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Background: determining the appropriate rehabilitation protocol is essential to influence the correction of flat feet, e.g., by activating the intrinsic muscles of the foot. Therefore, this study aimed to determine the impact of the exercises activating the intrinsic foot muscles for postural control in children with flat feet, with normal and excessive body weight. Methods: Fifty-four children aged 7 to 12 were enrolled in the research. Forty-five children were qualified for the final evaluation. Each child in the experimental group was demonstrated an appropriate technique for performing a short foot exercise without compensation by extrinsic muscle. The participants then performed a supervised short foot training session once a week and on other days of the week under the supervision of caregivers for 6 weeks. Flat feet were scored on the foot posture index scale. A postural test was evaluated with a Biodex balance system SD. Statistical significance in the foot posture index scale and postural test were evaluated using an analysis of variance (ANOVA) with Tukey’s post-hoc test. Results: according to the six indices of the foot posture index scale, five indicators showed statistically significant improvement after rehabilitation. At the 8–12 platform mobility level, it was revealed that the excessive body weight group had significant improvements in the overall stability index and medio-lateral stability index, with eyes closed. Conclusion: our results indicate that a 6-week rehabilitation program based on the activation of the intrinsic muscles of the foot resulted in an improvement in the foot position. This, in turn, affected balance control, especially in children with excess body weight in conditions of closed eyes.

Coach workshops based on seven principles (inspiration, explanation, expectation, support, reward, appreciation, growth and winning) enhance the sport experience of adult athletes. Therefore, we have investigated the effects of such workshops with coaches of child athletes. Study participants were coaches of 57 9- to 12-year old girls (practicing gymnastics) and boys (practicing football). Three coaches of 28 children attended three workshops over 12 weeks, while a control group of 5 coaches of 29 children attended no workshops. Measures of well-being and psychomotor performance were taken on the children before and after the intervention; differences in mean changes between intervention and control groups were adjusted for baseline, standardized, and assessed with a conservative magnitude-based decision method. There were clear substantial effects of the workshop on motivation averaged across several dimensions (girls, large, most likely beneficial), on a decision test (boys, small-moderate, very likely beneficial), on state anxiety self-reflection (girls, moderate, likely harmful), and on reaction time (boys, small, possibly harmful). The beneficial effects of the workshop in this pilot study are encouraging, but the unclear and potentially harmful effects and the roles of presenter- and coach-specific effects need to be investigated further with a representative sample of coaches and more children before the workshop is recommended for implementation.

Introduction: Percutaneous epidural adhesiolysis (epidural decompressive neuroplasty, percutaneous epidural neuroplasty) is treatment method for drug-resistant back pain, including post-surgery syndrome, sciatica or spinal canal stenosis. Aim: To describe the method and outcomes of epidural adhesiolysis. Material and methods: The review of the literature on the topic of epidural adhesiolysis. Results and discussion: This procedure is usually performed in the lumbo-sacral part of the spine, although it can be also done in the cervical or thoracic parts as well. Its purpose is to administer anesthetic drugs, steroids, saline solution or hyaluronidase into the epidural space via one of the three approaches: caudal, interlaminar and transforaminal. The efficacy of epidural adhesiolysis was proven in numerous randomized controlled trials. Conclusions: The efficacy of epidural adhesiolysis was proven in numerous randomized controlled trials. When performed by an experienced physician, epidural adhesiolysis is a safe and effective method with infrequent adverse events.

Study Design: A double-blinded, randomized controlled trial. Background: Surgery is effective in reducing pain intensity in patients with cervical disc disease. However, functional measurements demonstrated that the results have been not satisfactory enough. Thus, rehabilitation programs combined with the supplementation of vitamin D could play an essential role. Methods. The study recruited 30 patients, aged 20 to 70 years, selected for anterior cervical interbody fusion (ACIF). The patients were randomly divided into the placebo (Pl) and vitamin D (3200 IU D3/day) supplemented groups. The functional tests limits of stability (LOS), risk of falls (RFT), postural stability (PST), Romberg test, and foot pressure distribution were performed before supplementation (BS&mdash, week 0), five weeks after supplementation (AS&mdash, week 5), four weeks after surgery (BSVR&mdash, week 9), and 10 weeks after supervising rehabilitation (ASVR&mdash, week 19). Results. The concentration of 25(OH)D3 in the serum, after five weeks of supplementation, was significantly increased, while the Pl group maintained the same. The RFT was significantly reduced after five weeks of vitamin D supplementation. Moreover, a further significant decrease was observed following rehabilitation. In the Pl group, no changes in the RFT were observed. The overall postural stability index (OSI), LOS, and the outcomes of the Romberg test significantly improved in both groups, however, the effects on the OSI were more pronounced in the D3 group at the end of the rehabilitation program. Conclusions. Our data suggest that vitamin D supplementation positively affected the rehabilitation program in patients implemented four weeks after ACIF by reducing the risk of falls and improving postural stability.

Background: The introduction of early rehabilitation exercise is the foundation of treatment post-Posterior lumbar interbody fusion (PLIF) surgery, and the search for additional sources of reinforcement physiotherapy seems to be very important. Methods: The patients were randomly divided into the vitamin D3 (n = 15, D3) supplemented group and received 3200 IU per day for five weeks before surgery and the placebo group (n = 18, Pl) received vegetable oil during the same time. The patients began the supervisor rehabilitation program four weeks after surgery. Results: The limits of stability (LOS) were significantly improved in the D3 group after 5 and 14 weeks (p &lt, 0.05), while in the Pl group, progress was only observed after 14 weeks (p &lt, 0.05). The LOS were also higher in the D3 group than in the Pl group after five weeks of supervised rehabilitation (p &lt, 0.05). In the postural stability (PST) test, significant progress was observed in the D3 group after 14 weeks (p &lt, 0.02). In addition, neither rehabilitation nor supplementation had significant effects on the risk of falls (RFT). Conclusions: Vitamin D supplementation seems to ameliorate the effects of an early postoperative rehabilitation program implemented four weeks after posterior lumbar interbody fusion. Early physiotherapy treatment after PLIF surgery combined with vitamin D supplementation appears to be a very important combination with regard to the patients’ recovery process.

Introduction. Osteoporosis and osteopenia are related to changes in the quantity and quality of skeletal muscle and contribute to a decreased level of muscle strength. The purpose of this study was to evaluate the impact of Nordic walking training on muscle strength and the electromyographic (EMG) activity of the lower body in women with low bone mass. Material and methods. The participants of the study were 27 women with low bone mass. The sample was randomly divided into two groups: a control group and an experimental group. Women from the experimental group participated in 12 weeks of regular Nordic walking training. Functional strength was assessed with a 30-second chair stand test. The EMG activities of the gluteus maximus (GMax), rectus femoris (RF), biceps femoris (BF), soleus (SOL), and lumbar (LB) muscles were measured using a surface electromyogram. Results. Nordic walking training induced a significant increase in the functional strength (p = 0.006) of the lower body and activity of GMax (p = 0.013) and a decrease in body mass (p = 0.006) in women with reduced bone mass. There was no statistically significant increase in the EMG activities of the RF, BF, SOL, or LB muscles. The study did not indicate any significant changes in functional muscle strength, the EMG activity of the lower body, or anthropometry in women from the control group. Conclusions. Nordic walking training induces positive changes in lower body strength and the electromyographic activity of the gluteus maximus as well as a decrease in body mass in women with low bone mass.

Recent studies show that vitamin D deficiency may be responsible for muscle atrophy. The purpose of this study was to investigate markers of muscle atrophy, signalling proteins, and mitochondrial capacity in patients with chronic low back pain with a focus on gender and serum vitamin D level. The study involved patients with chronic low back pain (LBP) qualified for posterior lumbar interbody fusion (PLIF). Patients were divided into three groups: supplemented (SUPL) with vitamin D (3200 IU/day for 5 weeks), placebo with normal levels of vitamin D (SUF), and the placebo group with vitamin D deficiency (DEF). The marker of muscle atrophy including atrogin-1 and protein content for IGF-1, Akt, FOXO3a, PGC-1α, and citrate synthase (CS) activity were determined in collected multifidus muscle. In the paraspinal muscle, IGF-1 levels were higher in the SUF group as compared to both the SUPL and DEF groups (p<0.05). In the SUPL group, we found significantly increased protein content for pAkt (p<0.05) and decreased level of FOXO3a (p<0.05). Atrogin-1 content was significantly different between men and women (p<0.05). The protein content of PGC-1α was significantly higher in the SUF group as compared to the DEF group (p<0.05). CS activity in the paraspinal muscle was higher in the SUPL group than in the DEF group (p<0.05). Our results suggest that vitamin D deficiency is associated with elevated oxidative stress, muscle atrophy, and reduced mitochondrial function in the multifidus muscle. Therefore, vitamin D-deficient LBP patients might have reduced possibilities on early and effective rehabilitation after PLIF surgery.

Objective Different studies have demonstrated that regular exercise can induce changes in the lipid profile, but results remain inconclusive. Available data suggest that correction of vitamin D deficiency can improve the lipid profile. In this study, we have hypothesized that Nordic Walking training will improve lipid profile in elderly women supplemented with vitamin D. Methods A total of 109 elderly women (68 ± 5.12 years old) took part in the study. First group [experimental group (EG): 35 women] underwent 12 weeks of Nordic Walking (NW) training combined with vitamin D supplementation (4,000 IU/day), second group [supplementation group (SG): 48 women] was only supplemented with vitamin D (4,000 IU/day), and third group [control group (CG): 31 women] was not subject to any interventions. Blood analysis of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and 25-OH-D3 was performed at baseline and after the 12 weeks of NW training. Additionally, a battery of field tests specifically developed for older adults was used to assess the components of functional fitness. The same blood analysis was repeated for the EG 6 months after the main experiment. Results After 12 weeks of NW training and vitamin D supplementation, in the EG a decrease in TC, LDL-C, and TG was observed. In the SG, no changes in the lipid profile were observed, whereas in the CG an increase in the HDL-C level was noticed. Positive physical fitness changes were only observed in the EG. Conclusion Our obtained data confirmed baseline assumption that regular exercise induces positive alternations in lipid profile in elderly women supported by supplementation of vitamin D.

Background At present many young people experience too much body iron accumulation. The reason of this phenomenon is not clear. There is accumulating evidences that not proper diet and lack of exercise could be a main contributing factors. This investigation assessed the effects of a diet rich in simple sugars (glucose or fructose) on exercise-induced hepcidin which is hormone regulating iron metabolism. Methods A group of physically active young men completed an incremental exercise test before and after a 3-day diet supplemented with fructose (4 g/kg BM) or glucose (4 g/kg BM). After a 1-week break, they crossed over to the alternate mode for the subsequent 3-days period. Venous blood samples were collected before and after 1 h exercise and were analysed for serum hepcidin, IL-6, CRP, iron, and ferritin. The physiological response to exercise was also determined. Results The concentration of hepcidin increased 1 h after exercise for the baseline test (p

Zbigniew Marcin Ossowski,1 Wojciech Skrobot,2 Piotr Aschenbrenner,3 Vida Janina Cesnaitiene,4 Miroslaw Smaruj3 1Department of Health Promotion, 2Department of Kinesiology, 3Department of Physical Education, Gdansk University of Physical Education and Sport, Gdansk, Poland; 4Department of Health, Physical and Social, Lithuanian Sports University, Kaunas, Lithuania Background: Several studies have demonstrated the positive effects of physical activity on skeletal muscle mass and muscle strength in women with osteoporosis. However, the impact of Nordic walking training on sarcopenia-related parameters in women with low bone mass remains unknown. Therefore, the purpose of this study was to evaluate the impact of 12 weeks of Nordic walking training on skeletal muscle index, muscle strength, functional mobility, and functional performance in women with low bone mass. Materials and methods: The participants were 45 women, aged 63–79 years, with osteopenia or osteoporosis. The subjects were randomly assigned either to an experimental group (12 weeks of Nordic walking training, three times a week) or to a control group. Skeletal muscle mass and other body composition factors were measured with octapolar bioimpedance InBody 720 analyser. Knee extensor and flexor isometric muscle strength were measured using Biodex System 4 Pro™ dynamometers. This study also used a SAEHAN Digital Hand Dynamometer to measure handgrip muscle strength. The timed up-and-go test was used to measure functional mobility, and the 6-minutewalk test was used to measure functional performance. Results: Short-term Nordic walking training induced a significant increase in skeletal muscle mass (P=0.007), skeletal muscle index (P=0.007), strength index of the knee extensor (P=0.016), flexor (P