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Purpose: This meta-analysis aimed to (1) provide a comparison of peak changes in indirect markers of exercise-induced muscle damage (EIMD) in youths versus adults and (2) determine if the involved limb moderated this effect. Method: Studies were eligible for inclusion if they (1) provided a human youth versus adult comparison; (2) provided data on muscle strength, soreness, or creatine kinase markers beyond ≥24 hours; and (3) did not provide a recovery treatment. Effect sizes (ES) were presented alongside 95% confidence intervals. Results: EIMD exhibited larger effects on adults than in youths for muscle strength (ES = −2.01; P <.001), muscle soreness (ES = −1.52; P <.001), and creatine kinase (ES = −1.98; P <.001). The random effects meta-regression indicated that the effects of upper- and lower-limb exercise in youths and adults were significant for muscle soreness (coefficient estimate = 1.11; P <.001) but not for muscle strength or creatine kinase (P >.05). As such, the between-group effects for muscle soreness (ES = −2.10 vs −1.03; P <.05) were greater in the upper than lower limbs. Conclusion: The magnitude of EIMD in youths is substantially less than in their adult counterparts, and this effect is greater in upper than lower limbs for muscle soreness. These findings help guide practitioners who may be concerned about the potential impact of EIMD when training youth athletes. [ABSTRACT FROM AUTHOR]

Purpose: An inspiratory muscle warm-up (IMW) improves inspiratory muscle function, but the effects of high-intensity exercise are inconsistent. We aimed to determine the effects of high-intensity IMW on high-intensity exercise performance and muscle oxygenation. Methods: Ten healthy men (maximal oxygen uptake [ V ˙ O 2 max ] 52.2 [5.0] mL·kg–1·min–1) performed constant-load exercise to exhaustion on a cycle ergometer at V ˙ O 2 max under 2 IMW conditions: a placebo condition (PLA) and a high-intensity IMW condition (HIGH). The inspiratory loads were set at 15% and 80% of maximal inspiratory pressure, respectively. Maximal inspiratory pressure was measured before and after IMW. Oxyhemoglobin was measured in the vastus lateralis by near-infrared spectroscopy during exercise. Rating of perceived exertion (RPE) for a leg was measured after 1 and 2 minutes of exercise. Results: Exercise tolerance was significantly higher under HIGH than PLA (228 [49] s vs 218 [49] s, P =.003). Maximal inspiratory pressure was significantly increased by IMW under HIGH (from 125 [20] to 136 [25] cm H2O, P =.031). Oxyhemoglobin was significantly higher under HIGH than PLA at 80% of the total duration of exercise (P =.048). RPE for the leg was significantly lower under HIGH than PLA after 2 minutes of exercise (P =.019). Conclusions: Given that oxyhemoglobin is an index of local oxygen supply, the results of this study suggest that high-intensity IMW increases the oxygen supply to active limbs. It may also reflect a reduction in RPE in the leg. In addition, high-intensity IMW may improve exercise performance. [ABSTRACT FROM AUTHOR]

Background Landing with poor knee sagittal plane biomechanics has been identified as a risk factor for Anterior Cruciate Ligament (ACL) injury. However, it is unclear if the horizontal hop test battery reflects knee function and biomechanics. Hypothesis/Purpose To investigate the correlation between clinical limb symmetry index (LSI) and landing and propulsion knee biomechanics during the hop test battery using markerless motion capture. Study Design Cross-sectional biomechanics laboratory study Methods Forty-two participants with and without knee surgery (age 28.0 ± 8.0 years) performed the hop test battery which consisted of a single hop for distance, crossover hop, triple hop, and 6-m timed hop in the order listed. Eight high speed cameras were used to collect simultaneous 3D motion data and Theia 3D (Theia Markerless Inc.) was used to generate 3D body model files. Lower limb joint kinematics were calculated in Visual3D. Correlation (Spearman's ρ) was computed between clinical LSI and symmetry in peak and initial contact (IC) knee flexion angle during propulsion and landing phases of each movement. Results In the single hop, clinical LSI showed positive correlation with kinematic LSI at peak landing (ρ= 0.39, p=0.011), but no correlation at peak propulsion (ρ= -0.03, p=0.851). In the crossover hop, non-significant correlations were found in both propulsion and landing. In the triple hop, positive correlation was found at peak propulsion (ρ= 0.38, p=0.027), peak landing (ρ= 0.48 -- 0.66, p<0.001), and last landing IC (ρ= 0.45, p=0.009). In the timed hop, peak propulsion showed positive correlation (ρ= 0.51, p=0.003). Conclusions Single hop and triple hop distance symmetry reflected landing biomechanical symmetry better than propulsion symmetry. Poor scores on the hop test battery reflect asymmetrical knee landing biomechanics, emphasizing the importance of continuing to use the hop test battery as part of clinical decision making. Level of Evidence 3b [ABSTRACT FROM AUTHOR]

Aims: To investigate the effects of a telerehabilitation program on walking performance, lower and upper extremity function, fall frequency, respiratory function, and satisfaction in individuals with Duchenne muscular dystrophy (DMD). Methods: Thirty children (mean age 8.8 ± 4.2 years) were ambulant (Group 1), and 12 youth (18.5 ± 4.7 years) were non-ambulant (Group 2). The telerehabilitation program was applied by physiotherapists for 24 sessions (3 days/week). The 10-meter walking test, stand up from the supine position test, the modified upper extremity performance test, repetition of Lower and upper extremity movements, and the single breath count (SBC) test were administered. Fall frequency and satisfaction level were also recorded. Results: Significant improvement was found after telerehabilitation in upper extremity performance, repetition of lower and upper extremity movements, fall frequency, and SBC scores in Group 1. Changes in the 10-minute Walk and Stand Up from the Supine Position tests were not significant. There was a significant improvement in SBC scores in Group 2. Satisfaction with the service was 88%. Conclusions: The 8-week telerehabilitation program was effective in improving aspects of upper and lower extremity function, fall frequency, pulmonary function, and satisfaction levels in individuals with DMD. [ABSTRACT FROM AUTHOR]

The kick-start technique in competitive swimming generates a force acting on the starting platform owing to gravity, muscle contraction and resulting joint torque. To understand optimal body movement on the starting platform for maximising take-off velocity, it is necessary to investigate the joint torque in relation to the joint's rotation effects. Joint torques were calculated by inverse dynamics using kinetic and kinematic data. A one-way ANOVA showed significantly greater extensional torque for shoulders than for elbows or wrists, and for hips than for knees or ankles. The results indicated that the force of the hands was mainly influenced by extension torque at the shoulder joint. Hip joint extension torque on the front side lower limb (FSLL) was mainly used for supporting the body weight until hands off. After hands off, the front-foot force originated mainly by increases in ankle joint plantar flexion and knee joint extension torque on the FSLL. Rear side lower limb torque increases in the hip, knee and ankle joints provided the rear-foot force. This investigation clarified the magnitudes and functions of each joint torque acting on the extremities during the kick-start, providing practical information for improving starting performance. [ABSTRACT FROM AUTHOR]

For judo athletes with visual impairments and their coaches, understanding possible muscle adaptations can be challenging. As it is commonplace for these adaptations to include interlimb asymmetry, we analyzed the magnitude and direction of interlimb asymmetry in judo athletes with visual impairments and verified the association of this asymmetry with their unilateral physical performances. Participants were 18 elite judo athletes (10 male, 8 female) with visual impairments. These athletes performed three physical tests: countermovement jump (CMJ), medicine ball throw (MBT), and handgrip strength (HGS), while we conducted unilateral right and left side assessments using the interlimb asymmetry equation for each physical test. Our main results showed that the CMJ and MBT tests presented asymmetry values above 10%; with CMJ significantly higher than HGS (p = 0.050), and with inconsistencies across the three tests in the direction of interlimb asymmetry (k = −0.22–0.26). Unilateral CMJ (left limb) was negatively correlated with asymmetry (r = −0.51; p = 0.031), and unilateral MBT (right limb) was positively correlated with asymmetry (r = 0.52; p = 0.024). Based on these results, coaches should prioritize regular assessments of interlimb asymmetry using these specific tests. This data can guide the construction of training programs aimed at minimizing asymmetry and enhancing overall physical performance. Continuous monitoring and adjustment of training strategies based on asymmetry findings are crucial for optimizing muscle balance in judo athletes with visual impairments. [ABSTRACT FROM AUTHOR]

Dependent variables commonly studied during countermovement vertical jump (CMVJ) tests largely stem from male-only studies despite females'distinct energy storage and reutilisation strategies. This could limit progress among females seeking increased CMVJ performance through targeted changes in certain variables. We explored relationships between CMVJ performance metrics (jump height, modified reactive strength index, jump power, and takeoff momentum) and (a) temporal and force application variables and (b) inter-limb force and yank (i.e., rate of force development) asymmetry in 31 recreationally active females. Participants performed eight CMVJs while ground reaction force (GRF) data were obtained. Pearson product-moment correlation coefficients assessed the strength and direction of the associations. Twenty-six significant relationships (r ≥ ±0.357; p < 0.05) were detected across the CMVJ performance variables. The significantly correlated variables were generally isolated to only one of the four performance metrics. Only the percentage of concentric phase inter-limb force asymmetry was significantly associated with CMVJ performance, specifically jump power and takeoff momentum. Coaches and physical performance professionals should be aware of popular strategy variables' association or lack of association with commonly studied performance metrics when seeking to understand or improve specific CMVJ jumping abilities in females. [ABSTRACT FROM AUTHOR]

Ramos-Campo, DJ, Benito-Peinado, PJ, Caravaca, LA, Rojo-Tirado, MA, and Rubio-Arias, JÁ. Efficacy of split versus full-body resistance training on strength and muscle growth: a systematic review with meta-analysis. J Strength Cond Res 38(7): 1330-1340, 2024-No previous study has systematically compared the effect of 2 resistance training routines commonly used to increase muscle mass and strength (i.e., split [Sp] and full-body [FB] routines). Our objective was to conduct a systematic review and meta-analysis following PRISMA guidelines to compare the effects on strength gains and muscle growth in healthy adults. 14 studies (392 subjects) that compared Sp and FB routines in terms of strength adaptations and muscle growth were included. Regarding the effects of the Sp or FB routine on both bench press and lower limbs strength, the magnitude of the change produced by both routines was similar (bench press: mean difference [MD] = 1.19; [-1.28, 3.65]; p = 0.34 k = 14 lower limb: MD = 2.47 [-2.11, 7.05]; p = 0.29 k = 14 . Concerning the effect of the Sp vs. FB routine on muscle growth, similar effects were observed after both routines in the cross-sectional area of the elbow extensors ( MD = 0.3 ; [-2.65, 3.24]; p = 0.84 k = 4 ), elbow flexors ( MD = 0.17 [-2.54, 2.88]; p = 0.91 k = 5 ), vastus lateralis ( MD = - 0.08 ; [-1.82, 1.66]; p = 0.93 k = 5), or lean body mass ( MD = - 0.07 ; [-1.59, 1.44]; p = 0.92 k = 6 ) . In conclusion, the present systematic review and meta-analysis provides solid evidence that the use of Sp or FB routines within a resistance training program does not significantly impact either strength gains or muscle hypertrophy when volume is equated. Consequently, individuals are free to confidently select a re- sistance training routine based on their personal preferences. [ABSTRACT FROM AUTHOR]

BACKGROUND: It has been suggested that transcutaneous spinal cord stimulation (SCS) is effective in the rehabilitation of patients with spinal cord injury (SCI). However, the evidence is mainly based on case reports. OBJECTIVE: To summarize the influence of transcutaneous SCS on extremity motor function of patients with SCI in a meta-analysis. METHODS: A systematic literature search was performed in electronic databases including PubMed, Cochrane library, Embase, Web of Science, Wanfang, and CNKI to obtain relevant randomized controlled trials (RCTs). A random-effects model was used to pool the results by incorporating the impact of the potential heterogeneity. The most recent database search was conducted on December 31, 2023. RESULTS: Six small-scale open-label or single-blind RCTs were included. Transcutaneous SCS on the basis of conventional rehabilitation could significantly improve limb strength (mean difference: 4.82, p = 0.004; I2 = 0%) and attenuate spasticity (MD: -0.40, p = 0.02; I2 = 0%). The upper-extremity motor function was not significantly affected (p = 0.75). However, transcutaneous SCS significantly improved mobility as indicated by walking speed (MD: 0.13 m/s, p = 0.009; I2 = 0%) and walking distance (standardized MD: 0.62, I2 = 0%). CONCLUSION: Transcutaneous SCS is effective in improving limb strength, spasticity and mobility of patients with SCI. [ABSTRACT FROM AUTHOR]

Health-related social media increasingly competes with other forms of health communication for public attention. To advance understanding of the genesis of health-related social media communicating extreme fitness standards, we investigated women's creation of fitspiration, social-media content combining fitness images with effortful messages. In a pre-registered study, we hypothesized that creating extreme fitspiration content would relate positively to fitness fantasizing and to exercise self-efficacy, fitness perfectionism, physical activity, thin- and muscular-ideal internalizations, and self-objectification. Undergraduate women (N = 277) created their own fitspiration content by selecting from fitness images and messages that varied in extremity. Fitness fantasizing related positively to creating more extreme fitspiration. When controlling statistically for all other individual-difference variables, exercise self-efficacy and perfectionistic strivings emerged as key variables associated with creating extreme fitspiration content. Results suggest that women who are confident and strive toward challenging goals may create fitspiration content that communicates extreme standards. This work has implications for understanding a potential disconnect between fitspiration creators and consumers, which may illuminate ways to promote healthy fitness communications online. [ABSTRACT FROM AUTHOR]

Objective: Clarifying the distinctions between art-based creative activities in the domains of occupational therapy and art therapy in the context of stroke rehabilitation, while also describing the effects of art-based creative activities on stroke rehabilitation. Design: Scoping review. Data source: A systematic search was performed in nine databases (Web of Science, PubMed, EMBASE, Cochrane Library, CINAHL and four Chinese database) from their inception to December 2023. Review methods: The study included randomized and non-randomized controlled trials involving art-based creative activities, as well as qualitative research providing detailed intervention measures. The study focused on stroke patients, with primary outcomes related to patients' physiological recovery, psychological well-being, ADL, etc. Data extraction included information on intervention strategies and study results. Results: Seventeen studies were included, extracting six similarities and differences in creative activity between two domains. Creative activities were observed to have positive impacts on daily living activities, limb motor function, fine motor ability, and emotional well-being in stroke patients. Conclusion: Creative activities, whether in occupational therapy or art therapy, involve providing participants with tangible crafting materials for the creation of artistic works. Future stroke rehabilitation practices should tailor activities and intervention focus based on patients' rehabilitation needs, preferences, and cultural background. The current comprehensive analysis provides initial support for the potential positive role of creative activities in stroke rehabilitation, but further in-depth research is needed to confirm their effectiveness. [ABSTRACT FROM AUTHOR]

Synovial sarcoma is a rare but aggressive variant of soft-tissue sarcoma. Literature is sparse and reported mostly from the West. We analysed the clinical profiles and prognostic factors of extremity synovial sarcoma patients in order to study their clinical journey. This was a retrospective analysis. All patients with extremity synovial sarcoma treated between 1992 and 2020 were included. Patients with metastases at presentation were excluded. A descriptive analysis of demographic and clinicopathological features of patients undergoing limb salvage surgery (LSS) or amputation was carried out. Overall survival and disease-free survival were calculated for the entire cohort as well as for the LSS and amputation groups. Factors prognostic for survival were identified. In total, 157 patients had localised extremity synovial sarcoma. Predominantly, young adults (median 31 years) and males (61%) were affected. Over 70% of patients presented after recurrence or unplanned surgeries. Sixty-seven per cent of tumours were >5 cm, 69% were deep and 23% involved bone. The limb salvage rate was 64%. In the LSS group, adjuvant radiotherapy and chemotherapy were given to 72% and 68% of patients, respectively. In the amputation group, 72% of patients received adjuvant chemotherapy. In a median follow-up of 59 months, 39.4% of patients had recurrences, the majority (61.2%) were systemic. Five-year overall survival and disease-free survival were 53.4% and 49.8%, respectively. Overall survival was 63.9% and 29.7% in the LSS and amputation groups, respectively. On multivariate analysis, tumour size, depth, omission of radiotherapy and bone invasion were found to be the adverse prognostic factors. This is one of the largest studies on extremity synovial sarcoma. Mostly males and young adults were affected. The limb salvage rate was 64%, despite most being referred after unplanned surgery. Almost 70% of patients received radiotherapy and chemotherapy. Overall survival was inferior in the amputation group. Tumour size >5 cm, depth and bone invasion were negative, whereas adjuvant radiotherapy was a positive prognostic factor for survival. Chemotherapy had no impact on survival. • The study reflects the real-world picture of soft-tissue sarcoma patients in low-middle income countries. • Limb salvage rate was 64%, despite 73% of patients presenting after inadequate surgeries/local recurrences. • 39% of patients developed recurrences, the majority systemic with lung predominance. • Patients undergoing amputation had inferior disease-free and overall survival. • Poor prognostic factors were tumour size >5 cm, high grade, bone invasion and omission of radiotherapy. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the cross-over influence of lower limb fatigue on postural control. Using two experiments, cross-over fatigue was investigated using a proximal (Experiment 1—single-leg squat) and distal (Experiment 2—calf raise) muscle group. In Experiment 1, 15 healthy young participants underwent a single-leg standing task on both the right and left leg, with variations of having eyes open or closed and on stable or unstable surfaces, performing each task for 30 s. For Experiment 2, 20 individuals performed single-leg balance testing for the right and left leg and stable and unstable surfaces. Center-of-pressure data were collected during the balance tasks and were analyzed with linear (standard deviation) and nonlinear (detrended fluctuation analysis) metrics. The results lacked significant differences (p > 0.05) for cross-over fatigue effects on the non-exercised limb, which exhibited similar levels of postural sway between the pre- and post-fatigue balance tests. These tasks may have lacked an appropriate level of duration or intensity to cause a significant effect of central fatigue on the nervous system. The findings underscore the need to better understand how a specific fatiguing task during unilateral rehabilitation may alter postural control. [ABSTRACT FROM AUTHOR]

Background: Acupuncture is known to improve exercise capacity in patients with chronic obstructive pulmonary disease (COPD), but its mechanism remains unknown. Whether acupuncture improves exercise capacity in patients with COPD through alleviation of leg fatigue and dyspnea is examined by applying causal mediation analysis to previous trial data. Methods: Sixty-two patients with COPD completed treatments with either real or placebo acupuncture once a week for 12 weeks. Walk distance measured using the 6-minute walk test and intensities of leg fatigue and dyspnea in the modified Borg scale were evaluated at baseline and after treatment. The intervention effect of acupuncture against the placebo acupuncture on two mediators, changes in leg fatigue and dyspnea, and whether they mediated improvements in walk distance, were analyzed. Results: Linear regression analysis showed that the unstandardized regression coefficients [95% confidence interval (CI)] for the intervention effect by acupuncture were -4.9 (-5.8–-4.0) in leg fatigue and -3.6 (-4.3–-2.9) in dyspnea. Mediation analysis showed that when changes in leg fatigue were considered as a mediator, direct effect, indirect effect and proportion mediated were 47.1 m (95% CI, 4.6–85.1), 34.3 m (-2.1–82.1), and 42.1%, respectively, and when changes in dyspnea were considered as a mediator, they were 9.8 m (-32.9–49.9), 72.5 m (31.3–121.0), and 88.1%, respectively, and the effects of joint mediator were -5.8 m (-55.4–43.9), 88.9 m (32.7–148.5), and 107.0%, respectively. Conclusion: The improvement in exercise capacity by acupuncture is explained by changes in both leg fatigue and dyspnea. [ABSTRACT FROM AUTHOR]

Children with intellectual disabilities often face challenges in balance ability and lower limb muscle strength, which negatively impact their daily lives and motor function. Therefore, it is crucial to enhance the balance ability and lower limb muscle strength of children with intellectual disabilities. This study aimed to investigate the effects of a 12-week aquatic exercise and floor curling intervention on the balance ability and lower limb muscle strength of children with intellectual disabilities. Forty-two participants were randomly assigned to the aquatic exercise group, floor curling group, and control group. The aquatic exercise and floor curling groups received a 12-week intervention, while the control group engaged in supervised free activities. The participants' balance ability and lower limb muscle strength were assessed using the Berg Balance Scale and a muscle strength testing device before and after the intervention. The results showed significant improvements in balance ability and lower limb muscle strength for both the aquatic exercise group and the floor curling group after the intervention. The aquatic exercise group demonstrated an average improvement of 10.84% in balance ability and an overall average improvement of 16.28% in lower limb muscle strength. The floor curling group showed an average improvement of 9.04% in balance ability and an overall average improvement of 15.67% in lower limb muscle strength. These improvement results were statistically significant (p < 0.05) and ranged from medium to large effect sizes (d = 0.5~0.8). The findings of this study validate the positive effects of aquatic exercise and floor curling on the balance ability and lower limb muscle strength of children with intellectual disabilities. These interventions can be considered effective approaches for functional rehabilitation in children with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Ujakovic', F, and S? arabon, N. The effects of workload difference between limbs in plyometric and strength exercises in reducing asymmetry in change of direction ability during basketball season. J Strength Cond Res 37(11): 2282-2288, 2023--The topic of interlimb asymmetries has recently been extensively investigated; despite that, intervention for purpose of reducing them have been narrowly examined. The present study investigated the effects of maximal strength and plyometric resistance training program with 3:1 workload ratio (nondominant to dominant side) on change of direction deficit (CoDdef) asymmetry during the basketball season. Thirty-six highly trained male basketball players (19.3 6 4.9 years) from different age categories (U-17, U-19, and senior) were divided into 2 groups: the control group (n 5 18) and the intervention group (n 5 18). The intervention group performed once-aweek training that consisted of strength (Bulgarian split squats) and jumping (single-leg countermovement jumps [SLCMJs]) part in which nondominant-to-dominant workload ratio was 3:1 during the 8-week period. Preintervention and postintervention testing included single-leg isometric squat, SLCMJ, 10-m sprint, and 505 test. Analysis of covariance results showed a statistically significant difference with large effect size (p, 0.05; h2 5 0.26) when preintervention asymmetry was included as covariate. Post hoc analysis showed a statistically significant decrease in mean CoDdef asymmetry between preintervention (11.88%) and postintervention (4.47%) testing (p,0.01, effect size [ES]521.37). Isometric squat strength increased on nondominant side in the intervention group (p,0.05; ES50.77). No other performance or asymmetry variable showed significant change. In conclusion, a 3:1 workload of nonspecific movement task in favor of nondominant limb is an effective training strategy to reduce CoDdef asymmetry during basketball season. [ABSTRACT FROM AUTHOR]

The monitoring of athletes is crucial to preventing injuries, identifying fatigue or supporting return-to-play decisions. The purpose of this study was to explore the ability of Kohonen neural network self-organizing maps (SOM) to objectively characterize movement patterns during sidestepping and their association with injury risk. Further, the network's sensitivity to detect limb dominance was assessed. The data of 67 athletes with a total of 613 trials were included in this study. The 3D trajectories of 28 lower-body passive markers collected during sidestepping were used to train a SOM. The network consisted of 1247 neurons distributed over a 43 × 29 rectangular map with a hexagonal neighbourhood topology. Out of 61,913 input vectors, the SOM identified 1247 unique body postures. Visualizing the movement trajectories and adding several hidden variables allows for the investigation of different movement patterns and their association with joint loading. The used approach identified athletes that show significantly different movement strategies when sidestepping with their dominant or non-dominant leg, where one strategy was clearly associated with ACL-injury-relevant risk factors. The results highlight the ability of unsupervised machine learning to monitor an individual athlete's status without the necessity to reduce the complexity of the data describing the movement. [ABSTRACT FROM AUTHOR]

Background: In cross-training, the function of the homologous muscles in the contralateral limbs is influenced by motor activity in the unilateral limbs. It is strength gained in the contralateral limb after training the ipsilateral limb. The aim of this review was to evaluate the effectiveness of cross training in improving balance in stroke. Materials and Methods: Electronic databases such as PubMed/Medline and Google scholar were used to find the relevant studies. Four studies were included in this review (two randomized controlled trials, one pilot study and one case study), with a total of 106 participants, based on the eligibility criteria for the study. Outcome measures used included surface electromyography, 10-minute walk test (10MWT), timed-up and go (TUG) Test, Modified Ashworth scale and London Handicap scale. Results: All studies showed a significant decrease in TUG test and 10MWT scores. Cross training showed a positive effect in improving balance in patients with stroke. Conclusions: Cross training may be helpful in improving balance, but there is a need for further evidence to assess solely balance and not with mobility associated with stroke. More research is needed to draw firm conclusions. Studies with larger populations are needed. [ABSTRACT FROM AUTHOR]

Background: Low-friction slide sheets (SS) are designed to reduce compression loads on the body during manual handling tasks, such as boosting patients. Using SS has been shown to decrease muscle activity in the lower back and upper extremities. However, it is unclear if this effect varies with different bed positions. To investigate this, we studied the effects of SS use, bed height, and their combination on muscle activity during a simulated patient boost. Methods: Thirty-three Japanese undergraduate students (age 21.0 ± 1.1 years; 14 men, 19 women) participated. Participants were asked to boost a dummy figure on the bed three times each using four conditions. During the repositioning task, electromyography of eight muscles of the lower back and upper and lower extremities, hip and knee joint flexion angles, pelvic forward tilt angle, and position of the center of mass based on the posterior superior iliac spine were evaluated. Findings: Electrophysiological activities of muscles of lower back and upper extremities were significantly lower with SS than without it in both bed positions (30% and 40% of body height); the reduction in muscle activities with SS use was 20% to 40%. Lowering the bed did not affect the SS effect magnitude on reducing muscle activities, although postural changes, including hip and knee joint flexion, were observed. Conclusions/Application to Practice: SS reduced muscle activities in the back, upper, and lower extremities when the bed was in the low position, and this effect persisted at a bed height of ≥30% of the participant's height. [ABSTRACT FROM AUTHOR]

Purpose: Individuals with anterior cruciate ligament reconstruction (ACLR) generally exhibit limb underloading behaviors during walking, but most research focuses on per-step comparisons. Cumulative loading metrics offer unique insight into joint loading as magnitude, duration, and total steps are considered, but few studies have evaluated if cumulative loads are altered post-ACLR. Here, we evaluated if underloading behaviors are apparent in ACLR limbs when using cumulative load metrics and how load metrics change in response to walking speed modifications. Methods: Treadmill walking biomechanics were evaluated in 21 participants with ACLR at three speeds (self-selected (SS); 120% SS and 80% SS). Cumulative loads per step and per kilometer were calculated using knee flexion and adduction moment (KFM and KAM) and vertical ground reaction force (GRF) impulses. Traditional magnitude metrics for KFM, KAM, and GRF were also calculated. Results: The ACLR limb displayed smaller KFM and GRF in early and late stances, but larger KFM and GRF during midstance compared with the contralateral limb (P <0.01). Only GRF cumulative loads (per step and per kilometer) were reduced in the ACLR limb (P <0.01). In response to speed modifications, load magnitudes generally increased with speed. Conversely, cumulative load metrics (per step and per kilometer) decreased at faster speeds and increased at slow speeds (P < 0.01). Conclusions: Patients with ACLR underload their knee in the sagittal plane per step, but cumulatively over the course of many steps/distance, this underloading phenomenon was not apparent. Furthermore, cumulative load increased at slower speeds, opposite to what is identified with traditional single-step metrics. Assessing cumulative load metrics may offer additional insight into how load outcomes may be impacted in injured populations or in response to gait modifications. [ABSTRACT FROM AUTHOR]

Two experiments and a dynamic model forhuman limb selection are reported. In Experiment 1, left-handed and right-handed participants (N = 36) repeatedly used one hand for grasping a small cube. After a clear switch in the cube's location, perseverative limb selection was revealed in both handedness groups. In Experiment 2, the cubes were presented in a clockwise and counter-clockwise sequence to right-handed participants (N = 15). A spatial shift in the switch point between right-hand use and left-hand use was observed. The model simulates the experiments by implementing the nonlinear multiple-timescale dynamics of the action-selection process underlying limb selection. It integrates two mechanisms that were earlier proposed to underlie this selection aspect of manual activity: limb dominance and attentional information. Finally, the model is used to simulate an influential earlier experiment, by establishing a conceptual link between cross-lateral inhibition asymmetry and the direction and strength of handedness. [ABSTRACT FROM AUTHOR]

Context: The lower quarter Y-Balance Test (YBT-LQ) is associated with injury risk; however, ankle range of motion impacts YBT-LQ. Arch height and foot sensation impact static balance, but these characteristics have not yet been evaluated relative to YBT-LQ. Objective: Determine if arch height index (AHI), forefoot sensation (SEN), and ankle dorsiflexion predict YBT-LQ composite score (CS). Design: Descriptive cohort. Setting: Athletic training laboratory. Participants: Twenty general population (14 females and 6 males; mean [SD]: age 35 [18] y, weight 70.02 [16.76] kg, height 1.68 [0.12] m) participated in this study. Interventions: AHI measurement system assessed arch height in 10% (AHI10) and 90% (AHI90) weight-bearing. Two-point discrim-a-gon discs assessed sensation (SEN) at the plantar great toe, third and fifth metatarsal heads. Biplane goniometer and weight-bearing lunge tests were used to measure static and weight-bearing dorsiflexion, respectively. The YBT-LQ assessed dynamic single-leg balance. Results: For right-limb dynamic single-leg balance, AHI90 and SEN were included in the final sequential prediction equation; however, neither model significantly (P = .052 and .074) predicted variance in YBT-LQ CS. For left-limb dynamic single-leg balance, both SEN and weight-bearing lunge test were included in the final sequential prediction equation. The regression model (SEN and weight-bearing lunge test) significantly (P = .047) predicted 22% of the variance in YBT-LQ CS. Conclusions: This study demonstrates that foot characteristics may play a role in YBT-LQ CS. The authors did not assess limb dominance in this study; therefore, the authors are unable to determine which limb would be the stance versus kicking limb. However, altered SEN and weight-bearing dorsiflexion appear to be contributing factors to YBT-LQ CS. [ABSTRACT FROM AUTHOR]

The monitoring of body composition is common in sports given the association with performance. Surface anthropometry is often preferred when monitoring changes for its convenience, practicality, and portability. However, anthropometry does not provide valid estimates of absolute lean tissue in elite athletes. The aim of this investigation was to develop anthropometric models for estimating fat-free mass (FFM) and skeletal muscle mass (SMM) using an accepted reference physique assessment technique. Sixty-four athletes across 18 sports underwent surface anthropometry and dual-energy X-ray absorptiometry (DXA) assessment. Anthropometric models for estimating FFM and SMM were developed using forward selection multiple linear regression analysis and contrasted against previously developed equations. Most anthropometric models under review performed poorly compared with DXA. However, models derived from athletic populations such as the Withers equation demonstrated a stronger correlation with DXA estimates of FFM (r =.98). Equations that incorporated skinfolds with limb girths were more effective at explaining the variance in DXA estimates of lean tissue (Sesbreno FFM [R2 =.94] and Lee SMM [R2 =.94] models). The Sesbreno equation could be useful for estimating absolute indices of lean tissue across a range of physiques if an accepted option like DXA is inaccessible. Future work should explore the validity of the Sesbreno model across a broader range of physiques common to athletic populations. [ABSTRACT FROM AUTHOR]

Background: Current sports medicine and rehabilitation trends indicate an increasing use of wearable technology. The ability of these devices to collect, transmit, and process physiological, biomechanical, bioenergy, and environmental data may aid in anterior cruciate ligament reconstruction (ACLR) workload monitoring and return-to-sport decision-making. In addition, their ease of use allows assessments to occur outside the clinical or laboratory settings and across a broader timeline. Purpose: To (1) determine how wearable technology can assess external workload deficits between limbs (involved and uninvolved) and between groups (healthy controls vs patients with ACLR) during physical activity (PA) or sport and (2) describe the types of sensors, sensor specifications, assessment protocols, outcomes of interest, and participant characteristics from the included studies. Study Design: Scoping review; Level of evidence, 4. Methods: In February 2023, a systematic search was performed in the MEDLINE, EMBASE, CINAHL, SPORTDiscus, Scopus, IEEE Xplore, Compendex, and ProQuest Dissertations and Theses Global databases. Eligible studies included assessments of PA or sports workloads via wearable technology after ACLR. Results: Twenty articles met eligibility criteria and were included. The primary activity assessed was activities of daily living, although rehabilitation, training, and competition were also represented. Accelerometers, global positioning system units, pedometers, and pressure sensor insoles were worn to collect external workload data, which was quantified as kinetic, kinematic, and temporospatial data. Daily steps (count) and moderate to vigorous PA (min/day or week) were the most common units of measurement. A limited number of studies included outcomes related to between-limb asymmetries. Conclusion: The findings of this scoping review highlight the versatility of wearable technologies to collect patients' kinetic, kinematic, and temporospatial data and assess external workload outcomes after ACLR. In addition, some wearable technologies identified deficits in workload compared with healthy controls and between reconstructed and unaffected limbs. [ABSTRACT FROM AUTHOR]

Emergency nurse practitioners are expected to assess and manage a variety of patients. These patients may present with urgent care-type complaints to severe life-threatening illnesses or injuries. For some, dermatological problems can sometimes be just as challenging as a critically ill patient. Atopic dermatitis (AD) is one, if not, the most common chronic inflammatory disease. Its presentation can vary depending on the age of the patient, the patient's skin tone, and other comorbidities. Patients often seek emergency care related to the condition itself or associated complications. This article includes a review of the pathophysiology, clinical manifestations, and standard management of AD. Finally, the potential complications of AD are discussed. A better understanding of AD will allow emergency nurse practitioners to properly identify and treat this chronic condition, as well as its complications. [ABSTRACT FROM AUTHOR]

Aplasia cutis congenita (ACC) is a rare entity characterized by a congenital localized absence of the skin, dermal appendages, and subcutaneous tissue. The cause of ACC is not clear, but inheritance is the most widely accepted cause. We report a rare case of a full-term (37 + 5 weeks) female newborn who showed complete absence of skin in localized areas of the upper and lower extremities. The patient was diagnosed with ACC associated with epidermolysis bullosa (EB; a disease that causes the skin to blister easily) and was initially treated using conservative measures. We applied mupirocin topical ointment and a nonocclusive polyester mesh impregnated with hydrocolloid and petroleum jelly daily. Complete healing of the affected areas occurred after 3 weeks. Managing patients with ACC is often challenging and based on the severity of the lesions, the approach may include both surgical and conservative treatment. Our case report suggests that a conservative approach can be effective for managing certain types of ACC and EB lesions. However, further research is warranted to better understand the pathogenesis and optimal management of this entity. [ABSTRACT FROM AUTHOR]

Background: For elderly patients with many chronic and degenerative diseases (multiple comorbidities) and geriatric syndromes, chronic and complex problems should be comprehensively evaluated. The comprehensive geriatric assessment (CGA) is an evaluation of elderly patients in which clinical, medical, and functional evaluations are performed together. Current Concepts: Components of CGA include physical, psychological, and socioenvironmental content. In the physical aspect, the presence of various diseases, determination of the severity of each disease, multi-drug intake (polypharmacy), and vaccination records are evaluated. Geriatric syndromes should also be included in the evaluation. The functional evaluation comprises visual acuity, hearing, upper and lower extremity function, gait ability, balance, fall, urinary incontinence, weight change, oral health, nutritional status, and pain. In the psychological aspect, depression and cognitive function status are evaluated. The residential environment, degree of familial and social support, economic status, and advanced medical directives are evaluated in the socioenvironmental aspect. Discussion and Conclusion: Elderly patients with functional disabilities should be screened via the CGA for various problems and geriatric syndromes that the elderly are prone to developing. Problems found require further evaluation, treatment, and management. In this way, the health and quality of life of the elderly can be maintained and improved. [ABSTRACT FROM AUTHOR]

Background and Aims: Effective treatments for Charcot–Marie–Tooth (CMT) disease lack. Current treatments, such as ankle and foot surgery/orthoses, analgesics, and physiotherapy, focus on relieving the symptoms. Few randomized controlled trials (RCTs) investigated the effectiveness of exercise in patients with CMT, and a systematic review summarizing the effects of such treatments is outdated. This study aims to systematically review the effects of exercise on muscle strength, function, aerobic capacity, and quality of life in CMT. Methods: We included RCTs that compared exercise programs against sham exercise, usual care, no exercise, and different exercise programs in individuals diagnosed with CMT. Searches were performed on 10 electronic databases from inception up to July 2021. Authors analyzed titles, abstracts, and full texts and extracted information from the eligible trials. We used the Physiotherapy Evidence Database (PEDro) scale and the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) approach to evaluate the risk of bias and the certainty of the evidence, respectively. Results were synthesized narratively. Results: Eight citations (six studies; pooled n = 214) met the inclusion criteria. The mean age of participants was 38.49 (±13.02) years, and 83% were diagnosed with CMT1A. The mean PEDro score was 5.25 (range 2–9). Six trials were considered to have a high risk of bias. Moderate‐quality evidence suggests that strengthening the ankle dorsiflexors minimizes the progression of weakness at 24 months in children with CMT1A. For other outcomes, quality of the evidence ranged from very low to low. Interpretation: Based on the available, evidence we can only recommend exercise to improve muscle strength in children with CMT. More high quality and robust trials are needed. [ABSTRACT FROM AUTHOR]

Lack of time, lack of access to equipment, and environmental constraints are generally perceived as barriers to regular physical activity. Moreover, insufficient activity is known to promote sedentary behavior, which is a factor in many chronic diseases, negatively affects mental health, and reduces quality of life. Exercise snacks, defined as short and efficient bursts of exercise, are convenient and easy to implement, reduce sedentary time, increase physical activity, and promote the development of good exercise habits. Previous studies have found exercise snacks to be safe and feasible for the elderly, promoting physical function and reducing the incidence of falls and metabolic diseases. Exercise snacks have also been found to be effective in healthy adults as well as in patients with obesity and diabetes, helping decrease blood sugar and promoting cardiorespiratory fitness. Depending on the participant's age and tolerance, exercise snack patterns may be extended and distinguished into two forms: 10-minute bouts of gentle intermittent exercise twice a day and 60-second bouts of vigorous exercise 3 to 8 times a day. The main considerations for exercise snacks include: multi-joint exercise is better than single-joint exercise, lower body exercise is better than upper body exercise, and dynamic and rapid movement that pushes away from the ground promotes osteogenesis and helps prevent osteoporosis and fractures. Exercise snacks may be applied in healthcare practice and related research to promote health and improve quality of life for all. [ABSTRACT FROM AUTHOR]

Purpose: To examine the measurement properties of an adductor strength-assessment system in professional Australian footballers. Methods: Observational, longitudinal design. Test–retest reliability data were collected from 18 professional Australian footballers from 1 club on the same day during the 2017 Australian Football League season. Week-to-week variation data were collected on 45 professional Australian footballers from 1 club during the same season at 48, 72, and 120 h postmatch (rounds 1–23). Players lay beneath a GroinBar hip-strength testing system in supine position with their knee joints at an angle of 60°. Force (in newtons) was extracted for the left and right limbs of each player and a pain score from 0 to 10 (0 = no pain, 10 = maximum pain) was provided. Coefficient of variation (CV) and smallest worthwhile change were calculated on test–retest data. Signal-to-noise ratio was calculated for each major time point. Mean difference between force scores in a subgroup of players with and without groin pain (n = 18) was collected as evidence of construct validity for the system. Results: Test CV was 6.3% (4.9–9.0%). CV exceeded the smallest worthwhile change on both limbs. Intraclass correlation coefficient was.94. Signal-to-noise ratio ranged from 1.6 to 2.6 on average for 48, 72, and 120 h postmatch. Groin pain had a very likely moderate negative effect on adductor strength (effect size: 0.41). Conclusions: The system possesses greater measurement precision than dynamometry and sphygmomanometer adductor strength-assessment methods in professional Australian footballers. Increased groin pain reduced groin squeeze force production. Practitioners may interpret changes exceeding 6.3% in adductor strength as real. [ABSTRACT FROM AUTHOR]

Stroke seriously affects human health. Many studies have shown that enriched environment (EE) can promote functional recovery after stroke, but the intrinsic mechanisms remain unclear. In order to study the internal mechanisms of EE involved in functional recovery after ischemic stroke and which mechanism plays a leading role in the recovery of limb function after cerebral infarction, key proteins potentially involved in neuronal protection and synaptic remodeling in the ischemic penumbra have been investigated. In this study, adult C57BL/6 mice after permanent middle cerebral artery occlusion (pMCAO) were assigned to the EE and standard housing (SH) groups 3 days after operation. The EE house was spacious that contained a large variety of small toys; the SH was a normal sized cage. Sham-operated mice without artery occlusion were housed under standard conditions and were fed a normal diet. On days 3, 7, 14, and 21, postoperative motor functional recovery was tested using the modified neurological severity score (mNSS) and the Rotarod test. The expression of B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X protein (Bax), growth-associated protein-43 (GAP-43), and synaptophysin (SYN) was examined by western blotting and immunofluorescence staining. The motor functional recovery (based on the mNSS and Rotarod test 3, 7, 14, and 21 days post operation) of mice in the EE group improved significantly compared to the SH group. The expression of GAP-43 and SYN and the ratio of Bcl-2/Bax were all upregulated in the EE group compared to the SH group. In addition, we also explored the relationship between neuronal protection and synaptic remodeling in the EE-mediated recovery of limb function after cerebral infarction by correlation analysis. Correlation analysis showed that compared with the increase of Bcl-2/Bax ratio, the increased expression of GAP-43 and SYN was more closely related to the recovery of limb function in ischemic mice. These data support the hypothesis that EE can promote the process of improvement of limb dysfunction induced by ischemic stroke, and this behavior restoration may, via promoting neuroprotection in the ischemic penumbra, be dependent on the regulation of the expression of GAP-43, SYN, Bcl-2, and Bax. A limitation of the study was that we only observed several representative key indicators of synaptic remodeling and neuronal apoptosis, without an in-depth study of the potential mechanisms involved. [ABSTRACT FROM AUTHOR]

BACKGROUND: Injuries are the cause of professional and social deactivation. The rehabilitation program provided under Social Security prevention pension enables earlier rehabilitation measures. OBJECTIVE: The study's aim was to determine the efficiency of the rehabilitation as a part of Social Security prevention pension in the group of patients after limb injuries depending on the time when rehabilitation was undertaken. METHODS: The study was a retrospective data analysis, based on medical histories of 93 patients after injuries, rehabilitated as part of Social Security prevention pension from January 2016 until July 2017. The effects of rehabilitation were assessed in 2 groups: early (up to 6 months from the injury) and late rehabilitation (over 6 months). Medical effects are based on measurements of the motion range in extremities' joints, functional test results and final evaluation of the rehabilitation. RESULTS: For both groups, the motion range of most joints improved. Improvement among the group of early rehabilitated patients concerned everyday activities (p = 0.035), the results of medical rehabilitation (p = 0.046) and also the results of the functional tests. CONCLUSION: Comprehensive rehabilitation of patients after the injuries in Social Security prevention pension leads to better medical effects. The results are better for earlier rehabilitated patients. [ABSTRACT FROM AUTHOR]

The use of blood flow restriction is becoming more common and requires the use of individualized pressures in order to remain a safe and effective rehabilitation modality. Measuring limb occlusion pressure (LOP) allows the practitioner to set the restriction pressure so that full occlusion does not occur. Objective: Compare a research-grade clinical vascular doppler and a consumer-grade vascular doppler in the measurement of LOP. Design: A randomized crossover design measuring LOP in the upper and lower body. Methods: 20 participants (men=10) visited the laboratory on one occasion. Limb circumference in the arm and thigh was measured. Following 10 min of supine rest, LOP was measured either in the arm, using a 5 cm wide inelastic cuff, or in the leg, using a 10 cm wide inelastic cuff. Measurements were repeated at 5 min intervals until LOP had been measured in both limbs with both dopplers. Results: Bland-Altman analysis showed agreement between the two dopplers in both the upper body (mean bias: 0.6 (-1.3 - 2.4) mmHg) and lower body (mean bias: -1.5 (-4.4 - 1.4) mmHg). Two one-sided tests of equivalence determined that both dopplers measured a statistically equivalent LOP in the upper body (p = .547) and lower body (p = .288). Conclusions: In a healthy, young population, the consumer-grade vascular doppler measured LOP equally as well as the research-grade clinical doppler. [ABSTRACT FROM AUTHOR]

Context: Aging involves an overall deterioration of sensory functions, affecting the coordinated behavior, and suggesting a decline in the quality of afferent information from the periphery. Extra mental effort is required for the control of these movements and performing complex tasks requiring control of balance. Aim: The research was undertaken to determine the correlation between interlimb coordination with dynamic balance and cognition in geriatrics. Setting and Design: Cross-sectional study was done on geriatric people from Rehabilitation Center, Jamia Hamdard, Delhi. Subjects and Methods: A total of 35 healthy geriatrics were recruited from South Delhi by convenience sampling, based on the inclusion criteria of the study. Ethical approval was obtained from the ethics committee of the university and signed informed consent was obtained before the study. All the participants were assessed for interlimb coordination, dynamic balance, and cognition by Purdue Pegboard Test, Berg balance test, and mini-mental state examination, respectively, at Rehabilitation Center, Jamia Hamdard, Delhi. Statistical Analysis: Statistical analysis for correlation was performed through statistical software IBM SPSS Statistics 21.0 and the Pearson correlation test was used with a significance level set at 0.01. Results: Mean changes revealed the correlation between interlimb coordination and cognition (P = 0.000). Interlimb coordination and balance did not show any correlation (P > 0.01), and there was no adverse event during the study. Conclusion: It was concluded from the study that interlimb coordination is related to cognition and not to dynamic balance in healthy geriatric people. [ABSTRACT FROM AUTHOR]

A suction or elevated vacuum prosthetic socket that loses vacuum pressure may cause excessive limb motion, putting the user at risk of skin irritation, gait instability and injury. The purpose of this research was to develop a method to monitor distal limb motion and then test a small group of participants wearing suction sockets to identify variables that strongly influenced motion. A thin plastic insert holding two inductive sensor antennae was designed and printed. Inserts were placed in suction sockets made for four participants who regularly used suction or elevated vacuum suspension. Participants wore a liner with a trace amount of iron powder in the elastomer that served as a distance target for the sensors. In-lab testing demonstrated that the sensed distance increased when participants added socks and decreased when they removed socks, demonstrating proper sensor performance. Results from take-home testing (3–5 days) suggest that research investigation into cyclic limb motion for sock presence v. absence should be pursued, as should the influence of bodily position between bouts of walking. These variables may have an important influence on suspension. Long-term monitoring may provide clinical insight to improve fit and to enhance suction and elevated vacuum technology. [ABSTRACT FROM AUTHOR]

Purpose: To establish the influence of athlete-dependent characteristics on the generation and timing of system and individual joint powers during a countermovement jump (CMJ). Methods: Male national representative athletes from volleyball (n = 7), basketball (n = 6), and rugby (n = 7) performed a set of 3 CMJs at relative barbell loads of 0%, 10%, 20%, 30%, and 40% of absolute back-squat strength. Ground-reaction forces and joint kinematics were captured using a 16-camera motion-capture system integrated with 2 in-ground force plates. Limb lengths and cross-sectional areas were defined using 3-dimensional photonic scans. A repeated-measures analysis of variance determined the interaction between system and joint load–power profiles, whereas a multiregression analysis defined the explained variance of athlete-dependent characteristics on the load that maximized system power. Results: System and isolated hip, knee, and ankle peak powers were maximized across a spectrum of loads between and within sports; power values were not significantly different across loads. A positive shift in the timing of hip and ankle peak powers corresponded to a significant (P <.05) positive shift in the timing of system peak power to occur closer to toe-off. An optimal 3-input combination of athlete-dependent characteristics accounted for 68% (P <.001) of the explained variance in the load that maximized system peak power. Conclusion: The load maximizing system power is athlete-dependent, with a mixture of training and heredity-related characteristics influencing CMJ load–power profiles. The authors recommend that a combination of relative loads be individually prescribed to maximize the generation and translation of system CMJ power. [ABSTRACT FROM AUTHOR]

Cycling is commonly prescribed for physical rehabilitation of individuals with knee osteoarthritis (OA). Despite the known therapeutic benefits, no research has examined interlimb symmetry of power output during cycling in these individuals. We investigated the effects of external workload and cadence on interlimb symmetry of crank power output in individuals with knee OA versus healthy controls. A total of 12 older participants with knee OA and 12 healthy sex- and age-matched controls were recruited. Participants performed 2-minute bouts of stationary cycling at 4 workload-cadence conditions (75 W at 60 rpm, 75 W at 90 rpm, 100 W at 60 rpm, and 100 W at 90 rpm). Power output contribution of each limb toward total crank power output was computed over 60 crank cycles from the effective component of pedal force, which was perpendicular to the crank arm. Across the workload-cadence conditions, the knee OA group generated significantly higher power output with the severely affected leg compared with the less affected leg (10% difference; P =.02). Healthy controls did not show interlimb asymmetry in power output (0.1% difference; P >.99). For both groups, interlimb asymmetry was unaffected by external workload and cadence. Our results indicate that individuals with knee OA demonstrate interlimb asymmetry in crank power output during stationary cycling. [ABSTRACT FROM AUTHOR]

This study aimed to estimate the optimal body size, limb segment length, and girth or breadth ratios of 100-m breaststroke performance in youth swimmers. In total, 59 swimmers [male: n = 39, age = 11.5 (1.3) y; female: n = 20, age = 12.0 (1.0) y] participated in this study. To identify size/shape characteristics associated with 100-m breaststroke swimming performance, we computed a multiplicative allometric log-linear regression model, which was refined using backward elimination. Results showed that the 100-m breaststroke performance revealed a significant negative association with fat mass and a significant positive association with the segment length ratio (arm ratio = hand length/forearm length) and limb girth ratio (girth ratio = forearm girth/wrist girth). In addition, leg length, biacromial breadth, and biiliocristal breadth revealed significant positive associations with the 100-m breaststroke performance. However, height and body mass did not contribute to the model, suggesting that the advantage of longer levers was limb-specific rather than a general whole-body advantage. In fact, it is only by adopting multiplicative allometric models that the previously mentioned ratios could have been derived. These results highlighted the importance of considering anthropometric characteristics of youth breaststroke swimmers for talent identification and/or athlete monitoring purposes. In addition, these findings may assist orienting swimmers to the appropriate stroke based on their anthropometric characteristics. [ABSTRACT FROM AUTHOR]

The purpose of this study was to validate a new geometric solids model, developed to address the lack of female-specific models for body segment inertial parameter estimation. A second aim was to determine the effect of reducing the number of geometric solids used to model the limb segments on model accuracy. The full model comprised 56 geometric solids, the reduced model comprised 31, and the basic model comprised 16. Predicted whole-body inertial parameters were compared with direct measurements (reaction board, scales), and predicted segmental parameters with those estimated from whole-body dual x-ray absorptiometry scans for 28 females. The percentage root mean square error (%RMSE) for whole-body volume was <2.5% for all models and 1.9% for the full model. The %RMSE for whole-body center of mass location was <3.2% for all models. The % RMSE whole-body mass was <3.3% for the full model. The RMSE for segment masses was <0.5 kg (<0.5%) for all segments; Bland-Altman analysis showed the full and reduced models could adequately model thigh, forearm, foot, and hand segments, but the full model was required for the trunk segment. The proposed model was able to accurately predict body segment inertial parameters for females; more geometric solids are required to more accurately model the trunk. [ABSTRACT FROM AUTHOR]

Purpose: Asymmetry is a risk factor for male youth soccer players. There is a paucity of data confirming the presence of asymmetry using practically viable screening tasks in players at different stages of maturation. Methods: A cross-sectional sample (N = 347) of elite male youth soccer players who were either pre-, circa-, or post-peak height velocity (PHV) completed the following assessments: single-leg Y-Balance anterior reach, single-leg hop for distance, single-leg 75% hop and stick, and single-leg countermovement jumps. Results: Single-leg countermovement jumps landing force asymmetry was higher in both circa- and post-PHV groups (P < .001; d = 0.41-0.43). Single-leg 75% hop and stick landing force asymmetries were also highest in circa- PHV players, but between-group comparisons were not statistically significant and effect sizes were small. Single-leg hop for distance and single-leg Y-Balance anterior reach asymmetries reduced with maturation; however, no group differences were significant, with small to trivial effect sizes (d ≤ 0.25). Conclusion: Stage of maturation did not have a profound effect on asymmetry. Between-limb differences in functional performance seem to be established in early childhood; thus, targeted interventions to reduce this injury risk factor should commence in pre-PHV athletes and be maintained throughout childhood and adolescence to ensure asymmetry does not increase. [ABSTRACT FROM AUTHOR]

Objectives: The aims of this study were to distinguish between behavioral compensation and behavioral recovery and to determine the role of stroke lesions and the optimal timing of rehabilitation in true recovery. Design: Single pellet reaching test has been performed to analyze both quantitative and qualitative measures of forelimb function in a stroke animal model with lesions in the motor cortex, somatosensory cortex, or sensorimotor cortex. The four gestures of compensatory movement patterns that comprised a reach were head lift, limb withdrawal, pellet chasing, and phantom grasp. Results: Functional recovery improved in all the stroke groups after rehabilitation (P < 0.001). However, the compensatory movement patterns of the motor cortex and somatosensory cortex stroke groups initially increased and subsequently decreased (P = 0.0054), whereas those of the sensorimotor cortex stroke group increased and persisted (P = 0.0063). In the sensorimotor cortex stroke group, compensatory movement patterns significantly decreased when training was initiated 5 and 14 days after stroke (P = 0.0083, P = 0.0226, respectively), while they increased and persisted when training was initiated 1 day after stroke. Conclusions: These findings suggest that true recovery by task-specific training after stroke depends, probably, on the lesion size and the timing of rehabilitation. [ABSTRACT FROM AUTHOR]

Nunes, JP, Marcori, AJ, Ribeiro, AS, Cunha, PM, Kassiano, W, Costa, BDV, Aguiar, AF, Nakamura, M, Mayhew, JL, and Cyrino, ES. Differential responsiveness for strength gain between limbs after resistance training in older women: Impact on interlimb asymmetry reduction. J Strength Cond Res 36(11): 3209–3216, 2022—The present study compared strength responses between preferred (PREF) and nonpreferred (N-PREF) legs in older women. Muscular strength was measured unilaterally using an isokinetic dynamometer and was analyzed for reproducibility scores, acute performance, and responsiveness to a resistance training (RT) program. One hundred eleven women (aged ≥60 years) performed 12 weeks of whole-body RT (3 times a week; 4 lower-body exercises). Reproducibility scores (intraclass correlation coefficient ≥0.920; following test-retests in part of the sample at pretraining; n = 19), average acute performances, and average strength gains (PREF = ∼6.9%; N-PREF = ∼7.2%) were similar between legs (p > 0.05). However, the individual analyses showed that some subjects were considered responders to strength gains in 1 leg, whereas nonresponders in the other. Nonetheless, when considering the responses in all strength tests, most subjects (91%) were considered responder to at least 1 measure. In addition, it was observed that the strength ratio between PREF/N-PREF legs was altered for those who presented some asymmetry at baseline, as the limbs became more symmetrical in all strength measures after the RT. In conclusion, we observed that some older women may have different levels of strength between legs; however, a traditional 12-week RT program with bilateral exercises can reduce such asymmetry by inducing greater strength gains in the weaker leg. [ABSTRACT FROM AUTHOR]

Seipp, D, Feuerbacher, JF, Jacobs, MW, Dragutinovic, B, and Schumann, M. Acute effects of high-intensity interval running on lower-body and upper-body explosive strength and throwing velocity in handball players. J Strength Cond Res 36(11): 3167–3172, 2022—The purpose of this study was to determine the acute effects of handball-specific high-intensity interval training (HIIT) on explosive strength and throwing velocity, after varying periods of recovery. Fourteen highly trained male handball players (age: 25.4 (26.2 ± 4.2) performed HIIT consisting of repeated 15-second shuttle runs at 90% of final running speed (VIFT) to exhaustion. Upper-body and lower-body explosive strength and throwing velocities were measured before and immediately after HIIT, as well as after 6 hours. These tests included 3 repetitions of both bench press and squat exercise at 60% of the 1 repetition maximum (1RM) as well as 3 repetitions of the set shot without run up and jump shot, respectively. Explosive squat performance was significantly reduced at post (−5.48%, p = 0.026) but not at 6 h (−0.24%, p = 1.000). Explosive bench press performance remained statistically unaltered at post (0.32%, p = 1.000) and at 6 hour (1.96%, p = 1.000). This was also observed in the subsequent throws both immediately after (−0.60%, p = 1.000) (−0.31%, p = 1.000) and at 6 h (−1.58%, p = 1.000) (1.51%, p = 0.647). Our data show a reduction in explosive strength of the lower but not upper extremities when preceded by running HIIT. Since throwing velocity was not affected by intense lower-body exercise, combining lower-body HIIT and throwing practice may be of no concern in highly trained handball players. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the effects of bilateral asymmetrical limb proprioceptive neuromuscular facilitation (PNF) pattern exercises on lumbar multifidus (LM) activity, pain, disability, and lumbar range of motions (ROMs) compared to Swiss ball exercises in patients with chronic low back pain (CLBP). A randomized controlled trial was conducted at the Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Pakistan, between March 2020 and January 2021. A sample size of 150 patients with CLBP was randomized into 2 groups. Participants in the intervention group (n = 75) received bilateral asymmetrical limb PNF, while the comparison group (n = 75) received Swiss ball exercises. The scores of the visual analog scale, Oswestry Disability Index, Modified-Modified Schober's test, and percentage of the maximum voluntary contractions of LM (%MVC LM) through surface electromyography were recorded before and after 15 sessions of exercises. The Wilcoxon signed rank and Mann-Whitney U tests were employed for within-group and between-group comparisons of all outcomes, respectively. The considered level of significance was 0.05. The trial was registered with ClinicalTrials.gov (NCT04206137). Pain (in sitting, standing, and walking), disability on the Oswestry Disability Index, and left side %MVC LM were significantly improved (P <.001) in the PNF group compared to the comparison group except for right side %MVC LM and ROMs on the Modified-Modified Schober's test (P >.05). Bilateral asymmetrical limb PNF exercises showed improvement in pain, disability, and LM activity of patients with CLBP more than those who used Swiss ball exercises. [ABSTRACT FROM AUTHOR]

Simple Summary: Preoperative radiotherapy increases the risk of postoperative wound complication in the treatment of soft tissue sarcoma. This retrospective study evaluated risk factors and aimed to develop a nomogram for predicting major wound complication requiring secondary surgical intervention. We found that age, tumour size, and metastasis at presentation were independent risk factors of major wound complication. The nomogram constructed in the study effectively predicts and quantifies the risk of major wound complication. Preoperative radiotherapy increases the risk of postoperative wound complication in the treatment of soft tissue sarcoma (STS). This study aims to develop a nomogram for predicting major wound complication (MaWC) after surgery. Using the Oxford University Hospital (OUH) database, a total of 126 STS patients treated with preoperative radiotherapy and surgical resection between 2007 and 2021 were retrospectively reviewed. MaWC was defined as a wound complication that required secondary surgical intervention. Univariate and multivariate regression analyses on the association between MaWC and risk factors were performed. A nomogram was formulated and the areas under the Receiver Operating Characteristic Curves (AUC) were adopted to measure the predictive value of MaWC. A decision curve analysis (DCA) determined the model with the best discriminative ability. The incidence of MaWC was 19%. Age, tumour size, diabetes mellitus and metastasis at presentation were associated with MaWC in the univariate analysis. Age, tumour size, and metastasis at presentation were independent risk factors in the multivariate analysis. The sensitivity and specificity of the predictive model is 0.90 and 0.76, respectively. The AUC value was 0.86. The nomogram constructed in the study effectively predicts the risk of MaWC after preoperative radiotherapy and surgery for STS patients. [ABSTRACT FROM AUTHOR]

Objective. The aim of this study is to investigate the influence of grading rehabilitation nursing mode on limb function, speech function, and QOL of stroke patients. Methods. From January 2018 to April 2019, the stroke patients who received treatment in our hospital were selected as the study participants. Based on the random number table, they were assigned to CG (n = 60) and OG (n = 60). The routine rehabilitation nursing mode was used in the CG, and the grading rehabilitation nursing mode was used in the OG. The limb function, speech function, QOL, and nursing satisfaction were evaluated in both the groups, and the survival curve was analyzed after 12 months of follow-up. Results. The motor function of upper and lower limbs in OG was significantly higher than that in CG, and the total effective rate of speech function recovery in OG was 95.00%, which was obviously higher than 81.67% in CG (P < 0.05); the total QOL score in OG was (80.72 ± 7.15), which was significantly higher than (69.53 ± 6.42) in CG. The nursing satisfaction of the OG was higher (P < 0.05). The Kaplan–Meier curve analysis revealed that the difference of 12-month survival rate between CG and OG was statistically significant (χ2 = 4.710, P = 0.030). Conclusion. The application of grading rehabilitation nursing mode in stroke patients can effectively facilitate the recovery of extremity function and speech function, ameliorate the QOL and nursing satisfaction of patients, reduce the death and disability of patients, and prolong the survival time of patients. [ABSTRACT FROM AUTHOR]

Chaouachi, A, Ben Othman, A, Chaouachi, M, Hechmi, A, Farthing, JP, Granacher, U, and Behm, DG. Comparison of cross-education and global training effects in adults and youth after unilateral strength training. J Strength Cond Res 36(8): 2121–2131, 2022—Youth strength training research examining contralateral, homologous (cross-education), and heterologous (global training) effects after unilateral training have provided mixed results and the relationship to adults has not been compared. The objective was to compare adult and youth cross-education and global training effects on dominant and nondominant limb testing. Initially, 15 men and 15 prepubertal boys volunteered for each unilateral chest press (CP), handgrip training, and control groups (n = 89). Individuals trained their dominant limb 3 times per week for 8 weeks and had their dominant and nondominant limbs tested for CP and leg press 1 repetition maximum (1RM), handgrip, knee extension and flexion, and elbow extension and flexion maximum voluntary isometric contractions (MVICs). Adult CP training gains were significantly greater than youth with lower-body testing (p = 0.002–0.06), whereas youth CP training gains exceeded adults with upper-body tests (p = 0.03–0.07). Training specificity was evident with greater CP 1RM increases with CP vs. handgrip training for both youth (p < 0.0001) and adults (p < 0.0001). Handgrip training elicited greater gains in handgrip MVICs compared with other strength tests (p < 0.0001). In conclusion, only contralateral CP 1RM showed a training advantage for unilateral CP over unilateral handgrip training. Adults showed greater gains with lower-body testing, whereas youth showed greater gains with upper-body testing. [ABSTRACT FROM AUTHOR]

This study aimed to determine the effects of home-based dual-hemispheric transcranial direct current stimulation (dual-tDCS) combined with exercise on motor performance in patients with chronic stroke. We allocated 24 participants to the active or sham group. They completed 1-h home-based exercise after 20-min dual-tDCS at 2-mA, thrice a week for 4 weeks. The patients were assessed using the Fugl–Meyer Assessment (FMA), Wolf Motor Function Test, Timed Up and Go test, Five Times Sit-to-Stand Test, Six-meter Walk Test, and muscle strength assessment. Compared with the sham group, the active group showed improved FMA scores, which were sustained for at least 1 month. There was no between-group difference in the outcomes of the functional tasks. Home-based dual-tDCS could facilitate motor recovery in patients with chronic stroke with its effect lasting for at least 1 month. However, its effects on functional tasks remain unclear. tDCS is safe and easy for home-based self-administration for patients who can use their paretic arms. This could benefit patients without access to health care centres or in situations requiring physical distancing. This home-based tDCS combined with exercise has the potential to be incorporated into telemedicine in stroke rehabilitation. Twelve sessions of home-based dual-tDCS combined with exercises (3 days/week for 4 weeks) facilitated upper and lower limb motor recovery in patients with chronic stroke compared with exercise alone, with a post-effect for at least 1 month. Home-based tDCS could be safe and easily self-administrable by patients who can use their paretic arms. This intervention could be beneficial for patients living in the community without easy access to a health care centre or in situations where physical distancing is required. [ABSTRACT FROM AUTHOR]

Objective. The purpose of the systematic review is to verify the effect of biofeedback therapy on limb motor rehabilitation in patients with acute stroke and to provide evidence-based medicine for the promotion and use of biofeedback therapy. Methods. The randomized controlled trials (RCT) of biofeedback therapy in the treatment of cerebral palsy were searched in PubMed, EMBASE, ScienceDirect, Cochrane Library, China National Knowledge Infrastructure (CNKI), China VIP Database, Wanfang Database, and Chinese Biomedical Literature Database (CBM). The starting time and ending time of this study are from the time of building the database of the number of pieces to October 31, 2018. The data included in this study were extracted by two independent researchers and evaluated the bias risk of all the literature included in the study according to the Cochrane manual 5.1.0 criteria. RevMan5.4 statistical software was used to analyze the collected data by meta. Results. This systematic review included 9 RCT studies with a total of 1410 patients. The results of meta-analysis showed that there were significant differences in the improvement of lower limb muscle tension, comprehensive spasm scale score, EMG score, and passive range of motion of ankle joint between biofeedback therapy and routine rehabilitation therapy. Conclusion. Biofeedback therapy can improve lower limb muscle tension, spasticity, EMG integral value, and passive range of motion of ankle joint in children with cerebral palsy and provide better conditions for improving the motor ability of lower extremities in children with cerebral palsy. However, more studies and follow-up with higher methodological quality and longer intervention time are needed to further verify. [ABSTRACT FROM AUTHOR]