Ana Isabel Carita

Cervical and shoulder postural assessment of adolescents between 15 and 17 years old and association with upper quadrant pain

Background: There is sparse literature that provides evidence of cervical and shoulder postural alignment of 15 to 17-year-old adolescents and that analyzes sex differences. Objectives: To characterize the postural alignment of the head and shoulder in the sagittal plane of 15 to 17-year-old Portuguese adolescents in natural erect standing and explore the relationships between three postural angles and presence of neck and shoulder pain. Method: This cross-sectional study was conducted in two secondary schools in Portugal. 275 adolescent students (153 females and 122 males) aged 15 to 17 were evaluated. Sagittal head, cervical, and shoulder angles were measured with photogrammetry and PAS software. The American Shoulder and Elbow Surgeons Shoulder Assessment (ASES) was used to assess shoulder pain, whereas neck pain was self-reported with a single question. Results: Mean values of sagittal head, cervical, and shoulder angles were 17.2±5.7, 47.4±5.2, and 51.4±8.5º, respectively. 68% of the participants revealed protraction of the head, whereas 58% of them had protraction of the shoulder. The boys showed a significantly higher mean cervical angle, and adolescents with neck pain revealed lower mean cervical angle than adolescents without neck pain. 53% of the girls self-reported regular neck pain, contrasting with 19% of the boys. Conclusions: This data shows that forward head and protracted shoulder are common postural disorders in adolescents, especially in girls. Neck pain is prevalent in adolescents, especially girls, and it is associated with forward head posture.

Intrarater and Interrater Reliability of Photographic Measurement of Upper-Body Standing Posture of Adolescents

OBJECTIVEnThe purposes of this study were to determine the intrarater and interrater reliability of a photographic measurement of the sagittal postures of the cervical spine and shoulder, quantitatively characterize the postural alignment of the head and shoulders in the sagittal plane of Portuguese adolescents 15 to 17 years old in natural erect standing, and analyze differences in postural angles between sexes.nnnMETHODSnThis cross-sectional study was conducted in 2 secondary schools in Portugal where 275 adolescent students (146 females and 129 males) aged 15 to 17 years were evaluated. Sagittal head, cervical, and shoulder angles were measured with photogrammetry and the Postural Assessment Software.nnnRESULTSnFor interrater reliability, all of the intraclass correlation coefficient (ICC) values for the 3 angles were higher than 0.85. For intrarater reliability, the ICC values for the sagittal head angle, shoulder angle, and cervical angle were 0.83, 0.78, and 0.66, respectively. Mean values of sagittal head, cervical, and shoulder angles were 17.2° ± 5.7°, 47.4° ± 5.2°, and 51.4° ± 8.5°, respectively. Anterior head carriage was demonstrated by 68% of the adolescents, whereas 58% had protraction of the shoulder(s). Males had significantly higher mean cervical and sagittal head angles.nnnCONCLUSIONSnForward head posture and protracted shoulders were common postural disorders in adolescents 15 to 17 years old, with females revealing a lower mean cervical angle. The intrarater and interrater evaluation of standing sagittal posture of the cervical spine and shoulders by photogrammetry was reliable.

The effects of training and detraining after an 8 month resistance and stretching training program on forward head and protracted shoulder postures in adolescents: Randomised controlled study

PURPOSEnThis study aimed to evaluate the effects of a 32-week resistance and stretching training program applied in Physical Education classes on forward head posture and protracted shoulder posture of Portuguese adolescents (15-17 years old). The detraining effects after a 16-week period were also measured.nnnMETHODSnThis prospective, randomized and controlled study was conducted in two secondary schools in Portugal. One hundred and thirty adolescents with forward head and protracted shoulder posture were randomly assigned to a control or experimental group. The sagittal head, cervical and shoulder angle were measured before and after a 32-week time intervention period. The control group (nxa0=xa046) did only the Physical Education classes whereas the exercise group (nxa0=xa042) received a posture corrective exercise programme in addition to Physical Education classes. A 16 week detraining period followed the 32-week.nnnRESULTSnSignificant increase were observed in the cervical and shoulder angle in the experimental group following the 32 week-intervention period. After the 16-week detraining period no significant differences were observed in the three postural angles in the intervention group.nnnCONCLUSIONSnThe exercise intervention was successful at decreasing forward head and protracted shoulder in adolescents. Detraining period was not sufficient to reduce the overall training effects. This study supports the postural training and rehabilitation performed during Physical Education classes, with the aim of preventing and managing upper quadrant musculoskeletal pain. CLINICALTRIALS.nnnGOV IDENTIFIERnNCT02190331.

Reliability of the Active-Knee-Extension and Straight-Leg-Raise Tests in Subjects With Flexibility Deficits.

CONTEXTnThe active-knee-extension test (AKE) and the straight-leg-raise test (SLR) are widely used for flexibility assessment. A number of investigations have tested the reliability of these measures, especially the AKE. However, in most studies, the sample involved subjects with normal flexibility. In addition, few studies have determined the standard error of measurement (SEM) and minimal detectable difference (MDD), which can provide complementary and more clinically relevant information than the intraclass correlation coefficient (ICC) alone.nnnOBJECTIVESnThis study aimed to determine the AKE and SLR intrarater (test-retest) reliability in subjects with flexibility deficits, as well as the correlation between the 2 tests.nnnDESIGNnReliability study, test-retest design.nnnSETTINGnAcademic laboratory.nnnSUBJECTSn102 recreationally active participants (48 male, 54 female) with no injury to the lower limbs and with flexibility deficits in the hamstrings muscle group.nnnMAIN OUTCOMESnIntrarater reliability was determined using the ICC, complemented by the SEM and MDD.nnnMEASURESnAll participants performed, in each lower limb, 2 trials of the AKE and the SLR.nnnRESULTSnThe ICC values found for AKE and SLR tests were, respectively, .87-.94 and .93-.97. The values for SEM were low for both tests (2.6-2.9° for AKE, 2.2-2.6° for SLR), as well as the calculated MDD (7-8° for AKE; 6-7° for SLR). A moderate to strong, and significant, correlation between AKE and SLR was determined for the dominant limb (r = .71) and the nondominant limb (r = .67).nnnCONCLUSIONSnThese findings suggest that both AKE and SLR have excellent intrarater reliability. The SEMs and MDDs recorded are also very encouraging for the use of these tests in subjects with flexibility deficits.

Peak Vertical Jump Power as a Marker of Bone Health in Children.

The objective of this investigation was to evaluate the accuracy of peak vertical jump power (VJP) to identify children with bone mineral density (BMD) below average, defined as BMD measured by DXA and adjusted for body height at the whole body less head≤-u20091.0 standard deviation (SD). The sample included 114 boys and girls aged 8.5±0.4 years old. VJP was estimated from a countermovement jump performed on a contact mat using the measured flight time to calculate the height of rise of the center of gravity. Logistic regression analysis revealed that the odds ratio of having BMD≤1.0 SD decreased 1.2% per watt of power and the probability of BMD below average was 75.6% higher in boys than in girls with the same peak power jump. Receiver operating characteristic analysis showed that the best trade-off between sensitivity and specificity to identify children with BMD<-u20091.0 SD was 635 watts in boys (sensitivity=63.3%; specificity=69.2%; AUC=0.816, 95% CI: 0.681-0.95; p<0.001) and 515 watts in girls (sensitivity=75.0%; specificity=77.0%; AUC=0.849, 95% CI: 0.698-0.999; p=0.002). These cut-off values correspond to a vertical jump of 19.9u2009cm and 20.5u2009cm in 8-year-old boys and girls, respectively. The VJP showed a reasonable sensitivity and specificity as well good discriminant ability to identify children with BMD below average.

Effects of a Resistance and Stretching Training Program on Forward Head and Protracted Shoulder Posture in Adolescents

Objective The purpose of this study was to evaluate the effects of a 16‐week resistance and stretching training program applied in physical education (PE) classes on forward head posture and protracted shoulder posture in Portuguese adolescents. Methods This prospective, randomized, controlled study was conducted in 2 secondary schools. One hundred and thirty adolescents (aged 15‐17 years) with forward head and protracted shoulder posture were randomly assigned to a control or experimental group. Sagittal head, cervical, and shoulder angles were measured with photogrammetry and Postural Assessment Software. The American Shoulder and Elbow Surgeons Shoulder Assessment was used to assess shoulder pain, and neck pain during the last month was self‐reported with a single question. These variables were assessed before and after a 16‐week intervention period. The control group (n = 46) attended the PE classes, whereas the exercise group (n = 84) received a posture corrective exercise program in addition to PE classes. Results A significant increase in cervical and shoulder angles was observed in the intervention group from pretest to posttest (P < .05). For the shoulder pain scores in both groups, there were no significant changes after the 16 weeks. Conclusions A 16‐week resistance and stretching training program decreased forward head and protracted shoulder postures in adolescents.

The effect of performance indicators on the time the first goal is scored in football matches

Scoring the first goal in football could be crucial for winning a match. The aim of this study was to identify the performance indicators that influence the time the first goal is scored in high-level football matches. A total of 240 matches of the Portuguese Premier League played in 2009/10 season were analysed. The difference between the total number of goals scored and conceded during the competition up until the match considered, total ball possession time, shots on goal, set plays, disciplinary sanctions and substitutions were selected as predictor variables for the time the first goal is scored and loaded on a Cox regression model with time-dependent covariates. A greater goal difference (p < 0.05) and a larger number of shots on goal (p < 0.01) had a positive significant influence on the time the first goal was scored in the match by home teams; at the same time disciplinary sanctions (p < 0.01) and substitutions (p < 0.01) had a negative significant effect on the time of the first goal.

Analysis of Scoring Sequences in Matches of the Portuguese Premier League

Abstract The aim of this study was to examine the sequences of the first two goals scored in soccer matches in accordance with a range of different match contexts. Data from 1506 matches played in the Portuguese Premier League during six consecutive competitive seasons (2009-10 to 2014-2015) were analysed using descriptive statistics and the chi-square test in order to verify the association between variables and a Cox regression analysis was used to predict the time the second goal was scored in function of the time of the first goal scored in the match and the scoreline. The results revealed a higher frequency of the second goals being scored in the second half of a match (58%) and in the last 5 min periods of each half. A positive association was found for home teams and score-doubling goals (58%), as well as for away teams and score-equalizing goals (56%). For home and away teams the score-doubling goal of a match was strongly and positively associated with a win outcome for home (93%) and away teams (92%), while the score-equalizing goals were associated with a draw (home and away teams: 44%) and loss outcome (home: 33% and away teams: 32%). Finally, the Cox model showed that if the first goal was scored in the second half of the match, the probability of the second goal being scored was three times higher compared to the first half.

Lower limb body composition is associated to knee passive extension torque-angle response

PurposePeople vary in flexibility regarding maximum joint angle, resistance to stretch and mechanical responses during stretching exercises. Body composition (BC) has been been mentioned as one of the factors for flexibility differences. The aim of this study was to determine how body composition and anthropometric measures of the lower limb is associated with passive knee extension (PKE) torque-angle (T-A) response.MethodsTwenty-five male subjects with poor flexibility performed a maximal PKE repetition (velocity of 2°/s; 90 seconds in the static phase). Knee passive T-A, vastus medialis and semitendinosous electromyographic activity were recorded during the protocol. Viscoelastic stress relaxation (VSR) amplitude, knee passive stiffness (KPS), lower limb body composition assessed by dual energy x-ray absorptiometry, and anthropometry measures were determined.ResultsThigh skeletal muscle and bone mass, as well as thigh perimeter, showed a moderated correlation with passive torque (ru2009=u20090.45; ru2009=u20090.6; ru2009=u20090.59, respectively), joint angle (ru2009=u20090.46; ru2009=u20090.5; ru2009=u20090.5), and VSR (ru2009=u20090.46; ru2009=u20090.49; ru2009=u20090.5). Thigh skeletal muscle was also correlated with KPS (ru2009=u20090.42). All these correlations were statistically significant (pu2009<u20090.05).ConclusionsPassive knee extension T-A was found to be moderately correlated with lower limb BC. In particular, thigh perimeter and skeletal muscle mass were associated with knee passive stiffness and viscoelastic stress relaxation. More research is needed to understand what influences joint maximum angle, resistance to stretch and mechanical response to stretching.