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Background: Exercise has indisputable advantages for people with chronic conditions. Engaging in physical activity within natural environments, known as green exercise, contributes to both physical and mental well-being. The aim of this study was to investigate the perceptions of people with chronic conditions and health professionals and the perceived facilitators and barriers to therapeutic green exercise. Methods: This was a qualitative study based on two focus groups. Ethical approval was received, and a thematic analysis was used to analyze the discussions. Results: Seven patients and eight health professionals participated in the study. The thematic analysis yielded thirteen main themes. Safety concerns and inadequate infrastructures were key barriers. Core facilitators were socialization, and multisensory exposure. Conclusions: Patients with chronic conditions and health professionals believe that green exercise improves physical activity engagement, and it would be beneficial if incorporated in the rehabilitation process. There are challenges to overcome to make therapeutic green exercise for people with chronic conditions more accessible. [ABSTRACT FROM AUTHOR]

Background: The mechanoreceptors located in anterior cruciate ligament (ACL) constitute an afferent source of information toward the central nervous system. It has been proposed that ACL deficiency causes a disturbance in neuromuscular control, affects central programs and consequently the motor response resulting in serious dysfunction of the injured limb. Purpose: The objective of this study was to investigate whether chronic anterior cruciate ligament injury causes plastic changes in brain activation patterns. Study Design: Case control study; Level of evidence, 3. Methods: Seventeen right leg-dominant male participants with chronic anterior cruciate ligament deficiency and 18 matched healthy male participants with no special sport or habitual physical activity participated in this study. Patient selection criteria comprised a complete right unilateral anterior cruciate ligament rupture =6 months before testing. Brain activation was examined by using functional magnetic resonance imaging technique (1.5-T scanner). Results: Results show that patients with anterior cruciate ligament deficiency had diminished activation in several sensorimotor cortical areas and increased activation in 3 areas compared with controls: presupplementary motor area, posterior secondary somatosensory area, and posterior inferior temporal gyrus. Conclusion: The current study reveals that anterior cruciate ligament deficiency can cause reorganization of the central nervous system, suggesting that such an injury might be regarded as a neurophysiologic dysfunction, not a simple peripheral musculoskeletal injury. This evidence could explain clinical symptoms that accompany this type of injury and lead to severe dysfunction. Understanding the pattern of brain activation after a peripheral joint injury such as anterior cruciate ligament injury lead to new standards in rehabilitation and motor control learning with a wide application in a number of clinical and research areas (eg, surgical procedures, patient re-education, athletic training, etc). [ABSTRACT FROM AUTHOR]

The purpose of this study was to translate and investigate the validity and reliability of the modified Baecke Physical Activity Questionnaire (mBQ) in the Greek adult population. This is a cross-cultural study. The cross-cultural adaptation of the mBQ was performed according to official guidelines. The prefinal Greek translation was tested in 30 healthy participants. The reliability was determined (n = 100) by filling out the mBQ, two times, 1 week apart. For validation (n = 45), the scores between the mBQ and the International Physical Activity Questionnaire (IPAQ) were compared, and the correlation between mBQ and VO 2 max and between mBQ and interview (METS) were assessed. High statistical significant of test–retest reliability was found (intraclass correlation coefficient = 0.84; standard error of measurement = 0.48; smallest detectable difference = 16.7%; Cronbach's alpha = 0.92). Statistical significant correlation between the mBQ and the IPAQ (r = 0.425, P = 0.005), high correlation between the mBQ and METS (r = 0.691, P = 0.000), and moderate correlation between mBQ and VO 2 max (r = 0.388, P = 0.08) were found. The Greek mBQ was found to be reliable and valid for assessing the level of physical activity in the Greek population. NCT04890756. [ABSTRACT FROM AUTHOR]

Clinical importance of proprioception in feedback and feedforward control is an established knowledge (1). Among proprioceptors, muscle spindles are considered the most important. Muscle spindles are mainly detectors of speed stretch and length muscle whose information is necessary from CNS to compute the joint position and movement (2,3). Muscle fatigue produces neuromuscular deficits within the muscle, thus is a factor of joint injury. However, there are contradictory findings of muscle fatigue's impact on proprioception. Especially little is known about muscle fatigue on knee joint position sense (JPS) (4). The investigation of the effect of quadriceps' fatigue on the knee joint position sense. 54 healthy subjects (26 men and 28 women), without knee pathology, participated in the study (age 21.4 ±2.88). JPS assessed in the knee joint within the ROM 90°-0° and the target angle defined in 45°. For all the measurements an Isokinetic Dynamometer (Biodex System 3 Pro) was used. The experiment conducted in three stages, in continuous time: a) a three times passive demonstration and passive replication of the targeted joint angle, b) the knee extensors fatigue procedure, and c) the repetition of the first stage with the knee extensors in fatigue state. Muscle fatigue was achieved by the standard protocol of continuous maximal isokinetic voluntary concentric contractions in 20°/sec, until three continuous maximal trials were under the 50% of the extensor's maximal peak torque. During the measurements the subjects were blindfolded. The average error deviation from the target angle before (Μ=4.202, SE=0.23) and after (Μ=4.691, SE=0.31) the fatigue protocol showed non-significant statistical difference p= 0.127. Partial analysis among the trials, before and after the fatigue, also supported the general results. Results showed that knee extensors' fatigue seems to not have impact on JPS. Probably the function of the knee joint proprioceptive receptors is not affected in the state of muscle fatigue and the brain keeps processing the information accurately. The results indicated that muscle spindles may not contribute as much as other joint proprioceptors in JPS. [ABSTRACT FROM AUTHOR]

Proprioception is a significant factor in balance, coordination, joint stability and movement acuity (1). Among proprioception's components, joint position sense (JPS) and movement detection have been mostly assessed whereas little is known about the joint velocity proprioceptive sense (2). Finding the joint angular velocity(-ies) that is more comprehensible by the human's brain, and therefore more accurately reproduced, could be used, among others, in motor learning rehabilitation protocols. To investigate the knee angular velocities envelope inside which the joint can be moved with the most accuracy, depending on the task. 48 subjects (23 men and 25 women) without knee pathology participated in the study (age 21.4 ±3.85). Velocity replication (VR) was assessed in a spectrum of 5 different and randomly chosen low velocities (2°/s, 5°/s, 10°/s, 20°/s and 30°/s) by using concentric quadriceps contraction in an Isokinetic Dynamometer (Biodex System3 Pro). During the procedure the subjects were blindfolded, and the examiners were blind regarding the results.The passive demonstrations of each joint angular velocity were followed by active velocity replications. The number of passive demonstrations and active replications were adapted for each velocity in such a way, that each subject would stay almost the same amount of time, and therefore having the same effect or effort, in all of them. The knee angular velocities of 2°/s and 5°/s had the bigger mean percentage replication errors (68.2% and 29.0%) but the smallest mean errors in absolute value (1.4°/s for both the velocities). In the velocities of 10°/s, 20°/s and 30°/s the mean percentage replication errors were 26.3%, 26.1% and 29.0% respectively, while the mean errors in absolute value were 2.6°/s, 5.5°/s and 8.6°/s respectively. According to the present research, the knee joint can achieve a maximal precision of 1.4°/s angular velocity error, appear in joint velocities below 5°/s. Rehabilitation protocols require precision should focus is this kinematic envelope as, above this threshold, the angular velocity error increases gradually, as the joint velocity increases. For gross motor activities, where percentage joint angular velocity errors are more meaningful than the absolute error values, the kinematic envelope between 10°/s - 20°/s seem to be the ideal for motor learning tasks. According to our knowledge, this is the first attempt in the literature to investigate the knee angular velocity proprioception, and further investigation is needed on the velocity proprioceptive behavior of other joints, as well as any deviations in pathologies or trauma. [ABSTRACT FROM AUTHOR]

In the context of physiotherapy intervention, gait analysis offers valuable information for patient assessment. Therefore, there is a need for a tool that evaluates gait in a valid and reliable way. The instrumented treadmill H/P cosmos Pluto Med measures spatiotemporal, pressure and force parameters. What is the intra-day and inter-day reliability of gait parameters and the validity of the instrumented treadmill H/P cosmos Pluto Med, compared to the Kistler force plate; 44 healthy volunteers (26 Women / 18 Men) with an average height of 170 cm (± 9) and an average weight of 70.3 kg (± 13.6), ages between 19 and 29, participated in the study. The participants performed treadmill gait analysis, wearing running shoes, at a walking speed of 5 km/h, for 4 minutes. Three trials were conducted, twice on the first day with one hour interval between them (intra-day reliability), and once one week apart (inter-day reliability). Validation was examined by comparing the force data from the 3rd trial of Zebris treadmill with force data emerging from Kistler force platform (ten efforts) in 20 out of 44 volunteers (12 Women / 8 Men). The Intraclass Correlation Coefficient (ICC), Standard Error of Measurement (SEM), and Smallest Detectable Difference (SDD) were calculated to evaluate reliability and paired samples t-test and Pearson correlation coefficient to examine the validity of the Zebris system. The analysis revealed excellent reliability for spatial parameters, such as step length, for both intra- and inter-day reliability (ICC = 0.98, SEM = 0.50, SDD = 1.9%, and ICC = 0.92, SEM = 0.85 and SDD = 3.3% respectively). Maximum ground pressure parameters also showed excellent reliability with acceptable measurement error (Intra-day: ICC = 0.97, SEM = 0.80, SDD = 14,5%; Inter-day: ICC= 0.97, SEM = 0.73 and SDD = 13,6%). The comparison of Kistler force plate and Zebris Pluto med yielded a very high and significant correlation (r>0.90, p<0.001) but the mean forces measured from the two instruments were also significant different (p<0.001) with the Zebris system revealing in all measurements lower values. The results demonstrated that the instrumented treadmill H/P cosmos Pluto Med has excellent intra-day and inter-day reliability with small measurement error for most of gait parameters. There is also high correlation between the force plate and the treadmill although the mean forces they produce are different. This difference is probably related to the fact that the treadmill is constantly moving during walking while the force plate is stable on the ground. Therefore, the H/P cosmos Pluto Med integrated treadmill is a reliable and valuable tool for evaluating gait at both research and clinical levels. Its validity remains to be further investigated against similar instrument and measurement procedures for definite conclusions. [ABSTRACT FROM AUTHOR]