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This study investigated ankle discriminative acuity and performance and measurement consistency for tests undertaken with different joint position exposure times (PETs). Twenty-four participants were tested using a novel Smartphone Proprioception for Ankle Navigation (SPAN) under four PETs, i.e., 0.25s, 0.5s, 0.75s and 1s, delivered in a random sequence, and then re-tested within one week. The results indicated a PET main effect (F = 10.12, p = 0.004, partial ƞ2 = 0.14), and limb preference main effect (F = 5.39, p = 0.03, partial ƞ2 = 0.19), without significant interactions (p > 0.05). Ankle proprioception improved with prolonged PET, with the non-dominant side outperforming the dominant side. A PET of 0.25s showed good to excellent reliability, with intraclass correlation coefficients (ICCs) of 0.897 (95%CI: 0.761, 0.955) and 0.885 (95%CI: 0.736, 0.951), with standard errors of measurements (SEM) between 0.030 and 0.035, and minimum detectable change at 90% (MDC90) between 0.070 and 0.082, compared to poor to moderate reliability at the other three longer PETs (ICCs =0.352–0.736). The findings suggested the prolongation of PET can improve ankle proprioceptive performance but can amplify the inter-occasion variability, likely due to increased cognitive analysis with longer stimulus sampling. SPAN may thus be a cost-effective and accessible apparatus for clinical practice. [ABSTRACT FROM AUTHOR]

This prospective study aimed to determine which specific mobility tests were the most accurate for predicting falls in physically active older adults living in the community. Seventy-nine physically active older adults who met the American College of Sports Medicine physical activity guidelines volunteered. Participants were assessed and followed up for 12 months. Mobility assessments included the 30-s sit-to-stand test, five times sit-to-stand test, single-task timed-up-and-go test (TUG), motor dual-task TUG (Mot-TUG), and cognitive dual-task TUG (Cog-TUG). Mot-TUG and Cog-TUG performances were moderately correlated with number of falls (r =.359, p <.01 and r =.372, p <.01, respectively). When Mot-TUG, Cog-TUG, or Age were included as fall predictors, discrimination scores represented by the area under the receiver operating characteristic curve (AUC) were AUC (Mot-TUG) = 0.843 (p <.01), AUC (Cog-TUG) = 0.856 (p <.01), and AUC (Age) = 0.734 (p <.05). The cutoff point for Cog-TUG was 10.98 s, with test sensitivity of 1.00 and specificity of 0.66. Fall predictors for different populations may be based on different test methods. Here, the dual-task TUG test more accurately predicted falls in older adults who met American College of Sports Medicine's physical activity guidelines. [ABSTRACT FROM AUTHOR]

This study aimed to investigate whether patients with low back pain (LBP) had impaired lower limb proprioception and its association with somatosensory acuity. Thirty patients with LBP and 30 asymptomatic people volunteered, using Sway Discrimination Apparatus tests to assess somatosensory acuity during voluntary anteroposterior and mediolateral postural sway. Results showed significantly reduced somatosensory acuity in mediolateral sway in LBP patients (p = 0.005) with ankle, knee, and hip proprioception showing significantly impairment compared to asymptomatic controls (all p ≤ 0.012). Regression analysis showed that ankle and hip proprioception were significantly associated with somatosensory perception (0.001 ≤ p ≤ 0.026, 0.067 ≤ R2≤ 0.235). Overall, findings suggested a global deterioration of lower limb proprioception in LBP patients, with ankle and hip proprioception playing crucial role in somatosensory perception. [ABSTRACT FROM AUTHOR]

Emerging evidence has suggested that gluteus medius (GM) muscle activity may be critical for functional performance in individuals with chronic ankle instability (CAI). This study aimed to systematically review the literature to determine whether there are differences in GM muscle activity between individuals with and without CAI. A comprehensive search in PubMed, Embase, Cochrane Library, Web of Science, EBSCO, and PEDro databases was undertaken from the year of inception to 10 June 2024. Studies that investigated GM muscle activity during physical activities in healthy controls or copers and individuals with CAI were included. The quality assessment was conducted using the Newcastle-Ottawa Quality scale (NOS). After review, forty studies (1840 participants) were included; NOS scoring for the included studies ranged from 5/9 to 9/9 stars. GM activity was reported for seven activities: walking (14 studies), stance-transition (four studies), jump-landing (13 studies), perturbation (six studies), balance (four studies), cutting (three studies), and other functional exercises (seven studies). The outcome measures selected to examine each task varied across studies, and electromyography (EMG) results were inconsistent. Overall, although the quality of the available studies was generally high, there were substantial methodological differences, and the activity of GM muscles in CAI participants compared to controls was equivocal. A consensus on standardization of GM muscle activity assessment reporting should be established to guide future studies. [ABSTRACT FROM AUTHOR]

Impaired balance is a key symptom following acute concussion. Unfortunately, the recommended clinical balance assessment lacks sensitivity and discriminative ability, relying on the experience of the clinician for interpretation. The aim of this pilot study is to explore smartphone technology to remotely assess balance impairment in people with acute concussion. A smartphone app was developed to allow the clinician to connect remotely using their personal web browser to the participant's smartphone and collect motion data while instructing the participant to perform the following balance tests: standing on firm and foam surface with eyes opened and closed (FIRMEO, FIRMEC, FOAMEO, and FOAMEC). Outcome measures were processed from the raw acceleration to calculate the average acceleration magnitude from the mean and the root-mean square, with greater values indicating more sway. Eleven healthy controls (HCs) and 11 people with concussion (CON) participated. In all sway measurements, the CON group had significantly (p < 0.05) greater values when standing on a firm surface. In the FOAMEC condition, the CON group had significantly (p < 0.05) greater sway measures only in the AP direction, while significantly greater sway in all directions were found in the CON group in the FOAMEO condition. This study shows that remote balance assessment using a smartphone can discriminate between healthy controls and people with acute concussion. This technology could play an important role in concussion management to assist with determining recovery from concussions and the optimal timing for return to sport. [ABSTRACT FROM AUTHOR]

Background and Aims Uncertainty exists over whether multiple arterial grafting has a sex-related association with survival after coronary artery bypass grafting. This study aims to compare the long-term survival of using multiple arterial grafting vs. single arterial grafting in women and men undergoing coronary artery bypass grafting. Methods The retrospective study used the Australian and New Zealand Society of Cardiothoracic Surgical Database with linkage to the National Death Index. Patients from 2001 to 2020 were identified. Sex-stratified, inverse probability weighted Cox proportional hazard model was used to facilitate survival comparisons. The primary outcome was all-cause mortality. Results A total number of 54 275 adult patients receiving at least two grafts in primary isolated bypass operations were analysed. The entire study cohort consisted of 10 693 (19.7%) female patients and 29 711 (54.7%) multiple arterial grafting procedures. At a median (interquartile range) postoperative follow-up of 4.9 (2.3–8.4) years, mortality was significantly lower in male patients undergoing multiarterial than single arterial procedures (adjusted hazard ratio 0.82; 95% confidence interval 0.77–0.87; P <.001). The survival benefit was also significant for females (adjusted hazard ratio 0.83; 95% confidence interval 0.76–0.91; P <.001) at a median (interquartile range) follow-up of 5.2 (2.4–8.7) years. The interaction model from Cox regression suggested insignificant subgroup effect from sex (P =.08) on the observed survival advantage. The survival benefits associated with multiple arterial grafting were consistent across all sex-stratified subgroups except for female patients with left main coronary disease. Conclusions Compared to single arterial grafting, multiple arterial revascularization is associated with improved long-term survival for women as well as men. [ABSTRACT FROM AUTHOR]

Introduction: Low back pain (LBP) is associated with altered somatosensory perception, which is involved in both involuntary and voluntary control of posture. Currently, there is a lack of methods and tools for assessing somatosensory acuity in patients with LBP. The purpose of this study was (1) to assess the reliability of the sway discrimination apparatus (SwayDA) (2) to evaluate the differences in somatosensory acuity between patients with LBP and pain-free individuals, and (3) to examine relationships between somatosensory acuity, severity of LBP, and mobility in patients with LBP. Methods: Twenty participants (10 patients with LBP and 10 matched asymptomatic controls) were recruited in a test–retest reliability test. Another 56 participants were recruited for this study with 28 individuals presenting with LBP and a further twenty-eight being asymptomatic. The SwayDA was custom-built to measure somatosensory perception during voluntary anterior–posterior (SwayDA-AP), medial-lateral to the dominant side (SwayDA-ML-D), and non-dominant side (SwayDA-ML-ND) postural sway control. Participants also completed mobility tests, including 10 times and 1-min sit-to-stand tests (10-STS, 1 m-STS). The area under the receiver operating characteristic curve (AUC) was calculated to quantify somatosensory acuity in discriminating different voluntary postural sway extents. Results: The ICC (2.1) for the SwayDA-AP, SwayDA-ML-D, and SwayDA-ML-ND were 0.741, 0.717, and 0.805 with MDC95 0.071, 0.043, and 0.050. Patients with LBP demonstrated significantly lower SwayDA scores (tSwayDA-AP = −2.142, p = 0.037; tSwayDA-ML-D = -2.266, p = 0.027) than asymptomatic controls. The AUC values of the SwayDA-AP test were significantly correlated with ODI (rSwayDA-AP-ODI = −0.391, p = 0.039). Performances on the 1 m-STS and the 10-STS were significantly correlated with the AUC scores from all the SwayDA tests (−0.513 ≤ r ≤ 0.441, all p < 0.05). Discussion: The SwayDA tests evaluated showed acceptable reliability in assessing somatosensory acuity during voluntary postural sway. Somatosensory acuity was diminished in patients with LBP compared to asymptomatic controls. In patients with LBP, lower somatosensory acuity was associated with increased LBP-related disability. Future research could focus on investigating the factors contributing to the decreased somatosensory perception and mobility in individuals with LBP. [ABSTRACT FROM AUTHOR]

Traditional risk factors used for predicting poor postoperative recovery have focused on postoperative complications, adverse symptoms (nausea, pain), length of hospital stay, and patient quality of life. Despite these being traditional performance indicators of patient postoperative "status," they may not fully define the multidimensional nature of patient recovery. The definition of postoperative recovery is thus evolving to include patient‐reported outcomes that are important to the patient. Previous reviews have focused on risk factors for the above traditional outcomes after major surgery. Yet, there remains a need for further study of risk factors predicting multidimensional patient‐focused recovery, and investigation beyond the immediate postoperative period after patients are discharged from the hospital. This review aimed to appraise the current literature identifying risk factors for multidimensional patient recovery. Methods: A systematic review without meta‐analysis was performed to qualitatively summarize preoperative risk factors for multidimensional recovery 4–6 weeks after major surgery (PROSPERO, CRD42022321626). We reviewed three electronic databases between January 2012 and April 2022. The primary outcome was risk factors for multidimensional recovery at 4–6 weeks. A GRADE quality appraisal and a risk of bias assessment were completed. Results: In total, 5150 studies were identified, after which 1506 duplicates were removed. After the primary and secondary screening, nine articles were included in the final review. Interrater agreements between the two assessors for the primary and secondary screening process were 86% (k = 0.47) and 94% (k = 0.70), respectively. Factors associated with poor recovery were found to include ASA grade, recovery tool baseline score, physical function, number of co‐morbidities, previous surgery, and psychological well‐being. Mixed results were reported for age, BMI, and preoperative pain. Due to the observational nature, heterogeneity, multiple definitions of recovery, and moderate risk of bias of the primary studies, the quality of evidence was rated from very low to low. Conclusion: Our review found that there were few studies assessing preoperative risk factors as predictors for poor postoperative multidimensional recovery. This confirms the need for higher quality studies assessing risk for poor recovery, ideally with a consistent and multi‐dimensional definition of recovery. [ABSTRACT FROM AUTHOR]

Author(s): Selina M. Parry [sup.1], Catherine L. Granger [sup.1] [sup.2] [sup.3], Sue Berney [sup.3] [sup.4], Jennifer Jones [sup.4], Lisa Beach [sup.2], Doa El-Ansary [sup.1], René Koopman [sup.5], Linda Denehy [sup.1] [...], Purpose To identify measures used to evaluate the broad constructs of functional impairment and limitations in the critically ill across the continuum of recovery, and to evaluate, synthesise and compare the clinimetric properties of the measures identified. Methods A systematic review of articles was carried out using the databases Medline (1950-2014), CINAHL (1982-2014), EMBASE (1980-2014), Cochrane Library (2014) and Scopus (1960-2014). Additional studies were identified by searching personal files. Eligibility criteria for selection: Search 1: studies which assessed muscle mass, strength or function using objective non-laboratory measures; Search 2: studies which evaluated a clinimetric property (reliability, measurement error, validity or responsiveness) for one of the measures identified in search one. Two independent reviewers assessed articles for inclusion and assessed risk of bias using the consensus-based standards for selection of health status measurement instruments checklist. Results Thirty-three measures were identified; however, only 20 had established clinimetric properties. Ultrasonography, dynamometry, physical function in intensive care test scored and the Chelsea critical care physical assessment tool performed the strongest for the measurement of impairment of body systems (muscle mass and strength) and activity limitations (physical function), respectively. Conclusions There is considerable variability in the type of measures utilized to measure physical impairments and limitations in survivors of critical illness. Future work should identify a core set of standardized measures, which can be utilized across the continuum of critical illness recovery embedded within the International Classification of Functioning framework. This will enable improved comparisons between future studies, which in turn will assist in identifying the most effective treatment strategies to ameliorate the devastating longer-term outcomes of a critical illness.