1
|
Dávalos-Yerovi V, Sánchez-Rodríguez D, Chaler J, Marco E. [Precision medicine in rehabilitation settings]. Rehabilitacion (Madr) 2024; 58:100836. [PMID: 38211360 DOI: 10.1016/j.rh.2023.100836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Affiliation(s)
- V Dávalos-Yerovi
- Rehabilitation Research Group, Hospital del Mar Research Institute, Barcelona, España. Servicio de Medicina Física y Rehabilitación, Hospital Vall d'Hebron, Barcelona, España
| | - D Sánchez-Rodríguez
- Servicio de Geriatría, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium. WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. Servicio de Geriatria, Centre Fòrum-Hospital del Mar, Parc de Salut Mar, Barcelona, España
| | - J Chaler
- Servicio de Medicina Física y Rehabilitación y Laboratorio de Biomecánica, Hospital Egarsat, Barcelona, España. EUSES Physiotherapy, Campus de Bellvitge, UdG-UB, L'Hospitalet de Llobregat, Barcelona, España
| | - E Marco
- Servicio de Medicina Física y Rehabilitación, Hospital del Mar, Barcelona, Espanña. Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Barcelona, España. Faculty of Medicine, Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, España.
| |
Collapse
|
2
|
Chaler J, Marco E, Bascuñana H, de Miguel C. ['Rehabilitation 2030': A WHO initiative, a health necessity]. Rehabilitacion (Madr) 2023; 57:100829. [PMID: 37944417 DOI: 10.1016/j.rh.2023.100829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023]
Affiliation(s)
- J Chaler
- Servicio de Medicina Física y Rehabilitación y Laboratorio de Biomecánica, Hospital Egarsat, Barcelona, España; EUSES Physiotherapy, Campus de Bellvitge, UdG-UB, L'Hospitalet de Llobregat, España; Director de la revista Rehabilitación, Madrid, España
| | - E Marco
- Servei de Medicina Física y Rehabilitació, Hospital del Mar, Barcelona, España; Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Barcelona, España; Facultaty of Medicine, Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, España; Directora asociada de la revista Rehabilitación, Madrid, España.
| | - H Bascuñana
- Servicio de Medicina Física y Rehabilitación, Hospital de la Santa Creu i Sant Pau, Barcelona, España; Vicepresidenta de SERMEF, Madrid, España
| | - C de Miguel
- Servicio de Medicina Física y Rehabilitación, Hospital Universitario Ramón y Cajal, Madrid, España; Presidenta de SERMEF, Madrid, España
| |
Collapse
|
3
|
Herrera-Ligero C, Chaler J, Bermejo-Bosch I. Strengthening education in rehabilitation: Assessment technology and digitalization. Front Rehabilit Sci 2022; 3:883270. [PMID: 36188966 PMCID: PMC9449490 DOI: 10.3389/fresc.2022.883270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/08/2022] [Indexed: 11/29/2022]
Abstract
Rehabilitation is a discipline increasingly growing around the world due to several reasons, but probably the most important one is aging population and chronicity. A need to harmonize education has been identified, and although several International organizations such as the European Union of Medical Specialists (UEMS) and the International Society of Physical Medicine and Rehabilitation (ISPRM) have defined standards, given the quick growth of new evidence and assessment methods an urge to establish new ones arises. Functional assessment and tools used to do so are key in rehabilitation processes. This comprises self-reported questionnaires, conventional clinical evaluation but more notably high technology assessment methods, such as movement analysis systems, posturography, different types of dynamometers and kinesiologic electromyography among others. More recently, a wide range of wearable systems has been introduced in patient assessment. This is generating many published protocols as well as reliability and validity studies. The objective of this narrative review is to present main assessment technologies relevant to rehabilitation, its situation of this specific area in pre-graduate and post-graduate rehabilitation educational programs, and to elaborate a formative proposal including technological foundations of assessment and also highlighting the importance of solid reliability and validity of assessment methods comprehension. The main objective of this proposal is to provide basic knowledge about rehabilitation and methodologies for outcomes evaluation, including new technologies, to all health professionals, but especially to those who work or will work in the field of Rehabilitation.
Collapse
Affiliation(s)
- Cristina Herrera-Ligero
- Biomechanics Institute of Valencia, Polytechnic University of Valencia, Valencia, Spain
- Correspondence: Cristina Herrera-Ligero
| | - Joaquim Chaler
- University School of Health and Sport (EUSES & ENTI), University of Girona and University of Barcelona, L'Hospitalet de Llobregat, Catalonia, Spain
- PM&R Department, Hospital Egarsat, Barcelona, Spain
| | - Ignacio Bermejo-Bosch
- Biomechanics Institute of Valencia, Polytechnic University of Valencia, Valencia, Spain
| |
Collapse
|
4
|
Chaler J, Torra M, Pujol E, Maiques A, Anasetti F, Garreta R, Dvir Z. Wrist flexion and extension strength in patients with work-related chronic elbow pain: the isokinetic effort factor and its implications. J Shoulder Elbow Surg 2021; 30:2587-2595. [PMID: 34280574 DOI: 10.1016/j.jse.2021.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 06/03/2021] [Accepted: 06/07/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND The validity of isokinetic strength findings relating to forearm muscles in patients with chronic elbow pain and/or epicondylitis is not well established. Furthermore, given the nature of this disorder, ensuring maximal effort in performing the tests is an essential prerequisite. The isokinetic-based DEC parameter (defined as the difference between high- and low-velocity eccentric-to-concentric ratios of a given muscle) has been shown to efficiently detect maximal effort. The purpose of this study was therefore to assess the validity of isokinetic strength tests in patients with chronic elbow pain and/or epicondylitis. METHODS A cohort consisting of 44 male patients with chronic elbow pain (average evolution time, 262 ± 193.04 days) was recruited. The wrist extensor and flexor concentric and eccentric isokinetic strength of the involved and uninvolved sides was measured. The involved-uninvolved and flexor-extensor (F/E) ratios, as well as the DEC (eccentric-concentric difference), were computed based on peak moment values. Work disability and relapse within the first year were registered. In maximal performers, associations between deficits, F/E ratios, work disability, and symptom relapse were explored applying multiple comparisons. RESULTS Of the patients, 68.2% met the maximal-effort criteria, with the involved-side muscles being significantly weaker than their uninvolved-side counterparts in most cases. Although the mean deficit in this group was not associated with either work disability or relapse, patients with a relapse of symptoms within the first year had a significantly higher F/E ratio than those without relapse. CONCLUSION In patients presenting with chronic elbow pain who perform at the maximal level of effort, high wrist F/E strength ratios may predict symptom relapse.
Collapse
Affiliation(s)
- Joaquim Chaler
- Department of Physical Medicine and Rehabilitation, Hospital Egarsat, Barcelona, Spain; University School of Health and Sport (EUSES & ENTI), University of Girona and University of Barcelona, Barcelona, Spain.
| | - Mercè Torra
- Department of Physical Medicine and Rehabilitation, Hospital Universitari Mútua de Terrassa, Terrassa, Spain
| | - Eduard Pujol
- Department of Physical Medicine and Rehabilitation, Hospital Egarsat, Barcelona, Spain
| | - Anna Maiques
- Department of Physical Medicine and Rehabilitation, Hospital Egarsat, Barcelona, Spain
| | - Federica Anasetti
- Department of Physical Medicine and Rehabilitation, Hospital Egarsat, Barcelona, Spain
| | - Roser Garreta
- Department of Physical Medicine and Rehabilitation, Hospital Universitari Mútua de Terrassa, Terrassa, Spain
| | - Zeevi Dvir
- Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
5
|
Chaler J. [Remembering Silvia Ramón: An exemplary figure in the specialty of physical medicine and rehabilitation]. Rehabilitacion (Madr) 2021; 55:S0048-7120(21)00058-X. [PMID: 33931240 DOI: 10.1016/j.rh.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 03/30/2021] [Indexed: 11/23/2022]
Affiliation(s)
- J Chaler
- Editor Jefe de Rehabilitación (Madr), Madrid, España.
| |
Collapse
|
6
|
Chaler J, Gil A. [A note from the journal Rehabilitación]. Rehabilitacion (Madr) 2021; 55:1. [PMID: 33549172 DOI: 10.1016/j.rh.2021.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 01/26/2021] [Indexed: 10/22/2022]
Affiliation(s)
- J Chaler
- Editor jefe adjunto de Rehabilitación.
| | - A Gil
- Director Adjunto Revista Rehabilitación
| |
Collapse
|
7
|
Torra M, Pujol E, Maiques A, Quintana S, Garreta R, Chaler J. Detection of effort maximality in adults performing isokinetic wrist flexion and extension. ISOKINET EXERC SCI 2021. [DOI: 10.3233/ies-200274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: The difference between isokinetic eccentric to concentric strength ratios at high and low velocities (DEC) is a powerful tool for identifying submaximal effort in other muscle groups but its efficiency in terms of the wrist extensors (WE) and flexors (WF) isokinetic effort has hitherto not been studied. OBJECTIVE: The objective of the present study is to examine the usefulness of the DEC for identifying suboptimal wrist extensor and flexor isokinetic efforts. METHODS: Twenty healthy male volunteers aged 20–40 years (28.5 ± 3.2) were recruited. Participants were instructed to exert maximal and feigned efforts, using a range of motion of 20∘ in concentric (C) and eccentric (E) WE and WF modes at two velocities: 10 and 40∘/s. E/C ratios (E/CR) where then calculated and finally DEC by subtracting low velocity E/CR from high velocity ones. RESULTS: Feigned maximal effort DEC values were significantly higher than their maximal effort counterparts, both for WF and WE. For both actions, a DEC cutoff level to detect submaximal effort could be defined. The sensitivity of the DEC was 71.43% and 62.5% for WE ad WF respectively. The specificity was 100% in both cases. CONCLUSION: The DEC may be a valuable parameter for detecting feigned maximal WF and WE isokinetic effort in healthy adults.
Collapse
Affiliation(s)
- Mercè Torra
- PM&R Department, Hospital Universitari Mútua de Terrassa, Terrassa, Catalonia, Spain
| | - Eduard Pujol
- PM&R Department and Biomechanics Laboratory, Hospital Egarsat, Barcelona, Spain
| | - Anna Maiques
- PM&R Department and Biomechanics Laboratory, Hospital Egarsat, Barcelona, Spain
| | - Salvador Quintana
- Department of Medicine, Hospital Universitari Mútua de Terrassa, Terrassa, Catalonia, Spain
| | - Roser Garreta
- PM&R Department, Hospital Universitari Mútua de Terrassa, Terrassa, Catalonia, Spain
| | - Joaquim Chaler
- PM&R Department and Biomechanics Laboratory, Hospital Egarsat, Barcelona, Spain
- EUSES-Physiotherapy Barcelona, Campus Bellvitge, Universitat de Girona-Universitat de Barcelona, L’Hospitalet de Llobregat, Catalonia, Spain
| |
Collapse
|
8
|
Chaler J, Louati H, Uhthoff HK, Trudel G. Supraspinatus tendon transosseous vs anchor repair surgery: a comparative study of mechanical recovery in the rabbit. J Orthop Surg Res 2020; 15:585. [PMID: 33287832 PMCID: PMC7720526 DOI: 10.1186/s13018-020-02085-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 11/10/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Supraspinatus (SSP) tendon ruptures requiring surgical repair are common. Arthroscopic suture anchor fixation has gradually replaced transosseous repair in supraspinatus tendon tear. Our objective was to compare mechanical properties between transosseous and anchor supraspinatus repair in the first 6 postoperative weeks in a rabbit model. METHODS One hundred and fifty-two rabbits had one supraspinatus tendon repaired either with an anchor suture 1 week after detachment or with transosseous sutures. Rabbits were euthanized at 0, 1, 2, 4 or 6 postoperative weeks. Experimental and contralateral tendons (304 tendons) were mechanically tested to failure. Data are expressed as percent of contralateral. RESULTS Anchor repair had higher loads to failure compared to transosseous repair, at immediate repair (week 0, 52 ± 21% vs 25 ± 17%, respectively; p = 0.004) and at 1 postoperative week (64 ± 32% vs 28 ± 10%; p = 0.003) with no difference after 2 weeks. There was no difference in stiffness. Transosseous repairs showed higher rates of midsubstance failures compared to anchor repairs at 1 (p = 0.004) and 2 postoperative weeks (p < 0.001). Both transosseous and anchor repairs restored supraspinatus mechanical properties after 4 postoperative weeks. CONCLUSION Anchor repair provided better initial tensile strength while transosseous repair led to a faster normalization (namely, midsubstance) of the mode of failure. Research to optimize supraspinatus repair may need to consider the advantages from both surgical approaches.
Collapse
Affiliation(s)
- Joaquim Chaler
- Department of Physical Medicine and Rehabilitation, Egarsat, Terrassa, Barcelona, Spain.,Escola Universitaria de Salut i Esport, Universitat de Girona-Universitat de Barcelona, Campus Bellvitge, Hospitalet, Barcelona, Spain
| | - Hakim Louati
- Bone and Joint Research Laboratory, The Ottawa Hospital Research Institute, 451 Smyth Road, Ottawa, Ontario, K1H 5M2, Canada.,Division of Orthopedic Surgery, Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Hans K Uhthoff
- Bone and Joint Research Laboratory, The Ottawa Hospital Research Institute, 451 Smyth Road, Ottawa, Ontario, K1H 5M2, Canada.,Division of Orthopedic Surgery, Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Guy Trudel
- Bone and Joint Research Laboratory, The Ottawa Hospital Research Institute, 451 Smyth Road, Ottawa, Ontario, K1H 5M2, Canada. .,Division of Physical Medicine and Rehabilitation, Department of Medicine, Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Canada.
| |
Collapse
|
9
|
Laxe S, Miangolarra Page JC, Chaler J, Gil Fraguas L, Gómez A, Luna F, Llavona R, Del Pino-Algarrada R, Salaverría Izaguirre N, Sanchez Tarifa P, Santandreu ME, Garreta R. [Rehabilitation in the time of COVID-19]. Rehabilitacion (Madr) 2020; 54:149-153. [PMID: 32441268 PMCID: PMC7151338 DOI: 10.1016/j.rh.2020.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 04/07/2020] [Indexed: 12/14/2022]
Affiliation(s)
- S Laxe
- Servicio de Rehabilitación, Hospital Clínic de Barcelona, Barcelona, España.
| | - J C Miangolarra Page
- Departamento de Medicina Física y Rehabilitación, Universidad Rey Juan Carlos, Madrid, España; Servicio de Rehabilitación y Medicina Física del Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| | - J Chaler
- Servicio de Rehabilitación, Egarsat, Terrassa, Barcelona, España; Physiotherapy Barcelona, Universitat de Girona-Universitat de Barcelona, Campus de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | - L Gil Fraguas
- Rehabilitación, Gerencia de Atención Integrada de Guadalajara, Universidad de Alcalá de Henares (UAH), Alcalá de Henares, Madrid, España
| | - A Gómez
- Servicio Rehabilitación, Hospital Dr. Negrín de Gran Canaria, Las Palmas de Gran Canaria, España
| | - F Luna
- Área de Musculoesquelético, Dolor e Intervencionismo UGC Interniveles de Rehabilitación, Hospital Regional Universitario de Málaga, Málaga, España
| | - R Llavona
- Instituto Médico Ramón y Cajal, Gijón, Asturias, España
| | - R Del Pino-Algarrada
- Servicio de Rehabilitación, Hospital Universitario Puerta del Mar, Cádiz, España
| | - N Salaverría Izaguirre
- Servicio de Medicina física y rehabilitación, Hospital Universitario Donostia, Donostia, Guipúzcoa, España
| | - P Sanchez Tarifa
- Servicio de Rehabilitación, Hospital Universitario Puerta del Mar, Cádiz, España
| | - M E Santandreu
- Servicio de Rehabilitación del Complejo Hospitalario Insular y Materno Infantil, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España
| | - R Garreta
- Servicio de Medicina física y rehabilitación, Hospital Mútua de Terrassa, Servicio de Medicina física y rehabilitación, Egarsat, Terrassa, Barcelona, España
| |
Collapse
|
10
|
Chaler J, Gil Fraguas L, Gómez García A, Laxe S, Luna Cabrera F, Llavona R, Miangolarra Page JC, Del Pino Algarrada R, Salaverría Izaguirre N, Sánchez Tarifa P, Santandr Eu ME, Garreta Figuera R. Impact of Coronavirus disease 2019 outbreak on rehabilitation services and physical rehabilitation medicine and rehabilitation physicians' activities: perspectives from the Spanish experience. Eur J Phys Rehabil Med 2020; 56:369-371. [PMID: 32329590 DOI: 10.23736/s1973-9087.20.06304-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Joaquim Chaler
- Sociedad Española de Rehabilitación y Medicina Física (SERMEF), (Spanish Society of PM&R), Madrid, Spain - .,PM&R Department, Hospital Egarsat, Barcelona, Spain - .,Hospitalet de Llobregat, Universat de Barcelona, Barcelona, Spain -
| | - Lourdes Gil Fraguas
- Sociedad Española de Rehabilitación y Medicina Física (SERMEF), (Spanish Society of PM&R), Madrid, Spain.,PM&R Department, Hospital Universitario de Guadalajara, Guadalajara, Spain.,Universidad de Alcalá de Henares, Alcalá de Henares, Spain
| | - Arturo Gómez García
- Sociedad Española de Rehabilitación y Medicina Física (SERMEF), (Spanish Society of PM&R), Madrid, Spain.,PM&R Department, Hospital Universitario de Gran Canaria, Facultad de Medicina, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Sara Laxe
- Sociedad Española de Rehabilitación y Medicina Física (SERMEF), (Spanish Society of PM&R), Madrid, Spain.,ICEMEQ Department of Rehabilitation, Hospital Clínic Barcelona, Barcelona, Spain
| | - Francisco Luna Cabrera
- Sociedad Española de Rehabilitación y Medicina Física (SERMEF), (Spanish Society of PM&R), Madrid, Spain.,Unit of Clinical Management, Department of Rehabilitation, Regional University Hospital of Málaga, Málaga, Spain
| | - Ricardo Llavona
- Sociedad Española de Rehabilitación y Medicina Física (SERMEF), (Spanish Society of PM&R), Madrid, Spain.,Instituto Médico Ramón y Cajal, Gijón, Spain
| | - Juan C Miangolarra Page
- Sociedad Española de Rehabilitación y Medicina Física (SERMEF), (Spanish Society of PM&R), Madrid, Spain.,PM&R Department, Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain.,Laboratorio de Análisis del Movimiento, Biomecánica, Ergonomía y Control Motor (LAMBECOM), Facultad de Medicina, Universidad Rey Juan Carlos, Fuenlabrada, Spain
| | - Rogelio Del Pino Algarrada
- Sociedad Española de Rehabilitación y Medicina Física (SERMEF), (Spanish Society of PM&R), Madrid, Spain.,UGC Rehabilitación, Hospitales Universitarios de Puerto Real y Puerta Del Mar de Cádiz, Cádiz, Spain
| | - Natalia Salaverría Izaguirre
- Sociedad Española de Rehabilitación y Medicina Física (SERMEF), (Spanish Society of PM&R), Madrid, Spain.,Hospital Universitario Donostia, Guipúzcoa, Spain
| | - Pilar Sánchez Tarifa
- Sociedad Española de Rehabilitación y Medicina Física (SERMEF), (Spanish Society of PM&R), Madrid, Spain.,FEA Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Maria E Santandr Eu
- Sociedad Española de Rehabilitación y Medicina Física (SERMEF), (Spanish Society of PM&R), Madrid, Spain.,PM&R Department, Complejo Hospitalario Universitario Insular y Materno Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Roser Garreta Figuera
- Sociedad Española de Rehabilitación y Medicina Física (SERMEF), (Spanish Society of PM&R), Madrid, Spain.,PM&R Department, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain
| |
Collapse
|
11
|
Rojas-Martínez M, Alonso JF, Jordanić M, Mañanas MÁ, Chaler J. Analysis of Muscle Load-Sharing in Patients With Lateral Epicondylitis During Endurance Isokinetic Contractions Using Non-linear Prediction. Front Physiol 2019; 10:1185. [PMID: 31632282 PMCID: PMC6779029 DOI: 10.3389/fphys.2019.01185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 09/02/2019] [Indexed: 11/24/2022] Open
Abstract
The aim of this paper is to analyze muscle load-sharing in patients with Lateral Epicondylitis during dynamic endurance contractions by means of non-linear prediction of surface EMG signals. The proposed non-linear cross-prediction scheme was used to predict the envelope of an EMG signal and is based on locally linear models built in a lag-embedded Euclidean space. The results were compared with a co-activation index, a common measure based on the activation of a muscle pair. Non-linear prediction revealed changes in muscle coupling, that is load-sharing, over time both in a control group and Lateral Epicondylitis (p < 0.05), even when subjects did not report pain at the end of the exercise. These changes were more pronounced in patients, especially in the first part of the exercise and up to 50% of the total endurance time (p < 0.05). By contrast, the co-activation index showed no differences between groups. Results reflect the changing nature of muscular activation strategy, presumably because of the mechanisms triggered by fatigue. Strategies differ between controls and patients, pointing to an altered coordination in Lateral Epicondylitis.
Collapse
Affiliation(s)
- Mónica Rojas-Martínez
- Department of Bioengineering, Faculty of Engineering, Universidad El Bosque, Bogotá, Colombia
| | - Joan Francesc Alonso
- Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Biomedical Engineering Research Centre (CREB), Department of Automatic Control (ESAII), Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - Mislav Jordanić
- Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Biomedical Engineering Research Centre (CREB), Department of Automatic Control (ESAII), Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - Miguel Ángel Mañanas
- Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Biomedical Engineering Research Centre (CREB), Department of Automatic Control (ESAII), Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - Joaquim Chaler
- PM&R Department, Egarsat, Terrassa, Spain.,EUSES-Bellvitge, Universitat de Girona, Universitat de Barcelona, ENTI, Barcelona, Spain
| |
Collapse
|
12
|
Andrade Ortega JA, Chaler J, Conejero Casares JA, Durá Mata MJ, Esclarín-Ruz A, Laxe García S, Luna Cabrera F, Pujol Medina E, Rodríguez Bonache MJ, Villamayor Blanco B. [Rehabilitación in Medline]. Rehabilitacion (Madr) 2019; 53:69. [PMID: 31186098 DOI: 10.1016/j.rh.2019.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 04/26/2019] [Indexed: 06/09/2023]
Affiliation(s)
| | - J Chaler
- Servicio de Rehabilitación, Egarsat, Terrassa, Barcelona, España; Physiotherapy Barcelona, Universitat de Girona-Universitat de Barcelona, Campus de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
| | - J A Conejero Casares
- Unidad de Rehabilitación Infantil, Servicio de Medicina Física y Rehabilitación, Hospital Universitario Virgen Macarena, Sevilla, España
| | - M J Durá Mata
- Servicio de Medicina Física y Rehabilitación, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | | | | | - F Luna Cabrera
- Servicio de Rehabilitación y Medicina Física, Hospital Regional Universitario de Málaga, Málaga, España
| | - E Pujol Medina
- Servicio de Rehabilitación, Egarsat, Terrassa, Barcelona, España
| | | | - B Villamayor Blanco
- Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, España
| |
Collapse
|
13
|
Chaler J. [Letter to the Editor: Change in the board of Rehabilitación]. Rehabilitacion (Madr) 2019; 53:1. [PMID: 30929826 DOI: 10.1016/j.rh.2018.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 12/31/2018] [Indexed: 06/09/2023]
|
14
|
Pujol E, Chaler J, Sucarrats L, López I, Zeballos B, Garreta R, Dvir Z. Standard and Short RoM Isokinetic Testing: Comparative Analysis in Identifying Submaximal Shoulder External Rotator Effort. J Mot Behav 2017; 49:650-656. [PMID: 28140781 DOI: 10.1080/00222895.2016.1250719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
An isokinetic-related parameter termed the difference between eccentric-concentric strength ratios at two distinct test velocities (DEC) based on 60° (standard) range of motion (RoM) has been proven to be highly efficient detecting feigned muscular efforts. This study aimed to verify whether a DEC derived from a much shorter test RoM (20°) was equally useful than a long RoM-derived one. Eighteen healthy men (32.4 ± 6.4 years old) took part in a study focusing on shoulder external rotation isokinetic strength. Participants performed a genuine shoulder external rotator maximal effort (eight pairs of concentric and eccentric contractions at high and low velocities at short and long RoM) and then instructed to feign maximal effort. Contraction velocities were adjusted accordingly by applying a 1:4 gradient and peak moments registered. Both condition DEC was then calculated by subtracting the eccentric and concentric strength ratios at low velocities from those at high velocities. DEC scores in the feigned effort were significantly higher than maximal effort ones in both conditions in men. It enabled the setting of specific cutoff levels for separating the efforts. Both approaches revealed a coincident sensitivity (78%) whereas short RoM showed an even higher specificity: 88% versus 78%. Thus, the short RoM protocol provides clinically acceptable detection power.
Collapse
Affiliation(s)
- Eduard Pujol
- a Department of Physical Medicine and Rehabilitation , Egarsat , Terrassa , Spain
| | - Joaquim Chaler
- a Department of Physical Medicine and Rehabilitation , Egarsat , Terrassa , Spain.,b EUSES-Bellvitge , Universitat de Girona, Universitat de Barcelona, ENTI , Barcelona , Spain
| | - Laura Sucarrats
- a Department of Physical Medicine and Rehabilitation , Egarsat , Terrassa , Spain
| | - Inés López
- c Department of Physical Medicine and Rehabilitation , Consorci Sanitari Integral del Baix Llobregat, L'Hospitalet de Llobregat , Spain
| | - Blanca Zeballos
- d Department of Physical Medicine and Rehabilitation , Hospital Mútua de Terrassa , Terrassa , Spain
| | - Roser Garreta
- a Department of Physical Medicine and Rehabilitation , Egarsat , Terrassa , Spain.,d Department of Physical Medicine and Rehabilitation , Hospital Mútua de Terrassa , Terrassa , Spain
| | - Zeevi Dvir
- e Department of Physical Therapy , Sackler Faculty of Medicine, Tel Aviv University , Israel
| |
Collapse
|
15
|
Abstract
Objective: To examine the efficiency of the difference between the isokinetic eccentric to concentric strength ratios at high and low velocities (DEC) for identifying feigned maximal shoulder external rotation effort. Background: Previous studies have indicated that the DEC is a powerful identifier of feigned maximal effort. However comparison of maximal versus feigned maximal shoulder external rotation effort has not been undertaken. Due to the high prevalence of rotational shoulder disorders and their chronic ramifications in terms of occupational disability such a study is of specific interest. Design: Maximal and feigned maximal shoulder external rotation isokinetic efforts were compared. Setting: Functional evaluation unit at an occupational rehabilitation centre. Subjects: Seventeen healthy male volunteers aged between 20 and 40 years old. Main measure: Concentric and eccentric isokinetic tests at 30°/s and 120°/s in maximal and feigned maximal experimental conditions. DEC was calculated by subtracting the 30°/s eccentric/concentric peak torque ratios from the 120°/s ones for both experimental conditions. Results: A case-by-case analysis revealed that the DEC scores derived from the feigned effort were significantly greater than their maximal counterparts in all cases, leading to a cut-off value (0.81) which could distinguish between maximal and feigned performances. Conclusions: The findings indicate that the DEC is highly effective in identifying feigned shoulder external rotation effort in normal subjects.
Collapse
Affiliation(s)
- Joaquim Chaler
- Department of Physical Medicine and Rehabilitation, Mútua Egara, Terrassa, Spain.
| | | | | | | | | | | | | |
Collapse
|
16
|
Unyó C, Chaler J, Rojas-Martínez M, Pujol E, Müller B, Garreta R, Mañanas MA. A cross-sectional study comparing strength profile of dorsal and palmar flexor muscles of the wrist in epicondylitis and healthy men. Eur J Phys Rehabil Med 2013; 49:507-515. [PMID: 23138675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Strength training has been proposed by several authors to treat Lateral Epicondylitis. However, there is still a lack of information concerning muscle weakness and its relationship to imbalances and fatigability of forearm muscles during dynamic conditions in subjects after epicondylitis recovery. AIM To analyze the relationship between lateral humeral epicondylitis, and forearm muscle strength and fatigue. SETTING Rehabilitation specialized center POPULATION Cross-sectional study in eight former epicondylitis men free of symptoms and actively working at the moment of the evaluation and eight healthy men volunteers. METHODS Isokinetic tests were performed at different velocities in order to assess strength in concentric and eccentric contractions. Additionally, a long-term concentric test was carried out in order to analyze strength during endurance. The following variables were analyzed: Average torque of dorsal and palmar flexors of the wrist and ratio of agonist/antagonist for non-endurance contractions; length of initial and final plateaus and the slope of average torque decay during the endurance test. RESULTS In both groups, average torque produced by palmar flexor muscles was higher than that produced by dorsal flexor muscles. Patients showed higher strength in palmar flexor muscles, whereas dorsal flexor strength was similar for both populations. Palmar flexor vs. dorsal flexor ratio was significantly higher in patients for eccentric contractions. Regarding fatigue, results showed that torque decreased earlier in patients. CONCLUSIONS AND CLINICAL REHABILITATION IMPACT: Both palmar flexor force and palmar/dorsal ratio in eccentric exercise were significantly higher in patients. This finding indicates a muscular imbalance in patients underlying the epicondylitis condition. Additionally, former patients fatigued earlier. Findings indicate that muscle imbalances and fatigability might be related to lateral epicondylitis. This information may be useful in the design and monitoring of programs intended for lateral epicondylitis rehabilitation. More studies are necessary to conclude if these differences are cause or consequence of the epicondylitis.
Collapse
Affiliation(s)
- C Unyó
- Department of Physical Medicine and Rehabilitation, Egarsat- SUMA. Terrassa, Barcelona, Spain -
| | | | | | | | | | | | | |
Collapse
|
17
|
Chaler J, Pujol E, Unyó C, Quintana S, Müller B, Garreta R, Javierre C, Dvir Z. Maximality of shoulder external rotation effort in patients presenting with work related injury: The clinical applicability of the DEC parameter. J Electromyogr Kinesiol 2013; 23:865-71. [DOI: 10.1016/j.jelekin.2013.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 10/10/2012] [Accepted: 03/02/2013] [Indexed: 11/29/2022] Open
|
18
|
Rojas-Martínez M, Alonso JF, Chaler J, Mañanas MA. Analysis of muscle coupling during isokinetic endurance contractions by means of nonlinear prediction. Annu Int Conf IEEE Eng Med Biol Soc 2013; 2013:5005-5008. [PMID: 24110859 DOI: 10.1109/embc.2013.6610672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Isokinetic exercises have been extensively used in order to analyze muscle imbalances and changes associated with fatigue. It is known that such changes are difficult to assess from EMG signals during dynamic contractions, especially, using linear signal processing tools. The aim of this work was to use nonlinear prediction in order to analyze muscle couplings and interactions in this context and to assess the load-sharing of different muscles during fatigue. Results show promising for detecting interaction strategies between muscles and even for the interaction between muscles and the output torque during endurance tests.
Collapse
|
19
|
Saenz A, Avellanet M, Hijos E, Chaler J, Garreta R, Pujol E, Sandoval B, Buen C, Farreny A. Knee isokinetic test-retest: a multicentre knee isokinetic test-retest study of a fatigue protocol. Eur J Phys Rehabil Med 2010; 46:81-88. [PMID: 20332731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
AIM The aim of this study was to establish the test-retest reliability of a knee extensor and flexor muscle fatigue protocol using a biodex system 3 isokinetic dynamometer. METHODS Three-outpatient Rehabilitation Departments undertook the study. Fatigue was evaluated in the dominant knee of 90 healthy female volunteers, non-sportswomen, aged between 20 and 40. They performed 40 consecutive concentric knee flexions and extensions, at 120 degrees /s, on a Biodex 3 isokinetic dynamometer. Two evaluations were done over a period of seven days. Analysed variables were: maximal repetition of total work, maximal work repetition number, work to body weight ratio, total work, work during first and last third of the protocol, fatigue ratio, work fatigue. Statistical analysis determined mean values, medians and box-plots. Intraclass Correlation Coefficients (ICC) (confidence interval 95 %), t-test and one-way analysis of variance (ANOVA) evaluated reliability. Difference of means (di), standard error of measurement (SEM) and 95% of interval confidence (IC di) were also calculated (P<0.05). RESULTS All participants completed the study. Reliability data were excellent (ICC>0.75) for total work (0.85), work during first third (0.80) and last third (0.80) in extension, and for total work in flexion. Reliability data were fair to good (ICC 0.4-0.75) for the rest of the variables. Median varied less than 20% in all cases during test-retest. CONCLUSION This knee fatigue protocol is reliable for flexion and extension, above all when using the total work as a variable. The desirability of multicentre studies in rehabilitation and standardisation of protocols is emphasised.
Collapse
Affiliation(s)
- A Saenz
- Rehabilitation Department, Hospital Nostra Sra de Meritxell, Escaldes Engordany, Andorra
| | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Mananas MA, Rojas M, Mandrile F, Chaler J. Evaluation of muscle activity and fatigue in extensor forearm muscles during isometric contractions. Conf Proc IEEE Eng Med Biol Soc 2008; 2005:5824-7. [PMID: 17281583 DOI: 10.1109/iembs.2005.1615813] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Work-related upper extremity disorders as epycondylitis and tendonitis are closely related to localized muscle fatigue of extensor forearm muscles. The aim of this work is to evaluate levels of activity, fatigue and interactions between the main extensor muscles of the wrist. Surface EMG signals were acquired from extensor carpi radialis (ECR), extensor digitorum comunis (EDC) and extensor carpi ulnaris (ECU) muscles during isometric contractions using linear electrode array technique. Parameters such as muscle fiber conduction velocity (CV), EMG average rectified value (ARV) and frequency parameters were estimated to study muscle activity during selective contractions, during a non specific task at different percentage of the maximum voluntary contraction (MVC) level and during a fatiguing exercise at 50% MVC. Results show that it is possible to enhance significantly ECR and ECU muscle ARV during their selective activation. Moreover, in the non selective task, ECU muscle ARV significantly decreases with respect to the other muscles with the increase of the MVC level. The activity of ECR muscle in a non specific task is predominant with respect to the other muscles at 80%MVC. EMG spectral parameters and CV show fatigue in all muscles during a sustained contraction at 50%MVC.
Collapse
Affiliation(s)
- M A Mananas
- Dept. Automatic Control, Biom. Eng. Research Center (CREB), Technical University of Catalonia, UPC, Barcelona, Spain
| | | | | | | |
Collapse
|
21
|
Rojas M, Mañanas MA, Muller B, Chaler J. Activation of forearm muscles for wrist extension in patients affected by lateral epicondylitis. Annu Int Conf IEEE Eng Med Biol Soc 2007; 2007:4858-61. [PMID: 18003094 DOI: 10.1109/iembs.2007.4353428] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Work related upper extremity disorders are associated with cumulative trauma resulting from the continuous use of forearm muscles rather than from a specific incident. The aim of this work is to compare wrist extensor muscles activation between patients with lateral epicondylitis and healthy subjects. Differences can be used in the design of rehabilitation or injury prevention programs according to biomechanical deficits. Surface EMG signals from three forearm extensor muscles (Carpi Radialis-ECR, Digitorum Communis-EDC and Carpi Ulnaris-ECU) were recorded by linear electrode arrays in wrist extension as well as during selective contractions. Average Rectified Values (ARV) were calculated in order to identify the contribution of each muscle to different tasks. On the other hand, Muscle Fiber Conduction Velocity, Mean and Median Frequencies and also ARV were studied to obtain fatigue indexes related to metabolic changes in the muscles during a high force sustained contraction. Results showed muscular imbalance with lower ECR activity compensated by higher ECU activation, and higher fatigue indexes in patients with lateral epicondylitis.
Collapse
Affiliation(s)
- Monica Rojas
- Dept. Automatic Control, Biom. Eng. Research Center (CREB), Technical University of Catalonia, UPC, Barcelona, Spain.
| | | | | | | |
Collapse
|
22
|
Chaler J, Pujol E, Abril A, Maiques A, Unyó C, Garreta R. Poster 101. Arch Phys Med Rehabil 2005. [DOI: 10.1016/j.apmr.2005.07.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
23
|
Callé JR, Guerra M, Chaler J, Blanco A, Enseñat A. Hematological Changes In The Training Process For An Ironman Competition. Med Sci Sports Exerc 2005. [DOI: 10.1249/00005768-200505001-00263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
24
|
Chaler J, Carilla R, Labarta A, Fajari L, Riera J, Julia L. Trichloro-2,6-pyridylene, a Good Ferromagnetic Coupling Unit between Two Persistent Carbon Radical Centers. J Org Chem 2002. [DOI: 10.1021/jo00094a020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
25
|
Hesse S, Werner C, Paul T, Bardeleben A, Chaler J. Influence of walking speed on lower limb muscle activity and energy consumption during treadmill walking of hemiparetic patients. Arch Phys Med Rehabil 2001; 82:1547-50. [PMID: 11689974 DOI: 10.1053/apmr.2001.26607] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To identify the relationship between treadmill speed and energy consumption and lower limb muscle activity in ambulatory hemiparetic patients. DESIGN Experimental cohort. SETTING Inpatient rehabilitation clinic. PARTICIPANTS Twenty-four ambulatory hemiparetic subjects. INTERVENTION Subjects walked harness-secured on the treadmill with no body-weight support at self-reported (V SAS), slow (V SAS - 25%), and fast (V SAS + 25%) speed. MAIN OUTCOME MEASURES Assessment of basic, limb-dependent cycle parameters, lower limb muscle activity, and energy consumption. RESULTS Cadence (r = .75), stride length (r = .78), relative double-support duration (r = .31), mean muscle activity of the paretic tibialis anterior (r = .12), gastrocnemius (r = .37), vastus lateralis (r =.19), rectus femoris (r = .31), and biceps femoris (r = .45) muscles, as well as heart rate (r = .54), correlated positively with treadmill speed. Mean maximum heart rate was 131 beats/min. Energy (r = -.67) and cardiac cost (r = -.55) correlated negatively with gait speed (ie, patients walked more efficiently at faster velocities). The qualitative muscle activation pattern analysis revealed earlier (more normal) onset of activation of gastrocnemius, vastus lateralis, biceps femoris, and gluteus medius. CONCLUSIONS Patients should try to walk fast on the treadmill, thereby facilitating relevant weight-bearing muscles and improving gait efficiency.
Collapse
Affiliation(s)
- S Hesse
- Department of Neurological Rehabilitation, Klinik Berlin, Berlin, Germany.
| | | | | | | | | |
Collapse
|
26
|
Acebes JC, Chaler J, Olivé A, Rivas A, Tena X. Coexistence of tuberculous and pyogenic arthritis. Clin Exp Rheumatol 1995; 13:793. [PMID: 8835256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
|