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Purpose: Few studies have assessed listening effort (LE)--the cognitive resources required to perceive speech--among populations with intact hearing but reduced availability of cognitive resources. Attention/deficit/hyperactivity disorder (ADHD) is theorized to restrict attention span, possibly making speech perception in adverse conditions more challenging. This study examined the effect of ADHD on LE among adults using a behavioral dual-task paradigm (DTP). Method: Thirty-nine normal-hearing adults (aged 21-27 years) participated: 19 with ADHD (ADHD group) and 20 without ADHD (control group). Baseline group differences were measured in visual and auditory attention as well as speech perception. LE using DTP was assessed as the performance difference on a visual-motor task versus a simultaneous auditory and visual-motor task. Results: Group differences in attention were confirmed by differences in visual attention (larger reaction times between congruent and incongruent conditions) and auditory attention (lower accuracy in the presence of distractors) among the ADHD group, compared to the controls. LE was greater among the ADHD group than the control group. Nevertheless, no group differences were found in speech perception. Conclusions: LE is increased among those with ADHD. As a DTP assumes limited cognitive capacity to allocate attentional resources, LE among those with ADHD may be increased because higher level cognitive processes are more taxed in this population. Studies on LE using a DTP should take into consideration mechanisms of selective and divided attention. Among young adults who need to continuously process great volumes of auditory and visual information, much more effort may be expended by those with ADHD than those without it. As a result, those with ADHD may be more prone to fatigue and irritability, similar to those who are engaged in more outwardly demanding tasks.

Background and purpose: Whereas motor skills of the untrained upper limb (UL) can improve following practice with the other UL, it has yet to be determined if an UL motor skill can improve following practice of that skill with the lower limb (LL). Methods: Forty-five healthy subjects randomly participated in a 10-minute single-session intervention of (1) practicing 50 reaching movement (RM) sequences with the non-dominant left LL toward light switches (LL group); or (2) observing the identical 50 light switches sequences (Switches Observation (SO) group); or (3) observing nature films (Nature Observation (NO) group). RM sequence performance with the left UL toward the light switches was tested before and immediately after the intervention and retested after 24 h. Results: Reaching response time improved in the LL group more than in the SO and NO groups in the posttest (pBonferroni = 0.038 and pBonferroni < 0.001, respectively), and improved in the LL group more than in the NO group in the retest (pBonferroni = 0.004). Percentage of fails did not differ between groups across the timepoints. Conclusions: It appears that the actual practice of the RM sequence skill with the UL together with the cognitive element embedded in the observation of the RM sequences contributes to ipsilateral transfer from LL to UL. [ABSTRACT FROM AUTHOR]

Context: Decreased scapular upward rotation (UR) and diminished activation of the serratus anterior (SA) and lower trapezius (LT) are often observed among patients with subacromial impingement syndrome. Maintaining the elbow fully flexed during shoulder flexion may limit glenohumeral motion due to passive insufficiency of the triceps brachii and therefore facilitate greater scapular UR and increased scapular muscle activation. Objectives: To compare scapular UR, SA, upper trapezius (UT), middle trapezius, and LT activation levels between shoulder flexion with the elbow extended (Flexion-EE) to shoulder flexion with the elbow fully flexed (Flexion-EF). This study hypothesized that Flexion-EF would result in greater scapular UR, greater SA and LT activation, and a lower UT/SA and UT/LT activation ratio compared with Flexion-EE. Design: Cross-sectional study. Setting: A clinical biomechanics laboratory. Participants: Twenty-two healthy individuals. Main Outcome Measures: Scapular UR and electromyography signal of the SA, UT, middle trapezius, and LT, as well as UT/SA and UT/LT activation ratio were measured during Flexion-EE and Flexion-EF. Results: Flexion-EF resulted in greater scapular UR compared with Flexion-EE (P < .001). Flexion-EF resulted in greater S A activation, lower UT activation, and a lower UT/SA activation ratio compared with Flexion-EE (P< .001). Conclusions: Fully flexing the elbow during shoulder flexion leads to increased scapular UR primarily through greater activation of the SA. This exercise may be of value in circumstances involving diminished scapular UR, decreased activation of the SA, and an overly active UT such as among patients with subacromial impingement syndrome. [ABSTRACT FROM AUTHOR]

Background: Little information exists to guide the choice of exercise for regaining shoulder range of motion (ROM). The purpose of this study was to compare the maximal ROM reached, pain and difficulty associated with 4 commonly prescribed exercises. Methods: Forty (9 females) patients with various shoulder disorders and a limited flexion ROM performed 4 exercises for regaining shoulder flexion ROM in a randomized order. Exercises included the self-assisted flexion, forward bow, table slide and rope-and-pulley. Participants were videotaped while performing all exercises and the maximal flexion angle reached during each exercise was recorded using Kinovea motion analysis freeware (Kinovea 0.8.15). Pain intensity and the perceived level of difficulty associated with each exercise were also recorded. Results: The forward bow and table slide generated significantly greater ROM compared with the self-assisted flexion and rope-and-pulley (P ≤ 0.005). The self-assisted flexion was associated with a greater pain intensity compared with the table slide and rope-and-pulley (P = 0.002) and a greater perceived level of difficulty compared with the table slide (P = 0.006). Conclusions: Due to the greater ROM allowed, and similar or even lower level of pain or difficulty, clinicians may wish to initially recommend the forward bow and table slide for regaining shoulder flexion ROM. [ABSTRACT FROM AUTHOR]

The effects of action observation (AO) on motor performance can be modulated by instruction. The effects of two top-down aspects of the instruction on motor performance have not been fully resolved: those related to attention to the observed task and the incorporation of motor imagery (MI) during AO. In addition, the immediate vs. 24-h retention test effects of those instruction's aspects are yet to be elucidated. Forty-eight healthy subjects were randomly instructed to: (1) observe reaching movement (RM) sequences toward five lighted units with the intention of reproducing the same sequence as fast and as accurate as possible (Intentional + Attentional group; AO+At); (2) observe the RMs sequence with the intention of reproducing the same sequence as fast and as accurate as possible and simultaneously to the observation to imagine performing the RMs (Intentional + attentional + MI group; AO+At+MI); and (3) observe the RMs sequence (Passive AO group). Subjects' performance was tested before and immediately after the AO and retested after 24 h. During each of the pretest, posttest, and retest, the subject performed RMs toward the units that were activated in the same order as the observed sequence. Occasionally, the sequence order was changed by beginning the sequence with a different activated unit. The outcome measures were: averaged response time of the RMs during the sequences, difference between the response time of the unexpected and expected RMs and percent of failures to reach the target within 1 s. The averaged response time and the difference between the response time of the unexpected and expected RMs were improved in all groups at posttest compared to pretest, regardless of instruction. Averaged response time was improved in the retest compared to the posttest only in the Passive AO group. The percent of failures across groups was higher in pretest compared to retest. Our findings suggest that manipulating top-down aspects of instruction by adding attention and MI to AO in an RM sequence task does not improve subsequent performance more than passive observation. Off-line learning of the sequence in the retention test was improved in comparison to posttest following passive observation only. [ABSTRACT FROM AUTHOR]

Abstract: The aim of this study was to test the effects of kilohertz frequency alternating current (KHFAC) surface stimulation applied to the ulnar nerve on force and myoelectrical activity of the abductor digiti minimi (ADM) muscle. Eighteen healthy volunteers (age: 27.6 ± 7.9 years; 10 males, 8 females) were included in the study. Each subject participated in one session during which a biphasic 7 kHz rectangular pulse was delivered above the medial epicondyle of the humerus to induce ulnar nerve blocking. ADM electromyographic (EMG) activity and contraction force were measured before (Pre), immediately after, and following 5 and 10 min post stimulation (post 1, post 2). The results showed that EMG activity decreased immediately after stimulation compared to prestimulation, it returned to the level of prestimulation at 5 min (post 1), and decreased again at 10 min (post 2). Furthermore, analysis of compound adjusted z‐score indicated significant decrease of force and myoelectrical activity immediately, and 10 min post stimulation. The findings, which demonstrate that KHFAC surface stimulation of the ulnar nerve may decrease the motor activity of intrinsic hand muscle, can help to develop future methods of neuromodulation to treat hand spasticity. [ABSTRACT FROM AUTHOR]

Context: Altered movement patterns, including increased frontal-plane knee movement and decreased sagittal-plane hip and knee movement, have been associated with several knee disorders. Nevertheless, the ability of clinicians to visually detect such altered movement patterns during high-speed athletic tasks is relatively unknown. Objective: To explore the association between visual assessment and 2-dimensional (2D) analysis of frontal-plane knee movement and sagittal-plane hip and knee movement during a jump-landing task among healthy female athletes. Design: Cross-sectional study. Setting: Gymnasiums of participating volleyball teams. Patients or Other Participants: A total of 39 healthy female volleyball players (age = 21.0 6 5.2 years, height = 172.0 6 8.6 cm, mass = 64.2 6 7.2 kg) from Divisions I and II of the Israeli Volleyball Association. Main Outcome Measure(s): Frontal-plane knee movement and sagittal-plane hip and knee movement during jump landing were visually rated as good, moderate, or poor based on previously established criteria. Frontal-plane knee excursion and sagittal-plane hip and knee excursions were measured using free motion-analysis software and compared among athletes with different visual ratings of the corresponding movements. Results: Participants with different visual ratings of frontalplane knee movement displayed differences in 2D frontal-plane knee excursion (P < .01), whereas participants with different visual ratings of sagittal-plane hip and knee movement displayed differences in 2D sagittal-plane hip and knee excursions (P < .01). Conclusions: Visual ratings of frontal-plane knee movement and sagittal-plane hip and knee movement were associated with differences in the corresponding 2D hip and knee excursions. Visual rating of these movements may serve as an initial screening tool for detecting altered movement patterns during jump landings. [ABSTRACT FROM AUTHOR]

Limited ankle dorsiflexion (DF) range of motion (ROM) has been implicated in several lower extremity disorders. Effective screening for DF ROM may, therefore, help to identify "at risk" individuals. The primary purpose of this study was to determine the utility of 2 screening tests in detecting limited ankle DF ROM. Fifty-three healthy participants underwent an overhead squat (OS) test and a forward arm squat (FAS) test, as well as bilateral testing of weight-bearing and non- weight-bearing ankle DF ROM. Participants whose DF ROM fell below 1 SD from the sample average were considered to have limited DF ROM. The sensitivity, specificity, positive, and negative likelihood ratio (LR) of the OS and FAS in detecting individuals with limited DF ROM was calculated. The sensitivity of the OS was 1.00 regardless of the mode or the side of testing, whereas specificity ranged from 0.34 to 0.36. The positive LR of the OS ranged from 1.52 to 1.56, whereas negative LR was 0.00. The sensitivity of the FAS ranged from 0.56 to 0.70, whereas specificity ranged from 0.84 to 0.88. The positive and negative LR of the FAS ranged from 3.49 to 6.02, and 0.34 to 0.53, respectively. Our findings suggest that the OS and FAS may be used as complementing tests in screening for ankle DF limitation. Because of its excellent sensitivity, the OS should be performed first, and if negative, may confidently rule out limited DF ROM. However, given a positive OS, testing should proceed with the FAS, to more confidently rule in limited DF ROM. [ABSTRACT FROM AUTHOR]

* STUDY DESIGN: Controlled laboratory study. * BACKGROUND: Altered hip and knee kinematics have been associated with several knee disorders, including anterior cruciate ligament tear, patellofemoral pain, and iliotibial band syndrome. Limited ankle dorsiflexion (DF) range of motion (ROM), which has been linked with some of these disorders, has also been associated with altered knee kinematics. * OBJECTIVE: To explore the association of ankle DF ROM with hip and knee kinematics during a step-down task. * METHODS: Thirty healthy participants underwent a 3-D analysis of hip and knee kinematics during a lateral step-down test, followed by measurement of ankle DF ROM in weight bearing (WB) and non-weight bearing (NWB). Participants were dichotomized using the median values into low- and high-DF subgroups within both WB and NWB. Hip and knee kinematics were compared between the low- and high-DF subgroups. * RESULTS: Participants in the low-DF subgroups exhibited greater peak hip adduction (WB, P = .02; NWB, P<.01) and greater peak knee external rotation (WB, P = .02; NWB, P<.01) compared with participants in the high-DF subgroups. In addition, participants in the low-DF WB subgroup exhibited decreased peak knee flexion compared with participants in the high-DF WB subgroup (P<.01). * CONCLUSION: Individuals with lower ankle DF ROM exhibited hip and knee kinematics previously associated with several knee disorders, suggesting that this impairment may be involved in the pathogenesis of the same disorders. Assessment of ankle DF ROM may be useful as part of a preparticipation screening. Furthermore, deficits in ankle DF ROM may need to be addressed in individuals with altered movement patterns. [ABSTRACT FROM AUTHOR]

Altered movement patterns including contralateral pelvic drop, increased hip adduction, knee abduction, and external rotation have been previously implicated in several lower extremity pathologies. Although various methods exist for assessing movement patterns, real-time visual observation is the most readily available method. The purpose of this study was to determine whether differing visual ratings of trunk, pelvis, and knee alignment, as well as overall quality of movement, are associated with differences in 3-dimensional trunk, pelvis, hip, or knee kinematics during a lateral step down test. Trunk, pelvis, and knee alignment of 30 healthy participants performing the lateral step down were visually rated as "good" or "faulty" based on previously established criteria. An additional categorization of overall quality of movement as either good or moderate was performed based on the aggregate score of each individual rating criterion. Three-dimensional motion analysis of trunk, pelvis, hip, and knee kinematics was simultaneously performed. A faulty pelvis alignment displayed a greater peak contralateral pelvic drop (effect size [ES], 1.65; p < 0.01) and a greater peak hip adduction (ES: 1.04, p = 0.01) compared with participants with a good pelvis alignment. Participants with a faulty knee alignment displayed greater peak knee external rotation compared with participants with a good knee alignment (ES, 0.78; p = 0.02). Participants with an overall moderate quality of movement displayed increased peak contralateral pelvic drop (ES, 1.07; p = 0.01) and peak knee external rotation (ES, 0.72; p = 0.04) compared with those with an overall good quality of movement. Visual rating of quality of movement during a lateral step down test, as performed by an experienced physical therapist, is associated with differences in several kinematics previously implicated in various pathologies. [ABSTRACT FROM AUTHOR]

The article discusses a cross sectional study conducted to analyze whether weight bearing (WB) dorsiflexion (DF) ankle's range of motion (ROM) is bilaterally symmetrical. Topics discussed includes recruitment of participants of study, clinical measurements taken including body mass, height and age, difference in DF at nondominant and dominant side, correlation between WB and non-weight bearing (NWB) DF, WB DF being non symmetric bilaterally and limitations of the study such as sampling bias.

Context: Lower extremity movement patterns have been implicated as a risk factor for various knee disorders. Ankledorsiflexion (DF) range of motion (ROM) has previously been associated with a faulty movement pattern among healthy female participants. Objective: To determine the association between ankle DF ROM and the quality of lower extremity movement during the lateral step-down test among healthy male participants. Design: Cross-sectional study. Setting: Training facility of the Israel Defense Forces. Patients or Other Participants: Fifty-five healthy male Israeli military recruits (age = 19.7 ± 1.1 years, height = 175.4 ± 6.4 cm, mass = 72.0 ± 7.6 kg). Intervention(s): Dorsiflexion ROM was measured in weight-bearing and non–weight-bearing conditions using a fluid-filled inclinometer and a universal goniometer, respectively. Lower extremity movement pattern was assessed visually using the lateral step-down test and classified categorically as good or moderate. All measurements were performed bilaterally. Main Outcome Measure(s): Weight-bearing and non– weight-bearing DF ROM were more limited among participants with moderate quality of movement than in those with good quality of movement on the dominant side (P = .01 and P = .02 for weight-bearing and non–weight-bearing DF, respectively). Non-weight-bearing DF demonstrated a trend toward a decreased range among participants with moderate compared with participants with good quality of movement on the nondominant side (P = .03 [adjusted P = .025]). Weight-bearing DF was not different between participants with good and moderate movement patterns on the nondominant side (P = .10). Weightbearing and non-weight-bearing ankle DF ROM correlated significantly with the quality of movement on both sides (P < .01 and P < .05 on the dominant and nondominant side, respectively). Conclusions: Ankle DF ROM was associated with quality of movement among healthy male participants. The association seemed weaker in males than in females. [ABSTRACT FROM AUTHOR]

The article discusses the results of a cross-sectional study that determined the association between hip and ankle range-of-motion measures and quality of lower extremity movement measures among healthy women during the lateral step-down test. The study methodology is given. The study showed reduced ankle dorsiflexion range of motion among women with a moderate quality of movement. It is concluded that women who showed moderate quality of movement exhibit decreased ankle dorsiflexion range of motion.