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The upper body and trunk muscles are crucial to perform soccer kicks. Resistance training targeting these muscles may modify the pattern adopted during kicking. This study aimed to investigate the effect of resistance training of the arm and anterior trunk muscles on instep kicking kinematics. Twenty-six male participants were randomly allocated into a training group or control group. The training group underwent resistance training of arm and trunk muscles and practiced the instep kick for 8 weeks. The control group only practiced kicking during the same period. The trunk, hip, and knee kinematics were assessed during the instep kick before and after the intervention. Kinematics were analyzed according to their data distribution with statistical parametric or nonparametric mapping. The effect of the training on the 1-repetition maximum test was analyzed using a repeated-measures multivariate analysis of variance. The training group showed greater hip extension after the training during the backswing phase (Hedge g effect size of 0.316–0.321) and increased 1-repetition maximum for all exercises. There were no other differences. The present study documented the nonlocal effect of strengthening training in which arm and trunk muscle training resulted in changes in hip kinematics during the backswing phase of the instep kick. [ABSTRACT FROM AUTHOR]

Background: Individuals with spinal cord injury (SCI) often suffer from neuropathic pain which is often disabling and negatively affects function, participation, and quality of life (QoL). Pharmacological treatments lack efficacy in neuropathic pain reduction hence studying alternatives to drug treatment is necessary. Preclinical evidence of various aerobic exercises has shown positive effects on neuropathic pain but scientific studies investigating its effect in the SCI human population are limited. Methodology: This study is a double-blind, parallel, two-group, randomized controlled trial with an interventional study design that aims to evaluate the effectiveness of aerobic exercise program on neuropathic pain and quality of life (QoL) in individuals with chronic paraplegia. Thirty individuals with chronic paraplegia with the neurological level of injury from T2 to L2 will be recruited from the rehabilitation department at a super specialty hospital based on the inclusion criteria. Using a 1:1 allocation ratio, the participants will be randomly assigned to one of the two groups. The intervention group will perform high-intensity interval training (HIIT) aerobic exercise using an arm ergometer based on their peak heart rate, and the control group will perform free-hand arm aerobic exercise. In both groups, the intervention will be delivered as 30-min sessions, four times a week for 6 weeks. Outcome measures: International Spinal Cord Injury Pain Basic Data Set Version 3.0 will be used for diagnosing and assessing neuropathic pain and its interference with day-to-day activities, mood, and sleep. The International Spinal Cord Society (ISCoS) QoL basic data set will be used to assess QoL, and 6-min push test distance will be used to assess peak heart rate and aerobic capacity. Discussion: The effectiveness of the aerobic exercise program will be assessed based on the changes in neuropathic pain score and its interference with day-to-day activities, mood, sleep, QoL, and aerobic capacity after 3 weeks mid-intervention and after 6 weeks post-intervention. The trial will provide new knowledge about the effectiveness of the aerobic exercise program in improving neuropathic pain and QoL in individuals with chronic paraplegia. Trial registration: Clinical Trials Registry-India CTRI/2023/08/056257. Registered on 8 August 2023. [ABSTRACT FROM AUTHOR]

Beetroot juice supplementation (BRJ) should increase nitric oxide bioavailability under conditions of muscle deoxygenation and acidosis that are a normal consequence of the maximal effort exercise test used to identify forearm critical impulse. We hypothesized BRJ would improve oxygen delivery:demand matching and forearm critical impulse performance. Healthy males (20.8 ± 2.4 years) participated in a randomized crossover trial between October 2017 and May 2018 (Queen's University, Kingston, ON). Participants completed 10 min of rhythmic maximal effort forearm handgrip exercise 2.5 h post placebo (PL) vs. BRJ (9 completed PL/BRJ vs. 4 completed BRJ/PL) within a 2 week period. Data are presented as mean ± SD. There was a main effect of drink (PL > BRJ) for oxygen extraction (P = 0.033, ηp2 = 0.351) and oxygen consumption/force (P = 0.017, ηp2 = 0.417). There was a drink × time interaction (PL > BRJ) for oxygen consumption/force (P = 0.035, ηp2 = 0.216) between 75 and 360 s (1.25–6 min) from exercise onset. BRJ did not influence oxygen delivery (P = 0.953, ηp2 = 0.000), oxygen consumption (P = 0.064, ηp2 = 0.278), metabolites ((lactate) (P = 0.196, ηp2 = 0.135), pH (P = 0.759, ηp2 = 0.008)) or power-duration performance parameters (critical impulse (P = 0.379, d = 0.253), W′ (P = 0.733, d = 0.097)). BRJ during all-out handgrip exercise does not influence oxygen delivery or exercise performance. Oxygen cost of contraction with BRJ is reduced as contraction impulse is declining during maximal effort exercise resulting in less oxygen extraction. [ABSTRACT FROM AUTHOR]

Introduction: Kinesiophobia denotes an excessive and irrational apprehension towards physical activity or exercise among patients, stemming from a perception of susceptibility to painful injury or re-injury. Cardiac rehabilitation stands pivotal in the secondary prevention spectrum for individuals with cardiovascular ailments, with exercise constituting a cornerstone of this regimen. However, the emergence of kinesiophobia poses a formidable challenge, diminishing patient adherence to cardiac rehabilitation protocols, particularly among those grappling with chronic heart failure. To bolster exercise-based rehabilitation initiatives in this cohort, a thorough comprehension of the multifaceted factors precipitating kinesiophobia is imperative. This review endeavors to delineate prevailing evidence and prevalence concerning kinesiophobia triggers in chronic heart failure patients, while pinpointing research lacunae for future exploration. Methods: Employing a scoping review methodology, our investigation culled data from diverse scholarly databases, including Embase, PubMed, Scopus, CINAHL, Web of Science, Medline, Sinomed, CNKI, Wangfan, and VIP. Results: After thorough evaluation, 9 studies that met the inclusion criteria were ultimately incorporated. Discussion: Our findings underscore a notable prevalence of kinesiophobia in chronic heart failure patients, predominantly influenced by socio-demographic factors, psychological and cognitive factors, disease and treatment factors, as well as lifestyle and behavior. Armed with these insights, future interventions can be tailored to mitigate kinesiophobia levels, fostering enhanced engagement in exercise-centric cardiac rehabilitation endeavors among patients grappling with chronic heart failure. [ABSTRACT FROM AUTHOR]

Background: There are a myriad of exercise variations in which upper body (UB) and lower body (LB) exercises have been intermittently used. However, it is still unclear how training of one body region (e.g. LB) affects adaptations in distant body areas (e.g. UB), and how different UB and LB exercise configurations could help facilitate physiological adaptations of either region; both referred to in this review as vertical strength transfer. Objective: We aimed to investigate the existence of the vertical strength transfer phenomenon as a response to various UB and LB exercise configurations and to identify potential mechanisms underpinning its occurrence. Methods: A systematic search using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) for Scoping Reviews protocol was conducted in February 2024 using four databases (Web of Science, MEDLINE, Scopus and CINAHL) to identify peer-reviewed articles that investigated the vertical strength transfer phenomenon. Results: Of the 5242 identified articles, 24 studies met the inclusion criteria. Findings suggest that the addition of UB strength training to LB endurance exercise may help preserve power-generating capacity for the leg muscle fibres. Furthermore, systemic endocrine responses to high-volume resistance exercise may beneficially modulate adaptations in precedingly or subsequently trained muscles from a different body region, augmenting their strength gains. Last, strength training for LB could result in improved strength of untrained UB, likely due to the increased central neural drive. Conclusions: Vertical strength transfer existence is enabled by neurophysiological mechanisms. Future research should involve athletic populations, examining the potential of vertical strength transfer to facilitate athletic performance and preserve strength in injured extremities. [ABSTRACT FROM AUTHOR]

BACKGROUND: During the COVID-19 pandemic, physical inactivity and inactivity-related health problems have deepened in many individuals, including office workers. It is not yet known whether there are exercise programs through telerehabilitation that will provide rapid relief in a short time in office workers who apply part or full-time teleworking system. OBJECTIVE: To comparatively investigate influences of short-term upper extremity exercise trainings (UEET) on pain, musculoskeletal discomforts (MSD), physical activity (PA), mood, and quality of life (QOL) in office workers during COVID-19 restrictions. METHODS: Thirty office workers were divided into exercise (EG) (UEET and walking advice) and control (CG) (walking advice) groups. The UEET was applied for at least 20–40 minutes/day, 5–7 days/week for a one week between February 2022 and June 2022. Office workers' pain, MSD, PA level, mood and QOL were measured. RESULTS: Baseline characteristics of groups (EG: 37.8±7.04 years, CG: 41.6±7.97 years) were similar (p > 0.05). Following UEET, scores of office workers in EG on total step count, vigorous PA, moderate-intensity PA, walking, total PA, physical functioning, and body pain subscales of QOL significantly increased compared to scores of office workers in CG, while scores on neck, back and hip discomforts and anxiety and depression significantly decreased (p < 0.05). CONCLUSIONS: One-week UEET and walking advice can improve office workers' daily step counts, MSD, PA levels, mood, and QOL. Office workers who have a busy work schedule may do these UEET and walking exercises in break times to relieve perception of discomfort. [ABSTRACT FROM AUTHOR]

A noninvasive, immediate, and convenient method for assessing muscle tissue status during exercise-induced muscle damage (EIMD) has not been established. This study was designed to assess and determine parameters suitable for measuring EIMD after eccentric exercise, using multi-frequency bioimpedance analysis (BIA). Thirty-five young male participants performed dumbbell exercises with their left arm, and their BIA parameters were measured at various time points up to 168 h post exercise using a multi-frequency BIA device. At all-time points, intra and extracellular water content was greater in the left arm than in the right arm, whereas the impedance, reactance, resistance, and phase angle were lower in the left arm than in the right arm. Established EIMD indices, such as maximal isometric voluntary contraction, were measured and used in correlational analyses. Only reactance was correlated with biomarkers, indicating muscle damage (r = − 0.56 to − 0.49). Furthermore, reactance was found to correlate well with indirect indicators of EIMD, suggesting that it may be a suitable marker for evaluating EIMD. However, the relationship with the limited evaluation indices employed in this study is constrained. Future studies should investigate the correlation between reactance and direct damage indicators, such as structural damage, observed in biopsies. [ABSTRACT FROM AUTHOR]

Introduction: Coronary artery bypass surgery (CABG) is a common procedure for patients with coronary artery disease. This study aimed to investigate the effect of selected physical exercises on the expression of FGF-2 and VEGF-A in patients post-CABG. Material & Methods: In this semi-experimental study, 20 male patients from Afshar Hospital (Yazd City) who had undergone CABG were selected and randomly divided into two groups: a combined training group and a control group. The combined training group performed an 8-week program consisting of endurance training (15-20 minutes at 50-60% of HRmax) and resistance training (10-20 minutes, including three upper limb and two lower limb movements, each with three sets of 10 repetitions at 3060% of 1RM), conducted three times per week. Gene expression of Fibroblast Growth Factor 2 (FGF-2) and Vascular Endothelial Growth Factor A (VEGF-A) was measured using Real-Time PCR. Data were analyzed using paired t-tests and one-way ANOVA with a significance level set at P<0.05. Results: An increase in the expression of VEGF and FGF-2 genes was observed in the combined training group post-test compared to pre-test (p=0.019). Additionally, there was a significant difference in VEGF gene expression between the control and training groups (p=0.016). Significant differences were also found in FGF-2 expression between the combined exercise group and both the healthy control and patient control groups (p=0.001 for both). Conclusion: The results suggest that combined exercises may enhance physiological adaptations and improve the functional capacity of the heart and vessels in CABG patients by increasing growth factor expression. [ABSTRACT FROM AUTHOR]

Increases in power output and maximal oxygen consumption (VO2max) occur in response to sprint interval exercise (SIE), but common use of "all-out" intensities presents a barrier for many adults. Furthermore, lower-body SIE is not feasible for all adults. We compared physiological and perceptual responses to supramaximal, but "non-all-out" SIE between leg and arm cycling exercise. Twenty-four active adults (mean ± SD age: [25 ± 7] y; cycling VO2max: [39 ± 7] mL•kg-1•min-1) performed incremental exercise using leg (LCE) and arm cycle ergometry (ACE) to determine VO2max and maximal work capacity (Wmax). Subsequently, they performed four 20 s bouts of SIE at 130% Wmax on the LCE or ACE at cadence = 120-130 rev/min, with 2 min recovery between intervals. Gas exchange data, heart rate (HR), blood lactate concentration (BLa), rating of perceived exertion (RPE), and affective valence were acquired. Data showed significantly lower (p < 0.001) absolute mean ([1.24 ± 0.31] L•min-1 vs. [1.59 ± 0.34] L•min-1; d = 1.08) and peak VO2 ([1.79 ± 0.48] L•min-1 vs. [2.10 ± 0.44] L•min-1; d = 0.70) with ACE versus LCE. However, ACE elicited significantly higher (p < 0.001) relative mean ([62% ± 9%] VO2max vs. [57% ± 7%] VO2max, d ¼ 0.63) and peak VO2 ([88% ± 10%] VO2max vs. [75% ± 10%] VO2max, d = 1.33). Post-exercise BLa was significantly higher ([7.0 ± 1.7] mM vs. [5.7 ± 1.5] mM, p = 0.024, d = 0.83) for LCE versus ACE. There was no significant effect of modality on RPE or affective valence (p > 0.42), and lowest affective valence recorded (2.0 ± 1.8) was considered "good to fairly good". Data show that non "all-out" ACE elicits lower absolute but higher relative HR and VO2 compared to LCE. Less aversive perceptual responses could make this non-all-out modality feasible for inactive adults. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusions No definitive treatment has been established for refractory gastroesophageal reflux disease (GERD). Antireflux mucosectomy (ARMS) and antireflux mucosal ablation (ARMA) using argon plasma coagulation are promising methods. However, no study has compared these two. This study compared the efficacy and safety of the two procedures.This multicenter, retrospective, observational study included 274 patients; 96 and 178 patients underwent ARMA and ARMS, respectively. The primary outcome was subjective symptom improvement based on GERD questionnaire (GERDQ) scores. The secondary outcomes included changes in the presence of Barrett's esophagus, Los Angeles grade for reflux esophagitis, flap valve grade, and proton pump inhibitor withdrawal rates.The ARMS group had higher baseline GERDQ scores (10.0 vs. 8.0, P < 0.001) and a greater median postprocedure improvement than the ARMA group (4.0 vs. 2.0, P = 0.002), and even after propensity score matching adjustment, these findings remained. ARMS significantly improved reflux esophagitis compared with ARMA, with notable changes in Los Angeles grade (P < 0.001) and flap valve grade scores (P < 0.001). Improvement in Barrett's esophagus was comparable between the groups (P = 0.337), with resolution rates of 94.7% and 77.8% in the ARMS and ARMA groups, respectively. Compared with the ARMA group, the ARMS group experienced higher bleeding rates (P = 0.034), comparable stricture rates (P = 0.957), and more proton pump inhibitor withdrawals (P = 0.008).Both ARMS and ARMA showed improvements in GERDQ scores, endoscopic esophagitis, flap valve grade, and the presence of Barrett's esophagus after the procedures. However, ARMS demonstrated better outcomes than ARMA in terms of both subjective and objective indicators. [ABSTRACT FROM AUTHOR]

To investigate: (1) changes in body satisfaction during five months of handcycle training and one year after the training period; (2) whether longitudinal changes are dependent on sex, waist circumference and severity of the physical impairment; (3) associations between changes in physical capacity or body composition, and body satisfaction. Individuals (N = 143) with health conditions such as spinal cord injury filled out the Adult Body Satisfaction Questionnaire: at the start of the training (T1), directly after the training period (T2); and four months (T3) and one year after the training period (T4). At T1 and T2, physical capacity was determined with an upper-body graded exercise test, and waist circumference was measured. Handcycling classification was used as a proxy for the severity of impairment. Multilevel regression analyses showed that body satisfaction significantly increased during the training period and significantly decreased back to pre-training levels at follow-up. Individuals with more severe impairments showed a larger decrease at T4. Improvements in physical capacity and waist circumference were significantly associated with improvements in body satisfaction. Body satisfaction significantly increased during the training period, but significantly decreased during follow-up. Additional efforts might be necessary to keep individuals engaged in long-term exercise. Body image disturbances are frequently described in individuals with a physical impairment. An increase in body image can be achieved by improvements in physical capacity and waist circumference as a consequence of training. It is important to keep individuals engaged in exercise, as body satisfaction decreases after termination of the training period. For individuals with severe physical impairments additional efforts are necessary to keep them engaged in exercise. [ABSTRACT FROM AUTHOR]

The human forearm model is commonly employed in physiological investigations exploring local vascular function and oxygen delivery; however, the effect of arm dominance on exercising forearm hemodynamics and skeletal muscle oxygen saturation (SmO2) in untrained individuals is poorly understood. Therefore, the purpose of this study was to explore the effect of self-identified arm dominance on forearm hemodynamics and SmO2 in untrained individuals during submaximal, non-ischemic forearm exercise. Twenty healthy individuals (23±4 years, 50% female; 80% right-handed) completed three-minute bouts of supine rhythmic (1 second contraction: 2 second relaxation duty cycle) forearm handgrip exercise at both absolute (10kg; 98N) and relative (30% of maximal voluntary contraction) intensities in each forearm. Beat-by-beat measures of forearm blood flow (FBF; ml/min), mean arterial blood pressure (MAP; mmHg) and flexor digitorum superficialis SmO2 (%) were obtained throughout and averaged during the final 30 seconds of rest, exercise, and recovery while forearm vascular conductance was calculated (FVC; ml/min/100mmHg). Data are Δ from rest (mean±SD). Absolute force production did not differ between non-dominant and dominant arms (97±11 vs. 98±13 N, p = 0.606) whereas relative force production in females did (69±24 vs. 82±25 N, p = 0.001). At both exercise intensities, FBFRELAX, FVCRELAX, MAPRELAX, and the time constant tau for FBF and SmO2 were unaffected by arm dominance (all p>0.05). While arm dominance did not influence SmO2 during absolute intensity exercise (p = 0.506), the non-dominant arm in females experienced an attenuated reduction in SmO2 during relative intensity exercise (-14±10 vs. -19±8%, p = 0.026)–though exercise intensity was also reduced (p = 0.001). The present investigation has demonstrated that arm dominance in untrained individuals does not impact forearm hemodynamics or SmO2 during handgrip exercise. [ABSTRACT FROM AUTHOR]

Trunk compensatory movements frequently manifest during robotic-assisted arm reaching exercises for upper limb rehabilitation following a stroke, potentially impeding functional recovery. These aberrant movements are prevalent among stroke survivors and can hinder their progress in rehabilitation, making it crucial to address this issue. This study evaluated the efficacy of visual feedback, facilitated by an RGB-D camera, in reducing trunk compensation. In total, 17 able-bodied individuals and 18 stroke survivors performed reaching tasks under unrestricted trunk conditions and visual feedback conditions. In the visual feedback modalities, the target position was synchronized with trunk movement at ratios where the target moved at the same speed, double, and triple the trunk's motion speed, providing real-time feedback to the participants. Notably, trunk compensatory movements were significantly diminished when the target moved at the same speed and double the trunk's motion speed. Furthermore, these conditions exhibited an increase in the task completion time and perceived exertion among stroke survivors. This outcome suggests that visual feedback effectively heightened the task difficulty, thereby discouraging unnecessary trunk motion. The findings underscore the pivotal role of customized visual feedback in correcting aberrant upper limb movements among stroke survivors, potentially contributing to the advancement of robotic-assisted rehabilitation strategies. These insights advocate for the integration of visual feedback into rehabilitation exercises, highlighting its potential to foster more effective recovery pathways for post-stroke individuals by minimizing undesired compensatory motions. [ABSTRACT FROM AUTHOR]

OBJECTIVE: We aimed to examine the effects of a 5:2 diet (2 days per week of energy restriction by formula diet) or an exercise (2 days per week of high-intensity interval training and resistance training) intervention compared with routine lifestyle education (control) on glycemic control and cardiometabolic health among adults with overweight/obesity and type 2 diabetes. RESEARCH DESIGN AND METHODS: This two-center, open-label, three-arm, parallel-group, randomized controlled trial recruited 326 participants with overweight/obesity and type 2 diabetes and randomized them into 12 weeks of diet intervention (n = 109), exercise intervention (n = 108), or lifestyle education (control) (n = 109). The primary outcome was the change of glycemic control measured as glycated hemoglobin (HbA1c) between the diet or exercise intervention groups and the control group after the 12-week intervention. RESULTS: The diet intervention significantly reduced HbA1c level (%) after the 12-week intervention (−0.72, 95% CI −0.95 to −0.48) compared with the control group (−0.37, 95% CI −0.60 to −0.15) (diet vs. control −0.34, 95% CI −0.58 to −0.11, P = 0.007). The reduction in HbA1c level in the exercise intervention group (−0.46, 95% CI −0.70 to −0.23) did not significantly differ from the control group (exercise vs. control −0.09, 95% CI −0.32 to 0.15, P = 0.47). The exercise intervention group was superior in maintaining lean body mass. Both diet and exercise interventions induced improvements in adiposity and hepatic steatosis. CONCLUSIONS: These findings suggest that the medically supervised 5:2 energy-restricted diet could provide an alternative strategy for improving glycemic control and that the exercise regimen could improve body composition, although it inadequately improved glycemic control. [ABSTRACT FROM AUTHOR]

BACKGROUND: In the last decades, emerging evidence has shown that muscle growth is not homogeneous along a muscle head. This phenomenon is known as regional muscle hypertrophy and has led to several questions regarding the implications it may have for health and sports performance. OBJECTIVE: The aim of this study was to determine whether regional hypertrophy can be predicted by surface electromyography (sEMG). METHODS: 36 participants performed two arm exercises (preacher curls and inclined curls) in a random order to muscle failure at 70% of the 1 RM of the bicep curl exercise. As every participant performed a different number of repetitions, Peak sEMG and the integral of the sEMG of the last 3 repetitions was analyzed an compared to previously performed maximal voluntary isometric contractions (MVIC). RESULTS: The independent sample t -tests showed no significant differences neither in the peak nor in the integral of the sEMG between exercises for any given region. CONCLUSIONS: sEMG cannot be used to predict regional hypertrophy. [ABSTRACT FROM AUTHOR]

We report on the overall health status of persons suffering from spinal cord injury paralysis (SCI) after their initial participation in a supervised post-rehabilitative exercise program and their continued participation in specific health programs over the past decade. A follow up survey was performed in the summer of 2023 on 29 current or former clients who trained at the original Project Walk program (now Perfect Step) (N = 29 average age = 32.59 ± 12.52; Men = 22, 31.82 ± 14.5 years, Women = 7, 25.86 ± 3.75 years) to ask questions regarding their mobility, medical status, and physical function. The survey was completed either in person or through phone interviews, where questions were asked to assess current health and mobility status, necessary medical interventions, current exercise programs, and quality of life. Five participants (17.2%) stated that they had the ability to be 100% mobile after their participation while 10 participants improved their mobility to at least 10% of their day. Nine of the participants eliminated their need for pain medications during their exercise program, while 15 others had a reduction in dosages or number of medications (86% reduced their use of total medications during exercise). No person who participated in the exercise program used the emergency room or hospital physician visits during their exercise program for complications related to their injury. Twenty-five of the participants saw an improvement in their activities for daily living score (86%) at an average of 4.68 on The Perfect Step FMA. These findings indicate that persons suffering from paralysis who engage in at least six months of supervised exercise will have higher functional movement scores and fewer medical interventions over time than traditional SCI programs. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review describes the effectiveness of virtual reality (VR)-supported exercise therapy on upper limb motor function and activities of daily living after stroke. Methods: Studies published through January 24, 2022, were identified using CINAHL, Cochrane Library, Embase, Medline, and Web of Science. Randomized control trials comparing VR treatment with conventional therapy (CT) for upper extremity rehabilitation after stroke were included. Methodological quality was assessed using the Cochrane risk-of-bias tool. Results: Of 9 included studies, 5 concluded that the VR group outperformed control participants, 1 indicated the superiority of VR-supported exercises alone over CT, and 3 found VR comparable to CT in promoting upper limb motor function. Five studies analyzed independence in daily living, with 4 reporting no significant difference between VR and CT groups. No strong evidence indicated long-term benefits of VR-assisted exercise. All included studies demonstrated low risk of bias concerning random sequence generation, allocation concealment, outcome assessment blinding, incomplete outcome data, and selective reporting bias. However, a high risk of bias was observed regarding participant blinding due to the nature of the intervention. Conclusion: Most studies suggested that VR, used alongside CT, can improve motor function following stroke. However, the evidence was insufficient to conclude that VR outperforms conventional approaches. [ABSTRACT FROM AUTHOR]

To meet the increased demand for home workouts owing to the COVID-19 pandemic, this study proposes a new approach to real-time exercise posture classification based on the convolutional neural network (CNN) in an ensemble learning system. By utilizing MediaPipe, the proposed system extracts the joint coordinates and angles of the human body, which the CNN uses to learn the complex patterns of various exercises. Additionally, this new approach enhances classification performance by combining predictions from multiple image frames using an ensemble learning method. Infinity AI's Fitness Basic Dataset is employed for validation, and the experiments demonstrate high accuracy in classifying exercises such as arm raises, squats, and overhead presses. The proposed model demonstrated its ability to effectively classify exercise postures in real time, achieving high rates in accuracy (92.12%), precision (91.62%), recall (91.64%), and F1 score (91.58%). This indicates its potential application in personalized fitness recommendations and physical therapy services, showcasing the possibility for beneficial use in these fields. [ABSTRACT FROM AUTHOR]

Introduction: Although the use of application (app)s and wearable devices supporting diabetes treatment has spread rapidly in recent years, evidence of their impact, especially in combination of them, is limited. TOMOCO™ is a lifestyle improvement support app that features interactive virtual conversations according to the programmed algorithm guiding users toward their goals of lifestyle improvement. We hypothesized that TOMOCO™ in combination with Fitbit, which accurately tracks users' activity level, would encourage people with type 2 diabetes mellitus (T2DM) to change their lifestyles and improve their glycated hemoglobin (HbA1c) levels without changes in conventional therapy. Thus, we performed the present study to explore the effectiveness of this combination in Japanese participants with T2DM who had not achieved their glycemic targets. Methods: In this single-arm exploratory study, participants with T2DM used the TOMOCO™ and Fitbit in addition to the conventional diet/exercise therapy and anti-diabetic drug for 12 weeks. They were provided with feedback/advice by health care providers based on the TOMOCO™ and Fitbit records. The primary endpoint was the change in HbA1c from baseline to the end of the observation period. Data were expressed as mean ± standard deviation. Results: Fifty-nine (96.7%) of the 61 participants (male, 42 [71.2%]; age, 60.1 ± 8.7 years; HbA1c level, 7.48 ± 0.37% at screening) completed the study. At the end of the observation period, the HbA1c was significantly reduced (− 0.41 ± 0.41%, p < 0.001). This trend was consistent across the preselected patient characteristics, including sex, age, and body mass index. However, it was more pronounced in the participants with earlier stages of behavioral changes defined by the transtheoretical model at baseline. Conclusions: The unique features of TOMOCO™ in combination with Fitbit, together with conventional therapy, may promote a healthy lifestyle and thus contribute to improving HbA1c in people with T2DM. Clinical Trial Registration: jRCT1070220007. [ABSTRACT FROM AUTHOR]

BACKGROUND: Cognitive impairment (CI), which has been reported in COPD, has been related to physical performance. However, the association between CI and upper-extremity functions is unknown. We aimed to compare upper-extremity exercise capacity and grip strength between subjects with COPD with and without CI and to determine the relationship of upper-extremity functions with specific cognitive domains. METHODS: In this cross-sectional study, 76 subjects with COPD (mean age 66.8 ± 7.5 y, FEV1% 47.12 ± 14.10) were classified as with and without CI according to the Montreal Cognitive Assessment. Clinical characteristics, upper-extremity exercise capacity (6-min pegboard ring test [6PBRT]), grip strength (hand dynamometer), dyspnea severity (modified Medical Research Council dyspnea scale), disease-specific health status (COPD Assessment Test), and disease-specific quality of life (St George Respiratory Questionnaire) were compared between groups, and the relationship of upper-extremity functions with cognitive subdomains was analyzed by multivariate regression analysis. RESULTS: The number of 6PBRT rings (P = .01) and the grip strength (P = .033) were lower in subjects with CI. Subjects with CI had lower FEV1% (P = .038), arterial oxygenation (P = .002), exercise habits (P = .033), health status (P = .01), quality of life (P = .042); and higher dyspnea (P < .001), smoking consumption (P = .032), emergency admission (P = .02), and hospitalization (P = .042). The adjusted model showed that executive functions and attention were related to upper-extremity capacity (β = 14.4 and β = 10.2, respectively) and hand-grip strength (β = 1.85 and β = 1.49, respectively). CONCLUSIONS: These findings suggest that upper-extremity functions might be decreased especially concerning executive functions and attention in subjects with COPD with CI. [ABSTRACT FROM AUTHOR]

Rationale: A COPD Foundation working group sought to identify measures of exercise endurance, a meaningful aspect of physical functioning in everyday life among patients with chronic obstructive pulmonary disease (COPD) that is not fully accepted in regulatory decision making, hampering drug development. Objectives: To demonstrate, as we previously asserted (Casaburi COPD 2022;9:252), that constant work rate cycling endurance time is an appropriate exercise endurance measure in patients with COPD. Methods: To validate this assertion, we assembled an integrated database of endurance time responses, including 8 bronchodilator (2,166 subjects) and 15 exercise training (3,488 subjects) studies (Casaburi COPD 2022;9:520). Results: Construct validity was demonstrated: 1) peak physiologic and perceptual responses were similar for constant work rate and incremental cycling; 2) after bronchodilator therapy, there were greater increases in endurance time in patients with more severe airflow limitation; 3) after exercise training, endurance time increases were similar across airflow limitation severities; and 4) there were correlations between changes in endurance time and changes in mechanistically related physiologic and perceptual variables. Test–retest reliability was demonstrated, with consistency of changes in endurance time at two time points after the intervention. Responsiveness was confirmed, with significant increases in endurance time after active (but not placebo) bronchodilator therapy, with greater increases seen with more severe airflow limitation and after exercise training. On the basis of regression analysis using multiple anchor variables, the minimum important difference for endurance time increase is estimated to be approximately 1 minute. Conclusions: Constant work rate cycling endurance time is a valid exercise endurance measure in COPD, suitable for contributing to the evaluation of treatment benefit supporting regulatory decision making and evidence-based therapeutic recommendations. [ABSTRACT FROM AUTHOR]

BACKGROUND: The therapeutic effect and mechanism of robot-assisted upper limb training (RT) combined with intermittent theta burst stimulation (iTBS) for stroke patients are unclear. OBJECTIVE: The purpose of this study was to evaluate changes in brain activation after combination therapy and RT alone using functional near-infrared spectroscopy (fNIRS). METHODS: Patients were randomly assigned to two groups (iTBS + RT Group, n = 18, and RT Group, n = 18). Training was conducted five times a week for four weeks. fNIRS was used to measure changes in oxyhemoglobin in both the primary motor cortex (M1) and pre-motor and supplementary motor area (pSMA) during affected limb movement. Fugl-Meyer Assessment-Upper Extremity (FMA-UE) was employed for evaluating the function of upper limbs. RESULTS: Thirty-two patients with subacute stroke completed the study. The cortex of both hemispheres was extensively activated prior to treatment in the RT group. After training, overactivation decreased. The brain activation of the combined treatment group transferred to the affected side after the treatment. There was a notable enhancement in the FMA-UE scores for both groups, with the combined group's progress significantly surpassing that of the RT group. CONCLUSION: RT combined with iTBS can improve the motor function of stroke patients and promote the balance between cerebral hemispheres. [ABSTRACT FROM AUTHOR]

Aim: Circulating blood volume (BV) during exercise changes depending on the intensity and duration, and post‐exercise hypotension is observed after continuous exercise. We investigated the safety and efficacy of both interval and continuous IDE at anaerobic threshold (AT) levels with respect to hemodynamic stability and dialysis efficiency. Methods: In this crossover randomized controlled trial, 16 patients on haemodialysis were subjected to three trial arms, including non‐IDE, interval‐IDE, and continuous‐IDE arms. Systolic blood pressure (SBP), BV, and ultraviolet absorbance – an indicator of dialysis efficiency – were continuously measured, and each change was compared between the three arms by two‐way analysis of variance. Results: Continuous IDE decreased SBP from post‐exercise to the end of dialysis compared with baseline (pre 142.8 ± 19.0 vs. post 127.5 ± 24.5 mmHg, p =.02), whereas interval IDE maintained better SBP levels post‐exercise (pre 139.9 ± 17.1 vs. post 140.1 ± 15.8 mmHg, p = 1.0) than continuous IDE (non‐IDE 133.2 ± 19.9 vs. interval 140.1 ± 15.8 vs. continuous 127.5 ± 24.5 mmHg, p =.04). Moreover, interval IDE caused less tiredness and few symptoms (p <.05), despite reaching higher intensity than continuous IDE (p =.001). The BV of each IDE arm decreased during exercise and recovered post‐exercise to the same level as non‐IDE. Ultraviolet absorbance was not different between each arm (p =.16). Conclusion: AT‐level interval IDE maintains better hemodynamic stability from post‐exercise to the end of dialysis and may represent a novel approach that can be effectively performed with fewer symptoms. [ABSTRACT FROM AUTHOR]

Objective. To investigate the effect of kinesio tape applied to the supraspinatus muscle on shoulder scaption muscle strength and upper extremity stability in healthy women. Methods. 26 healthy female volunteers aged 20-30 years were included in the study. Individuals were randomized into two groups, kinesio taping (n = 13) and sham taping (n = 13). In the kinesio taping group a Y-shaped tape was applied to the supraspinatus muscle in the direction of facilitation while in the sham group an I tape was applied on the scapula. Before taping and 20 minutes after taping the shoulder scaption strength was measured with a dynamometer and functional evaluations were performed by the closed kinetic chain upper extremity stability test. Results. In the kinesio tape group, median scaption strength decreased after taping (p = 0.016). The median contact, normalized, and power scores increased significantly (respectively, p = 0.001, p = 0.001, and p = 0.001). In the sham group there was no significant difference in the median scaption strength after taping; the median contact, normalized and power scores increased significantly (p = 0.004, p = 0.004, and p = 0.006, respectively). There was no significant difference in scaption strength and upper extremity stability test scores between groups. After taping the changes were categorized as "no change", "increase" and "decrease" according to the minimal clinically significant difference value, the number of individuals with increased scaption strength was higher in the kinesio tape group compared to the sham group, although not statistically significant. Conclusions. The significance of kinesio taping applied to healthy women was not observed compared to sham taping on shoulder scaption muscle strength and upper extremity stability. [ABSTRACT FROM AUTHOR]

Background: To evaluate the safety and efficacy of the Minimally Invasive Micro Sclerotomy (MIMS) procedure in the management of uncontrolled open-angle glaucoma. Methods: A prospective, open-label, single-arm clinical evaluation with intra-subject comparisons performed at the Ophthalmologic Center after S.V. Malayan, Yerevan, Armenia. Included were adults with primary open-angle glaucoma (OAG) (N = 114) or exfoliative glaucoma (N = 6) who were uncontrolled (IOP > 21) on tolerated topical medication. Mild (N = 7), moderate (N = 66) and severe (n = 47) cases were prospectively included without preselection. Following subconjunctival Mitomycin C, an ab-interno MIMS procedure was performed alone (N = 100) or combined with phacoemulsification (N = 20). Patients were followed for 52 weeks. Procedure-related complications and adverse events were recorded. Success criteria were defined as -5 < IOP ≤ 21mmHg OR a reduction in IOP of ≥ 20% from baseline with (qualified success) or without (complete success) hypotensive medications. Results: Mean patient age was 69 ± 10.1 years. The mean duration of the procedure was 2:01 ± 0:41 min:sec. Scleral drainage channels were achieved in all cases. No device malfunctions, intraoperative complications, or serious adverse events were reported. Iris plugging of the sclerostomy site and early spikes in IOP were the most common adverse events. The only reason for failure was final IOP > 21 mmHg on tolerated medication. At 52 weeks (n = 93), mean IOP decreased by 38% from baseline (P < 0.001), from 27.9 ± 3.7 to 17.5 ± 5.3 mmHg, a difference of 10.5 mmHg (95% CI: -11.7, -9.3). One-year qualified success was documented in 82.1% (95% CI: 72.9%,89.2%) of the patients and complete success, in 70.5% (60.3-79.4%). 60% (95 CI:49.4%,69.9%) of the patients achieved maximum IOP level of 14 mmHg or at least 30% reduction in IOP. Conclusions: MIMS procedure is a relatively simple, short and safe minimally invasive bleb-forming procedure. Its efficacy, as found in this short-term evaluation, lends it suitable for mild and moderate uncontrolled open-angle glaucoma patients. Trial registration: ClinicalTrials.gov ID: NCT04503590 2019-05-29. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effectiveness of extracorporeal shockwave therapy (ESWT) on pain, range of motion (ROM) and disability on adhesive capsulitis (AC) in patients with type 2 diabetes mellitus (DM). Method: Clinical trials assessing the effectiveness of extracorporeal shockwave therapy on adhesive capsulitis in diabetes mellitus patients were included. Academic databases of Pubmed, Scopus, Web of Science, Cochrane Library, Science Direct, PEDro and grey literature sources such as Clinical trials.gov and Google Scholar were searched from the year 2000 to 2021.Physiotherapy Evidence Database (PEDro) scale was used to determine overall quality of each included article. Result: The search yielded eight studies evaluating the effectiveness of ESWT plus shoulder exercises and mobilization on AC in type 2 DM patient population. Compared to control treatment groups in majority of included studies ESWT appeared to be effective in managing pain, ROM and disability and showed large to very large treatment effects. Two of included studies reported positive effects of ESWT on inflammatory markers and blood glucose levels. Conclusion: Findings from this review suggested that ESWT combined with shoulder exercises and mobilization may be a useful treatment modality in shoulder AC for type 2 DM patients for pain reduction, disability and ROM improvement. There was insufficient data to confirm the findings of ESWT on blood glucose and inflammatory markers in diabetic patients. Therefore, future studies are needed to evaluate its effectiveness on these outcomes. Trial registration number: #CRD4202127949. [ABSTRACT FROM AUTHOR]

Objective: Preoperative exercise training, or prehabilitation, aims to optimize cardiorespiratory fitness before surgery to reduce the risk of adverse perioperative events and delayed recovery. However, traditional exercise such as walking and cycling can be difficult for people with degenerative joint diseases of the lower limbs, such as osteoarthritis. The purpose of this study was to compare the effect of three low‐impact interventions on cardiorespiratory fitness, physical function, and subjective health before total hip or knee arthroplasty. Methods: This was a randomized controlled trial involving 93 participants with severe knee or hip osteoarthritis awaiting joint replacement surgery. Participants underwent cardiopulmonary exercise testing (to measure peak oxygen consumption [V̇$$ \dot{V} $$O2]), then were randomized to heat therapy (Heat; 20–30 min immersed in 40°C water followed by ~15 min light‐resistance exercise), high‐intensity interval training (HIIT; 6–8 × 60 s intervals on a cross‐trainer or arm ergometer at ~90%–100% peak V̇$$ \dot{V} $$O2), or home‐based exercise (Home; ~15 min light‐resistance exercise); for up to 36 sessions (3 sessions per week for 12 weeks). Results: Peak V̇$$ \dot{V} $$O2 increased by 16% across HIIT and to a greater extent than Heat (+2.5 mL × min−1 × kg−1 [95% CI: 0.5–4.4], P = 0.009) and Home (+3.2 mL × min−1 × kg‐1 [1.2–5.2], P = 0.001). The anaerobic threshold increased across HIIT (+1.5 mL × min−1 × kg−1 [0.7–2.3], P < 0.001) and Heat (+1.2 mL × min−1 × kg−1 [0.4–1.9], P = 0.004), but not Home (−0.5 mL × min−1 × kg−1 [−1.3 to 0.3], P = 0.248). Subjective severity of osteoarthritis was unchanged with any intervention (P ≥ 0.250). Conclusion: Heat therapy and HIIT improved indices of cardiorespiratory fitness preoperatively in patients who have difficulty performing lower‐limb exercise. [ABSTRACT FROM AUTHOR]

Objectives. This study aimed to examine the effects of a short opponens splint and hand exercise program on pain, hand functionality, daily activities, and work efficacy in computer engineers with wrist pain. Methods. Forty-five engineers were randomized into three groups: group 1 (n = 15) utilized both splints and exercises, group 2 (n = 15) engaged in exercises only and group 3 (n = 15) received no treatment, across 8 weeks, thrice weekly. Only exercises were applied to group 2 (n = 15). No treatment was applied for group 3 (n = 15). The progress of subjects was controlled periodically each week. Outcome measurements including the Jamar hand dynamometer, pinchmeter, nine-hole peg test (9-NHPT), visual analog scale, Boston carpal tunnel syndrome questionnaire and Michigan hand outcome questionnaire (MHQ) were evaluated pre and post treatment during the study period. Results. Comparing the outcome measurements of the three groups showed a statistically significant difference between them except for the 9-NHPT and MHQ pain and esthetics (p < 0.05). According to post-hoc tests, groups 1 and 2 had more significant differences than group 3. Also, there was no statistically significant difference in any parameter between group 1 and group 2 (p > 0.017). Conclusion. Non-restrictive minimal orthosis or exercise programs are advisable for individuals with wrist pain. [ABSTRACT FROM AUTHOR]

Robot-assisted bilateral arm training has demonstrated its effectiveness in improving motor function in individuals post-stroke, showing significant enhancements with increased repetitions. However, prolonged training sessions may lead to both mental and muscle fatigue. We conducted two types of robot-assisted bimanual wrist exercises on 16 healthy adults, separated by one week: long-duration, low-resistance workouts and short-duration, high-resistance exercises. Various measures, including surface electromyograms, near-infrared spectroscopy, heart rate, and the Borg Rating of Perceived Exertion scale, were employed to assess fatigue levels and the impacts of exercise intensity. High-resistance exercise resulted in a more pronounced decline in electromyogram median frequency and recruited a greater amount of hemoglobin, indicating increased muscle fatigue and a higher metabolic demand to cope with the intensified workload. Additionally, high-resistance exercise led to increased sympathetic activation and a greater sense of exertion. Conversely, engaging in low-resistance exercises proved beneficial for reducing post-exercise muscle stiffness and enhancing muscle elasticity. Choosing a low-resistance setting for robot-assisted wrist movements offers advantages by alleviating mental and physiological loads. The reduced training intensity can be further optimized by enabling extended exercise periods while maintaining an approximate dosage compared to high-resistance exercises. [ABSTRACT FROM AUTHOR]

Objectives: To examine the feasibility of individuals with spinal cord injury or disease (SCI/D) to perform combined oropharyngeal and respiratory muscle training (RMT) and determine its impact on their respiratory function. Methods: A prospective study at a single Veterans Affairs (VA) Medical Center. Inclusion criteria included: 1) Veterans with chronic SCI/D (>6 months postinjury and American Spinal Injury Association (ASIA) classification A–D) and 2) evidence of OSA by apnea‐hypopnea index (AHI ≥5 events/h). Eligible participants were randomly assigned to either an experimental (exercise) group that involved performing daily inspiratory, expiratory (using POWERbreathe and Expiratory Muscle Strength Trainer 150 devices, respectively), and tongue strengthening exercises or a control (sham) group that involved using a sham device, for a 3‐month period. Spirometry, maximal expiratory pressure (MEP), maximal inspiratory pressure (MIP), polysomnography, and sleep questionnaires were assessed at baseline and at 3 months. Results: Twenty‐four individuals were randomized (12 participants in each arm). A total of eight (67%) participants completed the exercise arm, and ten (83%) participants completed the sham arm. MIP was significantly increased (p < 0.05) in the exercise group compared with the baseline. Conclusions: Combined oropharyngeal and RMT are feasible for individuals with SCI/D. Future studies are needed to determine the clinical efficacy of these respiratory muscle exercises. [ABSTRACT FROM AUTHOR]

A new portable arm exercise device is presented as a laboratory prototype to assist arm movements in rehabilitation therapies and movement exercises. Unlike the devices currently used, a portable design is proposed, with easy assembly and operational characteristics that enable it to be used by users in the home and in a familiar environment. Sensors are also provided on the rotating crank to validate and monitor the efficiency of the arm exercise. A low-cost prototype is assembled using off-the-shelf components and 3D-printed parts. Design issues are discussed and elaborated on to build a prototype for future laboratory testing using fairly simple experimental methodology. Preliminary testing by one author shows good feasibility of the device. The findings from the experimental results can be summarized as effective smooth-monitored cyclic motion in the crank rotation with limited values for acceleration less than 1 g and for acting user forces less than 22 N. The values detected are significantly lower in the left hand, with the testing subject being right-handed and healthy, without injury to her upper limbs. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the value of ultrasonography in predicting metachronous contralateral inguinal hernia (MCIH) and diagnosing contralateral persistent processus vaginalis (CPPV) in children with unilateral inguinal hernia, a prospective study was conducted. Methods: All participants underwent a preoperative ultrasound on the contralateral groin. Patients in group A1 received operating procedure according to ultrasound results (patients with negative contralateral US results received hernia repair on the affected side), and patients in group A2 received operation according to laparoscopic results (patients received hernia repair and CPPV ligation). All patients were followed up 2 years and compared to a historical control (group B) who underwent open hernia repair only on the affected side regardless of contralateral US results. Results: In groups A1 and A2, laparoscopic exploration revealed the presence of a CPPV in 490 cases. Ultrasound was found to be accurate in 104 out of the 490 cases with four false-positive and 386 false-negative results. This yielded an accuracy of 59.3%, a sensitivity of 21.2%, and a specificity of 99.2%. 10 patients in group A1, and 74 patients in group B developed MCIH. The accuracy, sensitivity, and specificity of the value of ultrasonography in predicting MCIH were 89.3%, 52.4%, and 92.5%, respectively. Conclusions: Preoperative ultrasonography of the contralateral groin is currently unable to accurately detect CPPV, but it appears to be a promising method in predicting MCIH by using rigorous diagnosing criteria. [ABSTRACT FROM AUTHOR]

Aims Scapula dyskinesis and reduced strength of the glenohumeral external rotator muscles are shoulder risk factors. The shoulder joint’s unstabilizing mechanisms can cause a decrease in the strength of the external rotator muscles, an imbalance of the rotator cuff muscles, and scapula dyskinesis. This study aimed to investigate the effect of an exercise program on scapula dyskinesis and the strength of glenohumeral rotator cuff muscles in overhead athletes. Materials & Methods The present quasi-experimental study with a control group and preand post-test plan was conducted on 62 female handball players (club-level, 18-25 years old) with scapula dyskinesis from 2021 to 2022 in Hamadan City, Iran. The lateral scapular slide test and hand dynamometers were used to measure scapula dyskinesis and the strength of glenohumeral rotator cuff muscles, respectively. The participants in the intervention group participated in eight weeks of three sessions of an exercise program. Data were measured before and after the intervention and were analyzed using the Mann-Whitney U test. Findings According to this test, there is a significant difference between the strength of external rotator muscles (p<0.001) in the intervention and control groups after exercises, so the strength of external rotator muscles and the strength of external/internal rotator muscles ratio (p<0.001) has increased after exercises. Also, scapula dyskinesis after exercises has decreased significantly (p=0.013). Conclusion The exercise program increases the strength of external rotator muscles and the ratio of external/internal rotator muscles and improves scapula dyskinesis in overhead athletes. [ABSTRACT FROM AUTHOR]

Studies have shown that neural responses following concentric (CON) and eccentric (ECC) muscle contractions are different, which suggests differences in motor control associated with CON and ECC contractions. This study aims to determine brain activation of the left primary motor cortex (M1) and left and right dorsolateral prefrontal cortices (DLPFCs) during ECC and CON of the right bicep brachii (BB) muscle at low‐ and high‐contraction intensities. Eighteen young adults (13M/5F, 21–35 years) were recruited to participate in one familiarization and two testing sessions in a randomized crossover design. During each testing session, participants performed either ECC or CON contractions of the BB (3 sets × 8 reps) at low‐ (25% of maximum ECC/CON, 45°/s) and high‐intensity (75% of maximum ECC/CON, 45°/s) on an isokinetic dynamometer. Eleven‐channel functional near‐infrared spectroscopy was used to measure changes in oxyhemoglobin (O2Hb) from the left M1, and left and right DLPFC during ECC and CON contractions. Maximum torque for ECC was higher than CON (43.3 ± 14.1 vs. 46.2 ± 15.7 N m, p = 0.025); however, no differences in O2Hb were observed between contraction types at low or high intensities in measured brain regions. High‐intensity ECC and CON contractions resulted in greater increases in O2Hb of M1 and bilateral DLPFC compared to low‐intensity ECC and CON contractions (p = 0.014). Our findings suggest no differences in O2Hb responses between contraction types at high and low intensities. High‐contraction intensities resulted in greater brain activation of the M1 and bilateral DLPFC, which may have implications for neurorehabilitation to increase central adaptations from exercise. [ABSTRACT FROM AUTHOR]

BACKGROUND: Scapular dyskinesis (SD) is a modification of the positioning and movement of the scapula and is associated with shoulder pain. Exercises to strengthen the shoulder and scapular muscles have been proposed as a therapeutic strategy to reduce pain and improve function. OBJECTIVE: We aimed to investigate the electromyographic activity of the periscapular and trunk muscles in individuals with shoulder pain and SD in different multi-joint exercises. METHODS: Thirty-two subjects with subacromial pain, of both sexes, with the presence or absence of SD, participated in this study. Volunteers performed five repetitions in five exercises (Closed Row; Pronated Row; Push-up; Scapular Push-up; T-push-up). The activity of the upper trapezius, middle trapezius, lower trapezius, serratus anterior, external oblique, and rectus abdominis muscles was recorded using electromyography. RESULTS: Our results showed a decrease in the electromyographic activity of the serratus anterior and external oblique during the T-push-up exercise in individuals with shoulder pain and SD. No differences were observed between groups for the trapezius and the rectus abdominis. CONCLUSIONS: Rehabilitation programs may initially prioritize rowing and push-up exercises to strengthen periscapular muscles. More complex exercises with greater mechanical demand on the kinetic chain, such as the T-push-up, may have to be implemented in later phases. [ABSTRACT FROM AUTHOR]

The construction of the recent armed conflict and the truth process, justice and reparation of guareantees of not repeated, as a fundamental anchor of the transitional justice defending the humanrights of the victims, it has beeen exarcebate the costruction of memory in our country. The recent article has as an obtective to describe the intelectual production about the uses and abuses of the memory, according to an exercise of documental revisión and the data base of cientific production, considering the practicum in terms of intervention, the thematics well talked about in this documentary and the methodology used for the analysis of the memory construction in the frame of the conflicto armed in Colombia and the victims affair during 2008 and 2017. The results indicates that there is a documental production about the comnstruction of the history memory in terms of reparation, ways of resistence ans judicial processs. [ABSTRACT FROM AUTHOR]

BACKGROUND: Cardiac dysfunction accompanies acute ischemic stroke and affects the effective implementation of early rehabilitation interventions. There is a lack of reference hemodynamic data on cardiac function in the subacute phase of ischemic stroke. OBJECTIVE: In this study, we aimed to identify appropriate cardiac parameters for exercise training utilizing a pilot study. METHODS: We used a transthoracic electrical bioimpedance non-invasive cardiac output measurement (NICOM) device to monitor cardiac function in real time for two groups [i.e., subacute ischemic stroke inpatients group (n = 10) and healthy control group (n = 11)] using a cycling exercise experiment. The parameters of both groups were compared to highlight the cardiac dysfunction in the subacute phase in patients with ischemic stroke. RESULTS: We considered stroke volume index (SVI) and systemic vascular resistance index (SVRi) as the primary outcomes, and there was significant intragroup difference (stroke group: P < 0.001; control group: P < 0.001, using one-way ANOVA) and significant intergroup difference at each individual time segment (P < 0.01, using independent t -test). Among the secondary outcomes, i.e., cardiac index (CI), ejection fraction (EF), end-diastolic volume (EDV), and cardiac contraction index (CTI), we found significant intergroup differences in CI, EF, and CTI scores (P < 0.01, using independent t -test). Significant interaction with respect to time and group were seen only in the SVRi and CI scores (P < 0.01, using two-way ANOVA). There was no significant inter- or intra-group differences in EDV scores. CONCLUSION: SVRI, SVI, and CI values highlight cardiac dysfunction in stroke patients the most. At the same time, these parameters suggest that cardiac dysfunction in stroke patients may be closely related to the increased peripheral vascular resistance caused by infarction and the limitation of myocardial systolic function. [ABSTRACT FROM AUTHOR]

In this study, we developed an AI-based real-time motion feedback system for patients with spinal cord injury (SCI) during rehabilitation, aiming to enhance their interest and motivation. The effectiveness of the system in improving upper-limb muscle strength during the Thera band exercises was evaluated. The motion analysis program, including exercise repetition counts and calorie consumption, was developed using MediaPipe, focusing on three key motions (chest press, shoulder press, and arm curl) for upper extremity exercises. The participants with SCI were randomly assigned to the experimental group (EG = 4) or control group (CG = 5), engaging in 1 h sessions three times a week for 8 weeks. Muscle strength tests (chest press, shoulder press, lat pull-down, and arm curl) were performed before and after exercises. Although both groups did not show significant differences, the EG group exhibited increased strength in all measured variables, whereas the CG group showed constant or reduced results. Consequently, the computer program-based system developed in this study could be effective in muscle strengthening. Furthermore, these findings may serve as a valuable foundation for future AI-driven rehabilitation exercise systems. [ABSTRACT FROM AUTHOR]

Muscle tissue swelling occurs immediately after exercise. Conventionally, this phenomenon has been evaluated by diagnostic imaging methods such as ultrasonic B-mode imaging. On the other hand, bioelectrical impedance analysis (BIA) is a simpler method to measure this phenomenon. In the BIA, changes in water volume inside and outside of muscle cells during exercise can be evaluated as changes in bioelectrical impedance (BI) . In this study, the local muscle fatigue was effectively measured using BIA by concentrating the current in a narrow area and the results were compared with muscle thickness measured by ultrasonic B-mode imaging. The measurement site was the upper arm, and the exercise condition was four sets of arm curl exercise. Measurements of upper arms were taken before exercise (base line:BL) and after each exercise set (post exercise:PE1-4) . BI was converted into external cell water resistance (RECW), internal cell water resistance (RICW), and their parallel resistance (RICW//RECW) . The results showed that RECW increased before PE1 and decreased after PE1. Therefore, exercise hyperemia was inferred to be a factor in muscle swelling after PE1. Then, the correlations between RECW, RICW, RICW//RECW and muscle thickness were calculated. Subsequently, a significant correlation was obtained between RICW//RECW and muscle thickness, especially after PE1. [ABSTRACT FROM AUTHOR]

Background: A wide variety of static, non-progressive motor impairments, such as cerebral palsy, can develop from birth or infancy as a result of damage to the central nervous system's neuromotor components. Regulating motor activity frequently requires communication between the cerebral cortex, thalamus, basal ganglia, brain stem, Cerebellum, spinal cord, and linking sensory-motor pathways. Task-oriented training is utilized as a rehabilitation technique to hone motor skills and as a programme to enhance muscular function or strength. Objective of this study is to compare the effectiveness of Conventional therapy and task-oriented strength training in children with cerebral palsy. Purpose: To compare the effectiveness of conventional therapy and task-oriented strength training in children with cerebral palsy. Materials and Methods: A total of 48 subjects were included into the study based on the selection criteria and informed consent was obtained from the parents of the children. Group A (n=24) will be treated with Conventional shoulder exercises while Group B (n=24) will be treated with task-oriented strength training with weights. Outcome measures include Shoulder ROM and GMFCS Scale. Results should be tabulated and statistically analyzed. Both training programs will be given for 4 weeks, weekly 5 days from November 2022 to April 2023. Result: Statistical analysis made with quantitative data revealed statistically significant differences between group A and group B. The test shows that subjects who received task oriented strength training have better effects in improving the motor function of children with Cerebral Palsy. [ABSTRACT FROM AUTHOR]

The article discusses the results of the PARACYS-RV trial, which aimed to compare the effectiveness of sacubitril/valsartan (an angiotensin receptor-neprilysin inhibitor) to placebo in adults with congenital systemic right ventricular (sRV) heart failure. The trial was prematurely terminated due to safety concerns, as there was a high rate of worsening heart failure events in patients who received placebo compared to those who received sacubitril/valsartan. Although the trial was inconclusive regarding the efficacy of sacubitril/valsartan, the results showed promising trends in improving exercise duration and reducing levels of N-terminal pro-B-type natriuretic peptide. The article emphasizes the need for further research and suggests future trials should avoid crossovers to placebo and discontinuation of other heart failure medications. [Extracted from the article]

People with spinal cord injury (SCI) tend to be more sedentary and increase fat accumulation, which could have a negative influence on metabolic flexibility. The aim of this study was to investigate the capacity to oxidize fat in a homogenous sample of men with thoracic SCI compared with healthy noninjured men during an arm cycling incremental test. Forty-one men, 21 with SCI and 20 noninjured controls, performed an incremental arm cycling test to determine peak fat oxidation (PFO) and the intensity of exercise that elicits PFO (Fatmax). PFO was expressed in absolute values (g/min) and relative to whole-body and upper-body lean mass ([mg·min-1].kg-1) through three different models (adjusting by cardiorespiratory fitness and fat mass). Gross mechanical efficiency was also calculated. PFO was higher in SCI than in noninjured men (0.27 + 0.07 vs. 0.17 + 0.07 g/min; 5.39 + 1.30 vs. 3.29 f 1.31 [mg·min-1]·kg-1 whole-body lean mass; 8.28 + 2.11 vs. 5.08 * 2.12 [mg·min-111·kg-1 upper-body lean mass). Fatmax was found at a significantly higher percentage of VOzpeak in men with SCI (33.6% + 8.2% vs. 23.696 * 6.4%). Differences persisted and even increased in the fully adjustment model and at any intensity. Men with SCI showed significantly higher gross mechanical efficiency at 35 and 65 W than the noninjured group. Men with SCI showed higher fat oxidation when compared with noninjured men at any intensity, even increased after full adjustment for lean mass, fat mass, and cardiorespiratory fitness. These findings suggest that SCI men could improve their metabolic flexibility and muscle mass for greater efficiency, not being affected by their fat accumulation. [ABSTRACT FROM AUTHOR]

Background. People with disabilities face considerable obstacles when exercising, which precludes them from the social and health benefits of physical activity. Especially for individuals with paraplegia with spinal cord injuries, it is necessary to maintain continuous participation in physical activity even after discharge, as it helps to maintain mobility and daily living activities through upper body strength. However, the participation rate of people with disabilities in physical activity in Korea is still low, mainly due to the lack of exercise equipment and facilities. Objectives. The aim of this study is to identify aspects that can be improved for better accessibility to exercise equipment for individuals with paraplegia with spinal cord injuries and to reach a consensus on possible guidelines for accessible exercise equipment. Methods. This study reviews and evaluated the usability of four existing upper-body exercise equipment for individuals with paraplegia with spinal cord injuries. To assess usability, task performance scores and time were measured, and a survey was conducted on safety and satisfaction. Based on these results, areas for improvement were identified. Through literature review, usability results, and opinions from various stakeholders, eight requirements for universal accessibility were proposed. Results. It is necessary to consider how wheelchair users access the exercise equipment. The access method to the exercise area (facility regulations, auxiliary equipment to be provided, etc.) and placement of exercise equipment should also be considered. Information such as explanations of the exercise equipment and how to use it should be located within the wheelchair user's field of vision. Considering the participation rate in sports for people with disabilities in Korea, it is necessary to explain the exact exercise equipment and exercise method. It is also necessary to consider how wheelchair users transfer from the wheelchair to the seat of the exercise equipment. Parts that require manipulation of each exercise equipment must be within the wheelchair user's range of motion. Various supports or assistive devices that provide body support according to each piece of equipment are needed. In addition to the wheelchair's own brake, it is necessary to provide a fixing device so that the wheelchair does not move during the exercise. Conclusion. For people with spinal cord injuries, the arm ergometer, aerobic exercise equipment, showed higher scores in performance, stability, and satisfaction compared to other exercise equipment. Among the strength exercise equipment, shoulder press had an effect on performance, seated lat pull-down had an effect on stability, and seated chest press had an effect on satisfaction. Therefore, when selecting exercise equipment, it is necessary to recommend aerobic and strength exercise equipment according to the preferences of people with spinal cord injuries. When developing strength exercise equipment, it is necessary to consider usability evaluation factors for individuals with spinal cord injury. [ABSTRACT FROM AUTHOR]

Arm cycling is used for cardiorespiratory rehabilitation but its therapeutic effects on the neural control of the trunk after spinal cord injury (SCI) remain unclear. We investigated the effects of single session of arm cycling on corticospinal excitability, and the feasibility of home-based arm cycling exercise training on volitional control of the erector spinae (ES) in individuals with incomplete SCI. Using transcranial magnetic stimulation, we assessed motor evoked potentials (MEPs) in the ES before and after 30 min of arm cycling in 15 individuals with SCI and 15 able-bodied controls (Experiment 1). Both groups showed increased ES MEP size after the arm cycling. The participants with SCI subsequently underwent a 6-week home-based arm cycling exercise training (Experiment 2). MEP amplitudes and activity of the ES, and movements of the trunk during reaching, self-initiated rapid shoulder flexion, and predicted external perturbation tasks were measured. After the training, individuals with SCI reached further and improved trajectory of the trunk during the rapid shoulder flexion task, accompanied by increased ES activity and MEP amplitudes. Exercise adherence was excellent. We demonstrate preserved corticospinal drive after a single arm cycling session and the effects of home-based arm cycling exercise training on trunk function in individuals with SCI. [ABSTRACT FROM AUTHOR]

Background: COVID-19 is a highly contagious disease where isolation of infected individuals is deemed warranted. If possible, home isolation is preferred over hospitalization. This implies a need for methods of observation that can ensure the safety of these patients. Preventive treatment methods that can both decrease the probability for development of critical disease and hopefully decrease the need for hospitalization would be an added benefit. This was a single-arm prospective pilot study performed to assess the feasibility of performing self-measurements of SpO2 and respiratory exercises in at-home isolated COVID-19 patients. Method: A total of 40 ambulant SARS-CoV-2-positive individuals in home isolation were followed up for a period of 14 days. At baseline, they were equipped with a pulse oximeter, PEF meter, a project diary to note all measurements, and simple instructions on how to perform respiratory exercises. No other contact was made, but participants were instructed to contact the hospital based on given criteria for blood oxygenation levels and dyspnea severity and to return study equipment and the project diary at the end of study. Results: During the follow-up period, 35 participants (87.5%) recorded daily SpO2 measurements, and 12 (30%) adhered to daily respiratory exercises as instructed. Four participants (10%) were admitted to hospital during the follow-up period. Five participants terminated follow-up prematurely. Conclusions: Performing self-measurements of SpO2 during home isolation due to COVID-19 infection is feasible. The feasibility of performing respiratory exercises in ambulant patients is questionable and may require more motivational interventions to increase adherence. Trial registration: ClinicalTrials.gov identifier: NCT04647747. [ABSTRACT FROM AUTHOR]