Manual Therapy, Posturology & Rehabilitation Journal

Applications of Pulsed Electromagnetic Field Therapy in Skeletal-Muscle System: An Integrative Review

Thu, 02 Feb 2023 00:00:00 -0300

Background: The Pulsed Electromagnetic Field (PEMF) technology has attracted increasing interest since consistent evidence of its therapeutic properties has been demonstrated to treat musculoskeletal conditions. However, this technology is not new, and has already been used in different experimental models and clinical studies for the treatment of tendinopathies, osteoarthritis, increased cell proliferation, bone consolidation, among others. Methods: In this work, we carried out an integrative review of clinical and experimental studies published in the last twenty years, on the available scientific evidence that demonstrate the effects of PEMF in different applications for health treatments. Five databases including Medline, Pubmed Central, Scopus, Lilacs and PEDro were searched for studies from 2001 to September 2022. The results were analyzed by the team of researchers and clinical professionals to assure methodological quality of the studies for the elaboration of the theoretical review on the effects of electromagnetic field stimulation on skeletal muscles, tendon or bones. Results: Sixty-two studies were included in this review, presenting evidence of the biological effects of PEMF that can suggest it´s possible use to treat different disorders. Conclusions: Pulsed electromagnetic fields (PEMF) present relevant clinical and experimental evidence of beneficial effects in the treatment of several musculoskeletal inflammatory disorders, such as tendinopathies and osteoarthritis, in addition to the treatment of urinary incontinence and abdominal diastasis. PEMF can be considered as the evolution of electrical currents for the treatment of musculoskeletal disorders, mainly due to its better tolerance by patients.

Can the high intensity interval running in slope affect concurrently explosive strength performance?

Thu, 16 Mar 2023 00:00:00 -0300

Background: Physical exercise programs are typically composed of activities directed to the development of different physical abilities, usually stimulated in the same session. Objective: The aim of the study was to determine the effect of one session of aerobic exercise at high intensity to 1% and 10% gradient on the height (HJump) and kinematics of the depth jump (PExc - eccentric, concentric phase PCon, and contact time – CT). Methods: Twenty-five moderately trained men (VO2Max 53.2 ± 4.3 mL.kg-1.min-1) attended five visits in the laboratory. Familiarity with the procedures in depth jump, VO2Max measures and their velocity associated (VVO2Max), and time to exhaustion performance (TLim) were performed at two initial visits. Results: On the three subsequent visits, the volunteers were subjected to three maximum depth jumps before and 10 min after the following conditions: (1) running intervals at high intensity of 10% gradient (R10%), (2) at 1% gradient (R1%), and control condition (CON). The order of conditions was determined randomly. A running condition did not induce significant changes from HJump (R1% 1.1% vs 1.0% R10%) when expressed as percentage difference from the CON condition. The PExc, PCon, and CT also did not change after running sessions (P> 0.05). None of the intervals running strategies were able to generate significant change in height and kinematics of the vertical depth jump. Conclusion: The prescription of the running at VVO2Max in 1% or 10% gradient does not seem to lead to concurrent effect, is suggested to ensure the concomitant development of maximal aerobic power and explosive strength.

Evaluation of pulsed electromagnetic field therapy to improve muscle strength and functional aspects in the elderly: A pilot study

Tue, 28 Mar 2023 00:00:00 -0300

Backgroung: Sarcopenia has been defined as a progressive and generalized disorder of skeletal muscle that involves accelerated loss of muscle mass and function. The prevalence of sarcopenia worldwide is up to 15% in healthy elderly, approximately 76% of acutely hospitalized elderly patients, and up to 69% of patients admitted for post-acute geriatric rehabilitation. The loss of muscle mass results in serious consequences and several chronic diseases and senility, characterized by functional losses, muscle weakness, loss of independence and increased risk of falls and death. Sarcopenia has been defined as a progressive and generalized muscle disorder. Here we investigate the effects of PEMF in muscle strength and functional capabilities of elderly sarcopenic patients. Methods. Fifteen elderly people of both sexes, aged between 65 and 80 years old, classified according to the degree of muscle weakness. The participants were submitted to PEMF therapy in 12 sessions three times a week with the following parameters. In the first two sessions, only submaximal contraction was applied during 30 min with a frequency of 5 Hz at the sport mode of the equipment. In the following 10 sessions we used cycles of Submaximal contractions – frequency of 5 Hz with 5s duration and Supramaximal contractions – frequency of 30 Hz with 5s duration. The intensity of the equipment was adjusted according to the sensitivity of the patient and session duration was 30 min. Results. the TUG functional tests showed a significant reduction in execution time, with an initial average of 40 ± 10s to 22 ± 6s after treatment sessions. The average increase in muscle strength was 27 ± 9% after PEMF treatment. Conclusions. This case series report is the first in the world scientific literature to demonstrate the effectiveness of PEMF (Supramaximus™) therapy in gaining muscle strength and functionality in elderly sarcopenic patients. PEMF therapy, at least for the treatment of sarcopenia in the elderly, can be considered as the definitive evolution of electrical currents, with greater effectiveness and acceptance by the patient.

The influence of the physical therapist's clinical practice time on the perception of body stability of the traditional frontal plank exercise: a pilot study

Thu, 30 Mar 2023 00:00:00 -0300

Background: The traditional frontal plank exercise has a greater demand for biomechanical stability and has been widely prescribed and used in the practice of health professionals and, verifying the influence of the time of clinical practice can contribute positively in the clinical, scientific and social scope. Objective: To verify the influence of the physical therapist's clinical practice time on the perception of body stability of the traditional frontal plank exercise. Method: Individuals were selected in a non-probabilistic and intentional way, constituting a sample of young male adults, with a body mass index within the normal range, with a self-reported level of moderate to advanced physical activity and with at least six months of previous training experience. of resistance. The subjects were instructed to perform the frontal plank for 30 seconds, seeking to maintain all the items in the description of the technique. No verbal commands and encouragement were given during the exercise in order to direct only the influence of the different times of clinical practice of the evaluators. At the end of the exercise, the two evaluators self-reported their feedback through a control sheet prepared by the researchers. Results: The sample of this study consisted of 10 participants, with a mean age of 30.6 years (±4.03). All were male, white, and had no history of trauma/injury. The evaluator with six months of experience pointed out that eight subjects performed the frontal plank with high stability, while the evaluator with six years of experience observed only three subjects with high stability in the execution of the exercise. Conclusion: The findings of this study showed that there is a tendency towards a difference in the proportions of perceptions of stability in the traditional frontal plank between physical therapists with six months and six years of clinical experience.

Different physiological, but similar affective responses, facing different workload quantification methods

Thu, 16 Mar 2023 00:00:00 -0300

Backgroung: The literature provides support for several different method by which it is possible to quantify, prescribe and control the aerobic workload. Objective: To compare physiological and the affective response among training methods prescribed by VO2 reserve, HR reserve, and rating of perceived exertion (RPE) self-adjusted. Methods: 27 participants were submitted to two trail sessions. In the 1st, a maximum treadmill effort test was performed to determine the VO2max. In the 2nd, the participants were randomly divided into 3 situations of 5 min, with 5 min interval among the situations. In situation 1 (C1), the participants ran at the velocity correspondent to 65% of the VO2 reserve; in situation 2 (C2), participants ran at 60% to 65% of HR reserve and in situation 3 (C3), the participants self-adjustment the velocity by a RPE scale, in a moderate effort (RPE 3-4). The level of body activation and the affective response were obtained pre and post-stimulus administered. An ANOVA was performed and the magnitude of the differences established, with a significance level of p ≤ 0.05. Results: There were no significant differences for velocity in the three situations (p = 0.458). The responses of HR induced by C1 and C3 were significantly higher vs. C2 (p = 0.027 and p = 0.043). The RPE did not show significant differences among the situations (p = 0.118). Finally, the level of activation and sensation perceived activity did not differ significantly (p = 0.168). Conclusion: It was concluded that the exercise responses from the HR reserve were significantly lower when compared to the VO2reserve and RPE. All prescription models provided similar affective responses.

Heliox improves minute-ventilation variability during incremental maximal exercise in COPD patients

Natalia S. Gomes, Weder A. da Silva, Rafael Pena, Gaspar Chiappa — Thu, 27 Apr 2023 00:00:00 -0300

Fundamento: A limitação do fluxo aéreo expiratório durante o exercício está presente em uma certa fração de pacientes com doença pulmonar obstrutiva crônica (DPOC) e está associada ao desempenho prejudicado do exercício. Objetivos: O objetivo deste estudo foi investigar se o Heliox normóxico (79% He-21%O ₂ ) pode melhorar a variabilidade da ventilação minuto ( v V´E) em pacientes com DPOC. Métodos: Em um estudo cruzado duplo-cego, 13 homens não hipoxêmicos (FEV ₁ = 36,1 + 9,32 previsto) realizaram testes cardiopulmonares incrementais até o limite de tolerância (T lim ) enquanto recebiam Heliox ou ar ambiente (AR). A análise da variabilidade ventilatória foi realizada com Poincaréanálises por SD ₁ (desvio padrão 1) e SD ₂ (desvio padrão 2), para ventilação minuto, volume corrente e frequência respiratória. As respostas da ventilação durante o exercício, o consumo de oxigênio e a tolerância ao exercício foram analisados. A resposta do débito cardíaco (QT) foi monitorada por cardiografia de impedância. Resultados: A ventilação com Heliox resultou em uma diminuição no consumo de oxigênio [V'O ₂ , 1161,71 ± 351,11 vs. 1238,05 ± 330,93 mL/min, P <0,05] e na produção de dióxido de carbono [V'CO ₂, 1217,41 ± 300,90 vs. 1288,02 ± 321,66 mL/min, P <0,05] em comparação com o ar ambiente, devido a um aumento na ventilação (35,37 ± 9,55 vs, 31,05 ± 7,75 L, P <0,05) e na eficiência ventilatória após a inalação de Heliox ( 12,63 ± 2,91 vs 9,31 ± 4,15%, P <0,05). As respostas da variabilidade da ventilação aumentaram significativamente com Heliox em comparação com o ar ambiente. Conclusões: Normóxico Heliox aumenta a variabilidade da ventilação minuto durante o exercício de alta intensidade em pacientes com DPOC moderada a grave.

Comparison between nonperiodized resistance training and nonlinear periodization on muscular peak power in Brazilian soccer players

Thu, 16 Mar 2023 00:00:00 -0300

Background: For decades the literature has been investigating the ideal dose-response regarding the frequency, intensity and volume of training that optimize the increase in muscle strength and power in athletes and non-athletes. Objective: Evaluate the effects of strength training from a nonlinear (NLP) and non-periodized (NP) model on muscular peak power in soccer players. Methods: Twelve male junior football players from a professional team in Cabo Frio (Brazil) were recruited and randomly divided into two groups (6 in each group). The groups were randomly divided into: G1 - (Body mass: 64.7 ± 6.5 kg; Height: 172.3 ± 5.8 cm; % fat: 5.1 ± 2.7; Age: 17.5 ± 1.0 years) performed RT with NLP model; G2 - (Body mass: 66.1 ± 4.7; Height: 177.1 ± 6.1 cm; % fat: 5.1 ± 1.2, age: 17.6 ± 0.5 years) performed RT with NP model. Both groups are subjected to 12 weeks of training. PNL strength training consisted of weight training sessions on alternate days, 3 times a week, the rest intervals were 120s among the exercises and included 10 exercises. NLP distribution was as follows: Day 1 (3x4-6 maximum repetitions [RM] with rest intervals of 120 sec between sets); Day 2 (3x8-10RM with 60-90 rest intervals between sets); and day 3 (3x12-15RM with rest intervals of 60 sec between sets). NP training performed the same duration, weekly frequency, exercises and number of sets (3 sets 8-10RM and 60-90 sec rest intervals). Before and after NP and NLP training, muscle peak, speed and agility were evaluated. Results: The ANOVA with mixed model showed no significant interaction between group and moment (F(1,10) = 0.133; p=0.72), and no significant main effect for group (F(1,10) = 0.032; p=0.86) in muscular peak power. There was a significant main effect for moment (F(1,10) = 14.872; p=0.003), where were showed that Post-training presented higher values of muscular peak power compared to Baseline (p= 0.003). Conclusion: It is concluded that both training organization models are effective and can be used to develop peak muscle power.

The influence of verbal encouragement on corporal stability during the traditional frontal plank exercise in young health adults: a pilot study

Thu, 30 Mar 2023 00:00:00 -0300

Background: It’s known that the frontal plank exercise presents a greater demand of the biomechanics stability and it is largely prescribed and used during the practice by the health professionals, known the verbal encouragement influence on corporal stability through the professional feedback can contribute positively in the clinical, social and scientific field. Objectives: Verify the verbal encouragement influences on corporal stability during the traditional frontal plank exercise in young health adults. Methods: Subjects were selected in an intentional non-probabilistic way, constituting a sample of young male adults, with normal body mass index, moderate to advanced self-reported physical activity level and with, at least, six months of previous resistance training experience. Participants were instructed to perform the traditional frontal plank for 30 seconds keeping all the items in the description of the technique, no command was given besides the following verbal incentives: “Contract, stabilize, force, maintain and force”. After the execution, the professional self-reported his perception of body stability, writing down his answers on the control form. Results: The sample consisted of 10 participants, with a mean age of 30.6 years (±4.03). All male, white and with no history of trauma/injury. For individuals with less than one time of weekly physical exercise, verbal encouragement showed a positive response in the perception of body stability. As for the remainder, who practiced physical exercise with greater recurrence, the evaluator's perception of high stability was given both with and without verbal encouragement. Conclusion: This pilot study showed that in individuals with less time of weekly physical exercise, verbal encouragement showed a positive response in body stability, changing from moderate to high. But, the individuals with more time of practice, the verbal encouragement showed no response in the perception of body stability.

Photoepilation with high power LED - holonyak: evaluation of efficacy, satisfaction and incidence of side-effects

Fri, 31 Mar 2023 00:00:00 -0300

Background: Devices that use light, especially lasers, have become popular and are commonly used in aesthetics and hair removal. Laser-assisted photo epilation was originally described in 1996 and the proposed mechanism is based on the destruction of the follicular unit. Diode laser has been demonstrated to be an effective method for hair removal, however, the safety of patients with different skin types and colours is questionable due to thermal damage as the main side-effect. In this sense, the technological innovation of Photoepilation using high power LED equipment with high head cooling efficiency represents a great advance for the area. In this work, we evaluated the results of photoepilation using high-power LED in 117 patients with phototypes 01 to 06. Methods: A High potency LED equipment (Holoniak® – Adoxy Equipments – Brazil) was used. The LED allows the therapist to customize illumination parameters according to the sensitivity of the patients. All 117 participants were submitted to an initial sensitivity test to the LED irradiation, in order to determine adequate parameters to each participant. Sensitivity test was performed in both stationary and scanning modes. In scanning mode the test started with the following parameters – temperature of the at 10oC, fluence of 5 J/Cm2 and frequency 2 – 3 Hz. In stationary mode the sensitivity test started with temperature of the probe at 10 oC, fluence of 10 J/Cm2 and frequency of 0.8 Hz. No phototype restrictions were applied. To analyze the satisfaction of results, we created an arbitrary scale ranging from 1 to 4, where Grade 1 was considered unsatisfactory, Grade 2 - little satisfactory, Grade 3 - satisfactory and Grade 4 - very satisfactory. We also analyzed the number of sessions needed to achieve the hair removal result for each skin phototype. Results: Analyzing the percentage of satisfaction after LED photoepilation, satisfaction grade 3 and 4 represent approximately 95% of the participants. Surprisingly, there was no statistical correlation between the increase in skin phototype and the number of sessions needed to achieve the complete photoepilation effect. Unlike laser technology, which usually requires a high number of sessions for higher phototypes. No correlation with age was also reported. Conclusion: We can conclude that high power LED technology with effective tip cooling was able to achieve highly efficient results for 95.7% of treated patients, without the need to increase the number of sessions for phototypes 4 to 6.

Autonomic activity, frailty phenotype and risk of falling in the elderly: Study protocol

Thu, 04 May 2023 00:00:00 -0300

Background: Generally, in the aging process, there is degradation of autonomic nervous control mechanisms, compromising the regulation of heart rate, which contributes to increased frailty and the risk of falls. This process is defined as a geriatric syndrome that leads to impairment of physiological systems and homeostatic imbalance. Objective: To correlate heart rate variability (HRV), frailty parameters, and the risk of falls in elderly people from a community center. Methods: This research will involve active seniors and participants from the Centro de Convivências de Praia Grande, São Paulo, Brazil. Clinical, demographic, and anthropometric data, psychological variables, and physical conditions will be collected through the International Physical Activity Questionnaire (IPAQ) and the risk of falls test. The heart rate R-R intervals will be analyzed using the H10 polar frequency meter and the HRV application, and transferred to the Kúbios software for further analysis.Results: Two hundred and fourteen participants are involved in this study, 181 (84.6%) of whom are female, 137 (64.0%) are white, with a mean age of 70.27 ± 7.07 years, a weight of 68.37 ± 11.15 kg, and a body mass index of 27.04 ± 4.04 kg/m2. Conclusion: A positive correlation is expected through the stratified analysis of frailty indices, risk of falls, and HRV, suggesting that the lower the HRV, the greater the risk of falls and the greater frailty in the elderly.

Assessment of predisposition in the acquisition of the english language and motor development in children with autism spectrum disorder: Case report

Mon, 27 Mar 2023 00:00:00 -0300

Background: Autism Spectrum Disorder (ASD) is a complex neurobiological disorder. Characterized by language deficits, however, it is known that there is a development of bilingualism in the autistic population. Delay in motor development is present in the population, with deficits in fine and gross motor coordination. Objective: The present study aims to evaluate the predisposition to acquire a second language and motor development in children with ASD. Method: The case report is composed of four children, verbal with the cognitive and physical capacity to participate in the evaluations. Mean age ± 8 years and 3 months, 50% male, 100% literate. Distributed into two groups: group I: two children diagnosed with ASD according to DSM-V and group II: two children with typical development. The group of children with ASD underwent the assessment protocol consisting of the application of the Childhood Autism Rating Scale (CARS) while the Revised Psychoeducational Profile (PEP-R) and the Placement Test were applied in both groups. Result: Children with ASD assessed with CARS had a low level of support. Regarding the PEP-R, the same group showed a deficit in the development of fine and gross motor coordination compared to group II. The child with ASD from the public network had a lower score compared to the child from the private network in relation to the level of development of bilingualism, both in reading and writing. Conclusion: It is possible to suggest that the development of fine and gross motor skills of children with ASD are deficient, however, they demonstrated a good result in the predisposition to learning a second language, including the child who studies in a public school. Although its development is a little smaller.