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Pereira MJ, André A, Monteiro M, Castro MA, Mendes R, Martins F, Gomes R, Vaz V, Dias G. Methodology and Experimental Protocol for Studying Learning and Motor Control in Neuromuscular Structures in Pilates. Healthcare (Basel) 2024; 12:229. [PMID: 38255116 PMCID: PMC10815589 DOI: 10.3390/healthcare12020229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/28/2023] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
The benefits of Pilates have been extensively researched for their impact on muscular, psychological, and cardiac health, as well as body composition, among other aspects. This study aims to investigate the influence of the Pilates method on the learning process, motor control, and neuromuscular trunk stabilization, specifically in both experienced and inexperienced practitioners. This semi-randomized controlled trial compares the level of experience among 36 Pilates practitioners in terms of motor control and learning of two Pilates-based skills: standing plank and side crisscross. Data will be collected using various assessment methods, including abdominal wall muscle ultrasound (AWMUS), shear wave elastography (SWE), gaze behavior (GA) assessment, electroencephalography (EEG), and video motion. Significant intra- and inter-individual variations are expected, due to the diverse morphological and psychomotor profiles in the sample. The adoption of both linear and non-linear analyses will provide a comprehensive evaluation of how neuromuscular structures evolve over time and space, offering both quantitative and qualitative insights. Non-linear analysis is expected to reveal higher entropy in the expert group compared to non-experts, signifying greater complexity in their motor control. In terms of stability, experts are likely to exhibit higher Lyapunov exponent values, indicating enhanced stability and coordination, along with lower Hurst exponent values. In elastography, experienced practitioners are expected to display higher transversus abdominis (TrA) muscle elasticity, due to their proficiency. Concerning GA, non-experts are expected to demonstrate more saccades, focus on more Areas of Interest (AOIs), and shorter fixation times, as experts are presumed to have more efficient gaze control. In EEG, we anticipate higher theta wave values in the non-expert group compared to the expert group. These expectations draw from similar studies in elastography and correlated research in eye tracking and EEG. They are consistent with the principles of the Pilates Method and other scientific knowledge in related techniques.
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Affiliation(s)
- Mário José Pereira
- Faculty of Sports Sciences and Physical Education, University of Coimbra, 3000-214 Coimbra, Portugal;
| | - Alexandra André
- Coimbra Health School, Polytechnic Institute of Coimbra, 3046-854 Coimbra, Portugal; (A.A.); (M.M.)
| | - Mário Monteiro
- Coimbra Health School, Polytechnic Institute of Coimbra, 3046-854 Coimbra, Portugal; (A.A.); (M.M.)
| | - Maria António Castro
- Laboratory IIA, ROBOCORP, Polytechnic Institute of Coimbra, 3045-093 Coimbra, Portugal; (M.A.C.); (R.M.); (F.M.); (R.G.); (G.D.)
- School of Health Sciences, Polytechnic Institute of Leiria, 2411-901 Leiria, Portugal
- Centre of Mechanical Engineering, Materials and Processes (CEMMPRE), University of Coimbra, 3000-214 Coimbra, Portugal
| | - Rui Mendes
- Laboratory IIA, ROBOCORP, Polytechnic Institute of Coimbra, 3045-093 Coimbra, Portugal; (M.A.C.); (R.M.); (F.M.); (R.G.); (G.D.)
- ESEC-UNICID-ASSERT, Polytechnic Institute of Coimbra, 3045-093 Coimbra, Portugal
- CIDAF (lida/dtp/04213/2020), University of Coimbra, 3000-214 Coimbra, Portugal
- Coimbra Education School, Polytechnic Institute of Coimbra, 3030-329 Coimbra, Portugal
| | - Fernando Martins
- Laboratory IIA, ROBOCORP, Polytechnic Institute of Coimbra, 3045-093 Coimbra, Portugal; (M.A.C.); (R.M.); (F.M.); (R.G.); (G.D.)
- ESEC-UNICID-ASSERT, Polytechnic Institute of Coimbra, 3045-093 Coimbra, Portugal
- Coimbra Education School, Polytechnic Institute of Coimbra, 3030-329 Coimbra, Portugal
- Instituto de Telecomunicações (IT), Delegação da Covilhã, 6201-001 Covilhã, Portugal
- InED—Centre for Research and Innovation in Education, Porto Polytechnic Institute, 4200-465 Porto, Portugal
| | - Ricardo Gomes
- Laboratory IIA, ROBOCORP, Polytechnic Institute of Coimbra, 3045-093 Coimbra, Portugal; (M.A.C.); (R.M.); (F.M.); (R.G.); (G.D.)
- ESEC-UNICID-ASSERT, Polytechnic Institute of Coimbra, 3045-093 Coimbra, Portugal
- CIDAF (lida/dtp/04213/2020), University of Coimbra, 3000-214 Coimbra, Portugal
- Coimbra Education School, Polytechnic Institute of Coimbra, 3030-329 Coimbra, Portugal
| | - Vasco Vaz
- Faculty of Sports Sciences and Physical Education, University of Coimbra, 3000-214 Coimbra, Portugal;
- CIDAF (lida/dtp/04213/2020), University of Coimbra, 3000-214 Coimbra, Portugal
| | - Gonçalo Dias
- Laboratory IIA, ROBOCORP, Polytechnic Institute of Coimbra, 3045-093 Coimbra, Portugal; (M.A.C.); (R.M.); (F.M.); (R.G.); (G.D.)
- ESEC-UNICID-ASSERT, Polytechnic Institute of Coimbra, 3045-093 Coimbra, Portugal
- CIDAF (lida/dtp/04213/2020), University of Coimbra, 3000-214 Coimbra, Portugal
- Coimbra Education School, Polytechnic Institute of Coimbra, 3030-329 Coimbra, Portugal
- Instituto de Telecomunicações (IT), Delegação da Covilhã, 6201-001 Covilhã, Portugal
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Kadah S, Soh SE, Morin M, Schneider M, Ang WC, McPhate L, Frawley H. Are pelvic pain and increased pelvic floor muscle tone associated in women with persistent noncancer pelvic pain? A systematic review and meta-analysis. J Sex Med 2023; 20:1206-1221. [PMID: 37507352 DOI: 10.1093/jsxmed/qdad089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/23/2023] [Accepted: 06/14/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND The association between pelvic pain and pelvic floor muscle (PFM) tone in women with persistent noncancer pelvic pain (PNCPP) is unclear. AIM To synthesize the evidence of the association between pelvic pain and PFM tone in women with PNCPP. METHODS A systematic review was conducted via MEDLINE, Emcare, Embase, CINAHL, PsycINFO, and Scopus to identify relevant studies. Studies were eligible if pelvic pain and PFM tone outcome measures were reported among women aged >18 years. The National Heart, Lung, and Blood Institute's Quality Assessment Tool for Observational Cohort and Cross-sectional Studies was used to assess study quality. Studies were pooled by assessment of PFM tone via a random effects model. Associations between the presence of pelvic pain and PFM tone were assessed with odds ratio (OR), while linear associations were assessed with Pearson or Spearman correlation. OUTCOMES Pelvic pain measures (intensity, threshold, and frequency) and resting PFM tone in women with PNCPP, as evaluated by any clinical assessment method or tool. RESULTS Twenty-four studies were included in this review. The presence of pelvic pain was significantly associated with increased PFM tone as assessed by digital palpation (OR, 2.85; 95% CI, 1.66-4.89). Pelvic pain intensity was inversely but weakly associated with PFM flexibility when evaluated through dynamometry (r = -0.29; 95% CI, -0.42 to -0.17). However, no significant associations were found between pelvic pain and PFM tone when measured with other objective assessment methods. CLINICAL IMPLICATIONS Pelvic pain and increased PFM tone may not be directly associated; alternatively, a nonlinear association may exist. A range of biopsychosocial factors may mediate or moderate the association, and clinicians may need to consider these factors when assessing women with PNCPP. STRENGTHS AND LIMITATIONS This review was reported according to the PRISMA guidelines. All possible findings from relevant theses and conference abstracts were considered in our search. However, nonlinear associations between pelvic pain and increased PFM tone were not assessed as part of this review. CONCLUSION Pelvic pain may be linearly associated with increased PFM tone and decreased PFM flexibility when measured with digital palpation or dynamometry; however, this association was not observed when other aspects of PFM tone were assessed through objective methods. Future studies are required using robust assessment methods to measure PFM tone and analyses that account for other biopsychosocial factors that may influence the association.
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Affiliation(s)
- Shaza Kadah
- Department of Physiotherapy, Monash University, Melbourne, Victoria 3199, Australia
- Department of Physical Therapy, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Sze-Ee Soh
- Department of Physiotherapy, Monash University, Melbourne, Victoria 3199, Australia
| | - Melanie Morin
- School of Rehabilitation Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Québec J1K2R1, Canada
| | - Michal Schneider
- Department of Medical Imaging and Radiation Sciences, Monash University, Melbourne, Victoria 3800, Australia
| | - W Catarina Ang
- Women's Health Services, Royal Women's Hospital, Melbourne, Victoria 3052 Australia
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Lucy McPhate
- Department of General Medicine, The Royal Melbourne Hospital, Melbourne, Australia
| | - Helena Frawley
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria 3010, Australia
- Allied Health Research, The Royal Women's Hospital, Melbourne, Victoria 3052 Australia
- Allied Health Research, Mercy Hospital for Women, Melbourne, Victoria 3084, Australia
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Dick TJM, Hug F. Advances in imaging for assessing the design and mechanics of skeletal muscle in vivo. J Biomech 2023; 155:111640. [PMID: 37244210 DOI: 10.1016/j.jbiomech.2023.111640] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 05/10/2023] [Indexed: 05/29/2023]
Abstract
Skeletal muscle is the engine that powers what is arguably the most essential and defining feature of human and animal life-locomotion. Muscles function to change length and produce force to enable movement, posture, and balance. Despite this seemingly simple role, skeletal muscle displays a variety of phenomena that still remain poorly understood. These phenomena are complex-the result of interactions between active and passive machinery, as well as mechanical, chemical and electrical processes. The emergence of imaging technologies over the past several decades has led to considerable discoveries regarding how skeletal muscles function in vivo where activation levels are submaximal, and the length and velocity of contracting muscle fibres are transient. However, our knowledge of the mechanisms of muscle behaviour during everyday human movements remains far from complete. In this review, we discuss the principal advancements in imaging technology that have led to discoveries to improve our understanding of in vivo muscle function over the past 50 years. We highlight the knowledge that has emerged from the development and application of various techniques, including ultrasound imaging, magnetic resonance imaging, and elastography to characterise muscle design and mechanical properties. We emphasize that our inability to measure the forces produced by skeletal muscles still poses a significant challenge, and that future developments to accurately and reliably measure individual muscle forces will promote newfrontiers in biomechanics, physiology, motor control, and robotics. Finally, we identify critical gaps in our knowledge and future challenges that we hope can be solved as a biomechanics community in the next 50 years.
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Affiliation(s)
- Taylor J M Dick
- The University of Queensland, School of Biomedical Sciences, Brisbane, QLD, Australia.
| | - François Hug
- The University of Queensland, School of Biomedical Sciences, Brisbane, QLD, Australia; Université Côte d'Azur, LAMHESS, Nice, France
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In Search of an Imaging Classification of Adenomyosis: A Role for Elastography? J Clin Med 2022; 12:jcm12010287. [PMID: 36615089 PMCID: PMC9821156 DOI: 10.3390/jcm12010287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 12/31/2022] Open
Abstract
Adenomyosis is a complex and poorly understood gynecological disease. It used to be diagnosed exclusively by histology after hysterectomy; today its diagnosis is carried out increasingly by imaging techniques, including transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI). However, the lack of a consensus on a classification system hampers relating imaging findings with disease severity or with the histopathological features of the disease, making it difficult to properly inform patients and clinicians regarding prognosis and appropriate management, as well as to compare different studies. Capitalizing on our grasp of key features of lesional natural history, here we propose adding elastographic findings into a new imaging classification of adenomyosis, incorporating affected area, pattern, the stiffest value of adenomyotic lesions as well as the neighboring tissues, and other pathologies. We argue that the tissue stiffness as measured by elastography, which has a wider dynamic detection range, quantitates a fundamental biologic property that directs cell function and fate in tissues, and correlates with the extent of lesional fibrosis, a proxy for lesional "age" known to correlate with vascularity and hormonal receptor activity. With this new addition, we believe that the resulting classification system could better inform patients and clinicians regarding prognosis and the most appropriate treatment modality, thus filling a void.
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