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Spiering BA, Clark BC, Schoenfeld BJ, Foulis SA, Pasiakos SM. Maximizing Strength: The Stimuli and Mediators of Strength Gains and Their Application to Training and Rehabilitation. J Strength Cond Res 2023; 37:919-929. [PMID: 36580280 DOI: 10.1519/jsc.0000000000004390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
ABSTRACT Spiering, BA, Clark, BC, Schoenfeld, BJ, Foulis, SA, and Pasiakos, SM. Maximizing strength: the stimuli and mediators of strength gains and their application to training and rehabilitation. J Strength Cond Res 37(4): 919-929, 2023-Traditional heavy resistance exercise (RE) training increases maximal strength, a valuable adaptation in many situations. That stated, some populations seek new opportunities for pushing the upper limits of strength gains (e.g., athletes and military personnel). Alternatively, other populations strive to increase or maintain strength but cannot perform heavy RE (e.g., during at-home exercise, during deployment, or after injury or illness). Therefore, the purpose of this narrative review is to (a) identify the known stimuli that trigger gains in strength; (b) identify the known factors that mediate the long-term effectiveness of these stimuli; (c) discuss (and in some cases, speculate on) potential opportunities for maximizing strength gains beyond current limits; and (d) discuss practical applications for increasing or maintaining strength when traditional heavy RE cannot be performed. First, by conceptually deconstructing traditional heavy RE, we identify that strength gains are stimulated through a sequence of events, namely: giving maximal mental effort, leading to maximal neural activation of muscle to produce forceful contractions, involving lifting and lowering movements, training through a full range of motion, and (potentially) inducing muscular metabolic stress. Second, we identify factors that mediate the long-term effectiveness of these RE stimuli, namely: optimizing the dose of RE within a session, beginning each set of RE in a minimally fatigued state, optimizing recovery between training sessions, and (potentially) periodizing the training stimulus over time. Equipped with these insights, we identify potential opportunities for further maximizing strength gains. Finally, we identify opportunities for increasing or maintaining strength when traditional heavy RE cannot be performed.
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Affiliation(s)
- Barry A Spiering
- Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Brian C Clark
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, Ohio
- Department of Biomedical Sciences, Ohio University, Athens, Ohio; and
| | | | - Stephen A Foulis
- Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Stefan M Pasiakos
- Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts
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Di Bacco VE, Gage WH. Evaluation of a smartphone accelerometer system for measuring nonlinear dynamics during treadmill walking: Concurrent validity and test-retest reliability. J Biomech 2023; 151:111527. [PMID: 36948001 DOI: 10.1016/j.jbiomech.2023.111527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 02/26/2023] [Accepted: 03/02/2023] [Indexed: 03/09/2023]
Abstract
The accelerometers embedded within smartphones may be a promising tool to capture gait patterns outside the laboratory and for extended periods of time. The current study evaluated the agreement and reliability of gait measures derived from a smartphone accelerometer system, compared to reference motion capture and footswitch systems during treadmill walking. Seventeen healthy young adults visited the laboratory on three separate days and completed three 8-minute treadmill walking trials, during each visit, at their preferred walking speed. The inter-stride interval series was calculated as the time difference between consecutive right heel contacts, located within the signals of the smartphone accelerometer, motion capture, and footswitch systems. The inter-stride interval series was used to estimate common linear gait measures and nonlinear measures, including fractal scaling index, approximate entropy, and sample entropy. Bland Altman plots with 95% limits of agreement and intraclass correlation coefficients assessed agreement and reliability, respectively. The smartphone system was found to be within the acceptable limits of agreement when compared to either reference system. The intraclass correlation coefficients values revealed moderate-to-excellent reliability for the smartphone system, with greater reliability found for linear compared to nonlinear measures and were similar to both reference systems, except for the fractal scaling index. These findings suggest the smartphone accelerometer system is a valid and reliable method for estimating linear and nonlinear gait measures during treadmill walking.
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Affiliation(s)
- Vincenzo E Di Bacco
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada.
| | - William H Gage
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
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Cano-de-la-Cuerda R, Jiménez-Antona C, Melián-Ortiz A, Molero-Sánchez A, Gil-de Miguel Á, Lizcano-Álvarez Á, Hernández-Barrera V, Varillas-Delgado D, Laguarta-Val S. Construct Validity and Test-Retest Reliability of a Free Mobile Application to Evaluate Aerobic Capacity and Endurance in Post-COVID-19 Syndrome Patients-A Pilot Study. J Clin Med 2022; 12:jcm12010131. [PMID: 36614932 PMCID: PMC9821392 DOI: 10.3390/jcm12010131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/22/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
Introduction: Disability associated with the symptoms of post-COVID-19 syndrome is one of its main features and can have a considerable impact on care and rehabilitation units. This, linked to a decreased aerobic capacity and endurance in post-COVID-19 syndrome patients, increases interest in studying the potential of mobile applications to assess performance capacity. The purpose of this research was to study how a free mobile application assesses aerobic capacity and endurance and its relationship with aerobic capacity, test-retest reliability, and endurance evaluated by a conventional test, along with fatigue and health-related quality of life. Methods: An observational study was conducted. RUNZI®, a free mobile application, was used by mounting a Samsung Galaxy S8 smartphone using a strap on the right forearm while all participants simultaneously performed a 6-Minute Walking Test (6MWT). Construct validity between the 6MWT and the total distance performed evaluated by RUNZI® was explored. Additionally, evaluation scales to assess fatigue (MFIS) and health-related quality of life (SF-36) were used to analyze the construct validity of RUNZI®. For test−retest reliability of the app, the same instructions about the 6MWT and procedure with the app were given to all participants at two different time periods. Results: A total of 16 post-COVID-19 syndrome patients (15 females and 1 male) completed the procedure. Distance measured with the RUNZI® showed an excellent correlation with the 6MWT assessed conventionally (p < 0.0001; r = 0.851). No statistical correlations were found between the distance assessed by the RUNZI® app with MFIS and the SF-36. Test−retest reliability was found to be close to statistical significance (p = 0.058) for distance (m) measured by RUNZI® with an ICC of 0.482. Conclusions: Instrumental 6MWT assessed by the RUNZI® app for the Android® operating system showed an excellent correlation with conventional 6MWT, indicating its construct validity in post-COVID-19 syndrome patients. Further, values for the test−retest reliability for the free mobile application were close to statistical significance with a reliability considered poor in an indoor setting.
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Affiliation(s)
- Roberto Cano-de-la-Cuerda
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Universidad Rey Juan Carlos (URJC), Alcorcón, 28922 Madrid, Spain
- Movement Analysis Laboratoy (LAMBECOM), Faculty of Health Sciences, Universidad Rey Juan Carlos (URJC), Alcorcón, 28922 Madrid, Spain
| | - Carmen Jiménez-Antona
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Universidad Rey Juan Carlos (URJC), Alcorcón, 28922 Madrid, Spain
- Correspondence: ; Tel.: + 34-91-488-86-50
| | - Alberto Melián-Ortiz
- Faculty of Nursing and Physiotherapy, Universidad Pontificia de Salamanca, 28040 Madrid, Spain
| | - Alberto Molero-Sánchez
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Universidad Rey Juan Carlos (URJC), Alcorcón, 28922 Madrid, Spain
- Movement Analysis Laboratoy (LAMBECOM), Faculty of Health Sciences, Universidad Rey Juan Carlos (URJC), Alcorcón, 28922 Madrid, Spain
| | - Ángel Gil-de Miguel
- Medical Specialties and Public Health, Faculty of Health Sciences, Universidad Rey Juan Carlos (URJC), Alcorcón, 28922 Madrid, Spain
| | - Ángel Lizcano-Álvarez
- Department of Nursing and Stomatology, Faculty of Health Sciences, Universidad Rey Juan Carlos (URJC), Alcorcón, 28922 Madrid, Spain
| | - Valentín Hernández-Barrera
- Medical Specialties and Public Health, Faculty of Health Sciences, Universidad Rey Juan Carlos (URJC), Alcorcón, 28922 Madrid, Spain
| | - David Varillas-Delgado
- Faculty of Health Sciences, Universidad Francisco de Vitoria (UFV), Pozuelo de Alarcón, 28223 Madrid, Spain
| | - Sofía Laguarta-Val
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Universidad Rey Juan Carlos (URJC), Alcorcón, 28922 Madrid, Spain
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Amudhan K, Vasanthanathan A, Anish Jafrin Thilak J. An insight into Transfemoral Prostheses: Materials, modelling, simulation, fabrication, testing, clinical evaluation and performance perspectives. Expert Rev Med Devices 2022; 19:123-140. [PMID: 35142577 DOI: 10.1080/17434440.2022.2039624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION A Transfemoral prosthesis restores any limb amputated above the knee. Designing and developing a transfemoral prosthesis that is consistent with human performance is a tough task. While prosthetic components are widely available in the market, ongoing research is being conducted to develop parts that would restore the lost capability, taking into account numerous social, economic and technological considerations. AREAS COVERED The present paper provides a comprehensive review about the mechanical aspects and performance of transfemoral prosthesis in recent years based on the research findings on materials, manufacturing methods and evaluations for suitability of the prostheses. The fundamental terminologies as well as technical advancements are covered in order to impart a better knowledge in the area of Lower Limb prostheses. This review also provides a concise description on the role of computers, advanced software packages, sensors and other hardware components for the design, fabrication and testing of transfemoral prosthetic devices in the current environment. EXPERT OPINION The current state of lower limb prostheses and future research opportunities are summarised to address upcoming challenges. Based on survey of various research works, adapting modern technology may aid in the development of functional and cost-efficient prosthetic components with superior safety, comfort and quality.
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Affiliation(s)
- K Amudhan
- Department of Mechanical Engineering, Mepco Schlenk Engineering College,626005, Tamilnadu, India
| | - A Vasanthanathan
- Department of Mechanical Engineering, Mepco Schlenk Engineering College,626005, Tamilnadu, India
| | - J Anish Jafrin Thilak
- Department of Mechanical Engineering, Mepco Schlenk Engineering College,626005, Tamilnadu, India
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Storm FA, Cesareo A, Reni G, Biffi E. Wearable Inertial Sensors to Assess Gait during the 6-Minute Walk Test: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2020; 20:E2660. [PMID: 32384806 PMCID: PMC7249076 DOI: 10.3390/s20092660] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/23/2020] [Accepted: 05/05/2020] [Indexed: 12/12/2022]
Abstract
Wearable sensors are becoming increasingly popular for complementing classical clinical assessments of gait deficits. The aim of this review is to examine the existing knowledge by systematically reviewing a large number of papers focusing on the use of wearable inertial sensors for the assessment of gait during the 6-minute walk test (6MWT), a widely recognized, simple, non-invasive, low-cost and reproducible exercise test. After a systematic search on PubMed and Scopus databases, two raters evaluated the quality of 28 full-text articles. Then, the available knowledge was summarized regarding study design, subjects enrolled (number of patients and pathological condition, if any, age, male/female ratio), sensor characteristics (type, number, sampling frequency, range) and body placement, 6MWT protocol and extracted parameters. Results were critically discussed to suggest future directions for the use of inertial sensor devices in the clinics.
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Affiliation(s)
- Fabio Alexander Storm
- Scientific Institute, IRCCS “E. Medea”, Bioengineering Lab, 23842 Bosisio Parini, Lecco, Italy; (A.C.); (G.R.); (E.B.)
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Developing a smartphone application, triaxial accelerometer-based, to quantify static and dynamic balance deficits in patients with cerebellar ataxias. J Neurol 2019; 267:625-639. [PMID: 31713101 DOI: 10.1007/s00415-019-09570-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 10/03/2019] [Accepted: 10/09/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Cerebellar ataxia is characterized by difficulty in the planning of movement and lack of anticipatory postural adjustments, which can result in deficits of balance. Being able to have quantitative measurements in clinical practice, to detect any improvements on balance resulting from new rehabilitation treatments or experimental drugs is very important. AIM The purpose of this study was to develop an application (APP) able to assess static and dynamic balance in patients with cerebellar ataxias (CA). The APP that works by a wearable device (smartphone) placed at the breastbone level and immobilized by an elastic band, measures the body sway by means of a triaxial accelerometer. METHODS We investigated 40 CA patients and 80 healthy subjects. All patients were clinically evaluated using the "Berg Balance Scale" (BBS) and the "Scale for the Assessment and Rating of Ataxia" (SARA). Balance impairment was quantitatively assessed using a validated static balance evaluating systems, i.e., Techno-body Pro-Kin footboard. All participants underwent static and dynamic balance assessments using the new APP. RESULTS We observed a strong correlation between the APP measurements and the score obtained with the BBS, SARA, and Pro-Kin footboard. The intra-rater reliability and the test-retest reliability of the APP measurements, estimated by intraclass correlation coefficient, were excellent. The standard error of measurement and the minimal detectable change were small. No learning effect was observed. CONCLUSIONS We can state that the APP is an easy, reliable, and valid evaluating system to quantify the trunk sway in a static position and during the gait.
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