Muscle function in women with systemic sclerosis: Association with fatigue and general physical function

BackgroundIndividuals with systemic sclerosis have muscle functions with varying degrees of muscle weakness and atrophy, which in turn can have a negative impact on functional and health-related quality of life. This study aimed to evaluate peripheral muscle performance using isokinetic dynamometry of the knee in women with systemic sclerosis and to correlate peripheral muscle dysfunction with disability levels and general fatigue.MethodsTwenty-six women with systemic sclerosis and a matched control group with an equal number of women underwent knee isokinetic dynamometry at angular speeds of 75°/s and 240°/s, isometric handgrip strength, the Health Assessment Questionnaire Disability Index, the Functional Assessment of Chronic Illness Therapy-Fatigue scale, and the Fatigue Impact Scale.FindingsWomen with systemic sclerosis showed significant reductions in almost all isokinetic parameters for the two angular velocities tested compared with the controls. An agonist/antagonist ratio with values < 40% was observed in approximately one-third of the patients. These patients had lower isometric handgrip strength. These patients also performed worse on the two general fatigue scales evaluated. Significant correlations were observed between the isokinetic parameters and the measured isometric handgrip strength, and the Health Assessment Questionnaire Disability Index.InterpretationSystemic sclerosis patients have reduced strength and endurance as well as a muscle imbalance between the quadriceps and hamstrings. In these patients, lower muscle dysfunction of the knee joint is associated with lower handgrip strength and physical incapacity.     

Reliability of forearm medial-anterior surface dimensional changes at different isometric hand grip forces

Indirect techniques of predicting hand grip force are fundamental to develop hand control systems for assistive devices. The purpose of this study was to determine the reliability of 3D position of forearm surface at different isometric hand grip forces. Three-dimensional motion analysis was used to measure displacement of 24 discrete and standardized surface markers placed on forearm in 20 healthy participants. The relative displacements were measured for isometric grip forces at 0%, 5%, 20% 50% and 80% of maximum voluntary contraction (MVC). Intraclass correlation coefficient (ICC) for relative radial displacement (RRD) of each marker was calculated. Averaged single measure ICC of 24 markers at five grip forces was 0.61; while the highest averaged single measure ICC (0.80) for all markers was achieved at 80% of MVC and the lowest (0.47) at 0% of MVC. The average measure ICC for each grip force across the 24 markers also increased with grip force from 0.80 at 0% of MVC to the maximum of 0.95 at 80% of MVC. In conclusion, RRD showed moderate and high ICCs for single and average measures respectively. Overall, this study suggests that the reliable dimensional changes of 3D positions of forearm surface might be considered as an indirect and non-invasive method to predict hand grip force in future.     

Diagnostic ultrasound assessment of deep fascia sliding mobility in vivo: A scoping review – Part 1: Thoracolumbar and abdominal fasciae

BackgroundFailure of fascial sliding may occur in cases of excessive or inappropriate use, trauma, or surgery, resulting in local inflammation, pain, sensitization, and potential dysfunction. Therefore, the mechanical properties of fascial tissues, including their mobility, have been evaluated in vivo by ultrasound (US) imaging. However, this seems to be a method that is not yet properly standardized nor validated.ObjectivesTo identify, synthesize, and collate the critical methodological principles that have been described in the literature for US evaluation of deep fascia sliding mobility in vivo in humans.MethodsA systematic literature search was conducted on ScienceDirect, PubMed (Medline), Web of Science and B-On databases, according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. The OCEBM LoE was used to evaluate the level of evidence of each study.ResultsFrom a total of 104 full-text articles retrieved and assessed for eligibility, 18 papers were included that evaluate the deep fasciae of the thoracolumbar (n = 4), abdominal (n = 7), femoral (n = 4) and crural (n = 3) regions. These studies addressed issues concerning either diagnosis (n = 11) or treatment benefits (n = 7) and presented levels of evidence ranging from II to IV. Various terms were used to describe the outcome measures representing fascial sliding. Also, different procedures to induce fascial sliding, positioning of the individuals being assessed, and features of US devices were used. The US analysis methods included the comparison of start and end frames and the use of cross-correlation software techniques through automated tracking algorithms. These methods had proven to be reliable to measure sliding between TLF, TrA muscle-fascia junctions, fascia lata, and crural fascia, and the adjacent epimysial fascia. However, the papers presented heterogeneous terminologies, research questions, populations, and methodologies.This two-part paper reviews the evidence obtained for the thoracolumbar and abdominal fasciae (Part 1) and for the femoral and crural fasciae (Part 2).ConclusionThe US methods used to evaluate deep fascia sliding mobility in vivo in humans include the comparison of start and end frames and the use of cross-correlation software techniques through automated tracking algorithms. These seem reliable methods to measure sliding of some fasciae, but more studies need to be systematized to confirm their reliability for others. Moreover, specific standardized protocols are needed to assess each anatomical region as well as study if age, sex-related characteristics, body composition, or specific clinical conditions influence US results.     

Effect of releasing quadratus lumborum muscle on hip and knee muscle length in asymptomatic individuals

BackgroundQuadratus lumborum muscle (QL) is one of several muscles subject to tightness and relevant to symptoms in the back and hip. Although releasing the tight QL seems to resolve these symptoms in clinic, no study has investigated the effects of such releasing on the length of the hip and knee muscles.ObjectiveTo compare muscle length of the hip and knee joints between pre- and post-releasing the QL.MethodsA quasi-experimental design (one-group pretest-posttest design) was conducted. Thirty asymptomatic participants with mean age of 20.40 years took part in the study. An examiner assessed the participants’ pelvic transverse gliding movement in standing and rotation of the upper trunk in supine to perceive the end feel of tissue resistance. The side with perceived more muscle tension was selected for receiving muscle release. Before manually releasing the QL, the participant was in the modified Thomas test position and pre-test range of motion (ROM) of hip flexion, hip abduction, and knee flexion angles was measured using a standard goniometer. After releasing the QL, the aforementioned angles were measured for post-test ROM.ResultsThe hip flexion angle was significantly reduced after releasing the QL (p < 0.05), whereas no statistically significant differences were found for the other 2 angles (p > 0.05).ConclusionThe length of iliopsoas muscle was increased after releasing the QL. The findings may be due to continuous fascial connection and similar attachment of the origins of these 2 muscles.Clinical trial registration numberNCT03016559.     

The effect of the Kinesio Tape on the muscle power performance of elite weightlifters

IntroductionTo investigate the effect of the Kinesio Tape on the muscle power of the elite weightlifters.MethodsA randomized controlled trial, single blind. Forty-two male weightlifters were randomly assigned to the experimental Kinesio Tape and sham Kinesio Tape groups of the study. The participants then performed a single leg vertical jump and a single leg horizontal jump with three attempts of each to obtain the measurement of muscle power. Outcome measures were included single-leg vertical countermovement jump, estimated peak power, and single-leg horizontal countermovement jump.ResultSignificant effect of Kinesio Tape on horizontal jumps distance among the weightlifters in the experimental group (p = 0.002). The study showed that the vertical jump height (p = 0.433), estimated peak power (p = 0.542) and horizontal jump distance (p = 0.841) measurements did not improve significantly between the groups at level p = 0.05.ConclusionThere is a small and better improvement noticed on the outcome measurements after Kinesio Tape application, which may be considered clinical importance for the sport. However, there was no statistically significant effect of Kinesio Tape between the groups.     

Recovery profiles of eccentric hamstring strength in response to cooling and compression

IntroductionThe effectiveness of different forms of cryotherapy and combined compression (cryo-compression) commonly used in sport to enhance recovery following exercise are not fully understood. Therefore, the exploration of protocols that use contemporary cryo-compression is warranted. The purpose of the study was to investigate the effectiveness of using a cryo-compression device to recover hamstrings eccentric strength following a fatiguing exercise.MethodsEighteen healthy male adult footballers were randomly allocated to receive cryo-compression or rest following a lower limb fatiguing protocol. Cryo-compression was applied for 15-min, target temperature of 10 °C, and high intermittent pressure (5–75 mm Hg) using the Game Ready® device. Rest consisted of 15-min in a prone position on a plinth. To induce hamstring fatigue, participants performed the Yo-Yo intermittent fatigue test (IFT). Skin surface temperature (T_sk) and hamstring eccentric strength measures were taken at three time points; pre-IFT, immediately post-fatigue test (IPFT), and immediately post-intervention (IPI) (rest or Game Ready®). Participants returned one week later and performed the Yo-Yo IFT again and were exposed to the opposite intervention and data collection.ResultsSignificant decreases in T_sk over the posterior thigh were reported for all timepoints compared to pre cryo-compression temperatures (p=<0.05). Overall data displayed no significant main effects for timepoint or condition for PT or AvT (p=<0.05). There was no timepoint × condition interaction for PT or AvT (p=<0.05). Collapse of the data by condition (CC/R) demonstrated no significant effect for time for PT or AvT (p=>0.05).ConclusionsNo significant changes in HES occurred after exposure to cryo-compression or rest applied immediately following the Yo-Yo IFT. Further investigations to maximise beneficial application of contemporary cryo-compression applications in sport are required. Multiple measures of performance over rewarming periods, within competitive training schedules after sport-specific training are required to develop optimal cooling protocols for recovery.     

Differential diagnosis of endometriosis in patient with nonspecific low back pain: A case report

BackgroundEndometriosis is one of the most widespread gynecological disorders and a very common condition amongst fertile women, thus it has to be considered one of the possible sources of lumbopelvic pain. Endometriosis is commonly related to low back pain (LBP) and therefore often mistaken for a musculoskeletal disorder.The purpose of this case report is to underline the primary role of clinical reasoning and assessment process, which led the physiotherapist to the differential diagnosis, considering endometriosis among the possible causes of low back pain.Case presentationS.C, 45 years old, complained to physiotherapist of lumbar spine and left buttock pain, spreading to the hypogastric, inguinal and left pubic areas. The patient's past medical history included gynecological visceral disorders, regularly monitored. Functional evaluation and clinical tests revealed a disorder referred to the lumbar spine and sacroiliac region. Initial physical therapy management included education, manual therapy and therapeutic exercise. Nevertheless, after five treatment sessions, the symptoms remained unchanged, and therefore the patient was referred to a gynecologist for a consultation. The patient underwent a laparoscopy for endometriosis eradication and the intervention resulted in complete abolition of symptoms, enabling the patient to return to work and to do physical activities.Conclusionsthis case report highlights the importance of a thorough clinical assessment and the identification of relevant findings from patient's medical history to be carried out by the physiotherapist. Those are of crucial importance to make an appropriate differential diagnosis and to screen amongst the possible causes of lumbopelvic pain also visceral ones as endometriosis, which often manifests with associated symptoms such as nonspecific LBP.