Search

L-citrulline (CIT) supplementation seems to improve resistance training performance; yet, whether malate has additive ergogenic effects when combined with CIT is unknown. This randomized, double-blind, placebo-controlled crossover trial aimed to compare the acute effects of CIT versus citrulline malate (CMA) supplementation on neuromuscular performance and exertion and emotional perceptions in young, trained men and women. 43 (21 women; 24.2 ± 3.7 years) participants ingested a placebo, CIT (5.3 g of CIT), or CMA (5.3 g of CIT, 2.7 g of malate) 45 min before three experimental sessions in a counterbalanced manner. We evaluated the upper and lower limb maximal neuromuscular and ballistic performance through the two-point method and countermovement jump. Strength-endurance was assessed across three sets of 10 repetitions in the squat and bench press exercises. Exertion and emotional perceptions were evaluated before and after the assessment and during the strength-endurance assessment. CIT and CMA supplementation did not enhance maximal neuromuscular performance (all p ≥.061, η p 2 ≤.066), or ballistic strength (all p ≥.348, η p 2 ≤.025). Neither CIT nor CMA supplementation improved strength-endurance as observed in the total number of repetitions (all p ≥.590, η p 2 ≤.013), repetitions before reaching velocity loss threshold (all p ≥.623, η p 2 ≤.010), mean velocity (all p ≥.792, η p 2 ≤.004), mean velocity decline (all p ≥.293, η p 2 ≤.029), and mean velocity maintenance (all p ≥.393 η p 2 ≤.022), or exertion and emotional perceptions (both p ≥.306, η p 2 ≤.028). In conclusion, CIT and CMA supplementation may not increase the neuromuscular performance during low- to moderate-volume resistance training sessions in young, trained adults. This trial was registered at ClinicalTrials.gov (No. NCT05183893). [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to analyze the effects of bilateral and unilateral plyometric-training (PT) programs on jumping, sprinting, and change-of-direction (COD) ability in male postpubertal basketball players. Methods: Forty-three young male basketball players (14.2 [1.2] y), from 4 squads belonging to an elite basketball club, were randomly assigned to 1 of 3 groups: (1) bilateral PT group (BG), (2) unilateral PT group (UG), and (3) control group (CG). The experimental groups followed a PT program twice weekly for 6 weeks, with BG and UG performing 2- and 1-legged jumps, respectively. Both groups completed the same number of vertical, horizontal, cyclic, and acyclic jumps. Pretraining and posttraining measurements included (1) countermovement jump (CMJ), (2) unilateral CMJ (CMJL and CMJR), (3) horizontal jump (HJ), (4) unilateral HJ (HJL and HJR), (5) straight-line sprint in 20 m (T20), and (6) V-Cut COD test (V-Cut). Results: CMJ, CMJL, and CMJR were significantly improved by BG and UG (P <.001), while CG did not change. Both the BG and the UG improved their performance significantly (P <.01) in HJL and HJR, but only BG significantly increased (P <.05) HJ and showed significantly greater improvements than CG. Furthermore, only BG improved V-Cut performance (P =.03). Neither group increased T20. CG did not improve in any tests. Conclusions: BG enhances single-leg and double-leg jump performance in vertical and horizontal directions, as well as COD ability. In contrast, an equivalent volume of unilateral PT only improves vertical jumps and unilateral HJs. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the impact of a 6-week upper-body plyometric-training (PT) program with varying volumes on the immunoendocrine, physiological parameters, and physical performance adaptations in male volleyball players. Methods: Twenty-four trained college players were randomly allocated into 3 groups with 8 participants. Each group performed 5 exercises at maximal effort with differences in volume: low (3 sets of 7 repetitions), moderate (3 sets of 10 repetitions), and high (3 sets of 13 repetitions). The training program lasted 6 weeks with participants undertaking 3 sessions of PT per week. Results: Following the intervention, all groups exhibited significant (P =.001) improvements in physical and physiological parameters, as well as skill-based performances, with effect sizes ranging from small to very large. Comparative analysis of individual changes indicated that the high-volume group resulted in greater adaptive responses in the medicine-ball throw (P =.004), peak (P =.001) and average (P =.022) power output, push-ups (P =.001), and strength (P =.032) compared with the low-volume group. No significant between-groups difference (P >.05) was observed regarding immunoendocrine measures, reaction time, attacking, and serving skills. Conclusions: The findings indicate that short-term upper-body PT positively influenced performance adaptations, emphasizing that the adaptive response to PT depends on the varying volumes. The study proposes that integrating higher volumes of PT results in more significant adaptive responses among volleyball players with the same immunoendocrine responses as the other training volumes. [ABSTRACT FROM AUTHOR]

Context: The single-leg hop is based solely on performance with no measure of movement quality. The purpose of this study was to (1) develop a real-time screening tool to capture single-leg functional performance and movement quality and (2) to provide preliminary validation (criterion validity) of a trained clinician's real-time movement quality assessment with 3D kinematics. Study Design: Cross-sectional. Methods: Fifty-nine adolescent athletes volunteered (15.2 [1.1] y, 165.8 [9.2] cm, and 61.5 [13.9] kg, 51 females and 8 males). Each participant performed 3 trials of the single-leg hop on their dominant leg. A 3-dimensional inertial measurement system was used to capture knee joint kinematics. A movement quality checklist for use during a single-leg hop (movement quality single-leg hop) was developed to score biomechanical errors based on lower-extremity injury risk factors. Four criteria were developed for the checklist: (1) knee valgus, (2) foot rotation, (3) lateral trunk flexion, and (4) erect posture. An independent t test was conducted for each dependent variable (knee flexion displacement and knee abduction displacement) by each independent variable (movement category presence of (1) lateral trunk flexion, (2) knee valgus, (3) foot rotation, and (4) erect posture/sound during landing [yes or no]). The alpha level was set at α <.05 for all analyses. Results: Knee flexion displacement was significantly decreased (P <.001, mean difference 9.40 [1.88]) and knee abduction displacement was significantly increased (P <.001, mean difference 9.41 [0.47]) for those who had knee valgus documented by the clinician. In additional, for those with visually documented erect posture/sound of landing, there was a significant decrease in knee flexion displacement (P <.001, mean difference 10.13 [2.34]). Conclusion: The movement quality single-leg hop checklist has shown promising preliminary validation (criterion validity) for clinicians to assess movement quality. Increased knee abduction and decreased knee flexion are common risk factors associated with knee injuries and this clinician friendly real-time checklist may highlight individuals who are at risk of sustaining a knee injury. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to compare kinematic data of the frontal trunk, pelvis, knee, and summated angles (trunk plus knee) among categorized grades using the single-leg squat (SLS) test, to classify the SLS grade, and to investigate the association between the SLS grade and the frontal angles using smartphone-based markerless motion capture. Methods: Ninety-one participants were categorized into 3 grades (good, reduced, and poor) based on the quality of the SLS test. An automated pose estimation algorithm was employed to assess the frontal joint angles during SLS, which were captured by a single smartphone camera. Analysis of variance and a decision tree model using classification and regression tree analysis were utilized to investigate intergroup differences, classify the SLS grades, and identify associations between the SLS grade and frontal angles, respectively. Results: In the poor group, each frontal trunk, knee, and summated angle was significantly larger than in the good group. Classification and regression tree analysis showed that frontal knee and summated angles could classify the SLS grades with a 76.9% accuracy. Additionally, the classification and regression tree analysis established cutoff points for each frontal knee (11.34°) and summated angles (28.4°), which could be used in clinical practice to identify individuals who have a reduced or poor grade in the SLS test. Conclusions: The quality of SLS was found to be associated with interactions among frontal knee and summated angles. With an automated pose estimation algorithm, a single smartphone computer vision method can be utilized to compare and distinguish the quality of SLS movement for remote clinical and sports assessments. [ABSTRACT FROM AUTHOR]

Context: Clinical balance assessments vary in reliability due to subjectivity in their scoring. A valid and objective accelerometer-based smartphone evaluation could benefit patients, clinicians, and researchers. Objective: Our objective was to assess the validity and reliability of smartphone-based standing balance. Design: A repeated-measures study was conducted with 23 healthy young adult participants across 2 sessions ∼7 days apart. Methods: Participants completed 30-second standing trials during tandem-stance eyes-open, tandem-stance eyes-closed, single-leg eyes-open, and single-leg eyes-closed conditions. Android and iOS smartphones were placed vertically on the lower back via a belt with 3 retroreflective markers attached and tracked by an 8-camera motion capture system. Sway path, range, and area were calculated from smartphone accelerometer and marker data. We assessed reliability using intraclass correlation coefficients (ICC[2,k]) and validity using Pearson r correlations between the marker and smartphones from visit 1. Results: Across eyes-open conditions, Android (ICC =.84–.96), iOS (ICC =.82–.98), and marker-based (ICC =.84–.95) assessments demonstrated good to excellent reliability. Across eyes-closed conditions, Android (ICC =.41–.87), iOS (ICC =.34–.79), and marker-based (ICC =.31–.87) assessments demonstrated poor to good reliability. Correlations between smartphones and the marker data were moderate to very high (r =.56–.97). Conclusions: The smartphone-based assessment was valid and reliable, indicating that clinicians and researchers can implement this method to measure balance with the opportunity for remote administration and increased patient tracking across various recovery timepoints. [ABSTRACT FROM AUTHOR]

Background: The aims of this cross-sectional study were to (a) assess actigraphy-based sleep parameters (total sample and gender differences), (b) assess differences in morphological parameters and physical function between short- versus normal-sleepers and poor- versus good-sleepers, and (c) assess the possible correlations between sleep variables and morphological and physical function parameters in older subjects. Methods: This study enrolled 42 healthy older participants (60–80 years). Participants completed the following clinical evaluations: (1) whole-body dual-energy X-ray absorptiometry to assess the appendicular skeletal muscle mass index; (2) magnetic resonance imaging acquisition to determine the cross-sectional muscle area of thigh muscles and intermuscular adipose tissue; (3) risk of fall assessment through the mini-Balance Evaluation Systems Test; (4) strength assessment: (a) chair stand test and (b) handgrip strength test; (5) sleep monitoring by actigraphy to assess total sleep time, sleep efficiency, wake after sleep onset, sleep latency, fragmentation index, mobile time, and subjective sleep quality. Results: 31.0% of subjects were short-sleepers (total sleep time < 6 hr), 19.1% were poor-sleepers (sleep efficiency < 85%), and gender differences were detected in mobile time (males: 15.8 ± 6.0 and females: 13.4 ± 6.8; p <.001) and fragmentation index (males: 35.3 ± 14.3 and females: 29.6 ± 14.6; p <.001); no significant differences were observed between groups (short- vs. normal-sleepers and poor- vs. good-sleepers) in morphological and physical function variables; correlation analysis showed that sleep latency negatively correlated with Mini-Balance Evaluation Systems Test (r = −.352; p =.022) and a positive correlation was detected between cross-sectional muscle area and mobile time (r =.349, p =.023). Conclusion: No differences were observed in morphological and function parameters between good- versus poor-sleepers, those subjects with worse sleep onset latency (i.e., longer time to fall asleep) registered higher for risk of fall. The potential role of sleep in the physiological mechanisms of muscular aging must be explored through cross-sectional cohort studies with a larger population. [ABSTRACT FROM AUTHOR]

This study aimed to determine the effects of walking-only intervention (walking was the only exercise in which people participated) on physical function, fall-related outcomes, and health-related quality of life in community-dwelling older adults. We conducted a systematic search across five electronic databases, assessing risk of bias using Minds Manual for Guideline Development. Meta-analyses were performed, and pooled standardized mean differences were calculated. Nine studies (a total of 1,309 participants) were included, showing that walking-only interventions improved walking endurance (standardized mean difference: 1.11, 95% confidence interval: [0.08, 2.15]) and health-related quality of life (standardized mean difference: 0.71, 95% confidence interval: [0.18, 1.25]). However, there were no significant improvements in other outcomes. The certainty of the evidence based on the Grading of Recommendations, Assessment, Development, and Evaluation approach for all outcomes was graded as very low, primarily due to significant inconsistency and imprecision. Our results suggest that walking-only intervention can be effective for enhancing walking endurance and health-related quality of life for community-dwelling older adults. Further studies are required to investigate the effects of walking-only intervention. This need stems from the limited number of randomized controlled trials, heterogeneous intervention settings and results, and the very low certainty of the evidence. [ABSTRACT FROM AUTHOR]

Background: The lumbar extensor muscles (LEMs) play an important role in body posture and physical function in older adults. Because lumbar extensor strength decreases more rapidly than limb muscle strength with age, it should be evaluated to aid healthy aging. This study investigated the association between LEM strength and physical performance in community-dwelling older adults. Methods: This prospective observational cohort study of spinal sarcopenia (SarcoSpine) was conducted at a single center. One hundred and ten consecutive individuals who completed the baseline survey, including conventional sarcopenic indices, lumbar spine three-dimensional magnetic resonance imaging, isokinetic lumbar extensor strength, and physical performance tests (Short Physical Performance Battery, Berg Balance Scale, and Back Performance Scale [BPS]), were enrolled. A multivariate linear regression analysis was performed to determine the variables for evaluating their association with LEM strength. Results: Among the conventional sarcopenic indices, gait speed was significantly correlated with Short Physical Performance Battery results and Berg Balance Scale score in men and women. Handgrip strength was significantly correlated with the BPS score for both sexes. In the multivariable linear regression, age (β = −2.12, p <.01) and BPS score (β = −3.54, p =.01, R2 =.29) were independent indicators of LEM strength. Conclusions: Our findings reveal the substantial association between LEM strength and BPS score in older women. The targeted intervention aimed at improving the LEMs strength would be needed to enhance physical performance in the aging population. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the role of antiphase trunk motion during quiet stance while maintaining constant visual and support surface conditions. Eyes-open quiet stance trials were performed on a firm support surface while wearing a rigid hip-knee orthotic brace that reduced antiphase trunk motion. Amplitude spectral density, coherence, and cophase were compared for hip-locked, hip-unlocked, and no-brace conditions. Amplitude spectral density calculations showed that trunk and leg sway velocities, and ankle torque (AT) decreased when antiphase trunk sway was allowed. Coherence and cophase estimates identified in-phase trunk-legs sway below 1 Hz and antiphase at higher frequencies. Legs-AT cophase calculations showed that the legs lagged the application of AT at all frequencies, while trunk-AT cophase showed the trunk lagged AT below 1 Hz and led AT at higher frequencies. The results demonstrate that antiphase trunk sway helps reduce sway velocity and AT. Furthermore, the trunk-leading cophase relationship with AT showed that antiphase trunk motion occurred before AT was applied. This implies that antiphase trunk motion facilitates changes in sway direction and helps regulate sway velocity. The results have significant implications for predicting postural control deficiencies due to injury, disease, and aging. [ABSTRACT FROM AUTHOR]

This study investigates the specific influence of step frequency (SF) and speed on the coordination between pelvic and thigh movements. Eight recreational male runners ran at different SFs and speeds on an instrumented treadmill. The coordination between the pelvis and thigh segments was analyzed using modified vector coding in the sagittal and frontal planes (FPs). Our findings show that hip range of motion increases as a function of SF in the sagittal plane. Pelvic tilt plays a compensatory role in hip extension, particularly at lower SFs. In the FP, pelvic roll increased at lower SFs, whereas the thigh abduction angle was participant dependant. Coordination analysis showed that thigh movements dominated the sagittal plane motion, which was simplified at higher SF. At low SF, the pelvic movements were increased and anticipated, playing a more dominant role in explaining motion. In the FP, pelvic movements dominated the motion. The increase in pelvic motion at low SFs stretches the hip flexors further and for a longer period. The link between SF, pelvic motion, and the risks of running-related injuries in the sagittal and FP is considered. Understanding these could help athletes and sports professionals optimize performance and reduce injury risk. [ABSTRACT FROM AUTHOR]

Jones fracture is a common injury in soccer players, caused by overload on the fifth metatarsal (M5) that can occur during crossover cutting. This study aimed to investigate the effects of the hip internal rotation (HIR) range in passive and dynamic conditions and foot progression angle (FPA) on the forces applied to the M5 during crossover cutting. The study included 20 men with experience playing soccer. The passive HIR was measured in the prone position. A 3-dimensional motion analysis system, force plates, and Footscan were used to measure the angle of the lower limb, including dynamic HIR, FPA, and plantar pressure to the M5, during crossover cutting in the 45° direction. Pearson correlation coefficient was measured to examine the relationship between variables. Passive and dynamic HIR were not related to the plantar pressure on the M5 (P >.05). However, increased FPA in movement direction correlated with a reduction in plantar pressure on the M5 (r = −.56, P <.01). Minimizing the FPA with respect to the new direction during crossover cutting reduced plantar pressure on the M5 and thus could prevent Jones fracture. [ABSTRACT FROM AUTHOR]

Purpose: Although previous studies have compared strength-training adaptations between free weights (FW) and machine-guided exercises, those studies did not use a Smith machine (SM), which most closely replicates the exercises performed with FW. Thus, the aim of the present study was to investigate the chronic effects of strength-focused, velocity-based training regimens using FW versus SM. Methods: Thirty-seven sport-science students (14 female) were assigned, balanced by sex and relative strength, to either an FW or SM training group. The training program lasted 8 weeks (2 sessions/wk), and participants performed 4 sets per exercise (back squat and bench press) at 70% of their 1-repetition maximum with moderate effort levels (20%–25% velocity loss). Load–velocity profile parameters (load-axis intercept, velocity-axis intercept, and area under the load–velocity relationship line), cross-sectional areas of the vastus lateralis and pectoralis major muscles, and the number of repetitions to failure in the bench-press exercise were assessed before and after the training program. Mechanical variables were assessed using both FW and SM. Results: All variables, with the exception of back-squat velocity-axis intercept (P =.124), improved in both training groups. The changes in load-axis intercept and area under the load–velocity relationship line were more pronounced when the training and testing conditions matched. Failure in the bench-press exercise and cross-sectional areas of the vastus lateralis and pectoralis major showed comparable improvements for both training groups, while velocity-axis intercept tended to improve more in the SM group. Conclusions: The general population, unconcerned with the specificity of strength adaptations, can choose a training modality (FW or SM) based on personal preferences. [ABSTRACT FROM AUTHOR]

Background: In high-performance sport, the support provided by sport scientists and other staff can be a valuable resource for coaches and athletes. Purpose: We propose and detail here the approach of "minimal, adequate, and accurate" sport-science support to ensure that programs of work and solutions are both economical and effective. Methods: Our support provision advocates for utilization of "minimal" resources (employing the least amount of time, tools, and funding) necessary to achieve the desired outcomes. We strive for "adequate" information that fulfills specific objectives without excess and with the requirement that methods and data used are "accurate" (valid and reliable). To illustrate the principles of this approach, we outline a real-world example of supporting 100-m track (athletics) sprinters preparing and competing in an international competition. The provision of performance support emphasizes an integrated approach, combining knowledge and insights from multiple sport-science disciplines. The key facets managed under this approach are (1) neuromuscular readiness, (2) wellness monitoring, (3) movement observation, (4) motivation, (5) biomechanics and performance analysis, and (6) qualitative feedback. These facets are based on the specific performance determinants and influencing factors of an event (100-m dash). Conclusions: Application of this quantitative and qualitative approach can enhance the ability to make informed decisions. Nevertheless, the approach must be planned, evaluated, and refined on a regular basis to enable effective decision making in sport-science support. The 3-element approach of "minimal, adequate, and accurate" should be codesigned and supported by the athletes, coaches, and staff to ensure successful implementation. [ABSTRACT FROM AUTHOR]

Purpose: This study's purpose was to investigate the midterm effects of alternative set configurations (cluster [CL] and rest redistribution [RR]) on lower- and upper-body neuromuscular capacities in female athletes. Method: Twenty team-sport female athletes were randomly assigned to a CL (n = 10) or RR (n = 10) training group. The study protocol comprised 2 pretests, 12 training sessions, and a posttest. Both groups engaged in identical exercises (squat and bench press), load intensity (75% of 1-repetition maximum), and volume (18 repetitions per exercise). The distinction between the groups lay in the total session rest time: The CL group had 23 minutes (3 sets of 6 repetitions with 30 s of intraset rest every 2 repetitions and 3 min of interset rest), whereas the RR group had 17 minutes (9 sets of 2 repetitions with 45 s of interset rest). Countermovement-jump height and load–velocity relationship variables (load-intercept, velocity-intercept, and area under the load–velocity relationship line) were assessed during the squat and bench-press exercises. Results: All dependent variables revealed greater values at posttest compared with pretest (P ≤.040; averaged Hedges g = 0.35 for CL and 0.60 for RR), but time × group interactions never reached statistical significance (P ≥.144). Likewise, the comparison of the magnitude of changes between the 2 groups revealed only trivial differences, except for a small greater change in bench-press area under the load–velocity relationship line for RRG (Hedges g = 0.40). Conclusions: RR is a more efficient strategy than CL for inducing strength gains in female athletes. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to compare the gross motor skills of children with a chronic physical illness with those of their healthy peers. Methods: Data for children with a chronic physical illness come from the Multimorbidity in Children and Youth Across the Life Course study, and data from children without a physical illness come from the Health Outcomes and Physical Activity in Preschoolers study. Multimorbidity in Children and Youth Across the Life Course and Health Outcomes and Physical Activity in Preschoolers included children ages 3–5 years and administered the Peabody Development Motor Scales-second edition. Participants were sex and age matched (20 male and 15 female pairs; Mage = 54.03 [9.5] mo). Results: Gross motor skills scores were "below average" for 47% of children with a physical illness compared with 9% of children without a physical illness (P =.003). Matched-paired t tests detected significant differences in total gross motor scores (dz = −0.35), locomotor (dz = −0.31), and object control (dz = −0.39) scores, with healthy children exhibiting better motor skills, and no significant difference in stationary scores (dz = −0.19). Conclusions: This skill gap may increase burden on children with physical illness and future research should assess gross motor skills longitudinally to establish whether the gap widens with age. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the performance of healthy Chilean children aged 3–10 years in the 6-minute walking test (6MWT) and cardiometabolic risk variables and to determine sex- and age-specific reference values. Methods: This study involved 1165 healthy children (age = 6.36 [1.70] y old). The 6MWT was used to evaluate exercise performance. Furthermore, anthropometric measures were collected, like weight, height, body mass index, waist circumference, and skin folds. Resting heart rate and blood pressure (BP) were also evaluated. Results: The prevalence of overweight and obesity was 35.0% and 25.4% in preschoolers and 29.0% and 36.2% in school-age children, respectively, showing significant differences (P <.05) between age groups. The distance walked (6-min walk distance) increased significantly year on year at ages from 3 to 10 years. According to the regression analysis, 6MWT performance was positively related to age, systolic BP, and height, whereas it was negatively related to ∑4 skinfold fat, resting heart rate, diastolic BP, and waist circumference. Conclusions: This study provides a reference equation and an age- and sex-adjusted percentile curve to assess the predicted 6MWT performance in a cohort of prepubertal Chilean children. The 6-minute walk distance depends mainly on age; however, other variables, such as resting heart rate, BP, skinfold fat, and waist circumference, add significant information and should be taken into account. [ABSTRACT FROM AUTHOR]

Background: Preexercise caffeine intake has proven to exert ergogenic effects on cycling performance. However, whether these benefits are also observed under fatigue conditions remains largely unexplored. We aimed to assess the effect of caffeine ingested during prolonged cycling on subsequent time-trial performance in trained cyclists. Methods: The study followed a triple-blinded, randomized, placebo-controlled cross-over design. Eleven well-trained junior cyclists (17 ± 1 years) performed a field-based 8-min time trial under "fresh" conditions (i.e., after their usual warm-up) or after two work-matched steady-state cycling sessions (total energy expenditure∼20 kJ/kg and ∼100 min duration). During the latter sessions, participants consumed caffeine (3 mg/kg) or a placebo ∼60 min before the time trial. We assessed power output, heart rate, and rating of perceived exertion during the time trial and mood state (Brunel Mood Scale) before and after each session. Results: No significant condition effect was found for the mean power output attained during the time trial (365 ± 25, 369 ± 31, and 364 32 W for "fresh," caffeine, and placebo condition, respectively; p =.669). Similar results were found for the mean heart rate (p =.100) and rating of perceived exertion (p = 1.000) during the time trial and for the different mood domains (all p >.1). Conclusions: Caffeine intake during prolonged exercise seems to exert no ergogenic effects on subsequent time-trial performance in junior cyclists. Future studies should determine whether significant effects can be found with larger caffeine doses or after greater fatigue levels. [ABSTRACT FROM AUTHOR]

Purpose: To correlate speed and heat scores with anthropometric variables and lower-limb strength and power in professional surfers. Methods: A total of 19 men participated in simulated competitions on different days. All surfed waves were scored, and each athlete's best 2 were used for their total heat score. Speed values were extracted by global positioning system and adjusted by Z score. Squat jump, countermovement jump, and drop jump were executed. Anthropometric variables and 1-repetition maximum (1RM) in the half squat were measured. Pearson product–moment correlation was used to analyze the relationships. Results: Height had a significant (P <.05) inverse association with speed indicators (r = −.36 to −.68), and body mass index had a moderate association with maximum wave speed of the highest score. Significant correlations with moderate to large magnitudes were found between maximum speed and vertical jumps (r =.46 to.56), average speed and vertical jumps (r =.48 to.59), and both maximum and average speed with 1RM (r =.52–.53). Athletes' best score and total heat score showed moderate to large associations with vertical jumps and 1RM (r =.48–.64), whereas second scores were correlated with the reactive strength index of the drop jump (r =.48) and 1RM (r =.51). Conclusions: Shorter surfers with lower center of gravity and those with superior lower-limb strength and power achieved greater speed and higher scores. Accordingly, surf coaches may consider prescribing dynamic strength and balance training based on an athlete's profile to improve performance. [ABSTRACT FROM AUTHOR]

Purpose: To compare the acute effects on mechanical, metabolic, neuromuscular, and muscle contractile responses to different velocity-loss (VL) thresholds (20% and 40%) under distinct blood-flow conditions (free [FF] vs restricted [BFR]) in full squat (SQ). Methods: Twenty strength-trained men performed 4 SQ protocols with 60% 1-repetition maximum that differed in the VL within the set and in the blood-flow condition (FF20: FF with 20% VL; FF40: FF with 40% VL; BFR20: BFR with 20% VL; and BFR40: BFR with 40% VL). The level of BFR was 50% of the arterial occlusion pressure. Before and after the SQ protocols, the following tests were performed: (1) tensiomyography, (2) blood lactate, (3) countermovement jump, (4) maximal voluntary isometric SQ contraction, and (5) performance with the load that elicited a 1 m·s−1 at baseline measurements in SQ. Results: No "BFR × VL" interactions were observed. BFR protocols resulted in fewer repetitions and lower increases in lactate concentration than FF protocols. The 40% VL protocols completed more repetitions but resulted in lower mechanical performance and electromyography median frequency during the exercise than the 20% VL protocols. At postexercise, the 40% VL protocols also experienced greater blood lactate concentrations, higher alterations in tensiomyography-derived variables, and accentuated impairments in SQ and countermovement-jump performances. The 20% VL protocols showed an increased electromyography median frequency at postexercise maximal voluntary isometric contraction. Conclusions: Despite BFR-accelerated fatigue development during exercise, a given VL magnitude induced similar impairments in the distinct performance indicators assessed, regardless of the blood-flow condition. [ABSTRACT FROM AUTHOR]

Purpose: This study sought to investigate the efficacy of Tabata-style high-intensity interval training (T-HIIT) on athletic performance in judoka and to determine the impact of the fecal organic acid profile before training on the improvement of athletic performance. Methods: Twenty males from Aichi University Judo Club (10 high-level competitors and 10 others) were included. Physical fitness tests such as the Uchikomi shuttle run, countermovement jump, squat jump, and chin-ups using a judo uniform were performed before and after T-HIIT. Fecal samples were collected before T-HIIT to measure the fecal concentration of organic acids. The fecal characteristics were categorized using the Bristol Stool Scale. Results: The mean number of repetitions of the Uchikomi shuttle run test significantly increased for all judoka following T-HIIT. However, improvements in other physical fitness tests varied, with some judoka showing improvements while others did not. The changes in countermovement jump (r = −.48, P =.029) and chin-ups using a judo uniform (r = −.45, P =.045) after T-HIIT were significantly negatively correlated with the fecal concentrations of succinic acid before T-HIIT. There was a significant correlation between the Bristol Stool Scale score and fecal concentrations of succinic acid (r =.45, P =.044). Compared with other compounds, the fecal concentrations of acetic acid and propionic acid were significantly greater in high-level competitors, while succinic acid concentrations tended to be lower. Conclusions: T-HIIT effectively improved the specialized endurance of the judoka. Modifying the fecal organic acid profile, especially the fecal succinic acid concentration, may enhance the efficacy of athletic performance improvements achieved by T-HITT. [ABSTRACT FROM AUTHOR]

Purpose: To investigate differences between females and males at lactate thresholds 1 (LT1) and 2 (LT2). Methods: Twenty-four female and twenty male participants performed an incremental cycle-ergometer test until exhaustion, where LT1 and LT2 were determined in each volunteer. Results: Power output at LT1 and LT2 was lower in females than in males (P <.001). In addition, power output relative to peak power was higher in females at LT1 and LT2 (P <.001). However, heart rate was higher in females than males at LT1 and LT2 (P =.008). Furthermore, the heart rate relative to maximal heart rate was higher in females compared with males at LT1 and LT2 (P =.002). Conclusion: Females and males may be in a different metabolic situation at the same percentage of maximum. This study helps to reduce sex bias in science, and future guidelines should consider establishing exercise prescription recommendations according to sex. Clinical Trial: NCT06104150. [ABSTRACT FROM AUTHOR]

Objective: This study aims to systematically validate the reliability and applicability of Iliac Tilt (IT) as a parameter for sagittal balance assessment, explore its relationship with traditional parameters such as Pelvic Tilt (PT) and Pubic-Sacral Angle (PSA), and analyze its performance across different stages of skeletal development. Methods: A retrospective study was conducted with 118 healthy pediatric participants. Full-length sagittal radiographs were obtained using the advanced EOS imaging system, and relevant sagittal plane parameters were measured using standardized methods. Participants were grouped based on Risser staging, and statistical analyses, including one-way analysis of variance (ANOVA), Pearson correlation analysis, and linear regression, were performed. Results: Iliac Tilt (IT) was significantly negatively correlated with Pelvic Tilt (PT) (r = -0.761, p < 0.001) and significantly positively correlated with Pubic-Sacral Angle (PSA) (r = 0.814, p < 0.001). Linear regression analysis revealed that IT was a significant predictor of both PT and PSA, with R² values of 0.736 and 0.717, respectively. Additionally, across different Risser stages, IT demonstrated high stability, while PSA and T1 Slope-Pelvic Incidence (T1SPI) showed significant changes with staging. Conclusion: As a novel parameter, Iliac Tilt (IT) demonstrates high reliability and broad applicability in reflecting posterior pelvic tilt and sagittal spinal balance. Compared to traditional parameters, IT offers a simpler measurement process, making it suitable for complex cases with limited imaging quality. It provides an efficient evaluation tool for clinical and research applications. Highlights: Introduction of a Novel Parameter: This study systematically validates Iliac Tilt (IT) as a new and reliable parameter for assessing sagittal spinal balance in adolescents, demonstrating its broad applicability. Strong Correlations Identified: IT shows a significant negative correlation with Pelvic Tilt (PT) (r = -0.761) and a significant positive correlation with Pubic-Sacral Angle (PSA) (r = 0.814), highlighting its effectiveness in reflecting pelvic and spinal alignment. Stability Across Developmental Stages: IT remains highly stable across different Risser stages of skeletal development, unlike traditional parameters such as PSA and T1 Slope-Pelvic Incidence (T1SPI), which vary significantly with skeletal maturity. Clinical Advantages: Compared to traditional sagittal parameters, IT offers a simpler and more reliable measurement process by requiring only unilateral iliac imaging, making it suitable for complex cases with limited imaging quality or special anatomical structures. Foundation for Future Research: The findings establish IT as a valuable tool for clinical and research applications in spinal health assessment, recommending further studies to explore its applicability in diverse age groups and pathological conditions. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the effects of exergames on rehabilitation outcomes in osteoarthritis (OA) patients. Materials and methods: A systematic review was reported according to the PRISMA statement. Randomized controlled trials (RCTs) were searched in Pubmed, Scopus, WoS, CINAHL, and PEDro (inception to November 2023). Studies that applied non-immersive exergames and assessed physical, functional, cognitive, pain, and psychosocial outcomes were included. Comparisons were other exercise modalities and non-intervention. Methodological quality was assessed with PEDro scale, and risk of bias (RoB) was assessed with Cochrane RoB-2 tool. Results: Eight studies were included (total of participants = 401). The mean PEDro score was 6.1, and seven studies had high RoB. Seven studies involved knee OA and one cervical OA. The most frequent duration for interventions was four weeks. Exergames were more effective than controls in at least one outcome in all studies. The outcomes for which exergames were most effective were functional disability, postural balance, muscle strength, proprioception, gait, range of motion, pain, quality of life, depression, and kinesiophobia. Conclusion: Non-immersive exergames constitute an effective strategy for optimizing several relevant outcomes in rehabilitation. However, more RCTs with high methodological quality are required to deepen the knowledge about the multidimensional effects of exergames in OA patients. IMPLICATIONS FOR REHABILITATION: Osteoarthritis (OA) is one of the leading causes of disability, involving high health costs and a public health problem. Physical exercise has recently been recognized as a first-line treatment in OA to reduce symptomatology and to improve or maintain physical functioning and quality of life. Non-immersive exergames are a safe therapeutic strategy to improve functional disability, postural balance, muscle strength, proprioception, gait performance, range of motion, and pain in OA patients. Similarly, non-immersive virtual reality strategies contribute to the improvement of depression, kinesiophobia, and quality of life in people with OA. [ABSTRACT FROM AUTHOR]

Purpose: This study was performed to investigate and compare the effects of intradialytic core stabilization and aerobic exercises on physical performance, fatigue, quality of life and dialysis adequacy. Materials and methods: The study involved 39 individuals on hemodialysis randomized into two groups: aerobic exercise (AE, n = 20) and core stabilization (CSE, n = 19). Over 8 weeks, the AE group performed pedal ergometer exercises, while the CSE group performed 4-phase core stabilization exercises. Physical performance (five times sit to stand test, 2-min step test), quality of life (Kidney Disease Quality of Life-36; KDQOL-36), fatigue levels (Piper Fatigue Scale), and dialysis adequacy (Kt/V and URR) were assessed. Results: After training, a significant improvement was observed in the physical performance, fatigue levels, and some parameters of KDQOL-36 of the patients (p < 0.05). However, no significant changes were observed in dialysis adequacy indicators (Kt/V and URR) (p > 0.05). When the amount of development obtained in both treatment groups is compared, kidney disease burden only in the subparameter of KDQOL-36 was statistically significantly improved in the CSE group compared to the AE group (p < 0.05). Conclusions: According to the results of the study, intradialytic core stabilization exercises appear to have similar effects to aerobic exercises and can be performed by HD patients. IMPLICATIONS FOR REHABILITATION: Core stabilization exercises and aerobic exercises performed during dialysis are well tolerated by hemodialysis patients. Over eight weeks, intradialytic core stabilization and aerobic exercises are effective in improving physical performance, fatigue level, and quality of life in hemodialysis patients. In hemodialysis patients, eight weeks of intradialytic core stabilization and aerobic exercises are not sufficient to improve dialysis adequacy. It is recommended to include intradialytic core stabilization and aerobic exercises in the rehabilitation of hemodialysis patients. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this prospective single group, time-series study was to determine the feasibility, adherence, and effectiveness of an individualized physical therapist (PT)-driven hybrid model of the exercise component of cardiac rehabilitation (CR) that uses a novel intensity-recovery progression protocol (IRPP) and cardiac testing template (CTT) to assess achieved heart rate (HR) intensity, HR recovery, and intensity-recovery total to guide treatment. Methods: Assessment of a questionnaire, treadmill 6-min walk (6MW), 1-min sit-to-stand (1STS), 1-min step, and 1-min agility square tests were assessed on 100 participants. Compared to traditional CR the 36-visit 1:1 hybrid model was individualized using the IRPP program and CTT. Results: Adherence was 35% (timely) and 44% (overall) completion. The per-protocol analysis (PPA) and intent-to-treat (ITT) analysis suggest significant improvement in objective assessments baseline to visit 15 (PPA = 11 of 14) (ITT = 13 of 14), baseline to visit 30 (PPA = 12 of 14) (ITT = 12 of 14) and visit 15 to visit 30 (PPA = 9 of 14) (ITT = 10 of 14). Improvement beyond the minimal clinically important difference (MCID) was 94.3% in the 6MW and 91.4% in the 1STS. Conclusions: The PT-driven IRPP program was feasible in terms of adherence and safety, showing significant improvement in a majority of assessments. Analysis of HR using the CTT may help clinical decision making for progression in CR. IMPLICATIONS FOR REHABILITATION: Cardiac rehabilitation (CR) is an underutilized means of improving health for people recovering from cardiac surgery. People recovering from cardiac surgery have complex reasons for why they choose to enroll in, drop out from, or complete a CR program. Reporting of outcomes in CR and progression in intensity is not often individualized. An individualized physical therapist driven CR program using both subjective and objective assessments may be successful at improving adherence and effectiveness in this cohort. [ABSTRACT FROM AUTHOR]

Autistic individuals often exhibit motor atypicalities, which may relate to difficulties in social communication. This study utilized a smart tablet activity to computationally characterize motor control by testing adherence to the two-thirds power law (2/3 PL), which captures a systematic covariation between velocity and curvature in motor execution and governs many forms of human movement. Children aged 4–8 years old participated in this study, including 24 autistic children and 33 typically developing children. Participants drew and traced ellipses on an iPad. We extracted data from finger movements on the screen, and computed adherence to the 2/3 PL and other kinematic metrics. Measures of cognitive and motor functioning were also collected. In comparison to the typically developing group, the autistic group demonstrated greater velocity modulation between curved and straight sections of movement, increased levels of acceleration and jerk, and greater intra- and inter-individual variability across several kinematic variables. Further, significant motor control development was observed in typically developing children, but not in those with autism. This study is the first to examine motor control adherence to the 2/3 PL in autistic children, revealing overall diminished motor control. Less smooth, more varied movement and an indication of developmental stasis in autistic children were observed. This study offers a novel tool for computational characterization of the autism motor signature in children's development, demonstrating how smart tablet technology enables accessible assessment of children's motor performance in an objective, quantifiable and scalable manner. [ABSTRACT FROM AUTHOR]

Purpose: To investigate associations between hormonal contraceptive use and physical performance, body composition, and musculoskeletal injuries in basic military training. Methods: Female British Army recruits (n = 450) were grouped as nonusers (n = 182), combined oral contraceptive users (COCP; n = 184), or progestin-only users (POC; n = 144). Physical performance (2.4-km run, lift strength, leg power), body composition, iron and vitamin D status, and bone metabolism were measured at the start (week 1) and end (week 13) of training. Lower body musculoskeletal injuries were recorded from medical records. Results: Training decreased 2.4-km run time (−3.7%) and fat mass (−9.6%), and increased lift strength (4.5%), leg power (1.5%), lean mass (5.4%), and whole-body (0.9%), arms (1.8%), and legs (1.4%) areal bone mineral density (P ≤ 0.015); the training response was not different between groups (P ≥ 0.173). Lift strength was lower in COCP users than nonusers (P = 0.044). Whole-body, trunk, and leg areal bone mineral densities were lower in POC users than nonusers and/or COCP users (P ≤ 0.041). There were no associations between hormonal contraceptive use and musculoskeletal or bone stress injury (P ≥ 0.429). Training did not change ferritin (P = 0.968), but decreased hemoglobin and total 25-hydroxyvitamin-D, and increased parathyroid hormone, c-telopeptide cross-links of type 1 collagen (βCTX), and procollagen type 1 N-terminal propeptide (PINP; P ≤ 0.005); the training response was not different between groups (P ≥ 0.368). Total 25-hydroxyvitamin-D was higher, and βCTX and PINP were lower, in COCP users than nonusers and POC users; parathyroid hormone was lower in COCP users than nonusers; and βCTX and PINP were higher in POC users than nonusers (P ≤ 0.017). Conclusions: Hormonal contraceptive use was not associated with performance or injury outcomes in military training. [ABSTRACT FROM AUTHOR]

Purpose: Motion capture technology is quickly evolving, providing researchers, clinicians, and coaches with more access to biomechanics data. Markerless motion capture and inertial measurement units (IMUs) are continually developing biomechanics tools that need validation for dynamic movements before widespread use in applied settings. This study evaluated the validity of a markerless motion capture, IMU, and red, green, blue, and depth (RGBD) camera system as compared with marker-based motion capture during countermovement jumps, overhead squats, lunges, and runs with cuts. Methods: Thirty adults were recruited for this study (sex: 18 females, 12 males; age: 25.4 ± 8.6 yrs; height: 1.71 ± 0.08 m; weight: 71.6 ± 11.5 kg). Data were collected simultaneously with four motion capture technologies (i.e., Vicon, marker-based; Theia/Optitrack, markerless; APDM Opals, IMUs; and Vald HumanTrak, RGBD camera). System validity for lower and upper body joint angles was evaluated using bias, root mean squared error (RMSE), precision, maximum absolute error, and intraclass correlation coefficients. System usability was descriptively analyzed. Results: Overall, markerless motion capture had the highest validity (sagittal plane RMSE: 3.20°–15.66°; frontal plane RMSE: 2.12°–9.14°; transverse plane RMSE: 3.160°–56.61°), followed by the IMU system (sagittal plane RMSE: 8.11°–28.37°; frontal plane RMSE: 3.26°–16.98°; transverse plane RMSE: 5.08°–116.75°), and lastly the RGBD system (sagittal plane bias: 0.55°–129.48°; frontal plane bias: 1.35°–52.06°). Conclusions: Markerless motion capture and IMUs have moderate validity for joint kinematics, whereas the RGBD system did not have adequate validity. Markerless systems have lower data processing time, require moderate technical expertise, but have high data storage size. IMUs are easier to use, can collect data in any location, but require participant set-up. Overall, individuals using motion capture should consider the specific movements, testing locations, and technical expertise available before selecting a system. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the measurement properties of activity monitoring for a rehabilitation (AMoR) platform for step counting, time spent in sedentary behavior, and postural changes during activities of daily living (ADLs) in a simulated home environment. Methods: Twenty-one individuals in the post-stroke chronic phase used the AMoR platform during an ADL protocol and were monitored by a video camera. Spearman's correlation coefficient, mean absolute percent error (MAPE), intraclass correlation coefficient (ICC), and Bland–Altman plot analyses were used to estimate the validity and reliability between the AMoR platform and the video for step counting, time spent sitting/lying, and postural changes from sit-to-stand (SI-ST) and sit-to-stand (ST-SI). Results: Validity of the platform was observed with very high correlation values for step counting (rs = 0.998) and time spent sitting/lying (rs = 0.992) and high correlation for postural change of SI-ST (rs = 0.850) and ST-SI (rs = 0.851) when compared to the video. An error percentage above 5% was observed only for the SI-ST postural change (7.13%). The ICC values show excellent agreement for step counting (ICC3, k = 0.999) and time spent sitting/lying (ICC3, k = 0.992), and good agreement for SI-ST (ICC3, k = 0.859) and ST-SI (ICC3, k = 0.936) postural change. Values of the differences for step counting, sitting/lying time, and postural change were within the limits of agreement according to the analysis of the Bland–Altman graph. Conclusion: The AMoR platform presented validity and reliability for step counting, time spent sitting/lying, and identification of SI-ST and ST-SI postural changes during tests in a simulated environment in post-stroke individuals. [ABSTRACT FROM AUTHOR]

Background: Patellofemoral joint kinematics is a complex three-dimensional(3D) motion, involving shift and rotation in the coronal, sagittal, and axial directions. Quantifying patellar tracking only at the axial level of the patella or with two-dimensional(2D) parameters may not be comprehensive. The current study sought to explore the spatial kinematics characteristics of the patella in three directions, especially the sagittal plane in patients with patellofemoral pain (PFP) based on Four-dimensional computed tomography (4D-CT). Methods: A total of 35 knees with PFP and 35 controls from March 2023 to May 2024 were evaluated. 3D shift and tilt of the patella were measured in the patellofemoral joint coordinate system established by MIMICS. The 3D shift and tilt of the patella in three directions (coronal, sagittal, and axial) were evaluated. Differences between groups were analyzed using two-way repeated measures ANOVA. Results: The 3D tiltsagittal and 3D tiltaxial trends differed between the two groups (P = 0.020, 0.018, respectively). The 3D shiftsagittal at knee flexions of 50° to 70° was significantly increased in the PFP group compared to the control group (P = 0.009, 0.015, respectively). The 3D tiltsagittal was significantly greater in the PFP group than in the control group at -10° to 10° and 50° to 70° of knee flexion (P = 0.004, 0.005, 0.046, 0.007, respectively). The 3D tiltaxial was significantly greater in the PFP group than in the control group at -10° to 0° and 40° to 70° of knee flexion (P = 0.033, 0.011, 0.004, 0.015, respectively). The 3D shiftcoronal at knee flexions of -10° to 20° were significantly decreased in the PFP group compared to the control group (P = 0.002, < 0.001, 0.018, respectively). Conclusion: It is necessary to evaluate the spatial position characteristics of the patellofemoral joint and the stability of the patella from multiple planes and angles at the dynamic level. Analyzing the spatial multi-plane kinematic characteristics of the patellofemoral joint may help in determining the etiology of PFP. [ABSTRACT FROM AUTHOR]

Background: The relationship between 24-hour (24-h) movement guidelines and frailty remains unclear. We aimed to investigate the associations between meeting 24-h movement guidelines and frailty and to conduct secondary analyses by age, gender, and ethnicity. Methods: In this study, we extracted data from the National Health and Nutrition Examination Survey (2007–2018) database. A total of 5,726 participants (50.25 ± 0.31 years) were included in this analysis, representing 38,240,356 noninstitutionalized U.S. individuals. Three 24-h movement behaviors, namely, physical activity, sedentary behavior (SB), and sleep, were self-reported using the standardized questionnaires. The 49-item frailty index was used to measure frailty. Multivariable logistic regression models and trend tests were used to examine the associations between meeting 24-h movement guidelines and frailty. Sensitivity analyses were also conducted to ensure the robustness of our results. Results: The total age-adjusted prevalence of frailty was 30.5%. In the fully adjusted model, compared with not meeting any of the 24-h movement guidelines, the adjusted odds ratios (AORs) of frailty were 0.786 (95% CI: 0.545, 1.133), 1.161 (95% CI: 0.787, 1.711), and 0.915 (95% CI: 0.616, 1.358) for participants meeting only moderate to vigorous physical activity (MVPA), only SB, and only sleep guidelines, respectively, but no statistically significant differences were observed (all P values > 0.05). Participants who met the SB + sleep guidelines (AOR = 0.613, 95% CI: 0.423, 0.887), MVPA + sleep guidelines (AOR = 0.389, 95% CI: 0.255, 0.593), and MVPA + SB guidelines (AOR = 0.555, 95% CI: 0.383, 0.806) presented a significantly lower risk of frailty by 39%, 61%, and 45%, respectively. Meeting all 3 guidelines (AOR = 0.377, 95% CI: 0.264, 0.539) and meeting 2 guidelines (AOR = 0.527, 95% CI: 0.377, 0.736) were associated with a lower risk of frailty (P value < 0.001), showing a linear trend (P for trend < 0.001). The strength of these associations varied somewhat by age, gender, and ethnicity. Conclusions: Significant associations between the 24-h movement guidelines and frailty were observed among U.S. adults. Future studies are warranted to examine the causality and trajectory of these associations. [ABSTRACT FROM AUTHOR]

Background: Mobilization with Movement (MWM) is an examination and management approach for correcting the intra-articular translational and rotational movements to facilitate the active physiological movement. The study aimed to determine the effects of MWM on Total Knee Arthroplasty (TKA) using a randomized controlled trial (RCT) design. Methods: The trial is registered (ISRCTN ref: 13,028,992). A blinded examiner assessed patients at pre-surgical (before TKA), post-surgical (at 3-weeks post-TKA), 6-weeks and 6-months post-TKA. Participants were randomly assigned to receive MWM (six sessions, between 3 and 6 weeks post-TKA) plus standard rehabilitation (intervention group) or standard rehabilitation alone (control group) of outpatient rehabilitation including range of motion and strengthening exercises, cycling, gait and stair training. Outcome measures were range of motion (goniometer), pain (visual analogue scales), physical function (Timed Up and Go (TUG)), a 15-m walk test, and health status (Western Ontario and McMaster (WOMAC) Osteoarthritis Index). Change in outcome measures from post-surgical to 6 weeks and 6 months post-TKA were compared between groups. The primary outcome was change in knee flexion range of motion at 6 weeks. Results: 84 women scheduled for TKA were randomly allocated to intervention (n = 42) or control (n = 42); mean ± (SD) age 65.1 ± 7.4 and 66.8 ± 8.9 years, respectively. The intervention group demonstrated significantly greater increase in knee flexion at both 6 weeks (median (IQR) + 10.000 (20.000) compared with + 2.500 (6.250) in the control group) and 6 months (+ 12.500 (15.000) and + 5.000 (10.000) respectively) (both p < 0.05). There were no differences between groups in secondary outcomes. Conclusion: Introducing MWM for TKA rehabilitation has greater benefits for women post-TKA in increasing knee joint flexion range of motion than the standard rehabilitation programs in the short and medium-term. This evidence-based approach offers a promising adjunctive intervention for optimizing recovery and rehabilitation process following TKA in women. Clinicians should consider including MWM approach in post-TKA rehabilitation programs. Level of Evidence: I [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to translate the Fear of Falling Avoidance Behavior Questionnaire (FFABQ) into Traditional Chinese (FFABQ-TC) and to evaluate the psychometric properties of FFABQ-TC in Taiwanese adults. Methods: We translated and culturally adapted the FFABQ into Traditional Chinese, ensuring linguistic accuracy and cultural relevance. A total of 230 Taiwanese community-dwelling adults participated in the study. Test-retest reliability was assessed in 30 participants, while 200 participants were included in the validity analysis. Known-groups validity was investigated by comparing the FFABQ-TC scores between fallers and non-fallers. Convergent validity was examined by correlating FFABQ-TC scores with Activities-specific Balance Confidence Scale (ABC), Geriatric Fear of Falling Measure (GFFM), and Timed-Up-and-Go (TUG) test. Results: The FFABQ-TC demonstrated excellent test-retest reliability (Intraclass Correlation Coefficient = 0.884) and excellent internal consistency (Cronbach's alpha = 0.930). Known-groups analysis revealed that FFABQ-TC significantly differentiated between fallers and non-fallers. Convergent validity was examined and showed significant correlations of FFABQ-TC with the ABC, the GFFM, and TUG. Conclusion: The psychometric properties of FFABQ-TC was established in Taiwanese adults for assessing FOF-related avoidance behaviors. The translated and adapted FFABQ-TC is a reliable and valid clinical tool for evaluating fall risk in this population. IMPLICATION FOR REHABILITATION: The current evidence supports the reliability and validity of the Traditional Chinese version of the Fear of Falling Avoidance Behavior Questionnaire (FFABQ-TC) in Taiwanese community-dwelling adults. FFABQ-TC is recommended as a reliable measurement to determine fall risk in clinical and research settings. [ABSTRACT FROM AUTHOR]

Background: Motion can exacerbate headache during a migraine attack, potentially leading to avoidance of routine physical activity. Advances in wrist-worn actigraphy facilitate objectively analyzing how headache episodes affect physical activity in everyday settings. The primary hypothesis was hypoactivity during daytime headache events. Secondary hypotheses are hypoactivity during the prodromal and postdromal hours closest to the headache event. Methods: During a 90-day prospective observational study, participants diagnosed with migraine wore an actigraphy device on their non-dominant wrist during daily life and work, while also logging migraine-related data in a dedicated smartphone application. There were no restrictions on use of acute and preventive headache treatments. Data from the wrist-worn accelerometer were used to (i) calculate activity energy expenditure, and (ii) predict types of human activities. These metrics were used to compare daytime prodromal, ictal, and postdromal phases of headache events with time-matched intervals during non-headache periods. Results: A significant reduction in daytime physical activity was observed during the ictal phase of headache attacks, as evidenced by decreases in both activity energy expenditure and human activity recognition prediction metrics. A reduction in movement was also observed during evening hours (18:00–24:00) on headache days. However, no significant physical activity changes were noted in the prodromal and postdromal phases. Reduced physical activity was more pronounced during the ictal phase when acute treatments were ineffective. Conclusions: This study is the first to examine the impact of headache on physical activity levels during daytime headache events by assessing changes in daily activities and activity energy expenditure in individuals with migraine, within their habitual environments and without restrictions on acute medication use. Our findings confirm reduced movement during the ictal phase of migraine attacks, supporting the primary hypothesis. Wrist-worn actigraphy further indicated that this reduction is more pronounced when patients experience movement sensitivity. Evening hypoactivity is also observed on headache days. Furthermore, attacks with ineffective acute treatment or moderate-to-high intensity were associated with more pronounced reductions in movement. In contrast, our data did not support the secondary hypothesis that physical activity would decrease during daytime prodromal and postdromal periods. Trial registration: NCT04983186 (www.ClinicalTrials.gov). [ABSTRACT FROM AUTHOR]

In various technology-enhanced learning (TEL) environments, knowledge co-creation progresses through multimodal interactions that integrate verbal and nonverbal modalities, such as speech and gestures. This study investigated two distinct analytical approaches for analyzing multimodal interactions—triangulating and interleaving—by applying them to collaborative learning processes during an online embodied mathematics intervention. The findings demonstrate that the interleaving approach captures the temporal dynamics and nuanced interplay between multimodal events, providing deeper insights into how shared meaning-making evolves over time. In contrast, the triangulating approach effectively identifies cumulative interaction patterns but does not account for their temporal structure. Specifically, the interleaving approach, employing epistemic network analysis, revealed statistically significant differences in discourse patterns between learners with larger and smaller variances in upper body movements during the co-design activity. These findings underscore the complementary value of the interleaving approach in analyzing multimodal interactions and offer practical implications for advancing understanding of collaborative learning processes in TEL environments. [ABSTRACT FROM AUTHOR]

Greater tuberosity (GT) fractures of the humerus contribute to 14–20% of all proximal humeral fractures (PHF) and provide considerable challenges because of their proximity to the rotator cuff, which may negatively affect shoulder function if left untreated. A 45-year-old man who had an isolated, non-displaced GT fracture in a motorbike accident is the subject of this case report. The patient received a new virtual reality (VR) intervention and a thorough rehabilitation programme after an initial period of immobility. Through the VR component, the patient was able to participate in immersive exercises designed to improve motivation and movement. Assessments of range of motion and the Constant-Murley Score (CMS), which increased from 16 on day 1 to 33 at the completion of therapy, were used to track progress. Significant gains in shoulder mobility and patient-reported outcomes were observed in the results, indicating that the use of virtual reality could increase the effectiveness of rehabilitation. Further investigation in larger clinical studies is necessary in the context of this example, which supports the potential use of VR as an adjuvant in shoulder rehabilitation following a GT fracture. [ABSTRACT FROM AUTHOR]

Background: Enhancing youth's physical fitness levels during childhood and adolescence through prior training programs can significantly optimize their athletic performance. The integrative neuromuscular training (INT) model is designed to improve neuromuscular function and prevent athletic injuries, and is superior to the traditional physical training method. This systematic review and meta-analysis aims to compare the effects of INT versus traditional physical fitness training (PT) on physical performance-related outcomes in young athletes. Methods: Six online databases (PubMed, MEDLINE, Embase, SPORTDiscus, Web of Science, PsycINFO) searched from inception through 15 January 2024. Meta-analysis was performed when data were available from two or more trials. Physical performance-related outcomes were analyzed using standardized mean differences (SMDs) and mean differences (MDs) with 95% confidence intervals (CIs). The certainty of evidence and quality of the included studies were rated using the GRADE scale and the revised Cochrane risk-of-bias tool respectively. Results: Seventeen randomized controlled trials with 649 young athletes were included in the systematic review. Of those, 1 study showed a low risk of bias, 1 showed a high risk, and 15 showed some concerns. Compared to the PT group, INT significantly improved dynamic balance (MD = 7.29%, 95%CI 3.31 to 11.28, p < 0.001, I2 = 64.7%), static balance (SMD = −0.54, 95%CI −0.84 to −0.24, p < 0.001, I2 = 0.0%), jumping performance (SMD = 0.53, 95%CI 0.32 to 0.73, p < 0.001, I2 = 0.0%), sprinting capacity (SMD = −0.76, 95%CI −1.13 to −0.39, p < 0.001, I2 = 57.6%) and maximal strength (SMD = 1.01, 95%CI 0.35 to 1.67, p = 0.002, I2 = 81.9%%). No significant between-group differences were identified for agility and flexibility. Conclusion: Our findings suggest that INT has the potential to be an effective training method to improve physical performance in young athletes. Moreover, further research is needed to determine the effects and associated doses for young athletes of different age groups. Key Points: Integrated neuromuscular training (INT) significantly improves balance, lower-body explosive power, and maximal strength in young athletes compared to traditional physical fitness training. INT interventions show significant enhancements in agility and flexibility after sensitivity analysis, indicating their potential for comprehensive physical performance improvements. Subgroup analysis suggests that longer interventions (over 12 weeks) and higher training frequencies (triweekly) show a trend towards greater improvements in young athletes' physical performance, despite not reaching statistical significance. [ABSTRACT FROM AUTHOR]

This article highlights the import of two phenomenological variables: the implicit temporal and bodily movement experience. Then, I propose some ideas to build a framework for mental health. The proposal begins by critically considering Stanghellini's conception of alterity, as he defines its relation through two conditions: reflexive self-awareness and "spoken word" dialogue. This conception prioritizes mental health work in the reflexive realm. In contrast, my conception prioritizes the pre-reflective realm of experience, in general, and focuses on the mineness sphere, in particular. This conception leads to consider two of Husserl's phenomenological findings: first, awareness has a temporal structure, and second, temporal experience is constituted from the flow of consciousness. These findings are considered in terms of their constitutive import to subjectivity through the two variables. Next, I propose a general idea for a phenomenological framework of mental health work, integrating the two phenomenological variables with the concepts of alterity and ipseity. The psychotherapeutic approach known as "rhythmic relating" is considered to illustrate the key clinical role these two variables play, supporting the general aim. The conclusion presents the consequences of the proposal. [ABSTRACT FROM AUTHOR]

Background: Peripheral artery disease (PAD) negatively affects walking performance, health-related quality of life (HRQoL) and mental health. Exercise training is recommended as a first-line treatment for PAD, with potential impact on all these outcomes, but the optimal program design is not completely ascertained. The aim of this study was to compare arm-ergometry (AEx) and treadmill supervised exercise training (TEx) on HRQoL and mental health in patients with PAD. Methods: This was an ancillary study of the ARMEX trial, a single-center, single-blinded, parallel group, randomized clinical trial, enrolling symptomatic PAD patients referred to a cardiovascular rehabilitation program (CRP). Participants were randomized (1:1) to a 12-week AEx or TEx, along with the core components of a CRP (nutritional and psychological support). Participants completed the short form 36 Health Survey and the Hospital Anxiety and Depression scale before and after the intervention. Differences between groups in the change from baseline to the end of the study were analyzed using ANCOVA, adjusted for baseline values, or the Mann-Whitney U test. Results: Fifty-six patients (66 ± 8.4 years; 87.5% male) were included: AEx (n = 28) and TEx (n = 28). Physical functioning, role-physical, bodily-pain, general health, mental health and physical component summary (PCS) significantly improved in AEx group. In the TEx group, physical functioning, role-physical, bodily-pain, vitality, social functioning, role-emotional and PCS significantly improved. Role-physical and role-emotional improved more in TEx, with no between-group differences in the other domains. Changes in PCS were significantly associated with changes in walking distances. Hospital Anxiety and Depression scale scores improved in both groups, without between-group differences. This improvement was associated with self-reported walking distance. Conclusion: Both exercise protocols improved HRQoL and mental health in patients with symptomatic PAD, highlighting exercise-based programs as important treatment strategies for this population. Trial registration number: ISRCTN54908548 (retrospectively registered). [ABSTRACT FROM AUTHOR]

In recent years Withania somnifera (Ashwagandha) gained a lot of interest as an adaptogen, aiding sleep, stress management and presenting health and sports-related benefits. Although clinical effects have been previously reviewed, the specific mechanism of Ashwagandha's action and its impact on different aspects of physical performance, body composition, as well as medical effects need more thorough analysis. Therefore, this narrative review delves into the available research examining the effects of Ashwagandha supplementation on such qualities as: strength, endurance, power, recovery, muscle mass, body fat, fertility, anxiety, metabolic health and aging, with additional focus on potential mechanisms underlying these effects. Moreover, we propose future perspectives based on the gaps observed in Ashwagandha research up to date. [ABSTRACT FROM AUTHOR]

Objective: This study investigates the interplay between muscle strength, information processing speed, EEG-specific biomarkers, and cognitive function in elderly individuals with cognitive impairments, emphasizing the mediating roles of information processing speed and EEG-specific biomarkers. Method: A cross-sectional study design was employed to recruit 151 elderly participants. The participants underwent grip strength and 30-s sit-to-stand tests to assess muscle strength, completed the Trail Making Test part A (TMT-A) and the Symbol Digit Modality Test (SDMT) to evaluate information processing speed, and utilized the Montreal Cognitive Assessment (MOCA) to gauge cognitive function. Additionally, EEG signals were recorded for 5 min to capture neural activity. Results: The difference in information processing speed among elderly individuals with varying degrees of cognitive impairment was statistically significant (p < 0.001). A significant negative correlation was observed between the MoCA score and the time consumption of TMT-A (r = −0.402, p < 0.01), and a significant positive correlation was found between the MoCA score and the SDMT score (r = 0.609, p < 0.01). Grip strength was negatively correlated with the time consumption of TMT-A (r = −0.336, p < 0.01) and positively correlated with the SDMT score (r = 0.336, p < 0.01). A significant negative correlation was found between the 30-s sit-to-stand test and the time consumption of TMT-A (r = −0.273, p < 0.01), and a significant positive correlation was observed between the 30-s sit-to-stand test and the SDMT score (r = 0.372, p < 0.01). Additionally, we observed that the α1 power value indicators were significantly correlated with the MoCA score, the time consumption of TMT-A, and the SDMT score (all p < 0.01). The α1 power values at F7 + F8 and T5 + T6 were identified as sensitive EEG indicators for muscle strength and information processing speed. The EEG-specific indicators (B = 0.019, 95% CI: 0.003, 0.047) and information processing speed (B = 0.137, 95% CI: 0.096, 0.292) were found to partially mediate the relationship between grip strength and MoCA scores, with information processing speed exerting a stronger mediating effect. Conclusion: Specific patterns were observed in the EEG of elderly individuals with cognitive impairments, which could objectively assess the risk of cognitive decline in this population. Muscle strength, information processing speed, and EEG-specific biomarkers were closely associated with cognitive function in elderly individuals. The potential pathway of interaction—muscle strength → EEG-specific biomarkers → information processing speed → cognitive function—provides valuable insights into advancing the field of cognitive research in the elderly. [ABSTRACT FROM AUTHOR]

Background: Iron deposition has been observed in Parkinsonism and is emerging as a diagnostic marker for movement disorders. Brain functional network disruption has also been detected in parkinsonism, and is believed to be accountable for specific symptoms in parkinsonism. However, how iron deposition influences brain network remains to be elucidated. Methods: We recruited 16 Parkinson's disease (PD), 8 multiple system atrophy (MSA) and 7 progressive supranuclear palsy (PSP) patients. T1-weighted, susceptibility weighted images and resting-state functional MRI (rs-fMRI) were acquired. Quantitative susceptibility mapping (QSM) analysis was performed to quantify iron deposition in substantia nigra, putamen and dentate nucleus. Cerebellar network, sensorimotor network, default mode network and language networks were segregated using independent analysis. Network and iron deposition status were evaluated in relation to diagnostic groups, motor and non-motor symptoms. The relationship between quantitative iron deposition and brain network status was further interrogated. To further validate the findings, 13 healthy controls and 37 PD patients who had available T1 and rs-fMRI scans were selected from Parkinson's progression markers initiative (PPMI) database, and network analysis was performed. Results: In local cohort, compared to PD, MSA patients showed greater iron deposition in putamen, while PSP patients had greater iron deposition in caudate nucleus and thalamus. Cerebellar and language networks showed significant difference across diagnostic groups, while default mode network and sensorimotor network did not. MSA patients had significantly impaired cerebellar network and language networks compared to PD patients. Cerebellar network was positively associated with motor symptom scores while language network was positively associated with MoCA scores in the patients. Iron deposition was negatively associated with both networks' activity in the patients. In PPMI cohort, impairment was found in both cerebellar and language networks in PD. Cerebellar and language networks correlated with motor and cognitive impairment, respectively. Conclusion: Cerebellar network and language networks are differently influenced in MSA, PD and PSP, which can serve as potential diagnostic marker. Impairment of cerebellar network and language network are associated with motor symptoms and cognitive impairment, respectively. Moreover, dysfunction of the networks is associated with iron deposition in deep nuclei (SN, DN, Putamen). [ABSTRACT FROM AUTHOR]

Background: The core stability program is commonly utilized as an intervention method to improve postural control. This study aimed to evaluate the effect of core stability exercises on upper limb reaching in children with hemiparetic cerebral palsy (CP). For this purpose, 30 hemiparetic CP children of both sexes were recruited for the study. The children were between the ages of 4 and 6. According to the modified Ashworth scale (MAS), the degree of spasticity varied from 1 to 1 + , and for children who were selected, the average Trunk Control Measurement Scale (TCMS) ranged from 25 to 42. Children were assigned into two groups at random (study group and control group). The pediatric reach test (PRT) was used to assess each child both before and after two consecutive months of therapy. The children in both groups received the same program of selected physical therapy exercises, but the children in the study group also performed the selected physical therapy program in addition to the core stability exercises. Results: By comparing the mean values of all assessed variables before and after therapy, both groups improved significantly (p = 0.0001). When comparing post-treatment outcomes, there were significant differences between the control and study groups in all assessed variables (p = 0.0001) in favor of the study group. Conclusion: Core stability exercises may be used to improve reaching in children with hemiparetic cerebral palsy. Trial registration: This study was authorized by the Faculty of Physical Therapy's ethics committee under the number "REC/012/003125" and registered in ClinicalTrial.gov with the number "NCT05316090" on 9 April 2022 retrospectively. [ABSTRACT FROM AUTHOR]

While optically-pumped magnetometer (OPM) technology offers a number of compelling advantages over its SQUID predecessor for magnetoencephalography (MEG), many studies and viewpoints focus on issues of (i) scalp placement, with commensurate increases in sensitivity to weak magnetic fields and (ii) room temperature operation (without the need for baths of liquid helium to maintain superconducting properties of SQUIDs). This article addresses another unique and tantalizing opportunity—the ability for the OPM array to be "wearable", and thus to move with the participant. This is critical in adoption of naturalistic paradigms that move beyond "laboratory neuroscience" toward "real world neuroscience". It is also critically important in application to pediatric populations who cannot or will not remain still during conventional MEG scan procedures. Application to the developing infant brain will be considered as well as application to pediatric neuropsychiatric and developmental disorders, such as autism spectrum disorder. Rather than present solutions, this article will highlight the challenges faced by conventional SQUID-based cryo-MEG and explore the potential avenues for OPM-MEG to make a positive impact to the field of pediatric neuroscience. [ABSTRACT FROM AUTHOR]

Background Pain is common in people with dementia in general hospitals. This can be difficult to identify. Objectives To evaluate the psychometric properties of PainChek electronic pain assessment tool. Design Cross-sectional psychometric study. Setting Six medical care of older people wards from two general hospitals in greater London, UK. Subjects 63 people with clinical diagnosis of dementia: mean 84 years (SD 6.7), 59% female, 69% living in their own homes, 64% white British, 77% moderate/severe dementia. Method Psychometric evaluation of PainChek, a point-of-care electronic pain assessment tool combining artificial intelligence, facial analysis and smartphone technology. From a total of 216 assessments, we tested PainChek's inter-rater reliability (IRR) (Cohen's kappa), internal consistency (Cronbach's alpha) and concurrent validity (Pearson's coefficient) between PainChek and Pain Assessment in Advanced Dementia (PAINAD) scores at rest and post-movement [95% confidence interval (95% CI) where appropriate]. We assessed convergent validity with Symptom Management–End of Life in Dementia scale (SM-EOLD) (Pearson's coefficient) and discriminant validity (rest vs post-movement). Results IRR was 0.714 (95% CI 0.562 to 0.81) (rest) and 0.817 (95% CI 0.692 to 0.894) (post-movement). Internal consistency was 0.755 (rest) and 0.833 (post-movement). Concurrent validity with PAINAD was 0.528 (95% CI 0.317 to 0.690) (rest) and 0.787 (0.604 to 0.891) (post-movement). Convergent validity with SM-EOLD was −0.555 (95% CI −0.726 to −0.318) (rest) and −0.5644 (95% CI −0.733 to −0.331) (post-movement). Discriminant validity was significant. Conclusions PainChek is a valid and reliable pain assessment tool for people with dementia in general hospitals. Further consideration will be needed for implementation into this setting. [ABSTRACT FROM AUTHOR]

Objective To investigate the effectiveness of formula nutrition supplementation (mainly containing glucosamine sulphate, chondroitin sulphate and rhizoma drynariae) plus supervised exercise versus exercise alone for the treatment of knee osteoarthritis (OA). Methods This was a double-blinded, single-centre, randomised, placebo-controlled trial. The study recruited 65 participants (40–75 years) with knee OA. Participants were randomly allocated to nutrition supplementation plus exercise (N + E) group or placebo plus exercise (P + E) group. The intervention lasted for 6 months. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. Secondary outcomes included physical function and performance scores, lower extremity strength and serum biomarkers. Results Among the 65 randomised patients, 56 (86%) completed the trial. At 3 months, more participants in the N + E group than in the P + E group achieved minimum clinically important difference (MCID) in WOMAC total score (19/30 [63.3%] vs 8/26 [30.8%]; P  < .01). At 6 months, more participants in the N + E group than in the P + E group achieved MCID in WOMAC stiffness score (19/30 [63.3%] vs 10/26 [38.5%]; P  < .05). Meanwhile, at 6 months the decreased percentages of WOMAC stiffness score in the N + E group was greater than in the P + E group (P  < .05). The flexor peak torque at 120°/s and 180°/s in the N + E group were significantly higher than those in the P + E group at 3 months (P  < .05). Moreover, compared with baseline, improvements in the WOMAC overall and pain score, visual analogue scale pain and 30-second chair stand test were observed in both groups at 6 months. However, these indicators in the N + E group were improved as early as 3 months (P  < .05). Conclusions The improvement effects of nutrition supplementation plus exercise were superior to those of exercise alone, and the improvement occurred earlier. Nutrition supplementation plus exercise would be a more efficient strategy for knee OA. [ABSTRACT FROM AUTHOR]

Objective: Fear of movement in patients with traumatic hand–arm injuries can negatively affect functional outcomes. Therefore, it is important to evaluate fear of movement in this patient population. The aim of this study was to investigate the validity and reliability of the Tampa Scale for Kinesiophobia in patients with traumatic hand–forearm injuries. Design: Cross-sectional. Setting: Hand rehabilitation unit in a university hospital. Participants: The study included 170 patients with traumatic hand–arm injuries and a mean age of 37.57 (11.85) years. Main measures: Tampa Scale for Kinesiophobia, Pain Catastrophizing Scale, Beck Anxiety Inventory and pain severity rating (via Visual Analog Scale) were completed by interview in the first session. In addition, Modified Hand Injury Scoring System was used to determine severity of the injury. Tampa Scale for Kinesiophobia was re-administered 15 days after the first session. Test–retest reliability, internal consistency, and construct validity of the Tampa Scale for Kinesiophobia were evaluated. In addition, exploratory factor analysis was completed using baseline data. Results: Cronbach's alpha for the scale was 0.604, and test–retest reliability was acceptable (ICC = 0.646). Tampa Scale for Kinesiophobia had a significant relationship with Beck Anxiety Inventory (r = 0.269, p < 0.001), Pain Catastrophizing Scale (r = 0.457, p < 0.001) and pain severity at rest (r = 0.168, p = 0.029). Factor analysis estimated the scale represented five subsections in this population. Conclusions: Psychometric properties of the Tampa Scale for Kinesiophobia were acceptable in patients with hand–forearm injuries. However, since our results were weaker than those in the literature, this should be considered when interpreting the results. [ABSTRACT FROM AUTHOR]