Background. Chronic tension-type headache is the primary headache with the highest prevalence. The present study is aimed at analyzing the associations between patient self-efficacy and headache impact with pain characteristics, kinesiophobia, anxiety sensitivity, and physical activity levels in subjects with chronic tension-type headache. Materials and Methods. An observational descriptive study was carried out. A total sample of 42 participants was recruited at university environment with diagnosis of tension-type headache. Headache characteristics (frequency, intensity, and duration), physical activity levels, pain related-self-efficacy, kinesiophobia, anxiety sensitivity, and headache impact were measured. Results. The HIT-6 ( $61.05\pm 6.38$ ) score showed significant moderate positive correlations with the ASI-3 score ( $17.64\pm 16.22$ ; $r=0.47$ ) and moderate negative correlations with the self-efficacy in the domains of pain management ( $31.9\pm 10.28$ ; $r=-0.43$ ) and coping with symptoms ( $53.81\pm 14.19$ ; $r=-0.47$ ). ASI-3 score had a negative large correlation with self-efficacy in the domains of pain management ( $r=-0.59$ ), physical function ( $53.36\pm 7.99$ ; $r=-0.55$ ), and coping with symptoms ( $r=-0.68$ ). Physical activity levels showed positive moderate correlations with the self-efficacy in the domain of physical function ( $r=0.41$ ). Linear regression models determined that the self-efficacy and anxiety sensitivity with showed a significant relationship with the HIT-6 score ( $R^2=0.262;p=0.008$ ) and with the ASI-3 score ( $R^2=0.565$ ; $p<0.001$ ). In addition, no correlations were found between pain intensity, duration or frecuency with psychosocial factors, or headache impact. Conclusions. The present study showed that patients with chronic tension-type headache had a great negative impact on daily tasks and physical activity levels, which were associated with higher anxiety levels and lower self-efficacy.

This systematic review aims to evaluate the impact of hormonal fluctuations during the menstrual cycle on the performance of female athletes. Methods: Following PRISMA guidelines, a comprehensive search was conducted in Scopus, Web of Science, and PubMed databases using the keywords: (“Menstrual cycle”) AND (“performance” OR “female athlete” OR “sport” AND NOT “male”); AND NOT (“contraceptive”). Inclusion criteria focused on original studies published between 2013 and 2023, in English or Spanish, involving eumenorrheic female athletes without menstrual disorders or oral contraceptive use. The studies were critically assessed using the McMaster scientific review method. Results: Thirteen eligible articles were reviewed, comprising a total sample of 152 athletes. Significant findings include increased flexibility during the ovulatory phase and enhanced aerobic and anaerobic capacities in the luteal phase. Additionally, the menstrual and premenstrual phases notably influenced aerobic and anaerobic capacities, performance perception, symptomatology, and exercise-induced muscle damage. Conclusion: Hormonal fluctuations can impact female athletes’ performance. However, further research is warranted due to inconsistent results stemming from variations in cycle phases studied, lack of standardized methodologies, small sample sizes, and short observation periods.

Background: There is a common interest in finding a common consensus in the approach of athletes suffering from DOMS with the aim of accelerating recovery and thereby enhancing performance. The objective of this study was to observe the effects of a paired-associative transcranial and peripheral electromagnetic stimulation on young athletes suffering from DOMS, induced by 1 h of eccentric and plyometric exercises.Methods: Forty-eight young athletes participated in this randomized control trial: 13 were assigned to the peripheral group (P); 12 were in the control group (Cont); 11 were assigned to the transcranial group (T) and 12 were included in the paired-associative group (Comb). The Visual Analogue Scale (VAS) of pain perception and the mechanical Pressure Pain Threshold (PPT) were the tools used to analyze the symptoms of DOMS. On the other hand, the Half Squat (HS) test evaluated with an accelerometer, and the 30 m sprint velocity (30-mSP) test were used to observe the evolution of the sports performance of the lower limbs. All evaluations were performed before and after the eccentric exercise session that caused DOMS, as well as at 24–48, and 72 h afterward.Results: The AS group improved the symptoms of the induced DOMS, since significant positive differences were observed in the VAS and PPT compared to the other groups (p < 0.001). In addition, the AS group showed a significant improvement in the HS and the 30-mSP tests (p < 0.001). Based on the results a treatment with both peripheral and transcranial electromagnetic stimulation improves recovery and performance in athletes at 72 h, although these data would need to be verified in future research with a larger sample size.Conclusion: Paired-associative electromagnetic stimulation improved DOMS symptomatology, velocity, and sports performance in the lower limbs.

Background: Strength-based exercise is widely used to treat tension-type headache, but the evidence of its benefit is unclear. This study aims to analyze the efficacy of a strength-based exercise program in patients with chronic tension-type headaches.Methods: A randomized controlled trial with a 12-week strength-based exercise program, with chronic tension-type headache. The headache characteristics (which were the primary outcomes: frequency, duration, and intensity), cervical muscle thickness at rest or contraction of multifidus and longus-colli muscle, cervical range of motion, pain pressure threshold of temporalis, upper trapezius, masseter, tibialis muscle and median nerve, and cervical craniocervical flexion test were assessed at baseline and 12-weeks of follow-up in the intervention group (n = 20) and the control group (n = 20) was performed on 40 patients (85% women, aged 37.0 ± 13.3 years).Results: Between baseline and week-12 of follow-up the intervention group showed statistically significant differences compared to control group in the following primary outcomes: duration and intensity of headaches. In addition, the intervention group improved the thickness of deep cervical muscles, reduced the peripheral sensitization, and improved the strength of deep cervical flexors.Conclusion: A 12-week strength training of neck and shoulder region induced changes in pain intensity and duration, and physical-related factors in patients with TTH. Future interventions are needed to investigate if normalization of pain characteristics and physical factors can lead to an increase of headache-related impact.

Women are two to four times more prone to anterior cruciate ligament (ACL) injuries than men. This raises questions about the role of the hormonal cycle in knee laxity, which may lead to increased tibial displacement and thus ACL tears. The objective was to update scientific knowledge on the influence of the menstrual cycle on knee laxity and the risk of ACL injury, with a focus on anterior tibial displacement, and on hormonal levels influenced or not by oral contraceptive use. Observational studies obtained from Pubmed, Web of Sciences and Scopus and published between 2015 and 2022 were included in this review. Studies were required to include data on menstrual cycle with/without oral contraceptives (OC) and knee laxity and/or ACL injury. A total of ten studies were selected for this systematic review. Three studies about hormone concentration and knee laxity showed an increase in estradiol during the ovulatory phase compared to the follicular phase. Of the five studies on OC, four showed a decrease in ACL laxity. Finally, four studies assessed ACL injury. The menstrual cycle appears to influence knee laxity in women. An increase in certain hormone levels was observed in the ovulatory and luteal phases when the anterior tibial translation was greater in the knee. However, based on the literature, we cannot conclude that there is a correlation between the menstrual cycle and the risk of ACL injury.

Background and objectives: Chronic tension-type headache (TTH) is the type of headache with the highest prevalence. The involvement of musculoskeletal structures in TTH is supported by evidence in the scientific literature. Among these, deep cervical muscle strength appears to be related to the function of the cervical spine and the clinical characteristics of TTH. This study aimed to correlate anatomical, functional, and psychological variables in patients with TTH. Materials and methods: An observational descriptive study was carried out with 22 participants diagnosed with TTH for at least six months. The characteristics of headaches, including ultrasound-based deep neck flexor and extensor muscle thickness, range of motion (ROM), and pressure pain threshold (PPT), were recorded. We also conducted the Pain Vigilance and Awareness Questionnaire (PVAQ) and the Craniocervical Flexion Test (CCFT). Results: Moderate–large negative correlations were found between the PVAQ and the muscle thickness of right deep flexors contracted (r = −0.52; p = 0.01), left multifidus contracted (r = −0.44; p = 0.04), right multifidus at rest (r = −0.48; p = 0.02), and right multifidus contracted (r = −0.45; p = 0.04). Moderate–large positive correlations were found between the CCFT score and the left cervical rotation ROM (r = 0.53; p = 0.01), right cervical rotation ROM (r = 0.48; p = 0.03), muscle thickness of left multifidus contracted (r = 0.50; p = 0.02), and muscle thickness of right multifidus at rest (r = 0.51; p = 0.02). The muscle thickness of the contracted right deep cervical flexors showed a moderate negative correlation with headache intensity (r = −0.464; p = 0.03). No correlations were found between PPT and the rest of the variables analyzed. Conclusions: In patients with TTH, a higher thickness of deep cervical muscles was associated with higher ROM and higher scores in the CCFT. In turn, the thickness of deep cervical muscles showed negative correlations with pain hypervigilance and headache intensity. These results contribute to a better understanding of the physical and psychosocial factors contributing to the development of TTH, which is useful for implementing appropriate prevention and treatment measures.