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Background. Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system and the main cause of disability in young people. Drug therapy cannot completely control many disabling symptoms in MS, such as cramps, pain, depression, and cognitive impairment. Non-invasive brain stimulation (NIBS) technology can be used as a tool to regulate changes in cortical excitability and plasticity in MS patients, thereby improving the disability symptoms that affect such patients. Aims. Our objective was to explore the effectiveness and safety of non-invasive brain stimulation in the treatment of fatigue in patients with multiple sclerosis. Methods. We performed a literature review in different databases: PubMed, Web of Science, Cochrane Library, Medline, Google Scholar. Full text articles that used NIBS for exercise performance improvement in athletes were included (only articles in English were found). We searched for articles available in each database until 30 October 2019. We used articles published in journals, randomized or pseudo-randomized, sham-controlled clinical trials to evaluate the effects of noninvasive brain stimulation (NIBS). The main result is the fatigue score before and after stimulation; the secondary result is the adverse event. Results. The general inverse variance method was used to aggregate data from cross-group and parallel group studies. A total of 14 studies (tDCS 11, TMS 2 and tRNS 1) which recruited 186 patients were included in the study. No qualified tACS, transcranial electrical therapy stimulation or non-invasive cortical electrical stimulation study with reduced impedance was found. The short-term and long-term therapeutic effects are for tDCS, TMS is significant, and TMS and tRNS are not superior to sham stimulation. Existing evidence supports the effectiveness of the 1.5 mA subgroup and the bilateral S1 subgroup of tDCS. Adverse events are mild and transient, but are comparable between real and sham stimulation. Conclusions. tDCS is a safe and effective way to treat fatigue in MS patients. However, there is further research needed to confirm our results in a large population and investigate the effectiveness of other NIBS subtypes. [ABSTRACT FROM AUTHOR]

Background. When transcranial direct current stimulation (tDCS) was reintroduced as a non-invasive brain stimulation technique, it had been known for more than 50 years that the main mechanism of action was the sub-threshold regulation of neuronal membrane potential, which depended on changing the cortical excitability and activity through the current flow of the target neuron. In this review we concentrated on the progress made for tDCS in the last few years in sports, which so far has partially found entrance into the design of clinical studies, and on results obtained in recently conducted clinical pilot studies. Aims. Our objective was to analyze the effects of tDCS în sport exercises, for normal or high-level practitioners. Methods. We performed a literature review în different databases: PubMed, Web of Science, SCOPUS, SportDiscus, Google Scholar. Full text articles that used tDCS for exercise performance improvement in athletes were included (only articles in English were found). We searched for articles available in each database until 15 January 2018. We used articles published in journals, randomized sham controlled trials comparing anodal stimulation and cathodal stimulation to a sham / control for performance in isometric, isokinetic or dynamic strength exercise and whole-body exercise. Results. We included 23 studies that met our selection criteria, in which tDCS produced changes in cycling training for: the whole body (9 articles), for muscle strength in isometric exercise (7 articles), for maximal isometric voluntary contraction (MIVC) (2 articles), for isokinetic exercises (3 articles) and during dynamic exercise (2 articles). Conclusions. The anodal stimulation (a-tDCS) on the motor cortex (M1) had better results than sham stimulation especially for cycling exercises; consequently, more studies and attempts of different montages are needed. Interest in tDCS is constantly growing, as evidenced by the growing number of studies in recent years. Consequently, positive results will appear more and more with the discovery of optimal stimulation parameters. In other words research must continue for this therapy of the future to become a consistent therapeutic alternative, especially in performance athletes. [ABSTRACT FROM AUTHOR]

Background. The definition of genu recurvatum is the presence of more than 5° hyperextension of the knee. Biomechanically, genu recurvatum appears during the stance phase, with the ground reaction force line passing anterior to the knee. From a practical point of view, retraining the gait in patients with genu recurvatum is relatively complex because of diverse etiologies. Aims. To present multiple approaches of rehabilitation strategies and their outcomes for treating patients with genu recurvatum. Methods. We performed a systematic literature review in different databases, PubMed, Science Direct, using the following key words: "genu recurvatum", "knee hyperextension", "rehabilitation". Results. Ten articles met our selection criteria. Three assessed retraining methods (functional electric stimulation or electrogoniometric feedback), five articles focused on orthoses and two articles on botulinum toxin. Conclusions. Genu recurvatum has a multifactorial etiology mechanism such as spasticity, muscle weakness and many others, and among post-stroke patients almost half of them develop genu recurvatum. Genu recurvatum is a disability factor, affecting gait, the quality of life of patients, generating pain and increasing the risk of fall-related injuries. [ABSTRACT FROM AUTHOR]

Background. TXB-A injections are the first-line treatment of many movement disorders, and the safety of doing them is essential to the effectiveness of therapy. Aims. Evaluation of safety of TXB-A guided injections in upper limb spasticity of post-stroke patients. Methods. The study group comprised 60 patients distributed in 3 subgroups of 20 based on background medication administered in post-stroke management: 20 patients in the antiplatelet background subgroup, 20 patients in the subgroup of anticoagulant background medication, and 20 without anticoagulant/antiplatelet background medication. From the 60 patient group, based on the number of TXB-A injection cycles, 3 other subgroups were produced: 20 patients performed 3 injection cycles, 20 performed 2 cycles, and 20 completed a single injection cycle. Every patient received a total dose of 1000 UI of TXB-A. After each set of local injections, ultrasounds were performed at the injection site searching for local hematomas. The moments evaluated were: T0 (the initial time - injection time), T1 (one month after the injection), T2 (3 months from T0 or 2 months from T1), T3 (1 month after T2), T4 (3 months after T2 or 2 months after T3) and T5 (1 month after T4). Results. The lowest p value of the 3 possible comparisons of the anticoagulant, antiplatelet, no anticoagulant/antiplatelet group of patients was 0.856, showing a purely random distribution of adverse effects manifested by local hematomas following ultrasound guided injections. Conclusions. Multiple cycles of US guided TXB-A injections with a minimum 3-month frequency between injections do not increase the risk of local haematomas. [ABSTRACT FROM AUTHOR]