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Abstract It has been found that fractal-like patterns are present in the temporal structure of the variability of healthy biological rhythms, while pathology and disease lead to their deterioration. Interestingly, it has recently been suggested that these patterns in biological rhythms are related with each other, reflecting overall health or lack of it, due to their interaction. However, the underlying neurophysiological mechanisms responsible for such dependency remain unknown. In addition, this relationship between different elements needs to be first verified before we even pursue understanding their interaction. This study aimed to investigate the relationship between two elements of the neuromuscular system, gait and muscle activity variability patterns in older adults. Twenty-one older adults walked at their preferred walking speed on a treadmill. Inter-stride intervals were obtained through an accelerometer placed on the lateral malleoli to assess the temporal structure of variability of stride-to-stride fluctuations. Inter muscle peak intervals were obtained through the electromyographic signal of the gastrocnemius to assess the temporal structure of the variability of the simultaneous muscle activity. The temporal structure of variability from both signals was evaluated through the detrended fluctuation analysis, while their magnitude of variability was evaluated using the coefficient of variation. The Pearson’s Correlation coefficient was used to identify the relationship between the two dependent variables. A significant strong positive correlation was found between the temporal structure of gait and muscle activity patterns. This result suggests that there is an interdependency between biological rhythms that compose the human neuromuscular system.

Cervical pain has been linked to increased motor unit activity, potentially associated with the initiation and progression of chronic neck pain. Therefore, this study aimed to compare the time-course changes in cervical superficial muscle activation patterns among dental students with and without neck pain throughout their initial semester of clinical training. We used an online Nordic Musculoskeletal Questionnaire for group allocation between neck pain (NP) (n = 21) and control group (CG) (n = 23). Surface electromyography (sEMG) of the sternocleidomastoid and upper bilateral trapezius was recorded before starting their clinical practice and after their first semester while performing a cranio-cervical flexion test (CCFT) in five increasing levels between 22 mmHg and 30 mmHg. After the first semester, both the CG (p < 0.001) and NP (p = 0.038) groups showed decreased sternocleidomastoid activation. The NP group exhibited a concomitant increase in upper trapezius coactivation (p < 0.001), whereas the muscle activation pattern in asymptomatic students remained unchanged (p = 0.980). During the first semester of clinical training, dental students exhibited decreased superficial flexor activity, but those with neck pain had increased co-contraction of the upper trapezius, likely to stabilize the painful segment. This altered activation pattern could be associated with further dysfunction and symptoms, potentially contributing to chronicity.

Abstract Background Falling and gait difficulties in people with Parkinson’s disease (PD) are associated with impaired reactive postural adjustments and impairments in attentional resources. Combined intensive balance motor and cognitive exercise can be beneficial. However, uncertainties persist regarding the true effects and safety when applying such training. Using trampoline beds may be a favorable safe environment for a highly intensive, cognitive, and balancing training approach. The primary goal of this randomized controlled trial is to assess the effects of an intensive cognitive-motor training program in a safe trampoline environment in addition to usual care on balance impairment, gait, physical capacity, fear of falling, falls frequency and severity, cognition, and clinical impairments in people with mild or moderate PD. Methods Sixty participants diagnosed with idiopathic PD, in stage 2–4 Hoehn and Yahr, with a clinical history of gait deficits and a fall history (at least one fall in the last 6 months) will be recruited and randomly allocated to an intervention group receiving cognitive-motor trampoline training or a control group undergoing their usual care. The intervention will consist of 8-week individual training sessions (1-h training, 3 days per week) led by specialized physiotherapists that will provide progressive, challenging training, and guarantee safety. Assessment will be conducted prior to and immediately after the 8-week intervention and at 3 months follow-up after participating in the study. Primary outcome measures will be balance performance (assessed using the Mini-BEST Test and nonlinear analysis) and change in gait parameters (Motor and Cognitive Timed-Up-Go and nonlinear analysis). Secondary outcomes will be change in clinical improvement (Movement Disorder Society Unified Parkinson’s Disease Rating Scale), falls (falls weekly registry), fear of falling (assessed using the Falls Efficacy Scale), physical capacity (6-min walk test), and cognition (Montreal Cognitive Assessment). Discussion This study will provide new evidence on the benefits of intensive cognitive-motor balance training on a trampoline for people living with PD. Better guidance on how professionals can apply safer dual-task balance and gait training in rehabilitation is needed. Trial registration ISRCTN Registry ISRCTN13160409 . Retrospectively registered on February 23, 2022

We investigated the effect of different sampling frequencies, input parameters and observation times for sample entropy (SaEn) calculated on torque data recorded from a submaximal isometric contraction. Forty-six participants performed sustained isometric knee flexion at 20% of their maximal contraction level and torque data was sampled at 1,000 Hz for 180 s. Power spectral analysis was used to determine the appropriate sampling frequency. The time series were downsampled to 750, 500, 250, 100, 50, and 25 Hz to investigate the effect of different sampling frequency. Relative parameter consistency was investigated using combinations of vector lengths of two and three and tolerance limits of 0.1, 0.15, 0.2, 0.25, 0.3, 0.35, and 0.4, and data lengths between 500 and 18,000 data points. The effect of different observations times was evaluated using Bland-Altman plot for observations times between 5 and 90 s. SaEn increased at sampling frequencies below 100 Hz and was unaltered above 250 Hz. In agreement with the power spectral analysis, this advocates for a sampling frequency between 100 and 250 Hz. Relative consistency was observed across the tested parameters and at least 30 s of observation time was required for a valid calculation of SaEn from torque data.

The present study aimed to investigate the effects of a continuous visual feedback and the isometric contraction nature on the complexity and variability of force. Thirteen healthy and young male adults performed three MVCs followed by three submaximal isometric force tasks at a target force of 40% of their MVC for 30 s, as follows: (i) push isometric task with visual feedback (Pvisual); (ii) hold isometric task with visual feedback (Hvisual); (iii) hold isometric task without visual feedback (Hnon-visual). Force complexity was evaluated through sample entropy (SampEn) of the force output. Force variability was analyzed through the coefficient of variation (CV). Results showed that differences were task-related, with Pvisual showing higher complexity (i.e., higher SampEn) and decreased variability (i.e., lower CV) when compared with the remaining tasks. Additionally, no significant differences were found between the two hold isometric force tasks (i.e., no influence of visual feedback). Our results are promising as we showed these two isometric tasks to induce different motor control strategies. Furthermore, we demonstrated that visual feedback’s influence is also dependent on the type of isometric task. These findings should motivate researchers and physiologists to shift training paradigms and incorporate different force control evaluation tasks.

Introduction: Although several approaches have been proposed to mitigate post-match fatigue, few studies have been conducted in team sports to understand the types of recovery methods and the underlying reasons for the choices of medical and technical staff. This study aimed to develop a valid and reliable online questionnaire to assess the recovery practices implemented by football clubs within 72 h post-match.Methods: Two research members developed the original questionnaire proposal, and two experts in sports science and sports medicine confirmed the content and face validities. Then, 20 football coaches (age: 39.4 ± 6.8 years) with a minimum of 5 years of experience in professional football (9.1 ± 4.9 years) and with an academic background participated in determining the ecological validity and reliability of the questionnaire. The acceptability and relevance of the questionnaire were determined using descriptive statistics.Results: After confirming the content and face validities, one questionnaire section with two questions was excluded due to lack of relevance, seven open-ended questions were removed due to the adherence of small participants (i.e., 45.4%), and one section was divided into three to facilitate clearness in reading. The remaining sections were considered acceptable and relevant (>94.1%). About 91.8% of nominal and ordinal items derived from the questionnaire questions showed good to very good reliability outcomes (average k classification: 0.73 ± 0.13; min–max: 0.22–1.00, p < 0.05; average wk classification: 0.82 ± 0.15; min–max: 0.22–1.00, p < 0.05).Conclusions: This study provided a novel, valid, reliable, and easy-to-use tool to examine the post-match recovery practices in professional football contexts.

Abstract Background Modeling physiological signals is a complex task both for understanding and synthesize biomedical signals. We propose a deep neural network model that learns and synthesizes biosignals, validated by the morphological equivalence of the original ones. This research could lead the creation of novel algorithms for signal reconstruction in heavily noisy data and source detection in biomedical engineering field. Method The present work explores the gated recurrent units (GRU) employed in the training of respiration (RESP), electromyograms (EMG) and electrocardiograms (ECG). Each signal is pre-processed, segmented and quantized in a specific number of classes, corresponding to the amplitude of each sample and fed to the model, which is composed by an embedded matrix, three GRU blocks and a softmax function. This network is trained by adjusting its internal parameters, acquiring the representation of the abstract notion of the next value based on the previous ones. The simulated signal was generated by forecasting a random value and re-feeding itself. Results and conclusions The resulting generated signals are similar with the morphological expression of the originals. During the learning process, after a set of iterations, the model starts to grasp the basic morphological characteristics of the signal and later their cyclic characteristics. After training, these models’ prediction are closer to the signals that trained them, specially the RESP and ECG. This synthesis mechanism has shown relevant results that inspire the use to characterize signals from other physiological sources.

Muscle coordination in human movement has been assessed through muscle synergy analysis. In sports science, this procedure has been mainly applied to the comparison between highly trained and unexperienced participants. However, the lack of knowledge regarding strength training exercises led us to study the differences in neural strategies to perform the power clean between weightlifters and untrained individuals. Synergies were extracted from electromyograms of 16 muscles of ten unexperienced participants and seven weightlifters. To evaluate differences, we determined the pairwise correlations for the synergy components and electromyographic profiles. While the shape of activation patterns presented strong correlations across participants of each group, the weightings of each muscle were more variable. The three extracted synergies were shifted in time with the unexperienced group anticipating synergy #1 (−2.46 ± 18.7%; p < 0.001) and #2 (−4.60 ± 5.71%; p < 0.001) and delaying synergy #3 (1.86 ± 17.39%; p = 0.01). Moreover, muscle vectors presented more inter-group variability, changing the composition of synergy #1 and #3. These results may indicate an adaptation in intermuscular coordination with training, and athletes in an initial phase of training should attempt to delay the hip extension (synergy #1), as well as the upper-limb flexion (synergy #2).

This study sought to investigate whether the stiffness of the biceps femoris long head differs between proximal and distal regions during isometric knee flexion at different contraction intensities and muscle lengths. Twelve healthy individuals performed knee flexion isometric contractions at 20% and 60% of maximum voluntary isometric contraction, with the knee flexed at 15 and 45 degrees. Muscle stiffness assessment was performed using ultrasound-based shear wave elastography. Proximal and distal regions of the biceps femoris long head were assessed. Biceps femoris long head muscle showed a greater stiffness (i) in the distal region, (ii) at higher contraction intensity, and (iii) at longer muscle length. The proximal-to-distal stiffness ratio was significantly lower than 1 (i.e., heterogenous) at lower contraction intensity regardless of the muscle length. However, this was not observed at higher contraction intensity. This study is the first to show heterogeneity in the active stiffness of the biceps femoris long head. Given the greater incidence of injury at the proximal region of biceps femoris long head, this study opens new directions for future research. Additionally, the present study results indicate that studies assessing muscle stiffness at one single muscle region should be interpreted with caution.

Muscle synergy extraction has been utilized to investigate muscle coordination in human movement, namely in sports. The reliability of the method has been proposed, although it has not been assessed previously during a complex sportive task. Therefore, the aim of the study was to evaluate intra- and inter-day reliability of a strength training complex task, the power clean, assessing participants’ variability in the task across sets and days. Twelve unexperienced participants performed four sets of power cleans in two test days after strength tests, and muscle synergies were extracted from electromyography (EMG) data of 16 muscles. Three muscle synergies accounted for almost 90% of variance accounted for (VAF) across sets and days. Intra-day VAF, muscle synergy vectors, synergy activation coefficients and individual EMG profiles showed high similarity values. Inter-day muscle synergy vectors had moderate similarity, while the variables regarding temporal activation were still strongly related. The present findings revealed that the muscle synergies extracted during the power clean remained stable across sets and days in unexperienced participants. Thus, the mathematical procedure for the extraction of muscle synergies through nonnegative matrix factorization (NMF) may be considered a reliable method to study muscle coordination adaptations from muscle strength programs.

Walking synchronized to external cues is a common practice in clinical settings. Several research studies showed that this popular gait rehabilitation tool alters gait variability. There is also recent evidence which suggests that alterations in the temporal structure of the external cues could restore gait variability at healthy levels. It is unknown, however, if such alterations produce similar effects if the cueing modalities used are different; visual or auditory. The modality could affect gait variability differentially, since there is evidence that auditory cues mostly act in the temporal domain of gait, while visual cues act in the spatial domain of gait. This study investigated how synchronizing steps with visual and auditory cues that are presented with different temporal structures could affect gait variability during treadmill walking. Three different temporal structured stimuli were used, invariant, fractal and random, in both modalities. Stride times, length and speed were determined, and their fractal scaling (an indicator of complexity) and coefficient of variation (CV) were calculated. No differences were observed in the CV, regardless of the cueing modality and the temporal structure of the stimuli. In terms of the stride time’s fractal scaling, we observed that the fractal stimulus induced higher values compared to random and invariant stimuli. The same was also observed in stride length, but only for the visual cueing modality. No differences were observed for stride speed. The selection of the cueing modality seems to be an important feature of gait rehabilitation. Visual cues are possibly a better choice due to the dependency on vision during walking. This is particularly evident during treadmill walking, a common practice in a clinical setting. Because of the treadmill effect on the temporal domain of gait, the use of auditory cues can be minimal, compared to visual cues.

Blood flow restrictive (BFR) exercise elicits a localized hypoxic environment compatible with greater metabolic stress. We intended to compare the acute changes in muscle microvascular oxygenation following low-intensity knee extension exercise, combined with different levels of BFR. Thirteen active young men (age: 23.8 ± 5.4 years) were tested for unilateral knee extension exercise (30 + 15 + 15 + 15 reps at 20% one repetition maximum) on four different conditions: no-BFR (NOBFR), 40, 60, and 80% of arterial occlusion pressure (AOP). Deoxyhemoglobin+myoglobin concentration Deoxy[Hb+Mb], total hemoglobin [T(H+Mb)] and tissue oxygen saturation [TOI] were measured on the vastus lateralis muscle using near-infrared spectroscopy (NIMO, Nirox srl, Brescia, Italy). The magnitude of change in Deoxy[Hb+Mb]during exercise was similar between 60 and 80% AOP. Overall, compared to that seen during 60 and 80% AOP, NOBFR as well as 40% AOP resulted in a lower magnitude of change in Deoxy[Hb+Mb] (p < 0.05). While the oxygen extraction decreased during each inter-set resting interval in NOBFR and 40% AOP, this was not the case for 60 or 80% AOP. Additionally, TOI values obtained during recovery from each set of exercise were similarly affected by all conditions. Finally, our data also show that, when performed at higher restrictive values (60 and 80%), BFR exercise increases total Deoxy[Hb+Mb] extraction (p < 0.05). Taken together, we provide evidence that BFR is effective for increasing deoxygenation and reducing tissue oxygenation during low-intensity exercise. We also showed that when using low loads, a relative pressure above 40% of the AOP at rest is required to elicit changes in microvascular oxygenation compared with the same exercise with unrestricted conditions.

This study analyzes the immediate effects of wearing a Therasuit on sagittal plane lower limb angular displacements during gait in children with unilateral spastic cerebral palsy (US-CP). Seven participants (median age = 7.00 years; ranging from 5.83 to 9.00 years) with US-CP, levels I and II of the Gross Motor Function Classification System, were assessed with kinematic gait analysis in three different conditions: (A) Baseline; (B) Therasuit without elastics and (C) Therasuit with elastics. Significant improvements were observed at the hip joint of both lower limbs during most of the gait cycle in participants wearing a Therasuit, including a decrease in the flexion pattern at the initial contact and swing phase in both lower limbs, and an increase in the extension pattern in the paretic lower limb during the stance phase. At the knee joint in the paretic lower limb, significant differences were found between the baseline and Therasuit with elastics conditions on the knee angle at initial contact, and between baseline and both Therasuit conditions on the flexion angle at swing phase. However, the inter-individual variability in kinematic patterns at the knee joint was high. At the ankle joint, decreased plantar flexion at initial contact and increased dorsiflexion during stance and swing phases were observed at the Therasuit with elastics condition, helping to correct the equinus-foot in the paretic lower limb during the whole gait cycle. The Z-values showed large effect sizes particularly for most of the angular hip variables in both lower limbs and for the angular ankle variables in the paretic lower limb. The Therasuit seems to have some positive immediate effects on gait kinematics in children with spastic unilateral cerebral palsy by providing a more functional and safer gait pattern. Future investigations with larger samples are recommended to further support these findings.