Antonio Sinelio Santos Cunha, Vitória Karoline Batista da Silva, Antonio Cícero Frizzi Junior
et al.
Este estudo analisou nove fatores associados ao burnout em atletas de futebol Sub-20: idade, índice de massa corporal (IMC), tempo de prática esportiva, frequência semanal de treinos, duração dos treinos, distância da residência familiar, número de visitas à família por ano, moradia com a família e dependência financeira do salário do atleta. A amostra incluiu 251 atletas masculinos de cinco equipes das divisões principais do campeonato. Dados dos participantes foram coletados por ficha estruturada, e o burnout do atleta foi avaliado pelo Questionário de Burnout para Atletas (QBA), que mensura exaustão física e emocional (EFE), reduzido senso de realização esportiva (RSR) e desvalorização esportiva (DES). A idade apresentou associação negativa com a EFE (β = -0,919; p = 0,001), o que indica menores níveis de exaustão em atletas mais velhos. O IMC teve relação positiva com a EFE (β = 1,025; p = 0,023), o que sugere maior exaustão em atletas com maior IMC. Morar com a família foi associado positivamente à DES (β = 1,161; p = 0,005) e ao burnout total (β = 1,068; p = 0,025), o que indica que atletas fora do ambiente familiar tendem a perceber o esporte de forma mais negativa e apresentam maior risco de burnout. Portanto, o suporte familiar e psicológico, aliado ao controle nutricional, é indispensável para o equilíbrio emocional e físico dos atletas, pois previne percepções associadas à síndrome de burnout, fortalece a gestão emocional e contribui para a promoção de um melhor desempenho esportivo e longevidade na carreira.
Massive irreparable rotator cuff tears are difficult to restore when the tendon quality is poor, and the tendon retraction prevents complete repair. In such cases, tendon allograft bridging can restore continuity but cannot replicate the native tendon–bone interface. In this study, we evaluated an Achilles-tendon–bone block allograft (BTA) for anatomic tendon–bone interface reconstruction in a rabbit model of chronic massive rotator cuff tear. Thirty-six rabbits underwent bilateral infraspinatus tendon detachment, followed by repair after 3 weeks using direct suture (DS), tendon allograft without bone block (TA), or BTA. At 8 and 16 weeks, we assessed the magnetic-resonance-imaging-based tendon maturation (signal-to-noise quotient (SNQ)), micro-computed-tomography-based bone volume fraction (BV/TV) and histology, immunohistochemistry (COL I, II, X), and biomechanical-testing-based healing. The BTA group showed superior tendon continuity, significantly lower SNQ, and higher BV/TV than the DS and TA groups (p < 0.05) at both timepoints. The histological examination demonstrated denser collagen fibers, greater fibrocartilage formation, and complete bone–bone fusion in BTA. The immunohistochemical assessment revealed higher COL II and COL X expression, indicating advanced fibrocartilage maturation and mineralization. At 16 weeks, the BTA group achieved the highest ultimate load to failure (113.45 ± 14.45 N) and stiffness (19.65 ± 3.41 N/mm) values, exceeding those of the TA and DS groups (p < 0.05). These results indicate that the Achilles-tendon–bone block allograft bridge effectively reconstructs the layered tendon–bone interface, promotes osteointegration and fibrocartilage regeneration, and enhances biomechanical strength, all of which support its potential as a translational option for functional enthesis reconstruction in massive rotator cuff tear repair.
Avery Hinks, Kaitlyn B.E. Jacob, Makenna A. Patterson
et al.
Background: Residual force enhancement (rFE), defined as increased isometric force following active lengthening compared to a fixed-end isometric contraction at the same muscle length and level of activation, is present across all scales of muscle. While rFE is always present at the cellular level, often rFE “non-responders” are observed during joint-level voluntary contractions. Methods: We compared rFE between the joint level and single fiber level (vastus lateralis biopsies) in 16 young males. In vivo voluntary knee-extensor rFE was measured by comparing steady-state isometric torque between a stretch-hold (maximal activation at 150°, stretch to 70°, hold) and a fixed-end isometric contraction, with ultrasonographic recording of vastus lateralis fascicle length (FL). Fixed-end contractions were performed at 67.5°, 70.0°, 72.5°, and 75.0°; the joint angle that most closely matched FL of the stretch-hold contraction's isometric steady-state was used to calculate rFE. The starting and ending FLs of the stretch-hold contraction were expressed as % optimal FL, determined via torque-angle relationship. Results: In single fiber experiments, the starting and ending fiber lengths were matched relative to optimal length determined from in vivo testing, yielding an average sarcomere excursion of ∼2.2–3.4 µm. There was a greater magnitude of rFE at the single fiber (∼20%) than joint level (∼5%) (p = 0.004), with “non-responders” only observed at the joint level. Conclusion: By comparing rFE across scales within the same participants, we show the development of the rFE non-responder phenomenon is upstream of rFE's cellular mechanisms, with rFE only lost rather than gained when scaling from single fibers to the joint level.
Vinicius de Oliveira Damasceno, Tercio Araújo do Rego Barros, Willemax dos Santos Gomes
et al.
The purpose of this present study was to develop and validate a prediction equation for body composition assessment using anthropometric measures of elderly women. This is cross-sectional correlational study with 243 older women ± 64.5 years old and body mass index (BMI) ± 28.70 kg/m². For the development of the equation it was utilized the method of hold-out sample validation. The participants were randomly divided into equation development group (96 elderly women) and a group for validation (147 elderly women). Total body mass, height, waist and hip circumferences, ratio waist-hip ratio and BMI were measured. The whole-body dual-energy X-ray absorptiometry (DXA) assessed body composition (percentage of body fat, fat mass, and fat-free mass). The equations were developed using multiple linear regression, with validation by the stepwise method; the comparison of the equations was analyzed by the paired Student's t test and the analysis of residual scores by the method of Blant and Altman. The New Equation presents a strong correlation (R = 0.83) and (R² = 0.69), and a standard error of estimation equals to 3.21% for percentage body fat prediction. The mean difference between the estimations of percentage body fat from DXA and the New Equation was 0.11% (t(0,180); P = 0.850). Therefore, the New Equation had an accuracy of 93.5% and a total error of 1.8%. The body fat estimation in older women using this New Equation based on BMI and age is valid and accurate.
<strong>هدف پژوهش حاضر، بررسی اثر فعالیت واماندهساز اندام بالایی بر فعالیت قشری- نخاعی و پاسخ مجتمع موتونورون نخاعی اندام پایینی بود. تعداد 10 آزمودنی مرد فعال بهصورت دردسترس و داوطلبانه (سن 99/2 </strong><strong>±</strong><strong> 1/28 سال، قد 1/4 </strong><strong>±</strong><strong> 77/1 متر، وزن 98/4 </strong><strong>±</strong><strong> 70/75 کیلوگرم) در سه جلسة مجزا در این پژوهش شرکت کردند. پس از اندازهگیری ویژگیهای آنتروپومتریک و آشنایی با انجام درست حرکت بارفیکس و تحریکات در جلسة اول، در جلسههای دوم و سوم، پتانسیل برانگیختة حرکتی (</strong><strong>MEP</strong><strong>)، پتانسیل برانگیختة گردنی- بصلالنخاعی (</strong><strong>CMEP</strong><strong>) و پاسخ حرکتی مستقیم بیشینه (</strong><strong>Mmax</strong><strong>)، بلافاصله 10 و 20 دقیقه پس از اتمام پروتکل خستگی (انجام حرکت بارفیکس تا واماندگی، هفت ست با فاصلة استراحتی یک دقیقه)، با استفاده از تحریک مغناطیسی قشر حرکتی مغز و مسیرهای نخاعی و تحریک الکتریکی عصب پیرامونی اندازهگیری شدند. نتایج پژوهش با استفاده از روش آماری تحلیل واریانس با اندازهگیری تکراری نشان داد که </strong><strong>MEP</strong><strong> عضلة ساقی قدامی (غیردرگیر) در مراحل بلافاصله (</strong><strong>= </strong><strong>0.001</strong><strong>P</strong><strong>)، 10 دقیقه (</strong><strong>₌</strong><strong> 0.001 </strong><strong> </strong><strong>P</strong><strong>) و پس از پروتکل خستگی نسبت به مقادیر استراحتی کاهش معناداری داشت.</strong><strong>CMEP </strong><strong>و </strong><strong>Mmax</strong><strong> تغییر معناداری را نسبت به مقادیر استراحتی نشان ندادند (</strong><strong>P = 0.5</strong><strong>،</strong><strong>0.07 </strong><strong> </strong><strong>P =</strong><strong>). براساس دادههای بهدستآمده، بهنظر میرسد که در پدیدة انتشار خستگی از اندام بالایی به پایینی، مراکز فوقنخاعی درگیر باشند. افزونبراین، این خستگی فوقنخاعی به زمان قابلتوجهی برای بازیافت نیاز دارد. </strong>
Katarzyna Stefańska, Monika Jakimiec-Komisarczyk, Paulina Terlecka
et al.
Cystic fibrosis (CF) is classified as metabolic and multisystem disease with autosomal recessive inheritance caused by mutations in the gene located on chromosome 7 encoding cystic fibrosis transmembrane conductance regulator (CFTR) protein. CFTR is a transmembrane chloride channel of epithelial cells and affects the activity of the mucous membrane of the sweat glands, airway epithelium, pancreatic ducts, vas deferens, bile ducts and intestines. In CF, increased concentration of chlorides in the sweat, pancreatic insufficiency and impaired absorption are observed as well as changes in the respiratory system related to, among others, impaired airway patency, weakening of the mucociliary clearance mechanism and the development of bacterial infections. CF is a chronic condition requiring comprehensive therapy. Nutritional treatment is an essential element of CF therapy. Malnutrition is a common complication in patient with CF and eating disorders. The majority of patients with CF have higher energy, protein and fat needs. In addition, supplementation with enzyme preparations, vitamins, sodium chloride, as well as the use of high-energy nutrients is recommended. The aim of the study was to evaluate current nutritional recommendations of patients with CF.
Krystian Ślusarz, Krzysztof Wierzbicki, Monika Adamczyk-Sowa
Syringomyelia is typically a progressive chronic condition caused by a disruption of normal cerebrospinal fluid flow. Earlier diagnosis is associated with better outcomes, because although the progression of neurological deficits usually stabilizes after intervention, many patients still remain at least partially symptomatic.
In this paper, we describe the case of a 33-year-old female patient with syringomyelia. The patient reported to the Department of Neurology due to sensory disorders and shoulder pain for several months. On admission, neurological examination revealed right hand muscular deficit, abolition of sensation of temperature and asymmetry of tendon reflexes. A few weeks earlier, outpatient magnetic resonance imaging (MRI) of the cervical spine showed the features of Arnold-Chiari malformation, syringomyelia and C5/C6 and C6/C7 discopathy. During hospitalization, MRI of the thoracic spine was performed, and the syringomyelic cavity C2–Th6 was revealed. The patient in stable condition was discharged home and referred to the neurosurgery department. The patient underwent a medial sub-occipital craniectomy and, a month later, was admitted to the neurological rehabilitation department due to paresis and sensory disturbances of right upper limb. As a result of the physiotherapy, the right arm's motor function and general physical condition improved.
The article presents clinical cases of patients with cerebral palsy (CP) in adolescence. The possibility of complex rehabilitation with the use of botulinum therapy (Xeomin) to reduce spasticity, improve active and passive movements is shown. Conclusion. The use of InkobotulinumtoxinА (Xeomin) has shown a significant, persistent, long-term effect on reducing spasticity, passive function and walking in adolescent patients with cerebral palsy. The use of the drug in the total dose of 7,8 to 9,1 U/kg body weight was effective and safe.
My-Linh Nguyen Luong, Kim L. Bennell, Michelle Hall
et al.
Abstract Background Most adults fail to meet global physical activity guidelines set out by the World Health Organization. In recent years, behavioural economic principles have been used to design novel interventions that increase physical activity. Immediate financial rewards, for instance, can motivate an individual to change physical activity behaviour by lowering the opportunity costs of exercise. This systematic review will summarise the evidence about the effectiveness of financial incentive interventions for improving physical activity in adults. Methods We will search MEDLINE, Embase, Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health Literature, Web of Science, Scopus, PsycINFO, EconLit, SPORTDiscus, the National Health Service Economic Evaluation Database, ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform from inception using a comprehensive, electronic search strategy. The search strategy will include terms related to ‘financial incentive’ and ‘physical activity’. Only randomised controlled trials that investigate the effect of financial incentives on physical activity in adult populations and that are written in the English language will be included. Two review authors will independently screen abstracts and titles, complete full text reviews and extract data on objective and self-reported physical activity outcomes. The authors will also assess the study quality using the Cochrane risk of bias tool and provide a systematic presentation and synthesis of the included studies’ characteristics and results. If more than two studies are sufficiently similar in population, settings and interventions, we will pool the data to conduct a meta-analysis. If we are unable to perform a meta-analysis, we will conduct a narrative synthesis of the results and produce forest plots for individual studies. Our subgroup analyses will examine the differential effects of an intervention in healthy populations compared to populations with disease pathology and compare the effects of interventions using financial rewards to interventions using financial penalties. Discussion This systematic review will determine the effectiveness of positive and negative financial incentives on physical activity in adults. Findings will help inform the development of public health interventions and research in this field. Systematic review registration PROSPERO 2017: CRD42017068263
Alberto A. Uribe, Fernando L. Arbona, David C. Flanigan
et al.
Introduction: Acute postoperative pain following knee arthroscopy is common in orthopedic surgeries. Managing pain postoperatively combines usage of opioids and non-steroidal anti-inflammatory drugs. The aim of this clinical study was to assess the efficacy of two different analgesic treatment regimens: intravenous (IV) ibuprofen and IV ketorolac for the treatment of postoperative pain pertaining to arthroscopic knee surgery.Methods: This was a single center, randomized, double-blind, parallel, active comparator clinical pilot study. Subjects were randomized to receive either IV ibuprofen, administered as two 800 mg doses or IV ketorolac, administered as a single 30 mg dose. Subjects in the ibuprofen group received 800 mg of IV ibuprofen within 2 h prior to surgery and a repeated second dose 4 h after the initial dose if they had not been discharged. Subjects in the ketorolac group received IV ketorolac 30 mg at the end of surgery, as per the manufacturer's recommendations. Pain assessments and opioid consumption data were collected up to 24 h postoperatively.Results: Of 53 randomized subjects, 51 completed the study. There were 20 subjects in the ibuprofen group and 31 subjects in the ketorolac group. The median (IQR) visual analog scale (VAS) pain score at resting upon post-anesthesia care unit (PACU) arrival was 33 (12, 52) vs. 9 (2, 25) (p = 0.0064) for the ketorolac and ibuprofen group, respectively. The median (IQR) visual analog scale (VAS) pain score at movement upon PACU arrival was 38 (20, 61) vs. 15 (6, 31) (p = 0.0018) for the ketorolac and ibuprofen group, respectively. Median VAS pain scores during movement taken at subsequent 30 min intervals in the ibuprofen group were less than half that of those reported in the ketorolac group for up to 90 min after arriving in PACU. The median VAS pain scores at rest and movement in the course of 120 min−24 h after PACU arrival was not statistically significant in both groups. Rescue opioid medication during PACU stay was required in 55.0% (N = 11) and 83.9% (N = 26), with a mean amount of narcotic consumption (oral morphine conversion) of 5.53 ± 5.89 mg vs. 19.92 ± 15.63 mg for the ibuprofen and ketorolac group, respectively (P < 0.001). However, opioid consumption during the first 24 h after PACU discharge was not statistically significant (p-value = 0.637). The mean time to first rescue medication was 77.62 ± 33.03 and 55.78 ± 35.37 for the ibuprofen and ketorolac group, respectively (p-value = 0.0456). There were no significant differences in patient satisfaction and documented adverse events during the first 24 h.Conclusion: This pilot study showed that the use of preemptive IV ibuprofen 800 mg could be considered to reduce postoperative pain and opioid consumption. Future prospective clinical trials using similar regimens should be conducted in order to gain a better understanding of how to best provide perioperative analgesic regimens.Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT01650519.
A atividade física proporciona benefícios para a saúde e qualidade de vida de mulheres idosas. Ainda são escassos os estudos longitudinais em mulheres idosas com duração superior a um ano de prática de exercício físico. Assim o objetivo do estudo foi analisar os efeitos de três anos de treino multicomponente na capacidade funcional de mulheres idosas. Métodos: 51 mulheres (66.7±5.30 anos e 159±0.11cm) participaram ao longo de três anos num programa constituído por períodos de nove meses de treino multicomponente seguidos de três meses de destreino. As avaliações decorreram no início/fim de cada período de treino e destreino. Resultados: No 1º, 2º e 3º ano verificaram-se aumentos estatisticamente significativos em todos os parâmetros da capacidade funcional (p<0.05). No entanto, o 2º ano revelou ser o período de treino onde observamos os maiores aumentos nos testes T6M (7.43%), SA (383.33%), AC (40.33%), FA (13.05%) e LS (12.5%) (p<0.05). Os testes T6M, LS, FA, AC, SA melhoraram entre 4.17% a 576.60% em todos os períodos de treino e diminuíram entre 3.21% a 85.31% em todos os períodos de destreino. Conclusões: Três anos de treino multicomponente contribuíram para a melhoria da capacidade funcional em mulheres idosas, principalmente no 2º ano de intervenção.