Acute neuromuscular responses to whole-body vibration in healthy individuals: A systematic review

Whole-body vibration (WBV) training has been employed alongside conventional exercise like resistance training to enhance skeletal muscle strength and performance. This systematic review examines the evidence regarding the effect of WBV on muscle activity, strength, and performance in healthy individuals. The Academic Search Ultimate, CINAHL, Cochrane CENTRAL, PubMed, ProQuest One Academic and SCOPUS databases were searched from 1990 to April 2023 to retrieve relevant studies. Methodological quality was assessed using the Modified Downs and Black checklist, while the level of evidence was evaluated through the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool. Even though the quality of the included studies was moderate to high, the level of evidence was very low owing to serious concerns with three or more GRADE domains (risk of bias, inconsistency, indirectness, imprecision, and publication bias) for each outcome of interest across studies. The review suggests that in WBV training, using moderate to high vibration frequencies (25-40 Hz) and high magnitudes (3-6 mm) can enhance muscle activation and strength in pelvis and lower limb muscles. However, findings regarding WBV effect on muscle performance measures were inconsistent. Future research with robust methodology is necessary in this area to validate and support these findings.

The impact of smartphone use duration and posture on the prevalence of hand pain among college students

BACKGROUND

Excessive smartphone usage among students can lead to discomfort in their hands and fingers. This study investigates the impact of smartphone holding posture, duration of usage, and the prevalence of wrist and finger pain among university students.

METHODS

This cross-sectional study involved 213 university students who were selected based on inclusion criteria. Data was collected through a demographic information questionnaire. Participants self-reported five different postures for holding and interacting with a smartphone. The prevalence, frequency, severity, and interference of wrist and finger discomfort were assessed using the Cornell Hand Discomfort Questionnaires (CHDQ).

RESULTS

The study revealed that the average age of participants was 21.3 ± 2.2 years. On average, they had been using smartphones for 7.9 ± 3.1 years and spent an average of 4.9 ± 2.5 h daily holding them in their hands. In terms of discomfort, more than 25% of students reported pain in areas C (thumb finger), E (Palm Pollicis), and F (wrist) of the right hand, which was significantly related to the duration of holding the smartphone in that hand. Additionally, smartphone holding duration significantly affected areas D (palm) and F of the left hand, with over 11% of students experiencing discomfort. The most prevalent posture among students (41% of participants) involved holding the smartphone with the right hand only, with the thumb touching the screen. Notably, areas B (χ2 = 21.7), C (χ2 = 10.27), D (χ2 = 65.54), and E (χ2 = 59.49) of the right hand, as well as areas C (χ2 = 6.58) and E (χ2 = 44.28) of the left hand, exhibited significant associations with the postures of holding the smartphone.

CONCLUSIONS

The duration of smartphone use and the postures in which it is held contribute to the prevalence of discomfort in the thumb area and related muscles among right-handed students.

Identifying best fall-related balance factors and robotic-assisted gait training attributes in 105 post-stroke patients using clinical machine learning models

BACKGROUND

Despite the promising effects of robot-assisted gait training (RAGT) on balance and gait in post-stroke rehabilitation, the optimal predictors of fall-related balance and effective RAGT attributes remain unclear in post-stroke patients at a high risk of fall.

OBJECTIVE

We aimed to determine the most accurate clinical machine learning (ML) algorithm for predicting fall-related balance factors and identifying RAGT attributes.

METHODS

We applied five ML algorithms- logistic regression, random forest, decision tree, support vector machine (SVM), and extreme gradient boosting (XGboost)- to a dataset of 105 post-stroke patients undergoing RAGT. The variables included the Berg Balance Scale score, walking speed, steps, hip and knee active torques, functional ambulation categories, Fugl- Meyer assessment (FMA), the Korean version of the Modified Barthel Index, and fall history.

RESULTS

The random forest algorithm excelled (receiver operating characteristic area under the curve; AUC = 0.91) in predicting balance improvement, outperforming the SVM (AUC = 0.76) and XGboost (AUC = 0.71). Key determinants identified were knee active torque, age, step count, number of RAGT sessions, FMA, and hip torque.

CONCLUSION

The random forest algorithm was the best prediction model for identifying fall-related balance and RAGT determinants, highlighting the importance of key factors for successful RAGT outcome performance in fall-related balance improvement.

Moving Towards a Medicine of Dance: A Scoping Review of Characteristics of Dance Interventions Targeting Older Adults and a Theoretical Framework

Background

Dance combines cultural and aesthetic elements with behaviors important for brain health, including physical activity, social engagement, and cognitive challenge. Therefore, dance could positively impact public health given the rapidly aging population, increasing incidence of Alzheimer's disease and related dementias, and lack of uptake of exercise in many older adults. Despite a high volume of literature, existing literature does not support evidence-based guidelines for dance to support healthy aging.

Objective

To conduct a scoping review of the dance intervention literature in older adults and provide information to facilitate a more consistent approach among scientists in designing dance interventions for older adults that stimulate physical and neurocognitive health adaptations.

Methods

Study characteristics (sample size, population, study design, outcomes, intervention details) were ascertained from 112 separate studies of dance reported in 127 papers that reported outcomes important for brain health (cardiorespiratory fitness, balance and mobility, cognition, mood, and quality of life).

Results

High heterogeneity across studies was evident. Class frequency ranged from < 1 to 5 classes per week, class length from 30-120 minutes, and intervention duration from 2 weeks to 18 months. Studies often did not randomize participants, had small (< 30) sample sizes, and used varied comparator conditions. Over 50 tests of cognition, 40 dance forms, and 30 tests of mobility were identified.

Conclusions

Based on these results, important future directions are establishing common data elements, developing intervention mapping and mechanistic modeling, and testing dosing parameters to strengthen and focus trial design of future studies and generate evidence-based guidelines for dance.

Advancing clinical understanding of surface electromyography biofeedback: bridging research, teaching, and commercial applications

INTRODUCTION

Expanding the use of surface electromyography-biofeedback (EMG-BF) devices in different therapeutic settings highlights the gradually evolving role of visualizing muscle activity in the rehabilitation process. This review evaluates their concepts, uses, and trends, combining evidence-based research.

AREAS COVERED

This review dissects the anatomy of EMG-BF systems, emphasizing their transformative integration with machine-learning (ML) and deep-learning (DL) paradigms. Advances such as the application of sophisticated DL architectures for high-density EMG data interpretation, optimization techniques for heightened DL model performance, and the fusion of EMG with electroencephalogram (EEG) signals have been spotlighted for enhancing biomechanical analyses in rehabilitation. The literature survey also categorizes EMG-BF devices based on functionality and clinical usage, supported by insights from commercial sectors.

EXPERT OPINION

The current landscape of EMG-BF is rapidly evolving, chiefly propelled by innovations in artificial intelligence (AI). The incorporation of ML and DL into EMG-BF systems augments their accuracy, reliability, and scope, marking a leap in patient care. Despite challenges in model interpretability and signal noise, ongoing research promises to address these complexities, refining biofeedback modalities. The integration of AI not only predicts patient-specific recovery timelines but also tailors therapeutic interventions, heralding a new era of personalized medicine in rehabilitation and emotional detection.

Direct biomechanical manipulation of human gait stability: A systematic review

People fall more often when their gait stability is reduced. Gait stability can be directly manipulated by exerting forces or moments onto a person, ranging from simple walking sticks to complex wearable robotics. A systematic review of the literature was performed to determine: What is the level of evidence for different types of mechanical manipulations on improving gait stability? The study was registered at PROSPERO (CRD42020180631). Databases Embase, Medline All, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, and Google Scholar were searched. The final search was conducted on the 1st of December, 2022. The included studies contained mechanical devices that influence gait stability for both impaired and non-impaired subjects. Studies performed with prosthetic devices, passive orthoses, and analysing post-training effects were excluded. An adapted NIH quality assessment tool was used to assess the study quality and risk of bias. Studies were grouped based on the type of device, point of application, and direction of forces and moments. For each device type, a best-evidence synthesis was performed to quantify the level of evidence based on the type of validity of the reported outcome measures and the study quality assessment score. Impaired and non-impaired study participants were considered separately. From a total of 4701 papers, 53 were included in our analysis. For impaired subjects, indicative evidence was found for medio-lateral pelvis stabilisation for improving gait stability, while limited evidence was found for hip joint assistance and canes. For non-impaired subjects, moderate evidence was found for medio-lateral pelvis stabilisation and limited evidence for body weight support. For all other device types, either indicative or insufficient evidence was found for improving gait stability. Our findings also highlight the lack of consensus on outcome measures amongst studies of devices focused on manipulating gait.

Neurofascialvascular training for the treatment of Raynaud's phenomenon: A case report

Primary Raynaud's phenomenon (PRP) is characterised by episodic, reversible, and disabling vasospasms of the peripheral arteries. In the most severe cases, it can lead to ulceration of the fingers and toes. Neuro fascial VascularTraining (NFVT) is a novel therapeutic approach for treating PRP. NFVT aims to enhance peripheral circulation and stimulate the autonomic nervous system (ANS) by engaging multiple physiological mechanisms simultaneously. This integrated approach works to reduce vasospasms and alleviate associated symptoms through neurodynamic and myofascial interventions. A 54-year-old woman, who has experienced pain and hypoesthesia in her hands for 9 years, received a diagnosis of PRP without systemic sclerosis in 2014. The patient reported daily colour changes in her fingers, along with pain and a temporary decrease in tactile sensitivity. The patient engaged in ten 30-minute exercise sessions, and the clinical outcomes were assessed based on several parameters. These included the frequency and duration of vasospastic attacks, evaluated using the Raynaud Condition Score, as well as pain and tingling, measured through the daily Numeric Rating Scale. The Composite Autonomic Symptom Score (COMPASS 31) was utilised to assess dysautonomia, while the frequency of medication use and the Disabilities of the Arm, Shoulder, and Hand questionnaire were also considered. The results indicated a significant improvement in symptoms. NFVT improved symptoms and motor dysfunction in a patient with Raynaud's syndrome, demonstrating how NFVT can increase peripheral blood flow, stimulate the ANS, and improve symptoms in PRP.

Comparing health risks and musculoskeletal issues between professional and casual mobile esports players: a cross-sectional descriptive study in Jakarta

Mobile gaming poses significant health risks, such as musculoskeletal (MSK) and eye problems, as players maintain the same posture for long periods. The objective of the current study is to describe the prevalence and assess the association of musculoskeletal and eye problems among professional gamers (PG) and casual gamers (CG) with their physical activity level and physical fitness. A total of 94 mobile-gaming athletes (43 PG, 51 CG) were prospectively recruited in this study. Descriptive analysis was performed for BMIs, fatigue scores, musculoskeletal problems profile, and eye problems profile. The associations between physical activity level, BMI, grip strength, flexibility, and MSK injury were tested with a Chi-square test. A total of 65.96% of the players experienced MSK complaints, with the shoulder (26.2%), neck (25.4%), and hand (21.3%) being the top three affected regions. This study also found ocular issues among the players, with eye fatigue (n = 50) as the most frequent complaint. Differential outcomes were observed between the PG and CG groups regarding physical activity (p = 0.001) and flexibility (p = 0.02). Conversely, no statistically significant variances were detected between the PG and CG concerning musculoskeletal (MSK) disorder indicators (p = 1.000), body mass index (BMI) (p = 0.132), body fat (BF) percentage (p = 0.317), grip strength (p = 0.006 for the right side, p = 0.116 for the left side), or waist circumference (p = 0.680). Furthermore, a significant association was observed between physical activity and BMI (p = 0.029). Study results showed that two-thirds of players experienced MSK injury, with the most common complaints being neck, shoulder, hand, and wrist pain. All participants reported at least one eye problem, with the majority reporting multiple complaints. There were significant differences observed in physical activity and flexibility between the PG and CG groups; however, no correlation was found between musculoskeletal injury incidence and the players' physical fitness variables. This lack of correlation may be attributed to the relatively short career span of gamers.

Effects of combined anodal transcranial direct current stimulation and motor control exercise on cortical topography and muscle activation in individuals with chronic low back pain: A randomized controlled study

BACKGROUND

Aberrant movement in chronic low back pain (CLBP) is associated with a deficit in the lumbar multifidus (LM) and changes in cortical topography. Anodal transcranial direct current stimulation (a-tDCS) can be used to enhance cortical excitability by priming the neuromuscular system for motor control exercise (MCE), thereby enhancing LM activation and movement control. This study aimed to determine the effects of a 6-week MCE program combined with a-tDCS on cortical topography, LM activation, movement patterns, and clinical outcomes in individuals with CLBP.

METHODS

Twenty-two individuals with CLBP were randomly allocated to the a-tDCS group (a-tDCS; n = 12) or sham-tDCS group (s-tDCS; n = 10). Both groups received 20 min of tDCS followed by 30 min of MCE. The LM and erector spinae (ES) cortical topography, LM activation, movement control battery tests, and clinical outcomes (disability and quality of life) were measured pre- and post-intervention.

RESULTS

Significant interaction (group × time; p < 0.01) was found in the distance between LM and ES cortical locations. The a-tDCS group demonstrated significantly fewer discrete peaks (p < 0.05) in both ES and LM and significant improvements (p < 0.05) in clinical outcomes post-intervention. The s-tDCS group demonstrated a significant increase (p < 0.05) in the number of discrete peaks in the LM cortical topography. No significant changes (p > 0.05) in LM activation were observed in either group; however, both groups demonstrated improved movement patterns.

DISCUSSION

Our findings suggest that combined a-tDCS with MCE can separate LM and ES locations over time while s-tDCS (MCE alone) reduces the distance. Our study did not find superior benefits of adding a-tDCS before MCE for LM activation, movement patterns, or clinical outcomes.

Characteristics of Physical Activity Interventions for People With Visual Impairments: A Scoping Review

This study evaluated physical activity interventions designed for individuals with visual impairments and sought to guide health intervention scientists aiming to promote physical activity in this demographic. We delved into the specifics of participants' visual impairments, intervention features, accommodation approaches, and replicability prospects. The search spanned four databases, namely PubMed, CINAHL, SportDiscus, and Scopus, providing a wide scope and diversity of potential studies. There were no restrictions on publication years. We reviewed 13 studies, totaling 15 interventions. A consensus on visual-impairment definitions remains elusive, and the intervention dosages displayed variability. Notably, 66.7% (n = 7) integrated behavior-change techniques to amplify physical activity levels. Multiple studies employed audio descriptions as an accommodation method. While most studies provided adequate information for potential replication, detailed study protocols were frequently absent. It is essential for developed interventions to be persistently evaluated and fine-tuned to optimize results.

Treating Dystonia in a Soccer Player Through an Integrated Rehabilitative Approach: A Case Report

CONTEXT

Sport-related dystonia is a rare form of activity-specific dystonia that can severely impair an athlete's ability to perform. Due to a lack of data on the condition, it is difficult to diagnose and often overlooked, and no gold standard treatment has yet been defined.

CASE PRESENTATION

We present a rare and challenging case of sport-related dystonia that affected a 24-year-old male professional soccer player. The patient presented with severe rigidity and dystonia of the right lower-extremity, particularly the ankle and foot. The symptoms set on >1 year prior to the presentation to our outpatient clinic. He began to complain of stiffness and difficulty moving his lower limbs, especially his right leg, initially when playing soccer, but then also when walking normally. On presentation, he was unable to run and walked with difficulty, supporting his body weight only on the outside of his right foot. He also reported a motor trick and reverse motor trick involving the oral musculature in order to move his lower limb more freely.

MANAGEMENT AND OUTCOMES

An integrated rehabilitation approach based on postural rehabilitation, neuromuscular rehabilitation, and dental intervention was used to successfully treat this condition. The approach included: (1) postural rehabilitation with the Mézières-Bertelè method to reduce muscular stiffness, (2) neuromuscular re-education with Tai Chi exercises and electromyography-guided biofeedback, and (3) dental intervention and swallowing rehabilitation to limit impaired oral habits (due to the relationship between his impaired lower limb movements and motor tricks of the oral musculature). After 7 months of integrated rehabilitation, the patient returned to professional soccer.

CONCLUSIONS

This case report highlights the potential efficacy of an integrative rehabilitation approach for sports dystonia, particularly in cases where traditional treatments may not be effective. Such an approach could be considered a valuable option in the management of this rare, but debilitating, condition in athletes. Further research is needed to assess the effectiveness of this approach in larger populations.

The Burden and Quality of Life in Caregivers of Individuals With Stroke During the COVID-19 Pandemic in Turkey: A Cross-Sectional Study

This study investigated the caregiving burden, quality of life and life satisfaction of caregivers of individuals with stroke during the pandemic period. A descriptive a study was performed with a sample of caregivers (n = 80) of inpatient individuals with stroke in Kayseri, Turkey. The Bakas Caregiving Outcomes Scale, Short Form Health Survey-36, and Temporal Satisfaction with Life Scale were used as well as some open-ended questions. Using descriptive analysis and correlations, results showed that caregiving burden of the participants was correlated to quality of life and life satisfaction during the COVID-19 (p < 0.05). Specific types of burden include: stress, isolation, financial issues, disruption of therapy, patient-caregiver relationship, and kinship relations. These findings provide important information about the increased burden of caregivers during the pandemic. This study offers information to design a framework of interventions to reduce the physical, social, and psychological effects on caregivers in similar conditions.

Fatigue predicts level of community integration in people with stroke

BACKGROUND

The independent predictive power of fatigue for community integration has not been investigated, although there is an increasing amount of literature that recognizes the importance of fatigue in people with stroke.

OBJECTIVES

To examine the correlation between community integration and fatigue, walking endurance, and fear of falling; and to quantify the relative contribution of fatigue to community integration in people with stroke.

METHODS

This was a cross-sectional study with 75 community-dwelling people with stroke. Data were collected using the Community Integration Measure (CIM), Fatigue Assessment Scale (FAS), 6-minute walk test (6MWT), and Survey of Activities and Fear of Falling in the Elderly (SAFE). Multiple linear regressions (forced entry method) were used to quantify the relative power of the FAS score to predict community integration in a model covering distance in the 6MWT and the SAFE score.

RESULTS

After controlling for age, the CIM score significantly correlated with the scores for FAS (r=-0.48, p < 0.001), 6MWT distance (r = 0.24, p = 0.039), and SAFE (r=-0.39, p = 0.001). The entire model, including age, FAS score, 6MWT distance, and SAFE score, explained 26.1% of the variance in the CIM scores (F [4, 70] = 7.52, p < 0.001). The FAS scores independently explained 10.6% of the variance in the CIM scores.

CONCLUSIONS

This study suggests that fatigue is an independent predictor of community integration among people with stroke, taking into account walking endurance and fear of falling.

Efficacy of head postural correction program on craniovertebral angle, scapular position, and dominant hand grip strength in forward head posture subjects: A randomized controlled trial

OBJECTIVE

Forward head posture (FHP) is a common postural disorder that alters shoulder function. This study examined the efficacy of a corrective program involving postural correction exercises (PCEs), scapular stabilization exercises (SSEs), and kinesiotaping (KT) on improving craniovertebral angle (CVA), scapular position, and dominant hand grip strength (HGS) in individuals with FHP.

METHODS

Sixty subjects (8 males and 52 females, 18-40 years old) were randomly allocated into four equal groups: Group A: received PCEs only, Group B: received PCEs and SSEs, Group C: received PCEs and KT, Group D: received PCEs, SSEs and KT. All subjects received treatment for 4 weeks (4 times/week) and postural advice. Outcome measures included cranio-vertebral angle (CVA), scapular position using Lateral Scapular Slide Test and dominant HGS using a CAMRY dynamometer that were assessed at baseline and 4 weeks post intervention.

RESULTS

Comparing all groups post training revealed that there were statistically significant increases (p < 0.05) in all measured variables (CVA, scapular position and dominant HGS) in favor of group (D).

CONCLUSION

Combination of PCEs, SSEs and KT interventions has achieved the best gains in terms of CVA, dominant HGS and regaining optimal scapular position in FHP subjects.

Ground reaction force analysis in flexible and rigid flatfoot subjects

BACKGROUND

Flatfoot is a structural and functional deformity of the foot that might change ground reaction force variables of gait. Evaluating the components of ground reaction force in three dimensions during gait is considered clinically important. This study aimed to investigate the components of ground reaction force, impulse, and loading rate during gait in people with flexible and rigid flatfoot compared to healthy subjects. 20 young women with flatfoot in two experimental groups (10 with rigid flatfoot and 10 with flexible flatfoot) and 10 healthy women in the control group participated in this study. Ground reaction force components during gait were measured using two force plates. The peak of ground reaction forces, impulse, and loading rate were then extracted. Data were processed and analyzed using MATLAB and SPSS software. One-way ANOVA with a significant level (P˂0.05) was used for statistical analysis. The results showed that peak braking force was higher in the rigid flatfoot group than in the control group (p = 0.016) and the flexible flatfoot group (p = 0.003). The posterior force loading rate was significantly higher in the rigid flatfoot group than in the flexible flatfoot group (P = 0.04). There was no significant difference in vertical loading rate between groups (P˃0.05). Since the maximal posterior ground reaction force was higher in the subjects with rigid flatfoot than in those with flexible flatfoot and healthy subjects, the increase in posterior ground reaction force is associated with an increase in anterior shear force at the knee.

Neck and shoulder strains under various head flexing positions while standing and sitting with and without back support for male and female smartphone users

This study recruited 30 young participants (15 men and 15 women) to examine the smartphone usage patterns in three postures (standing, supported sitting, and unsupported sitting) and at five head angle (HA) positions (0°-40°). Cervical erector spinae (CES) and upper trapezius (UTZ) muscle activity, neck flexion (NF), gaze angle (GA), viewing distance (VD), and discomfort scores were collected. Results showed that HA and posture almost affected all responses, while CES muscle activity, NF, and VD differed between sexes. Strain in the neck and shoulder region increased with HA increase. Particularly, when the HA exceeded 20°, the discomfort scores considerably increased. Unsupported sitting should be avoided during smartphone use because of relatively poor responses in all variables. However, both standing and supported sitting have their respective benefits. Sex-related differences were typically observed in the standing position, with women tending to have lower NF but higher CES muscle activity compared with men.Practitioner summary: Although smartphones have become daily necessities, the overall quantitative neck and shoulder strain of using smartphones in different postures is rarely evaluated. We suggest that maintaining the HA within 20° is recommended because of relatively low load on the neck and shoulders. An unsupported sitting should be avoided during smartphone use.

An external focus promotes motor learning of an aiming task in individuals with hearing impairments

Research has shown that external relative to internal focus (IF) instructions may improve motor performance as well as cognitive function (e.g., attentional stability and task-focus). The aim of the study was to examine the influence of attentional focus instructions on skill acquisition and learning of an aiming task in individuals with hearing impairments. The participants (N = 39, Mage = 17.87 ± 1.88 years) performed a bowling task with their dominant hand to knock down as many pins as possible. On day 1, they were randomly divided into three attentional focus groups; IF (focus on your throwing hand), external focus (EF) (focus on the pins), and control (no-focus) instructions. Each participant performed 36 trials, divided into 3 blocks of 12 trials. Attentional focus instructions were given before each block, with a brief reminder provided after each 3 trials. On day 2, retention and transfer (further distance) tests were performed. Results showed that while there were no significant differences between groups in the pre-test, the EF group outperformed both IF and control groups in retention and transfer tests. No significant difference was found between the control and IF. The findings suggest that the advantages of the external relative to the IF and no-focus instructions may generalize to individuals with hearing impairments.

Cutoff values of motor and cognitive measures for predicting and discriminating levels of activities of daily living after stroke: a scoping review

The various assessments performed by rehabilitation professionals not only indicate the patient's current functional status but can also help determine the future status (prediction) or the ability to perform untested tasks (discrimination). In particular, the cutoff values are the simplest predictive and discriminative tool that can be widely used in clinical practice. The purpose of this scoping review was to summarize the current literature on cutoff values of motor and cognitive function for predicting or discriminating levels of activities of daily living after stroke. A literature search was conducted using the PubMed, CINAHL, and Scopus databases. The creation of the search criteria, primary screening of titles and abstract, and secondary screening by full-text review were performed by two rehabilitation professionals. A total of 54 articles were included. The summary of the cutoff values for prediction based on longitudinal studies revealed that an NIHSS score ≤8 and mRMI score ≥19 at acute hospitalization can predict good functional independence and walking independence, respectively, indicating reliable cutoff values. Cutoff values for predicting specific ADLs, such as toilet use or dressing, were not reported, which was a potential research gap identified in this review. Alternatively, the summary of the cutoff values for discrimination based on cross-sectional studies revealed that 288-367.5 m on the 6-min walk test and 25.5-27.6 points on the FMA-LL can discriminate community and noncommunity walkers. Considering the difference between prediction and discrimination, the reliable predicted cutoff values revealed in this review are useful for planning an intervention based on early prediction. Conversely, cutoff values for discrimination can estimate different performances with simpler test, or use as target values during rehabilitation.

Correlation analysis between biomechanical characteristics of lower extremities during front roundhouse kick in Taekwondo and effective scores of electronic protectors

Objective: The purpose of this study is to analyze the inherent relationship between the score values and the biomechanical characteristics of the forward kicking motion, we aim to identify the fundamental variables influencing the score values of the forward kicking motion and establish the key biomechanical factors that effectively trigger scoring in the forward kicking motion. Methods: The DaeDo electronic scoring system was used with the Vicon optical motion capture system and the Kistler 3D force platform to obtain kinematic and kinetic variables of the front roundhouse kick motion. Linear bivariate correlation analysis and principal component analysis were used to analyze the associations between kinematic, kinetic variables, and scoring values, and summarize key biomechanical factors for effectively scoring. Results: The peak ankle plantar flexion angle and knee extension torque of the kicking leg showed a significant negative correlation with scoring values (r < 0, p < 0.05), while other variables showed no statistical significance. The peak knee flexion angle and hip extension angular velocity of the supporting leg showed a significant positive correlation with scoring values (r > 0, p < 0.01), while the peak ankle plantar flexion torque showed a significant negative correlation with scoring values (r < 0, p < 0.05), and other variables showed no statistically significant correlation. The absolute values of eigenvectors of the first and second principal components, which included hip angular velocity, ankle angle, knee torque, and hip torque, were relatively large, indicating their strong influence on effective scoring triggering. Conclusion: Maintaining ankle dorsiflexion and a larger knee flexion angle in the kicking leg is favorable for triggering scoring. Higher knee flexion angle and hip extension angular velocity in the supporting leg are also advantageous for triggering scoring. "Body posture" and "Strength" are key factors that effectively trigger scoring.

Features, measurements, determinants, treatments, and outcomes of musculoskeletal symptoms in postmenopausal women: A scoping review

BACKGROUND

The literature lacks a consistent review of musculoskeletal symptoms in postmenopausal women.

AIM

To identify features, measurements, determinants, treatments, and outcomes of musculoskeletal symptoms in postmenopausal women.

METHOD

A scoping review was completed using six databases: Embase, Medline, Cochrane, CINAHL, Web of Science, and Scopus up to December 2022. Sixty-three articles were identified.

RESULTS

Musculoskeletal symptoms in postmenopausal women include somatic symptoms of non-specific origin, upper and lower limb symptoms, spinal pain, and decline in physical performance. Measurements were categorized into four groups: musculoskeletal symptoms for menopause, general musculoskeletal symptoms, menopause-specific quality of life, and general quality of life questionnaires. The determinants were grouped into four themes: demographics, physical determinants, psychosocial determinants, and lifestyle. Pharmacological interventions, supplementation options, and exercise regimens exist for postmenopausal women with musculoskeletal symptoms.

CONCLUSION

A comprehensive policy is needed to address musculoskeletal symptoms in postmenopausal women, promoting diverse treatments for improved quality of life.

Effects of chronic neck pain on grip strength and psychomotor skills in adults

BACKGROUND

It can be challenging to perform activities of daily living in patients with chronic neck pain. As the severity of the pain increases, the quality of the movements decreases. Not only the neck, but also the shoulder, elbow, grip strength and psychomotor skills are affected by these pains.

OBJECTIVE

In this study, it was aimed to investigate the effect of neck pain on grip strength and psychomotor skills in adults diagnosed with chronic neck pain.

METHODS

A cross-sectional study was conducted to examine the effect of pain on grip strength and psychomotor skills in patients with chronic neck pain. This study was planned to be carried out between October 2019 and May 2020 at the Private Yaşam Medical Center in Adana, with the official permission of the institution manager, but this period was carried out between October 2019 and November 2020 due to the fact that sufficient number of patients could not be reached due to the COVID-19 global epidemic. A total of 80 individuals, including 40 control and 40 patients, were included in the study. Forty adult patients who applied to the clinic with a diagnosis of chronic neck pain and 40 healthy adults without a diagnosis of chronic neck pain were included in the study. Conducted with 80 adults between the age of 19 and 74 years old. Individuals were divided into Group 1-control group (n = 40) and Group 2-patient group (n&#x02009;=&#x02009;40). Information such as age, height, body weight and occupation of the groups were noted. Visual analogue scale and Neck Disability Index were applied to both the groups; hand grip strength with a Jamar hydraulic hand dynamometer, finger lateral grip strength with a pinchmeter and psychomotor skills with the Purdue Pegboard test were evaluated.

RESULTS

In the study, hand grip strength (p < .05), finger lateral grip strength (p < .05), psychomotor skills (p < .01) showed a statistically significant decrease in the patient group compared to the control group.

CONCLUSION

It is thought that in addition to the routine treatments for neck pain in the treatment plan of patients with chronic neck pain, exercises to improve the functionality and psychomotor skills in daily living activities can be included in the direction of increasing the grip strength and will guide future studies.

Influence of taping on joint proprioception: a systematic review with between and within group meta-analysis

Taping is increasingly used to manage proprioceptive deficits, but existing reviews on its impact have shortcomings. To accurately assess the effects of taping, a separate meta-analyses for different population groups and tape types is needed. Therefore, both between- and within-group meta-analyses are needed to evaluate the influence of taping on proprioception. According to PRISMA guidelines, a literature search was conducted across seven databases (Web of Science, PEDro, Pubmed, EBSCO, Scopus, ERIC, SportDiscus, Psychinfo) and one register (CENTRAL) using the keywords "tape" and "proprioception". Out of 1372 records, 91 studies, involving 2718 individuals, met the inclusion criteria outlined in the systematic review. The meta-analyses revealed a significant between and within-group reduction in repositioning errors with taping compared to no tape (Hedge's g: -0.39, p < 0.001) and placebo taping (Hedge's g: -1.20, p < 0.001). Subgroup and sensitivity analyses further confirmed the reliability of the overall between and within-group analyses. The between-group results further demonstrated that both elastic tape and rigid tape had similar efficacy to improve repositioning errors in both healthy and fatigued populations. Additional analyses on the threshold to detection of passive motion and active movement extent discrimination apparatus revealed no significant influence of taping. In conclusion, the findings highlight the potential of taping to enhance joint repositioning accuracy compared to no tape or placebo taping. Further research needs to uncover underlying mechanisms and refine the application of taping for diverse populations with proprioceptive deficits.

What are the experiences, preparation, and support needs of early career clinical educators within an Australian tertiary health service?: a qualitative study

BACKGROUND

There is increasing demand for professional practice placement opportunities, supported by health professional educators, to enable future health workforce development. Early career health professionals performing the educator role is one strategy that can help meet this demand. However, there is a need to consider how best to prepare and support early career health professionals to become educators. This study aimed to explore the experiences and perspectives of early career occupational therapy clinical educators including their preparation and support needs.

METHODS

Semi-structured interviews were completed with ten early career occupational therapists who had supervised their first or second student on a professional practice placement. The participants worked within an Australian tertiary hospital and health service in various clinical settings. Interviews were completed within six weeks of placement completion and lasted approximately one hour. They were recorded and transcribed verbatim and reflexive inductive thematic analysis was undertaken to identify key themes.

RESULTS

Ten occupational therapists, who had been working for an average of two years and two months, consented to participate. Initially, participants expressed mixed emotions about taking on the clinical educator role. They then described their adjustment to the role responsibilities, challenges encountered, and the development of the educator-student relationship. Participants found that the experience of supervising a student enhanced their educator, clinical, and professional skills and confidence. The important support elements of tailored educator preparation, placement design, and timely access to relevant resources and experienced staff were identified.

CONCLUSIONS

This study demonstrated how early career health professionals can possess desirable educator attributes, such as enthusiasm for taking on the role and cultivating collaborative learning relationships with their students. The experience of being an educator also presents a professional development opportunity for early career health professionals. Insights gained about the specific preparation and support needs of early career clinical educators warrant consideration by organisations and staff involved in the provision of student professional practice placements. Overall, this study's findings signify the importance of engaging and investing in early career health professionals to support student clinical education and to develop our current and future healthcare workforce.

Danish short form Örebro Musculoskeletal Pain Screening Questionnaire: Translation, cross-cultural adaptation, and evaluation of measurement properties

BACKGROUND

Low back pain (LBP) is the leading cause of disability and an increasing sick leave in Denmark. Psychosocial risk factors have been linked to the development of LBP-related disability and work-absenteeism. The short form Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ-sf) was developed to screen for psychosocial risk factors and assess the risk of long-term disability and work-absenteeism.

OBJECTIVE

To translate and cross-culturally adapt ÖMPSQ-sf into Danish and evaluate test-retest reliability with relative and absolute reliability and internal consistency in LBP-patients in a secondary setting.

METHODS

A six-step translation and cross-culturally adaptation process was used. Forty-four patients with subacute and chronic LBP were recruited at an outpatient clinic.

RESULTS

Test-retest reliability (n= 37) was found to be excellent (ICC2.1= 0.92), Internal Consistency (n= 44) was adequate (Cronbach's alpha = 0.72). Absolute reliability included Standard Error of Measurement (SEM = 3.97 points), 95% Limits of Agreement (95% LOA = 0.08, -15.90-15.74), and Smallest Detectable Change (SDC = 10.87 points).

CONCLUSION

The Danish ÖMPSQ-sf showed acceptable measurements properties in subacute and chronic LBP-patients. Further research is needed to assess other measurement properties of the ÖMPSQ-sf, in relation to validity, responsiveness, and the predictive ability before application in research or clinical practice.

General and Specific Quality of Life Course of Individuals with Different Levels of Stroke Severity: A One-Year Prospective Longitudinal Study

OBJECTIVES

To compare the course of generic and specific health-related quality of life (HRQOL) of individuals with stroke, and its physical, mental, and social domains, at three, six, and 12 months after hospital discharge, considering the levels of stroke severity.

METHODS

This is a longitudinal study, in stroke individuals, assessed during hospital admission by the National Institutes of Health Stroke Scale (NIHSS), and divided into mild (NIHSS ≤3) or moderate/severe (NIHSS ≥4) disease. At three, six, and 12 months after hospital discharge, the individuals were assessed for generic (Short Form Health Survey-36: total score and physical and mental domains) and specific (Stroke Specific Quality of Life Scale: total score and social domain) HRQOL. A 2 × 2 repeated measures analysis of variance (ANOVA) with post-hoc was applied.

RESULTS

146, 122, and 103 individuals were assessed at three, six and 12 months, respectively HRQOL courses showed different behaviors according to stroke severity (3.37≤F ≤ 4.62; 0.010≤p ≤ .036). Individuals with mild stroke showed significant changes in the physical domain, with a reduction between three and six months, and an increase between six and 12. Moderate/severe individuals showed a significant increase in all HRQOL variables between three and six months, and a maintenance of values for almost all variables, except for physical domain, which improved significantly between three and six months, and got significantly worse between six and 12.

CONCLUSIONS

HRQOL during the first year after stroke showed distinct trajectories, being stroke severity an important factor in identifying stroke subjects at risk of HRQOL decline.

CLINICAL IMPLICATIONS

These results demonstrate the importance of considering not only the phase of the stroke, the severity, and the general and specific HRQOL, but also the physical, social, and mainly the mental domain, which has long been neglected, when assessing this population.

Quality of Life, Physical Activity Participation, and Perceptions of Physical Rehabilitation Among Community-Reintegrated Veterans With Lower Limb Amputation in Sri Lanka: Convergent Parallel Mixed Methods Study

BACKGROUND

Lower limb amputation (LLA) impacts physical activity (PA) participation and quality of life (QoL). To minimize the effects of these challenges, LLA survivors need to have opportunities to engage in appropriately tailored rehabilitation throughout their lives. However, in Sri Lanka, where a 3-decade civil war resulted in trauma-related LLA among young male soldiers, access to rehabilitation was limited to the immediate postinjury period. Developing rehabilitation interventions for these veterans requires an understanding of their current health status and rehabilitation perceptions.

OBJECTIVE

This study was conducted to evaluate the QoL and PA participation of veterans with LLA and explore perceptions of factors influencing their PA participation and expectations for a future community-based physical rehabilitation (CBPR) intervention.

METHODS

This mixed methods study combined a comparative cross-sectional quantitative survey with qualitative semistructured interviews in 5 districts of Sri Lanka. QoL and PA participation were assessed among community-reintegrated veterans with LLA (n=85) and compared with a matched able-bodied cohort (control; n=85) using Mann-Whitney U and Chi-square tests. PA was assessed in terms of metabolic equivalent of task (MET) minutes per week and was computed for walking, moderate-intensity, and vigorous-intensity activities. PA was classified as sufficiently active, low, or sedentary. The design of interview questions was guided by the Theoretical Domains Framework and followed a phenomenological approach. Interviews were conducted with 25 veterans and were analyzed thematically, and the perceptions regarding PA participation and CBPR were codified using the Consolidated Framework for Implementation Research (CFIR).

RESULTS

Based on the quantitative survey findings, scores for both physical (P<.001) and psychological (P<.001) well-being and participation in walking (P=.004) and vigorous-intensity activities (P<.001) were significantly lower among veterans than among controls. A "sedentary" classification was made for 43% (34/79) of veterans and 12% (10/82) of controls. Veterans mostly engaged in moderate-intensity PA inside the house (49/79, 62%) and in the yard (30/79, 38%). Qualitative interviews revealed that barriers to PA exist at individual (eg, comorbidity burden), primary care (eg, absence of community rehabilitation services), and policy levels (eg, limited resources) and facilitators exist primarily at societal (eg, inclusive community) and individual levels (eg, preinjury activity baseline and positive attitudes toward exercise). Expectations regarding CBPR included individualized rehabilitation parameters; functional exercises; and involvement of peers, amputee societies, and community health care providers. The nonresponse rate for interviews was 7% (2/27).

CONCLUSIONS

The findings of reduced PA participation, poor QoL, and physical and psychological impairments among relatively young veterans reveal the long-term impacts of living with LLA in the absence of long-term rehabilitation. Policy-level changes need to be implemented along with behavior-change strategies to promote PA participation and minimize physical inactivity-induced health issues. Veterans' perceptions regarding future CBPR programs were positive and centered on holistic, individualized, and peer-led activities.

Reliability and construct validity of the Craniocervical Flexion Test in patients with migraine

BACKGROUND

Migraine may be accompanied by several cervical musculoskeletal dysfunctions, for example an altered performance on the Craniocervical Flexion Test (CCFT). However, CCFT measurement properties are still unclear in patients with migraine.

OBJECTIVES

To determine intra- and inter-examiner reliability, construct validity, standard measurement error (SEM), and minimal detectable change (MDC) of the CCFT in patients with migraine.

METHODS

Women diagnosed with migraine were considered eligible for this study. Participants were assessed by two examiners for the inter-examiner reliability, and with 7-10 days interval for the intra-examiner reliability. Construct validity was assessed considering headache and neck pain frequency and intensity, and self-reported questionnaires, including the Headache Impact Test - 6 items (HIT-6), the 12-item Allodynia Symptom Checklist/Brazil (ASC-12), and the Neck Disability Index (NDI). In addition, participants performed cervical endurance and maximal voluntary isometric contraction of the cervical flexors.

RESULTS

A total of 103 women with migraine were recruited. The intra-examiner reliability was rated as good (ICC= 0.81, 95% CI: 0.73, 0.87), while the inter-examiner reliability was rated as moderate (ICC= 0.55, 95% CI: 0.40, 0.67). The intra and inter-examiner SEM were 1.31 and 1.36 mmHg respectively, and MDC were 3.63 and 3.77 mmHg. The HIT-6 and the cervical endurance flexion test were associated with the CCFT in a multiple linear regression model (p = 0.004, R = 0.35).

CONCLUSION

The CCFT presents adequate intra- and inter-examiner reliability. Better performance on the CCFT test was associated with better HIT-6 scores and greater cervical endurance time, which was not influenced by the presence of neck pain.

Characteristics and Effects of Home-Based Digital Health Interventions on Functional Outcomes in Older Patients With Hip Fractures After Surgery: Systematic Review and Meta-Analysis

BACKGROUND

Digital health interventions (DHIs) have been used to improve postoperative functional ability in older patients with hip fractures. However, there is limited information on the characteristics of home-based DHIs, and controversy exists regarding their impact on functional outcomes in this population.

OBJECTIVE

This study aims to provide an overview of the characteristics and effects of home-based DHIs on functional outcomes in older patients with hip fractures after surgery.

METHODS

We conducted a systematic review and meta-analysis following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Five electronic medical databases (PubMed, Embase, Cochrane, ProQuest, and CINAHL) were searched up until January 3, 2023. We included clinical trials or randomized controlled trials (RCTs) in English involving home-based DHIs for postoperative care among older patients with hip fractures. Excluded studies involved patients not hospitalized, not discharged to home, not directly using DHIs, or with inaccessible full text. The PROSPERO registration number is CRD42022370550. Two independent reviewers screened and extracted data (SP and NB). Disagreements were resolved through discussion and agreement with the third author (KP). Home-based DHIs were characterized in terms of purpose and content, mode of delivery, and health care provider. Functional outcomes assessed included Timed Up and Go (TUG) test, Short Physical Performance Battery (SPPB), and Functional Independence Measure (FIM). Summary measures were calculated using mean differences with 95% CIs. Risk of bias was assessed using the Risk-of-Bias 2 assessment tool for RCTs and ROBINS-I for non-RCTs. The quality of evidence was assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation).

RESULTS

Of 2125 identified studies, 16 were included in the systematic review, involving 1467 participants. Six studies were included in the meta-analysis (4 for TUG, 4 for SPPB, and 2 for FIM). Home-based DHIs predominantly involved communication and feedback, education, and telerehabilitation. Telephone calls were the most common mode of delivery, followed by web-based software and mobile apps. Physical therapists were the main health care providers. The meta-analysis showed that home-based DHIs improved functional outcomes compared with usual care, with decreased TUG scores (mean difference=-7.89; 95% CI -10.34 to -5.45; P<.001), significantly increased SPPB scores (mean difference=1.11; 95% CI 0.51-1.72; P<.001), and increased FIM scores (mean difference=7.98; 95% CI 5.73-10.24; P<.001).

CONCLUSIONS

Home-based DHIs that integrate communication and feedback, education, and telerehabilitation have demonstrated effectiveness in enhancing functional outcomes among older patients recovering from hip fractures after surgery. These interventions are commonly administered by physical therapists, who play a crucial role in facilitating and guiding the rehabilitation process. However, while the existing evidence supports the efficacy of such interventions, further research is needed to enhance our understanding and optimize the implementation of home-based DHIs for this specific population.

Gender differences in neck muscle activity during near-maximum forward head flexion while using smartphones with varied postures

Women frequently express heightened neck discomfort even though they exhibit smaller neck flexion (NF) during smartphone use. Differences in natural posture while using smartphones may result in varying muscle activation patterns between genders. However, no study focused on this issue. This study investigated the influence of gender on neck muscle activity and NF when using smartphones, ranging from slight (20°) to nearly maximal forward head flexion, across different postures. We analyzed smartphone usage patterns in 16 men and 16 women and examined these behaviors across different scenarios: standing, supported sitting, and unsupported sitting, at 20°, 30°, 40°, and the maximum head angles. During data collection, muscle activity was measured, expressed as a percentage of the maximum voluntary contraction (%MVC), in the cervical erector spinae (CES) and upper trapezius (UTZ), along with NF. Results show significant influences of gender, head angle, and posture on all measures, with notable interactions among these variables. Women displayed higher muscle activities in CES and UTZ, yet exhibited lesser NF, while using smartphones in both standing (12.3%MVC, 10.7% MVC, and 69.0°, respectively) and unsupported sitting (10.8%MVC, 12.3%MVC, and 71.8°, respectively) compared to men (standing: 9.5%MVC, 8.8%MVC, and 76.1°; unsupported sitting: 9.7%MVC, 10.8%MVC, and 76.1°). This study provides a potential rationale for gender-related disparities in injury outcomes, emphasizing that women experience higher neck and shoulder discomfort level, despite their smaller NF during smartphone use, as found in previous research. Additionally, the cervical flexion-relaxation phenomenon may occur when the head angle exceeded 40°. The near-maximum head angle during smartphone use might induce the cervical flexion-relaxation phenomenon, potentially aggravating neck issues. We recommend limiting smartphone usage postures that exceed the near-maximum head angle, as they are commonly adopted by individuals in the daily smartphone activities.

Acute viral bronchiolitis phenotype in response to glucocorticoid and bronchodilator treatment

OBJECTIVE

To analyze whether infants admitted to hospital with Acute Viral Bronchiolitis (AVB), who received glucocorticoids and bronchodilators, and who had an atopic phenotype, spent less time in hospital and/or less time on oxygen therapy when compared to those who did not have the phenotype.

METHOD

A cross-sectional, retrospective epidemiological study was developed with data from medical records of infants admitted to hospital due to AVB from 2012 to 2019 in a sentinel public hospital. It was verified that the frequency of prescription of glucocorticoids, bronchodilators and antibiotics. Length of stay and oxygen therapy duration were then compared in the group that used glucocorticoids and bronchodilators between those who had a personal or family history of atopy and those who did not. Subsequently, the length of hospital stay was compared among infants who received antibiotic therapy and those who did not.

RESULTS

Fifty-eight infants were included. Of these, 62.1 % received an antibiotic, 100 % a bronchodilator and 98.3 % a glucocorticoid. When comparing infants without a family history of atopy, those who received antibiotics had a longer hospital stay (p = 0.01).

CONCLUSION

The presence of an atopic phenotype did not interfere with the length of stay and/or oxygen therapy duration of those who received bronchodilators and glucocorticoids. Increased length of stay of infants without a family history of atopy, who used antibiotics without evidence of bacterial co-infection, and the high frequency of prescription of non-recommended drugs call attention to stricter protocol implementation and professional training in AVB diagnosis and care.

The perceptions of nurses and physicians in primary care of rehabilitation for frail older adults

OBJECTIVES

To investigate the perceptions of primary care nurses and physicians of the potential contributions of physiotherapists (PTs) and occupational therapists (OTs) in the treatment of frail older persons, as well as the obstacles to, and opportunities for, collaboration.

DESIGN

A qualitative study.

PARTICIPANTS AND SETTING

Nurses (n = 9) and physicians (n = 8) in primary care in the county council [14 women (82%)] with experience working with older people.

METHOD

Interview study conducted with a semi-structured interview guide. Analyses were carried out with content analysis with an inductive approach.

RESULTS

The analysis resulted in six categories: knowledge of physiotherapy and occupational therapy interventions; what triggers the need for physiotherapy and occupational therapy?; the availability of rehabilitation interventions; teamwork opportunities and difficulties; motivating the patient; the site of the rehabilitation.

CONCLUSIONS

Close and clear collaboration between nurses and physicians and PTs and OTs is an important factor in ensuring that rehabilitation interventions provide the greatest possible benefit to the patient. Improving communication between different healthcare providers and clarifying the contact routes is a prerequisite for patients to be able to get the rehabilitation they need. More research is needed to determine the best approach to achieving this goal.

Males with patellofemoral pain have altered movements during step-down and single-leg squatting tasks compared to asymptomatic males: A cross-sectional study

Background and Aims

Patellofemoral pain (PFP) is common in males, causing reduced physical activity and chronic pain. One proposed cause of PFP is aberrant biomechanics during tasks loading the patellofemoral joint. Consistent evidence exists for females with PFP, but it is uncertain if males with PFP have altered biomechanics. This study investigated the kinematics of males with PFP compared to pain-free males during forward step-down (StDn) and single-leg squat (SLSq).

Methods

A cross-sectional study including 40 males aged 20-39 years (28.28 ± 5.46) was conducted (20 PFP, 20 pain-free). Participants performed StDn and SLSq while motion was captured with a video-based motion capture system (Motion Analysis Corporation). Triplanar peak angles and angular ranges of motion (ROM) of the trunk, pelvis, and weight-bearing hip, knee, and ankle were dependent variables. Mixed-model ANOVA tests were used to determine the presence of significant interactions and main effects of group and task.

Results

Males with PFP had significantly lower peak knee adduction angles compared to pain-free males (p = 0.01). Significant group x task interactions were found for hip and pelvis ROM (p < 0.05). PFP participants had increased hip and pelvis ROM during StDn in the frontal and transverse planes but reduced or nearly equal ROM for these variables during SLSq. Peak hip adduction, hip internal rotation, contralateral pelvic drop and anterior tilt, trunk flexion, and ankle dorsiflexion were greater during StDn compared to SLSq (p < 0.05). ROM of the hip, pelvis, trunk, and ankle were greater during StDn compared to SLSq (p < 0.05).

Conclusion

Males with PFP had reduced peak knee adduction angles in StDn and SLSq. Males with PFP demonstrated increased hip and pelvis ROM during StDn versus SLSq, particularly in the frontal and transverse planes. Clinicians should consider StDn as a clinical test since aberrant movement may be easier to detect than in SLSq.

The effects of mechanical hippotherapy riding on postural control, balance, and quality of life (QoL) in patients with stroke

PURPOSED

This study aimed to investigate the effects of exercises by mechanical hippotherapy devices on postural control, balance, mobility, and Quality of Life in patients with stroke.

MATERIAL AND METHODS

This was a randomized controlled clinical trial with a total of 30 which were randomly divided into two groups. The participants in the mechanical hippotherapy group (MHG) (n = 15) were given exercises with a mechanical hippotherapy device for 15 min in addition to intensive conventional treatments (45 min), while the control group (CG) (n = 15) received additional 15 min of postural control and balance exercises for five days per week for four consecutive weeks. The primary outcome was The Berg Balance Scale (BBS). Secondary outcomes were the Fugl-Meyer (FM) Rating Scale, Biodex Balance Measurement (BBM), Trunk Impairment Scale (TIS), the Timed Up and Go Test (TUG) and quality of Life Short Form (SF-36).

RESULTS

In the MHG, FM-Lower extremity score (-6.4, p = 0.024), FM-Upper extremity score (-12.87, p = 0.013), TIS (-5.87, p = 0.04) and TUG (5.73, p = 0.027) improved statistically significant compared to CG.

CONCLUSION

Exercises using mechanical hippotherapy devices could improve postural control, functional mobility and balance in patients with stroke. It may also improve the quality of life.

CLINICAL TRIAL REGISTRATION NUMBER

NCT03528993IMPLICATIONS FOR REHABILITATIONNCT03528993It was concluded from our results that mechanical hippotherapy could be included in the treatment programs of stroke patients.

Establishing Normative Values for Performance-Based Tests in Older Thai Adults: A Nationwide Cross-Sectional Study

OBJECTIVE

To determine normative values and identify contributing factors for physical performance tests in older, Thai, community-dwelling adults.

DESIGN

Nationwide cross-sectional study.

SETTING

Thai older community-dwelling adults.

PARTICIPANTS

Thai older community-dwelling adults aged ≥60 years who had no major health problems (N=1430) between March 2021 and August 2022.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Normative values for the timed Up and Go (TUG) test, gait speed test, and 5-times sit-to-stand (5TSTS) test were determined for sex and age groups. Multivariable quantile regression analysis was employed to evaluate the participants, considering factors that may influence physical performance, such as height, and Charlson comorbidity index (CCI).

RESULTS

The study included 1430 eligible participants. Their mean age was 68.4±5.8 years, and 58.5% were women. Men demonstrated superior physical performance in the medians (p50) of the TUG (10.0 s vs 11.0 s), gait speed (0.98 m/s vs 0.91 m/s), and 5TSTS (14.0 s vs 16.1 s) tests compared with women. These differences were consistently observed across age groups. Moreover, age, sex, and height were significantly associated with poor physical performance.

CONCLUSION

This study observed variations in the normative values of TUG, gait speed, and 5TSTS tests among different age groups of older, Thai, community-dwelling adults. Additionally, our findings identified age, sex, and height as significant contributing factors to physical performance in this population.

Physical therapy for acute and sub-acute low back pain: A systematic review and expert consensus

OBJECTIVE

To review the effectiveness of different physical therapies for acute and sub-acute low back pain supported by evidence, and create clinical recommendations and expert consensus for physiotherapists on clinical prescriptions.

DATA SOURCES

A systematic search was conducted in PubMed and the Cochrane Library for studies published within the previous 15 years.

REVIEW METHODS

Systematic review and meta-analysis, randomized controlled trials assessing patients with acute and sub-acute low back pain were included. Two reviewers independently screened relevant studies using the same inclusion criteria. The Physiotherapy Evidence Database and the Assessment of Multiple Systematic Reviews tool were used to grade the quality assessment of randomized controlled trials and systematic reviews, respectively. The final recommendation grades were based on the consensus discussion results of the Delphi of 22 international experts.

RESULTS

Twenty-one systematic reviews and 21 randomized controlled trials were included. Spinal manipulative therapy and low-level laser therapy are recommended for acute low back pain. Core stability exercise/motor control, spinal manipulative therapy, and massage can be used to treat sub-acute low back pain.

CONCLUSIONS

The consensus statements provided medical staff with appliable recommendations of physical therapy for acute and sub-acute low back pain. This consensus statement will require regular updates after 5-10 years.

Adjunctive electrophysical therapies used in addition to land-based exercise therapy for osteoarthritis of the hip or knee: A systematic review and meta-analysis

Objectives

To review evidence for effectiveness of electrophysical therapies (EPTs), used adjunctively with land-based exercise therapy, for hip or knee osteoarthritis (OA), compared with 1) placebo EPTs delivered with land-based exercise therapy or 2) land-based exercise therapy only.

Methods

Six databases were searched up to October 2023 for randomised controlled trials (RCTs)/quasi-RCTs comparing adjunctive EPTs alongside land-based exercise therapy versus 1) placebo EPTs alongside land-based exercise, or 2) land-based exercise in hip or knee OA. Outcomes included pain, function, quality of life, global assessment and adverse events. Risk of bias and overall certainty of evidence were assessed. We back-translated significant Standardised Mean Differences (SMDs) to common scales: 2 points/15% on a 0-10 Numerical Pain Rating Scale and 6 points/15% on the WOMAC physical function subscale.

Results

Forty studies (2831 patients) evaluated nine different EPTs for knee OA. Medium-term effects (up to 6 months) were evaluated in seven trials, and one evaluated long-term effects (>6 months). Adverse events were reported in one trial. Adjunctive laser therapy may confer short-term effects on pain (SMD -0.68, 95%CI -1.03 to -0.34; mean difference (MD) 1.18 points (95% CI -1.78 to -0.59) and physical function (SMD -0.60, 95%CI -0.88 to -0.34; MD 12.95 (95%CI -20.05 to -5.86)) compared to placebo EPTs, based on very low-certainty evidence. No other EPTs (TENS, interferential, heat, shockwave, shortwave, ultrasound, EMG biofeedback, NMES) showed clinically significant effects compared to placebo/exercise, or exercise only.

Conclusions

Very low-certainty evidence supports laser therapy used adjunctively with exercise for short-term improvement in pain and function. No other EPTs demonstrated clinically meaningful effects.

Effect of Kinesio taping versus mechanical cervical traction combined with physiotherapy program on chronic neck pain in young female university students

Background

Mechanical neck pain is common among young female university students and can lead to disability and reduced physical activity.

Objectives

The aim of this study was to compare the effect of Kinesio taping (KT) to mechanical cervical traction (MCT) on young female university students with chronic neck pain.

Methods

Sixty young female university students with mechanical neck pain participated in this study; their ages ranged from 19 years to 23 years. They were assigned to three equal groups: the control group (A) received infrared, massage, stretching, and strengthening exercises three days per week for 6 weeks. Experimental group B received cervical traction in addition to the same program as the control, and experimental group C received KT in addition to the same program as the control group. Absolute pain intensity by the visual analogue scale (VAS) and neck disability index (NDI) were measured pre-and post-treatment intervention. Data were gathered at baseline, and after 6 weeks of intervention for three groups.

Results

The MANOVA test showed a significant reduction in NDI and pain level after 6 weeks between pre-and post-treatment intervention in group B (P < 0 . 001 and P < 0 . 001 , respectively). There was a significant reduction in pain after 6 weeks in group C. There was also a significant reduction in NDI and pain level after 6 weeks in group B versus control group (P < 0 . 001 and P = 0 . 001 , respectively). In addition, a significant reduction in pain level and NDI after 6 weeks was detected in group B compared to group C (P < 0 . 001 , P = 0 . 014 , respectively) while a significant reduction in pain level only between the control group (A) and group C was detected (P < 0 . 001 ).

Conclusion

In young female university students with mechanical neck pain, cervical traction combined with physiotherapy program was found to be more effective than KT with physiotherapy program or physiotherapy program alone in reducing pain and enhancing functional abilities after 6 weeks. This will help physiotherapists make more informed decisions concerning the clinical effects of MCT.

Interventions to improve outdoor mobility among people living with disabilities: A systematic review

Background

Around 15% of the global population live with some form of disabilities and experience worse health outcomes, less participation in the community and are part of fewer activities outside the home. Outdoor mobility interventions aim to improve the ability to move, travel and orient outside the home and could influence the number of activities outside the home, participation and quality of life. However, outdoor mobility interventions may also lead to harm like falls or injuries or have unforeseen effects which could lead to mortality or hospitalization.

Objectives

To assess the efficacy of interventions aiming to improve outdoor mobility for adults living with disabilities and to explore if the efficacy varies between different conditions and different intervention components.

Search Methods

Standard, extensive Campbell search methods were used, including a total of 12 databases searched during January 2023, including trial registries.

Selection Criteria

Only randomized controlled trials were included, focusing on people living with disabilities, comparing interventions to improve outdoor mobility to control interventions as well as comparing different types of interventions to improve outdoor mobility.

Data Collection and Analysis

Standard methodological procedures expected by Campbell were used. The following important outcomes were 1. Activity outside the home; 2. Engagement in everyday life activities; 3. Participation; 4. Health-related Quality of Life; 5. Major harms; 6. Minor harms. The impact of the interventions was evaluated in the shorter (≤6 months) and longer term (≥7 months) after starting the intervention. Results are presented using risk ratios (RR), risk difference (RD), and standardized mean differences (SMD), with the associated confidence intervals (CI). The risk of bias 2-tool and the GRADE-framework were used to assess the certainty of the evidence.

Main Results

The screening comprised of 12.894 studies and included 22 studies involving 2.675 people living with disabilities and identified 12 ongoing studies. All reported outcomes except one (reported in one study, some concerns of bias) had overall high risk of bias. Thirteen studies were conducted in participants with disabilities due to stroke, five studies with older adults living with disabilities, two studies with wheelchair users, one study in participants with disabilities after a hip fracture, and one study in participants with cognitive impairments. Skill training interventions versus control interventions (16 studies) The evidence is very uncertain about the benefits and harms of skill training interventions versus control interventions not aimed to improve outdoor mobility among all people living with disabilities both in the shorter term (≤6 months) and longer term (≥7 months) for Activity outside the home; Participation; Health-related Quality of Life; Major harms; and Minor harms, based on very low certainty evidence. Skill training interventions may improve engagement in everyday life activities among people with disabilities in the shorter term (RR: 1.46; 95% CI: 1.16 to 1.84; I 2 = 7%; RD: 0.15; 95% CI: -0.02 to 0.32; I 2 = 71%; 692 participants; three studies; low certainty evidence), but the evidence is very uncertain in the longer term, based on very low certainty evidence. Subgroup analysis of skill training interventions among people living with disabilities due to cognitive impairments suggests that such interventions may improve activity outside the home in the shorter term (SMD: 0.44; 95% CI: 0.07 to 0.81; I 2 = NA; 118 participants; one study; low certainty evidence). Subgroup analysis of skill training interventions among people living with cognitive impairments suggests that such interventions may improve health-related quality of life in the shorter term (SMD: 0.49; 95% CI: 0.12 to 0.88; I 2 = NA; 118 participants; one study; low certainty evidence). Physical training interventions versus control interventions (five studies) The evidence is very uncertain about the benefits and harms of physical training interventions versus control interventions not aimed to improve outdoor mobility in the shorter term (≤6 months) and longer term (≥7 months) for: Engagement in everyday life activities; Participation; Health-related Quality of Life; Major harms; and Minor harms, based on very low certainty evidence. Physical training interventions may improve activity outside the home in the shorter (SMD: 0.35; 95% CI: 0.08 to 0.61; I 2 = NA; 228 participants; one study; low certainty evidence) and longer term (≥7 months) (SMD: 0.27; 95% CI: 0.00 to 0.54; I 2 = NA; 216 participants; one study; low certainty evidence). Comparison of different outdoor mobility interventions (one study) The evidence is very uncertain about the benefits and harms of outdoor mobility interventions of different lengths in the shorter term (≤6 months) and longer term (≥7 months) for Activity outside the home; Engagement in everyday life activities; Participation; Health-related Quality of Life; Major harms; and Minor harms, based on very low certainty evidence. No studies explored the efficacy of other types of interventions.

Authors’ Conclusions

Twenty-two studies of interventions to improve outdoor mobility for people living with disabilities were identified, but the evidence still remains uncertain about most benefits and harms of these interventions, both in the short- and long term. This is primarily related to risk of bias, small underpowered studies and limited reporting of important outcomes for people living with disabilities. For people with disabilities, skill training interventions may improve engagement in everyday life in the short term, and improve activity outside the home and health-related quality of life for people with cognitive impairments in the short term. Still, this is based on low certainty evidence from few studies and should be interpreted with caution. One study with low certainty evidence suggests that physical training interventions may improve activity outside the home in the short term. In addition, the effect sizes across all outcomes were considered small or trivial, and could be of limited relevance to people living with disabilities. The evidence is currently uncertain if there are interventions that can improve outdoor mobility for people with disabilities, and can improve other important outcomes, while avoiding harms. To guide decisions about the use of interventions to improve outdoor mobility, future studies should use more rigorous design and report important outcomes for people with disabilities to reduce the current uncertainty.

Transtibial osseointegration following unilateral traumatic amputation: An observational study of patients with at least two years follow-up

IMPORTANCE

Most patients use a traditional socket prosthesis (TSP) to ambulate independently following transtibial amputation. However, these patients generally require prosthesis repairs more than twice annually and an entirely new prosthesis every two years. Furthermore, transtibial amputation patients have four times the skin ulceration rate of transfemoral patients, prompting more frequent prosthesis refitting and diminished use. Trans-Tibial osseointegration (TTOI) is a promising technique to address the limitations of TSP, but remains understudied with only four cohorts totaling 41 total procedures reported previously. Continued concerns regarding the risk of infection and questions as to functional capacity postoperatively have slowed adoption of TTOI worldwide.

OBJECTIVE

This study reports the changes in mobility, quality of life (QOL), and the safety profile of the largest described cohort of patients with unilateral TTOI following traumatic amputation.

DESIGN

Retrospective observational cohort study. The cohort consisted of patients with data outcomes collected before and after osseointegration intervention.

SETTING

A large, tertiary referral, major metropolitan center.

PARTICIPANTS

Twenty-one skeletally mature adults who had failed socket prosthesis rehabilitation, with at least two years of post-osseointegration follow-up.

MAIN OUTCOMES AND MEASURES

Mobility was evaluated by K-level, Timed Up and Go (TUG), and Six Minute Walk Test (6MWT). QOL was assessed by survey: daily prosthesis wear hours, prosthesis problem experience, general contentment with prosthesis, and Short Form 36 (SF36). Adverse events included any relevant unplanned surgery such as for infection, fracture, implant loosening, or implant failure.

RESULTS

All patients demonstrated statistically significant improvement post osseointegration surgery with respect to K-level, TUG, 6MWT, prosthesis wear hours, prosthesis problem experience, general prosthesis contentment score, and SF36 Physical Component Score (p < 0.01 for all). Three patients had four unplanned surgeries: two soft tissue refashionings, and one soft tissue debridement followed eventually by implant removal. No deaths, postoperative systemic complications, more proximal amputations, or periprosthetic fractures occurred.

CONCLUSIONS AND RELEVANCE

TTOI is likely to confer mobility and QOL improvements to patients dissatisfied with TSP rehabilitation following unilateral traumatic transtibial amputation. Adverse events are relatively infrequent and not further disabling. Judicious use of TTOI seems reasonable for properly selected patients.

LEVEL OF EVIDENCE

2 (Therapeutic investigation, Observational study with dramatic effect).

Pain catastrophizing in rheumatic diseases: prevalence, origin, and implications

Pain is a crucial factor in rheumatic disorders, and reducing it is a primary goal of successful treatment. Adaptive pain-coping strategies can enhance this improvement, but maladaptive approaches such as pain catastrophizing may worsen overall patient well-being. This narrative review aims to provide a concise overview of the existing knowledge on pain catastrophizing in the most prevalent specific rheumatic disorders. The objective of this study was to improve understanding of this phenomenon and its implications, as well as to pinpoint potential directions for future research. We conducted searches in the MEDLINE/PubMed, SCOPUS, and DOAJ bibliography databases to identify articles related to pain catastrophizing in rheumatoid arthritis, psoriatic arthritis, axial spondylarthritis, systemic sclerosis, systemic lupus erythematosus, Sjögren's syndrome, juvenile idiopathic arthritis, and osteoarthritis (non-surgical treatment). Data extraction was performed on November 1, 2023. The investigators screened the identified articles to determine their relevance and whether they met the inclusion criteria. Following a bibliography search, which was further expanded by screening of citations and references, we included 156 records in the current review. The full-text analysis centred on pain catastrophizing, encompassing its prevalence, pathogenesis, and impact. The review established the role of catastrophizing in amplifying pain and diminishing various aspects of general well-being. Also, potential treatment approaches were discussed and summarised across the examined disorders. Pain catastrophizing is as a significant factor in rheumatic disorders. Its impact warrants further exploration through prospective controlled trials to enhance global patient outcomes.

Stigma and the use of umbrellas, hiking poles and walking sticks to aid walking in Hong Kong

Background

The use of walking aids is widely acknowledged as one of the most relied-on forms of assistive technology. Using stick-shaped devices, such as a cane, is often the entrance for many people to the world of assistive technologies, often accompanied by the negative stigma associated with ageing and disability.

Objectives

This study investigated the perception of disability and needs of the Hong Kong population using walking aids, aiming to inform device design and service provision.

Methods

We observed 391 individuals using cane-like devices in their natural environment and conducted semi-structured interviews with 28 participants to understand stigma, barriers to acquisition, training, and design requirements.

Results

Half of the interviewees (50%, n = 14) did not feel disabled when using a walking stick, while 39% felt slightly disabled. 56% of the observed sample used non-medical-looking aids like hiking poles or umbrellas. Most interviewees (79%) purchased off-the-shelf devices, but less than half received seller support in choosing appropriate aids.

Conclusion

The feelings associated with using walking sticks and similar devices are mostly positive. There is a preference in Hong Kong for using devices without a medical appearance to aid walking, such as umbrellas and hiking poles. There is a need to raise awareness of the risks of using umbrellas to aid walking and empower the user to make informed decisions when purchasing walking aid devices. In addition, there is a need to support the supply chain of walking aids, including umbrellas and hiking poles, to provide more information on device use, misuse, training, and maintenance.

Factors influencing imaging clinical decision-making in low back pain management. A scoping review

BACKGROUND

The use of diagnostic imaging in low back pain (LBP) management is often inappropriate, despite recommendations from clinical practice guidelines. There is a limited understanding of factors that influence the imaging clinical decision-making (CDM) process.

AIM

Explore the literature on factors influencing imaging CDM for people with LBP and consider how these findings could be used to reduce inappropriate use of imaging in LBP management.

DESIGN

Scoping review.

METHOD

This review followed the Preferred Reporting Items for Systematic Review extension for scoping reviews. A digital search was conducted in Medline, the Cumulative Index of Nursing and Allied Health Literature, Scopus, and the Cochrane Central Register of Controlled Trials for eligible studies published between January 2010-2023. Data reporting influences on imaging CDM were extracted. Data were then analysed through an inductive process to group the influencing factors into categories.

RESULTS

After screening, 35 studies (5 qualitative and 30 quantitative) were included in the review, which reported factors influencing imaging CDM. Three categories were developed: clinical features (such as red flags, pain, and neurological deficit), non-modifiable factors (such as age, sex, and ethnicity) and modifiable factors (such as beliefs about consequences and clinical practice). Most studies reported non-modifiable factors.

CONCLUSIONS

The results of this scoping review challenge the perception that imaging CDM is purely based on clinical history and objective findings. There is a complex interplay between clinical features, patient and clinician characteristics, beliefs, and environment. These findings should be considered when designing strategies to address inappropriate imaging behaviour.

Bothersome symptoms at midlife in relation to body fat percentage

OBJECTIVES

Increasing obesity has been associated with a higher frequency of symptoms at midlife. Bothersomeness represents an important measure of perceived symptom severity, but has received relatively little consideration, and relationships between symptom bothersomeness and obesity are not known. We evaluated the association between body fat percentage (%BF) and the bothersomeness of symptoms at midlife.

METHODS

This cross-sectional study included women aged 40-60 in Qatar (n = 841). Participants reported frequency and bothersomeness of midlife symptoms hypothesized to be related to body composition. Initially, we characterized the relationship between continuous %BF and presence (yes/no) and bothersomeness (yes/no) for each symptom using restricted cubic spline (RCS) models to test nonlinearity. Subsequently, we used multinomial logistic regressions to evaluate associations between %BF and multilevel symptom outcomes, where categories were: (a) no symptoms or bother, (b) symptoms without bothersomeness, and (c) symptoms with bothersomeness.

RESULTS

The highest frequency of bothersomeness was reported for aches/stiffness in joints (51%), followed by trouble sleeping (34%), night sweats (21%), urinary incontinence (18%), hot flashes (16%), and shortness of breath (15%). In unadjusted multinomial logistic regressions, aches/stiffness in joints with and without bothersomeness had the same significant relationship with %BF. Bothersome night sweats, urinary incontinence, and hot flashes were significantly associated with %BF (p < .05), but those same symptoms without bothersomeness were not significantly associated with %BF.

CONCLUSIONS

Our findings suggest that bothersomeness is an important variable that tracks with body fat and gives different information than report of the presence/absence of a symptom alone.

Contextual Factors-Enriched Standard Care on mechanical neck pain (ContextualizAR trial): Protocol for a randomised controlled trial

BACKGROUND

Understanding the influence of contextual factors (CFs) on interventions for mechanical neck pain (MNP) is essential for evidence-based practice in physical therapy. However, the specific effects and synergies of combining different CFs remain unclear.

OBJECTIVE

The primary purpose of this study will be to determine if a CFs-Enriched Standard Care (SC) approach is an effective treatment for MNP in terms of reducing pain and improving function.

METHODS

This will be an assessor-blinded, 2-group (1:1) randomised clinical trial (RCT) aiming to enrol 94 participants with neck pain persisting for more than 4 weeks. Both groups will undergo 4 weeks of SC twice weekly, following established clinical practice guidelines. In the intervention group, CFs will be enhanced, encompassing the physical, psychological, and social elements inherent in the clinical encounter, based on existing evidence. The primary outcomes will encompass changes in pain and disability after 4 weeks of treatment, with a follow-up reassessment at week 12 post-treatment. Secondary outcomes will include changes in Active Range of Motion, Global Rating of Change, and Satisfaction with treatment. The change between groups after treatment and at the 12-week follow-up will be reported for all outcomes, considering the difference from scores recorded at baseline.

RESULTS

We hypothesise that a 4-week CFs-Enriched SC approach will be superior to SC alone in terms of patient-reported disability and pain, with measurements conducted using the Northwick Park Neck Pain Questionnaire and the Numeric Pain Rating Scale, respectively.

CONCLUSION

This RCT rigorously assesses the effect of purposeful manipulation of CFs during MNP treatment. By elucidating the role of these factors, our findings have the potential to significantly refine clinical practice in managing MNP, thereby enhancing patient care, and advancing the fields of physical therapy and rehabilitation.

Effect of Adding Early Bedside Cycling to Inpatient Cardiac Rehabilitation on Physical Function and Length of Stay After Heart Valve Surgery: A Randomized Controlled Trial

OBJECTIVE

To assess whether adding bedside cycling to inpatient cardiac rehabilitation (CR) early after heart valve surgery could lead to better physical function and shorter length of hospital stays.

DESIGN

This is a single-centered, randomized, controlled, parallel-group intervention study.

SETTINGS

This study was conducted at the National Heart Institute from December 2022 to June 2023.

PARTICIPANTS

Thirty-one patients following heart valve surgery completed this study after being randomized into 2 groups: an intervention group (n1=16) and an active control group (n2=15). Eligibility criteria were heart valve surgery with median sternotomy, clinical stability, and age from 20 to 40 years.

INTERVENTIONS

The intervention group received early bedside cycling for the lower limbs, using a mini bike, in addition to an inpatient CR program, and the control group received the inpatient CR program alone.

MAIN OUTCOME MEASURE

The primary outcome was the physical functional capacity assessed by the 6-minute walk distance (6MWD). The secondary outcomes were the Barthel Index (BI), the forced vital capacity (FVC), the length of intensive care unit (ICU) stay, the total length of hospital stay, and the physical component summary (PCS) of the 12-item Short Form (SF-12) Health Survey.

RESULTS

Compared with the control group, the intervention group showed significantly greater 6MWD (P<.001), BI score (P<.001), and FVC (P=.006) at hospital discharge, and shorter ICU stay (P=.002) and total hospital stay (P=.015). At 1-month follow-up, the intervention group showed a non-significantly higher PCS mean score than the control group (P=.057).

CONCLUSION

Adding early bedside cycling to a usual inpatient CR program after heart valve surgery could induce significantly greater short-term physical functional capacity as assessed by the 6MWD, better activities of daily living as evaluated by the BI, higher pulmonary function as measured by the FVC, and shorter lengths of ICU and total hospital stays than the usual inpatient CR program alone.

Effect of core stabilization versus rebound therapy on balance in children with cerebral palsy

OBJECTIVE

This study aimed to compare the effect of core stabilization exercises and rebound therapy on balance in children with hemiplegic cerebral palsy (CP).

METHODS

Fifty- two children of spastic hemiplegic CP aged 5 up to 8 years from both genders were assigned randomly into two groups: core stability and rebound therapy groups. Both groups received 3 sessions/week, 1.5-h training per session, for 12 successive weeks. The measurement was performed at baseline and post-treatment. Balance as a primary outcome for this study was measured by a Biodex Balance System (BBS), and knee extensor strength and functional capacity as secondary outcomes were assessed using a hand-held dynamometer, and a six-minute walk test (6MWT), respectively.

RESULTS

All variables showed a significant improvement after intervention in each group (p < 0.0001), with significant improvement in all stability indices (overall, anteroposterior, and mediolateral) in core stability group when compared to rebound therapy group.

CONCLUSION

Core stability exercises and rebound therapy are recommended in the rehabilitation of children with hemiplegic CP. Core stability exercises were more effective than rebound therapy for balance improvement.

TRIAL REGISTRATION NUMBER

NCT05739396.

Modified Squat Test for Predicting Knee Muscle Strength in Older Adults

BACKGROUND

Methods for evaluating the strength of the knee extensor muscles play a vital role in determining the functionality of the lower limbs and monitoring any alterations that occur over time in older individuals. This study assessed the validity of the Modified Squat Test (MST) in predicting knee extensor muscle strength in older adults.

METHODS

This study included a total of 110 older adults. We collected demographic information such as sex, age, body weight, height, and thigh circumference. Muscle strength was assessed by measuring the maximum voluntary isometric contraction of the knee extensors, and by performing the MST (5 and 10 repetitions) and single-leg standing balance test. Stepwise multiple linear regression analysis was used to investigate multiple factors impacting the prediction of knee extensor strength.

RESULTS

Factors such as age, sex, thigh circumference, performance on the single-leg standing eye-open (SSEO) task, and the time required to complete the 10 MST repetitions together explained 77.8% of the variation in knee extensor muscle strength among older adults. We further developed a predictive equation to calculate strength as follows: strength = 36.78 - 0.24 (age) + 6.16 (sex) + 0.19 (thigh circumference) + 0.05 (SSEO) - 0.54 (time required to complete 10 MST repetitions) ± 5.51 kg.

CONCLUSION

The 10-repetition MST is an invaluable instrument for establishing an equation to accurately predict lower limb muscle strength.

Does Preoperative Back Pain Impact Patient-reported Outcomes in Patients Undergoing Minimally Invasive Transforaminal Lumbar Interbody Fusion for Isthmic Spondylolisthesis?

STUDY DESIGN

Retrospective review.

OBJECTIVE

To determine postoperative clinical outcomes in patients undergoing minimally invasive (MIS) transforaminal lumbar interbody fusion (TLIF) for isthmic spondylolisthesis (IS).

BACKGROUND

Few studies have examined the postoperative clinical trajectory in patients undergoing MIS-TLIF specifically for IS.

METHODS

Patients were separated into two cohorts based on the previously defined Visual Analog Scale (VAS) back pain (BP) for severe pain: VAS-BP <7 and VAS-BP ≥7. Patient-reported outcome measures (PROMs) of Patient-Reported Outcomes Measurement Information System-physical function (PF), 12-item Short Form (SF-12) Physical/Mental Component Score, Patient Health Questionnaire-9, VAS-BP, VAS leg pain, and Oswestry Disability Index were collected preoperatively and up to 2-year postoperatively. Minimum clinically important difference (MCID) was calculated through previously defined thresholds.

RESULTS

A total of 160 patients were recorded, with 58 patients in the VAS-BP <7 cohort. The VAS-BP <7 cohort demonstrated significant improvement in all PROMs at one or more postoperative time points. The VAS-BP ≥7 demonstrated significant improvement at 3 or more postoperative time points in all PROMs except for SF-12 Mental Component Score. The VAS-BP <7 cohort reported significantly superior preoperative and postoperative PROMs in all domains, except for SF-12 Physical Component Score. The VAS-BP ≥7 cohort had higher MCID achievement rates at one or more time points in multiple PROMs.

CONCLUSION

Patients undergoing MIS-TLIF for IS demonstrated significant postoperative improvement in PF, mental function, pain, and disability outcomes independent of preoperative severity of BP. Patients with lower preoperative BP demonstrated superior outcomes in PF, mental function, pain, and disability. However, patients with greater preoperative BP achieved higher rates of MCID in mental function, BP, and disability outcomes. Patients with greater severity of preoperative BP undergoing MIS-TLIF for IS may experience greater rates of clinically relevant improvement in mental function, BP, and disability outcomes.