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Knee osteoarthritis (KOA) is commonly associated with multiple musculoskeletal impairments. The purpose of this review was (1) to investigate the effectiveness of LLLT plus ET on pain, ROM, muscle strength, and function in KOA immediately after therapy and (2) whether the effectiveness of LLLT plus ET could be sustained at follow-up (4 - 32 weeks). Six databases were systematically searched upto December 2021 to find relevant articles. Included studies were RCTs written in English, which compared LLLT plus ET with placebo LLLT plus ET in KOA. Three independent reviewers extracted data and assessed the quality of included studies. Standard mean difference (SMD) was used in meta-analysis using random effect model. Of the 6307 articles, 14 RCTs (820 patients) met the inclusion criteria. The results demonstrated that there was a significant difference in pain immediately after therapy (SMD: −0.58, p = 0.001) and at follow-up (SMD: −1.35, p = 0.05) in LLLT plus ET group. There were no significant differences in knee ROM, muscle strength, and knee function outcomes immediately and at follow-up. Our findings indicate that LLLT plus ET could be considered to alleviate pain in the KOA. LLLT reduces pain at 4–8J with a wavelength of 640–905nm per point applied for 10–16 sessions at a frequency of 2 sessions/week. An exercise therapy program at prescribed dosage involving major muscle groups might help. However, LLLT plus ET is no more effective than placebo LLLT plus ET in improving ROM, muscle strength, and function in KOA. [ABSTRACT FROM AUTHOR]

Background. Dynamic stretching (DS) and foam rolling (FR) are frequently being used as warm-up to improve bio-motor ability. The review aimed to compare the acute effects (immediate and five minutes post-intervention) of DS and FR on flexibility, jump height, and muscular strength in the athletic and physically active population. Methods. Electronic databases (Medline/PubMed, Web of Science, Scopus, Google Scholar, Cochrane Library, PEDro, and Hooked on evidence databases) were searched to obtain relevant studies. The methodological quality of the studies was assessed with the Physiotherapy evidence database (PEDro) scale. Meta-analysis was performed using the Rev Man 5.3 software to pool outcomes using the random-effects model, standardized mean difference (SMD) and 95% confidence interval (CI), and significance level set to p < 0.05. Results. 406 papers were found and eight were included (n = 174).There was no significant mean difference between FR and DS on flexibility (immediate) (SMD: 0.15 (95%CI 0.23-0.52); p = 0.45), flexibility (five-minute) (SMD: 0.11 (95%CI -0.26-0.48); p = 0.55), jump height (immediate) (SMD: 0.20 (95%CI 0.12-0.53); p = 0.22), leg extensor strength (immediate) (SMD: 0.28 (95%CI 0.34-0.89); p = 0.37) and leg flexor strength (immediate) (SMD: 0.69 (95%CI 0.52-1.91); p = 0.26). The dosimetry from the qualitative summarization of studies suggests 2 sets (60 seconds each) of each FR and DS were performed on each muscle of the lower quadrant. Conclusions. FR and DS exert similar magnitude of effect on flexibility, jump height, and muscular strength. The findings could help clinicians plan mode of warm-up for athletes. Study registration. The study was registered in PROSPERO vide n. CRD42021225107. [ABSTRACT FROM AUTHOR]

The benefits of Blood Flow Restriction Therapy (BFRT) have gained attention in recent times. This review aimed to evaluate the immediate (up to 24 hours), intermediate (up to 6 weeks), and long term (6–10 weeks) effects of BFRT plus exercises (EX) compared to EX only on athletic performance (sprint and jump performance), muscle strength, and hypertrophy in athletes and physically active population. A literature search was conducted to select randomized controlled trials across four electronic databases from inception till April 2021. The search yielded twenty-seven studies in total. Based on eligibility criteria, twenty-one studies were analyzed. No differences were found between both groups for immediate (standardized mean difference [SMD] −0.02, 95% confidence interval [CI] −0.31, 0.27) and long-term effects (SMD −0.30, 95%CI −0.90, 0.30) on sprint performance. For jump performance, no significant effect was observed immediately (SMD −0.02 (95% CI −1.06, 1.02) and long term (SMD −0.40 (95% CI −1.46, 0.67). Similarly, muscle torque at intermediate (SMD 0.90 (95% CI −1.01, 2.81) and long term (SMD −0.54 (95% CI −1.19, 0.12), muscle strength at intermediate (SMD 1.12 (95% CI 0.20, 2.04), and long term (SMD −0.07 (95% CI −0.56, 0.42) also showed non-significant effects. Muscle hypertrophy at intermediate (SMD 0.16 (95% CI −0.31, 0.63) and long term (SMD −0.20 (95% CI −0.90, 0.50) were not statistically significant. There was no significant difference observed in BFRT plus EX group compared to the EX-group on athletic performance, muscle strength, and muscle hypertrophy. [ABSTRACT FROM AUTHOR]

Background: Subacute mechanical low back pain (MLBP) has been found to increase significantly in athletes in the past decade. Manual therapy combined with exercises seems to be promising option; however, its potential effect in athletes is not fully known yet. Aim: The study aimed to compare between the effects of mulligan sustained natural apophyseal glides (SNAG) combined with exercise, muscle energy technique (MET) combined with exercise therapy and exercise therapy alone on pain, strength and muscle activity in athletes with subacute mechanical low back pain (MLBP). Methods: The athletes were screened for inclusion into the study using physical examination and Oswestry Disability Index (ODI). The study was a randomized 3 arm repeated measure design and a total of thirty athletes completed the study (n = 30). Athletes in group 1 received mulligan sustained natural apophyseal glides (SNAG) combined with exercise, group 2 received muscle energy technique (MET) combined with exercise while those in group 3 were submitted to exercise only. Athletes in all groups received treatment 3 times a week for 4 weeks. The outcome measures were visual analog scale (VAS) scores, back extensor strength and electromyographic (s EMG) muscle activity of longissimus lumborum (LL) and transversus abdominis (Tr A). Results: The VAS score were decreased in all three groups (p < 0.05); however, group 2 and group 1 were more effective than group 3 (p < 0.05). The back extensor strength increased in two groups (p < 0.05): group 2 showed a significant increase compared to group 1. The s EMG muscle activity of LL and Tr A increased in two groups (p < 0.05): group 2 showed a significant increase compared to group 1. There were significant time, group and interaction effects for the three outcome measures (p < 0.05). Conclusion: The addition of MET combined with exercise therapy reduces pain level, improves back extensor strength and muscle activity of LL and TrA in athletes suffering with subacute MLBP more than mulligan SNAG combined with exercise therapy and exercise therapy alone. [ABSTRACT FROM AUTHOR]

Introduction: Shoulder complaints are the third most common musculoskeletal presentation, after back and neck disorders, in primary care. Among people with shoulder pain, Shoulder Impingement Syndrome (SIS) has the highest prevalence and accounts for 27% of shoulder disorders. Various treatment options are available for SIS. However, literature suggests the need of a review regarding the addition of Manual Therapy (MT) to the Therapeutic Exercise (TE) program. Aim: To investigate the effectiveness of MT combined with TEs versus TEs alone for the management of SIS. Materials and Methods: The study examined published randomised controlled trials and quasi-experimental studies. A comprehensive search of two electronic databases (PubMed and PEDro) was performed from inception till the last week of August, 2020. The selected studies were assessed on methodological quality rating using the PEDro scale and the modified downs and black scale for experimental and quasiexperimental studies, respectively. The extracted outcomes were pain levels, strength, Range of Motion (ROM) and Shoulder Pain and Disability Index (SPADI) scale score. The meta-analysis was done on continuous data and the data were summarised qualitatively and quantitatively. Results: Seven trials were included (n=437) after evaluation. Standard Mean Difference (SMD) with 95% CI was used to denote summary effects of the outcome measures. Pain {SMD: -1.07; 95%CI: -1.85, -0.28; p<0.01} showed positive effect when managed with MT combined with TE while external rotation strength {SMD: 0.55; 95%CI 0.27, 0.84; p<0.01} improved with TE alone. The majority of the studies (six out of seven) had low risk of bias. Conclusion: The results indicate that evidence exists for improvement in pain level and muscle strength with MT combined with TE and TE alone respectively. The qualitative evidence suggests that glenohumeral mobilisation and exercises are associated with best outcomes for SIS management. [ABSTRACT FROM AUTHOR]

Reduction in isometric strength of the scapulohumeral muscles is a commonly seen impairment in overhead athletes afflicted with shoulder impingement syndrome (SIS). The purpose of this study was to compare the effects of two different treatment programs: progressive resistance exercises plus manual therapy (PRE plus MT) and motor control exercises (MCE), on isometric strength of upper trapezius (UT), middle trapezius (MTr), lower trapezius (LT), serratus anterior (SA), supraspinatus (Supr.), anterior deltoid (A.D), and latissimus dorsi (LD). 80 male university-level overhead athletes clinically diagnosed with SIS were randomly allocated into either of the two groups: PRE plus MT and MCE group. Athletes in the PRE plus MT group underwent graduated exercises with resistance elastic band, stretching exercises, and mobilization of the thoracic and shoulder joints. MCE group was submitted to motor control exercises in varied planar positions. Athletes in both groups underwent management 3 times a week for 8 weeks. Isometric strength of UT, MTr, LT, Supr, A.D, SA, and LD was measured at three-time points: baseline, 4th week, and 8th week. Relative to baseline, both interventions were found to be effective in increasing and optimizing the isometric strength of muscles (p < 0.05) except for supraspinatus in the MCE group (p > 0.05). However, athletes in PRE plus MT group presented a more pronounced increase in isometric strength than those in the MCE group. Between groups analysis found the largest isometric strength improvement in PRE plus MT group for A.D, followed by Supr. and UT muscles (p < 0.05 ; effect size: 0.39 to 0.40). The study concluded that compared to MCE, PRE plus MT provides greater improvement in the isometric strength of scapulohumeral muscles. [ABSTRACT FROM AUTHOR]

Whole Body Vibration (WBV) is a well-known modality which is increasingly being used by athletes to improve their conditioning levels. Muscle strength and power are major health related fitness components that contribute to marked success in athletic events. Recently, this exercise modality has been utilised by number of researches to investigate its role and efficacy in muscular conditioning. Muscle strength and power have been found to significantly increase when WBV is added to the conventional exercise program but the mechanism by which this strength and power increases has not been well documented. The present review aimed to highlight the impact of WBV on muscle strength, power, muscle activity, and the mechanism by which these gains occur in athletic populations. [ABSTRACT FROM AUTHOR]