Jamilson Simões Brasileiro

Purpose: To evaluate bilateral isokinetic performance symmetry of knee extensors and flexors 6 months after anterior cruciate ligament reconstruction using a rectus femoris tendon autograft. Methods: This retrospective case series included patients consecutively recruited at a single tertiary sports medicine center between January 2023 and July 2024. Inclusion required primary anterior cruciate ligament reconstruction with a rectus femoris autograft, no prior knee surgeries, and a minimum 6‐month follow‐up; patients with revision or multiligamentous procedures were excluded. Isokinetic testing was performed at 6 months using a computerized dynamometer. The nonoperative limb was tested first, followed by the operative limb. Patients performed 5 maximal effort trials at 60°/s for both extension and flexion. Measured outcomes included peak torque (PT), PT normalized to body weight, angle at PT, total work (TT), and mean power (PM) for both knee extension and flexion. Paired t‐tests compared operated and nonoperated limbs. Statistical significance was set at P ≤ .05. Results: Thirty‐one male patients (mean age, 26.3 ± 4.7 years) were included, with a mean follow‐up of 6.2 ± 0.4 months. At 6 months, the operated limb achieved 71% of contralateral PT and 75% of contralateral PM, with significant deficits in extension PT ( P < .001), PT normalized to body weight ( P < .001), TT ( P < .001), and PM ( P = .002), while no significant difference was found for angle at PT ( P = .457). Flexor performance showed near‐complete recovery, with the operated limb reaching 93% of contralateral peak torque and 90% of TT, with P = .355, .340, .902, .153, and .316 for PT, PT normalized to body weight, angle at PT, TT, and PM, respectively. Conclusions: At 6 months, anterior cruciate ligament reconstruction with a rectus femoris autograft was associated with complete recovery of knee flexor performance but persistent deficits in knee extensor performance. Level of Evidence: Level IV, retrospective case series.

Purpose: To compare isokinetic quadriceps performance 6 months after anterior cruciate ligament reconstruction (ACLR) using rectus femoris (RF) versus hamstring tendon (HT) autografts. Methods: In this cross‐sectional study, 75 male patients who underwent primary ACLR with RF ( n = 31) or HT ( n = 44) autografts were evaluated ~6 months postoperatively. Bilateral isokinetic testing at single angular velocity 60°/s (Biodex Multi‐Joint System 4) measured peak torque (PT), PT normalized to body weight (PT/BW), angle at peak torque (aPT), total work (TW), and mean power (PM). Between‐group comparisons used independent t‐tests; paired comparisons were conducted within the RF group. Results: No between‐group differences were detected for PT, PT/BW, aPT, TW, or PM ( p > 0.05 for all—primary contrast PT: mean diff. 5.3 Nm; 95% CI –20.4 to 30.9; p = 0.689). Within the RF group, the operated limb showed lower PT, PT/BW, TW, and PM than the contralateral limb (all p ≤ 0.002), with no difference in aPT. Conclusions: At 6 months after ACLR, quadriceps performance did not differ between RF and HT autografts. These early data do not address return‐to‐sport timing or graft healing and should not be interpreted as evidence of equivalence (it is not powered for equivalence/non‐inferiority); rather, they support RF as a potential option warranting longer‐term studies incorporating functional tests and patient‐reported outcomes. Level of Evidence: Level III, cross‐sectional comparative study.

The main purpose of this study was to evaluate the effects of exercising on a vibratory platform on older adults’ lower limb performance, muscle activation and balance.A total of 44 volunteers exer...

Background There is evidence that core stabilisation, strength and endurance training contribute to reduce low back pain in the general population. However, we are not aware of the effect of these exercises on fighter aviation pilots. Therefore, the present study aims to investigate the effects of an exercise protocol on chronic low back pain in Brazilian Air Force fighter pilots. Changes in neck pain, lumbar disability, range of motion, strength and resistance were also investigated. Methods Fourteen participants with chronic low back pain were randomised into two groups: stabilisation exercise group (SEG—n=7), exercise protocol twice a week for 12 weeks) and the regular exercise group (REG—n=7), which performed their own usual exercise routine. The evaluations were carried out before and after the training period. The primary outcome was the intensity of low back pain and the secondary outcomes were cervical pain, functional disability, range of motion, maximum isometric strength and trunk muscle resistance. Results The SEG had a significant reduction in low back pain compared with the REG (difference of 2.3 points, p=0.04) and a lower rate of cervical pain (difference of 2.5 points, p=0.01) at the end of the protocol. Maintenance of trunk muscle strength was also observed in the SEG over the period, while the REG presented a decrease in flexural strength to the right side (difference between groups: −3.7%, p=0.04). There were no differences in the rates of disability, range of motion or resistance to fatigue between groups. Conclusions The stabilisation exercise programme focused on the core muscles was successful in decreasing the fighter pilots’ chronic lumbar pain. Pilots are normally active; however, our results indicate that specific trunk training programmes should be offered considering the work needs of these subjects. Clinical trials ‘Exercise protocol for pilots with back pain’ (registered: 09 October 2018)—NCT03713814 (https://clinicaltrials.gov/ct2/show/NCT03713814).

Introduction Low back pain in military pilots is a frequent condition which constantly leads to absences from work, decreased concentration and performance during flight, as well as changes in work functions. Methods This is a cross-sectional analytical study including 28 fighter pilots who underwent an evaluation comprising muscle strength and fatigue resistance, trunk mobility and application of questionnaires to identify associated clinical factors. Results It was observed that 68% of the pilots reported low back pain with an average pain intensity of 3.7 at numerical pain scale in the last week. No significant differences were observed regarding the range of motion and trunk muscle strength when pilots with low back pain were compared with asymptomatic pilots. However, lateral right trunk muscle (mean difference=16, 95% CI 0.6 to 33.0]) and lateral left trunk muscle (mean difference=22, 95% CI 1 to 44) fatigue sooner in pilots with low back pain when the two groups were compared (p=0.04 for both). Conclusion There was a high rate of low back pain complaints among fighter pilots. There was also a significant reduction in fatigue resistance of the lateral trunk muscles in symptomatic pilots when compared with asymptomatic pilots. These factors must be considered in the physical training of this population.

BACKGROUND: Smartphone devices have been used to measure range of motion (ROM) in different joints. OBJECTIVE: To verify the concurrent validity of thoracolumbar ROM using a mobile application and a digital inclinometer, as well as the intrarater rel

Context: Whole-body vibration (WBV) has been widely used in clinical and sport practice. These devices produce constant vibrations, originating symmetrical waves that move along the vertical axis. It is suggested that mechanical stimuli produced by high vibration can be an alternative to improve neuromuscular performance and balance in different populations. However, there is still a lack of consensus in the literature regarding neurophysiological responses in the skeletal muscle immediately after the use of WBV, specifically in individuals subjected to anterior cruciate ligament reconstruction. Objective: To investigate the immediate effects of WBV on neuromuscular performance of the quadriceps femoris and postural oscillation of individuals subjected to anterior cruciate ligament reconstruction. Design: This is a blinded randomized controlled trial. Setting: University laboratory. Participants: Forty-four men. Intervention: Participants were randomized into 2 groups: control group (n = 22, exercise protocol on the vibrating platform turned off) and WBV group (n = 22, exercises on the vibrating platform turned on, at a frequency of 50 Hz and amplitude of 4 mm). Main Outcome Measures: The volunteers underwent a dynamometric evaluation of the quadriceps femoris and electromyographic activity of vastus lateralis and vastus medialis muscles, in addition to oscillation of the center of pressure at 2 different moments: before and immediately after the intervention protocol. Results: The intragroup comparison evidenced differences between preassessments and postassessments for the variables of laterolateral amplitude, peak torque, and total work. However, no significant difference was observed in the intergroup comparison after WBV protocol. Conclusion: The use of WBV did not immediately alter the performance of the quadriceps femoris and the electromyographic activity of vastus lateralis and vastus medialis muscles. In addition, it also did not interfere with pressure center oscillation of individuals subjected to anterior cruciate ligament reconstruction.

Patellofemoral pain (PFP) is one of the most frequent musculoskeletal dysfunctions in the knee and its treatment is controversial. This study analyzed the effects of Kinesio Taping (KT) immediately and 72 hours after its application on the electromyographic (EMG) activity of the vastus medialis oblique (VMO) muscle, on the isokinetic performance of the quadriceps femoris and on the pain of subjects with PFP. Fifty-four participants were divided into three groups and performed one of the following protocols: (1) control group (CG)—remained at rest; (2) KT tension group (TG)—KT application with tension in the VMO region; and (3) KT without tension group (WTG)—KT application without tension in the same region. VMO and vastus lateralis (VL) EMG activity (RMS and onset), isokinetic performance and pain intensity were evaluated at three moments: before KT application, immediately after and 72 hours after. A mixed model ANOVA was used for statistical analysis with a significance level of 5% (p ≤ 0.05). No differences between the evaluated groups were found in relation to EMG variables and isokinetic performance. A reduction in pain intensity was found in the WTG in comparison to CG, after 72 hours. KT does not alter EMG parameters nor the isokinetic performance of subjects with PFP. However, we noticed reduced pain in the group submitted to the technique without tension 72 hours after its application.