Fidel Hita-Contreras

Osteosarcopenic obesity and fall prevention strategies

Sarcopenia, obesity, and osteoporosis are three interrelated entities which may share common pathophysiological factors. In the last decades, overall survival has drastically increased. Postmenopausal women, due to their estrogen depletion, are at higher risk of developing any of these three conditions or the three, which is termed osteosarcopenic obesity. One of the most common health problems among these patients is the elevated risk of falls and fractures. Falls and fall-related injuries are one of the major causes of mortality and morbidity in older adults, and have a significant impact on social, economical and health-related costs. Several extrinsic and intrinsic risk factors have been described that play a role in the etiology of falls. A therapeutic approach to osteosarcopenic obesity aimed at the prevention of falls must include several factors, and act on those risk elements which can be effectively modified. An adequate weight-loss diet and a good nutritional intake, with an appropriate amount of vitamin D and the right protein/carbohydrates ratio, may contribute to the prevention of falls. The recommendation of physical exercise, both traditional (resistance or aerobic training) and more recent varieties (Tai Chi, Pilates, body vibration), can improve balance and positively contribute to fall prevention, whether by itself or in combination with other therapeutic strategies. Finally, a pharmacological approach, especially one focused on hormone therapy, has shown to have a positive effect on postmenopausal womens balance, leading to a decreased risk of falls.

Regulatory systems in bone marrow for hematopoietic stem/progenitor cells mobilization and homing.

Regulation of hematopoietic stem cell release, migration, and homing from the bone marrow (BM) and of the mobilization pathway involves a complex interaction among adhesion molecules, cytokines, proteolytic enzymes, stromal cells, and hematopoietic cells. The identification of new mechanisms that regulate the trafficking of hematopoietic stem/progenitor cells (HSPCs) cells has important implications, not only for hematopoietic transplantation but also for cell therapies in regenerative medicine for patients with acute myocardial infarction, spinal cord injury, and stroke, among others. This paper reviews the regulation mechanisms underlying the homing and mobilization of BM hematopoietic stem/progenitor cells, investigating the following issues: (a) the role of different factors, such as stromal cell derived factor-1 (SDF-1), granulocyte colony-stimulating factor (G-CSF), and vascular cell adhesion molecule-1 (VCAM-1), among other ligands; (b) the stem cell count in peripheral blood and BM and influential factors; (c) the therapeutic utilization of this phenomenon in lesions in different tissues, examining the agents involved in HSPCs mobilization, such as the different forms of G-CSF, plerixafor, and natalizumab; and (d) the effects of this mobilization on BM-derived stem/progenitor cells in clinical trials of patients with different diseases.

Effects of a Contrast Training Program Without External Load on Vertical Jump, Kicking Speed, Sprint, and Agility of Young Soccer Players

Abstract García-Pinillos, F, Martínez-Amat, A, Hita-Contreras, F, Martínez-López, EJ, and Latorre-Román, PA. Effects of a contrast training program without external load on vertical jump, kicking speed, sprint, and agility of young soccer players. J Strength Cond Res 28(9): 2452–2460, 2014—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 groups 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 &Dgr;BAT and &Dgr;average 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.

Effects of proprioceptive training program on core stability and center of gravity control in sprinters.

Abstract Romero-Franco N, Martínez-López EJ, Lomas-Vega R, Hita-Contreras F, and Martínez-Amat A. Effects of proprioceptive training program on core stability and center of gravity control in sprinters. J Strength Cond Res 26(8): 2071–2077, 2012—The purpose of this study was to determinate the effect of a 6-week specific-sprinter proprioceptive training program on core stability and gravity center control in sprinters. Thirty-three athletes (age = 21.82 ± 4.84 years, height = 1.76 ± 0.07 m, weight = 67.82 ± 08.04 kg, body mass index = 21.89 ± 2.37 kg·m−2) from sprint disciplines were divided into a control (n = 17) and experimental (n = 16) groups. A 30-minute proprioceptive training program was included in the experimental group training sessions, and it was performed for 6 weeks, 3 times each week. This program included 5 exercises with the BOSU and Swiss ball as unstable training tools that were designed to reproduce different moments of the technique of a sprint race. Stability with eyes open (EO) and eyes closed, postural stability, and gravity center control were assessed before and after the training program. Analyses of covariance (&agr; = 0.05) revealed significant differences in stability in the medial-lateral plane with EO, gravity center control in the right direction and gravity center control in the back direction after the exercise intervention in the experimental athletes. Nevertheless, no other significant differences were demonstrated. A sprinter-specific proprioceptive training program provided postural stability with EO and gravity center control measures improvements, although it is not clear if the effect of training would transfer to the general population.

Effects of joint mobilization on chronic ankle instability: a randomized controlled trial.

Abstract Purpose: To evaluate the effects of joint mobilization, in which movement is applied to the ankles 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 Rehabilitation Functional 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.

Oral quercetin supplementation hampers skeletal muscle adaptations in response to exercise training

We aimed to test exercise‐induced adaptations on skeletal muscle when quercetin is supplemented. Four groups of rats were tested: quercetin sedentary, quercetin exercised, placebo sedentary, and placebo exercised. Treadmill exercise training took place 5 days a week for 6 weeks. Quercetin groups were supplemented with quercetin, via gavage, on alternate days throughout the experimental period. Sirtuin 1 (SIRT1), peroxisome proliferator‐activated receptor γ coactivator‐1α mRNA levels, mitochondrial DNA (mtDNA) content, and citrate synthase (CS) activity were measured on quadriceps muscle. Redox status was also quantified by measuring muscle antioxidant enzymatic activity and oxidative damage product, such as protein carbonyl content (PCC). Quercetin supplementation increased oxidative damage in both exercised and sedentary rats by inducing higher amounts of PCC (P < 0.001). Quercetin supplementation caused higher catalase (P < 0.001) and superoxide dismutase (P < 0.05) activity in the non‐exercised animals, but not when quercetin is supplemented during exercise. Quercetin supplementation increased SIRT1 expression, but when quercetin is supplemented during exercise, this effect is abolished (P < 0.001). The combination of exercise and quercetin supplementation caused lower (P < 0.05) mtDNA content and CS activity when compared with exercise alone. Quercetin supplementation during exercise provides a disadvantage to exercise‐induced muscle adaptations.

Changes in Biochemical Markers of Pain Perception and Stress Response After Spinal Manipulation

STUDY DESIGN Controlled, repeated-measures, single-blind randomized study. OBJECTIVES To determine the effect of cervical or thoracic manipulation on neurotensin, oxytocin, orexin A, and cortisol levels. BACKGROUND Previous studies have researched the effect of spinal manipulation on pain modulation and/or range of movement. However, there is little knowledge of the biochemical process that supports the antinociceptive effect of spinal manipulation. METHODS Thirty asymptomatic subjects were randomly divided into 3 groups: cervical manipulation (n = 10), thoracic manipulation (n = 10), and nonmanipulation (control) (n = 10). Blood samples were extracted before, immediately after, and 2 hours after each intervention. Neurotensin, oxytocin, and orexin A were determined in plasma using enzyme-linked immuno assay. Cortisol was measured by microparticulate enzyme immuno assay in serum samples. RESULTS Immediately after the intervention, significantly higher values of neurotensin (P<.05) and oxytocin (P<.001) levels were observed with both cervical and thoracic manipulation, whereas cortisol concentration was increased only in the cervical manipulation group (P<.05). No changes were detected for orexin A levels. Two hours after the intervention, no significant differences were observed in between-group analysis. CONCLUSION The mechanical stimulus provided by spinal manipulation triggers an increase in neurotensin, oxytocin, and cortisol blood levels. Data suggest that the initial capability of the tissues to tolerate mechanical deformation affects the capacity of these tissues to produce an induction of neuropeptide expression. J

Benefits of physical exercise in postmenopausal women

Physical inactivity not only places womens health at risk during menopause, but also increases menopausal problems. Abundant evidence links habitual physical exercise (PE) to a better status on numerous health indicators and better quality of life and to the prevention and treatment of the ailments that typically occur from mid-life onwards. We can infer that PE is something more than a lifestyle: it constitutes a form of therapy in itself. A panel of experts from various Spanish scientific societies related to PE and menopause (Spanish Menopause Society, Spanish Cardiology Society, Spanish Federation of Sports Medicine) met to reach a consensus on these issues and to decide the optimal timing of and methods of exercise, based on the best evidence available.

Cross-cultural adaptation and validation of the Falls Efficacy Scale International in Spanish postmenopausal women.

ObjectiveFalls are a serious public health problem and one of the most important concerns for older people. The risk of falling is dramatically increased in osteoporotic postmenopausal women. The Falls Efficacy Scale International (FES-I) is a reliable and validated questionnaire that can assess the fear of falling. Our objective is to develop the FES-I cross-cultural adaptation to the Spanish postmenopausal population. MethodsFES-I was translated into Spanish language. One hundred postmenopausal women (50-65 years old) completed the FES-I and the 36-item Short-Form Health Survey (SF-36) questionnaire. Content validity was determined by a group of experts and participants. FES-I internal consistency and test-retest reliability were analyzed. Exploratory factor analysis was used to assess construct validity. Criterion validity has been evaluated using the Spearman correlation coefficient with the 36-item Short-Form Health Survey. ResultsFES-I has an excellent test-retest reliability (intraclass correlation coefficient, 0.972; P < 0.001) and good internal consistency (Cronbach &agr; = 0.940). Factor analysis showed one unifactorial structure with two underlying dimensions related to less or more demanding physical activities. FES-I global score showed a negative correlation with the two SF-36 summary measures (P < 0.001). ConclusionsThe Spanish version of FES-I showed high reliability and validity in the adaptation for the Spanish postmenopausal population. Future studies are required to assess the sensitivity to change and to predict the risk of future falling.

Effects of a six-week Pilates intervention on balance and fear of falling in women aged over 65 with chronic low-back pain: A randomized controlled trial

OBJECTIVE The purpose of our study was to evaluate the effects of six weeks of Pilates regarding functional balance, fear of falling and pain in community living women older than 65 years old with chronic low-back pain. STUDY DESIGN A single blind controlled randomized trial of six weeks of Pilates in addition to physiotherapy treatment (n=50) vs. physiotherapy treatment alone (n=47) was conducted on 97 community living women (71.14 ± 3.30 years) with chronic low-back pain (CLBP). MAIN OUTCOME MEASURES Main outcome measures were fear of falling (FoF), assessed by the Falls Efficacy Scale-international; functional mobility and balance, measured with the Timed up and Go Test; and pain, evaluated using the numeric rating scale. RESULTS Only the Pilates group showed improvement in FoF (ES; d=.68) and functional mobility and balance (ES; d=1.12) after treatment, and also had better results in pain (ES; d=1.46) than the physiotherapy-only group. CONCLUSIONS Six weeks of Pilates exercises may be effective in fall prevention through the improvement of FoF, functional balance, and pain in Spanish women over 65 years old with CLBP.