Muscle Training Research Articles

Progress in research and application of respiratory surface electromyography in respiratory and critical care medicine

Continuous monitoring of respiratory drive plays an important role in guiding mechanical ventilation and assessing changes in disease, but respiratory drive cannot be measured directly. Respiratory and critical care practitioners often monitor respiratory effort to reflect respiratory drive, such as esophageal pressure and esophageal diaphragm electrical activity, but these methods are limited by their invasive nature, high technical requirements, and high cost. Esophageal diaphragmatic electromyography only monitors the activity level of the diaphragm and ignores other respiratory muscles, especially in patients who breathe forcefully and cannot truly reflect the patient's inspiratory effort. As a result, the monitoring of esophageal pressure and esophageal diaphragmatic electromyography activity are limited in clinical application. Surface electromyography (sEMG) of respiratory muscles is a non-invasive method for monitoring respiratory electromyographic activity that can be used to monitor the activity levels of all respiratory muscles and evaluate their functional status. This paper summarized the progress of sEMG in evaluating dyspnea, predicting acute exacerbations of chronic obstructive pulmonary disease, diagnosing bronchial asthma, guiding mechanical ventilation, and formulating respiratory muscle training programs to provide a new method of assessing respiratory effort.

Effect of inspiratory and expiratory muscle training on respiratory function and decannulation outcome in patients with tracheostomy after stroke: a randomized controlled trial

ABSTRACT Background This study aimed to evaluate the clinical efficacy and safety of inspiratory and expiratory muscle training (IEMT) for patients who underwent tracheostomy after stroke. Methods The study was an investigator-initiated, single-center, two-arm, evaluator-blinded, randomized clinical trial conducted at West China Hospital of Sichuan University, China, from January 2022 to June 2022. The patients were randomly divided into the intervention group and control group. Patients in both groups received conventional clinical, rehabilitation treatment and usual care. The intervention group also received IEMT for three weeks. There were three primary outcomes including maximal inspiratory pressure (MIP, cmH2O), maximal expiratory pressure (MEP, cmH2O) and decannulation outcome after intervention (n, %). The secondary outcomes were other respiratory function outcomes, motor function, activities of daily living (ADL), quality of life (QoL) and the new pulmonary infection rate after the intervention at three weeks. Results A total of 50 participants were enrolled [25 in each group; 39 (78%) were men; mean (SD) age, 55.94 (11.97) years]. At three weeks, significant differences were found in the MIP [control vs IEMT: 39.04 (6.21) vs 56.28 (10.41), p < 0.001]; MEP [43.48 (5.36) vs 62.16 (10.18), p < 0.001], and tracheal tube extraction success rate [2 (8%) vs 9 (36%), p = 0.019] between the two groups. In addition, the new pulmonary infection rate in the intervention groups were significantly different (all p < 0.05) from those in the control group. Conclusions IEMT can improve respiratory function, decannulation outcome, among patients with tracheostomy after stroke.

Activity-related dyspnea and exercise intolerance in chronic obstructive pulmonary disease: recent insights.

Exertional dyspnea and exercise intolerance remain key patient-related outcomes in chronic obstructive pulmonary disease (COPD). Improvement in treatment strategies is pendant further understand of their underpinnings across the spectrum of disease severity. Emerging literature has been reviewed based on a conceptual framework that relates ventilatory demand to capacity under the modulating influence of sub-cortical and cortical centers (symptom perception and affective interpretation). Evidence supporting these fundamental tenets is critically appraised, focusing on mechanistic and interventional studies that shed novel light on the sources of heightened and/or mechanically constrained ventilation. Mechanistic studies using proxies of the inspiratory neural drive (e.g., diaphragm electromyography) were particularly informative, as well as interventional trials aimed at decreasing afferent stimulation and/or symptom perception via pharmacological (e.g., low-dose opiates in selected patients, high flow oxygen, oral nitrate) and nonpharmacological (e.g., novel exercise training paradigms, inspiratory muscle training, breathing techniques) interventions. Therapeutic and rehabilitative strategies to lessen dyspnea's devastating impact on quality of life should minimize demand in the setting of reduced capacity and increased sensation awareness in COPD. The most successful attempts so far have amalgamated pharmacological and nonpharmacological approaches tailored to the main underlying mechanisms on an individual basis.

The impact of physical exercise with additional visual tasks on UDVA and accommodation sensitivity in children: the mediating role of kinetic visual acuity

PurposeThis study investigates the impact of physical exercise supplemented with visual tasks on children’s uncorrected distance visual acuity (UDVA), kinetic visual acuity (KVA), and accommodative sensitivity, with an analysis of the mediating role of KVA.MethodsA total of 168 third-grade students from four natural classes in a primary school in Suzhou City were randomly assigned to either an experimental group (n = 86) or a control group (n = 82). The experimental group engaged in 30 cycles of ciliary muscle training tasks with visual targets presented for 3 s during physical exercises, while the control group participated in regular physical exercises. The intervention lasted 16 weeks, during which KVA, UDVA, and accommodative sensitivity of children were measured before and after the intervention using a kinetic visual acuity tester, a standard logarithmic visual acuity chart lightbox, and a lens flipper.ResultsPost-intervention, the experimental group showed significant improvements in KVA, UDVA, and accommodative sensitivity (p &amp;lt; 0.05). The control group did not show significant changes in KVA and UDVA (p &amp;gt; 0.05), but did exhibit a significant improvement in accommodative sensitivity (p &amp;lt; 0.05). Additionally, children in the experimental group demonstrated significantly higher levels of KVA, UDVA, and accommodative sensitivity compared to the control group after the intervention (p &amp;lt; 0.05). A moderate positive correlation was found between KVA and both UDVA and accommodative sensitivity. KVA partially mediated the effect of additional visual tasks during physical exercise on UDVA in children (left eye 95% CI: 0.011—0.180; right eye 95% CI: 0.023—0.167). Moreover, KVA partially mediated the effect of additional visual tasks during physical exercise on accommodative sensitivity (95% CI: 0.021—0.245).ConclusionIncorporating additional visual tasks into physical exercise effectively enhances KVA, UDVA, and accommodative sensitivity in children. There is a significant positive correlation between KVA and UDVA as well as between KVA and accommodative sensitivity. These visual tasks directly impact UDVA and accommodative sensitivity and indirectly influence them through the mediating effect of KVA.

Power-Assisted Scissors Reduce Adductor Pollicis Muscle Fatigue: A Comparative Study in Female College Students

Hand fatigue commonly occurs in repetitive tasks, such as cutting with scissors, leading to discomfort, reduced productivity, and musculoskeletal disorders. Recent advances in assistive technology have introduced power-assisted scissors to reduce the muscular load. Pinching and grasping mainly involve the adductor pollicis muscles of the hand. Measuring the electromyographic (EMG) activity of these muscles provides valuable insights into the muscular effort required for such tasks. Studies have indicated that power-assisted devices can effectively reduce muscle strain and fatigue. However, research on the effect of power-assisted scissors on adductor pollicis muscle activity is limited. This study examines the differences in adductor pollicis muscle activity using power-assisted scissors versus traditional scissors. The experiment consisted of 20 participants performing a scissor manipulation task with and without power assistance. Frequency analysis of the adductor pollicis muscle EMG data indicated that scissors with power assistance significantly reduced muscle fatigue (95% confidence interval, 10.705 [4.523–19.751], p &lt; 0.01, η2 = 0.01). Understanding the efficacy of power-assisted scissors has significant implications for occupational health—particularly in professions that involve extensive manual cutting, such as tailoring and hairdressing. This study can contribute to the design of ergonomic tools that enhance comfort and reduce musculoskeletal disorder risks.

Epidemiology of injuries in UK based golfers: a retrospective study

ABSTRACT Objectives Golf participation numbers have increased in recent years within the UK and globally. A recent systematic review and meta-analysis of injuries in amateur and professional golfers showed over half of golfers sustain an injury during their lifetime. This review recommended that future research should utilize the recent international consensus on reporting of injury in golf. The aim of this study was to determine the frequency and severity of injuries sustained by UK-based golfers in the previous year. Methods A retrospective cross-sectional online survey consisting of 35 questions was disseminated to UK-based golfers. Non-overlapping 95% confidence intervals (CI) were utilized to indicate significant differences. Results There were 303 participants included for analysis. The overall injury incidence was 41.26 injuries per 1000 hours (CI 35.96–47.33). Consistent with the wider literature, the lower back at 9.94 injuries per 1000 hours (CI 7.48–13.22) is the most frequent injury site. The lower back had a mean time loss of 54 ± 89 days before full recovery. Repetitive movement injuries were noted to have a higher incidence (22.00 per 1000 hours, CI 18.19–26.61) in comparison to acute injuries (10.79 per 1000 hours, CI 8.21 to 14.18). Conclusion Anatomically, the proportion of injuries observed was comparable to previous epidemiology studies, with the lower back and elbow having the highest incidences in this largely amateur group of golfers. Most injuries were identified to be a muscle strain, joint sprain, or tendinopathy; however, no single identifiable mechanism of injury was identified.

Correlation between MRI findings and functional outcomes in patients with calf muscle strain injuries: a retrospective study on 78 patients

BackgroundCalf muscle strain injuries (CMSI), also known as “tennis leg,” are frequently observed in middle-aged and physically active people, including non-professional athletes. While magnetic resonance imaging (MRI) is frequently used to assess the extent of these injuries, the relationship between MRI findings and long-term functional outcomes in non-athletic populations remains underexplored. This study aimed to investigate the correlation between MRI-detected injury severity and functional outcomes using the Achilles Tendon Rupture Score (ATRS) and the Tegner Activity Scale (TAS).MethodsA retrospective review was conducted on 78 non-athletic patients diagnosed with CMSI and were followed for an average of 25.6 ± 16.1 months. Injury severity was classified into three grades: Grade 1 (edema without architectural disruption), Grade 2 (partial muscle disruption with hematoma), and Grade 3 (complete muscle disruption or tendon detachment) based on MRI examination. The functional outcomes were assessed using the ATRS and TAS. A simple linear regression analysis was conducted to assess the impact of demographic variables and MRI findings on ATRS.ResultsThe mean ATRS at the final follow-up was 92.9 ± 10.6, with 75.6% of patients achieving an excellent outcome. Despite the excellent ATRS scores, a notable reduction in TAS was evident from the pre-injury assessment (4.4 ± 1.2) to the final follow-up (3.8 ± 1.3; p < 0.001). Moreover, 44.9% of patients did not resume their pre-injury activity levels. The regression analysis demonstrated no statistically significant correlation between MRI-detected injury severity, demographic factors (age, gender, BMI), and ATRS outcomes (R² = 0.094, adjusted R² = -0.011).ConclusionMRI-detected injury severity does not significantly predict long-term functional outcomes in patients with CMSI, even though most patients achieved excellent ATRS scores. However, nearly half of the patients did not return to their pre-injury activity levels. These findings suggest that additional factors might influence recovery, and further research is needed to elucidate these factors in non-athletic patients.Level of evidenceLevel IV, Retrospective case series.

Conservative treatments for women with stress urinary incontinence: a systematic review and network meta-analysis

ObjectiveThis study aimed to compare the effectiveness of various conservative treatment strategies for women with stress urinary incontinence.MethodsA comprehensive search of PubMed, Web of Science, Embase, and the Cochrane Library was conducted from their inception through March 2024, without restrictions on language or location. Randomized controlled trials (RCTs) comparing the efficacy of conservative treatments for stress urinary incontinence, using short-term pad test or the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) score as outcome measures, were included. We conducted a network meta-analysis using a random-effects model to compare the effectiveness of different conservative treatment strategies, employing prediction interval plots and league tables, and ranked them according to the surface under the cumulative ranking curve (SUCRA). The quality of the included studies was assessed following the Cochrane Handbook for Systematic Reviews of Interventions.ResultsA total of 31 RCTs involving 1,900 patients across 8 intervention categories were included in the analysis. SUCRA rankings indicated that electrical stimulation (SUCRA = 95.9%) was the most effective therapy for improving ICIQ-UI SF scores, followed by biofeedback electrical stimulation (SUCRA = 84.9%), radiofrequency (SUCRA = 77.5%), biofeedback (SUCRA = 57.8%), magnetic stimulation (SUCRA = 45.3%), pelvic floor muscle training (SUCRA = 38.4%), Er: YAG laser (SUCRA = 37.4%), and CO2 laser (SUCRA = 7.4%). In terms of reducing urine leakage, the treatments were ranked in descending order as follows: Er: YAG laser (SUCRA = 97.5%), biofeedback electrical stimulation (SUCRA = 83.4%), biofeedback (SUCRA = 67.0%), radiofrequency (SUCRA = 59.5%), electrical stimulation (SUCRA = 48.4%), pelvic floor muscle training (SUCRA = 43.0%), magnetic stimulation (SUCRA = 27.8%), and CO2 laser (SUCRA = 21.4%). Based on the clustered rankings of the two metrics, biofeedback electrical stimulation was identified as the most effective therapy for improving stress urinary incontinence.ConclusionBased on the combined analysis of two indicators, we found that biofeedback electrical stimulation may be the optimal therapy for the conservative management of stress urinary incontinence.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024569845.

Heel Pain After Landing in a Soccer Player: A Case of Abductor Hallucis Strain

BACKGROUND: Plantar heel pain is often attributed to the plantar fascia and calcaneal fat pad, both for athletes and sedentary individuals. Another potential cause of heel pain is Abductor Hallucis muscle (AbdH) strain. CASE PRESENTATION: The athlete jumped for a header during a league game, and after he landed on his left foot with a dorsiflexed ankle, he felt sudden pain and was not able to continue. The initial physical examination has overlapping features of AbdH and plantar fascia injury. Detailed physical examinations and radiological images revealed AbdH strain. OUTCOME AND FOLLOW-UP: Immobilization and cold therapy were started as the first line of treatment, then stretching and gradual loading were added. The patient was able to play after 3 weeks. DISCUSSION: AbdH strain is a rare cause of heel pain, but it should be kept in mind, especially when a suspected mechanism of injury occurs.

Optimising the Dose of Static Stretching to Improve Flexibility: A Systematic Review, Meta-analysis and Multivariate Meta-regression.

Static stretching is widely used to increase flexibility. However, there is no consensus regarding the optimal dosage parameters for increasing flexibility. We aimed to determine the optimal frequency, intensity and volume to maximise flexibility through static stretching, and to investigate whether this is moderated by muscle group, age, sex, training status and baseline level of flexibility. Seven databases (CINAHL Complete, Cochrane CENTRAL, Embase, Emcare, MEDLINE, Scopus, and SPORTDiscus) were systematically searched up to June 2024. Randomised and non-randomised controlled trials investigating the effects of a single session (acute) or multiple sessions (chronic) of static stretching on one or more flexibility outcomes (compared to non-stretching passive controls) among adults (aged ≥ 18years) were included. A multi-level meta-analysis examined the effect of acute and chronic static stretching on flexibility outcomes, while multivariate meta-regression was used to determine the volume at which increases in flexibility were maximised. Data from 189 studies representing 6654 adults (61% male; mean [standard deviation] age = 26.8 ± 11.4years) were included. We found a moderate positive effect of acute static stretching on flexibility (summary Hedges' g = 0.63, 95% confidence interval 0.52-0.75, p < 0.001) and a large positive effect of chronic static stretching on flexibility (summary Hedges' g = 0.96, 95% confidence interval 0.84-1.09, p < 0.001). Neither effect was moderated by stretching intensity, age, sex or training status, or weekly session frequency and intervention length (chronic static stretching only) [p > 0.05]. However, larger improvements were found for adults with poor baseline flexibility compared with adults with average baseline flexibility (p = 0.01). Furthermore, larger improvements in flexibility were found in the hamstrings compared with the spine following acute static stretching (p = 0.04). Improvements in flexibility were maximised by a cumulative stretching volume of 4min per session (acute) and 10min per week (chronic). Static stretching improves flexibility in adults, with no additional benefit observed beyond 4min per session or 10min per week. Although intensity, frequency, age, sex and training status do not influence improvements in flexibility, lower flexibility levels are associated with greater improvement following both acute and chronic static stretching. These guidelines for static stretching can be used by coaches and therapists to improve flexibility. PROSPERO CRD42023420168.

Do We Need to Re-Focus on Functional Female Urethral Disorders in Lower Urinary Tract Dysfunction? ICI-RS 2024.

Insights into the role of the urethra in maintaining continence and in normal voiding have been provided with advances in imaging techniques. Also, functional urethral testing is used to understand which treatments are optimal for women with functional bladder outlet obstruction (BOO), but which testing is better for which treatment? This review aims to describe our current understanding of female urethral function and dysfunction and to provide future research directions for treating functional female urethral disorders. This is a consensus report of the proceedings of a research proposal discussed at the annual International Consultation on Incontinence-Research Society (ICI-RS), 6th-8th June 2024 (Bristol, UK): "Do we need to re-focus on functional female urethral disorders in lower urinary tract dysfunction? ICI-RS 2024". Regarding female urethral nomenclature, it was agreed that the same terminology should be used in the orientation of the female urethra as in the male. Also, functional MRI and computer modeling could aid further understanding of urethral function in women with voiding dysfunction and OAB symptoms. As for functional urethral assessment, options include video-urodynamics with leak point pressure (LPP) testing, urethral pressure profilometry (UPP), and striated urethral sphincter electromyography (EMG). Future testing may include the use of modalities (borrowed from cardiologic assessment of vascular structures such as resistive measures obtained with ultrasound) for the purpose of assessing urethral closure. UPP testing has limitations in measurement and reproducibility in assessing urethral pressure. Urethral sphincter EMG is difficult to perform and reproduce. LPP also has limitations related to testing and to patient effort, in addition to being influenced by factors such as bladder volume and compliance. When performing urethral surgery, it is imperative to dissect in tissue planes that preserve urethral function. Regarding therapeutic modalities for the treatment of functional female urethral dysfunction, conservative management includes pelvic floor muscle training with or without biofeedback, electrical stimulation, and extracorporeal magnetic stimulation. Furthermore, there was a robust discussion on the use of cognitive-behavioral therapy to address psychological comorbidities, thereby improving female LUTD. The evidence supporting long-term pharmacologic treatment of female urethral LUTD remains scarce. As for invasive management options, the evidence supporting the use of botulinum toxin in female LUTD is limited. Finally, the very existence of BNO and the validity of its diagnosis was discussed. Furthermore, bladder neck incision as a treatment of BNO was debated, and the indications for this procedure include a therapeutic decision balancing benefit to complications. Improving the treatment of female functional storage and voiding disorders depends on optimal urethral function assessment. Functional MRI to better understand urethral function, expanding the use of UPP testing, LPP testing, and emerging modalities while maintaining urethral function during female urethral surgery, and addressing psychological comorbidities whilst pursuing both conservative and invasive options (for refractory symptoms) are all important considerations in treating functional female urethral disorders.

Effect of prehabilitation on outcomes following upper gastrointestinal surgery: a systematic review and meta-analysis

It is accepted in several areas of surgery that prehabilitation can improve post-operative outcomes. Prehabilitation describes preoperative interventions aimed at optimizing patient condition prior to surgery to improve postoperative outcomes. It is hypothesized that prehabilitation reduces postoperative complications in the setting of upper gastrointestinal surgery. A systematic search strategy was performed based on a research question formulated with reference to the PICO framework. Eligible studies were those that included a predefined prehabilitation intervention, a comparison to usual care and conducted on patients undergoing upper gastrointestinal surgery. Included studies were evaluated for bias and underwent data extraction. Meta-analysis was also performed for outcomes where possible. Eight studies met criteria for inclusion in this review. The nature and length of prehabilitation programs varied widely, with interventions lasting from two to six weeks. Reported outcomes included post-operative pulmonary complications, mortality and length of hospital stay. A meta-analysis was undertaken for mortality and postoperative pulmonary complications. Meta-analysis showed postoperative pulmonary complications were reduced (RR0.68, 95% CI 0.50-0.93) in the intervention group compared to the control group, as was mortality (RR 0.59, 95% CI 0.35-1.00). Prehabilitation, especially inspiratory muscle training appears to be effective in reducing pulmonary complications in patients scheduled for upper gastrointestinal surgery. With the available data it is uncertain if this translates to reduced length of stay or mortality. There is scope for further research to better define a role for prehabilitation in upper gastrointestinal surgery, specifically the optimal prehabilitation modality and length.

Benefits from Implementing Low- to High-Intensity Inspiratory Muscle Training in Patients Undergoing Cardiac Surgery: A Systematic Review

Cardiac surgery procedures are among the main treatments for people with cardiovascular disease, with physiotherapy playing a vital part. Respiratory complications are common and associated with prolonged Intensive Care Unit (ICU) and hospital stay, as well as increased mortality. Inspiratory muscle training has been found to be beneficial in improving respiratory muscle function in critically ill patients and patients with heart failure. The purpose of this review is to present the results of implementing inspiratory muscle training (IMT) programs in patients before and/or after cardiac surgery. The PubMed, Embase and Science Direct databases were searched from January 2012 to August 2023. In the present review, randomized controlled clinical trials (RCTs), clinical trials and quasi-experimental studies conducted in adult patients pre and/or post cardiac surgery were included. Fifteen studies were considered eligible for inclusion in the review. The results revealed that the IMT programs varied in intensity, repetitions, and duration in all included studies. Most studies implemented the IMT after the surgery. Statistical significance between groups was noted in Maximal Inspiratory Pressure and the 6-Minute Walk Distance Test. Preoperative and postoperative programs could improve inspiratory muscle strength, pulmonary function, and functional capacity as well as decrease the length of hospital stay in patients undergoing cardiac surgery. No clear evidence emerged favoring low or higher IMT intensities. The combination of IMT with other forms of exercise might be beneficial in patients undergoing cardiac surgery. However, further RCTs are required to provide confirming evidence.

Interventions for the management of long covid (post-covid condition): living systematic review

ObjectiveTo compare the effectiveness of interventions for the management of long covid (post-covid condition).DesignLiving systematic review.Data sourcesMedline, Embase, CINAHL, PsycInfo, Allied and Complementary Medicine Database, and Cochrane Central Register of...

Hatha yoga, integrating the segmental stabilization exercise model, can improve trunk muscle endurance in healthy adults.

Low back pain is a very common symptom worldwide and an increasingly important public health problem. Exercises to stabilize the lumbar spine and pelvis have been shown to be effective in preventing or reducing the risk of low back pain. Hatha yoga practice is now increasingly appearing in prevention research and has the potential to improve trunk muscle endurance. The prevention research on endurance training of trunk muscle lacks evidence. The aim of this study was to investigate the effectiveness of a professional and scientifically based exercise program to improve and balance trunk muscle endurance in healthy adults. A non-randomized control study was conducted. Participants were healthy adults without low back pain or injury who had not performed exercises to improve trunk muscle endurance prior to participation in the study. An analysis of the proposed exercise program's effectiveness was conducted. The participants were divided into two groups: the exercise group (EG) performed a three-month hatha yoga exercise program (60 min twice a week) that included the spinal and pelvic segmental stabilization exercise model, or the control group (CG), in which participants were asked to maintain their previous lifestyle during the study period. Trunk muscle endurance was measured at baseline (PRE) and after completion of the exercise program (POST) in both groups. The changes in the measured variables were analyzed (PRE-POST analysis, EG-CG comparison). Seventy-two subjects (nEG = 36, age 32.2 ± 6.8 years; nCG = 36, age 29.9 ± 7.8 years) participated in the study. After the exercise program, the EG participants had significantly better results in endurance in three of the four trunk muscle groups (p < 0.05), but not in any of the endurance ratios. Hatha yoga when integrating the segmental stabilization exercise model can significantly improve the endurance of at least three of the four major trunk muscle groups. For clinical relevance, the long-term effects of the proposed exercise program should be investigated in individuals with low back pain.

Is inertial training more effective than traditional resistance training in young healthy males?

Inertial training, also called flywheel training is more and more popular among sportsmen. The available data concerning the effectiveness of inertial training compared to conventional resistance strength training are contradictory. The aim of this study was to compare the impact of inertial training (IT) vs. traditional gravity-dependent resistance training (TRT) on elbow flexor and knee extensor strength. Twenty-six young, recreationally active males were randomized into IT group (n = 13) or TRT group (n = 13). Both groups performed strength training three times a week for 6 weeks. Before and after training, the maximum force of the trained muscles was evaluated under training conditions (one repetition maximum under gravity-dependent conditions and maximal force under inertial conditions) and isometric conditions. Countermovement jump, squat jump, pull-up test, and limb circumference were also evaluated. Elbow flexor muscle strength and arm circumference increased significantly in both IT and TRT over the course of training. There were no significant differences in relative muscle strength increases between groups. Knee extensor muscle strength also improved significantly in IT, regardless of the tested conditions, while TRT showed significant changes in one repetition maximum and isometric force but no significant changes in force obtained under inertial conditions. Thigh circumference increased in IT (P ≤ 0.05) but was unchanged in TRT. Jumping abilities improved significantly in both groups, without any differences between groups. We cannot confirm the superiority of inertial training over traditional resistance training definitively. Nevertheless, inertial training had a slight advantage over traditional resistance training when knee extensor muscle training was considered.

EFICÁCIA DO TREINAMENTO DA MUSCULATURA DO ASSOALHO PÉLVICO ASSOCIADO A OUTROS RECURSOS FISIOTERAPÊUTICOS PARA TRATAMENTO DE MULHERES COM INCONTINÊNCIA URINÁRIA DE ESFORÇO: REVISÃO DE LITERATURA

Background: Urinary Incontinence (UI) consists of any involuntary voiding loss, being frequent in the female population. The most common types of UI are: stress urinary incontinence (SUI), urge urinary incontinence (UUI), and mixed urinary incontinence (IUM). This condition negatively affects patients, impairing psychological well-being and quality of life. Physiotherapy plays an assertive role in the rehabilitation of patients suffering from Urinary Incontinence, with pelvic floor muscle training (PFMT) being one of the most used resources to help prevent and treat this condition. Pourpose: To understand the efficacy of PFMT associated with other physical therapy resources in the treatment of women with SUI. Methods: This is a literature review study, whose databases were PEDro, Pubmed and Capes Journals. The inclusion criteria were articles from randomized clinical trials or experimental studies on the role of PFMT associated with other physical therapy resources in the treatment of women with SUI. Results: This review included seven articles that verified the efficacy of PFMT associated with other physiotherapeutic resources, of which PFMT in conjunction with biofeedback, electroacupuncture and resistance training obtained beneficial results with some caveats, while PFMT associated with reflective involuntary training did not obtain significant results. Conclusion: Pelvic floor muscle training remains the best protocol for reducing symptoms of stress urinary incontinence.

Platelet-Poor Plasma for the Treatment of Acute Hamstring Muscle Injuries in Collegiate Football Athletes: A Cohort Study.

To evaluate the efficacy of platelet-poor plasma injections for the treatment of acute hamstring muscle strains. Cohort study. Outpatient Sports Medicine Clinic. Twenty consecutive patients with an acute hamstring muscle injury from 2021 to 2022 were included. Platelet-poor plasma injection into the hamstring muscle strain. Time (days) until return to full unrestricted participation in sport. All patients were male collegiate football athletes, with an average age of 20 (±1.6) years old. The most commonly injured muscle was the semitendinosus (65%). After treatment with platelet-poor plasma, patients on average returned to full, unrestricted participation in sport at 29.4 (±7.2) days postinjury, with a statistically significant improvement in pain as early as 2 weeks postinjection. No recurrent injuries to the affected hamstring muscles were seen within 12 months. PPP may be a safe and effective treatment for acute hamstring muscle strains and may potentially expedite time to return to play.

Electrical Muscle Stimulation for the Conservative Management of Female Pelvic Floor Muscle Dysfunction: A Scoping Review

Background: Electrical muscle stimulation (EMS) is a conservative management tool for the treatment of pelvic floor dysfunctions (PFDs). The aim of this review was to scope, summarize and critically evaluate available research investigating the impact of various modes of EMS on PFDs in females. Methods: Joanna Briggs Institute methodology for scoping reviews was used with The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Three databases were searched. Articles published in English that included female participants living with pelvic floor muscle dysfunction where EMS was used as a conservation care intervention were included in the review. Included studies were analyzed following Arksey and O’Malley’s framework. The Cochrane Risk of Bias Tool for randomized trials was used to assess risk of bias for the randomized controlled trials (RCTs), and Hawker and Payne’s quality appraisal criteria was used to appraise the data from the other included papers systematically. Results: A total of 37 studies, including 20 RCTs were included. A favorable impact, across various outcomes, was found across trials which investigated different types of EMS with varying protocols. The heterogenous nature of intervention protocols limited the ability to apply any statistical or meta-analyses. EMS demonstrates a positive effect for improving outcomes related to PFDs in adult women. Included studies support the use of EMS for stress, urgency and mixed urinary incontinence. All versions of EMS studied were found to provide significant improvements, which included them being used as a sole intervention or as an adjunct intervention. High intensity forms of EMS were consistently found to require shorter intervention times. Conclusions: EMS demonstrates improvement across outcomes for PFDs among adult women. In particular, the results of this review suggest that EMS may be particularly useful in women living with stress urinary incontinence (SUI) or who those are unable to perform voluntary muscle contractions when pelvic floor muscle training is attempted. Further research related to more novel versions of high intensity EMS approaches is needed.

The Effect of Added Mass on Pulmonary Function

A comparative study of the volume-velocity parameters of the human external respiration system was carried out under the influence of an additional weight load: a body armor weighing 11 kg and a backpack weighing 15 kg. The nature of changes in the main spirometric parameters under the influence of an added mass is typical for restrictive disorders of pulmonary function. A marked decrease in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) values was observed when performing the test with a protective vest. In the conditions of a combination of body armor and a backpack, these changes were more pronounced (p 0.01). At the same time, there were no significant changes in the Tiffno index values (FEV1/FVC). In addition, a significant decrease in the values of maximum voluntary ventilation (MVV) was revealed by 8.1% under the influence of body armor, and by 18.5% with a combination of a vest and a backpack relative to the control (p 0.01). A significant correlation was shown between the maximum force of contraction of the inspiratory muscles and the maximum voluntary ventilation of the lungs both in the control and with an additional weight load. It is possible that the inspiratory muscles training, aimed at increasing their strength and endurance, can be an effective strategy for minimizing the adverse effects of increased weight load when performing work with special protective equipment in various areas of human professional activity.