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Jain D, Porfido T, de Souza NL, Brown AM, Caccese JB, Czykier A, Dennis EL, Tosto-Mancuso J, Wilde EA, Esopenko C. Neural Mechanisms Associated With Postural Control in Collegiate Soccer and Non-Soccer Athletes. J Neurol Phys Ther 2024; 48:151-158. [PMID: 38709008 DOI: 10.1097/npt.0000000000000476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 01/15/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND AND PURPOSE Sport-specific training may improve postural control, while repetitive head acceleration events (RHAEs) may compromise it. Understanding the neural mechanisms underlying postural control may contextualize changes due to training and RHAE. The goal of this study was to determine whether postural sway during the Balance Error Scoring System (BESS) is related to white matter organization (WMO) in collegiate athletes. METHODS Collegiate soccer ( N = 33) and non-soccer athletes ( N = 44) completed BESS and diffusion tensor imaging. Postural sway during each BESS stance, fractional anisotropy (FA), and mean diffusivity (MD) were extracted for each participant. Partial least squares analyses determined group differences in postural sway and WMO and the relationship between postural sway and WMO in soccer and non-soccer athletes separately. RESULTS Soccer athletes displayed better performance during BESS 6, with lower FA and higher MD in the medial lemniscus (ML) and inferior cerebellar peduncle (ICP), compared to non-soccer athletes. In soccer athletes, lower sway during BESS 2, 5, and 6 was associated with higher FA and lower MD in the corticospinal tract, ML, and ICP. In non-soccer athletes, lower sway during BESS 2 and 4 was associated with higher FA and lower MD in the ML and ICP. BESS 1 was associated with higher FA, and BESS 3 was associated with lower MD in the same tracts in non-soccer athletes. DISCUSSION AND CONCLUSIONS Soccer and non-soccer athletes showed unique relationships between sway and WMO, suggesting that sport-specific exposures are partly responsible for changes in neurological structure and accompanying postural control performance and should be considered when evaluating postural control after injury.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content, available at: http://links.lww.com/JNPT/A472 ).
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Affiliation(s)
- Divya Jain
- Divya Jain and Tara Porfido are considering as co-first authors. Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York City, New York (D.J., N.L.D., A.C., C.E.); Department of Rehabilitation & Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, New Jersey (T.P., A.M.B.); School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, Ohio (J.B.C.); Department of Neurology, University of Utah (E.L.D., E.A.W.); George E. Wahlen Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, Utah (E.L.D., E.A.W.); and Abilities Research Center, Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York City, New York (J.T.-M.)
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Sanchez-Ruiz R, de la Plaza San Frutos M, Sosa-Reina MD, Sanz-Esteban I, García-Arrabé M, Estrada-Barranco C. Associations between respiratory function, balance, postural control, and fatigue in persons with multiple sclerosis: an observational study. Front Public Health 2024; 12:1332417. [PMID: 38572010 PMCID: PMC10987765 DOI: 10.3389/fpubh.2024.1332417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/08/2024] [Indexed: 04/05/2024] Open
Abstract
Introduction Fatigue, postural control impairments, and reduced respiratory capacities are common symptoms in persons diagnosed with Multiple Sclerosis (MS). However, there is a paucity of evidence establishing correlations among these factors. The aim of this study is to analyze respiratory function in persons with MS compared to the control group as well as to analyze the relationship between fatigue, respiratory function and postural control in persons with MS. Materials and methods A total of 17 persons with MS and 17 healthy individuals were enrolled for this cross-sectional study. The evaluated parameters included fatigue assessed using the Visual Analog Scale-fatigue (VAS-F) and the Borg Dyspnea Scale, postural control assessed through the Mini Balance Evaluation System Test (Mini-BESTest), Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and Trunk Impairment Scale (TIS); and respiratory capacities measured by Maximum Inspiratory Pressure (MIP), Maximum Expiratory Pressure (MEP), Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), FEV1/FVC ratio, Diaphragmatic excursion and diaphragmatic thickness. Results A very high correlation was observed between the Borg Dyspnoea Scale and the BBS (r = -0.768), TUG (0.867), and Mini-BESTest (r = -0.775). The VAS-F exhibited an almost perfect correlation solely with the TUG (0.927). However, none of the variables related to fatigue exhibited any correlation with the respiratory variables under study. Balance-related variables such as BBS and Mini-BESTest demonstrated a very high and high correlation. Respectively, with respiratory function variables MEP (r = 0.783; r = 0.686), FVC (r = 0.709; r = 0.596), FEV1 (r = 0.615; r = 0.518). BBS exhibited a high correlation with diaphragmatic excursion (r = 0.591). Statistically significant differences were noted between the persons with MS group and the control group in all respiratory and ultrasound parameters except for diaphragmatic thickness. Conclusion The findings suggest that decreased postural control and balance are associated with both respiratory capacity impairments and the presence of fatigue in persons with MS. However, it is important to note that the alterations in respiratory capacities and fatigue are not mutually related, as indicated by the data obtained in this study. Discrepancies were identified in abdominal wall thickness, diaphragmatic excursion, and respiratory capacities between persons with MS and their healthy counterparts.
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Affiliation(s)
| | | | | | | | - Maria García-Arrabé
- Faculty of Physical Activity and Sport Sciences, European University of Madrid, Madrid, Spain
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Richmond SB, Dames KD. A static posturography guide to implementing time-to-boundary. J Biomech 2024; 166:112050. [PMID: 38503063 DOI: 10.1016/j.jbiomech.2024.112050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 03/07/2024] [Accepted: 03/13/2024] [Indexed: 03/21/2024]
Abstract
The emergence of time-to-boundary provides an advanced representation of the spatiotemporal characteristics of postural control through the estimation of the time required for the center of pressure to reach the boundary of the base of support. Time-to-boundary has demonstrated its utility in several healthy and clinical adoptions; however, unknown inconsistencies among studies exist. Text and graphical representations understandably highlight idealistic standards, but new investigators to this measure are forced to wade through the same potential pitfalls that others have addressed, but the field has neglected to concatenate. The purpose of this communication is to share recent methodological advancements made to enhance time-to-boundary and describe the components of the time-to-boundary code that is being made publicly accessible for the first time. We anticipate future researchers who wish to apply this methodology to their data processing toolbox could utilize our script in full, with any deviations in potential future developments noted in clear fashion. Historically, researchers (including ourselves) have had to interpret text-based descriptions of the existing literature into quantitative steps in a computational mathematics script. In contrast to fixed process measures that do not require investigator input (e.g., path length), time-to-boundary poses two distinct but connected challenges to investigators. The coding process itself can be a hurdle for novices or practitioners. Second, transferring logical considerations such as robust, objective event detection routines must be defended in the review process. This comprehensive guide to time-to-boundary, as used in our applications, should enhance adoption and advance the comprehension of postural control.
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Affiliation(s)
- Sutton B Richmond
- Department of Applied Physiology and Kinesiology, University of Florida, 1864 Stadium Rd., Gainesville, FL 32608, USA.
| | - Kevin D Dames
- Biomechanics Laboratory, Kinesiology Department, State University of New York at Cortland, Cortland, NY 13045, USA.
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Sandroff BM, Rafizadeh CM, Motl RW. Neuroimaging Technology in Exercise Neurorehabilitation Research in Persons with MS: A Scoping Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23094530. [PMID: 37177732 PMCID: PMC10181711 DOI: 10.3390/s23094530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023]
Abstract
There is increasing interest in the application of neuroimaging technology in exercise neurorehabilitation research among persons with multiple sclerosis (MS). The inclusion and focus on neuroimaging outcomes in MS exercise training research is critical for establishing a biological basis for improvements in functioning and elevating exercise within the neurologist's clinical armamentarium alongside disease modifying therapies as an approach for treating the disease and its consequences. Indeed, the inclusion of selective neuroimaging approaches and sensor-based technology among physical activity, mobility, and balance outcomes in such MS research might further allow for detecting specific links between the brain and real-world behavior. This paper provided a scoping review on the application of neuroimaging in exercise training research among persons with MS based on searches conducted in PubMed, Web of Science, and Scopus. We identified 60 studies on neuroimaging-technology-based (primarily MRI, which involved a variety of sequences and approaches) correlates of functions, based on multiple sensor-based measures, which are typically targets for exercise training trials in MS. We further identified 12 randomized controlled trials of exercise training effects on neuroimaging outcomes in MS. Overall, there was a large degree of heterogeneity whereby we could not identify definitive conclusions regarding a consistent neuroimaging biomarker of MS-related dysfunction or singular sensor-based measure, or consistent neural adaptation for exercise training in MS. Nevertheless, the present review provides a first step for better linking correlational and randomized controlled trial research for the development of high-quality exercise training studies on the brain in persons with MS, and this is timely given the substantial interest in exercise as a potential disease-modifying and/or neuroplasticity-inducing behavior in this population.
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Affiliation(s)
- Brian M Sandroff
- Center for Neuropsychology and Neuroscience Research, Kessler Foundation, 1199 Pleasant Valley Way, West Orange, NJ 07052, USA
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ 07103, USA
| | - Caroline M Rafizadeh
- Center for Neuropsychology and Neuroscience Research, Kessler Foundation, 1199 Pleasant Valley Way, West Orange, NJ 07052, USA
| | - Robert W Motl
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL 60607, USA
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Richmond SB, Otto G, Dames KD. Characterization of trial duration in traditional and emerging postural control measures. J Biomech 2023; 147:111438. [PMID: 36641826 DOI: 10.1016/j.jbiomech.2023.111438] [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: 08/08/2022] [Revised: 12/07/2022] [Accepted: 01/06/2023] [Indexed: 01/11/2023]
Abstract
Researchers may select from varied technological and practical options when evaluating balance. Methodological choices inform the quantitative outcomes observed and allow practitioners to diagnose balance abnormalities. Past investigations have differed widely on sampling duration, and these discrepancies hinder comparisons among studies and confidence in outcomes where trials were excessively short. This study aimed to identify necessary trial lengths for common and emerging center of pressure-based measures. We hypothesized that dependent variables would fluctuate over time but eventually reach a stable magnitude. Ninety-seven apparently healthy adults performed quiet standing for 180-seconds (s) with eyes (A) open and (B) closed on a force platform. Anterior-posterior and medial-lateral elements of the center of pressure were used to calculate velocity, time-to-boundary, and Hurst exponents using 15, 30, 90, 120, 150, and 180 s of data. Two-way repeated measures ANOVAs were used to differentiate postural measures over time and between vision conditions. Outcomes were considered stable when significant changes in the measure were no longer observed in the time factor. Dependent measures stabilized for velocity between 60 and 120 s, time-to-boundary between 120 and 150 s, and the Hurst exponent between 30 and 120 s. Velocity measures stabilized quicker with eyes open, whereas vision had no effect or the eyes closed condition was faster to stabilize in time-to-boundary and detrended fluctuation analysis measures. We conclude that 150 s of standing data is sufficient to capture a broad range of postural stability outcomes regardless of vision condition.
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Affiliation(s)
- Sutton B Richmond
- Department of Applied Physiology and Kinesiology, University of Florida, 1864 Stadium Rd., Gainesville, FL 32608, USA.
| | - Garrett Otto
- Mathematics Department, State University of New York at Cortland, 126D Moffett Building, Cortland, NY 13045, USA
| | - Kevin D Dames
- Kinesiology Department, State University of New York at Cortland, 1157 Professional Studies Building, Cortland, NY 13045, USA
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Osuka S, Sudo H, Yamada K, Tachi H, Watanabe K, Sentoku F, Chiba T, Iwasaki N, Mukaino M, Tohyama H. Effects of Posterior Spinal Correction and Fusion on Postural Stability in Patients with Adolescent Idiopathic Scoliosis. J Clin Med 2022; 12:jcm12010270. [PMID: 36615069 PMCID: PMC9821153 DOI: 10.3390/jcm12010270] [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: 12/04/2022] [Revised: 12/24/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
The present study aimed to assess the effects of posterior spinal correction and fusion on postural stability in patients with adolescent idiopathic scoliosis (AIS). The study included 41 female patients with AIS at our institution. All patients performed three 10 s single-leg standing trials on a force plate. The center of pressure (COP) was measured preoperatively, and at 1 week and 6 months postoperatively. The postural stability parameters were absolute minimum time-to-boundary (TTB), mean of the minimum TTB, mean COP velocity, standard deviation, range, and 95% confidence ellipse area. One-way repeated analysis of variance or Friedman test was applied to the postural stability parameters. Multiple comparisons were performed using the Bonferroni correction. The absolute minimum TTB and the mean minimum TTB showed a significant increase 6 months post-operation as compared to preoperatively and 1 week postoperatively. The COP velocity significantly decreased at 6 months post-operation compared to preoperatively and 1 week postoperatively. These changes in postural stability indicate that spinal correction and fusion can be considered to improve postural stability during single-leg standing tests in the postoperative period.
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Affiliation(s)
- Satoshi Osuka
- Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Hokkaido, Japan
- Department of Rehabilitation, Hokkaido University Hospital, Sapporo 060-8648, Hokkaido, Japan
| | - Hideki Sudo
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Hokkaido, Japan
- Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo 060-8638, Hokkaido, Japan
- Correspondence:
| | - Katsuhisa Yamada
- Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo 060-8638, Hokkaido, Japan
| | - Hiroyuki Tachi
- Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo 060-8638, Hokkaido, Japan
- Department of Orthopaedic Surgery, Eniwa Hospital, Eniwa 061-1449, Hokkaido, Japan
| | - Kentaro Watanabe
- Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Hokkaido, Japan
- Department of Rehabilitation, Hokkaido University Hospital, Sapporo 060-8648, Hokkaido, Japan
| | - Fuma Sentoku
- Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Hokkaido, Japan
- Department of Rehabilitation, Hokkaido University Hospital, Sapporo 060-8648, Hokkaido, Japan
| | - Takeshi Chiba
- Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Hokkaido, Japan
- Department of Rehabilitation, Hokkaido University Hospital, Sapporo 060-8648, Hokkaido, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo 060-8638, Hokkaido, Japan
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine, Hokkaido University Hospital, Sapporo 060-8648, Hokkaido, Japan
| | - Harukazu Tohyama
- Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Hokkaido, Japan
- Department of Rehabilitation Medicine, Hokkaido University Hospital, Sapporo 060-8648, Hokkaido, Japan
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Nakamoto M, Ideguchi N, Iwata S, Tomita S, Morimoto N, Fukuda S, Kudo S. Validity and Reliability of Criteria for Plantar Sensation Assessment Using Semmes-Weinstein Monofilament as a Clinically Usable Index. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14092. [PMID: 36360967 PMCID: PMC9656000 DOI: 10.3390/ijerph192114092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
There is no standard clinically adaptable criterion for assessing plantar sensation for pre- and post-intervention comparisons. Studies using Semmes-Weinstein monofilaments (SWMs) to investigate intervention effects on plantar sensation vary in procedure and do not consider measurement errors. This study aimed to develop a simple criterion using SWMs to assess plantar sensation, determine the measurement error range, and identify areas of low error. Six examiners assessed 87 healthy young adults in Experiment 1, while two examiners assessed 10 participants in Experiment 2. Filaments were graded from 1 to 20 based on increasing diameter. The smallest grade that could be perceived for three sequential stimuli was used as the criterion (smallest perceivable grade, SPG). The SPG was significantly smaller at the hallux and larger at the heel than at other sites. There were no significant differences between the SPG of the repeated tests performed by the same versus different examiners. The interquartile range of the differences was <±3 at all sites. Thus, our criteria were reliable in evaluating the effects of plantar sensation interventions, especially at the heel and the middle of the metatarsal heads and could contribute to the development of more effective treatments for plantar sensations.
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Affiliation(s)
- Masami Nakamoto
- Inclusive Medical Science Research Institute, Morinomiya University of Medical Sciences, 1-26-16, Nanko-kita, Suminoe-ku, Osaka 559-8611, Japan
- Department of Physical Therapy, Morinomiya University of Medical Sciences, 1-26-16, Nanko-kita, Suminoe-ku, Osaka 559-8611, Japan
| | - Norio Ideguchi
- Inclusive Medical Science Research Institute, Morinomiya University of Medical Sciences, 1-26-16, Nanko-kita, Suminoe-ku, Osaka 559-8611, Japan
| | - Satoru Iwata
- Graduate School of Health Science, Morinomiya University of Medical Sciences, 1-26-16, Nanko-kita, Suminoe-ku, Osaka 559-8611, Japan
| | - Shunsuke Tomita
- Graduate School of Health Science, Morinomiya University of Medical Sciences, 1-26-16, Nanko-kita, Suminoe-ku, Osaka 559-8611, Japan
| | - Nao Morimoto
- Graduate School of Health Science, Morinomiya University of Medical Sciences, 1-26-16, Nanko-kita, Suminoe-ku, Osaka 559-8611, Japan
| | - Shion Fukuda
- Graduate School of Health Science, Morinomiya University of Medical Sciences, 1-26-16, Nanko-kita, Suminoe-ku, Osaka 559-8611, Japan
| | - Shintarou Kudo
- Inclusive Medical Science Research Institute, Morinomiya University of Medical Sciences, 1-26-16, Nanko-kita, Suminoe-ku, Osaka 559-8611, Japan
- Department of Physical Therapy, Morinomiya University of Medical Sciences, 1-26-16, Nanko-kita, Suminoe-ku, Osaka 559-8611, Japan
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Peterson DS, Phan V, Richmond SB, Lee H. Effects of dual-tasking on time-to-boundary during stance in people with PD: A preliminary study. Clin Biomech (Bristol, Avon) 2021; 88:105420. [PMID: 34216987 DOI: 10.1016/j.clinbiomech.2021.105420] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 05/16/2021] [Accepted: 06/24/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Quiet stance is impacted by Parkinson's disease and dual-tasking. Recently developed outcomes such as the time-to-boundary provide unique insight into balance by integrating center of pressure position with base of support. However, little is known about the effects of Parkinson's disease on time-to-boundary. In particular, the effects of distracting cognitive tasks, and how people with Parkinson's disease prioritize balance and cognitive tasks are poorly understood. METHODS 14 people with Parkinson's disease and 13 controls completed quiet standing and cognitive Stroop tasks separately (single-task) and together (dual-task). 2-dimentional, medio-lateral, and anterior-posterior time-to-boundary were calculated via force-plate data. Traditional sway outcomes, including sway area and path length, were also calculated. Cognitive performance was measured as the verbal reaction time after auditory stimulus delivery. Prioritization was assessed by taking the difference between cognitive and postural dual-task interference. FINDINGS Time-to-boundary was worse in Parkinson's disease compared to controls (2-dimentional: p = .019; anterior-posterior: p = .062; medio-lateral: p = .012). Medio-lateral time-to-boundary, but not anterior-posterior, was significantly worse during dual-tasking than single-tasking (p = .024). Neurotypical adults tended to prioritize cognition over medio-lateral postural outcomes. INTERPRETATION People with Parkinson's disease exhibit worse time-to-boundary than their neurotypical peers, and medio-lateral outcomes were sensitive to single to dual-task performance changes. Further, participants generally showed cognitive prioritization, such that cognitive performance was less impacted than medio-lateral postural outcomes by dual-tasking.
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Affiliation(s)
- D S Peterson
- College of Health Solutions, Arizona State University, 425 N 5(th) St., Phoenix, AZ, USA; Phoenix VA Medical Center, 650 E Indian School Rd., Phoenix, AZ, USA.
| | - V Phan
- School for Engineering of Matter, Transport and Energy, Arizona State University, 501 E Tyler Mall, Tempe, AZ, USA
| | - S B Richmond
- Department of Applied Physiology and Kinesiology, University of Florida, 1864 Stadium Rd., Gainesville, FL, USA
| | - H Lee
- School for Engineering of Matter, Transport and Energy, Arizona State University, 501 E Tyler Mall, Tempe, AZ, USA
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