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Wheelchair users often experience prolonged periods of stationary sitting. Such periods are accompanied with increased loading of the ischial tuberosities. This can lead to the development of pressure ulcers which can cause complications such as sepsis. Periodic pressure offloading is recommended to reduce the onset of pressure ulcers. Experts recommend the periodic execution of different movements to provide the needed pressure offloading. Wheelchair users, however, might not remember to perform these recommended movements in terms of both quality and quantity. A system that can detect such movements could provide valuable feedback to both wheelchair users as well as clinicians. The objective of this study was to present and validate the WiSAT - a system for characterizing in-seat activity for wheelchair users. WiSAT is designed to detect two kinds of movements - weight shifts and in-seat movements. Weight shifts are movements that offload pressure on ischial tuberosities by 30% as compared to upright sitting and are maintained for 15 seconds. In-seat movements are shorter transient movements that involve either a change in the center of pressure on the sitting buttocks or a transient reduction in total load by 30%. This study validates the use of WiSAT in manual wheelchairs. WiSAT has a sensor mat which was inserted beneath a wheelchair cushion. Readings from these sensors were used by WiSAT algorithms to predict weight shifts and in-seat movements. These weight shifts and in-seat movements were validated against a high-resolution interface pressure mat in a dataset that resembles real-world usage. The proposed system achieved weight shift precision and recall scores of 81% and 80%, respectively, while in-seat movement scores were predicted with a mean absolute error of 22%. Results showed that WiSAT provides sufficient accuracy in characterizing in-seat activity in terms of weight shifts and in-seat movement.

This paper will go through an attempt to predict vital data namely BPM and pulse interval of human being. Study involves data set produced with a total of 83 subjects spread across various categories by age group and BMI ratio. A specialized device fabricated for this purpose designed on a development board divided in two layers of printed circuit board based on Atmega328p microcontroller enables the collection of data using a pulse sensor. The machine learning algorithm running on the device saves encoded data files and produces calculation based on the previous data saved. Thus, the accuracy improves after every data sample obtained enabling the device with experience-based learning. The system makes use of a few mathematical equations on the dataset obtained for each category and is successfully able to predict BPM and pulse interval more than 70% times for age group 21 to 25 involving proportionate subjects according to BMI ratio with a database of 140 samples for each parameter taken from 70 subjects; predict BPM more than 50% times and pulse interval more than 30% times for age group 51 to 55 also involving proportionate subjects according to BMI ratio with a database of 26 samples for each parameter taken from 13 subjects while subjects were sitting or standing idle represented by the class “Regular”.

Text Neck Syndrome is repeated stress injury to the neck, or it is a pain encountered in the neck due to excessive usage of handheld devices for a prolonged period. In this paper, we have used the Microsoft Kinect sensor to create the dataset for normal and abnormal sitting postures by obtaining 3D skeletal coordinates of people. Features are extracted from the data collected from the Kinect sensor data based on the various parameters like Minkowski distance, Euclidean distance, Manhattan distance, etc. Then we have applied different machine learning algorithms, namely, K-nearest neighbours, Random forest, Support vector machine, Logistic and Linear Regression, to classify them. The performance of various algorithms is analysed. The best testing accuracy achieved is 92.85% by using Random Forest and Support Vector Machine algorithms.

Lower limb flexibility is known to be decreased in those living in mountainous areas, and musculoskeletal growth is often influenced by lifestyle factors. The purpose of this study was to determine the relationship between the means of transportation to school and lower limb musculoskeletal function and low back pain.During routine medical examinations conducted in two cities in a prefecture in 2016, a questionnaire was administered. The parents of 15,259 students who attended elementary school answered questions evaluating the following parameters: (1) anteflexion limit in the standing posture, (2) crouching failure, (3) one leg standing failure, (4) low back pain during lumbar extension, (5) lower limb alignment abnormalities, and (6) flat foot. Students were divided into a walking commuting group (13,569 students) and a vehicle commuting group (1690 students), and findings were compared between the two groups using chi-square tests.In the walking and vehicle commuting groups, anteflexion limit in the standing posture was present in 23.3% and 26.1% of students, respectively (p = 0.013). Crouching failure was present in 4.6% and 7.3% of students (p 0.001); one leg standing failure in 5.3% and 8.5% of students (p 0.001); low back pain in 5.0% and 7.1% of students (p 0.001); positive leg alignment abnormalities in 7.3% and 8.0% of students (p = 0.260); and flat foot in 7.4% and 8.7% of students (p = 0.067), respectively. Significant differences were observed in all four of the failure measures. No significant differences were observed in the two methods evaluating morphological abnormalities.The decreased walking duration and increased sitting duration associated with vehicle commuting had little effect on lower limb morphology but could induce lower limb dysfunction and low-back pain in children. Thus, supplemental walking should be instated for children who commute by car.

Summary Kinesio taping (KT) is a popular intervention among the physiotherapists since it facilitates the reduction of pain and improvement of activities. However, there is little evidence about the therapeutic application of KT in pregnant women. A 33-year-old woman with a history of one term normal vaginal delivery referred to us at the 26th weeks of her second pregnancy. Almost 2 months before her referral, she experienced constant pain in the legs, ankles, and lumbar. The patient also reported burning sensation and sweating in the sole of her feet and sleep disturbance. She had a painful functional impairment that made walking, standing, sitting, and personal activities difficult. The patient did not take any sedatives during pregnancy. Therefore, KT was applied to the lower thoracic region for 5 days at three times. The Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI) were utilized to assess pain-related disability in the patient. After KT application, both VAS and ODI scores showed a significant decrease. Furthermore, she reported a remarkable improvement in her walking ability, feet sweating, and sleep disturbance. The present case report explained the use of KT on the lower thoracic spine in a patient suffering from low back and leg pains, as well as burning sensation and sweating of the sole of feet during pregnancy. The results revealed an improvement in patient symptoms, which may be due to the application of KT on the lower thoracic region. It seemed that her symptoms were due to pregnancy-induced physiologic changes in the body and sympathetic nervous system (SNS) disorder. Based on this study, it can be concluded that KT is a safe and inexpensive technique that can be used as a complementary therapy of low back and leg pains and SNS disorder in pregnant women.

Intracardiac platypnea–orthodeoxia syndrome (POS) is a pathological condition that leads to a reduction in oxygenation in the sitting position. The detection rate of patent foramen ovale that causes POS increases with Valsalva manoeuvre and cough. We report the case of a 92-year-old woman with POS, which could not be diagnosed in the sitting position. The Valsalva manoeuvre could not be performed because of dementia, and POS was diagnosed on the forward-bending position and abdominal compression. It was assumed that forward-bending increases the right atrial pressure by compressing the right ventricle along with elongation of the aorta, and abdominal compression increases the shunt volume by increasing the venous return. If POS is suspected in patients with dementia which cannot be diagnosed in the sitting position, forward-bending and abdominal compression, instead of the Valsalva manoeuvre, might be useful.

Sedentary behavior (SB) and physical activity (PA) are important risk factors of cardiovascular disease morbidity and mortality. In addition to increasing the amount of moderate-to-vigorous PA (MVPA), the current PA guidelines recommend that adults should reduce SB, or any waking activity performed while sitting, reclining, or lying, with low energy expenditure. While mounting evidence has emphasized the benefits of increasing MVPA, little has focused on the effect of SB on health. Therefore, this review discusses the pathophysiological effects of SB and the potential physiological benefits of reducing/breaking up SB at the levels below the current guidelines for PA. Such knowledge is important, given that the majority of the United States population performs insufficient or no MVPA and is at high risk of being negatively impacted by SB. Interventions targeting sedentary time, such as breaking up SB by standing and moving, may be safe, feasible, and applicable to execute daily for a wide range of the population. This review also discusses the importance of monitoring SB in the era of the coronavirus disease 2019 (COVID-19) pandemic and the clinical implications of sitting less and moving more.

Background Emergency nurses are at higher risk than the average worker of experiencing lumbar pain. This is the first study to undertake real time monitoring to quantify lumbar movements of nurses working in the emergency department (ED). Methods Emergency nurses at a single Australian ED were recruited for a prospective observational case study. Participants worked in four discrete clinical areas of the ED; In-charge, triage, resuscitation, and cubicles. Data collected included participant demographics, lumbar pain pre- and post-shift, and real-time recording of lumbar movements. Results Sixty-two nurses participated. There were statistically significant differences in time spent standing (p = 0.005), sitting (p ≤ 0.001) and in locomotion (moving) (p ≤ 0.001) when compared by clinical role. Triage nurses spent over half their shift sitting, had the most sustained (> 30 s) flexions (60+ degrees) and had a median of 4 periods of uninterrupted sitting (10−30 mins) per shift. Conclusions Differences in movement demands were identified based on various clinical roles in the ED. Triage was associated with greater periods of uninterrupted sitting and with greater degrees of sustained flexion, both of which are predictors for back pain. This study provides foundation evidence that triage may not be the most appropriate location for staff returning from back injury.

Contains fulltext : 291534.pdf (Publisher’s version ) (Open Access) AIM: The aim of this study is to investigate associations between the physical activity (PA) spectrum (sedentary behavior to exercise) and tissue-specific insulin resistance (IR). METHODS: We included 219 participants for analysis (median [IQR]: 61 [55; 67] years, BMI 29.6 [26.9; 32.0] kg/m(2) ; 60% female) with predominant muscle or liver IR, as determined using a 7-point oral glucose tolerance test (OGTT). PA and sedentary behavior were measured objectively (ActivPAL) across 7 days. Context-specific PA was assessed with the Baecke questionnaire. Multiple linear regression models (adjustments include age, sex, BMI, site, season, retirement, and dietary intake) were used to determine associations between the PA spectrum and hepatic insulin resistance index (HIRI), muscle insulin sensitivity index (MISI) and whole-body IR (HOMA-IR, Matsuda index). RESULTS: In fully adjusted models, objectively measured total PA (standardized regression coefficient β = 0.17, p = 0.020), light-intensity PA (β = 0.15, p = 0.045) and moderate-to-vigorous intensity PA (β = 0.13, p = 0.048) were independently associated with Matsuda index, but not HOMA-IR (p > 0.05). A higher questionnaire-derived sport index and leisure index were associated with significantly lower whole-body IR (Matsuda, HOMA-IR) in men but not in women. Results varied across tissues: more time spent sedentary (β = -0.24, p = 0.045) and a higher leisure index (β = 0.14, p = 0.034) were respectively negatively and positively associated with MISI, but not HIRI. A higher sport index was associated with lower HIRI (β = -0.30, p = 0.007, in men only). CONCLUSION: While we confirm a beneficial association between PA and whole-body IR, our findings indicate that associations between the PA spectrum and IR seem distinct depending on the primary site of insulin resistance (muscle or liver). 01 april 2023

A male patient was scheduled for urgent amputation of his right forearm. His right forearm was stuck inside the insertion slot of a meat grinder, resulting in severe pain to his injured arm. His upper body could not move to sit in a semi-upright position. An endotracheal tube was successfully placed after rapid sequence intubation using a video laryngoscope from behind the patient on the first attempt. This case report is the first documentation of successful anesthetic induction with subsequent endotracheal intubation using a video laryngoscope from behind an injured patient whose upper body was upright with limited positioning.

Background: Psychological distress (stress) has been linked to an increased risk of chronic diseases and is exacerbated by a range of workplace factors. Physical activity has been shown to alleviate psychological distress. Previous pedometer-based intervention evaluations have tended to focus on physical health outcomes. This study aimed to investigate the immediate and long-term changes in psychological distress in employees based in Melbourne, Australia after their participation in a four-month pedometer-based program in sedentary workplaces. Methods: At baseline, 716 adults (aged 40 ± 10 years, 40% male) employed in primarily sedentary occupations, voluntarily enrolled in the Global Corporate Challenge© (GCC©), recruited from 10 Australian workplaces to participate in the GCC® Evaluation Study, completed the Kessler 10 Psychological Distress Scale (K10). Of these, 422 completed the K10 at baseline, 4 months and 12 months. Results: Psychological distress reduced after participation in a four-month workplace pedometer-based program, which was sustained eight months after the program ended. Participants achieving the program goal of 10,000 steps per day or with higher baseline psychological distress had the greatest immediate and sustained reductions in psychological distress. Demographic predictors of immediate reduced psychological distress (n = 489) was having an associate professional occupation, younger age, and being ‘widowed, separated or divorced’. Conclusions: Participation in a workplace pedometer-based program is associated with a sustained reduction in psychological distress. Low-impact physical health programs conducted in groups or teams that integrate a social component may be an avenue to improve both physical and psychological health in the workplace.

Objective The aim of this study was to examine lymphatic diameters in lower limbs of healthy volunteers in different body positions using lymphatic ultrasound examinations. Methods Thirty-five healthy volunteers participated in this study. Those who had a history of varicose veins in the leg, deep venous thrombosis, or surgery on their legs or abdomen were excluded. We measured the vertical width of the lymphatics with a 33 MHz linear ultrasound probe, at 20 cm above the knee (thigh) and 10 cm below the knee (lower leg). First, the participants were placed supine, then sitting, and then standing. We performed lymphatic ultrasound examinations in each body position. The Student t test was used to compare lymphatic vessel diameters in the supine, sitting, and standing positions. The significance level was set at .05. Results Among 35 healthy volunteers, 17 were men and 18 were women. Mean age was 30.9 (range, 23-55) years. The mean body mass index was 21.3 kg/m2 (range, 29.0-16.1 kg/m2). We could not detect lymphatic vessels in 1 thigh and 3 lower legs, leaving 69 thighs and 67 lower legs for evaluation. In the thigh, the mean lymphatic diameters in the supine and standing positions were 0.154 mm and 0.150 mm, respectively, which were not significantly different. In the lower leg, the mean lymphatic diameters in the supine, sitting, and standing positions were 0.160 mm, 0.163 mm, and 0.164 mm, respectively, which were not significantly different. In the thigh, the mean lymphatic diameter in the supine position was larger in the men (0.17 mm) than in the women (0.14 mm) (P = .022). Similarly, in the lower leg, the mean lymphatic diameter in the supine position was greater in the men (0.19 mm) than in the women (0.14 mm) (P = .0044). There was no correlation between the supine lymphatic diameters and the age or body mass index of the participants. Conclusions In healthy legs, lymphatic diameters do not change with body positioning. Supine lymphatic vessel diameters are greater in men than in women.

Wearable activity recognition can collate the type, intensity, and duration of each child's physical activity profile, which is important for exploring underlying adolescent health mechanisms. Traditional machine-learning-based approaches require large labeled data sets; however, child activity data sets are typically small and insufficient. Thus, we proposed a transfer learning approach that adapts adult-domain data to train a high-fidelity, subject-independent model for child activity recognition. Twenty children and twenty adults wore an accelerometer wristband while performing walking, running, sitting, and rope skipping activities. Activity classification accuracy was determined via the traditional machine learning approach without transfer learning and with the proposed subject-independent transfer learning approach. Results showed that transfer learning increased classification accuracy to 91.4% as compared to 80.6% without transfer learning. These results suggest that subject-independent transfer learning can improve accuracy and potentially reduce the size of the required child data sets to enable physical activity monitoring systems to be adopted more widely, quickly, and economically for children and provide deeper insights into injury prevention and health promotion strategies.

Coronavirus disease-2019 (COVID-19) has a profound impact on the health care system worldwide. In the COVID-19 pandemic, hospitals are required to halt elective surgeries and procedures for preventing nosocomial infections and saving medical resources. In these situations, emergency procedures are required for life-threatening cardiovascular diseases such as acute coronary syndrome and cardiogenic shock. To prevent the spread of COVID-19, a social distance is essentially required. In ordinary percutaneous coronary intervention (PCI), operators manipulate the devices standing at the patient's tableside during the whole procedure, which may involve a certain risk of exposure to patients with COVID-19. A robotic-assisted PCI (R-PCI) allows operators to manipulate devices remotely, sitting at a cockpit located several meters away from the patient, and in addition, the assistant can be at the foot of the bed, much further from the access site. R-PCI can help to minimize the radiation exposure and the amount of person-to-person contact, and consequently may reduce the risk for the exposure to the virus., Graphical abstract Image, graphical abstract

Purpose Our objective was to estimate the impact of the absence of Out-of-Bed (OoB) mobilization during intensive care unit (ICU) stay among patients ≥70 years on their long-term autonomy. Methods We conducted an ancillary study of the multicenter FRAGIREA study, including patients aged over 70 years, admitted to ICU for more than 48 h. We excluded the patients who died before day 180, who were lost to follow-up, and for whom the baseline autonomy (ADL) score was not available. Patients were classified into the OoB or non-OoB-mobilization group, and the impact of OoB mobilization on the decreased 6-month autonomy was estimated. Results Among the 548 patients of the FRAGIREA cohort, 276 were included in the present study. Among them, 226 had OoB mobilization and 50 did not. 220/276 (80%) patients experienced the transfer to chair as rehabilitation therapy, passive mobilization and transfer to upright sitting were also frequently performed. A decrease in the 6-month autonomy was observed for 63 (23%) patients. After the elimination of potential confounders, non-OoB-mobilization patients had a greater risk of 6-month decreased autonomy (aOR 2.43 [1.18; 4.98]). Conclusions Mobilization during the ICU stay of elderly ICU patient survivors was associated with a lower decreased autonomy at 6 months.

BACKGROUND/PURPOSE This retrospective study aimed to determine which factors, such as cognition, motor recovery, swallowing function, and bladder and bowel functions, significantly predicted independence in the activities of daily living (ADL) at hospital discharge in a domestic population of patients experiencing post-acute stroke who received in-hospital rehabilitation. METHODS We reviewed medical records that were retrieved from the Integrated Medical Database, National Taiwan University Hospital (NTUH-iMD) of 3000 patients who suffered from stroke and were admitted to NTUH from 2014 to 2017. The main outcome measure was independence in the basic ADL (modified Barthel index [mBI]) at discharge. Regression analyses were used to identify prognostic factors for the basic ADL (mBI). RESULTS The total mBI improved from 40.7 ± 33.0 to 63.1 ± 34.1 in eligible 2538 patients during their hospital stay. The baseline daily activity function (R2 change = 0.042) was the most important prognostic factor associated with independence at discharge, followed by dependence in sitting up (R2 change = 0.014), impaired sitting balance (R2 change = 0.010), the Brunnstrom stage of hemiplegic lower limb (R2 change = 0.006), and the presence of bladder incontinence (R2 change = 0.006) assessed by physician upon rehabilitation admission (R2 = 0.53, p

Older adults may be subject to prolonged bedrest during hospitalization for acute cardiovascular disease, which can contribute to poor functional outcomes posthospitalization. Our objective was to describe mobility status in hospitalized older adults with acute cardiovascular disease.Patients aged ≥ 60 years old in the cardiac intensive care unit and cardiovascular ward at a tertiary care academic centre in Montréal, Québec were prospectively enrolled from April 2019 to March 2020. Activity levels were measured with the ActiGraph GT9X Link 3-axis accelerometer (ActiGraph, Pensacola, FL). Sedentary was defined as lying in bed or in a sitting position. Health-related quality of life (HRQOL) was measured with the Short-Form 36 (SF-36) questionnaire by telephone at 1 month posthospitalization. The primary outcome was percentage of sedentary time during hospitalization.There were 35 patients included in the analysis (75.7 ± 6.9 years old; 45.7% female; 22.9% ischemic heart disease; 20.0% heart failure). Patients spent 91.2% ± 5.5 in a sedentary position during their hospital stay. Mean steps per minute were 1.0 ± 1.2, and mean kcals consumed per day were 116.6 ± 124.5. In the multivariable analysis, a higher percentage of sedentary time and lower steps per minute were each associated with lower total SF-36 scores at 1-month posthospitalization (bothOlder adults with acute cardiovascular disease may be sedentary for a large part of their hospital stay. Increased sedentary time is associated with worse self-reported posthospital HRQOL. Future studies are needed to determine whether interventions to increase activity during hospitalization improve posthospital HRQOL and functional outcomes.Les personnes âgées hospitalisées en raison d’une maladie cardiovasculaire en phase aiguë peuvent être sujettes à un alitement prolongé qui peut contribuer à des résultats fonctionnels médiocres après l’hospitalisation. Notre objectif était de décrire l’état de mobilité des personnes âgées hospitalisées en raison d’une maladie cardiovasculaire en phase aiguë.Nous avons inscrit de façon prospective les patients de ≥ 60 ans de l’unité des soins intensifs cardiaques et de l’unité de cardiologie d’un centre universitaire de soins tertiaires à Montréal, au Québec, d’avril 2019 à mars 2020. Nous avons mesuré les niveaux d’activité physique à l’aide de l’accéléromètre ActiGraph GT9X Link 3-axis (ActiGraph, Pensacola, Floride, É.-U.). Nous avons défini la sédentarité par le fait d’être couché au lit ou en position assise. Nous avons mesuré la qualité de vie liée à la santé (QVLS) à l’aide du questionnaire SF-36 (Short Form-36) par téléphone un mois après l’hospitalisation. Le critère de jugement principal était le pourcentage de temps sédentaire durant l’hospitalisation.Dans l’analyse, on comptait 35 patients (75,7 ± 6,9 ans; 45,7 % de femmes; 22,9 % atteints d’une cardiopathie ischémique; 20,0 % atteints d’insuffisance cardiaque). Les patients passaient 91,2 % ± 5,5 en position sédentaire durant leur séjour à l’hôpital. Les pas moyens par minute étaient de 1,0 ± 1,2, et les kcal moyennes consommées par jour étaient de 116,6 ± 124,5. Dans l’analyse multivariée, un pourcentage plus élevé de temps sédentaire et un nombre inférieur de pas par minute étaient chacun associés à des scores totaux plus faibles au SF-36 un mois après l’hospitalisation (Les personnes âgées atteintes d’une maladie cardiovasculaire en phase aiguë se retrouvent sédentaires pendant une grande partie de leur séjour à l’hôpital. L’augmentation du temps sédentaire est associée à une plus mauvaise QVLS après l’hospitalisation selon les personnes âgées interrogées. Des études ultérieures sont nécessaires pour déterminer si les interventions pour accroître l’activité physique durant l’hospitalisation améliorent la QVLS et les résultats fonctionnels après l’hospitalisation.

An 89-year-old woman was admitted to our hospital for subacute onset of right upper and lower limb weakness and was diagnosed with acute cerebral infarction. During rehabilitation, close observation revealed that her oxygen saturation decreased in the sitting position and improved in the recumbent position without any subjective symptoms of dyspnea. Transthoracic and transesophageal echocardiography and cardiac catheterization revealed a large patent foramen ovale with an atrial septal aneurysm with right-to-left shunting through the defect, and she was diagnosed with platypnea-orthodeoxia syndrome. Her right hemiplegia caused the trunk to collapse, so the patient slumped when in sitting position, and the trunk tilted to the right forward, resulting in an increased right-to-left shunt. Her peripheral capillary oxygen saturation improved in the upright sitting position supported by therapists. This case suggests that right hemiplegia may exacerbate the symptoms of platypnea-orthodeoxia syndrome.

Background Children with Down Syndrome (DS) present with neuromuscular disturbances leading to delayed developmental milestones, poor quality of movement and poor balance. The aim of this study is to discuss the role of trunk muscle strength in the functional performance of children with DS. Methodology 28 children were recruited in the study, 14 with DS and 14 age and gender-matched controls. Trunk muscle strength, reaching ability and balance were assessed using a Handheld Dynamometer, Modified Functional Reach test and Pediatric Balance Scale, respectively. Results Children with DS present with poorer trunk muscle strength, reaching ability and balance as compared to typically developing (TD) children. There was a positive correlation between trunk muscle strength and lateral reaching in children with DS. A strong to moderate correlation was observed between the trunk muscle strength and balance in children with DS. Discussion Children with DS demonstrated a significantly weak trunk muscle groups. Lateral reaching distance is reduced due to the poor proximal control and they present with near-normal forward reach distance attributed to compensation using the lower trunk muscles. They exhibit poor balance in the components that require a small base of support. Conclusion Children with DS exhibit weak trunk muscles along with lesser reaching distance and poor balance. Also, trunk muscle strength influences lateral reaching ability. Trunk muscle strength, mainly trunk extensors impacted functional balance in sitting, standing and while performing transfers.

A prototype chair with anterior chest and arm supports has been designed to reduce compressive spine loads. The purpose of this study was to compare the effects of this offloading design on seated height compared to a control configuration of the same chair. 20 males sat on each configuration for 1 hour. Seated height, perceived pain, spine angles, seat pressure, and participants' experiences were measured. Spine height loss was significantly reduced in the offloading (-0.75 ± 3.79mm) compared to the control configuration (-6.16 ± 4.27mm, p

IntroductionThis study investigated the effects of seating distance and orientation on engagement in novice and experienced learners in a large classroom explicitly designed for Team-based Learning (TBL). Learning what affects TBL engagement may improve its implementation.MethodsParticipants were novice first-year and experienced second-year undergraduate medical students in Singapore (male=103, female=57). Their age ranged from 18 to 23 (M=19.5, SD=1.06). This quasi-experimental study considered two factors. Firstly, the distance from the teams’ table to the tutor’s table. Secondly, students’ orientation at each table, with either their front or back facing the tutor. Engagement was measured using two instruments, Situational Cognitive Engagement Measure and Classroom Engagement Survey at two TBL sessions – before and after swapping seating arrangements.ResultsFor experienced students, seating distance did not significantly affect engagement (p=0.08–0.89). Novice student’s engagement levels decreased significantly for those who moved further; M=3.30 to 2.98 (p=0.009–0.023). However, overall engagement also decreased post-swap regardless of direction moved; M=3.26 to 3.00 (p=0.004). For both cohorts, seating orientation did not significantly affect engagement (p=0.07–0.62). Those unaffected by seating arrangement commended the classroom’s design, such as screens all around and quality audio-visual system. Novice students exhibited a stronger preference to sit nearer to the tutor than experienced students. Both groups preferred sitting with their front- facing the tutor.DiscussionWithin specially designed TBL classrooms, seating distance and orientation did not significantly affect engagement. Technologically enhanced team-centric spaces provide a favorable environment for TBL, though students’ preferences for seats may change with more TBL experience.

BACKGROUND: A validated method to assess sitting and standing posture in a clinical setting is needed to guide diagnosis, treatment and evaluation of these postures. At present, no systematic overview of assessment methods, their clinimetric properties, and usability is available. OBJECTIVE: The objective of this study was to provide such an overview and to interpret the results for clinical practice. METHODS: A systematic literature review was performed according to international guidelines. Two independent reviewers assessed risk of bias, clinimetric values of the assessment methods, and their usability. Quality of evidence and strength of recommendations were determined according to the Grading of Recommendations Assessment, Development and Evaluation working group (GRADE). RESULTS: Out of 27,680 records, 41 eligible studies were included. Thirty-two assessment instruments were identified, clustered into five categories. The methodological quality of 27 (66%) of the articles was moderate to good. Reliability was most frequently studied. Little information was found about validity and none about responsiveness. CONCLUSIONS: Based on a moderate level of evidence, a tentative recommendation can be made to use a direct visual observation method with global posture recorded by a trained observer applying a rating scale.

The current study aimed to determine whether participants with and without forward head posture (FHP) would respond differently in cervical nerve root function to various sitting positions. We measured peak-to-peak dermatomal somatosensory-evoked potentials (DSSEPs) in 30 participants with FHP and in 30 participants matched for age, sex, and body mass index (BMI) with normal head posture (NHP), defined as having a craniovertebral angle (CVA) >55°. Additional inclusion criteria for recruitment were individuals between the ages of 18 and 28 who were in good health and had no musculoskeletal pain. All 60 participants underwent C6, C7, and C8 DSSEPs evaluation. The measurements were taken in three positions: erect sitting, slouched sitting, and supine. We identified statistically significant differences in the cervical nerve root function in all postures between the NHP and FHP groups (p < 0.001), indicating that the FHP and NHP reacted differently in different positions. No significant differences between groups for the DSSEPs were identified for the supine position (p > 0.05), in contrast to the erect and slouched sitting positions, which showed a significant difference in nerve root function between the NHP and FHP (p < 0.001). The NHP group results were consistent with the prior literature and had the greatest DSSEP peaks when in the upright position. However, the participants in the FHP group demonstrated the largest peak-to-peak amplitude of DSSEPs while in the slouched position as opposed to an erect position. The optimal sitting posture for cervical nerve root function may be dependent upon the underlying CVA of a person, however, further research is needed to corroborate these findings.

OBJECTIVES The active factor along with light exercise can reduce static muscle work and increase muscle flexibility and endurance. Accordingly, this study aimed to design and prototype a new active footrest, implemented in conventional sitting workstations and to test its usability among office workers. METHODS The steps taken to design and prototype the active footrest were a) selection of an exercise appropriate for goals of ergonomic interventions, b) idea development, c) selection of the best conceptual design, d) design with SOLIDWORKS version 2016 software, and e) fabrication of a prototype. Afterward, the usability of the active footrest prototype was assessed among 20 office workers (10 females) using field data by the System Usability Scale. RESULTS Upon the completion of the design steps, the active footrest prototype was prototyped by taking into account design criteria (e.g. functionality, inclusive design, easy application, and reduction of additional body movement), anthropometric data and mechanical properties. The participants rated the usability of the active workstation as 89 ± 8.21 (out of 100) and indicating good usability results. CONCLUSION In this study, an active footrest was designed and prototyped to perform knee extension exercise with the capability of being implemented in conventional sitting workstations.

Platypnea-orthodeoxia syndrome is a rare clinical entity characterized by dyspnea and arterial blood deoxygenation in a sitting position. An 89-year-old woman was diagnosed with subacute cerebellar infarction. Her blood oxygen saturation decreased to 88% in a sitting position, resulting in dyspnea. Cardiological thoracic computed tomography revealed an unruptured aortic aneurysm, an enlarged ascending aorta, right atrial compression, and counterclockwise rotation of the heart. An anatomical distortion of the atrial septum induced by these abnormalities directed the atrial venous inflow such that the right-left shunt flow was exacerbated in a sitting position.

Background Early mobilization is incorporated into many enhanced recovery pathways. Inadequate analgesia or excessive opioids may restrict postoperative mobilization. The authors tested the hypotheses that in adults recovering from abdominal surgery, postoperative pain and opioid consumption are inversely related to postoperative mobilization, and that postoperative mobilization is associated with fewer potentially related complications. Methods The authors conducted a subanalysis of two trials that enrolled adults recovering from abdominal surgery. Posture and movement were continuously monitored for 48 postoperative hours using noninvasive untethered monitors. Mobilization was defined as the fraction of monitored time spent sitting or standing. Results A total of 673 patients spent a median [interquartile range] of 7% [3 to 13%] of monitored time sitting or standing. Mobilization time was 1.9 [1.0 to 3.6] h/day for patients with average pain scores 3 or lower, but only 1.2 [0.5 to 2.6] h/day in those with average scores 6 or greater. Each unit increase in average pain score was associated with a decrease in mobilization time of 0.12 (97.5% CI, 0.02 to 0.24; P = 0.009) h/day. In contrast, there was no association between postoperative opioid consumption and mobilization time. The incidence of the composite of postoperative complications was 6.0% (10 of 168) in the lower mobilization quartile, 4.2% (7 of 168) in the second quartile, and 0% among 337 patients in the highest two quartiles (P = 0.009). Conclusions Patients recovering from abdominal surgery spent only 7% of their time mobilized, which is considerably less than recommended. Lower pain scores are associated with increased mobility, independently of opioid consumption. Complications were more common in patients who mobilized poorly. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

To evaluate the predictive value of intraoperative neuromonitoring (IONM) in brainstem cavernous malformation (BSCM) surgery.Surgically treated patients with BSCM were included. All patients received IONM consisting of motor-evoked potentials (MEPs) and somatosensory-evoked potentials (SSEPs). Neurologic examination was conducted preoperatively and at discharge and follow-up3 months after BSCM removal. Demographic, radiographic, and clinical features were assessed. Study end points were new motor or somatosensory deficits and functional disability.A total of 62 patients were included. MEP decrease was associated with new motor deficits at discharge (P = 0.022), and SSEP decrease was associated with new somatosensory deficits at discharge (P0.001) and follow-up (P0.001). Sensitivity and specificity values for MEPs (discharge: 31% and 93%; follow-up: 33% and 91%) and SSEPs (discharge: 82% and 80%; follow-up: 85% and 79%) were calculated, respectively. Receiver operating characteristic analyses with area under the curve (AUC) metrics revealed acceptable performance of MEPs (AUC, 0.75; P = 0.022) and SSEPs (AUC, 0.72; P = 0.004) in predicting early deficits. Intraoperative decrease of MEPs (P = 0.047) and SSEPs (P = 0.017) was associated with early functional disability. Surgery-related subdural air accumulation impaired IONM reliability in predicting early (P = 0.048) and long-term (P = 0.013) deficits.Established IONM warning criteria may be valid for BSCM removal. However, surgical approaches in the sitting position significantly limit the predictive value of IONM, to some extent because of intraoperative pneumocephalus.

Purpose: We tested whether a single session of heavy-load resistance priming conducted in the morning improved double-poling (DP) performance in the afternoon. Methods: Eight national-level male cross-country skiers (mean [SD]: 23 [3] y, 184 [6] cm, 73 [7] kg, maximum oxygen consumption = 69 [6] mL·kg−1·min−1) carried out 2 days of afternoon performance tests. In the morning, 5 hours before tests, subjects were counterbalanced to either a session of 3 × 3 repetitions (approximately 85%–90% 1-repetition maximum) of squat and sitting pullover exercises or no exercise. The performance was evaluated in DP as time to exhaustion (TTE) (approximately 3 min) on a treadmill and 30-m indoor sprints before and after TTE (30-m DP pre/post). Furthermore, submaximal DP oxygen cost, countermovement jump, and isometric knee-extension force during electrical stimulation were conducted. Participants reported perceived readiness on test days. Results: Resistance exercise session versus no exercise did not differ for TTE (approximately 3 min above) (mean ± 95% confidence interval = 3.6% ± 6.0%; P = .29; effect size [ES], Cohen d = 0.27), 30-m DP pre (−0.56% ± 0.80%; P = .21; ES = 0.20), 30-m DP post (−0.18% ± 1.13%; P = .76; ES = 0.03), countermovement jump (−2.0% ± 2.8%; P = .21; ES = 0.12), DP oxygen cost (−0.13% ± 2.04%; P = .91; ES = 0.02), or perceived readiness (P ≥ .11). Electrical stimulation force was not different in contraction or relaxation time but revealed low-frequency fatigue in the afternoon for the resistance exercise session only (−12% [7%]; P = .01; ES = 1.3). Conclusion: A single session of heavy-load, low-volume resistance exercise in the morning did not increase afternoon DP performance of short duration in high-level skiers. However, leg low-frequency fatigue after resistance priming, together with the presence of small positive effects in 2 out of 3 DP tests, may indicate that the preconditioning was too strenuous.

Older adults spend more time, on average, engaged in sedentary behaviors (SBs) compared with younger cohorts. This is concerning, because prolonged SB is associated with detrimental outcomes. The purpose of this study was to explore the degree to which older adults’ motives to limit their SB were internalized, consistent with self-determination theory. Following the qualitative description approach, seven focus groups (n = 27) of community-dwelling older adults were conducted. Focus groups were transcribed verbatim and coded using a thematic approach. Results revealed some motivation subthemes, which appeared to endorse similar content, varied in the degree to which participants internalized them, differentiating these motives along the self-determination theory motivational continuum. These findings demonstrated that not all motives are equal, highlighting the importance of theory-driven future SB interventions.

Introduction: Low back pain is one of the most common musculoskeletal disorders leading to disability around the world. Several studies have suggested that prolonged computer/ laptop work contributes to the development of low back pain and discomfort. The results of the studies conducted on the association of back discomfort and muscle activity are contradictory. Thus, the present study aims to evaluate the relationship between the activity level and relative rest time of the trunk muscles with back discomfort while working with a laptop in a sitting position. Material and Methods: First, 20 young healthy males performed laptop work including mouse work and typing in conventional and ergonomic setups. In the ergonomic setup, the screen height and keyboard placement were specifically adjusted for each individual. In addition, the electromyographic activity of the lumbar erector spinae, right and left multifidus and transversus abdominis, rectus abdominis, external oblique muscles, and the posture of the lumbar spine were recorded in the first and last two minutes of an 8-min task. After the end of each task, the participants scored their back discomfort. Results: The results showed a positive correlation (r=0.57 and p=0.009) between back discomfort and the EMG amplitude of the lumbar erector spinae muscle. In addition, back discomfort was negatively correlated to the relative rest time of the multifidus muscle (r=0.50 and p=0.023), and a positive correlation was reported with the relative rest time of the transversus and rectus abdominis (r=0.47, p=0.039, and r=0.45, p=0.049, respectively). Conclusion: The relative rest time of the trunk muscles may be a better index than that of the EMG amplitude to highlight the risk factors for back discomfort. However, a causative link between muscle activity and discomfort cannot be implied from this study. The current results do not undermine the role of other factors associated with the increased level of discomfort during sitting.

To increase the quality of citizens' lives, we designed a personalized smart chair system to recognize sitting behaviors. The system can receive surface pressure data from the designed sensor and provide feedback for guiding the user towards proper sitting postures. We used a liquid state machine and a logistic regression classifier to construct a spiking neural network for classifying 15 sitting postures. To allow this system to read our pressure data into the spiking neurons, we designed an algorithm to encode map-like data into cosine-rank sparsity data. The experimental results consisting of 15 sitting postures from 19 participants show that the prediction precision of our SNN is 88.52%.

Purpose: In this study, the effect of the Vojta approach on neck stability and static balance in children with hypotonia was studied.Methods: Seventeen children with hypotonia were randomly divided into the Vojta approach group (n=9) and the general physical therapy group (n=8). Each group was applied intervention for 30 minutes per session, 3 times a week, for a total of 4 weeks. Ultrasonography was used to measure deep neck flexor muscle thickness, craniovertebral angle (CVA) to measure neck alignment along the spine segment, and Balancia software program to measure static balance.Results: In the Vojta approach group, the deep neck flexor muscle thickness was significantly increased (P

Kamulyan waste bank is a place to collect the waste from the household around Lowanu Village, Brontokusuman, Mergangsan, Yogyakarta. This waste is distributed to garbage collectors and sorted. Plastic waste that cannot be recycled is used as material for making ecobricks. Ecobricks are materials made from used plastic bottles filled with plastic sachets, plastic bags, and similar materials that are compressed. In making ecobricks, workers perform activities in a sitting position on the floor with both legs folded in and a slightly bent posture. This work attitude causes muscle complaints in the upper and lower neck, upper arm, right elbow, left wrist, and left hand. The purpose of the study was to improve work attitudes to reduce muscle complaints in body parts by designing ergonomic work facilities. This research was conducted with ergonomics intervention on the design of ecobrick plastic compaction work facilities with the Nordic Body Map-VAS Modified Questionnaire. The muscle complaints of the workers' body parts were determined using the Nordic Body Map questionnaire. The results of the study provide a design for compaction of ecobrick plastic materials with dimensions of table length 134.44 cm, table width 66.39 cm, table height 71.63 cm, length of seat mat 41.41 cm, width of seat mat 43.49 cm, height seat 44.51 cm, backrest height 55.5 cm, and backrest width 45.88 cm. Based on the NBM-VAS questionnaire, it shows that the initial condition of pain or pain in the upper neck and lower neck with a moderate pain value is aimed at a scale of 6.5 cm and 7.3 cm to mild pain with a scale of 4.2 cm and 4.3 cm. . Moderate pain in the left wrist and left hand with a scale of 6.1 cm, respectively, to no pain on a scale of 3.1 cm and 3 cm.

BACKGROUND An adaptive seating system is a basic rehabilitation need for children and youth with cerebral palsy (CP) as it supports the structure and function of the musculoskeletal system and can positively affect their activities and participation. Despite the importance of adaptive seating systems, there is limited access to such systems in low-income countries. OBJECTIVES To determine the percentage of children and youth between 4 and 18 years of age with CP in Egypt whose activity level and sitting ability suggest the need for an adaptive seating system. STUDY DESIGN Observational cross-sectional study. METHODS One hundred ninety-three participants were included after fulfilling the criteria of the Surveillance of Cerebral Palsy of Europe. Their level of activity was assessed by a physical therapist using the Gross Motor Function Classification System (GMFCS), and their sitting ability was evaluated using the Level of Sitting Scale (LSS). Participants were considered to require an adaptive seating system if they scored GMFCS level IV or V and LSS level 1-5 concurrently. RESULTS Approximately 44% of the study participants were classified as GMFCS level IV or V and LSS level 1-5, suggesting that they were in need of an adaptive seating system. CONCLUSIONS There is a large percentage of children and youth with CP in Egypt who need an adaptive seating system to be integrated into their rehabilitation.

Objective To describe spinal osteotomy in lateral position, which might be a new strategy for correcting thoracolumbar kyphotic deformity combined with severe hip flexion contracture, and to present two cases in which this method was successfully performed. Methods Spinal osteotomies in lateral position were performed in two patients with severe thoracolumbar kyphosis combined with hip flexion contracture, which was not suitable for operation in the prone position. Case 1: a 33‐year‐old female AS patient still had severe hip flexion contracture due to poor rehabilitation after total hip replacement (THR). The range of movement of the hip was only about 15° in right and 10° in left. Pre‐operativethoracic kyphosis (TK), thoracolumbar kyphosis (TLK), lumbar lordosis (LL), and sagittal vertical axis (SVA) were 52.4°, 49.1°, 42.7°, and 315 mm, respectively. Pedicle subtraction osteotomy (PSO) at L3 was performed in the lateral position. The eggshell procedure was used during osteotomy. Case 2: a 45‐year‐old male AS patient presented coexisting rigid thoracolumbar kyphosis and hip flexion contracture. The range of movement of the hip was only about 20° in right and 25° in left. Pre‐operativeTK, TLK, LL and SVA were 34.9°, 66.8°, 58.8° and 290.8 mm, respectively. PSO at L2 was performed in lateral position. The eggshell procedure was also used. Results Sagittal malalignments of both patients were greatly improved. For case 1, the total operation time was 5.5 h. The blood loss was 1500 mL and the amount of allogeneic blood transfusion was 1580 mL during the operation. SVA was reduced to 127 mm and LL decreased from preoperative 42.7° to −28.4°. The correction angle through L3 was 34.7° and the correction angle through the osteotomy segment was 62.9°. For case 2, the duration of surgery was 6.5 h. The operative blood loss was 2000 mL and the total amount of blood transfusion was 2020 mL. SVA was reduced to 209.8 mm and LL decreased from preoperative 58.8° to 9.2°.The correction angle through L2 was 37.1° and the correction angle through the osteotomy segment was 55°. No intra‐operative or post‐operative complications were observed. Six months after PSO, case 1 had good posture for standing and sitting. The case 2 underwent bilateral THRs nine months after PSO. Conclusion PSO could be performed in the lateral position successfully. For AS patients who cannot be placed in the prone position due to coexisting severe thoracolumbar kyphosis and hip flexion contracture, performing spinal osteotomy in the lateral position as the first step is an alternative., For AS patients who cannot be placed in the prone position due to coexisting severe thoracolumbar kyphosis and hip flexion contracture, performing spinal osteotomy in the lateral position is an alternative and can be performed successfully.

Precision handicraft workers are often exposed to stressful postures and poor working conditions while performing different jobs, that are directly associated with the development of musculoskeletal disorders (MSDs). This cross-sectional study aimed at evaluating the prevalence of MSDs and contributing risk factors among male precision handicraft workers. 334 handicraft workers involved in different precision activities: 125 gemstone cutters, 98 miniature painters, and 111 metal craft workers, were surveyed. Information about the prevalence of musculoskeletal symptoms and work-related factors was collected using the self-reported questionnaire and direct observation methods, viz. rapid upper limb assessment (RULA) and rapid entire body assessment (REBA). Chi-square test was performed to analyze the association of MSD symptoms between the handicraft occupations. Further, binary logistic regression was used to identify the potential risk factors for MSD symptoms among workers. In all occupational groups, most participants reported high prevalence of MSDs primarily in the neck (61.6%), lower back (74.8%), and knee (54.7%) regions. Results revealed that age, work experience, prolonged work hours, sustained awkward posture, continuous work without break, extensive work pressure, and poor job control increased the risk of MSD symptoms in different body regions, while with a higher level of education, MSDs in the neck and lower back regions reduced. The findings indicated incompatibility between precision handicraft workers and the occupational environment. Logistic regression models showed significant contribution of physical and psychosocial work-related factors in developing MSD symptoms. Ergonomic interventions are imperative to evade adverse consequences on the occupational health of precision craft workers.

Background: COVID-19 restrictions and alterations to daily living (e.g. working from home, caregiving responsibilities) necessitated changes in physical activity (PA) behavior. Purpose: The purpose of this study is to understand how PA within specific domains and behavior settings changed during the COVID-19 pandemic. Methods: An e-survey, conducted April-June 2020, examined changes in PA across domains and settings in a national sample of adults (N=805; M age=38.7 ± 14.9 yrs; 78.0% female). Results: Respondents reported domain-specific increases in household and recreational PA, but decreases in active transportation, occupational PA, and public transportation use. Weekly minutes of PA changed significantly across all behavior settings, with reported increases in home-based, neighborhood, parks/trails, and total PA, and decreases in PA through recreational sports and fitness facilities. Total weekly PA minutes increased by 10.6% (Z= 4.428, p < .000). Those with caregiving responsibilities reported increases in household PA (2=9.82, p=0.007) and PA frequency (2=8.21, p=0.02). Those without caregiving responsibilities were more likely to report increases in sitting (2=20.55, p

The purpose of this investigation was to investigate how the exercise habits of college students changed during the COVID-19 pandemic lockdown. Data were collected via an online survey distributed through the University of Southern Maine student email distribution list. All current university students were invited to participate in the survey starting in February 2021 through March 2021. The study included a questionnaire designed to capture the exercise habits of university students three months before the lockdown of COVID-19 (January – March 2020) and their exercise habits after a lockdown in (February - April 2021). The survey questions were based on the American College of Sports Medicine (ACSM) physical activity guidelines to analyze the participant's exercise habits. The participants showed a decrease in the exercise along with an increase in weekly sitting time. Before COVID-19, 21.8% of participants were sitting >35 hours per week. After the COVID-19 lockdown, 50.45% of participants were sitting >35 hours per week. The results of this study could be used for further research to promote an increase in exercise at home. With the uncertainty of the pandemic, motivating people to stand and walk more could be the first step in breaking the increase in sitting habits and help to increase exercise habits. The COVID-19 pandemic has indeed imposed many restrictions on our daily routines, but it could also guide us to new approaches for prescribing exercise programs in the future.

The study aimed to develop and validate a cut-off for daily postures to discriminate workers with low back pain. The self-reported episode of low back pain in the last year and during the previous week and the total spent time in occupational postures of 529 workers were used to screen workers who more likely would report low back pain. The receiver operating characteristics curve verified the ability of daily time in each posture in discriminating workers with low back pain in a training sample. Then, the chi-squared test and measurements of the diagnostic accuracy were performed in the testing sample. The daily time spent in a given posture was not able to accurately discriminate against workers with low back pain. Total time spent walking was the only daily posture that discriminated workers with low back pain in the last year in the testing sample, albeit with low accuracy. Practitioner Summary: The daily time spent in a given posture was not able to accurately distinguish workers with low back pain. Total spent time in walking presented modest diagnostic accuracy and should be interpreted cautiously. The spent time in a particular posture did not detect workers with LBP in the last week.

Background Hip- and wrist-worn ActiGraph accelerometers are widely used in research on physical activity as they offer an objective assessment of movement intensity across the day. Herein we characterize and contrast key structured physical activities and common activities of daily living via accelerometry data collected at the hip and wrist from a sample of community-dwelling older adults. Methods Low-active, older adults with obesity (age 60+ years) were fit with an ActiGraph GT3X+ accelerometer on their nondominant wrist and hip before completing a series of tasks in a randomized order, including sitting/standing, sweeping, folding laundry, stair climbing, ambulation at different intensities, and cycling at different intensities. Participants returned a week later and completed the tasks once again. Vector magnitude counts/second were time-matched during each task and then summarized into counts/minute (CPM). Results Monitors at both wear locations similarly characterized standing, sitting, and ambulatory tasks. A key finding was that light home chores (sweeping, folding laundry) produced higher and more variable CPM values than fast walking via wrist ActiGraph. Regression analyses revealed wrist CPM values were poor predictors of hip CPM values, with devices aligning best during fast walking (R2 = 0.25) and stair climbing (R2 = 0.35). Conclusions As older adults spend a considerable portion of their day in nonexercise activities of daily living, researchers should be cautious in the use of simply acceleration thresholds for scoring wrist-worn accelerometer data. Methods for better classifying wrist-worn activity monitor data in older adults are needed.

Introduction Previous research suggests that African Americans are less likely than Caucasians to perceive tinnitus in sustained silence. Objective To evaluate the association between non-cutaneous melanin as indicated by eye color and the emergence of temporary tinnitus during a brief period of silence. Methods A cross-section of adults grouped according to their eye color were exposed to silence. A total of 62 adults, aged 18 to 35 years (10 males, 52 females) were required to sit in silence for 10 minutes, after which they filled out a questionnaire to report their eye color and any perception of sounds in the ears or head. Results In total, 63% of the participants perceived tinnitus while sitting in silence, and, of these 95% perceived the tinnitus sounds within 5 minutes of sitting in silence. Though African Americans were less likely to perceive tinnitus in silence, this difference was not significant (p = 0.6). After a period of silence, 69% of the subjects with light-colored eyes and 58% of the dark-eyed subjects perceived tinnitus. This difference was not statistically significant (χ2(1) = 0.77; p = 0.38). Conclusion When exposed to reduced auditory stimulation, 3 out of 5 normal-hearing people are likely to experience tinnitus. However, there was no relationship between eye color and the perception of tinnitus in silence. Although melanin has been shown to play a role in the protection of the ear against noise trauma and the effects of age-related hearing loss, its role in the emergence of tinnitus needs further investigation.

This study aims to explore the issue of Sumang and moral panic including the level of understanding of adolescents, and forms and causes of violation of Sumang's values. The research method used qualitative with a case study approach. The research subjects consisted of 35 adolescents (14-20 years), 2 Guidance Counseling teachers, 3 parents, and 3 cultural community leaders. The data collection techniques used open questionnaires and direct interviews. The results of the study show, first, that the majority of adolescents who do not know Sumang mat cause adolescent behavior became inconsistent with the values in Gayo society. Second, Sumang's form of violation is in the form of Percerakan (words), Pelangkahen (steps), Penengon (vision), and Pengunulen (sitting). Third, the factor that causes Sumang's culture to fade is due to a paradigm shift in the values of success and happiness in the Gayo community.

This study aimed to explore the rates of motor difficulties in children from the Australian Autism Biobank, and how early motor concerns impacted on children functionally. Children with autism aged 2–7 years, including 441 with a Vineland Adaptive Behavior Scale (VABS-II) motor subscale and 385 with a Mullen Scales of Early Learning (MSEL) fine motor subscale were included (n total = 514; 80% male). Approximately 60% of children on the MSEL and ~ 25% on the VABS-II had clinically significant motor impairments. More children with delayed sitting and walking motor milestones had early childhood parent reported motor difficulties (p

Study design Cross-sectional study. Objectives To compare cardiac autonomic modulation of individuals with spinal cord injury (SCI) that practice different amounts of moderate to vigorous physical activity (PA) and able-bodied controls at rest and during a non-immersive Virtual Reality task. Setting Athletes with SCI of wheelchair basketball, wheelchair tennis, wheelchair handball, WCMX (wheelchair motocross), and para-swimming were assessed at the Faca na Cadeira Institute, ICEL and Clube Esperia in Sao Paulo, Brazil; non-athletes with SCI and able-bodied controls were assessed at the Acreditando Centro de Recuperacao Neuromotora, Sao Paulo, Brazil. Methods One-hundred forty-five individuals were assessed: 36 athletes with traumatic SCI (41.1 ± 16.8 years old), 52 non-athletes with traumatic SCI (40.2 ± 14.1 years old), and 57 able-bodied individuals (39.4 ± 12.5 years old). Cardiac autonomic modulation was assessed through heart rate variability (HRV) measured in the sitting position at rest and during a VR game activity. Results We found significantly more favourable HRV for athletes with SCI when compared to non-athletes with SCI, but no differences between athletes with SCI and able-bodied controls. In addition, athletes and able-bodied controls showed adequate autonomic nervous system (ANS) adaptation (rest versus physical activity in VR), i.e., they experienced parasympathetic withdrawal during VR physical activity, which was not found in non-athletes with SCI. Conclusion The practice of moderate to vigorous physical activity is associated with healthier cardiac autonomic modulation in adults with SCI, which may lead to more favourable health outcomes. Trial registration ClinicalTrials.gov Identifier: NCT04618003, retrospectively registered.

PURPOSE Adequate patient positioning is of paramount importance in neurosurgery. Complications related to the position are common and make up for more than 16% of the claims towards anaesthesiologists and neurosurgeons. This paper aims to provide the anaesthesiologist with a practical guide to avoid common pitfalls related to the patient positioning process. METHOD We performed a systematic review of the medical literature for the identification, screening, and inclusion of articles. The bibliographic search was conducted on June 1st, 2021 by two of the authors. In this review, we included articles indexed by MEDLINE, Cochrane Library, or Google Scholar. RESULTS We retrieved a total of 5706 unique papers from our initial search. However, after the initial screening, 5363 papers were removed is not related to our research leaving a total of 343 papers. We examined the full text of all the 343 articles including 68 of them in the final qualitative analysis. DISCUSSION In this review we examine the most common neurosurgical positions: supine, sitting, lateral, park-bench, prone, jack-knife, and knee-chest. For each of them, the proper positioning and related complications are described. Particular attention is given to the prevention and management of these complications, providing a practical guide for clinicians.

OBJECTIVE Previous studies reveal improved perception of time spent, as well as overall experience, for patients when their inpatient provider is seated during an encounter. With our study, we aim to establish whether family experience and perception of time is improved when a pediatric inpatient provider team sits for patient and family-centered rounds. PATIENTS AND METHODS From February 2017 to November 2017, 99 inpatient encounters were randomly assigned to either a sitting or standing rounding team. Mean total time spent on rounds, family perception of time spent on rounds, and overall family experience with rounds (by using top-box analysis of physician communication questions) were compared between the 2 groups. RESULTS Total time spent on rounds was similar between the 2 groups (14.2 minutes in the sitting group and 12.7 minutes in the standing group; P = .23), and families in general overestimated the time spent with physicians in both groups (15.9 minutes in sitting group and 14.8 minutes in the standing group; P = .45). There were no significant differences in top-box experience responses (62% in sitting and 55% in standing; P = .12). CONCLUSIONS Sitting during the patient and family-centered rounds encounter did not affect actual or perceived time spent during rounds. Families may have a slightly more positive experience with seated rounds, but the difference in this study did not reach a level of statistical significance.

AimsCam and pincer morphologies are potential precursors to hip osteoarthritis and important contributors to non-arthritic hip pain. However, only some hips with these pathomorphologies develop symptoms and joint degeneration, and it is not clear why. Anterior impingement between the femoral head-neck contour and acetabular rim in positions of hip flexion combined with rotation is a proposed pathomechanism in these hips, but this has not been studied in active postures. Our aim was to assess the anterior impingement pathomechanism in both active and passive postures with high hip flexion that are thought to provoke impingement.MethodsWe recruited nine participants with cam and/or pincer morphologies and with pain, 13 participants with cam and/or pincer morphologies and without pain, and 11 controls from a population-based cohort. We scanned hips in active squatting and passive sitting flexion, adduction, and internal rotation using open MRI and quantified anterior femoroacetabular clearance using the β angle.ResultsIn squatting, we found significantly decreased anterior femoroacetabular clearance in painful hips with cam and/or pincer morphologies (mean -11.3° (SD 19.2°)) compared to pain-free hips with cam and/or pincer morphologies (mean 8.5° (SD 14.6°); p = 0.022) and controls (mean 18.6° (SD 8.5°); p < 0.001). In sitting flexion, adduction, and internal rotation, we found significantly decreased anterior clearance in both painful (mean -15.2° (SD 15.3°); p = 0.002) and painfree hips (mean -4.7° (SD 13°); p = 0.010) with cam and/pincer morphologies compared to the controls (mean 7.1° (SD 5.9°)).ConclusionOur results support the anterior femoroacetabular impingement pathomechanism in hips with cam and/or pincer morphologies and highlight the effect of posture on this pathomechanism. Cite this article: Bone Jt Open 2021;2(11):988–996.