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Background: The myofascial induction technique (MIT) has been shown to increase shoulder range of motion (ROM) in breast cancer survivors and decrease pain pressure threshold over the radial nerve in patients with epicondylalgia. To the authors' best knowledge, no study on trigger points and MIT has been published to date. The effect on ROM of latent trigger points is also unknown., Methods: A total of 20 twins with one latent trigger point of the gastrocnemius muscle were evaluated pre- and post-MIT in the calf. We measured static footprint variables in a pre-post study., Results: We found differences in PPT ( p = 0.001) and no differences in ROM with knee flexed ( p = 0.420) or stretched ( p = 0.069)., Conclusions: After Calf MIT, latent myofascial trigger points improve PPT but no change in ankle dorsiflexion with knee bent or knee flexed were found in non-restriction healthy subjects.

Background: Hard insoles have been proposed to decrease plantar pressure and prevent foot pain and paresthesia due to repetitive loading. The aim of this research was to analyze the effect of three different hard insoles in cycling on healthy subjects., Methods: A crossover randomized trial was carried out. The mean age of the subjects was 35 ± 3.19 years, and all of them were men. While the subjects were cycling on a stationary bicycle, their plantar pressure was recorded with nine in-shoe sensors placed in nine specific foot areas to test a standard ethylene-vinyl-acetate 52° Shore A hardness insole, a polypropylene 58° Shore D insole, and a polypropylene 58 0 Shore D insole with selective aluminum 60 HB Brinell hardness in the metatarsal head and hallux., Results: The maximum plantar pressure decreased significantly with the polypropylene insole containing selective aluminum in the metatarsal head and hallux areas. The maximum plantar data of the polypropylene aluminum insole in the M2 area (5.56 kgF/cm 2 ), fifth metatarsal styloid process (6.48 kgF/cm 2 ), M3-M4 area (4.97 kgF/cm 2 ), and hallux (8.91 kgF/cm 2 ) were of particular interest compared to the other insoles., Conclusions: The use of insoles made of polypropylene with aluminum in the metatarsal head and hallux areas decreases the maximum plantar pressure in cycling compared to standard EVA and polypropylene insoles.

Purpose: This study assessed the impact of different types of medial foot arch on postural stability and core center of gravity muscle activity among collegiate athletes., Methods: The study sample included 103 university-level athletes across various sports (soccer, rugby, basketball, volleyball, field tennis, table tennis, karate, and cheerleading) from the College of Magdalena (Colombia) who exhibited distinct types of medial foot arch: 32 high, 35 low, and 36 neutral arches. Surface electromyography (sEMG) was employed to assess conduction velocity, magnitude values, latency, and fatigue in focal muscles including the spinal erector (SE), internal oblique (IO), external oblique (EO), and rectus abdominis (AR), while measurements of static and dynamic postural control were also considered. Post hoc analysis was performed with Bonferroni correction for all electromyographically measured muscle groups, as well as for measurements of static and dynamic postural stability. Pearson's or Spearman's correlation tests were used to compare the different types of feet., Results: There were no substantial differences observed between the distinct types of feet in terms of focal muscle activity, static stability, or dynamics. Even though the mean values indicated higher muscle activity and stability among those with high foot arches and lower values among those with low arches compared to the neutral foot type, this observed difference was deemed statistically insignificant. We also observed a positive correlation between internal oblique muscle activity and the average power of dynamic postural stability, which remained consistent across all foot types. Our findings indicate that static instability is directly correlated with dynamic instability in the anteroposterior direction, while a clear inverse relationship was established in the lateral direction upon examining the variable correlations., Conclusions: The presence of high or low foot arches did not significantly impact the activity of the muscles responsible for maintaining the body's center of gravity or postural stability among university-level athletes. This suggests the existence of neuromuscular compensation mechanisms that attempt to restore balance and compensate for any changes in postural stability caused by varying foot types. Through targeted training that emphasizes activation of the internal oblique muscle, athletes may see improved postural stability. Our findings indicate that static stabilization exercises can also prove beneficial in improving dynamic stability in the anteroposterior plane, while a more dynamic approach may be required to improve dynamic stability in the lateral plane.

Background: Hallux limitus is a common foot disorder whose incidence has increased in the school-age population. Hallux limitus is characterized by musculoskeletal alteration that involves the metatarsophalangeal joint causing structural disorders in different anatomical areas of the locomotor system, affecting gait patterns. The aim of this study was to analyze dynamic plantar pressures in a school-aged population both with functional hallux and without., Methods: A full sample of 100 subjects (50 male and 50 female) 7 to 12 years old was included. The subjects were identified in two groups: the case group (50 subjects characterized as having hallux limitus, 22 male and 28 female) and control group (50 subjects characterized as not having hallux limitus, 28 male and 22 female). Measurements were obtained while subjects walked barefoot in a relaxed manner along a baropodometric platform. The hallux limitus test was realized in a seated position to sort subjects out into an established study group. The variables checked in the research were the surface area supported by each lower limb, the maximum peak pressure of each lower limb, the maximum mean pressure of each lower limb, the body weight on the hallux of each foot, the body weight on the first metatarsal head of each foot, the body weight at the second metatarsal head of each foot, the body weight at the third and fourth metatarsal head of each foot, the body weight at the head of the fifth metatarsal of each foot, the body weight at the midfoot of each foot, and the body weight at the heel of each foot., Results: Non-significant results were obtained in the variable of pressure peaks between both study groups; the highest pressures were found in the hallux with a p -value of 0.127 and in the first metatarsal head with a p -value 0.354 in subjects with hallux limitus. A non-significant result with a p -value of 0.156 was obtained at the second metatarsal head in healthy subjects. However, significant results were observed for third and fourth metatarsal head pressure in healthy subjects with a p -value of 0.031 and regarding rearfoot pressure in subjects with functional hallux limitus with a p -value of 0.023., Conclusions: School-age subjects with hallux limitus during gait exhibit more average peak plantar pressure in the heel and less peak average plantar pressure in the third and fourth metatarsal head as compared to healthy children aged between 7 and 12 years old.

Background: The presence of hallux limitus in adulthood is frequently encountered in clinical practice, generating other biomechanical, structural, and functional compensations in dynamics secondary to blockage of the main pivot in the sagittal plane, the first metatarsophalangeal joint. In addition, the presence of functional hallux limitus (FHL) in school-age children is also increasing. Currently, there is a lack of scientific literature about this condition in the pediatric population, and early diagnosis is necessary to reduce future biomechanical disorders and avoid the development of foot arthritis. The purpose of this research was to identify static plantar pressures in school-age children with and without hallux limitus., Methods: A total sample of 106 children aged between six and twelve years old was divided into two groups: the case group (53 subjects with functional hallux limitus) and the control group (53 subjects without functional hallux limitus). Data were acquired with the participants in a standing barefoot position on the pressure platform, and the hallux limitus functional test was performed in a sitting position to classify the individuals into the determined study group. The variables analyzed in the research were: plantar pressure, bilateral forefoot and rearfoot surface area, bilateral forefoot and rearfoot ground reaction forces, bilateral forefoot and rearfoot distribution of body weight, total left and right surface area, maximum pressure of the left foot and right foot, medium pressure of the left foot and right foot, ground reaction forces of the left foot and right foot, and the weight of each foot., Results: Age was the only descriptive quantitative variable that showed a significant difference between the two study groups, with a p -value of 0.031. No statistically significant differences were found between groups in the bilateral forefoot and rearfoot surface area, ground reaction forces, distribution of body weight, or maximum and medium plantar pressure in the left and right foot., Conclusions: Changes in the location of the maximum pressure were observed, particularly in older participants with FHL, but these results were not significant. The findings of this study did not show significant differences between the static plantar pressures of school-age individuals with and without functional hallux limitus.

Upper-limb position-sustained tasks (ULPSIT) are involved in several activities of daily living and are associated with high metabolic and ventilatory demand and fatigue. In older people, this can be critical to the performance of daily living activities, even in the absence of a disability., Objectives: To understand the ULPSIT effects on upper-limb (UL) kinetics and performance fatigability in the elderly., Methods: Thirty-one (31) elderly participants (72.61 ± 5.23 years) performed an ULPSIT. The UL average acceleration (AA) and performance fatigability were measured using an inertial measurement unit (IMU) and time-to-task failure (TTF)., Results: The findings showed significant changes in AA in the X- and Z-axes ( p < 0.05). AA differences in women started earlier in the baseline cutoff in the X-axis, and in men, started earlier between cutoffs in the Z-axis. TTF was positively related to AA in men until 60% TTF., Conclusions: ULPSIT produced changes in AA behavior, indicative of movement of the UL in the sagittal plane. AA behavior is sex related and suggests higher performance fatigability in women. Performance fatigability was positively related to AA only in men, where movement adjustments occurred in an early phase, though with increased activity time.

The objective of this study was to evaluate, in a group of Galician inmates, if there were variations in the levels of physical and mental health and anxiety-depressive symptomatology, depending on the sports' practice performed. The relationship between these constructs was also investigated. The sample was composed of 509 people deprived of liberty in prisons in the Autonomous Community of Galicia, Spain. A quantitative methodology was used, with the questionnaire as an information collection instrument, Student's t -tests, Pearson's correlation analysis and a stepwise regression analysis were carried out. The results indicated that those who performed physical activity during their stay in prison had higher levels of physical and mental health, as well as lower indicators of anxiety-depressive symptoms. People who did not practice sports showed a decrease in their perceived health levels when compared to those perceived in their pre-prison stage. A negative association was shown between perceived health levels and anxiety-depressive symptomatology. Perceived physical health, alone, explained 35% of the variance in perceived mental health. These results add to knowledge about the relationships between perceived health, anxiety-depressive symptoms and sports practice in the group of people deprived of liberty, highlighting the importance of promoting physical activity in penitentiary institutions.

Multiple sclerosis (MS) is a neurological, chronic, inflammatory, and progressive disease with musculoskeletal problems and neurodegenerative disorders that causes worsening of the health status of patients. The aim of this study was to determine the level of depression in MS patients compared to a population of healthy subjects. The established sample size was 116 subjects matched with the same age, sex, and body mass index. The subjects were recruited from different multiple sclerosis associations and neurology clinics in different public health areas (case group n = 58) and healthy subjects from the same locality (control group n = 58). The scores and categories of the Beck Depression Inventory (BDI) in its Spanish version were collected. There was a clear statistically significant difference (p < 0.05) in the BDI scores between both groups. As a result, we found that the subjects with MS presented worse results with BDI = 9.52 ± 7.70 points compared to the healthy subjects with a BDI score = 5.03 ± 5.14. Within the BDI categories, there were statistically significant differences (p < 0.001), which were greater for the MS group. Depression is a dangerous factor for MS patients, being a trigger for a poorer quality of life.

The home confinement caused by COVID-19 has caused university students to express feelings, negative experiences, and concerns about the confinement situation they were experiencing. This prompted the development of research on resilience, which shows that it is closely related to well-being. The general objective is to determine if resilience acts as a guarantor of personal growth and, therefore, of the self-perception of well-being. The research is developed with qualitative methodology and is framed in the interpretative phenomenological analysis approach and is framed in the hermeneutic-dialectical method. The selection of participants was carried out through an intentional sampling, by non-random methods, among university students. Fifty-two students participated, 41 are women (78.84%) and 11 men (21.15%), with an average age of 20.7 years. The information was collected through a diary card in which they had to collect their experiences and prepare a short speech identifying three temporal moments of confinement: beginning, during, and end. The information was collected between 16 April and 15 May 2020. An inductive analysis was carried out, and the emerging categories were defined: personal growth, resilience, and well-being. Personal growth materializes through three subcategories: personal changes, interpersonal changes, and changes in the philosophy of life. The university students showed that the vital transformation related with resilience acts as a guarantor of personal growth and self-perception of well-being. A voluntary, conscious, and intelligent evolution of people is detected, and personal changes, interpersonal changes, and changes in the philosophy of life are identified as factors of personal growth.

Pelvic floor hypertonicity and narrowing of the levator ani hiatus is traditionally assumed in women with dyspareunia and considered a therapeutical target by physical therapists. However, accurate pre-treatment assessment of pelvic floor muscles is difficult to perform in clinical sites. In addition, the abdominal musculature has not been evaluated in this population, despite its relationship with pelvic floor disfunctions. The purpose of this study was to determine the existence of differences in the length of the anteroposterior diameter of the levator ani hiatus (APDH), the thickness of the abdominal wall musculature and the interrecti distance (IRD) in subjects with dyspareunia compared to a control group. A cross-sectional observational study was designed using ultrasound imaging to measure the APH, the thickness of the abdominal musculature—rectus abdominis (RA), transverse abdominis (TrAb), internal oblique (IO), external oblique (EO)—and IRD at rest and during contraction. Thirty-two women were recruited through advertising and social webs and divided into two groups: dyspareunia (n = 16) and no dyspareunia (n = 16). There were no statistically significant differences (p < 0.05) in RA, TrAb, OI and OE muscle thickness. No differences in APH or in supraumbilical and infraumbilical IRD were found. The findings of this study suggest that the relationship between the abdominal structure/levator ani hypertonia and dyspareunia remains uncertain.

The objective of this investigation was to describe the work engagement perceived by UK workers during the COVID-19 pandemic. A descriptive cross-sectional study was conducted. The sample included 1085 participants, aged 18 years and older, living in the UK during the COVID-19 pandemic, who were active workers. Data were collected using an online questionnaire and the UWES-9. They were analysed using descriptive statistics, a t -test for equality of means or ANOVA, and the Chi-squared Automatic Interaction Detection method. The mean value in the UWES-9 was 3.46 (SD = 1.11). Participants with lower satisfaction (21.8%) gave significantly low or very low UWES-9 scores in 58.5% of the cases. Greater work engagement was obtained with more resources and less conflict, risk, and stress. In cases where there had been contact with COVID-19, this was associated with slightly lower levels of work engagement. These results could motivate and guide companies to adopt risk prevention measures and protocols to return to normal working conditions after the initial crisis phase of the pandemic.

The present study aimed to compare by ultrasound imaging (USI) the tibial posterior (TP), medial gastrocnemius (MG) and soleus muscle in patients with and without plantar fasciitis (PF). A sample of 42 individuals was recruited and divided into two groups: PF and a healthy group. The thickness, cross-sectional area (CSA), echointensity and echovariation were assessed in both groups by USI. TP, soleus and MG variables did not report differences (p > 0.05) for thickness and CSA. For the echotexture parameters significant differences were found for MG echointensity (p = 0.002), MG echovariation (p = 0.002) and soleus echointensity (p = 0.012). Non-significant differences (p > 0.05) were reported for soleus echovariation, TP echointensity and TP echovariation variables. The thickness and CSA of the TP, GM and soleus muscle did not show significant differences between individuals with and without PF measured by USI. Muscle quality assessment reported an increase of the MG echointensity and echovariation, as well as a decrease of echointensity of the soleus muscle in the PF group with respect to the healthy group. Therefore, the evaluation of the structure and muscle quality of the extrinsic foot muscles may be beneficial for the diagnosis and monitoring the physical therapy interventions.

Background: Harderness insoles decrease plantar pressure and reduce the foot injury incidence in sport. The purpose of our study was to analyze the plantar pressure variation in moto riders after riding in a real speed circuit with a custom foot 52 0 Shore EVA insole., Methods: A crossover randomized trial study was performed (consent no. #050520165316). Riders were assessed by an expert motorsport senior podiatry. The participants' mean age was 35 ± 3.29. Participants completed a 20 min training riding with their own motorcycle in a real speed circuit. Plantar pressures were registered with a baropodometric platform evaluating an Ethyl Vinyl Acetate custom foot insole (CFI) manufactured with 3 mm thickness and 52° Shore A hardness. The Plantar pressures were registered before riding, after riding without EVA insole, and after riding with EVA insole., Results: Total Plantar pressures in right and left foot, and total surface area decrease after riding with EVA insoles., Conclusion: The use of an EVA insole with 52 0 shore A hardness riding on a motorcycle in speed circuit decreased the total plantar pressures and surface areas values.

Few studies have checked the impact of the hormonal/immunological dimorphism of patients on the cellular composition of platelet-rich plasma products (PRP). Whole blood (WB) from 26 volunteers was concentrated using a device previously characterized. Platelet and white blood cell (WBC) counts in WB and PRP were compared between genders, and after the population was split into pre (≤50 years)- and post (>50 years)-menopausal ages. In WB, platelet−total WBC densities were comparable in men and women. The phagocytic cell composition differed (p ≤ 0.04). After dividing by ages, phagocytic cell discrepancies were linked to women > 50 years (p ≤ 0.05), and differences emerged in lymphocyte counts (lower in >50 years groups, within and between genders, p ≤ 0.05). In PRP, densities were significantly higher, but the PRP/WB ratios varied according to blood cell (lower for phagocytic cells) and between subjects (more favorable at a lower density of a particular blood cell in WB). This “system compensatory efficiency” reduced/reverted PRP differences in the leukocyte composition between genders/age−sex groups in WB. In PRP, neutrophils were higher in younger men than older women (p < 0.05). WB lymphocyte differences between age−sex groups persisted. Age is a more determining factor than sex in the preparation of PRP. Post-menopause, sexual dimorphism strongly influences the composition of leukocytes, also conditioned by the capture efficiency of the system.

Objective: The primary aim of the present study was to compare the echo intensity (EI) and echovariation (EV) of the intrinsic foot muscles (IFMs) between individuals with and without plantar fasciitis (PF), using ultrasound imaging. The secondary objective was to study the intra-rater reliability of the echotexture variables. Methods: A case−control study was conducted with 64 participants, who were divided into the following two groups: A, the PF group (n = 32); B, the healthy group (n = 32). Results: The comparison between the two groups did not identify significant differences (p > 0.05) between the flexor hallucis brevis (FHB), flexor digitorum brevis (FDB), quadratus plantae (QP) and abductor hallucis brevis (AHB) variables for the EI and EV. Moreover, excellent intra-rater reliability was reported for the following ultrasound imaging EI variables: ABH (ICC = 0.951), FHB (ICC = 0.949), FDB (ICC = 0.981) and QP (ICC = 0.984). Conclusions: The muscle quality assessment using the EI and EV variables did not identify differences in the FHB, FDB, AHB and QP muscles between individuals with and without PF through USI evaluation. The reliability of all the IFM measurements was reported to be excellent.

Cancer is a condition that can increase the risk of frailty. In addition, palliative oncological patients in home hospitalization can find their activities of daily living affected. The main objective was to measure the degree of frailty in the oncological population in home hospitalization comparing Barthel and Frail-VIG Indexes. This is a descriptive cross-sectional study. A sample of oncological patients in home hospitalization ( n = 50) that included 27 men and 23 women were recruited, and disability due to frailty was measured using the VIG frailty index and the Barthel scale for Activities of Daily Living (ADLs). Spearman's correlation coefficients were categorized as weak (rs ≤ 0.40), moderate (0.41 ≤ rs ≥ 0.69) or robust (0.70 ≤ rs ≥ 1.00), with a strong indirect correlation between the domains using the toilet, transferring and wandering on the Frail-VIG scale with an r (s) value -0.810 ( p < 0.001), -0.831 ( p < 0.001) and -0.805 ( p < 0.001), respectively, and a moderate indirect correlation for the domains of eating -0.718 ( p < 0.001), dressing -0.770 ( p < 0.001) and urination -0.704 (<0.001). The Frail-VIG index above 0.35 points, that is, from moderate to severe, does not affect ADLs except in the nutritional dimension in a palliative oncological population in home hospitalization. The preliminary outcomes obtained should be considered to determine the impact of nutritional status with regard to ADLs in palliative oncological patients in a home hospitalization unit.

Based on the high prevalence of asthma in the population, and its relationship with various musculoskeletal and postural disorders, the aim of this study was to evaluate the plantar pressures in asthmatic patients compared to a control group. A case-control study involving 90 participants was conducted, consisting of 45 asthma patients and 45 healthy paired controls. Static plantar pressure data were recorded using a portable pressure sensor platform. Statistically significant differences were shown in the body weight on the left heel ( p = 0.031), and the right forefoot maximum peak pressure was lower in the case group ( p = 0.042). The findings of this study show alterations in static plantar pressures in asthmatic patients compared to healthy individuals. Specifically, the subjects with asthma showed less maximum pressure in the right forefoot and less weight on the left heel, which appear to be associated with the asthma disease.

Reduced plantar foot sensation, postural instability, and gait difficulties are characteristic of Parkinson´s disease patients. A systematic review was carried out to determine the effect of the different types of insoles and shoes in these patients. Several databases were used to search for relevant articles reporting Parkinson´s disease patients undergoing treatment with any type of insole and footwear. All titles and abstracts were reviewed independently by two reviewers and the available data were extracted. The study eligibility criteria were any type of experimental study that included Parkinson's disease patients treated with any type of insole or footwear. Eight studies were selected. Interventions used were textured insoles, footwear modifications, and habitual footwear. Three different outcomes were evaluated in each study: gait parameters, balance, and plantar sensation. According to the data available from this systematic review, the most important conclusion is that more controlled studies are needed in this research field. There are indications to suggest that textured insoles have positive effects on gait parameters, balance, and plantar sensation in Parkinson's disease patients.

Background: The effect of Leg-Length Discrepancy (LLD) on dynamic gait parameters has been extensively discussed. Podobarography is the study of foot-to-ground pressure distribution. It has been used to test plantar footprint deviations that could reveal pathology., Purpose: The aim of this study is to determine the effects of simulated LLD on dynamic gait parameters measured with a pressure platform in healthy subjects., Methods: Thirty-seven healthy subjects participated in observational cross-sectional research. A procedure was performed to capture the dynamic parameters of each participant under five different simulated LLD conditions. Support time, mean pressure, and peak pressure measures were registered on three trials for each foot and LLD level per session. An analysis of variance (ANOVA) test for repeated measures was performed to check for differences between the different simulated LLD levels., Results: The stance time of the short leg had no significant changes. The stance time of the long leg increased by 3.51% ( p < 0.001), mean pressure of the short leg increased by 1.23% ( p = 0.005), and decreased by 5.89% in the long leg ( p < 0.001). Peak pressure of the short leg decreased by 2.58% ( p = 0.031) and the long leg decreased by 12.11% ( p < 0.001)., Conclusions: This study demonstrates that increasing LLD causes an asymmetrical foot-loading pattern, with decreased mean and peak pressure on the longer limb, and consequently an overload on the short side. Furthermore, an increasing LLD causes increased stance time on the long leg.

Background: The effects of the dry needling technique and pain reduction have been demonstrated in numerous quality studies. However, the mechanical effects of dry needling are largely unknown., Methods: A total of 18 subjects with flexor digitorum brevis muscle myofascial trigger point were evaluated pre- and post-deep dry needling. We measured static footprint variables in a pre-post study., Main Findings: We found differences in rearfoot maximum pressure (119.22-111.63 KPa; p = 0.025), midfoot maximum pressure (13.68-17.26 KPa; p = 0.077), midfoot medium pressure (4.75-6.24 KPa; p = 0.035) and forefoot surface (86.58-81.75 cm 2 ; p = 0.020). All variables with significant differences decrease, with the exception of forefoot surface which showed an increase., Conclusions: After flexor digitorum brevis muscle dry needling, midfoot plantar pressures (maximum and medium) and forefoot surface were increased, and rearfoot maximum pressure was decreased.

Objective: M-mode ultrasound imaging (US) reflects the motion of connective tissue within muscles. The objectives of this study were to evaluate inter-rater and intra-rater reliability of soleus muscle measurements between examiners with different levels of US experience in asymptomatic subjects and to investigate the level of soleus muscle isometric activity in two positions (knee extended and knee flexed at 30°)., Methods: Thirty volunteers without a history of ankle pain were evaluated with US examinations of the soleus muscle. Each muscle was scanned independently by two evaluators. Muscle at rest thickness, maximal isometric contraction thickness, time and velocity measures were detailed and blinded to the other examiner., Results: Intra- and inter-rater reliability at rest, in maximal isometric contraction thickness, contraction time and contraction velocity measures for both positions (extended and flexed knee) were reported from good to excellent for all outcome measurements. The position with the knee extended reported a statistically significant increase in thickness after motion showing 1.33 ± 0.27 mm for measurements at rest thickness with knee extended versus 1.50 ± 0.29 mm for measurements at end thickness with the knee in flexed position ( p = 0.001), as well as 1.31 ± 0.23 mm for rest thickness with the knee in flexed position measurements with respect to 1.34 ± 0.24 mm for maximal isometric contraction thickness with extended knee measurements ( p = 0.058)., Conclusions: This study found that intra- and inter-examiner reliability of M-mode ultrasound imaging of the soleus muscle was excellent in asymptomatic subjects and the soleus muscle activity was different between the position with the knee extended and the position with the knee flexed.

New trends in ultrasound imaging are focused on exploration of morphology and muscle quality. The main goal of the study was to evaluate the first-order descriptor and echostructure of lumbar multifidus at the L4 vertebral level in athletes with and without chronic lumbopelvic pain (CLPP). A case-control study was performed in 15 semiprofessional athletes with CLPP and 15 without (healthy athletes). Lumbar multifidus echointensity and echovariation were measured for muscle quality assessment. Echostructure was used to evaluate lumbar multifidus cross-sectional area (CSA) at resting and during muscle contraction, respective differences during both phases (CSA Dif. ), activation patterns, and thoracolumbar fasciae morphology and thickness. Significant differences with a large effect size were observed in quantitative data from CLPP and healthy athletes for left lumbar multifidus CSA Dif. and thoracolumbar fasciae morphology. Categorical data showed statistically significant differences with a small-to-moderate effect size for lumbar multifidus activation pattern and thoracolumbar fasciae morphology. Athletes with CLPP showed a reduced CSA difference between lumbar multifidus contraction and at resting and higher disorganization of thoracolumbar fasciae morphology compared to healthy athletes. These findings suggest the importance of dynamic exploration of the lumbar region and connective tissue in sports performance and injury prevention.

Background: The diagnostic of flat and crest-shaped of first metatarsal heads has been associated as an important risk factor for hallux deformities, such as hallux valgus and hallux rigidus. The rounded form of the first metatarsal head on the dorsoplantar radiograph of the foot has been believed to be associated with the development of hallux valgus. Purpose: The aim of this study was to clarify the effect of tube angulation on the distortion of first metatarsal head shape, and verify the real shape of the metatarsal head in anatomical dissection after an X-ray has been taken. Materials and Methods: In this prospective study at Universidad Complutense de Madrid, from December 2016 to June 2019, 103 feet from embalmed cadavers were included. We performed dorsoplantar radiograph tube angulation from 0° until 30° every 5° on all specimens; then, two observers verified the shape of the first metatarsal head in the radiographs and after its anatomic dissection. Kappa statistics and McNemar Bowker tests were used to assess and test for intra and interobserver agreement of metatarsal shape. Results: We calculated the intraobserver agreement, and the results showed that the first metatarsal head is distorted and crested only when the angle of the X-ray beam is at 20° of inclination ( p < 0.001). The interobserver agreement showed good agreement at 0°, 5°, 10°, 20°, and 25° and was excellent at 30° ( p < 0.001). Conclusion: All of the studies that we identified in the literature state that there are three types of shapes of the first metatarsal head and relate each type of head to the diagnosis of a foot pathology, such as hallux valgus or hallux rigidus. This study demonstrates that there is only the round-shaped form, and not three types of metatarsal head shape. Therefore, no diagnoses related to the shape of the first metatarsal head can be made.

Subungual osteochondroma (SO) is an infrequent and non-malignant bone tumour of the distal phalanx, especially prominent in paediatric populations. The aim of this research was to describe a case series of paediatric feet with SO which received surgical treatments. The secondary purpose was to compare these descriptive data by sex distribution., Methods: Twenty-three paediatric feet with SO confirmed by clinical or radiological features received surgical treatment. Socio-demographic (age, sex, height, weight and BMI) and clinical features (side, location, tumour or pain presence, and nail lift before surgery, as well as recurrence and adverse effects at one month after intervention) were reported., Results: Regarding clinical features before intervention, the most frequent locations of SO were the first toe (86.8%) and the right lower limb (56.5%). In addition, the presence of the tumour, pain and nail lift showed a prevalence of 91.3%, 69.5% and 47% of the study sample, respectively. Considering clinical features at one month after intervention, the most frequent adverse effect was the pain presence (69.5%). In addition, one case (4.4%) presented ulceration. Only one patient (4.4%) suffered from recurrence with a new tumour. There were not statistically significant differences by sex distribution ( p > 0.05)., Conclusions: This novel study showed that surgery treatment for SO in paediatric populations presented a very low recurrence degree with minor adverse effects and without differences by sex distribution. Thus, further randomized clinical trials should be carried out in order to determine the effectiveness of this intervention in this special population., Competing Interests: The authors declare no conflict of interest

Background: Primary dysmenorrhea (PD) is one of the most common gynecological disorders in women of reproductive age that may affect quality of life. It is believed that the underlying cause of PD may be the excessive production of prostaglandins (PGs), however, between 20%-25% of women with PD did not respond to pharmacological treatments, showing that nociceptive mechanisms underlying PD are still not understood. The purpose of this study was to measure and compare, through the use of ultrasound imaging, the thickness at rest of the abdominal wall, as well as the interrecti distance (IRD), in women with and without PD., Methods: A cross-sectional study has been performed using ultrasound imaging (USI) to measure the resting thickness of the external oblique (EO), internal oblique (IO), transversus abdominis (TrAb), rectus abdominis (RA), as well as the IRD in a sample of 39 women, 19 with PD and 20 without PD (median ± IR age: 20 ± 4 and 22.5 ± 7 years, respectively)., Results: Findings of muscular thickness did not reveal statically significant differences ( p < 0.05) in EO, IO, TrAb, RA, and the IRD between the PD group and control group., Conclusions: These findings suggest that the thickness of the abdominal wall is not associated with PD., Competing Interests: The authors declare no conflict of interest.

Background: Anatomic and histological landmarks of the extensor digitorum longus (EDL) tendon insertion in the proximal nail matrix may be key aspects during surgery exposure in order to avoid permanent nail deformities., Objective: The main purpose was to determine the anatomic and histological features of the EDL's insertion to the proximal nail matrix of the second toe., Methods: A sample of fifty second toes from fresh-frozen human cadavers was included in this study. Using X25-magnification, the proximal nail matrix limits and distal EDL tendon bony insertions were anatomically and histologically detailed., Results: The second toes' EDLs were deeply located with respect to the nail matrix and extended superficially and dorsally to the distal phalanx in all human cadavers. The second toe distal nail matrix was not attached to the dorsal part of the distal phalanx base periosteum., Conclusions: The EDL is located plantar and directly underneath to the proximal nail matrix as well as dorsally to the bone. The proximal edge of the nail matrix and bed in human cadaver second toes are placed dorsally and overlap the distal EDL insertion. These anatomic and histological features should be used as reference landmarks during digital surgery and invasive procedures.

Purpose: To compare and quantify with ultrasound imaging (USI) the inter-recti distance (IRD), rectus abdominis (RA), external oblique (EO), internal oblique (IO), transversus abdominis (TrAb), and multifidus thickness and the RA and multifidus cross-sectional area (CSA) between individuals with and without chronic mid-portion Achilles tendinopathy (AT)., Methods: A cross-sectional study. A sample of 143 patients were recruited and divided into two groups: A group comprised of chronic mid-portion AT ( n = 71) and B group composed of healthy subjects ( n = 72). The IRD, RA, EO, IO, TrAb, and multifidus thickness, as well as RA and multifidus CSA, were measured by USI., Results: USI measurements for the EO ( p = 0.001), IO ( p = 0.001), TrAb ( p = 0.041) and RA ( p = 0.001) thickness were decreased as well as IRD ( p = 0.001) and multifidus thickness ( p = 0.001) and CSA ( p = 0.001) were increased for the tendinopathy group with respect the healthy group. Linear regression prediction models ( R 2 = 0.260 - 0.494; p < 0.05) for the IRD, RA, EO, and IO thickness ( R 2 = 0.494), as well as multifidus CSA and thickness were determined by weight, height, BMI and AT presence., Conclusions: EO, IO, TrAb, and RA thickness was reduced and IRD, multifidus thickness and CSA were increased in patients with AT.

Background: Deep dry needling (DDN) and ischemic compression technic (ICT) may be considered as interventions used for the treatment of Myofascial Pain Syndrome (MPS) in latent myofascial trigger points (MTrPs). The immediate effectiveness of both DDN and ICT on pressure pain threshold (PPT) and skin temperature of the latent MTrPs of the triceps surae has not yet been determined, especially in athletes due to their treatment requirements during training and competition., Objective: To compare the immediate efficacy between DDN and ICT in the latent MTrPs of triathletes considering PPT and thermography measurements., Method: A total sample of 34 triathletes was divided into two groups: DDN and ICT. The triathletes only received a treatment session of DDN ( n = 17) or ICT ( n = 17). PPT and skin temperature of the selected latent MTrPs were assessed before and after treatment., Results: Statistically significant differences between both groups were shown after treatment, showing a PPT reduction ( p < 0.05) in the DDN group, while PPT values were maintained in the ICT group. There were not statistically significant differences ( p > 0.05) for thermographic values before and treatment for both interventions., Conclusions: Findings of this study suggested that ICT could be more advisable than DDN regarding latent MTrPs local mechanosensitivity immediately after treatment due to the requirements of training and competition in athletes' population. Nevertheless, further studies comparing both interventions in the long term should be carried out in this specific population due to the possible influence of delayed onset muscle soreness and muscle damage on PPT and thermography values secondary to the high level of training and competition., Competing Interests: The authors declare no conflict of interest.

Background: Leukocyte and platelet-rich fibrin (L-PRF) may be considered a co-adjuvant intervention that may play a key role in blood coagulation and tissue repair after nail surgeries. The aim of this study was to determine the effectiveness of L-PRF versus nitrofurazone on the post-surgical bleeding and wound cicatrization period in patients with bilateral onychocryptosis during surgeries of chemical matrixectomies with 88% phenol solution. Methods: A randomized single-blind clinical trial was registered with the European Clinical Trials Database (EudraCT) with identification number 2016-002048-18. Twenty healthy participants with bilateral onychocryptosis ( n = 40) were recruited and bilaterally received both protocols for both halluces. Patients with a mean age mean of 45.55 ± 12.19 years attended a specialized foot and ankle surgery clinic. Both halluces of each patient were randomized and allocated to receive L-PRF (experimental group; n = 20 halluces) or nitrofurazone (control group; n = 20 halluces) interventions in conjunction with surgery of chemical matrixectomies with 88% phenol solution for bilateral ingrown of toenail border (medial and lateral). Patients were blinded to their intervention in each hallux. The primary outcome measurement was post-surgical bleeding. The secondary outcome measurements were post-surgical pain intensity, inflammation, infection, analgesic intake, and wound cicatrization period. Results: Statistically significant differences ( p < 0.001) were found between both groups showing a reduction for wound cicatrization period and post-surgical bleeding for the L-PRF intervention with respect to nitrofurazone treatment. The rest of the outcome measurements did not show any statistically significant differences ( p > 0.05). Conclusions: L-PRF rather than nitrofurazone in conjunction with chemical matrixectomies performed with 88% phenol solution reduced the wound cicatrization period and bleeding after nail surgery. Thus, L-PRF may be considered a first-line co-adjuvant intervention for patients who suffer from nail problems, such as onychocryptosis, that require surgical procedures.

Background: Postural balance and fall efficacy (self-perceived confidence in performing daily physical activities) have been found to be risk factors associated with falls in older adults. Stretching is one intervention that has been investigated to improve balance and therefore reduce fall risk. Various forms of stretching have been evaluated with different outcomes, but there is a lack of knowledge about the effect of stretching (continuous and intermittent) on plantar pressures and balance. Therefore, the aim of the present study was to analyze the effects of stretching (continuous and intermittent) of the bilateral ankle plantar flexors on plantar pressures and static balance., Methods: A randomized clinical trial was carried out. Forty-eight healthy subjects (42 females and 6 males) were recruited in an outpatient clinic. Subjects were randomly assigned to an intermittent stretching group (five sets of 1 min; 15 s of rest) or a continuous stretching group (2 min of continuous stretching) of the plantar flexors. Plantar pressures and balance using stabilometry were measured before and after stretching., Results: There were significant differences between intermittent and continuous stretching in rearfoot maximum pressure, forefoot surface area, and center of pressure surface area with eyes open., Conclusions: Bilateral intermittent stretching of the ankle plantar flexors was found to be more effective than continuous stretching for the reduction of rearfoot maximum pressure and improved balance.

Background: Based on changes in lung function and musculoskeletal disorders in patients with asthma, this study aimed to compare the tarsal tunnel and fibular bone pressure pain thresholds (PPTs) of patients with asthma and healthy matched-paired controls. Methods: A case-control study was performed. One hundred participants were recruited: 50 asthma patients and 50 healthy matched-paired controls. Bilaterally, tarsal tunnel and fibula bone PPTs were registered. Results: Statistically significant differences ( p < 0.01) were shown bilaterally for tarsal tunnel PPT. With the exception of fibula PPT ( p > 0.05), asthma patients presented less tarsal tunnel PPT than healthy participants. Statistically significant differences ( p < 0.05) were shown for two linear regression prediction models of the right ( R ² = 0.279) and left ( R ² = 0.249) tarsal tunnels PPTs as dependent variables, and based on sex, group, contralateral tarsal tunnel PPT and ipsilateral fibula PPT as independent variables. Conclusions: The study findings showed that a bilateral tarsal tunnel mechanosensitivity increase is exhibited in patients diagnosed with asthma. The presence of asthma may bilaterally predict the PPT of tarsal tunnel. These findings may suggest the presence of central sensitization in asthma patients, which could clinically predispose them to musculoskeletal disorders, such as tarsal tunnel syndrome.

Background: Extensor tendon disorders may cause severe functional impairments, and there is a lack of knowledge about their anatomic associations with the proximal fingernail matrix., Objective: To delineate the association between the distal extensor pollicis longus tendon (EPLT) insertion and the limit of the fingernail matrix in the thumb., Methods: The limit of the fingernail matrix and the distal bony insertion of the EPLT were identified in five thumbs from fresh-frozen human cadavers. An additional five thumbs were fixed and the longitudinal thumb sections were histologically analyzed., Results: The terminal limit of the matrix and fingernail was dorsal and overlapped to the EPL tendon, which was located between the fingernail matrix and the phalanx, and extended dorsally to the distal section of the terminal phalanx in all ten thumb bodies., Conclusion: The fingernail matrix is not directly inserted into the periosteum of the dorsal section of the base to the distal phalanx, because this anatomic relationship is separated by the deep fibers of the EPLT.

Objective: To assess clinical differences in the Achilles tendons of runners with ankle equinus wearing either compressive or standard stockings., Design: Case⁻control study., Methods: In this study, we conducted clinical examinations of 98 sportsmen (runners) with equinus, before and after 30 min of running on a treadmill; 49 runners wore compressive stockings and 49 wore standard stockings. Clinical assessments of the runners' Achilles tendons were based on the pressure pain threshold (PPT) and skin temperature analysis., Results: Achilles tendon evaluations identified significant differences in skin temperature modification and PPT between the compressive and standard stocking groups., Conclusions: Based on our findings, we propose that higher skin temperatures are associated with lower pressure pain thresholds in the Achilles tendons of runners with ankle equinus.