Whole-body patterns of the range of joint motion in young adults: masculine type and feminine type

Effects of Myofascial Release Techniques on Joint Range of Motion of Athletes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Although myofascial release techniques (MRTs) are commonly used to improve athletes' range of motion (ROM), the effectiveness of MRTs may vary depending on the specific method performed. This systematic review and meta-analysis aimed to evaluate the effects of MRTs on the ROM performance of athletes. (2) Methods: The electronic databases of Cochrane Library, PubMed, Scopus, and Web of Science were searched to identify relevant articles published up to June 2023. This study utilized the PRISMA guidelines, and four databases were searched. The methodological quality of the studies was assessed using the PEDro scale, and the certainty of evidence was reported using the GRADE scale. The overall effect size was calculated using the robust variance estimator, and subgroup analyses were conducted using the Hotelling Zhang test. (3) Ten studies met the inclusion criteria. The overall effect size results indicated that the myofascial release intervention had a moderate effect on ROM performance in athletes when compared to the active or passive control groups. (4) Conclusions: Alternative MRTs, such as myofascial trigger point therapy, can further improve the ROM performance of athletes. Gender, duration of intervention, and joint type may have a moderating effect on the effectiveness of MRTs.

Analyzing the Differences in the Degree of Force Application Between Novice and Expert Physiotherapists Using a Muscle Deformation Sensor

BACKGROUND

Training physiotherapists require substantial experience and a lengthy period of time to achieve proficiency. However, establishing an objective method for quantifying the degree of force applied during treatment remains elusive, making training difficult.

OBJECTIVES

This study aims to clarify the difference in the degree of force application between novice and expert physiotherapists using muscle deformation sensors and to assist in teaching.

METHODS

A muscle deformation sensor array was utilized to capture the muscle bulging (muscle deformation), and the degree of force was visualized. The experiment involved two types of physiotherapy: upper and lower extremity exercises. Subsequently, the muscle deformation value and standard deviations of the muscle deformation data obtained were compared.

RESULTS

Significant differences between novices and experts were observed in forearm muscle deformation values and standard deviations across both types of physiotherapies (p<0.05). Additionally, a distinction was observed in the left lower limb flexor muscles during upper extremity exercise (p<0.05).

CONCLUSION

The results of this survey showed notable differences in the degree of force application between novices and experts, as demonstrated by our findings. Moreover, these implications extend beyond physiotherapy to sports, hobbies, and the teaching of traditional skills.

Scalable musculoskeletal model for dynamic simulations of upper body movement

A musculoskeletal (MSK) model is a valuable tool for assessing complex biomechanical problems, estimating joint torques during motion, optimizing motion in sports, and designing exoskeletons and prostheses. This study proposes an open-source upper body MSK model that supports biomechanical analysis of human motion. The MSK model of the upper body consists of 8 body segments (torso, head, left/right upper arm, left/right forearm, and left/right hand). The model has 20 degrees of freedom (DoFs) and 40 muscle torque generators (MTGs), which are constructed using experimental data. The model is adjustable for different anthropometric measurements and subject body characteristics: sex, age, body mass, height, dominant side, and physical activity. Joint limits are modeled using experimental dynamometer data within the proposed multi-DoF MTG model. The model equations are verified by simulating the joint range of motion (ROM) and torque; all simulation results have a good agreement with previously published research.

Scalable musculoskeletal model for dynamic simulations of lower body movement

A musculoskeletal (MSK) model is an important tool for analysing human motions, calculating joint torques during movement, enhancing sports activity, and developing exoskeletons and prostheses. To enable biomechanical investigation of human motion, this work presents an open-source lower body MSK model. The MSK model of the lower body consists of 7 body segments (pelvis, left/right thigh, left/right leg, and left/right foot). The model has 20 degrees of freedom (DoFs) and 28 muscle torque generators (MTGs), which are developed from experimental data. The model can be modified for different anthropometric measurements and subject body characteristics, including sex, age, body mass, height, physical activity, and skin temperature. The model is validated by simulating the torque within the range of motion (ROM) of isolated movements; all simulation findings exhibit a good level of agreement with the literature.

The association of hamstring tightness with lumbar lordosis and trunk flexibility in healthy individuals: gender analysis

Objectives: The purpose of this study was to investigate if there is a relation between hamstring tightness and lumbar lordosis as well as trunk flexibility based on gender differences and to analyze the differences in hamstring tightness, lumber lordosis and trunk flexibility in healthy adults. Methods: One hundred young healthy adults were recruited and distributed into 2 equal groups according to gender: group A (female group) and group B (male group). Hamstring tightness (HT) was measured by Active Knee Extension (AKE) test and Straight Leg Raise (SLR) test, the angle of lumbar lordosis was measured with a flexible ruler from standing position and trunk flexion flexibility (TFF) was measured by Fingertip-to-Floor Test. Results: There was a significant correlation between TFF and both measures of HT (SLR, p = 0.001; AKE, p = 0.001) in females. While, there was a non-significant correlation in males (SLR, p = 0.900; AKE, p = 0.717). Moreover, there was a non-significant correlation between lumbar lordosis and HT measures in both groups as (p > 0.05). Furthermore, there were significant differences between males and females in hamstring flexibility, TFF and lumbar lordosis as (p < 0.05). Conclusion: Gender differences in the relationship between hamstring tightness and trunk flexion flexibility are significant. However, there was no significant difference between males and females in the relationship between hamstring tightness and lumbar lordosis.

Men and women differ in their interest and willingness to participate in exercise and sports science research

Unequal proportions of male and female participants in exercise research might be attributed, in part, to differences in interest and willingness to participate. We tested if men and women are equally interested and willing to undergo exercise research procedures and if they consider different factors when deciding to participate. Two samples completed an online survey. Sample 1 (129 men, 227 women) responded to advertisements on social media and survey-sharing websites. Sample 2 (155 men, 504 women) was comprised of undergraduate psychology students. In both samples, men were significantly more interested to learn their muscle mass amount, running speed, jump height, and ball throwing ability, and more willing to receive electrical shocks, cycle or run until exhaustion, complete strength training that causes muscle soreness, and take muscle-building supplements (all p ≤ 0.013, d = 0.23-0.48). Women were significantly more interested to learn their flexibility, and more willing to complete surveys, participate in stretching and group aerobics interventions, and participate in home exercise with online instruction (all p ≤ 0.021, d = 0.12-0.71). Women rated the following significantly more important when deciding to participate: study's implications for society; personal health status; confidence in own abilities; potential anxiety during testing; type of research facility; time to complete study; and invasiveness, pain/discomfort, and possible side effects of procedures (all p < 0.05, d = 0.26-0.81). Differences in interest and willingness to participate in research probably contribute to different proportions of men and women as participants in exercise research. Knowledge of these differences might help researchers develop recruitment strategies aimed at encouraging both men and women to participate in exercise studies.

Assessment of Patients' Quality of Life during Conservative Treatment after Distal Radius Fracture

Introduction: This study aimed to assess patients' quality of life after distal radius fracture treatment (at least six months, but no more than ten years, after the treatment) based on the analysis of objective and subjective parameters and the influence of the fractured side on the final results. Materials and Methods: The study sample consisted of 30 women who claimed to be right-handed, divided depending on the side of the fracture (left vs. right limb). Patients were evaluated with a goniometer for active wrist movement, pronation, and supination in the elbow joint. Furthermore, the global grip strength of the upper limb was assessed using a dynamometer (Biometrics Ltd.) device, after which patients were asked to complete a wrist evaluation questionnaire (PRWE) and the Polish version of the SF-36 questionnaire assessing the quality of life. Results: There were statistically significant differences in the active movement of the wrist of the injured limb compared to the non-injured limb. In addition, inferior results were reported for injury of the right limb to those of the left. Conclusions: Injury of the right limb as opposed to injury of the left limb can have a negative impact on the assessment of quality of life in patients with right-limb dominance.

Residual dorsal displacement following surgery in distal radial fractures: A cause for trouble?

PURPOSE

Distal radius fractures have great impact on activities of daily living of affected patients. Repeatedly, a non-anatomic restoration of the volar tilt can be observed in a minimum of 20% in postoperative X-ray control examinations. Hence, the question arises whether the achieved reduction is functionally acceptable, or whether a further attempt should be made to improve the surgical outcome.

METHODS

The data presented here originate from a prospective analysis including three therapy studies on surgical treatment options for fractures of the distal radius between 2004 and 2011. For this study, the participants were divided into two groups: The first group represents the cases with non-anatomical restoration of the volar tilt with - 5° to 5°. The second group contains patients with an anatomical volar tilt between 6° and 15°.

RESULTS

A total of 624 patients were screened according to the inclusion criteria. Radiological evaluation showed consolidation of all fractures. The mean volar tilt as measured in standard x-rays of the wrist was 0° and 8°, respectively. The range of wrist motion in relation of the healthy opposite side was comparable in all directions (for example comparison group 1: Ext/Flex 94/94%; group 2: Ext/Flex 93/93%). Functional assessment of postoperative midterm results employing the Castaing and Gartland & Werley scores 2.3 years after surgery did not reveal significant differences between both groups.

CONCLUSION

According to the available data, a volar tilt in the range of - 5° to 5° can be tolerated intraoperatively without any risk of loss of function regarding the patient's manual abilities.

Variações baseadas em gênero no movimento e na força isométrica do tronco em jovens adultos com dor lombar: Um estudo de caso-controle prospectivo

Objective  To determine gender-based variations in trunk range of motion (RoM) and isometric strength (IS) in symptomatic and asymptomatic young adults.

Methods  In this prospective case-control study, 73 subjects with low back pain (LBP) and 80 asymptomatic subjects were analyzed. Dynamometer-based device trunk RoM and IS measurements in extension, flexion, and rotation were compared in both groups and gender-based subgroups. Multivariate analysis was used to determine factors influencing trunk RoM and IS.

Results  Symptomatic males had significantly less extension RoM and extension, flexion, and rotation isometric trunk strength (ITS) ( p  < 0.0001) compared with asymptomatic males, whereas no significant difference was found between asymptomatic and symptomatic females. However, the mean extension-flexion RoM and mean extension-flexion ITS ratios were significantly lower ( p  = 0.04) in asymptomatic females compared with symptomatic females. Female gender was significantly associated with less extension and flexion ITS in both asymptomatic and symptomatic subjects.

Conclusion  Males with LBP had significant global ITS weakness when compared with asymptomatic males. Despite no significant ITS difference in symptomatic versus asymptomatic females, LBP caused significant extension-flexion RoM and ITS imbalance in females. These gender-based variations in trunk RoM and IS, especially the extensor-flexor IS imbalance in females, must be considered while designing rehabilitation treatment protocols for LBP.

Surrogate lower limb design for ankle-foot orthosis mechanical evaluation

Purpose

This study designs and provides a pilot evaluation of a novel surrogate lower limb (SLL) that provides anatomically realistic three-dimensional (3D) foot motion, based on a literature consensus of passive lower limb motion. This SLL is intended to replace single axis surrogates currently used in mechanical testing of ankle-foot orthoses (AFO).

Material and Methods

The SLL design is inspired by the Rizzoli foot model, with shank, hindfoot, midfoot, forefoot, and toe sections. Ball and socket joints were used between hindfoot-midfoot (HM)-forefoot sections. Forefoot-toes used a hinge joint. Three-dimensional printed nylon, thermoplastic polyurethane (TPU) and polylactic acid (PLA), as well as casted silicone rubber were used to re-create foot components. After fabrication, motion capture was performed to measure rotation using fiducial markers. The SLL was then loaded under both static and cyclic loads representing a 100 kg person walking for 500,000 cycles.

Results

Most joints were within 5° of target angles. The SLL survived static loads representing 1.5 times body weight for both static and cyclical loading.

Conclusions

This SLL moved as designed and survived testing loads, warranting further investigation towards enabling essential mechanical testing for AFO currently on the market, and helping to guide device prescription.

Is There a Difference Between the Joint Ultrasounds of Healthy Women and Men? A Study With Small, Medium, and Large Joints

To compare joint ultrasound measurements between the sexes in healthy volunteers. A cross-sectional study compared the joint ultrasound measurements between the sexes in healthy volunteers. Quantitative (synovial hypertrophy and perpendicular measurement in the largest synovial recess) and semiquantitative (synovial hypertrophy, power Doppler, and bone erosion; score 0-3) ultrasound measurements were performed. Forty-six articular recesses were evaluated and compared between group 1 (100 females) and group 2 (60 males) who were matched by age and BMI. For the quantitative measurements, 7360 recesses were studied. For the semiquantitative measurements, 22,720 recesses were evaluated. Higher values (p < .05) were found in females for the quantitative measurements of synovial hypertrophy for the following: radiocarpal, distal radioulnar and ulnocarpal, second/third dorsal and second/third palmar interphalangeal, second palmar metacarpophalangeal, glenohumeral, hip, talocrural, talonavicular, and talocalcaneal recesses; the highest difference was found for the hip (6.21 ± 1.35 vs. 4.81 ± 2.40) and distal radioulnar (1.46 ± 0.40 vs. 1.07 ± 0.70) recesses. For the semiquantitative measurements, significant differences were found. For synovial hypertrophy, higher measurements for females in the second/third palmar metacarpophalangeal, second palmar proximal interphalangeal, hip, tibiotalar, talonavicular, talocalcaneal, and second metatarsophalangeal recesses (highest difference for second palmar metacarpophalangeal [44 (22.0%) vs. 5 (4.2%)]). For power Doppler, there were higher values for females in the talonavicular recesses and higher values for males in the first/second/fifth metatarsophalangeal recesses (highest difference for fifth [9 (7.5%) vs. 2 (1.0%)]). For bone erosion, there were higher measurements for females in the radiocarpal recesses (10 [5.0%] vs. 0 [0.0%]) and higher values for males in the talonavicular recesses (4 [3.3%] vs. 0 [0.0%]). Higher quantitative and semiquantitative ultrasound measurements of synovial hypertrophy were typically found in females.

Normative Reference Values for Trunk Range of Motion and Isometric Muscle Strength in Asymptomatic Young Indian Adults

PURPOSE

To determine normative reference values for trunk range of motion (ROM) and isometric strength (TIS) in asymptomatic young, Indian adults.

METHODS

Age, gender, body mass index, lifestyle, and dynamometer-based device measurements of trunk ROM and TIS in extension (EXT), flexion (FLX), and rotation (ROT) were recorded and analysed in 80 asymptomatic subjects between 20 and 40 years of age. Correlation analysis was performed to determine factors influencing EXT and FLX ROM and TIS.

RESULTS

The normative reference values for mean trunk EXT, FLX, right ROT, and left ROT ROM were 23° (95th percentile 31.9°), 40.2°(95th percentile 51.5°), 36.8°(95th percentile 57.7°), and 35.4° (95th percentile 55.7°), respectively; and for mean EXT, FLX, right ROT, and left ROT TIS were 118.1 Nm (95th percentile 278.8 Nm), 63.8 Nm (95th percentile 159.4 Nm), 39.9 Nm (95th percentile 113.6 Nm), and 42.8 Nm (95th percentile 108.9 Nm), respectively. The mean EXT (p = 0.0002), right (p = 0.02), and left ROT ROM (p = 0.01), and the mean EXT, FLX, and ROT TIS (p < 0.0001) were significantly greater in males compared to females. The FLX, EXT, and ROT TIS showed significant strong correlation with EXT and FLX TIS. Mean TIS values in Indian subjects were lower when compared to subjects from other countries.

CONCLUSION

This study established normative reference values for trunk ROM and TIS in asymptomatic young Indian adults. These reference values can be helpful to diagnose trunk ROM and TIS deficits, identify subjects at risk for LBP and disability, and individualise rehabilitation treatment in them.

A Reference Range of Dart-Thrower's Motion at the Wrist in a Healthy Adult Population

PURPOSE

Dart-thrower's motion (DTM) is a functional wrist movement from maximum radial extension to maximum ulnar flexion. This study defines a reference range of DTM in a healthy population.

METHODS

Goniometric measurements were collected from both wrists of 200 healthy volunteers. Mean age was 21.1 years (range, 18-25 years), 126 volunteers (63%) were female, and 177 (89%) were right-handed. Volunteers also reported perceived difficulty of performing DTM.

RESULTS

For male subjects, the mean arc of motion was 126° (range, 83°-166°) for dominant and 114° (range, 62°-148°) for nondominant wrists. For female subjects, the mean values were 129° (range, 79°-170°) and 126° (range, 70°-167°), respectively. On multiple regression analysis, female subjects had a significantly increased range of dominant and nondominant arc of motion compared with males. Older subjects had significantly increased dominant but reduced nondominant arc of motion. High inter- and intrarater reliability was observed for goniometric measurement of DTM (intraclass correlation coefficients, 0.93-0.98).

CONCLUSIONS

This study quantified a reference range of DTM in normal individuals.

CLINICAL RELEVANCE

This study provides a reference range for DTM in a young adult population, which may aid clinical comparison of measurements of wrist movement and evaluation of conditions and treatments that impact DTM.

Human Lower Limb Joint Biomechanics in Daily Life Activities: A Literature Based Requirement Analysis for Anthropomorphic Robot Design

Daily human activity is characterized by a broad variety of movement tasks. This work summarizes the sagittal hip, knee, and ankle joint biomechanics for a broad range of daily movements, based on previously published literature, to identify requirements for robotic design. Maximum joint power, moment, angular velocity, and angular acceleration, as well as the movement-related range of motion and the mean absolute power were extracted, compared, and analyzed for essential and sportive movement tasks. We found that the full human range of motion is required to mimic human like performance and versatility. In general, sportive movements were found to exhibit the highest joint requirements in angular velocity, angular acceleration, moment, power, and mean absolute power. However, at the hip, essential movements, such as recovery, had comparable or even higher requirements. Further, we found that the moment and power demands were generally higher in stance, while the angular velocity and angular acceleration were mostly higher or equal in swing compared to stance for locomotion tasks. The extracted requirements provide a novel comprehensive overview that can help with the dimensioning of actuators enabling tailored assistance or rehabilitation for wearable lower limb robots, and to achieve essential, sportive or augmented performances that exceed natural human capabilities with humanoid robots.

Flexibility in Spanish Elite Inline Hockey Players: Profile, Sex, Tightness and Asymmetry

Limited ranges of motion (ROM) have been considered as a relevant risk factor for team sports injuries. The main purposes of the current study were to describe the lower extremity ROM profile, muscular tightness and asymmetries in elite inline hockey players and to examine sex-related differences. Twenty professional inline hockey players from 2 Spanish National Teams (male and female) were measured of passive hip extension [HE], hip adduction with hip flexed 90° [HAD-HF], hip flexion with the knee flexed [HF-KF] and extended [HF-KE], hip abduction with the hip neutral [HAB] and hip flexed 90° [HAB-HF], hip external [HER] and internal [HIR] rotation, knee flexion [KF], ankle dorsiflexion with the knee flexed [ADF-KF] and extended [ADF-KE] ROMs of the dominant and non-dominant leg ROMs were taken. A paired t-test was carried out to assess asymmetries. ROM values were classified as “normal versus tightness”, and “normal versus asymmetry” according to the proposed reference values. The effect size for each variable was analyzed. Male team exhibited asymmetry in HF-KF (133.2° dominant vs. 129.8° non-dominant; p = 0.042; d = 0.7243 [moderate effect sizes]) and female team in ADF-KF (38.8° dominant vs. 41.0 non-dominant; p = 0.001; d = 0.6 [moderate effect sizes]) and HAB ROM (41.2° dominant vs. 38.8 non-dominant; p = 0.005; d = 1.1767 [moderate effect sizes]). Male players reported asymmetry in HAD-HF (n = 5), HER (n = 4) and HE (n = 3), whereas female players presented asymmetries in HER (n = 4), HE (n = 3) and KF (n = 2). Overall, 20–100% of all participants showed limited KF, HF_KE, HIR, HE, ADF_KF, HAD-HF, HF-KF, ADF_KE, HTR and HER ROM. The results of this study reinforce the requirement of prescribing exercises aimed at improving hip, knee and ankle ROM within everyday inline hockey practices. In addition, as some asymmetries were found, unilateral flexibility training should be considered where appropriate.

Monitoring Methods of Human Body Joints: State-of-the-Art and Research Challenges

The world's population is aging: the expansion of the older adult population with multiple physical and health issues is now a huge socio-economic concern worldwide. Among these issues, the loss of mobility among older adults due to musculoskeletal disorders is especially serious as it has severe social, mental and physical consequences. Human body joint monitoring and early diagnosis of these disorders will be a strong and effective solution to this problem. A smart joint monitoring system can identify and record important musculoskeletal-related parameters. Such devices can be utilized for continuous monitoring of joint movements during the normal daily activities of older adults and the healing process of joints (hips, knees or ankles) during the post-surgery period. A viable monitoring system can be developed by combining miniaturized, durable, low-cost and compact sensors with the advanced communication technologies and data processing techniques. In this study, we have presented and compared different joint monitoring methods and sensing technologies recently reported. A discussion on sensors' data processing, interpretation, and analysis techniques is also presented. Finally, current research focus, as well as future prospects and development challenges in joint monitoring systems are discussed.

Magnitude of physiological curvatures of the spine and the incidence of contractures of selected muscle groups in students

Study aim: The aim of this study was to evaluate the incidence of contractures of selected muscle groups with respect to the magnitude of the physiological curvatures of the spine in young men with above-average levels of physical activity.

Material and methods: The study included 96 students at the University of Physical Education in Warsaw aged between 20 and 22 years (21.2 ± 1.05). Ninety-five percent of the students participated in sports training activities. The study was conducted between January and February 2016. The selected traits of the body posture were evaluated with an inclinometer, which was used to measure the inclination angles of sections of the spine relative to the vertical. The ranges of motion in the shoulder complex and the pelvic complex were measured with a goniometer. Values of 175º (for the shoulder complex) and 174° (for the hip joint) were assumed to indicate a decreased range of motion.

Results: The analysis of the individual results concerning mobility disorders in the shoulder complex and the pelvic complex revealed significant abnormalities in the researched group of students. About 90% of the study participants showed contrac­tures of selected muscle groups within the shoulder girdle, primarily in the right upper limb. Similar results were obtained for the incidence of contractures in the flexors of the hip joint. Flexion contractures in the hip joint were observed in around 84% of the participants, primarily in the left lower limb. The correlations between the inclination angles of the sections of the spine relative to the vertical and the ranges of motion in the shoulder complex and the pelvic complex, established using Pearson correlation coefficients, were ambiguous. The angles γ, β1 and α were inversely proportional to the range of raising motions of the upper limbs through flexion, where the correlation coefficients of all angles were statistically significant. Similar tendencies were observed for the correlations between the angles β2, β1 and α and the range of the extension movements at the hip joint, although the correlation coefficients were statistically significant only in the case of the angle β1.

Conclusions: Ranges of movement in the shoulder complex and pelvic complex have an influence on magnitude of physiologi­cal curvatures of the spine and the functioning of body posture.