Objective:
To assess the effectiveness of 12 weeks of Pilates practice on disability, pain and kinesiophobia in patients with chronic non-specific low back pain.
Design:
This is a randomized ...controlled trial.
Setting:
This study was conducted in the university laboratory.
Subjects:
A total of 64 participants with chronic non-specific low back pain were included.
Interventions:
Participants were randomly allocated to intervention group consisted in Pilates intervention during 12 weeks (n = 32) or control group who received no treatment (n = 32).
Main measures:
Disability, pain and kinesiophobia were assessed by Roland Morris Disability Questionnaire, visual analogue scale and Tampa Scale of Kinesiophobia, respectively. Measurements were performed at baseline, at 6 and 12 weeks after study completion.
Results:
There were significant differences between groups with observed improvement in Pilates intervention group in all variables after treatment (P < 0.001). Major changes on disability and kinesiophobia were observed at six weeks of intervention with no significant difference after 12 weeks (P < 0.001). Mean changes of the intervention group compared with the control group were 4.00 (0.45) on the Roland Morris Disability Questionnaire and 5.50 (0.67) in the Tampa Scale of Kinesiophobia. Pain showed better results at six weeks with a slightly but statistically significant improvement at 12 weeks with Visual Analogue Scale scores of 2.40 (0.26) (P < 0.001).
Conclusion:
Pilates intervention in patients with chronic non-specific low back pain is effective in the management of disability, pain and kinesiophobia.
The scapholunate interosseous ligament (SLIL) plays a fundamental role in stabilizing the wrist bones, and its disruption is a frequent cause of wrist arthrosis and disfunction. Traditionally, this ...structure is considered to be a variety of fibrocartilaginous tissue and consists of three regions: dorsal, membranous and palmar. Despite its functional relevance, the exact composition of the human SLIL is not well understood. In the present work, we have analyzed the human SLIL and control tissues from the human hand using an array of histological, histochemical and immunohistochemical methods to characterize each region of this structure. Results reveal that the SLIL is heterogeneous, and each region can be subdivided in two zones that are histologically different to the other zones. Analysis of collagen and elastic fibers, and several proteoglycans, glycoproteins and glycosaminoglycans confirmed that the different regions can be subdivided in two zones that have their own structure and composition. In general, all parts of the SLIL resemble the histological structure of the control articular cartilage, especially the first part of the membranous region (zone M1). Cells showing a chondrocyte‐like phenotype as determined by S100 were more abundant in M1, whereas the zone containing more CD73‐positive stem cells was D2. These results confirm the heterogeneity of the human SLIL and could contribute to explain why certain zones of this structure are more prone to structural damage and why other zones have specific regeneration potential.
Research Highlights
Application of an array of histological analysis methods allowed us to demonstrate that the human scapholunate ligament is heterogeneous and consists of at least six different regions sharing similarities with the human cartilage, ligament and other anatomical structures.
Analysis of the human scapholunate ligament using an array of quantitative histological, histochemical and immunohistochemical methods allowed us to propose a novel molecular classification of the different regions of this structure involved in maintaining the stability of the human wrist.
Background
Pelvic floor dysfunction and urinary incontinence are two of the most frequent gynecological problems, and pelvic floor muscle training is recommended as a first‐line treatment, with new ...approaches such as hypopressive exercises. This study aimed to analyze the efficacy of an 8‐week supervised training program of hypopressive exercises on pelvic floor muscle strength and urinary incontinence symptomatology.
Design
Blinded randomized controlled trial.
Settings
Women with pelvic floor dysfunction and urinary incontinence symptoms, aged 18–60 years.
Participants
A total of 117 participants were randomly allocated to the hypopressive exercises group (n = 62) or a control group that received no intervention (n = 55) and completed the study.
Main Outcome Measures
Clinical and sociodemographic data were collected, as well as pelvic floor muscle strength (using the Modified Oxford Scale); the genital prolapse symptoms, colorectal symptoms, and urinary symptoms (with the Pelvic Floor Distress Inventory PFDI‐20); the impact of pelvic floor disorders (PFD) on women's lives (with the Pelvic Floor Impact Questionnaire PFIQ‐7); and the severity of urinary incontinence symptoms (using the International Consultation on Incontinence Questionnaire ICIQ).
Results
The results showed an improvement in the hypopressive group in the pelvic floor muscle strength F (1117) = 89.514, p < 0.001, a significantly lower score for the PFIQ7 total score, t (112) = 28.895, p < 0.001 and FPDI20 t (112) = 7.037, p < 0.001 as well as an improvement in ICIQ‐SF values after 8 weeks of intervention in comparison with the control group.
Conclusions
After performing an 8‐week of hipopressive exercises intervention, a decrease in pelvic floor disorders associated symptoms can be observed. In addition, pelvic floor muscle contractility is improved and a decrease in severity and symptoms associated with urinary incontinence has been reported.
The Sarcopenia and Quality of Life questionnaire (SarQol®) is a self-administered multidimensional sarcopenia-specific tool designed for community-dwelling subjects aged 65 years and older. The ...purpose of the present study was to evaluate the psychometric properties of the Spanish version of the SarQoL®. A total of 252 participants aged ≥ 65 years voluntarily participated in this cross-sectional study. Handgrip strength and bioelectrical impedance analysis were used for sarcopenia screening. Discriminative power, internal consistency, test–retest reliability, and floor and ceiling effects were analyzed. The generic 36-item Short-Form Health Survey (SF-36), the European Quality of Life 5-Dimension-3 Level (EQ-5D-3L), and the Hospital Anxiety and Depression Scale (HADS) were also used for convergent and divergent validity. Significant differences between sarcopenic (
n
= 66) and non-sarcopenic participants were observed for SarQoL® total score (
p
= 0.008) and for all domains except D2—locomotion. A high internal consistency of SarQoL® total score (Cronbach’s alpha = 0.904) was found, and significant domain-to-total score correlations were obtained (all
p
< .001). Test–retest data showed excellent reliability for SarQoL® total score (ICC = 0.99; 95%CI 0.98–0.99) and in all dimensions, except for D6—leisure and D7—fears activities (substantial). No floor and ceiling effects were observed for SarQoL® total score. SarQoL® total score showed good and acceptable correlations(
p
< 0.001) with the selected domains of the SF-36 and EQ-5D-3L which have similar dimensions (convergent validity). Low and non-significant correlations existed with anxiety, depression, and EQ-5D-3L self-care and pain/discomfort domains (divergent validity). The Spanish SarQoL® shows satisfactory general psychometric properties in Spanish-speaking older adults from Spain and is able to discriminate between older adults with and without sarcopenia.
Influence of pelvic floor disorders on sexuality in women Martínez‐Galiano, Juan Miguel; Peinado‐Molina, Rocío Adriana; Martínez‐Vazquez, Sergio ...
International journal of gynecology and obstetrics,
March 2024, 2024-Mar, 2024-03-00, 20240301, Volume:
164, Issue:
3
Journal Article
Peer reviewed
Open access
Objective
To determine the association between different pelvic floor disorders and the presence of sexual dysfunction in women.
Method
An observational study of non‐pregnant women was carried out in ...Spain in 2021 and 2022. To assess the presence of pelvic floor problems, the Pelvic Floor Distress Inventory (PFDI‐20) was used, consisting of the subscales Pelvic Organ Prolapse Distress Inventory‐6 (POPDI‐6; prolapse symptoms), Colorectal‐Anal Distress Inventory (CRADI‐8; colorectal symptoms), and Urinary Distress Inventory‐6 (UDI‐6; urinary symptoms). The validated tool, Female Sexual Function (FSF), was used to evaluate female sexual function.
Results
In total, 1008 women participated. Of these, 288 (28.6%) had some type of sexual dysfunction. Regarding symptoms, 52 (5.2%) stated that they do not reach orgasm and 172 (17.1%) said they had never or occasionally felt sexual desire in the last month. Women with sexual dysfunctions had higher mean scores on the POPDI‐6, CRADI‐8, and UDI‐6 subscales than those who did not have sexual dysfunction (P ≤ 0.005). Risk factors identified included being postmenopausal, with an adjusted odds ratio (aOR) of 2.98 (95% confidence interval CI 2.12–4.18), and a greater impact of the symptoms of pelvic floor problems as assessed by the PFDI‐20 scale, in such a way that for each point increase the probability of sexual dysfunction increases with an aOR of 1.008 (95% CI 1.005–1.011).
Conclusion
Women with pelvic floor disorders and postmenopausal women present sexual dysfunction more frequently.
Synopsis
The high prevalence of sexual dysfunction in women associated with pelvic floor disorders is an important public health problem.
Although several studies have been published regarding the morphology and anatomical variations of the human shoulder joint, most have dealt with adult individuals. Those looking into the development ...of the joint have been focused on specific structures or have observed specimens in advanced gestational stages. The goal of this paper is to perform a complete analysis of the embryonic and early fetal development of the elements in the shoulder joint, and to clarify some contradictory data in the literature. In our study, serial sections of 32 human embryos (Carnegie stages 16–23) and 26 fetuses (9–13 weeks) were analyzed. The chondrogenic anlagen of the humerus and the medial border of the scapula can be observed from as early as Carnegie stage 17, whereas that of the rest of the scapula appears at stage 18. The osteogenic process begins in week 10 for the humeral head and week 11 for the scapula. At stage 19 the interzone becomes apparent, which will form the glenohumeral joint. In the next stage the glenohumeral joint will begin delaminating and exhibiting a looser central band. Denser lateral bands will join the humeral head (caput humeri) and the margins of the articular surface of the scapula, thus forming the glenoid labrum, which can be fully appreciated by stage 22. In 24‐mm embryos (stage 21) we can observe, for the first time, the long head of the biceps tendon (which is already inserted in the glenoid labrum by week 9), and the intertubercular sulcus, whose depth is apparent since week 12. Regarding ligamentous structures, the coracohumeral ligament is observed at the end of Carnegie stage 23, whereas the primitive glenohumeral ligament already appeared in week 10. The results of this study provide a detailed description of the morphogenesis, origin and chronological order of appearance of the main intrinsic structures of the human shoulder joint during late embryonic and early fetal development. We expect these results to help explain several functional aspects of the shoulder joint, and to clarify some contradictory data in the literature regarding this complex anatomical and biomechanical structure, helping future researchers in their efforts.
Objective:
To investigate the effects of adding stretching to a moderate-intensity aerobic exercise programme in women with fibromyalgia.
Design:
Randomized controlled trial.
Subjects:
Sixty-four ...female patients who were diagnosed with fibromyalgia syndrome based on the American College of Rheumatology criteria were recruited (mean age: 54.27 ± 6.94 years).
Interventions:
The control group (n = 32) underwent supervised moderate-intensity cycling (50%–70% of the age-predicted maximum heart rate) three times per week for 12 weeks. The experimental group (n = 32) underwent the same exercise programme plus a stretching programme once per week for 12 weeks.
Main measures:
The main measures of this study were sleep quality assessed by the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale, the impact of fibromyalgia on quality of life assessed by the Fibromyalgia Impact Questionnaire, and pain perception assessed by the visual analogue scale at baseline, after 4 weeks, and after 12 weeks.
Results:
The experimental group experienced significant improvements at 4-week measure compared with control group: Pittsburgh Sleep Quality Index (P < 0.001); Epworth Sleepiness Scale (P = 0.002); Fibromyalgia Impact Questionnaire (0.93 ± 7.39, P < 0.001); and visual analogue scale (0.52 ± 0.05, P < 0.001). Also at 12-week measure, experimental group experienced significant improvements compared with control group: Pittsburgh Sleep Quality Index (P < 0.001), Epworth Sleepiness Scale (P < 0.001); Fibromyalgia Impact Questionnaire (1.15 ± 9.11, P < 0.001); and visual analogue scale (0.81 ± 0.62, P < 0.001).
Conclusion:
Adding stretching to a moderate-intensity aerobic exercise programme increased sleep quality, decreased the impact of fibromyalgia on the quality of life, and reduced pain compared with just a moderate-intensity aerobic exercise programme in our sample of women with fibromyalgia.
the main objective was to analyze the effects that an exercise programme based on the Pilates method would have on balance confidence, fear of falling, and postural control among women ≥60 years old.
...a total of 110 women (69.15 ± 8.94 years) participated in this randomized, controlled trial that took place in Jaén (Spain). The participants were randomly assigned to either a control group (
= 55), which received no intervention, or to a Pilates group (
= 55), which carried out an exercise programme based on the Pilates method in 60-minute sessions for 12 weeks. The Falls Efficacy Scale-International and the activity-specific balance confidence scale were respectively used to assess fear of falling and balance confidence in performing activities of daily living. Postural control was evaluated using a stabilometric platform.
Regarding balance confidence, the Pilates group showed higher values compared to the control group (77.52 ± 18.27 vs 72.35 ± 16.39, Cohen's
= 0.030). Women in the Pilates group showed lower fear of falling, compared to those of the control group (22.07 ± 5.73 vs 27.9 ± 6.95, Cohen's
= 0.041). Finally, concerning static balance, participants of the Pilates group experienced statistically significant improvements on the velocity and anteroposterior movements of the centre of pressure with eyes open and closed respectively (Cohen's
= 0.44 and 0.35 respectively).
A 12-week Pilates training programme has beneficial effects on balance confidence, fear of falling and postural stability, in elderly women.
The purpose of this study was to determine the effects of a 12-week contrast training (CT) program (isometric + plyometric), with no external loads, on the vertical jump, kicking speed, sprinting, ...and agility skills of young soccer players. Thirty young soccer players (age, 15.9 ± 1.43 years; weight, 65.4 ± 10.84 kg; height, 171.0 ± 0.06 cm) were randomized in a control group (n = 13) and an experimental group (n = 17). The CT program was included in the experimental group's training sessions, who undertook it twice a week as a part of their usual weekly training regime. This program included 3 exercises: 1 isometric and 2 plyometric, without external loads. These exercises progressed in volume throughout the training program. Performance in countermovement jump (CMJ), Balsom agility test (BAT), 5-, 10-, 20-, and 30-m sprint, and soccer kick were assessed before and after the training program. A 2-factor (group and time) analysis of variance revealed significant improvements (p < 0.001) in CMJ, BAT, and kicking speed in the experimental group players. Control group remained unchanged in these variables. Both groups significantly reduced sprint times over 5, 10, 20, and 30 m (p ≤ 0.05). A significant correlation (r = 0.492, p < 0.001) was revealed between ΔBAT and Δaverage kicking speed. Results suggest that a specific CT program without external loads is effective for improving soccer-specific skills such as vertical jump, sprint, agility, and kicking speed in young soccer players.
Abstract
Purpose: To evaluate the effects of joint mobilization, in which movement is applied to the ankle's dorsiflexion range of motion, on dynamic postural control and on the self-reported ...instability of patients with chronic ankle instability (CAI). Methods: A double-blind, placebo-controlled, randomized trial with repeated measures and a follow-up period. Ninety patients with a history of recurrent ankle sprain, self-reported instability, and a limited dorsiflexion range of motion, were randomly assigned to either the intervention group (Joint Mobilizations, 3 weeks, two sessions per week) the placebo group (Sham Mobilizations, same duration as joint mobilization) or the control group, with a 6 months follow-up. Dorsiflexion Range of Motion (DFROM), Star Excursion Balance Test (SEBT) and CAI Tool (CAIT) were outcome measures. A separate 3 × 4 mixed model analysis of variance was performed to examine the effect of treatment conditions and time, and intention-to-treat (ITT) analysis was applied to evaluate the effect of the independent variable. Results: The application of joint mobilization resulted in better scores of DFROM, CAIT, and SEBTs in the intervention group when compared with the placebo or the control groups (p < 0.001). The effect sizes of group-by-time interaction, measured with eta-squared, oscillated between 0.954 for DFROM and 0.288 for SEBT posteromedial distance. In within-group analysis, the manipulation group showed an improvement at 6 months follow-up in CAIT mean = 5.23, CI 95% (4.63-5.84), DFROM mean = 6.77, CI 95% (6.45-7.08), anterior SEBT mean = 7.35, CI 95% (6.59-8.12), posteromedial SEBT mean = 3.32, CI 95% (0.95-5.69), and posterolateral SEBT mean = 2.55, CI 95% (2.20-2.89). Conclusion: Joint mobilization techniques applied to subjects suffering from CAI were able to improve ankle DFROM, postural control, and self-reported instability. These results suggest that joint mobilization could be applied to patients with recurrent ankle sprain to help restore their functional stability.Implications for RehabilitationFunctional instability is a very common sequela in patients with CAI, resulting in reduced quality of living due to the limitations it imposes on daily life activities.The mobilization with movement technique presented by Mulligan, and based on the joint mobilization accompanied by active movement, appears as a valuable tool to be employed by physical therapists to restore ankle function after a recurrent ankle sprain history.ROM restriction, subjective feeling of instability and dynamic postural control are benefiting from the joint mobilization application.
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