Jean Pierre Baeyens

The effect of post-exercise cryotherapy on recovery characteristics: a systematic review and meta-analysis

The aim of this review and meta-analysis was to critically determine the possible effects of different cooling applications, compared to non-cooling, passive post-exercise strategies, on recovery characteristics after various, exhaustive exercise protocols up to 96 hours (hrs). A total of n = 36 articles were processed in this study. To establish the research question, the PICO-model, according to the PRISMA guidelines was used. The Cochrane’s risk of bias tool, which was used for the quality assessment, demonstrated a high risk of performance bias and detection bias. Meta-analyses of subjective characteristics, such as delayed-onset muscle soreness (DOMS) and ratings of perceived exertion (RPE) and objective characteristics like blood plasma markers and blood plasma cytokines, were performed. Pooled data from 27 articles revealed, that cooling and especially cold water immersions affected the symptoms of DOMS significantly, compared to the control conditions after 24 hrs recovery, with a standardized mean difference (Hedges’ g) of -0.75 with a 95% confidence interval (CI) of -1.20 to -0.30. This effect remained significant after 48 hrs (Hedges’ g: -0.73, 95% CI: -1.20 to -0.26) and 96 hrs (Hedges’ g: -0.71, 95% CI: -1.10 to -0.33). A significant difference in lowering the symptoms of RPE could only be observed after 24 hrs of recovery, favouring cooling compared to the control conditions (Hedges’ g: -0.95, 95% CI: -1.89 to -0.00). There was no evidence, that cooling affects any objective recovery variable in a significant way during a 96 hrs recovery period.

Somatotype, training and performance in Ironman athletes

Abstract The aim of this study was to describe the physiques of Ironman athletes and the relationship between Ironmans performance, training and somatotype. A total of 165 male and 22 female competitors of the Ironman Switzerland volunteered in this study. Ten anthropometric dimensions were measured, and 12 training and history variables were recorded with a questionnaire. The variables were compared with the race performance. The somatotype was a strong predictor of Ironman performance (R=0.535; R2=0.286; sign. p<0.001) in male athletes. The endomorphy component was the most substantial predictor. Reductions in endomorphy by one standard deviation as well as an increased ectomorphy value by one standard deviation lead to significant and substantial improvement in Ironman performance (28.1 and 29.8 minutes, respectively). An ideal somatotype of 1.7–4.9–2.8 could be established. Age and quantitative training effort were not significant predictors on Ironman performance. In female athletes, no relationship between somatotype, training and performance was found. The somatotype of a male athlete defines for 28.6% variance in Ironman performance. Athletes not having an ideal somatotype of 1.7–4.9–2.8 could improve their performance by altering their somatotype. Lower rates in endomorphy, as well as higher rates in ectomorphy, resulted in a significant better race performance. The impact of somatotype was the most distinguished on the run discipline and had a much greater impact on the total race time than the quantitative training effort. These findings could not be found in female athletes.

Intra-session test–retest reliability of pelvic floor muscle electromyography during running

Introduction and hypothesisThe prevalence of female stress urinary incontinence is high, and young adults are also affected, including athletes, especially those involved in “high-impact” sports. To date there have been almost no studies testing pelvic floor muscle (PFM) activity during dynamic functional whole body movements. The aim of this study was the description and reliability test of PFM activity and time variables during running.MethodsA prospective cross-sectional study including ten healthy female subjects was designed with the focus on the intra-session test–retest reliability of PFM activity and time variables during running derived from electromyography (EMG) and accelerometry.ResultsThirteen variables were identified based on ten steps of each subject: Six EMG variables showed good reliability (ICC 0.906–0.942) and seven time variables did not show good reliability (ICC 0.113–0.731). Time variables (e.g. time difference between heel strike and maximal acceleration of vaginal accelerator) showed low reliability. However, relevant PFM EMG variables during running (e.g., pre-activation, minimal and maximal activity) could be identified and showed good reliability.ConclusionFurther adaptations regarding measurement methods should be tested to gain better control of the kinetics and kinematics of the EMG probe and accelerometers. To our knowledge this is the first study to test the reliability of PFM activity and time variables during dynamic functional whole body movements. More knowledge of PFM activity and time variables may help to provide a deeper insight into physical strain with high force impacts and important functional reflexive contraction patterns of PFM to maintain or to restore continence.

Walking with robot assistance: the influence of body weight support on the trunk and pelvis kinematics.

Abstract Purpose: The goal was to assess in healthy participants the three-dimensional kinematics of the pelvis and the trunk during robot-assisted treadmill walking (RATW) at 0%, 30% and 50% body weight support (BWS), compared with treadmill walking (TW). Methods: 18 healthy participants walked (2 kmph) on a treadmill with and without robot assistance (Lokomat; 60% guidance force; 0%, 30% and 50% BWS). After an acclimatisation period (four minutes), trunk and pelvis kinematics were registered in each condition (Polhemus Liberty™ [240 Hz]). The results were analysed using a repeated measures analysis of variance with Bonferroni correction, with the level of suspension as within-subject factor. Results: During RATW with BWS, there were significantly (1) smaller antero-posterior and lateral translations of the trunk and the pelvis; (2) smaller antero-posterior flexion and axial rotation of the trunk; (3) larger lateral flexion of the trunk; and (4) larger antero-posterior tilting of the pelvis compared with TW. Conclusions: There are significant differences in trunk and pelvis kinematics in healthy persons during TW with and without robot assistance. These data are relevant in gait rehabilitation, relating to normal balance regulation. Additional research is recommended to further assess the influence of robot assistance on human gait. Implications for Rehabilitation The trunk and pelvis moves in a different way during walking with robot assistance. The data suggest that the change in movement is due to the robot device and the harness of the suspension system more than due to the level of suspension itself.

Robot-assisted walking with the Lokomat: the influence of different levels of guidance force on thorax and pelvis kinematics.

BACKGROUND Little attention has been devoted to the thorax and pelvis movements during gait. The aim of this study is to compare differences in the thorax and pelvis kinematics during unassisted walking on a treadmill and during walking with robot assistance (Lokomat-system (Hocoma, Volketswil, Switzerland)). METHODS 18 healthy persons walked on a treadmill with and without the Lokomat system at 2kmph. Three different conditions of guidance force (30%, 60% and 100%) were used during robot-assisted treadmill walking (30% body weight support). The maximal movement amplitudes of the thorax and pelvis were measured (Polhemus Liberty™ (Polhemus, Colchester, Vermont, USA) (240/16)). A repeated measurement ANOVA was conducted. FINDINGS Robot-assisted treadmill walking with different levels of guidance force showed significantly smaller maximal movement amplitudes for thorax and pelvis, compared to treadmill walking. Only the antero-posterior tilting of the pelvis was significantly increased during robot-assisted treadmill walking compared to treadmill walking. No significant changes of kinematic parameters were found between the different levels of guidance force. INTERPRETATION With regard to the thorax and pelvis movements, robot-assisted treadmill walking is significantly different compared to treadmill walking. It can be concluded that when using robot assistance, the thorax is stimulated in a different way than during walking without robot assistance, influencing the balance training during gait.

Body weight support during robot-assisted walking: Influence on the trunk and pelvis kinematics

BACKGROUND Efficacy studies concerning robot assisted gait rehabilitation showed limited clinical benefits. A changed kinematic pattern might be responsible for this. Little is known about the kinematics of the trunk and pelvis during robot assisted treadmill walking (RATW). OBJECTIVE The aim of this study was to assess the trunk and pelvis kinematics of healthy subjects during RATW, with different amounts of body weight support (BWS) compared to regular treadmill walking (TW). METHOD Eighteen healthy participants walked on a treadmill, while kinematics were registered by an electromagnetic tracking device. Hereafter, the kinematics of pelvis and trunk were registered during RATW (guidance force 30%) with 0%, 30% and 50% BWS. RESULTS Compared to TW, RATW showed a decrease in the following trunk movements: axial rotation, anteroposterior flexion, lateral and anteroposterior translation. Besides, a decrease in lateral tilting and all translation of the pelvis was found when comparing RATW with TW. Furthermore, the anteroposterior tilting of the pelvis increased during RATW. CONCLUSION In general, there was a decrease in trunk and pelvis movement amplitude during RATW compared with regular TW. Though, it is not known if these changes are responsible for the limited efficacy of robot assisted gait rehabilitation. Further research is indicated.

Differences in ball speed and three-dimensional kinematics between male and female handball players during a standing throw with run-up

BackgroundThe purpose of this paper was to examine differences in ball release speed and throwing kinematics between male and female team-handball players in a standing throw with run-up. Other research has shown that this throwing type produces the highest ball release speeds and comparing groups with differences in ball release speed can suggest where this difference might come from. If throwing technique differs, perhaps gender-specific coordination- and strength-training guidelines are in order.MethodsMeasurements of three-dimensional kinematics were performed with a seven-camera VICON motion capture system and subsequent joint angles and angular velocities calculations were executed in Mathcad. Data-analysis with Statistical Parametric Mapping allowed us to examine the entire time-series of every variable without having to reduce the data to certain scalar values such as minima/maxima extracted from the time-series.ResultsStatistical Parametric Mapping enabled us to detect several differences in the throwing kinematics (12 out of 20 variables had one or more differences somewhere during the motion). The results indicated two distinct strategies in generating and transferring momentum through the kinematic chain. Male team-handball players showed more activity in the transverse plane (pelvis and trunk rotation and shoulder horizontal abduction) whereas female team-handball players showed more activity in the sagital plane (trunk flexion). Also the arm cocking maneuver was quite different.ConclusionsThe observed differences between male and female team handball players in the motions of pelvis, trunk and throwing arm can be important information for coaches to give feedback to athletes. Whether these differences contribute to the observed difference in ball release speed is at the present unclear and more research on the relation with anthropometric profile needs to be done. Kinematic differences might suggest gender-specific training guidelines in team-handball.

Trunk muscle activity during walking in persons with multiple sclerosis: the influence of body weight support.

BACKGROUND Although the trunk is important for maintaining balance during walking only very limited information about the trunk muscle activity during walking with body weight support (BWS) is reported in literature. OBJECTIVE The aim of this study was to measure the effect of BWS on the trunk muscle activity during treadmill walking. METHODS 14 persons with multiple sclerosis and 14 healthy persons walked on a treadmill with 0%, 10%, 20%, 30%, 50% and 70% BWS. Bilateral EMG measurements (surface electrodes) on the m. rectus abdominis, m. obliquus externus, m. erector spinae and m. multifidus were performed. The maximal muscle activation was presented as a percentage of a performance related reference contraction. A repeated measures ANOVA with simple contrasts was applied (SPSS20). RESULTS In general when comparing walking with BWS with walking with 0% BWS there is an increase in m. obliquus externus activity and a decrease in back muscle activity. With increasing percentages of BWS an increase in activity of the abdominal muscles and a decrease in back muscle activity was found, with most changes in high percentages BWS. CONCLUSION Based on the results, it is recommended to decrease the percentage BWS as fast as possible beneath 30% BWS.

In vivo determination of the diclofenac skin reservoir: comparison between passive, occlusive, and iontophoretic application.

Aim There is scarce information concerning the pharmacodynamic behavior of topical substances used in the physiotherapy setting. The aim of the present study was to estimate the formation and emptying of the diclofenac (DF) skin reservoir after passive, semiocclusive, and electrically assisted applications of DF. Subjects and methods Five different groups of healthy volunteers (ntotal=60, 23 male and 37 female), participated in this study. A 1% DF (Voltaren Emulgel) formulation (12 mg) was applied on the volar forearms on randomized defined circular skin areas of 7 cm2. DF was applied for 20 minutes under three different conditions at the same time. The presence of DF in the skin results in a reduction of the methyl nicotinate (MN) response. To estimate the bioavailability of DF in the skin, MN responses at different times following initial DF application (1.5, 6, 24, 32, 48, 72, 96, and 120 hours) were analyzed. Results At 1.5 hours after the initial DF application, a significant decrease in MN response was detected for the occluded and iontophoretic delivery. Passive application resulted in a decrease of the MN response from 6 hours post-DF application. The inhibition remained up to 32 hours post-DF application for the iontophoretic delivery, 48 hours for the occluded application, and 72 hours for the passive delivery. At 96 and 120 hours post-DF application none of the MN responses was inhibited. Conclusion The formation and emptying of a DF skin reservoir was found to be dependent on the DF-application mode. Penetration-enhanced delivery resulted in a faster emptying of the reservoir.

Influence of the timing of ultrasound application on the penetration of corticosteroids

The application of ultrasound to enhance the transdermal transport of drugs is often referred to as ‘sonophoresis’. In physiotherapy sonophoresis is applied to the skin through two different procedures: (1) the pre‐treatment procedure where the skin is treated with ultrasound irradiation prior to the drug application and (2) a simultaneous treatment mode, where the skin is treated with ultrasound during the application of the pharmacologic substance. The aim of this study was to compare the bioavailability of halcinonide in the stratum corneum comparing the ultrasound pre‐treatment vs. the simultaneous treatment method.