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Balance and mobility deficits are most prevalent impairments in patients with traumatic brain injury (TBI). The evidence has proposed that rehabilitation plays an important role in improving balance and mobility post-TBI. Virtual reality (VR) is a computer technology that provides immersed users to generate feedback such as visual, audio, and haptic.This review aimed to examine the effects of the VR treatment intervention on balance and mobility in patients with TBI and to define the most effective VR treatment protocol.SCOPUS, PEDro, PubMed, REHABDATA, EMBASE, and the web of science were searched for experimental trials examining the impacts of VR training on balance and mobility in patients with TBI from inception until July 2022. Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the selected studies.Five randomized controlled trials (RCTs) met the inclusion criteria. The PEDro scores ranged from 6 to 8, with a median of 6. A total of 157 patients with TBI were included in this review, 31.2% of whom were females. The findings showed that VR intervention is not superior to traditional physiotherapy interventions in improving balance and mobility post- TBI.The preliminary findings showed that the influence of VR on the balance and mobility ability in patients with TBI is promising. Combining VR with other concurrent rehabilitation interventions may show more significant improvements in balance and mobility compared to VR interventions alone. The optimal VR treatment protocol remains unclear. Further randomized controlled trials are strongly needed.

Purpose: On-water measurement systems are required to properly evaluate the effectiveness of the paddling technique by professional kayak athletes. These systems have to be able to measure kinematic (speed, acceleration, roll and pitch of the boat) as well as dynamic parameters (stroke frequency, force acting on paddle and foot brace) by using inertial and force sensors properly synchronized. Methods: We present a wireless multi-node real time data logger customized for flatwater sprint kayaks. The system presents a modular hardware architecture, based on a central unit and wireless sensor nodes, which have been designed to be scaled for use on K1, K2 and K4 boats. It consists of a high frequency (20Hz) GPS, an Inertial Motion Unit (IMU) with nine DOF and two force channels, respectively placed on the paddle and footrest, for each of the athletes belonging the crew. Data from all the channels are synchronously acquired, processed by a microprocessor unit, wirelessly sent via a Wi-Fi link to client terminals (PC, tablet or smartphone) and also stored in a local memory for future offline analyses. Results: Some results about training sessions of K1 and K2 crews will be presented with the aim of highlighting the features of the system together with its capabilities to obtain specific parameters related to the effectiveness of the paddling technique. Conclusion: Athletes and coach can visualise the training data on a suited web page. It provides real time feedback on some of the main parameters (time, speed, stroke frequency, force symmetry) and, at the end of the training session. Moreover, these can be downloaded to a PC for further deep analysis.

Context: Spasticity is one of the most prevalent impairments following spinal cord injury (SCI). It can lead to a decrease in the patient's functional level. Transcutaneous spinal cord stimulation (tSCS) has demonstrated motor function improvements following SCI. No systematic reviews were published examining the influences of tSCS on spasticity post-SCI. Objectives: This review aimed to investigate the effects of tSCS on spasticity in patients with SCI. Methods: PubMed, SCOPUS, PEDro, CINAHL, MEDLINE, REHABDATA, AMED, and Web of Science databases were searched until June 2021. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the selected studies. Results: Six studies met the inclusion criteria. Five studies were pilot studies, and one was a case series. The scores on the PEDro scale ranged from two to four, with a median score of four. The results showed heterogenous evidence for the effects of tSCS on spasticity reduction post-SCI. Conclusions: TSCS appears safe and well-tolerated intervention in patients with SCI. The evidence for the effectiveness of tSCS on spasticity in chronic SCI patients is limited. Further randomized controlled studies are strongly needed to study the effects of tSCS on patients with SCI.

A lot of authors have been studied the consequence of postural control strategies through investigating the effects of foot-surface contact. In this context an important variable of textured surfaces or insoles could be related to material stiffness. We apply a particular textured insoles to evaluate neuromuscular response of plantar stimulation during walking.Could textured insoles alter the human locomotion during walking at different speeds?Ten adults (age: 27 ± 5 years) completed three trials on the multifunction treadmill at 0.42 msPlantar stimulation improved cadence, stride time, stride length and gait line parameters with increasing speed. First force peaks and maximum force forefoot were always significant. The maximum force midfoot was significant at 0.42 and 0.89 msThe perception of shape and texture through its linear response to skin deformation over a wide range of deformations could be the reason why the significant differences increase in the higher speed. In conclusion, sensory interventions fallowing appropriate insoles can influence significantly gait. Walking strategy positively adjusts locomotion with high efficiency.

The COVID-19 pandemic has shocked the entire planet. The soccer world has also suffered major upheavals, and many professional soccer players have been infected with the virus. The aim of this study was to evaluate the incidence of injuries in Italian Serie A professional soccer players before and during the COVID-19 pandemic. Methods: We evaluated the incidence of muscle injuries between four competitive seasons of the Italian Serie A (2016–2017, 2017–2018, and 2018–2019 pre-COVID-19 vs. 2020/2021 post-COVID-19) in professional soccer players. Results: Significant differences were found in muscular injuries between the post-COVID-19 season and the previous seasons (p < 0.001). The median split of the players’ positivity duration was of 15 days. The players’ long positivity (PLP) group showed a significant number of muscular injuries compared to the players’ short positivity (PSP) group (p < 0.0014, ES = 0.81, Large). The total teams’ days of positivity were significantly related to the total team number of muscular injuries (r = 0.86; CI 95% 0.66 to 0.94; p < 0.0001). In conclusion, this data showed that the competitive season post-COVID-19 lockdown has a higher incidence of muscle injuries in Italian Serie A soccer players compared to the pre-pandemic competitive season.

Figure roller skating is a discipline composed of various movements which involve jumps, artistic figures and spins in a seamless program which has both technical and shapely difficult. A biomechanical analysis of a double salchow was performed using a 2D video analysis of one European and in two Italian roller skaters. On average, the high level (HL) roller skater showed a horizontal velocity of the center of mass higher than the average, especially in the prop stage, whereas the medium level (ML) and low level (LL) athletes reduced their velocity significantly. The spin angular velocity of the ML and LL skaters was always higher than of the HL. This phenomenon would seem to be a compensatory strategy for a lower jump height, with a reduced trunk-thigh angle and less thigh lever arm (coxo-femur/knee joints) during the take-off and landing phases of the double salchow jump.

Background: We tested the hypothesis that Whole Body Vibration (WBV) positively affects the fatigue process ensuing from repeated bouts of maximal efforts, as induced by repeated sprints ability (RSA). Eleven male soccer players performed three sets of six repeated shuttle sprints (40 metres). Methods: Eleven male soccer players (age 23,6±4,5 years) were cross-randomized to perform WBW before RSA and during the recovery between sets (WBV-with) or to warm-up and passive recovery between sets (WBV-without). The effects of WBV were quantified by sprint time (ST) and blood lactate concentration (LA), collected up to 15th min after completion of tests. Results: ST during RSA showed a better maintenance of performance in the WBV-with compared to WBV-without condition in all three sets, reaching a statistical significance between-groups during the 2nd and 3rd set (P< 0.05). No significant differences in ST over the sets were detected in WBVwith, whereas a significant decrease was observed in the WBV-without condition (P

Background: Upper extremity deficits are the most popular symptoms following stroke. Task-oriented training has the ability to increase motor area excitability in the brain, which can stimulate the recovery of motor control.Objective: This study was aimed to examine the efficiency of the task-oriented approach on paretic upper extremity following a stroke, and to identify efficient treatment dosage in those populations.Method: We searched through PubMed, Scopus, Physiotherapy Evidence Database (PEDro), National Rehabilitation Information (REHABDATA), and Web of Science databases. Randomized clinical trials (RCTs) and pseudo-RCTs those investigating upper extremity in patients with stroke published in English language were selected. Different scales and measurement methods to assess range of motion, strength, spasticity, and upper extremity function were considered. The quality assessment of included articles was evaluated utilizing the PEDro scale. Effect sizes were calculated.Results: Six RCTs were included in the present study. The quality assessment for included studies ranged from 6 to 8 with 6.5 as a median. A total of 456 post-stroke patients, 41.66% of which were women, were included in all studies. The included studies demonstrated a meaningful influence of task-oriented training intervention on the hemiplegic upper limb motor functions but not spasticity post-stroke.Conclusion: Task-oriented training does not produce a superior effect than other conventional physical therapy interventions in treating upper extremity in patients with stroke. There is no evidence supporting the beneficial effect of task-oriented on spasticity. Task-oriented training with the following dosage 30 to 90 minutes/session, 2 to 3 sessions weekly for 6 to 10 weeks may improve motor function and strength of paretic upper extremity post-stroke.

Background Spinal cord injury (SCI) is a critical medical condition that causes numerous impairments leading to accompanying disability. Robotic-assisted gait training (RAGT) offers many advantages, including the capability to increase the intensity and total duration of training while maintaining a physiological gait pattern. The effects of the RAGT ‘Lokomat’ on various impairments following SCI remain unclear. Objectives This review was conducted to examine the impacts of the RAGT ‘Lokomat’ on the impairments following SCI. Methods We searched PubMed, SCOPUS, PEDro, REHABDATA, MEDLINE, EMBASE, and web of science from inception to January 2021. Experimental studies examining the effects of the Lokomat on the impairments following incomplete SCI were selected. The methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Results Sixteen studies were met the inclusion criteria. Thirteen were randomized controlled trials, two were clinical trials, and one was a pilot study. The scores on the PEDro scale ranged from two to eight, with a median score of six. The results showed evidence for the beneficial effects of the Lokomat on many motor impairments following incomplete SCI. Conclusions The Lokomat may improve gait speed, walking distance, strength, range of motion, and mobility after incomplete SCI. There is insufficient evidence for the effect of the Lokomat on balance, depression, cardiorespiratory fitness, and quality of life. The effects of the Lokomat on the lower extremity spasticity were limited.

The use of whole-body vibration (WBV) for therapeutic purposes is far from being standardized and an empirical foundation for reporting guidelines for human WBV studies has only very recently been published. Controversies about safety and therapeutic dosage still exist. The present study aimed to investigate the metabolic and mechanical effects of low-intensity WBV according to the ISO 2631 norm on subjects with obesity. Forty-one obese subjects (BMI ≥ 35 kg/m2) were recruited to participate in a 3-week multidisciplinary inpatient rehabilitation program including fitness training and WBV training. During WBV the posture was monitored with an optoelectronic system with six infrared cameras (Vicon, Vicon Motion System, Oxford, UK). The primary endpoints were: variation in body composition, factors of metabolic syndrome, functional activity (sit-to-stand and 6-min walking test), muscle strength, and quality of life. The secondary endpoints were: modification of irisin, testosterone, growth hormone, IGF1 levels. We observed significant changes in salivary irisin levels, Group 2 (p &lt, 0.01) as compared to the control group, while muscle strength, function, and other metabolic and hormonal factors did not change after a 3-week low-intensity WBV training with respect to the control group. Future studies are needed to further investigate the potential metabolic effect of low-intensity WBV in managing weight.

Sarcopenic obesity (OS) is a multifactorial condition characterized by the simultaneous presences of sarcopenia and obesity. It represents a natural phenomenon related to aging that can significantly increase the risk of osteoporosis, frailty, mobility, disability and mortality. It is estimated that approximately 45% of the elderly American population—about 18 million people—are affected by sarcopenia and that the risk of disability is 1.5–4.6 fold greater in elderly people suffering from sarcopenia than older people with unaffected muscle mass. The prevalence of OS is increasing in adults over 65 years of age; people with OS present greater health risks than people who are only sarcopenic or obese. Therefore, the study of OS and the search for effective treatment are important due to the constant increase of the elderly population. OS is a relatively new concept in the panorama of age-related diseases. There is currently no single definition of the pathology; however, the evidence suggests a close correlation to the onset of cardiovascular disease and mortality. Although many questions remain unresolved today, it is important to note that OS can be prevented and treated by adopting a healthy lifestyle. The ideal approach is based on the targeted intervention to both slow down the course of sarcopenia and promote a decrease in adipose mass.The beneficial potential of physical activity, expressed through strength and resistance exercises, on OS is widely documented. The benefits obtained from aerobic exercises and strength exercises are shown at the level of muscle mass, muscle strength, muscular capacity and mitochondrial activity. However, the best results were obtained by coupling adequate nutritional treatment with regular physical activity. The adequate intake of proteins high in essential amino acids promotes protein synthesis and muscle health, effectively counteracting the onset of sarcopenia. In case of malnutrition a supplementation with BCAA-based supplements, leucine, vitamin D and β-HMB might help to improve and reduce the effects of sarcopenia. The deficiency of muscle mass in obese elderly subjects will be one of the health challenges of the future to reduce the risk of chronic diseases.

In the past 40 years, scientific research has shown how Whole Body Vibration concept represents a strong stimulus for the whole organism. Low (&lt, 30 Hz), medium (30&ndash, 80 Hz), and high (&gt, 80 Hz) frequency vibrations can have both positive and negative effects, depending on the oscillation type and duration of exposure to which the body is subjected. However, very little is known about the effects of vibratory training on the brain. In this regard, we verified whether three vibratory training protocols, differing in terms of vibration frequency and exposure time to vibration, could modulate synaptic plasticity in an experimental mouse model, by extracellular recordings in vitro in hippocampal slices of mice of 4 and 24 months old. Our results showed that vibratory training can modulate synaptic plasticity differently, depending on the protocol used, and that the best effects are related to the training protocol characterized by a low vibration frequency and a longer recovery time. Future studies will aim to understand the brain responses to various types of vibratory training and to explore the underlying mechanisms, also evaluating the presence of any structural and functional changes due to vibratory training.

Human movements, such as walking and running, are able to generate rhythmic motor patterns, with the consequent appearance of hidden time-harmonic structures. Such harmonic structures are represented (at comfortable speed) by the occurrence of the golden ratio as ratio of durations of specific walking and running gait sub-phases. Preliminary experimental evidences suggest that front crawl swimming may behave, under this point of view, like walking and running. This paper aims to demonstrate that a mathematical connection between the golden ratio and the front crawl swimming stroke actually exists, at a pace that plays the role of the comfortable speed in walking and running. Generalized Fibonacci sequences are used to this purpose. They rely on the durations of aggregate phases of the front crawl swimming stroke with a clear physical meaning, while characterizing self-similarity of front crawl strokes in its simple nature and enhanced (stronger) variant. Experimental data on front crawl swimmers illustrate the theoretical derivations, suggesting that the pace playing the role of the comfortable speed in walking and running is the middle/long-distance one, while showing that the self-similarity level increases with the swimming technique and the enhanced self-similarity is associated with the performance of top-level swimmers.

The aim was to assess the relationship between aerobic fitness and metabolic power metrics in elite male soccer players, and the possible differences that playing positions might impose during match play over new metabolic power metrics. Sixty-two elite professional male soccer players (13 central backs, 13 side backs, 22 midfielders, and 14 forwards) took part in the study. Players were monitored during eleven months of full training (including pre-season and in-season) and over all official matches (Serie A matches, Italy Cup matches). Aerobic fitness tests were conducted one week after the start of the preseason, and 8, 24 and 36 weeks after the beginning of the Championship. Players' aerobic fitness and metabolic power metrics were considered as the mean of all seasonal testing and of pooling data of 38 championship matches and 3 or 6 Italy Cup matches for all the calculations respectively. The velocity at 4 mmol·L

Background The aim of this study was to compare kinematics parameters among official matches and SSGs of an Italian premier league soccer team. Methods Eighteen elite professional male soccer players (4 central defenders, 4 wide defenders, 3 central midfielders, 3 box-to-box midfielders, 2 wingers and 2 strikers) took part in the study. Players were monitored during four months of full training (including pre-season and in-season) and over 26 matches (14 Serie A matches, 9 Europa League matches, and 3 friendly matches), from July 2017 until November 2017. The kinematic parameters during official matches and SSGs were evaluated through Video Match Analysis. Results The kinematic data analysis shows that the metabolic power, that constitutes an integrated measure of acceleration and velocity, fails to reflect what occurs during actual matchplay. Conclusions An increased attention should be place in planning SSGs during training to better reproduce actual match situations.

Context: Spasticity is one of the most common secondary impairment after spinal cord injury (SCI). It can lead to an increase in the level of disability. The functional electrical stimulation cycling (FES-cycling) promotes recovery in patients with SCI. No systematic review has been published examining the influence of FES-cycling on the spasticity of lower extremities post-SCI. Objective: This review aimed to investigate the effects of the FES-cycling on the lower extremities spasticity in patients with SCI. Methods: PubMed, Scopus, PEDro, REHABDATA, Web of Science, and MEDLINE were searched until December 2019. The methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Results: Ten studies were met the inclusion criteria. Two were randomized clinical trials, cohort study (n = 2), and pilot study (n=6). The scores on the PEDro scale ranged from one to nine, with a median score of three. The results showed evidence for the beneficial effects of FES-cycling on the spasticity of lower extremities in individuals with SCI. Conclusion: The FES-cycling intervention may reduce the lower extremities spasticity in patients with various injury levels of SCI. It is not a suitable intervention for medically unstable patients or with contraindication for lower extremities movement. Further randomized controlled trials with a large sample size strongly warranted to confirm our findings.

Background and Aims: We aimed to investigate cross-sectional relationships of relative handgrip strength (RHGS) with presence of diabetes and hypertension in a community setting. Methods and Results: Between 2016 and 2018, we enrolled 601 consecutive women with an average age of 70.7 ± 6.9 years (mean ± SD). Nutritional status was evaluated by the Mini Nutritional Assessment (MNA) score. Muscular strength and level of fitness were assessed by handgrip strength (HGS) and other standardized physical functional tests. The majority of participants were overweight or obese (80% with BMI > 25). Prevalence of diabetes and hypertension was 13 and 60%, respectively. Participants in the lowest quartile of HGS adjusted for BMI (RHGS) had significantly higher prevalence of diabetes and hypertension compared with those in the lower quartile (20.7 vs. 5.3% and 49.3 vs. 39.3%, respectively, p < 0.01 for both), whereas differences in nutritional status were not observed. Likelihood of having diabetes was significantly reduced in women with higher RHGS values (OR 0.77; 0.59–0.86 CI95%; p=0.002), independently of age, abdominal adiposity and presence of hypertension. RHGS was positively correlated with most of the physical functional tests performed. Conclusion: RHGS is an easy-to-obtain and inexpensive measure of muscular strength, independently associated with presence of diabetes in overweight elderly women. Prospective studies are required to assess its predictive value in individuals at risk of new onset or progression of diabetes.

Sport-climbing popularity increased intensely over the past years. Particularly, children&rsquo, s and adolescents&rsquo, interest therein is constantly growing. Despite a large effort in preventing injuries and muscle overloads, a fine-tuned training for each sensitive phase of child development is still needed. The objective of the study was to evaluate an innovative training program aimed at the preservation of joint mobility during the developmental age. This article relies on the results of a steady training program allowing to retain joints integrity among the practice of sport climbing in children. Joint mobility changes have been monitored before and after a one-year training program in fifteen subjects aged between 8 and 18 years. Subjects were divided into three groups depending on age (Turgor Secundus, Proceritas Secunda and Turgor Tertius). The motor tests administered were the sit-and-reach test, coxo-femoral mobility test and scapula&ndash, humeral mobility test. Our results showed that one-year training improved joint mobility at each analyzed phase, suggesting that this training program could improve mobility and flexibility. Given the importance of joint mobility preservation for discipline-related injuries prevention and eventually recovering, it is essential to provide a specific training program as a route to approach sport climbing, and even more importantly, at an early age. This work represents a preliminary study in order to demonstrate both efficacy on the joint mobility and the requirement of our playful work to support the global sport-climbing workout.

Background Balance deficits are common impairments in individuals with post-traumatic brain injury (TBI). Balance deficits can restrict the activities of daily living and productive participation in social life. To date, no systematic reviews have examined the impact of physical therapy intervention on balance post-TBI. Objective To examine the effects of physical therapy interventions on balance impairments in individuals with TBI. Methods We systematically searched in PubMed, EMBASE, Scopus, PEDro, MEDLINE, REHABDATA, and Web of Science for randomized controlled trials (RCTs), clinical control trials, and pilot studies that examined the effects of physical therapy interventions on balance deficits in individuals post-TBI. The methodological quality was estimated using the Physiotherapy Evidence Database (PEDro) scale. Results Eight studies published from 2003 to 2019 were included in this study. A total of 259 TBI participants post-TBI were included in this review, 71 (27.41%) of which were females. The methodological quality of the selected studies ranged from low to high. There were no significant differences between experimental interventions, virtual reality (VR), vestibular rehabilitation therapy (VRT), control group interventions, and other traditional physical therapy interventions. Conclusions The evidence about the effects of the physical therapy interventions in improving the balance ability post-TBI was limited. Further randomized controlled trials are strongly warranted to understand the role of physical therapy in patients with TBI who complain about balance deficits.

The full comprehension of the impact with which each force is involved in kayak propulsion is very difficult. The measure of the force on the paddle or the stroke rate only is often not enough for the coach to identify the best actions useful to improve the performances of a kayaker. To this purpose, the synchronous measurement of all parameters involved in the kayak propulsion, both dynamic (force acting on paddle and foot brace) and kinematic (stroke frequency, displacement, velocity, acceleration, roll, yaw, and pitch of the boat) could suggest to the coach more appropriate strategies for better understanding of the paddler’s motion and the relevant effects on the kayak behavior. Some simulation models, as well as measurement systems of increasing complexity, have been proposed in the recent years. In this paper, we present the e-Kayak system: A multichannel Digital Acquisition (DAQ) system specifically customized for flatwater kayaking. The system will be described in depth and its capability investigated through specific measurement results.

Background The aim of this study was to demonstrate that a normal protein diet along with minimal sports activity can be enough to lose fat mass and maintain muscle mass. Methods All participants were prescribed a hypocaloric nutritionally balanced Mediterranean-style diet tailored to the individual for 8 weeks. Body composition and energy expenditure were measured. Sedentary patients (G1) were only recommended to perform minimal aerobic training, while sport subjects (G2) were prescribed structured physical activity and higher calorie and protein contents in the diet. Results There were no significant differences between the two groups for any of the measured parameters. Conclusions The models of lifestyle changes that are currently circulating were for the most part ineffective. It does not appear to be necessary to increase the protein content of the diet above that recommended by guidelines in order to lose weight. Even prescribing specific physical activity is not necessary to maintain muscle mass.

Background The upper extremity spasticity following stroke limits individuals' activities of daily living. Focal muscle vibration (FMV) is a device producing vibration signals affecting the central nervous system. Objective This systematic review was conducted to investigate the effects of FMV on individuals with stroke, and to identify the effective training protocol in reducing upper extremities spasticity post-stroke. Methods We searched in SCOPUS, PEDro, PUBMED, REHABDATA, and Web of Science for randomized clinical trials (RCTs) and pseudo-RCTs published in English. The outcome measure included is the Modified Ashworth Scale (MAS). The methodological quality of the included trials was evaluated using the Cochrane Collaboration's instrument. Effect sizes were calculated. Results Eight articles published from 2012 to 2019 were included in this systematic review. A total of 268 post-stroke patients, 28.73% of which were females, were included in all studies. The methodological quality for included studies ranged from moderate to high. FMV showed some evidence in reducing hemiplegic upper extremity spasticity in patients with stroke. Conclusions The FMV may be an efficient intervention in reducing upper extremity spasticity in the stroke population. The efficient treatment protocol and dosage remain unclear. Additional randomized controlled trials are strongly needed to study the effects of FMV on spasticity in individuals with stroke.

Nowadays, in modern elite sport, the identification of the best training strategies which are useful in obtaining improvements during competitions requires an accurate measure of the physiologic and biomechanical parameters that affect performance. The goal of this pilot study was to investigate the capabilities of the e-Kayak system, a multichannel digital acquisition system specifically tailored for flatwater sprint kayaking application. e-Kayak allows the synchronous measure of all the parameters involved in kayak propulsion, both dynamic (including forces acting on the paddle and footrest) and kinematic (including stroke frequency, displacement, velocity, acceleration, roll, yaw, and pitch of the boat). After a detailed description of the system, we investigate its capability in supporting coaches to evaluate the performance of elite athletes’ trough-specific measurements. This approach allows for a better understanding of the paddler’s motion and the relevant effects on kayak behavior. The system allows the coach to carry out a wide study of kayak propulsion highlighting, and, at the same time, the occurrences of specific technical flaws in the paddling technique. In order to evaluate the correctness of the measurement results acquired in this pilot study, these results were compared with others which are available in the literature and which were obtained from subjects with similar characteristics.

A harmonically self-similar temporal partition, which turns out to be subtly exhibited by elite swimmers at middle distance pace, is formally defined for one of the most technically advanced swimming strokes—the butterfly. This partition relies on the generalized Fibonacci sequence and the golden ratio. Quantitative indices, named ϕ-bonacci butterfly stroke numbers, are proposed to assess such an aforementioned hidden time-harmonic and self-similar structure. An experimental validation on seven international-level swimmers and two national-level swimmers was included. The results of this paper accordingly extend the previous findings in the literature regarding human walking and running at a comfortable speed and front crawl swimming strokes at a middle/long distance pace.

Objectives: This retrospective clinical study was intended to assess the ideal number of calories in the Mediterranean-style diet (MD) required for maximum weight reduction through a greater decrease in fat mass (FM) and maintenance of fat-free mass (FFM). Methods: We analysed the data of 90 non-smoking subjects (56 females, age = 32.5 ± 9.6 years, BMI = 28.3 ± 5.4 kg/m2, data as mean ± SD). The participants underwent two-month individualised MDs with similar macronutrient composition (55% carbohydrate, 30% fat, 15% protein and fibre > 30 g) but different amounts of energy, which varied daily from 374 kcal to 1305 kcal compared with the total energy expenditure measured by metabolic Holter. The sample was divided into nine groups of 10 subjects in order to establish the amount of energy restriction that was most effective in terms of achieving fat loss and maintaining muscle mass. Results: All subject groups had significant improvements in body composition parameters (weight loss = 2.7 ± 1.8 kg, FM loss = 2.2 ± 1.2 kg and FFM loss = 0.5 ± 1.3 kg). Differences between the nine groups were not significant but higher FM loss was observed in groups one, three, six and eight. Groups one and four had the highest FFM increase and groups two, three and eight had the highest FFM loss. Conclusions: These data suggest that increasing the amount of energy restriction in a low-calorie MD might be useless in terms of obtaining a higher FM loss but a lower restriction could be more effective for maintaining FFM.

The vertical jump is a commonly used test and widely studied in literature. Indeed, it is one of the most prevalent method of assessment on sport performance because the jump height is highly correlated with leg extensor muscles power. This paper deals with the study on a new contact mat system whose performances have been compared with a force platform. Some tests have been performed and the relative comparative results will be presented. The study shows a significant concurrent validity of Wi-JumpLe system for the flight and ground contact time measurements. In conclusion, the new contact mat structure together with the electronic measurement system is legitimate to assess vertical jump height and leg extensors muscle power.

Background Balance dysfunctions are one of the most prevalent impairments post incomplete spinal cord injury (SCI). The evidence has proposed that the rehabilitation can be efficacious in treating balance dysfunctions in patients with SCI. Virtual reality (VR) is a computer technology designate 3-D setting which provides immersed users to generate numerous feedbacks such as visual, audio, and haptic. Objective To investigate the effects of VR on balance ability in individuals with incomplete SCI and to identify efficient training protocol. Methods We searched in SCOPUS, PEDro, PUBMED, REHABDATA, EMBASE, and web of science for experimental trials studying impacts of VR training on balance in patients with incomplete SCI that published in English. Physiotherapy Evidence Database (PEDro) scale was used to evaluate the methodological quality for selected studies. Results Five pilot studies were met the inclusion criteria. The PEDro scores ranged from 2 to 3, with a median of 2. All selected studies enrolled less than 20 patients. The findings showed beneficial effects of VR in improving balance ability in patients with incomplete SCI. Conclusions The preliminary findings showed that the influence of VR training on the balance ability in patients with incomplete SCI is promising. Applying 12 to 20 sessions of 30 to 60 min of VR training may show meaningful effects. Further randomized controlled trials strongly needed.

Objective This systematic review was conducted to examine the effects of whole-body vibration training on motor impairments among patients with neurological disorders and to investigate which the whole-body vibration training parameters induced improvement in motor impairments. Design PubMed, SCOPUS, PEDro, REHABDATA, and Web of Science were searched for randomized controlled trials and pseudo-randomized controlled trials investigated the effect of whole-body vibration on motor impairments in patients with neurological disorders. The methodological quality was rated using the Cochrane Collaboration's tool. Results Twenty studies were included in this systematic review. Four studies included patients with multiple sclerosis, cerebral palsy (n = 2), stroke (n = 9), Parkinson disease (n = 3), spinal cord injuries (n = 1), and spinocerebellar ataxia (n = 1). The results showed different evidence of benefits and nonbenefits for whole-body vibration training in motor impairments outcomes. Conclusions There is weak evidence for a positive effect of short-term whole-body vibration training on spasticity of lower limbs, mobility, balance, and postural control. Besides, positive effect of the long-term effect of whole-body vibration training on mobility in patients with neurological disorders. The optimal whole-body vibration training parameters in treating patients with neurological disorders remain unclear.

Walking impairments consider one from common secondary impairments post-traumatic brain injury (TBI) and spinal cord injury (SCI). As the evidence showed that RAS is effective in improving the gait ability in those with other neurological disorders, we propose that RAS is also effective in those with TBI and SCI. The aim was to test our hypothesis. Two pilot studies were included. In the first study, eight individuals with TBI participated in RAS experimental 1. Besides, five individuals participated in RAS experimental 2. In the second study, seventeen individuals with incomplete SCI participated RAS intervention. The included studies reported beneficial effects of RAS on gait ability in TBI and SCI population. Specifically, in the walking pattern aspect post-TBI, the cadence post thoracic incomplete SCI, besides, velocity and stride length post cervical incomplete SCI. Despite no confirmed conclusion that can be drawn, the initial findings of the existing evidence on the influences of RAS on gait ability in individuals with TBI and SCI are promising. Special attention should be given by researchers to conduct more researches on this topic to confirm using this approach in clinical practice in the future.

Background Traumatic brain injury (TBI) can causes numerous cognitive impairments usually in the aspects of problem-solving, executive function, memory, and attention. Several studies has suggested that rehabilitation treatment interventions can be effective in treating cognitive symptoms of brain injury. Virtual reality (VR) technology potential as a useful tool for the assessment and rehabilitation of cognitive processes. Objectives The aims of present systematic review are to examine effects of VR training intervention on cognitive function, and to identify effective VR treatment protocol in patients with TBI. Methods PubMed, Scopus, PEDro, REHABDATA, EMBASE, web of science, and MEDLINE were searched for studies investigated effect of VR on cognitive functions post TBI. The methodological quality were evaluated using PEDro scale. The results of selected studies were summarized. Results Nine studies were included in present study. Four were randomized clinical trials, case studies (n = 3), prospective study (n = 1), and pilot study (n = 1). The scores on the PEDro ranged from 0 to 7 with a mean score of 3. The results showed improvement in various cognitive function aspects such as; memory, executive function, and attention in patients with TBI after VR training. Conclusion Using different VR tools with following treatment protocol; 10–12 sessions, 20–40 min in duration with 2–4 sessions per week may improves cognitive function in patients with TBI. There was weak evidence for effects of VR training on attention post TBI.

Background The purpose of this study was to assess the effects of textured insoles on static upright posture before and after lower limb muscle fatigue. Textured insoles used contained small and non-deformable pebbles of various sizes that are able to stimulate a major number of mechanoreceptors. It was inserted inside footwear. Methods Ten healthy young adults participated in the study (mean age 26.1±3.07 years). They were asked to stand on a force platform in four sensory states: vision, no vision, with and without natural plantar stimulation. For each sensory state the subjects underwent a single 30-second trial in pre-fatigue and post-fatigue conditions. Muscle fatigue was induced by 60 seconds of continuous jumping. Center of pressure displacement, sway velocity, antero-posterior and medio-lateral sway velocity were measured using force platform. Results Textured insoles had a stabilizing effect on balance compared to control insoles. Textured insoles significantly reduced CoPDISP and VA/P levels in closed eyes pre-fatigue condition. Post-fatigue all postural parameters improved in both vision and no vision conditions. Conclusions Textured insoles with rigid stimulation significantly improved CoPDISP, independently of vision, supplying relevant and complete sensory information and improving balance in fatigue conditions.

Background: Upper extremity functional impairments are common consequences of stroke. Therefore, continuous investigation of effective interventions for upper extremity functions after stroke is a necessity. Segmental muscle vibration (SMV) is one of the interventions that incorporate sensory stimulation to improve motor cortical excitability. The aim of this study was to investigate the influence of 5-minute SMV application along with supervised physical therapy (SPT) on improving activities of daily living and motor recovery on the hemiparetic upper extremity in patients with stroke. Methods: A sample of 37 patients poststroke (29 males) was randomly allocated to either SPT control group (n=18) or SPT and SMV (SPT-SMV) experimental group (n=19). All patients received 3 sessions per week of SPT for 8 weeks. The SPT-SMV experimental group received SMV at the end of each SPT session. Outcome measures used were Barthel index (BI), modified Ashworth scale, manual muscle testing, and goniometry for range of motion (ROM) assessment. Results: Thirty-four patients completed the study. Patients in both groups improved significantly after treatment in BI, elbow ROM, and elbow muscles strength. However, muscle tone in elbow joint of the hemiplegic upper extremity improved significantly after SMV only in the experimental group (SPT-SMV). Conclusion: The SPT intervention can improve functional outcomes of upper extremity in people after stroke. However, using SMV may have superior effect on improving muscle tone after stroke. Abbreviations: ADL = activities of daily living, BI = Barthel index, MAS = modified Ashworth scale, MMT = manual muscle testing, ROM = range of motion, SMV = segmental muscle vibration, SPT = supervised physical therapy, SPT-SMV = supervised physical therapy and segmental muscle vibration.

Purpose The purpose of this paper is to examine gender differences in food habits and food choices, including decisions in healthy eating, to personalize diet therapies to be as effective possible for long-term weight loss. Design/methodology/approach In this cross-sectional study, eating behaviours were assessed using a questionnaire composed of 12 questions concerning food habits, 17 concerning food taste, and four about healthy eating. There were 2,021 (1,276 women) Caucasian adults enrolled in the study. Findings Statistically significant differences in women compared to men occurred for the following questionnaire entries reading eating habits: whole grain food (10.0 per cent higher in women; p p p < 0.001); eggs (5.0 per cent lower in women, p = 0.03); meat (9.3 per cent lower in women, p p Research limitations/implications The authors observed strong evidence of profound gender-specific differences between men and women in terms of dietary habits, the taste of food and in the relationship with meals. Practical implications The findings suggest a need for the creation of gender-specific programs for promoting a healthy lifestyle. Social implications A need for the creation of gender-related programs for promoting healthy lifestyle has been demonstrated. Originality/value Reasons for the different eating behaviours among men and women have been found. Western society’s perception of the ideal body weight is much lower for women than for men. In general, social perceptions influence nutritional behaviour to a great extent. Women’s greater nutritional knowledge and sex-specific taste preferences also account for the differences in eating behaviour.

Background: To date, studies on muscle force and power-velocity (F-v and P-v) relationships performed in water are absent. Aim: The goal of this study is to derive the F-v and P-v regression models of water polo players in water vertical thrust performance at increasing load. Methods: After use of a control object for direct linear transformation, displacement over the water and elapsed time was measured, by using a high-speed 2D-videoanalysis system, on 14 players involved in the study. Results: Intra-operator and player’s performance interclass correlation coefficient (ICC) reliability showed an excellent level of reproducibility for all kinematic and dynamic measurements considered in this study with a coefficient of variation (CV) of less than 4.5%. Results of this study have shown that an exponential force-velocity relationship seems to explain better the propulsive force exerted in the water in lifting increasing loads compared to the linear one, while the power and velocity have been shown to follow a second-order polynomial regression model. Conclusion: Given the accuracy of the video analysis, the high reliability and the specificity of the results, it is pointed out that video analysis can be a valid method to determine force-velocity and power-velocity curves in a specific environment to evaluate the neuromuscular profile of each water polo player.

Among the different devices available for the assessment of the vertical jump height based on the flight time measurement, the contact mats are surely one of the simplest and portable systems and, for this reason, they are more widely used. This paper deals with the comparative evaluation of the performances of a new contact mat system with respect to a force platform. Some tests have been performed and the relative comparative results will be presented. The study shows a significant concurrent validity of Wi-JumpLe system for the flight and ground contact time measurements. In conclusion, the new contact mat structure together with the electronic measurement system is legitimate to assess vertical jump height and leg extensors muscle power.

Reactive silicon infiltration (RSI) is a process to produce silicon carbide parts by infiltrating microporous preforms bound by pyrolized carbon. Even if RSI is considered one of the fastest manufacturing techniques for the production of SiC parts, long time is required to heat and cool the electric furnaces used for their batch processing. In this paper, we show the benefits of applying microwave power to perform RSI. In this sense a new set up in which preforms are embedded into powder field modifiers is presented. The use of SiC/BN powders as microwave field modifiers revealed the twofold advantage of being an efficient way to heat up the components uniformly while being impermeable to molten silicon. Si–SiC bulk, composite and macroporous ceramics were successfully infiltrated in few minutes. Due to plasma formation, vacuum was not applied. Infiltrations were thus performed at ambient pressure. Finally the different microstructures produced by microwave heating at ambient pressure were compared with standard material produced by conventional heating under vacuum.

The use of a network of wearable sensors placed on the athlete or installed into sport equipment is able to offer, in a real sport environment rather than in the unspecific spaces of a laboratory, a valuable real-time feedback to the coach during practice. This is made possible today by the coordinate use of a wide range of kinematic, dynamic, and physiological sensors. Using sensors makes training more effective, improves performance assessment, and can help in preventing injuries. In this paper, a new wireless sensor network (WSN) system for elite sport applications is presented. The network is made up of a master node and up to eight peripheral nodes (slave nodes), each one containing one or more sensors. The number of nodes can be increased with second level slave nodes, the nature of sensors varies depending on the application. Communication between nodes is made via a high performance 2.4 GHz transceiver, the network has a real-life range in excess of 100 m. The system can therefore be used in applications where the distance between nodes is long, for instance, in such sports as kayaking, sailing, and rowing. Communication with user and data download are made via a Wi-Fi link. The user communication interface is a webpage and is therefore completely platform (computer, tablet, smartphone) and operating system (Windows, iOS, Android, etc.) independent. A subset of acquired data can be visualized in real time on multiple terminals, for instance, by athlete and coach. Data from kayaking, karting, and swimming applications are presented.

Nowadays, in modern elite sport, the identification of the best training strategies which are useful in obtaining improvements during competitions requires an accurate measure of the physiologic and biomechanical parameters that affect performance. The goal of this pilot study was to investigate the capabilities of the e-Kayak system, a multichannel digital acquisition system specifically tailored for flatwater sprint kayaking application. e-Kayak allows the synchronous measure of all the parameters involved in kayak propulsion, both dynamic (including forces acting on the paddle and footrest) and kinematic (including stroke frequency, displacement, velocity, acceleration, roll, yaw, and pitch of the boat). After a detailed description of the system, we investigate its capability in supporting coaches to evaluate the performance of elite athletes&rsquo, trough-specific measurements. This approach allows for a better understanding of the paddler&rsquo, s motion and the relevant effects on kayak behavior. The system allows the coach to carry out a wide study of kayak propulsion highlighting, and, at the same time, the occurrences of specific technical flaws in the paddling technique. In order to evaluate the correctness of the measurement results acquired in this pilot study, these results were compared with others which are available in the literature and which were obtained from subjects with similar characteristics.

Background and Objectives: Ankle joint is the most common site of injury for basketball athletes. An effective warm-up (WU) is a period of preparatory exercise to improve training performance and reduce sports injuries. Continuous examination of effective WU routines in basketball players is a necessity. The aim of this study was to investigate the effects of general and combined warm up on ankle injury range of motion (ROM) and balance in young female basketball players. Materials and Methods: A sample of 28 young female basketball players were randomly allocated to either global warm up control group (GWU) (n = 11) or combined warm up experimental group (CWU) (n = 17). All participants performed 7-min of run. The CWU group performed a single leg stance barefoot with eyes closed, plank forearm position and triceps sural stretching. Participants in GWU performed walking ball handling and core stability using a Swiss ball. Both WU routines were conducted 3 times per week for 10 weeks. Outcome measurements were the Stabilometric platform and dorsiflexion lunge test. Results: Twenty-eight young female basketball players completed the study. Participants in the experimental group improved significantly in the range of motion (ROM) in right and left ankle and the center of pressure displacement (CoP). The control group did not show any changes in ankle dorsiflexion and a significant reduction in all body balance parameters. Conclusions: An 8-min combined warm-up routine for 10 weeks improves the ankle dorsiflexion ROM and CoP displacement that plays a key role in ankle injuries prevention in basketball players. Further studies are strongly needed to verify our findings.

BACKGROUND The study aims to analyze and quantify the improvements of some physical skills in a group of subjects over 65 years old who practice regular activities in the gym and in a microgravity environment. METHODS The study included 132 subjects (68.9±5.5 years, 72.7±14.4 kg, 155.3±9.2, 30.6±5 kg/m2) who perform regular physical activity adapted and controlled for the elderly twice a week (50' per session) for a period of 8 months. The tests evaluate flexibility, abdominal and leg strength and balance. The groups, in baseline, are homogeneous between them to anthropometric parameters and the initial performance of motor skills analyzed. A mixed between-within subject ANOVA was conducted to assess the impact of the training regimens. Data from this study showed an increase in muscular strength (leg and abdominal muscles), body balance and muscular flexibility after 8 months of both training methods. RESULTS Both experimental groups had significant improvements in motor skills considered and interesting results were observed in water activity, overall, in balance (+66%, P

Background: The aim of this study was to confirm the effects of long term (chronic) stimulating surface (textured insole) on body balance of elderly people. Methods: Twenty-four healthy elderly individuals were randomly distributed in two groups: control and experimental (67.75 ± 6.04 yrs, 74.55±12.14 kg, 163.7 ± 8.55 cm, 27.75 ± 3.04 kg/m2). Over one month, Control Group (CG) used smooth insoles and the Experimental Group (ExG) used textured insoles every day. Velocity net (Vnet), anteroposterior (VA/P), mediolateral (VM/L) and sway path of CoP were assessed in different eye conditions before and after the experimental procedure. Results: A mixed between-within subject ANOVA was conducted to assess the impact of soft and textured insoles and two visual conditions (vision vs no vision) across two time periods (α ≤ 0.05). The results showed any statistical difference between groups in each parameter assessed in this study. CoP, Vnet and VM/L in the experimental group showed a statistically significant effect of textured insoles only without vision (CoP: P= 0.002; η2=0.35), Vnet P=0.02; η2=0.24, VM/L P=0.04; η2=0.177) whereas VA/P showed no statistically significant effect in the same group and condition. There was no significant effect in Vnet, VA/P, VM/L and COP in control group that used smooth insole for both eye conditions. Conclusions: The results confirm that postural stability improved in healthy elderly individuals, increasing somatosensory information's from feet plantar mechanoreceptors. Long term stimulation with textured insoles decreased CoP, Vnet and VM/L with eyes closed.

The mechanism of propulsion in swimming has been widely researched in recent years, but not completely clarified. While it is obvious that the movement of arms provides most of the thrust, it is unclear how each phase of the stroke translates into body acceleration. Investigation is carried out mainly by video analysis or using Inertial Measurement Units (IMUs) which do not measure forces. In this paper, we present a wearable data acquisition system for swimmers. The system is composed of two instrumented paddles, measuring the pressure difference between palm and back of the hands, and an IMU. The paddles provide information about the forces that cause propulsion, while the IMU measures the effects of these forces. Data are acquired by a microcontroller unit placed in waterproof case at the athlete’s waist, and transferred to PC via a Bluetooth link. Early experimental data are presented.