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Background: People with Down syndrome often present with balance deficits, which compromise safety during daily activity. While evidence shows that exercise can improve balance in the Down syndrome population, it is unclear if a telehealth method will elicit similar benefits. We aimed to examine the effects of a virtual exercise program on balance in adults with Down syndrome. Methods: Eighteen low-active participants with Down syndrome completed a 12-week telehealth exercise program based on the Mann Method. Balance testing took place before and after the intervention, which included: TUG, MCTSIB, FICSIT-4, and FRT. This study was registered as a clinical trial on ClinicalTrials.gov, identifier: NCT04647851. Results: Significant improvement was seen in the TUG (p = 0.043), FICSIT-4 (p = 0.019) and FRT (p = 0.019). All participants achieved maximum scores on the MCTSIB in pre- and post-testing. Conclusions: Balance in low-active adults with Down syndrome significantly improved following the telehealth exercise program, which we attribute to the tailored exercises that address visual/vestibular deficits and hip muscle weakness.

Background: People with Down syndrome often present with balance deficits, which compromise safety during daily activity. While evidence shows that exercise can improve balance in the Down syndrome population, it is unclear if a telehealth method will elicit similar benefits. We aimed to examine the effects of a virtual exercise program on balance in adults with Down syndrome. Methods: Eighteen low‐active participants with Down syndrome completed a 12‐week telehealth exercise program based on the Mann Method. Balance testing took place before and after the intervention, which included: TUG, MCTSIB, FICSIT‐4, and FRT. This study was registered as a clinical trial on ClinicalTrials.gov, identifier: NCT04647851. Results: Significant improvement was seen in the TUG (p =.043), FICSIT‐4 (p =.019) and FRT (p =.019). All participants achieved maximum scores on the MCTSIB in pre‐ and post‐testing. Conclusions: Balance in low‐active adults with Down syndrome significantly improved following the telehealth exercise program, which we attribute to the tailored exercises that address visual/vestibular deficits and hip muscle weakness. [ABSTRACT FROM AUTHOR]

Context: Popularity of using handheld devices in clinical settings has increased, especially the use of motion analysis applications (MAAs). Video-based measurement tools have been found reliable in measuring knee valgus in subjects without anterior cruciate ligament (ACL) injury. However, there is a need for validation of using a MAA to measure knee valgus in an injured population, given that they may exhibit higher degrees of knee valgus. Objective: To examine the reliability and validity of using a MAA to measure knee valgus during functional activities used to assess return to sport after ACL reconstruction (ACLR). Design: Reliability and validity study. Setting: University laboratory. Participants: Twelve participants with ACLR and 20 healthy individuals. Interventions: Each subject performed single-leg drop landing, single-leg hop, and 90° cut with simultaneous 3-dimensional (3D) motion capture and video recording on an iPad. Main Outcome Measures: Peak knee valgus during the landing phase was measured using a MAA and 3D analysis. To obtain reliability, peak knee valgus was measured on 2 separate days. Reliability was determined using intraclass correlation coefficients and standard errors of measurement. Validity was assessed using Pearson correlation coefficients by comparing peak knee valgus between the MAA and 3D analysis. The t tests were used to compare knee valgus obtained between raters, within raters, and between the MAA and 3D analysis. Results: Our data revealed excellent intrarater and interrater reliability with low standard errors of measurement of using a MAA for both groups. Significant, moderate to large associations were found in comparing peak knee valgus between the MAA and 3D analysis. However, knee valgus was significantly different between the MAA and 3D analysis across all tasks in both groups. Conclusion: Although a MAA is reliable for measuring peak knee valgus in individuals with ACLR and healthy controls, the actual values obtained by a MAA should be viewed with caution. [ABSTRACT FROM AUTHOR]

Although increased bone water content resulting from repetitive patellofemoral joint loading has been suggested to be a possible mechanism underlying patellofemoral pain (PFP), there is little data to support this mechanism. The purpose of the current study was to determine whether running results in increases in patella water content and pain and whether 48 hours of rest reduces patella water content and pain to pre-running levels. Ten female runners with a diagnosis of PFP (mean age 25.1 years) participated. Patella water content was quantified using a chemical-shift-encoded water-fat magnetic resonance imaging (MRI) protocol. The visual analog scale (VAS) was used to quantify subjects' pain levels. MRI and pain data were obtained prior to running, immediately following a 40-minute running session, and 48 hours post-running. Pain and patella water content were compared among the 3 time points using one-way ANOVA's with repeated measures. Immediately post-running, persons with PFP reported significant increases in pain and exhibited elevated patella water content. Pain and patella water content decreased to pre-running levels following 48 hours of rest. Our findings suggest that transient changes in patella water content associated with running may, in part, contribute to patellofemoral symptoms. [ABSTRACT FROM AUTHOR]

Introduction: In individuals with patellofemoral pain (PFP), addressing increased knee valgus during weight-bearing activities typically involves strengthening weak hip muscles. However, recent literature highlights the role of altered descending central control in abnormal movements associated with PFP. While transcranial direct current stimulation (tDCS) has demonstrated the capacity to enhance neuroplasticity, its application targeting the corticomotor function of gluteal muscles in PFP remains unexplored. This study aimed to investigate the effects of combining bimodal tDCS with exercise on frontal plane kinematics in individuals with PFP. The hypothesis was that bimodal tDCS, specifically targeting the corticomotor function of the gluteal muscles, would augment the effectiveness of exercise interventions in improving frontal plane kinematics compared to sham stimulation., Methods: Ten participants with PFP participated in two sessions involving either bimodal tDCS or sham stimulation, concurrently with hip strengthening exercises. Weight-bearing tasks, including single leg squat, single leg landing, single leg hopping, forward step-down, and lateral step-down, were performed and recorded before and after each session. Pain visual analog scale (VAS) scores were also documented. A one-way ANOVA with repeated measures was employed to compare kinematics, while a Friedman test was used to compare VAS across the three conditions (pre-test, post-tDCS, and post-Sham)., Results: We observed no significant differences in trunk lean angle, hip and knee frontal plane projection angles, or dynamic valgus index among the three conditions during the five weight-bearing tasks. VAS scores did not differ across the three conditions., Discussion and Conclusion: A single session of tDCS did not demonstrate immediate efficacy in enhancing frontal plane kinematics or relieving pain in individuals with PFP. Considering observed positive outcomes in other neurological and orthopedic populations with multi-session tDCS applications, suggesting potential cumulative effects, further research is essential to explore the effects of multi-session tDCS on weight-bearing movement and underlying neurophysiology in individuals with PFP., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ho, Wallace, Aquino, Broadwell, Whimple and Liang.)

Background: A consequence of a high riding patella is reduced osseous stability and malalignment of the patella (i.e., lateral patellar tilt and displacement). Although quantification of patellar height is a routine part of the radiographic examination of the patellofemoral joint, it is not clear which measure of patellar height is best associated with patella alignment., Hypothesis/purpose: To determine if patellar articular overlap (PAO) is better associated with lateral patellar tilt and lateral patellar displacement compared to traditional measures of patellar height., Study Design: Cross-sectional., Methods: Magnetic resonance images were obtained from 50 female participants (21 with patellofemoral pain and 29 healthy controls) under loaded conditions (25-35% bodyweight) at 15-20 degrees of knee flexion. Measurements of lateral patellar tilt and displacement as well as the PAO, Insall-Salvati ratio (ISV), Caton Deschamps-index (CD-index), or the Blacburn Peel-index (BP-index) were obtained from sagittal and axial plane images., Results: The PAO was found to significantly correlated with lateral patellar tilt (r = -0.77, p < 0.001). In contrast, the ISV, CD-index, or the BP-index were not found to be associated with lateral patellar tilt (r = 0.13, p = 0.34; r = -0.14, p = 0.33; r = -0.08, p = 0.56, respectively). Both the PAO and ISV were found to be significantly correlated with lateral patellar displacement (r = -0.52, p < 0.001; r = 0.43, p = 0.002, respectively). Conversely, the CD-index and BP-index were not found to be associated with lateral patellar displacement (r = 0.03 p = 0.83; r = 0.05 p = 0.74, respectively)., Conclusion: Of the measures of patellar height evaluated, the PAO was found to provide the greatest association with lateral patellar tilt and displacement., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Despite 2D motion analysis deemed valid and reliable in assessing gait deviations in runners, current use of video-based motion analysis among orthopedic physical therapists is not prevalent., Purpose/hypothesis: To investigate clinician-perceived effectiveness, adherence, and barriers to using a 2D running gait analysis protocol for patients with running-related injuries., Study Design: Survey., Methods: Thirty outpatient physical therapy clinics were contacted to assess interest in participation. Participating therapists were trained on 2D running gait analysis protocol and given a running gait checklist. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to assess the implementation process by collecting a baseline survey at the beginning of the study, effectiveness and implementation surveys at two months, and a maintenance survey at six months., Results: Twelve of the 15 responding clinics met eligibility criteria, giving a Reach rate of 80%. Twelve clinicians from 10 different clinics participated, giving an Adoption rate of 83%. For Effectiveness , the majority of clinicians valued having a checklist, and reported the protocol was easy to conduct, the methodology was reasonable and appropriate, and patients saw the benefits of using the protocol. Assessing Implementation , 92% performed all steps of the protocol on all appropriate runners. Average time spent conducting the protocol was 32 minutes. With respect to Maintenance , 50% reported continuing to use the protocol, while 50% answered they were not to continue use., Conclusion: Clinicians expressed a perceived benefit of implementing a running gait analysis protocol with common themes of ease of use, being a useful adjunct to evaluating a patient, and increased satisfaction with treating injured runners. Potential barriers for not using the protocol included not having an appropriate clinic setup, time constraints, and not having adequate caseload., Level of Evidence: 3b., Competing Interests: The authors report no conflicts of interest.