.05 and 4.74 rad . s(-1) for the athletes as a whole over the training period. Although velocity-specific strength adaptations have been shown to occur rapidly in untrained and non-concurrently training individuals, the present results suggest a lack of velocity-specific performance changes in elite concurrently training sprint runners performing a combination of traditional and semi-specific resistance training exercises.

Influência do kinesio taping e stretching global activo na flexibilidade, em jogadores de futebol

Objectivos do estudo - Avaliar a influência do Stretching Global Activo com e sem o Kinesio Taping na flexibilidade em jogadores de futebol entre os 18 e os 30 anos antes do treino, utilizando o teste de elevação dos membros inferiores em extensão (straight leg raising).

EMG of the transverse abdominus and multifidus during pilates exercises

The purpose of this research study was to evaluate the intensity of muscle activation of Transverse Abdominus /Oblique Internal (TrA/OI) and Multifidus (Mu) during the performance of four Pilates exercises (and variations), compared, in order to understand the importance of these exercises in the lumbopelvic stability in healthy subjects. The sample consisted of 8 individuals. Using the surface electromyography (EMG), it was found that there are differences in the intensity of muscle activation in the analyzed exercises and, therefore, “Shoulder bridge” and “ShoulderBridge_extension (right and left legs)“ are the more appropriate exercises for co-activation between TrA/OI and Mu muscles for the reeducation of lumbopelvic stability.

Pubalgia num atleta de futebol: estudo de caso

Introdução: No fu tebol os atletas são submetidos a um grande número de treinos e jogos, não havendo muitas vezes tempo necessário para o repouso ou alongamentos, estes factores predispõem o aparecimento de lesões incapacitantes como a pubalgia. O fisioterapeuta deverá realizar uma correcta avaliação e interpretação dos sintomas e das alterações posturais e biomecânicas do paciente com pubalgia. Objectivo: Através deste estudo de caso pretende-se descrever a avaliação e intervenção num caso de um jogador de fu tebol com pubalgia, salientando o processo de raciocínio clín ico desenvolvido ao longo do tratamento. Intervenção: Após a avaliação inicial, foi estabelecido, em conjunto com o atleta, um plano de tratamento por um períodlo de cinco semanas com três sessões semanais e exercícios durante os restantes dias. A intervenção visou a diminuição da dor, normalização das alterações articu lares, reforço da musculatu ra enfraquecida, promoção da estabilidade lombopélvica, restabelecimento da mobilidade das cadeias musculares encurtadas e retorno à actividade desportiva. Resultados: Verificou-se uma diminuição da dor, associada a um aumento de flexibilidade e de força. Conclusão: Através da abordagem pelo conceito de cadeias lesionais associado ao tratamento global de fisioterapia (exercícios terapêuticos, electroterapia, massagem), obteve-se melhorias clinicamente importantes num período de cinco semanas, verificando-se no fim do tratamento a ausência de sintomatologia, o que permitiu o retorno do atleta à actividade desportiva.

BabeLO : an extensible converter of programming exercises formats

In the last two decades, there was a proliferation of programming exercise formats that hinders interoperability in automatic assessment. In the lack of a widely accepted standard, a pragmatic solution is to convert content among the existing formats. BabeLO is a programming exercise converter providing services to a network of heterogeneous e-learning systems such as contest management systems, programming exercise authoring tools, evaluation engines and repositories of learning objects. Its main feature is the use of a pivotal format to achieve greater extensibility. This approach simplifies the extension to other formats, just requiring the conversion to and from the pivotal format. This paper starts with an analysis of programming exercise formats representative of the existing diversity. This analysis sets the context for the proposed approach to exercise conversion and to the description of the pivotal data format. The abstract service definition is the basis for the design of BabeLO, its components and web service interface. This paper includes a report on the use of BabeLO in two concrete scenarios: to relocate exercises to a different repository, and to use an evaluation engine in a network of heterogeneous systems.

CrimsonHex: a learning objects repository for programming exercises

A repository of learning objects is a system that stores electronic resources in a technology-mediated learning process. The need for this kind of repository is growing as more educators become eager to use digital educa- tional contents and more of it becomes available. The sharing and use of these resources relies on the use of content and communication standards as a means to describe and exchange educational resources, commonly known as learning objects. This paper presents the design and implementation of a service-oriented reposi- tory of learning objects called crimsonHex. This repository supports new definitions of learning objects for specialized domains and we illustrate this feature with the definition of programming exercises as learning objects and its validation by the repository. The repository is also fully compliant with existing commu- nication standards and we propose extensions by adding new functions, formalizing message interchange and providing a REST interface. To validate the interoperability features of the repository, we developed a repository plug-in for Moodle that is expected to be included in the next release of this popular learning management system.

Orchestration of e-learning services for automatic evaluation of programming exercises

Managing programming exercises require several heterogeneous systems such as evaluation engines, learning objects repositories and exercise resolution environments. The coordination of networks of such disparate systems is rather complex. These tools would be too specific to incorporate in an e-Learning platform. Even if they could be provided as pluggable components, the burden of maintaining them would be prohibitive to institutions with few courses in those domains. This work presents a standard based approach for the coordination of a network of e-Learning systems participating on the automatic evaluation of programming exercises. The proposed approach uses a pivot component to orchestrate the interaction among all the systems using communication standards. This approach was validated through its effective use on classroom and we present some preliminary results.

A promoção da flexibilidade com alunos do 1º ano da Escola de Dança do Orfeão de Leiria

Relatório Final de Estágio apresentado à Escola Superior de Dança com vista à obtenção do Grau de Mestre em Ensino de Dança.

Futures of work and skills: some foresight exercises in Europe and USA

The Knowledge-based society brought a new way of living and working. The increasing decline of work in primary sector and traditional industries, related with the significant increase of employment in the service sector and in the knowledge work, changed the way companies and individuals establish their relations, the way work and life is organised. These changes are usual and fast and so the feeling of insecurity and unpredictability become more and more sharp. In this context, foresight exercises are necessary tools helping in the identification of the key variables and main trends of evolution. This report will present some foresight studies about work and skills in Europe and USA, in order to contribute to think about possible evolutions and trends.

Specifying a programming exercises evaluation service on the e-Framework

The e-Framework is arguably the most prominent e-learning framework currently in use. For this reason it was selected as basis for modelling a programming exercises evaluation service. The purpose of this type of evaluator is to mark and grade exercises in computer programming courses and in programming contests. By exposing its functions as services a programming exercise evaluator is able to participate in business processes integrating different system types, such as Programming Contest Management Systems, Learning Management Systems, Integrated Development Environments and Learning Object Repositories. This paper formalizes the approaches to be used in the implementation of a programming exercise evaluator as a service on the e-Framework.