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BACKGROUND: Low frequency vibrations from motorized vehicles and heavy equipment have been associated with musculoskeletal disorders. Spine degeneration on diagnostic imaging provides direct and objective measures of the possible effects of such exposures on the spine. OBJECTIVE: The objective of this systematic review was to evaluate the association of exposure to whole-body vibration (WBV) with spine degeneration on imaging. METHODS: We conducted electronic searches in MEDLINE, CINAHL, EMBASE, and Web of Science to July 2021. Two reviewers independently screened search results, assessed quality, and extracted data. Studies evaluating the exposure to WBV and lumbar spine degeneration on imaging were included. RESULTS: Fifteen studies (16 manuscripts) were included. Seven studies including a meta-demonstrated moderate quality evidence of no association between WBV and disc degeneration. There was also moderate quality evidence of no association between WBV and disc height narrowing and osteophytes. Overall, there was low level evidence of no association between WBV and other degenerations findings. CONCLUSIONS: There was moderate to low quality evidence suggesting no association between WBV exposures with spine degeneration on imaging. The results of this study currently do not support assertion that motorized vehicle and WBV exposure accelerates degeneration and causes structural damage to the spine.

Purpose: This study investigated if associations exist between enrolment delay and VO2peak over five years of maintenance-phase cardiac rehabilitation (CR) in males and females. Method: Data were extracted from the records of participants who had enrolled for ≥ 1 year in CR and completed ≥ 2 cardiopulmonary exercise tests. Mixed model analyses examined VO2peak trajectories for up to five years of enrolment. Interactions between enrolment delay × enrolment duration, baseline age × enrolment duration, and baseline VO2peak × enrolment duration were explored for inclusion in the model. Results: The charts of 151 males (aged 63.9 ± 9.4 y) and 32 females (aged 65.3 ± 9.0 y) were included in the analyses. The enrolment delay following a cardiovascular event was 1.8 ± 3.0 years for males and 1.3 ± 1.7 years for females. No associations were found between enrolment delay × enrolment duration on VO2peak in males (β[SE], 0.07[0.05]; 95% CI −0.02, 0.16, p = 0.12) or in females (β[SE], 0.07[0.13]; 95% CI −0.18, 0.33, p = 0.57), but predicted trajectories suggest clinically significantly improvements in VO2peak (range, 1.3 to 1.6 mL/kg/min). Conclusions: Early enrolment in CR is recommended and encouraged, but the benefits of long-term CR are possible despite delays.

Objective Women experience greater disability following stroke, but biological sex differences in both overall and specific domains of functional capacity are not well understood. The primary objective of this study was to examine sex differences in overall functional capacity (Short Physical Performance Battery [SPPB] score) cross-sectionally and longitudinally over a 3-year follow-up period. The secondary objective was to determine whether sex differences exist in specific domains of functional capacity of walking speed and lower extremity functional strength. Methods This study was a secondary analysis of data of individuals with stroke from the National Health and Aging Trends Study. For the cross-sectional analyses, general linear models were used to examine differences between 293 men and 427 women in SPPB, walking speed, and the 5-Times Sit-to-Stand Test (5XSST). For the longitudinal analysis, survey-weighted, multivariable-adjusted generalized linear mixed models were used to compare 3-year trajectories in SPPB scores between the sexes (87 men, 153 women). Results Women had lower SPPB scores at baseline (difference = 0.9, linearized SE = 0.3) and over 3 years. SPPB scores declined similarly between men and women. Women had lower walking speed (difference = 0.08 m/s, SE = 0.02) as compared with men, but men and women had similar 5XSST scores (difference = 0.6 seconds, SE = 0.5). Conclusion Older women with stroke have clinically meaningfully lower overall functional capacity as compared with older men but decline at a similar rate over time. Walking speed was lower in older women with stroke, but similar between sexes in 5XSST. Impact Women with stroke have poorer functional capacity compared with men, which reinforces the importance of targeted stroke rehabilitation strategies to address these sex-specific disparities. Lay Summary Women with stroke have poorer outcomes in terms of their ability to move around the community when compared with men. However, both men and women with stroke have similar physical functioning over time.

Aging is associated with increased risk of cardiovascular and cerebrovascular events, which are preceded by early, negative remodeling of the vasculature. Low physical activity is a well-established risk factor associated with the incidence and development of disease. However, recent physical activity literature indicates the importance of considering the 24-h movement spectrum. Therefore, the purpose of this review was to examine the impact of the 24-h movement spectrum, specifically physical activity (aerobic and resistance training), sedentary behavior, and sleep, on cardiovascular and cerebrovascular outcomes in older adults, with a focus on recent evidence (

BackgroundHigh-intensity interval or circuit-based strength training utilizes brief intense periods of strengthening exercises interspersed with rest/light activity or performed in a continuous circuit. The physical and cognitive effects of this time-efficient approach in community-dwelling older adults have not been systematically reviewed.ObjectivesTo determine the effects of high-intensity interval or circuit-based strength training interventions on physical and cognitive functioning for community-dwelling older adults, and the associated adherence, retention, and adverse event rates.MethodsSix databases will be searched from inception to November 2021; MEDLINE, EMBASE, CINAHL, AgeLine, SPORTDiscus, and Web of Science. To assess physical and/or cognitive functioning effects, randomized and quasi-randomized controlled trials (RCTs and Q-RCTs) of high-intensity interval or circuit-based strengthening interventions in community-dwelling older adults, utilizing any comparator, will be included. The above criteria will be extended to include non-randomized study designs to assess adherence, retention, and adverse events. All screening, data extraction and risk of bias will be assessed by two independent reviewers. Risk of bias will be assessed utilizing the Cochrane RoB 2 tool for randomized and ROBINS-I for non-randomized studies. Qualitative synthesis will be used to present information on adherence, retention, and adverse event rates. Qualitative and/or quantitative synthesis will be used to present physical and cognitive functioning effects depending on which method is deemed appropriate for the various outcomes.ConclusionThis systematic review will be the first to summarize the physical and/or cognitive effects, adherence, retention, and adverse events reported in high-intensity interval and circuit-based strengthening interventions for community-dwelling older adults.Systematic review registration numberCRD42021284010

Rationale Cardiovascular exercise is an effective method to improve cardiovascular health outcomes, but also promote neuroplasticity during stroke recovery. Moderate-intensity continuous cardiovascular training (MICT) is an integral part of stroke rehabilitation, yet it may remain a challenge to exercise at sufficiently high intensities to produce beneficial adaptations to neuroplasticity. High-intensity interval training (HIIT) could provide a viable alternative to achieve higher intensities of exercise by using shorter bouts of intense exercise interspersed with periods of recovery. Methods and design This is a two-arm, parallel-group multi-site RCT conducted at the Jewish Rehabilitation Hospital (Laval, Québec, Canada) and McMaster University (Hamilton, Ontario, Canada). Eighty participants with chronic stroke will be recruited at both sites and will be randomly allocated into a HIIT or MICT individualized exercise program on a recumbent stepper, 3 days per week for 12 weeks. Outcomes will be assessed at baseline, at 12 weeks post-intervention, and at an 8-week follow-up. Outcomes The primary outcome is corticospinal excitability, a neuroplasticity marker in brain motor networks, assessed with transcranial magnetic stimulation (TMS). We will also examine additional markers of neuroplasticity, measures of cardiovascular health, motor function, and psychosocial responses to training. Discussion This trial will contribute novel insights into the effectiveness of HIIT to promote neuroplasticity in individuals with chronic stroke. Trial registration ClinicalTrials.govNCT03614585. Registered on 3 August 2018

Supplemental digital content is available in the text., Ingestion of proteins with high leucine content during resistance training (RT) can augment hypertrophy. Some data suggest that a leucine metabolite, β-hydroxy, β-methylbutyrate (HMB), is substantially more anabolically efficacious than leucine. Purpose We aimed to test whether supplementation with HMB versus leucine, added to whey protein, would result in differential muscle hypertrophy and strength gains in young men performing RT. Methods Twenty-six resistance-trained men (23 ± 2 yr) performed 12 wk of RT with three phases. Phase 1: 8 wk of periodized RT (three training sessions per week). Phase 2: 2 wk overreaching period (five sessions per week). Phase 3: 2 wk taper (three sessions per week). Participants were randomly assigned to twice daily ingestion of: whey protein (25 g) plus HMB (1.5 g) (whey+HMB; n = 13) or whey protein (25 g) plus leucine (1.5 g) (whey+leu; n = 13). Skeletal muscle biopsies were performed before and after RT. Measures of fat- and bone-free mass, vastus lateralis (VL) muscle thickness and muscle cross-sectional area (CSA) (both by ultrasound), muscle fiber CSA, and 1-repetition maximum (1-RM) strength tests were determined. Results We observed increases in fat- and bone-free mass, VL muscle thickness, muscle CSA and fiber type CSA and 1-RM strength with no differences between groups at any phase. We observed no differences between groups or time–group interactions in hormone concentrations at any phase of the RT program. Conclusions β-Hydroxy-β-methylbutyrate added to whey did not result in greater increases in any measure of muscle mass, strength, or hormonal concentration compared to leucine added to whey. Our results show that HMB is no more effective in stimulating RT-induced hypertrophy and strength gains than leucine.

Research Objectives 1) To identify challenges for conducting ongoing and future rehabilitation research during and after the COVID-19 pandemic, and 2) to develop strategies that can support ongoing and future rehabilitation research. Design A two-hour facilitated online workshop with guided discussion. Setting Online workshop synchronously recorded via Zoom. Participants Trainees (14 doctoral; 2 MSc students; 1 post-doctoral fellow) and research faculty (5 physiotherapy; 3 occupational therapy), School of Rehabilitation Science, McMaster University, Canada. Interventions Not applicable. Main Outcome Measures Workshop transcript and field notes were cross-compared by 4 workshop facilitators from which 3 main categories emerged: 1) pandemic protocol adjustment, 2) participant accessibility, and 3) knowledge dissemination. Results 1) Pandemic protocol adjustment: Workshop participants identified concerns with transitioning pre- to post-pandemic research, such as variations in intervention protocols and psychometric properties of virtually guided outcome assessments. Strategies identified: Delivering toolkits containing equipment needed for virtually guided assessments, and their comprehensive psychometric evaluation prior to use. 2) Participant accessibility: Virtually guided rehabilitation research may present barriers to participation for some populations due to a lack of internet access and proficiency. Strategies identified: Including community stakeholders in the decision-making process to help guide the development of safe and feasible study protocols, and simplifying protocols to maintain participants’ adherence. 3) Knowledge dissemination: Virtually delivered conferences have required additional preparation time due to requirements of pre-recorded presentations, and hinder important conversations between conference attendees. Strategies identified: Researchers should account for delays in knowledge translation plans for funding applications, and conference organizers should consider hosting networking events for attendees. Conclusions This workshop served as a catalyst for creative solutions to complex methodological challenges that can be integrated within existing and future rehabilitation-focused studies during the COVID-19 pandemic and beyond. Author(s) Disclosures None.

A new High-Temperature Superconducting ECR (HTS-ECR) ion source is under development in Research Center for Nuclear Physics (RCNP), Osaka University. This ion source will be used for production of high intensity proton, deuteron and He ion beams. The HTS-ECR magnets are composed of three solenoid coils and a set of sextupole coils made of REBCO tapes, a high-temperature superconductor. The HTS-ECR ion source is designed to operate at frequency of 2.45 GHz and 10 GHz. Performance test of the HTS coils had been carried out at 31 K and 77 K. This HTS coil technology will be applied to development of a meter-size HTS coil system of a high intensity compact AVF cyclotron. This paper introduces the basic design of the HTS-ECR ion source. The performance test results showed that REBCO solenoids remain superconducting state with a current up to 400 A. Simulation results of the magnetic field and electromagnetic field distributions in a plasma chamber fulfilled the requirements of electron cyclotron resonance conditions at 2.45 GHz and 10 GHz. Simulation result of mirror ratios and electromagnetic field amplitudes are also presented in this paper.

Smoking is an important risk factor for cardiovascular disease and all-cause mortality. Cardiac rehabilitation (CR) is effective for reducing the risk of recurrent cardiac events through improving cardiorespiratory fitness (CRF). Little is known about the influence of smoking on CRF throughout long-term CR. The purpose of this analysis was to compare CRF trajectories among individuals with positive and negative smoking history enrolled in long-term CR. Participants had a positive smoking history if they currently or formerly smoked (Smoke+, n = 55, mean age = 64.9 ± 9.0 years) and had a negative history if they never smoked (Smoke–, n = 34, mean age = 61.4 ± 9.0 years). CRF (peak oxygen uptake) was measured at baseline and annually thereafter for 6 years. The Smoke+ group had lower CRF compared with the Smoke– group over enrollment (β = −3.29 (SE = 1.40), 95% confidence interval (CI) −6.04 to −0.54, p = 0.02), but there was no interaction of smoking history and enrollment (β = 0.35 (SE = 0.21), 95% CI: −0.06 to 0.77, p = 0.10). Moreover, trajectories were not influenced by pack-years (β = 0.01 (SE = 0.01), 95% CI: −0.01 to 0.04, p = 0.23) or time smoke-free (β = −0.002 (SE = 0.01), 95% CI: −0.02 to 0.02, p = 0.80). Although the trajectories of CRF do not appear to be affected by smoking behaviour, individuals without a history of smoking maintained higher CRF throughout enrollment. Novelty: The benefits of long-term exercise-based cardiac rehabilitation on cardiorespiratory fitness are similar between those who have smoked and those who have never smoked. Neither the number of pack-years nor the length of time spent smoke-free influence cardiorespiratory fitness trajectories following long-term cardiac rehabilitation.

Objective: To evaluate the construct validity and responsiveness of the Rapid Assessment of Physical Activity (RAPA) for measuring physical activity (PA) in adults living with HIV. Design: Secondary analysis of an interrupted time-series intervention study. Setting: Community-based fitness facility in Toronto, Canada. Participants: Sixty-seven adults (N=67) living with HIV (n=5 women; mean age, 51.8±11.6 years) with available baseline data to assess for construct validity of the RAPA, of which 50 (n=4 women; age, 53.2±11.4 years) had follow-up data to evaluate responsiveness. Interventions: Two months of a community-based exercise intervention involving thrice weekly multicomponent exercises. Main Outcome Measures: We used a single-item PA questionnaire as a convergent outcome to the RAPA, while peak oxygen consumption, general health status, and number of concurrent health conditions were divergent outcomes. We tested 11 a priori hypotheses (6 construct validity, 5 responsiveness) using Spearman ρ, Wilcoxon signed-rank tests, Cohen's d, standardized effect size (SES), and standardized response mean (SRM). We considered acceptable construct validity and responsiveness if >75% of hypotheses were confirmed. Results: All of the hypotheses (100%) for construct validity were confirmed. The RAPA demonstrated moderate correlations with the single-item PA questionnaire (ρ=0.61), and negligible correlations with divergent outcome measures (ρ=0.08-0.21). Two of the 5 hypotheses (40.0%) for responsiveness were confirmed. RAPA scores were significantly greater after 2 months of training (P

Background and Objective The barrier function of long junctional epithelium is thought to be important after periodontal initial therapy and periodontal surgery. Although the difference between long junctional epithelium and normal junctional epithelium regarding their resistance to destruction of periodontal tissue has been investigated, the mechanism still remains unclear. Using our rat experimental periodontitis model in which loss of attachment and resorption of alveolar bone is induced by the formation of immune complexes, we investigated the resistance of periodontal tissue containing long junctional epithelium and normal junctional epithelium to destruction. Material and Methods Rats were divided into four groups. In the immunized long junctional epithelium (I-LJE) group, rats were immunized with lipopolysaccharide (LPS), and curettage and root planing procedures were performed on the palatal gingiva of the maxillary first molars to obtain reattachment by long junctional epithelium. In the immunized normal junctional epithelium (I-JE) group, rats were immunized without curettage and root planing procedures. In the nonimmunized long junctional epithelium (nI-LJE) group, rats were not immunized but curettage and root-planing procedures were performed. In the control group, neither immunization nor curettage and root-planing was performed. In all rats, periodontal inflammation was induced by topical application of LPS into the palatal gingival sulcus of maxillary first molars. The rats were killed at baseline and after the third and fifth applications of LPS. Attachment loss and the number of inflammatory cells and osteoclasts in the four groups were compared histopathologically and histometrically. Results After the third application of LPS in the I-LJE group, attachment loss showed a greater increase than in control and nI-LJE groups, and inflammatory cell infiltration and osteoclasts were increased more than in the other groups. After the fifth application of LPS, attachment loss was greater and there was a higher degree of inflammatory cell infiltration in nI-LJE and I-LJE groups than in control and I-JE groups. Conclusion Our findings suggest that the destruction of periodontal tissue is increased in tissue containing long junctional epithelium compared with normal junctional epithelium and that the immunized condition accelerates the destruction by forming immune complexes.

We have estimated broadband ( f =0.5–8 Hz) site amplification factors at 1800 sites in Japan based on the coda normalization method using 4001 seismograms obtained from 48 events. The results show that, in the low‐frequency band ( f =0.5–1 Hz), the site amplification factor varies over a wide range from −4 to 24 dB, with larger site amplification factors (>8 dB) in such major basins as Kushiro, Rumoi, Sapporo, Aomori, Sendai, Niigata, Tokyo, Toyama, Nagoya, Osaka, Oita, and Kagoshima. On the other hand, the site amplification factor in the high‐frequency band ( f =4–8 Hz) varies over a relatively narrow range from 0 to 18 dB at each station and has no clear correlation with the surface geology of each station. We then examined the contribution of the site amplification at each station to the anomalous distribution of the intensity pattern during large earthquakes by correcting the observed ground accelerations at each K‐NET and KiK‐net station with their corresponding estimated site amplification factors. The corrected pattern of intensity shows simple concentric isoseismal intensity contours around the hypocenter, indicating the applicability of our estimates to strong motion predictions. We confirmed that our estimates are superior to those derived from geology, such as those based on the regression of the averaged S ‐wave velocity from the surface to a depth of 30 m (![Graphic][1] ), with a smaller standard deviation of intensity variations based on a standard decay function of intensity versus hypocentral distance. [1]: /embed/inline-graphic-1.gif