Journal of Functional Morphology and Kinesiology最新文献

Background: Heart failure with reduced ejection fraction (HFrEF) markedly impairs quality of life (QoL) and life expectancy. The main therapeutic goals are to reduce mortality, improve functional capacity, and enhance QoL. Exercise training is an evidence-based, non-pharmacological component of standard care that improves functional capacity and clinical outcomes in HFrEF. This review examines the effects of endurance and resistance training on peak oxygen uptake (VO₂peak), ventilatory efficiency (VE/VCO₂ slope), health-related QoL, and cardiovascular outcomes in patients with HFrEF. Methods: A structured narrative review was conducted using comprehensive searches of PubMed, EMBASE, and the Cochrane Library for English-language studies published between January 2004 and October 2024. Eligible studies included adult HFrEF populations undergoing aerobic and/or resistance training with reported effects on VO₂peak, ventilatory efficiency, QoL, or clinical outcomes. Given the heterogeneity of interventions, comparators, and outcome metrics, data were synthesized descriptively. Results: Across 18 studies (plus one sub-analysis) including 3401 patients, 17 trials assessed VO₂peak and 16 reported significant improvements, with an average increase of approximately 2 mL·kg^-1·min^-1. Six studies assessed ventilatory efficiency, and five demonstrated reductions in VE/VCO₂ slope averaging 4.4 units. Eleven studies analyzed QoL, and nine reported significant improvements corresponding to an ≈5-point decrease in the Minnesota Living with Heart Failure Questionnaire (MLHFQ). In the largest trial, exercise training was associated with modest but statistically significant reductions in all-cause mortality or hospitalization (HR 0.89) and cardiovascular mortality or heart-failure hospitalization (HR 0.85) after adjustment for baseline prognostic factors. Conclusions: Structured exercise training improves aerobic capacity, ventilatory efficiency, and QoL in patients with HFrEF, with supportive evidence for reduced morbidity and mortality. These findings underscore the value of structured exercise as a core component of modern HFrEF management.

Background: Osteoporotic vertebral fractures in the thoracic-lumbar spine are common in older adults and can lead to pain, kyphotic posture, impaired postural control, and altered gait. These changes increase the risk of falls and reduce functional mobility, highlighting the need for effective assessment and intervention strategies. Objectives: To analyze stability and gait in patients who sustained a thoracic-lumbar spinal fracture and underwent minimally invasive surgery. Methods: Seventeen patients participated in this study (women = 11, age 68.36 ± 6.15 years, body weight 68.18 ± 12.8 kg, height 161.45 ± 5.26 cm; men = 6, age 62.67 ± 4.41 years, body weight 78.5 ± 20.36 kg, height 176.67 ± 12.64 cm). All participants had undergone minimally invasive spinal surgery using percutaneous screws reinforced with bone cement 12 months prior. Each patient underwent two assessments: postural stability measurement and biomechanical gait analysis. Statistical analysis was performed using Statistica software (StatSoft, PL), with significance set at p < 0.05. Results: In the stability test, seven participants could not complete the measurement due to falls (FRT = 6.45 ± 2.43), six performed within the normal range (FRT = 2.41 ± 0.9), and four were below the normal range for their age group (FRT = 2.22 ± 1.7). Patients exhibited slower walking speed, shorter stride length, and reduced hip extension during the stance phase (approximately 5° less) due to a forward-leaning posture and cautious gait. Foot placement was flat rather than heel-first, likely as a compensatory strategy to enhance safety. Conclusions: Patients after osteoporotic thoracic-lumbar vertebral fractures treated with minimally invasive surgery demonstrate shorter, wider, and slower steps, along with reduced postural stability, indicating a persistent risk of forward falls.

Background: This study examined nutritional intake, body composition, menstrual health, and performance in elite female trail runners. Methods: A cross-sectional multivariate analysis was conducted on 35 athletes (14 eumenorrheic, 21 amenorrheic/oligomenorrheic). Nutritional intake was assessed through 7-day and 24 h food records; anthropometry followed ISAK standards; performance was evaluated via ITRA and UTMB rankings. Statistical analyses included t-tests, MANCOVA, regression models, and Random Forest, adjusting for body composition and covariates. Results: Although energy availability (EA) did not differ significantly between groups, 94.3% of athletes had clinically low EA (<30 kcal/kg FFM/day). Amenorrheic athletes consumed more simple carbohydrates (21.8 ± 5.7% vs. 17.2 ± 3.1%), protein (2.5 ± 0.6 vs. 1.7 ± 0.2 g/kg/day), fiber, and lipids, while eumenorrheic athletes consumed more complex carbohydrates (129.7 ± 27.0 vs. 82.5 ± 33.3 g/day) and most vitamins. Both groups had inadequate calcium and iron intake. Low EA was moderately associated with an ectomorphic somatotype (r = 0.418). Performance negatively correlated with simple carbohydrates (r = -0.624) and positively with complex carbohydrates, total energy, protein, polyunsaturated fats, and zinc (r = 0.300-0.580). No significant performance differences were found between menstrual status groups. Conclusions: Menstrual irregularities did not affect performance, but nutritional patterns strongly influenced both performance and energy availability. Personalized nutrition strategies are essential for optimizing performance and safeguarding health in elite female trail runners.

Background: Functional electrical stimulation (FES) is widely used in post-stroke rehabilitation to restore motor activity and improve walking. However, the immediate effects of a single FES session on gait biomechanics and muscle activity remain insufficiently studied. This pilot study aimed to evaluate the direct neuromotor effects of a single multichannel FES session during walking in patients with post-stroke hemiparesis. Methods: Eight patients with hemiparesis in the early or late recovery period after ischemic stroke underwent gait biomechanics and electromyography (EMG) assessment before and immediately after a single 30 min FES session. FES was applied to the tibialis anterior, gastrocnemius, quadriceps femoris, and hamstring muscles of the paretic limb during walking, synchronized with gait phases. Spatial-temporal, kinematic, and EMG parameters were recorded using an inertial system. Pre- and post-intervention data were compared using paired tests (a paired t-test or the Wilcoxon signed rank test, p < 0.05), while the standardized effect sizes (Cohen's d) were calculated for all pre-post comparisons. Results: A significant decrease was observed in the single support phase of the paretic limb after FES (p < 0.05). Knee joint movement amplitude increased significantly in the nonparetic limb. Surface EMG amplitudes decreased in the tibialis anterior of the nonparetic limb and in the hamstring and gastrocnemius of the paretic limb (p < 0.05). No significant changes were detected in overall gait speed, rhythm, or phases of muscle activity peaks. Conclusions: A single session of multichannel FES induces neuromotor changes reflected by redistribution of muscle activity and compensatory adjustments in gait biomechanics without immediate improvement in global kinematic parameters. The direct biomechanical changes in the gait function can be interpreted as evidence of the onset of fatigue. The procedure demonstrated good tolerability and safety, confirming its feasibility for early post-stroke rehabilitation.

Objectives: The acromiohumeral distance (AHD) is widely used to evaluate subacromial pathology, particularly rotator cuff-related disorders. However, substantial heterogeneity exists across studies in imaging protocols, measurement definitions, and diagnostic thresholds. This systematic review aimed to synthesize current evidence on AHD measurement methods, assess reliability and diagnostic performance across imaging modalities, and examine the clinical relevance of AHD as both a structural and functional biomarker. Methods: A systematic search of PubMed, Web of Science, and SciELO (January 2006-May 2025) was conducted following PRISMA 2020. Eligible studies reported quantitative AHD measurements using ultrasound, MRI, or radiography in adults. Two reviewers independently conducted screening, extraction, and QUADAS-2 assessments. Due to heterogeneity, results were narratively synthesized. Results: Twenty-nine studies met the inclusion criteria. Definitions of AHD and imaging procedures varied substantially. Ultrasound showed the most consistent intra- and inter-observer reliability, whereas MRI and radiography demonstrated greater protocol-dependent variability. Reduced AHD values were frequently associated with full-thickness rotator cuff tears, while larger values typically characterized asymptomatic individuals. Several studies also reported reductions in AHD during arm elevation, supporting its interpretation as a functional parameter influenced by scapular motion and neuromuscular control. Conclusions: AHD is a reliable and clinically informative measure when acquired using standardized protocols, with Ultrasound demonstrating the highest reproducibility. Its sensitivity to positional and dynamic factors supports its role as both a structural and functional biomarker. Further research should prioritize standardized imaging procedures, dynamic assessment methods, and evaluation of emerging technologies to improve the diagnostic and prognostic value of AHD.

Background: Motor competence (MC) is defined as the ability to perform a wide range of motor skills with proficiency and control. The present quasi-experimental study design examines the impact of two structured intervention programs on MC in children who practiced athletics at the same club, aged 6 to 10 years, implemented over 12 weeks. Methods: The sample consisted of 64 children, assigned to two intervention groups: Intervention Group A (IG_A) composed of 15 male and 17 female children (9.57 ± 0.86 years) and Intervention Group B (IG_B), of 14 male and 18 female children (9.08 ± 1.33 years). IG_A received athletics-based training exclusively, three times per week, while IG_B undertook two weekly athletics sessions and one complementary activity session, such as handball, gymnastics, swimming, and motor games. MC was assessed using the modified Körperkoordinationstest für Kinder (KTK3+). The KTK3+ consists of three original KTK tasks, [Backward Balance (BB), Sideways Moving (MS), and Jumping Sideways (JS)] and an additional Eye-Hand Coordination (EHC) task. For statistical analysis, ANOVA repeated measures 2 × 2 was used. Results: In relation to JS, the performance on this test did not change with the intervention programs in either of the two groups. For BB and MS, both groups improved their performances in a similar way through the program implementation. Differently, for EHC, results showed that only IG_B improved its performance significantly (p < 0.001) with the program's intervention, with a large Cohen's d effect size (0.84). Finally, as a general analysis, the KTK3+ raw results (RS) and results translated to Global Motor Quotient (GQM), revealed significant differences between IG_A and IG_B post-intervention, with p < 0.001 for both variables' comparison and with large Cohen's d effect sizes for both (1.581 for RS and 1.595 for GQM), favoring IG_B. Conclusions: Both programs led to improvements in the various KTK3+ battery tasks. However, only the program that combined athletics training with multiactivity training led to significant improvements in the EHC test and in the overall KTK3+ results of the children involved.

Background: Physical function, muscle strength, and fatigue are often impaired in patients with multiple sclerosis (MS). This study aimed to assess these parameters and their associations. Methods: This cross-sectional study included patients with relapsing-remitting MS. Physical function was assessed using the dynamic gait index (DGI), two-minute walk test (2MWT), and Expanded Disability Status Scale (EDSS). Muscle strength and fatigue were assessed using a load cell (measured in kgf). Generalized linear models (GLMs) with log link and gamma distribution examined the associations between MS and physical function, muscle strength, and fatigue. In the MS group, GLMs explored links between fatigue, muscle strength, and physical function. Results: Forty-seven individuals participated (18 MS; 27 controls). Patients with MS showed reduced physical function and muscle strength, and higher fatigue. Knee extension fatigue was associated with DGI (Exp β = 0.23; p = 0.03), 2MWT (Exp β = 0.11; p = 0.02), and EDSS (Exp β = 17.17; p < 0.0001); knee flexion fatigue was associated with EDSS (Exp β = 2.45; p = 0.006). Knee flexion and extension strength were also associated with EDSS. Conclusions: Patients with MS show reduced physical function and strength, increased fatigue, and knee muscle performance. The associations between strength, fatigue, and functional outcomes varied in magnitude, with knee-related measures, especially knee extension fatigue, showing the most consistent relationships.

Background: Differences in total daily energy expenditure (TDEE) across sports, sex, and skill level support the need for sport- and athlete-specific energy intake recommendations. The purpose of the current review was to examine TDEE and related markers of energy expenditure across field-based team sports. A secondary aim was to evaluate physical activity levels (PAL), calculated as TDEE divided by resting metabolic rate (RMR), and their utility in estimating energy needs within team sports. Methods: The review was limited to studies that included the field-based team sports of rugby or soccer and reported energy expenditure data using doubly labeled water (DLW). A literature review identified 11 studies meeting criteria. Weighted means (Xw) and standard deviations (SDw) were calculated for each variable when pooled across each sport category. Results: Rugby (4417 ± 654 kcal·d^-1) had a higher average TDEE than soccer (3157 ± 331 kcal/day; p < 0.001). When normalized to body mass, rTDEE was similar between sports (rugby: 49.5 ± 1.3 kcal·kg^-1·day^-1; soccer: 49.3 ± 1.8 kcal·kg^-1·day^-1; p = 0.967). PAL values were significantly higher in rugby (2.2 ± 0.4) compared to soccer (1.7 ± 0.2; p = 0.004). RMR was also greater in rugby (2136 ± 322 kcal·d^-1) compared to soccer (1835 ± 208 kcal·d^-1; p = 0.04). Conclusions: Rugby athletes exhibited higher TDEE values than soccer athletes, reflecting greater absolute energy demands. However, similar relative TDEE values suggest that differences in body size and composition likely contribute to the observed differences in absolute expenditure. These findings underscore the importance of individualized nutrition strategies within team sports and highlight PAL as a useful metric to contextualize energy requirements.

Background: Current clinical practice still lacks consistent evidence in the physiotherapy management of rotator cuff-related pain syndrome (RCS). The purpose of this trial was to compare the effectiveness of a scapular-focused treatment with and without real-time electromyographic biofeedback (EMGBF) to a control therapy in patients with RCS, in the short-term. Methods: 60 patients with RCS were divided into three groups: the scapular-focused exercise protocol group (P_G n = 20), the scapular-focused exercise protocol with EMGBF group (P+EMGBF_G n = 20), and the control therapy group (CT_G n = 20). Values of pain and function [Shoulder Pain and Disability Index (SPADI) questionnaire, complemented by the Numeric Pain Rating Scale (NPRS) and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire], scapular stabilizer neuromuscular control (SSNC), scapular stabilizer activation onset (SSAO), dynamic scapular alignment, range of motion (ROM), and glenohumeral flexor and abductor muscle strength (GMS) were assessed at baseline and after 6 weeks and compared within and between groups. Results: There were significant differences in pain and function, SSNC, SSAO, dynamic scapular alignment, ROM, and GMS in all groups between the initial and 6-week assessments. However, the P+EMGBF_G showed superior results in pain and function, SSNC, and dynamic scapular alignment than the CT_G and superior results in SSNC than the P_G. The P_G had superior results in pain and function and dynamic scapular alignment than the CT_G. Conclusions: This trial supports the use of a scapular-focused exercise protocol as a comparative approach that effectively improves pain and function in patients with rotator cuff-related shoulder pain syndrome. These results in pain and function were shown to be independent of the use of EMGBF.

Background: Prolonged standing is common in industrial environments and may induce functional adaptations in the foot and postural system. This study aimed to evaluate short-term changes in foot posture and plantar pressure distribution after a working day in assembly line workers. Methods: Forty participants (31 males, 9 females; mean age 44 ± 7 years; BMI 26.1 ± 3.6 kg/m²) performed standing tasks during an 8 h shift. Static baropodometric measurements and 3D foot scans were obtained before and after the workday to assess plantar pressure, contact area, and arch height. The Spanish versions of the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) and the Foot Function Index (FFI) were used to evaluate discomfort and functional status. Paired t-tests were applied, and correlations were analyzed (p < 0.05). Results: Left-foot arch height decreased significantly after the workday (mean change = 0.6 mm; p = 0.027). Both mean and peak plantar pressures declined (p < 0.001), along with moderate reductions in contact area (p ≤ 0.05). The center of pressure shifted mediolaterally, and discomfort was most frequent in the lower back, knees, and feet. A positive correlation was found between arch height reduction and FFI score (r = 0.349; p = 0.028). Conclusions: Prolonged standing was associated with measurable adaptations in foot posture and plantar pressure, possibly indicating short-term fatigue or compensatory postural adjustments. These results emphasize the importance of assessing plantar load and foot morphology as indicators of potential functional responses to sustained standing and as possible targets for ergonomic and rehabilitation strategies.