Notes from the Field: The Construction of a Logistical Model for Sports-Related Injury Risk Assessment. A Cross-Sectional Pilot Study

Handball is a high-intensity contact sports activity characterized by repetitive movements, leading to sport-specific muscle patterns. However, at some stage, this pattern may turn into imbalance, predisposing athletes for injuries. The complexity of muscular interactions often makes it difficult to see a whole picture of an athlete’s postural disorders and assess them within the framework of his stereotyped movements. We attempted to find an association between the muscle pattern and the number of injuries in a limited group of handball players by constructing a static logistical model. The constructed decision table of the static logistical model included seven conditional attributes of the muscle imbalance as preconditions for injury development and one decision attribute representing the number of experienced injuries of 25 university handball players. The findings displayed a sport-specific pattern of muscle alignment in athletes without or only one injury. However, all players with repetitive injuries had unilateral m. gluteus maximus weakness. In the latter case, impaired core body musculature can lead to increased share forces and stress for the gluteus maximus muscle leading to weakness of this crucial dynamic stabilizer. The logistical model allowed defining muscle imbalance associated with sports-related injuries in a limited group of athletes.

Hand-Held Dynamometry to Safely Measure Muscle Strength in Patients In Intensive Care

Background: Intensive care unit-acquired weakness (ICU-AW) has been increasingly studied and associated with prognostic factors of negative outcomes during the hospitalization of critically ill patients. Therefore, it is essential to evaluate the muscle strength of patients in the intensive care unit (ICU) with accurate quantitative tools, such as the hand-held dynamometer (HHD), which directly measures the strength of large muscle groups, providing earlier and more accurate decision making. The objective of the present study was to evaluate the safety of using HHD to measure the strength of large muscle groups in ICU patients, in addition to determining the prevalence of muscle imbalance in these patients, and correlating HHD measures with the Medical Research Council (MRC) scale. Methods: A cross-sectional study was conducted, inferring the impact of strength measurement of the main muscle groups using HHD on vital signs, dyspnea, and pain. The occurrence of adverse events during the evaluation was also observed. Safety was assessed using the paired t-test, calculating the prevalence of muscle imbalance in the sample and Pearson’s correlation between the strength measurement instruments. Results: The sample consisted of 46 volunteers, and no clinically significant variability was observed for pre- and post-safety variables. A high prevalence of muscle imbalance was found in the sample, and there was a strong correlation between HHD and MRC. Discussion: Strength measurement using HHD in the ICU is safe and well-tolerated, providing information on the individual condition of large muscle groups and improving the ability to diagnose muscle imbalance in the ICU patients.

Functional Arthralgies of Knee Joint as a Complex Problem in the Modern Rehabilitation System

The purpose of the study was to search for and analyze data from modern sources of information on the features of the occurrence and manifestations of pain in the knee joint and approaches to treatment. Materials and methods. The paper presents an analysis and generalization of modern scientific and methodological literature of domestic and foreign authors according to the Internet and Google Scholar service on the peculiarities of arthralgia of the knee joint and concomitant manifestations of this disorder (back pain, posture, etc.). Results and discussion. The article analyzed modern views on the occurrence and development of the process of pain syndrome in the knee joint. Sources on request in the Google Scholar service were analyzed, where the overwhelming majority of publications are described by pain slander and approaches to its treatment after the occurrence of anatomical changes in the structures of bone and soft-wound structures or after surgical interventions. Thus, the prevailing approach is the purpose of non-steroidal anti-inflammatory drugs in combination with chondroprotectors. According to the authors of the article, this approach to the treatment of pain in the area of the knee joint does not take into account one of the main components of the occurrence of arthralgia – muscle imbalance, both at the local level of the lower extremities and muscular-fascial chains. According to the theory of muscular chains, the dislocation of bones forming the knee joint leads to uneven loading of the femoral and tibial bones to the metaphizar deposits, which leads to a circulatory disorder and further leads to degenerative-dystrophic diseases. Understanding this component of pathogenesis can give a specialist in physical therapy and ergotherapy a more informed approach to the development of balanced treatment tactics aimed at eliminating the primary causes of pain syndrome. Conclusion. Pain in the knee joint can be caused not only by degenerative-dystrophic changes in the bones, but also can be associated with muscle imbalance of the posterior surface line. The development of a rehabilitation program for knee pain should include not only the use of local remedies, but also take into account the impact on the relevant reflex areas in the spine. Emerging degenerative-dystrophic processes in the bones that are part of the structure of the knee joint can be caused by their dislocation due to muscle imbalance. Uncontrolled and unauthorized use of analgesics by patients with knee pain can smooth the clinical picture and reduce the effectiveness of rehabilitation measures

EFFECT OF LOWER LIMB PROXIMAL TO DISTAL MUSCLE IMBALANCE CORRECTION ON FUNCTIONAL PES PLANUS DEFORMITY IN YOUNG ADULTS

The pes planus deformity is seen more in adults. Pes planus or low foot medial longitudinal arch, contributes to lower extremity injury due to the muscular imbalance. This deformity causes proximal to distal muscle imbalance in lower limb. Effective correction of muscle imbalance is prime important in correction of pes planus. The purpose of the study was to find the effect of exercise in pes planus to correct the imbalance, improve the condition & prevent the injuries along with the long-term effect of the pes planus deformity. To study and find the effect of lower limb proximal to distal muscle imbalance correction in pes planus deformity in young adults. 40 people with functional pes planus deformity were randomly assigned to a group that received the baseline treatment for the muscle imbalance along with the intrinsic muscle strengthening exercises (experimental group) or a group that received only intrinsic muscle strengthening exercises (control group). Each group received 6 weeks treatment. Statistical analysis were performed using paired t test and unpaired t test. In pre-intervention, there was no statistically significant difference seen with p values for the navicular drop test for the right leg and left leg 0.1127, 0.1504 respectively. Ink test p values for the right leg, left leg 0.4184, 0.8719 respectively. While on comparing the post-interventional values using the unpaired t test, revealed that there was extremely significant difference seen with p value for both legs the navicular drop test was 0.0001 and for the ink test (right leg=0.0008, left leg=0.0318). Our study reported that muscular imbalance corrective exercises along with the intrinsic muscle strengthening was more effective in improving the condition and muscle imbalance caused by the pes planus. So, muscular imbalance corrective exercises and intrinsic muscle strengthening exercises should be recommended to correct the deformity or prevent the abnormalities in people with functional pes planus.

Comparison of scapular upward rotator muscle activities and activity ratios during three scapular upward rotator strengthening exercises

BACKGROUND: The focus of exercises for restoring the imbalance between scapular upward rotator muscles – upper trapezius (UT), serratus anterior (SA), and lower trapezius (LT) – commonly aims to increase SA and LT activities while not increasing UT activity. OBJECTIVES: The purpose of this study was to compare the activity of the UT, SA, and LT muscles during scapation and protraction exercises, which are two traditional exercises, and during a newly designed scapular upward rotation (SUR) exercise. METHODS: A total of 29 healthy young adult men performed all three exercises with maximum isometric contraction. The electromyographic activities of the UT, SA, and LT were recorded. RESULTS: UT demonstrated the highest activity during scapation. SA activity was the lowest during protraction. However, no difference was found in SA activity during the performance of scapation and SUR. The SA/UT ratio was the highest during scapation. CONCLUSIONS: SUR is a new exercise that can be performed at moderate intensity for shoulder rehabilitation to restore scapular upward rotator muscle imbalance.

Effects of scapular stabilization exercises on posture and muscle imbalances in women with upper crossed syndrome: A randomized controlled trial

BACKGROUND: Scapular stabilization exercises can improve forward shoulder posture in young women. However, the effects of optimal exercise protocols on neck and shoulder postures, scapular muscle imbalance and thoracic kyphosis are still unclear. OBJECTIVES: To investigate the effects of scapular stabilization exercises on neck and shoulder postures, scapular muscle imbalance and thoracic kyphosis in young women with upper crossed syndrome. METHODS: Thirtyninewomenaged 1825 years with upper crossed syndrome were recruited. Participants were randomly allocated intotwo groups. The exercise group performed scapular stabilization exercises using elastic bands at 10 repetitionsset, 3 setsday, and 3 daysweek for 4 weeks. The control group did not perform any exercises during the experimental period. The cervical and shoulder angles were evaluated using the Kinovea program. A caliper, handheld dynamometer and flexi ruler were used to evaluate the length of the pectoralis minor, strength of the scapular stabilizer muscles and degree of the mid-thoracic curve, respectively. RESULTS: The exercise group showed significant differences (p< 0.05) in the increase in cervical and shoulder angle, length of the pectoralis minor, and strength of the scapular muscles, except in the degree of mid-thoracic curve compared to the control group. CONCLUSION: This study indicated that scapular stabilization exercises can improve forward head and shoulder posture, increase the flexibility of the pectoralis minor and strengthen the scapular muscles.

Stress Fracture in Non-Athletes: A Systematic Review

The present study seeks to discuss the incidence of a stress fracture in not athletes. This type of pathology occurs as a result of a repetitive number of movements in a given region, fatigue and muscle imbalance are the main responsible for these fractures, which mainly affect runners and military, groups that are more susceptible to a large amount of impact In practice, and has been increasing in non-athletes. To do so, it reviews the literature based on the first descriptions of the stress fracture, the causes of this type of occurrence, the results on the patient's body, and the modes of treatment and recovery. The objective of this study is to review the literature currently available to aggregate the most relevant information regarding this pathology.