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Background: Increasing the elderly's balance through physical activity not only results in improved health and increases the independence of the elderly, but also reduces the heavy costs associated with the fall which imposed on family and society. Therefore, the purpose of this study was to investigate and determine the benefits of the Pilates exercises on the static balance, dynamic balance, and functional balance of the elderly. Materials and Methods: The papers which was published from March 2010 to 2018 were included in this study. The Pilates keywords were searched together with aging, elderly, and old subjects. The research literature was done in the Medline, Embase, Pubmed, Scopus, and SID databases. Results: The results of this meta-analysis indicated that the Pilates exercises had a significant and high effect size (P=0.000) on time up and go time (TUG) (Hedges g=1.078), the significant and moderate effect size on the functional balance (Hedges g=0.685), and the significant and low effect size on the static equilibrium (Hedges g=0.668). Conclusion: The results of this meta-analysis study showed that the Pilates exercises were effective exercises to improve static, dynamic, and the functional balance in the elderly subjects. More high-quality research is needed to examine the effect of the Pilates exercises on other aspects of the balance in the elderly as well as assess the effectiveness of the Pilates program in longer time and during the follow up program. more...

Toe-in gait is a pathology in which the child walks and turns the foot inward instead of pointing straight ahead. The alignment of the lower limb structure changes in this disease, increasing the incidence of knee and hip osteoarthritis. This study aimed to determine the kinematic and joint loading in subjects walking with a toe-in gait pattern. This study selected two groups of subjects: normal subjects and those with toe-in gait due to an increased femoral head anteversion angle (each group consisted of 15 subjects). A Qualisys motion analysis system and a Kistler force plate were used to record the motions and forces applied to the leg while walking. OpenSim software (version 3.3) was used to analyze the range of motion, moments, muscle forces, and joint contact forces in both groups of subjects. The mean values of stride length for normal subjects (1.1 ± 0.141 m) and those with toe-in gait (0.94 ± 0.183 m) differed significantly. The mediolateral component of the ground reaction force decreased significantly in the toe-in gait group compared to normal subjects ( p -value = 0.05). The peak force of most of the hip joint muscles increased significantly in those with toe-in gait compared to normal subjects ( p -value < 0.05). The results of this study showed that those with toe-in gait, due to an increase in femoral head anteversion angle, only had a change in rotation of the pelvic and hip joint. There was no significant difference between walking speed and most ground reaction force components between normal subjects and those with toe-in gait. As the peaks of most of the hip joint muscles increased significantly in the toe-in gait group, this increased joint contact forces (especially the anteroposterior component of the hip joint and the mediolateral component of the knee joint), which may ultimately increase the incidence of hip and knee joint osteoarthritis., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. more...

Introduction and Aim: Exercise training is effective for improving cardiometabolic health in children and adolescents, but less is known about its impact on inflammatory markers. We therefore, undertook a systematic review and meta-analysis to investigate the role of exercise training on pro-inflammatory cytokines including interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP) in children and adolescents., Method: A comprehensive search was conducted in three electronic databases including PubMed, Web of Science, and Scopus, from inception to December 2023 to identify exercise trials with and without control groups, involving participants with mean ages ranging from ≥ 6 to < 18 years, of age with measurements of at least one of the following pro-inflammatory cytokines IL-6, TNF-α, or CRP. Standardized mean differences (SMD) and 95 % confidence interval (ICs) were calculated using random effects models., Results: Thirty-eight studies involving 2043 children and adolescents were included. The results show that exercise training resulted in significant reductions in IL-6 [SMD: -0.44; 95 % CI: -0.68, -0.21; P = 0.001] and CRP [SMD: -0.28; 95 % CI: -0.41, -0.16; P = 0.001], but not TNF-α [SMD: -0.15; 95 % CI: -0.38, -0.07; P = 0.19]. Subgroup analyses showed that IL-6 and CRP were reduced with aerobic training in adolescents, as was CRP with high-intensity interval training., Conclusion: These results provide evidence that exercise training is effective for reducing IL-6 and CRP in adolescents, but not in children, and any benefits may be modulated by the type of exercise performed., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.) more...

Background: Individuals with diabetic neuropathy may experience plantar ulcers and postural instability. Although use of an insole with arch support has the potential to decrease the incidence of plantar ulcers, the choice of proper design and material density concerning postural stability is challenging. The objective of this pilot study was to conduct a preliminary evaluation of the immediate effects of custom-made ethyl vinyl acetate insoles with arch support and Shore A values of 30 or 50 on static balance in patients with diabetes and neuropathic foot/feet., Methods: Ten women with diabetes participated in this study. Static balance was analyzed while in double-limb standing with eyes closed and eyes open and while standing on a dominant limb with eyes open wearing shoes only and wearing shoes and insoles with Shore A values of 30 and 50., Results: With insole, the mean values of center of pressure excursions decreased significantly while standing on double limbs with eyes closed. The improvement in static balance was greater while using the insole with greater density; however, the difference was not statistically significant., Conclusions: An insole with arch support made of ethyl vinyl acetate Shore A of 30 and 50, which could decrease plantar pressure concentration, had no negative effect on the static balance of diabetes. Therefore, further research on the long-term effects of such insoles on the static balance of diabetes is suggested. more...

Stability is defined as the ability to control the amplitude and velocity of center of gravity (CoG) changes during quiet standing, and to decrease the risk of falling during walking. Few studies exist which examine the local dynamic stability of those with knee joint osteoarthritis (OA). Nevertheless, it is debatable whether the stability of OA subjects differs from that of normal subjects or not. The aim of this study was to evaluate the static and local dynamic stability of the subjects with knee OA in comparison to normal subjects. Fifteen OA subjects and 15 healthy subjects with matching age, weight, and gender participated in this study. A Qualysis motion analysis system incorporating a Kistler force plate was used to record data during quiet standing and when walking on a treadmill. Static stability was evaluated based on center of pressure (COP) sways excursion, path length and velocity in mediolateral and anteroposterior axes. Local dynamic stability was evaluated by the use of short Lyapunov exponent when subjects walk on treadmill. A two-sample test-test was used for the final analysis (α = 0.05). Mean values of the COP excursion in mediolateral and anteroposterior directions, and the velocity of COP in both mediolateral and anteroposterior directions, differed significantly between healthy and OA subjects ( p  < 0.05). Local dynamic stability of OA subjects appeared to be reduced compared to healthy subjects, especially when ambulating at higher walking speeds ( p -value < 0.05). Study results demonstrated that both static and local dynamic stability decreased in OA subjects. This may be in part due to altered control mechanisms which are required for response to perturbations during standing and walking to ensure stability. As a decrease in local dynamic stability is correlated to an increased risk of falling, it is important that this group should receive appropriate treatment interventions to improve standing and walking stability. more...

Measurement of muscle forces related to aging can help to better identify the gait impairment mechanisms in the elderly. To this end, musculoskeletal modeling has been developed to estimate muscle forces. This study aimed to check the validity of OpenSim modeling (i.e., computed muscle control) approach in elderly subjects. Kinematic and kinetic data and Electromyography (EMG) signals for four different muscles were collected in nine healthy elderly males during walking. Dynamic simulation was done within OpenSim. Correlation analysis was performed to quantitatively compare the maximum estimated muscle forces with maximum measured muscle activities during the first double limb support, single limb support, and the second double limb support phases. The area-time plots of OpenSim and EMG data during gait cycle were obtained for qualitative assessment. In quantitative assessment, a low to moderate correlation was observed for the peak of muscle force and muscle activation of four muscles during sub phases of gait. The muscle forces pattern from OpenSim was found to be relatively similar to the muscle activity pattern from EMG especially for Gastrocnemius Medialis. A low to moderate consistency between OpenSim and EMG in the elderly can be explained by using a single mathematical estimation approach. more...

Running asymmetry has not been assessed among patients with anterior cruciate ligament (ACL) deficiency. The aim of this study was to evaluate the spatiotemporal and muscle force asymmetry indexes in the subjects with ACL reconstruction (ACLR) compared with normal subjects. Eight individuals with a reconstructed ACL and eight individuals with intact ACLs were participated in this study. A Vicon motion analysis system and two Kistler force plates were used to record data. Muscle forces analysis was done by the use of OpenSim software. The results of this study showed that ACLR group had a significant weakness in hip abductor, extensor, and adductor muscles of the affected limb compared with healthy subjects ( p  < 0.05). In ACLR group, asymmetry of gluteus minimus muscle force was significantly greater than that of healthy group ( p  = 0.04). After the reconstruction of the ACL, there is still a significant asymmetry in muscle force as well as a reduction in force production of ACLR group especially in reconstructed side which put a person at high risk of reinjuries. Thus, strengthening of these muscles on the affected side to increase running performance of ACLR group is recommended., Competing Interests: None declared., (Thieme. All rights reserved.) more...

Background: The influence of various musculoskeletal disorders has been evaluated using different kinetic and kinematic parameters. But the efficiency of walking can be evaluated by measuring the effort of the subject, or by other words the energy that is required to walk., Objective: The aim of this study was to identify mechanical energy differences between the normal and pathological groups. Four groups of 15 healthy subjects, 13 Parkinson subjects, 4 osteoarthritis subjects, and 4 ACL reconstructed subjects have participated in this study. The motions of foot, shank and thigh were recorded using a three dimensional motion analysis system. The kinetic, potential and total mechanical energy of each segment was calculated using 3D markers positions and anthropometric measurements., Results: Maximum value and sample entropy of energies was compared between the normal and abnormal subjects. Maximum value of potential energy of OA subjects was lower than the normal subjects. Furthermore, sample entropy of mechanical energy for Parkinson subjects was low in comparison to the normal subjects while sample entropy of mechanical energy for the ACL subjects was higher than that of the normal subjects., Conclusion: Findings of this study suggested that the subjects with different abilities show different mechanical energy during walking. more...