Functional Performance In Individuals Research Articles

Improving Walking Energy Efficiency in Transtibial Amputees Through the Integration of a Low-Power Actuator in an ESAR Foot.

Reducing energy consumption during walking is a critical goal for transtibial amputees. The study presents the evaluation of a semi-active prosthesis with five transtibial amputees. The prosthesis has a low-power actuator integrated in parallel into an energy-storing-and-releasing foot. The actuator is controlled to compress the foot during the stance phase, supplementing the natural compression due to the user's dynamic interaction with the ground, particularly during the ankle dorsiflexion phase, and to release the energy stored in the foot during the push-off phase, to enhance propulsion. The control strategy is adaptive to the user's gait patterns and speed. The clinical protocol to evaluate the system included treadmill and overground walking tasks. The results showed that walking with the semi-active prosthesis reduced the Physiological Cost Index of transtibial amputees by up to 16% compared to walking using the subjects' proprietary prosthesis. No significant alterations were observed in the spatiotemporal gait parameters of the participants, indicating the module's compatibility with users' natural walking patterns. These findings highlight the potential of the mechatronic actuator in effectively reducing energy expenditure during walking for transtibial amputees. The proposed prosthesis may bring a positive impact on the quality of life, mobility, and functional performance of individuals with transtibial amputation.

Relation Between Cognitive Assessment and Clinical Physical Performance Measures After Mild Traumatic Brain Injury

ObjectivesTo investigate the relation between cognitive and motor performance in individuals with mild traumatic brain injury (mTBI) and examine differences in both cognitive and motor performance between adults after mTBI and healthy controls. DesignMulti-center, cross-sectional study. SettingThree institutional sites (Courage Kenny Research Center, Minneapolis, MN, Oregon Health & Science University, Portland, OR, and University of Utah, Salt Lake City, UT). ParticipantsData were collected from 110 participants (N=110), including those with mTBI and healthy controls, who completed cognitive and physical performance assessments. InterventionsNot applicable. Outcome MeasuresCognitive assessments involved the Automated Neuropsychological Assessment Metrics to evaluate domains of attention, memory, reaction time, processing speed, and executive function. Physical performance was evaluated through clinical performance assessments, such as the 1-min walk test, the modified Illinois Agility Test, the Functional Gait Assessment Tool, the High-Level Mobility Assessment Tool, a complex turning course, and a 4-Item Hybrid Assessment of Mobility for mTBI. Participants also completed additional trials of the 1-min walk test, modified Illinois Agility Test, and complex turning course with a simultaneous cognitive task. ResultsIndividuals with mTBI performed worse on cognitive assessments, as well as several of the physical performance assessments compared with healthy controls. Complex tasks were more strongly related to cognitive assessments compared with simple walking tasks. ConclusionsCombining complex motor tasks with cognitive demands may better demonstrate functional performance in individuals recovering from mTBI. By understanding the relation between cognitive and physical performance in individuals recovering from mTBI, clinicians may be able to improve clinical care and assist in return to activity decision-making.

Effect of Active Release Technique and Cyriax approach on pain, grip strength and functional performance in individuals with lateral epicondylitis: a randomized clinical trial protocol

Background: Tennis elbow, also known as lateral epicondylitis, is a painful condition characterized by irritation of the tendons that link the forearm muscles on the outside of the elbow, which can result from using the elbow too much. Active Release Technique (ART) is defined as a hands-on approach that manages cases to enable the identification and treatment of soft tissue injuries. Through the removal of fibrosis and adhesions that can develop in tissues as a result of overload from frequent use, the aim of ART, a soft tissue treatment, is to lessen tissue stress. Deep transverse friction (DTF) and Mill's manipulation, which are used shortly after DTF, have been used by Cyriax and Cyriax to successfully treat tennis elbow. ART and Cyriax techniques have shown promise for lateral epicondylitis sufferers. There hasn't yet been any research comparing these two approaches for participants with lateral epicondylitis. The aim is to examine the efficiency of ART with the Cyriax technique on lateral epicondylitis pain, strength, and function. Methods: A total number of 60 participants will be included as per the inclusion criteria and then they will be further divided into 30 in each group. The physiotherapy intervention will be given to Groups A (ART) and Group B (Cyriax technique) along with conventional 12 sessions spread across four weeks, three times per week. Each patient will be evaluated during and after treatment on the baseline and after four weeks using the Visual Analogue Scale (VAS), hand grip strength dynamometer, and Patient-rated Tennis Elbow Evaluation (PRTEE) scale. Conclusions: This physiotherapy intervention could be used in the treatment of lateral epicondylitis if our study's hypothesis is found to be accurate. Registration: CTRI (CTRI/2023/06/053660; 08/06/2023).

Force Steadiness And Functional Performance In Individuals With Chronic Kidney Disease Compared To Healthy Controls

Force Steadiness And Functional Performance In Individuals With Chronic Kidney Disease Compared To Healthy Controls

Investigation of the correlation between knee joint position sense and physical functional performance in individuals with transtibial amputation.

In individuals with transtibial amputation, the distal part of the lower extremity is lost. Therefore, the knee joint is of greater importance to be able to provide physical performance. The aim of this study was to evaluate the correlation between knee joint position sense and physical functional performance in individuals with transtibial amputation. The study included 21 subjects with transtibial amputation. A digital inclinometer was used to evaluate the joint position sense of the amputated side knee joint. The timed up and go test, the 4-square step test, and 10-m walk test were used to evaluate physical functional performance. Linear regression analysis was used to investigate the associations between independent variables and functional performance tests. The mean age of the participants was 52.52 ± 15.68 years. The mean of the error in knee joint position sense was 5.33 degree (standard deviation = 3.08 degree). The error in knee joint position sense of the amputated limb predicted 45% of the variance in the 4-square step test and 22% of the variance in the 10-m walk test ( P < 0.05). The knee joint position sense on the amputated side was found to be associated with physical functional performance in individuals with transtibial amputation. Residual limb knee joint position sense should be considered when prescribing prostheses and planning rehabilitation programs.

Improving Lower Extremity Functional Indices of People With Dynamic Knee Valgus With Therapeutic Exercises: A Systematic Review and Meta-analysis

Purpose: One of the most significant contributors to lower extremity degeneration alterations and its effects on balance and sports performance is dynamic knee valgus (DKV) as a faulty movement pattern. Different exercise interventions have been conducted to improve DKV. Extensive research and meta-objective analysis were conducted to assess how exercise interventions affected people with lower extremity functional indicators of DKV. Methods: The electronic databases Scopus, Web of Science (WoS), PubMed, Google Scholar, and Iranian databases SID and Magiran were systematically searched from inception to September 2021. Only full-text articles published in English/Persian peer-reviewed journals that met this study criterion were tracked. Two researchers evaluated the methodological quality of research findings separately, employing the Downs and Black Checklist. After collecting significant data from eligible studies, the results were integrated by applying a random-effects meta-analysis approach. Results: The final systematic review and meta-analysis comprised seven of the 3470 papers deemed potentially relevant. The outcome illustrates that different exercise interventions may be effective in improving dynamic balance (SD=0.93 degrees, 95%CI: 0.54-1.32, P&lt;0.001) and functional performance (Hedge’s g=1.695, 95% CI=1.22-2.17, Z=6.99, P&lt;0.001) in 250 DKV participants. Conclusion: Exercise interventions appear to be an effective method to enhance dynamic balance and functional performance in individuals experiencing DKV; nevertheless, these results should be regarded as preliminary due to the limited number of studies and their limitations.

Association between Kinesiophobia and Knee Pain Intensity, Joint Position Sense, and Functional Performance in Individuals with Bilateral Knee Osteoarthritis.

In current clinical practice, fear of movement has been considered a significant factor affecting patient disability and needs to be evaluated and addressed to accomplish successful rehabilitation strategies. Therefore, the study aims (1) to establish the association between kinesiophobia and knee pain intensity, joint position sense (JPS), and functional performance, and (2) to determine whether kinesiophobia predicts pain intensity, JPS, and functional performance among individuals with bilateral knee osteoarthritis (KOA). This cross-sectional study included 50 participants (mean age: 67.10 ± 4.36 years) with KOA. Outcome measures: The level of kinesiophobia was assessed using the Tampa Scale of Kinesiophobia, pain intensity using a visual analog scale (VAS), knee JPS using a digital inclinometer, and functional performance using five times sit-to-stand test. Knee JPS was assessed in target angles of 15°, 30°, and 60°. Pearson’s correlation coefficients and simple linear regressions were used to analyze the data. Significant moderate positive correlations were observed between kinesiophobia and pain intensity (r = 0.55, p < 0.001), JPS (r ranged between 0.38 to 0.5, p < 0.05), and functional performance (r = 0.49, p < 0.001). Simple linear regression analysis showed kinesiophobia significantly predicted pain intensity (B = 1.05, p < 0.001), knee JPS (B ranged between 0.96 (0° of knee flexion, right side) to 1.30 (15° of knee flexion, right side)), and functional performance (B = 0.57, p < 0.001). We can conclude that kinesiophobia is significantly correlated and predicted pain intensity, JPS, and functional performance in individuals with KOA. Kinesiophobia is a significant aspect of the recovery process and may be taken into account when planning and implementing rehabilitation programs for KOA individuals.

Exercises to escalate lower extremity muscle strength in stroke patients: a scoping review

Introduction: Stroke sufferers with weakness and paralysis of the lower extremities are at risk of experiencing balance disorders. It causes the risk of falling for stroke sufferers. The effects of falls can result in physical injuries such as bruises, abrasions, lacerations, and even fractures, head injuries, and bleeding. The effects of falling cause physical injury and increase the longer treatment time, so that it adds to the burden on the patient and family to pay for patient care. This literature review aims to identify the types of interventions that can increase the strength of the muscle' lower extremity to prevent falls in stroke sufferers.Method: This study used JBI Scoping Review Method (Joanna Briggs Institute) from 2 database sources: Pubmed and Ebscohost. Publication 2015-2021. Keywords to search are stroke, fall risk, intervention, body balance, muscle strength.Results: There were 1,446 articles found, and six articles were worthy of review. The interventions used are training motor imagery (MI) using structured, progressive circuit class therapy (SPCCT), taping techniques from gluteal taping and hip abductor taping using elastic bands, rehabilitation programs wearing regent suits (RS) based on electromyography (EMG), low-intensity mobility training, perturbation-based balance training (PBT) and a combined assessment of the weight-bearing ratio and the four square step test. The combination of MI with structured, SPCCT provides a greater therapeutic effect on gait and leg muscle strength in stroke patients. Gluteal taping and hip abductor taping techniques using elastic bands improve functional performance in individuals with chronic stroke. A rehabilitation program that wears an RS and EMG were more effective than usual treatment in increasing the EMG pattern during movement and activities of daily living. A PBT can help prevent falls in everyday life after stroke, and the weight-bearing ratio and four square step tests can predict falls in stroke patients more precisely than the berg balance scale.Conclusion: In conclusion, the exercises, techniques and programs performed can increase lower extremity muscle strength, improve walking balance and reduce the risk of falls in stroke patients. These interventions require different times and tools according to the training carried out.

Development and Comparative Efficacy of Lagos Neuropathy Protocol for Improving Recovery of Symptom and Functional Independence Performance in Individuals with Diabetic Peripheral Sensorimotor Polyneuropathy.

Diabetic peripheral sensorimotor polyneuropathy (DPSP) has been treated with sketchy outcomes and available approaches are not applicable for self-administration. This study developed protocol for managing symptoms of DPSP and assessed its comparative efficacy. Study developed Lagos Neuropathy Protocol (LNP) through existing concept in DPSP and tested its safety, clinical applicability, and ease of self-administration. Its efficacy was compared with Buerger-Allen Exercise (BAE) by involving 31(11males) with DPSP, randomized into LNP and BAE and treated for 10-week. Toronto Clinical Scoring System was used to diagnose DPSP while Diabetic Neuropathy Examination was used to diagnose distal polyneuropathy. Sensory/pressure perception was assessed using 10 g-monofilament while Short Physical Performance Battery, Bergs Balance Scale and Visual Analogue Scale was used to assess functional performance, strength and balance, and pain respectively. LNP has three domains: sensory/pressure/proprioception, strength/balance, and pain/swelling. Most (80%) of the participants rated the LNP as excellently safe while the rest (20%) rated as very good in safety. All the participants rated LNP excellent in terms of self-administration and suitability for clinical use without adverse effect. The mean age of the participants for the comparative phase was 66.20±9.48years while their length of diagnoses of diabetes was 15.80±13.35years. About a third (32.5%) had DPSP. Both LNP and BAE had significant improvement (p<0.05) in sensory/pressure perception, pain, strength and balance, and functional performance but LNP had better significant improvement. LNP is safe, good for self-administration, clinically applicable and efficacious in improving sensory/pressure perception, balance, pain and functional performances in individuals with DPSP.

Relationship of trunk extensor endurance on dynamic postural control and functional performance in non-specific low back pain

Background: The evaluation of causes and consequences of non-specific low back pain along with related symptoms are critical in terms of planning the treatments of patients. Muscular imbalance can cause postural impairment and reduced functional performance in individuals with low back pain. Therefore, determining the role of trunk muscular endurance in individuals with non-specific low back pain and its reflections on dynamic postural control and functional performance are very important for both patients and physiotherapists in terms of establishing an effective treatment program.Methodology: 39 participants with non-specific LBP aged between 18-50 years were included in this study. Biering–Sorensen test, Y-balance test and 5 min walk test were the outcome measures used to evaluate trunk extensor endurance, dynamic postural control and functional performance.Result: Using Karl Pearson’s Correlation coefficient, strong positive correlation was observed between trunk extensor endurance and 5-minute walk test, and between trunk extensor endurance and Y-balance test, which was found to be highly statistically significant.Conclusion: This study concludes that there is a strong positive correlation exist between trunk extensor endurance and dynamic postural control, and also between trunk extensor endurance and functional performance in patients with non-specific low back pain.

Relationship between DTI Brain Connectivity and Functional Performance in Individuals with Traumatic Brain Injury.

this study examines the relationship between brain structural connectivity, and physical and cognitive performances in individuals with Traumatic Brain Injury (TBI). Nine moderate to severe TBI participants were included in the study, and regression analysis was performed to explore if DTI connectivity of 16 regions of interest can predict individuals' : 1) Maximum Voluntary Contraction (MVC), 2) time component of Wolf Motor Function Test (WMFT), 3) Reaction Time (RT) during bimanual force matching task, 4) Performance Error Measurement (PEM) during bimanual force matching task, and 5) cognitive assessment of task switching using Trail Making (TM) test. Results showed that slower WMFT, PEM, and TM can be predicted by weaker cerebrospinal tract connectivity. Higher Caudate connectivity predicted higher WMFT and slower RT, and higher right Cingulum predicted faster TM. Current results suggest that measures of cognitive-motor interference may be better indicators of functional performance than single cognitive and motor performance tests.

An exploratory study of vibration therapy on muscle function in patients with peripheral artery disease

ObjectiveThe purpose of this exploratory study was to determine whether a single session of vibration therapy (VT) would improve muscular and functional performance in individuals with symptomatic peripheral artery disease (PAD). MethodsIn a randomized, balanced cross-over design fourteen PAD participants with intermittent claudication (mean ± standard deviation; age, 73.9 ± 4.6 years; height, 172.6 ± 68.4 cm; body mass, 85.2 ± 15.7 kg) performed VT and control that involved repeated chair rises, timed up-and-go test, and 6-minute walk test. Each intervention was separated by at least 2 days. Wearable VT devices were positioned on the right and left lower limbs that were turned on during functional testing but were turned off for the control intervention. ResultsVT significantly improved (P < .05) repeated chair rises and timed up-and-go test compared with control with a small effect size of 0.46 and 0.45, respectively. Similarly, a significant (P < .01) and meaningful change in 6-minute walk test was noted in VT compared with control. ConclusionsThis exploratory study suggest that VT may enhance functional strength, mobility, and walking performance by extending the onset of claudication and increasing walking distance in PAD with intermittent claudication. However, further study is required to confirm and extend these preliminary findings and determine the potential mechanisms of action in VT.

Comparison of functional and isokinetic performance between healthy women and women with fibromyalgia

BackgroundFibromyalgia is a condition that predominantly affects women and is characterized by chronic pain. As a consequence, it has been suggested that there is a decrease in muscle strength, a prime component of physical fitness, and thus a reduction in functional performance. Therefore, it is necessary to perform a complete and reliable physical evaluation of functional performance. The aim of this study was to compare the functional and isokinetic performance between women with fibromyalgia and healthy women. MethodsThis is a cross-sectional study that evaluated 40 women divided into 2 groups: Healthy Group (HG) (n = 20); Fibromyalgia Group (FG) (n = 20), aged between 30 and 50 years. The individuals were submitted to an evaluation of functional performance through the following tests: Timed Up and Go (TUGT), Chair Stand Test, 6-Minute Walk test (6MWT), Sit and Reach Test, and Isokinetic performance of the knee extensor and flexor groups. Statistical analysis was performed by the statistical SPSS 22.0 software for Windows. ResultsA lower index was observed in the 6-min Walk Test (p < 0.001), Chair Stand Test (p < 0.001), and VO2 Peak (p < 0.001) for FG. There were no significant differences in isokinetic performance (p > 0.05). ConclusionsThe results point to lower functional performance in individuals with fibromyalgia when compared to healthy individuals of the same age and physical activity level. Therefore, it is evident that performing therapeutic exercises of different modalities to improve the functional performance of patients with FM is important.

Effects of Kinesio tape on lower limb muscle strength, hop test, and vertical jump performances: a meta-analysis

BackgroundTo date, published systematic reviews concerning the effects of Kinesio Taping (KT) on muscle strength have not analysed facilitatory and inhibitory applications separately. As a result, their results could be substantially affected by clinical heterogeneity. This meta-analysis was conducted to determine the effectiveness of using a facilitatory application of KT for lower limb muscle strength and functional performance (distance in a single-leg hop and vertical jump height) in individuals without disabilities and in those with musculoskeletal conditions (muscle fatigue, chronic musculoskeletal diseases, and post-operative orthopaedic conditions).MethodsSearches were conducted on six major electronic databases. Randomised controlled trials that used facilitatory KT were included. Standardised mean differences (SMDs) were calculated and random-effects models were used for analysis.ResultsThirty-seven randomised controlled trials were included. KT was superior to controls for improving lower limb muscle strength in individuals with muscle fatigue (short-term effect, pooled SMD = 0.53, 95% CI = 0.09 to 0.96; long-term effect, pooled SMD = 0.61, 95% CI = 0.12 to 1.11) and in individuals with chronic musculoskeletal diseases (pooled SMD = 1.24, 95% CI = 0.33 to 2.16) with large effect sizes. The use of KT in populations without disabilities was not supported. There is insufficient evidence for the effect of KT on functional performance in individuals with musculoskeletal conditions.ConclusionsContrary to prior research, the existing evidence shows that KT can improve lower limb muscle strength in individuals with muscle fatigue and chronic musculoskeletal diseases. The effect sizes produced in this meta-analysis show that KT may be superior to some existing treatments for these conditions. In addition, this study suggests that practitioners may wish to avoid the use of KT in individuals without disabilities.Trial registrationPROSPERO registration number CRD42017075490, registered on 21 November 2017.

Effects of Core Neuromuscular Training on Pain, Balance, and Functional Performance in Women With Patellofemoral Pain Syndrome: A Clinical Trial

ObjectiveThe purpose of this study was to determine the effects of core neuromuscular training on pain, balance, and performance in women with patellofemoral pain syndrome (PFPS). MethodsThis randomized single-blind trial was based on a convenience sample of 28 women with unilateral PFPS. All participants were assigned randomly to the intervention or control group with a block randomization method. The control group received routine physical therapy exercise for PFPS. The intervention group received core neuromuscular training in addition to routine physical therapy exercise. The outcome measures evaluated were pain intensity (Visual Analog Scale), function (Kujala patellofemoral questionnaire and step-down performance test), and balance (Y balance test). ResultsIn both groups the pain score was significantly lower after treatment (P = .001). The slope of this trend was greater in the intervention group. The Kujala and step-down scores improved significantly after treatment in both groups, although the improvements were greater in the intervention group. The Y balance score improved in all 3 directions after therapy in both groups (P < .05); improvement was significantly greater in the intervention group only in the posteromedial direction (P = .016). ConclusionFor the group of participants studied, a 4-week core neuromuscular training plus routine physiotherapy exercise was more effective than routine physiotherapy exercise alone for improving pain, balance, and functional performance in individuals with PFPS.

Improved Functional Performance in Individuals With Dementia After a Moderate-Intensity Home-Based Exercise Program: A Randomized Controlled Trial.

Individuals with dementia (IWDs) experience difficulties across cognitive and functional domains. Nonpharmacological interventions aimed at reducing disability are greatly needed. Exercise is a low-cost and easily implemented approach, but investigation has yielded mixed evidence to date. The purpose of the current study was to evaluate a novel and innovative moderate-intensity functional exercise intervention for IWDs, which was developed using principles from exercise science along with a Strength-Based Approach, consisting of 24 home-based sessions. A randomized, controlled intervention trial with a 2-group pretest and posttest design was used with a sample of 23 community-dwelling IWDs (intervention group: n = 13; comparison group: n = 10). Average age of participants was 73.9 years (standard deviation, 9.1) with mild to moderate cognitive impairment (Mini-Mental State Examination, Mean = 20.8; standard deviation, 5.0). A 99.0% attendance rate indicated high adherence to the moderate-intensity exercise program. Efficacy was examined using multiple linear regression. Group assignment significantly predicted performance in key outcome measures, with IWDs from the intervention group improving in lower extremity strength (B = 5.92, t = 3.26, P = .004), balance (B = 4.04, t = 4.13, P = .001), and fast gait speed (B = .32, t = 2.61, P = .02). These findings indicated IWDs are able to participate in and benefit from a moderate-intensity functional exercise program, consisting of strength and balance activities. The current intervention used a Strength-Based Approach to facilitate implementation of exercise activities that could be completed by the sample. Therefore, integration of these techniques into mainstream clinical practice and research should be feasible with this patient population. Future research directions and implications of these findings also are discussed.

Exploring Associations with 6-Minute Walk Test Performance in Adolescents and Young Adults with Down Syndrome: a Pilot Study

Six-minute walk test (6MWT) has been shown to be a valid and reliable measure of functional performance with respect to mobility in individuals with Down syndrome (DS). However, a wide variability of walking distance was observed from previous studies. Thus, there is a need to investigate the possible influencing factors of walking distance of the 6MWT in this population. In the current study, fourteen adolescents and young adults with DS, aged 14-30 yr. were recruited. Anthropometric variables, such as chronological age (CA), mental age (MA), Body Mass Index (BMI), level of physical activity (PA), grip strength, represented as muscular strength, leg length, resting heart rate (RHR), exercise heart rate (EHR) and walked distance of 6MWT (6MWD) were measured during their laboratory visit. Our results indicated the positive associations between the level of PA, grip strength, leg length and 6MWD. The total of 37.7% of the variance in 6MWD can be explained while considering the level of PA and grip strength in this population. Future research is still needed to include elderly populations with DS and more measures (i.e., motivation, leg length) to implement effective intervention and optimize functional performance in individuals with DS.

Effects of high-frequency transcranial magnetic stimulation on functional performance in individuals with incomplete spinal cord injury: study protocol for a randomized controlled trial

BackgroundRepetitive transcranial magnetic stimulation (rTMS) has been investigated as a new tool in neurological rehabilitation of individuals with spinal cord injury (SCI). However, due to the inconsistent results regarding the effects of rTMS in people with SCI, a randomized controlled double-blind crossover trial is needed to clarify the clinical utility and to assess the effect size of rTMS intervention in this population. Therefore, this paper describes a study protocol designed to investigate whether the use of rTMS can improve the motor and sensory function, as well as reduce spasticity in patients with incomplete SCI.MethodsA double-blind randomized sham-controlled crossover trial will be performed by enrolling 20 individuals with incomplete SCI. Patients who are at least six months post incomplete SCI (aged 18–60 years) will be recruited through referral by medical practitioners or therapists. Individuals will be randomly assigned to either group 1 or group 2 in a 1:1 ratio, with ten individuals in each group. The rTMS protocol will include ten sessions of high-frequency rTMS (5 Hz) over the bilateral lower-limb motor area positioned at the vertex (Cz). Clinical evaluations will be performed at baseline and after rTMS active and sham.DiscussionrTMS has produced positive results in treating individuals with physical impairments; thus, it might be promising in the SCI population. The results of this study may provide new insights to motor rehabilitation thereby contributing towards the better usage of rTMS in the SCI population.Trial registrationClinicalTrials.gov, NCT02899637. Registered on 25 August 2016.

Effects of two proprioceptive training programs on ankle range of motion, pain, functional and balance performance in individuals with ankle sprain.

Following ankle sprain, residual symptoms are often apparent, and proprioceptive training is a treatment approach. Evidence, however, is limited and the optimal program has to be identified. To investigate the effects of two post-acute supervised proprioceptive training programs in individuals with ankle sprain. Participants were recruited from a physiotherapy center for ankle sprain rehabilitation. In a pre-post treatment, blinded-assessor design, 22 individuals were randomly allocated to a balance or a proprioceptive neuromuscular facilitation (PNF) group. Both groups received 10 rehabilitation sessions, within a six-week period. Dorsiflexion range of motion (ROM), pain, functional and balance performance were assessed at baseline, at the end of training and eight weeks after training. Follow-up data were provided for 20 individuals. Eight weeks after training, statistically significant (p< 0.017) improvements were found in dorsiflexion ROM and most functional performance measures for both balance and PNF groups. Eight weeks after training, significant (p< 0.017) improvements in the frontal plane balance test and pain were observed for the balance group. Balance and PNF programs are recommended in clinical practice for improving ankle ROM and functional performance in individuals with sprain. Balance programs are also recommended for pain relief.

Phisical modalities on the functional performance in knee osteoarthritis: a sytematic review

Abstract Introduction: Despite recent advances in the treatment of osteoarthritis (OA), few studies have evaluated the longitudinal effect of physical modalities in functional capacity in patients with knee OA. Thereby, since the physical components and pain can affect the functional performance of daily activities, the effect of these treatment’s form is still to be established. Objective: Evaluate the effectiveness of therapeutic ultrasound, electrical stimulation and phototherapy in the functional performance, in patients with knee osteoarthritis. Methods: Articles present in the PubMed, Lilacs, SciELO and PEDro’s databases were evaluated. The used keywords were “pulsed ultrasound therapy”, “ultrasound therapy”, “electric stimulation” and “low level laser therapy” in combination with “knee osteoarthritis”. Were included in this presented review, randomized clinical studies using ultrasound, electrical and laser stimulation in subjects with knee osteoarthritis. To evaluate the methodological quality of the selected studies, was used the PEDro’s scale. The dependent variables of the study were: pain, physical function, joint stiffness, life quality and functional performance. Results: 268 studies were found, of these, 41 studies met eligibility criteria and were classified for analysis in full. The used methodology in the studies varied widely, however, in most cases there was improvement in functional performance of individuals with knee OA, with the use of physical modalities, for the pulsed ultrasound, continuous ultrasound, electrical stimulation and laser resourses. Conclusion: The physical modalities used in the studies demonstrated improvement in functional performance of individuals with knee OA.