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Aim: To study if functional electrical stimulation (FES) of the peroneal nerve, which activates dorsiflexion, can improve body functions, activities, and participation and could be an effective alternative treatment in individuals with unilateral spastic cerebral palsy (CP). Method: A randomized cross‐over trial was performed in 25 children with unilateral spastic CP (classified in Gross Motor Function Classification System levels I and II) aged 4 to 18 years (median age at inclusion 9 years 8 months, interquartile range = 7 years–13 years 8 months), 15 patients were male. The study consisted of two 12‐week blocks of treatment, that is, conventional treatment (ankle foot orthosis [AFO] or adapted shoes) and FES, separated by a 6‐week washout period. Outcome measures included the Goal Attainment Scale (GAS), the Cerebral Palsy Quality of Life questionnaire, and a three‐dimensional gait analysis. Results: Eighteen patients completed the trial. The proportion of GAS goals achieved was not significantly higher in the FES versus the conventional treatment phase (goal 1 p = 0.065; goal 2 p = 1.00). When walking while stimulated with FES, ankle dorsiflexion during mid‐swing decreased over time (p = 0.006, average decrease of 4.8° with FES), with a preserved increased ankle range of motion compared to conventional treatment (p < 0.001, mean range of motion with FES +10.1° compared to AFO). No changes were found in the standard physical examination or regarding satisfaction with orthoses and feelings about the ability to dress yourself. In four patients, FES therapy failed; in 12 patients FES therapy continued after the trial. Interpretation: FES is not significantly worse than AFO; however, patient selection is critical, and a testing period and thorough follow‐up are needed. [ABSTRACT FROM AUTHOR]

Background: Prior studies investigated selected discrete sagittal‐plane outcomes (e.g., peak knee flexion) in relation to running economy, hereby discarding the potential relevance of running technique parameters during noninvestigated phases of the gait cycle and in other movement planes. Purpose: Investigate which components of running technique distinguish groups of runners with better and poorer economy and higher and lower weekly running distance using an artificial neural network (ANN) approach with layer‐wise relevance propagation. Methods: Forty‐one participants (22 males and 19 females) ran at 2.78 m∙s−1 while three‐dimensional kinematics and gas exchange data were collected. Two groups were created that differed in running economy or weekly training distance. The three‐dimensional kinematic data were used as input to an ANN to predict group allocations. Layer‐wise relevance propagation was used to determine the relevance of three‐dimensional kinematics for group classification. Results: The ANN classified runners in the correct economy or distance group with accuracies of up to 62% and 71%, respectively. Knee, hip, and ankle flexion were most relevant to both classifications. Runners with poorer running economy showed higher knee flexion during swing, more hip flexion during early stance, and more ankle extension after toe‐off. Runners with higher running distance showed less trunk rotation during swing. Conclusion: The ANN accuracy was moderate when predicting whether runners had better, or poorer running economy, or had a higher or lower weekly training distance based on their running technique. The kinematic components that contributed the most to the classification may nevertheless inform future research and training. [ABSTRACT FROM AUTHOR]

Background: DFNA9 is a genetic disease of the inner ear, causing progressive bilateral sensorineural deafness and bilateral vestibulopathy (BV). In this study, DizzyQuest, a mobile vestibular diary, and the MOX accelerometer were combined to assess the daily life functional limitations and physical activity of patients with DFNA9 suffering from BV. These parameters might be appropriate as potential candidacy criteria and outcome measures for new therapeutic interventions for BV. Methods: Fifteen DFNA9 patients with BV and twelve age-matched healthy controls were included. The DizzyQuest was applied for six consecutive days, which assessed the participants' extent of functional limitations, tiredness, types of activities performed during the day, and type of activity during which the participant felt most limited. The MOX accelerometer was worn during the same six days of DizzyQuest use, measuring the participants intensity and type of physical activity. Mixed-effects linear and logistic regression analyses were performed to compare the DFNA9 patients and control group. Results: DFNA9 patients with BV felt significantly more limited in activities during the day compared to the age-matched controls, especially in social participation (p < 0.005). However, these reported limitations did not cause adjustment in the types of activities and did not reduce the intensity or type of physical activity measured with accelerometry. In addition, no relationships were found between self-reported functional limitations and physical activity. Conclusions: This study demonstrated that self-reported functional limitations are significantly higher among DFNA9 patients with BV. As a result, these limitations might be considered as part of the candidacy criteria or outcome measures for therapeutic interventions. In addition, the intensity or type of physical activity performed during the day need to be addressed more specifically in future research. [ABSTRACT FROM AUTHOR]

Understanding how loading and damage on common running injury locations changes across speeds, surface gradients, and step frequencies may inform training programs and help guide progression/rehabilitation after injuries. However, research investigating tissue loading and damage in running is limited and fragmented across different studies, thereby impairing comparison between conditions and injury locations. This study examined per‐step peak load and impulse, cumulative impulse, and cumulative weighted impulse (hereafter referred to as cumulative damage) on three common injury locations (patellofemoral joint, tibia, and Achilles tendon) across different speeds, surface gradients, and cadences. We also explored how cumulative damage in the different tissues changed across conditions relative to each other. Nineteen runners ran at five speeds (2.78, 3.0, 3.33, 4.0, 5.0 m s−1), and four gradients (−6, −3, +3, +6°), and three cadences (preferred, ±10 steps min−1) each at one speed. Patellofemoral, tibial, and Achilles tendon loading and damage were estimated from kinematic and kinetic data and compared between conditions using a linear mixed model. Increases in running speed increased patellofemoral cumulative damage, with nonsignificant increases for the tibia and Achilles tendon. Increases in cadence reduced damage to all tissues. Uphill running increased tibial and Achilles tendon, but decreased patellofemoral damage, while downhill running showed the reverse pattern. Per‐step and cumulative loading, and cumulative loading and cumulative damage indices diverged across conditions. Moreover, changes in running speed, surface gradient, and step frequency lead to disproportional changes in relative cumulative damage on different structures. Methodological and practical implications for researchers and practitioners are discussed. [ABSTRACT FROM AUTHOR]

Spatiotemporal metrics such as step frequency have been associated with running injuries in some studies. Wearables can measure these metrics and provide real‐time feedback in‐field, but are often not validated. This study assessed the validity of commercially available wireless instrumented insoles (ARION) for quantifying spatiotemporal metrics during level running at different speeds (2.78–5.0 m s−1,) and slopes (3° and 6° up/downhill) to an instrumented treadmill. Mean raw, percentage and absolute percentage error, and limits of agreement (LoA) were calculated. Agreement was statistically quantified using four thresholds: excellent, <5%; good, <10%; acceptable, <15%; and poor, >15% error. Excellent agreement (<5% error) was achieved for stride time across all conditions, and for step frequency across all but one condition with good agreement. Contact time and swing time generally showed at least good agreement. The mean difference across all conditions was −0.95% for contact time, 0.11% for stride time, 0.6% for swing time, −0.11% for step frequency, and −0.09% when averaged across all outcomes and conditions. The accuracy at an individual level was generally good to excellent, being <10% for all but two conditions, with these conditions being <15%. Additional experiments among four runners showed that step length could also be measured with an accuracy of 1.76% across different speeds with an updated version of the insoles. These findings suggests that the ARION wearable may not only be useful for large‐scale in‐field studies investigating group differences, but also to quantify spatiotemporal metrics with generally good to excellent accuracy for individual runners. [ABSTRACT FROM AUTHOR]