Adapted protocol of rate of force development and relaxation scaling factor for neuromuscular assessment in patients with knee osteoarthritis

In elderly individuals, the effectiveness of sensorimotor training on postural control and muscular strength is comparable to resistance-endurance training

While classical resistance exercise is an effective way to improve strength and control postural sway, it may not be suitable for some elderly individuals with specific health disorders (e.g., aneurysms). Therefore, there is a need to explore alternative modalities. The study aimed to evaluate the effects of sensorimotor training on muscle strength and postural control in the female elderly population and subsequently compare these effects with a traditional combined resistance-endurance training program. A total of 34 healthy, active elderly women aged from 65 to 75 years, (average age 72.7 ± 4.4 years, height 161.6 ± 5.1 cm, and weight 66.9 ± 8.4 kg) were randomly assigned to three groups undergoing different 10-week interventions: the resistance-endurance training (RET, n = 11), the sensorimotor training (SMT, n = 12) and the control group (COG, n = 11). Prior to and after the interventions all participants underwent tests of maximal voluntary contraction of the dominant and non-dominant leg; postural sway tests with open and closed eyes; novel visual feedback balance test; 10-meter maximal walking speed (10 mMWS) and stair climb test. A T-test and repeated measures ANOVA were used, followed by the Bonferroni post hoc test, to compare the pre and post-measurements and assess differences in gains between groups. Results showed a significant main effect of time on strength (p < 0.001). In addition, significant differences in time × group interaction on strength (p < 0.01), postural control (p < 01), and ascendant and descended vertical speed (p < 0.001) were observed. Besides, the RET group improved significantly the maximal voluntary contraction of both dominant (16.3%, p ≤ 0.01) and non-dominant leg (10.9%, p ≤ 0.05). SMT group improved maximal voluntary contraction of both dominant (16.6%, p ≤ 0.001) and non-dominant leg (12.7%, p ≤ 0.01). In addition, they also improved mean velocity of the centre of pressure (COP) in postural sway test with eyes open (24.2%, p ≤ 0.05) as well as eyes closed (29.2%, p ≤ 0.05), mean distance of COP in novel visual feedback balance test (37.5%, p ≤ 0.001), ascendant and descended vertical velocity (13.6%, p ≤ 0.001 and 17.8%, p ≤ 0.001, respectively). Results show not only resistance training but sensorimotor intervention boosts strength too. This intervention also enhances postural control and functional abilities for both ascending and descending movements.

Aging and Possible Benefits or Negatives of Lifelong Endurance Running: How Master Male Athletes Differ from Young Athletes and Elderly Sedentary?

Regular physical activity, recommended by the WHO, is crucial in maintaining a good physical fitness level and health status and slows down the effects of aging. However, there is a lack of knowledge of whether lifelong endurance running, with a volume and frequency above the WHO limits, still brings the same benefits, or several negative effects too. The present study aims to examine the protentional benefits and risks of lifelong endurance running training in Master male athletes, as this level of physical activity is above the WHO recommendations. Within the study, four main groups of participants will be included: (1) endurance-trained master athletes, (2) endurance-trained young athletes, (3) young sedentary adults, and (4) elderly sedentary. Both groups of athletes are strictly marathon runners, who are still actively running. The broad spectrum of the diagnostic tests, from the questionnaires, physical fitness testing, and blood sampling to muscle biopsy, will be performed to obtain the possibility of complexly analyzing the effects of lifelong endurance physical activity on the human body and aging. Moreover, the study will try to discover and explain new relationships between endurance running and diagnostic parameters, not only within aging.

Cross-cultural adaptation, validity and rehability of the QUIPA tool: Turkish version

The Quality Indicators for Physiotherapy Management of Hip and Knee Osteoarthritis (QUIPA) is the only patient-reported outcome measure to assess the quality indicators of physiotherapy management of hip/knee osteoarthritis (OA). It consists of 3 subscales and a total of 18 questions. The purpose of this research was to translate and adapt the QUIPA into the Turkish language using a cross-cultural approach as well as test its validity and reliability for Turkish-speaking patients with hip/knee OA. Ninety-two patients with hip/knee OA were enrolled in the research. The cross-cultural adaptation of the QUIPA was performed according to guidelines defined by Beaton et al. Participants completed the QUIPA tool twice at an interval of 7 days. Test-retest reliability and internal consistency were determined by interpreting the intraclass correlation coefficient (ICC) and Cronbach’s alpha coefficient, respectively. Construct validity was tested via exploratory factor analysis. For the first, second, and third subscales and total score of QUIPA, ICC was found to be 0.895, 0.947, 0.665, and 0.925, respectively. Cronbach’s alpha coefficient was 0.682, 0.797, 0.593, and 0.812. The Exploratory Factor Analysis demonstrated that the QUIPA tool is based on 3 factors. These results indicate that the Turkish version of the QUIPA has excellent test-retest reliability and good internal consistency. Therefore, the Turkish version of the QUIPA seems to be a valid and reliable tool to assess the quality indicators of physiotherapy management of hip/knee OA in Turkish-speaking patients. It is intended to be used in clinical settings and research works.

Quantification of Inter-Limb Symmetries With Rate of Force Development and Relaxation Scaling Factor

The inter-limb (a)symmetries have been most often assessed with the tests that quantify the maximal muscle capacity. However, the rapid force production and relaxation during submaximal tasks is equally important for successful sports performance. This can be evaluated with an established rate of force development and relaxation scaling factor (RFD-SF/RFR-SF). The aims of our study were (1) to assess the intra-session reliability of shortened RFD-SF/RFR-SF protocol and its absolute and symmetry outcome measures, (2) to compare the main absolute RFD-SF/RFR-SF outcome measures (slopes of RFD-SF and RFR-SF: kRTD-SF and kRFR-SF, theoretical peak RFD/RFR: TPRFD and TPRFR) across gender and sports groups, and (3) to compare inter-limb symmetries across gender and sports groups for main outcome measures (kRFD-SF, kRFR-SF, TPRFD, and TPRFR). A cross-sectional study was conducted on a group of young health participants (basketball and tennis players, and students): 30 in the reliability study and 248 in the comparison study. Our results showed good to excellent relative and excellent absolute reliability for the selected absolute and symmetry outcome measures (kRFD-SF, kRFR-SF, TPRFD, and TPRFR). We found significantly higher absolute values for kRFD-SF and TPRFD in males compared to females for the preferred (kRFD-SF: 9.1 ± 0.9 vs. 8.6 ± 0.9/s) and the non-preferred leg (kRFD-SF: 9.1 ± 0.9 vs. 8.5 ± 0.8/s), while there was no effect of sport. Significantly lower symmetry values for kRFR-SF (88.4 ± 8.6 vs. 90.4 ± 8.0%) and TPRFR (90.9 ± 6.8 vs. 92.5 ± 6.0%) were found in males compared to females. Moreover, tennis players had significantly higher symmetry values for kRFR-SF (91.1 ± 7.7%) and TPRFR (93.1 ± 6.0%) compared to basketball players (kRFR-SF: 88.4 ± 8.7% and TPRFR: 90.9 ± 6.7%) and students (kRFR-SF: 87.6 ± 8.7% and TPRFR: 90.5 ± 6.7%). Our results suggest that the reduced RFD-SF/RFR-SF protocol is a valuable and useful tool for inter-limb (a)symmetry evaluation. Differences in symmetry values in kRFR-SF and TPRFR (relaxation phase) were found between different sports groups. These may be explained by different mechanisms underlying the muscle contraction and relaxation. We suggest that muscle contraction and relaxation should be assessed for in-depth inter-limb symmetry investigation.

Advancements in the Protocol for Rate of Force Development/Relaxation Scaling Factor Evaluation

Brief submaximal actions are important for wide range of functional movements. Until now, rate of force development and relaxation scaling factor (RFD-SF and RFR-SF) have been used for neuromuscular assessment using 100-120 isometric pulses which requires a high level of attention from the participant and may be influenced by physiological and/or psychological fatigue. All previous studies have been conducted on a smaller number of participants which calls into question the eligibility of some of the outcome measures reported to date. Our aims were: (1) to find the smallest number of rapid isometric force pulses at different force amplitudes is still valid and reliable for RFD-SF slope (k _{R F D -SF}) and RFR-SF slope (k _RFR-SF ) calculation, (2) to introduce a new outcome measure - theoretical peak of rate of force development/relaxation (TP _RFD and TP _RFR ) and (3) to investigate differences and associations between k _RFD-SF and k _RFR-SF . A cross-sectional study was conducted on a group of young healthy participants; 40 in the reliability study and 336 in the comparison/association study. We investigated the smallest number of rapid isometric pulses for knee extensors that still provides excellent reliability of the calculated k _RFD-SF and k _RFR-SF (ICC₂,₁ ≥ 0.95, CV < 5%). Our results showed excellent reliability of the reduced protocol when 36 pulses (nine for each of the four intensity ranges) were used for the calculations of k _RFD-SF and k _RFR-SF . We confirmed the negligibility of the y-intercepts and confirmed the reliability of the newly introduced TP _RFD and TP _RFR . Large negative associations were found between k _RFD-SF and k _RFR-SF (r = 0.502, p < 0.001), while comparison of the absolute values showed a significantly higher k _RFD-SF (8.86 ± 1.0/s) compared to k _RFR-SF (8.03 ± 1.3/s) (p < 0.001). The advantage of the reduced protocol (4 intensities × 9 pulses = 36 pulses) is the shorter assessment time and the reduction of possible influence of fatigue. In addition, the introduction of TP _RFD and TP _RFR as an outcome measure provides valuable information about the participant's maximal theoretical RFD/RFR capacity. This can be useful for the assessment of maximal capacity in people with various impairments or pain problems.