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Background In recent years, various psychological interventions have garnered attention as effective support methods to promote self-management and comprehensively understand those with physical and psychological problems associated with knee pain. The purpose of this study was to implement an instructional design (ID) based self-management program for outpatients diagnosed with KOA and to verify the effectiveness of the program. Methods In this single-arm uncontrolled before-after comparative intervention study, 41 subjects diagnosed with symptomatic knee osteoarthritis participated in an intervention program. Their pain, physical function, self-efficacy, self-care agency, and daily life difficulties were evaluated. A mixed-effects model was employed to examine the changes in each outcome from baseline to immediately before and after the intervention, and after one, three, and six months. Results "Pain at the beginning of walking," "pain from standing to sitting position," and "pain after longdistance walking" reduced significantly immediately after the intervention and after one month. "Pain when climbing stairs" reduced significantly immediately after the intervention and after one, three, and six months. The sit-to-stand test showed significant improvement from baseline to immediately after and one, three, and six months after the intervention. Self-care agency scores improved significantly immediately after the intervention and after one and six months. Conclusion The intervention program effectively improved physical function, self-care agency, and selfefficacy, and reduced pain from one to six months. Innovation: This program could lead to an increase in the healthy life expectancy of the older adults. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the influence of inter-limb leg lean tissue mass (LTM) asymmetry on stair climb (SC) performance in firefighters. Forty-one career firefighters (age = 32.3 ± 8.2 years, body mass = 92.1 ± 18.6 kg, stature = 178.3 ± 7.9 cm) visited the laboratory on one occasion and completed a whole body and leg composition assessment followed by a timed and weighted SC task. Percent body fat (%BF) and leg LTM were determined during a DEXA scan and regional thigh analysis. Asymmetry was assessed by the percent difference between limbs (dominant limb LTM – non-dominant limb LTM)/dominant limb LTM × 100) and a ± 3% cut-off for asymmetry classification. Participants ascended and descended 26 stairs four times as quickly as possible while wearing a weighted (22 kg) vest. Point biserial correlations were used to assess the relationship of inter-limb leg LTM asymmetry and SC performance before and after controlling for age and %BF. Results indicated that inter-limb leg LTM asymmetry was associated with longer SC task time (poorer performance) both before (r = 0.432, P = 0.005) and after (r = 0.502, P = 0.001) controlling for age and %BF. Our findings indicated that inter-limb leg LTM asymmetry negatively impacts firefighter SC performance, which may be improved with appropriate exercise interventions. PRACTITIONER SUMMARY: This study examined the influence of leg inter-limb lean tissue mass (LTM) asymmetry on SC performance in career firefighters. We found that inter-limb leg LTM asymmetry was associated with reduced SC performance, prior to and after controlling for age and percent body fat. Interventions that mitigate these asymmetries may improve occupational performance. [ABSTRACT FROM AUTHOR]

Purpose: To explore the differences in long-term ankle joint function between one-stage and staged microsurgical repair of open Achilles tendon defects. Methods: A retrospective analysis of the surgical treatment and follow-up data of 147 patients with open Achilles tendon defects from January 2007 to September 2023 was conducted. Patients were divided into a one-stage reconstruction group (n = 81) and a staged reconstruction group (n = 66) on the basis of whether one-stage microsurgical repair was used. In the one-stage reconstruction group, 43 patients underwent vascular anastomosed fascia lata free anterolateral thigh perforator flap transplantation for repair, and 38 patients underwent descending genicular artery free flap transplantation with the adductor magnus tendon. In the staged reconstruction group, the sural neurovascular flap was used to repair the soft tissue defect in the heel area in the first stage. In the second stage, 31 patients underwent flexor hallucis longus tendon transfer, and 35 patients underwent peroneus longus muscle tendon transfer with the lateral calcaneal artery. Observations included evaluation of the continuity and healing of the Achilles tendon via colour Doppler ultrasound 3 months postoperatively and assessment of ankle joint function 2 years postoperatively using the American Orthopedic Foot and Ankle Society ankle–hindfoot score (AOFAS) and the Achilles tendon total rupture score (ATRS). Results: Three months after surgery, colour Doppler ultrasound revealed good continuity of the Achilles tendon in all patients, with slight thickening and irregular fibre orientation. Two years after surgery, the ATRS and AOFAS scores of the one-stage reconstruction group were superior to those of the staged group (PATRS < 0.05, PAOFAS < 0.05). Among the one-stage reconstruction group, patients who underwent descending genicular artery-free flap transplantation with the adductor magnus tendon presented better performance in walking on uneven surfaces, fast stair climbing, abnormal gait, plantar flexion and dorsiflexion, and inversion and eversion than did those who underwent vascular anastomosed fascia lata free anterolateral thigh perforator flap transplantation, although there was no overall functional difference (PAOFAS = 0.792; PATRS < 0.001). In the staged repair group, patients who underwent peroneus longus muscle tendon transfer with the lateral calcaneal artery in the second stage had better postoperative follow-up ankle joint function than did those who underwent flexor hallucis longus tendon transfer (PAOFAS < 0.001; PATRS < 0.001). Preoperative injury classification of the heel region (P < 0.001), size of the defect area in the heel region (PAOFAS < 0.001, RAOFAS = -0.397; PATRS < 0.001, RATRS = -0.436), and length of the Achilles tendon defect (PAOFAS < 0.001, RAOFAS = -0.429; PATRS < 0.001, RATRS = -0.280) were associated with postoperative follow-up ankle joint function, whereas preoperative wound infection was not associated with postoperative follow-up ankle joint function (PAOFAS = 0.690, PATRS = 0.759). The surgical method (OR = 49.725, 95% CI: 16.996 ~ 145.478) and the preoperative heel region defect area (OR = 0.947, 95% CI: 0.903 ~ 0.992) were found to be independent risk factors affecting the postoperative follow-up of ankle joint function in patients with open Achilles tendon defects. Conclusion: The use of a one-stage microsurgical reconstruction method for open Achilles tendon defects is more conducive to Achilles tendon healing and results in a better long-term ankle joint function prognosis. The use of vascularised tendon tissue to repair Achilles tendon defects is a good choice that meets the needs of anatomically and physiologically functional reconstruction of the Achilles tendon. [ABSTRACT FROM AUTHOR]

Background: Depressive symptoms are a serious health issue that can cause profound, lifelong suffering for people who are affected by it. This study aimed to evaluate the effect of sarcopenia, oral frailty, and social frailty on depressive symptoms among Chinese participants aged ≥ 60 years old in China. Methods: This research utilized a cross-sectional design and used convenience sampling to select participants from Anhui Province, China. Demographic questionnaire, SARC-F (Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls), OFI-8 (Oral Frailty Index-8), the HALFT (Help, Participation, Loneliness, Financial, Talk) scale, and PHQ-9 (Patient Health Questionnaire-9) were used to conduct the survey. A chi-square test was performed to evaluate the differences between categorical variables, spearman correlation analysis was used to find the correlation between depressive symptoms and factors. Four regression models were set up to evaluate the effect of factors on depressive symptoms and select the appropriate adjustment variables. Results: Of 1453 participants, 33.5% had sarcopenia, 51.4% had oral frailty, 31.5% had pre-social frailty, 14.5% had social frailty, and 32.2% had depressive symptoms. Spearman correlation analysis indicated that depressive symptoms significantly correlated with sarcopenia (r = 0.415), oral frailty (r = 0.282), and social frailty (r = 0.410). In crude analysis, sarcopenia (OR = 0.179, 95%CI 0.141–0.227), oral frailty (OR = 3.946, 95%CI 3.101–5.021), pre-social frailty (OR = 4.449, 95%CI 3.401–5.818), and social frailty (OR = 12.552, 95%CI 8.833–17.837) were significantly associated with depressive symptoms in older adults. After adjusting for the covariates, sarcopenia (OR = 4.301, 95%CI 3.322–5.569), oral frailty (OR = 3.136, 95%CI 2.430–4.046), pre-social frailty (OR = 3.664, 95%CI 2.775–4.836) and social frailty (OR = 9.488, 95%CI 6.560-13.723) were significantly associated with depressive symptoms. (P <0.05). Conclusion: This research indicated that sarcopenia, oral frailty, pre-social frailty, and social frailty, were significant and positively associated with depressive symptoms. These results provide clinicians with a reference for identifying high-risk older adults and give public health policymakers a scientific approach to taking targeted interventions. Future research should further explore the two-way relationship between these factors and depressive symptoms and assess the effectiveness of different interventions. This will help to improve the quality of life and mental health. [ABSTRACT FROM AUTHOR]

Background: Although finger joint capsulitis has been described among the most frequent injuries in climbers, no clinical studies on treatment strategies and outcomes are available. Study design: Prospective case series study. Methods: Between 2015 and 2018 we prospectively treated 50 patients (38 male, 12 female) with a total number of 69 independent finger joint capsulitis according to a clinic specific treatment regimen and evaluated the outcome retrospectively. Therapy consisted of either conservative management, steroid injections, radiosynoviorthesis or a combination depending on the treatment regimen, prior therapy and timeline of symptoms. Outcomes were assessed using visual analogue scale (VAS), Buck-Gramcko score and a climbing specific outcome score with secondary patient recall. Results: The proximal interphalangeal joint of the middle finger was the most commonly affected joint, and there was no correlation with osteoarthritis. All climbers returned to sport within 12 months. The majority were able to maintain their level of performance after injury and the difference in climbing level before and after injury was not statistically significant (p = 0.22). The total time spent climbing was significantly less after the injury than before the injury (p < 0.001). The Buck-Gramcko score showed excellent results. The overall functional outcome was good to very good with a mean score of 1.6 ± 0.7, as was the climbing specific score of 1.7 ± 0.9. Pain was significantly less after treatment than before (p < 0.001). Conclusion: Good to very good functional and sport-specific outcomes were seen with the stage-specific treatment regimen presented, allowing all patients studied to resume climbing. A better understanding of the underlying pathogenesis is essential in order to better assess long-term progress. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to determine the effectiveness of a medial off-loader brace with sensor monitoring capabilities and associated phone application in improving outcomes for individuals with knee osteoarthritis. Methods: This is a randomized clinical trial of participants with knee osteoarthritis, aged 40–75 with two groups: 1) brace-only and 2) brace+sensor (sensor providing walking time, knee range of motion, and 7-day activity streak). Both groups received a prefabricated custom-fitted medial off-loader brace and 12-wk self-guided exercise therapy program. Baseline and postintervention assessments included subjective and objective outcomes. Results: Sixty participants were recruited (n = 30/group). The brace+sensor group demonstrated higher study retention (88.89%) compared with the brace-only group (73.33%). Significant improvement in Knee Injury and Osteoarthritis Outcome Survey knee pain and other Knee Injury and Osteoarthritis Outcome Survey subscores compared with baseline was observed for both groups. However, only the brace+sensor group improved beyond the established minimal clinically important difference for Knee Injury and Osteoarthritis Outcome Survey pain (11.31 ± 13.87). Knee Injury and Osteoarthritis Outcome Survey activities of daily living was also significantly improved in the brace+sensor group compared with brace-only group (P = 0.049). Both treatment groups had significant improvement in functional outcomes (10-m walk, 5× sit-to-stand, P < 0.05). Only the brace+sensor group had significant improvements in the 6-min walk test (P = 0.02) and reduction in participant weight (P = 0.01) at 12 wks. Conclusions: Incorporating wearable technology in standard bracing for individuals with knee osteoarthritis has potential in improving clinical outcomes. [ABSTRACT FROM AUTHOR]

Kahneman’s dual-process model postulates that two systems are involved in decision-making: slow thinking, defined as analytical processing of information, and fast thinking, where decisions emerge from intuitive, automatic responses. Climbers in Olympic bouldering typically engage in slow thinking to interpret movements and explore climbing strategies. However, time constraints imposed by regulations, combined with ineffective decision-making and failed climbing attempts, may compel them to make more intuitive, fast decisions. This study examined climbers’ decision-making and bouldering performance under varying time constraints. A total of 48 elite climbers were asked to climb three boulders, each within a different timeframe: four, two, and one minute. Data collection included boulder previewing times, appropriateness of decision-making, completed boulders, climbing attempts, and climbing times. Findings revealed that, as time constraints increased, absolute previewing time decreased, while previewing ratio relative to given time increased. Climbers made better decisions, did more attempts, had longer total climbing times, and were more successful when given time was longer, while relative climbing time increased when time was lower. Findings indicate that increased time constraints negatively affected climbers’ strategic behaviour and bouldering performance. This decline in decision-making and performance may be attributed to less time for slow thinking and actual climbing. [ABSTRACT FROM AUTHOR]

Background: Falls on stairs are a major cause of severe injuries among older adults, with stair descent posing significantly greater risks than ascent. Variations in stair descent phenotypes may reflect differences in physical function and biomechanical stability, and their identification may prevent falls. Aims: This study aims to classify stair descent phenotypes in older adults and investigate the biomechanical and physical functional differences between these phenotypes using hierarchical cluster analysis. Methods: Eighty-two older adults participated in this study. Stair descent was measured using a three-dimensional motion analysis system. Physical function was assessed using measures of muscle strength, walking speed, the Timed Up and Go Test (TUG), and the Community Balance and Mobility Scale (CB&M). Results: Hierarchical cluster analysis was performed on kinematic data obtained during stair descent. Three phenotypes were identified: neutral (N-type; 24%), extension (E-type; 52%), and rotation (R-type; 23%). There were no significant differences in lower limb muscle strength or walking speed among the different types, and TUG scores showed no differences in terms of mobility or balance abilities. However, CB&M scores were significantly lower for E-type and R-type compared to N-type. Sub-analyses revealed that while there were no differences in the mobility factor of CB&M between E-type and R-type, the strength factors were significantly lower compared to those for N-type. Discussion: These results suggest that E-type and R-type stair-descent patterns may be influenced by declines in standing balance ability and muscle strength. Conclusions: These findings may inform fall-prevention training programs related to stair descent among older adults. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the feasibility of computer model-based evaluation of knee joint functional capacity in comparison with manual assessment. Methods: This study consisted of two phases: (1) developing an automatic knee joint action recognition and classification system on the basis of improved YOLOX and (2) analyzing the feasibility of assessment by the software system and doctors, identifying the knee joint function of patients, and determining the accuracy of the software system. We collected 40–50 samples for use in clinical experiments. The datasets used in this study were collected from patients admitted to the Joint Surgery Center. In this study, the knee joint assessment items included stair climbing, walking on uneven surfaces, and knee joint function. To assess the computer model's automatic evaluation of knee joint function, MedCalc 20 statistical software was used to analyze the consistency of the Lequesne functional index between the computer model's automated determinations and manual independent assessments. Results: The weighted kappa coefficients between the doctors' assessments and the software system's assessments were 0.76 (95% confidence intervals:0.59 ~ 0.92) for climbing up and down stairs, 0.64 (95% confidence intervals:0.45 ~ 0.82) for walking on uneven floors, and 0.68 (95% confidence intervals:0.53 ~ 0.84) for the Lequesne functional index, indicating good consistency between the assessments of the software system and doctors. Conclusion: This paper introduces an automatic knee joint action recognition and classification method based on improved YOLOX. By comparing the results obtained by orthopedic doctors and the software system, the feasibility of this software system was validated in the clinic. [ABSTRACT FROM AUTHOR]

Purpose: Previous studies reported that anterior knee pain (AKP) occurs with an incidence of 32% after opening-wedge high tibial osteotomy (OWHTO). However, the biomechanical effects of this procedure on patellofemoral joints (PFJs) remain unclear. We aimed to quantify the changes in the kinematics and cartilage conditions of the PFJ during stair climbing before and after OWHTO. Methods: We recruited 15 patients who underwent unilateral OWHTO. All patients performed continuous stair climbing under the surveillance of a dual fluoroscopic imaging system to determine accurate 6-degree-of-freedom (6-DOF) PFJs and 3D hip-knee-ankle (HKA) angles before and 6 months after OWHTO. The volume penetration centres between the patellar and femoral cartilage models were defined as contact centres. Eleven of these patients underwent quantitative T2 relaxation MRI to determine whether and how PFJ cartilage degeneration progressed. Results: After OWHTO, patella valgus (mean − 3.73°, P = 0.02) and internal rotation (mean 3.14°, P = 0.03) increased compared with the preoperative conditions during the stair climbing motion. In addition, the patellae of OWTHO knees were located more laterally after surgery (1.56 ± 2.24 mm, P = 0.02) at knee flexion. Moreover, lateral shifts in the contact patterns of both the medial and lateral patellar facets together with increased T2 values (207.10 ± 21.84 ms, P = 0.04) of the lateral patella cartilage were found after surgery. Finally, the lateral patellar shift increased with decreasing varus 3D-HKA after surgery (R= -0.79, P < 0.001). Therefore, controlling 3D-HKA may be helpful in limiting lateral patellar shift. Conclusion: OWHTO changed the patellofemoral kinematics and contact patterns during stair climbing, especially the lateral patellar shift, which may lead to degeneration of the PFJ cartilage. Avoiding overcorrection of the HKA angle beyond 5 degrees of valgus reduces lateral patellar translation, which may help prevent AKP. Additional clinical studies are necessary to validate these biomechanical findings and clarify their impacts on patient outcomes. [ABSTRACT FROM AUTHOR]

This scoping review aimed to evaluate the effect of exercise combined with vitamin D supplementation on skeletal muscle health in older individuals. We implemented a systematic search of electronic databases, including PubMed, the Cochrane Library, Web of Science and Embase, which was conducted from the time of library construction to January 2024. Eligible studies were randomised controlled trials including men and women aged ≥ 65 years or mean age ≥ 65 years; exercise training and vitamin D supplementation; outcomes of muscular strength, function, muscular power, body composition and quality of life; and results compared with those of exercise intervention alone. The results showed thirteen studies including 1483 participants were identified. The proportions of male and female sex were 22·05 and 77·95 %, respectively. Exercise intervention methods included resistance exercises and multimodal exercise training. All vitamin D interventions involved supplementation with vitamin D3. A significant increase was identified in short physical performance battery and stair climbing but not in skeletal muscle mass, skeletal strength, the timed up and go test and gait speed in older adults after exercise combined with vitamin D supplementation. In conclusion, exercise combined with vitamin D supplementation has additive health effects on short physical performance battery and stair climbing. Furthermore, when vitamin D was deficient at baseline, the combined effect of exercise and vitamin D intervention significantly increased the timed up and go test and gait speed in older adults. In future randomised controlled trials on this topic, baseline vitamin D nutritional status, health condition and sex should be considered. [ABSTRACT FROM AUTHOR]

Background: Menisci, one of the most important anatomical structures of the knee joint, plays a role in load transfer, stability, shock absorption, prevention of articular cartilage degeneration, and proprioception. Type I collagen, the main component of the meniscus, and type II collagen fibers play an important role in the stability of the knee joint. This study aimed to evaluate the effects of Naturagen® 4 Joint product containing type I, II, and III collagen on pain, quality of life, and physical functions in patients with meniscopathy. Methods: This randomized, double-blind, placebo-controlled clinical study included 32 patients (collagen = 17 and placebo = 15) with meniscopathy. Patients completed the Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthrtis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS), Oxford Knee Score (OKS), Tampa Scale for Kinesiophobia (TSK), Short Form Health Survey (SF-12), Lower Extremity Functional Scale (LEFS), Foot Function Index (FFI), proprioceptive sensation, Timed Up and Go (TUG), 6-Minute Walking Test (6MWT), The Five Repetition Sit to Stand Test (5STS), Stair Climbing Test (SCT), Berg Balance Scale (BBS) and back and leg strength tests and scales were applied. All tests were repeated before and after eight weeks of collagen supplementation. Results: The study showed that eight weeks of supplementation with various collagen types had statistically significant effects on pain, quality of life, kinesiophobia, and foot function scale scores in patients with meniscopathy (p < 0.05). Similarly, eight weeks of supplementation showed a statistically significant difference in leg strength (p = 0.057), but no significant difference was found in back strength, proprioception, balance, and various functional test results (p > 0.05). Conclusions: The results of the study showed that the eight-week collagen-based supplement had a positive effect on pain and quality of life levels and some functional test results in patients with meniscopathy. Longer-term studies and diversification of subject groups will help to understand better the effects of the product on meniscal tears and symptoms. Trial registration: The study was retrospectively registered in the Iranian Clinical Trials Registry on 14/05/2024 with the number IRCT20240411061470N2. [ABSTRACT FROM AUTHOR]

Smart wearable devices detection and recording of people's everyday activities is critical for health monitoring, helping persons with disabilities, and providing care for the elderly. Most of the research that is being conducted uses a machine learning-based methodology; however, these approaches frequently have issues with high computing resource consumption, burdensome training data gathering, and restricted scalability across many contexts. This research suggests a behaviour detection technology based on multi-source sensing and logical reasoning to address these problems. In order to realize the natural fusion of signal processing and logical reasoning in behavior recognition research, this work designs a lightweight behavior recognition solution using the pertinent theories of ontology reasoning in classical artificial intelligence. Machine learning technology is also employed for behavior recognition using the same data set. Once the best model has been chosen, the cross-person recognition results after testing and modification of parameters are 90.8% and 92.1%, respectively. This technology was used to create a behaviour recognition system, and several tests were run to assess how well it worked. The findings demonstrate that the suggested strategy achieves over 90% recognition accuracy for 11 different daily activities, including jogging, walking, and stair climbing. Additionally, the suggested strategy dramatically minimises the quantity of user-provided training data needed in comparison to machine learning-based behaviour identification techniques. [ABSTRACT FROM AUTHOR]

Background Few studies have explored the association between stair climbing and osteoarthritis (OA) to determine whether the former is a protective or risk factor for the latter. This study prospectively evaluated the associations among stair climbing, genetic susceptibility, and their interaction with the risk of incident hip/knee OA. Methods The cohort analyses included 398 939 participants from the UK Biobank. Stair climbing was assessed using a questionnaire. Genetic risk scores consisting of 70, 83, and 87 single-nucleotide polymorphisms for hip, knee, and hip/knee OA were constructed. Cox proportional hazard regression models were used to estimate hazard ratios and 95% confidence intervals for the associations among stair climbing, genetic predisposition, and hip and/or knee OA risk. Results After 3 621 735 person-years of follow-up, 31 940 patients developed OA. Stair climbing was positively associated with incident hip/knee (p for trend < .001) and knee (p for trend < .0001) OA but not hip OA. After adjustments, compared with no stair climbing, climbing >150 steps/d was associated with a higher risk of hip/knee OA (hazard ratio, 1.08; 95% confidence interval: 1.03–1.12) and knee OA (hazard ratio, 1.13; 95% confidence interval, 1.06–1.20). Although no significant interaction between stair climbing and the genetic risk scores of OA risk was found, the above associations were only significant in participants with middle and high genetic risk scores. Conclusions A higher frequency of stair climbing was positively associated with the risk of knee OA but not hip OA, highlighting the importance of avoiding frequent stair climbing in preventing knee OA, especially in genetically predisposed individuals. [ABSTRACT FROM AUTHOR]

Objective: Selective androgen receptor modulators (SARMs) are potential treatments for ameliorating age‐related physical dysfunctions caused by sarcopenia, cachexia and chronic illnesses such as cancer. The purpose of this systematic review is to analyse the effect of SARMs on physical performance and body and evaluate their safety profile. Methods: A systematic review search criteria following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines was performed in three databases for studies reporting physical parameter outcomes after SARM intervention. Study variables included title, author, publication date, study year, number of patients, dosage, mean age, mean follow‐up time, pre and post‐intervention outcomes and rates of complications. Results: Nine studies, including 970 patients with a mean age of 57.1 years (35.3−75.9) and a mean follow‐up of 80 days (14−180), were included. Six SARMs were analysed: LGD‐4033, PF‐06260414, GSK2881078, GTx‐024, MK‐0773 and OPK‐88004. Mean pre‐intervention stair climbing power (five studies), one repetition maximum leg press (four studies) and short physical performance battery (SPPB) score (two studies), lean body mass (seven studies) and fat mass (five studies) were 352.24 W (69.79−678.7), 1822.77 N (1176.8−2407.3), 9.15 (7.95−9.9), 49.46 kg (30.94−63.9) and 21.99 kg (13.3−33), respectively. Mean post‐intervention values were 315.16 W (89.46−525.73 W), 2191.27 N (1375.87−2462.9 N), 9.79 (8.88−10.4), 50.86 kg (31.02−67.29) and 21.85 kg (12.54−32.16), respectively. Conclusion: SARMs have a positive effect on physical performance and body composition and are associated with moderate rates of mild to moderate adverse effects (AEs) and a low rate of severe AEs. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Prolonged sedentary behavior can acutely reduce peripheral and central vascular function, thereby increasing the risk of cardiovascular disease. Interrupting sedentary behavior may be a potential practical strategy to prevent vascular dysfunction caused by prolonged sitting. However, current research findings on its acute effects are inconsistent, and specific application recommendations have not yet been established. This study aims to perform a Metaanalysis on the acute effects of interrupting sedentary behavior on peripheral and central vascular function in adults and to explore its regulatory factors. METHODS: Following PRISMA reporting guidelines, literature search was conducted in March 2024 using the keywords of "interrupting," "sedentary," and "vascular function" in the Web of Science Core Collection, PubMed, and China National Knowledge Infrastructure (CNKI) databases. Acute randomized crossover trials addressing the acute effects of interrupting sedentary behavior on peripheral and central vascular function in adults were included. Risk of Bias 2 developed by Cochrane was used to assess bias risk, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used to evaluate the evidence level. The "meta" and "metaphor" packages in R (version 4.2.0) were used for main effect aggregation (Hedge's g acted as the effect size indicator), publication bias testing, subgroup analysis, and regression analysis. RESULTS: Twenty-two randomized crossover trials involving 364 subjects (aged 21 to 70 years) were included. Meta-analysis results showed that compared with prolonged sitting, interrupting sedentary behavior acutely improved peripheral vascular blood flow volume (Hedge's g=0.48, 95% confidence interval: 0.14- 0.82, P < 0.01, I²=63%, low evidence level), shear stress (Hedge's g=0.65, 95% confidence interval: 0.37-0.93], P < 0.01, I²=54%, moderate evidence level), and flow-mediated dilation (Hedge's g=0.43, 95% confidence interval: 0.15-0.72, P < 0.01, I²=61%, moderate evidence level). Disease had a significant moderating effect on the main effect aggregation for blood flow volume (P=0.01 between subgroups), while the mode (P=0.01 between subgroups) and frequency (P=0.02 between subgroups) of interruptions had significant moderating effects on shear stress. Improvements in peripheral vascular shear stress from interrupting sedentary behavior were affected by age (β=-0.02, 95% confidence interval: -0.03-0.01, P=0.09) and body mass index (β=-0.10, 95% confidence interval: -0.18 to -0.02, P < 0.01). Improvements in flow-mediated dilation were influenced by the total number of interruptions (β=-0.09, 95% confidence interval: -0.17 to -0.01, P=0.03) and the duration of sitting during the control period (β=-0.21, 95% confidence interval: -0.34 to -0.09, P < 0.01). Each additional hour of sitting was associated with a 0.67% reduction in the acute improvement effect of flow-mediated dilation from interrupting sedentary behavior (P < 0.01), and acute benefits disappeared when sitting control time exceeded 6 hours. A qualitative systematic review found that interrupting sedentary behavior did not significantly affect pulse wave velocity in various populations but could effectively prevent central vascular function decline in older adults due to prolonged sitting. CONCLUSION: Interrupting sedentary behavior acutely improves peripheral vascular blood flow volume (low evidence level), shear stress (moderate evidence level), and flow-mediated dilation (moderate evidence level) in adults and may prevent or protect against central vascular function decline in older adults due to prolonged sitting (very low evidence level). Characteristics of subjects (disease factors, sex, age, and body mass index), interruption intervention schemes (mode, frequency, total number of interruptions), and duration of sitting control all influence the acute improvement effects of interrupting sedentary behavior on vascular function. It is recommended that adults interrupt sedentary behavior with exercises involving large muscle groups, such as stair climbing, at high frequencies (e.g., once every 40 minutes) with at least 5 minutes of moderate- to low-intensity activity each time, and limit the cumulative duration of prolonged sitting to no more than 6 hours per day. [ABSTRACT FROM AUTHOR]

Urban settings present considerable obstacles for those use personal mobility wheelchairs, especially when it comes to manoeuvring stairs. The objective of this study is to improve the safety and ease of use of wheelchairs designed for ascending stairs. The study aims to tackle the significant issue of instability and limited ability to adjust to different types of terrain. This research employs a holistic methodology that combines theoretical dynamic analysis, hardware design and simulation, and field testing, in addition to advanced machine learning approaches for surface prediction. Theoretical models guarantee the stability of the wheelchair, while hardware simulations offer valuable insights into its structural integrity. The data obtained from inertial measurement unit (IMU) sensors during field tests is analysed and categorised using models like random forest and gradient boosting, which exhibit exceptional accuracy in forecasting movement circumstances. The results demonstrate that the implementation of these combined techniques greatly enhances the wheelchair's capacity to safely manoeuvre over urban barriers. The study finds that the suggested solutions show great potential for creating intelligent mobility aids, which might be used to improve accessibility for those with mobility limitations. [ABSTRACT FROM AUTHOR]

Abstract Background context Physical activities such as walking and climbing stairs are pervasive in human daily life. Individuals with scoliosis frequently encounter dysfunction in their muscle recruitment. Multiple studies have corroborated the presence of muscle dysfunction in individuals diagnosed with scoliosis. However, there is currently a noteworthy research gap regarding the exploration of changes in muscle characteristics and disparities from those observed in individuals without scoliosis during everyday activities, specifically stair climbing. Purpose This study aims to examine the unique patterns of muscle activity during daily life in individuals with scoliosis and distinguish the specific differences between scoliosis patients and the healthy controls. The findings of this study are significantly important for the future accurate assessment of scoliosis and the development of rehabilitation treatment plans. Study design Case–control study. Sample size Twenty eight idiopathic scoliosis patients and twenty eight controls. Outcome measures Root Mean Square(RMS), Maximum Voluntary Isometric Contraction(MVIC)%, RMS ratio(RMS convex / RMS concave). Methods The surface electromyography (sEMG) device used in this study was the Delsys Trigno, with a sampling frequency of 1500 Hz. It recorded the activation level, peak contraction, and average activation level of the erector spinae (at T6, T10, and L3 levels), gluteus maximus, gluteus medius, external oblique, and rectus abdominis muscles during three different types of locomotion for both the 28 individuals with idiopathic scoliosis and the 28 control participants. Results The movement patterns of the idiopathic scoliosis patients significantly differ from those of the normal population during level walking and ascending or descending stairs. In level walking, there is an asymmetry in the activation levels of the T6 and L3 erector spinae muscles, with lower activation on the convex side compared to the concave side. Similarly, during stair ascent, the activation of the T6 and T10 erector spinae muscles is asymmetric, with higher activation on the convex side than the concave side. Moreover, during stair descent, the activation of the T6 erector spinae muscle is asymmetric, with higher activation on the convex side than the concave side. Conclusions During level walking and stair activities, idiopathic scoliosis patients exhibit pronounced abnormal movement patterns that significantly differ from those of the control group. Under different activity conditions such as level walking, ascending and descending stairs, idiopathic scoliosis patients demonstrate abnormal muscle activation in different segments of the spine. It is crucial for clinicians to prioritize the symmetry of muscle activation in the spinal region of idiopathic scoliosis patients and consider incorporating symmetry training for these muscles.

Objective Methods Results Interpretation This study aimed to evaluate the potential of exercise as an abortive treatment for patients with cluster headache (CH).A cross‐sectional survey was conducted among CH patients at a single center in Korea. Demographics and headache characteristics were compared between those who found exercise effective and those who did not. We analyzed the type and intensity of exercise used. Headache improvement was measured as intensity reduction, with ≥50% improvement defined as a reduction in intensity by half or more. Exercise intensity was categorized as moderate (“possible to talk but hard to sing”) or high (“difficult to speak without pausing”). Case reports of patients exercising during CH attacks were also reviewed.Among 167 registered CH patients, 136 patients provided responses about exercise during CH attacks; 39.7% (54/136) attempted exercise as treatment. Improvement was reported by 42.6% (23/54), with ≥50% improvement in 29.6% (16/54). Patients who found exercise effective had lower Headache Impact Test‐6 scores. Effective exercises included running (39.1%), squats (30.4%), and stair climbing (21.7%), with high‐intensity exercise effective for 52.2% and moderate intensity for 43.5%. Among the 23 patients who benefited from exercise, 18 reported their most effective treatment, which were exercise alone in 50% (9/18), followed by exercise with triptans in 38.9% (7/18), and oxygen with or without triptans in 5.5% (1/18).About 40% of CH patients attempted exercise for acute CH management, with 30% experiencing over 50% improvement. While evidence is limited, exercise may help alleviate headaches and could be considered an adjunctive treatment for CH attacks. [ABSTRACT FROM AUTHOR]

Introduction: Regular physical activity (PA) has a beneficial effect on joint pain, stiffness, strength, flexibility, and aerobic capacity in patients with rheumatoid arthritis (RA). Objective: The aim of this study was to assess the level of PA in patients with rheumatoid arthritis and to identify potential barriers to this activity. Material and Methods: The study involved 132 patients with RA. Participants completed the International Physical Activity Questionnaire (IPAQ), the Functional Assessment of Chronic Illness Therapy—Fatigue Scale (FACIT-F), the Tampa Scale for kinesiophobia (TSK), Strength, Ambulation, Rising from a chair, Stair climbing and history of Falling questionnaire (SARC-F) for sarcopenia assessment, and the Patient Health Questionnaire-9 (PHQ-9) for depression. Basic socio-epidemiological data, disease activity score in 28 joints (DAS28), duration of disease, and therapy information were retrieved from electronic patient records. Latent class analysis (LCA) was used to identify subpopulations of patients. Results: The study included 109 women (82.6%) and 23 men (17.4%). Low levels of PA were observed in 16 patients (12%), moderate levels in 70 patients (53%), and high levels in 42 patients (35%). Symptoms of pronounced fatigue were significantly associated with low PA (28.5 ± 11.3 vs. 37 ± 7 vs. 37 ± 10; p = 0.002). The risk of sarcopenia was significantly higher in RA patients with low PA (p = 0.05). Kinesiophobia was present in all three groups (65.2%). LCA identified two classes. In the first class, patients were more likely to be non-exercisers compared to the second class. Patients in the first class were characterized by a higher probability of being female, obese, with lower education levels. Patients in the first class had pronounced fatigue, kinesiophobia and more frequent symptoms of depression. The second class (65% of the total population) included patients who exercised moderately to frequently (93%) and were middle-aged. They were less obese, highly educated, employed, and majority of them achieved low disease activity or remission. In addition, they had lower risks for sarcopenia, depression, fatigue, and kinesiophobia. Conclusions: This study showed that RA patients with moderate and high levels of PA have better disease control, fewer symptoms of fatigue and depression, and a lower risk of sarcopenia. However, kinesiophobia was significantly present in all three groups, indicating a need for further promotion of this non-pharmacological treatment. [ABSTRACT FROM AUTHOR]

Introduction: With the increasing prevalence of diabetes worldwide, it seems that resistance training can reduce cardiac dysfunction in diabetic models. The aim of the present study is the effectiveness of resistance training on reticulophagy-related proteins in the left ventricle of the heart of type 2 diabetic rats. Materials and Methods: In this experimental study, 12 2-month-old male Sprague Dawley rats with an average weight of 280±20 grams were selected. Type 2 diabetes was induced by injecting nicotinamide and streptozotocin solutions. Rats were randomly divided into the diabetic resistance training group and the diabetic control group. Resistance training consisted of 8 weeks and 3 sessions per week of climbing a vertical ladder with an 85degree slope, one meter long with 26 steps and 2 cm space between each step. To analyses the data, independent t-tests, and t-dependent tests were used in SPSS version 29 software. Results: The protein content of ATF6 (P=0.001) and mTOR (P=0.03) showed a significant decrease and increase, respectively, compared to the control group in the left ventricle of the heart after 8 weeks of resistance training. On the other hand, there was no significant change in JNK1 protein content in the left ventricle of the heart (P=0.16). The level of blood sugar (mg/dl) did not show a significant change between the eighth week compared to the first week in the resistance training group (P=0.07), but a significant difference was observed between the eighth week in the control group compared to the resistance training group (P=0.001). Conclusion: It seems that resistance training for 8 weeks is capable of modulating proteins related to reticulophagy in the heart of people with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Introduction: Nocturnal lower urinary tract symptoms are common in geriatric rehabilitation inpatients but have not been well described. The aim of this study was to compare patient characteristics stratified by self-reported nocturia severity in geriatric rehabilitation inpatients. Methods: The REStORing health of acutely unwell adulTs (RESORT) is an observational, longitudinal, prospective inception cohort of geriatric rehabilitation inpatients who underwent a Comprehensive Geriatric Assessment (CGA) at admission and discharge. Nocturia was captured by item 7 of the American Urology Association Symptom Score (AUASS) and dichotomised as ≤1 void and >1 void at night as per the International Continence Society definition. Differences in demographic, functional, and medical characteristics of the inpatients with and without nocturia >1 were compared. Results: Overall, 641 inpatients completed the nocturia item (mean age 82.6 [SD 7.7] years, 59.9% female). Nocturia occurred >once per night in 57.4%; mean number of episodes was 1.96 (SD 1.38), ranging from 0 to 5. There was no change in nocturia severity between admission and discharge. Daily urinary incontinence, urinary urgency, and comorbid illness were independently associated with multiple nocturia episodes. A history of falls within the last year, difficulty climbing stairs pre-admission, higher faecal incontinence score, impaired quality of life domains, higher levels of anxiety and depression were significantly more common in inpatients with multiple episodes of nocturia compared to no or only one episode of nocturia. Conclusion: Lower urinary tract symptoms, poor functional status and frailty markers were associated with repeated episodes of nocturia. Targeted intervention may reduce the severity of nocturia, with potential to improve sleep quality, impact therapeutic gains and influence discharge destination. [ABSTRACT FROM AUTHOR]

Estimation of the knee joint strength by maximum voluntary isometric contraction (MVIC) is a common practice to assess strength, coordination, safety to return to work or engage in sports after an injury, and to evaluate the efficacy of treatment modalities and rehabilitation strategies. In this study, we utilize a previously validated coupled finite element‐musculoskeletal model of the lower extremity to explore the sensitivity of output measures (posterior cruciate ligament [PCL]/muscle/contact forces and passive moments) in knee MVIC flexion exercises at seated position. To do so, at three knee flexion angles (KFA), input measures (resistance moment and contribution moments of quadriceps and gastrocnemii) were varied at four levels each using the Taguchi design of experiment. Our findings reveal significant increases in PCL forces with KFA (p < 0.01), net MVIC moment (p < 0.01), and resistance moment of quadriceps (p < 0.01). In contrast, they drop at larger activity in gastrocnemii (p < 0.01). Tibiofemoral (TF) contact forces increase with the net MVIC moment (p < 0.01). The passive knee flexion moment, while highly dependent on the location at which computed, also increases with the net MVIC moment (p < 0.01). Changes in KFA, MVIC moment, and proportions thereof carried by quadriceps and/or gastrocnemii substantially affect biomechanics of the joint. Compared with level walking and stair ascent, slightly larger contact forces/stresses and much greater PCL forces are computed. This study improves our understanding of the knee joint behavior during MVIC in effective evaluation and rehabilitation interventions. Besides, it emphasizes the importance of positioning the joint center in model studies. [ABSTRACT FROM AUTHOR]

This paper proposes a control method for semi-autonomous stair climbing using an articulated mobile robot. Stair-climbing motion is achieved by propagating a single backward wave along the body of the robot. The robot moves forward by shifting a part of the body lifted from the step (the elongating part) from front to back. Semi-autonomous stair climbing is accomplished by automatically determining when to shift the elongating part backward based on the relative position between the step and the robot. Furthermore, we developed an actual robot that can measure the relative position between itself and the environment to climb stairs semi-autonomously. The developed robot is equipped with several short-range sensors on the lower part of its body, which can measure the relative distance between the robot and the stair tread surface. The effectiveness of the proposed control method was verified by simulations using a physics simulator and by experiments with the developed robot. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the course of basic activities of daily living (ADL) from admission up to six months after the stroke and the longitudinal associations between stroke-related neurological deficits at admission to the stroke unit and course of basic ADL. Materials and Methods: 180 individuals with a first-ever stroke were assessed at admission to the stroke unit and at follow-ups of three and six months. Stroke-related neurological deficits were assessed at admission with the National Institutes of Stroke Scale (NIHSS). Independence in basic ADL was assessed at admission and three and six months after the stroke by the Modified Barthel Index (MBI). Generalized Estimating Equations (GEE) were performed. Results: Dependence in basic ADL reduced overtime, with most changes occurring over the first three months. Individuals, who had moderate/severe stroke-related neurological deficits (NIHSS ≥6) at admission, had higher chances of becoming more dependent in activities related to feeding (OR:1.27;95%CI = 1.03-1.55;p = 0.021), bathing (OR:1.30;95%CI = 1.11-1.50;p = 0.0005), dressing (OR:1.19;95%CI = 1.04-1.36;p = 0.010), transfers (OR:1.24;95%CI = 1.05-1.46;p = 0.0072), stair climbing (OR:1.46;95%CI = 1.27-1.66;p < 0.0001), and ambulation (OR:1.21;95%CI = 1.02-1.43;p < 0.0001). Conclusions: Decreases in dependence in basic ADL occurred mainly over three months after the stroke and showed different patterns for specific ADL. Baseline moderate/severe stroke-related neurological deficits were associated with poor functional status in basic ADL over the follow-up period. IMPLICATIONS FOR REHABILITATION: Stroke survivors experience dependence in basic activities of daily living (ADL) which is reduced over six months after the stroke and showed different individual variability in patterns of recovery. Patients with moderate/severe stroke-related neurological deficits had higher chances of becoming dependent in activities related to feeding, bathing, dressing, transfers, stair climbing, and ambulation. Rehabilitation professionals should consider assessing stroke-related neurologic deficits within the first hours after stroke, with particular attention to individuals with moderate/severe impairments. [ABSTRACT FROM AUTHOR]

Background: Functional dependency may serve as a marker for positive SARC-F screen (Strength, Assistance with walking, Rise from a chair, Climb stairs and Falls) among older adults at the Emergency Department (ED). We compared functional dependency between SARC-F– (<4) and SARC-F+ (≥4) groups at the ED. Methods: A secondary analysis of cohorts from two quasi-experimental studies among patients aged ≥65 years old presenting to the ED of a 1,700-bed tertiary hospital. We compared both groups for baseline characteristics using univariate analyses, and performed multiple linear regression to examine the association between Modified Barthel Index (MBI) and Lawton's instrumental activities of daily living (IADL) against SARC-F, and binary logistic regression to examine the associations between individual ADL domains and SARC-F+. We compared the area under receiver operating characteristic curves (AUC) to detect SARC-F+ for MBI, IADL, frailty, age, cognition and comorbidity. Results: SARC-F+ patients were older (86.4±7.6 years), predominantly female (71.5%) and frail (73.9%), more dependent on walking aids (77.2%), and had lower premorbid MBI (median 90.0 [interquartile range 71.0–98.0]) and IADL (4.0 [2.0–5.0]) (both p<0.001). MBI (β=–0.07, 95% confidence interval [CI] –0.086 to –0.055) and IADL (β=–0.533, 95% CI –0.684 to –0.381) were significantly associated with SARC-F. Dependency in finances (odds ratio [OR]=14.7, 95% CI 3.57–60.2, p<0.001), feeding (OR=12.4, 95% CI 1.45–106, p=0.022), and stair-climbing (OR=10.49, 95% CI 4.96–22.2, p<0.001) were the top three functional items associated with SARC-F. MBI (AUC=0.82, 95% CI 0.77–0.84) and IADL (AUC=0.78, 95% CI 0.72–0.84) showed superior discrimination for SARC-F+ compared to other measures (AUC=0.58–0.70). Conclusion: Functional dependency is strongly associated with positive SARC-F screen among older adults at the ED. This highlights the need for increased vigilance, especially in the presence of dependency in relevant domains such as managing finances, feeding, and stair-climbing. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: The COVID-19 pandemic has profoundly affected the physical activity (PA) levels and dietary habits of individuals, particularly children and adolescents in Saudi Arabia, owing to widespread closures and social distancing measures, including school closures. Methods: A cross-sectional study was conducted to assess the impact of distance learning (DL) on PA and dietary habits among public middle school girls during the pandemic. The Arab Teens Lifestyle Questionnaire (ATLS) was used to assess habitual PA, sedentary behavior, and dietary habits. Results: A total of 300 middle school female students, with an average age of 14 years, participated in the study. The results indicated a generally low level of PA among students during DL and after school reopening, with a significant decrease in specific types of PA, such as walking and stair climbing during DL. However, after schools reopened, there was a significant increase in students' participation in activities such as swimming, dancing, and housework (P < 0.05). Moreover, sleep hours and TV-watching time increased compared to the DL period. Despite the prevalence of students frequently consuming soft drinks, sugary treats, fried and fast foods, as well as sweets and chocolates during the lockdown, middle school girls also consumed a lot of fruits and vegetables. Conclusion: Assessing students' habitual PA and dietary habits during the lockdown may provide insights into their future health and well-being post-pandemic. This assessment can help in identifying strategies to redirect current PA levels to maintain health and prevent potential long-term health implications. [ABSTRACT FROM AUTHOR]

Objectives: Down syndrome (DS) is associated with challenges like increased fat mass and reduced muscle tone. This study aims to analyze the impact of resistance training on improving muscle strength and physical function in individuals with DS. Methods: We conducted a comprehensive search of PubMed, Scopus, Google Scholar, Cochrane Library, and China National Knowledge Infrastructure for studies published up to August 2023. Standardized mean differences and 95% confidence intervals were used to evaluate the efficacy of resistance training. Results: Eight randomized controlled trials (RCTs), including 127 participants with DS, met the inclusion criteria. Resistance training significantly improved muscle strength in the knee extensors (SMD: 1.009, 95% CI: 0.505–1.513), knee flexors (SMD: 1.133, 95% CI: 0.106 to 2.16), and upper limbs (SMD: 0.748, 95% CI: 0.152–1.343). The SMD for upper limb function was 0.385 (95% CI: 0.004–0.765), showing a small improvement. For walking ability, the SMD was 0.259 (95% CI: −0.171–0.690), and for stair climbing ability, the SMD was 0.257 (95% CI: −0.189–0.703), both indicating no significant changes. Improvements in upper limb physical function were significant, but no notable improvements were seen in lower limb functions. Conclusions: Resistance training for more than four weeks enhances muscle strength in individuals with DS, with greater gains seen in younger participants. While improvements were noted in upper limb physical function, lower limb function remained largely unchanged. These findings suggest that resistance training is a valuable exercise for improving muscle strength and physical function in individuals with DS. [ABSTRACT FROM AUTHOR]

Vision-based stair modeling can help autonomous mobile robots deal with the challenge of climbing stairs, especially in unfamiliar environments. To address the problem that current monocular methods are difficult to model stairs accurately without depth information in scenes with fuzzy visual cues, this paper proposes a depth-aware stair modeling method for monocular vision. Specifically, we take the prediction of depth images and the extraction of stair geometric features as joint tasks in a convolutional neural network, with the designed information propagation architecture, we can achieve effective supervision for stair geometric feature learning by depth features. In addition, to complete the stair modeling, we take the convex lines, concave lines, tread surfaces and riser surfaces as stair geometric features and apply Gaussian kernels to enable StairNetV3 to predict contextual information within the stair lines. Combined with the depth information obtained by depth sensors, we propose a point cloud reconstruction method that can quickly segment point clouds of stair step surfaces. The experiments show that the proposed method has a significant improvement over the previous best monocular vision method, with an intersection over union increase of 3.4 % , and the lightweight version has a fast detection speed and can meet the requirements of most real-time applications. [ABSTRACT FROM AUTHOR]

Climbing stairs is relatively challenging for seniors, post-stroke individuals or even healthy young men when carrying heavy objects. In this paper, we have developed a rigid-soft hybrid exosuit that helps the wearer to climb the stairs by offering a driving torque to the knee joint. By combining the advantage of rigid and soft exoskeletons, the exosuit is more comfortable when assisting wearers at a high level of assistance. To simplify the detection system, but keep it versatile, only the surface electromyography sensor is used to detect human movement. This paper uses a hierarchical control strategy based on gait detection and force tracking. To verify the capability of this exosuit system, we conducted experiments with four healthy users walking upstairs in different levels of assistance and climbing speeds. By comparing the muscle activity of participants with exosuit and without exosuit, the vastus lateralis activity was reduced by 3% to 15%, depending on the subject. This research shows the assisting capability of this exosuit under different assistance levels and climbing speeds. [ABSTRACT FROM AUTHOR]

This 6‐week pilot study aimed to investigate the feasibility, perceived efficacy, and participation perspectives of a university campus stair climbing‐based exercise snack (ES) intervention and to compare it to moderate‐intensity continuous training (MICT). Healthy, young, inactive adults (age: 21.6 ± 2.3 years, BMI: 22.5 ± 3.6 kg/m2) were randomly assigned to three groups (ES, MICT, and Control [CON]). ES (n = 14, 6 females) and MICT (n = 13, 9 females) groups performed three sessions per week over 6 weeks, while the control group (n = 15, 9 females) maintained their habitual lifestyle. ES involved 3 × ~30 s 'all‐out' stair‐climbing (6 flights, total 126 steps and 18.9 m elevation) bouts separated by > 1 h rest, and MICT involved 40 min stationary cycling at 60%–70% HRmax. Mixed linear effect models were used to explore within and between‐group differences, and the change in magnitude was determined using mean difference (MD), 95% confidence interval (CI), and Cohen's d effect size. Fourteen participants also completed post‐intervention semi‐structured interviews. Retention rates of 93% (ES, 14/15), 93% (MICT, 13/14), and 100% (CON, 15/15) were achieved from baseline to post‐assessments, with compliance (participants' attendance to scheduled ES sessions) of 97% (733/756 sessions) and 93% (217/234 sessions) in ES and MICT, respectively. No significant differences were found between ES and MICT for future intentions (4.8 ± 1.4 and 5.0 ± 0.9), enjoyment (PACES, 89.0 ± 16.4 and 94.5 ± 11.9), and satisfaction. A significant group × time interaction was found in the quality of life and perceived stress. ES and MICT significantly increased the quality of life by 8% (MD = 5.5 [95% CI = 0.3, 10.7], Cohen's d = 0.64) and 6% (MD = 4.6 [95% CI = 0.9, 8.2], Cohen's d = 0.88) compared to baseline, whereas CON experienced a significant decrease (MD = −7.9 [95% CI = −14.4, −1.6], Cohen's d = 0.56). ES significantly decreased perceived stress by 7% (MD = −4.6 [95% CI = −8.9, −0.3], Cohen's d = 0.58), while MICT (MD = 2.0 [95% CI = −0.1, 4.1], Cohen's d = 0.28) and CON (MD = −2.4 [95% CI = −6.1, 1.3], Cohen's d = 0.22) had no significant effects. The majority (12/14) of participants generally demonstrated positive attitudes toward participation in ES and found it easier than expected while highlighting enablers, barriers, and future recommendations. Stair climbing‐based ES could be integrated into the campus setting, appeared feasible, and was similar to MICT regarding future intentions, enjoyment, and satisfaction. Both ES and MICT might induce relevant positive effects on the quality of life, and ES demonstrated greater benefits compared to MICT or CON for reducing perceived stress. Interviews provided positive insights into fostering adherence to ES among university students. [ABSTRACT FROM AUTHOR]

Purpose: Vigorous intermittent lifestyle physical activity (VILPA) are bursts of incidental vigorous activity that occur during day-to-day activities outside of the exercise-domain. Vigorous intermittent lifestyle physical activity has shown promise in lowering risk of mortality and chronic disease. However, there is an absence of an empirically derived definition. Using physiological and effort-based metrics commonly used to define vigorous intensity, we investigated the minimum time needed to elicit physiological and perceived exertion responses to standardized activities of daily living. Methods: Seventy adults (age = 58.0 ± 9.6 yr; 35 female) completed 9 VILPA activities of daily living in a randomized order, which included fast walking, fast incline walking, stair climbing, stationary cycling, and carrying external weight equal to 5% and 10% of body weight. Metabolic rate (by continuous indirect calorimetry), heart rate (telemetry) and perceived effort (Borg Scale) were measured during exercise. Time to reach VILPA was assessed using %V̇O2max, %HRmax, and rating of perceived exertion thresholds. Results: The mean time to elicit VILPA ranged from 65 to 95 s (mean ± sd = 76.7 ± 3.8 s) for %V̇O2max, 68 to 105 s (mean ± sd = 82.8 ± 6.8 s) for %HRmax, and 20 to 60 s (mean ± sd = 44.6 ± 6.7 s) for rating of perceived exertion. For each of the three indices, there was no difference in the time to elicit VILPA responses by sex or age (P > 0.08), and times were also consistent between activities of daily living tasks. For example, for females and males, the average time to elicit vigorous responses while walking on a flat surface was 85.8 s (±16.9 s) and 80 s (±13.9 s), respectively, and for stair climbing while carrying 10% of body weight the duration was 78.4 s (±17.6 s) and 76.9 (±17.7 s). Conclusions: When participants undertook activities of daily living, VILPA elicited a physiological response at an average of 77 to 83 s for %V̇O2max and %HRmax, and 45 s for perceived exertion. The absence of a difference in the time to reach VILPA between sex and age suggests that a consistent behavioral VILPA translation can be used in interventions and population-based studies designed to assess the health effects of incidental physical activity. [ABSTRACT FROM AUTHOR]

Background: Habits including regular physical activity are necessary for maintaining good health. Functional mobility, including walking and going up and down stairs, is essential for personal autonomy and well-being. Pain is a condition related to biological and psychosocial aspects that influence people's lives. Objective: The main objectives of this study were (1) to analyse the associations between physical activity frequency (PAF) and self-perceived health (SPH) and functional mobility (walking and going up and down stairs) in middle-aged and older people living in Spain with different pain levels; and (2) to analyse the risk factors for having a negative SPH and functional mobility difficulties by calculating the probabilistic risks adjusted by different variables (sex, body mass index, social class, civil status, smoking status, pain level, and PAF). Methods: A cross-sectional study based on the European Health Survey data in Spain (EHSS 2014-2020) and The Spanish National Health Survey (SNHS 2017) was carried out, with a final sample of 21,152 participants with ages between 40 and 79 years. Results: Associations between high pain levels and worse SPH and difficulties in walking and climbing stairs were found. Lower PAF levels were associated with higher-probability risks of having a negative SPH and difficulties in walking and climbing stairs. Conclusions: Physical inactivity emerged as an important risk factor for worse SPH and functional mobility. These associations underline the importance that PA programmes can play in the improvement of health and functional mobility, as well as in other aspects, in people with pain. [ABSTRACT FROM AUTHOR]

BACKGROUND: Research on muscle activity to reduce injuries during firefighting training has getting increasing attention. OBJECTIVE: The purpose of this study was to assess the activity changes in nine muscles of firefighters during the seven firefighting training programs, and to analyze the influence of different firefighting training programs on muscle activity. METHODS: Ten healthy male firefighters were recruited to measure the field surface electromyographic activities (including the percentage of Maximum Voluntary Contraction electromyography (% MVC) and the integrated electromyography value (iEMG)) during all the firefighting training programs. RESULTS: The results showed that the electromyographic activity of gastrocnemius (GA) was stronger in climbing the hooked ladder and climbing the six-meter long ladder training programs. Arms, shoulders, and lower limb muscles were more activated, myoelectric activities were more intense, and fatigue in these areas was more likely to occur during climbing five-story building with loads. Compared with other muscles, erector spine (ES) had a higher degree of activation during different postures of water shooting. The Borg scale scores of shoulders, trunk, thighs and calves were also higher. CONCLUSION: After completing all training programs, GA, tibialis anterior (TA), trapezius (TR), and ES were strongly activated, and all muscles had obvious force. The % MVC and iEMG analyses correspond well with the Borg Scale score. The results can provide certain reference for reducing the musculoskeletal injury of firefighters, carrying out scientific training and formulating effective injury prevention measures for them. [ABSTRACT FROM AUTHOR]

The document delves into various historical events and figures, such as the Aber Day Kegger in Montana, the Andrus Hotel in Dillon, and Dolores LaChapelle's life and work. It utilizes primary sources like newspapers and interviews to explore topics like student activism, environmental ethics, and skiing culture in the Western United States. By drawing on diverse perspectives and sources, the text offers a comprehensive overview of the cultural and historical significance of these subjects for researchers interested in these areas. Additionally, it discusses avalanche research in the San Juan Mountains, state control of the atmosphere in twentieth-century America, and Dolores LaChapelle's contributions to ecophilosophy and the skiing community, particularly in the Alta ski area. [Extracted from the article]

Objectives: To assess the clinical and molecular profile of patients with Duchenne Muscular Dystrophy (DMD) presenting to a tertiary center in Eastern Region of Uttar Pradesh, India. Methods: In this retrospective study, case records of all patients diagnosed as DMD were analyzed to ascertain the clinical phenotype and molecular profile. Multiplex polymerase chain reaction (mPCR) technique, Multiplex Ligation Dependent Probe Amplification (MLPA) and Next Generation Sequencing (NGS) were used for establishing the molecular diagnosis. Leiden Open Variation Database (LOVD) frame checker online tool was used to predict clinical severity of the cases. Results: Records of 112 children with DMD were analyzed. The median (IQR) age of onset and clinical presentation of disease was 60 (12, 132) months and 90 (33, 156) months, respectively. The most common clinical presentations were difficulty in standing from sitting position (n = 107), difficulty in climbing stairs (n = 106), and difficulty in walking (n = 99). Bilateral calf muscle hypertrophy and a positive Gower's sign was seen in 110 and 108 patients at presentation. The median (IQR) creatinine phosphokinase (CPK) levels at diagnosis were 6296.5 (4320, 7432.5) U/L. The genetic variation in 111 patients were reported as deletion (n = 105), duplication (n = 3), and point variation (n = 3). 22 patients could benefit from the available exon skipping therapy. Exondys (exon 51 skipping) could be used in 14 patients. Conclusion: Deletions were recorded in a much higher proportion of patients compared to previous studies from India. There were 22 patients who could have been benefitted by the available exon skipping therapy. [ABSTRACT FROM AUTHOR]

Background/Objectives Older people with functional limitations find it difficult to age in place alone, without cohabiting with relatives. In light of this, this paper aimed to investigate possible gender differences in this respect among seniors living in Italy. Methods: The study presents findings from the IN-AGE ("Inclusive ageing in place") study carried out in 2019 in this country assessing the ability of seniors aged 65 years and over to carry out basic and instrumental activities of daily living (ADLs and IADLs), in addition to two mobility limitations (going up/down the stairs and bending to pick up an object) and sensory limitations (hearing and eyesight). Qualitative/semi-structured interviews were administered to 120 older people living in three Italian regions (Lombardy, Marche, and Calabria). Quantitative and qualitative analyses were performed by differentiating between genders and among activities carried out autonomously, with help, or not performed (i.e., the senior is "not able"). Possible sources of support were also explored. Results: The main results revealed that cleaning the house, shopping, bathing/showering, and washing the laundry are particularly difficult, with men reporting greater difficulties than women. Moreover, for both genders, the family—especially children—represents the main source of help, in addition to public and private services, but the results differ between males and females. Conclusions: These results can offer insights for policymakers in the development of adequate gender-sensitive policies. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the accuracy and reliability of accelerometer-based pedometers placed on the wrist, waist, and shoe's midsole during walking, running, and stair climbing. Twenty healthy adults were recruited. Steps were recorded by the pedometers and visually assessed from simultaneously recorded video to evaluate the accuracy of each pedometer in different locations of attachment. One week later, steps were recorded again by the pedometers only to evaluate the reliability of each pedometer in different locations of attachment. The wrist-worn pedometer presented significantly greater error scores compared to the midsole-worn pedometer during walking (p < 0.001), running (p = 0.006), and stair climbing (p = 0.003). Additionally, mean absolute precent error and Bland-Altman plots indicated that the pedometer worn in the midsole was most accurate for running and stair climbing, followed by waist-worn and wrist-worn pedometers. Furthermore, the midsole-worn and waist-worn pedometers showed strong reliability during walking and running, but only the midsole-worn pedometer presented acceptable reliability during stair climbing. The pedometer's position impacts the accuracy and reliability of step counts, especially for walking and stair climbing. Embedding the pedometer into the midsole seems an effective approach to improve the accuracy and reliability of step counts. [ABSTRACT FROM AUTHOR]

Highlights The rice husk and straw biochar particles were statistically analyzed, and two representative particles were obtained. A particle model was established using the discrete element method and the Johnson-Kendall-Roberts method. This study used a response surface design method to calibrate biochar particle parameters. The discrete element method (DEM) is widely used in modelling particulate materials and related applications. DEM modelling requires the calibration of a large number of microparameters that are difficult to experimentally measure. This study aims to obtain the contact parameters of different types of biochar accurately and quickly and proposed a parameter calibration method for biochar particles to verify, which uses particle density, moisture content, inter-particle friction coefficient, particle and steel plates. A mathematical model was established for predicting parameter of friction coefficient, Johnson-Kendall-Roberts (JKR) surface energy, and contact behavior. The parameters were verified using the engineering design measurement method and a simulation analysis using a commercial software called Rocky. The results showed that: (a) the data obtained using the cylinder lifting method and the stacking and angle of repose tests of the drawing plate method were stable, the angle of repose of the biochar pellet pile was measured to be 36.55°; (b) the steepest climbing test results indicated that with the increased of Biochar-biochar rolling coefficient, Biochar-steel restitution coefficient, and JKR value, the angle of repose gradually increases; (c) a quadratic regression model was established through a Box-Behnken experiment, and it was found that the interaction term had an extremely significant effect on the angle of repose of biochar particles; (d) a preliminary design of a biochar return machine was created based on the calibration, simulation and actual test results. [ABSTRACT FROM AUTHOR]

Hinokitiol is a natural bioactive compound synthesized as a secondary metabolite in numerous aromatic, medicinal plants and commonly used in food and cosmetic industries. The investigation was carried out to screen the potential activity of hinokitiol against LPS-induced inflammation, algesia, and oxidative stress in experimental animals. The hinokitiol was screened in two doses, i.e. 0.2 mg/kg (H-1), 0.4 mg/kg (H-2), and inflammoalgesia were induced by intraplantar administration of lipopolysaccharides (LPS) at a dose of 1 mg/kg. The assessment was carried out on the 7th, 14th, 21st, and 28th days for the severity of arthritic hyperalgesia score, secondary inflammatory lesions, stair climbing ability, motility, and dorsal flexion-pain score test. Serum analysis was carried out for tumor necrosis factor-alpha (TNF-a), interleukin (IL-2 and IL-6), prostaglandin (PGE-2), nitric oxide (NO), and thymus/spleen index. The joint samples were further subjected to histopathological observations. The results showed that treatment with H-1 and H-2 shows dose-dependent significant decreases (P<0.05) in arthritic hyperalgesia and secondary lesions, whereas a significant increase (P<0.05) in stair climbing ability, motility, and dorsal flexion pain score test was noted. Treatment with H-1 and H-2 shows significant lowering (P<0.05) in serum TNF-a, IL-2, IL-6, PGE-2, NO, and thymus/spleen index. Histopathological observations indicated minimal damage and restored the synovial structure. The present study reveals that hinokitiol shows significant anti-inflammatory, anti-algesic, and antioxidant effects against LPS-induced inflammation in experimental animals. [ABSTRACT FROM AUTHOR]

Total hip replacement (THR) with cemented stem is a common procedure for patients with hip osteoarthritis. When primary THR fails, removal of the cement is problematic and poses challenges during revision surgeries. The possibility of proximal partial cementing of the hip stem was explored to mitigate the problem. 3D finite element analysis was performed to investigate the feasibility of reduced cement length for effective implant fixation and load transmission. Three levels of cement reduction (40 mm, 80 mm, and 100 mm) in the femoral stem were evaluated. All models were assigned loadings of peak forces acting on the femur during walking and stair climbing. The experimental and predicted max/min principal bone strains were fitted into regression models and showed good correlations. FE results indicated stress increment in the femoral bone, stem, and cement due to cement reduction. A notable increase of bone stress was observed with large cement reduction of 80–100 mm, particularly in Gruen zones 3 and 5 during walking and Gruen zones 3 and 6 during stair climbing. The increase of cement stresses could be limited to 11% with a cement reduction of 40 mm. The findings suggested that a 40-mm cement reduction in hip stem fixation was desirable to avoid unwanted complications after cemented THR. [ABSTRACT FROM AUTHOR]

Currently, the incidence of accidents involving falls from height at construction sites caused by workers climbing guardrails is still high. Traditional unsafe behavior management mainly relies on a safety patrol of construction-site supervisors, which consumes considerable laborpower and time. There is still a critical need for an automated safety management method to identify unsafe guardrail climbing behavior. This study proposes a worker behavior identification method based on visual data fusion of a worker's surrounding environment and posture data. Videos of seven participants' guardrail climbing behavior through multiangle and multidistance cameras were analyzed to verify this method. By analyzing the environment and posture of the participants, three methods based on environment, posture, and fusion data were used to detect the stage of guardrail climbing action of the workers and compare them with the ground truth labeled by safety experts. The precision and recall of worker guardrail climbing behavior based on the fusion method were 82% and 83% respectively, which is better performance than that obtained using a single method. The data fusion–based method avoids the misjudgment generated by a single detection method and can identify the guardrail climbing behavior more accurately. Practical Applications: Guardrail climbing is a typical unsafe behavior that exposes workers to a high risk of falling from height. However, there is a lack of research on the interaction between workers and guardrail systems in the construction industry. This study provides a nonintrusive method for automating detection and management of guardrail climbing behavior on construction site. Using existing surveillance cameras, this method can be deployed at low cost with slight interference with workers. Based on the detection, appropriate interventions are expected to effectively reduce workers' unsafe behaviors during construction and improve safety on site. The detection of guardrail climbing, which is one of the variety of unsafe behaviors associated with falls from height, can enrich the intelligent construction safety management system effectively. Moreover, this study also provides reference and quantitative indicators (e.g., a guardrail climbing unsafe behavior database) for risk assessment and early warning of workers who are exposed to risk of fall from height. [ABSTRACT FROM AUTHOR]

This study aimed to analyze and predict various types of knee pain in knee osteoarthritis (KOA) patients based on Semi-Quantitative MRI Osteoarthritis Knee Score (SQ-MOAKS) features. The goal was to identify structural abnormalities in the knee joint associated with different types of pain, thereby aiding in the development of personalized treatment plans. Subjects were selected from the Osteoarthritis Initiative (OAI) database, including 297 patients who underwent both SQ-MOAKS assessment on knee MRI images and WOMAC knee pain assessment. Univariate and multivariate logistic regression analyses were used for feature selection, followed by the construction of multi-risk factor models and corresponding nomograms for each pain type. The predictive values of the models were evaluated using ROC curves and related metrics (AUC, accuracy, sensitivity, specificity), and the DeLong test was used to assess the significance of differences between various ROCs and AUCs. Significant associations were found between specific SQ-MOAKS features and different types of knee pain. Bone marrow lesions (BML) and cartilage morphology (CM) features were crucial in predicting the walking pain and rest pain, while osteophytes (OS) were more associated with nocturnal pain and pain during stair climbing. The models demonstrated high predictive accuracy, particularly for walking pain and rest pain. This study demonstrated that SQ-MOAKS features could effectively predict different types of knee pain, revealing the structural basis of knee pain in KOA patients. These results prompted the use of SQ-MOAKS in developing personalized treatment strategies, enhancing clinical decision-making, and improving patient quality of life. [ABSTRACT FROM AUTHOR]