Júlio Guilherme Silva

Myofascial release (MFR) is commonly used to reduce pain and facilitate movement in individuals with low back pain; however, whether adding active mobility exercises provides an incremental short-term benefit remains unclear. This randomized, controlled, three-condition crossover trial compared the acute and 48-h effects of MFR alone, MFR combined with active mobility exercises (MFR+MOB), and a Control condition in physically active men with chronic nonspecific low back pain. Thirty-two participants were enrolled, and 31 completed all experimental conditions and were included in the complete-case analysis. Pain intensity, trunk/posterior-chain flexibility, and bilateral active hip-flexion range of motion were assessed at baseline, immediately post-intervention, 10 min post-intervention, and 48 h. Nonparametric repeated-measures analyses preserved the within-participant structure of the crossover design. Pain reduction differed across conditions at all post-intervention time points (all p < 0.001), with both MFR and MFR+MOB showing greater reductions than Control, whereas MFR and MFR+MOB did not differ at Post-0 (adjusted p = 0.402), Post-10 (p = 0.683), or Post-48h (p = 0.672). Trunk/posterior-chain flexibility improved relative to Control after both active interventions, with no differences between MFR and MFR+MOB. Hip-flexion responses were more heterogeneous and were not consistently superior at 48 h. These findings indicate that a single session of MFR was associated with short-term reductions in pain and changes in mobility-related outcomes, while adding active mobility exercises did not provide a consistent incremental benefit over MFR alone within 48 h.

Background: Post-COVID-19 syndrome (PCS) is associated with persistent pulmonary, autonomic, and hemodynamic impairments. However, the acute effects of spinal manipulation on these systems in adults with PCS remain unclear. Purpose: To investigate the acute effects of combined cervical and thoracic spinal manipulation on pulmonary function, heart rate variability, and blood pressure in adults with PCS. Methods: This exploratory, hypothesis-generating study included 10 adults with PCS randomized to three sequences of spinal manipulation, sham manipulation, and control using a Latin-square crossover design with one-week washouts. Spirometry (FVC, FEV1, and FEV1/FVC) was assessed immediately after each intervention. Blood pressure and heart rate variability indices (RMSSD, SDNN, pNN50, LF, HF, and LF/HF ratio) were recorded at rest and 15, 30, 45, and 60 minutes post-intervention. Friedman/Wilcoxon tests and baseline-corrected sensitivity analyses were performed. Results: No significant differences were observed among conditions for FVC, FEV1, FEV1/FVC (all p>0.70), or the area under the curve of blood pressure, RMSSD, pNN50, HF, and LF/HF ratio (all p>0.27). Differences in SDNN and LF did not survive Bonferroni-corrected comparisons and disappeared after baseline correction, indicating between-session baseline variability rather than intervention effects. Conclusion: A single session of combined cervical and thoracic spinal manipulation did not produce consistent acute improvements in pulmonary function, blood pressure, or heart rate variability in adults with PCS. These physiological variables should not be considered primary indicators of response to an isolated manipulation session.

Introduction: Acute neuromuscular fatigue impairs athletic performance and increases the risk of musculoskeletal injury. Recovery strategies such as manual massage (MM) and intermittent pneumatic compression (IPC) have been proposed to mitigate these effects, although their efficacy in elite youth soccer remains under debate. Objective: To compare the acute effects of MM and IPC on muscle damage recovery, lower limb strength, and power in Brazilian Under-20 soccer athletes. Methods: A randomized crossover study was conducted with twenty male youth athletes (18.65 ± 0.67 years) from the under-20 category of Paysandu Sport Club—Brazil. Each athlete underwent both MM and IPC interventions, separated by a seven-day washout. Variables assessed included serum creatine kinase (CK), quadricep and hamstring isometric voluntary contraction (IVC), and vertical jump (VJ). Results: MM resulted in a CK reduction of Δ = −77.1 U/L (p = 0.042; d = 0.37), indicating a moderate effect size, while IPC induced a larger reduction of Δ = −138.0 U/L (p = 0.160; d = 1.41), with a very large effect size despite the lack of statistical significance. Neither intervention produced significant changes in quadricep or hamstring IVC, nor in VJ height (p > 0.05). Conclusions: Both MM (statistical difference) and IPC (clinical difference) were viable recovery strategies for attenuating acute serum CK without impairing neuromuscular performance in elite under-20 soccer players.

Introduction: Acute neuromuscular fatigue impairs athletic performance and increases the risk of musculoskeletal injury. Recovery strategies such as manual massage (MM) and intermittent pneumatic compression (IPC) have been proposed to mitigate these effects, although their efficacy remains controversial. Objective: To compare the MM and IPC effects on muscle damage recovery, lower limb strength, and power in Under-20 soccer athletes. Methods: A cross-sectional crossover studyn was conducted with twenty male youth athletes (n = 20) from the under-20 category (18.65 ± 0.67 years) of Paysandu Sport Club – Brazil, who underwent a fatigue protocol followed by either MM or IPC, with a seven-day washout between sessions. The following variables were assessed: serum creatine kinase (CK), quadriceps and hamstrings isometric voluntary contraction (IVC), and vertical jump (VJ). Results: CK decreased following the MM (pre: 382.50 ± 163.02 U/L; post: 305.40 ± 239.98 U/L; p=0.042) but not for IPC (pre: 337 ± 114.50 U/L; post: 199 ± 89.50 U/L); p=0.16). After the crossover, IPC elicited a significant reduction in CK (pre: 307 ± 198 U/L; post: 256 ± 84.75 U/L; p=0.028), whereas MM did not reach statistical significance (pre: 316.70 ± 116.66 U/L; post: 252.50 ± 91.77 U/L; p=0.094). Neither intervention (MM or IPC) resulted in significant improvements in Quadriceps or Hamstring (p>0.05) IVC or VJ height (p>0.05). Conclusion: MM and IPC are viable recovery tools to mitigate biochemical markers of muscle stress without compromising performance, a crucial consideration for high-performance environments where recovery windows are narrow.

Azygos lobe is one of the most common pulmonary variations. Although numerous studies discuss to the clinical and surgical implications of anatomical variations, there are few investigations about this topic. The aim of this study was to discuss the anatomy of the pulmonary azygos lobe and its possible clinical and surgical correlations. In this systematic review, a total of 48 results were found between 1968 and 2020. After application of eligibility criteria, 16 articles were included to analysis. Our results showed there were no reports of surgery complications in azygos lobe presence. In all articles that described the anatomical variation, the pulmonary azygos lobe received tertiary segmental branches. Among the surgical implications in the presence of the azygos lobe, complications are of low complexity. It is necessary to teach about this anatomical variation in medical schools in cadavers. Emphasizing the obvious morphological modifications in the superior mediastinum.

The aim of this study was to evaluate the accuracy of a motion palpation procedure, the flexion-extension test, in localizing the spinous process of the seventh cervical vertebra (C7). We analyzed 101 adult participants with metal markers that permitted the identification of the C7 spinous process. This analysis occurred during a flexion-extension test and was confirmed by radiography. Data sample characteristics were analyzed by descriptive statistics, and the relationship between independent variables (weight, height, sex, age, and body mass index [BMI]) and dependent variables (coincidence between the most prominent vertebra and the stationary vertebra, as determined by the flexion-extension test) was determined via logistic regression. The sample population was 48.5% male with a mean age of 56.8 years (standard deviation, ±14.9) and a mean BMI of 25.54 kg/m² (standard deviation, ±5.5). In 54.5% of cases, the C7 spinous process was correctly identified by the flexion-extension test. The agreement between the flexion-extension test and radiography in accuracy of localization of the C7 spinous process was significant (P = .021), as was the correct localization of C7 (P = .05). The localization of the C7 spinous process was more accurate in individuals with a BMI 2 and whose most prominent vertebra coincided with the stationary vertebra as determined by the flexion-extension test.