Effects of body mass index on foot posture alignment and core stability in a healthy adult population

Biomechanical variations in patients with flatfoot deformity: Impact of gender, age, and BMI on foot kinetics and kinematics

Background

Flatfoot is considered by the collapse of the foot arch, altered biomechanics and impacting functional abilities. The biomechanical gait alteration of foot kinematics and kinetics in individuals with flatfoot, based on gender, age and Body mass index (BMI) in each cohort is unclear. This study explores how gender, age, and body mass index (BMI) impact distinct foot biomechanical characteristics, including ankle joint angle (Jc°), Ground force reaction angle (GFR°), Achilles tendon force (T), Ankle joint force (Jc) and vertical ground reaction force (VGRF) during the gait stance phase, in flatfoot versus normal-foot individuals on Indian Population.

Method

A foot pressure test and sagittal plane motion analysis were performed on 142 individuals with normal-foot arches and 102 with flatfoot, stratified by gender, age, and BMI. Calculations of the magnitude and direction of forces in ankle joint equilibrants relied on inverse dynamic analysis, vertical ground force reaction and mapping motion data of the gait stance phases.

Result

In the midstance phase, females with high BMI (HBMI) in the middle and older age group (p = 0.029 and p = 0.014), and males with HBMI in the older age group (p = 0.039) demonstrate significantly higher V G R F . Females and males with HBMI in middle and older age groups, along with males with normal BMI in the older age cohort, show positive and negative ranges of GFR°, indicating gait instability. In the push-off phase, females with HBMI in a middle-aged group exhibit significantly lower T a n d J c (p = 0.023 and p = 0.026) respectively.

Conclusion

The biomechanical issues in individuals with flatfoot, while accounting for the influence of gender, age and BMI, are crucial for tailored interventions and precise solutions to biomechanical issues, thereby enhancing foot function and reducing discomfort.

Effects of Pilates Exercises on Core Stability After Recovery from COVID-19: A Randomized Controlled Trial

Purpose

The primary objective was to investigate the effects of Pilates exercises on CS, and the secondary objective was to assess static trunk balance after recovery from COVID-19.

Patients and Methods

145 recovered COVID-19 university students between the ages of 19 and 25 participated in this single-blinded, randomized controlled trial study. The participants were divided into a Pilates group and a control group, each of which received a home exercise program. Core muscle endurance was measured using the five basic endurance tests and static balance using the Prokin system with open eyes (OE) and closed eyes (CE) at baseline and after three months of treatment.

Results

All measured parameters showed improvement within the groups after treatment. Group comparison revealed a significant increase in the Pilates group in all core endurance tests (P<0.001). The Prokin system results showed improvement in the Pilates group after treatment, while perimeter with OE, CE, and ellipse area with EC decreased (P<0.001), but there was no significant difference in ellipse with OE between the groups.

Conclusion

Pilates exercises positively improved core muscle endurance and trunk balance in people infected with COVID-19, which will be reflected in their quality of movement patterns and quality of life.

Physical therapy management of an athlete with a Kim lesion using physical agents, manual therapy, and therapeutic exercise: a case report

BACKGROUND

Several operative procedures have been described for treating a Kim lesion. However, no physical therapy intervention has been documented as conservative treatment for these cases.

OBJECTIVE

The purpose of this report was to describe a physical therapy management protocol for an athlete with a Kim lesion.

CASE DESCRIPTION

A 22-year-old female volleyball athlete presented to physical therapy with an 8-month history of right shoulder pain when performing the serve and attack sports gestures. Pain was 5/10 on the visual analogue scale (VAS). Pain was localized along the glenohumeral joint, around the long head of the biceps brachii tendon, and at the subscapularis tendon insertion. Shoulder range of motion (ROM) was limited to flexion (150°), abduction (158°), and internal rotation (80°). Kim lesion was confirmed by clinical tests (Kim test and Jerk test) and via magnetic resonance imaging. Shoulder functional outcomes were verified through the University of California Los Angeles (UCLA) shoulder rating scale. Upper extremity sensorimotor control was verified in bimanual support by stabilometry on a baropodometer. Core function was assessed through a plank test and a side plank test. The 8-week course of treatment included manual therapy, physical agents, shoulder and scapular mobilizations, resistance and sensorimotor exercises, core strengthening, and functional exercises.

OUTCOMES

Physical therapy interventions resulted in a decrease in VAS pain (3/10), an increase in shoulder ROM (10.8°) and in UCLA shoulder score (from 22 to 33 points), a reduction in the center of pressure displacement (27-56%), and an increase in plank test (45%) and side plank test (21-29%) performance. The athlete had a full return to sport after the treatment.

CONCLUSION

We concluded that the protocol used for conservative management of Kim lesion resulted in clinical satisfactory physical and functional outcomes for the athlete.

Isokinetic trunk muscle performance in adolescents with different body mass indices

Objective

This study aims to evaluate the isokinetic performance for the peak torque and average power of the spinal flexor and extensor muscles in adolescents aged 12 to 18 years. The study also analyses the differences between the trunk muscle peak torque and average power with body mass index (BMI).

Method

The peak torque and average power of the trunk flexor and extensor muscles were measured in 180 adolescents (aged 12–18 years). The participants were classified into four groups according to BMI. The Biodex isokinetic dynamometer in concentric mode at speeds of 60° and 120°/sec was used for assessment.

Results

One-way multivariate analysis of variance MANOVA results demonstrated a significant difference in trunk muscle peak torque and average power with different BMI (F = 14.692, p = 0.0005). A Pearson's correlation analysis demonstrated a significantly negative correlation between weight and peak torque of trunk flexors and extensors (r = - 0.43, p = 0.0001; r = −0.31, p = 0.007, respectively). Finally, the results showed a negative correlation between weight and average power of trunk flexors and extensors (r = −0.54, p = 0.0001; r = −0.31, p = 0.007).

Conclusion

In this study, overweight and obese adolescents are found to be correlated with decreased trunk muscle torque and power. Thus, therapeutic interventions for overweight and obese adolescents, along with exercise training programmes, may help improve muscle performance including peak torque and power. Finally, these measures may enhance the quality of life of such adolescents.

Changes in the Sensory Weighting Strategies in Balance Control Throughout Maturation in Children

BACKGROUND

 The central nervous system integrates information from different sensory inputs (vestibular, visual, and somatosensory) to maintain balance. However, strategies for weighing sensory information change as maturation occurs.

PURPOSE

 The purpose of this study was to: (1) evaluate postural control development in a large sample of healthy children aged 5 to 17 years old, (2) analyze changes in sensory weighting strategies as maturation occurs, and (3) determine the extent to which anthropometric characteristics (height, weight, body mass index [BMI]) influence postural control.

SAMPLE SIZE

 This study recruited 120 healthy children, equally distributed in gender and number, into four age groups (5-8 years, 9-11 years, 12-14 years, and 15-17 years) and compared them to a control group of 20 healthy adults (aged 20-25 years).

RESEARCH DESIGN

 The sensory organization test (SOT) was used to assess overall balance and the use of specific sensory inputs to maintain postural control. All children underwent the six SOT conditions: (1) eyes open, surround and platform stable, (2) eyes closed, surround and platform stable, (3) eyes open, sway-referenced surround, platform stable, (4) eyes open, sway-referenced platform, (5) eyes closed, sway-referenced platform, and (6) eyes open, sway-referenced surround and platform.

DATA ANALYSIS

 Condition-specific equilibrium scores (ES), composite equilibrium scores (CES), and sensory analysis ratios were analyzed to determine whether the performance was related to age, gender, or specific anthropometric characteristics (height, weight, and BMI).

RESULTS

 Data showed a significant age-associated improvement in ES for all 6 conditions (p < 0.05) and in CES (p = 0.001). For both genders, (1) somatosensory function was adult-like by age 5 to 8 years, (2) visual function peaked around age 12 years, and (3) vestibular function reached maturity by age 15 to 17 years (p < 0.05). A moderate positive correlation (r(140) = 0.684, p = 0.01; two-tailed) between height and CES was found and a weak positive correlation (r(140) = 0.198, p = 0.01) between height and somatosensory ratio was noted. Lower vestibular ratio scores were observed in children who had a higher BMI (p = 0.001).

CONCLUSION

 The efficient use of individual sensory system input to maintain balance does not occur at the same age. Age and gender affect the changes in sensory weighting strategies, while height and BMI influence postural control in children. These factors need to be accounted for in child assessment.

Normative Data for the Sway Balance System

OBJECTIVE

Static balance, postural stability, and reaction time are commonly impaired after a sport-related concussion. The Sway Balance System assesses postural sway (ie, stability) and simple reaction time using the triaxial accelerometer built into iOS mobile devices. The purpose of this study was to provide normative data for children and adolescents and to examine for age and sex differences on the Sway Balance System.

DESIGN

Cross-sectional study.

SETTING

Middle and high schools across the United States.

PARTICIPANTS

Participants were 3763 youth aged 9 to 21 years who completed the Sway Balance System Sports protocol in accordance with the company's recommended methods (ie, 1 acclimation trial and 2-3 baseline tests).

INDEPENDENT VARIABLES

Age and sex.

MAIN OUTCOME MEASURES

Sway Balance score (0-100) and Sway Reaction Time score (0-100).

STATISTICAL ANALYSIS

A multivariate analysis of variance examined the effects of age and sex on balance and reaction time scores.

RESULTS

Sway Balance and Reaction Time scores significantly differed by age [F(10, 7494) = 39.68, P < 0.001, V = 0.10, = 0.05] and sex [F(4, 7494) = 55.29, P < 0.001, V = 0.06, = 0.03]. Post hoc analyses revealed that older groups generally had better scores than younger groups on all balance comparisons (ps < 0.001) and many reaction time comparisons. Girls performed better than boys on balance [F(2, 3747) = 53.79, P < 0.001, = 0.03] and boys had faster reaction times [F(2, 3747) = 37.11, P < 0.001, = 0.02].

CONCLUSIONS

Age and sex are important factors to consider when assessing Balance and Reaction Time scores using the Sway Balance System's Sports protocol in youth. We provide age- and sex-based normative values for the Sway Balance System, which will likely be helpful when using this technology to assess and manage concussions.

Comparison of upper limb kinematics in two activities of daily living with different handling requirements

INTRODUCTION

Recently, kinematic analysis of the drinking task (DRINK) has been recommended to assess the quality of upper limb (UL) movement after stroke, but the accomplishment of this task may become difficult for poststroke patients with hand impairment. Therefore, it is necessary to study ADLs that involve a simpler interaction with a daily life target, such as the turning on a light task (LIGHT). As the knowledge of movement performed by healthy adults becomes essential to assess the quality of movement of poststroke patients, the main goal of this article was to compare the kinematic strategies used by healthy adults in LIGHT with those that are used in DRINK.

METHODS

63 adults, aged 30 to 69 years old, drank water and turned on a light, using both ULs separately, while seated. The movements of both tasks were captured by a 3D motion capture system. End-point and joint kinematics of reaching and returning phases were analysed. A multifactorial analysis of variance with repeated measures was applied to the kinematic metrics, using age, sex, body mass index and dominance as main factors.

RESULTS

Mean and peak velocities, index of curvature, shoulder flexion and elbow extension were lower in LIGHT, which suggests that the real hand trajectory was smaller in this task. In LIGHT, reaching was less smooth and returning was smoother than DRINK. The instant of peak velocity was similar in both tasks. There was a minimal anterior trunk displacement in LIGHT, and a greater anterior trunk displacement in DRINK. Age and sex were the main factors which exerted effect on some of the kinematics, especially in LIGHT.

CONCLUSION

The different target formats and hand contact in DRINK and LIGHT seem to be responsible for differences in velocity profile, efficiency, smoothness, joint angles and trunk displacement. Results suggest that the real hand trajectory was smaller in LIGHT and that interaction with the switch seems to be less demanding than with the glass. Accordingly, LIGHT could be a good option for the assessment of poststroke patients without grasping ability. Age and sex seem to be the main factors to be considered in future studies for a better match between healthy and poststroke adults.

Methodological considerations for kinematic analysis of upper limbs in healthy and poststroke adults. Part I: A systematic review of sampling and motor tasks

BACKGROUND AND PURPOSE

The purpose of this study was to review the methods used to analyze the kinematics of upper limbs (ULs) of healthy and poststroke adults, namely specificities of sampling and motor tasks.

SUMMARY OF REVIEW

A database of articles published in the last decade was compiled using the following search terms combinations: ("upper extremity" OR "upper limb" OR arm) AND (kinematics OR motion OR movement) AND (analysis OR assessment OR measurement). The articles included in this review (1) had the purpose to analyze objectively a three-dimension kinematics of ULs, (2) studied functional movements or activities of daily living (ADL) involving uppers limbs, and (3) studied healthy and/or poststroke adults. Fourteen articles were included (four studied a healthy sample, three analyzed poststroke patients, and seven examined both poststroke and healthy participants).

CONCLUSION

Most of the recommended demographic and stroke information, such as some preexisting conditions to stroke, initial stroke severity, and stroke location, were not collected by all or most of the articles. Time poststroke onset was presented in all articles but showed great variability. Few articles identified anthropometric characteristics and adjusted task environment to them. Most of the samples were composed mainly by males and had a low mean age, which does not represent poststroke population. Most articles analyzed "functional movements", namely simulations of ADL. Implication of key findings: Future research should identify the recommended information to allow an adequate stratification. Acute phase after stroke, real ADL with different complexities, and ipsilesional UL should be studied.