Fisioterapia

The aim of the study was to develop a novel real-time, computer-based synchronization system to continuously record pressure and craniocervical flexion ROM (range of motion) during the CCFT (craniocervical flexion test) in order to assess its feasibility for measuring and discriminating the values of ROM between different pressure levels. This was a descriptive, observational, crosssectional, feasibility study. Participants performed a full-range craniocervical flexion and the CCFT. During the CCFT, a pressure sensor and a wireless inertial sensor simultaneously registered data of pressure and ROM. A web application was developed using HTML and NodeJS technologies. Forty-five participants successfully finished the study protocol (20 males, 25 females; 32 (11.48) years). ANOVAs showed large effect significant interactions between pressure levels and the percentage of full craniocervical flexion ROM when considering the 6 pressure reference levels of the CCFT (p < 0.001; 2 = 0.697), 11 pressure levels separated by 1 mmHg (p < 0.001; 2 = 0.683), and 21 pressure levels separated by 0.5 mmHg (p < 0.001; 2 = 0.671). The novel time synchronizing system seems a feasible option to provide real-time monitoring of both pressure and ROM, which could serve as reference targets to further investigate the potential use of inertial sensor technology to assess or train deep cervical flexors.

To analyze the microbiota of the physiotherapist’s work environment to understand the existing potential risks and to adopt appropriate preventive measures.

The craniocervical flexion test (CCFT) is recommended when examining patients with neck pain related conditions and as a deep cervical retraining exercise option. During the execution of the CCFT the examiner should visually assess that the amount of craniocervical flexion range of motion (ROM) progressively increases. However, this task is very subjective. The use of inertial wearable sensors may be a user-friendly option to measure and objectively monitor the ROM. The objectives of our study were (1) to measure craniocervical flexion range of motion (ROM) associated with each stage of the CCFT using a wearable inertial sensor and to determine the reliability of the measurements and (2) to determine craniocervical flexion ROM targets associated with each stage of the CCFT to standardize their use for assessment and training of the deep cervical flexor (DCF) muscles.

The purpose of the study was to determine if an intensive preseason training program modifies the inflammatory status in professional soccer players and if this inflammatory profile may be associated with the physical state. We compared plasma protein biomarkers, using proteomics, and the physiological state and cardiac function in 12 professional soccer players and 9 recreational soccer players. Reduced cardiac low frequency [LF] after the pre-season training program previous competition with respect to recreational soccer players was found. No differences were found in cardiac high frequency, cardiac high frequency/ low frequency ratio, tension index and oxygen volume consumption. Alpha-1-antitrypsin isotype-3, fibrinogen-gamma isotypes-1, 2 and 3 and vitamin-D-binding protein isotype-1 were reduced in professionals players compared with those in recreational players. However, an increased content of alpha-1- antitrypsin isotype-6 and alpha-1-antichymotrypsin 1 and 4 were found in professional soccer players. Spearman´s analysis showed a positive correlation between LF and fibrinogengamma chain isotype 3; but LF was negatively correlated with alpha-antichymotrypsin isotype 4. Professional soccer players submitted to an intensive training showed differences in the content of plasma proteins associated with inflammatory/ oxidative stress and thrombosis with respect to recreational soccer players. Proteomics analysis in combination with the analysis of cardiac function assessment may be useful to know more in depth molecular processes associated with sport and intensive exercise.

Jugador profesional de tenis de 26 años (188 cm ,82 kg) que durante el transcurso de un partido de un torneo Máster Series sufre dolor en zona abdominal al realizar un servicio. Los problemas de la musculatura abdominal constituyen una de las lesiones características del jugador de tenis. Son lesiones muy frecuentes al punto que una gran parte de los tenistas profesionales han sufrido este tipo de problemas en algún momento de su carrera. Se presentan en jugadores de todos los niveles y, por su naturaleza incapacitante para la ejecución del servicio y su tendencia a la recidiva, han de ser consideradas lesiones potencialmente graves, en especial, para el tenista de alta competición. La gran mayoría de las lesiones de la pared abdominal involucran al músculo recto mayor contralateral al brazo dominante (el que se utiliza para sacar). El músculo recto abdominal y las fibras laterales del oblicuo externo son considerados los movilizadores primarios de la flexión del tronco. Durante la fase de preparación del servicio de tenis, el jugador aleja la raqueta del cuerpo, principalmente, mediante la abducción-rotación externa del hombro y la hiperextensión de la columna lumbar, con el objetivo de aumentar el recorrido y velocidad de la raqueta. Durante esa fase del lanzamiento, el recto abdominal contralateral ha mostrado una elevada actividad electromiográfica predisponiendo a su lesión por estiramiento.

La articulación escapulotorácica y la acromioclavicular (AC) están íntimamente interrelacionadas formando el complejo suspensorio del hombro. Por lo tanto, las luxaciones AC de cualquier grado pueden afectar al ritmo escapular y a su biomecánica. En este artículo se revisa el concepto de disquinesis, cuáles son los criterios para su evaluación y las diferentes clasificaciones. Además, se profundiza en la relación entre la luxación AC y la disquinesis. Los aspectos anatómicos, la presencia aumentada de la disquinesis en el contexto de las diferentes lesiones de la AC y las hipótesis sobre sus causas. Finalmente se comentan los resultados del tratamiento conservador y quirúrgico en el contexto de la luxación AC grado 3 en cuanto a la disquinesis.

Shoulder pain is one of the most frequent causes of disability in overhead sports and often forces athletes andworkers to stop their activities. Scapular dyskinesis is not an injury or a musculoskeletal diagnosis, but rather analteration of the normal position or motion of the scapula during coupled scapulohumeral movements. Theunderlying pathology can be multifactorial in nature, and understanding the various contributing factors is importantin order to properly diagnose and treat the patient. An additional goal should be the prevention of further pathologyor symptoms. In the present article the concept of scapular dyskinesis is reviewed along with a review of theliterature regarding related pathology and our observations. Scapular dyskinesis can exist in asymptomaticindividuals. In symptomatic patients with shoulder pain the scapular rhythm should be evaluated and treated. Someof the associated pathologies could be subacromial impingement, internal impingement, chronic acromioclaviculardislocations grade III, chronic neck pain. Physical therapy is usually the preferred treatment of choice and effectiveto treat these patients.

This study aimed to study the coactivation patterns of the hamstring and quadriceps muscle groups during submaximal strength exercises commonly used in injury prevention in soccer without the use of maximum voluntary isometric contraction testing. This was used to compare: (i) the inter-limb differences in muscle activation; (ii) the intra-muscular group activation pattern and (iii) the activation pattern during different phases of the exercise. Muscle activation was recorded by surface electromyography in 19 elite, male, youth soccer players. Participants performed the following: Bulgarian squat, lunge and squat. Electrical activity was recorded for the rectus femoris, vastus medialis, vastus lateralis, biceps femoris and semitendinosus. No significant inter-limb differences were found (F1, 13 = 619; p = 0.82; 2 = 0.045). Significant di erences were found in the muscle activation between individual muscles within the quadriceps and hamstrings muscle group for each of the exercises: Bulgarian squat (F1,18 = 331: p < 0.001; n2 = 0.80), lunge (F4,72 = 114.5; p < 0.001; n2 = 0.86) and squat (F1,16 = 247.31; p < 0.001; n2 = 0.93). Differences were found between the different phases of each of the exercises (F2,26 = 52.27; p = 0.02; n2 = 0.80). The existence of an activation pattern of each of the muscles in the three proposed exercises could be used for muscle assessment and as a tool for reconditioning post-injury.

Isokinetics is a tool commonly used in professional soccer. There is ongoing debate among researchers as to the isokinetic reference values a player should have. Objectives: To determine the absolute peak torque (PT) and average work of professional soccer players in relation to their positions on the field, and to establish the reference values for these variables. Methods: Purposeful sampling was used to select 289 professional soccer players. The sample included 32 goalkeepers, 100 defenders, 98 midfielders, and 59 strikers. The participants were measured preseason. The players were asked to perform a 10-minute warm-up on an exercise bike, and then to perform 5 repetitions at low speed, 10 at medium speed, and 25 at high speed, with 30 to 40-s of rest between each set of repetitions. The contraction method was concentric-concentric in a dynamometer Isomed 2000. Results: The average age, weight, and height of the players was 21.9 years, 74.3 kilograms, and 1.8 meters, respectively. The goalkeepers presented higher PT at the 3 measured speeds, and the higher average work at 180°/s and 240°/s in relation to defenders and midfielders. The strikers presented higher average work at 240°/s in relation to midfielders, and higher PT in relation to the defenders and midfielders. Absolute values. were shown and reference values were established. Conclusions: The goalkeepers and strikers were the players that showed the greatest differences in their favor in relation to the other positions. The peak torque values and average work were described in relation to the player’s position on the field. This study resulted in the creation of a tool for health professionals working with professional soccer players, providing reference values for these players in relation to their position on the field that can be used as benchmarks, by health professionals, to optimize soccer players’ performance

The aim of this study was to determine blood pressure (BP) and heart rate (HR) responses triggered during an isokinetic testing protocol in professional soccer players and compare cardiovascular parameters at completion of this isokinetic protocol with those during a treadmill test. Using purposive sampling, 63 professional soccer players were recruited. Cardiovascular responses were measured noninvasively during a bilateral testing protocol of knee flexion and extension. Treadmill ergospirometry following an incremental speed protocol was performed to analyze the same cardiovascular parameters at rest and at completion of this test. There were significant differences in diastolic blood pressure (DBP) and HR according to field position. The parameters presented high homogeneity at both competitive levels. Systolic blood pressure, mean arterial pressure, HR, and rate pressure product at completion of the treadmill test were significantly higher than those at completion of the isokinetic protocol. Intermittent isokinetic testing protocol of the knee triggers normal and safe BP and HR responses in healthy professional soccer players. The HR of the defenders was higher than those of the forwards and midfielders but was independent of the competitive level. The values of cardiovascular parameters at isokinetic protocol completion were lower than those during the treadmill test.