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Purpose: Core strength is vital for athletic performance, and many more exercises that involve the kinetic chain have been designed for able-bodied athletes. Disabilities that impair the kinetic chain can reduce the effectiveness of strength training. However, the impact of amputation on core strength training of people with disabilities and its underlying mechanism remains unclear. This study aimed to evaluate the muscle activation patterns and levels in athletes with amputation during 4 basic and modified weight-bearing core strength-training exercises. Methods: Fifteen elite athletes with unilateral amputation (170.6 [7.3] cm; 63.9 [11.9] kg; 25.9 [5.3] y) volunteered for this study. Surface electromyography was used to measure the muscle activity mainly in the lumbopelvic–hip complex-stabilizing muscles during 4 kinetic chain trunk exercises with and without modifications. Results: The significance level was set at α =.05. The results showed a significant difference in muscle activation between different body sides (P <.05). Specifically, amputation on the support position resulted in a diagonal pattern of muscle activation, and amputation on the free distal segments resulted in a unilateral dominant pattern with higher activation in muscles on the nonamputated side (P <.05). Modifications led to significant decreases in muscle activation asymmetry index (P <.05). Conclusions: Amputation caused muscle activation asymmetry and 2 activation patterns. Modifications by enhancing proximal stability and adjusting distal loading effectively reduced the asymmetry of muscle activation. Coaches and clinicians can use these results to tailor exercises for athletes with disabilities in training and rehabilitation. [ABSTRACT FROM AUTHOR]

Objective: Chronic low back pain (CLBP) is a prevalent health condition worldwide. Several therapeutic interventions aim to improve CLBP. Pain Neuroscience Education (PNE) helps patients better understand their pain from biological and physiological perspectives, which clinicians use to reduce pain and disability in patients with chronic musculoskeletal conditions. Neuromuscular exercises (NMS) are also treatments adopted in CLBP. This study will investigate whether PNE combined with an NMS program improves pain, functional and psychological outcomes more than NMS alone in patients with CLBP. Methods: In this single-blind randomized controlled trial, 60 patients (male and female; age range, 30–60 years) diagnosed with CLBP will be randomly assigned to one of the following groups: (1) PNE plus NMS (n = 30; 24 sessions of PNE plus NMS in a total of 8 weeks, 3 each week), and (2) NMS alone (n = 30; 24 sessions of NMS sessions in a total of 8 weeks, 3 each week). Outcome assessors will be blinded to the group allocation. The primary outcome will be pain. Secondary outcomes will be disability, fear-avoidance beliefs about work and physical activity, self-efficacy, exercise anxiety, and kinesiophobia. Outcomes will be assessed at baseline, after 8 weeks of intervention, and 6 months post-intervention. Discussion: The findings of this RCT will help shed light on new treatment strategies to address the biopsychosocial dimensions of CLBP. The study protocol will be conducted in a clinical setting, offering the opportunity for future implementation in healthcare systems. Moreover, it will help clarify whether a combined treatment (PNE with NMS) is more effective than NMS alone for improving pain, functional and psychological outcomes in CLBP. Trial registration: Study registration: The study was prospectively registered in the Iranian Registry of Clinical Trials—IRCT20190427043384N2 (https://www.irct.ir/trial/69146). Registered on March 17, 2023. [ABSTRACT FROM AUTHOR]

Background: The efficacy of various supervision methods for stabilization exercises in patients with chronic low back pain (CLBP) remains uncertain. Objective: To evaluate the impact of supervised and unsupervised stabilization exercises in patients with CLBP. Methods: Sixty-six participants were assigned to the in-person-supervised, tele-supervised, or unsupervised groups. All participants received a 20–30-minute exercise program three times a week for 4 weeks. We assessed functionality (Oswestry Disability Index), pain intensity (Numeric Rating Scale), and kinesiophobia (Tampa Scale of Kinesiophobia) before and after the 4 weeks. The outcomes were analyzed using effect size, minimum clinically important difference (MCID), minimal detectable change (MDC), Wilcoxon test, and post hoc analyses. Results: While the unsupervised group improved in all measures (p <.05) both the tele-supervised (p =.001) and in-person-supervised (p <.001) groups achieved superior functionality exceeding MDC. The in-person-supervised group demonstrated greater functionality (p <.001) than the tele-supervised group, exceeding MCID. Pain intensity decreased in the tele-supervised (p =.011) and in-person-supervised groups (p <.001) compared to the unsupervised group, exceeding MCID and MDC. No significant difference was found in post-treatment NRS score changes between the supervised groups (p =.071). The in-person-supervised group displayed a greater reduction in kinesiophobia than the tele-supervised (p <.001) and unsupervised groups (p <.001) but not exceeding MCID or MDC. Effect sizes were large within and between groups except for a small effect size between the tele-supervised and unsupervised groups in kinesiophobia. Conclusion: While tele-supervised stabilization exercises alleviate pain and enhance functionality, in-person-supervised exercises may be more effective in improving functionality and reducing kinesiophobia in patients with CLBP. [ABSTRACT FROM AUTHOR]

This study aimed to explore the effect of the menstrual cycle (MC) phases (i.e., early follicular phase [EFP], late follicular phase [LFP], and mid-luteal phase [MLP]) on the repetitions performed to momentary failure in back squat and bench press exercises, as well as to determine subsequent fatigue (i.e., change in countermovement jump [CMJ], perceived effort, and muscle soreness). Twelve physically active eumenorrheic women performed a back squat and bench press set to momentary failure at 80% of the one-repetition maximum during the EFP, LFP, and MLP. The results revealed that subjects were able to perform 2.2 [0.2 to 4.2] more repetitions in the LFP with respect to the EFP for the back squat exercise (p = 0.009), but no significant differences were observed for the bench press (p = 0.354). The EFP displayed a larger CMJ height drop (−0.86 [−1.71 to −0.01] cm) with respect to the LFP (0.01 [−0.57 to 0.58] cm) and the MLP (−0.36 [−1.15 to 0.43] cm). Neither the perceived effort of each set to failure nor the resulting muscle soreness differed between MC phases. Therefore, practitioners should be aware that the MC could condition the repetitions available to momentary failure and the resulting allostatic load. [ABSTRACT FROM AUTHOR]

Background: With its high and increasing lifetime prevalence, back pain represents a contemporary challenge for patients and healthcare providers. Monitored exercise therapy is a commonly prescribed treatment to relieve pain and functional limitations. However, the benefits of exercise are often gradual, subtle, and evaluated by subjective self-reported scores. Back pain pathogenesis is interlinked with epigenetically mediated processes that modify gene expression without altering the DNA sequence. Therefore, we hypothesize that therapy effects can be objectively evaluated by measurable epigenetic histone posttranslational modifications and proteome expression. Because epigenetic modifications are dynamic and responsive to environmental exposure, lifestyle choices-such as physical activity-can alter epigenetic profiles, subsequent gene expression, and health traits. Instead of invasive sampling (e.g., muscle biopsy), we collect easily accessible buccal swabs and plasma. The plasma proteome provides a systemic understanding of a person's current health state and is an ideal snapshot of downstream, epigenetically regulated, changes upon therapy. This study investigates how molecular profiles evolve in response to standardized sport therapy and non- controlled lifestyle choices. Results: We report that the therapy improves agility, attenuates back pain, and triggers healthier habits. We find that a subset of participants' histone methylation and acetylation profiles cluster samples according to their therapy status, before or after therapy. Integrating epigenetic reprogramming of both buccal cells and peripheral blood mononuclear cells (PBMCs) reveals that these concomitant changes are concordant with higher levels of self-rated back pain improvement and agility gain. Additionally, epigenetic changes correlate with changes in immune response plasma factors, reflecting their comparable ability to rate therapy effects at the molecular level. We also performed an exploratory analysis to confirm the usability of molecular profiles in (1) mapping lifestyle choices and (2) evaluating the distance of a given participant to an optimal health state. Conclusion: This pre-post cohort study highlights the potential of integrated molecular profiles to score therapy efficiency. Our findings reflect the complex interplay of an individual's background and lifestyle upon therapeutic exposure. Future studies are needed to provide mechanistic insights into back pain pathogenesis and lifestyle-based epigenetic reprogramming upon sport therapy intervention to maintain therapeutic effects in the long run. [ABSTRACT FROM AUTHOR]

Background: Low back pain is the leading cause of global disability for which exercise therapy is a widely recommended treatment. Research indicates that contextual factors may also influence treatment outcomes in low back pain. Examples include the patient-therapist relationship and other treatment-related circumstances that affect patient expectations. By focusing on the specific treatment effect, clinical trials often ignore the effect of contextual factors, thereby contributing to the so-called efficacy paradox. This means that treatment effects observed in clinical practice are often greater than those reported in clinical trials. This systematic review aims to investigate the proportion of improvement in pain and disability that can be attributed to contextual effects in the outcome of exercise therapy for patients with low back pain. Methods: A meta-analysis was conducted. PubMed, Embase, and the Cochrane database were searched for eligible articles reporting randomized controlled trials that compared exercise therapy to placebo interventions. Risk of bias was assessed with the Revised Cochrane Risk of Bias Tool. Outcomes of interest were pain and disability. Meta-analysis was carried out to calculate the proportion attributable to contextual effects for both pain and disability. The body of evidence was assessed using the GRADE methodology. Results: Eight studies met the inclusion criteria and were included in the meta-analysis. Five studies were rated as having a moderate risk of bias and two studies had a low risk of bias. Proportion attributable to contextual effects was 0.60 (95% CI 0.40–0.89) for pain and 0.69 (95% CI 0.48–1.00) for disability. Certainty of the evidence as assessed with the GRADE methodology was low. Conclusions: A large extent of pain and disability improvement after exercise therapy in low back pain is attributable to contextual effects although this conclusion is based on low certainty evidence. [ABSTRACT FROM AUTHOR]

Introduction: Hypopressive exercise (HE) can be viewed as a mind--body activity, characterized by the integration of breath control and stretching postures. Proponents of HE claim that this type of training can offer potential therapeutic or health benefits. To date, there is no existing comprehensive published overview on HE. This scoping review aims to map and summarize the current literature reporting data on HE and identify key knowledge gaps and future research directions. Methods: This review considered studies that report on the immediate, short-, or long-term practice of HE regardless of condition, sex, age, and/or level of practice or physical condition. Any context or setting was considered for inclusion. This review was performed in accordance with the methodological framework proposed by the Joanna Briggs Institute and by Arksey and O'Malley. MEDLINE, CINAHL, SPORTDiscus, Scopus, and Web of Science were searched from inception up to July 2023. Literature was mapped following the Patterns-Advances-Gaps-Evidence for Practice Recommendations framework to identify patterns and inform practice. Results: In total, 87 studies were identified that reported on the following themes: (1) therapeutic application of a short- or long-term HE programs (n = 56); (2) physiologic and physical responsiveness to a short- or long-term HE programs (n = 22); (3) psychologic and behavioral response to a short-term HE program (n = 14); and (4) acute or immediate physiological responses (n = 21). Literature gaps included poor methodological design, incomplete reporting of intervention, lack of male participants, and exploration of muscle groups distinct from the pelvic floor and abdominal muscles. Discussion: There is a need for high-quality randomized controlled trials, adherence to reporting guidelines on exercise, and the use of active control groups to verify clinical significance, the dose response, and health applications of HE. [ABSTRACT FROM AUTHOR]

Background: The patient with pusher syndrome (PS) is characterized by showing postural control alterations due to a lack of perception of his own body in the space. It appears when the patient actively pushes with his unaffected limbs towards the injured side, reacting with resistance to passive straightening towards the midline. Between 10% and 50% of strokes present PS. Nowadays, there is no clearly defined treatment for PS. Objective: To design and validate an exercise program using visual feedback and specific core stability exercises (FeViCoS) for the treatment of patients with PS. Methods: Validation was conducted by expert consensus using the Delphi method. Thirteen neurorehabilitation experts participated in the process. An online questionnaire with 18 Likert‐type questions was used to evaluate the designed program. Consensus was considered reached if there was convergence between the quartile 1 and 3 values (RIQ = Q1‐Q3) or if the relative interquartile range (RIR) was less than 20%. The degree of agreement between experts was measured by calculating the Fleiss' kappa coefficient. Results: A total of 2 rounds were required to achieve 97.44% consensus with 100% participation. The RIR was less than or equal to 20% for all questions. The Fleiss' kappa index (0.831) showed that the degree of agreement between experts was excellent. Conclusion: Neurorehabilitation experts considered FeViCoS valid for the therapeutic approach to patients with PS. Expert consensus suggests a novel strategy in physical therapy clinical practice to improve balance and postural orientation in patients with subacute stroke and PS. [ABSTRACT FROM AUTHOR]

Exercise is a first-line treatment for chronic low back pain (CLBP), reducing pain and disability in the short term. However, exercise benefits decrease over time, with a lack of long-term exercise adherence a potential reason for this. This study aimed to synthesize the perceptions and beliefs of individuals with CLBP and identify their barriers and enablers to exercise adherence. We searched CENTRAL, Embase, CINAHL, SPORTDiscus, PubMed, PsycINFO, and Scopus databases from inception to February 28, 2023, for qualitative studies that explored the factors influencing exercise adherence for people with CLBP. A hybrid approach combining thematic synthesis with the Theoretical Domains Framework was used to analyze data. We assessed methodological quality using the Critical Appraisal Skills Programme checklist and the level of confidence of the themes generated using the Confidence in the Evidence from Reviews of Qualitative Studies. Twenty-three papers (n521 studies) were included (n5677 participants). Four main themes affected exercise adherence: (1) exercise, pain, and the body, (2) psychological factors, (3) social factors, and (4) external factors. These themes contained 16 subthemes that were predominantly both barriers and enablers to exercise adherence. The individual's experiences of barriers and enablers were most appropriately represented across a spectrum, where influencing factors could be a barrier or enabler to exercise adherence, and these could be specific to pre-exercise, during-exercise, and post-exercise situations. These findings may be used to improve exercise adherence and ultimately treatment outcomes in people with CLBP. [ABSTRACT FROM AUTHOR]

Objective: This systematic review and meta-analysis aimed to evaluate the influence of core muscle training on throwing ball velocity among overhead throwing athletes. Design: A literature search was performed from inception to July 2023 for randomized controlled trials investigating the effects of core muscle training on overhead throwing ball velocity. The primary outcome was the change in standing throwing ball velocity. The secondary outcome focused on the enhancement of step/jump throwing ball velocity. Results: Ten randomized controlled trials were included, revealing a significant improvement in standing throwing ball velocity in the group undergoing core muscle training (Hedges’ g = 0.701, 95% confidence interval = 0.339 to 1.063, P < 0.001). Longer treatment duration and a higher frequency of core muscle training sessions per week contributed to improved standing throwing ball velocity. However, core muscle training did not show significant benefits for step (Hedge’s g = 0.463, 95% confidence interval = −0.058 to 0.985, P = 0.082) and jump throwing ball velocity (Hedges’ g = 0.550, 95% confidence interval = −0.051 to 1.152, P = 0.073). Conclusions: Core muscle training significantly enhanced standing ball throwing velocity. However, its effect on step/jump throwing ball velocity was less certain. Further research is needed to explore the impact of core muscle training (especially its long-term effects) on throwing ball velocity. [ABSTRACT FROM AUTHOR]

Background: The diaphragm muscle constitutes the internal component of the Lumbo-Pelvic-Hip Complex (LPHC), and its stability is suggested to influence lower limb joint function, particularly the alignment of the patellofemoral joint and the tracking path mechanism of the patella. Objectives: To compare the endurance of the LPHC and diaphragm contractility in females with patellofemoral pain syndrome (PFPS) and a healthy control group. Methods: Fifty-six females, including twenty-eight diagnosed with patellofemoral pain syndrome and twenty-eight healthy females matched as controls (aged 15 - 45), were invited to participate in this case-control study. Endurance scores of trunk extensor, flexor, and lateral flexor muscles, endurance ratios, and the percentage of diaphragm muscle contractility using the ultrasonography method were compared between the two groups. Results: The endurance time of trunk flexors and right and left lateral muscle groups in the PFPS group significantly differed compared to the control group (P < 0.05). Diaphragm contractility in both the right (Mean ± SD: 21.82 ± 3.61; P < 0.001) and left (Mean ± SD: 22.92 ± 2.99; P = 0.007) sides was significantly lower in the PFPS group compared to the control group. Conclusions: Lumbo-Pelvic-Hip Complex stability and diaphragm respiratory function and contractility were impaired in females with PFPS. [ABSTRACT FROM AUTHOR]

Cerebral palsy (CP) is defined as a set of developmental illnesses that affect posture and mobility, causing activity restriction owing to abnormalities that are not progressive in the developing brain of the foetus or neonate. Children with cerebellar ataxic cerebral palsy often exhibit undeveloped or malformed cerebellar structures, resulting in challenges for the cerebellum to integrate the neural input required to control movement and balance smoothly. Patients with cerebellar ataxic cerebral palsy have difficulty in maintaining balance and trunk control which leads to difficulty in performing their activities of daily living and result in dependency. Thus, reporting cases like these is crucial to evaluate the impact of core stabilization intervention and treadmill walking on balance in a child having cerebellar ataxic cerebral palsy. A 7-year-old female child born at full term delivered via normal vaginal delivery with a birth weight of 2700 gm had no difficulties during antenatal, natal or postnatal phases. At the age of 6 years, mother noticed that the child had difficulty in standing and walking independently, she had difficulty in performing her activities of daily living independently. The patient underwent an 8 weeks intervention consisting of core stabilization exercise protocol and treadmill walking along with traditional physiotherapy intervention. The outcome measures included Paediatric Balance Scale for static balance and My Fitness Trainer (MFT)for dynamic balance. The patient showed significant improvement in both static as well as dynamic balance following the intervention. Thus, combined impact of core stabilization exercise protocol and treadmill walking can bring early effective changes on balance in a patient with cerebellar ataxic cerebral palsy. [ABSTRACT FROM AUTHOR]

In the modern era, AI-driven algorithms have significantly influenced medical diagnosis and therapy. In this pilot study, we propose using Streamlit 1.38.0 to create an interactive dashboard, PoAna.v1—Pose Analysis, as a new approach to address these concerns. In real-time, our system accurately tracks and evaluates individualized rehabilitation exercises for patients suffering from low back pain using features such as exercise visualization and guidance, real-time feedback and monitoring, and personalized exercise plans. This dashboard was very effective for tracking rehabilitation progress. We recruited 32 individuals to participate in this pilot study. We monitored an individual's overall performance for one week. Of the participants, 18.75% engaged in rehabilitative exercises less frequently than twice daily; 81.25% did so at least three times daily. The proposed Long Short-Term Memory (LSTM) architecture had a training accuracy score of 98.8% and a testing accuracy of 99.7%, with an average accuracy of 10-fold cross-validation of 98.54%. On the pre- and post-test assessments, there is a significant difference between pain levels, with a p < 0.05 and a t-stat value of 12.175. The proposed system's usability score is 79.375, indicating that it provides a user-friendly environment for the user to use the PoAna.v1 web application. So far, our research suggests that the Streamlit 1.38.0-based dashboard improves patients' engagement, adherence, and success with exercise. Future research aims to add more characteristics that can improve the complete care of low back pain (LBP) and validate the effectiveness of this intervention in larger patient cohorts. [ABSTRACT FROM AUTHOR]

This document summarizes a Cochrane Review titled "Exercise therapy for treatment of acute non-specific low back pain." The review examined the benefits and harms of exercise therapy for adults with acute nonspecific low back pain compared to sham/placebo treatment or no treatment. The review included 23 studies with a total of 2674 participants. The findings suggest that exercise therapy may not have a significant effect on pain or functional status compared to sham/placebo treatment, no treatment, or other conservative treatments. However, the certainty of evidence was generally low or moderate. The review did not report on perceived recovery, health-related quality of life, or adverse events. The authors concluded that exercise therapy does not provide any benefit for acute nonspecific lower back pain. They suggest that exercise therapy may still have a role in the treatment of chronic low back pain, but personalized approaches, patient education, shared decision-making, and alternative evidence-based interventions should be considered by rheumatologists when treating acute low back pain. Regular monitoring and reassessment of treatment plans are also important. [Extracted from the article]

Background: Core muscles constitute the centre of the kinetic chain, and core exercises have been effective in improving outcomes in many postsurgical lower extremity musculoskeletal conditions. However, the literature on the implementation of core exercises after TKA has not been summarised. Objective: The objective was to review the evidence on the effect of core exercises on clinical and functional outcomes after TKA in individuals with knee osteoarthritis (OA). Methods: PubMed, Scopus, CINAHL, Web of Science, the Cochrane Library, and ProQuest databases were explored with appropriate keywords for studies published on the effect of core exercises on TKA from inception to 1 April 2024. Two authors independently screened the titles and abstracts and full‐texts, and a third author solved the discrepancies. Risk of bias assessment was done with the Joanna Briggs Critical Appraisal tool. The final articles were systematically summarised. Results: A total of 1485 records were retrieved. Sixty‐four articles were included for screening full‐texts, and four articles were ultimately included. Core exercises were administered for three to 6 weeks. The administration of core exercises along with the standard knee rehabilitation programme significantly improved balance, mobility, knee function, transverse abdominis muscle thickness, transversus abdominis contraction, and quality of life after TKA (p < 0.05). Conclusions: Core exercises can be administered as an adjunct to standard rehabilitation programs to improve clinical and functional outcomes after TKA. However, there is a dearth of literature in this domain, and more studies are warranted. Trial Registration: PROSPERO Registration Number: CRD42024542992 [ABSTRACT FROM AUTHOR]

Chronic low back pain (CLBP) is a prevalent musculoskeletal disorder that significantly impairs daily functioning and quality of life. Exercise therapy, particularly core stabilization exercises and Back School programs, are commonly used interventions for CLBP management. This study aims to compare the effectiveness of these two exercise programs in reducing pain, improving functional disability, and enhancing lumbar spine range of motion in patients with CLBP. Methods: This randomized controlled trial included 40 participants with CLBP, aged 35 to 60 years, from the physiotherapy outpatient department of Deccan Hospital, Hyderabad. Participants were randomly assigned to Group A (Back School program) or Group B (core stabilization exercises), with 20 participants in each group. Both interventions were administered four times a week over a 4-week period. Outcome measures, including the Visual Analogue Scale (VAS), Roland-Morris Disability Questionnaire (RMDQ), and lumbar spine range of motion (TROM), were assessed at baseline and post-intervention. Data analysis included paired and independent t-tests, with significance set at p≤0.05. Results: Both groups showed significant improvements in all outcome measures. Group A's mean VAS score decreased from 7.4 to 5.52, RMDQ score from 16.65 to 9.45, and TROM increased from 1.585 degrees to 2.09 degrees. Group B demonstrated greater improvements, with VAS decreasing from 7.2 to 2.4, RMDQ from 16.6 to 6.75, and TROM increasing from 1.53 degrees to 2.51 degrees. Group B's improvements were significantly greater across all measures (p < 0.0001). Conclusion: Core stabilization exercises resulted in superior outcomes compared to the Back School program, suggesting they may be a more effective intervention for managing CLBP. These findings support the use of core stabilization exercises as a primary therapeutic approach in CLBP management. [ABSTRACT FROM AUTHOR]

Autonomous exercise within nonspecific low back pain rehabilitation is a necessary tool to treat low back pain. The purpose of this study was to quantify adherence and compliance during two different 6-week home-exercise programs. Forty adults were randomly allocated to a gamified and packet group. Adherence, compliance, and system usability assessments occurred after 3 and 6 weeks. Packet group adherence was similar at 3 weeks and at 6 weeks. System usability was significantly greater at 6 weeks than at 3 weeks in the packet group. Adherence or compliance was not influenced. The usability of the intervention methodology was considered great by both groups. [ABSTRACT FROM AUTHOR]

This study aimed to examine physical therapists' perspectives in conservative treatments of pediatric patients with adolescent idiopathic scoliosis (AIS). A cross-sectional survey design was used. A validated questionnaire was distributed to physical therapists, and the responses were analyzed. Preferred treatment frequency was 60 minutes (53.8%), twice weekly (41.5%), over 3 to 5 months (44.6%). Top 3 clinical interventions were core and trunk stability enhancement (90.8%), abdominal strengthening (83.1%), and postural correction (80.0%). Top 3 therapeutic goal-setting parameters were activity-based (78.5%), quality-of-life measure-based (56.9%), and participation-based (50.8%). The most common quality-of-life survey used was Oswestry low back pain disability questionnaire (15.6%) followed by Scoliosis Research Society-22 instrument (12.5%). According to our data, physical therapists believe that pediatric patients with AIS can benefit with addressing core and trunk stability, a 60-minute per session, twice weekly, over 3 to 5 months based on activity-based goal-setting and quality-of-life measures using Oswestry questionnaire. [ABSTRACT FROM AUTHOR]

The association between low back pain and lumbar spine local dynamic stability (LDS) appears to be modulated by if and how someone catastrophizes about pain, suggesting that the cognitive perceptions of pain may influence an individual's ability to control lumbar spine motion. Previous work also demonstrates that directing cognitive resources and attentional focus can influence movement performance. Therefore, we aimed to examine whether distracting attentional focus would influence lumbar spine LDS during repetitive flexion-extension movements. Sixteen participants performed repetitive spine flexion-extension movements under two baseline conditions (pre- and post-), and while attentional focus was distracted by either an external sensory stimulus or a cognitive-motor dual-task, both targeted at the hands. Lumbar spine LDS was examined over 30 continuous movement repetitions using maximum Lyapunov exponents. In comparison to both Baseline and Post-Baseline trials, the perceived mental workload was significantly elevated during the cognitive-motor dual-task trial but not the external sensory stimulus trial. The only statistically significant effect on LDS occurred in the Post-Baseline trial, where LDS was higher than in the cognitive-motor dual-task. In combination with previous work, these findings suggest that distracting attentional focus during repetitive lumbar spine flexion-extension movements does not have a negative influence on lumbar spine LDS. [ABSTRACT FROM AUTHOR]

Background: Low back pain (LBP) is a common symptom that imposes a significant socioeconomic burden. Appropriate exercises that enhance the recovery of anatomical structures using biomechanical methods and improve lumbar stability are recommended for patients with LBP. Therefore, clinicians should prescribe appropriate exercises to alleviate LBP, improve function, and prevent recurrence. Current Concepts: Individualized and structured multimodal exercises (strengthening, aerobic, core stability exercises, and stretching) under the supervision of healthcare professionals are recommended for patients with LBP. It is preferable to focus on isometric trunk muscle exercises for strengthening, and strengthening the large muscles (back and gluteal muscles) attached to the thoracolumbar fascia is recommended rather than exercises that involve repeated extension and flexion of the trunk muscles. Individualized aerobic and core stability exercises are recommended, and stretching exercises focusing on extension movements are preferred. It is also important to educate patients regarding the etiology of LBP, harmful postures for LBP, and methods to maintain lumbar lordosis in daily life. Discussion and Conclusion: An appropriate exercise prescription can contribute to better clinical outcomes in patients with LBP. Although exercise is important for recovery and prevention of recurrence, inappropriate exercise can potentially exacerbate LBP; therefore, careful consideration is required. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Chronic low back pain (CLBP) is a highly prevalent condition among adults and is correlated to high levels of pain, high disability, and lower quality of life. Pain neuroscience education (PNE) helps to explain the pain experience and can affect psychosocial factors, such as fear of movement, anxiety, socioeconomic status, work life satisfaction, etc. More recently, virtual reality (VR) programs have emerged allowing for immersive PNE experiences. Objective: The purpose of this randomized clinical trial is to determine the feasibility of using a VR application for the delivery of immersive PNE (VR-PNE) and other activity training for patients with CLBP presenting to outpatient physical therapy (PT) clinics. Methods: A two-arm, parallel group, randomized controlled feasibility trial of patients was conducted at 12 outpatient PT clinics from March 9, 2022, through September 9, 2022. The intervention group received PT as usual and VR-PNE while the control group received PT as usual. Between group feasibility, acceptability outcomes and other patient-reported outcomes were assessed at six weeks. Results:: A total of 595 individuals were evaluated for low back pain during the recruitment period. Seventy individuals were eligible and met definition for CLBP, 52 enrolled and 32 completed the trial. Participant adherence was 63.6% for VR-PNE and 63.2% for PT as usual. Participants found VR-PNE acceptable and reported satisfaction scores (0-100) of 87.37 ± 11.05 compared to 81.17 ± 23.72 in the PT as usual group. There were no significant differences between groups for the BBQ, BRS, FABQ-PA, FABQ-W, GROC, NPRS, NPQ, PCS, and PSEQ at 6 weeks. Conclusion: The results of the trial suggest that VR-PNE may be acceptable and feasible for patients with CLBP. Study procedures and PT delivery modifications should be considered for the next iteration of this study to improve follow-up assessment rates. [ABSTRACT FROM AUTHOR]

Context: Horse riding (HR) has gain popularity in Portugal, thereby increasing the number of related injuries. This study identifies frequently occurring injuries in Portuguese riders, the conditions under which they occur, and preventive measures. Design: A retrospective cohort study. Methods: We included 216 Portuguese riders practicing HR at the time of the study with ≥1 year of experience. Data were obtained from a questionnaire that characterized first and second rider injuries; we opted for a systematic method to assess the riders' injuries, in a temporal order. Questions regarding demographic data, sports-related background, systematic training workload, number and characteristics of the first 2 injuries, and the need for treatment were included in the questionnaire. Results: Most first and second injuries were musculoskeletal, occurred from falling off the horse during training, and primarily affected the lower limb. Rehabilitation was required in almost 50% of all cases. The occurrence of injury was significantly associated with the number of days of training per week, years of experience, height and weight of the rider, and practice of another sport. Riding different horses was also significantly associated with the number of injuries. Conclusions: The most frequently occurring injuries during HR are musculoskeletal and in the extremities. Injury prevention is essential in HR, as most riders have at least one injury while practicing. Rehabilitation should involve a physiatrist and core strengthening exercises. [ABSTRACT FROM AUTHOR]

Context: Core stability training has been recommended as a vital element in improving movement's pattern and athletic performance. The main objective of this study was to investigate the effect of 12-week McGill core stability training on movement patterns, shooting accuracy, and throwing performance. Design: Randomized controlled clinical trial. Setting: University research laboratory. Methods: Forty male basketball players were randomly assigned to experimental and control groups. The experimental group completed 12-week McGill core stability training, while the control group completed routine exercise training. Patterns of functional movements was measured through functional movement screen (FMS), shooting accuracy measured by static 3-point shooting (S3P) and dynamic 60-second 3-point shooting test, and throwing performance measured by Functional Throwing Performance Index. Results: Comparison revealed that regardless of received training, after 12 weeks both groups showed significant improvement in all outcome measures. However, experimental group had significantly higher post test scores in FMS (P = .02), S3P (P = .007), and dynamic 60-second 3-point shooting test (P = .01). For Functional Throwing Performance Index, there was no group differences (P = .96). The results of follow-up assessments showed for all measurements including FMS (P = .03), S3P (P = .004), dynamic 60-second 3-point shooting test (P < .001), and Functional Throwing Performance Index (P = .005); experimental group had higher scores than the control group. Conclusions: According to the results, implementing McGill core stability training in basketball routine training would be advisable since significant improvement can be obtained in the measured parameters. [ABSTRACT FROM AUTHOR]

Green exercise, defined as physical activity in natural settings, shows promise for enhancing exercise participation and improving health. This systematic review aimed to assess the effectiveness of green exercise in people with chronic conditions. Seven electronic databases were searched and of the 7801 screened articles, 14 trials met the inclusion criteria. Green exercise was a safe and well-tolerated intervention, with low drop-out levels. It was found to positively affect participants’ quality of life in three studies and mental health in four studies. Compared to non-exercise groups, green exercise significantly improved physical and mental health in patients with breast cancer, COPD, cardiovascular disease risk, chronic low back pain, obesity, and diabetes. However, it had no impact on the physical health of stroke patients or the cognitive performance of those with ADHD. Green exercise appears to be a safe intervention that can improve various chronic health issues. [ABSTRACT FROM AUTHOR]

Current medical treatments for diastasis recti often involve exercises to strengthen the core muscles, along with abdominal binders or supports. However, there is limited evidence comparing the effectiveness of surface electromyography (SEMG) biofeedback-assisted core strengthening exercises combined with kinesiotaping to other approaches. This study aimed to assess the impact of three interventions on core strength, inter-rectus distance, and quality of life in postpartum women with diastasis recti. The interventions included core strengthening exercises with kinesiotaping and SEMG biofeedback-assisted core strengthening with kinesiotaping. This randomized controlled trial (NCT05897255) included 24 postpartum women divided into three groups. We measured inter-rectus distance, quality of life using the Short Form Health Survey 36, and core strength using the McGill torso battery test. The SEMG biofeedback provided auditory and visual cues. We used one-way analysis of variance to compare outcomes between groups, while a t-test for within-group analysis. Both the SEMG biofeedback-assisted and non-assisted core strengthening exercises with kinesiotaping groups showed significantly greater improvements in energy, bodily pain, general health, physical functioning, and limitations due to physical problems than the core strengthening group. Additionally, the SEMG biofeedback-assisted group demonstrated a greater reduction in inter-rectus distance. There were no statistically significant differences in core strength improvement among the three groups. Core strengthening exercises with SEMG-assisted kinesiotaping were superior to core strengthening alone in reducing inter-rectus distance, enhancing physical function, energy levels, and general health, and decreasing bodily pain and limitations due to physical problems. Core strength improvements were similar across all groups. [ABSTRACT FROM AUTHOR]

Background: Chronic back pain affected 619 million people globally in 2020 which accounts for a heavy disease burden causing tremendous productivity losses. Current therapies including ibuprofen, duloxetine, and opioids might cause side effects and even severe drug use disorders. Therefore, a non‐pharmacologic therapy with better or equivalent efficacy and fewer side effects is needed. Methods: We did a multi‐center, single‐blinded, randomized, positive drug controlled, clinical trial. Patients with chronic back pain in moderate severity were randomized into receiving hot stone massage or flurbiprofen plaster group. Both interventions were 2 weeks with a follow‐up of 4 weeks. The primary outcome was the change in the score of the Global Pain Scale (GPS) from baseline to week 2. Secondary outcomes included Numerical Rating Scale (NRS), Chronic Pain Acceptance Questionnaire (CPAQ), Pain Self‐Efficacy Questionnaire (PSEQ), Hospital Anxiety and Depression Scale (HADS), and Short Form‐36 (SF36) from baseline to week 2 and week 6. Exploratory outcome assessment included the muscle thickness measured by ultrasound. Any adverse event was monitored throughout the study period. Results: A total of 120 patients were enrolled in this trial. At 2 weeks GPS decreased significantly in the hot stone massage group compared to the flurbiprofen group (difference between groups = ‐8.1 points, 95% confidence interval [CI] ‐15.8 to ‐0.3, p = 0.047). Moreover, hot stone massage also showed more improvement at 2 weeks compared to flurbiprofen, including NRS (‐0.5 points, 95% CI ‐1.0 to ‐0.1, p = 0.029), PSEQ (5.4 points, 95% CI 0.5 to 10.2, p = 0.030), and mental component of Short Form‐36 (SF‐36) (1.7 points, 95% CI 0.4 to 2.9, p = 0.010), but not in CPAQ (p = 0.131), HADS (p = 0.303 for depression, p = 0.399 for anxiety), or SF‐36 (p = 0.129 for physical component, p = 0.246 for social component, p = 0.076 for fatigue component). A total of two participants in the hot stone massage group reported mild pain on skin surface when receiving the procedure at the first intervention session. [ABSTRACT FROM AUTHOR]

Futsal carries a high risk of injury for players. This systematic review aimed to assess the existing literature on injury prevention strategies for futsal players. The literature was searched using PubMed, Web of Science, and Scopus databases from inception to 20 March 2024. Relevant articles were searched using the terms "futsal" AND "injury" AND "prevention". Fourteen studies were included in the review. The review identified several injury prevention strategies with potential benefits for futsal players. Structured warm-up routines were shown to improve balance and eccentric strength and to reduce total, acute, and lower limb injuries. Proprioceptive training methods were suggested to improve joint stability and landing mechanics, which may reduce the risk of injury. Furthermore, multicomponent methods that include components such as core stability and flexibility have shown potential for reducing injury rates in futsal players. Finally, by reducing fatigue and improving movement control, strength training procedures designed to correct muscular imbalances may improve performance, which may ultimately minimize the risk of injury. This systematic review demonstrates the potential benefits of different injury prevention strategies for futsal players. The combination of several strategies, such as proprioceptive training, multicomponent programs, warm-up routines, and strength training specifically designed to address muscular imbalances, appears promising. [ABSTRACT FROM AUTHOR]

Background: Core-stability exercise is an exercise modality used in the management of patients with low back pain (LBP). Telerehabilitation is a new treatment approach that is gaining traction as an alternative rehabilitation approach. This study determined the effect of telerehabilitation-based core stability exercise (TCSE) and clinical-based core stability exercise (CCSE) on pain-related disability, pain self-efficacy, and psychological factors in patients with non-specific chronic low back pain (CLBP). Materials and methods: Fifty participants (24 males and 26 females) with a mean age of 40.28 years participated in this randomized controlled study and were recruited from the out-patients physiotherapy clinic of 2 tertiary hospitals in Lagos State and were allocated into two groups (telerehabilitation-based core stability exercise group and clinical-based core stability exercise group which serves as the control) using computer-generated random number sequence. Pain-related disability, pain self-efficacy, and psychological status were assessed at baseline, and at the completion of the 4th and 8th week. Patients received supervised intervention protocols twice weekly for 8 consecutive weeks. Independent t-test, Mann–Whitney U test, and Friedman test were used in analyzing the data at an alpha level of 5%. Results: There was a statistically significant difference (P = 0.0001) noted within each group (telerehabilitation-based core stability exercise group and clinical-based core stability exercise group) in all the outcome measures assessed (Pain Disability Index, Pain Self-efficacy Questionnaire and Depression-Anxiety-Stress scale) but no group was superior to one another when compared. Conclusion: Telerehabilitation-based core stability exercise was as efficacious as clinical-based core stability exercise in decreasing pain-related disability, improving pain self-efficacy and psychological factors, and should be incorporated as part of the treatment program in musculoskeletal rehabilitation for individuals with non-specific CLBP. Trial registration: PACTR202208607830603, 16th August 2022—retrospectively registered, https://pactr.samrc.ac.za/ [ABSTRACT FROM AUTHOR]

Background: Patients with chronic pain usually regard pain as a stressful situation. The literature revealed that chronic pain is associated with social and cognitive dysfunction. Recently, the literature started to support using cognitive behavioral therapy to reduce the effect of chronic nonspecific low back pain. Objectives: The study aimed to assess the effect of cognitive behavioral therapy versus core stabilization training in the treatment of subjects with non-specific chronic low back pain. Methods: Ninety subjects were enrolled in the current study, with mean age (32.30 ± 4.38) and mean weight (72.27 ± 10.88). They were equally randomized into three equal groups A, B, and C using opaque envelopes and computer-generalized numbers. Group A received cognitive behavioral therapy plus traditional treatment, group B received a core stabilization training program plus traditional treatment, and group C received only traditional treatment. Visual Analog Scale, Fear Avoidance and Belief Questionnaire, and Oswestry Disability Index were used pre- and post-treatment to measure the outcomes in response to the treatment plans. Results: Statistical analysis revealed that there was a significant decrease in the Visual Analog Scale, Fear Avoidance and Belief Questionnaire, and Oswestry Disability Index post-treatment compared with pre-treatment in group A (P < 0.001), group B (P < 0.001), and group C (P < 0.001). Also, the results revealed that there was a significant decrease in the Visual Analog Scale, Fear Avoidance and Belief Questionnaire work/lifestyle, and Oswestry Disability Index of group A compared with group B (P < 0.05) and group C (P < 0.001) and a significant decrease in outcome measures in group B compared with group C (P < 0.05). Conclusion: The results of the current study support the involvement of cognitive therapy in the management of chronic pain as it guides the patient to be aware of the underlying mechanism of chronic pain and the management maneuvers to overcome such pain. Also, the results provide credit to cognitive behavioral therapy in terms of long-term relief of chronic pain. [ABSTRACT FROM AUTHOR]

This paper addressed the identity work of female exercisers during menstruation. Specifically, we considered (a) behavioural expectations attached to the sport and exercise role identity during menstruation, (b) menstruation as a discreditable stigma, and (c) the impression management strategies that exercisers put in place to successfully enact the desired sport and exercise role identity during menstruation. Data were generated via 30 semi-structured interviews with female exercisers from diverse ethnic groups. Interviews were audio-recorded, transcribed, and analysed using phronetic iterative analysis. Data were interpreted through symbolic interactionist and dramaturgical theorisations of identity, impression management, and stigma. Our analysis highlighted the importance of the sport and exercise role identity, which was reflected in the time and money that the participants invested in their sport and exercise engagement. We illustrated that, during menstruation, behavioural expectations determined the participants’ hidden management of menstrual symptoms to ensure the successful enactment of their desired sport and exercise role identity. This was because menstruation represented a discreditable stigma, a blemish that had to be hidden away from the view of others. Our participants therefore implemented impression management strategies including the use of props (e.g. pain relief), and management of their appearance (e.g. clothing, hair, makeup), manner (e.g. a stoic expression), and staging (e.g. standing at the back of an exercise class) to help with the enactment of their sport and exercise role identity. We believe this study makes a substantial contribution to the literature addressing menstruation within sport and exercise by unpacking the norms and expectations associated with menstruation. In turn, this study is giving voice to the unique needs and experiences of menstruating exercises and with this, contributes to normalising conversations about menstruation and its impact on menstruators’ daily lives. [ABSTRACT FROM AUTHOR]

Postural sway has not been investigated before or after a neck exercise intervention in individuals with chronic whiplash-associated disorders (WAD). The aim of the study was to investigate postural sway in individuals with chronic WAD grades 2 and 3: (a) compared with healthy matched controls at baseline; (b) after three months of neck-specific exercise and (c) to investigate the correlation between postural sway with self-reported dizziness during motion and balance problems/unsteadiness. This is a longitudinal prospective experimental case–control intervention study. Individuals with WAD (n = 30) and age- and gender-matched healthy volunteers (n = 30) participated. Postural sway was assessed using an iPhone application. Measurements were carried out at baseline, and for those with WAD a second measurement was performed at the three-month follow-up when neck-specific exercise intervention ended. The WAD group performed significantly worse than the healthy group in both pathway and ellipse area double stance eyes closed at baseline (main outcome), but not at the three-month follow-up. The WAD group significantly improved after rehabilitation in both pathway double stance eyes closed and pathway single stance eyes open. The correlation between postural sway and self-rated dizziness during motion and balance problems was low to moderate. One may conclude that postural sway was improved after a neck-specific exercise programme. The study results strengthen earlier findings that individuals with WAD have worse balance outcome when they have to rely on neck proprioception (eyes closed). The study results may be important for the development of improved rehabilitation methods for WAD. [ABSTRACT FROM AUTHOR]

Background/aim: Strengthening the muscles of the lumbar region in individuals with neck pain may be protective against future back problems. In addition, telerehabilitation applications, which gained momentum in the literature and clinical practice during the COVID-19 pandemic, are among the applications preferred by patients thanks to their various advantages. This study aimed to compare the effects of telerehabilitation and spinal stabilization exercises applied with face-to-face approaches on the thickness of the transversus abdominis (M.TrA) and lumbar multifidus (M.LM) muscles in patients with nonspecific neck pain. Materials and methods: The primary outcomes were the thickness of the M.TrA and M.LM. Neck pain intensity and neck disability were secondary outcomes. Muscle thickness was evaluated with an ultrasound device, neck pain intensity was assessed with a visual analog scale, and disability was assessed with the Neck Disability Index. Patients were randomly assigned to the telerehabilitation group (TRG) (n = 13) or the control group (CG) (n = 13). While the TRG did the exercises with live videos and video recordings, the CG did exercises face-to-face in the clinic. Both groups performed the same exercises for 45 minutes per session 3 days a week for 8 weeks. Results: At the end of the treatment, the thicknesses of the M.TrA and M.LM were increased and neck pain intensity and neck disability were decreased in both groups (p < 0.05). The groups were similar in terms of these variables (p > 0.05). Conclusion: Telerehabilitation and face-to-face spinal stabilization exercises are both beneficial for spinal muscle architecture and clinical variables as a preventive measure against future lower back problems in individuals with neck pain. [ABSTRACT FROM AUTHOR]

BACKGROUND: Weakness and atrophy in trunk muscles have been associated with chronic low back pain (CLBP). OBJECTIVE: This study aimed to identify isometric exercises resulting the highest trunk muscle activity for individuals with and without CLBP. METHODS: Fourteen males with CLBP and 15 healthy age-matched healthy subjects were recruited for this study. Muscle activity during maximal voluntary isometric contraction (MVIC) was measured for a comparative reference with surface electromyography (sEMG) from six trunk muscles. Thereafter maximum EMG amplitude values were measured during eleven trunk stability exercises. The maximal EMG activity in each exercise relative to the MVICs was analyzed using generalizing estimating equations (GEE) models with the unstructured correlation structure. RESULTS: The GEE models showed statistically significant differences in muscle activity between exercises within both groups (p < 0.001), with no significant differences between groups (p > 0.05). The highest muscle activity was achieved with the hip flexion machine for multifidus, side pull with a resistance band for lumbar extensors, side and single-arm cable pull exercises for thoracic extensors, rotary plank and the hip flexion machine for abdominal. CONCLUSION: This study found five isometric trunk exercises that exhibited highest muscle activity depending on muscle tested, with no significant difference between individuals with and without CLBP. [ABSTRACT FROM AUTHOR]

Thoracic outlet syndrome (TOS) involves inconsistent symptoms, presenting a challenge for medical providers to diagnose and treat. Thoracic outlet syndrome is defined as a compression injury to the brachial plexus, subclavian artery or vein, or axillary artery or vein occurring between the cervical spine and upper extremity. Three common subcategories are now used for clinical diagnosis: neurogenic, arterial, and venous. Postural position and repetitive motions such as throwing, weightlifting, and manual labor can lead to symptoms. Generally, TOS is considered a diagnosis of exclusion for athletes due to the poor accuracy of clinical testing, including sensitivity and specificity. Thus, determining a definitive diagnosis and reporting injury is difficult. Current literature suggests there is not a gold standard diagnostic test. Rehabilitation has been shown to be a vital component in the recovery process for neurogenic TOS and for arterial TOS and venous TOS in postoperative situations. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to investigate the effects of post-activation performance enhancement (PAPE) after three warm-up protocols on back squat performance in trained men. Methods: Fourteen resistance-trained men performed conditioning activity (CA) with high-load (HL-CA), low-load (LL-CA), or usual specific warm-up as a control (CON). HL-CA consisted of one set of three repetitions with 90% of one repetition maximum (RM); LL-CA consisted of one set of six repetitions with 45% of 1 RM performed at maximal velocity; CON involved eight repetitions with 45% of 1 RM at controlled velocity. The participant's performance was measured using the total number of repetitions and volume load (reps × load × sets). Results: There were no significant differences between warm-up for the total number of repetitions (p = 0.17) or total volume load (p = 0.15). There was no difference between conditions for the number of repetitions (main condition effect; p = 0.17); however, participants achieved a significantly higher volume load after HL-PAPE than after CON for the first set (p = 0.04). Conclusion: High or low equated-load CA used as warm-up strategies did not potentiate subsequent performance enhancement in multiple-set back squat exercise performed until muscle failure in comparison with usual warm-up. [ABSTRACT FROM AUTHOR]

Stroke is a significant public health challenge as it is the second most common cause of death and the third leading cause of disability globally. Additionally, stroke incidence and the number of stroke deaths have been rising. Efforts to prevent stroke have been made, including high-risk approaches where patients are screened for cardiovascular risk factors, and population-based approaches which attempt to reduce stroke rates by improving overall population health. We summarize studies of population-based approaches to stroke prevention involving greater than 1,000 participants identified on a PubMed database search. Based on these programs, challenges of population-based stroke prevention programs are discussed and potential keys to success are highlighted. Population-based stroke prevention programs face challenges including cost and interest of the public and certain stakeholders. Additionally, secular trends for improvement in risk factors and catastrophic adverse environmental circumstances add to the complexity of analyzing program success. Factors leading to successful programs include validated digital solutions for self-monitoring of risks, backing by global policy and legislation, flexibility to the needs of the population, intersectoral programs, community engagement, information dissemination back to the populations, and high-risk screening to develop a complementary combination approach to stroke prevention. [ABSTRACT FROM AUTHOR]

In today's interconnected global economy, maritime trade is a pillar of prosperity, yet maritime accidents loom as a formidable challenge. The intricate nature of these accidents, coupled with rapid technological advancements, necessitates the evolution of systematic analysis methods. Conventional systemic approaches, while valuable, struggle to encapsulate the intricate web of mutual and dynamic dependencies inherent in these incidents. Furthermore, the call for more quantitative support in decision‐making and the ability to account for emergent factors has become increasingly imperative. This study aims to analyze maritime accidents by introducing a quantitative and dynamic model. The endeavour begins with establishing an extended Accident Map‐based model, a robust framework that unveils a sophisticated accident causation model. This preliminary action establishes the groundwork for integrating an innovative Spherical Fuzzy Set, navigating the complex landscape of knowledge acquisition. The subsequent phase charts a transformative course by mapping the model onto a dynamic Bayesian Network to conduct a forward and backward analysis. The essence of the model lies in its dynamic nature, allowing for real‐time updates that reflect the evolving maritime accidents risk factors. The approach is validated through a partial benchmark exercise, a reality check, an independent peer review, and a sensitivity analysis. The model can explore emerging contributing factors, reduce uncertainty, and consider relationships between factors that yield designing more effective safety measures. [ABSTRACT FROM AUTHOR]

Introduction. Exercise is beneficial for improving general health, wellbeing, and specific medical conditions. In musculoskeletal conditions such as chronic low back and neck pain, prescribed exercise has been found to be moderately effective in decreasing pain and improving function. Osteopaths are primary contact health professionals who manage predominantly musculoskeletal complaints. This work presents a secondary data analysis of the Australian osteopathy practice‐based research network and profiles the characteristics of osteopaths who often use exercise prescription in patient care. Methodology. Secondary analysis of a cross‐sectional survey of 992 osteopaths was registered with the Osteopathy Research and Innovation Network, an Australian practice‐based research network. Demographics, practice, and treatment characteristics of Australian osteopaths who "often" use exercise prescription in patient care were examined. Results. Seven‐hundred and thirty‐three Australian osteopaths (74%) indicated that they use exercise prescription "often" in patient care. Australian osteopaths who often use exercise prescription are more likely to be colocated with another osteopath (ORa 1.54) and send referrals to an exercise physiologist (ORa 1.94) and a specialist medical practitioner (ORa 1.72). Those osteopaths who often used exercise prescription were also more likely to discuss physical activity (ORa 5.61) and nutrition (ORa 1.90). Australian osteopaths who use exercise prescription often were more likely to treat patients with sports injuries (ORa 2.43) and use soft tissue techniques (ORa 1.92), trigger point techniques (ORa 2.72), and sports taping (ORa 1.78). Conclusion. Osteopaths who utilise exercise prescription were more likely to discuss physical activity, diet, and nutrition and utilise referral networks with specialist medical practitioners and exercise physiologists. Australian osteopaths who often use exercise prescriptions were also more likely to treat patients with sport injury. The results suggest that most Australian osteopaths use exercise prescription and have referral networks with other health professionals for patient management. Further work is required to explore the type of exercise prescription used and for what conditions. [ABSTRACT FROM AUTHOR]

The aim of this present clinical trial is to evaluate the effectiveness of a multicomponent prehabilitation programme administered through educational videos versus another programme based on written exercise recommendations, in patients scheduled for lumbar radiculopathy surgery. This study will be a multicentre, controlled, randomised, parallel clinical trial. One hundred participants undergoing lumbar radiculopathy surgery who meet the established inclusion criteria will be recruited at different Spanish hospitals. The experimental group will follow a 4-week prehabilitation programme combining therapeutic exercise, back care education, and pain neuroscience education delivered through videos designed for consumption at home. The control group will be provided with written instructions to perform therapeutic exercises during the same prehabilitation time period. The primary outcome of the study will be disability, assessed using the Spanish version of the Oswestry Disability Index. The secondary outcomes will be pain perception, health-related quality of life, fear avoidance, kinesiophobia, catastrophising, anxiety, depression, physical activity, and the treatment satisfaction of the patients. This study will provide evidence for the effectiveness of a home-based multicomponent prehabilitation programme that addresses some already identified barriers to patient attendance in face-to-face programmes. Understanding the medium and long-term effects of pre-surgery lumbar muscle training and pain neuroscience education administered via instructional videos watched by patients at home, will help improve the design of prehabilitation programmes in this population while also improving the cost-effectiveness of such interventions. [ABSTRACT FROM AUTHOR]

Background: Low back pain (LBP) is a common health condition and the leading cause of years lived with disability worldwide. Most LBP episodes have a favourable prognosis, but recurrences within a year are common. Despite the individual and societal impact related to LBP recurrences, there is limited evidence on effective strategies for secondary prevention of LBP and successful implementation of intervention programmes in a real-world context. The aim of this study is to analyse the effectiveness of a tailored exercise and behavioural change programme (MyBack programme) in the secondary prevention of LBP; and evaluate acceptability, feasibility and determinants of implementation by the different stakeholders, as well as the implementation strategy of the MyBack programme in real context. Methods: This protocol describes a hybrid type I, randomized controlled trial to evaluate the effectiveness and implementation of MyBack programme in the context of primary health care. The Behaviour Change Wheel framework and FITT-VP principles will inform the development of the behaviour change and exercise component of MyBack programme, respectively. Patients who have recently recovered from an episode of non-specific LBP will be randomly assigned to MyBack and usual care group or usual care group. The primary outcome will be the risk of LBP recurrence. The secondary outcomes will include disability, pain intensity, musculoskeletal health, and health-related quality of life. Participants will be followed monthly for 1 year. Costs data related to health care use and the MyBack programme will be also collected. Implementation outcomes will be assessed in parallel with the effectiveness study using qualitative methods (focus groups with participants and health providers) and quantitative data (study enrolment and participation data; participants adherence). Discussion: To our knowledge, this is the first study assessing the effectiveness and implementation of a tailored exercise and behaviour change programme for prevention of LBP recurrences. Despite challenges related to hybrid design, it is expected that data on the effectiveness, cost-effectiveness, and implementation of the MyBack programme may contribute to improve health care in patients at risk of LBP recurrences, contributing to direct and indirect costs reduction for patients and the health system. Trial registration number: NCT05841732. Highlights: • LBP recurrences are common and account for a significant proportion of the costs and disability associated with low back pain. However, evidence on secondary prevention of LBP remains scarce. • A hybrid effectiveness-implementations design will be used to analyse the effectiveness, cost-effectiveness, and implementation of an exercise and behavior change programme in primary care. • Mixed method will used to analyze the implementation strategies. This data could inform the refinement of the implementation strategy and promote the adoption of the MyBack programme in the future. • This study data may improve the delivery of care in people at risk of recurrence and bring important benefits to individuals and society. [ABSTRACT FROM AUTHOR]

Purpose: The aims of this study are to evaluate the effectiveness of different exercise interventions on patients with adolescent idiopathic scoliosis and to provide evidence-based exercise prescriptions for this population. Methods: The PubMed, Embase, Cochrane Library, Web of Science, CNKI, Chinese Biomedical Literature Database (CBM), VIP, andWanfang Data Knowledge Service Platform were searched until January 2023. The data were pooled and a meta-analysis was conducted. Results: A total of 19 studies were conducted with 778 participants. The Schroth exercises group (mean difference = -3.48, 95% confidence interval = -4.73 to -2.23, P < 0.00001) and strength training group (mean difference = -3.43, 95% confidence interval = -4.06 to -2.80, P < 0.00001) had better recovery of the Cobb angle than the other groups. The Cobb angle rehabilitation effect was good in the time of less than 60-min group. In addition, there was no significant difference found between the different intervention periods groups (P > 0.05). Conclusions: Schroth exercise and strength training significantly improved Cobb angle of adolescent idiopathic scoliosis patients; exercising for less than 60 mins is effective for Cobb angle rehabilitation, but prolonging exercise time cannot improve training effectiveness; 12 wks of exercise significantly improved Cobb angle, but prolonged training periods did not have a significant impact. [ABSTRACT FROM AUTHOR]

Little is known about the contribution of placebo effects and changes observed with no treatment in interventions for nonspecific low back pain (NSLBP). This systematic review assessed the proportions of the overall treatment effect that may be attributable to specific treatment effects, placebo effects, and changes observed with no treatment in randomized controlled trials (RCTs) in patients with NSLBP. Trials published before 2019 were identified from a published systematic review, and the search was updated in MEDLINE, Embase, and Cochrane Central for trials published between January 2019 and March 2023. Three-arm RCTs comparing the effects of experimental interventions vs placebo control vs no intervention reporting pain intensity, physical function, and/or health-related quality of life (HRQoL) were included. Sixteen RCTs with 1436 adults with chronic NSLBP testing conservative and mainly passive interventions were included. For pain intensity (16 studies), 33%, 18%, and 49% of the overall short-term treatment effect was attributable to specific treatment effects, placebo effects, and changes observed with no treatment, respectively. For physical function (11 studies) and HRQoL (6 studies), these proportions were 34%, 13%, and 53%, and 11%, 41%, and 48%, respectively. These results show that approximately half of the overall treatment effect of conservative and mainly passive interventions for patients with chronic NSLBP is attributable to changes observed with no treatment, rather than specific or placebo effects of treatments. However, the certainty of evidence was very low to low, suggesting that the true effects might be markedly different from the effect sizes underlying these estimates. [ABSTRACT FROM AUTHOR]

AIM: To investigate the effects of exercise training (swimming combined with wheel running) on dendritic spine remodeling in the medial prefrontal cortex of rats with autism spectrum disorder (ASD) induced by valproic acid (VPA), and to explore the roles of microtubule affinity regulating kinase 1 (MARK1), microtubule-associated protein 1A (MAP1A) and postsynaptic density protein-95 (PSD-95). METHODS: The ASD model rats and normal control rats were generated by collecting the male offspring of rats exposed to VPA or normal saline during pregnancy. The rats were randomly divided into an exercise group and a sedentary group, with 9 to 11 rats in each group. The effect of exercise on the sociability of the rats with ASD was evaluated by a social behavior test. The density and morphology of dendritic spines in the prelimbic cortex (PrL) and infralimbic cortex (IL) were observed following stereotaxic injection of a fluorescent virus. Western blot was used to assess the protein expression of PSD-95 and synaptophysin (Syn), and RNA in situ hybridization was used to determine the RNA expression and colocalization of MARK1, MAP1A and PSD-95. RESULTS : The time spent in the chamber containing an unfamiliar rat and the time and frequency of sniffing the unfamiliar rat were significantly lower in the ASD model group than that in the control group, demonstrating that the sociability of the ASD model rats was impaired (P<0. 05). After exercise intervention, the social behavior of the ASD model rats significantly improved (P<0. 05). The total spine density, mushroom spine density, and stubby spine density were significantly increased in the PrL but not in the IL of the ASD model rats, and these changes were effectively reversed after exercise intervention. Western blot analysis showed that exercise intervention effectively abrogated the increase in the protein expression of PSD-95 in the PrL of the ASD model rats (P<0. 05). However, the expression of Syn in the PrL and the expression of PSD-95 and Syn in the IL were not significantly different. RNA in situ hybridization experiments showed that exercise intervention effectively reduced the number of RNA-positive particles of MARK1, MAP1A and PSD-95 in the PrL of the ASD model rats and reduced the colocalization of MARK1 and MAP1A, MARK1 and PSD-95 and MAP1A and PSD-95. CONCLUSION: Exercise intervention may improve the remodeling of dendritic spines through MARK1/MAP1A/PSD-95 signaling in the PrL, thereby improving the social behavior of ASD model rats. [ABSTRACT FROM AUTHOR]

Perception of Velocity (PV) is the ability to estimate single repetition velocity during resistance training (RT) exercises. The main purpose of the study was to evaluate the effects of Mental Fatigue (MF) on the accuracy of barbell PV. The secondary aims were to evaluate whether MF affected RT performance and ratings of perceived exertion (RPE; OMNI‐RES) in the back squat. Twenty‐four (14 Females, 10 Males) resistance‐trained participants underwent 2 familiarization sessions and 1RM test for the back squat. In two separate sessions, PV was tested for light, medium, and heavy loads in 2 conditions in random order: at rest (REST) and in MF condition (POST‐MF) induced by previous incongruent Stroop color‐word task. MF and Motivation were assessed through visual analog scales (VAS; 0–100) before and after the Stroop task. For each load subjects performed 2 repetitions and reported the RPE value. Mean propulsive velocity (Vr) of the barbell was recorded with a linear encoder, while the perceived velocity (Vp) of the subjects was self‐reported using the Squat‐PV scale. The PV accuracy was calculated through the delta score (ds: Vp–Vr). Following the Stroop task MF increased significantly (p < 0.001; F (1, 23) = 52.572), while motivation decreased (p < 0.05; F (1, 23) = 7.401). Ds, Vr, and RPE did not show significant differences between conditions (p > 0.05) for the three loads analyzed. MF induced by previous demanding cognitive task did not affect PV accuracy. Furthermore, subjects maintained unchanged both RT performance and RPE values associated with each load, even when mentally fatigued. Highlights: Prior demanding cognitive task such as 45‐min of incongruent Stroop color‐word task induces MF.The perception of barbell velocity is a stable subjective parameter that remains unchanged even if the practitioners are mentally fatigued.MF does not affect the ability to achieve target velocities and the RPE values experienced for a given load. [ABSTRACT FROM AUTHOR]

Purpose: In a rested state, foam rolling has been shown to improve blood flow to the working tissues. When inducing post-activation performance enhancement (PAPE), previous research suggests a longer recovery period between the conditioning activity and performance assessment in weaker participants (back squat <2.0 × body mass). It is possible that a cool-down effect may take place between the conditioning activity and performance assessment for these participants. Therefore, the purpose of this investigation was to determine if foam rolling could help mitigate any cool-down effect to help participants capitalize on PAPE. Methods: Seventeen physically active participants completed baseline jumps followed by rest (control), back squat exercise (heavy squats), rest and foam rolling (FR), and heavy squats followed by foam rolling (combo). VJ performance was assessed three times post-treatment with 2 min between each assessment. Results: VJ height and impulse were greater at baseline than at any other time point across all sessions (p <.001). Impulse for the control and FR sessions were greater than the squats session (p <.015). Impulse for the combo session was less than the FR session (p =.04). Conclusions: Foam rolling did not have a significant impact on attenuating any cool-down effect. In addition, our heavy squats protocol appears to induce too much fatigue that possibly masked the effects of PAPE. [ABSTRACT FROM AUTHOR]

• Exercise programs are effective in reducing low back pain for both nursing staff: nurses and nursing assistants. • Focusing on back and trunk exercises provide evidence based for low back pain relief for nurses and nursing assistants. • Exercise program for nurses and nursing assistants are more successful in those under 40 years old engaging in shorter exercise (20 sessions). Introduction : Nurses have a high prevalence of low back pain due to ergonomic hazards in healthcare workplaces. While exercise programs have been suggested as an intervention strategy, the effectiveness of low back pain programs has been inconsistent in the research literature. The purpose of study is to determine the effect of exercise programs to reduce low back pain among nursing staff. Methods : A systematic review and meta-analysis was conducted with five databases and systematically searched. Following the PRISMA guidelines, included studies evaluated low back pain relief among nurses or nursing assistants and described the exercise program. Two reviewers independently appraised, extracted, and synthesized all available studies. The study protocol was registered in PROSPERO (CRD42022359511). Results : A total of 296 articles with 1,355 nursing staff from nine countries were obtained. Nine randomized controlled trials with a moderate to low risk of bias quality were included. Exercise programs had a small but significant effect on low back pain of nursing staff (SMD = -0.48; 95% CI = -0.76 to −0.19; p = 0.03, I2 = 62%, p = 0.001). A subgroup analysis of nurses and nursing assistants showed moderate and small effects, respectively (I2 = 0% p < 0.0001, SMD −0.73 CI 95% [-0.97 to –0.48], p = 0.76, and I2 = 0% p = 0.002, SMD −0.23 CI 95% [-0.38 to −0.08], p < 0.88). Exercise for back and trunk exhibited a moderate effect on low back pain (SMD −0.56 CI 95% [-0.86 to −0.25], p = 0.01, I2 = 66%, p < 0.0004). A subgroup analysis comparing age, under 40 years old revealed a moderate effect size (SMD = -0.59; 95% CI = -0.83to −0.35; p = 0.06; I2 = 64%, p < 0.0001). Conclusions : Exercise programs are an effective treatment to reduce low back pain in nurses and nursing assistants, especially among younger staff. Practical application : Back and trunk exercise programs should be recommended for nursing staff with low back pain. [ABSTRACT FROM AUTHOR]