Search Results (44)

During the coronavirus 2019 pandemic, sports activities were restricted, raising concerns about their impact on the physical condition of adolescent athletes, which remained largely unquantified. This study was designed with two primary objectives: first, to precisely quantify and elucidate the differences in the physical condition of adolescent athletes before and after activity restrictions due to the pandemic; and second, to innovatively develop and validate a non-contact medical checkup application. Medical checks were conducted on 563 athletes designated for sports enhancement. Participants were junior high school students aged 13 to 15, and the sample consisted of 315 boys and 248 girls. Furthermore, we developed a smartphone application and compared self-checks using the application with in-person checks by orthopedic surgeons to determine the challenges associated with self-checks. Statistical tests were conducted to determine whether there were statistically significant differences in range of motion and flexibility parameters before and after the pandemic. Additionally, items with discrepancies between values self-entered by athletes using the smartphone application and values measured by specialists were detected, and application updates were performed. Student’s t-test was used for continuous variables, whereas the chi-square test was used for other variables. Following the coronavirus 2019 pandemic, athletes were stiffer than during the pre-pandemic period in terms of hip and shoulder joint rotation range of motion and heel–buttock distance. The dominant hip external rotation decreased from 53.8° to 46.8° (p = 0.0062); the non-dominant hip external rotation decreased from 53.5° to 48.0° (p = 0.0252); the dominant shoulder internal rotation decreased from 62.5° to 54.7° (p = 0.0042); external rotation decreased from 97.6° to 93.5° (p = 0.0282), and the heel–buttock distance increased from 4.0 cm to 10.4 cm (p < 0.0001). The heel–buttock distance and straight leg raising angle measurements differed between the self-check and face-to-face check. Although there are items that cannot be accurately evaluated by self-check, physical condition can be improved with less contact by first conducting a face-to-face evaluation under appropriate guidance and then conducting a self-check. These findings successfully address our primary objectives. Specifically, we demonstrated a significant decline in the physical condition of adolescent athletes following pandemic-related activity restrictions, thereby quantifying their impact. Furthermore, our developed non-contact medical checkup application proved to be a viable tool for monitoring physical condition with reduced contact, although careful consideration of measurable parameters is crucial. This study provides critical insights into the long-term effects of activity restrictions on young athletes and offers a practical solution for health monitoring during infectious disease outbreaks, highlighting the potential for hybrid checkup approaches. Full article

Introduction: Shear wave elastography (SWE) has been widely used to assess the mechanical properties of peripheral nerves, including the sciatic nerve. However, the relationship between sciatic nerve stiffness and posterior chain flexibility remains unclear. Therefore, we aimed to examine differences in sciatic nerve stiffness and shear wave speed (SWS) based on limb dominance and hamstring flexibility, and to explore their association with posterior chain mobility assessed through AKE and ASLR tests in healthy individuals. Methods: An observational study was conducted on 25 healthy, physically active participants (49 lower limbs). Sciatic nerve stiffness was measured using SWE at a standardized location in the posterior thigh. Posterior chain flexibility was assessed using the Active Knee Extension (AKE) and Active Straight Leg Raise (ASLR) tests. Participants were categorized based on hamstring flexibility, and comparisons were made between dominant and non-dominant limbs. Results: Participants with limited hamstring flexibility exhibited significantly higher AKE and ASLR values (p < 0.001) and showed an increased stiffness and SWS towards greater sciatic nerve (p = 0.05), although correlations between SWE values and flexibility tests were not significant. No significant differences were found between dominant and non-dominant limbs in AKE (p = 0.28), ASLR (p = 0.47), SWE (p = 0.38), or SWS (p = 0.34) values. Conclusions: Although no significant correlations were found between SWE parameters and flexibility tests, individuals with limited posterior chain mobility exhibited higher sciatic nerve stiffness in healthy participants. Full article

Although it has been found that soccer produces limb imbalance, it has not been rigorously determined how to evaluate it in soccer players or which low-cost tests are the most effective for its analysis. Therefore, the objective of this systematic review was to identify and examine the evidence and evaluations of limb imbalance produced in professional soccer players. A systematic search was conducted in three databases (PubMed, Web of Sciences, and Scopus) to identify relevant studies published before 23 May 2022. Of the 2364 studies identified initially, only 12 articles were included in the systematic review. The results revealed that injury risks can be detected in professional soccer players through the YBT (Y Balance Test). The PSLR (Passive Straight Leg Raise) test, as well as the evaluation of the ROM (range of motion) in movements of adduction and internal hip rotation, seem to be two reliable tests to detect imbalances in the flexibility of the extremities. The FMS (Functional Motion Screen) test is inversely related to the performance in jump tests; thus, its combination can help to detect asymmetries in power generation. Finally, strength assessment tests in soccer players can negatively alter the flexibility values of agonist/antagonist muscles. Therefore, it is advisable to monitor both strength and flexibility tests synergistically to obtain a comprehensive evaluation. Full article

Background/Objective: Maintaining sufficient ankle joint range of motion (ROM) contributes to efficient movement in sports and daily activities. Static stretching (SS), while effective, demands significant time, highlighting the need for alternative, time-efficient approaches to improve ROM. Therefore, this study aimed to evaluate the effectiveness of combined intervention (CI) using neuromuscular electrical stimulation (NMES) and elastic tape versus SS. Methods: This randomized crossover trial was conducted in healthy university students. They underwent both interventions with a 1-week washout period. The CI entailed the application of elastic tape to the plantar surface of the foot coupled with NMES targeting the posterior lower leg muscles for 1 min. SS was administered for 5 min using a tilt table. Outcome measures included the dorsiflexion angle (DFA), finger-floor distance (FFD), straight leg raise (SLR) angle, plantar flexor strength (PFS), and knee flexor strength (KFS), assessed pre- and post-intervention. DFA was analyzed using equivalence testing with a predefined margin. Results: Both interventions yielded significant improvements in DFA, FFD, and SLR. The combination of NMES and elastic tape demonstrated equivalence to 5 min of SS in enhancing DFA. Neither intervention resulted in a significant reduction in PFS or KFS. Conclusions: The CI of NMES and elastic tape effectively and safely improves flexibility in a short time. Its time efficiency makes it a promising alternative to SS, especially for brief warm-ups or limited rehabilitation time. Further research should explore its long-term effects and broader applicability. Full article

The accurate and reliable measurement of hip flexion angles during the Straight Leg Raise (SLR) test is essential for clinical and research purposes. Despite the widespread use of motion analysis tools, few studies have examined the reliability of affordable, open-source software 0.9.5 like Kinovea for this application. This study aimed to evaluate the intra- and inter-examiner reliability of Kinovea for measuring the hip flexion angle during the SLR test in individuals with and without low back pain (LBP). An observational study was conducted involving 53 participants (38 with LBP and 15 asymptomatic controls). Each participant underwent two SLR test sessions conducted by two examiners with varying levels of experience. The hip flexion angles were measured using Kinovea software based on video recordings. Intra- and inter-examiner reliability were assessed using the Intraclass Correlation Coefficient (ICC), Standard Error of Measurement (SEM), and Minimal Detectable Change (MDC). The effects of examiner experience and patient group were also analyzed. Kinovea demonstrated excellent intra- and inter-examiner reliability for measuring hip flexion angles, with ICC values ranging from 0.985 to 0.998. The SEM values were low (0.5°–1.5°), and the MDC values at 95% confidence ranged from 1.3° to 4.0°. No significant differences were found between the examiners’ experience or the patient groups. Thus, Kinovea offers a reliable, cost-effective, and user-friendly method for measuring hip flexion angles during the SLR test. Its consistency and precision, even across examiners with differing experience levels, highlight its potential to standardize assessments and improve diagnostic and therapeutic applications. Future research should explore its use in more complex movement analyses and diverse clinical populations to further validate its utility. Full article

Background: Low back pain (LBP) is a leading cause of disability worldwide, often driven by distinct pain mechanisms: nociceptive, neuropathic, and central sensitization. Accurate classification of these mechanisms is critical for guiding effective, targeted treatments. Methods: A scoping review was conducted following the Joanna Briggs Institute methodology and reported according to PRISMA-ScR guidelines. A comprehensive literature search was performed in MEDLINE, Cochrane CENTRAL, Scopus, PEDro, and Web of Science. Eligible studies included adults with LBP and focused on clinical criteria for classifying pain mechanisms. Data on study methods, population characteristics, and outcomes were extracted and synthesized. Results: Nine studies met the inclusion criteria. Nociceptive pain was characterized by localized symptoms proportional to mechanical triggers, with no neurological signs. Neuropathic pain was associated with burning sensations, dysaesthesia, and a positive neurodynamic straight leg raise (SLR) test. Central sensitization featured widespread pain, hyperalgesia, and disproportionate symptoms. Tools such as painDETECT, DN4, and the Central Sensitisation Inventory (CSI) were validated for neuropathic and central sensitization pain. Central sensitization and neuropathic pain were linked to greater disability and psychological distress compared to nociceptive pain. Conclusions: This review aims to provide a historical perspective on pain mechanism classifications and to explore how previous frameworks have influenced current diagnostic concepts in physiotherapy practice. By synthesizing key clinical criteria used to differentiate between nociceptive, neuropathic, and central sensitization pain, this review proposes a practical framework to improve the accuracy of pain classification in clinical settings. Full article

Background/Objectives: The active straight leg raise requires intricate coordination between the hip, knee, pelvis, and spine. Despite its complexity, limited research has explored the relationship between lower limb raising velocity and trunk muscle motor control during an active straight leg raise in healthy individuals. This study aimed to explore the potential effects of increased lower limb raising velocity on core muscle contractions during active straight leg raises. Methods: Six healthy adult men (mean age: 24.5 ± 2.5 years) participated in this study. Electromyography signals were recorded using surface electrodes placed on the rectus abdominis, external oblique, and internal oblique/transverse abdominis muscles. The participants performed active straight leg raises at three different velocities: 3 s, 2 s, and as fast as possible (max). The electromyography data were analyzed from 250 ms before to 1000 ms after movement initiation, with muscle activity expressed as a percentage of the maximal voluntary isometric contraction. Statistical analyses were conducted using non-parametric tests, including the Friedman test for overall differences, followed by pairwise Wilcoxon signed-rank tests with Bonferroni correction for multiple comparisons (p < 0.05). Results: During the 250 ms before movement initiation, the internal oblique/transverse abdominis, external oblique, and rectus abdominis muscles showed greater activity in the max condition compared to the 3 s and 2 s conditions (Friedman test, p < 0.05), but no significant differences were found in pairwise comparisons (Wilcoxon test, p > 0.05). Similarly, during the 500 ms after movement initiation, internal oblique/transverse abdominis activity was higher in the max condition, with no significant pairwise differences observed. Conclusions: Faster lower limb raising velocities during active straight leg raise may enhance core stability by activating anticipatory and sustained internal oblique/transverse abdominis, external oblique, and rectus abdominis activity on the raised limb side. Training to promote this activation could improve dynamic stability in rapid or asymmetric movements. Full article

Background/Objectives: Hamstring shortening is a significant musculoskeletal condition affecting the posture and mobility of the spine and lower extremities. This study examined the impact of incorporating neurodynamic slump stretch and suboccipital muscle inhibition into passive static stretching on hamstring flexibility in individuals with short hamstrings. Methods: 117 female participants were classified into three groups: the control group, which received passive static stretch of the hamstring muscle; the neurodynamic slump group, which received neurodynamic slump stretch with passive static stretch; and the suboccipital muscle inhibition group, which received suboccipital muscle inhibition with passive static stretch, for three sessions a week, 10 min each, for four weeks. The outcome measures were the popliteal angle test (PAT), straight leg raising (SLR) test, and forward bending test (FBT) at baseline, immediately following the first session and after four weeks. Results: Statistically significant differences were found within groups (p < 0.001) for all outcome measures. Between the groups, there was a more significant improvement in the PAT and the SLR tests, favoring the neurodynamic slump and suboccipital muscle inhibition groups in comparison with the passive static stretch group (p < 0.001) with no significant difference between the two groups after the first session and at four weeks of treatment. However, the FBT showed no significant differences immediately following the first session or at four weeks of treatment (p > 0.05). Conclusions: This study found that incorporating neurodynamic slump stretch and suboccipital muscle inhibition into passive static stretch techniques effectively treats short hamstrings in healthy individuals. Full article

Background/Objective: Short hamstring syndrome is common in the general population and can lead to impaired balance, function, and posture, and increased risk of injuries. Local treatments have obtained controversial results, so it is necessary to evaluate the effectiveness of other types of therapy such as osteopathic treatment. To evaluate the efficacy of osteopathic techniques in increasing the elasticity of the hamstring musculature in short hamstring syndrome. Methods: A systematic review of randomised controlled trials was conducted in PubMed, Medline, Cinhal, Scopus, WOS, SPORTDiscuss, and PEDro. The PEDro scale was used to evaluate the methodological quality and the RoB2 for the evaluation of biases. Results: A total of eight articles were selected. Most of the participants were assessed with the Active Knee Extension or Straight Leg Raise tests. The osteopathic techniques used were the muscle energy technique, suboccipital inhibition, and vertebral mobilisations. As for the control interventions, they mainly included passive stretching and placebo. Conclusions: The results suggest that osteopathic techniques are more effective than placebo or other interventions in increasing flexibility in adult patients with short hamstring syndrome. This effect can be explained by neurophysiological (Golgi apparatus, neuromuscular spindle activity, and Hoffmann reflex) and structural factors (dura mater, posture, and myofascial chains). Nevertheless, the evidence suggests that it would be beneficial to incorporate this type of treatment into flexibility improvement programmes. Full article

This study investigated the effect of digital therapeutics on ROM, flexibility, dynamic balance, satisfaction, and adherence. A sample of 34 volunteers was randomly assigned into a Digital Therapeutic Group (DTG) (n = 17) and a Non-Digital Therapeutic Group (NDG) (n = 17). The groups performed four calf muscle stretches and two hamstring stretches for 4 weeks. Flexibility and balance were evaluated to assess the effectiveness of the exercise program. A survey was conducted to assess subjects’ satisfaction, and exercise performance record papers and video records were assessed for exercise adherence. The paired t-test was used to compare the two populations before and after the program. The independent t-test was used to compare the change scores between groups. In the pre- and post-comparison within each group, the DTG group showed significant differences in all items except the dorsiflexion range of motion (ROM) (p < 0.05). The left straight leg raise (SLR) was significantly different (p < 0.05), and there was a significant difference in exercise satisfaction and participation between the two groups (p < 0.05). DTG showed improved flexibility, dynamic balance, and higher exercise satisfaction and adherence than NDG. The application, providing lower extremity stretching, can improve dorsiflexion ROM, flexibility of the lower extremity, dynamic balance, exercise satisfaction, and exercise adherence. Full article

This study was conducted to compare and analyze whether Pilates exercise and yoga exercise help improve the performance of female fencers and prevent injury, and the dynamic balance test (LQ-YBT) and functional movement screening (FMS) test score of the elite adult female fencers were compared and analyzed as evaluation indicators. Participants were randomly classified into Pilates (n = 10) and yoga groups (n = 10), members of which took part in 50 min of exercise (5 min of warm-up, 40 min of main exercise, and 5 min of cool-down) twice weekly for eight weeks. The results obtained from this study were analyzed via independent t-test and 2-way ANOVA. The results were as follows: LQ-YBT measures (reaching distance) increased significantly for both groups, as did FMS scores (deep squat, hurdle step, inline lunge, shoulder mobility, active straight-leg raise, trunk-stability push-up, and rotary stability). These results suggest that Pilates exercise and yoga exercise might be likely effective in improving the performance of adult female fencers and injury prevention by increasing their dynamic balance ability and functional movement. Full article

Hip range of movement (ROM) impairments could affect individuals’ quality of life. The aim of this study is to describe a new flexometric method (FM) as a means to estimate hip ROM and to determine its concurrent validity and inter-rater and intra-rater reliability. Hip ROM was measured by performing the straight leg raise test (SLR) and hip abduction test (HA). The WIMU system is the gold standard. ROM was calculated in degrees using a trigonometric function based on values derived from measurements with a flexometer. The SLR and the HA showed high concurrent validity and good inter- and intra-rater reliability with an interclass correlation coefficient value that was at all times > 0.9. The minimal detectable change at the 90% confidence level for inter- and intra-rater reliability was equal to or greater than 5.7° in SLR-Right, 5.6° in SLR-Left, 5.1° in HA, 6.3° in SLR-Right, 4.9° in SLR-Left, and 5.4° in HA, respectively. This study suggests that the FM is a valid and reliable tool for assessing hip ROM. Due to its convenience and cost-effectiveness, this method could be widely used to measure the ROM of several joints in field-based tests. Full article

Peripheral nerves are subjected to mechanical tension during limb movements and body postures. Nerve response to tensile stress can be assessed in vivo with shear-wave elastography (SWE). Greater tensile loads can lead to greater stiffness, which can be quantified using SWE. Therefore, this study aimed to conduct a systematic review and meta-analysis to perform an overview of the effect of joint movements on nerve mechanical properties in healthy nerves. The initial search (July 2023) yielded 501 records from six databases (PubMed, Embase, Scopus, Web of Science, Cochrane, and Science Direct). A total of 16 studies were included and assessed with a modified version of the Downs and Black checklist. Our results suggest an overall tendency for stiffness increase according to a pattern of neural tensioning. The main findings from the meta-analysis showed a significant increase in nerve stiffness for the median nerve with wrist extension (SMD [95%CI]: 3.16 [1.20, 5.12]), the ulnar nerve with elbow flexion (SMD [95%CI]: 2.91 [1.88, 3.95]), the sciatic nerve with ankle dorsiflexion (SMD [95%CI]: 1.13 [0.79, 1.47]), and the tibial nerve with both hip flexion (SMD [95%CI]: 2.14 [1.76, 2.51]) and ankle dorsiflexion (SMD [95%CI]: 1.52 [1.02, 2.02]). The effect of joint movement on nerve stiffness also depends on the nerve segment, the amount of movement of the joint mobilized, and the position of other joints comprised in the entirety of the nerve length. However, due to the limited number of studies, many aspects of nerve behavior together with the effect of using different ultrasound equipment or transducers for nerve stiffness evaluation still need to be fully investigated. Full article

The straight leg raise test (SLR) has been proposed to detect increased nerve mechanosensitivity of the lower limbs in individuals with low back pain. However, its validity in the diagnosis of lumbosacral radiculopathy shows very variable results. The aim of this study was to analyse the diagnostic validity of the SLR including well-defined diagnostic criteria (a change in symptoms with the structural differentiation manoeuvre and the reproduction of the patient’s symptoms during the test or the asymmetries in the range of motion or symptoms location between limbs) in a sample of participants in phase III with suspicion of lumbar radiculopathy using the electrodiagnostic studies (EDX) as the reference standard. A phase III diagnostic accuracy study was designed. In total, 142 individuals with suspected lumbosacral radiculopathy referred for EDX participated in the study. Each participant was tested with EDX and SLR. SLR was considered positive using three diagnostic criteria. The sensitivity of the SLR for Criterion 3 was 89.02% (CI 81.65–96.40), the specificity was 25.00% (CI 13.21–36.79), and the positive and negative likelihood ratios were 1.19 (CI 1.01–1.40) and 0.44 (0.21–0.94), respectively. SLR showed limited validity in the diagnosis of lumbosacral radiculopathy. The incorporation of more objective diagnostic criteria (asymmetry in range of motion or localisation of symptoms) improved the diagnostic validity but the imprecision of the confidence intervals limited the interpretation of the results. Full article

The objective was to evaluate the clinical joint and limb measures in professional female soccer players. The study was a cross-sectional observational design. It was a preseason clinical setting. The inclusion criteria were outfield professional female soccer players, based in the UK, competing in the highest English league. The exclusion criteria included players who had had surgery in the last six months or had missed a single training session or match due to injury in the previous three months. In terms of the outcome measures, the dependent variables were the true limb length, ankle dorsiflexion, knee flexion and extension, hip flexion, extension, internal rotation and external rotation, and straight leg raise measured using video analysis software. Additionally, passive clinical knee and ankle stability tests were conducted. The independent variables were leg dominance and playing position (defender, midfielder, and attacker). For the results, all the ROM measurements demonstrated limb symmetry (p = 0.621). However, there were significant main effects of the playing position on the ankle dorsiflexion and hip internal rotation, with defenders demonstrating a significantly reduced range of motion in comparison to midfielders and attackers. A notable finding from the bilateral passive stability measures was that 38.3% of players exhibited ankle talar inversion instability when using a talar tilt. In conclusion, bilateral differences do not appear to be apparent in this population; however, positional differences may occur in the ankle and hip range of motion measures. A high proportion of this population may present with passive ankle inversion instability. Future research should consider whether this leads to a higher risk of injury in this population. Full article