The latest medical research on Physiotherapy

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about physiotherapy gathered by our medical AI research bot.

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Physiological Factors Associated with Unsatisfied Inspiration at Peak Exercise in Healthy Adults.

Medicine and Science in Sports

Contrary to common belief, a growing body of evidence suggests that unsatisfied inspiration (UI), an inherently uncomfortable quality of dyspnea, is experienced by ostensibly healthy adults during high-intensity exercise. Based on our understanding of the mechanisms of UI among people with chronic respiratory conditions, this analysis tested the hypothesis that the experience of UI at peak exercise in young, healthy adults reflects the combination of high ventilatory demand and critical inspiratory constraints.

In a retrospective analysis design, data included 321 healthy individuals (129 females) aged 25 ± 5 yrs. Data were collected during one visit to the laboratory, which included anthropometrics, spirometry, and an incremental cardiopulmonary cycling test to exhaustion. Metabolic and cardiorespiratory variables were measured at peak exercise, and qualitative descriptors of dyspnea at peak exercise were assessed using a list of 15 descriptor phrases.

34% of participants (n = 109) reported sensations of UI at peak exercise. Compared to the Non-UI group, the UI group achieved a significantly higher peak work rate (243 ± 77 vs. 235 ± 69 W, P = 0.016, d = 0.10), rate of O2 consumption (3.32 ± 1.02 vs. 3.27 ± 0.96 L·min-1, P = 0.018, d = 0.05), minute ventilation (120 ± 38 vs. 116 ± 35 L·min-1, P = 0.047, d = 0.11), and breathing frequency (50 ± 9 vs. 47 ± 9 breaths·min-1, P = 0.014, d = 0.33), while having a lower exercise-induced change (peak-baseline) in inspiratory capacity (0.07 ± 0.41 vs. 0.20 ± 0.49 L, P = 0.023, d = 0.29). The inspiratory reserve volume to minute ventilation ratio at peak exercise was also lower in the UI vs. Non-UI group. Dyspnea intensity and unpleasantness ratings were significantly higher in the UI vs. Non-UI group at peak exercise (both P < 0.001).

Healthy individuals reporting UI at peak exercise have relatively greater inspiratory constraints compared to those who do not select UI.

Lower Extremity Kinematic and Kinetic Characteristics as Effects on Running Economy of Recreational Runners.

Medicine and Science in Sports

Determine associations between running economy (RE) and running sagittal plane kinematic and kinetic parameters.

A total of thirty male recreational runners (age: 21.21 ± 1.22 years, VO2max: 54.61 ± 5.42 ml·kg-1·min-1) participated in two separate test sessions. In the first session, the participant's body composition and RE at 10 and 12 km·h-1 were measured. In the second session, measurements were taken for the sagittal plane of hip, knee, and ankle angles and range of motion (ROM), as well as ground reaction force.

Moderate correlations were found between lower energy costs at 12 km·h-1 and smaller hip flexion at toe-off (r = 0.373) as well as smaller peak hip flexion during stance (r = 0.397). During the swing phase, lower energy costs at 10 km·h-1 were moderately correlated with smaller peak knee flexion and smaller knee flexion and extension ROM (r = 0.366 ~ 0.443). Lower energy costs at 12 km·h-1 were moderately correlated with smaller peak hip and knee flexion as well as knee extension ROM (r = 0.369 ~ 0.427). In terms of kinetics, there was a moderate correlation between higher energy costs at 10 km·h-1 and larger peak active force, as well as larger peak braking and propulsion force (r = -0.470 ~ 0.488). Lower energy costs at 12 km·h-1 were moderately to largely correlated with smaller peak impact and braking force (r = 0.486 and -0.500, respectively). Regarding the statistical parametric mapping analysis, most outcomes showed associations with RE at 10 km·h-1, including knee flexion (42.5% ~ 65.5% of the gait cycle), ankle plantarflexion (32.5% ~ 36% of the gait cycle), active force (30.5% ~ 35% of the stance phase), and propulsion force (68% ~ 72.5% of the stance phase). Lower energy costs at 12 km·h-1 were correlated with smaller hip flexion (5.5% ~ 12% and 66.5% ~ 74%) and smaller knee flexion (57% ~ 57.5%) during the running gait cycle.

This study indicates that biomechanical factors are associated with RE in recreational runners. To design effective training methods to improve RE, coaches and runners should focus on the sagittal plane kinematics of the hip, knee, and ankle, as well as lower vertical and horizontal kinetic parameters.

Effect of repeated prolonged exercise on liver fat content and visceral adipose tissue in well-trained older men.

Scandinavian J Med Sci Sports

Liver fat (LF) and visceral adipose tissue (VAT) content decreases with training, however, this has mainly been investigated in sedentary obese or healthy participants. The aim of this study was to investigate the effects of repeated prolonged exercise on LF and VAT content in well-trained older men and to compare baseline LF and VAT content to recreationally active older men.

A group of five well-trained older men were tested before and after cycling a total distance of 2558 km in 16 consecutive days. VAT content and body composition was measured using DXA before a bicycle ergometer test was performed to determine maximal fat oxidation (MFO), maximal oxygen consumption ( VO 2 max $$ {\mathrm{VO}}_{2_{\mathrm{max}}} $$ ), and the relative intensity at which MFO occurred (Fatmax). LF content was measured on a separate day using MRI. For comparison of baseline values, a control group of eight healthy age- and BMI-matched recreationally active men were recruited.

The well-trained older men had lower VAT (p = 0.02), and a tendency toward lower LF content (p = 0.06) compared with the control group. The intervention resulted in decreased LF content (p = 0.02), but VAT, fat mass, and lean mass remained unchanged. VO 2 max $$ {\mathrm{VO}}_{2_{\mathrm{max}}} $$ , MFO, and Fatmax were not affected by the intervention.

The study found that repeated prolonged exercise reduced LF content, but VAT and VO 2 max $$ {\mathrm{VO}}_{2_{\mathrm{max}}} $$ remained unchanged. Aerobic capacity was aligned with lower LF and VAT in older active men.

The effects of a combined physical activity and health education program on health knowledge and well-being of socially vulnerable children.

Scandinavian J Med Sci Sports

The purpose of the present study was to evaluate the effects of the football-based health education program "11 for Health" on health knowledge and...

Biomechanical Comparison Between Superior Capsular Reconstruction and Lower Trapezius Tendon Transfer in Irreparable Posterosuperior Rotator Cuff Tears.

Am J Sports Med

Superior capsular reconstruction (SCR) and lower trapezius tendon transfer (LTT) have recently been used to manage irreparable posterosuperior rotator cuff tears (PSRCTs). There has been a paucity of comparative biomechanical considerations between the 2 procedures.

To compare the glenohumeral stability and biomechanical properties between SCR and LTT in PSRCTs involving the entire infraspinatus tendon region.

Controlled laboratory study.

Eight fresh-frozen cadaveric shoulders were tested at 0°, 20°, and 40° of shoulder abduction. Maximum internal, external, and total humeral range of motion (ROM), superior translation of the humeral head, and subacromial contact characteristics were compared among 4 conditions: (1) intact rotator cuff, (2) PSRCTs involving the entire infraspinatus tendon region, (3) LTT using Achilles allograft (12 N and 24 N of loading), and (4) SCR using fascia lata allograft.

Although a decrease in total ROM was noted in LTT with 12 N compared with the tear condition, LTT with both 12 N and 24 N as well as SCR did not restrict total rotational ROM compared with the intact condition. LTT had decreased total ROM compared with tear condition at 20° of abduction (P = .042), while no significant decrease was confirmed at all abduction angles after SCR. SCR and LTT with 24 N decreased superior translation compared with the PSRCT condition at 0° and 20° of abduction (P < .037) but not significantly at 40° of abduction, whereas LTT with a 24-N load decreased glenohumeral superior translation at all abduction angles (P < .039). Both SCR and LTT decreased subacromial contact pressure compared with the tear condition (P < .014) at all abduction angles. SCR decreased subacromial contact pressure at 0° and 40° of abduction (P = .019 and P = .048, respectively) compared with LTT with 12 N of loading, while there was no difference between SCR and LTT with 24 N of loading in all abduction angles. SCR increased the contact area compared with the PSRCT condition at all abduction angles (P < .023), whereas LTT did not increase the contact area.

SCR and LTT decreased glenohumeral superior translation and contact pressure compared with PSRCT conditions. The LTT was superior to SCR in terms of superior translation of the humeral head at a higher shoulder abduction angle, whereas the SCR showed more advantageous subacromial contact characteristics compared with LTT.

These biomechanical findings provide insights into these 2 fundamentally different procedures for the treatment of young and active patients with PSRCTs involving the entire infraspinatus tendon region.

The Sprint Mechanics Assessment Score: A Qualitative Screening Tool for the In-field Assessment of Sprint Running Mechanics.

Am J Sports Med

Qualitative movement screening tools provide a practical method of assessing mechanical patterns associated with potential injury development. Biomechanics play a role in hamstring strain injury and are recommended as a consideration within injury screening and rehabilitation programs. However, no methods are available for the in-field assessment of sprint running mechanics associated with hamstring strain injuries.

To investigate the intra- and interrater reliability of a novel screening tool assessing in-field sprint running mechanics titled the Sprint Mechanics Assessment Score (S-MAS) and present normative S-MAS data to facilitate the interpretation of performance standards for future assessment uses.

Cohort study (diagnosis); Level of evidence, 3.

Maximal sprint running trials (35 m) were recorded from 136 elite soccer players using a slow-motion camera. All videos were scored using the S-MAS by a single assessor. Videos from 36 players (18 men and 18 women) were rated by 2 independent assessors blinded to each other's results to establish interrater reliability. One assessor scored all videos in a randomized order 1 week later to establish intrarater reliability. Intraclass correlation coefficients (ICCs) based on single measures using a 2-way mixed-effects model, with absolute agreement with 95% CI and kappa coefficients with percentage agreements, were used to assess the reliability of the overall score and individual score items, respectively. T-scores were calculated from the means and standard deviations of the male and female groups to present normative data values. The Mann-Whitney U test and the Wilcoxon signed-rank test were used to assess between-sex differences and between-limb differences, respectively.

The S-MAS showed good intrarater (ICC, 0.828 [95% CI, 0.688-0.908]) and interrater (ICC, 0.799 [95% CI, 0.642-0.892]) reliability, with a standard error of measurement of 1 point. Kappa coefficients for individual score items demonstrated moderate to substantial intra- and interrater agreement for most parameters, with percentage agreements ranging from 75% to 88.8% for intrarater and 66.6% to 88.8% for interrater reliability. No significant sex differences were observed for overall scores, with mean values of 4.2 and 3.8 for men and women, respectively (P = .27).

The S-MAS is a new tool developed for assessing sprint running mechanics associated with lower limb injuries in male and female soccer players. The reliable and easy-to-use nature of the S-MAS means that this method can be integrated into practice, potentially aiding future injury screening and research looking to identify athletes who may demonstrate mechanical patterns potentially associated with hamstring strain injuries.

A Randomized Trial of Healthy Weight Gain in Athletic Individuals.

Medicine and Science in Sports

To evaluate the outcomes of a 10-week diet and exercise regimen designed to promote healthy weight gain with excess energy from peanut-containing or high-carbohydrate foods.

19 male and 13 female athletes were randomly assigned to receive 500 additional kcal/day above typical intake through provision of either peanut-based whole foods/snacks (PNT group) or a similar, high-carbohydrate, peanut-free snack (CHO group) along with supervised, whole-body RT (3 days/week for 60-120 minutes). Body composition was assessed by dual-energy x-ray absorptiometry at baseline and post-intervention. Results: Total body mass (TBM) increased 2.2 ± 1.3 kg with 1.5 ± 1.1 kg as LBM after week 10. The PNT group (N = 16; 27 ± 7 years; 10 men, 6 women) gained less TBM than the CHO group (N = 16; 23 ± 3 years; 9 men, 7 women) (1.6 ± 1.1 kg vs 2.7 ± 1.2 kg, respectively, P = 0.007) with no differences in LBM (1.2 ± 1.1 kg vs 1.9 ± 1.0 kg, P = 0.136).

These results suggest that the addition of 500 kcal/day from whole foods/snacks in combination with a rigorous RT program promotes a similar weight gain of ~0.22 kg/week, primarily as LBM, over 10 weeks in both male and female athletes. However, snack macronutrient content may impact the effectiveness of this regimen.

Five Weeks of Sprint Interval Training Improve Muscle Glycolytic Content and Activity But Not Time to Task Failure in Severe Intensity Exercise.

Medicine and Science in Sports

This study examined the impact of a 5 weeks sprint interval training (SIT) intervention on time to task failure (TTF) during severe intensity constant work rate (CWR) exercise, as well as in glycolytic enzymatic content and activity, and glycogen content.

Fourteen active males were randomized into either a SIT group (n = 8) composed of 15 SIT-sessions over 5 weeks, or a control group (n = 6). At pre-training period, participants performed: i) ramp incremental test to measure the cardiorespiratory function; ii) CWR cycling TTF at 150% of the power output (PO) at the respiratory compensation point (RCP-PO) with muscle biopsies at rest and immediately following task failure. After 5 weeks, the same evaluations were repeated (i.e., exercise intensities matched to current training status), and an additional cycling CWR matched to pre-training 150% RCP-PO was performed only for TTF evaluation. The content and enzymatic activity of glycogen phosphorylase (GPhos), hexokinase (HK), phosphofructokinase (PFK), and lactate dehydrogenase (LDH), as well as the glycogen content, were analyzed. Content of monocarboxylate transporter isoform 4 (MCT4) and muscle buffering capacity were also measured.

Despite improvements in total work performed at CWR post-training, no differences were observed for TTF. The GPhos, HK, PFK, and LDH content and activity, and glycogen content also improved post-training only in the SIT group. Further, the MCT4 concentrations and muscle buffering capacity was also improved only for SIT group. However, no difference in glycogen depletion was observed between groups and time.

Five weeks of SIT improved the glycolytic pathway parameters and total work performed, however, glycogen depletion was not altered during CWR severe intensity exercise, and TTF remained similar.

Plant Protein Blend Ingestion Stimulates Post-Exercise Myofibrillar Protein Synthesis Rates Equivalently to Whey in Resistance-Trained Adults.

Medicine and Science in Sports

Whey protein ingestion is typically considered an optimal dietary strategy to maximize myofibrillar protein synthesis (MyoPS) following resistance exercise. While single source plant protein ingestion is typically less effective, at least partly, due to less favorable amino acid profiles, this could theoretically be overcome by blending plant-based proteins with complementary amino acid profiles. We compared the post-exercise MyoPS response following the ingestion of a novel plant-derived protein blend with an isonitrogenous bolus of whey protein.

Ten healthy, resistance trained, young adults (male/female: 8/2; age: 26 ± 6 y; BMI: 24 ± 3 kg·m-2) received a primed continuous infusion of L-[ring-2H5]-phenylalanine and completed a bout of bilateral leg resistance exercise before ingesting 32 g protein from whey (WHEY) or a plant protein blend (BLEND; 39.5% pea, 39.5% brown rice, 21.0% canola) in a randomized, double-blind crossover fashion. Blood and muscle samples were collected at rest, and 2 and 4 h after exercise and protein ingestion, to assess plasma amino acid concentrations, and postabsorptive and post-exercise MyoPS rates.

Plasma essential amino acid availability over the 4 h postprandial post-exercise period was ~44% higher in WHEY compared with BLEND (P = 0.04). From equivalent postabsorptive values (WHEY, 0.042 ± 0.020%·h-1; BLEND, 0.043 ± 0.015%·h-1) MyoPS rates increased following exercise and protein ingestion (time effect; P < 0.001) over a 0-2 h (WHEY, 0.085 ± 0.037%·h-1; BLEND, 0.080 ± 0.037%·h-1) and 2-4 h (WHEY, 0.085 ± 0.036%·h-1; BLEND, 0.086 ± 0.034%·h-1) period, with no differences between conditions during either period or throughout the entire (0-4 h) postprandial period (time × condition interactions; all P > 0.05).

Ingestion of a novel plant-based protein blend stimulates post-exercise MyoPS to an equivalent extent as a whey protein, demonstrating the utility of plant protein blends to optimize post-exercise skeletal muscle reconditioning.

The Effects of Load, Crank Position, and Sex on the Biomechanics and Performance during an Upper Body Wingate Anaerobic Test.

Medicine and Science in Sports

The upper body Wingate Anaerobic Test (WAnT) is a 30-second maximal effort sprint against a set load (percentage of body mass). However, there is no consensus on the optimal load and no differential values for males and females, even when there are well-studied anatomical and physiological differences in muscle mass for the upper body. Our goal was to describe the effects of load, sex, and crank position on the kinetics, kinematics, and performance of the upper body WAnT.

Eighteen participants (9 females) performed three WAnTs at 3, 4, and 5% of body mass. Arm crank forces, 2D kinematics, and performance variables were recorded during each WAnT.

Our results showed an increase of ~49% effective force, ~36% peak power, ~5° neck flexion, and ~ 30° shoulder flexion from 3-5% load (p < .05). Mean power and anaerobic capacity decreased by 15%, with no changes in fatigue index (p < .05). The positions of higher force efficiency were at 12 and 6 o'clock. The least force efficiency occurred at 3 o'clock (p < .05). Sex differences showed that males produced 97% more effective force and 109% greater mean power than females, with 11.7% more force efficiency (p < .001). Males had 16° more head/neck flexion than females, and females had greater elbow joint variability with 17° more wrist extension at higher loads. Males cycled ~32% faster at 3 vs 5% load with a 65% higher angular velocity than females. Grip strength, MVIC, mass, and height positively correlated with peak and mean power (p < .001).

In conclusion, load, sex, and crank position have a significant impact on performance of the WAnT. These factors should be considered when developing and implementing an upper body WAnT.

Concurrent Validity and Reliability of Video-Based Approach to Assess Physical Function in Adults with Knee Osteoarthritis.

Physical Therapy

The aim of this study was to determine the concurrent validity and reliability of the Osteoarthritis Research Society International recommended performance-based tests delivered by video-based in adults with knee osteoarthritis.

Thirty-two participants (aged 40 to 70 years; 15 men) undertook assessments of 4 performance-based tests via both video-based (real-time and recorded) and face-to-face approaches, on the same day. Outcome measures were performance-based test and the number of technical issues encountered. The performance-based tests included the 40-Meter Fast-Paced Walk Test (velocity, m/s), the 30-Second Chair Stand Test (number of repetitions), the Stair Climb Test (time, seconds), and the Timed "Up & Go" Test (TUG; time, seconds). The Bland-Altman limit of agreement measures, standard error of measurement (SEM), coefficient of variation (CV), minimal detectable changes (MDCs), and bias (mean difference) were employed to analyse the concurrent validity between video-based and face-to-face approaches of the performance-based tests. Reliability was measured using intraclass correlation coefficients (ICC), CV, and SEM.

A high degree of concurrent validity for the TUG (bias = -0.22), the 30-Second Chair Stand Test (bias = -0.22), the Stair Climb Test (bias = -0.31), and the 40-Meter Fast-Paced Walk Test (bias = -0.06) was found. SEM and CV values were within the acceptable level for concurrent validity. There was a high degree of reliability demonstrated for all tests analysed. ICC measures ranged from 0.95 to 1.00 for intrarater reliability, and from 0.95 to 0.99 for interrater reliability.

Video-based assessment is a promising public health tool to measure physical function in adults with knee osteoarthritis.

Igniting the Fire of Discovery: Creating Partnerships between Research, Education, and Practice.

Physical Therapy

In the 28th H.P. Maley Lecture, Stacey Dusing, PT, PhD, FAPTA, shares a perspective on the importance of clinician-scientists in bridging the chasm...