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Neslihan Duruturk, Nihan Ozunlu Pekyavas, Atakan Yρlmaz and Metin Karatas

Objective:

Aerobic and anaerobic exercise capacities are important components of athletic performance. The use of Kinesio Taping® (KT) as a supplementary treatment in athletic settings has increased in the recent years. KT can facilitate muscle contraction, which may be useful for improving performance. The purpose of this study was to determine whether the application of KT to the quadriceps muscle has any effect on anaerobic and aerobic performance in young healthy individuals.

Design:

Randomized, controlled, double-blind clinical study.

Setting:

Baskent University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation.

Patients:

Thirty-two healthy male participants were randomly assigned to either the KT group or a sham KT (SKT) group.

Interventions:

The KT muscle facilitation technique was applied to the quadriceps muscle bilaterally and measurements were taken 45 min later to ensure full adhesion.

Main Outcome Measures:

The Wingate cycle ergometer test was used to assess peak anaerobic power (peak AnP, in Watts) and exercise capacity (Watt/kg), while the 6-minute walk test (6MWT) was used to assess aerobic exercise capacity of the participants. Comparisons between groups were performed using the nonparametric Mann-Whitney U test, while those between baseline and posttaping used the nonparametric Wilcoxon test.

Results:

No significant difference was found between the two groups in the aerobic or anaerobic test parameters (p > .05). Within the groups, a significant improvement in time factors in peak AnP (929.7 2 ± 184.37 W to 1043.49 ± 224.42 W) was found only in the KT group (p = .028) and no other parameter was significantly different (p > .05).

Conclusions:

KT applied to the quadriceps muscle can positively improve anaerobic exercise performance and athletic performance capacity. However, KT did not affect aerobic capacity. Further research is needed to show that KT can improve and support anaerobic and aerobic exercise capacity in healthy participants or athletes.

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Derya Celik, Ahmet Dirican and Gul Baltaci

Context: Handheld dynamometry (HHD) is considered an objective method of measuring strength, but the reliability of the procedure can be compromised by inadequate tester strength and insufficient stabilization of the dynamometer especially, for the scapular muscles. Objective: Primarily, to determine the intrarater reliability of HHD when testing shoulder and scapular muscle strength, and secondarily, to report reliability when corrected for body-mass index (BMI). Design: Technical report. Setting: University physiotherapy department. Participants: 57 adults (17 men, 40 women; mean age = 35.05 ± 13.5 y), both healthy individuals and patients with shoulder impingement. Intervention: HHD. Main Outcome Variables: Muscle strength of the upper, middle, and lower trapezius; anterior deltoid; serratus anterior; supraspinatus; and latissimus dorsi determined by HHD. Each muscle was assessed 3 times, and the mean value was calculated. The subjects were divided into 3 groups according to BMI. Group 1: BMI ≤ 20 kg/m2 (n = 22); Group 2: BMI ≤ 24.9 kg/m2 (n = 54); and Group 3: BMI ≤ 29.9 kg/m2 (n = 38). Results: Correlations were calculated for each pair of strength scores. Intraclass correlation coefficients (ICCs) ranged from .77 to .99 in healthy subjects and from .75 to .99 in patients, for all muscle groups except the upper trapezius (P < .05). Reliability values ranged from good to high in healthy subjects but were less consistent for the upper trapezius (ICC .45-.65). The relationship with BMI and muscle strength illustrates that as BMI increases, there is a decrease in reliability values of the lower trapezius (ICC = .35-.65). Conclusion: The study demonstrates that evaluating the strength of scapular and shoulder muscles using HHD presents reliable results for both patients with impingement syndrome and healthy subjects. Reliability values were compressed when testing the trapezius in subjects with higher BMI. This is likely a result of the examiner's difficulty in overcoming the patients with this maneuver.

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Irem Duzgun, Gul Baltaci, Filiz Colakoglu, Volga Bayrakci Tunay and Derya Ozer

Objective:

To investigate the effect of a 12-wk weighted-jump-rope training program on shoulder strength.

Design:

Pretest to posttest experimental design.

Setting:

University sports physiotherapy laboratory.

Participants:

24 healthy volleyball players age 13-16 y.

Intervention:

Group 1 took weighted-rope training (n = 9), group 2 took unweighted-rope training (n = 8), and group 3 did not train with any specific program (n = 7).

Main Outcome Measures:

Players’ strength determined with an isokinetic dynamometer (Isomed 2000) at 180 and 60°/s on external and internal rotators, supraspinatus peak torque, and total work of the dominant shoulder. Kruskal–Wallis and Mann–Whitney U tests were used to determine the difference among the groups.

Results:

At pretraining evaluation, there were no significant differences in the test scores of the isokinetic test of full can and empty can between the groups at 60 and 180°/s. There was no statistically significant difference for 60 and 180°/s between pretraining and posttraining assessment (P > .05) except that total eccentric work increased in groups 1 and 3 but decreased in group 2 at 180°/s during the full can (P < .05). There was no significant difference among the groups between the pretraining and posttraining testing at both 180 and 60°/s for the empty can (P > .05). Internal-rotation values at 60 and 180°/s decreased for both peak torque and total work for all groups. External-rotation peak torque and total work at 60°/s increased for group 1. External-rotation peak torque and total work at 180°/s increased for all groups.

Conclusions:

The results indicate that a jump-rope training program is a good conditioning method for overhead athletes because of its potential benefits to shoulder strength.

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João Breno Ribeiro-Alvares, Maurício Pinto Dornelles, Carolina Gassen Fritsch, Felipe Xavier de Lima-e-Silva, Thales Menezes Medeiros, Lucas Severo-Silveira, Vanessa Bernardes Marques and Bruno Manfredini Baroni

Context: Hamstring strain injury (HSI) is the most prevalent injury in football (soccer), and a few intrinsic factors have been associated with higher injury rates. Objective: To describe the prevalence of the main intrinsic risk factors for HSI in professional and under-20 football players. Design: Cross-sectional study. Setting: Physiotherapy laboratory, Federal University of Health Sciences of Porto Alegre (Brazil). Participants: A total of 101 football players (52 professional and 49 under-20 players). Intervention: An evidence-based testing protocol for screening HSI risk factors. Main Outcome Measures: Anamnesis, ultrasonography of the hamstrings, passive straight-leg raise test, Functional Movement Screen, and isokinetic dynamometry were performed. Eleven HSI risk factors for each leg were assessed, besides the player’s age as a systemic risk factor. Reports were delivered to the coaching staff. Results: Professionals had greater prevalence of HSI history compared with under-20 players (40% vs 18%). No between-group differences were found for the other screening tests. Altogether, 30% of players had already sustained at least one HSI; 58% had a history of injuries in adjacent regions; 49% had short biceps femoris fascicles; 66% and 21% had poor passive and active flexibility, respectively; 42% and 29% had deficits in functional movements and core stability, respectively; 7% and 26% presented bilateral imbalance for hamstring concentric and eccentric strength, respectively; 87% and 94% obtained low values for hamstring-to-quadriceps conventional and functional ratios, respectively. Two-thirds of players had 3 to 5 risk factors per leg. None of the players was fully free of HSI risk factors. Conclusion: Most football players present multiple risk factors for sustaining an HSI. Hamstring weakness is the most prevalent risk factor, but the teams should also be aware of deficits in flexibility, core stability, functional movements, and hamstring fascicle length.

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Robson Dias Scoz, Cesar F. Amorim, Bruno O.A. Mazziotti, Rubens A. Da Silva, Edgar R. Vieira, Alexandre D. Lopes and Ronaldo E.C.D. Gabriel

Objective: To assess the diagnostic validity of an isokinetic testing to detect partial injuries on the anterior cruciate ligament (ACL). Design: Prospective diagnostic study. Settings: Orthopedic clinic, physiotherapy clinic, orthopedic hospital, and diagnostic/image clinic. Participants: Consecutive patients (n = 29) with unilateral knee complaint submitted to physical examination, magnetic resonance images (MRIs), and isokinetic testing prior to surgery of ACL reconstruction. Interventions: Not applicable. Main Outcome Measures: The isokinetic torque curves data from extensor and flexor muscles were converted to frequency domain by fast Fourier transformation and compared with healthy contralateral limb. Differences were categorized as unstable knees and these conclusions were compared with patient’s physical examinations (doctor’s conclusion on ACL integrity) and MRIs (as the radiologist conclusions on ACL integrity). After surgery, all intraoperatively confirmed partial injured patient’s data were collected. The diagnostic accuracy measures to compare the conclusions of all 3 professionals included sensitivity, specificity, positive predictive value, negative predictive value, disease prevalence, positive likelihood ratio, and accuracy—all using a confidence interval of 95%. Results: Compared with MRI, the sensitivity of isokinetic test for an ACL partial injury was 90.00%, specificity 83.33%, positive predictive value 52.94%, negative predictive value 97.56%, and accuracy 84.48%. Compared with physical examination, the sensitivity of isokinetic test for an ACL partial injury was 85.71%, specificity 78.43%, positive predictive value 35.29%, negative predictive value 97.56%, and accuracy 79.31%. Conclusions: This method of isokinetic data analysis through fast Fourier transformation can be used to improve diagnostic accuracy of a difficult detection injury. Even present, a partial ACL injury can produce a stable knee during isokinetic testing and could be used to detect candidates for conservative treatment based on strengthening exercises, reducing surgery risks, and financial and social impact on patient’s life.

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Konstantinos Fousekis, Evdokia Billis, Charalampos Matzaroglou, Konstantinos Mylonas, Constantinos Koutsojannis and Elias Tsepis

Context:

Elastic bandages are commonly used in sports to treat and prevent sport injuries.

Objective:

To conduct a systematic review assessing the effectiveness of elastic bandaging in orthopedic- and sports-injury prevention and rehabilitation.

Evidence Acquisition:

The researchers searched the electronic databases MEDLINE, CINAHL, SPORTDiscus, EMBASE, and Physiotherapy Evidence Database (PEDro) with keywords elastic bandaging in combination, respectively, with first aid, sports injuries, orthopedic injuries, and sports injuries prevention and rehabilitation. Research studies were selected based on the use of the term elastic bandaging in the abstract. Final selection was made by applying inclusion and exclusion criteria to the full text. Studies were included if they were peer-reviewed clinical trials written in English on the effects of elastic bandaging for orthopedic-injury prevention and rehabilitation.

Evidence Synthesis:

Twelve studies met the criteria and were included in the final analysis. Data collected included number of participants, condition being treated, treatment used, control group, outcome measures, and results. Studies were critically analyzed using the PEDro scale.

Conclusions:

The studies in this review fell into 2 categories: studies in athletes (n = 2) and nonathletes (n = 10). All included trials had moderate to high quality, scoring ≥5 on the PEDro scale. The PEDro scores for the studies in athletes and nonathletes ranged from 5 to 6 out of 10 and from 5 to 8 out of 10, respectively. The quality of studies was mixed, ranging from higher- to moderate-quality methodological clinical trials. Overall, elastic bandaging can assist proprioceptive function of knee and ankle joint. Because of the moderate methodological quality and insufficient number of clinical trials, further effects of elastic bandaging could not be confirmed.

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Tülay Çevik Saldıran, Emine Atıcı, Derya Azim Rezaei, Özgül Öztürk, Burcu Uslu, Burcu Ateş Özcan and Begüm Okudan

Context: The research on the change in properties of the lower leg muscles by different intensity sinusoidal vertical whole-body vibration (SV-WBV) exposures has not yet been investigated. Objective: The purpose of this study was to determine effect of a 20-minute different intensity SV-WBV application to the ankle plantar flexor and dorsiflexor muscles properties and hamstring flexibility. Design: Prospective preintervention–postintervention design. Setting: Physiotherapy department. Participants: A total of 50 recreationally active college-aged individuals with no history of a lower leg injury volunteered. Interventions: The SV-WBV was applied throughout the session with an amplitude of 2 to 4 mm and a frequency of 25 Hz in moderate-intensity vibration group and 40 Hz in a vigorous-intensity vibration group. Main Outcome Measures: The gastrocnemius and tibialis anterior muscle tone was assessed with MyotonPRO, and the strength evaluation was made on the same lower leg muscles using hand-held dynamometer. The sit and reach test was used for the lower leg flexibility evaluation. Results: The gastrocnemius muscle tone decreased on the right side (d = 0.643, P = .01) and increased on the left (d = 0.593, P = .04) when vigorous-intensity vibration was applied. Bilateral gastrocnemius muscle strength did not change in both groups (P > .05). Without differences between groups, bilateral tibialis anterior muscle strength increased in both groups (P < .01). Bilateral gastrocnemius and tibialis anterior muscle tone did not change in the moderate-intensity vibration group (P > .05). Flexibility increased in both groups (P < .01); however, there was no statistically significant difference between the groups (d = 0.169, P = .55). Conclusions: According to study results, if SV-WBV is to be used in hamstring flexibility or ankle dorsiflexor muscle strengthening, both vibration exposures should be preferred. Different vibration programs could be proposed to increase ankle plantar flexor muscle strength in the acute results. Vigorous-intensity vibration exposure is effective in altering ankle plantar flexor muscle tone, but it is important to be aware of the differences between the lower legs.

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Blanca de la Cruz Torres

Context: Lateral epicondylalgia (LE) refers to a painful condition at or around the lateral epicondyle of the humerus. LE is one of the most common injuries of the elbow; however, the cause of the pathology is not clear. Patients often experience symptoms consistent with a radial nerve injury; however, data on the involvement of the radial nerve are needed. Objective: To analyze the relationship between electrophysiologic excitability and morphology of the radial nerve in patients with unilateral chronic LE. Design: Cross-sectional study. Setting: Department of Physiotherapy, University of Seville. Patients: A total of 56 elbows (28 right, 28 left) in 28 patients (12 females, 16 males; age 49 [7.37] y) were recruited by convenience sampling. Main Outcome Measures: Strength–duration curves (chronaxia and accommodation index) and cross-sectional area (CSA) of the radial nerve were made in all participants. All parameters were compared between both limbs. Also, pain with palpation in the lateral epicondyle and functional pain of involved extremities was assessed using visual analog scale and the Patient-Rated Tennis Elbow Evaluation, respectively. Results: Symptomatic limb showed higher CSA values of the radial nerve when compared with the asymptomatic limb (P < .001). On the symptomatic limb, duration of symptoms was positively correlated with CSA values. Chronaxia values were all normal and similar between both limbs (P = .35). Regarding accommodation index, 14 (54%) patients showed accommodation indices that suggested pathological radial nerve on the right limb, 4 (14%) on the left limb, 5 (18%) on both limbs, and 4 (14%) had none of the affected nerves. Eight-six percent of patients showed accommodation indices that suggested pathological radial nerve, independently of symptomatic limb. In these cases, affected nerves had higher CSA than the unaffected nerve (P = .01). On the affected nerves, duration of symptoms was positively correlated with accommodation indices. Conclusions: These findings suggest that patients with unilateral chronic LE show a decreased excitability in any radial nerve, independently of the symptomatic limb, and that pathological nerves have higher CSA than the nonpathological nerves.

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. Haegele * 12 06 2020 1 07 2020 37 3 304 323 10.1123/apaq.2019-0126 apaq.2019-0126 APPLICATIONS The Physiotherapy in Preschools Program: Describing a Student-Led Assessment Service for Children With Possible Motor Skill Difficulties Margarita D. Tsiros * Emily J. Ward * Sophie Lefmann * Susan

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Neil Maguire, Paul Chesterton and Cormac Ryan

is to highlight that although pain is a very real experience, it can be an overprotective mechanism, even in the absence of tissue damage. In addition to patients, PNE has been used to improve knowledge for clinicians 7 and physiotherapy students. 8 A recent randomized control trial 8 reported