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Abstract Objective Explore the effects of a 4-week intervention using semi-custom insoles in recreational runners with patellofemoral pain. Design Mixed methods. Participants Seventeen (10 males and 7 females) recreational runners. Setting Laboratory. Outcome measurements Participants were separated into specific subgroups, then provided with a pair of semi-custom insoles, for a period of 4-weeks. Lower extremity kinetics/kinematics during running at 4.0 m/s were obtained. In addition, knee pain was examined using the Knee injury and Osteoarthritis Outcome Score-Patellofemoral scale (KOOS-PF). Data were collected before and after wearing the insoles for 4-weeks. Results Significant improvements were shown for KOOS-PF in both subgroups (strong: (pre) = 63.84 & (post) = 71.49 and weak and tight: (pre) = 53.03 & (post) = 72.73), although only improvements in the weak and tight group exceeded the minimum clinically important difference (MCID). In addition, significant reductions in peak patellofemoral stress were shown in both subgroups (strong: (pre) = 6.82 & (post) = 6.39KPa/BW and weak and tight: (pre) = 7.66 & (post) = 6.28KPa/BW), although only reductions in the weak and tight group exceeded the MCID. Conclusions Semi-custom insoles may be a mechanism to reduce patellofemoral pain symptoms in recreational runners from the weak and tight subgroup. It is proposed that this improvement was mediated through reductions in patellofemoral loading in this subgroup. Highlights • First intervention to examine semi-custom orthoses in runners with patellofemoral pain. • First study to examine the effects of conservative treatments in different subgroups. • Examination of psychological wellbeing alongside self-reported pain symptoms is also provided. [ABSTRACT FROM AUTHOR]

• MS patients experienced fear, loss of control and hopelessness at diagnosis. • Choosing disease modifying treatments was accompanied by fear and uncertainty. • Treatment decisions gave opportunity to increase hope, control, and acceptance. • Treatment choices were motivated by a desire for normality. • Patients were concerned about future employment and family planning. People with Relapsing Remitting Multiple Sclerosis (RRMS) are increasingly included as active participants in shared decision making around their treatment options. Choosing a first disease modifying treatment (DMT) is a complex process that often takes place soon after a diagnosis has been given. Patients therefore are often required to make difficult decisions at a time when they are still coming to terms with their illness. This study investigated the views and experiences of recently diagnosed patients with RRMS when they were making their initial DMT choice. This was a qualitative study involving in-depth semi-structured interviews with patients with RRMS in a National Health Service (NHS) setting in the United Kingdom. Data were collected from 6 patients and analysis was guided by an Interpretive Phenomenological Analysis (IPA) approach. Initial reactions to diagnosis were characterized by strong emotions and a feeling of despair and hopelessness. Subsequently the DMT decision was shaped by multiple considerations around maintaining normality, and restoring hope and control over one's life whilst reconciling uncertainty around efficacy. Considering the future with a DMT elicited reflections around employment and family planning. Emotions and lived experience related to recent MS diagnosis can impact on the initial DMT decision in number of ways. Health care professionals need to understand the lived experience of patients making DMT decisions soon after diagnosis when engaging in shared decision making. [ABSTRACT FROM AUTHOR]

Janssen JC, Le-Ngoc L. Intratester reliability and validity of concentric measurements using a new hand-held dynamometer. Objective: To assess the reliability of a new hand-held dynamometer (HHD) to perform concentric measurements, and to determine the agreement between the HHD and the criterion standard isokinetic dynamometer. Design: Elbow flexion concentric measurements were performed on a mechanical arm using the HHD and the isokinetic dynamometer. Setting: Engineering laboratory and university strength-testing facility. Participants: Three patient profiles, differing in range of motion (ROM) and strength, were simulated by a mechanical arm. Interventions: Not applicable. Main Outcome Measures: Peak torque and ROM obtained from concentric elbow flexion profiles. Results: Intratester reliabilities, measured with the intraclass correlation coefficient (ICC1,1), of the peak torque and start and end ROM are excellent for both the HHD (.99, .98, and .99, respectively) and the isokinetic dynamometer (.99 for all 3 variables). The angle of peak torque was rated fair to good in intrareliability for both devices, at .64 (HHD) and .69 (isokinetic dynamometer). Validity, measured within the limits of agreement (LOA) between the 2 devices, was clinically acceptable for peak torque and start ROM, although not for end ROM and angle of peak torque. Conclusions: It is possible to use the new HHD to obtain dynamic measurements of joint motion. Intratester reliability of the HHD is excellent and is in clinical acceptable agreement with the isokinetic dynamometer for peak torque and start ROM. End ROM was, however, not in agreement because of a systematic error in the isokinetic dynamometer measurement for 1 of the 3 tested profiles. Intratester reliabilities of the angle of peak torque were fair to good for both the HHD and isokinetic dynamometer, but the LOA were not clinically acceptable. Stability of the arm and speed of measurement might be confounding factors in this study. [Copyright &y& Elsevier]

Background: Freezing of gait (FOG) remains one of the most common debilitating aspects of Parkinson's disease and has been linked to injuries, falls and reduced quality of life. Although commercially available portable cueing devices exist claiming to assist with overcoming freezing; their immediate effectiveness in overcoming gait initiation failure is currently unknown. This study investigated the effects of three different types of cueing device in people with Parkinson's disease who experience freezing.Methods: Twenty participants with idiopathic Parkinson's disease who experienced freezing during gait but who were able to walk short distances indoors independently were recruited. At least three attempts at gait initiation were recorded using a 10 camera Qualisys motion analysis system and four force platforms. Test conditions were; Laser Cane, sound metronome, vibrating metronome, walking stick and no intervention.Results: During testing 12 of the 20 participants had freezing episodes, from these participants 100 freezing and 91 non-freezing trials were recorded. Clear differences in the movement patterns were seen between freezing and non-freezing episodes. The Laser Cane was most effective cueing device at improving the forwards/backwards and side to side movement and had the least number of freezing episodes. The walking stick also showed significant improvements compared to the other conditions. The vibration metronome appeared to disrupt movement compared to the sound metronome at the same beat frequency.Conclusion: This study identified differences in the movement patterns between freezing episodes and non-freezing episodes, and identified immediate improvements during gait initiation when using the Laser Cane over the other interventions. [ABSTRACT FROM AUTHOR]

Due to current measurement, sizing and fitting approaches, poor bra fit is prevalent amongst larger breasted women. The impact of improving bra fit hasn't yet been explored. This pre-clinical study aimed to explore immediate and short-term biomechanical responses to changing breast support garment. Asymptomatic participants (n=24) performed a static standing task, drop jumps and seated typing whilst kinematic data from the breasts and spine were recorded. Three breast support conditions were assessed: Usual, professionally fitted bra in the immediate term (PFB), and the same professionally fitted bra after four weeks wear (PFB28). Bra fit assessments were included for both bras. All participants failed the bra fit assessment when wearing the Usual bra and 67% (n=16) failed when wearing the PFB. Less bra fit issues were present in the PFB, resulting in immediate biomechanical changes relating to breast support and spinal posture, yet nothing in the short term (PFB28). This research sets the foundations for future work to investigate whether the implementation of better fitting breast support garments can influence musculoskeletal pain amongst larger breasted women, whilst attributing potential improvement of symptoms, objective measures of breast support and spinal posture. [ABSTRACT FROM AUTHOR]