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Background: Drop foot is common post-stroke, elevating fall risks and mobility limitations. It is caused by weakness and lack of control of the tibialis anterior muscle (TA), for which various rehabilitation treatments are used. A reliable objective estimate of changes in TA muscle morphology and composition can enhance treatment optimization. Objectives: We aimed to ascertain 3D freehand ultrasound (3DfUS) reliability in measuring TA muscle volume, length, and echo intensity in stroke patients and healthy controls and its validity by comparing these features across legs, between patients and controls, and between clinical subgroups (i.e. patients with and without ankle contracture, spastic muscle overactivity, and foot dorsiflexor paresis). Methods: We included 9 stroke patients and 9 healthy controls to define reliability and 26 stroke patients and 28 healthy controls to define validity. For reliability, data were collected and processed by 2 different operators and processors. For inter- and intra-rater reliability, intra-class correlation coefficient (ICC) and standard error of measurement (SEM) were used. For validity, Wilcoxon-Signed-Ranked and Mann-Whitney U tests were used for comparisons between groups and subgroups. Results: All measurements showed good to excellent inter- and intra-rater reliability (ICC: 0.816 to 0.997, SEM: 0.5% to 7.8%). Comparison analyses revealed no differences in muscle features among legs, groups, or subgroups. Conclusion: While the 3DfUS is a reliable method to define TA morphology and composition, its clinical validity needs further investigation into factors influencing muscle property changes across various age groups and post-stroke time points. MeSH terms: Stroke; Skeletal muscle morphology; muscle composition; 3D freehand ultrasonography, Anterior Tibial Muscle [ABSTRACT FROM AUTHOR]

There is a growing interest in muscle characteristics of the lumbar multifidus related to low back pain, but findings between studies are inconsistent. One of the issues explaining these conflicting findings might be the use of two‐dimensional measures of cross‐sectional area and thickness of the lumbar multifidus in most studies, which might be a suboptimal representation of the entire muscle volume. A three‐dimensional volumetric assessment, combined with standardized imaging and processing measurement protocols, is highly recommended to quantify spinal muscle morphology. Three‐dimensional freehand ultrasonography is a technique with large potential for daily clinical practice. It is achieved by combining conventional two‐dimensional ultrasound with a motion‐tracking system, recording the position and orientation of the ultrasound transducer during acquisition, resulting in a three‐dimensional reconstruction. This study investigates intra‐ and interprocessor reliability for the quantification of muscle volume of the lumbar multifidus based on three‐dimensional freehand ultrasound and its validity, in 31 patients with low back pain and 20 healthy subjects. Two processors manually segmented the lumbar multifidus on three‐dimensional freehand ultrasound images using Stradwin software following a well‐defined method. We assessed the concurrent validity of the measurement of multifidus muscle volume using three‐dimensional freehand ultrasound compared with magnetic resonance imaging in 10 patients with low back pain. Processing reliability and agreement were determined using intraclass correlation coefficients, Bland–Altman plots, and calculation of the standard error of measurement and minimal detectable change, while validity was defined based on correlation analysis. The processing of three‐dimensional freehand ultrasound images to measure lumbar multifidus volume was reliable. Good to excellent intraclass correlation coefficients were found for intraprocessor reliability. For interprocessor reliability, the intraclass correlation coefficients were moderate to good, emphasizing the importance of processing guidelines and training. A single processor analysis is preferred in clinical studies or when small differences in muscle volume are expected. The correlation between magnetic resonance imaging and three‐dimensional freehand ultrasound measurements of lumbar multifidus volume was moderate to good but with a systematically smaller multifidus volume measured on three‐dimensional freehand ultrasound. These results provide opportunities for both researchers and clinicians to reliably assess muscle structure using three‐dimensional freehand ultrasound in patients with low back pain and to monitor changes related to pathology or interventions. To allow implementation in both research and clinical settings, guidelines on three‐dimensional freehand ultrasound processing and training were provided. [ABSTRACT FROM AUTHOR]

Sufficient physical activity after breast cancer treatment is crucial for improvement of a wide range of health-related outcomes and survival. The first aim of this pilot study was to explore whether adding supervised hydrotherapy sessions to a standard 12-week exercise program consisting of already two supervised sessions of landbased exercises has beneficial effects on physical and mental functioning and quality of life in breast cancer survivors. As a secondary aim, the added value of a third supervised training session with land-based exercises to the same standard exercise program was investigated. Breast cancer patients who finished primary cancer treatment were allocated to one of the three 12-week exercise programs, i.e. a standard exercise program with two supervised land-based exercise sessions per week (control group) or the same standard program with an additional weekly supervised hydrotherapy session (hydrotherapygroup) or land-based exercise session (land-based exercise group). The efficacy of the three programs was tested by comparing changes in physical and mental functioning and quality of life from pre- until post-intervention. Twenty-six (41%) patients were allocated to the control group, 21 (33%) to the hydrotherapy-group and 16 (26%) to the land-based exercise group. The results show no differences in any outcome between the three groups. Comparing the two exercise programs with three supervised sessions, results show a significantly larger improvement in the self-reported moderate (median (IQR) +1240 (412;3330) vs. +50(-1088;1125);p=0.020) and total physical activity level (+2982 (878;5457) vs. +370(-576;1718);p=0.008) in the hydrotherapy-group compared to the land-based exercise group. The opposite was found for the outcome 'physical symptoms', a subscale from the health-related quality of life questionnaire with a larger improvement in the land-based exercise group compared to the hydrotherapy-group (+3(0.6;4.8) vs. +0.6(- 0.8;2.1); p=0.008). In conclusion, the results of this pilot study indicate that adding a third weekly supervised session to a 12-week exercise program consisting of already two weekly supervised sessions had no added value for the improvement of physical and mental functioning and quality of life after breast cancer treatment. If a third supervised session is organized, hydrotherapy may be a valuable exercise modality since moderate and total physical activity levels seem to improve more compared to an exercise program with three supervised land-based exercise sessions. For self-reported physical symptoms although, a land-based exercise program seems more beneficial. Because of the limited sample size and pilot study design all obtained findings need to be interpreted with caution. [ABSTRACT FROM AUTHOR]

Keywords: AQUA questionnaire; athletes; atopy; FeNO EN AQUA questionnaire athletes atopy FeNO 1 5 5 03/30/23 20230301 NES 230301 Allergic sensitization and allergic diseases have been reported to have a high prevalence in athletes.[[1]] Moreover, atopy has been significantly associated with bronchial hyperreactivity and exercise-induced bronchoconstriction in elite athletes.[[3]] Sensitization to allergens is generally determined by a skin prick test (SPT) and/or allergen-specific serum IgE analysis.[5] Recently, the Allergy Questionnaire for Athletes (AQUA©),[6] a screening tool to predict atopy in elite adult athletes, was validated for screening of atopy in young elite athletes.[7] This screening tool may help with the early identification of atopy, which may burden the physical performances, and is especially helpful in young elite athletes.[5] Increased fractional exhaled NO (FeNO) levels are, considered to be an effective, noninvasive tool to assess the presence of eosinophilic airway inflammation and as tool to diagnose childhood asthma.[[8], [10]] This has also been correlated with allergic sensitization.[11] Therefore, we hypothesize that measuring FeNO levels may also be a useful noninvasive method to predict atopy in this population. The AUC of FeNO increased from 0.765 ( I p i < .0001) to 0.814 ( I p i < .0001) if we considered multiple sensitizations (participants with >=2 positive SPTs; Figure 1C), suggesting that FeNO levels might be a useful indicator for multiple sensitizations within atopic athletes. Can AQUA© questionnaire and FeNO predict atopy in early-career athletes? (C) ROC curve indicating the sensitivity and specificity of AQUA© (left) and FeNO (right) to predict atopy and multiple sensitizations (for FeNO). [Extracted from the article]

Background: Impaired muscle activation may predispose subjects to develop chronic ankle instability. It has been suggested that impairments are found not only in structures around the injured ankle but also [...]