Background: Deep gluteal syndrome (DGS) is an increasingly recognized cause of posterior hip pain, particularly in athletes and physically act give individuals. It results from entrapment of neural structures within the deep gluteal space, frequently associated with musculotendinous imbalance, repetitive hip movements, and sport-specific biomechanical stress. Purpose: To systematically describe the musculotendinous and neural entrapment mechanisms underlying DGS, with particular focus on clinical presentation, imaging findings, and management strategies in athletes. Furthermore, a secondary aim was to evaluate the frequency and clinical relevance of DGS-related conditions reported in athletes. Methods: A systematic descriptive review was conducted in accordance with PRISMA guidelines. PubMed, Scopus, PEDro, and the Cochrane Library were searched. Studies addressing anatomical predispositions, clinical features, imaging characteristics, and conservative or surgical treatment were included. Results: Eighty-four studies met the inclusion criteria. DGS encompasses multiple entrapment patterns involving the sciatic, pudendal, posterior femoral cutaneous and superior gluteal nerves. In athletes, repetitive hip flexion–adduction–internal rotation movements, overuse microtrauma and hypertrophic musculature appear to contribute to neural compression. Clinical diagnosis remains challenging due to symptom overlap with lumbar disorders. MRI represents the primary imaging modality, although findings may be subtle or nonspecific. Initial management is conservative, while endoscopic decompression may be indicated in refractory cases. Conclusion: There are seven clinical conditions that may cause DGS: ischiofemoral impingement, piriformis syndrome, gemelli-internal obturator syndrome, posterior femoral cutaneous nerve entrapment, superior gluteal nerve entrapment, pudendal neuropathy, and proximal hamstring syndrome. Therefore, DGS is an “umbrella term” that encompasses different pathologies resulting in very similar clinical presentations. In the athletic population, the two most frequent conditions are pudendal neuropathy and proximal hamstring syndrome.
Muscle tendons are anatomical structures that transfer force between muscle and bones, providing protection to the muscle in the presence of excessive stress by delaying transmission of mechanical energy to the muscle fibers. This acts as an energy buffer during tasks that produce high levels of force, particularly in lengthened positions. This paper examined the current literature investigating the comparative effects of eccentric and concentric contractions, as well as various load-intensities on improving muscle tendon mechanical properties. Fifteen studies were examined which consisted of randomized controlled trials and blinded studies, specific to the areas of sports medicine, clinical rehabilitation, biomechanics and clinical orthopaedics and trauma. The examined literature demonstrated that tendon mechanical properties can be positively influenced by both types of contractions, with eccentric contractions being favourable within the initial stages of tendon rehabilitation. In addition, the amount of external load applied to the tendon has a strong correlation to the rate of tissue turnover, with heavier loads producing significantly greater tendon adaptations compared to lighter loads. This is related to heavier loads disrupting the cellular environment of the tissue, thus increasing the anabolic responses within the collagen fibers. The findings provide a practical opportunity for coaches and practitioners, in which implementing heavy resistance training using both types of contractions with load intensities between 70-85%1RM, can significantly improve the mechanical properties of the tendon, therefore enhancing sport performance and decreasing injury risk.
First isolated in 1949 and introduced into clinical practice in the early 1950s, hydrocortisone revolutionized the treatment of inflammatory and endocrine disorders. Despite the development of more potent and longer-acting glucocorticoids, it remains indispensable in modern medicine. This review explores hydrocortisone’s enduring relevance by examining its pharmacokinetic properties, therapeutic indications, and versatility across clinical contexts. The favorable safety profile of hydrocortisone and its predictable pharmacokinetics allow its practice for both topical and systemic administration. Topical formulations are widely used for mild to moderate inflammatory skin conditions, while localized injections deliver targeted relief in joint and soft-tissue disorders. Systemic regimens, ranging from physiological replacement to high-dose medication, address endocrine deficiencies, acute crises, and severe inflammatory flares. This review summarizes clinical evidence on the safety and efficacy of hydrocortisone across a broad spectrum of conditions, reinforcing its role as a reliable and versatile glucocorticoid in modern medicine.
Background: Exercise is a central regulator of metabolic and neurotrophic processes, in which irisin and brain-derived neurotrophic factor (BDNF) play key roles in mediating muscle–brain communication. Objective: This systematic review aimed to summarize the effects of different exercise modalities and immobilization on irisin and BDNF expression, focusing on the PGC-1alpha–FNDC5–irisin signaling pathway. Methods: The review followed the PRISMA 2020 guidelines. Studies published between January 1995 and September 2025 were identified through PubMed, Scopus, Web of Science, and Google Scholar using Boolean search combinations (‘irisin’ AND ‘BDNF’ AND ‘exercise’). Inclusion criteria covered human and animal studies exploring the irisin–BDNF axis. Data were extracted independently and synthesized qualitatively. Risk of bias was assessed using Cochrane domains. Results: Evidence indicates endurance, resistance, and high-intensity interval training increase circulating irisin and hippocampal BDNF levels. Acute exercise induces transient increases, whereas chronic training produces sustained adaptations. Immobilization reduces both irisin and BDNF expression. Conclusions: Current evidence suggests the PGC-1alpha–FNDC5–irisin–BDNF axis may constitute a molecular link between skeletal muscle activity and brain health; causal conclusions are limited by the associative and largely preclinical nature of the evidence. This review was not prospectively registered. Methodological heterogeneity precluded meta-analysis. Data extraction sheets and full search strings are available as supplementary material.
Background: Changes in posture resulting from aging occur due to several factors, such as alterations in hormonal production, sarcopenia, osteoporosis, and the natural reduction in physical activity levels. Objective: The aim of this study was to evaluate and compare the effects of strength training and aquatic resistance on the posture of elderly women. Methods: This is a cross-sectional exploratory study composed of 33 female volunteers aged 60 years or older, who practiced either strength training or aquatic resistance. The sample was divided into three groups: 10 in the strength training group (STG), 11 in the aquatic resistance group (ARG), and 12 in the control group (CG). The evaluation included the administration of a questionnaire, postural analysis using the Portland State University (PSU) method, and body composition assessment through an electronic scale and dual-energy X-ray absorptiometry (DXA). Results: The results showed that the postural correction index (PCI) was higher in the STG (70.9 +/- 8.1%), followed by the ARG (63.9 +/- 4.8%) and the CG (57.5 +/- 8.1%). The STG exhibited a significantly higher PCI compared to the CG (Delta = 18.9%; p = 0.001), but there was no significant difference compared to the ARG. A positive correlation was also observed between the PCI and lean mass (r = 0.544; p = 0.001). Conclusion: This study suggests that strength training provides significant benefits for the posture of elderly women, with the STG showing better postural indices compared to the CG and higher values than the ARG.
Background: Quadriceps fatigue compromises soccer performance and safety. This RCT tested whether local muscle vibration (LMV) provides superior recovery versus passive rest for strength, dynamic balance, and hop performance post-fatigue in semi-professional players. Methods: Twenty-six male soccer players (control group: 26.84 +/- 4.52 years; LMV group: 25.85 +/- 5.36 years) were randomly assigned to either the control (n = 13) or LMV group (n = 13). After a quadriceps fatigue protocol, the LMV group received 2 minutes of 60 Hz local vibration, while the control group rested passively for the same duration. Quadriceps maximal voluntary contraction (MVC), single-leg hop test, and Y-balance test were assessed at baseline, post-fatigue, and post-intervention/rest. Two-way repeated measures ANOVA was used for analysis. Results: MVC declined post-fatigue (LMV: p = 0.005, Cohen's d = 0.76; control: p = 0.004, Cohen's d = 0.80), with LMV showing better recovery (p = 0.004, Cohen's d = 0.80) versus control (p = 0.046, Cohen's d = 0.55). Single leg hop improved post-LMV (p = 0.010, Cohen's d = 0.71). Y-balance test improvements occurred in anterior reach (LMV: p = 0.012, d = 0.50), posteromedial (LMV: p = 0.039; control: p = 0.002), posterolateral and composite scores (all p <= 0.002, with medium to large effect sizes). Conclusion: LMV produced superior recovery versus passive rest, with complete strength restoration, improved hop performance, and improved anterior dynamic balance. These improvements are likely due to enhanced muscle activation and better motor control following vibration. As a non-invasive intervention, LMV shows clinical utility for athletic recovery. The findings support its integration into sports rehabilitation, pending further investigation of optimal protocols across athletic populations.
Background: Wide-Awake Local Anesthesia No Tourniquet (WALANT) is a relatively new anesthetic technique for elective forefoot surgery that avoids general or neuraxial anesthesia, popliteal nerve blocks, and tourniquet use while allowing active intraoperative patient participation. Originally developed for hand surgery, its application to forefoot procedures remains insufficiently characterized. Methods: We conducted a single-center prospective case series of 30 consecutive adult patients undergoing elective forefoot surgery under a standardized WALANT protocol. The anesthetic solution consisted of subcutaneous 1% lidocaine with epinephrine 1:200,000. Primary outcomes were intraoperative and postoperative pain measured using the Numeric Rating Scale (NRS 0-10) at four timepoints, and patient satisfaction across seven domains using a 5-point Likert scale. Secondary outcomes included operative time and safety profile within 48 hours. Results: Mean age was 65.2 +/- 9.7 years; 80% of patients were female. Indications included hallux valgus (56.7%), hallux rigidus (16.7%), hallux valgus with metatarsalgia (13.3%), and isolated metatarsalgia (13.3%). Mean operative time was 32.3 +/- 9.4 minutes. Mean intraoperative NRS was 0.17 +/- 0.38, increasing to 0.23 +/- 0.50 at immediate recovery, 1.47 +/- 2.01 at 6 hours, and 1.97 +/- 1.90 at 24 hours. No intraoperative complications occurred, and no case required conversion to regional or general anesthesia. Minimal pain during surgery (agree/strongly agree) was reported by 96.7% of patients, and overall surgical experience was rated positively by 83.3%. Nine patients (30%) presented with mild postoperative wound oozing requiring dressing reinforcement or change; no hematomas, infections, neurovascular injuries, or reoperations were observed. Conclusion: WALANT is a safe, effective, and well-tolerated anesthetic strategy for elective forefoot surgery, providing near-complete intraoperative analgesia and high patient satisfaction without the need for tourniquet or regional block. Mild postoperative wound oozing appears to be an expected effect of tourniquet-free surgery and should be regarded as a manageable, anticipated event rather than a true surgical complication, provided appropriate patient education is delivered.
Background: Buttock claudication is an uncommon but disabling manifestation of peripheral arterial disease, caused by stenosis or occlusion of the internal iliac artery. It results in exertional buttock pain and impaired ambulation. Diagnosis is often challenging, since symptoms overlap with orthopedic and neurological conditions, frequently delaying appropriate management. While revascularization remains the standard of care, conservative treatments are required when surgical management is not feasible or indicated. Objective: To review and synthesize the available evidence on conservative treatment approaches for buttock claudication, with a focus on rehabilitative strategies. Methods: A narrative review of the literature was conducted. Studies investigating non-surgical treatment of buttock claudication were identified, with emphasis on exercise therapy, pharmacological interventions, and risk factor modification. Results: The review identified a critical paucity of evidence specific to conservative management of buttock claudication. No published studies explicitly investigated rehabilitative protocols or structured exercise interventions in this population. Available data are limited to extrapolations from distal peripheral arterial disease, where supervised exercise therapy, cardiovascular risk factor modification, and pharmacological optimization (e.g., antiplatelet agents, statins, vasodilators) have demonstrated efficacy. Based on these findings, a preliminary conceptual framework for conservative care in buttock claudication is proposed. Conclusion: Evidence supporting conservative treatment of buttock claudication is virtually absent. Dedicated clinical studies are urgently needed to establish and validate rehabilitation-oriented protocols and optimize non-invasive management strategies for this condition.
Background: The repetitive, high-demand nature of competitive swimming places significant stress on the shoulder joint, frequently leading to pain and instability. These issues-associated with neuromuscular control deficits-underscore the importance of thorough shoulder function assessment to guide rehabilitation interventions. Objective: The aim of this study was to evaluate the shoulder functional stability during the Upper Quarter Y Balance Test (UQ-YBT), considering handedness as a factor. Design: Cross-sectional study. Settings: Rehabilitation department of a sports club. Participants: Thirty-two (20 female) right-handed young swimming athletes aged 13-16 years old (min-max) participate in the study. Main Outcome Measure(s): The UQ-YBT was performed over a force platform and was expressed in terms of reaching distances normalized by upper limbs’ length, while the postural sway data acquired was expressed in resultant distance path length. A two-way ANOVA was applied to check for main effect and interaction between handedness and UQ-YBT direction. The association between UQ-YBT and path length was assessed through Pearson correlation analysis. Results: The UQ-YBT performance was progressively lower from medial to inferolateral and superolateral directions (p <0.006), with differences between hands for inferolateral (right > left hand, p = 0.003) and medial (left > right hand, p = 0.005) directions. Postural sway for the superolateral direction was significantly higher than that observed during the inferolateral and medial directions (p <0.001), and no handedness effect was found (p >0.078). A significant correlation was found for UQ-YBT medial direction distances and the medial path length, for both hands (r ranged 0.449-0.576, p <0.013). Conclusions: The level of challenge presented by the functional test, rather than upper limb lateral specialization, had the greatest influence on shoulder complex stability control.
Background: Ultrasonography is widely used to assess muscle structure and function, offering precise muscle thickness analysis. The gastrocnemius and soleus muscles are essential for lower limb strength in activities like jumping and running. Morphological analysis aids sports and rehabilitation by evaluating motor function and optimizing training. Understanding muscle structure-function relationships can improve training programs and injury prevention strategies. Objective: To determine the relationship between the thickness of the triceps surae muscles and selected motor performance parameters, including jump height and power. Methods: The study involved 47 participants (24 women, 23 men) aged 18-25, selected based on inclusion criteria. High-resolution ultrasonography assessed triceps surae muscle thickness, with probe placement individually adjusted. After measurements, participants performed motor tests, including vertical and squat jumps, each repeated three times with 1-minute rest intervals. Results: Significant correlations were found between soleus muscle thickness and jump test outcomes, particularly among male participants. The correlation between the transverse dimension of the soleus muscle and vertical jump height was r = 0.8831, p <0.001, while for squat jump height, it was r = 0.9418, p <0.001. Similarly, the longitudinal dimension of the soleus muscle showed a strong correlation with vertical jump height (r = 0.8847, p <0.001) and squat jump height (r = 0.9413, p <0.001), confirming its crucial role in power generation during jumping tasks. Conclusions: Soleus muscle thickness is a reliable predictor of lower limb power. These findings underscore the potential of ultrasonography in biomechanical diagnostics and emphasize the importance of accounting for sex differences in muscle function analysis.
Background and aim: Trigger finger is a condition that involves a sudden locking or release of a finger while bending or straightening. Various treatment options exist for this condition, including splinting and radial shock wave therapy Methods: This study was conducted as a randomized controlled trial on 38 patients with trigger fingers assigned to two treatment groups. The first group received the combined treatment of RSWT and splinting, while the second group received splinting alone. The parameters assessed included pain intensity (VAS), functional disability (Quick DASH), frequency of triggering, and functional impact of triggering at baseline, 6 weeks (after treatment termination), and 3 Results: A repeated measures analysis of variance test showed that all measured scores improved significantly over time. However, the contrast of time and group in the variables of pain intensity (VAS), functional impact of triggering, frequency of triggering and hand disability index (Quick DASH) was not significant. Conclusion: This study showed that both approaches are effective in reducing symptoms and improving function in patients with trigger finger. The interaction of time and group was not significant for variables, indicating that the addition of shockwave did not make a significant difference in any of the indices in short-term follow-up.
Purpose: Spatial frequency analysis (SFA) of ultrasound images quantitatively characterizes tissue morphology. However, the impact of machine settings on SFA for tendon pathology remains underexplored. We characterize how variations in settings influence SFA parameters in supraspinatus tendon images and identify which parameters differentiate between healthy and pathological tendons. Methods: Ten shoulders (5 with partial tears and 5 healthy) were imaged to examine how ultrasound settings (frequency, dynamic range, gain) influence SFA parameters. Tendons were scanned at 9 and 12 MHz with all possible dynamic range and gain combinations, resulting in 1680 images. Linear mixed-effects models analyzed the impact of settings on four SFA parameters. Results: SFA peak spatial frequency radius (PSFR) significantly differed between healthy and pathological tendons, regardless of settings (Coef. = 0.55, SE = 0.04, p <0.001). 12 MHz frequency notably enhanced PSFR’s discriminatory power, showing higher values in healthy tendons (1.34 mm-1) and lower in partial tears (1.09 mm-1) compared to 9 MHz (1.22 mm-1 and 1.04 mm-1). P6, Q6, and Amax parameters were affected by machine settings. Conclusion: Optimal ultrasound settings enhance SFA’s ability to discriminate between healthy and pathological supraspinatus tendons, with PSFR as the most robust parameter. 12 MHz significantly improves pathology discrimination.
Background: Non-weight-bearing joint fixation causes severe joint contracture, and neuromuscular electrical stimulation (NMES) is assumed to have a preventive effect. However, the effective intervention frequency of NMES for preventing joint contractures has not yet been clarified. Objective: To clarify the effective intervention frequency of NMES for preventing joint contracture caused by joint fixation in non-weight-bearing rats. Methods: Ten-week-old male Wistar rats underwent right ankle joint fixation in full plantar flexion with non-weight-bearing hindlimbs for 1 week. The rats were divided into three groups: non-weight-bearing joint fixation without NMES (NS group), non-weight-bearing joint fixation with one NMES per day (electrical stimulation one time [1T ES group]), and non-weight-bearing joint fixation with two NMESs per day (electrical stimulation two times [2T ES group]). We evaluated ankle dorsiflexion angle, extensibility, amounts of types I and III collagen, cross-sectional area, and wet weight of the soleus muscle-to-body weight ratio. Results: The ankle dorsiflexion angle and extensibility of the soleus muscle on the last day of the experiment were higher in the 1T ES and 2T ES groups than in the NS group. The ankle dorsiflexion angle on the last day of the experiment was higher in the 2T ES group than in the 1T ES group. Conclusion: NMES twice daily had a greater preventive effect on joint contracture caused by joint fixation with non-weight-bearing than NMES once daily.
Background: Studies of elite adult athletes have generally shown similar injury patterns on artificial turf (AT) and natural grass (NG). Since widely ranging physical, mental, cognitive, behavioral, and social development occurs during childhood and adolescence, we propose that the influence of playing surfaces on childhood and adolescent athlete injury characteristics might differ. Objective: This scoping review compared childhood and adolescent athlete sport injuries on NG and AT to determine which surface was favored based on study conclusions. Eligibility Criteria: A broad range of studies were included with a requirement that mean participant age was between 9-25 years and that evaluated musculoskeletal or concussion injuries having occurred on either NG or AT. Sources of Evidence: The PubMedD, Embase, and Web of Science databases were searched using the search terms “adolescent and sports injury and natural grass or artificial turf”. Only English language studies were included. Review and meta-analysis, clinical, biomechanical, training performance/physiology, dissertations and theses, meeting abstracts, case reports, case series, editorials/commentaries/letters to the editor were excluded. The primary investigator reviewed each study that was identified as having involved childhood or adolescent-age athletes. Charting Methods: Publication year, country of origin, subject number, age, gender, study purpose, study methods, key study findings, study conclusion, and whether or not NG or AT was favored information was extracted. Results: After screening, 46 studies contributed to this review. Overall, 26 studies (56.5%) favored NG, eight studies favored AT, and 12 reported no differences between playing surfaces. From the late childhood to young adulthood developmental period, study conclusions suggest that a NG surface was favored for reducing sports injury risk. Conclusions: Athletes who perform on NG from late childhood to late adolescence may experience better musculoskeletal and concussion injury prevention.
Background: The occurrence of work-related musculoskeletal disorders (WMSDs) due to workplace factors is not well described in bread making workers, an understudied population globally. However, the task is very repetitive and exhaustive in nature. Objective: To evaluate the prevalence of work-related musculoskeletal disorders and its associated risk factors among bread making workers. Methods: WMSD symptoms in past 12 months using a self-modified musculoskeletal questionnaire (Nordic Questionnaire), were assessed in 229 bread making workers from District Aligarh, Uttar Pradesh, India. Chi-square tests and binary logistic regression were performed to analyze associations of MSD related to task variables. Results: The results showed 149 (65.1%) participants reported MSD symptoms with prevalence in shoulder (n = 107, 46.7%), buttock (n = 87, 37.9%) and lower arm (n = 69, 30.1%). Duration of heat exposure per day significantly affects lower arm region (p = 0.027), hand (p = 0.032) and lower back (p = 0.029). Types of equipment significantly affected hand, neck, and shoulder discomfort (p <0.05). Workers involved in making both dough and bread were at higher risk of discomfort in middle back (OR = 2.106) and thighs (OR = 2.022). Workers using tandoor (fire pits) were at higher risk of discomfort in shoulder (OR = 1.541) and upper arm (OR = 2.61). Conclusion: The results showed a high prevalence of WMSD among bread making workers, with the shoulder, buttock and lower arm being the most affected body parts. Exposure of this workforce to ergonomic hazards and WMSDs increases the urgent need for public policy to address work strategies that protect workers and place this issue at the top of occupational health priorities.
Objectives: Diagnosis of distal myopathies is challenging. Muscle magnetic resonance imaging (MRI) is an increasingly recognized tool for diagnosis and follow-up of muscle diseases. Given the rarity of these diseases, the unique MRI pattern of their muscle involvement remains unclear. Materials and methods: We conducted a comprehensive search in PubMed, Scopus, and Google Scholar Library to identify English-language case reports and case series studies of different myopathies published between January 2000 and September 2024. The type of gene mutation in patients, their MRI findings, including regions imaged, muscles involved and spared, and the Mercuri scoring system for assessing the fat infiltration, were extracted from the studies. Results: Thirty-four studies consisting of 6 mutations were analyzed. The tibialis anterior was the most severely compromised muscle in myosin heavy chain-7 (MYH7), titin (TTN), glucosamine (UDP-N-acetyl)-2-epimerase/N-acetylmannosamine kinase (GNE), and dysferlin (DYSF) mutations. Extensor digitorum was in second place in TTN-associated myopathy. Hamstring muscles and gastrocnemius medial heads were moderately affected in GNE and DYSF cases, while vastus muscles and calf muscles were severely involved in adenylosuccinate synthase 1-related myopathies (ADSSL1). In matrin-3 (MATR3) mutation cases, the gastrocnemius and semimembranous muscles had the most pronounced fat infiltration. Conclusion: We defined unique patterns for different myopathies that can be implemented in the initial clinical assessment of patients with distal myopathy. We advise further studies with a larger number of patients.
Objectives: This study aimed to clarify changes in the range of motion and joint stiffness following joint immobilization and remobilization using a rat knee joint contracture model. Methods: Male Wistar rats were divided into two immobilization groups (knee joint immobilization for 4 or 8 weeks), two remobilization groups (immobilization followed by an equivalent period of remobilization), and two age-matched control groups (normal rearing). After the rearing period, each group was allowed to extend the knee joint until a torque value of 120 mNm was reached. Torque curves were then created from the data collected, and the knee extension angles and slope of the approximate straight line of the linear region were compared between the groups. Results: At 8 weeks, the knee extension angle at 10 and 30 mNm differed significantly between the three groups, with the immobile group having the lowest value, followed by the remobilized and control groups. Although knee extension angles at other torque levels and at 4 weeks were significantly lower in the immobile and remobilized groups than in the control group, no significant differences were observed between the immobile and remobilized groups. The slope of the linear region differed significantly between the three groups at 4 and 8 weeks, with the immobile group having the lowest values, followed by the remobilized and control groups. Conclusions: Joint immobilization caused the torque curve to begin its linear region at an earlier stage, with a slower slope. Remobilization over the same duration did not sufficiently improve these changes.
The present study aimed to analyze the association between ratings of perceived exertion (RPE) and the responses of muscle hypertrophy and maximal dynamic strength after a period of resistance training. For this purpose, ten healthy, untrained adult women underwent 12 weeks of knee extension training, performing 3–6 sets of seven repetitions at 60% of one-repetition maximum (1 RM) with a three-minute rest between sets. At the end of the last set, the RPE (Borg scale: 6-20) was reported. Before and after the training period, the cross-sectional areas (CSA) of the vastus lateralis (VL), vastus intermedius (VI) and rectus femoris muscle (RF) were measured and summed, and maximal dynamic strength was assessed using the 1 RM test. Spearman’s correlation coefficient was used to verify the relationship between the percentage changes in individual and summed muscles CSA (CSA_summed), as well as 1 RM performance, and the median RPE reported by participants across the training sessions. The results indicated a weak and non-significant relationship between RPE and hypertrophy of VL (p = -0.050; p = 0.892), VI (p = 0.186; p = 0.607), and RF (p = 0.235; p = 0.513), as well as the CSA_summed (p = 0.242; p = 0.501). Likewise, no significant correlation was observed between RPE and maximal strength gains (p = 0.025; p = 0.946). Thus, under the present exploratory conditions, no clear association was detected between RPE and hypertrophy or strength outcomes, suggesting that RPE may not be a reliable predictor of chronic adaptations in untrained women.
Sports hernias (SH), more correctly defined as weakness of the posterior wall of the inguinal canal, play a major role in the etiopathogenesis of groin pain syndrome (GPS). Important and indisputable anatomical reasons do not justify the application of conservative treatments, which are, nonetheless, still often recommended. This study analyzes both the anatomy of the inguinal canal and the imaging examination that allows a correct definition of SH and clarifies why, SH necessarily requires surgical treatment at least in professional athletes.
Background: Pelvic floor muscle training (PFMT) is widely recommended for managing urinary incontinence (UI), especially in aging populations. However, the evidence of neuromuscular function following PFMT remains limited. The objective of this study is to investigate the improvement in neuromuscular function after PFMT and assess potential differences based on participants’ age. Method: A systematic review and meta-analysis were conducted by screening randomized controlled trial (RCTs) studies. The selection of studies followed inclusion and exclusion criteria. Subgroup analyses were performed to compare outcomes between studies with the middle-age and elderly group. Meta-analysis was conducted using RevMan 5.4.1 software. Results: A total 10 RCT studies were included, total participants, number of the middle-age & elderly subgroup. Analyses on the middle-age subgroup, PFMT significantly improved pelvic floor muscle strength (MD = -0.53; 95% CI: -1.04 to -0.03; p = 0.04; I2 = 58%). In contrast, elderly subgroups showed non-significant (MD = -3.36; 95% CI: -6.83 to 0.12; p = 0.06; I2 = 97%). Conclusion: PFMT intervention shows effectiveness in increasing pelvic floor muscle strength in adults 45-59 years old (middle-age group). Meanwhile, the elderly subgroups (> 60 years old) did not show a statistically significant benefit, which may be influenced by number of subjects in subgroup and high number of vaginal delivery factors. Additionally, high heterogeneity in elderly subgroups emphasized the need for more targeted and high-quality RCTs that focus specifically on elderly populations.
