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Background: Trunk rotation during pitching correlates with pitching velocity and load on the joints of the upper limb. Trunk rotation is often focusing on during teaching the pitching motion. Athletes who exhibit early trunk rotation during pitching often have low thoracic spine rotational range of motion. The purpose of this study was to investigate the relationship between the range of thoracic spine rotation measured using the lumbar locked rotation test (LLR-t), hip-shoulder separation (H/S) and thoracic rotation angle at stride foot contact (SFC), and ball velocity. Study design: Descriptive laboratory study. Methods: Fifteen healthy male high school students belonging to a baseball club were recruited for participation. The throwing side and non-throwing side LLR-t was performed using an inclinometer. Hip-shoulder separation and thoracic rotation angle during SFC were measured using a pitching motion analysis application: Pitch AI. In addition, a tracking device specifically designed for pitching：Pitching2.0 was employed to measure ball velocity. Correlations between LLR angle, H/S, trunk rotation angles at SFC, and ball velocity were examined using Pearson's correlation coefficient. Result: There was a positive correlation（r=0.52，p=0.047） between the LLRt angle and H/S. Additionally, there was a negative correlation（r=-0.62, p =0.01） between the LLRt angle on the throwing side and thoracic rotation angle. There was a positive correlation(r=0.54, p=0.04) between ball velocity and H/S and a negative correlation(r=-0.56, p=0.03) between ball velocity and thoracic rotation angle during SFC. Conclusion: The LLR-t measures thoracic rotation angle with the pelvis-lumbar spine fixed. The results indicated that throwing side LLR was related to the thoracic angle during SFC and hip-shoulder separation. Level of evidence: 3 [ABSTRACT FROM AUTHOR]

Background: The seated wall angel (SWA) is an intervention to improve upper quarter mobility but has not been described as a clinical test with scoring. Hypothesis/ Purpose: To explore the clinical utility of the SWA as a test with scoring. The authors hypothesized that SWA test scores would be lower on the injured than uninjured side, improve over time, and show stronger association with patient-reported shoulder function than shoulder mobility tests. Study Design: Prospective cohort. Methods: Patients diagnosed with anterior shoulder instability and referred to physical therapy participated. Testing occurred after physical therapy examination (initial) and six weeks later (follow-up). Rehabilitation was not controlled. Testing included clinical tests (SWA, passive shoulder external rotation range of motion, total arc of motion) and patient-reported outcomes including the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, (ASES) and the Western Ontario Shoulder Instability Index (WOSI). The SWA test was scored 0 to 3 points bilaterally based on number of body contacts with the wall (i.e., elbows and fingertips, posterior fingers, posterior forearm). Passive range of motion was measured with a standard goniometer. SWA scores were compared between sides at initial testing and compared between testing timepoints on the injured side. Associations among injured side clinical test values and patient-reported outcome scores were examined. Results: Mean (SD) SWA score on the injured side was significantly lower than the uninjured side at initial testing [1.6 (1.0) vs 2.2 (1.1), p = 0.045] and significantly increased at follow-up testing [2.4 (1.0), p = 0.041]. Only SWA test score was significantly correlated with ASES (r=0.597) and WOSI (r=-0.648) scores at initial testing, and SWA test score was significantly correlated with WOSI score at follow-up testing (r=-0.611). Conclusions: The clinical utility of the SWA test is supported by distinguishing the injured and uninjured sides and having stronger associations with patient-reported shoulder function than shoulder mobility tests. [ABSTRACT FROM AUTHOR]

Background: Throwing velocity is an important research topic in sports science, and it is an essential performance variable for athletes in overarm-throwing sports like baseball, team handball, water polo, softball, and cricket. The aim of the present review was to investigate the effect of specific strength training on throwing velocity for overarm throws. Methods: The literature was analysed using the Preferred Reporting Items for Systematic reviews and Meta-analyses, searching in SPORTDiscus and MEDLINE. Seventeen studies were included in this review, and the training studies were divided into four categories: (a) overweight and underweight balls, (b) forearm loading, (c) pulley device training, and (d) strength training with a resistance band. Results: All strength training studies with resistance band and the forearm loading categories increased the throwing velocity, varying from 3.7 to 26%. However, only half of these studies found that training was associated with a significantly higher increase versus the control group. Findings were inconsistent in other categories. Conclusion: Based on the findings of the present review, no clear conclusion can be made on which of the specific strength training methods is best for increasing throwing velocity. However, some recommendations can be offered. Firstly, the throwing training period should be long enough (≥ 6 weeks) with a high enough workload. Throwing training with a resistance band increases throwing velocity significantly for junior and less experienced overarm-throwing athletes. Furthermore, throwing with underweighted balls of similar size will ensure a positive effect on throwing velocity. Also, throwing training with combined over- and underweighted balls can be used if the overweighted balls are carefully selected to ensure there is no negative impact on throwing kinematics and injuries. For the other categories, the results were conflicting. Furthermore, due to the low number of studies in the pulley device and forearm loading categories, more studies should be conducted to investigate their effects on throwing velocity. Key Points: • All strength training studies with resistance band and the forearm loading categories increased the throwing velocity, varying from 3.7 to 26%. • Only half of these studies found that training was associated with a significantly higher increase versus the control group, while findings were inconsistent in other categories. • Due to the low number of studies in the pulley device and forearm loading categories, more studies should be conducted to investigate their effects on throwing velocity. [ABSTRACT FROM AUTHOR]

Background/Objectives: This quasi-experimental study examined the effectiveness of an intensive, group-based pediatric constraint-induced movement therapy (pCIMT) program for young children. Methods: Thirty-five children aged 21 months to 6 years, with unilateral hemiparesis (HP), or weakness on one side of the body from varying etiologies, participated in a 4-week intensive, interprofessional, theme- and group-based pCIMT clinic program in the Midwest, United States. The program ran for 4 weeks with 3 h of therapy per day, 5 days per week with 3 weeks of 24 h casting for the unaffected arm, followed by 1 week of bimanual focus. Outcome measures included the Quality Upper Extremity Skills Test (QUEST), Assisting Hand Assessment (AHA), Canadian Occupational Performance Measure (COPM), and Pediatric Evaluation of Disability Inventory (PEDI). Results: The participants statistically significantly improved the unilateral function of the HP arm in four of five QUEST variables (p < 0.009), bimanual coordination as measured by the AHA (p < 0.001), and some areas of occupational performance as measured by the COPM (p < 0.001) and PEDI (p < 0.05). Conclusions: This study revealed the intensive, group-based pCIMT clinic model was effective and feasible to implement with the support from various stakeholders. [ABSTRACT FROM AUTHOR]

Background: Growth-specific physical characteristics in adolescence may mediate throwing-related loads and movement patterns associated with elbow injuries. In a previous study, the authors calculated the forearm-hand inertia, which is the moment of inertia centered at the elbow joint. Purpose: To determine the relationship of forearm-hand inertia values with throwing motion patterns and elbow valgus load in adolescent baseball players. Study Design: Descriptive laboratory study. Methods: A total of 35 adolescent baseball players underwent measurements by dual-energy x-ray absorptiometry (DXA) scans and a throwing trial. Forearm-hand inertia was determined as the joint moment around the elbow using the subregion analysis mode of DXA. Elbow valgus torque and ball speed during throwing were measured using a dedicated sensor and speed gun, and throwing efficiency was calculated by dividing the elbow valgus load by the ball speed. Players were divided according to the throwing motion pattern in which maximum acceleration occurred: pelvis–upper arm–forearm (proximal-to-distal sequencing [PDS] group; n = 19) or pelvis-forearm–upper arm (proximal upper extremity [PUE] group; n = 16). The groups were compared in terms of ball speed, elbow valgus torque, throwing efficiency, and forearm-hand inertia using t tests and analysis of covariance, with forearm-hand inertia as covariates. The chi-square test was used to examine the relationship between throwing motion patterns and forearm-hand inertia. Results: The PUE group had a higher elbow valgus load (effect size [ES] = 0.65; P =.03), throwing efficiency (ES = 0.63; P =.02), and forearm-hand inertia values (ES = 0.64; P =.04) than the PDS group. In addition, a significant relationship was observed with throwing patterns when forearm-hand inertia values were 350 kg·m2 (OR, 2.36; 95% CI, 1.09-5.12; P =.012) and 400 kg·m2 (OR, 1.68; 95% CI, 0.99-2.85; P =.037). Conclusion: Study results indicated that growth-specific physical characteristics in adolescent baseball players exhibited in forearm-hand inertia mediated the relationship between high elbow valgus and poor throwing efficiency caused by poor throwing motion patterns. Clinical Relevance: A better understanding of the details in muscle function with throwing mechanics may prevent future injuries. [ABSTRACT FROM AUTHOR]

Background and objective: Stroke is one of the neurological disorders which is caused by disturbance in blood supply to the brain resulting in weakness in contralateral limbs and axial musculature. Stroke is the leading cause of physical impairment where the most prominent motor deficit is paresis of one side of body, which is contralateral to the event. This study was conducted with an aim to assess the effectiveness of bilateral upper extremity training on trunk performance, posture and gait in patients with subacute stroke. Method: 30 subjects with subacute stroke were selected for the study. Subjects were treated for 3 days/week for 12 sessions with 45 minutes of task oriented, strengthening training and PNF technique for bilateral upper extremity along with conventional training. The rehabilitation protocol consists of bilateral functional exercises, activity of daily living goal, exercises in multiple movement games, strengthening exercises for lower limb, controlled sitting training, sit to stand training, weight bearing and balance training Conclusion: Significant improvement in all items of TIS, PASS and DGI were observed after intervention (P< 0.001). The study concluded that bilateral upper extremity training is more effective in improving trunk control, posture and gait in subacute stroke patients. [ABSTRACT FROM AUTHOR]

Individuals working in the field of dentistry have a high prevalence of musculoskeletal disorders (MSDs) owing to monotonous and one-sided physical exertion. Inertial measurement units (IMU) are increasingly shifting into focus for assessing postural risk at work. Therefore, the present study aimed to evaluate the effects of an ergonomic lecture and training intervention on postural risk and MSDs in dental assistant students using inertial sensor-based motion capture (MoCap). Eighteen female dental assistant students (age: 19.44 ± 6.83 years; height: 164.59 ± 5.32 cm; weight: 64.88 ± 16.52 kg; BMI: 19.70 ± 4.89 kg/m2), randomly divided into intervention (n = 9) and control (n = 9) groups, participated in the present study. The participants completed the Nordic Questionnaire on MSD prevalence, after which a 90 s MoCap with Xsens IMU was performed. A lecture on ergonomics was provided, followed by a five-week intervention for the intervention group. Follow-up assessments were performed, and 5- and 18-week follow-up MSD questionnaires were administered. Mixed analysis of variance (MANOVA) showed a significant difference in the Rapid Upper Limb Assessment (RULA) and part-scores of the upper arm and wrist. Despite a reduction in MSDs, no significant differences in the time of measurement and groups were detected after the five-week training intervention and the 18-week follow-up questionnaire. A targeted ergonomics lecture was effective for dental assistant students, and technologies such as IMU improved workplace ergonomics in dentists. Further studies with a longer measurement periods, follow-up, and larger sample sizes are recommended. [ABSTRACT FROM AUTHOR]

Background: Stroke is the leading cause of long-term disability impacting patients' daily lives. Adequate and ongoing rehabilitation is a necessity. Due to disability problems, rehabilitation in the health care system is limited. Traditional medicine has been promoted in Thailand for stroke rehabilitation, with physical therapy as the primary treatment plan. However, despite more options, many patients still receive inadequate rehabilitation. The development of an appropriate rehabilitation model is still necessary. This study aims to study factors influencing limb movements in post-stroke patients. Methods: This cross-sectional study comprised 120 ischemic stroke patients obtained by multi-stage sampling in Muang district, Phitsanulok province. The data were collected using questionnaires with Cronbach's alpha coefficient of 0.89. The ability to move the muscles of the limbs of the patients was assessed using the motor power assessment form, and binary logistic regression statistics analyzed the factors influencing limb movements. Result: Data analysis shows that 76% of the stroke patients were female, 39.3% aged 61–70 years had a mean of 62 years and a standard deviation (S.D.) of 8.9, 4.6% of stroke patients had a duration of illness of 6–12 months, and 94.2% had a caregiver. 53.1% received rehabilitation once a week, and 92.5% received Thai massage. Thai traditional medicine utilization methods consist of Thai massage, herbal compresses, herbal steam, and taking herbal medicines. There are two factors influencing the ability to move the limb muscles of stroke patients as follows: (1) the massage with the Thai traditional medicine rehabilitation method (Adj OR = 28.917, p-value = 0.006) and (2) the number of rehabilitation sessions per week (Adj OR = 2.465, p-value < 0.001). These two variables explain the variance of regaining limb movement among post-stroke patients of 42.5% at a significance level of 0.05. In this analysis, the predictive accuracy was 70%. Conclusion: Rehabilitation using Thai massage, together with the number of rehabilitation sessions per week, influenced the ability of limb movement in post-stroke patients. In other words, increasing the number of rehabilitation times per week and using Thai massage in rehabilitation will help stroke patients move their limbs better. [ABSTRACT FROM AUTHOR]

Introduction: Complex distal humerus coronal shear fractures are rare injuries. These fractures involve small articular fragments and are challenging to fix. Design: Aprospective case series of 10 patients was done at a level 1 trauma centre between February 2017 and July 2021. Dubberley type 3 fractures were included in the study. Intervention: All patients underwent ORIF using posterior approach with olecranon osteotomy by a single surgeon. Patients were followed up for a minimum of 12 months postoperatively. Outcome Measures: The primary outcome measures were radiographic union and functional status of the limb (DASH score and MEPI score). Results: All patients achieved radiographic union of fracture as well as the osteotomy. The mean DASH score as measured on the final follow-up was 12.6 ± 10.2 and the mean MEPI score was 90 ± 8.2. None of the cases needed reoperation. Conclusion: Consistently good functional outcomes can be obtained in complex coronal shear fractures by posterior approach with olecranon osteotomy. Dubberley type 3b patients should undergo additional plate fixation. [ABSTRACT FROM AUTHOR]

The priorities of individuals with chronic stroke are not always reflected in clinical practice. This study provides insight into meaningful factors related to long-term motor recovery in stroke survivors. Thirty individuals with chronic stroke participated in semi-structured interviews about movement, recovery, and barriers to and facilitators of mobility and paretic arm use. The interviews were analyzed using inductive thematic analysis. Three categories, the individual, environment, and task, defined five emergent themes. Individual: (1) mindset is a strong and consistent influencer of daily physical activity and overall recovery; (2) severe physical impairment limits physical activity and recovery, regardless of other factors; and (3) a negative perception of disability impacts mindset and willingness to move in public. Environment: (4) social and physical environments influence physical activity and recovery. Task: (5) participation in meaningful activities increases physical activity and promotes long-term recovery. Strategies to incorporate paretic arm use, exercise, and encouragement from others facilitate physical activity. Insufficient paretic limb function, environmental obstacles, and fear are barriers to physical activity. Neurorehabilitation must address the factors that are meaningful to stroke survivors. Building motor capacity is essential and must be integrated with factors such as a positive mindset and proper environment. Individual differences reinforce the need for personalized care. [ABSTRACT FROM AUTHOR]

Background: When the lead leg of a pitcher contacts the ground, the knee braces and then rapidly extends, initiating energy transfer to begin pelvis and trunk rotation. Purpose: To investigate the relationship of lead knee extension during the pitching delivery with peak lead knee extension velocity, ball velocity, and elbow varus torque in high school and professional pitchers. Study Design: Descriptive laboratory study. Methods: Data from 50 professional (PRO) and 50 high school (HS) pitcher groups were retrospectively analyzed. Pitchers threw 8 to 12 fastballs under 3-dimensional motion analysis (480 Hz). The groups were divided according to high or low lead knee extension: PRO-high (n = 18), PRO-low (n = 16), HS-high (n = 16), and HS-low (n = 17). Lead knee flexion, lead knee extension velocity, ball velocity, and elbow varus torque were analyzed between groups. Regression analyses were performed to quantify associations between lead knee extension and ball velocity and elbow varus torque for all pitchers. Results: At foot contact, all pitchers landed with similar knee flexion. PRO-high and HS-high pitchers had significantly greater lead knee extension through remaining pitching time points compared with the PRO-low and HS-low pitchers. PRO-high pitchers had faster ball velocity than PRO-low pitchers (39.8 ± 1.1 vs 39.3 ± 1.3 m/s, respectively), and HS-high pitchers had faster ball velocity than HS-low pitchers (34.1 ± 2.6 vs 31.2 ± 1.8 m/s, respectively) (P <.05). PRO-high pitchers had decreased elbow varus torque compared with PRO-low pitchers (85.3 ± 10.7 vs 95.4 ± 13.3 N·m, respectively); conversely, HS-high pitchers had greater elbow varus torque than HS-low pitchers (64.2 ± 14.7 vs 56.3 ± 12.2 N·m, respectively). For every 1° increase in lead knee extension, ball velocity increased by 0.47 m/s (P <.001) and elbow varus torque increased by 0.27 N·m (P =.025). Conclusion: Proper lead knee extension allowed efficient energy transfer through the kinetic chain to produce optimal ball velocity and minimize elbow varus torque in professional pitchers. Conversely, while proper lead knee extension improved ball velocity among high school pitchers, this did not minimize elbow varus torque. Clinical Relevance: Professional pitchers can extend their lead knee with minimal impact at the elbow. In high school pitchers, cognizance of proper full-body pitching mechanics remains a priority over increased velocity. [ABSTRACT FROM AUTHOR]

Upper limb impairment is common after stroke, with a significant impact on the stroke survivor's function, social participation and quality of life. Clinical guidelines are needed to inform clinical practise, tailor interventions to improve outcomes and address unresolved research questions. This review contributes to the evidence guiding clinical practise for upper limb motor recovery after stroke by summarising the recommendations from the UK rehabilitation guidelines (National Institute for Health and Care Excellence (NICE) and the Intercollegiate Stroke Working Party (ISWP)) and the European Stroke Organisation (ESO) guidelines, all published in 2023. All three guidelines target researchers, clinical practitioners, stroke survivors and their social networks. An important feature in all three guidelines was therapeutic intensity, with all guidelines recommending increased therapeutic intensity. Unlike the ESO, the NICE and ISWP additionally include specific research recommendations. While the NICE guidelines seem more holistic and target a wider audience, the three guidelines are complimentary. We recommend that a future consensus statement should be developed in partnership between all three organisations, agreeing on scope and using the same terminology, on recommendations to improve stroke rehabilitation in the UK and Europe. [ABSTRACT FROM AUTHOR]

Background. It is still not clear what physiologically differentiates trained individuals from untrained individuals regarding the ability to hypertrophy, with speculation that these individuals may present different swelling levels in response to the same training load. Objective. This study aimed to compare the response of muscular swelling between eight adults from the More Experienced Group (MEG) and eight participants from the Less Experienced Group (LEG). Methods. The swelling response in the biceps brachii muscle was assessed by measuring the variation in cross-sectional area at 50% of the arm length (pre vs post) using B-mode ultrasound through a paired t-test. This comparison was conducted after the completion of four sets to failure at 70% of the one maximum repetition test in the preacher barbell curl exercise. Additionally, the mean values for the maximum number of repetitions (MNR), time under tension (TUT), and the rate of perceived exertion (RPE) for the four sets were also compared using a paired t-test. Results. LEG exhibited greater muscle swelling compared to the MEG (22.59 ± 7.05%; 15.71 ± 5.40%, respectively: p < 0.001), although no significant differences were observed in MNR, TUT, and RPE. Conclusions. Experience level appears to influence the response of muscular swelling, indicating that individuals with less experience tend to have greater swelling than those with more experience in strength training. Thus, more trained individuals should seek to implement training strategies, such as an increase in training load, if maintaining muscular swelling is desired. [ABSTRACT FROM AUTHOR]

Background A strong body of literature has been published outlining muscle activity differences during sports performance in groups of overhead athletes. However, there are limited studies that have directly compared the muscle activity in overhead athletes with and without history of shoulder injury during functional everyday tasks. Purpose This study aimed to identify muscle activities across fourteen upper extremity and core muscles during three functional everyday movements in athletes with and without history of shoulder injury. Study Design Cross-Sectional Study Methods Thirty-two male overhead throwing athletes (fifteen healthy and seventeen injured) were recruited and completed three everyday functional movements of high elevation, low elevation, and rotation, using their dominant arm to move an object between two fixed positions. Electromyography (EMG) was recorded for fourteen muscles including: biceps brachii, deltoids (anterior, medial, and posterior), trapezius (upper and lower), pectoralis major, latissimus dorsi, serratus anterior, infraspinatus, external obliques, and gluteus maximus (all surface electrodes) and supraspinatus (fine wire electrode). Mixed model repeated measures ANOVA and post-hoc analysis assessed mean muscle activity (%MVC) between groups and each movement phase. Results Upper trapezius elicited higher mean activity in healthy athletes during both phases of the arm rotation task (p < 0.05). No differences between groups were evident for arm elevation tasks. Qualitative analysis of muscle patterns during functional tasks reflected a temporal shift in muscle activation timings and magnitudes between athlete groups, suggesting potential compensatory mechanisms in injured athletes. [ABSTRACT FROM AUTHOR]

Background/Purpose No studies have observed the effects of a collegiate lacrosse season on movement pattern quality, dynamic postural control, or the accuracy of athletes' perceived movement pattern quality. The purpose was to examine the effects of a nontraditional fall season on movement pattern quality, perceived movement pattern quality, and dynamic postural control in collegiate lacrosse athletes. Design Cross-sectional laboratory study. Methods Fifty men's (age=19.38±1.24 years, height=182.63±6.16 cm, mass=82.37±8.46 kg) and 22 women's (age=19.68±1.17 years, height=165.10±6.88 cm, mass=64.09±8.72 kg) lacrosse players were recruited. Outcome measures included individual Functional Movement Screen™ (FMS™) scores, self-reported perceived movement pattern quality scores, lower and upper extremity Y-Balance Test (YBT) measurements, and active dorsiflexion range of motion (ROM) before the start and again at the end of the fall lacrosse season. Preand post-season measurements were assessed using paired t-tests and chi-squared analyses. Results FMS™ composite scores did not significantly change from preseason to postseason for males (p=0.74) or females (p=0.07). Male perceived movement pattern quality was significantly higher than measured for 10 of 12 movements (p<0.05). Female perceived movement pattern quality was significantly higher than measured for four of 12 movements (p<0.05). Asymmetry frequency significantly increased in males in the hurdle step from two individuals to nine ( 1=25.52, p<0.01), inline lunge from 10 to 20 ( 1=12.50, p<0.01), and shoulder mobility from 4 to 21 ( 1=78.53, p<0.01). Asymmetries in male athletes significantly decreased in the active straight leg raise from 26 to 8 ( 1=25.96, p<0.01). YBT composite scores increased in males for the right leg (p=0.001) and left leg (p<0.03). Right dorsiflexion ROM (p<0.001) and left dorsiflexion ROM (p<0.001) significantly decreased in males from preseason to postseason. YBT scores for the right leg significantly increased in females from preseason to postseason (p=0.01). YBT scores for females for the right arm significantly increased from preseason to postseason (p=0.045). [ABSTRACT FROM AUTHOR]

Background: Assessment of upper limb function is critical in the rehabilitation process of people with Parkinson's Disease (PD), and universally validated outcome measures are needed to allow comparisons across the practice. Moreover, the study of psychometric properties of the same tool on different clinical populations guarantees the possibility of reliably evaluating the same rehabilitation treatment in people with different clinical conditions. Aim of the study: The aim of this research was to evaluate the psychometric characteristics of the Italian adaptation of the Jebsen Taylor Hand Function Test (JTHFT) in individuals with PD. Methods: The reliability and validity of the test were assessed in accordance with international standards. Internal consistency was measured using Cronbach's alpha, and test–retest reliability was determined via the intraclass correlation coefficient (ICC). The construct validity and cross-cultural validity of the test were evaluated using Pearson's correlation coefficient with three assessment tools on upper limb function, independence, and quality of life, with hand grip power measured by a dynamometer and an Italian pangram. Finally, responsiveness after a one month of rehabilitation treatment was measured using the Wilcoxon rank test. Results: Fifty-two Italian people with PD were recruited. Cronbach's alpha values ranged from 0.556 (non-dominant hand) to 0.668 (dominant hand); ICC values ranged from 0.754 to 0.988. Construct validity showed that several statistically significant correlations were detected. Wilcoxon's test showed that the assessment tool can detect a change in this population after treatment. Conclusions: The JTHFT is a reliable, valid, and respondent tool to evaluate the upper limb and hand functionalities in PD patients. It should be added to the toolkit for measuring upper limb performance in this population, adding value to clinical evaluation and ensuring comparable results for different clinical populations and different countries. [ABSTRACT FROM AUTHOR]

Purpose: Walking is a complex activity that involves multiple parts of the body, including the lower limb, upper limb, trunk, head, and neck. Contrary to popular belief, walking is not solely related to the forward movement of the legs. Biomechanical analysis, especially in terms of mechanical power, is an essential aspect... [ABSTRACT FROM AUTHOR]

Background and Aims: Traumatic bilateral brachial plexus injuries in adults are rare and present unique challenges in management. We report a case of a 21-year-old veterinary student who sustained bilateral brachial plexus injuries following a fall from a moving two-wheeler. Case Presentation: The patient suffered a C5,6 brachial plexus injury on the right side and a C5–7 injury on the left side. Remarkably, the right-sided injury showed signs of recovery after four months, while the left-sided injury took seven months to resolve completely. Despite the severity of the injuries, the patient underwent a conservative approach and did not undergo any surgical intervention. Results: Following months of dedicated rehabilitation, the patient achieved significant recovery and was able to return to her veterinary studies. This case highlights the potential for recovery in traumatic bilateral brachial plexus injuries with conservative management, emphasising the importance of patient-specific treatment strategies and rehabilitation protocols. Conclusion: Conservative management can lead to significant recovery in traumatic bilateral brachial plexus injuries. Patient-specific treatment strategies and dedicated rehabilitation are crucial components of successful outcomes in such cases. [ABSTRACT FROM AUTHOR]

To assess the evidence for the effect of strength and conditioning on physical qualities and aesthetic competence in dance populations, three electronic databases (PubMed, Scopus, SPORTDiscus) were searched (until September 2022) for studies that met the following criteria: (i) dancers aged >16 years; (ii) structured strength and conditioning intervention; and (iii) with physical qualities and aesthetic competence as outcome measures. Methodological quality and risk of bias of the included studies were assessed through the systematic review tool "QualSyst". Meta‐analyses of effect sizes (Hedges' g) with forest plots explored the effects of the strength and conditioning interventions. Thirty‐six studies met the inclusion criteria and were included in this review. Meta‐analysis indicated strength and conditioning significantly (p < 0.05) improved lower body power (g = 0.90, 95% CI: 0.53–1.27), upper body strength (g = 0.98, 95% CI: 0.39–1.57), lower body strength (g = 1.59, 95% CI: 0.97–2.22), and flexibility (g = 0.86, 95% CI: 0.05–1.66). Strength and conditioning interventions were found to be effective at improving physical qualities in dancers, recommending their participation in additional sessions to enhance overall fitness and ultimately dance performance. It is recommended that future strength and conditioning intervention research should include sample size calculations, with participants recruited from a specific dance genre and skill level in order to evaluate how strength and conditioning influences dance performance. Highlights: Resistance training, plyometric training, whole body vibration training, and combined training are the most common strength and conditioning interventions in dance.Strength and conditioning, regardless of modalities, are found effective at improving some physical qualities in dancers.Dancers are recommended to participate in additional strength and conditioning for overall dance performance enhancement. [ABSTRACT FROM AUTHOR]

While significant progress has been made in understanding the resistance training (RT) strategy for muscle hypertrophy increase, there remains limited knowledge about its impact on fat mass loss. This study aimed to investigate whether full‐body is superior to split‐body routine in promoting fat mass loss among well‐trained males. Twenty‐three participants were randomly assigned to 1 of 2 groups: full‐body (n = 11, training muscle groups 5 days per week) and split‐body (n = 12, training muscle groups 1 day per week). Both groups performed a weekly set volume‐matched condition (75 sets/week, 8–12 repetition maximum at 70%–80 % of 1RM) for 8 weeks, 5 days per week with differences only in the routine. Whole‐body and regional fat were assessed using DXA at the beginning and at the end of the study. Full‐body RT elicited greater losses compared to split‐body in whole‐body fat mass (−0.775 ± 1.120 kg vs. +0.317 ± 1.260 kg; p = 0.040), upper‐limb fat mass (−0.085 ± 0.118 kg vs. +0.066 ± 0.162 kg; p = 0.019), gynoid fat mass (−0.142 ± 0.230 kg vs. +0.123 ± 0.230 kg; p = 0.012), lower‐limb fat mass (−0.197 ± 0.204 kg vs. +0.055 ± 0.328 kg; p = 0.040), and a trend in interaction in android fat mass (−0.116 ± 0.153 kg vs. +0.026 ± 0.174 kg; p = 0.051), with large effects sizes (η2p ≥ 0.17). This study provides evidence that full‐body is more effective in reducing whole‐body and regional fat mass compared to split‐body routine in well‐trained males. Highlights: For strength and conditioning professionals, as well as practitioners aiming to optimize fat mass loss while minimizing delayed onset muscular soreness induced by training, the full‐body routine should be considered and recommended.Our findings shed new light on the manipulation of resistance training variables, particularly training routines, to optimize fat mass loss in the late stages of resistance training.This strategy appears to be particularly relevant for individuals aiming for esthetic physique performance. [ABSTRACT FROM AUTHOR]

The purpose of this study was to clarify the temporal coordination between gaze, head, and arm movements during forehand rallies in table tennis. Collegiate male table tennis players (n = 7) conducted forehand rallies at a constant tempo (100, 120, and 150 bpm) using a metronome. In each tempo condition, participants performed 30 strokes (a total of 90 strokes). Gaze, head, and dominant arm (shoulder, elbow, and wrist) movements were recorded with an eye‐tracking device equipped with a Gyro sensor and a 3‐D motion capture system. The results showed that the effect of head movements relative to gaze movements was significantly higher than that of eye movements in the three tempo conditions. Our results indicate that head movements are closely associated with gaze movements during rallies. Furthermore, cross‐correlation coefficients (CCs) between head and arm movements were more than 0.96 (maximum coefficient: 0.99). In addition, head and arm movements were synchronized during rallies. Finally, CCs between gaze and arm movements were more than 0.74 (maximum coefficient: 0.99), indicating that gaze movements are temporally coordinated with arm movements. Taken together, head movements could play important roles not only in gaze tracking but also in the temporal coordination with arm movements during table tennis forehand rallies. Highlights: This study examined temporal coordination between gaze, head, and arm movements during table tennis rallies.Head movements were closely associated with gaze movements, suggesting that head movements play important roles in gaze tracking during rallies.Head and gaze movements were temporally coordinated with arm movements. This result suggests that head movements could also play important roles in the temporal coordination with arm movements during rallies. [ABSTRACT FROM AUTHOR]

Arm-cycling is a versatile exercise modality with applications in both athletic enhancement and rehabilitation, yet the influence of forearm orientation remains understudied. Thus, this study aimed to investigate the impact of forearm position on upper-body arm-cycling Wingate tests. Fourteen adult males (27.3 ± 5.8 years) underwent bilateral assessments of handgrip strength in standing and seated positions, followed by pronated and supinated forward arm-cycling Wingate tests. Electromyography (EMG) was recorded from five upper-extremity muscles, including anterior deltoid, triceps brachii lateral head, biceps brachii, latissimus dorsi, and brachioradialis. Simultaneously, bilateral normal and propulsion forces were measured at the pedal-crank interface. Rate of perceived exertion (RPE), power output, and fatigue index were recorded post-test. The results showed that a pronated forearm position provided significantly (p < 0.05) higher normal and propulsion forces and triceps brachii muscle activation patterns during arm-cycling. No significant difference in RPE was observed between forearm positions (p = 0.17). A positive correlation was found between seated handgrip strength and peak power output during the Wingate test while pronated (dominant: p = 0.01, r = 0.55; non-dominant: p = 0.03, r = 0.49) and supinated (dominant: p = 0.03, r = 0.51; don-dominant: p = 0.04, r = 0.47). Fatigue changed the force and EMG profile during the Wingate test. In conclusion, this study enhances our understanding of forearm position's impact on upper-body Wingate tests. These findings have implications for optimizing training and performance strategies in individuals using arm-cycling for athletic enhancement and rehabilitation. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review describes the effectiveness of virtual reality (VR)-supported exercise therapy on upper limb motor function and activities of daily living after stroke. Methods: Studies published through January 24, 2022, were identified using CINAHL, Cochrane Library, Embase, Medline, and Web of Science. Randomized control trials comparing VR treatment with conventional therapy (CT) for upper extremity rehabilitation after stroke were included. Methodological quality was assessed using the Cochrane risk-of-bias tool. Results: Of 9 included studies, 5 concluded that the VR group outperformed control participants, 1 indicated the superiority of VR-supported exercises alone over CT, and 3 found VR comparable to CT in promoting upper limb motor function. Five studies analyzed independence in daily living, with 4 reporting no significant difference between VR and CT groups. No strong evidence indicated long-term benefits of VR-assisted exercise. All included studies demonstrated low risk of bias concerning random sequence generation, allocation concealment, outcome assessment blinding, incomplete outcome data, and selective reporting bias. However, a high risk of bias was observed regarding participant blinding due to the nature of the intervention. Conclusion: Most studies suggested that VR, used alongside CT, can improve motor function following stroke. However, the evidence was insufficient to conclude that VR outperforms conventional approaches. [ABSTRACT FROM AUTHOR]

Purpose: The paper aims to comment on interdisciplinary cooperation in preoperative planning, the technical details of materials and technologies used in the production process, and the differences between them from the engineers' and surgeons' points of view. Also, intraoperative difficulties, technical issues, and intraoperative tips are described in detail. Design/methodology/approach: Four patients with forearm fracture malunions were enrolled in a retrospective study. The study group consisted of two boys with improperly healed both-bone forearm fractures (radius and ulna), a girl with a radius shaft fracture malunion, and an adult patient with a distal radius fracture malunion. All patients underwent corrective osteotomy of the forearm bones using patient-specific instrumentation made with three-dimensional printing technology to improve the function of the upper limb. The production process and technical preparation of gauges and implants were presented in detail. Findings: The paper presents in detail the intraoperative difficulties resulting from planning and creating patient-specific instrumentation. Moreover, some intraoperative difficulties, technical issues and intraoperative tips are described depending on the indications and the type of surgery. A total estimate of preoperative time needed for surgical planning, including the time needed to produce individual implants, is approximately four weeks. The estimated surgical time saved is approximately 30 minutes, but a more important aspect is the ability to achieve greater precision in osteotomy and deformation correction. Research limitations/implications: The limitations of the work are the small number of patients assessed and the different profiles of the patients presented. Originality/value: Most published papers focus on the indications for and advantages of these procedures and the clinical results of these procedures. It is typical for developing technologies to highlight the positive aspects of the technique. We present possible drawbacks and technical issues regarding preoperative planning and intraoperative tips and difficulties, which are rarely seen in the literature. [ABSTRACT FROM AUTHOR]

Frailty is a geriatric syndrome associatedwith the lack of physiological reserve and consequent adverse outcomes (therapy complications and death) in older adults. Recent research has shown associations between heart rate (HR) dynamics (HR changes during physical activity) with frailty. The goal of the present study was to determine the effect of frailty on the interconnection betweenmotor and cardiac systems during a localized upper-extremity function (UEF) test. Fifty-six individuals aged 65 or above were recruited and performed the previously developed UEF test consisting of 20-s rapid elbow flexion with the right arm. Frailty was assessed using the Fried phenotype. Wearable gyroscopes and electrocardiography were used to measure motor function and HR dynamics. In this study, the interconnection between motor (angular displacement) and cardiac (HR) performancewas assessed, using convergent cross-mapping (CCM). A significantly weaker interconnection was observed among pre-frail and frail participants compared to non-frail individuals (p < 0.01, effect size = 0.81 ± 0.08). Using logistic models, pre-frailty and frailty were identified with sensitivity and specificity of 82%-89%, using motor, HR dynamics, and interconnection parameters. Findings suggested a strong association between cardiac-motor interconnection and frailty. Adding CCM parameters in a multimodal model may provide a promising measure of frailty. [ABSTRACT FROM AUTHOR]

Objective: Motor imagery-based brain--computer interface (MI-BCI) is a promising novel mode of stroke rehabilitation. The current study aims to investigate the feasibility of MI-BCI in upper limb rehabilitation of chronic stroke survivors and also to study the early event-related desynchronization after MI-BCI intervention. Methods: Changes in the characteristics of sensorimotor rhythm modulations in response to a short brain--computer interface (BCI) intervention for upper limb rehabilitation of stroke-disabled hand and normal hand were examined. The participants were trained to modulate their brain rhythms through motor imagery or execution during calibration, and they played a virtual marble game during the feedback session, where the movement of the marble was controlled by their sensorimotor rhythm. Results: Ipsilesional and contralesional activities were observed in the brain during the upper limb rehabilitation using BCI intervention. All the participants were able to successfully control the position of the virtual marble using their sensorimotor rhythm. Conclusions: The preliminary results support the feasibility of BCI in upper limb rehabilitation and unveil the capability of MI-BCI as a promising medical intervention. This study provides a strong platform for clinicians to build upon new strategies for stroke rehabilitation by integrating MI-BCI with various therapeutic options to induce neural plasticity and recovery. [ABSTRACT FROM AUTHOR]

Aim: Is upper quadrant neural tissue extensibility affected in asymptomatic health care professionals? Participants: Ninety asymptomatic health care professionals of 26–60 years (30 surgeons, 30 dentists, 30 physiotherapist) were selected on the basis of inclusion and exclusion criteria. Methodology: This was a cross-sectional type of observational study, and the data was collected by simple random sampling, in which various ULTT were performed on both upper extremities for median (ULTT1), radial (ULTT2), and ulnar (ULTT3) nerve. Elbow position was measured at first onset of discomfort perceived by participants (R1) and, secondly, when the firm resistance to movement was felt by the examiner (R2), by using universal goniometer. The test was considered positive if the symptoms arise before 60° of end elbow ROM. Results: The results showed that there was reduced upper quadrant neural tissue extensibility in asymptomatic health care professionals. The median nerve was most affected, and the ulnar nerve was least affected. The prevalence rate of reduced neural extensibility was highest among dentists as compared to the surgeons and physiotherapists. High correlation was found between R1and R2 for all three ULTT (p-value = 0.000). Conclusion: More than half, specifically 51.1%, of asymptomatic health care professionals had reduced extensibility of the neural tissues in their upper limbs. Therefore, early introduction of exercise will help in combating the occurrence of these nerve-related issues in further life. [ABSTRACT FROM AUTHOR]

Neuropilates is an intervention approach that was developed as a modified version of the Pilates Method to be used for neurological rehabilitation. The main objective of this study was to analyze the effectiveness of regular physiotherapy and occupational therapy rehabilitation in comparison to a combination of traditional rehabilitation with Neuropilates in adults with post-stroke motor disabilities. This was a rater- and analyst-blinded randomized clinical trial with a three-month intervention and a one-month follow up. Participants were randomly allocated to either the experimental group (EG, receiving a combination of conventional therapy and Neuropilates; n = 15) or the control group (CG, receiving solely conventional therapy; n = 15). Once adjusted for baseline FIM scores, the results showed significant differences favoring the EG in daily functioning (FIM), static balance (FRT), right-hand manual dexterity (NHPT) and right-upper limb coordination (BBT). Satisfaction with the received treatment as measured with the CSQ-8 was significantly higher for the EG. In conclusion, the incorporation of Neuropilates, facilitated by a single experienced therapist, can be a valuable complement to conventional physical and occupational therapy. However, Neuropilates-based interventions should be supervised and tailored to each individual by a professional specifically trained in the method. [ABSTRACT FROM AUTHOR]

The floor apparatus is associated with the highest rate of injury for male and female gymnasts in training and competition. This study aims to determine the magnitude of the upper and lower body impact loading when performing foundation floor tumbling skills and sequences. Fourteen sub‐elite artistic gymnasts (male, n = 9; female, n = 5) performed eight tumbling skills and sequences while wearing four inertial measurement units (IMU; upper back, lower back, forearm, and tibia). The peak resultant acceleration (PRA) during all ground contacts was calculated. The forearm and upper back PRA were analyzed for hand contacts, while the lower back and tibia PRA were analyzed for foot contacts. Descriptive statistics (median and inter‐quartile range), Wilcoxon signed‐rank tests and Friedman's ANOVA were calculated between IMU positions and gymnastics skills. Distal IMUs (forearm and tibia) recorded significantly higher loading than proximal IMUs (upper and lower back) for all ground contacts. Proximal IMUs experienced dampening due to shock attenuation properties of the human body, as these positions are located further away from the impact site. Additionally, some foundation skills exposed gymnasts to higher loading when the skill was performed separately, while other skills exposed gymnasts to higher loading when the skill was performed in a tumbling sequence. Training foundation skills separately and as a part of a tumbling sequence exposes the upper and lower body structures to high levels of impact loading. These results can be used by coaches to help in the design of safe training programs. Highlights: Distal segments (forearm and tibia) experienced significantly higher magnitudes of impact loading than the proximal areas (upper and lower back) during foundation gymnastics skills, most likely due to the shock attenuation properties of the human body when absorbing ground impacts.During the round‐off skill, gymnasts experienced greater lower back impact loading upon landing when performing the skill separately, but experienced greater upper back loading during the hand contact phase when performing the skill as part of a sequence (i.e., round‐off to backwards handspring, and round‐off, backwards handspring to backwards somersault).Impact loading differed between skills performed separately and skills that were performed within a tumbling sequence. Therefore, the loading experienced on the body was different due to the context in which the skill was performed (i.e., having to connect another skill afterward).Skill sequences should be considered as distinct or individual skills, rather than a combination of foundation skills, to better address the observed differences when prescribing and monitoring training loads. [ABSTRACT FROM AUTHOR]

Objective. To investigate the effect of kinesio tape applied to the supraspinatus muscle on shoulder scaption muscle strength and upper extremity stability in healthy women. Methods. 26 healthy female volunteers aged 20-30 years were included in the study. Individuals were randomized into two groups, kinesio taping (n = 13) and sham taping (n = 13). In the kinesio taping group a Y-shaped tape was applied to the supraspinatus muscle in the direction of facilitation while in the sham group an I tape was applied on the scapula. Before taping and 20 minutes after taping the shoulder scaption strength was measured with a dynamometer and functional evaluations were performed by the closed kinetic chain upper extremity stability test. Results. In the kinesio tape group, median scaption strength decreased after taping (p = 0.016). The median contact, normalized, and power scores increased significantly (respectively, p = 0.001, p = 0.001, and p = 0.001). In the sham group there was no significant difference in the median scaption strength after taping; the median contact, normalized and power scores increased significantly (p = 0.004, p = 0.004, and p = 0.006, respectively). There was no significant difference in scaption strength and upper extremity stability test scores between groups. After taping the changes were categorized as "no change", "increase" and "decrease" according to the minimal clinically significant difference value, the number of individuals with increased scaption strength was higher in the kinesio tape group compared to the sham group, although not statistically significant. Conclusions. The significance of kinesio taping applied to healthy women was not observed compared to sham taping on shoulder scaption muscle strength and upper extremity stability. [ABSTRACT FROM AUTHOR]

Purpose: This study investigates the relationship between the scores of upper extremity functional tests with isokinetic strength, range of motion, shoulder proprioception, and posture of male volleyball players. Methods: A total of 30 male university volleyball players aged 18 to 24 years were selected by the convenience sampling method. The concentric... [ABSTRACT FROM AUTHOR]

Background: Cerebral palsy (CP) is one of the primary causes of physical disabilities in children that affects posture and movement. Upper-extremity (UE) function is frequently impaired, which may result in activity and participation limitations in people with CP. The use of kinesiotape (KT) has increased in the treatment of CP for various purposes. The aim of this systematic review was to assess the efficacy of KT for improving UE function in children and adolescents with CP. Methods: The literature search was carried out in PubMed, Cochrane, PEDro, Web of Science and SCOPUS databases. The methodological quality was analyzed with the PEDro scale. Review Manager (RevMan 5.4.1) was used for data extraction and risk of bias assessment. Results: A total of five randomized clinical trials were included. The use of KT showed improvement in UE functionality in three studies, with significant outcomes for range of motion (ROM) (three studies), fine motor skills (two studies), grip strength (one study) and manual dexterity (one study). Moreover, it also showed significant improvements in spasticity and gross motor function (one study). Overall, methodological quality was moderate, and the risk of bias was high in the domains related to blinding. Conclusion: The use of KT showed improvement in UE function in children and adolescents with CP. However, further research is needed to reinforce the conclusions on the efficacy of KT as a therapeutic tool. [ABSTRACT FROM AUTHOR]

Children with unilateral cerebral palsy (UCP) require task-oriented practice several hours per week to produce meaningful gains in affected upper extremity (UE) motor function. Clinicians find it challenging to provide services at the required intensity and sustain child engagement. This pilot study assessed the acceptance and utility of a child-friendly program using dual-joystick-operated ride-on toys incorporated into an intensive UE rehabilitation camp. Eleven children with UCP between four and 10 years received ride-on-toy navigation training for 20–30 min/day, five days/week, for three weeks as part of camp programming. We report session adherence and percent time children spent in task-appropriate attention/engagement across sessions. The overall effects of camp programming on children's motor function were assessed using the Shriner's Hospital Upper Extremity Evaluation (SHUEE) from pretest to posttest and using training-specific measures of bimanual UE use and navigational accuracy. Children showed excellent adherence and sustained task-appropriate engagement across sessions. The combined program led to improved navigational accuracy (p-values ≤ 0.007) as well as spontaneous affected UE use during bimanual activities outside the training context (p < 0.001). Our pilot study provides promising evidence for using modified, commercially available ride-on toys to incentivize rehabilitation and boost repetitive, task-oriented UE practice among children with UCP. [ABSTRACT FROM AUTHOR]

Advances in technology and artificial intelligence (smart healthcare) open up a range of possibilities for precision intervention in the field of health sciences. The objectives of this study were to analyse the functionality of using supervised (prediction and classification) and unsupervised (clustering) machine learning techniques to analyse results related to the development of functional skills in patients at developmental ages of 0–6 years. We worked with a sample of 113 patients, of whom 49 were cared for in a specific centre for people with motor impairments (Group 1) and 64 were cared for in a specific early care programme for patients with different impairments (Group 2). The results indicated that in Group 1, chronological age predicted the development of functional skills at 85% and in Group 2 at 65%. The classification variable detected was functional development in the upper extremities. Two clusters were detected within each group that allowed us to determine the patterns of functional development in each patient with respect to functional skills. The use of smart healthcare resources has a promising future in the field of early care. However, data recording in web applications needs to be planned, and the automation of results through machine learning techniques is required. [ABSTRACT FROM AUTHOR]

The clinical management of traumatic chest incisions accompanied by rib fractures presents the formidable challenge. The study was carried out to compare the outcomes of auscultatory triangle internal fixation (ATIF) and external fixation (EF) in such injuries. From June 2019 to June 2022, 105 patients with multiple rib fractures participated in the cohort study in which they were divided into two groups: 53 patients underwent ATIF and 52 patients underwent EF. The incidence of surgical site infection, wound healing time, incidence of wound dehiscence, number of dressing changes, pain as measured by the visual analogue scale (VAS), duration of hospitalization, period of return to work, pulmonary complications and functionality of the upper limbs as assessed by the Disability of Arm, Shoulder, and Hand (DASH) questionnaire were among the parameters evaluated. In comparison with EF, ATIF demonstrated the decreased incidence of wound dehiscence (1.9% vs. 9.6%) (p < 0.05), surgical site infection (3.8 vs. 11.5) and wound healing time (12.3 ± 2.1 vs. 18.5 ± 3.7 days) (p < 0.05). Furthermore, during their ATIF treatment, patients required fewer changes of dressing (3.5 ± 0.8 vs. 5.7 ± 1.2) and demonstrated enhanced pain management, reduced hospital stays and expedited return to work (p < 0.05). ATIF group demonstrated enhancements in both upper limb functionality and post‐operative pulmonary function (p < 0.05). The utilization of ATIF as opposed to EF for the treatment of traumatic chest wounds accompanied by rib fractures yields superior outcomes in terms of wound healing, infection reduction and restoration of pulmonary and upper limb functionality. [ABSTRACT FROM AUTHOR]

Several interventions using resistance training have been attempted for people with heart failure. Still, the overall effectiveness of resistance training in improving muscle strength and peak oxygen uptake based on age remains inconclusive. This study aimed to investigate the efficacy of resistance training on muscle strength and VO2 peak in patients with heart failure based on age. A search was conducted using English articles from 2000 to 2023 to find information on resistance training from Embase, CINAHL, MEDLINE, Cochrane, PEDro, and Google Scholar. Standardized mean difference and 95% confidence intervals were calculated, and publication biases were presented by funnel plots and Egger's test. The Critical Appraisal Skills Programme was used to examine the quality of the studies. Results showed that 23 randomized control trial articles fulfilled the inclusion criteria, comprising 830 respondents, with 422 in the intervention and 408 in the control group. In the middle-aged subgroup, resistance training had a significant effect on increasing muscle strength in the upper limb and lower limb. Similarly, a significant effect was observed in the older subgroup for the upper limb and lower limb. Resistance training significantly increased VO2 peak in middle-aged and older patients with heart failure. Resistance training was identified as one of the effective ways to improve muscle strength and VO2 peak, and it should be recommended as a part of the rehabilitation for people with heart failure. Additionally, the components of interventions should be considered based on the patient's age to maximize the exercise programs using resistance training. [ABSTRACT FROM AUTHOR]

Background: The importance of several scapulothoracic muscles, including trapezius and serratus anterior, in maintaining physiological scapula kinematics has been highlighted in the past. However, the relationship between the scapula and the latissimus dorsi muscle remains unclear. Our clinical surgical observation is that the latissimus dorsi does not directly attach but rather runs superficial to the inferior angle of the scapula. Based on this observation, we hypothesise that the latissimus dorsi creates a dynamic track on which the scapula glides under the muscle belly during elevation of the arm, creating the latissimus-scapula overlap (LSO). Methods: All consecutive patients who had a whole-body computed tomography scan (CT) in case of polytrauma evaluation between 2018 and 2021, with complete depiction of the scapula and latissimus dorsi muscle, were analysed. 150 shoulders in 90 patients with arms up were matched according to their age (within five years), gender, and affected side with 150 shoulders in 88 patients with arms down. Patients with pathologies of the upper extremities or thorax that potentially could alter LSO measurements were excluded. LSO was calculated as a ratio of the measured area of the latissimus dorsi projection on the scapula and the total scapula area. Results: The mean age of the 178 patients (48 females; 13 males) was 60 years. The arms-up group showed a significantly higher LSO than the arms-down group (19.9 ± 6.3% vs. 2.7 ± 2.2%; p < 0.0001). In the arms-up group, approximately one fifth of the scapula was overlapped inferiorly by the muscle belly of the latissimus dorsi, contrary to the almost non-existing LSO in the arms-down group. Conclusion: With arms up, humans show a significantly higher LSO in comparison to arms down indicating that the latissimus dorsi indeed creates a dynamic track on which the scapula is forced to travel during abduction of the arm. This finding of increased LSO during the elevation of the arm warrants further consideration of the role of the latissimus dorsi in scapula kinematics and potentially scapular dyskinesis. Level of evidence: Level two diagnostic study. [ABSTRACT FROM AUTHOR]

Background: Substance use disorders pose unique challenges, affecting individuals physiologically and socially. This study addresses the fundamental question of how adherence to exercise programs impacts those with substance use disorders, examining both in-person and online interventions. Methods: A 12-week analysis involving 26 participants assessed physical fitness, strength, and quality of life. Participants were categorized into in-person and online exercise groups, with their adherence tracked through attendance and a dedicated app. Results: The in-person group exhibited higher adherence rates and significant improvements, in contrast to the challenges encountered by the online groups, particularly in substance use disorder cohorts. Statistical analyses highlighted these differences, emphasizing the pivotal role of the exercise program delivery format. Conclusions: This research advocates for hybrid models, blending professional supervision with online flexibility, recognizing the distinct challenges of substance use disorders. Insights from this study will contribute to shaping more effective, personalized interventions in the complex landscape of substance use disorders, offering guidance for advancing treatment strategies. [ABSTRACT FROM AUTHOR]

(1) Background: Healthy aging is the process of developing and maintaining functional capacity and optimizing involvement in order to improve one's quality of life as people age. This study aimed to encourage healthy aging in people with cognitive impairment, as well as a control group, via the use of the Nintendo Switch combined with occupational therapy sessions, aiming to improve gross and fine motor skills, functionality, quality of life, and cognitive status. (2) Methods: A randomized clinical trial was undertaken. The sample was randomized using the OxMar software program Attribution 4.0 International, facilitating the division into a control group (CG), who received conventional occupational therapy sessions, and an experimental group (EG), who received therapy incorporating the Nintendo Switch, in addition to conventional occupational therapy sessions. The intervention period with the Nintendo Switch lasted for 8 weeks. (3) Results: Thirty-two participants were included in the study. Significant differences were found in the vast majority of the variables analyzed, which shows an improvement following the intervention; these improvements were mainly observed in measures of skill and the perception of quality of life. (4) Conclusions: An eight-week intervention with the Nintendo Switch alongside conventional occupational therapy helps to maintain cognitive status and functional independence. Following 8 weeks of intervention with the Nintendo Switch, improvements in gross motor dexterity, fine motor dexterity, and quality of life were observed in older people with cognitive impairment. [ABSTRACT FROM AUTHOR]

During full tethered swimming no hydrodynamic resistance is generated (since v = 0) and all the swimmer's propulsive force (FP) is utilized to exert force on the tether (FT = FP). During semi-tethered swimming FP can be made useful to one of two ends: exerting force on the tether (FST) or overcoming drag in the water (active drag: Da). At constant stroke rate, the mean propulsive force (FP) is constant and the quantity FP - FST (the "residual thrust") corresponds to Da. In this study we explored the possibility to estimate Da based on this method ("residual thrust method") and we compared these values with passive drag values (Dp) and with values of active drag estimated by means of the "planimetric method". Based on data obtained from resisted swimming (full and semi-tethered tests at 100% and 35, 50, 60, 75, 85% of the individual FT), active drag was calculated as: DaST = kaST .vST² = FP - FST ("residual thrust method"). Passive drag (Dp) was calculated based on data obtained from passive towing tests and active drag ("planimetric method") was estimated as: DaPL = Dp.1.5. Speed-specific drag (k = D/v²) in passive conditions (kp) was )25 kg.m-1 and in active conditions (ka) )38 kg.m-1 (with either method); thus, DaST > Dp and DaST > DaPL. In human swimming active drag is, thus, about 1.5 times larger than passive drag. These experiments can be conducted in an ecological setting (in the swimming pool) by using basic instrumentation and a simple set of calculations. [ABSTRACT FROM AUTHOR]

Collegiate baseball players with professional aspirations often participate in summer leagues; foremost among them is the Cape Cod Baseball League (CCBL). Injuries acquired during the collegiate baseball season can be carried into the CCBL season and vice versa. To assess the history of throwing arm injury and current functionality in midseason CCBL players. Cross-sectional study. Online questionnaire. A total of 123 CCBL players participated. Qualifying athletes were ≥18 years old and were rostered CCBL players with remaining collegiate eligibility. After collecting background information, we used the Kerlan-Jobe Orthopaedic Clinic (KJOC) Shoulder and Elbow questionnaire to assess the history of throwing arm injury and current functionality. The maximum KJOC score is 100.0; higher scores correspond with greater functionality. The mean KJOC score was 86.6 ± 14.5 (n = 92); 24.5% (23/94) of players reported a prior diagnosis of throwing arm injury other than a strain or sprain. A total of 49 (49/96, 51.0%) players had undergone rehabilitation for a throwing arm injury, and 7 (7/96, 7.3%) had experienced a medical procedure. Players with no previous treatment (n = 41, mean KJOC score = 88.9 ± 19.0) more frequently demonstrated KJOC scores of ≥90 than players with such treatment (n = 55, 80.9 ± 17.1; P <.001). The 18 players with time-loss arm injury in the last year had lower mean KJOC scores (71.3 ± 20.0) than players with no injury or time loss (90.3 ± 9.8; P <.001). Similarly, players who reported current arm trouble (n = 15) had lower KJOC scores (71.6 ± 17.5) than players with healthy arms (89.5 ± 11.9; P <.001). The average KJOC score of the CCBL players was <90, with particularly low scores in athletes with prior arm injury and treatment. [ABSTRACT FROM AUTHOR]

Applying evidence-based therapies in stroke rehabilitation plays a crucial role in this process, as they are supported by studies and results that demonstrate their effectiveness in improving functionality, such as mirror therapy (MT), cognitive therapeutic exercise (CTE), and task-oriented training. The aim of this study was to assess the effectiveness of MT and CTE combined with task-oriented training on the functionality, sensitivity, range, and pain of the affected upper limb in patients with acute stroke. A longitudinal multicenter study recruited a sample of 120 patients with acute stroke randomly and consecutively, meeting specific inclusion and exclusion criteria. They were randomly allocated into three groups: a control group only for task-oriented training (TOT) and two groups undergoing either MT or CTE, both combined with TOT. The overall functionality of the affected upper limb, specific functionality, sensitivity, range of motion, and pain were assessed using the Fugl–Meyer Assessment Upper Extremity (FMA-UE) scale validated for the Spanish population. An initial assessment was conducted before the intervention, a second assessment after completing the 20 sessions, and another three months later. ANCOVA analysis revealed statistically significant differences between the assessments and the experimental groups compared to the control group, indicating significant improvement in the overall functionality of the upper limb in these patients. However, no significant differences were observed between the two experimental groups. The conclusion drawn was that both therapeutic techniques are equally effective in treating functionality, sensitivity, range of motion, and pain in the upper limb following a stroke. [ABSTRACT FROM AUTHOR]

(1) Background: The most common musculoskeletal pathology among healthcare professionals is neck and/or shoulder pain. The aim of this study was to determine the dominant upper limb functionality concerning the ability to replicate a given movement pattern among employees reporting neck or upper limb pain while using a computer during the COVID-19 pandemic. (2) Methods: The study was conducted from March to April 2021 on a group of 45 medical employees who used a computer workstation for 4 to 6 h of their working time. In the design of this study, three study groups were created: a group of patients with pain syndrome of segment C5/C7 of the spine, a group of patients with shoulder pain syndrome, and a control group of healthy volunteers. (3) Results: The examined groups significantly differed in the correctness of performing the given movement (p = 0.001) and the minimum value of inclination during the exercise session (p = 0.026), as well as the maximum lowering (p = 0.03) in relation to the control group. (4) Conclusions: The VECTIS device can be used to assess the accuracy of reflecting the prescribed movement of the upper limb in rehabilitation programs for patients with cervical spine pain syndrome and shoulder pain syndrome. [ABSTRACT FROM AUTHOR]

Background: A disorder characterized by airway obstruction and breathing difficulty is known as chronic obstructive pulmonary disease. Fatigue is one of the typical signs and symptoms of COPD. Fatigue is the term used to describe a persistent feeling of exhaustion, and it can have a significant negative influence on person's capacity to carry out everyday tasks. Purpose: The purpose of this study is to analyze how low impact aerobic training and upper limb strengthening exercise is effective in dyspnea and fatigue level among individuals with COPD. Materials and Methods: The 106 subjects were selected based on inclusion and exclusion criteria from Hepziba Chest Clinic and Spirometry centre, Nagercoil. The pre and post-test values were measured using the BORG scale and Fatigue Severity Scale. The subjects were allocated into two groups. Low impact Aerobic training group:(n=53) received aerobic training with conventional exercise and Upper limb strengthening group:(n=53) received upper limb strengthening exercise with conventional exercise. The study was done for four weeks. The entire procedure was performed from October 2022 to july 2023 Results: When comparing the low impact Aerobic training group with upper limb strengthening group, the low impact Aerobic training group indicates significant (p<0.0001) effect in lowering the fatigue level as assessed by Borg scale and Fatigue Severity Scale. Conclusion: The study concluded that Low impact Aerobic training had a significant effect compared to upper limb strengthening exercise on Dyspnea and Fatigue Severity Scale among individuals with COPD. [ABSTRACT FROM AUTHOR]

Background: Stroke is the quickly developing clinical indication of a focal disruption of brain function that lasts more than 24 hours or results in death, with no discernible cause other than vascular origin. Despite the fact that the majority of patients are able to walk again, 30% to 60% of survivors are no longer able to use the arm that was injured. CIMT aims at improves both the motor and functional capacities of a paretic arm. PNF exercises alter the order in which muscles are stimulated, increases the efficiency of joint movement. Purpose: To compare the effectiveness of Constraint Induced Movement Therapy and Proprioceptive Neuromuscular Facilitation for treating upper extremity functions in stroke. Materials and Methods: A total of 30 participants were selected from Sree Annai Physiotherapy Clinic Chennai. According to the inclusion and exclusion criteria. Subjects willing to participate were allocated into two groups Constraint Induced Movement Therapy group and Proprioceptive Neuromuscular Facilitation group. The participants underwent Pre-test measurement with Fugl-Meyer Assessment Upper Extremity FMA-UE and were repeated for Post-test measurement. Study period: November 2022 to April 2023. Results: When comparing the mean differences of the two groups, Constraint Induced Movement Therapy group displays a greater difference than Proprioceptive Neuromuscular Facilitation group. Therefore, it can be said that Constraint Induced Movement Therapy is more advantageous for the upper extremity functions than Proprioceptive Neuromuscular Facilitation. Conclusion: The study concluded that Constraint Induced Movement Therapy is found to be more effective than Proprioceptive neuromuscular facilitation technique for upper extremity function recovery. [ABSTRACT FROM AUTHOR]

Background: The background of the study focuses on addressing the challenges in hand function that these children face due to their condition. Action observation training aims to leverage the brain's mirror neuron system to improve motor skills by observing and imitating actions. Bimanual arm training involves coordinated movement of both arms to enhance functional abilities. Purpose: The study compared the effects of action observation training and bimanual arm training on hand function in children with hemiparetic cerebral palsy. Materials and Methods: A total of 30 children were chosen according to the inclusion and exclusion criteria. The subjects were separated into two groups: action observation training (AOT) and bimanual arm training (BAT). The Fugl Meyer assessment scale (FMA) and the Box and Block test (BBT) were used for evaluating the result. Results: Both groups were homogenous at baseline, with a p value of 0.7866 in FMA and 0.6002 in BBT. The result of this study demonstrated that the action observation training group showed a better improvement than bimanual arm training with a p value of < 0.0001. Conclusion: This study concluded that AOT improved hand function in cerebral palsy children. [ABSTRACT FROM AUTHOR]

In this study, we developed an AI-based real-time motion feedback system for patients with spinal cord injury (SCI) during rehabilitation, aiming to enhance their interest and motivation. The effectiveness of the system in improving upper-limb muscle strength during the Thera band exercises was evaluated. The motion analysis program, including exercise repetition counts and calorie consumption, was developed using MediaPipe, focusing on three key motions (chest press, shoulder press, and arm curl) for upper extremity exercises. The participants with SCI were randomly assigned to the experimental group (EG = 4) or control group (CG = 5), engaging in 1 h sessions three times a week for 8 weeks. Muscle strength tests (chest press, shoulder press, lat pull-down, and arm curl) were performed before and after exercises. Although both groups did not show significant differences, the EG group exhibited increased strength in all measured variables, whereas the CG group showed constant or reduced results. Consequently, the computer program-based system developed in this study could be effective in muscle strengthening. Furthermore, these findings may serve as a valuable foundation for future AI-driven rehabilitation exercise systems. [ABSTRACT FROM AUTHOR]

Tailoring motor activities to the unique needs of children with special educational requirements has shown considerable efficacy. Our study aimed to develop a structured program specifically designed to enhance psychomotor abilities, focusing on balance and motor–cognitive skills among 28 students (aged 12–14) from two institutional centers in Romania. The program spanned 36 weeks, with biweekly 30 min sessions. Psychomotor skills were assessed through tests measuring balance, speed of movements, and upper limb motor laterality. Initial and final data were collected for evaluation. A statistical analysis, employing the Kolmogorov–Smirnov and Wilcoxon Z tests, compared the assessments. The results indicated significant improvements in movement speed, with a notable increase in stimulus identification (averaging from approximately 13 to 14) (p < 0.05) and reduced processing time (decreasing from about 28.7 to 28 s) (p < 0.05). However, while the structured program demonstrated substantial enhancements in specific motor and cognitive–motor skills, it did not yield significant changes in dynamic balance, maintaining values close to 0.9 (p > 0.05) for open-eyed balance and 0.88 (p > 0.05) for closed-eyed balance. Additionally, an analysis of the processing speed in pulses per second showcased a marginal decline, from approximately 0.46 to 0.45, revealing notable disparities between the initial and final measurements (p < 0.05). [ABSTRACT FROM AUTHOR]

To assess changes in treatment modalities for supracondylar humerus fractures (SCHFs) at a large pediatric university hospital, we analyzed patient data from 2014 to 2022. A total of 233 SCHFs treated surgically at our hospital were included. To evaluate postoperative outcome and quality of life, DASH and EuroQol-5D-Y questionnaires were sent to patients. In addition to a significant fluctuation in fracture severity, we found an increase in training interventions (more surgeries were performed by trainees) and a significant decrease in surgery times after 2016. From 2020, there was a significant shift in the type of surgical method away from closed reduction with elastic stable intramedullary nailing (ESIN) and towards closed reduction and crossed K-wire osteosynthesis (CRK). Surgeries performed in the morning and evening hours increased, while those performed in the afternoon and after midnight decreased. After a mean follow-up of 4 years, there was no difference in elbow function between ESIN and open reduction and K-wires (ORK). Treatment with ESIN was equivalent to ORK in terms of function, at least in the medium-term follow-up. In summary, the combination of shifting treatment from SCHF to daytime hours, increasing trainee participation and using cross K-wire fixation instead of ESIN had no negative impact on surgery times. In our setting, these measures have reduced resource utilization and increased efficiency without compromising patient care. [ABSTRACT FROM AUTHOR]

Introduction: This study aims to investigate the relationship between upper extremity lateralization and dual-task cost in individuals with Hemiplegic Cerebral Palsy (HCP). This is a new and unknown issue in Cerebral Palsy. Material and methods: The descriptive, cross-sectional study was conducted with 63 individuals between the ages of 7 and 17 years: 40 with Hemiplegic Cerebral Palsy and 23 typically-developing peers. The individuals with HCP received a pre-assessment performed with the Gross Motor Function Classification System, Manual Ability Classification System, and Communication Function Classification System. Left-right judgement was assessed by the laterality judgement task, and manual ability was evaluated with the Nine Hole Peg Test (NHPT). Functional tests included upper extremity functional tests; dual-task interference was also assessed between this test and the NHPT. Results: A significant difference was found between the HCP group and the typically-developing group regarding lateralization accuracy and dual-task cost (p < 0.05). Lateralization response time was related with dominant cognitive NHPT dual-task cost (r = 0.327, p = 0.040). Lateralization accuracy was also related to dominant cognitive NHPT dual-task cost, and lateralization response time with non-dominant motor NHPT dual-task cost (r = -0.360, p = 0.023; r = 0.312, p = 0.050, respectively). Conclusions: Individuals with HCP have difficulty with dual tasks compared to typically developing peers. A relationship was observed between upper extremity lateralization and dual-task cost in individuals with HCP. This can be a significant consideration when designing more effective intervention approaches on upper extremity lateralization and dual-task individuals with HCP. [ABSTRACT FROM AUTHOR]