Rotator cuff pathologies involving supraspinatus are a common cause of musculoskeletal morbidity and can lead to significant disability affecting the overall quality of life. Architectural parameters of the muscle directly influence its functional properties. Therefore, understanding of fiber bundle changes with surgery and different exercises can assist clinicians in planning better surgical and shoulder rehabilitative protocols. The first objective of this thesis was to systematically review human cadaveric studies of the normal supraspinatus architecture and highlight the key aspects that should be considered while performing studies of skeletal muscle architecture. The second objective was to understand the impact of surgical repair on the structural and functional recovery of the supraspinatus. The final objective was to provide a scientific rationale behind choosing an exercise to strengthen supraspinatus by investigating its muscle architecture. Study 1 systematically reviewed human cadaveric studies of the normal supraspinatus architecture. Results showed that the overall quality of majority of included is poor and there was a large range in the reported architectural values of the entire muscle. In conclusion, there were only a few studies providing the level of detail and quality suitable for advancing our understanding of shoulder biomechanics. Study 2 quantified and compared the fiber bundle architecture of the pathologic supraspinatus pre- and post-operatively at multiple time points. Results showed significant lengthening of fiber bundles after one month of surgery which then decreased significantly by 6 months of surgery. In contrast, an initial decrease followed by an increase in pennation angle overtime was found. The results suggest that the stretching applied to the tendon and muscle during repair could affect the length-tension relationship of the muscle, which in turn can compromise its function and may lead to inferior surgical outcomes. Study 3 compared the efficacy of three commonly prescribed supraspinatus strengthening exercises in the rehabilitation setting based on the architectural changes following resistance training. Results showed there was no change in FBL and increased strength after resistance training with prone horizontal abduction exercise. Findings suggest that prone horizontal abduction may be a more suitable exercise to strengthen supraspinatus.

Submitted by Ronildo Prado (ronisp@ufscar.br) on 2016-09-21T19:00:11Z No. of bitstreams: 1 DissGHRC.pdf: 1218495 bytes, checksum: fb017af87bda85cd4fb78f46ec458e37 (MD5) / Approved for entry into archive by Ronildo Prado (ronisp@ufscar.br) on 2016-09-21T19:00:52Z (GMT) No. of bitstreams: 1 DissGHRC.pdf: 1218495 bytes, checksum: fb017af87bda85cd4fb78f46ec458e37 (MD5) / Approved for entry into archive by Ronildo Prado (ronisp@ufscar.br) on 2016-09-21T19:01:01Z (GMT) No. of bitstreams: 1 DissGHRC.pdf: 1218495 bytes, checksum: fb017af87bda85cd4fb78f46ec458e37 (MD5) / Made available in DSpace on 2016-09-21T19:01:08Z (GMT). No. of bitstreams: 1 DissGHRC.pdf: 1218495 bytes, checksum: fb017af87bda85cd4fb78f46ec458e37 (MD5) Previous issue date: 2014-09-04 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Menopause is highly associated with the increase of several metabolic disorders. In addition menopause promotes accelerated loss of muscle strength and mass, process known as sarcopenia, generating a deleterious role in the performance of physical functions. In this sense, resistance training has been recommended for the treatment of numerous diseases associated with menopause, as well as sarcopenia, as a nonpharmacological intervention. The aim of this study was to investigate the effects of the resistance training using the vertical ladder as a model on the muscle cross-sectional area and the percentage of muscle fiber types in the plantaris muscle of intact or ovariectomized rats and/or under hormone reposition therapy. Holztman adult female rats were distributed in 7 groups: Sham operated sedentary (Sham-Sed), Sham operated resistance trained (Sham-Tr), Ovariectomized sedentary (Ovx-Sed), Ovariectomized resistance trained and hormone reposition (Ovx-Tr-TRH), Ovariectomized sedentary and hormone reposition (Ovx-TRH), Ovariectomized resistance trained (Ovx-Tr), Ovariectomized and placebo reposition (Ovx-TRH-Pl). During a 12-week resistance training the animals climbed the vertical ladder of 1.1m with weights attached to their tails. Each session was carried out every 72 hours with 4-9 climbs. The ovariectomy promoted a reduction in cross-sectional area of the type I and II fiber when compared to Sham-Sed group, whereas the resistance training in the ovariectomy (Ovx-Tr group) was able to increase the cross-sectional area of the two fiber types (p<0.05). Moreover, TRH did not prevent the reduction of cross-sectional area of the type II fiber however it attenuated the reduction in cross-sectional area of type I fiber. The ovariectomy, hormone reposition and resistance training had no effect into promote alterations in the absolute number of muscle fiber types of the plantaris muscle and there was no correlation in the percentage of fiber muscle types. Our results indicate that resistance training can be a useful tool to prevent skeletal muscle mass reduction induced by ovariectomy. / A menopausa está associada ao risco aumentado de várias alterações metabólicas. Além disso, promove perda acelerada de massa e força muscular, em um processo de sarcopenia, gerando um papel deletério no desempenho de funções físicas. Nesse sentido, o treinamento resistido, como intervenção não farmacológica, vem sendo recomendado para o tratamento de várias doenças associadas à menopausa bem como a sarcopenia. O objetivo deste estudo foi verificar os efeitos do treinamento resistido em escada sobre a área de secção transversa e porcentagem dos tipos de fibras do músculo plantar de ratas intactas ou ovariectomizadas, e/ou submetidas à reposição hormonal. Foram utilizadas 77 ratas Holztman divididas em 7 grupos: Sham operado sedentário (Sham-Sed); Sham operado treinado (Sham-Tr); Ovariectomizado sedentário (Ovx- Sed); Ovariectomizado treinado e com terapia de reposição hormonal (Ovx-Tr-TRH); Ovariectomizado sedentário com terapia de reposição hormonal (Ovx-TRH); Ovariectomizado treinado (Ovx-Tr); e Ovariectomizado com reposição placebo (Ovx- TRH-Pl). Um período de 12 semanas de treinamento resistido foi realizado, durante o qual os animais subiram uma escada vertical de 1,1 m com pesos atados na cauda. As sessões foram realizadas a cada 72 horas, com 4-9 subidas. Foi possível observar que a Ovx promoveu uma redução da área de secção transversa das fibras tipo I e tipo II em relação ao grupo Sham-Sed, enquanto que o TR na condição de Ovx (grupo Ovx-TR) foi capaz de aumentar a área de secção transversa dos dois tipos de fibras (p<0,05). Além disso, a TRH adotada não preveniu a redução da área de secção transversa das fibras tipo II, mas atenuou a redução da área de secção transversa das fibras tipo I. A Ovx, a TRH e o Tr não promoveram alterações com relação ao número absoluto dos tipos de fibras encontradas no músculo plantar e não ocorreu nenhuma correlação relevante na porcentagem dos tipos de fibras musculares. Nossos achados indicaram que o Tr pode ser uma ferramenta importante na prevenção da redução da massa do músculo esquelético induzida pela Ovx.

Submitted by Izabel Franco (izabel-franco@ufscar.br) on 2016-10-11T18:40:53Z No. of bitstreams: 1 DissSRN.pdf: 925824 bytes, checksum: a11a80cba1cb31584bc593e3626fd32d (MD5) / Approved for entry into archive by Marina Freitas (marinapf@ufscar.br) on 2016-10-21T13:07:55Z (GMT) No. of bitstreams: 1 DissSRN.pdf: 925824 bytes, checksum: a11a80cba1cb31584bc593e3626fd32d (MD5) / Approved for entry into archive by Marina Freitas (marinapf@ufscar.br) on 2016-10-21T13:08:02Z (GMT) No. of bitstreams: 1 DissSRN.pdf: 925824 bytes, checksum: a11a80cba1cb31584bc593e3626fd32d (MD5) / Made available in DSpace on 2016-10-21T13:08:10Z (GMT). No. of bitstreams: 1 DissSRN.pdf: 925824 bytes, checksum: a11a80cba1cb31584bc593e3626fd32d (MD5) Previous issue date: 2016-04-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Resistance training (RT) is the main method to promote increases in muscle strength and hypertrophy, in which loads higher than 60% of one repetition maximum (1-RM) are commonly recommended. Other studies suggest performing RT to the point of muscle failure, which can be defined as the inability to move a load beyond a critical angle or as the inability to complete a repetition in a full range of motion due to fatigue, in order to maximize strength gains and hypertrophy. However, it is still unclear if RT to muscle failure is really necessary. Thus, the aim of this study was to discuss the effects of RT to failure on motor units (MUs) recruitment and adaptive responses, providing arguments to how RT to failure might differently affect muscle adaptations on different populations. In conclusion, evidence regarding untrained individuals suggests that high-intensity RT (HIRT) to failure is not necessary for maximal increases in strength and mass. On the other hand, performing RT to failure might be necessary for optimal increases in strength and mass when training at low intensities (LIRT). Regarding trained individuals, evidence point greater strength gains when HIRT is performed to failure. Nonetheless, muscle failure seems to be an interesting strategy when it comes to optimizing hypertrophy gains for trained individuals. / O treinamento de força (TF) é o principal método de exercício utilizado para promover aumentos na força e massa muscular esquelética, onde cargas superiores a 60% de uma repetição máxima (1-RM) são comumente recomendadas. Outros estudos sugerem que, para maximizar os aumentos na força e hipertrofia muscular, sejam realizadas repetições até a falha muscular, definida como a incapacidade de mover uma carga específica além de um ângulo crítico ou como a incapacidade de completar uma repetição na amplitude de movimento completa devido à fadiga. Contudo, ainda não está claro se o TF até a falha é realmente necessário. Assim, o objetivo deste estudo foi discutir os efeitos do TF até a falha no recrutamento de unidades motoras (UMs) e respostas adaptativas, fornecendo argumentos do por que o TF até a falha afetar diferentemente as adaptações musculares em diferentes populações. Em conclusão, as evidências acerca dos indivíduos destreinados parecem sugerir que o TF de alta intensidade (TFAI) até a falha muscular não é necessário para ganhos máximos na força e hipertrofia. Em contrapartida, realizar repetições até a falha parece essencial para que o TF de baixa intensidade (TFBI) resulte em aumentos significativos na força e massa muscular. Já para indivíduos treinados, as evidências apontam maiores ganhos de força no TF de alta intensidade até a falha. Porém, a falha muscular parece uma estratégia interessante na otimização dos ganhos hipertróficos de indivíduos treinados.

Apesar das perdas provocadas pela sarcopenia, o sistema neuromuscular do idoso ainda mantém parte da sua plasticidade. No entanto, as adaptações promovidas pelos treinamentos de força (TF) e de potência (TP) não foram totalmente elucidadas, assim como se existem diferenças entre essas adaptações nessa população. Para responder tais questões, 43 idosos (63,8 ± 4,0 anos; 67,2 ±13,4kg e 160,2 ±8,4cm), inexperientes em treinamento com pesos e independentes participaram desse estudo. Os voluntários foram distribuídos em três grupos: GF (n= 14; 70 a 90% de 1RM), GP (n= 16; 30 a 50% de 1RM) e GC (n= 13, não treinou). Durante 16 semanas o GF e o GP realizaram duas sessões de treino semanalmente. Os resultados significantes foram: aumento de 42,7% em GF e 33,8% em GP no teste de 1RM (leg press) e 31% em GF e 25,4% em GP (chest press); aumento de 6% em GF e 3,6% em GP na ASTq; aumento de 22,4% em GF e 17,1% em GP na CVIM e uma diminuição de 28% em GF e 32% em GP no REM. Não houve diferenças significativas entre GF e GP nas variáveis analisadas. Nenhum dos grupos apresentou aumento no sinal eletromiográfico nem na TDF. Não houve alteração significativa na funcionalidade. Portanto, ainda que com características distintas, o TF e o TP são similares em relação às adaptações analisadas, equiparando-se como estratégias de treinamento eficazes no combate à sarcopenia e seus efeitos / In spite of sarcopenia-induced losses, elderly peoples neuromuscular system keeps its plasticity. However, strength and power training-induced adaptations have not been completely elucidated. It also unknown if these adaptations are related to elderly functionality. Fourty three healthy and independent old men and women (63.8 ± 4.0 yrs; 67.2 ±13.4kg e 160.2 ±8.4cm) with no resistance training experience volunteered for this study. Participants were randomly distributed into three groups: GF (n= 14; 70 - 90%-1RM), GP (n= 16; 30 - 50%-1RM) e GC (n= 13, no training). GF and GP trained twice a week for 16 weeks. Leg-press (42.7% in GF and 33.8% in GP) and chest-press 1-RM (31% in GF and 25.4% in GP), quadriceps cross sectional area (6% in GF and 3.6% in GP), maximal voluntary isometric contraction (22.4% in GF and 17.1% in GP) were significantly increased in both groups. Electromechanical delay decreased 28% in GF and 32% in GP. There were no significant differences between groups. EMG and rate of force development did not change throughout the training period. Only main effect of time was observed for the functional tests. These results suggest that even with different characteristics, both strength and power training induce similar neuromuscular adaptations. Thus, both training regimens are equally effective in preventing and treating sarcopenia

Background: Low back pain (LBP) is often associated with lumbar spinal instability (LSI). The multifidus muscle is considered a stabilizer of the spine and has been studied extensively with Rehabilitative Ultrasound Imaging (RUSI). There may be a relationshipbetween clinical signs of LSI, decreased cross-sectional area (CSA) of the multifidus and weakness. Having the ability to detect multifidus weakness without the use of RUSI may serve to be invaluable to the clinician in detecting multifidus weakness.Purpose: To investigate the relationship between the modified prone straight leg raise test (MPSLR) and CSA of the multifidusmuscle as measured by RUSI and to investigate the relationship between MPSLR and RUSI findings with the presence of low back pain symptoms that interfere with regular daily activities. Subjects: Participants consisted of two groups of subjects. One group (n=30, 87% male) comprised individuals in general good health, aged 18-55, without history of back pain. The second group (n=36, 56% male) comprised individuals aged 18-55, with history of low back pain within the past 12 months. Methodology: Subjects performed a MPSLR test to identify multifidus weakness. All subjects repeated the same test with concurrent RUSI to visualize the multifidusand measure its CSA. Results: A significant association between a positive MPSLR, asymmetry of the multifidus, and pain was observed (p r = .049, p = .696) was not observed. A sensitivity of 94% and a specificity of 63% was also discovered in the ability of the MPSLR test to detect asymmetry of themultifidus muscle within subjects. A positive MPSLR combined with a high Oswestry score of 25-30 further reinforced the probability of pain (p < .001) Conclusion: The MPSLR test demonstrated a strong association between a positive test and asymmetry of themultifidus muscle within subjects. Clinical Relevance: The MPSLR test can be used to identify patients at risk for LBP symptoms due to asymmetrical changes in the multifidus muscle of the lumbar spine, and aid in directing an appropriate rehabilitation approach to those patients in need of specific multifidus exercise prescription.

Median Nerve Ultrasonography Examination Correlates for the Diagnosis of Moderate to Severe Carpal Tunnel Syndrome Objective: The aim of the study was to investigate the associations of cross-sectional area (CSA) of the median nerve measured by ultrasonography (US), the median to ulnar nerve ratio (MUR), the median to ulnar nerve difference (MUD) and the ratio of CSA of the median nerve to height squared (MHS) in relation to electrodiagnostic classification of moderate and severe carpal tunnel syndrome (CTS) and thus to identify patients suitable for surgical treatment. Materials and Methods: A prospective study was conducted in patients aged ≥ 18 years who underwent both median and ulnar nerve US and electrodiagnostic studies (EDS). 124 wrists of 62 patients were examined. The patients' characteristics were acquired through a questionnaire. CTS was diagnosed using EDS and classified according to the guidelines of the Czech Republic Association of Electrodiagnostic Medicine. The CSA of the median nerve and of the ulnar nerve were measured at the carpal tunnel inlet, i.e. at the level of the pisiform bone. Results: The median nerve swells at the wrist in CTS. Median nerve CSA at the tunnel inlet ≥ 12mm2 correlates with electrodiagnostic classification of moderate to severe carpal tunnel syndrome. At...

In this study, we examined how hill running affects the Achilles tendon, which is a common location for injuries in runners. Twenty females ran for 10 min on three randomly selected grades (-6%, 0%, +6%). Achilles tendon (AT) cross-sectional area (CSA) was imaged using Doppler ultrasound and peak vertical forces were analyzed using high-speed (240 Hz) videography. A metabolic cart and gas analyzer ensured a similar metabolic cost across grades. Data were analyzed using a forward selection regression. Results showed a decrease in AT CSA from pre-run to post-run (p = .0001). Peak vertical forces were different across grades (p = .0001) with the largest occurring during downhill running and smallest during uphill running. The results suggest that the Achilles tendon is affected by running and a decrease in CSA appears to be a normal response. The AT CSA does not differ between grade conditions when metabolic cost of running is matched, suggesting an adaptive effect of the AT. Coaches and athletes can use this knowledge to develop workout protocols that transition runners to downhill running and allow them to adapt to these greater forces.

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Purpose: To determine if jumping-performance changes during a peaking phase differed among returners and new players on a female collegiate volleyball team and to determine which variables best explained the variation in performance changes. Methods: Fourteen volleyball players were divided into 2 groups—returners (n = 7) and new players (n = 7)—who completed a 5-wk peaking phase prior to conference championships. Players were tested at baseline before the preseason on measures of the vastus lateralis cross-sectional area using ultrasonography, estimated back-squat 1-repetition maximum, countermovement jump height (JH), and relative peak power on a force platform. Jumping performance, rating of perceived exertion training load, and sets played were recorded weekly during the peaking phase. Results: There were moderate to very large (P < .01, Glass Δ = 1.74) and trivial to very large (P = .07, Δ = 1.09) differences in JH and relative peak power changes in favor of returners over new players, respectively, during the peaking phase. Irrespective of group, 7 of 14 players achieved peak JH 2 wk after the initial overreach. The number of sets played (r = .78, P < .01) and the athlete’s preseason relative 1-repetition maximum (r = .54, P = .05) were the strongest correlates of JH changes during the peaking phase. Conclusions: Returners achieved greater improvements in jumping performance during the peaking phase compared with new players, which may be explained by the returners’ greater relative maximal strength, time spent competing, and training experience. Thus, volleyball and strength coaches should consider these factors when prescribing training during a peaking phase to ensure their players are prepared for important competitions.