Since manual palpation is a subjective procedure for identifying and differentiate Myofascial Trigger Points -MTrPs-, the use of Shear Wave Elastography -SWE- as an objective alternative is increasing. This study aimed to analyze pain pressure thresholds -PPTs- and SWE differences between active MTrPs, latent MTrPs and control points located in the upper trapezius to analyze the association of SWE features with clinical severity indicators (e.g., pain extension area, PPTs, neck pain and neck disability). An observational study was conducted to calculate the correlation and to analyze the differences of sociodemographic, clinical and SWE features on 34 asymptomatic subjects with latent MTrPs and 19 patients with neck pain and active MTrPs. Significant PPT differences between active with latent MTrPs (p < 0.001) and control points (p < 0.001) were found, but no differences between latent MTrPs and control points (p > 0.05). No stiffness differences were found between active MTrPs with latent MTrPs or control points (p > 0.05). However, significant control point stiffness differences between-samples were found (p < 0.05). SWE showed no significant correlation with clinical severity indicators (p > 0.05). No stiffness differences between active and latent MTrPs were found. Neck pain patients showed increased control point stiffness compared with asymptomatic subjects. SWE showed no association with clinical severity indicators.

Background: Chronic low back pain (LBP) has been stated as one of the main health concerns in the XXI century due to its high incidence. Objective: The objective of this study was to determine the effects of an 8-week program of hypopressive abdominal gymnastics (HAG) on inspiratory muscle strength, diaphragm thickness, disability and pain in patients suffering from non-specific chronic LBP. Methods: A total of 40 patients with chronic LBP were randomly divided into two groups. The experimental group carried out an 8-week supervised program of HAG (two sessions/week), whereas the control group did not receive any treatment. Outcomes were measured before and after the intervention, comprising diaphragm thickness during relaxed respiratory activity, maximal inspiratory pressure (PI_max), pain intensity (NRS), pressure pain threshold and responses to four questionnaires: Physical Activity Questionnaire (PAQ), Roland–Morris Disability Questionnaire (RMQ), Central Sensitization Inventory (CSI) and Tampa Scale of Kinesiophobia-11 Items (TSK-11). Results: Statistically significant differences (p < 0.05) were observed for greater thickness of the left and right hemi-diaphragms at inspiration, as well as higher PI_max and decreased NRS, CSI and RMQ scores in the intervention group. After treatment, the increases in the thickness of the left and right hemi-diaphragms at inspiration and PI_max, as well as the decrease in the NRS and RMQ scores, were only predicted by the proposed intervention (R² = 0.118–0.552). Conclusions: An 8-week HAG intervention seemed to show beneficial effects and predicted an increase in diaphragm thickness and strength during inspiration, as well as a reduction in pain intensity, central sensitization and disability, in patients suffering from chronic non-specific LBP with respect to non-intervention.

Inspiratory muscle training may benefit respiratory function, cardiocirculatory parameters, quality of life and functionality in neuromuscular diseases. This pilot study aimed to demonstrate the POWERbreathe^® inspiratory muscle training effects on maximum inspiratory pressure (PI_max), heart rate (HR) and HR variability, as well as the quality of life impairment and functionality in patients with Amyotrophic Lateral Sclerosis (ALS). A pilot single-blinded, non-randomized controlled clinical trial was carried out. A total of 20T ALS patients were enrolled and divided into experimental (n = 10) and control (n = 10) groups. The experimental group received POWERbreathe^® inspiratory muscle training in conjunction with usual care, and the control group received only usual care for 8 weeks. PI_max (measured by POWERbreathe^® KH1), HR and HR variability (evaluated by Polar H7), quality of life impairment [measured by the Amyotrophic Lateral Sclerosis Assessment Questionnaire—40 items (ALSAQ-40)] and functionality [assessed by the ALS Functional Rating Scale Revised (ALSFRS-R)] were collected at baseline and after 8 weeks of intervention. We detected statistically significant differences (p < 0.05) with an effect size ranging from medium to large (Cohen’s d = 0.72–1.37); relative to the control group, the experimental group had an increased PI_max (mean difference = 10.80 cm H₂O; 95% CI = 3.42–18.17) and ALSFRS-R score (mean difference = 5.30 points; 95% CI = −0.03–10.63) and reduced HR (mean difference = −8.80 beats-per-minute; 95% CI = −20.27–2.67) and R-R interval (mean difference = 78.30 ms; 95% CI = 2.89–153.70). POWERbreathe^® inspiratory muscle training, in addition to usual care, may improve inspiratory strength and heart rate in patients with ALS. These results encourage larger and longer trials investigating potential clinically relevant benefits of inspiratory muscle training to these patients over the disease course.

Background/Objectives: Muscle tissues are a common source of symptoms related to low back pain (LBP), with myofascial trigger points (MTrPs) being a significant contributor. Since previous meta-analyses support interventions targeting MTrPs for reducing pain and improving functional disability in patients with LBP, this review aimed to synthesize current knowledge on the prevalence of MTrPs in LBP patients. Methods: To conduct this systematic review, data were collected from PubMed, Cochrane, and Web of Science. Published articles at any time up to February 2025 that comprised descriptive, observational, or experimental studies in English/Spanish language reporting the prevalence of active or latent MTrPs in patients with LBP were eligible. After assessing the methodological quality, a structured and qualitative synthesis was conducted using a standardized form that captured participant characteristics, evaluated muscles, the number or percentage of active and latent MTrPs in each group, clinical features, summarized results, and conclusions. Results: Nine articles with acceptable methodological quality were included. The prevalence of active MTrPs in patients with LBP was quadratus lumborum (ranging from 30% to 55%), gluteus medius (from 34% to 45%), piriformis (42%), psoas (from 5% to 10%), and lumbar iliocostalis (from 33% to 38%). Latent MTrPs were most common in the gluteus medius (74%) and quadratus lumborum (14–17%), with the piriformis, psoas, and lumbar iliocostalis also affected. Conclusions: Active and latent MTrPs are common in muscles such as the quadratus lumborum, gluteus medius, and iliocostalis in individuals with LBP, with prevalence varying by pain chronicity and etiology. MTrPs in the gluteal region are more frequent in lumbosacral radiculopathy, suggesting a neurogenic-like component. Since the subjectivity of manual palpation and study heterogeneity limit generalizability of the results, future research should standardize diagnostic criteria of MTrPs to ensure the consistency of results.

Purpose: The aim of this study was to determine whether variations in technical and neuromuscular performance occur across different times of the day in basketball players. Methods: Twenty semiprofessional, female basketball players (23 ± 4 years) competing in a second-division national basketball competition completed separate testing batteries in the morning (08:30) and in the afternoon (17:30) in a randomized counterbalanced order. Testing sessions consisted of a free-throw accuracy test to assess technical performance, as well as flexibility (ankle dorsiflexion range-of-motion test), dynamic balance (modified star excursion balance test), vertical jump height (squat jump, countermovement jump with and without arm swing), strength (isometric handgrip), change-of-direction speed (V-cut test), and linear speed (20-m sprint) tests to assess neuromuscular performance. Mechanism variables were also obtained including tympanic temperature, urinary specific gravity, and rating of perceived exertion at each session. Results: Squat jump height (6.7%; p = .001; effect size (ES) = 0.33), countermovement jump height with (4.1%; p = .018; ES = 0.27) and without arm swing (5.9%; p = .007; ES = 0.30), and 20-m sprint time (-1.4%; p = .015; ES = -0.32) were significantly superior in the afternoon compared to morning. Tympanic temperature was significantly higher in the afternoon than morning (1.4%; p < .001; ES = 1.31). In contrast, no significant differences between timepoints were evident for all remaining variables (p > .05; ES = -0.33 to 0.16). Conclusions: Some neuromuscular variables exhibited a time-of-day effect with better jump and sprint performance in the afternoon compared to morning in semiprofessional, female basketball players.

Pain drawings (PDs) are used for assessing pain extent as a complementary outcome to other pain measurements, consisting of shading a body chart template to report the location and extent of pain. However, the accuracy and reliability of digital PDs remain controversial due to the heterogeneity of methods used. This study aimed to develop an easy-to-use application for assessing its diagnostic accuracy in comparison with the classic paper-and-pencil method. A test-retest reliability study was conducted, recruiting 95 patients with musculoskeletal pain symptoms. Participants shaded 2 sets of 3 different PDs (paper-and-pencil PD, digital PD using the finger and digital PD using the digital stylus). Intraclass correlation coefficients (ICC), standard error of measurement and minimal detectable changes (MDC) were calculated for each method. Finally, repeated measure analysis of variance assessed the mean differences between trials and methods and the convergent validity between methods was calculated using Pearson's correlation coefficients. All methods were excellently reliable (all, ICC>0.94). However, digital PDs obtained higher ICCs (ICC≥0.970) and greater accuracy to detect whether changes reflect a real change and are not due to a measurement errors (MDC = 0.72%-0.80 % for digital PDs versus MDC = 1.13 % for paper-and-Pencil PDs). No significant score differences were found among the instruments for assessing pain extent (p > 0.05). Finally, the PAIN EXTENT app showed adequate convergent validity (r > 0.850). The PAIN EXTENT app is a fast and easy-to-use instrument compatible with operative systems and devices commonly used for assessing and monitoring pain extent in the clinical and research settings.