Neuromuscular Exercise Research Articles

ANALYZING THE EFFECTIVENESS OF PROGRAMS ON SHOULDER FUNCTION IN PATIENTS WITH KINESIOPHOBIA.

Background: Involvement of overhead activities is present in many of the games. In volleyball it’s very important. In a competitive atmosphere the collegiate players tend to get injuries, because of that they are developing apprehension. They are becoming kinesiophobia, there are very less studies are available related to this domain, Objective: This study analyzed the effectiveness of SINEX (Shoulder instability neuromuscular exercises) program on shoulder function in patients with kinesiophobia compared to HOMEX (Home based standard care exercise) program. Methods: This is an experimental study; participants were volleyball players who is kinesiophobic. Study setting was KG Campus, study duration is 6 months, and Treatment duration is 12 weeks. Total sample size was 22. By using random sampling method, the population divided into two groups. SINEX was given for Group A and HOMEX for Group B. The outcome measures were SPADI (shoulder pain and disability index) and Spiking velocity. Results: The study assessed the Shoulder function, after the training program, the player improved as well as the player was able to perform the game as well. Both SPADI and spiking velocity show positive improvement. T values of SPADI and Spiking velocity is 11.731 and 2.765 at p<0.05. Conclusion: SINEX (Shoulder instability neuromuscular exercises) program shows better improvement on shoulder function in patients with kinesiophobia compared to HOMEX (Home based standard care exercise) program.

Effects of pain neuroscience education combined with neuromuscular exercises on pain, functional disability and psychological factors in chronic low back pain: A study protocol for a single-blind randomized controlled trial.

Chronic low back pain (CLBP) is a prevalent health condition worldwide. Several therapeutic interventions aim to improve CLBP. Pain Neuroscience Education (PNE) helps patients better understand their pain from biological and physiological perspectives, which clinicians use to reduce pain and disability in patients with chronic musculoskeletal conditions. Neuromuscular exercises (NMS) are also treatments adopted in CLBP. This study will investigate whether PNE combined with an NMS program improves pain, functional and psychological outcomes more than NMS alone in patients with CLBP. In this single-blind randomized controlled trial, 60 patients (male and female; age range, 30-60 years) diagnosed with CLBP will be randomly assigned to one of the following groups: (1) PNE plus NMS (n = 30; 24 sessions of PNE plus NMS in a total of 8 weeks, 3 each week), and (2) NMS alone (n = 30; 24 sessions of NMS sessions in a total of 8 weeks, 3 each week). Outcome assessors will be blinded to the group allocation. The primary outcome will be pain. Secondary outcomes will be disability, fear-avoidance beliefs about work and physical activity, self-efficacy, exercise anxiety, and kinesiophobia. Outcomes will be assessed at baseline, after 8 weeks of intervention, and 6 months post-intervention. The findings of this RCT will help shed light on new treatment strategies to address the biopsychosocial dimensions of CLBP. The study protocol will be conducted in a clinical setting, offering the opportunity for future implementation in healthcare systems. Moreover, it will help clarify whether a combined treatment (PNE with NMS) is more effective than NMS alone for improving pain, functional and psychological outcomes in CLBP. Study registration: The study was prospectively registered in the Iranian Registry of Clinical Trials-IRCT20190427043384N2 (https://www.irct.ir/trial/69146). Registered on March 17, 2023.

Comparison of dynamic neuromusuclar stabilisation and Maitland’s mobilisation on nerve conductivity in subjects with cervical radiculopathy

Aim. To compare the effect of Dynamic Neuromuscular Stabilisation and Maitland mobilisation in improving nerve conductivity and muscle activity in patients with cervical radiculopathy Methodology. A pilot study done on 34 subjects with unilateral cervical radiculopathy was conducted based on selection criteria. Subjects were divided into 2 groups. Group DNS received Dynamic neuromuscular stabilisation exercise. Group MM received Maitland mobilisation. Pre-test was done using NCV for median nerve conductivity and EMG for pronator teres muscle activity. Following the intervention’s termination, a post-test was conducted using the same measurements. The gathered data was put to use in statistics. Result. The statistics revealed that there is no significant difference between two groups. But group DNS who were treated with Dynamic neuromuscular stabilisation showed a better improvement in nerve conductivity and muscle activity than the subjects treated with Maitland mobilisation in cervical radiculopathy.

Indirect markers of muscle damage in military physical training session with neuromuscular and aerobic exercises in circuit (Cross operational): acute effects and recoverability

The Brazilian army recently developed the military physical training “Cross Operational” (CO), composed of four different difficulty levels. The moderate/high intensity character of CO can damage the muscle fibers, characterized by alterations at the cellular level, which can be evaluated indirectly by intramuscular proteins showing up in the bloodstream. In this context, the analysis of muscle damage biomarkers can be used as part of an initial injury prevention tool and in the evaluation of training progression and post-exercise recovery. This study aimed to observe the acute effect of CO on indirect markers of muscle damage in military personnel of the Brazilian army. Twenty-four male recruits aged between 18 and 26 years participated in the study. The four sessions corresponding to the CO levels were performed in cross-design, with a seven-day washout period, and blood samples were collected at rest, immediately after, 24 and 48 hours after each training session. The measured markers were creatine kinase (CK), myoglobin (Mb) and lactate dehydrogenase (LDH). In all CO levels, CK had a significant increase 24 hours after CO, whereas Mb and LDH incresead immediately after CO. Regarding recovery time, LDH returned to baseline values within 48 hours in all levels, whereas CK and Mb, after 48 hours of recovery, reduced but did not return to baseline in level 4. The serum elevations of the biomarkers studied, like those found in studies with other consolidated physical training methods, suggest that CO can contribute to the improvement of the physical training of military personnel.

The Effect of Proprioceptive Neuromuscular Facilitation Exercise on Flexibility and Strength of Stroke Patients

The Effect of Proprioceptive Neuromuscular Facilitation Exercise on Flexibility and Strength of Stroke Patients

Effects of Neuromuscular Exercise on Dynamic Balance, Vertical Jump and Trunk Endurance in Ice Hockey Players: A Randomized Controlled Trial

This study aims to investigate the impact of a 12-week neuromuscular exercise program on balance, vertical jump, and core endurance parameters in female ice hockey players. Y balance test, vertical jump test and McGill test were used for evaluation of dynamic balance, vertical jump and trunk endurance, respectively. A 12-week training program was conducted on 50 female ice hockey players. The exercise group showed significant differences in anterior and posteromedial balance scores for both right and left (p<0.05), but there was no significant difference in posterolateral scores (p>0.05). The control group didn't show significant improvements in the vertical jump (p>0.05), while the neuromuscular exercise group demonstrated a statistically significant improvement (p<0.05). Trunk extension endurance improved significantly in the control group (p<0.05), but there were no significant differences in trunk flexion and lateral endurance (p>0.05). In contrast, the neuromuscular exercise group significantly improved all trunk endurance values (p<0.05). Neuromuscular exercise training applied to ice hockey players can improve the balance, vertical jump, and trunk endurance parameters. Therefore, the inclusion of neuromuscular exercise programs in the training programs of female ice hockey players can enhance their physical performance and may reduce the risk of injury.

Comparing the efficacy of exercise therapy on adult flexible flatfoot individuals through a network meta-analysis of randomized controlled trials

The aim of this study is to compare the efficacy of different exercise interventions for adult flexible flatfoot. Nine databases (PubMed, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), SCOPUS, PRDro, Google Scholar, China National Knowledge Infrastructure(CNKI) and Wanfang data) were systematically searched from their inception until February 2024. The search resulted in 2112 records, with 11 studies included. All networks revealed low heterogeneity and non-significant inconsistency (I2 ≤ 25.0%). Three network plots were formed for navicular drop. Firstly, compared with the control group, strengthening the posterior tibial muscle + stretching the iliopsoas muscle + TCE (MD: 3.32, 95% CI: 1.78, 4.89), PNF (MD: 1.81, 95%CI: -0.05, 3.70), SFE (MD: 1.23, 95%CI: 1.02, 1.44) all showed better effects. And strengthening the posterior tibial muscle + stretching the iliopsoas muscle + TCE exercise is considered to be the most effective intervention, with SUCRA of 0.97. Secondly, compared with the control group, hip-focused neuromuscular exercise (MD: 6.22, 95% CI: -1.69, 14.12), SFE with EMG biofeedback (MD: -0.81, 95%CI: -1.59, 3.21) all showed better effects. And hip-focused neuromuscular exercise is considered to be the most effective intervention, with SUCRA of 0.92. Thirdly, the internal foot muscle training combined with gluteus muscle strengthening is significantly better than the other two groups, with SUCRA of 0.99. For the foot posture index, comprehensive reinforcement (MD: 1.95, 95% CI − 0.19, 4.03) showed better effects compared with the control group. In the probability ranking table, comprehensive reinforcement is significantly better than the other two groups, with SUCRA of 0.98. For the foot function index, orthoses wear + stretching + eccentric progressive resistive exercise of tibialis posterior is significantly better than the other two groups, with SUCRA of 0.92. In conclusion, various exercise therapies improve the arch shape and function of patients with flexible flatfoot, particularly hip muscle and lower limb overall muscle training.

Associations between changes in leg extensor muscle power and physical function after supervised exercise in patients with hip osteoarthritis. Secondary analysis from the hip booster trial

ObjectiveTo investigate associations between changes in leg extensor muscle power of the affected limb (ΔLEP) and changes in physical function after 12 weeks of progressive resistance training (PRT) or neuromuscular exercise (NEMEX) in patients with hip osteoarthritis. DesignSecondary analyses of a randomized controlled trial. From 160 participants enrolled in the clinical trial and cluster randomized to PRT (n ​= ​82) or NEMEX (n ​= ​78), a total of 147 (92%) had complete follow-up data and were included in the analyses. Simple linear and multivariate linear regression models estimated the crude and adjusted associations between ΔLEP normalized to body weight (watt/kg) and changes in performance-based and patient-reported measures of physical function. ResultsAdjusted estimates [95% confidence intervals] showed associations between ΔLEP (watt/kg) and changes in 30-s chair stand test (β: 2.34 [1.33; 3.35], R2: 0.13), 9-step timed stair climb test (β: −1.47 [-2.09; −0.85], R2: 0.38), 40-m fast paced walking test (β: −2.20 [-3.30; −1.11], R2: 0.09), Activities of Daily Life function (β: 8.63 [3.16; 14.10], R2: 0.23) and Sport and Recreation function (β: 10.57 [2.32; 18.82], R2: 0.21) subscales from the Hip disability and Osteoarthritis Outcomes Score. Group allocation to PRT did not lead to greater regression coefficients than in NEMEX. ConclusionsChanges in leg extensor muscle power after supervised exercise are consistently associated with changes in physical function across performance-based and patient-reported measures in patients with hip osteoarthritis. These associations seem to be independent of allocation to PRT or NEMEX.

Comparative Impact of Core Stabilization vs Proprioceptive Neuromuscular Facilitation Exercises on Muscle Activation, Endurance, and Balance in Obese Children: A Randomized Controlled Trial.

BACKGROUND The purpose of the study was to compare the effects of core stabilization exercise (CSE) and proprioceptive neuromuscular facilitation (PNF) exercise on core muscle activation, core muscle endurance, proprioception, and balance in 80 obese children. MATERIAL AND METHODS In this single-blind, randomized controlled study, 80 obese children aged 10-13 years were randomly divided into 3 groups. The first group received CSE (n=27) and the second group received PNF exercises (n=27) 3 days a week for 8 weeks. The third group, which was the control group (n=26), received no treatment. Participants were evaluated before treatment (BT) and after treatment (AT) and at follow-up (3 months after treatment). Core muscle activation level was evaluated by Sahrmann Core Stability test (SCST), lumbar core muscle endurance was evaluated by McGill core endurance tests, and lumbar joint position sense (JPS) was evaluated by laser cursor. The single-leg standing balance test (SLSBT) and Y balance test (YBT) were used for static and dynamic balance, respectively. RESULTS AT and at follow-up, core activation, core endurance, JPS, and static balance were significantly different between the groups (P<0.05). There was no significant difference between the groups in YBT dominant and non-dominant side mixed reach distances (P>0.05). Clinical effect sizes were higher in the CSE group for all outcome measures. CONCLUSIONS CSE and PNF exercises improve the level of core muscle activation, lumbar core muscle endurance, lumbar JPS, and balance in obese children. However, the results of this study show that CSE are more clinically effective in obese children. The effects decline in the medium term.

A Systematic Review of the Effectiveness of Rehabilitation Programmes or Strategies to Treat People With Persistent Knee Pain Following a Total Knee Replacement.

Persistent high levels of knee pain after a total knee replacement have been estimated to affect 5%-10% of people and this is related to dissatisfaction with surgery, reduced function and reduced quality of life. This systematic review aims to evaluate the effectiveness of rehabilitation programs or strategies to reduce persistent pain and improve function and quality of life in people following a total knee replacement. The systematic review was conducted following PRISMA guidelines with a search of relevant online databases up to 17 July 2024. The search criteria included English language randomised controlled trials of rehabilitation programs or strategies in any setting to treat people with persistent knee pain more than 3 months after a total knee replacement. Rehabilitation could include exercise, education, cognitive strategies and self-management programs and excluded medication trials, procedural techniques and complementary therapies. After removal of duplicates, there were 468 abstracts screened for eligibility with 23 remaining for full-text screening and finally, one study meeting the eligibility criteria. This study's interventions were pain neuroscience education alone and pain neuroscience education plus neuromuscular exercise. There were no statistically significant between-group differences for pain reduction or functional improvement. The evidence examining the value of rehabilitation programs or strategies for pain reduction and functional improvement in people with persistent pain following total knee replacement is deficient. Given the high number of people affected annually, further research concerning both prevention and management of persistent pain after knee replacement is warranted.

Acute effects of different types of stretching exercises on explosive power: A pilot study

Athletes usually use warm-up and stretching exercises before starting a vigorous physical activity. The aim of this study was to investigate the positive and negative effects of different stretching and flexing exercises on kicking acceleration performance in taekwondo. A total of 12 elite taekwondo athletes (7 boys and 5 girls) with an average age of 20.75±1.48 years, an average height of 171±10.06 cm, an average body weight of 61.8±11 kg, and an average Body Mass Index (BMI) of 21.1±2.5 kg/m2 participated in this study. For the kick acceleration test (KAT), an accelerometer was used by attaching it to the ankle of the participants with the help of a smart phone and a smart watch. For KAT measurements, static stretching exercise (SSE), dynamic stretching exercise (DSE), proprioceptive neuromuscular facilitation exercise (PNFE) and ballistic stretching exercise (BSE) methods were applied on different days during the warm-up phase. In this study with elite level Taekwondo athletes, significant differences were found between palding chagi and dollyo-chagi kick acceleration values after SSE and PNFE applications (p

Acute effect of injury-prevention-exercise-based warm-up vs. small-sided-game-based warm-up on speed performance in young amateur soccer players

Purpose: This study aimed to investigate the effects of an Injury-Prevention-Exercise (IPE)-based warm-up and a Small-Sided-Game (SSG)-based warm-up on subsequent speed performance in young soccer players. Method: Twelve male soccer players from the fourth division regional league in Algeria participated in the study. The participants completed both the IPE-based warm-up and the SSG-based warm-up in a counterbalanced order with a one-week interval between conditions. Linear and curved sprint performances, and change of direction (COD) speed, were assessed. Results: The results showed no significant differences between the two warm-up protocols in linear sprint performance (10m and 20m tests) or COD speed (zigzag test) (p &gt; .05). However, in curved sprinting, the IPE-based warm-up demonstrated a significant improvement in the 8.5m curve sprint on the right side (p = .017, ES = -1.04). No significant differences were observed in the other curved sprint variables (17m on both sides and 8.5m on the left side). Conclusion: the findings suggest that the IPE-based warm-up may enhance speed performance in curved sprints. However, both warm-up protocols had similar effects on linear sprint performance and COD speed. Coaches and Strength and conditioning coaches should consider incorporating neuromuscular exercises in warm-ups to optimize curved sprint performance in young soccer players.

The effects of an 8-week dynamic neuromuscular stabilization exercise on pain, functional disability, and quality of life in individuals with non-specific chronic low back pain: a randomized clinical trial with a two-month follow-up study

BackgroundLow back pain (LBP) is a common disorder and is considered one of the leading causes of disability worldwide, resulting in adverse health, social, and economic outcomes. This study aimed to investigate the effects and durability of 8-week Dynamic Neuromuscular Stabilization (DNS) exercises on pain, functional disability, and quality of life in individuals aged 30 to 50 years with non-specific chronic low back pain (NSCLBP).MethodsThis research employed a pre- and post-test design with a follow-up period, in which 29 participants (16 in the control group and 13 in the exercise group) remained until the end of the study. Pain intensity, functional disability, and quality of life were assessed using the visual analog scale (VAS), the Oswestry Disability Index, and the SF-36 questionnaire, respectively, before intervention, immediately after, and two months post-intervention. The control group continued their routine daily activities, while the exercise group performed DNS exercises three times a week for 8 weeks. The data was analyzed using a mixed-design ANOVA (P ≤ 0.05).ResultsThe results showed improvements in pain (F (2,24) = 5.31, P = 0.01, η2 = 0.31), functional disability (F (2,24) = 4.17, P = 0.03, η2 = 0.26), and quality of life (F (2,24) = 4.70, P = 0.02, η2 = 0.28) in the exercise group at the Post-test compared to the Pre-test. However, the durability of the exercise effects at the follow-up assessment was not sustainable compared to the Post-test and Pre-test (P > 0.05).ConclusionAn 8-week period of DNS exercises can improve pain, functional disability, and quality of life in individuals with NSCLBP. However, a 2-month period of detraining can reduce the positive outcomes of these exercises.Trial registrationThe researchers retrospectively registered this trial on 21/04/2024, with the identifier IRCT20240107060646N1 in the Iranian Registry of Clinical Trials (IRCT) at the following address: https://irct.behdasht.gov.ir.

Manual Therapy Versus Exercise Therapy in Patients with Osteoarthritis of Knee -A Comparative Study

AIM OF THE STUDY: The aim of the study to compare the effectiveness of manual therapy versus exercise therapy in patients with knee osteoarthritis in terms of decreasing pain HYPOTHESIS • Null Hypothesis: There may be no significant difference in the effectiveness of manual therapy and exercise therapy in patients with knee osteoarthritis • Alternate Hypothesis: There may be significant difference in the effectiveness of manual therapy and exercise therapy in patients with knee osteoarthritis INTERVENTION Group A: MANUAL THERAPY Manual physiotherapy protocol consisted of Treatment is done for two sessions per week for four weeks. Knee Mandatory interventions: 1. Knee flexion, non-thrust Antero-posterior directed force to the tibia, 2. Tibio-femoral joint ,non-thrust 3. Knee extension, non-thrust Postero-anterior directed force to the tibia 4. Tibio-femoral joint, non-thrust 5. Patellar gliding force, non-thrust 6. Manual stretch to quadriceps, hamstring, triceps surae muscle groups 7. Soft tissue manipulation ,quadriceps and Peripatellar connective tissue, hamstring, hip adductor and triceps surae muscles groups Treatment is done for two sessions per week for four weeks. Group B: EXERCISE THERAPY This group performed a closely supervised standardized knee exercise program at twice a week for four weeks at eight treatment sessions. This program consists of active range of motion exercise for knee, muscle strengthening exercise for hip and knee, muscle stretching for lower limbs and riding a stationary bike. Aerobic exercises • Up to 10 minutes stationary bicycle or walk. Stretching exercises: • Standing calf stretch – 3 repetitions with 30 sec hold • Supine hamstring stretch -3 repetitions with 30 sec hold • Prone quadriceps stretch –3 repetitions with 30 sec hold Range of motion exercises: • In long sitting position, • Knee mid flexion to end range extension – two 30 sec bouts with 3 sec hold at end range • In long sitting position, knee mid flexion to end range flexion – two sec bouts with 3 sec hold at end range Strengthening exercises: • Static quad sets in knee extension –one set of 10 repetitions with 6 sec hold,10 sec rest between repetitions. • Short arc terminal extension exercises for the knee joint. • Quadriceps non-weight bearing progressive resistance exercises with weighted cuffs. • Supine Straight Leg Rise (SLR) Neuro muscular control exercises: Closed chain progression: • Seated leg press – one 30 sec bout • Standing weight –shifting exercises • Side- stepping • Step ups • Forward-backward and shuttle – walking drills RESULTS: Knee function of all patients increased significantly after the 4-week intervention program in both the groups of MANUAL THERAPY and EXERCISE THERAPY but Group A Manual therapy improved more significantly when compared to Group B Exercise therapy. CONCLUSION: Treatment effect was more in the patients received Manual therapy when compared to Exercise therapy. This finding suggest that Manual therapy can be useful intervention supplement in patients with osteoarthritis of knee.

Utility of a Neuromuscular Activation Exercise Protocol on Surgeon Posture.

Surgeons are at risk for musculoskeletal disorders from ergonomic strain in the operating room. These deficits may stem from neuromuscular control deficits. Neuromuscular activation exercises (NMEs) may strengthen the brain-muscle connection. This study aimed to assess the utility of a surgeon-oriented NME protocol on posture. Surgeons, operating room staff, and medical students completed a professionally established NME routine. An electronic application, PostureScreen®, assessed participants' posture. A long-term cohort was assessed before and after a 2 to 6-week routine. A short-term cohort was assessed immediately before and after completion. All participants additionally completed a postintervention survey. After intervention, the short-term cohort (n = 47) had significantly reduced frontal and sagittal postural deviation (P < 0.05). A significant decrease in effective head weight was additionally demonstrated with decreased neck flexion and increased cerebral-cervical symmetry (P < 0.05).The long-term cohort (n = 6) showed a significant postintervention decrease in lateral and anterior shoulder translation (P < 0.05). Total anterior translational deviations demonstrated trend-level decrease (P = 0.078). This demonstrates that after intervention, participants' shoulders were more centered with the spine as opposed to shifted right or left. Survey results showed participants favored exercises that immediately brought relief of tension. A decrease in postural deviations associated with NME in both cohorts demonstrates NME as a potential mechanism to protect surgeon musculoskeletal health and improve well-being. Survey results demonstrate areas of refinement for NME protocol design.

Comparison between Task-Oriented Training and Proprioceptive Neuromuscular Facilitation Exercise on Upper Extremity Function in Spastic Cerebral Palsy

Comparison between Task-Oriented Training and Proprioceptive Neuromuscular Facilitation Exercise on Upper Extremity Function in Spastic Cerebral Palsy

Exercise and Pain Neuroscience Education for Patients With Chronic Pain After Total Knee Arthroplasty

Up to 20% of patients develop chronic pain after total knee arthroplasty (TKA), yet there is a scarcity of effective interventions for this population. To evaluate whether neuromuscular exercise and pain neuroscience education were superior to pain neuroscience education alone for patients with chronic pain after TKA. A superiority randomized clinical trial was conducted at 3 outpatient clinics at Aalborg University Hospital in Denmark. Participants with moderate-to-severe average daily pain intensity and no signs of prosthesis failure at least 1 year after primary TKA were included. Participant recruitment was initiated on April 12, 2019, and completed on October 31, 2022. The 12-month follow-up was completed on March 21, 2023. The study included 24 sessions of supervised neuromuscular exercise (2 sessions per week for 12 weeks) and 2 total sessions of pain neuroscience education (6 weeks between each session) or the same pain neuroscience education sessions alone. The interventions were delivered in groups of 2 to 4 participants. The primary outcome was change from baseline to 12 months using the mean score of the Knee Injury and Osteoarthritis Outcome Score, covering the 4 subscales pain, symptoms, activity of daily living, and knee-related quality of life (KOOS4; scores range from 0 to 100, with higher scores indicating better outcomes). The outcome assessors and statistician were blinded. All randomized participants were included in the intention-to-treat analysis. Among the 69 participants (median age, 67.2 years [IQR, 61.2-71.9 years]; 40 female [58%]) included in the study, 36 were randomly assigned to the neuromuscular exercise and pain neuroscience education group, and 33 to the pain neuroscience education-alone group. The intention-to-treat analysis showed no between-group difference in change from baseline to 12 months for the KOOS4 (7.46 [95% CI, 3.04-11.89] vs 8.65 [95% CI, 4.67-12.63] points; mean difference, -1.33 [95% CI, -7.59 to 4.92]; P = .68). Among the 46 participants who participated in the 12-month assessment in the 2 groups, 16 (34.8%) experienced a clinically important improvement (a difference of ≥10 points on the KOOS4) with no between-group difference. No serious adverse events were observed. In this randomized clinical trial, the results demonstrated that neuromuscular exercises and pain neuroscience education were not superior to pain neuroscience education alone in participants with chronic pain after TKA. Approximately one-third of the participants, regardless of intervention, experienced clinically important improvements. Future studies should investigate which patient characteristics indicate a favorable response to exercises and/or pain neuroscience education. ClinicalTrials.gov Identifier: NCT03886259.

Efficacy of neuromuscular exercises to promote movement quality and reduce musculoskeletal injury during initial military training in Royal Navy recruits

IntroductionMusculoskeletal injuries (MSKIs) are a significant problem in the Royal Navy, contributing to 48% of all medical discharges from service between 2019 and 2020. The objective of the study was...

The Clinical Management of Electrical Stimulation Therapies in the Rehabilitation of Individuals with Spinal Cord Injuries.

Background: People with spinal cord injuries (SCIs) often have trouble remaining active because of paralysis. In the past, exercise recommendations focused on the non-paralyzed muscles in the arms, which provides limited benefits. However, recent studies show that electrical stimulation can help engage the paralyzed extremities, expanding the available muscle mass for exercise. Methods: The authors provide an evidence-based approach using expertise from diverse fields, supplemented by evidence from key studies toward the management of electrical stimulation therapies in individuals with SCIs. Literature searches were performed separately using the PubMed, Medline, and Google Scholar search engines. The keywords used for the searches included functional electrical stimulation cycling, hybrid cycling, neuromuscular electrical stimulation exercise, spinal cord injury, cardiovascular health, metabolic health, muscle strength, muscle mass, bone mass, upper limb treatment, diagnostic and prognostic use of functional electrical stimulation, tetraplegic hands, and hand deformities after SCI. The authors recently presented this information in a workshop at a major rehabilitation conference. Additional information beyond what was presented at the workshop was added for the writing of this paper. Results: Functional electrical stimulation (FES) cycling can improve aerobic fitness and reduce the risk of cardiovascular and metabolic diseases. The evidence indicates that while both FES leg cycling and neuromuscular electrical stimulation (NMES) resistance training can increase muscle strength and mass, NMES resistance training has been shown to be more effective for producing muscle hypertrophy in individual muscle groups. The response to the electrical stimulation of muscles can also help in the diagnosis and prognosis of hand dysfunction after tetraplegia. Conclusions: Electrical stimulation activities are safe and effective methods for exercise and testing for motor neuron lesions in individuals with SCIs and other paralytic or paretic conditions. They should be considered part of a comprehensive rehabilitation program in diagnosing, prognosing, and treating individuals with SCIs to improve function, physical activity, and overall health.

The Role of Dynamic Neuromuscular Stabilization Exercises in Stress Urinary Incontinence Among Females Aged 18-40 Years

The Role of Dynamic Neuromuscular Stabilization Exercises in Stress Urinary Incontinence Among Females Aged 18-40 Years