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The first complete upper and lower limbswimming cycle after the underwater segment of start and turns represents the breakout phase in competitive swimming. The aim of the present research was to examine the effect of the breakout movements on the stroking variables and coordinative patterns of competitive swimmers. Thirty-three national-level male swimmers performed 4 x 25 m maximal efforts (one of each stroke in random order) from a push start and were recorded by two sequential cameras in the sagittal plane. The average velocity, stroke length, and stroke frequency; the relative duration (%) of the stroke phases; and the inter-limb discrete relative phases were calculated using direct linear transformation algorithms for the breakout and free-swimming phases. In general terms, swimming velocity during breakout was faster (δ 0.27 ± 0.04 m/s, p < 0.001, ES = 0.33) than free swimming (in all strokes but breaststroke), not because of a faster previous underwater kicking or a modified coordinative swimming pattern, but because of an increase in the stroke rate (δ 4.68 ± 0.79 cycles/min, p < 0.001, ES = 0.36). These results indicate how swimmers manage the changing constraints during breakout from underwater to surface swimming. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate the effect of combined turning and balance training on ground reaction force (GRF) characteristics during walking and turning in older men.Methods: Thirty older men were selected and randomly divided into two equal experimental (EG: age = 65.47 ± 2.50 years; BMI = 24.57 ± 0.68 kg/m2) and control (CG: age = 65.80 ± 2.34 years; BMI = 24.72 ± 0.64 kg/m2) groups. EG participants completed 12 weeks of training. Kinetic data were recorded using the force plate.Results: After the training, there was a significant difference between the EG and CG in the peak of GRF components and related time parameters as well as the required coefficient of friction in all directions. There was a significant decrease and increase in the stance time and loading rate respectively after the training in EG.Conclusions: The results showed improvement in gait and turning performance of older men. Therefore, combined exercises with emphasis on the turning components for older men are recommended. [ABSTRACT FROM AUTHOR]

There are increasing calls for planetary health (which includes sustainable healthcare) to be included in tertiary health professions education. With already busy curricula, particularly in medicine, educators need to find innovative ways of integrating these important concepts without adding to learners' workload. This study investigated whether planetary health concepts could be integrated into a Physiology subject as a stop-gap approach while longitudinal planning for longitudinal curriculum integration was underway. Each week, a planetary health fact (Did you know?) with a corresponding link were embedded at the bottom of a relevant PowerPoint lecture slide to match the topic of the week in a health science and medicine Physiology subject. The embedded facts were a mix of effects on health and the environmental impacts of healthcare activities, such as medical imaging. No other formal planetary health teaching was conducted in the subject. At the end of the semester, 44% of 100 students completed a survey regarding their perceptions of the planetary health inclusions. Participants reported an appreciation of the facts, found them helpful for their overall learning, and were interested in learning about healthcare's large environmental footprint. Seventy-one percent were able to provide a reasonable definition of planetary health. Half of the participants reported their actions, behaviours, and thoughts had changed as a result of the planetary health inclusions. This study provides a relatively simple approach for individual educators to include planetary health concepts into existing health professions subjects until more longitudinal curriculum revisions can be undertaken. Based on our findings, we would, however, recommend providing students with a brief introduction in terms of why planetary health has been included either at the start of the first lecture or as a 10-min video. [ABSTRACT FROM AUTHOR]

Ultra-short race-pace training (USRPT) is a high-intensity training modality used in swimming for the development of specific race-technique. However, there is little information about the fatigue associated to this modality. In a crossover design, acute responses of two volume-equated sessions (1000-m) were compared on 14 national swimmers: i) USRPT: 20×50-m; ii) RPT: 10×100-m. Both protocols followed an equivalent work-recovery ratio (1:1) based on individual 200-m race-pace. The swimming times and the arm-strokes count were monitored on each set and compared by mixed-models. Blood lactate [La-] and countermovement jump-height (CMJ) were compared within and between conditions 2 and 5 min after the protocols. The last bouts in RPT were 1.5–3% slower than the target pace, entailing an arm-strokes increase of ~0.22 for every second increase in swimming time. USRPT produced lower [La-] ([Mean ± standard deviation], 2 min: 8.2±2.4 [p = 0.021]; 5 min: 6.9±2.8 mM/L [p = 0.008]), than RPT (2 min: 10.9±2.3; 5 min: 9.9±2.4 mM/L). CMJ was lowered at min 2 after RPT (-11.09%) and USRPT (-5.89%), but returned to baseline in USRPT at min 5 of recovery (4.07%). In conclusion, lower fatigue and better recovery were achieved during USRPT compared to traditional high-volume set. [ABSTRACT FROM AUTHOR]

Research on gesture input modalities, including touchscreen and mid-air interactions, is getting more widespread. A few studies have compared these two input modalities according to subjective methods. However, there is no empirical research on their differences in physiological measures. The purpose of this study was to quantify the differences between touchscreen and mid-air interactions when performing swipe gestures in four orthogonal directions on a tablet combining the indices of electromyography (EMG), electrogoniometry, user performance, and subjective assessment. Our results indicated that mid-air interaction obtained significantly lower muscular loads in the upper limb, smaller wrist joint excursions, shorter task completion time, and better subjective ratings than touchscreen interaction when users with elbow support performed swipe gestures on a tablet. We also found that performing swipe gestures in the vertical direction tended to possess higher muscular loads than in the horizontal direction during touchscreen interaction. Besides, we revealed that swipe right had the largest radial/ulnar deviation, and swipe down had the largest flexion/extension excursion. Furthermore, swipe up brought the worst subjective ratings among the four gesture types. These findings could provide a scientific basis for guiding the appropriate selection and use of the two input modalities in the future HCI field. [ABSTRACT FROM AUTHOR]

Wheelchair tennis (WT) propulsion is uniquely characterized by the requirement for racket holding coupled with effective hand-rim contact. Thus, investigations involving strategies to enhance chair mobility skills are merited. The aim was to examine the effects of organized practice on WT match play responses and the impact of racket holding during practice. Following physiological profiling involving graded and peak exercise testing, 16 able-bodied (AB) participants performed bouts of WT match play interspersed with practice involving wheelchair mobility drills completed with (R) or without (NR) a tennis racket. A data logger recorded distance and speed. Self-efficacy was reported. Significant main effects for match revealed higher post-practice overall and forwards distances (p < 0.05), peak (p < 0.005) and average (p < 0.05) speeds and self-efficacy (SE) (p = 0.001) were attained. During practice, lower distances and speeds were achieved with R, with a lower physiological cost than NR. Practice increases court movement and SE with no associated increases in physiological cost. Changes represent enhanced court mobility. Differences between practice characteristics provide options for skill development and optimization of health outcomes. Wheelchair tennis participation is likely to confer positive health effects in those with a disability or physical impairment. As chair propulsion combined with racket holding represents a complex skill challenge, novices may find the sport challenging to play. Tennis-specific mobility drills improve confidence and chair propulsion skill with likely crossover into tennis match play competence and ability. [ABSTRACT FROM AUTHOR]

This project examined the interrelationships between power production and upper body kinematics during a series of medicine ball push-press (MBP-P) throws. Twenty-five regular weight trainers (body mass = 86 ± 10 kg) performed a series of ballistic vertical MBP-P throws at loads representing 5% and 10% of their assessed 5RM bench press. Throws were performed lying supine on a force platform (1 kHz) with upper body kinematics assessed using standard infra-red motion capture techniques (0.5 kHz). Gross measures of performance and power production such as peak vertical ball velocity (Velpeak), peak force (Fpeak) and power (Ppeak) were recorded during the propulsive phase of the movement. Comparative analyses indicated that despite significant reductions in Velpeak from the 5% to 10% loads (P < 0.001), Fpeak remained largely unchanged (P = 0.167). Analysis of inter-trial variability showed that the gross measures of performance and power were relatively stable (Coefficient of Variation [CV%] <13%), while most upper limb segmental kinematics varied considerably between trials (CV% up to 70%). This project highlights the complexity of the relationships between power production and upper body kinematics during light load ballistic MBP-P throwing. Additionally, it shows how trained athletes can achieve similar outcomes during ballistic movements using a variety of movement strategies. [ABSTRACT FROM AUTHOR]

Purpose: Neck muscle vibration immediately improves cervical joint position sense and dynamic postural control but increases pressure pain thresholds in neck pain patients. The aim of this study was to explore longer lasting effects of neck muscle vibration on sensorimotor control and pressure pain threshold. Materials and methods: Five series of neck muscle vibration were delivered to 15 neck pain patients and 11 healthy controls in this case control study. Outcomes were cervical joint position sense, arm-matching acuity, and pressure pain threshold at the zygapophyseal joint of C2/C3, the angulus superior, and the tibialis anterior muscle. Results: Cervical joint position sense acuity improved in neck pain patients and declined in healthy controls even after 24 h. Arm-matching acuity improved in patients assessed after 15 min, as was pressure pain threshold at the angulus superior in neck pain patients. In contrast, changes in the pressure pain threshold at the tibia were only observable immediately after vibration. Conclusion: Neck muscle vibration induced short-lasting general as well as longer-lasting specific effects on analgesia and sensorimotor function. Based on our observations, future studies should investigate potential benefits of neck muscle vibration as adjunct to physical therapy in order to improve cervical sensorimotor function. A single session of neck muscle vibration improves cervical joint position sense in neck patients for up to 24 h. Neck muscle vibration improves arm-matching acuity in neck pain patients. Neck muscle vibration increases pressure pain thresholds at the stimulated place but decrease pressure pain thresholds more distally. Neck muscle vibration shows distinct effects in neck pain patients and healthy control. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to test the concurrent validity of using hydraulic dynamometers in comparison to the gold standard isokinetic dynamometers in measuring wrist and forearm strength. Materials and methods: Healthy adults between the ages of 18–65 participated, including 24 participants, 8 men and 16 women. The examiner used a handheld dynamometer, forearm/wrist dynamometer, and an isokinetic dynamometer to measure force/torque production in forearm rotation and wrist flexion/extension using a standardized protocol of two handle types for each motion. Sequence of testing was randomized. The data were analyzed using Pearson correlation coefficients and paired t-tests. Results: When matched for handle type, three of the four correlations between the strength measurements taken with the different dynamometers were moderate to high with Pearson product moment coefficients ranging from 0.72 to 0.96; the screwdriver handle demonstrated less than acceptable correlation (r = 0.45, 0.67 for wrist flexion and extension, respectively). There were significant differences in most of the force/torque values obtained by different handle types for wrist and forearm motions. Discussion and conclusions: Overall, the dynamometers demonstrated acceptable correlations supporting concurrent validity for measuring forearm and wrist strength, except with the screwdriver handle. However, different tools, positions, and handle interfaces provided different absolute values, therefore the tools cannot be used interchangeably. It is recommended that repeated measurements to monitor patient progress are taken with the same tool and handle type. [ABSTRACT FROM AUTHOR]

Primary Objective: To investigated the long-term effect of childhood Traumatic Brain Injury (TBI) on adulthood Relationship Quality (RQ), examining injury severity, age of injury, and markers of prefrontal cortex (PFC) functioning, apathy, disinhibition, and executive dysfunction. Research Design: Longitudinal, between-subjects, cross-sectional design using retrospective and current data. Methods and Procedures: Participants (N = 169; 61 mild TBI (mTBI); 65 moderate to severe TBI (MSTBI); 43 orthopaedic injury (OI); Injury age: 1-17 years; Testing age: 18-31 years) completed a structured interview regarding their injury, demographic characteristics and RQ, the National Adults Reading Test, and Frontal Systems Behaviour Scale. Data were analyzed using IBM SPSS 25. Main Outcomes and Results: Adults who had experienced childhood TBI had significantly poorer RQ than adults who had experienced childhood OI. Severity of TBI did not impact adulthood RQ. Earlier age of injury predicted reduced adulthood RQ in the MSTBI group. Greater PFC dysfunction predicted poorer RQ in adults with a history of childhood TBI. While elevated levels of apathy, disinhibition, and executive dysfunction were associated with poorer RQ, no individual marker had predictive value. Conclusion: Experiencing a childhood TBI can have a long-term negative influence on adulthood RQ. Such RQ deficits can underpin reduced life satisfaction and increased health issues. [ABSTRACT FROM AUTHOR]

Objectives: This study compared the role of the adductor magnus muscle (Amag) as a hip extensor while performing active prone hip extension (PHE), PHE with hip adduction (PHE-ADD), and PHE with hip abduction (PHE-ABD) with the gluteus maximus (Gmax) and hamstrings. Methods: The study recruited 22 healthy participants. Electromyography data were recorded from the Amag, Gmax, and medial and lateral hamstrings during PHE, PHE-ADD, and PHE-ABD. Normalized electromyographic data were examined using one-way, repeated-measures analyses of variance. Results: The magnitude of the Amag, Gmax, and hamstring activations did not differ significantly while performing PHE (p = 0.41). Furthermore, the Amag and hamstring activations were significantly greater than the Gmax activation when performing PHE-ADD (p < 0.05). The Gmax showed significantly greater activation during PHE-ABD than the Amag and medial and lateral hamstrings (p < 0.05). Conclusions: Based on these results, we advocate including the Amag as a hip extensor during the PHE test or exercise. Our preliminary results have the potential to be applied directly to the PHE test, for investigating the muscle-activation pattern of the Amag with the Gmax and hamstrings in patients with hip or lower back pain. [ABSTRACT FROM AUTHOR]

This study determined the extent of diversity and relationships among 74 Aloe germplasm collected mainly from the Indian arid zone by characterizing 18 morphological traits (8 quantitative and 10 qualitative). High coefficient of variation (CV) was observed in quantitative traits (aloin content [AC] [43.1%], leaf width [LW] [32.0], polysaccharide [30.7], and inflorescence length [18.5]) through CV. Range and mean values for important biochemical traits of Aloe vera were 0.009-10.94 and 5.77, respectively, for aloin and 0.16-0.61 and 0.40, respectively, for polysaccharide (mg 100 mL-1) content. Leaf rind thickness (LRT) showed the highest variability (0.8-1.8 mm), followed by leaf length (LL) (30-57.5 mm) and LW (99.2-17.3 mm). Pearson's correlation study revealed both positive and negative relationships among the quantitative traits of aloe genotypes ranging from −0.19 (AC and LL/LRT) to 0.48 (leaf thickness and LRT). Dendrogram was generated for the six quantitative traits by using Euclidean distance-based unweighted pair group method with arithmetic mean method of cluster analysis which formed four major clusters at coefficient value of 3.7 with two subclusters each. Cluster analysis clearly brought out two groups as non-bitter and bitter ones. The pattern obtained through cluster analysis confirmed by two-dimensional scatter plot of principal components analysis (PCA) accounted for 67.73% of cumulative variance. Despite limitation in estimating the total genetic variation, the present study indicated that morphological and biochemical traits were useful in preliminary evaluation and can be used as a general approach for assessing genetic diversity among morphologically distinguishable aloe genotypes. [ABSTRACT FROM AUTHOR]

We investigated the biological systems involved in maintaining equilibrium during unstable and perturbed conditions in 39 healthy older women and estimated the annual difference in performance across the older age spectrum using regression. The largest annual difference in equilibrium occurred when the somatosensory system received inaccurate feedback and visual input was removed. With age, weight distribution became asymmetric at the onset of backwards perturbations, possibly in preparation for executing a stepping strategy. When one sensory system was challenged, postural responses were stable suggesting other systems compensated. When multiple sensory systems were challenged, significant differences in postural control emerged with age. [ABSTRACT FROM AUTHOR]

We examined the influence of competitive standard of the opponent on activity profile and fatigue during preseason friendly soccer matches. Time motion analysis was performed in a male professional soccer team (N = 14) during six friendly games played against professional, semi-professional and amateur-level opponents (PL, SPL and AL). The reference team covered higher acceleration distance, acceleration and deceleration > 2 m· s−2 distance against PL than AL (ES = 0.77 to 0.91). Acceleration and deceleration distance > 2 m· s−2 was also higher (ES = 0.66 to 0.84) against SPL than AL. Greater decreases in total distance, distance> 16 km· h−1 and > 22 km· h−1, total acceleration and deceleration, acceleration and deceleration distance > 2 m· s−2 (ES = 0.84 to 2.20) were also observed during PL compared to AL opponent. Playing against a stronger opponent seems to be more physically demanding, with special emphasis on events related with change of velocity (accelerations and decelerations). Declines in physical performance appear more evident against a higher opponent. [ABSTRACT FROM AUTHOR]

It has been purported that the mechanism for muscular improvement after a gluteal warm-up protocol is likely to occur from neural activation. However, little is known about whether changes in muscular performance are due to changes in muscle activity. Therefore, the aim of this study was to determine whether a lower-limb warm-up that targets the gluteal muscle group would improve countermovement jump and short-distance sprinting through increased muscle activity. Ten semi-professional rugby union players (age 25.4 ± 2.9 yr; height 1.83 ± 6.7 m; body mass 96.8 ± 10.6 kg) with at least three years of resistance training experience volunteered for the study. In a cross-over design, participants performed countermovement jumps and 5 m sprints before and after a gluteal warm-up and a 10 min rest (control). Electromyography was used to measure muscle activity of the gluteus maximus and biceps femoris. Countermovement jump height significantly improved (7.9%, p < 0.05) after the lower-limb warm-up protocol compared with the control (3.2%). There was a significant (p < 0.05) improvement in sprint times over 2.5 m and 5 m regardless of the condition. There was no significant change in the muscle activity in any of the conditions. The results indicate that a lower-limb warm-up can acutely enhance countermovement jump performance compared to a control. [ABSTRACT FROM AUTHOR]

Purpose: To compare the effectiveness of pain neuroscience education (PNE) and neck/shoulder exercises with no intervention in adolescents with chronic idiopathic neck pain (CINP). Methods: Forty-three adolescents with CINP were randomly allocated to receive PNE and shoulder/neck exercises (n = 21) or no intervention (n = 22). Data on pain intensity, neck flexor and extensor muscles endurance, scapular stabilizers endurance, pain catastrophizing, anxiety, and knowledge of pain neurophysiology were collected. Measurements were taken before and after the intervention. Results: All participants completed the study. Analysis using ANCOVA revealed a significant increase in the neck extensors endurance capacity (adjusted mean ± SE change = + 47.5 ± 13.5 s versus +14.2 ± 13.1 s) and knowledge of pain neurophysiology (adjusted mean ± SE change = + 9.8 ± 3.2 versus −0.6 ± 0.6) in the group receiving the intervention. A higher mean decrease in pain intensity, pain catastrophizing and anxiety and a higher mean increase in the scapular stabilizers endurance capacity were also found in the intervention group, but differences did not reach statistical significance. Conclusions: Results suggest a potential benefit of PNE and exercise for adolescents with CINP. Further studies with larger sample sizes are needed. [ABSTRACT FROM AUTHOR]

The knowledge about measurement errors of the measuring tool is important before its use, as clinical decisions are going to be made based on its results. Here we investigate intrarater and interrater reliability and the minimal detectable change (MDC) of thoracoabdominal mobility measurements using photogrammetry, considering novice and experienced raters. Thoracoabdominal mobility of 17 healthy participants was assessed; photographs during apnea in maximal inspiration and expiration were used to calculate latero-lateral and anteroposterior diameters of the thorax (at axillary and xiphoid level) and abdomen. One novice and one experienced rater measured the same photographs three times. We found good reliability for the experienced rater (average Intraclass Correlation Coefficient (ICC): 0.98; average MDC: 0.3) and for interrater comparison (average ICC: 0.97; average MDC: 0.35) for all measures, with poorer results for latero-lateral mobility of abdomen. The novice rater presented moderate reliability for latero-lateral mobility of the thorax at axillary level and abdomen (ICC: 0.52 and 0.61; MDC: 1.42 and 2.05, respectively) and good reliability for the other measures (average ICC: 0.81; average MDC: 1.52). The photogrammetric analysis of thoracoabdominal mobility presented itself as a reliable method when used by an experienced professional. However, considering that the measurement of latero-lateral mobility is more subjected to errors, it should be used with caution. The MDC presented should be taken into account as a threshold to be certain that the measure is not under the measurement error due to rater variability. [ABSTRACT FROM AUTHOR]

The purpose was to determine the effect of lowering minimum eye height through an externally focused object on knee and hip flexion and impact forces during jump-landing. Kinematics and ground reaction forces were collected when 20 male and 19 female participants performed jump-landing trials with their natural minimum eye height, and trials focusing on lowering their minimum eye height to an external object, which was set at 5% or 10% of standing height lower. Participants demonstrated decreased minimum eye height and increased peak knee and hip flexion during early-landing and stance phase when focusing on lowering eye height to the external object (p < 0.01). Peak vertical ground reaction forces during early-landing also decreased for the greater force group (p < 0.001). Jump-landing training through manipulating eye height provides a strategy that involves an external focus and intrinsic feedback, which may have advantages in promoting learning and practical application. [ABSTRACT FROM AUTHOR]

The central aim of this experiment was to compare acoustic parameters, formant frequencies and vowel space area (VSA), in adolescents with hearing-impaired (HI) and their normal-hearing (NH) peers; for kinematic parameters, the movements of vocal organs, especially the lips, jaw and tongue, during vowel production were analysed. The participants were 12 adolescents with different degrees of hearing impairment. The control group consisted of 12 age-matched NH adolescents. All participants were native Chinese speakers who were asked to produce the Mandarin vowels /a/, /i/ and /u/, with subsequent acoustic and kinematic analysis. There was significant difference between the two groups. Additionally, the HI group produced more exaggerated mouth and less tongue movements in all vowels, compared to their NH peers. Results were discussed regarding possible relationship between acoustic data, articulatory movements and degree of hearing loss to provide an integrative assessment of acoustic and kinematic characteristics of individuals with hearing loss. [ABSTRACT FROM AUTHOR]

Introduction: Out-of-hospital cardiac arrest (OHCA) is a major cause of death and morbidity in the United States. Quality cardiopulmonary resuscitation (CPR) has proven to be a key factor in improving survival. The aim of our study was to investigate the outcomes of OHCA when mechanical CPR (LUCAS 2 Chest Compression System™) was utilized compared to conventional CPR. Although controlled trials have not demonstrated a survival benefit to the routine use of mechanical CPR devices, there continues to be an interest for their use in OHCA. Methods: We conducted a retrospective observational study of OHCA comparing the outcomes of mechanical and manual chest compressions in a fire department based EMS system serving a population of 1.4 million residents. Mechanical CPR devices were geographically distributed on 11 of 33 paramedic ambulances. Data were collected over a 36-month period and outcomes were dichotomized based on utilization of mechanical CPR. The primary outcome measure was survival to hospital discharge with a cerebral performance category (CPC) score of 1 or 2. Results: This series had 3,469 OHCA reports, of which 2,999 had outcome data and met the inclusion criteria. Of these 2,236 received only manual CPR and 763 utilized a mechanical CPR device during the resuscitation. Return of spontaneous circulation (ROSC) was attained in 44% (334/763) of the mechanical CPR resuscitations and in 46% (1,020/2,236) of the standard manual CPR resuscitations (p = 0.32). Survival to hospital discharge was observed in 7% (52/763) of the mechanical CPR resuscitations and 9% (191/2,236) of the manual CPR group (p = 0.13). Discharge with a CPC score of 1 or 2 was observed in 4% (29/763) of the mechanical CPR resuscitation group and 6% (129/2,236) of the manual CPR group (p = 0.036). Conclusions: In our study, use of the mechanical CPR device was associated with a poor neurologic outcome at hospital discharge. However, this difference was no longer evident after logistic regression adjusting for confounding variables. Resuscitation management following institution of mechanical CPR, specifically medication and airway management, may account for the poor outcome reported. Further investigation of resuscitation management when a mechanical CPR device is utilized is necessary to optimize survival benefit. [ABSTRACT FROM AUTHOR]

Background and Purpose: Headache disorders are considered one of the ten most disabling conditions, for both males and females, according to the World Health Organization. Chronic type tension headache (CTTH) has a prevalence of 2–3% within the general population. The purpose of this research was to investigate the effect of stimulating noninvasively the trigeminal nerve in the supraorbital area (SOES) for treatment of CTTH.Methods: In an 8-week period of intervention, 45 patients were divided equally into three groups. Both group A “study” and group B received conventional physical therapy program three times a week. Group A received additional SOES for 20 minutes daily. Group C was on prescribed medications only. Assessments occurred pre and post intervention using Headache Impact Test (HIT), headache frequency, and visual analogue scale (VAS) for pain.Results: In between groups, comparison showed statistically significant differences between all groups (p < 0.000). Within-group comparisons showed that both groups A and B showed a significant improvement in all measured data. Improvement percent of group A was HIT = 18.4% and VAS = 63.0%, p ≤ 0.0001, and group B was HIT = 12.5% and VAS = 28.2%, p ≤ 0.0002, while group C showed no significant improvement with improvement percent HIIT = 1.2% and VAS = 8.6%, p ≤ 0.5. Patients in groups A and B reported less headache frequencies than group C.Conclusion: SOES had positive therapeutic results for treatment of CTTH. [ABSTRACT FROM PUBLISHER]

Objectives: To assess: (1) the presence of any carry-over effect between interventions; (2) the immediate effects of inferior shoulder mobilization on shoulder and scapular muscle activity; and (3) to compare muscle activity response between the control and mobilization conditions. Repeated measures, cross-over, pre-post intervention study with sample of convenience. Methods: Twenty-two asymptomatic individuals performed 10 repetitions of shoulder abduction before and after the control and mobilization, with a dosage of three sets of 30-s duration, with grade-IV. The order of intervention was randomized. Surface electromyography was used for recording activity of upper and lower trapezius; anterior, middle and posterior deltoids; supraspinatus; infraspinatus; and serratus anterior. Repeated measures mixed-model analysis of variance was used to assess immediate changes in muscle activity levels following inferior shoulder mobilization. Statistical parametric mapping (SPM) was used for comparing muscle activity waveforms between control and mobilization conditions throughout the range of motion. Results: No systematic changes in muscle activity levels were found between: (1) baseline and follow-up for each condition, at the concentric and eccentric phases of shoulder abduction; (2) control and mobilization conditions during the concentric and eccentric phases of shoulder abduction. SPM results suggested no differences in muscle activity pattern between conditions. Conclusions: Inferior shoulder mobilization did not produce immediate effects on shoulder and scapular muscle activity. It is possible that the dose used was insufficient to generate an immediate neuromuscular response to the mobilization. [ABSTRACT FROM AUTHOR]

Introduction: The objective was to study the behavior of the larynx during shouted voice production, when the larynx is exposed to extremely high subglottic pressure. Materials and methods: The study involved electroglottographic, acoustic, and aerodynamic analyses of shouts produced at maximum effort by three male participants. Results and discussion: Under a normal speaking voice, the voice sound pressure level (SPL) is proportional to the subglottic pressure. However, when the subglottic pressure reached high levels, the voice SPL reached a maximum value and then decreased as subglottic pressure increased further. Furthermore, the electroglottographic signal sometimes lost its periodicity during the shout, suggesting irregular vocal fold vibration. [ABSTRACT FROM AUTHOR]

Tendon stress may be one of the important risk factors for running-related tendon injury. Several methods have been used to estimate Achilles tendon (AT) loading during a human performance such as inverse dynamics (ID) and inverse dynamics-based static optimisation (IDSO). Our purpose was to examine differences between ID and IDSO estimates of AT loading during running. Kinematic data were captured simultaneously with kinetic data. Imaging of the AT cross-sectional area was performed with ultrasound for 17 healthy runners (height: 170.2 ± 6.2 cm, mass: 63.9 ± 11.0 kg, age: 21.8 ± 1.4 years). AT stress, strain, and force were estimated from both ID and IDSO approaches. The two methods resulted in minimal differences (3.6–4.7%) in estimated peak AT stress, strain, and force (P = 0.051–0.054); however, IDSO estimates were greater (32.7–36.8%) during early-stance phase of running (P = 0.000–0.008). This difference in AT load during early-stance may be due to the inability of the ID to account muscle coactivation. The similarity between the peak AT loading for ID and IDSO methods revealed that the advantage of IDSO used to estimate muscle forces had little effect on the ankle plantar flexor peak forces during running. Therefore, the use of IDSO with a higher computational cost compared with ID may not be necessary for estimating AT stress during running. [ABSTRACT FROM PUBLISHER]

The study aimed to determine whether or not commercial golf gloves influence performance variables and forearm muscle activity during golf play. Fifteen golfers participated in the laboratory based study, each performing 8 golf swings with a Driver and 7-iron whilst wearing a glove and 8 without wearing the glove. Club head speed, ball speed and absolute carry distance performance variables were calculated. Surface electromyography was recorded from the flexor digitorum superficialis and extensor carpi radialis brevis on both forearm muscles. Club head speed, ball speed and absolute carry distance was significantly higher when using the Driver with the glove in comparison to the Driver without the glove (p < 0.05). No significant differences were evident when using the 7-iron and no significant differences were displayed in muscle activity in either of the conditions. Findings from this study suggest that driving performance is improved when wearing a glove. [ABSTRACT FROM AUTHOR]

Purpose:This study investigated the influence of tube phonation into water on vocal fold vibration. Method:Eight participants were analyzed via high-speed digital imaging while phonating into a silicon tube with the free end submerged into water. Two test sequences were studied: (1) phonation pre, during, and post tube submerged 5 cm into water; and (2) phonation into tube submerged 5 cm, 10 cm, and 18 cm into water. Several glottal area parameters were calculated using phonovibrograms. Results:The results showed individual differences. However, certain trends were possible to identify based on similar results found for the majority of participants. Amplitude-to-length ratio, harmonic-to-noise ratio, and spectral flatness (derived from glottal area) decreased for all tube immersion depths, while glottal closing quotient increased for 10 cm immersion and contact quotient for 18 cm immersion. Closed quotient decreased during phonation into the tube at 5 cm depth, and jitter decreased during and after it. Conclusion:Results suggest that the depth of tube submersion appears to have an effect on phonation. Shallow immersion seems to promote smoother and more stable phonation, while deeper immersion may involve increased respiratory and glottal effort to compensate for the increased supraglottal resistance. This disparity, which is dependent upon the degree of flow resistance, should be considered when choosing treatment exercises for patients with various diagnoses, namely hyperfunctional or hypofunctional dysphonia. [ABSTRACT FROM AUTHOR]

The aim of this study was to measure the reliability of the extra load index (ELI) as a method for assessing relative load carriage economy. Seventeen volunteers (12 males, 5 females) performed walking trials at 3 km·h−1, 6 km·h−1and a self-selected speed. Trial conditions were repeated 7 days later to assess test–retest reliability. Trials involved four 4-minute periods of walking, each separated by 5 min of rest. The initial stage was performed unloaded followed in a randomised order by a second unloaded period and walking with backpacks of 7 and 20 kg. Results show ELI values did not differ significantly between trials for any of the speeds (p = 0.46) with either of the additional loads (p = 0.297). The systematic bias, limits of agreement and coefficients of variation were small in all trial conditions. We conclude the ELI appears to be a reliable measure of relative load carriage economy. Practitioner Summary:This paper demonstrates that the ELI is a reliable measure of load carriage economy at a range of walking speeds with both a light and heavy load. The ELI, therefore, represents a useful tool for comparing the relative economy associated with different load carriage systems. [ABSTRACT FROM AUTHOR]

The upper extremities play an important role in managing the rope-turning technique required to perform continuous double unders. However, acute adaptions in this technique may occur as a jumper fatigues. The purpose of this study was to examine how turning technique is adapted with fatigue. Three-dimensional kinematic data of the upper extremity were collected from 10 trained athletes as they performed consecutive double unders to volitional fatigue. Time series wrist, elbow and shoulder joint angles were calculated where joint angle waveforms representing 10 unique trials from the beginning (“fresh”) and end (“fatigued”) of the continuous jumping protocol for all participants were analysed using principal component analysis. Participants reported stopping due to cardiovascular and shoulder muscular fatigue. From a kinematics perspective, with fatigue athletes used a more internally rotated range of motion at the shoulder, which we believe prompted a series of more distal adaptions in order to maintain rope turning, preserving consecutive double under performance. The presence of a maladaptive adaptation at the shoulder may increase the risk of developing shoulder injuries. Coaches should consider helping jumpers develop appropriate shoulder muscle endurance such that they can continue to maximise their training and proficiency, while protecting against potential fatigue-related maladaptation. [ABSTRACT FROM AUTHOR]

An increase in salivary leukocytes may contribute to the exercise-induced increase in salivary antimicrobial proteins (AMPs). However, exercise-induced changes in salivary leukocytes have not been studied. The purpose of the study was to describe salivary leukocyte changes with exercise. Participants (n = 11, 20.3 ± 0.8 years, 57.2 ± 7.6 ml kg−1 min−1peak oxygen uptake ((VO) ̇2peak), 11.1 ± 3.9% body fat) ran for 45 min at 75% of VO2peak. Stimulated saliva (12 mL) was collected pre- and immediately post exercise. Saliva was filtered through a 30 µm filter before analysis of leukocytes (CD45+), granulocytes (CD45+CD15+), monocytes (CD45+CD14+), T-cells (CD45+CD3+), and B-cells (CD45+CD20+) using flow cytometry. Saliva was analysed for Lysozyme (Lys) using ELISA. Exercise did not alter any leukocyte subset. The major constituent of leukocytes pre-exercise were granulocytes (57.9 ± 30.3% compared with monocytes: 5.1 ± 2.7%, T-cells: 17.1 ± 8.9%, B-cells: 12.1 ± 10.2%) (P < 0.05). In a subset ofn = 6, Lys secretion rate increased after exercise (pre: 5,170 ± 5,215 ng/min; post: 7,639 ± 4,140 ng/min) (P < 0.05). Exercise does not result in increased granulocytes, but does increase Lys. Further, these data suggest that an increase in salivary leukocytes is not needed to increase Lys. [ABSTRACT FROM AUTHOR]

Many coaches often instruct swimmers to keep the elbow in a high position (high elbow position) during early phase of the underwater stroke motion (pull phase) in front crawl, however, the high elbow position has never been quantitatively evaluated. The aims of this study were (1) to quantitatively evaluate the “high elbow” position, (2) to clarify the relationship between the high elbow position and required upper limb configuration and (3) to examine the efficacy of high elbow position on the resultant swimming velocity. Sixteen highly skilled and 6 novice male swimmers performed 25 m front crawl with maximal effort and their 3-dimensional arm stroke motion was captured at 60 Hz. An attempt was made to develop a new index to evaluate the high elbow position (Ihe: high elbow index) using 3-dimensional coordinates of the shoulder, elbow and wrist joints. Iheof skilled swimmers moderately correlated with the average shoulder internal rotation angle (r = −0.652,P < 0.01) and swimming velocity (r = −0.683,P < 0.01) during the pull phase. These results indicate that Iheis a useful index for evaluating high elbow arm stroke technique during the pull phase in front crawl. [ABSTRACT FROM AUTHOR]

Recreational tennis players tend to have higher incidence of tennis elbow, and this has been hypothesised to be related to one-handed backhand technique and off-centre ball impacts on the racket face. This study aimed to investigate for a range of participants the effect of off-longitudinal axis and off-lateral axis ball–racket impact locations on racket and forearm joint angle changes immediately following impact in one-handed tennis backhand groundstrokes. Three-dimensional racket and wrist angular kinematic data were recorded for 14 university tennis players each performing 30 “flat” one-handed backhand groundstrokes. Off-longitudinal axis ball–racket impact locations explained over 70% of the variation in racket rotation about the longitudinal axis and wrist flexion/extension angles during the 30 ms immediately following impact. Off-lateral axis ball–racket impact locations had a less clear cut influence on racket and forearm rotations. Specifically off-longitudinal impacts below the longitudinal axis forced the wrist into flexion for all participants with there being between 11° and 32° of forced wrist flexion for an off-longitudinal axis impact that was 1 ball diameter away from the midline. This study has confirmed that off-longitudinal impacts below the longitudinal axis contribute to forced wrist flexion and eccentric stretch of the wrist extensors and there can be large differences in the amount of forced wrist flexion from individual to individual and between strokes with different impact locations. [ABSTRACT FROM AUTHOR]

Purpose:To investigate between-leg differences in hip and thigh muscle strength and leg extensor power in patients with unilateral hip osteoarthritis. Further, to compare between-leg differences in knee extensor strength and leg extensor power between patients and healthy peers. Methods:Seventy-two patients (60–87 years) with radiographic and symptomatic hip osteoarthritis not awaiting hip replacement and 35 healthy peers (63–82 years) were included. Hip and thigh muscle strength and leg extensor power were measured in patients and knee extensor strength and leg extensor power in healthy. Results:The symptomatic extremity in patients was significantly (p < 0.05, pairedt-test) weaker compared with the non-symptomatic extremity for five hip muscles (8–17%), knee extensors (11%) and leg extensor power (19%). Healthy older adults had asymmetry in knee extensor strength (6%,p < 0.05) comparable to that found in patients, but had no asymmetry in leg extensor power. Conclusions:Patients had generalized weakening of the affected lower extremity and numerically the largest asymmetry was evident for leg extensor power. In contrast, healthy peers had no asymmetry in leg extensor power. These results indicate that exercise interventions focusing on improving leg extensor power of the symptomatic lower extremity and reducing asymmetry may be beneficial for patients with hip osteoarthritis.Implications for RehabilitationEven in patients with mild symptoms not awaiting hip replacement a generalized muscle weakening of the symptomatic lower extremity seems to be present.Between-leg differences in leg extensor power (force × velocity) appears to be relatively large (19%) in patients with unilateral hip osteoarthritis in contrast to healthy peers who show no asymmetry.Compared to muscle strength the relationship between functional performance and leg extensor power seems to be stronger, and more strongly related to power of the symptomatic lower extremity.Our results indicate that exercise interventions focusing on improving leg extensor power of the symptomatic lower extremity and reducing asymmetry may be beneficial for patients with mild symptoms not awaiting hip replacement. [ABSTRACT FROM AUTHOR]

This study analysed the behaviour of the geometric curvature of the spine during sirshasana. The position of dorsal retroreflective markers was computed via stereophotogrammetric analysis in six males and five females (29.4 ± 8.8 years, 63.0 ± 11.4 kg, 1.66 ± 0.08 m [average ± standard deviation]). The spinal points were projected onto the sagittal and frontal planes of the trunk, a polynomial was fitted to the data and the two-dimensional geometric curvature was quantified. The inferior lumbar lordosis decreased compared to the orthostatic position and gait, which may favour the posterior protrusion of the lumbar spinal nucleus pulposus in people with posterior herniation. The lateral deviation at the middle of the thoracic spine increases during sirshasana, which may reflect increased difficulties for postural control and spinal loads. It could be useful for promoting positive spinal structural and functional chronic adaptations for healthy participants, if the yoga programme is carefully planned and the spinal alignment is carefully monitored during a headstand. However, it may aggravate some spinal diseases, especially scoliosis. [ABSTRACT FROM AUTHOR]

This article deals with kinematic and kinetic conditions in volleyball attack and identifies loads in the shoulder joint. Joint angles and velocities of individual segments of upper limb were measured with the use of the motion capture system XSENS. Muscle forces and loads in skeletal system were calculated by means of mathematical model elaborated in AnyBody system. Spikes performed by players in the best and worst way were compared with each other. The relationships were found between reactions in shoulder joint and flexion/extension, abduction/adduction and rotation angles in the same joint and flexion/extension in the elbow joint. Reactions in shoulder joint varied from 591 N to 2001 N (in relation to body weight [BW] 83-328%). The analysis proved that hand velocity at the moment of the ball hit (which varied between 6.8 and 13.3 m s-1) influences on the value of reaction in joints, but positions of individual segments relative to each other are also crucial. It was also proved in objective way, that position of the upper limb during spike can be more or less harmful assuming that bigger reaction increases possibility of injury, what can be an indication for trainers and physiotherapists how to improve injury prevention. [ABSTRACT FROM AUTHOR]

This study examined whether Sanders' model is suitable for estimating accurately the propulsive force generated by the hands' motion in swimming comparing the calculated force obtained using the model and the measured force during an actual propulsive action. The measured and calculated forces were obtained from 13 swimmers who, while tethered, performed a sculling motion in a prone position for the purpose of displacing the body by moving it forward. Kinematic analyses were conducted to obtain the calculated force, while the measured force was obtained via the use of a load cell. The calculated force was lower than the measured force and accounted for only a small part of the variation in the measured force. The forces could not be used interchangeably, and there were fixed and proportional differences between them. Consequently, this study indicates that Sanders' model is not suitable for estimating accurately the propulsive force generated by the swimmer's hands during sculling motion. However, research that integrates analyses from different approaches could result in improvements to the model that would render it applicable for estimating the propulsive forces during movements that are characterised by directional changes of the hands. [ABSTRACT FROM AUTHOR]

Undulatory underwater swimming (UUS) is one of the major skills contributing to performance in competitive swimming. UUS has two phases- the upbeat is performed by hip extension and knee flexion, and the downbeat is the converse action. The purpose of this study was to determine which kinematic variables of the upbeat and downbeat are associated with prone UUS performance in an elite sample. Ten elite participants were filmed performing three prone 20 m UUS trials. Seven landmarks were manually digitised to calculate eighteen kinematic variables, plus the performance variable- horizontal centre of mass velocity (VCOM). Mean VCOM was significantly correlated with body wave velocity (upbeat r = 0.81, downbeat r = 0.72), vertical toe velocity (upbeat r = 0.71, downbeat r = 0.86), phase duration (upbeat r = -0.79), peak hip angular velocity (upbeat r = 0.73) and mean knee angular velocity (upbeat r = -0.63), all significant at P < 0.05. A multiple stepwise regression model explained 78% of variance in mean VCOM. Peak toe velocity explained 72% of the variance, and mean body wave velocity explained an additional 6%. Elite swimmers should strive for a high peak toe velocity and a fast caudal transfer of momentum to optimise underwater undulatory swimming performance. [ABSTRACT FROM AUTHOR]

This study compared the effects of six warm-up modalities on peak power output (PPO) during the high-pull exercise. Nine resistance-trained males completed six trials using different warm-ups: highpull specific (HPS), cycle, whole body vibration (WBV), cycle+HPS, WBV+HPS and a control. Intramuscular temperature (Tm) was increased by 2°C using WBV or cycling. PPO, Tm and electromyography (EMG) were recorded during each trial. Two high-pulls were performed prior to and 3 min after participants completed the warm-up. The greatest increase in PPO occurred with HPS (232.8 ± 89.7 W, P < 0.001); however, this was not different to combined warm-ups (cycle+HPS 158.6 ± 121.1 W; WBV +HPS 177.3 ± 93.3 W, P = 1.00). These modalities increased PPO to a greater extent than those that did not involve HPS (all P < 0.05). HPS took the shortest time to complete, compared to the other conditions (P < 0.05). EMG did not differ from pre to post warm-up or between modalities in any of the muscles investigated. No change in Tm occurred in warm-ups that did not include cycling or WBV. These results suggest that a movement-specific warm-up improves performance more than temperature- related warm-ups. Therefore, mechanisms other than increased muscle temperature and activation may be important for improving short-term PPO. [ABSTRACT FROM AUTHOR]

This investigation compared the effects of external pre-cooling and mid-exercise cooling methods on running time trial performance and associated physiological responses. Nine trained male runners completed familiarisation and three randomised 5 km running time trials on a non-motorised treadmill in the heat (33°C). The trials included pre-cooling by cold-water immersion (CWI), mid-exercise cooling by intermittent facial water spray (SPRAY), and a control of no cooling (CON). Temperature, cardiorespiratory, muscular activation, and perceptual responses were measured as well as blood concentrations of lactate and prolactin. Performance time was significantly faster with CWI (24.5 ± 2.8 min;P = 0.01) and SPRAY (24.6 ± 3.3 min;P = 0.01) compared to CON (25.2 ± 3.2 min). Both cooling strategies significantly (P < 0.05) reduced forehead temperatures and thermal sensation, and increased muscle activation. Only pre-cooling significantly lowered rectal temperature both pre-exercise (by 0.5 ± 0.3°C;P < 0.01) and throughout exercise, and reduced sweat rate (P < 0.05). Both cooling strategies improved performance by a similar magnitude, and are ergogenic for athletes. The observed physiological changes suggest some involvement of central and psychophysiological mechanisms of performance improvement. [ABSTRACT FROM PUBLISHER]

The effects of exercise on the core musculature have not been investigated in prepubescents. The main purpose of the present study was to determine the volume and degree of asymmetry ofrectus abdominis, obliquesandtransversus abdominis, quadratus lumborum, iliopsoas, gluteusandparavertebralismuscles in prepubescent tennis players and in untrained boys. The muscle volume was determined using magnetic resonance imaging (MRI) in 7 male prepubescent tennis players and 10 untrained controls (mean age 11.0 ± 0.8 years, Tanner 1–2). After accounting for height and body weight as covariates, the tennis players had 14–34% greater volume than the controls in all the muscles analysed (P < 0.05) except inparavertebralis, dominantquadratus lumborumand non-dominantgluteus, which had similar volumes in both groups (P = NS). Compared to controls, the tennis players displayed a greater degree of asymmetry inquadratus lumborumandrectus abdominis(3% vs. 15%,P < 0.01 and 8% vs. 17%,P = 0.06, respectively). The level of asymmetry ofobliquesandtransversus abdominis, iliopsoas, gluteus andparavertebralismuscles was similar in both groups (P = NS). In conclusion, tennis playing at prepubertal ages induces a selective hypertrophy of the core musculature and exaggerates the degree of asymmetry ofquadratus lumborumandrectus abdominiscompared to untrained boys. [ABSTRACT FROM PUBLISHER]

This study aimed to explore how asymptomatic athletes with a patellar tendon abnormality (PTA), who are at high risk of developing patellar tendinopathy, alter their landing technique and net patellar tendon loads generated in response to fatigue. Seven asymptomatic players with a PTA performed five successful vertical stop-jump trials before and after a fatigue protocol. Fatigue protocol involved participants repeatedly performing sets of 30 submaximal jump exercises on a sledge apparatus followed by 30 s rest until the task failure criteria were reached. Three-dimensional ground reaction forces, lower limb kinematics and net peak patellar tendon force were recorded during the stop-jump task. No significant between-fatigue condition differences in net patellar tendon loading, or most secondary outcome variables were observed. Only some fatigue changes were seen during the vertical landing phase. Asymptomatic PTA participants did not modify their landing technique or net patellar tendon loading during a stop-jump task in response to fatigue. The lack of between-fatigue condition differences displayed by the asymptomatic PTA participants during both landing phases suggest that these individuals may not be capable of sufficient movement variability in their landing strategies to adapt to fatigue. [ABSTRACT FROM PUBLISHER]

A reduction in gluteus maximus (GM) strength may contribute to the etiology of musculoskeletal impairments and lower-extremity injuries. Currently, there is a paucity of evidence regarding the efficacy of implementing a short-term gluteal activation programme to improving muscle performance. Twenty four semi-professional rugby males were assigned randomly to a gluteal activation group (GLUTE) or a control group (CON). During the 6-week training intervention, the GLUTE and CON groups performed the same training, however that GLUTE group performed seven gluteal activation exercises three times weekly prior to their normal training sessions. Whilst the CON group performed the conventional training with no gluteal activation exercises. Electromyography (EMG) was measured during a maximal isometric unilateral squat (MVIC) and unilateral hip extension force from the left and right vastus lateralis, gluteus maximus, and biceps femoris. After 6 weeks of training there was no significant main or interaction effect (p > 0.05) of EMG and peak force for MVIC and hip extension between GLUTE and CON. The current gluteal activation programme did not enhance EMG activity and hip extension force therefore, the body-weight exercises may not have been sufficient to elicit the appropriate changes. [ABSTRACT FROM AUTHOR]

Conclusion: In conclusion, these result showed HADSCs could differentiate into chondrocytes-like cells, dependent on signaling induced by TGF-β3 and chondrocytes. This is a promising result and showed that HADSCs is a potential source for future microtia repair. The technique of co-culture is a positive way forward to assist the microtia tissue. Objective: Reconstructive surgery for the repair of microtia still remains the greatest challenge among the surgeons. Its repair is associated with donor-site morbidity and the degree of infection is inevitable when using alloplastic prosthesis with uncertain long-term durability. Thus, human adipose derived stem cells (HADSCs) can be an alternative cell source for cartilage regeneration. This study aims to evaluate the chondrogenic potential of HADSCs cultured with transforming growth factor-beta (TGF-β) and interaction of auricular chondrocytes with HADSCs for new cartilage generation. Methods: Multi-lineages differentiation features of HADSCs were monitored by Alcian Blue, Alizarin Red, and Oil Red O staining for chondrogenic, adipogenic, and osteogenic differentiation capacity, respectively. Further, HADSCs alone were culture in medium added with TGF-β3; and human auricular chondrocytes were interacted indirectly in the culture with and without TGF-βs for up to 21 days, respectively. Cell morphology and chondrogenesis were monitored by inverted microscope. For cell viability, Alamar Blue assay was used to measure the cell viability and the changes in gene expression of auricular chondrocyte markers were determined by real-time polymerase chain reaction analysis. For the induction of chondrogenic differentiation, HADSCs showed a feature of aggregation and formed a dense matrix of proteoglycans. Staining results from Alizirin Red and Oil Red O indicated the HADSCs also successfully differentiated into adipogenic and osteogenic lineages after 21 days. Results: According to a previous study, HADSCs were strongly positive for the mesenchymal markers CD90, CD73, CD44, CD9, and histocompatibility antigen. The results showed HADSCs test groups (cultured with TGF-β3) displayed chondrocytes-like cells morphology with typical lacunae structure compared to the control group without TGF-β3 after 2 weeks. Additionally, the HADSCs test groups increased in cell viability; an increase in expression of chondrocytes-specific genes (collagen type II, aggrecan core protein, SOX 9 and elastin) compared to the control. This study found that human auricular chondrocytes cells and growth factor had a positive influence in inducing HADSCs chondrogenic effects, in terms of chondrogenic differentiate of feature, increase of cell viability, and up-regulated expression of chondrogenic genes. [ABSTRACT FROM AUTHOR]

Analytical methods to assess thigh muscle balance need to provide reliable data to allow meaningful interpretation. However, reproducibility of the dynamic control ratio at the equilibrium point has not been evaluated yet. Therefore, the aim of this study was to compare relative and absolute reliability indices of its angle and moment values with conventional and functional hamstring–quadriceps ratios. Furthermore, effects of familiarisation and angular velocity on reproducibility were analysed. A number of 33 male volunteers participated in 3 identical test sessions. Peak moments (PMs) were determined unilaterally during maximum concentric and eccentric knee flexion (prone) and extension (supine position) at 0.53, 1.57 and 2.62 rad · s–1. A repeated measure, ANOVA, confirmed systematic bias. Intra-class correlation coefficients and standard errors of measurement indicated relative and absolute reliability. Correlation coefficients were averaged over respective factors and tested for significant differences. All balance scores showed comparable low-to-moderate relative (<0.8–0.9) and good absolute reliability (<10%). Relative reproducibility of dynamic control equilibrium parameters augmented with increasing angular velocity, but not with familiarisation. At 2.62 rad · s–1, high (moment: 0.906) to moderate (angle: 0.833) relative reliability scores with accordingly high absolute indices (4.9% and 6.4%) became apparent. Thus, the dynamic control equilibrium is an equivalent method for the reliable assessment of thigh muscle balance. [ABSTRACT FROM AUTHOR]

Objective: The Pressure Biofeedback Unit (PBU) is used to assess the transversus abdominis muscle activity in order to determine the effectiveness of segmental stabilization, but not to verify its accuracy for measuring the pressure values of breathing from transversus abdominis activation. The objective of this study was to cross-validate the PBU pressure evaluated in transversus abdominis muscle activation with the respiratory pressure assessed through manovacuometry in order to verify the extent to which the PBU can be used to indirectly evaluate the strength of the respiratory muscle in both men and women and verify the reliability of the methods. Participants: A total of 39 healthy subjects. Methods: Manovacuometry and Pressure Biofeedback Unit tests were performed in three days each with three replications: 1) Maximal Inspiratory Pressure; 2) Maximal Expiratory Pressure; and 3) Pressure Biofeedback Unit. Results: Both tests showed good reliability and low correlation between the Pressure Biofeedback Unit and Maximal Inspiratory Pressure (r = 0.40; p = 0.01) and Maximal Expiratory Pressure (r = 0.33; p = 0.04). High differences were observed between pressures and wide limits of agreement in Bland–Altman analysis. Conclusion: It seems that the Pressure Biofeedback Unit is not able to effectively predict the respiratory muscles' strength as routinely evaluated through the use of the manovacuometry presenting a low cross-validation and good reliability. [ABSTRACT FROM AUTHOR]

PurposeInterventions focused on singing may provide additional benefits to established voice and respiratory therapies, due to their greater emphasis on the respiratory muscle control system in those with Parkinson’s disease (PD) progresses. The purpose of this study was to examine if singing can improve voice, respiratory pressure and quality of life (QOL) in persons with PD.MethodsThis pilot study measured the effects of a singing intervention in 27 participants with PD. Participants were assigned to a high (met twice weekly) or low (met once weekly) dosage group. Voice, respiratory and QOL measures were recorded before and after an 8-week singing intervention. Sessions were led by board-certified music therapists and included a series of vocal and articulation exercises and group singing.ResultsBoth groups demonstrated significant improvements in maximum inspiratory and expiratory pressure, as well as phonation time. While other voice measures improved, they did not reach statistical significance. Voice QOL and whole health QOL also significantly improved.ConclusionThese results suggest singing may be a beneficial and engaging treatment choice for improving and maintaining vocal function and respiratory pressure in persons with PD. Implications for RehabilitationIn a small sample, group singing proved beneficial for improving voice and respiratory impairment in persons with Parkinson’s disease.Completing group singing one time per week for 8 weeks was as effective as completing group singing two times per week for 8 weeks in persons with Parkinson’s disease.Group singing is an effective means of improving overall quality of life in persons with Parkinson’s disease. [ABSTRACT FROM PUBLISHER]

PurposeA better understanding of how people with multiple sclerosis (pwMS) recover from exercise may help inform interventions.MethodsWe explored physiological and perceptual responses following exercise of different intensities, using a crossover exposure-response design, in 14 adults with multiple sclerosis (MS) and 9 controls. A cycling exercise test determined maximum capacity (Wpeak). Participants then performed 20-min exercise sessions relative to Wpeak (random order separated by 7 days): (1) 45% and (2) 60% continuous cycling and (3) 90% intermittent cycling (30 s cycling, 30 s rest). During a 45-min recovery period, tympanic temperature (Temp°C), exertion in breathing (RPEbr) and legs (RPEleg), and cortical excitability (MEParea) were measured.ResultsEleven pwMS and eight controls completed the study. Controls performed better on the exercise test (p < 0.05), thus more absolute work during subsequent sessions. PwMS took longer to recover RPEleg with recovery time increasing with intensity (45%-6 min; 60%-15 min; 90%-35 min) and correlating with Temp°C. MEParea was significantly depressed in both groups at 45% and 60% (p < 0.001), in the MS group this also correlated with RPEleg.ConclusionsFeelings of leg exertion may persist after exercise in some pwMS, especially at high intensities. This may relate to body temperature and, after continuous exercise, cortical excitability. These results support considering the recovery period post exercise and provide an insight into potential correlates of post-exercise fatigue.Implications for RehabilitationA better understanding of how pwMS recover following exercise may help inform exercise prescription a long side fatigue management.This study showed that, in pwMS, the time taken to recover from feelings of leg fatigue increased with the intensity of the exercise session rather that total work performed and was related to increase in body temperature.The results of this relatively small study support the need to consider a recovery period after exercise and provide an insight into potential physiological correlates [ABSTRACT FROM PUBLISHER]

Objective: To investigate the positive rate for the Cochlin tomo-protein (CTP: an inner ear-specific protein) detection test among patients with inner ear-related clinical manifestations and evaluate the clinical characteristics of definite perilymphatic fistula (PLF). Methods: We have performed an ELISA-based CTP detection test using middle ear lavage (MEL) samples from 497 cases of suspected PLF enrolled from 70 clinical centers nationwide between 2014 and 2015. In addition to the CTP-positive rate, audio-vestibular symptoms were compared between CTP-positive and -negative cases. Results: 8–50% of patients in category 1 (trauma, middle and inner ear disease cases), and about 20% of those in categories 2, 3 and 4 (external origin antecedent events, internal origin antecedent events, and without antecedent event, respectively) were positive for CTP. In category 1 cases, the earlier tested samples showed a higher CTP-positive rate, whereas no differences were observed in categories 2, 3 or 4. The characteristic clinical features in the earlier tested cases were nystagmus and fistula sign in CTP test-positive cases in category 1, and streaming water-like tinnitus in those in categories 2, 3 and 4. Conclusion: The present study clarified that CTP detection test-positive patients exist at considerable rates among patients with inner ear-related manifestations. [ABSTRACT FROM AUTHOR]

Objectives: Matrix metalloproteinase-9 (MMP-9) is an inducible metalloproteinase that can degrade the cerebrovascular matrix leading to disruption of the blood–brain barrier and exacerbation of oedema in neurotrauma. Therefore, our aim was to determine whether MMP-9 plasma levels were associated with intensive care unit (ICU) mortality after severe traumatic brain injury (TBI) despite the presence of extracerebral injuries. Methods: This cohort enrolled 80 patients who suffered severe TBI (Glasgow Coma Scale: 3–8 at hospital admission). The plasma MMP-9 level was determined by enzyme-linked immunosorbent assay assay at ICU admission. Results: Severe TBI was associated with a 32.5% ICU mortality rate. There was no association between the presence of extracerebral injuries (72.5% of the patients) and ICU mortality (P = 0.419). Higher plasma MMP-9 concentrations were associated with fatal outcome: 181.1 ± 16.0 ng/mL for survivors and 257.0 ± 23.2 ng/mL for nonsurvivors (mean ± S.E.M., P = 0.009). In contrast, there was no significant difference between MMP-9 levels and associated lesions: 220.8 ± 26.3 ng/mL for isolated TBI and 196.8 ± 15.8 ng/mL for patients with extracerebral injuries (P = 0.397). Conclusion: Increased plasma MMP-9 levels predicted short-term fatal outcome following severe TBI, regardless the presence of extracerebral injuries. [ABSTRACT FROM AUTHOR]

It is commonly believed that a torn ACL or a damaged meniscus may be associated with altered knee joint movements. The purpose of this study was to measure the tibiofemoral kinematics of ACL deficiency with concomitant meniscus deficiency. Unilateral knees of 28 ACL deficient participants were studied while ascending stairs. Among these patients, 6 had isolated ACL injuries (group I), 8 had combined ACL and medial meniscus injuries (group II), 8 had combined ACL and lateral meniscus injuries (group III) and 6 had combined ACL and medial-lateral meniscus injuries (group IV). Both knees were then scanned during a stair climb activity using single fluoroscopic image system. Knee kinematics were measured at 0°, 5°, 10°, 15°, 30° and 60° of flexion during ascending stairs. At 0°, 15° and 30° flexion of the knee, the tibia rotated externally by 13.9 ± 6.1°,13.8 ± 9.5° and 15.9 ± 9.8° in Group I. Group II and III exhibited decreased external rotation from 60° to full extension. Statistical differences were found in 0°, 15°and 30° of flexion for the 2 groups compared with Group I. In general, the tibia showed anterior translation with respect to the femur during ascending stairs. It was further determined that Group III had larger anterior translation compared with Group IV at 0° and 5° of flexion (−6.9 ± 1.7 mm vs. 6.2 ± 11.3 mm,P = 0.041; −9.0 ± 1.8 mm vs. 8.1 ± 13.4 mm,P = 0.044). During ascending stairs the ACL deficient knee with different deficiencies in the meniscus will show significantly different kinematics compared with that of uninjured contralateral knee. Considering the varying effect of meniscus injuries on knee joint kinematics, future studies should concentrate on specific treatment of patients with combined ACL and meniscus injuries to protect the joint from abnormal kinematics and subsequent postoperative degeneration. [ABSTRACT FROM PUBLISHER]

Objective: To quantify pain response in girls affected by Rett syndrome (RTT) using electrodermal activity (EDA), a measure of skin conductance, reflecting sympathetic activity known to be modulated by physical and environmental stress. Methods: EDA increase, heart rate (HR) increase and Face Legs Activity Cry Consolability (FLACC) values calculated during venipuncture (invasive) and vital signs collection (non-invasive) events were compared with values calculated during a prior baseline and a RTT clinical severity score (CSS). Results: EDA and HR increase were significantly higher than baseline during venipuncture only and not significantly correlated with FLACC or CSS. EDA increase was the most sensitive measure of pain response. Conclusions: These preliminary findings revealed that motor impairment might bias non-verbal pain scales, underscore the importance of using autonomic measures when assessing pain and warrant further investigation into the utility of using EDA to objectively quantify RTT pain response to inform future RTT pain management. [ABSTRACT FROM AUTHOR]