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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]

Objectives: To investigate the efficacy of adding radial extracorporeal shockwave therapy or sham to exercise for people with insertional Achilles tendinopathy. Design: A two-armed, parallel-group, explanatory, single-centre, randomised controlled trial within a superiority framework. Setting: Private clinic. Participants: People diagnosed with insertional Achilles tendinopathy who were over 18 years old with a symptom duration of greater than 3 months. Intervention: A total of 76 people were randomly assigned (one-to-one ratio) to receive three sessions of radial extracorporeal shockwave therapy or sham to the affected side (or most affected side if bilateral). All participants received identical education and exercise. Outcome measures: The primary outcome was the Victorian Institute of Sports Assessment – Achilles questionnaire. Measures were recorded at baseline, 6 weeks and 12 weeks. Results: At 12 weeks, the questionnaire data were available for 37 people (96%) in the radial extracorporeal shockwave therapy group and 36 people (95%) in the sham group. For the primary outcome, we found no evidence for between-group differences at 6 (3, 95% confidence interval −4.6–10.5) or 12 weeks (4.6, 95% confidence interval −2.5–11.6). There was also no evidence for a between-group difference for any secondary outcome measures at either 6 or 12 weeks (p >.05). No serious adverse events were reported. Conclusion: The addition of radial extracorporeal shockwave therapy to exercise and education did not lead to improvements in pain, function or other outcomes compared to sham at 6 or 12 weeks among people with insertional Achilles tendinopathy. ANZCTR Reg No: ACTRN12620000035921 [ABSTRACT FROM AUTHOR]

Background: Mulligan's mobilization with movement (MWM) is a manual therapy technique designed to address musculoskeletal pain and joint mobility. Despite immediate reported improvements by patients, the clinical significance of MWM compared with other interventions remains uncertain. Objective: To assess the clinical effectiveness of MWM for shoulder pathologies compared with other treatment methods. Methods: The databases PubMed, Web of Science, Cochrane Library, Scopus, and the Physiotherapy Evidence Database (PEDro) were searched up to June 2024. Inclusion criteria were limited to randomized controlled trials published in English and Turkish languages, focusing on the MWM technique for shoulder pathologies. Two independent reviewers evaluated methodological quality based on the PEDro scale. Outcome data were analyzed for pain, function, and range of motion (ROM) using SPSS Statistics 29.0. Results: Twenty-seven studies (1157 participants) were included. MWM demonstrated statistical superiority in function (MD = −11.24, 95% CI: [−18.33, −4.16], p = 001) and shoulder flexion and abduction ROM compared with other mobilization techniques. There was a significant MD in pain intensity, which was −1.55 cm (95% CI: [−2.60, −0.51], p = 0.00), with high heterogeneity (I2 = 93%), favoring MWM in comparison with control group. MWM was significantly better for shoulder abduction ROM in comparison with physical therapy interventions (MD = −14.44, 95% CI: [1.98, 26.90], p = 0.02) with high heterogeneity (I2 = 90%) and control group (SMD = 56.67, 95% CI: [7.71, 111.63], p = 0.02) with high heterogeneity (I2 = 96%). However, clinical significance was not consistently achieved. Conclusions: Although some statistical significance was found when comparing MWM with other her treatment methods, it was observed that most of the statistically significant data did not reach clinical significance. Upon closer examination, outcome measures that showed clinical significance, either the interventions in the comparison group were inadequate, not evidence-based, or the improvements within the group were not logical. [ABSTRACT FROM AUTHOR]

Firefighter work-related fatigue can be measured by objective physical performance or subjective perceptions of fatigue; however, the two fatigue constructs are not related. Excess adiposity is common among career firefighters and negatively impacts performance fatigability. Objective: The purpose of this study was to (1) examine the relationship between perceived work-related fatigue and performance fatigability, and (2) assess the impact of percent body fat (%BF) on perceived fatigue constructs in career firefighters. Methods: Thirty-nine career firefighters completed body composition testing, the Occupational Fatigue Exhaustion Recovery (OFER15) scale assessing three subscales of work-related fatigue (acute fatigue, chronic fatigue, and inter-shift recovery), and maximal leg extensor isometric strength testing prior to and following an isotonic fatiguing protocol. Results: Performance fatigability was not associated with any of the OFER15 perceived work-related fatigue variables (P ≥ 0.513). Greater %BF was associated with greater %∆ peak torque (r = −0.41, P = 0.010) but none of the OFER15 perceived work-related fatigue variables (P ≥ 0.638). Conclusions: Performance fatigability was not associated with OFER15 perceived work-related fatigue, and greater adiposity negatively impacted performance fatigability but not perceived fatigability. [ABSTRACT FROM AUTHOR]

Background: Practical, applicable, valid, and reliable tools are needed to assess physical performance in patients with Total Knee Arthroplasty (TKA) in a variety of settings, including routine clinical assessment, research studies, and community-based programs. Objective: The aim of this study is to evaluate the validity and reliability of the Short Physical Performance Battery (SPPB) among patients with TKA. Methods: We included 45 patients who underwent TKA surgery (mean age 68.89 ± 9.26). The SPPB, Timed up and go (TUG) test and, Hospital for Special Surgery (HSS) Knee Score were administered to the patients. SPPB was performed twice on the same day with 1 h rest. Results: The ICC(2,1) coefficient, MDC95 and SEM values were 0.97, 1.02 and 0.37 respectively. The Pearson correlation coefficient of the SPPB with the TUG and HSS was −.78, and 0.74 respectively. Conclusion: SPPB has excellent reliability, and strong validity in assessing physical performance in patients with TKA. SPPB can identify even minimal detectable difference in physical performance and can be reliably used to monitor patient outcomes in the postoperative period for a comprehensive assessment of TKA in many physical performance domains, including balance, walking speed, and lower extremity strength. Clinical Trial Number: NCT06201637 [ABSTRACT FROM AUTHOR]

Background: Proprioceptive impairment contributes to gait and balance impairments in patients with stroke. Diagnosis functional impairments and evaluation treatment efficacy require quantitative proprioception assessment. However, proprioception assessment has remained limited to ordinal scale measurement, with a lack of ratio scale measurements. Purpose: This case report describes a physiotherapy management program focusing on proprioceptive impairment in patients with stroke using quantitative tests such as Threshold to Detect Passive Motion (TDPM) and Joint Position Sense (JPS). Case Description: A63-year-old male patient with an acute pontine lacunar infarction was admitted to our hospital. His muscle strength, selective movement, and trunk activity were preserved. However, the Berg Balance Scale (BBS) and Gait Assessment andIntervention Tool (GAIT) score were 42 and 9 points, observing balance impairment and the buckling knee pattern with hip ataxia during gait. Based on these, TDPM and JPS using image capture were performed. In physiotherapeuticdiagnosis, proprioceptive impairments in the hip and knee joints were the primary functional impairments related to balance and gait. To address these proprioceptive impairments, a 13-day treatment protocol incorporating transcutaneous electrical nerve stimulation (intensity: sensory threshold, frequency: 100 Hz) targeting the quadriceps femoris was performed. Outcomes: The patient was discharged after achieving independent ambulation and improvement in BBS (56 points) and GAIT (2 points) scores, exceeding the minimum clinically important difference. Recovery of proprioceptive impairment corresponded withimproved balance and gait ability. Conclusion: Quantitatively evaluating proprioceptive impairments may provide novel rehabilitation for patients with stroke who have proprioceptive impairments and contribute to clinical decision-making. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to determine the effect duration of a talocrural mobilization on individuals with restricted dorsiflexion during a static weight bearing lunge test (WBLT) and dynamic 3D motion capture-based peak ankle dorsiflexion during a forward step down (FSD) task. Secondarily, we aimed to correlate any immediate changes in ankle mobility with concurrent changes in proximal joint kinematics during the FSD post-mobilization. Methods: Seventy-six individuals were screened for dorsiflexion restriction, of which 26 (15 females, 22.3 ± 2.2 years old, body mass index 25.2 ± 2.9 kg/m2) qualified with a WBLT of ≤ 35° on at least one limb. A baseline WBLT measure and 3D motion capture of 5 consecutive FSD repetitions on a 6-inch box were obtained. Participants then viewed an instructional video of a talocrural joint self-mobilization using a resistance band. WBLT and FSD were collected again immediately post-mobilization and at 5-min intervals for 60 min or until the WBLT returned to baseline for 2 consecutive measures. Results: WBLT dorsiflexion showed a mean increase of 6.5 degrees (p < 0.001) post-mobilization. The effect faded over time and no longer differed from baseline 25 min post-mobilization (p = 0.964). Dynamic peak ankle dorsiflexion did not change post-mobilization at any time point (p ≥ 0.546). No 3D kinematic time-course changes were observed at the hip or knee. However, immediate raw alterations in dorsiflexion correlated with alterations for hip and knee flexion. Discussion/Conclusion: A talocrural joint mobilization increased static dorsiflexion per the WBLT for a 20–25-min period with regression to baseline. However, increased dynamic ankle dorsiflexion was not observed during the FSD task. Improved mobility alone does not appear to change movement patterns. Clinicians should be aware of both effect duration and the potential need for task-specific training to better facilitate dynamic utilization of increased mobility. [ABSTRACT FROM AUTHOR]

The study aimed to determine the acute effects of subtetanic neuromuscular electrical stimulation (NMES) combined with active recovery between sprint exercises on blood lactate accumulation, sprint performance, and muscle fatigue. Sixteen healthy young individuals [23(4) years, 10 males] underwent a 1-min rest followed by sprint interval training consisting of four 15-sec maximal sprint exercises with three 5-min active cycling sessions. Participants engaged in voluntary cycling at 40% of peak oxygen consumption, with or without NMES (VOLES or VOL; interventions). Blood lactate concentration ([La]b) was assessed at the end of the rest and each intervention periods. Mean power was assessed during each sprint exercise session. Maximum voluntary contraction (MVC) of the knee extensor was measured before and after sprint interval training to evaluate muscle fatigue. The [La]b was significantly higher in VOLES than in VOL (main effect, P=0.037). Mean power did not differ between conditions (main effect and interaction, P>0.050). MVC after sprint interval exercise was significantly lower in VOLES than in VOL (interaction, P<0.001). Subtetanic NMES combined with voluntary cycling enhanced blood lactate accumulation and induced greater voluntary fatigue but resulted in similar peripheral muscle fatigue and sprint exercise performance compared with voluntary cycling without NMES. [ABSTRACT FROM AUTHOR]

Background: Patient-reported outcome (PROs) instruments of knee function quality of life are routinely administered to patients after anterior cruciate ligament reconstruction (ACLR). The Patient Acceptable Symptom State (PASS), an evidence-based threshold defining perceived outcomes, may be a useful indicator of strength and functional performance. Purpose: To compare strength and functional performance between patients recovering from ACLR who did and did not meet PASS thresholds on associated PROs. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 223 patients who had undergone ACLR (106 women, 117 men; 7.62 ± 1.71 months after ACLR) completed isokinetic knee extensor and flexor strength at 90 deg/s, hop performance (single-limb hop for distance [SLHD], triple hop for distance [THD], 6-m timed hop [6MH]), and PROs (International Knee Documentation Committee Subjective Form [IKDC], Knee injury and Osteoarthritis Outcome Score [KOOS], and Anterior Cruciate Ligament Return to Sport After Injury [ACL-RSI]) assessments in a controlled laboratory setting at an academic institution. Independent-samples t tests compared strength and hop measures between patients who did and did not achieve a PASS on the PROs. Limb symmetry index (LSI) was calculated as (ACLR Limb ÷ Contralateral Limb) × 100%. Strength and hop performance LSI outcomes were converted into indicator variables, categorized as either a "pass" or "fail" based on the operational definition of having an LSI value ≥90%. Chi-square tests compared strength and hop LSI PASS status measures to PRO PASS status. Results: Patients who achieved IKDCPASS were significantly stronger and had more symmetric limbs than those who did not achieve IKDCPASS. Values for IKDCPASS were as follows: knee extension ACLR limb 1.72 ± 0.47 N·m/kg, contralateral limb 2.40 ± 0.45 N·m/kg, LSI 71.64% ± 15.23%; knee flexion ACLR limb 1.04 ± 0.29 N·m/kg, contralateral limb 1.05 ± 0.26 N·m/kg, LSI 99.12% ± 17.22%. Values for IKDCFAIL were knee extension ACLR limb 1.47 ± 0.52 N·m/kg, contralateral limb 2.25 ± 0.47 N·m/kg, LSI 64.66% ± 17.07%; knee flexion ACLR limb 0.88 ± 0.28 N·m/kg, contralateral limb 0.97 ± 0.28 N·m/kg, LSI 90.46% ± 17.41%. Effect sizes ranged from small to moderate (P <.001; d = 0.3-0.55). IKDCPASS status was significantly associated with an LSI ≥90% for knee flexion peak torque (χ2 = 9.66; P =.002), SLHD (χ2 = 9.61; P =.002), and THD (χ2 = 3.97; P =.02), with a moderate effect size (P <.05; d = 0.41-0.73). Significant relationships were found with KOOSPASS (Pain, Activities of Daily Living [ADL], and Sport) and LSI ≥90% for peak knee flexion torque with a moderate effect size (Pain and ADL, P <.001; Sport, P =.04; d = 0.59-0.72) and SLHD with a strong effect size for the Symptom subscale (Symptom, P <.01, d = 1.21; Pain, P =.003; ADL, P =.04; Sport, P =.001). No differences were found in strength outcomes for patients who achieved ACL-RSIPASS versus those who did not (P >.05). Patients who achieved ACL-RSIPASS had more symmetric SLHD and THD LSI scores and jumped farther on their contralateral limb for the THD compared with ACL-RSIFAIL patients (P <.05; d = 0.50-0.64). Conclusion: Patients meeting thresholds for the IKDCPASS and KOOSPASS (Pain, ADL, and Sport subscales) demonstrated greater knee strength bilaterally, and hopped farther and more symmetrically, compared with patients who scored below the PASS threshold on the same PROs. Using PASS thresholds for PROs can aid clinicians when considering when patients can safely return to activities after ACLR. [ABSTRACT FROM AUTHOR]

Ginsenosides, active compounds derived from Panax ginseng, exhibit promising potential in enhancing physical performance. This study investigates the impact of UG0712 (UG), a novel ginsenoside compound, on endurance capacity, body weight, organ weights, blood parameters, and specific transcriptomic changes in liver and muscle tissues using a C57BL/6N mouse model. The mice received UGs orally at three doses: UG50 (50 mg/kg), UG100 (100 mg/kg), and UG200 (200 mg/kg) for a specified duration. Endurance capacity, physiological parameters, and transcriptome signatures in liver and muscle tissues were assessed. UG administration significantly improved time to exhaustion, with UG50 and UG200 showing substantial enhancements. Body and organ weights exhibited no notable differences, suggesting a lack of adverse effects. Biochemical markers, except for decreased creatine kinase levels in the UG100 group, showed no significant variations. Transcriptome analysis revealed limited group separation and dose-dependent patterns. The UG100 group displayed significant enrichment in lipid metabolism and muscle-related terms. Identified dose-dependent improvements in endurance capacity highlight UGs' potential as supplements. The absence of adverse effects on body and organ weights, along with positive effects on biochemical markers, supports their safety. Despite limited dose-dependent patterns in transcriptomic analyses, the UG100 group showcased significant enrichment in pathways related to muscle and lipid metabolism. These findings offer valuable insights for athletes and aging individuals seeking to enhance physical performance, warranting further exploration into UG effects' on molecular mechanisms. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to provide evidence for the interpretation of the projected frontal area (PFA) during front crawl. To achieve this goal, we developed a method for calculating the PFA of each body segment using digital human technology and compared the pressure drag under two calculation conditions: a combination of the PFA with and without accounting for the horizontal velocity of each body segment. Methods: Twelve competitive male swimmers performed a 15-m front crawl at 1.20 m·s−1. The three-dimensional positions of the reflective markers attached to the swimmer's body were recorded using an underwater motion-capture system. Based on the body shape of each swimmer obtained from the photogenic body scanner, individual digital human body models were created with the color of the model's vertices divided into eight body segments. The time series of the volumetric swimming motion was reconstructed using inverse kinematics. The PFA of each body segment was then calculated by the automatic processing of a series of parallel frontal images. The pressure drag index, defined as the value excluding the drag coefficient while simultaneously considering the PFA and the horizontal velocity, was calculated under two conditions: the static condition (accounting for only the PFA of each body segment) and the dynamic condition (accounting for the PFA and horizontal velocity of each body segment). Results: Notably, the pressure drag index was higher under the static condition than under the dynamic condition for the humerus, ulna, and hand segments (P < 0.001). Conclusions: The results obtained using our methodology indicate that the PFA of the upper limb segments overestimates their contribution to pressure drag during front crawl under the static condition. [ABSTRACT FROM AUTHOR]

Purpose: This study compared the effects of off- and on-bike resistance training (RT) on endurance cycling performance as well as muscle strength, power, and structure. Methods: Well-trained male cyclists were randomly assigned to incorporate two sessions/week of off-bike (full squats, n = 12) or on-bike (all-out efforts performed against very high resistances and thus at very low cadences, n = 12) RT during 10 wk, with all RT-related variables (number of sessions, sets, and repetitions, duration of recovery periods, and relative loads [70% of one-repetition maximum]) matched between the two groups. A third, control group (n = 13), did not receive any RT stimulus, but all groups completed a cycling training regime of the same volume and intensity. Outcomes included maximum oxygen uptake (V̇O2max), off-bike muscle strength (full squat) and on-bike ("pedaling") muscle strength, and peak power capacity (Wingate test), dual-energy X-ray absorptiometry-determined body composition (muscle/fat mass), and muscle structure (cross-sectional area, pennation angle). Results: No significant within/between-group effect was found for V̇O2max. Both the off-bike (mean Δ = 2.6%–5.8%) and on-bike (4.5%–7.3%) RT groups increased squat and pedaling-specific strength parameters after the intervention compared with the control group (−5.8% to –3.9%) (P < 0.05) with no significant differences between them. The two RT groups also increased Wingate performance (4.1% and 4.3%, respectively, vs –4.9% in the control group, P ≤ 0.018), with similar results for muscle cross-sectional area (2.5% and 2.2%, vs –2.3% in the control group, P ≤ 0.008). No significant within/between-group effect was found for body composition. Conclusions: The new proposed on-bike RT could be an effective alternative to conventional off-bike RT training for improving overall and pedaling-specific muscle strength, power, and muscle mass. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine associations between clinical measures (self-reported and clinician administered) and subsequent injury rates in the year after concussion return to play (RTP) among adolescent athletes. Methods: We performed a prospective, longitudinal study of adolescents ages 13–18 yr. Each participant was initially assessed within 21 d of concussion and again within 5 d of receiving RTP clearance from their physician. Participants completed self-report measures: the Pittsburgh Sleep Quality Index and Tampa Scale of Kinesiophobia, and clinician-administered measures: single- and dual-task tandem gait and reaction time (RT; simple and clinical) assessments. They then completed monthly surveys for a year after RTP, which assessed exposure to injury (sport participation) and subsequent injuries (musculoskeletal or concussions) sustained. We used Poisson regression models to calculate injury rate ratios with the number of subsequent injuries sustained as the outcome, adjusted for RTP clearance time and competitive exposures for each measure. Results: Forty-one participants were included (age = 15.5 ± 1.3 yr, 56% female, 9.6 ± 4.6 d postconcussion; 38.0 ± 31.5 d to RTP). A higher injury rate per athletic exposure was observed for simple RT ≥ 505 ms versus <505 ms (injury rate ratio = 2.96, 95% confidence interval = 1.41-6.60, P = 0.005). Injury rates did not significantly differ by Pittsburgh Sleep Quality Index or Tampa Scale of Kinesiophobia scores, single/dual-task tandem gait time, or clinical RT. Conclusions: Simple RT may be one risk factor that is associated with higher rates of subsequent injury after adolescent concussion. A simple RT measure incorporated into a comprehensive concussion RTP assessment may identify some individuals at higher risk of subsequent injury in the year after concussion, although further research is needed to better understand this relationship. [ABSTRACT FROM AUTHOR]

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This article, the first in a two-part series, introduces and discusses the importance of movement and gait on the lower extremity in relation to chronic venous insufficiency (CVI) and chronic oedema (CO). It outlines and highlights the importance of the venous and lymphatic systems and their influence on how fluid is moved from the periphery into the trunk. The article introduces and explores the role of important anatomical systems like the veno-muscular pumps within the lower extremity, and how underlying musculoskeletal (MSK) issues that affect movement and walking can influence the onset, chronicity, and severity of CVI and CO. It also touches on how fluid is moved from the lower extremity into the trunk. Finally, the importance of compression and its benefits are explained through key scientific principles and the vital role that it plays in fluid movement from the periphery into the trunk. The second part of the series will focus on how movement, orthotics and footwear can complement compression and their role in reducing peripheral oedema, improving gait and managing pain in the foot and ankle. [ABSTRACT FROM AUTHOR]

Background: While one-legged and two-legged bodyweight squats on unstable and stable surfaces are commonly used during patellofemoral rehabilitation, patellofemoral loading during these exercises is unknown. Understanding how patellofemoral force and stress magnitudes affects different squat variations will aid clinicians in determining how and when to prescribe and progress these squatting types of exercises in patients with patellofemoral pain. Hypothesis/Purpose: To quantify patellofemoral force and stress between two squat type variations (BOSU squat versus floor squat) and between two leg variations (one-legged squat versus two-legged squat). It was hypothesized that patellofemoral force and stress would be greater in BOSU squat than floor-squat, and greater in one-legged squat than two-legged squat. Study Design: Controlled laboratory biomechanical, repeated-measures, counterbalanced design. Methods: Sixteen healthy participants performed one-legged and two-legged BOSU and floor squats. Kinematic and ground-reaction force data were used to calculate resultant knee force and torque using inverse-dynamics, with electromyographic data employed in a knee muscle model to predict resultant knee force and torque at every 10° between 10°-100° knee-angles during the squat-descent and squat-ascent. Repeated-measures 2-way ANOVA (p < 0.01) was employed for statistical analyses. Results: Collapsed across one-legged and two-legged conditions, patellofemoral joint force and stress were significantly greater during floor squats than BOSU squats at 40°, 50°, and 70° knee-angles during squat descent and 60° and 50° knee-angles during squat ascent. Collapsed across BOSU and floor squats, patellofemoral joint force and stress were significantly greater for one-legged squats than two-legged squats at all knee-angles. Significant interactions between squat types and leg conditions were found at 30°, 40°, 50°, 60°, and 100° knee-angles during squat-descent, and 100°, 90°, 80°, and 70° knee-angles during squat-ascent, with patellofemoral joint force and stress significantly greater in two-legged floor-squat than two-legged BOSU squat, but no significant differences between one-legged floor-squat and one-legged BOSU squat. Conclusions: Squatting progression employing lower to higher patellofemoral loading over time during PFP rehabilitation may be considered: 1) two-legged BOSU squats at lower knee angles (0° - 50°); 2) two-legged floor squats at lower knee angles (0° - 50°); 3) one-legged BOSU and floor squats at lower knee angles (0° - 50°); 4) two-legged BOSU squats at lower and higher knee angles (0° - 100°); 5) two-legged floor squats at lower and higher knee angles (0° - 100°); 6) one-legged BOSU and floor squats at lower and higher knee angles (0° - 100°). Level of Evidence: 2 [ABSTRACT FROM AUTHOR]

Background: Meniscus injuries often accompany anterior cruciate ligament (ACL) tears. However, little is known about how different surgical approaches to treat concomitant meniscus injuries impact hop performance after ACL reconstruction. Purpose: The purpose of this study was to compare hop test inter-limb symmetry for patients who had undergone ACL reconstruction without an associated meniscal surgery, patients who had undergone ACL reconstruction with a meniscus repair, and patients who had undergone ACL reconstruction with a partial meniscectomy. Study Design: Cross-sectional study Methods: Hop test data collected at the time of return-to-sport testing (average of 6.4 ± 1.4 months after surgery) was extracted from electronic medical records for 192 patients who had undergone ACL reconstruction. Of these patients, 102 had undergone an isolated ACL reconstruction, 60 had undergone an ACL reconstruction along with a meniscus repair, and 30 had undergone an ACL reconstruction along with a partial meniscectomy. Analysis of variance was used to compare limb symmetry indices for the single- and triple-hop tests. These limb symmetry indices reflected the ratio of the hop distance for the involved limb relative to the uninvolved limb, expressed as a percentage. Results: The sample was comprised of 100 males and 92 females. Their average age was 20.6 ± 8.2 years. There were significant differences among the groups for the single-hop test (p = 0.031) and triple-hop test (p = 0.024) limb symmetry indices. For both tests, the patients who had undergone ACL reconstruction with a partial meniscectomy tended to exhibit greater deficits in hop performance for their involved limb (relative to their uninvolved limb), compared to those without a meniscal injury and those who had undergone meniscus repair. Conclusions: The results of this study suggest that patients who undergo ACL reconstruction along with a partial meniscectomy tend to experience less complete and/or delayed recovery of involved-limb hop performance, which could reflect more persistent deficits in lower body power. Level of Evidence: 3 [ABSTRACT FROM AUTHOR]

Background: Approximately 40% of college/university students have overweight/obesity; physical activity and sleep play a role. To address these interrelated behaviors, Canada recently released 24-Hour Movement Guidelines. This study aimed to determine (1) the percent of students with overweight/obesity meeting Canadian 24-Hour Movement Guidelines, (2) whether health behaviors differ by demographics, and (3) whether meeting guidelines is associated with BMI. Methods: University students 18–35 years (n = 459) enrolled in a randomized controlled weight management trial completed 1 week of ActiGraph measured activity, self-reported sleep duration, researcher-measured height/weight, and demographics at baseline. ANOVA and t-tests determined differences in student demographics and BMI among those meeting vs not meeting each guideline. Results: Of the analytic sample (n = 403), 341 (84.6%) met the MVPA guideline, 284 (70.5%) met the LIPA guideline, 236 (58.6%) met the sleep guideline, 62 (15.4%) met the sedentary time guideline, and 34 (8.4%) met all guidelines. Students meeting MVPA (30.8±4.3 vs 32.5±4.5, P =.008) or sleep (30.7±4.4 vs 31.6±4.3, P =.04) guidelines had significantly lower BMIs compared to those not meeting each guideline. Percent of students meeting sleep (P =.039) or all guidelines (P =.012) differed by race/ethnicity. Conclusion: Meeting MVPA/sleep guidelines is associated with lower BMI; these behaviors are important targets for future weight management programs. [ABSTRACT FROM AUTHOR]

Back support exosuits aim to reduce tissue demands and thereby risk of injury and pain. However, biomechanical analyses of soft active exosuit designs have been limited. The objective of this study was to evaluate the effect of a soft active back support exosuit on trunk motion and thoracolumbar spine loading in participants performing stoop and squat lifts of 6 and 10 kg crates, using participant-specific musculoskeletal models. The exosuit did not change overall trunk motion but affected lumbo-pelvic motion slightly, and reduced peak compressive and shear vertebral loads at some levels, although shear increased slightly at others. This study indicates that soft active exosuits have limited kinematic effects during lifting, and can reduce spinal loading depending on the vertebral level. These results support the hypothesis that a soft exosuit can assist without limiting trunk movement or negatively impacting skeletal loading and have implications for future design and ergonomic intervention efforts. Practitioner Summary: Back support exosuits have the potential to reduce musculoskeletal workplace injuries. We examined and modelled the impact of a soft active exosuit on spine motion and loading. The exosuit generally reduced vertebral loading and did not inhibit trunk motion. Results of this study support future research to examine the exosuit as an ergonomic intervention. [ABSTRACT FROM AUTHOR]

Background: Patient education is a key aspect of physical therapy practice; however, the differences in how experienced and novice physiotherapists perceive and apply patient education practice remain underexplored. Understanding these differences influences training approaches and improves physical therapy practice quality. This research aims to determine the difference in self-reported patient education practice between experienced and novice physiotherapists. Methods: A previously published online survey instrument was used to collect data from physiotherapists employed in public health institutions in Bosnia and Herzegovina. The survey questions included demographic characteristics and questions about approaches to patient education, perceived importance, and factors contributing to skills development. Participants were recruited in two groups: experienced physiotherapists with work experience ≥ 11 years (n = 139) and novice physiotherapists with work experience ≤ 5 years (n = 45). Descriptive statistics, such as numbers and percentages, were used to summarize participant responses. Results: Experienced physiotherapists more frequently provided advice on posture, movement correction, daily activity strategies, and pacing while addressing patient concerns and exploring perceptions (p < 0.05). In contrast, novice physiotherapists placed significantly greater value on continuing education courses, considering them an important factor in developing patient education skills (p < 0.05). Conclusions: Experienced physiotherapists prioritize patient education focusing on posture, movement, and self-care strategies compared to novice physiotherapists. However, novice physiotherapists place a higher importance role on continuous education. Identifying these differences may help tailor training and mentorship to improve physiotherapy practice, ensuring better patient outcomes. [ABSTRACT FROM AUTHOR]

Introduction: PNE, focusing on cognitive aspects, aims to change patients' beliefs about pain. However, it is unclear if these cognitive changes are sufficient to influence other components such as neuroplastic changes. Objective: To assess whether 3-h pain neuroscience education (PNE) can induce changes in brain-derived neurotrophic factor (BDNF) levels and pain intensity in chronic pain patients. Methods: A double-blind randomized clinical trial was conducted with 66 participants aged 18–65 years old (50.86 ± 8.61) with chronic primary musculoskeletal pain divided into two groups: an intervention group receiving 3-h PNE lecture and a control group that received an educational booklet. Primary outcomes included plasma BDNF levels and perceived pain intensity (VAS). Secondary outcomes included anxiety (HADS-A), depression (HADS-D), catastrophizing (PCS), kinesiophobia (TSK), stress (PSS), and knowledge about pain. Measurements were taken in both groups before and after a three-hour intervention. Data were analyzed using paired t-tests and Cohen's d for effect sizes. Results: The results showed no significant changes in BDNF levels for the PNE lecture group (p = 0.708) or the educational booklet group (p = 0.298). Both groups showed significant reductions in pain intensity (PNE: p < 0.001, d = 0.70; booklet: p = 0.036, d = 0.39). Secondary variables, such as knowledge (PNE: p < 0.001, d = −0.972; booklet: p < 0.001, d = −0.975) and anxiety (PNE: p < 0.001, d = 0.70; booklet: p = 0.035, d = 0.39), also showed significant improvements. Conclusions: PNE did not significantly change BDNF levels but effectively improved pain intensity, pain-related knowledge, and other clinical variables. These findings suggest that while PNE has cognitive benefits, it may not be sufficient to induce immediate neurobiological changes. Further research is needed to explore long-term effects and incorporate additional therapeutic domains. [ABSTRACT FROM AUTHOR]

Since its introduction by Laban (1926), the idea of kinesphere has been shared and broadened by many professions, adding internal motion to the visible movement, and also voice, smell or the energetic intention. This systematised review summarises the information out of the 499 obtained resources from the adapted SALSA framework on kinesphere: definition, interpretations, psychological and clinical implications, as a basis for future research. The used space of the kinesphere is described to be a psycho-physical process influenced by internal aspects of the person and environmental factors such as context, gender or culture. Its size has been linked to a sense of security and belonging. The article provides examples to work with the kinesphere to gain awareness of one's boundaries, improve presence and relating, and legitimise one's own space. This is especially recommended for individuals who have suffered abuse or trauma, as well as patients with anorexia, ASD or depression. [ABSTRACT FROM AUTHOR]

This paper intends to review my experiences as an apprentice with Marian Chace, pioneer of the newly developing profession of dance therapy, at the St. Elizabeth's Psychiatric Care Hospital in 1966. It also aims to explore ways that Chace's work anticipated current approaches to dance movement psychotherapy (DMP). Chace emphasised the importance of dance as nonverbal communication and taught her apprentices to aim for the highest levels of authenticity in their own expression. She often worked in a circle allowing all to feel included. Through her movement, Marian reflected back to the patients their nonverbal expressions. Current research into mirror neurons explores the theoretical basis for methods, which Chace used intuitively, decades before any neurological basis was discovered, revealing how the reflection and empathetic attunement used by Chace may have helped advance therapeutic processes. [ABSTRACT FROM AUTHOR]

Background: Despite their prominence in the sport and human movement sciences, to date, there is no systematic insight about the development and content of movement quality assessments in athletic populations. This is an important gap to address, as it could yield both practical and scientific implications related to the continued screening of movement quality in athletic contexts. Hence, this study aimed to systematically review the (i) developmental approach, (ii) movements included, (iii) scoring system utilised, and (iv) the reliability of movement competency assessments used in athletic populations. Methods: Electronic databases (SPORTDiscus, MEDLINE, CINAHL, Web of Science, Scopus) were searched for relevant articles up to 12 May 2023. Studies were included if they reported data about the developmental approach, movements included, scoring system utilised and reliability of assessment in an athletic population. A modified Downs and Black checklist was used to measure study quality. Results: From a total of 131 identified studies: (i) 26 (20%) described the developmental approach of an assessment; (ii) 113 (86%) included descriptions of the movements included; (iii) 106 (81%) included a description of scoring system and criteria; and (iv) 77 (59%) studies included reliability statistics. There were 36 assessments identified within these studies, comprising 59 movements in total. Each assessment scored movement quality through a Likert or binary classification system. Conclusion: First, the results demonstrate that choosing an appropriate movement quality assessment in an athletic population may be a complex process for practitioners as the development approach, movements included and scoring criteria vary substantially between assessments. Second, academics could use these results to help design new assessments for novel applications that meet rigour and reliability requirements. Third, these results have the potential to foster guidelines of use for the reliable assessment of movement quality in athletic populations. Key Points: • The developmental approach, movements included and reliability of movement quality assessments vary within the literature. Given this, it is suggested that practitioners and researchers think critically when selecting an assessment that is appropriate for their context. • The assessment of composite scores appears more reliable than movement specific scores. Moreover, users of various movement quality assessments should be aware that rater experience can affect assessment reliability. • The relationship between movement quality assessments and their target application may not be universal. Therefore, the development of new assessments is warranted for emerging applications and to overcome issues in current assessments. [ABSTRACT FROM AUTHOR]

Background: While the effects of sleep deprivation on cognitive function are well-documented, its impact on high-intensity endurance performance and underlying neural mechanisms remains underexplored, especially in the context of search and rescue operations where both physical and mental performance are essential. This study examines the neurophysiological basis of sleep deprivation on high-intensity endurance using electroencephalography (EEG). In this crossover study, twenty firefighters were subjected to both sleep deprivation (SD) and normal sleep conditions, with each participant performing endurance treadmill exercise the following morning after each condition. EEG signals were recorded before and after high-intensity endurance exercise, and power spectrum analysis and functional connectivity analysis were performed on sleep related frequency bands rhythm: δ (0.5–4 Hz) and θ (4–8 Hz). The EEG power spectral and functional connectivity were measured by repeated measure analysis of variance. Results: The SD condition had an average sleep duration of 3.78 ± 0.69 h, while the duration for normal sleep was 7.63 ± 0.52 h. After high-intensity endurance exercise, the SD condition had a higher maximum heart rate (p < 0.05) and shorter exercise time (p < 0.05) than normal sleep. Compared with before exercise, the δ band in the left parietal lobe P7 channel increased significantly (p < 0.01), and the θ band in the central Cz channel and the left and right parietal lobe P7 and P8 channel increased significantly (p < 0.01 & p < 0 0.05) in SD and normal sleep conditions after exercise. After exercise, compared with normal sleep, the δ band power in occipital O1 and Oz channels and parietal P7 and TP7 channels in SD significantly decreased (p < 0.05 & p < 0.01); the power of the θ band decreased significantly in the occipital O1 channel, central CZ channel and the left and right parietal P7 and P8 channel (p < 0.05 & p < 0.01). Whole connectivity showed a significant increase (p = 0.001) in the δ band for the SD condition at post-exhaustion. Local connectivity analysis identified a localized network in the δ band with reduced (p < 0.001) post-exhaustion in the SD condition displaying inter-hemispheric differences in certain connections (FP1-CP4, T7-C4, T7-TP8, and O1-FT8) and intra-hemispheric (C3-CPz and Pz-P4) variations. Conclusions: Sleep deprivation significantly reduced maximum endurance performance, indicating decreased neural activity in the central and parietal brain regions. Alterations in δ and θ frequency band power, along with disrupted connectivity, may highlight the neurophysiological basis underlying this decline. Key Points: • Sleep deprivation significantly impairs high-intensity endurance performance, demonstrated by reduced time to exhaustion and increased maximum heart rate compared to normal sleep conditions. • Sleep-deprived states result in a marked decrease in δ and θ band activity within the central and parietal brain regions, which are essential for motor control and endurance capacity. • Sleep deprivation diminishes the efficiency of information transmission within the δ band network, suggesting disrupted connectivity that may hinder cognitive and motor processes critical to sustaining performance. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to validate the accuracy of the Active Style Pro HJA-750C (ASP) in measuring metabolic equivalents (METs) during walking and reaching tasks in individuals with subacute stroke using a respiratory gas analyzer as a reference. Methods: Twenty-three hospitalized patients with subacute stroke participated in this study. They performed sitting and standing reaching tasks, as well as walking while wearing a VO2 Master respiratory gas analyzer and ASP devices on both the paretic and non-paretic sides. The METs values recorded by the ASP were compared with those obtained using a VO2 Master respiratory gas analyzer. Pearson's correlation coefficients were calculated for each task, and Bland–Altman plots were used to assess the agreement between the two methods. Results: The ASP demonstrated good concurrent validity, with correlation coefficients of 0.71 and 0.74 for the sitting reaching task, 0.75 and 0.79 for the standing reaching task, and 0.83 and 0.85 for walking when the ASP was placed on the paretic and non-paretic sides, respectively. Bland–Altman analysis indicated no significant fixed or proportional errors. The ASP accurately measures METs whether worn on the affected or unaffected side of the waist. Conclusion: The ASP provides valid measurements of physical activity during walking and reaching tasks in patients with subacute stroke. These findings suggest that ASP is a valuable tool for monitoring physical activity in clinical rehabilitation settings. [ABSTRACT FROM AUTHOR]

Objective: To assess the stability of odontoid parameters on flexion-extension motion and to validate the accuracy of the physiological cervical lordosis (CL) predictive formula across different cervical positions. Methods: Standard cervical spine lateral radiographs in neutral, flexion, and extension positions were collected to measure odontoid incidence (OI), odontoid tilt (OT), C2 slope (C2S), CL, T1 slope (T1S), and T1S minus CL (T1S-CL). Friedman's test was used to assess the differences in parameters among the three cervical spine positions. The predictive performance of the formula CL = 0.36× OI − 0.67 × OT − 0.69 × T1S was assessed and validated using the Pearson correlation coefficient (r), coefficient of determination (R²), mean squared error (MSE), and mean absolute error (MAE). Results: No significant differences were found for OI and T1S among the three different cervical spine positions (p = 0.162 and p = 0.186, respectively). There was a strong, significant positive correlation between the predicted value and actual value of physiological CL at three cervical positions (neutral, flexion, and extension). The predictions for the neutral position were the most accurate, with statistical measures of r = 0.85 (p < 0.01), R²=0.82, MAE = 4.28, and MSE = 27.77. Conclusion: OI is a stable and reliable anatomic parameter, not affected by cervical spine flexion-extension motion. OI can serve as a supplementary parameter for evaluating cervical sagittal balance and compensatory ability. The formula CL = 0.36×OI − 0.67×OT − 0.69×T1S provides the best predictions for physiological CL in the neutral position. [ABSTRACT FROM AUTHOR]

Purpose: Our aim was to investigate the test-retest reliability of the 2-min walk test (2MWT), timed up and go test (TUG), and five times sit-to-stand test (FTSST) in prostate cancer (PC) patients. Methods: This study was conducted with 73 patients who were classified into two groups as frail and non-frail determined by the Geriatric-8 questionnaire. Patients performed the 2MWT, TUG, and FTSST tests for two times. The test-retest reliability of the 2MWT, TUG, and FTSST was assessed by calculating the intraclass correlation coefficient (ICC). The standard error of measurement (SEM95) and minimal detectable change (MDC95) values were calculated. Results: All tests showed excellent test-retest reliability for both groups (ICC(2.1) > 0.90). The SEM95 and MDC95 values of 2MWT were 3.09, 8.57, and 3.15 m, 8.73 m for frail and non-frail groups. The SEM95 and MDC95 values of TUG for the frail group were 0.6 and 1.66 and 0.43 and 1.19 for the non-frail group, respectively. The SEM95 and MDC95 values of FTST for the frail group were 0.68 and 1.88 and for the non-frail group 0.86 and 2.38. Conclusions: The 2MWT, TUG, and FTSST showed excellent reliability in frail and non-frail older adults with PC which can be used to assess physical performance. IMPLICATIONS FOR REHABILITATION: The 2-minute walk test (2MWT), Timed up and go test (TUG) and five times sit to stand tests (FTST) are excellent reliable tests for both frail and non-frail prostate cancer patients. The Minimal Detectable Change (MDC95) value of 2MWT, TUG, and FTST provides important information to clinicians about the clinical progression of oncological patients Clinicians can use one of this evidence-based outcome measures to check change of independent mobility performance with prostate cancer patients. [ABSTRACT FROM AUTHOR]

Background: Population-levels of physical activity have remained stagnant for years. Previous approaches to modify behaviour have broadly neglected the importance of whole-systems approaches. Our research aimed to (i) understand, (ii) map, (iii) identify the leverage points, and (iv) develop solutions surrounding participation in physical activity across an English rural county. Methods: A systems-consortium of partners from regional and local government, charities, providers, deliverers, advocacy groups, and health and social care, and public health engaged in our research, which consisted of two-phases. Within Phase 1, we used secondary data, insight-work, a narrative review, participatory workshops, and interviews in a pluralistic style to map the system-representing physical activity. Phase 2 began with an initial analysis using markers from social network analysis and the Action Scales Model. This analysis informed a participatory workshop, to identify leverage points, and develop solutions for change within the county. Results: The systems-map is constructed from biological, financial, and psychological individual factors, interpersonal factors, systems partners, built, natural and social environmental factors, and policy and structural factors. Our initial analysis found 13 leverage points to review within our participatory workshop. When appraised by the group, (i) local governing policies, (ii) shared policies, strategies, vision, and working relationships, (iii) shared facilities (school, sport, community, recreation), and (iv) funding were deemed most important to change. Within group discussions, participants stressed the importance and challenges associated with shared working relationships, a collective vision, and strategy, the role of funding, and management of resources. Actions to leverage change included raising awareness with partners beyond the system, sharing policies, resources, insight, evidence, and capacity, and collaborating to co-produce a collective vision and strategy. Conclusions: Our findings highlight the importance and provide insight into the early phase of a whole-systems approach to promoting physical activity. Our whole-systems approach within Suffolk needs to consider methods to (i) grow and maintain the systems-consortium, (ii) create a sustainable means to map the system and identify leverage points within it, and (iii) monitor and evaluate change. [ABSTRACT FROM AUTHOR]

This scoping review aimed to evaluate the effect of exercise combined with vitamin D supplementation on skeletal muscle health in older individuals. We implemented a systematic search of electronic databases, including PubMed, the Cochrane Library, Web of Science and Embase, which was conducted from the time of library construction to January 2024. Eligible studies were randomised controlled trials including men and women aged ≥ 65 years or mean age ≥ 65 years; exercise training and vitamin D supplementation; outcomes of muscular strength, function, muscular power, body composition and quality of life; and results compared with those of exercise intervention alone. The results showed thirteen studies including 1483 participants were identified. The proportions of male and female sex were 22·05 and 77·95 %, respectively. Exercise intervention methods included resistance exercises and multimodal exercise training. All vitamin D interventions involved supplementation with vitamin D3. A significant increase was identified in short physical performance battery and stair climbing but not in skeletal muscle mass, skeletal strength, the timed up and go test and gait speed in older adults after exercise combined with vitamin D supplementation. In conclusion, exercise combined with vitamin D supplementation has additive health effects on short physical performance battery and stair climbing. Furthermore, when vitamin D was deficient at baseline, the combined effect of exercise and vitamin D intervention significantly increased the timed up and go test and gait speed in older adults. In future randomised controlled trials on this topic, baseline vitamin D nutritional status, health condition and sex should be considered. [ABSTRACT FROM AUTHOR]

Fatigue is prevalent in immune-mediated inflammatory and neurodegenerative diseases, yet its assessment relies largely on patient-reported outcomes, which capture perception but not fluctuations over time. Wearable sensors, like inertial measurement units (IMUs), offer a way to monitor daily activities and evaluate functional capacity. This study investigates the relationship between sit-to-stand and stand-to-sit transitions and self-reported physical and mental fatigue in participants with Parkinson's, Huntington's, rheumatoid arthritis, systemic lupus erythematosus, primary Sjögren's syndrome and inflammatory bowel disease. Over 4 weeks, participants wore an IMU and reported fatigue levels four times daily. Using mixed-effects models, associations were identified between fatigue and specific kinematic features, such as 5th and 95th percentiles of sit-to-stand performance, suggesting that fatigue alters the control and effort of movement. These kinematic features show promise as indicators for fatigue in these patient populations. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to adapt, validate, and evaluate the feasibility of a mindful exercise program (Mindful Standing Yoga combined with Baduanjin) for older patients with primary osteoporosis. Methods: The study was conducted in 3 stages. Stage 1 involved a qualitative focus group discussion with 6 experts to gather perspectives on modifying the exercise program. Stage 2 used a Delphi approach with another 6 experts to validate the program. In Stage 3, a feasibility study was conducted with 20 eligible patients (out of 23 initially enrolled) at a traditional Chinese medicine hospital, using a single-group pre- and posttest design. The strenuousness of the adapted exercise was assessed through heart rate (HR) and rating of perceived exertion (RPE). Its effects were measured using the Global Pain Scale (GPS), the Five Facets Mindfulness Questionnaire—Short Form (FFMQ-SF), the Tampa Kinesiophobia-11 Scale, and the Timed Up and Go test. Patient satisfaction and feedback were also collected. Results: The modified program, consisting of 9 movements and taking 30 min to complete, was validated by experts as suitable, safe, and effective for practice. HR and RPE measurements confirmed it as a low-intensity exercise and not strenuous for the study population. The program significantly improved back pain and mindfulness in the feasibility study, with most participants expressing satisfaction with the protocol. Conclusion: Experts and participants affirmed that the program was appropriate and satisfactory for older patients with primary osteoporosis, particularly those with back pain. Further high-quality randomized controlled trials are needed to validate its effectiveness. [ABSTRACT FROM AUTHOR]

Introduction: Motor dysfunction is an important feature of early-stage dementia. Gait provides a non-invasive biomarker across the dementia continuum. Gait speed and rhythm aid risk stratification of incident dementia in subjective cognitive impairment (SCI) and are associated with cognitive domains in mild cognitive impairment (MCI) and dementia. However, hand movement analysis, which may be more accessible, has never been undertaken in SCI and rarely in MCI or dementia. We aimed to address this gap and improve understanding of hand motor-cognitive associations across the dementia continuum. Methods: A total of 208 participants were recruited: 50 with dementia, 58 MCI, 40 SCI, and 60 healthy controls. Consensus diagnoses were made after comprehensive gold-standard assessments. A computer key-tapping test measured frequency, dwell-time, rhythm, errors, and speed. Associations between key-tapping and cognitive domains and diagnoses were analysed using regression. Classification accuracy was measured using area under receiver operating characteristic curves. Results: Hand frequency and speed were associated with memory and executive domains (p ≤ 0.001). Non-dominant hand rhythm was associated with all cognitive domains. Frequency, rhythm, and speed were associated with SCI, MCI, and dementia. Frequency and speed classified ≥94% of dementia and ≥88% of MCI from controls. Rhythm of the non-dominant hand classified ≥86% of dementia and MCI and 69% of SCI. Conclusion: Our findings show hand motor dysfunction occurs across the dementia continuum and, similar to gait, is associated with executive and memory domains and with cognitive diagnoses. Key-tapping performance differentiated dementia and MCI from healthy controls. More research is required before recommending key-tapping as a non-invasive motor biomarker of cognitive impairment. Plain Language Summary: Dementia affects motor function as well as memory and cognition. It causes subtle changes in the brain that accumulate over many years, affecting the speed and rhythm of movements before manifesting as cognitive impairment. Detecting these dementia-related changes in movement can aid in detecting those who may be at risk of developing dementia in the future. To understand the dementia-related changes in hand movements, we invited a group of participants from patients attending a cognitive clinic. All patients underwent a comprehensive clinical assessment. We also invited a group of healthy participants for comparison. A simple 60 s online computer key-tapping test was used to test hand movement. We examined features of key-tapping performance including frequency, speed, number of incorrect taps, and rhythm. Clinic participants were grouped by diagnosis as subjective cognitive impairment, mild cognitive impairment, and dementia. Key-tapping performance of each group was compared with the healthy participants' performance. We found that key-tapping performance declines progressively with the increase in severity of cognitive impairment, with the dementia group having the most impaired key-tapping performance. Using the hand movement test, we correctly identified more than 80% of patients with mild cognitive impairment and dementia from the healthy group. The computer key-tapping test is simple, quick, and can be accessed online. It has the potential to be used as a screening tool for people with cognitive symptoms. [ABSTRACT FROM AUTHOR]