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Background: COVID-19 has affected the practice of physiotherapy, and telerehabilitation (TR) may be seen as an alternative model of care if it is accepted by patients and physiotherapists. This study investigates the perceived usefulness of TR and the intention to use it among physiotherapists and patients from Belgium and France concerned with musculoskeletal disorders (MSDs) during the pandemic period., Methods: An online questionnaire based on the technology-acceptance model was designed. Sociodemographic data were collected and Likert scales were proposed to assess perceived ease-of-use, perceived usefulness and intention to use TR. Data were collected between 17 January and 17 March 2021; 68 patients and 107 physiotherapists answered., Results: In total, 88% of patients and 76% physiotherapists had not used TR at the time they answered. Only 12% of patients and 1% of physiotherapists are willing to use TR, and 50% of physiotherapists think they will never use TR compared to 25% of patients. A total of 98% of participants agreed that they had a good mastery of the technological tools requested., Conclusions: Physiotherapists are more reluctant to use TR than patients, regardless of convincing EBM results. This is related to their own representation of proper MSD management, which must include the use of hands-on techniques.

Before and immediately after passive upper limb neurodynamic mobilizations targeting the median nerve, grip ([Formula: see text]) and load ([Formula: see text]) forces applied by the thumb, index and major fingers (three-jaw chuck pinch) were collected using a manipulandum during three different grip precision tasks: grip-lift-hold-replace (GLHR), vertical oscillations (OSC), and vertical oscillations with up and down collisions (OSC/COLL/u, OSC/COLL/d). Several parameters were collected or computed from [Formula: see text] and [Formula: see text]. Maximum pinch strength and fingertips pressure sensation threshold were also examined. After the mobilizations, [Formula: see text] max changes from 3.2 ± 0.4 to 3.4 ± 0.4 N (p = 0.014), d[Formula: see text] from 89.0 ± 66.6 to 102.2 ± 59.6 [Formula: see text] (p = 0.009), and d[Formula: see text] from 43.6 ± 17.0 to 56.0 ± 17.9 [Formula: see text] ([Formula: see text]0.001) during GLHR. [Formula: see text] SD changes from 0.9 ± 0.3 to 1.0 ± 0.2 N (p = 0.004) during OSC. [Formula: see text] peak changes from 17.4 ± 8.3 to 15.1 ± 7.5 N ([Formula: see text]0.001), [Formula: see text] from 12.4 ± 6.7 to 11.3 ± 6.8 N (p = 0.033), and [Formula: see text] from 2.9 ± 0.4 to 3.00 ± 0.4 N (p = 0.018) during OSC/COLL/u. [Formula: see text] peak changes from 13.5 ± 7.4 to 12.3 ± 7.7 N (p = 0.030) and [Formula: see text] from 14.5 ± 6.0 to 13.6 ± 5.5 N (p = 0.018) during OSC/COLL/d. Sensation thresholds at index and thumb were reduced (p = 0.001, p = 0.008). Precision grip adaptations observed after the mobilizations could be partly explained by changes in cutaneous median-nerve pressure afferents from the thumb and index fingertips.

Pulmonary arterial hypertension (PAH) is characterized by an important occlusive vascular remodeling with the production of new endothelial cells, smooth muscle cells, myofibroblasts, and fibroblasts. Identifying the cellular processes leading to vascular proliferation and dysfunction is a major goal in order to decipher the mechanisms leading to PAH development. In addition to in situ proliferation of vascular cells, studies from the past 20 years have unveiled the role of circulating and resident vascular in pulmonary vascular remodeling. This review aims at summarizing the current knowledge on the different progenitor and stem cells that have been shown to participate in pulmonary vascular lesions and on the pathways regulating their recruitment during PAH. Finally, this review also addresses the therapeutic potential of circulating endothelial progenitor cells and mesenchymal stem cells.

The objective of this study was to explore the effects of static and dynamic hamstring muscles stretching on kinematics and esthetics of grand battement (high velocity kicks) in adolescent recreational dancers. Sixteen participants were assessed before and immediately after both stretching modalities. Kinematics of movement was measured by an optoelectronic system and esthetics was scored by a jury of professional dancers. Both stretching modalities led to significant kinematic differences compared with without stretching. Significant linear correlations between kinematic parameters and esthetic scores have been observed: improving dancers' physical performances has noticeable impact on the perception of their movements.

Background: Kinematic characteristics of walking with an asymptomatic genu recurvatum are currently unknown. The objective of this study is to characterize the lower limb sagittal joint and elevation angles during walking in participants with asymptomatic genu recurvatum and compare it with control participants without knee deformation at different speeds., Methods: The spatio-temporal parameters and kinematics of the lower limb were recorded using an optoelectronic motion capture system in 26 participants (n = 13 with genu recurvatum and n = 13 controls). The participants walked on an instrumented treadmill during five minutes at three different speeds: slow, medium and fast., Results: Participants with genu recurvatum showed several significant differences with controls: a narrower step width, a greater maximum hip joint extension angle, a greater knee joint extension angle at mid stance, a lower maximum knee joint flexion angle during the swing phase, and a greater ankle joint extension angle at the end of the gait cycle. Participants with genu recurvatum had a greater minimum thigh elevation angle, a greater maximum foot elevation angle, and a change in the orientation of the covariance plane. Walking speed had a significant effect on nearly all lower limb joint and elevation angles, and covariance plane parameters., Conclusion: Our findings show that genu recurvatum reshapes lower limb sagittal joint and elevation angles during walking at different speeds but preserves the covariation of elevation angles along a plane during both stance and swing phases and the rotation of this plane with increasing speed., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

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Indices characterising the long-range temporal structure of walking stride interval (SI) variability such as Hurst exponent (H) and fractal dimension (D) may be used in addition to indices measuring the amount of variability like the coefficient of variation (CV). We assess the added value of the former indices in a clinical neurological context. Our aim is to demonstrate that they provide a clinical significance in aging and in frequent neurodegenerative diseases such as Parkinson's disease, Huntington, and amyotrophic lateral sclerosis. Indices assessing the temporal structure of variability are mainly dependent on SI time series length and algorithms used, making quantitative comparisons between different studies difficult or even impossible. Here, we recompute these indices from available SI time series, either from our lab or from online databases. More precisely, we recompute CV, H, and D in a unified way. The average SI is also added to the measured parameters. We confirm that variability indices are relevant indicators of aging process and neurodegenerative diseases. While CV is sensitive to aging process and pathology, it does not discriminate between specific neurodegenerative diseases. H, which measures predictability of SI, significantly decreases with age but increases in patients suffering from amyotrophic lateral sclerosis. D, catching complexity of SI, is correlated with total functional capacity in patients with Huntington's disease. We conclude that the computation of H complements the clinical diagnosis of walking in patients with neurodegenerative diseases and we recommend it as a relevant supplement to classical CV or averaged SI. Since H and D indices did not lead to the same observations, suggesting the multi-fractal nature of SI dynamics, we recommend to open clinical gait analysis to the evaluation of more parameters., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Assessing the risk of fall in elderly people is a difficult challenge for clinicians. Since falls represent one of the first causes of death in such people, numerous clinical tests have been created and validated over the past 30 years to ascertain the risk of falls. More recently, the developments of low-cost motion capture sensors have facilitated observations of gait differences between fallers and nonfallers. The aim of this study is twofold. First, to design a method combining clinical tests and motion capture sensors in order to optimize the prediction of the risk of fall. Second to assess the ability of artificial intelligence to predict risk of fall from sensor raw data only. Seventy-three nursing home residents over the age of 65 underwent the Timed Up and Go (TUG) and six-minute walking tests equipped with a home-designed wearable Inertial Measurement Unit during two sets of measurements at a six-month interval. Observed falls during that interval enabled us to divide residents into two categories: fallers and nonfallers. We show that the TUG test results coupled to gait variability indicators, measured during a six-minute walking test, improve (from 68% to 76%) the accuracy of risk of fall's prediction at six months. In addition, we show that an artificial intelligence algorithm trained on the sensor raw data of 57 participants reveals an accuracy of 75% on the remaining 16 participants.

Four-and-a-half LIM domain protein 2 (FHL2) is an adaptor molecule regulating various cellular processes, including signal transduction, transcription, and cell survival. Although involved in inflammation and immune responses, its role in the germinal center reaction and B cell maturation remains unknown. We found that FHL2 -/- mouse spleens displayed enlarged follicles with more B cells. When a T cell-dependent immune response was elicited using SRBC, FHL2 -/- germinal center area was enhanced 2-fold compared with wild type (WT), concomitant with expanded dark zones. Nevertheless, the SRBC-induced rise in spleen IgG1 expression, and plasma IgG1 levels observed in WT were absent in FHL2 -/- mice, and circulating plasma cells were also reduced in FHL2 -/- This could be explained by deficient upregulation of spleen activation-induced cytidine deaminase mRNA. Interestingly, FHL2 -/- B cells successfully underwent class-switch recombination in vitro, and both activation-induced cytidine deaminase induction and IgG1 response to SRBC were equivalent in B cell-deficient μMT mice transplanted with WT or FHL2 -/- bone marrow, suggesting that the defects observed in FHL2 -/- mice were not B cell intrinsic. However, spleen lysates from FHL2 -/- mice revealed a disturbed spleen microenvironment, with reduced CXCL12 and CXCL13 levels compared with WT. Our data suggest that spleen FHL2 expression is essential for a normal germinal center reaction and proper induction of class-switch recombination in response to a T cell-dependent Ag, leading to the emergence of Ab producing plasma cells. This could be due to the regulation of spleen cytokine production by FHL2., (Copyright © 2020 The Authors.)

Digital natives developed in an electronic dual tasking world. This paper addresses two questions. Do digital natives respond differently under a cognitive load realized during a locomotor task in a dual-tasking paradigm and how does this address the concept of safety? We investigate the interplay between cognitive (talking and solving Raven's matrices) and locomotor (walking on a treadmill) tasks in a sample of 17 graduate level participants. The costs of dual-tasking on gait were assessed by studying changes in stride interval time and its variability at long-range. A safety index was designed and computed from total relative change between the variability indices in the single walking and dual-task conditions. As expected, results indicate high Raven's scores with gait changes found between the dual task conditions compared to the single walking task. Greater changes are observed in the talking condition compared to solving Raven's matrices, resulting in high safety index values observed in 5 participants. We conclude that, although digital natives are efficient in performing the dual tasks when they are not emotional-based, modification of gait are observable. Due to the variation within participants and the observation of high safety index values in several of them, individuals that responded poorly to low cognitive loads should be encouraged to not perform dual task when executing a primate task of safety to themselves or others., Competing Interests: The authors have declared that no competing interests exist. The commercial affiliation to Eleda International Ltd does not alter our adherence to PLOS ONE policies on sharing data and materials.

Objective: The purpose of this study was to investigate if spinal height increases using 3-dimensional (3-D) spinal position with and without manual distraction load and to assess the correlation between spine height changes and degrees of trunk rotation., Methods: Fifty-six participants were randomly placed in one of two groups: (1) 3-D spinal position with manual distraction load, and (2) without manual distraction load. Spinal height was measured before and after the interventions using a stadiometer. For the statistical analysis, we used a 2 (Loading status: pre- versus post-intervention height) X 2 (3-D spinal position: with versus without manual distraction load) repeated measures Analysis of Variance (ANOVA) was used to identify significant interaction and main effects. Paired t-tests were used to calculate differences in spinal height changes between the two interventions. Pearson correlation coefficient was used to measure correlations between changes in spinal heights and degrees of trunk rotation., Results: Mean spinal height increase with 3-D spinal position with and without manual distraction load was 6.30 mm (±6.22) and 5.69 mm (±4.13), respectively. No significant interaction effect was present between loading status and 3-D spinal position but a significant main effect in loading status was. Paired t-tests revealed significant differences in spinal heights between pre-and post-3-D spinal position with and without manual distraction load. No significant correlation was measured between trunk rotation and spinal height changes., Conclusion: 3-D spinal position with or without distraction load increased spinal height. This suggests that 3-D spinal positioning without manual distraction could be used in home settings to help maintain intervertebral disc (IVD) health., (Copyright © 2020. Published by Elsevier Inc.)

Various noninvasive measurement devices can be used to assess cervical motion. The size, complexity, and cost of gold-standard systems make them not suited to clinical practice, and actually difficult to use outside a dedicated laboratory. Nowadays, ultra-low-cost inertial measurement units are available, but without any packaging or a user-friendly interface. The so-called DYSKIMOT is a home-designed, small-sized, motion sensor based on the latter technology, aiming at being used by clinicians in "real-life situations". DYSKIMOT was compared with a gold-standard optoelectronic system (Elite). Our goal was to evaluate the DYSKIMOT accuracy in assessing fast head rotations kinematics. Kinematics was simultaneously recorded by systems during the execution of the DidRen Laser test and performed by 15 participants and nine patients. Kinematic variables were computed from the position, speed and acceleration time series. Two-way ANOVA, Passing-Bablok regressions, and dynamic time warping analysis showed good to excellent agreement between Elite and DYSKIMOT, both at the qualitative level of the time series shape and at the quantitative level of peculiar kinematical events' measured values. In conclusion, DYSKIMOT sensor is as relevant as a gold-standard system to assess kinematical features during fast head rotations in participants and patients, demonstrating its usefulness in both clinical practice and research environments., Competing Interests: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Sensorimotor control strategies during cervical axial rotation movements have been previously explored in narrow age ranges but never concurrently in Children and Seniors during a well-standardized task. However, the lifespan developmental approach provides a framework for research in human sensorimotor control of the head-neck complex. A cross-sectional design was used to investigate the influence of age on head-neck dynamic performance adopted by asymptomatic Children, Adults and Seniors using a standardized task (DidRen Laser test). Participants performed 5 cycles of left/right head-neck complex fast rotational movements toward 3 targets with 30° of angular separation. Dynamic performances were computed from total execution time of the test and kinematic variables derived from rotational motion of head measured by an optoelectronic system. Eighty-one participants, aged 8-85 yrs, were stratified in four groups: Children, Younger adults, Older adults and Seniors. Children were significantly slower than Younger (p<0.001) and Older adults (p<0.004) and Seniors slower than Younger adults (p<0.017) to perform the test. Children adopted a lower average speed compared to Younger (p<0.001) and Older adults (p<0.008). Children reached the peaks speed significantly later than Younger (p<0.004) and Older adults (p<0.04) and acceleration significantly later than Younger (p<0.001) and Older adults (p<0.013). From the peak acceleration, Children reached end of the cycle significantly slower than Younger (p<0.008) and Older adults (p<0.008). Children significantly differed from all other groups for rotational kinetic energy, with smaller values compared to Younger adults (p<0.001), Older adults (p<0.005) and Seniors (p<0.012). Variability was also significantly higher for Seniors and Children. In conclusion, age influences head-neck visually elicited rotational dynamics, especially in Children. These results suggest that age should be taken into account when establishing normative data and assessing dynamic head-neck sensorimotor control of patients with neck pain., Competing Interests: The authors have declared that no competing interests exist.

Kinematic behavior during fast cervical rotations is a useful parameter for assessing sensorimotor control performances in neck-pain patients. However, the influence of age in asymptomatic individuals from children to older people still needs to be explored. Our aim was to assess the impact of age on sensorimotor control performance of the head-neck with execution time and kinematic variables (time of task, mean speed/acceleration/deceleration, overshoots (OSs), minimum/maximum speed) during standardized fast rotation target task using the DidRen Laser test. A total of 80 volunteers were stratified in four different age-groups: Children (8-14 years): n = 16; Young Adults (18-35 years): n = 29; Old Adults (36-64 years): n = 18; Seniors (65-85 years): n = 17. Results showed that to perform the test, Children were slower (69.0 (60.6-87.3)s) compared to Young Adults (49.6 (45.6-55.6)s) with p < 0.001, and Old Adults (51.7 (48.4-55.8)s) with p < 0.001. It was also slower in Seniors (57 (52.3-67.6)s) compared to Young Adults with p < 0.013. Mean speed was slower in Children (9.4 ± 2.3 °s -1 ) and Seniors (10.6 ± 2.4 °s -1 ) compared to Young Adults (13.7 ± 1.9 °s -1 ) with p < 0.001 and Old Adults (13.3 ± 2.4 °s -1 ) with p < 0.001. Mean acceleration was slower for Children (8.4(7.6-10.2) °s -2 ) compared to Young Adults (11.1 (8.8-15.3) °s -2 ) with p < 0.016, and Old Adults (12.0(8.4-15.3) °s -2 ) with p < 0.015. Mean deceleration was slower for Children (-1.9(-2.6-1.4) °s -2 ) compared to Young Adults (-2.9(-3.7-2.5) °s -2 ) with p < 0.001 and Old Adults (-3.2(-3.7-2.3) °s -2 ) with p < 0.003. The DidRen Laser test allows us to discriminate age-specific performances for mean speed, acceleration and deceleration. Seniors and Children needed to be slower to become as precise as Young Adults and Old Adults. No difference was observed for OSs which assesses accuracy of movement. Age should therefore be considered as a key parameter when analyzing execution time and kinematic results during DidRen Laser test. These normative data can therefore guide clinicians in the assessment of subjects with neck pain., Competing Interests: The authors declare that they have no competing interests.

Previous research on unstable footwear has suggested that it may induce mechanical noise during walking. The purpose of this study was to explore whether unstable footwear could be considered as a noise-based training gear to exercise body center of mass (CoM) motion during walking. Ground reaction forces were collected among 24 healthy young women walking at speeds between 3 and 6 km h -1 with control running shoes and unstable rocker-bottom shoes. The external mechanical work, the recovery of mechanical energy of the CoM during and within the step cycles, and the phase shift between potential and kinetic energy curves of the CoM were computed. Our findings support the idea that unstable rocker-bottom footwear could serve as a speed-dependent noise-based training gear to exercise CoM motion during walking. At slow speed, it acts as a stochastic resonance or facilitator that reduces external mechanical work; whereas at brisk speed it acts as a constraint that increases external mechanical work and could mimic a downhill slope.

Purpose: This study evaluates the impact of a 3-week period of intensive pelvic floor muscles training (PFMT), with or without instrumentation, on clinical and static magnetic resonance imaging (MRI) changes of puborectalis (PR) and iliococcygeus (IL) muscles., Methods: 24 healthy young women were enrolled in the study and 17 achieved the 9 sessions of 30 min training exercises and conducted all assessments. Participants were randomly assigned in two training groups: voluntary contractions combined with hypopressive exercises (HYPO) or biofeedback exercises combined with transvaginal electrical stimulations (ELEC). Clinical and T2-weighted MRI assessments were realized before and after training., Results: Modified Oxford Grading System (MOGS) scores for left PR and perineal body significantly increased in the two groups (p = 0.039, p = 0.008), but MOGS score for right PR significantly increased only in HYPO (p = 0.020). Muscle volumes of right and left IL significantly decreased (p = 0.040, p = 0.045) after training as well as signal intensities of right and left PR (p = 0.040, p = 0.021) and thickness of right and left IL at mid-vagina location (p = 0.012, p = 0.011)., Conclusions: A short period of intensive PFMT induces clinical and morphological changes in PFMs at rest suggesting a decrease in IL volume and adipose content of PR. Although the results suggested that an intensive non-instrumented PFMT is as effective as an instrumented training, future controlled studies with greater sample sizes are needed to establish the relative and absolute effectiveness of each of the two interventions.

Pain perception, trunk mobility and apparent diffusion coefficient (ADC) within all lumbar intervertebral discs (IVDs) were collected before and shortly after posterior-to-anterior (PA) mobilizations in 16 adults with acute low back pain. Using a pragmatic approach, a trained orthopaedic manual physical therapist applied PA mobilizations to the participants' spine, in accordance with his examination findings. ADC all was computed from diffusion maps as the mean of anterior (ADC ant ), middle (ADC mid ), and posterior (ADC post ) portions of the IVD. After mobilization, pain ratings and trunk mobility were significantly improved and a significant increase in ADC all values was observed. The greatest ADC all changes were observed at the L 3 -L 4 and L 4 -L 5 levels and were mainly explained by changes in ADC ant and ADC post , respectively. No significant changes in ADC were observed at L 5 -S 1 level. The reduction in pain and largest changes in ADC observed at the periphery of the hyperintense IVD region suggest that increased peripheral random motion of water molecules is implicated in the IVD nociceptive response modulation. Additionally, ADC changes were observed at remote IVD anatomical levels that did not coincide with the PA spinal mobilization application level.

Background: Pw1 gene expression is a marker of adult stem cells in a wide range of tissues. PW1-expressing cells are detected in the heart but are not well characterized., Objectives: The authors characterized cardiac PW1-expressing cells and their cell fate potentials in normal hearts and during cardiac remodeling following myocardial infarction (MI)., Methods: A human cardiac sample was obtained from a patient presenting with reduced left ventricular (LV) function following a recent MI. The authors used the PW1 nLacZ+/- reporter mouse to identify, track, isolate, and characterize PW1-expressing cells in the LV myocardium in normal and ischemic conditions 7 days after complete ligature of the left anterior descending coronary artery., Results: In both human and mouse ischemic hearts, PW1 expression was found in cells that were mainly located in the infarct and border zones. Isolated cardiac resident PW1 + cells form colonies and have the potential to differentiate into multiple cardiac and mesenchymal lineages, with preferential differentiation into fibroblast-like cells but not into cardiomyocytes. Lineage-tracing experiments revealed that PW1 + cells differentiated into fibroblasts post-MI. Although the expression of c-Kit and PW1 showed little overlap in normal hearts, a marked increase in cells coexpressing both markers was observed in ischemic hearts (0.1 ± 0.0% in control vs. 5.7 ± 1.2% in MI; p < 0.001). In contrast to the small proportion of c-Kit + /PW1 - cells that showed cardiogenic potential, c-Kit + /PW1 + cells were fibrogenic., Conclusions: This study demonstrated the existence of a novel population of resident adult cardiac stem cells expressing PW1 + and their involvement in fibrotic remodeling after MI., (Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

Background: Contrary to common belief of clinicians that hemorrhagic stroke survivors have better functional prognoses than ischemic, recent studies show that ischemic survivors could experience similar or even better functional improvements. However, the influence of stroke subtype on gait and posture outcomes following an intervention blending conventional physiotherapy with robotic-assisted gait therapy is missing., Objective: This study compared gait and posture outcome measures between ambulatory hemorrhagic patients and ischemic patients, who received a similar 4 weeks' intervention blending a conventional bottom-up physiotherapy approach and an exoskeleton top-down robotic-assisted gait training (RAGT) approach with Lokomat., Methods: Forty adult hemiparetic stroke inpatient subjects were recruited: 20 hemorrhagic and 20 ischemic, matched by age, gender, side of hemisphere lesion, stroke severity, and locomotor impairments. Functional Ambulation Category, Postural Assessment Scale for Stroke, Tinetti Performance Oriented Mobility Assessment, 6 Minutes Walk Test, Timed Up and Go and 10-Meter Walk Test were performed before and after a 4-week long intervention. Functional gains were calculated for all tests., Results: Hemorrhagic and ischemic subjects showed significant improvements in Functional Ambulation Category (P<0.001 and P = 0.008, respectively), Postural Assessment Scale for Stroke (P<0.001 and P = 0.003), 6 Minutes Walk Test (P = 0.003 and P = 0.015) and 10-Meter Walk Test (P = 0.001 and P = 0.024). Ischemic patients also showed significant improvements in Timed Up and Go. Significantly greater mean Functional Ambulation Category and Tinetti Performance Oriented Mobility Assessment gains were observed for hemorrhagic compared to ischemic, with large (dz = 0.81) and medium (dz = 0.66) effect sizes, respectively., Conclusion: Overall, both groups exhibited quasi similar functional improvements and benefits from the same type, length and frequency of blended conventional physiotherapy and RAGT protocol. The use of intensive treatment plans blending top-down physiotherapy and bottom-up robotic approaches is promising for post-stroke rehabilitation.

Rationale: Pulmonary arterial hypertension is characterized by vascular remodeling and neomuscularization. PW1(+) progenitor cells can differentiate into smooth muscle cells (SMCs) in vitro., Objective: To determine the role of pulmonary PW1(+) progenitor cells in vascular remodeling characteristic of pulmonary arterial hypertension., Methods and Results: We investigated their contribution during chronic hypoxia-induced vascular remodeling in Pw1(nLacZ+/-) mouse expressing β-galactosidase in PW1(+) cells and in differentiated cells derived from PW1(+) cells. PW1(+) progenitor cells are present in the perivascular zone in rodent and human control lungs. Using progenitor markers, 3 distinct myogenic PW1(+) cell populations were isolated from the mouse lung of which 2 were significantly increased after 4 days of chronic hypoxia. The number of proliferating pulmonary PW1(+) cells and the proportion of β-gal(+) vascular SMC were increased, indicating a recruitment of PW1(+) cells and their differentiation into vascular SMC during early chronic hypoxia-induced neomuscularization. CXCR4 inhibition using AMD3100 prevented PW1(+) cells differentiation into SMC but did not inhibit their proliferation. Bone marrow transplantation experiments showed that the newly formed β-gal(+) SMC were not derived from circulating bone marrow-derived PW1(+) progenitor cells, confirming a resident origin of the recruited PW1(+) cells. The number of pulmonary PW1(+) cells was also increased in rats after monocrotaline injection. In lung from pulmonary arterial hypertension patients, PW1-expressing cells were observed in large numbers in remodeled vascular structures., Conclusions: These results demonstrate the existence of a novel population of resident SMC progenitor cells expressing PW1 and participating in pulmonary hypertension-associated vascular remodeling., (© 2016 American Heart Association, Inc.)

In gait lab, the quantification of the ground reaction forces (GRFs) acting upon individual limbs is required for dynamic analysis. However, using a single force plate, only the resultant GRF acting on both limbs is available. The aims of this study are (a) to develop an algorithm allowing a reliable detection of the front foot contact (FC) and the back foot off (FO) time events when walking on a single plate, (b) to reconstruct the vertical GRFs acting upon each limb during the double contact phase (DC) and (c) to evaluate this reconstruction on healthy and clinical gait trials. For the purpose of the study, 811 force measurements during DC were analyzed based on walking trials from 27 healthy subjects and 88 patients. FC and FO are reliably detected using a novel method based on the distance covered by the centre of pressure. The algorithm for the force reconstruction is a revised version of the approach of Davis and Cavanagh [24]. In order to assess the robustness of the algorithm, we compare the resulting GRFs with the real forces measured with individual force plates. The median of the relative error on force reconstruction is 1.8% for the healthy gait and 2.5% for the clinical gait. The reconstructed and the real GRFs during DC are strongly correlated for both healthy and clinical gait data (R(2)=0.998 and 0.991, respectively)., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Pouring hot water from a kettle into a cup may prove a hazardous task, especially for the elderly or the visually-impaired. Individuals with deteriorating eyesight may endanger their hands by performing this task with both hands, relaying on tactilo-kinesthetic feedback (TKF). Auditory feedback (AF) may allow them to perform the task singlehandedly, thereby reducing the risk for injury. However since relying on an AF is not intuitive and requires practice, we aimed to determine if AF supplied during the task of pouring water can be used naturally as visual feedback (VF) following practice. For this purpose, we quantified, in young healthy sighted subjects (n = 20), the performance and kinematics of pouring water in the presence of three isolated feedbacks: visual, tactilo-kinesthetic, or auditory. There were no significant differences between the weights of spilled water in the AF condition compared to the TKF condition in the first, fifth or thirteenth trials. The subjectively-reported difficulty levels of using the TKF and the AF were significantly reduced between the first and thirteenth trials for both TKF (p = 0.01) and AF (p = 0.001). Trunk rotation during the first trial using the TKF was significantly lower than the trunk rotation while using VF. Also, shoulder adduction during the first trial using the TKF was significantly higher than the shoulder adduction while using the VF. During the AF trials, the median travel distance of the tip of the kettle was significantly reduced in the first trials so that in the thirtieth trial it did not differ significantly from the median travel distance during the thirtieth trial using TKF and VF. The maximal velocity of the tip of the kettle was constant for each of the feedback conditions but was higher in 10 cm s(-1) using VF than TKF, which was higher in 10 cm s(-1) from using AF. The smoothness of movement of the TKF and AF conditions, expressed by the normalized jerk score (NJSM), was one and two orders of magnitude higher from the VF, respectively. The median NJSM then decreased significantly by the fifth trial. Monitoring in-house activity via motion capture and classification of movements, i.e. liquid pouring, can assist with daily activities via AF. As a built-in feature in a smart home, this task-specific AF may prevent burn injuries of the visually-impaired., (Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.)

Objective: To investigate the role of bone morphogenetic proteins (BMPs) on α-B-crystallin (CRYAB) expression and its physiological consequences on endothelial cells (ECs)., Approach and Results: We report that the gene encoding for the small heat shock protein, CRYAB, is a transcriptional target of the BMP signaling pathway. We demonstrate that CRYAB expression is upregulated strongly by BMPs in an EC line and in human lung microvascular ECs and human umbilical vein ECs. We show that BMP signals through the BMPR2-ALK1 pathway to upregulate CRYAB expression through a transcriptional indirect mechanism involving Id1. We observed that the known antiapoptotic effect of the BMPs is, in part, because of the upregulation of CRYAB expression in EC. We also show that cryab is downregulated in vivo, in a mouse model of pulmonary arterial hypertension induced by chronic hypoxia where the BMP pathway is downregulated., Conclusions: We demonstrate a cross-talk between BMPs and CRYAB and a major effect of this regulatory interaction on resistance to apoptosis.

Little is known of the performance characteristics of the shotokan karate mae-geri kick. The aim of this study was to compare the execution time, the lower limb kinetics and kinematics, and their respective repeatability in the mae-geri kick of karate athletes of two different standards. Seventeen adult black belt karate competitors (9 national and 8 international athletes) performed six kicks with their dominant lower limb on a striking surface, combining maximum force impact and velocity. Execution time of movement and lower limb kinematics were recorded with a high-speed camera. Maximum force at impact and the forces exerted on the ground were measured using three force plates. The duration of the kick was significantly shorter for international than for national standard athletes. However, no significant difference in the maximum impact force of the kick was observed between the two groups. In addition, significant kinematic differences were observed between the groups, with two angles of motion and one velocity peak occurring sooner in the kick movement for the international athletes, specifically for the knee joint. International athletes also performed the kick with a significantly higher repeatability for duration and kinematics, specifically during the pre-loading phase that precedes the attack phase. We conclude that the duration of the kick and repeatability of lower limb kinematics could be useful in selecting top-level karate athletes and monitoring their training status.

The objective of this study was to assess the passive elastic and viscous stiffness components of ankle in young, middle-aged and old adult female fibromyalgia subjects and compare the results with age-matched healthy control subjects. The passive musculoarticular stiffness of the ankles of 60 fibromyalgia subjects and 52 controls was quantified by measuring the ankle resistance to imposed sinusoidal rotary displacements at nine different oscillation frequencies. For each frequency, the resulting torque response of the ankles was decomposed into elastic and viscous components of the total stiffness. The self-perceived stiffness intensity of the ankles was assessed in fibromyalgia subjects by means of a visual analogue scale. Two-way ANOVA test indicated a significant effect of fibromyalgia (P < 0.001) and age (P < 0.001) on elastic stiffness results and a significant effect of age (P < 0.001) on viscous stiffness results. Post hoc Holm-Sidak test indicated that younger and middle-aged fibromyalgia subjects had a significant elastic stiffness increase of more than two times that of controls (P = 0.038 and P < 0.001, respectively). Middle-aged fibromyalgia subjects had a significant viscous stiffness increase of 1.2 times that of controls (P = 0.038). No significant differences in stiffness were observed between older fibromyalgia subjects and controls. In conclusion, the self-perceived stiffness increase of ankle reported by younger and middle-aged fibromyalgia subjects is due to changes in elastic and/or viscous musculoarticular structures around the ankle. The absence of changes in older fibromyalgia subjects is probably related to the ageing process of controls.

The energy cost of gait (C) is greater in amputee than in normal subjects. Our objective was to assess the influence of lower speed, inefficient pendulum mechanism and disturbed smoothness of centre of body mass (CM(b)) displacement on C in unilateral amputees and to have a better understanding the relationship between these variables. Twelve adult patients (six traumatic transfemoral and six vascular transtibial amputees) participated in the study. Lower limb kinematics, displacement of CM(b), mechanical work done by the muscles to move the CM(b) and the segments due to their movements relative to the CM(b), efficiency of the pendulum mechanism, and C were assessed simultaneously in the 12 amputees walking at their self-selected speed. Our results show that C depended on gait speed, and efficiency of pendulum-like mechanism of walking but did not depend on the smoothness of CM(b). The use of only a single variable to explain the extra cost in amputee gait could sometimes be misleading.

This preliminary study presents the development and testing of an instrumented treadmill device measuring the ground reaction forces (GRFs) and the feasibility of using this force measuring treadmill (FMT) in clinical gait analysis. A commercially available treadmill was modified and fitted out with three-dimensional strain-gauge force transducers. Tests of linearity, centre of pressure position (CoP), cross talk, natural frequency, background noises, and belt speed were undertaken in order to assess the performance of the FMT. In addition, the GRFs and segmental kinematics were recorded while healthy subjects and patients walked on the FMT, in order to compute the net ankle joint moments and the body centre of mass (CMb) kinematics and mechanics. The preliminary results of technical tests were satisfactory with an error less than 10% and dynamic tests in healthy subjects corresponded to the literature. The results of patients were clearly disturbed, demonstrating the ability of the FMT to discriminate pathological gaits from normal ones. We concluded that the GRFs measurements obtained from the FMT seem valid and the clinical assessment of net joint moments and CMb kinematics and mechanics seem feasible. The FMT could be useful device for clinical research and routine gait analysis since it allows gaining some extra room and quickly collecting the GRFs during a large number of successive gait cycles and over a wide range of steady-state gait speeds. However, more work is needed in this area in order to confirm the present results, collect reference data and validate the methodology across pathologies.

The purpose of this study was to better understand the relationship between knee pain, locomotor functional status, and health-related quality of life (HRQoL) outcomes in osteoarthritic (OA) patients undergoing primary total knee arthroplasty (TKA). Nine OA patients were recruited. Pain, locomotor function, and HRQoL were evaluated one day before and 6 months after TKA by means of a visual analogue scale (VAS) for knee pain, the function score of the Knee Society (KS), the metabolic cost of gait (C), the total mechanical work during gait (Wtot), and the Medical Outcomes Study Short Form-36 Health Survey (MOS SF-36). Our results showed a decrease in knee pain and metabolic cost of gait and an improvement in quality of life. Moreover we showed a relationship between: (1) the VAS score for knee pain, the function score of the KS, and MOS SF-36 Physical Functioning, Role-Physical, and Bodily Pain subscales; and (2) the C, the Wtot, and the MOS SF-36 Vitality subscale.

Body centre of gravity (CG) mechanics and electromyographic activity of flexor-extensor antagonistic muscles of the lower limb were simultaneously recorded in lowest and middle-level gait disorders. Muscle co-contractions between tibialis anterior and triceps surae, and between rectus femoris and hamstrings were evaluated. CG mechanics was assessed by the external mechanical work (W(ext)) done to translate the CG with respect to the ground, and the recovery quantifying the efficacy of gait mechanism by the amount of energy transferred between gravitational potential and kinetic energies of the CG. The results showed a strong relationship between CG mechanics and the co-contractions of the main flexor-extensor ankle muscles. In middle-level gait disorders, our results suggest that the ankle antagonistic muscle co-contractions and the CG mechanics could provide information about gait mechanism and the integrity level of the locomotor program.