Neuromuscular Exercise Research Articles

Comparing the Efficacy of Dynamic Neuromuscular Stabilization Exercises and Kegel Exercises on Stress Urinary Incontinence in Women: A Pilot Study.

Background and objective Stress urinary incontinence (SUI) is a prevalent condition affecting women of various age groups, significantly impacting their quality of life. To address this multifaceted issue, a comprehensive approach that goes beyond traditional pelvic floor exercises is needed. Dynamic neuromuscular stabilization (DNS) exercises, targeting the integrated spinal stabilization system, offera promising alternative. Thus, this study aimed to compare the effectiveness of DNS exercises and Kegel exercises in managing SUI among women. Methods This single-blinded, pilot study involved 24 women aged 18-40 years with mild to moderate SUI. Participants were divided into DNS and Kegel exercise groups. Outcome measures included perineometer readings, electromyography (EMG) data, and the Urogenital Distress Inventory-6 (UDI-6). Statistical analysis compared baseline and 12-week data within and between groups, and rank-biserial correlation coefficient (r) as a measure of effect size in our study wascalculated. Results At 12 weeks, the DNS group showed significant improvement in pelvic floor muscle strength compared to Kegel exercises (p = 0.005). Both groups had significantly enhanced pelvic floor muscle strength (p < 0.05). A significant change occurred for EMG average, EMG peak, and EMG maximum voluntary contraction (MVC) at 12 weeks (average p = 0.005; peak p = 0.001; MVC p = 0.009), with significant improvements in both groups (p < 0.05). For UDI-6, a significant difference emerged between the two groups at 12 weeks (p < 0.05), with significant improvements in both groups individually from baseline to 12 weeks (p < 0.05). The effect size "r" for all variables indicated a medium to large effect size, underscoring the substantial and significant impact of DNS exercises in managing SUI among women compared to Kegel exercises. Conclusion This study suggests that DNS exercises, emphasizing the coordinated activation of the diaphragm, abdominals, multifidus, and pelvic floor, may provide a more effective approach for managing SUI in women compared to traditional Kegel exercises.

Effects of yoga exercise in reducing the risk of knee osteoarthritis and fibulin-3 levels among overweight population: a randomized controlled trial

Background and purpose: One of the main risk factors for knee osteoarthritis is overweight. The purpose of this study is to determine the effectiveness of yoga exercise in reducing the risk of knee osteoarthritis and fibulin-3 levels in overweight populations. Methods: This study was a randomized controlled trial involving 24 participants who met the inclusion and exclusion criteria. Participants were randomly divided into two groups: group one was given yoga exercise intervention and group two was given neuromuscular coordination exercise as the control group. Risk of knee osteoarthritis measurements were carried out using The Western Ontario and McMasters University Osteoarthritis Index (WOMAC). Fibulin-3 measurement used ELISA technique using human fibulin-3 kit, FBLN3 BT-LABkit 96T E4667Hu. Results: Participants of both groups were comparable, except for age where the control group is slightly older. Pre and post-test comparison showed improvement in pain, stiffness, physical function, total WOMAC score, and fibulin-3 levels in both groups. While, the post-test comparison between the two groups showed that yoga group has better scores on all indicators compared to the control groups which was statistically significant (p≤0.001). Conclusion: Both interventions are effective in reducing the risk of knee osteoarthritis and fibulin-3 levels, but yoga showed better result. We recommend yoga training to reduce the risk of knee osteoarthritis compared to conventional training. Future research is needed to measure other knee osteoarthritis biomarkers that describe the pathological process of knee osteoarthritis.

Neuromuscular Dysfunction Precedes Cognitive Impairment in a Mouse Model of Alzheimer's Disease.

Alzheimer's disease (AD) develops along a continuum that spans years prior to diagnosis. Decreased muscle function and mitochondrial respiration occur years earlier in those that develop AD; however, it is unknown what causes these peripheral phenotypes in a disease of the brain. Exercise promotes muscle, mitochondria, and cognitive health and is proposed to be a potential therapeutic for AD, but no study has investigated how skeletal muscle adapts to exercise training in an AD-like context. Utilizing 5xFAD mice, an AD model that develops ad-like pathology and cognitive impairments around 6 mo of age, we examined in vivo neuromuscular function and exercise adapations (mitochondrial respiration and RNA sequencing) before the manifestation of overt cognitive impairment. We found 5xFAD mice develop neuromuscular dysfunction beginning as early as 4 mo of age, characterized by impaired nerve-stimulated muscle torque production and compound nerve action potential of the sciatic nerve. Furthermore, skeletal muscle in 5xFAD mice had altered, sex-dependent, adaptive responses (mitochondrial respiration and gene expression) to exercise training in the absence of overt cognitive impairment. Changes in peripheral systems, specifically neural communication to skeletal muscle, may be harbingers for AD and have implications for lifestyle interventions, like exercise, in AD.

A scoping review of the different types of exercise programs proposed for the improvement of postural balance in adolescents with idiopathic scoliosis.

Adolescent idiopathic scoliosis (AIS), which is the most common type of scoliosis, is a progressive disease that occurs in children aged 10-16 years. Abnormal curvature in AIS provokes spinal asymmetry of the upper body alignment and might deteriorate postural balancing and control ability. To evaluate the effect of exercise interventions on balance and postural stability in patients with adolescent idiopathic scoliosis. Embase, Scopus, Pubmed (Medline) and Web of Science databases were searched using the terms idiopathic scoliosis, physiotherapy, and balance. The articles selected were published in English in peer-reviewed journals from 2012 to July 2022. Ten studies met the inclusion criteria. The PEDro scale values ranged from 2 to 6 (mean, 3.6), indicating a low level of scientific rigor. In the sample studies, spinal stabilization exercises were most often trialed (n= 3), followed by Schroth's exercise (n= 2), stretching and self-elongation exercise (n= 2), the exercise protocol of Blount and Moe, physiotherapeutic scoliosis-specific exercise, and proprioceptive neuromuscular facilitation exercise (all n= 1). Physical therapists will be able to apply hippotherapy, Schroth exercise, physiotherapy scoliosis-specific exercise, trunk stabilization, proprioceptive neuromuscular facilitation exercise, spinal stabilization exercise, core stabilization exercise, and body awareness therapy to manage balance impairments in patients with adolescent idiopathic scoliosis, and further studies are needed to provide stronger evidence.

The Effect Of Integrated Neuromuscular Inhibition Technique On Improving Neck Functional Ability In Tension-Type Headache

Tension-type headache is one of the most common complaints of musculoskeletal pain due to myofascial trigger points. The presence of pain and soreness in the neck and head, tightness, stiffness, spasms, and limitation of motion is a complaint that is often experienced by patients. Methods: This study aims to determine the effect of the Integrated Neuromuscular Inhibition Technique exercise on increasing the functional ability of the neck in Tension-Type Headache conditions. This research is a pre-experimental study with a pre-test and post-test one-group design using an accidental sampling technique with a total sample of 30 people. The place of research was conducted at the Telkomedika Makassar Clinic. A tool to measure the functional ability of the neck using the Neck Disability Index (NDI). Result: The results of the study were an increase in the functional ability of the neck based on measurements of the Neck Disability Index (NDI), namely a pre-test value of 48.80 to a post-test of 41.13 in the condition of Tension-Type Headache at the Telkomedika Clinic Makassar because after being given Integrated Neuromuscular Inhibition Technique therapy (INIT) decreased neck pain, decreased spasm of the neck muscles, and increased functional ability of the neck. Conclusion: Integrated Neuromuscular Inhibition Technique exercises can improve the functional ability of the neck in Tension-Type Headache conditions at the Telkomedika Clinic in Makassar.

Effects of a school-based integrative neuromuscular training exercise intervention on physical fitness among children with autism spectrum disorder

Effects of a school-based integrative neuromuscular training exercise intervention on physical fitness among children with autism spectrum disorder

Neuromuscular Response during Different Side-Cutting Maneuvers and Its Influence on the Risk of Knee Injuries.

The objective of this study was to investigate the impact of a customized exercise program on electromyographic (EMG) variables during side-cutting maneuvers. Fifty-seven physically active volunteers were recruited and randomized into two groups: a control group (CG) and an experimental group (EG). The CG maintained their regular physical activity, while the EG followed an individualized, integrated exercise regimen that included strength, neuromuscular, proprioceptive, eccentric training, and whole-body vibration (WBV) exercises, lasting for 12 weeks. EMG-Root Means Square (RMS) values for the quadriceps (Q) and hamstrings (H) were measured immediately following initial foot contact at 50, 100, 150, and 200 milliseconds. Changes in EMG activity were evaluated before and after a twelve-week intervention, and the effect size (ES, 90% confidence limit [90%CL]) was calculated. The results showed that the EG participants exhibited enhanced co-contraction as measured by the hamstring/quadriceps ratio (H/Q ratio) during both open and cross-cutting side maneuvers after the twelve-week intervention. Furthermore, the customized, integrated exercise program that combined strength, neuromuscular, proprioceptive, eccentric training, and WBV exercises were could potentially serve as a beneficial neuromuscular and biomechanical strategy for addressing knee injury risk in non-professional, physically active populations at high risk for such injuries.

A self-managed exercise therapy program for wrist osteoarthritis: study protocol for a randomized controlled trial

BackgroundPost-traumatic wrist osteoarthritis (OA) can eventually lead to pain, muscular weakness, and stiffness of the wrist, which can affect the function of the entire upper limb and reduce the quality of life. Although there is strong evidence that all patients with OA should be offered adequate education and exercises as a first-line treatment, an effective self-management program, including structured education and therapeutic exercises, has not yet been introduced for individuals with wrist OA. This trial aims to evaluate the effectiveness of an exercise therapy program with joint protective strategies to improve neuromuscular control (intervention group) compared to a training program with range of motion exercises (control group).MethodsThis is a single-blinded randomized controlled trial (RCT) with two treatment arms in patients with symptomatic and radiographically confirmed wrist OA. The trial will be conducted at a hand surgery department. The participants will be randomly assigned either to a neuromuscular exercise therapy program or to a training program with range of motion exercises only. Participants in both groups will receive a wrist orthosis and structured education on wrist anatomy, pathophysiology, and joint protective self-management strategies. The programs consist of home exercises that will be performed twice a day for 12 weeks. The Patient-Rated Wrist Evaluation (PRWE) is the primary outcome measure of pain and function. Wrist range of motion (ROM), grip strength, the Numeric Pain Rating scale (NPRS), Disabilities of the Arm, Shoulder, and Hand (DASH), the General Self-Efficacy Scale (GSES), Global Rating of Change (GROC), and conversion to surgery are the secondary measures of outcome. Assessments will be performed at baseline and at 3, 6, and 12 months after baseline by a blinded assessor.DiscussionThe upcoming results from this trial may add new knowledge about the effectiveness of a self-managed exercise therapy program on pain and function for individuals with wrist OA. If the present self-management program proves to be effective, it can redefine current treatment strategies and may be implemented in wrist OA treatment protocols.Trial registrationClinicalTrials.gov, NCT05367817. Retrospectively registered on 27 April 2022. https://clinicaltrials.gov.

Mechanisms Underlying Menstrual Cycle Effects on Exercise Performance: A Scoping Review

This scoping review aims to provide a comprehensive overview of biological mechanisms underlying the menstrual cycle’s impact on various performance-determining anatomical and physiological parameters. It is intended to identify the various proposed vital concepts and theories that may explain performance changes following hormonal fluctuations. The review was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews protocol. A framework of six groups was built such as skeletal muscle physiology, muscle damage, tendons and ligaments, neuromuscular control, cardiovascular system, and exercise metabolism to cluster studies thematically and to specify the concept of “performance.” Original research studies published between 1970 and 2021 that were conducted with a naturally menstruating population were considered. Changes in performance regarding the menstrual cycle phase were crucial for inclusion. Topic-specific reviews and systematic reviews were included if they addressed the impact of female steroid hormones on any structure or part of the human body. The review indicates that the impact of estrogen and progesterone is primarily responsible for observed changes in athletic performance during the menstrual cycle. Estrogen seems capable of fostering protein synthesis, diminishing collagen metabolism, preventing muscle damage due to its antioxidant effects, and restraining inhibitory, while promoting excitatory, control by interacting with neurotransmitters. Progesterone is assumed to increase thermoregulation and enhance ventilatory drive by interacting with hypothalamic pathways and may further amplify inhibitory control by interacting with neurotransmitters. The female steroid hormones and the endocrinologic system collaborate in complex interrelationships with biological systems to maintain homeostasis. However, proposed mechanisms are often derived from animal studies and studies conducted in vitro and still remain to be proven true in the human regularly menstruating population. In the future, it is crucial to rely on studies that followed the methodology for cycle monitoring recommendations thoroughly. Otherwise, it is not possible to determine whether hormonal fluctuations cause observed changes in performance or not.

Feasibility of pain informed movement program for people with knee osteoarthritis

ObjectiveTo establish the feasibility of an intervention consisting of neuromuscular exercise, mind-body techniques, and pain neuroscience education (PNE), referred to as Pain Informed Movement in people with knee Osteoarthritis (KOA). This program has the potential to improve our understanding of intrinsic pain modulation and its role in the management of chronic pain. MethodsThis was a single-arm feasibility trial with a nested qualitative component. Primary outcome: complete follow-up. Inclusion criteria: age ≥40 years, KOA clinical diagnosis or meeting KOA NICE criteria, and pain intensity ≥3/10. The program consisted of 8-week in-person and at-home exercise sessions. PNE and mind-body techniques were provided as videos and integrated into the exercise sessions. Participants completed questionnaires and physical assessments including blood draws at baseline and program completion. Secondary feasibility outcomes: acceptability of the intervention, burden, rates of recruitment, compliance and adherence, and adverse events. A priori success criteria were identified. Participants were invited to an online focus group. Results19 participants were enrolled, with a complete follow-up rate of 74% (mean age 63.3 years (SD 10.5), 73% female), indicating modifications were necessary to proceed. All other success criteria were met. The focus groups revealed that the video content pertaining to the mind-body techniques would benefit from on screen demonstrations. ConclusionThe Pain Informed Movement program is deemed feasible, with minor modifications needed to proceed. A pilot two-arm RCT will be conducted to establish the feasibility and explore potential effects of Pain Informed Movement compared to conventional neuromuscular exercise and standard OA education.

Pain Informed Movement for people with knee osteoarthritis: Protocol for a pilot randomized controlled trial

ObjectiveConservative pain management strategies for knee osteoarthritis (KOA) have limited effectiveness and do not employ a pain-mechanism informed approach. Pain Informed Movement is a novel intervention combining mind-body techniques with neuromuscular exercise and pain neuroscience education (PNE), aimed at improving endogenous pain modulation. While the feasibility and acceptability of this program has been previously established, it now requires further evaluation in comparison to standard KOA care. DesignThis protocol describes the design of a pilot two-arm randomized controlled trial (RCT) with an embedded qualitative component. The primary outcome is complete follow-up rate. With an allocation ratio of 1:1, 66 participants (33/arm) (age ≥40 years, KOA diagnosis or meeting KOA NICE criteria, and pain intensity ≥3/10), will be randomly allocated to two groups that will both receive 8 weeks of twice weekly in-person exercise sessions. Those randomized to Pain Informed Movement will receive PNE and mind-body technique instruction provided initially as videos and integrated into exercise sessions. The control arm will receive neuromuscular exercise and standard OA education. Assessment will include clinical questionnaires, physical and psychophysical tests, and blood draws at baseline and program completion. Secondary outcomes are program acceptability, burden, rate of recruitment, compliance and adherence, and adverse events. Participants will be invited to an online focus group at program completion. ConclusionThe results of this pilot RCT will serve as the basis for a larger multi-site RCT aimed at determining the program's effectiveness with the primary outcome of assessing the mediating effects of descending modulation on changes in pain.

Neuromuscular exercise and counseling for treating recurrent low back pain in female healthcare workers-Findings from a 24-month follow-up study of a randomized controlled trial.

Female healthcare workers have a high prevalence of low back pain (LBP)-related sickness absence. Here, we report findings of a 24-month follow-up of a previously published 6-month randomized controlled trial (RCT). By adopting an RCT with 6 months of intervention and follow-up at 6, 12, and 24 months, we assessed the maintenance of changes in the effectiveness (LBP and fear of pain) of the interventions (neuromuscular exercise [NME], back-care counseling, both combined) using a generalized linear mixed model adjusted for baseline covariates. The incremental cost-effectiveness ratio was calculated in terms of quality-adjusted life years (QALY). A bootstrap technique was used to estimate the uncertainty around a cost-effectiveness acceptability curve. Of the 219 females, 71% had data at 24 months. Between 6 and 24 months, LBP intensity (primary outcome) remained low in all intervention arms (-20% to -48%) compared to the control (-10% to -16%). Pain interfering with work remained low in the combined and exercise arms for up to 24 months. At 24 months, the total costs were lowest in the combined arm (€484 vs. €613-948, p < 0.001), as were the number of back-related sickness absence days (0.16 vs. 1.14-3.26, p = 0.003). The analysis indicated a 95% probability of the combined arm to be cost-effective per QALY gained at €1120. Six months of weekly NME combined with four counseling sessions was cost-effective for treating LBP and the effect was maintained over 24 months. ClinicalTrials.gov, NCT01465698, 7/11/2011, prospective.

The Effect of Local-indigenous Games and Neuro-muscular Exercises on Static and Dynamic Balance in Obese Children

Purpose: This study aims to investigate the impact of neuromuscular exercises (NE) and local-indigenous games (LIG) on the static and dynamic balance of obese children. Methods: Thirty obese children were randomly assigned to NE (n=15, mean age 10.47±2.1 years, body mass index (BMI) 29.15±3.01 kg/m2) or LIG (n=15, mean age 10.67±1.52 years, body mass index (BMI) 29.45±3.41 kg/m2) groups. Both groups underwent 12 training sessions, during which dynamic and static balance were measured with the Biodex device before and after training. Analysis of covariance (ANCOVA) and independent t-test were used to compare balance indices between the two groups. Results: No significant differences were observed in static anterior-posterior balance between NE (0.82±0.10) and LIG (0.68±0.09). Similarly, no significant differences were found in static lateral-medial balance (NE: 0.82±0.10; LIG: 0.68±0.09) (P&gt;0.05). Moreover, the dynamic anterior-posterior balance did not differ significantly between NE (0.79±0.08) and LIG (0.97±0.26) as well as the dynamic lateral-medial balance did not differ significantly (NE: 0.74±0.10; LIG: 0.93±0.15) (P&gt;0.05). Conclusion: This study suggests that both NE and LIG are effective in improving balance indices in obese children. However, no significant differences were observed between the two interventions.

The Effect of Dynamic Neuromuscular Stabilization Exercises on Balance and Fear of Falling in Female Elderly

Introduction: The present study was an attempt to investigate the effect of a course of dynamic neuromuscular stabilization (DNS) exercises on balance and fear of falling in female elderly with a history of falling.&#x0D; &#x0D; Methods: In this quasi-experimental study, 30 female elderly people with a history of falling based on entry and exit criteria were purposefully selected as a sample of study. Then, they were randomly assigned into two control and exercise groups. The variables related to static balance and dynamic balances were assessed by sharpened Romberg Test and Standing Up and Walking Test, respectively. Also, Falls Efficacy Scale International was used to measure the fear of falling. The exercise group performed DNS exercises for 8 weeks, 3 sessions, and 50 minutes per session. Data were analyzed by using paired t-test and analysis of covariance in SPSS24 software at the significant level of p &lt; 0.05.&#x0D; &#x0D; Results: A significant difference between pretest and posttest in static balance with open eyes (p = 0.0001, t = -7.19), static balance with closed eyes (p = 0.0001, t = -8.02), dynamic balance (p = 0.0001, t = 6.49) and fear of falling (p = 0.0001, t = 7.29) in DNS exercise group. Also, there were significant differences between DNS and control groups in static balance with open eyes (p = 0.0001, F = -14.67), static balance with closed eyes (p = 0.0001, F = 14.002), dynamic balance (p = 0.0001, F = 20.12) and fear of falling (p = 0.006, F = 09.07).&#x0D; &#x0D; Conclusion: It is recommended that therapists use dynamic neuromuscular stabilization exercises in female elderly to improve balance and reduce the fear of falling.

Effects of Eight-week Dynamic Neuromuscular Stabilization Exercises on the Static and Dynamic Balance of Educable Mentally Retarded Female Students

Background and Aims Balance is an important factor in people with intellectual disability to have an independent life. These people are weak static and dynamic balance due to lack of development in their central nervous system, defects in the sensory-motor pathways, and having a sedentary life. This study aims to determine the effect of eight weeks of dynamic neuromuscular stabilization (DNS) exercises on static and dynamic balance of educable mentally retarded female students Methods In this study, participants were 26 educable mentally retarded female students aged 15-20 years (Mean age: 17.19±1.50 years, IQ: 61.15±6.07, weight: 58.9±12.73 kg, height: 157.92±6.07 cm) who were selected using purposive and convenience sampling methods and randomly divided into two groups of training (n=13) and control (n=13). Before and after training, their static balance and dynamic balance on the right and left feet were evaluated using a foot scan device. Subjects in the training group performed DNS exercises at 24 sessions, each session for 40 minutes. No intervention was provided to the control group; they performed their routine activities. Repeated measures analysis of variance was used to analyze the data. The significance level was set at 0.05. Results After eight weeks of DNS exercises, the results showed a significant improvement in static balance (F=72.54, P=0.001), dynamic balance on the right foot (F=90.90, P=0.002) and dynamic balance on the left foot (F=61.58, P=0.001) in the training group compared to the pretest scores and compared to the control group. Conclusion DNS exercises can be used as an effective method to improve static and dynamic balance of educable mentally retarded female students.

The effect of mindfulness and motivational interviewing along with neuromuscular exercises on pain, function, and balance of women affected by knee osteoarthritis: a rater-blinded randomized controlled clinical trial

Purpose This study aimed to evaluate the effect of motivational interviewing (MI) and mindfulness (MF) added to neuromuscular (NM) exercises on improving pain, function, balance, and quality of life in patients with knee osteoarthritis (KOA). Methods This randomized clinical trial was conducted on sixty patients who were randomly assigned to the MI + NM, MF + NM, and NM groups. The groups received four training sessions for six weeks. Physical function with Western Ontario and McMaster Universities Arthritis Index timed up and go, going up and down eight stairs, pain with visual analogue scale, quality of life with SF36, and balance with Biodex were evaluated before and after interventions. Results Within-group comparisons showed that NM + MI, NM + MF, and NM groups experienced significant improvement in all factors after six-week (p < 0.05). However, between groups, comparisons in the post-test revealed that the MI + NM group had a more significant effect on pain, function, and static balance than the MF + NM group. Nevertheless, the MF + NM group improved the quality of life better than the MI + NM and NM groups (p < 0.05). Conclusion Adding psychological interventions to physical exercises had a better effect on improving the symptoms of patients. Additionally, the MI showed more effectiveness in improving the symptoms of patients.

Impact of Different Physiotherapy Programs on Balance and Gait in Patients with Cerebral Infarction

Background. An ischemic stroke has long-term adverse effects on the physical, emotional, and social well-being of the stroke survivor, so it is very important to help the patient regain independence and lost functions as quickly and efficiently as possible. Dynamic Neuromuscular Stability exercises can restore movement patterns in these patients by simulating central nervous system.&#x0D; The aim. To compare the effects of conventional physiotherapy and dynamic neuromuscular stabilization integrated into conventional physiotherapy on balance and gait in patients with cerebral infarction.&#x0D; Methods. The study included 30 subjects who survived an ischemic stroke. Subjects were randomly divided into two groups of 15 people in each for different interventions: Conventional physiotherapy and Conventional physiotherapy combined with integrated dynamic neuromuscular stabilization. Subjects were examined at a baseline and after the interventions. Patients’ balance was assessed using the Biodex platform, which was chosen to evaluate fall risk, trunk stability, stability limits and sensory organization. Gait parameters (step length and step width) of the affected and unaffected leg were assessed using the Zebris FDM-T treadmill.&#x0D; Results. Both conventional physiotherapy and physiotherapy with integrated dynamic neuromuscular stabilization improved gait parameters of the patients, as well as improving the results of the tests of fall risk, postural stability, stability limits, and the results of the sensory integration test when testing with eyes open on a stable surface (p&lt;0.05). However, the results of the sensory integration tests while standing on a stable surface with eyes closed (p&lt;0.001), with eyes open on an unstable surface (p&lt;0.001) and with eyes closed on an unstable surface (p=0.021) improved only post physiotherapy with integrated dynamic neuromuscular stabilization.&#x0D; Conclusions. Both conventional physiotherapy and physiotherapy with integrated dynamic neuromuscular stabilization significantly improved gait and balance parameters in stroke patients.&#x0D; Keywords: Dynamic neuromuscular stabilization, stroke, balance, trunk stability, gait.

Injury-Reduction Programs Containing Neuromuscular Neck Exercises and the Incidence of Soccer-Related Head and Neck Injuries.

Concern is growing among soccer players, coaches, and parents regarding head and neck injuries, including concussion, particularly from heading a ball. Thus, we need to explore soccer-specific head injury risk-reduction initiatives. One such initiative is to condition the neck musculature of young players by adding neuromuscular neck exercises to existing injury-reduction exercise programs. To investigate the effect of neuromuscular neck exercises completed as part of an injury risk-reduction exercise program on the incidence of soccer-related head and neck injuries in adolescent soccer players. Prospective cohort study. Two sports high schools and 6 soccer clubs during the 2021 soccer season. A total of 364 male and female soccer players, aged 12 to 18 years. Members of 1 sports high school and 2 soccer clubs performed neuromuscular neck exercises as part of an injury-reduction program during training (neck training group). Members of another sports high school and 4 soccer clubs performed an injury-reduction program but without neck exercises (comparison group). Self-reported injury data were collected from each player at the end of the season and used to calculate incidence rate ratios (IRRs) with 95% CIs. In total, 364 players completed the study, including 146 players in the neck training group and 218 players in the comparison group. Despite players in the neck training group being less likely to self-report a concussion (IRR = 0.23; 95% CI = 0.03, 1.04) and pain on heading a ball (IRR = 0.62; 95% CI = 0.34, 1.07), only a lower incidence of possible concussive events (IRR = 0.38; 95% CI = 0.14, 0.90; P < .05) was significant. Integrating neuromuscular neck exercises into injury-reduction exercise programs has the potential to reduce the risk of adolescent soccer players sustaining a possible concussive event, concussion, or pain on heading a ball.

Individualized Mental Fatigue Does Not Impact Neuromuscular Function and Exercise Performance.

Recent studies have questioned previous empirical evidence that mental fatigue negatively impacts physical performance. The purpose of this study is to investigate the critical role of individual differences in mental fatigue susceptibility by analyzing the neurophysiological and physical responses to an individualized mental fatigue task. In a pre-registered (https://osf.io/xc8nr/), randomized, within-participant design experiment, twenty-two recreational athletes completed a time to failure test at 80% of their peak power output under mental fatigue (individual mental effort) or control (low mental effort). Before and after the cognitive tasks, subjective feeling of mental fatigue, neuromuscular function of the knee extensors, and corticospinal excitability were measured. Sequential Bayesian analysis until it reached strong evidence in favor of the alternative hypothesis (BF10 > 6) or the null hypothesis (BF10 < 1/6) were conducted. The individualized mental effort task resulted in a higher subjective feeling of mental fatigue in the mental fatigue condition: 0.50 (95%CI 0.39 - 0.62) AU compared to control: 0.19 (95%CI 0.06 - 0.339) AU. However, exercise performance was similar in both conditions (control; 410 (95%CI 357 - 463) vs. mental fatigue 422 (95%CI 367 - 477) seconds, BF10 = 0.15). Likewise, mental fatigue did not impair knee extensor maximal force generating capacity (BF10 = 0.928) and did not change the extent of fatigability or its origin after the cycling exercise. There is no evidence that mental fatigue adversely affects neuromuscular function or physical exercise, even if mental fatigue is individualized, computerized tasks seem not to affect physical performance.

The effects of a two-week neuromuscular intervention on biopsychosocial variables in people with patellofemoral pain: an observational study.

Patellofemoral pain (PFP) is common and predominately affects active populations. Altered biomechanics and psychosocial variables have been reported in people with PFP, but the effects of neuromuscular exercise on these variables is unknown. We aimed to investigate changes in biopsychosocial measures following a two-week neuromuscular intervention in people with PFP. We measured pain (visual analogue scale), function (Kujala), activity level (Tegner), psychological well-being (Orebro), lower-limb isometric strength (handheld dynamometry), three-dimensional (3D) lower limb kinematics, and surface electromyography (sEMG), in people with PFP. 3D lower-limb kinematics and sEMG were synchronously sampled during step-up, step-down, and overground running. All measures were repeated after participants had completed a two-week neuromuscular intervention consisting of three exercises completed once per day, five days per week. 18 participants completed pre/post testing (60% females, mean age 30.6 years ±7.0, height 173.4cm ±10.4, mass 70.2kg ±12.4, symptom duration 39.0 months ±58.8), with three of 21 participants lost to follow-up. Across all clinical measures (muscle onsets, muscle activation and kinematics), the 95% bootstrapped confidence intervals (CI) of the mean difference contained the null hypothesis following the two-week neuromuscular intervention, indicating no significant differences. A two-week neuromuscular intervention did not change biomechanical or psychosocial measures in people with PFP. Interventions with a longer duration or greater load magnitude are required to fully evaluate the biopsychosocial mechanisms of effect for exercise in people with PFP.