Low back pain (LBP) is a health problem that affects 70-80% of the population in Western countries. Because of the biomechanical relationship between the lumbar region and the hip, it is thought that strengthening the muscles of this joint could improve the symptoms of people with LBP. The objective of the study is to evaluate the current evidence on the efficacy of hip strengthening exercises to reduce pain and disability in people with LBP. Clinical trials were collected from PubMed, PEDro, and Scopus databases published up to September 2022. Based on Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and using CASpe and PEDro tools for methodological quality assessment, we selected studies that included hip strengthening exercises as part of LBP treatment and measured pain and/or disability parameters. Among the 966 records identified in the search, a total of 7 studies met the established selection criteria. Overall, participants who performed hip strengthening exercises had significantly improved in pain and disability. The methodological quality of the included studies was assessed as “good”. In conclusion, the addition of hip muscle strengthening exercises iterating LBP effectively improving pain and disability.

This paper describes the design and development of an active device that was applied to shoulder rotation rehabilitation. It implements a force control in a similar way to the haptic devices that reflect a force on the user’s hand according to the rehabilitation parameters. This device was tested with patients, combining clinician manipulation and programmed exercises. The results were excellent, given that the range of movement of the shoulder increased in most of the pa-tients. The results of the Usability Scale questionnaire were also promising.

The aim of this study was to verify the effects of blood flow restriction on movement velocity and muscle activity during the back-squat exercise. Methods: Twenty-four university students participated in this study. In two randomized 72-hours apart sessions, participants performed a 4-set protocol consisting of 30-15-15-15 repetitions performed at 30% of their one-repetition maximum in the back-squat exercise. In both sessions, neuromuscular function was monitored by surface electromyography (EMG) and movement velocity (mean propulsive velocity [MPV], peak concentric velocity [Vmax] and the effort index [EI]). Blood flow restriction (BFR) was applied during exercise in one of the experimental sessions with 80% of full arterial occlusion pressure over lower limbs. Results: BFR condition showed higher (p<0.05) EI, peak and rooted mean square normalized EMG in set 1 compared to set 2. Similar MPV and Vmax were observed at each set for both BFR and control conditions. No significant differences were observed between conditions at any set. Conclusions: BFR did not imply changes in neuromuscular performance during low-intensity resistance training, but it might induce greater intra-series velocity loss and less activation of the muscles involved.

The restrictions imposed by the Covid-19 pandemic left many older adults isolated and confined. Under active aging theory, self-management is crucial for well-being among older adults coping with aging. The current study examines how (a) initial self-management, and (b) changes in self-management due to independent physical training, affect psychological outcomes in a sample of care home residents following outbreak of the pandemic. 64 older adults (53 females, 11 males), mean age is 82.23, reported on their self-management abilities, then embarked on six months of training in chair exercises (one session per week). The training exercises were halted after 22 sessions due to the pandemic, but some residents continued to practice independently. Eight weeks after the outbreak of the pandemic, residents who had continued to practice at least once per week (n = 35) and those who had not continued to practice (n = 29) were questioned again about their self-management, and about five psychological outcomes: anxiety, traumatic stress, satis-faction, general mood, and post-traumatic growth (PTG). Self-management improved among older adults who independently practiced the exercises, and declined among those who did not. Pre-pandemic self-management significantly predicted post-outbreak traumatic stress symptoms, anxiety, general mood, and satisfaction with life, but not PTG. However, the difference in self-management between the pre-pandemic and post-outbreak measures was associated with PTG, and made a unique contribution to prediction of the other effects. Self-management abilities among older adults can be seen as a protective factor against adverse psychological outcomes at times of trauma. Further, the improvement in self-management among older adults who independently practiced physical excises made a unique contribution beyond initial self-management abilities.

The affected upper limb in children with Unilateral Spastic Cerebral Palsy (US CP) has motor and somatosensory impairments, that contribute negatively to children’s bimanual performance and quality of life. Mirror Therapy (MT) is being studied to become an approachable intensive and home-based therapy, suitable for children with US CP. The aim of this study is to examine the feasibility of a 5-week home-based program of MT for children with US CP. Six children aged 8-12 years old performed the therapy, five days per week, 30 minutes per day. A minimum of an 80% of compliance was required. The evaluations included the feasibility of the therapy (compliance, total dosage, perceived difficulty of the exercises, and losses of follow-ups and evaluations), the bimanual performance, the somatosensory function and the quality of life at baseline, at the end of the intervention, and at 1-month follow-up. All children completed the therapy and were included in the analysis. The total accomplishment was 86.47 ± 7.67. The perceived difficulty of the exercises ranged from 2,37 to 4,51. As a conclusion, a home-based program of Mirror Therapy is suitable and feasible for children with US CP.

Background: The aim of the study is to present the process of monitoring the changes in the effi-ciency of equilibrium reactions in the children with postural disorders, in the course of the thera-peutic process. Methods: The shape of spine and the efficiency of equilibrium reactions in standing posture and during gait were assessed in all the subjects. The subjects were put in 2 groups: with the shape of spine disorder and without one. The recommended set of therapeutic activities in home conditions lasted about 20 minutes and was performed by the child with parent’s supervision. The therapeutic program was based on elements of the PNF and Vojta methods. The following parameters were measured: maximum movement of the center of presure (CoP) in the frontal plane during gate, maximum movement of the CoP in the sagittal plane, movement of the CoP in the frontal plane in static conditions, movement of the CoP in the sagittal plane in static conditions. Results: Six statistically significant differences were recorded, all of them were related to measurement I. The Friedman test result was statistically significant for all the indexes. Post-hoc analyzes were performed using the Dunn-Bonferroni test. Conclusions: 1. The children with shape of spine disorders are featured by lower efficiency of equivalent reactions in relation to the children without disorders. 2. The therapy with the application of neurophysiological methods in the treatment of shape of spine disorders improves equilibrium reactions in these patients. 3. Long-lasting and thorough observations of the therapeutic process in the children with shape of spine disorders should include the monitoring of the efficiency of equilibrium reactions

Background: Low-level (LLLT) and high-intensity laser therapy (HILT) can be beneficial additions to knee osteoarthritis (KOA) rehabilitation exercises; however, it is still being determined which modality is more effective. Aim: To compare the effects of LLLT and HILT as adjuncts to rehabilitation exercise (LL+EX and HL+EX) on clinical outcomes in KOA. Methods: Thirty-four adults with mild to moderate KOA were randomly allocated to either LL+EX (n = 17) or HL+EX (n = 17) groups. All participants underwent their designated laser treatment combined with rehabilitation exercises weekly for twelve consecutive weeks. The Knee Injury and Osteoarthritis Outcome Score (KOOS), Numerical Pain Rating Scale (NPRS), active knee flexion, and Timed Up-and-Go test (TUG) were assessed at baseline and immediately post-intervention. Results: Post-intervention, both groups significantly improved their KOOS, NPRS, active knee flexion, and TUG scores compared to baseline (p < 0.01). The mean difference of change in KOOS, NPRS, and active knee flexion scores for the HL+EX group surpassed the minimal clinically important difference threshold. In contrast, the LL+EX group only demonstrated clinical significance in NPRS scores. Conclusions: Incorporating HILT as an adjunct to usual KOA rehabilitation led to significantly higher improvements in pain, physical function, and knee-related disability compared to LLLT.

Abstract Introduction Exercise is an effective component in rehabilitation of a range of chronic conditions. There is a growing interest in the use of exercise-based nature interacted rehabilitation (EBNIR), but an overview of current evidence is missing. To provide an informed base for future work within this field of EBNIR, the objective of this scoping review was to map existing exercise-based rehabilitation interventions conducted with incidental or intentional nature interaction focusing on its populations, types of outcomes, and theoretical rationale for people with physical and mental disabilities. Methods This scoping review identified peer-reviewed publications, registered upcoming trials and grey literature. To map all available knowledge, we performed a comprehensive search of selected databases (MEDLINE; EMBASE; CINAHL; Cochrane; Web of Science; Pedro) from inception to October 2022. Data was synthesised in a thematic presentation guided by TIDieR, supplemented by a checklist developed for this study accounting nature incidental or intentional interaction by measuring all nature elements implemented in the intervention. Results Twelve studies including 856 participants met the inclusion criteria. 11 were completed trials and 1 was registered in clinicaltrials.gov to be run in 2023. A total of 856 patients were enrolled in the 12 studies (range 18-262, median 50). The included studies were different in terms of design (observational n=4, qualitative n=1, RCT=7), intervention dosage and frequency, control intervention, diagnosis, number of patients, and outcomes included. The used exercise-based interventions consisted of outdoor walks, neck exercises and surfing interventions in patients with physical or mental health conditions. The interventions were incidental or intentional interacted with nature to a varying degree. Conclusion This scoping review presents an overview of limited and diverse evidence within the field of exercise-based rehabilitation incidental or intentional interacting with nature, in patients with physical or mental health conditions. Our review provides an overview that will be helpful in the design of future EBNIR trials.

Polymyalgia rheumatica (PMR) is the most common inflammatory rheumatic disease among people over the age of 50 and occurs with symptoms such as musculoskeletal pain and stiffness in the neck, shoulders and hips. To date, corticosteroids represent the cornerstone of PMR treatment, although it is well known that their prolonged use is associated with several adverse effects, making it crucial to find therapeutic alternatives to their use. The purpose of this case report was to describe the effectiveness of 10 whole-body cryostimulation (WBC) sessions on a 74-year-old woman suffering from PMR. An improvement in disease impact, fatigue, pain, quality of sleep and total physical activity was observed after WBC. Moreover, the patient reduced her daily drug intake by 67% following WBC treatments. Given the increasing prevalence of PMR and considering the side effects that drug treatments can lead to, WBC could represent a valuable adjuvant and well-tolerated alternative for the treatment of PMR.

Background: The prevalence of physical inactivity has been rising in many countries in recent years, adding to the burden of non-communicable diseases and affecting overall health worldwide. The aim of this study is to determine the impact of physical activity on mortality from ischemic heart disease (IHD) separately for those respondents who were diagnosed with IHD and for those who were not diagnosed with IHD in their baseline health survey. Methods: In the baseline survey (2006–2008), 7100 men and women ages 45–72 were examined within the framework of the international study Health, Alcohol, and Psychosocial Factors in Eastern Europe (HAPIEE). 6770 participants were available for statistical analysis (after excluding 330 respondents due to missing information on study variables). Physical activity was determined by leisure-time physical activities (hours/week). All participants in the baseline survey were followed up for IHD mortality events until December 31, 2018. Results: Using multivariate Cox regression analysis, it was found that moderate and higher levels of physical activity significantly reduced the risk of IHD mortality (HR=0.54 and HR=0.60 respectively) in men who were not diagnosed with IHD at baseline compared with physically inactive subjects. It was found that among men and women who were diagnosed with IHD at baseline, physical activity reduced the risk of mortality from IHD compared with those who were physically inactive (HR=0.54 and HR=0.41 respectively). Using mediation analysis, was found that physical activity directly predicted statistically lower IHD mortality (P<0.05) in men and women. Conclusion: Physical activity was a significant factor that directly predicted statistically lower IHD mortality, regardless of whether subjects had IHD at baseline or not.

Equine Assisted Activities (EAA) are considered a suitable innovative rehabilitative practice for children with neurodevelopmental disorders, including Autism Spectrum Disorder (ASD). While standardized scales have been previously used as a tool to evaluate the effects of EAA on different domains of functioning in ASD children, few studies have considered an ethological approach as a means to describe human-horse interactions in the context of ASD. In this study, we aimed to evaluate the behaviour of 19 children with ASD - in comparison with 19 typically developing children (TD) - during EAA sessions. We developed an ethogram from the video-recordings, to assess spatial relationships, social interactions and communicative behaviours displayed by the child towards the horse, as well as the occurrence of problem behaviours. Results indicate that children’s behaviours during EAA sessions are modulated by sex and age, while previous children’s experience with EAA appeared to improve interpersonal distance and horse handling. Results from this study highlight the importance of exploring children's behavioural response during animal-assisted activities through direct measurements. This may allow linking the quality/strength of the child-horse relationship to the benefits obtained by the child, particularly in the social/communicative domain, a core symptom of ASD.

Coinfection of B virus (HBV) and hepatitis Delta virus (HDV) lead to severe forms of progressive liver diseases. However, commercially available antiviral drugs have shown considerable adverse effects and low efficacy in managing these patients. Thus, there is a pressing need to develop new, innovative, and evidence-based therapies for these pathological entities. In line with this, some investigators have attempted to develop anti-viral drugs targeting HBV/HDV coinfection. In another development, investigators have also attempted to establish immune therapy targeting for HBV infection as recovery or effective control of HBV infection also lead to efficient control of HDV infection. This review has discussed an account of the evolving antiviral and immune therapeutic drugs for HBV/HDV infection. Also, based on current scientific knowledge how we have described the pros and cons of these drugs as no suitable drug has been developed during the last forty years for treating HBV infection except the availability of two” repurposed drugs”; interferons and its derivatives and nucleoside analogs, for managing HBV or HBV/HDV coinfection. It seems that an evolving and innovative therapeutic regimen that combines both antiviral drugs and immune modulators may be the best and realistic option for management of HBV/HDV coinfection.

In this article, we introduce a new approach to human movement by defining the movement as a static object or a super object in one two-dimensional image. This method can allow researchers to label and describe the total movement as an object isolated from a reference video. This ap-proach allows us to perform various tasks, including finding similar movements in a video, measuring, and comparing movements, generating new similar movements, and defining chore-ography by controlling specific parameters in the human body skeleton. As a result of the pre-sented approach, we can eliminate the need to label images manually, disregard the problem of finding the beginning and the end of a movement, overcome synchronization issues between movements, and perform any deep learning network-based operation that processes super objects in images in general. As part of this article, we will demonstrate two application use cases: one il-lustrates how to verify and score a requested movement. In contrast, the other illustrates how to generate similar movements in the human skeleton space by addressing the challenge of supply-ing sufficient training data for deep learning applications (DL). A Variational Auto Encoder (VAE) simulator and an EfficientNet-B7 classifier architecture embedded within a Siamese twin neural network are presented in this paper in order to demonstrate two use cases. These use cases demonstrated the versatility of our innovative concept in measuring, categorizing, inferring hu-man behavior, and generating gestures for other researchers.

Background: Blood flow restriction training (BFRT) uses occlusion during low-intensity resistance training (<50% of repetition maximum, 1RM) to reduce arterial blood flow and venous return, imposing greater metabolic stress but similar muscular hypertrophy and strength gains as high-intensity resistance training (HIRT). However, no study, to date, has incorporated BFRT in a collegiate strength and conditioning setting to assess ecological validity. We aimed to investigate the effects of adding 6-weeks of accessory BFRT or HIRT to NCAA Division III soccer players prescribed resistance training regimen on muscle strength and hypertrophy. Methods: Male and female (n=17) athletes were randomly assigned to complete biceps curls 2x/week under BFRT or control (HIRT), following the regularly scheduled strength training. Bicep strength (1RM) and circumference (BC) were assessed at weeks 0, 3, and 6. Results: In men, no significant interaction between time and condition was observed for BC (p=0.861), though condition (BFRT vs Control, p=0.025) and time (p=0.024) were significant. For 1RM, there was no significant interaction between time and condition (BFRT vs HIRT, p=0.067) or of condition (p=0.598), but there was a significant effect of time (p=0.004). In women, there was no significant interaction between time and condition (p=0.765) or of condition (p=0.971) on BC, but time was significant (p=0.045). For 1RM, there was no significant interaction between time and condition (p=0.227) or of condition (p=0.741), but time was (p=0.018). Conclusion: BFRT induced similar increases in muscle strength and hypertrophy as HIRT in soccer players, suggesting that BFRT could be incorporated into collegiate athlete training.

The use of active video games or exergames has been booming recently, as they are motivating and promote exercise and healthy lifestyle habits for their users, and these immersive virtual reality (IVR) exercise programs could be compared to traditional physical exercise programs. A starting point for this would be to explore the physiological responses that can be generated by its use. Therefore, the main objective of this study was to evaluate the response across certain physiological parameters (heart rate, blood pressure and stress) after an IVR exergame exposure in a sample of healthy adults, and secondarily to explore its feasibility and usefulness as a tool to facilitate physical exercise. 37 healthy adults (22-54 years, 54.1% women) participated in the study. They carried out one exergaming session with the HTC Vive ProTM hardware. The primary outcome was evaluated using the concentration of cortisol, heart rate and blood pressure. Secondary outcomes were evaluated with safety using the Simulator Sickness Questionnaire (SSQ); usability evaluated with the System Usability Scale (SUS); personal experiences evaluated with Game Experience Questionnaire (GEQ) and perceived exertion through the Borg perceived effort scale. All participants completed the IVR session without significant adverse effects, and all physiological parameters analysed increased significantly in relation to pre-intervention levels. Perceived exertion corresponded to a moderate to intense exercise (6.30±0.50/10 on the modified Borg scale). All the sample considered the experience as good or very good and would recommend it. These findings support that our IVR session can be compared to a moderate to intense physical activity, as it involved similar perceived exertion with significant increases in heart rate, blood pressure and salivary cortisol levels.

The unique physical demands of soccer necessitate optimal nutrition strategies for enhancing players' performance, recovery, and overall health. However, the effects of nutrition interventions on professional soccer players remain underexplored. This review aims to synthesize the current literature on the impact of nutrition interventions on professional soccer players' performance to inform future research and practical applications. The review will follow the PRISMA guidelines and the Cochrane Handbook of Systematic Reviews. We will employ a four-part search strategy to identify relevant studies, including electronic bibliographic databases, trial registers, the web of clinical trials, and bibliography screening. Inclusion criteria will encompass randomized clinical trials involving professional or semiprofessional soccer players utilizing a nutrition or diet intervention. Quality assessment will be conducted using the Risk of Bias 2 (RoB 2) tool. A narrative synthesis will be provided, detailing the intervention types and their effects on performance. This review will offer a comprehensive understanding of the potential benefits of nutrition interventions for soccer professionals, helping coaches, nutritionists, and players to tailor their approaches for optimal performance and recovery.

Background: Irish dance is growing in popularity, evolving to a more athletic and demanding dance style. Aims: To conduct a systematic review, previously registered with PROSPERO, to identify prevalence, incidence, and injury pattern among Irish dancers and analyse associated risk factors. Methods: Six online databases, plus two dance-specific science publications were searched systematically. Studies were included if the pattern of injuries among Irish dancers were evaluated or the factors associated with injury were analysed, published in English or Portuguese, in peer-reviewed scientific journals. Four reviewers assessed the quality and level of evidence using the Downs and Black criteria and a modified Oxford Centre of Evidence-Based Medicine 2009 model, respectively. Results: Eleven articles were included, 8 level 3c (cross-sectional) and 3 level 3b (prospective). Mean DB percentage score was 63% ± 7,2%. Prevalence ranged from 72,2% to 92,6%, affecting mostly the foot/ankle complex. Only 2 articles reported incidence, which ranged from 3,4–10,6 injuries/1000 hours danced depending on injury definition. Psychological factors, elite level, and insufficient/poor sleep were associated with musculoskeletal injury. Conclusions: Injury prevalence and incidence is high in Irish dancers, with the foot and ankle more affected. Due to heterogeneity in injury definitions, methods, and populations, along with the need for improvement in studies quality, recommendations were made for future research.

Background: More than 270 million participants and 128,893 professional players play soccer. Research only weakly supports the impact of diets and supplements on the performance and recovery of professional soccer players. Methods: We conducted a comprehensive search in Pub-Med, Scopus, Web of Science, and clinical trial registers. Inclusion criteria focused on professional or semi-professional soccer players, nutrition or diet interventions, performance improvement outcomes, and randomized clinical trial study types. We assessed quality using the Risk of Bias 2 (RoB 2) tool. We identified 16 eligible articles involving 310 participants. No nutritional intervention during the recovery period effectively improved recovery. However, several perfor-mance-based interventions showed positive effects, such as tart cherry supplementation, raw pistachio nut kernels, bicarbonate and mineral ingestion, creatine supplementation, betaine consumption, symbiotic supplements, and a high carbohydrate diet. These interventions influenced various aspects of soccer performance, including endurance, speed, agility, strength, power, explosiveness, and anaerobic capacity. Conclusions: Specific strategies, such as solutions with bicarbonate and minerals, high carbohydrate diets, and supplements like creatine, betaine, and tart cherry, can enhance the performance of professional soccer players. These targeted nutritional interventions may help optimize performance and provide the competitive edge required in professional soccer. We did not find any dietary interventions that could enhance recovery during recovery.

The present study aimed to develop a mathematical model to estimate the performance of an indoor rowing event of 6000m through an 500 m all out test in junior athletes. We selected141 subjects from the Brazilian rowing confederation database (15.9 ± 1.0 years), subsequently randomised the sample to the development (~70%) and cross-validation (~30%) groups of the mathematical model. Performance data for 500m and 6000m were collected (there was a 48h washout between one test and anoth-er).Subsequently, the mathematical model: Time(min) 6000m = { [( Time(s) 500-m * 6) * 2] / 60} + 1.3, was developed by arithmetic modeling using machine learning and Regression analysis, being tested by intraclass correlation coefficient (ICC), Concordance correlation coefficient (CCC), Validity (Cb ), preci-sion (ρ) and bland-Altman plotting. The prediction of the result of 6000m through the mathematical model utilizando apenas o desempenho de 500m “all-out” test showed a significant reliability in de-velopment group (r2 = 0.730, ICC = 0.753; CCC = 0.895, Cb = 0.879, ρ: 0.957, pure error: 0.2 secounds (1.0% estimative error)); and in cross-validation group (r2 = 0.710, ICC = 0.747; CCC = 0.888, Cb = 0.875, ρ: 0.903, pure error: 0.3 secounds (1.4% estimative error)). When comparing the estimated re-sults of the 6000m performance by the mathematical model with the real performance of 6000m per-formed in indoor rowing, no statistical differences were observed. In addition, the mathematical model did not present a significant proportion bias in relation to the 6000 m performance in both groups. The mathematical model for predicting 6000m performance through a 500m fast test was significant for national level junior rowing athletes.

Film therapy, the therapeutic use of movies in psychological therapies, is a growing area of interest to therapists and researchers. This paper presents the MOVIE model of film therapy, a widely applicable, trauma-informed framework for working with film imagery and themes in individual or group therapy, counsellor education and self-help. Film or cinema therapy is a highly accessible and relatable method for many diverse client and student groups with benefits that include, catharsis and emotional processing, greater ease of dialogue around issues, increased empathy, and interpersonal learning, engaging with new perspectives and learning skills. Following the model clients mindfully observe and voice their emotional and psychological responses to movie watching, identify how the imagery, characters, themes, and narrative symbolise personal experience and consider any new possibilities that emerged through re-authoring personal narratives. The model is informed by a practice focused review of literature.

During the COVID-19 pandemic, percutaneous tracheostomy proved to be an effective option in the management of patients with prolonged periods of intubation; in fact, among other things, it allowed early discharge from ICUs and contributed to reducing overcrowding in intensive care settings, a central critical point in the COVID pandemic. As a direct consequence, the management and the weaning of frail, tracheostomized and ventilated patients was diverted to sub-intensive or normal hospitalisation wards. One central challenge in this setting is the resumption of swallowing and oral feeding, which needs an interdisciplinary management involving Phoniatrician, ENT, Pneumologist and Speech Therapist. With this article, we aim to share the experience of a Swiss COVID-19 Center[1] and to draw up a narrative review on the issues concerning the management of the tracheostomy cannula during swallowing resumption, integrating the most recent evidence from the literature with the clinical experiences of the professionals directly involved in the management of tracheostomized COVID-19 patients. In view of the heterogeneity of COVID-19 patients, we believe that the procedures described in the article are applicable to a larger population of patients undergoing tracheostomy weaning.

Introduction: The purpose of this study was to determine the normative values of muscles’ contractile properties, lateral symmetry, and the impact of aging on muscle contractility in gymnastics. Materials and Methods: A survey of 81 athletes from different disciplines was undertaken: MAG (n = 26), WAG (n = 28), and RG (n = 27). The athletes’ average age was 15.41 ± 5.03 years. We try to establish the normative values for contraction time (muscle pairs) in gymnastics for Slovenian athletes for ten skeletal muscles. Results: Athletes’ age affects contractility in a negative way. Differences between the duration of contractility and age were found in all disciplines: m. BF (r = 0.48, p < 0.001), m. TB (r = 0.37, p < 0.013), m. ES (r = 0.17, p < 0.025), m. VL (r = 0.36, p < 0.00) and m. VM (r = 0.40, p < 0.000) at a statistical significance of p < 0.05. Conclusions: A comparison between the left and right sides shows little asymmetry in WAG and that the occurrence of injuries is in the middle range. In RG we see a bigger deviation, which could trigger the emergence of pain or injury in m. BF (13%) and m. GL (14.5%), but in MAG the deviation is greater in m. BB (12%), m. BF (11%) and m. GM (13%).

Overweight and obesity, including its prevalence and consequences reflect a leading public health problem. Studies have already shown that physical activity leads to a reduction in body weight in children and adults. However, the university setting has rarely been investigated. The aim of this review is therefore to examine and summarize the effectiveness of physical-activity-based interventions to reduce obesity and overweight in university students. Three databases (PubMed, Scopus &amp; Web of Science) were searched for relevant studies published in English between January 2010 and February 2022. Quantitative studies, conducting a physical-activity-based intervention with overweight or obese university students and reporting changes in BMI, were included. Data were described in a narrative synthesis. Eleven of 16 included studies reported a significant reduction in BMI. However, all studies except one were able to demonstrate some BMI improvements, whereas all studies reported significant changes in at least one health-related indicator. Aerobic exercises were able to demonstrate the greatest reductions in BMI. This review is the first systematic presentation on the effectiveness of physical-activity-based interventions on overweight and obese university students. Future work should reconsider BMI as the primary outcome because it is prone to bias. More interventions are needed to improve strategies.

Important current limitations of the implementation of Evidence-Based Practice (EBP) in the rehabilitation field are related to the validation process of new technologies and interventions. Indeed, most of the strict guidelines that have been developed for the validation of new drugs (i.e., double or triple blinded, strict control of the doses and intensity) cannot – or only partially – be applied in rehabilitation. Well powered high quality randomized controlled trials are more difficult to organize in rehabilitation (e.g., longer duration of the intervention in rehabilitation, more difficult to standardize the intervention compared to drugs’ validation studies, limited funding’s since not sponsorized by big pharma companies), which reduces the possibility of conducting systematic reviews and meta-analyses, as currently high level of evidence is sparse. The current limitations of EBP in rehabilitation are presented in this paper and innovative solutions are suggested such as: technology-supported rehabilitation systems, continuous assessment, pragmatic trials, rehabilitation treatment specification systems, and advanced statistical methods, to tackle the limitations to increase the quality of the research in rehabilitation. The development and implementation of new technologies should increase the quality of research and the level of evidence supporting rehabilitation provided some adaptation in our research methodology.

Patients often need the use of their arms to assist with functional activities, but after bone disruption, pushing is frequently limited to less than 4.5 kg. No method exists to measure arm weight bearing objectively in clinical settings. This project aimed to design, construct, and test a walker for patients who need to limit arm force to prevent excessive bone stress during post-fracture (iatrogenic or traumatic) ossification. First, a qualitative study was conducted to obtain critiques of a Clinical Force Measuring (CFM) walker prototype from rehabilitation professionals. Key statements and phrases were coded that allowed “themes” to emerge from transcribed interviews, which guided device revisions. Next, a second CFM Walker prototype was designed based on the qualitative data and device criteria/constraints and finally tested. The result was fabrication of a new lightweight, streamlined, and cost-effective prototype walker with a simple visual display and auditory cue with upper limit alarms. Key features included attachments for medical equipment and thin film force-sensing resistors integrated into the walker handles that progressively activated 3 LEDs and a buzzer when arm force exceeded programmed thresholds. The innovative CFM Walker will help patients with restricted arm weight bearing, especially elderly adults, recover safer and faster in the future.

Patients recovering from bone disruption due to trauma or surgery need to limit movement to minimize shear force, thereby protecting callus formation and osteogenesis. Patients often use their arms to assist with functional activities, but pushing is frequently limited to <10 lb (4.5 kg). With only verbal instructions, patients’ ability to accurately limit weight-bearing (WB) force is poor. A therapeutic intervention to improve patient adherence with upper extremity (UE) WB guidelines during functional mobility using an instrumented walker could be beneficial. Therefore, the purpose of this article is to describe a feedback training protocol to improve the ability to modulate weight-bearing force in older adults and then provide an overview of the efficacy of this protocol and subsequent development of a Clinical Force Measuring Walker. An instrumented walker was used to measure UE WB during functional mobility in older healthy subjects (n = 30) before, during, and after (immediately and 2 hours) a visual and auditory concurrent feedback training session. During feedback training, force was significantly reduced with all 3 sessions as compared to baseline. When using the front wheeled walker, UE WB force during the second and third feedback training trials went down compared to the first trial. During the third feedback training trial, force was greater than the two previous trials while transferring sit-to-stand and stand-to-sit. After completion of practice with feedback, UE WB force was significantly reduced and remained so 2 hours later. These findings suggest that feedback training is effective for helping patients to modulate UE WB. Use of an instrumented walker and feedback training would be beneficial in clinical practice, especially with older patients. A more intensive feedback training with additional trials and or simultaneous visual and auditory cues during whole-practice may be needed to get UE WB below a 10 lb threshold.

Obtaining a good socket fit is an iterative process dependent on the skill and experience of the prosthetist creating it, and requiring individualisation based on the size and shape. There is no standard measurement system used to aid prosthetic socket creation, despite the severe impacts on physical health and quality of life if one is ill-fitting. Pressure sensors embedded in a prosthetic socket were used to collect data at the socket-residuum interface. To choose an interpolation method, a 2D grid was used, with previously collected walking test pressure data, to simplify the sensor array with a border for extrapolation. Four multivariable interpolation methods were evaluated to create a colour map of the pressure data. Radial Basis Function interpolation was chosen as it produced a clear image with a graduated interpolation between data points and was used to create a colour map across the surface of a 3D prosthetic socket model. For the model to be accessible to clinical audiences, a desktop application was created using PyQt to view the model. The created application allowed for connection to the sensors via Bluetooth, with the pressure data updating the colour map on the 3D model in real-time. The created application shows the potential for a clinical product, however further development informed by feedback from rehabilitation clinicians and prosthesis users is required

Micro-blade design is an important factor in the cutting of single cells and other biological structures. This paper describes the fabrication process of three dimensional (3D) micro-blades for the cutting of single cells in a microfluidic “guillotine” intended for fundamental wound repair and regeneration studies. Our microfluidic guillotine consists of a fixed 3D micro-blade centered in a microchannel to bisect cells flowing through. We show that the Nanoscribe two-photon polymerization direct laser writing system is capable of fabricating complex 3D micro-blade geometries. However, structures made of the Nanoscribe IP-S resin have low adhesion to silicon, and they tend to peel off from the substrate after at most two times of replica molding in poly(dimethylsiloxane) (PDMS). Our work demonstrates that the use of a secondary mold replicates Nanoscribe printed features faithfully for at least 10 iterations. Finally, we show that complex micro-blade features can generate different degrees of cell wounding and cell survival rates compared with simple blades possessing a vertical cutting edge fabricated with conventional 2.5D photolithography. Our work lays the foundation for future applications in single cell analyses, wound repair and regeneration studies, as well as investigations of the physics of cutting and the interaction between the micro-blade and biological structures.

What do you want to do ?New mailCopyBackground: to analyze the changes that a therapeutic physical exercise program is capable of causing in the functionality of patients suffering from ALS and in addition, to analyze the respiratory capacity. Methods: a systematic review of the PubMed, SCOPUS, Cochrane, SciELO, PEDro, CINAHL and MEDline databases is carried out. The information was filtered using the following MeSH terms: "Amyotrophic lateral sclerosis", "Physical Therapy", "Physical and Rehabilitation Medicine". Clinical trials published in the last 5 years were included in which one of the interventions was therapeutic physical exercise in patients with ALS, which included the ALSFRS-R as a result variable. Results: 10 clinical trials with a total of 421 patients were analyzed, of which 183 underwent rehabilitation with physical exercise and were part of the case group; the rest belong to the control group and their treatment was mostly passive. The observed trend is of a decrease of approximately 6 points in the ALSFRS-R scale at 6 months in the case groups; however, no behavior pattern was met in the controls. Conclusions: Therapeutic physical exercise could contribute to slow down the deterioration of the musculature of people with ALS, thus facilitating the performance of their daily activities.

Law enforcement is an intermittently physically demanding job, interspersed with long periods of sedentary activity. To prepare for the physical demands of the job, law enforcement agencies enlist recruits into academies with a focus on physical training. Often academies focus on aerobic based exercise despite anaerobic fitness being strongly correlated to occupational tasks. The objective of this article is to analyse the changes in fitness of police recruits during academy training. Initial and final fitness test results, encompassing muscular power, strength, endurance as well as aerobic and anaerobic fitness, were measured to analyse changes in fitness. Dependent t-tests showed significant increases (p &lt; 0.05) across all fitness tests, with a trend towards larger increases in aerobic and muscle endurance-based tests. Recruits from this academy tended to have higher fitness results compared to other academies and were either average or below average compared to age matched standards in the general populations. Physical training should persist for recruits beyond the academy to continue develop fitness throughout their career. Academies should add a focus on muscular strength and power training as these measures relate to occupational tasks, which may better prepare recruits for demands they will be expected to face in the field.

Objectives Independent validation of risk scores after hip fracture is uncommon, particularly for evaluation of outcomes other than death. We aimed to assess the Nottingham Hip Fracture Score (NHFS) for prediction of mortality, physical function, length of stay and postoperative complications. Design Analysis of routinely collected prospective data partly collected by follow-up interviews. Setting and Participants Consecutive hip fracture patients were identified from the Northumbria hip fracture database between 2014-2018. Patients were excluded if they were not surgically managed or if scores for predictive variables were missing. Methods C-statistics were calculated to test the discriminant ability of the NHFS, Abbreviated Mental Test Score (AMTS), and ASA grade for in-hospital, 30- and 120-day mortality, functional independence at discharge, 30-days and 120-days, length of stay, and postoperative complications. Results We analysed data from 3208 individuals, mean age 82.6 (SD 8.6). 2192 (70.9%) were female. 194 (6.3%) died during the first 30-days, 1686 (54.5%) were discharged to their own home, 211 (6.8%) had no mobility at 120-days, 141 (4.6%) experienced a postoperative complication. The median length of stay was 18 days (IQR 8-28). For mortality, c-statistics for the NHFS ranged from 0.68-0.69, similar to ASA and AMTS. For postoperative mobility, the c-statistics for the NHFS ranged from 0.74-0.83, similar to AMTS (0.61-0.82) and better than the ASA grade (0.68-0.71). Length of stay was significantly correlated with each score (p<0.001 by Jonckheere-Terpstra test); NHFS and AMTS showed inverted U-shaped relationships with length of stay. For postoperative complications, c-statistics for NHFS (0.54-0.59) were similar to ASA grade (0.53-0.61) and AMTS (0.50-0.58). Conclusions and Implications The NHFS performed consistently well in predicting functional outcomes, moderately in predicting mortality, but less well in predicting length of stay and complications. There remains room for improvement by adding further predictors such as measures of physical performance in future analyses.

This article presents a methodology for the design of rehabilitation devices that considers factors involved in a clinical environment. This methodology integrates different disciplines that work together. The methodology is composed by 3 phases and 13 stages with specific tasks, the first phase includes the clinical context considering the requirements of the patient and therapist during the rehabilitation, the second phase is focused in engineering based on the philosophy of digital twin, and in the third phase is evaluated the device. This article explains the characteristics of the methodology and how it was applied in the design of an exoskeleton for passive rehabilitation of the upper limb.

Aim: To develop an index for quantitative assessment of the upper limb motor function in children with cerebral palsy before and after robot-assisted therapy. Method: An upper limb motor function index was developed using kinematic, surface electromyography and three-axis inertial measurements unit data collected from 15 children with cerebral palsy (CP) and 15 typically developed children. Children with CP underwent 18 robot-assisted therapy sessions with the REAplan device. All children were evaluated, using kinematic data from the REAplan, electromyography and three-axis inertial measurements unit readings from its accelerometer. A principal component analysis was conducted to produce an evaluation index, which is able to detect the deviation from the upper limb motor function of typically developing children group. Children with CP were evaluated twice before and after the intervention with Box and Blocks test and Finger-To-Nose test. The discriminative and concurrent validity of the upper limb motor function index were investigated. Results: The upper limb motor function index was higher in children with CP post therapy (p<0.001). Finger-To-Nose test values improved after robot-assisted therapy (p<0.03). A weak but positive correlation was observed between upper limb motor function index and clinical tests (r=0.012, p=0.95 and r=0.13, p= 0.54 for Box and Blocks test and Finger-To-Nose test respectively). Interpretation: The upper limb motor function index successfully differentiated between the typically developing children and children with CP and was effective in assessing the improvement of the upper limb motor function after robot-assisted therapy. The upper limb motor function index could be extended to assess and monitor rehabilitation therapies of other populations, such as those with stroke and Parkinson’s disease.

Low back pain (LBP) is a pandemic and costly musculoskeletal condition in the United States. Patients with LBP may endure surgery, injections, and expensive visits to emergency departments. Some suggest that using physical therapy or chiropractic in the earlier stage of LBP reduces the utilization of expensive health services and lowers the treatment costs. Nevertheless, there is no consistent evidence to declare which one of these methods is a cost-effective treatment within a short (less than a year) period of time. The purpose of this study was to investigate the cost-effectiveness of chiropractic versus physical therapy in the United States. A decision tree analytic model was used for estimating the economic outcomes. The findings showed that in the chiropractic group, the total average cost was $48.56 lower than the physical therapy group, and daily adjusted life years (DALY) was 0.0043 higher than the physical therapy group. Chiropractic care was shown to be a cost-effective alternative compared with physical therapy for adults with at least three weeks of low back pain over six months.

(1) Background: Previous systematic review suggested a beneficial effect of progressive muscle relaxation (PMR) for cancer patients receiving chemotherapy. However, poor quality of eligible studies impaired the reliability and validity of findings. Moreover, additional potential studies with good quality published in Chinese language have been published recently. The aim of the present systematic review was to investigate the value of PMR training in preventing and alleviating nausea and vomiting caused by chemotherapy among cancer patients. (2) Methods: We assigned two independent investigators to search all potential studies in PubMed, Cochrane Controlled Register of Trial (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), China Biomedical Literature database (CBM), China National Knowledge Infrastructure (CNKI), and Wanfang data. We used data extraction sheet extracted all essential information, and used the Cochrane risk of bias assessment tool to appraise the quality of eligible studies. Finally, we qualitatively summarized the results of all included studies. (3) Results: Six studies enrolling 288 patients were considered to meet our selection criteria finally. Of these 6 studies, three were labeled as moderate quality, and the remaining studies were low quality. All included studies consistently suggested that PMR has a positive impact on nausea and vomiting caused by chemotherapy among cancer patients especially alleviating the incidence, frequency and degree of delayed nausea and vomiting. (4) Conclusions: Independent studies indicated that PMR was a beneficial approach to prevent and alleviate nausea and vomiting caused by chemotherapy among cancer patients. However, further studies considering other types of primary tumors should be designed in order to increase the generality of PMR because studies included in the present systematic review mainly enrolled lung cancer and breast cancer.

Background: This study investigated the prevalence of worsening problems using Post Stroke Checklist (PSC) at 3, 6, and 12 months post-stroke and their associations with health-related quality of life. Methods: In stroke patients admitted between June 2014 and December 2015, PSC and EuroQol-5Dthree level (EQ-5D-3L) were assessed at post-stroke 3 (n=181), 6 (n=175), and 12months (n=89). The prevalence of worsening problems and its association withEQ-5D-3L at post-stroke 3 and 6months were analyzed. Results: An average of 0.59 (range 0–12), 1.47 (range 0–12), and 1.00 (range 0–10) worsening problems per patient was identified at 3, 6, and 12months after stroke, respectively. The most frequently and continuously identified worsening problems were mood disturbances (reported by 8.8%, 16.0% and13.5% of patients at 3, 6, and 12 months post-stroke, respectively). Worsening mobility was significantly associated with worse EQ-5D index at post-stroke 3 months (β,-0.583; 95% CI, -1.045 to -0.120). The worsening of mobility and communication was significantly associated with worse EQ-5D index at post-stroke 6 months (mobility: β,-0.170; 95% CI, -0.305 to -0.034, communication: β,-0.164; 95% CI, -0.309 to -0.020). Conclusions: PSC may be useful for the detection of various subjective worsening problems during serial clinical follow-up after stroke. Appropriate rehabilitation and management strategy to solve the identified problems could improve the quality of life in stroke survivors.

Aims: A community-based multi-component intervention (increasing awareness of the importance of physical activity in chronic illness management through reading comic books, training regarding warm-up stretching exercises, identifying facilitators and barriers to exercise through photosharing, supporting self-reflection and development of action plans) was developed to promote physical activity (PA) among patients with diabetes and hypertension. This study aimed to evaluate the efficacy of this intervention on health behaviour (walking) and health outcomes. Design: A non-randomized controlled trial with waitlisted control and pre- and post-measures. Setting: Community centres for the elderly. Participants: A total of 204 older adults with diabetes and/or hypertension were recruited. They were assigned to either the intervention group (IG) or waitlisted to the control group (CG). Intervention: Under the supervision of a nurse, six weekly group meetings were arranged in community centres for the elderly in which the participants freely exchanged their views regarding the barriers and facilitators of regular physical activity. Participants were encouraged to take photos in their neighbourhood or at home and brought these photos to share at the group meetings. The photos showed both the barriers and the facilitators to PA. In the last meeting, each participant worked out a plan to perform PA in the coming four weeks. Measures: PA referred to the number of steps taken per day and it was measured by a Garmin Accelerometer at baseline, Week 6 and Week 10. Other measures included the nine-item Self-Efficacy Scale for Exercise - Chinese version (SEE-C), the 23-item Chinese Barriers to Exercise Scale and Senior Fitness Tests. Generalised Estimating Equations (GEE) models compared the outcomes over time between IG and CG. Results: A statistically significant difference in the changes in the average number of steps taken daily between the two groups at Week 10 (mean difference = 965.4; 95% confidence interval: 92.2, 1838.6, p = 0.030) was observed, although the difference at Week 6 was non-significant (mean difference = 777.6; 95% confidence interval: −35.3, 1590.5, p = 0.061). IG participants also showed significant improvements in lower body strength (mean difference = 0.967; 95% confidence interval: 0.029, 1.904, p = 0.043) and lower limb flexibility (mean difference = 2.068; 95% confidence interval: 0.404, 3.731, p = 0.015) at Week 10 compared to CG participants. Conclusion: This multi-component intervention improved the participants’ physical activity level and physical fitness, particularly in lower limb flexibility and body strength.

Objective: To map the literature pertaining to adult Person-Centered Rehabilitation (PCR).Data Sources: Following our previously published scoping review protocol, data were identified through: three major databases, snowball searches and expert consultation.Study Selection: Two independent reviewers identified English-language papers which addressed adult physical rehabilitation and met one or more of the six pre-defined inclusion categories for PCR content. Data Extraction: Two independent reviewers extracted key characteristics of included papers (e.g. aims, methods, participants). Quantitative methods (descriptive statistics, regression analysis) and qualitative content analyses were used to synthesize the results. Data synthesis: Of 5084 unique records initially screened, 145 papers were included: 111 empirical, including 11 systematic reviews. Empirical papers had data from 13498 clients and 3849 providers, in total. Yearly publications grew exponentially from 2000 to 2017 (r²= 0.65; p<0.01). Publications were unevenly distributed by countries (e.g. United States’ publications per population size was 45 times lower than New Zealand’s). Most papers focused in more than one profession, setting-type or health conditions, respectively 57.2%, 66.2%, and 60.7%. Finally, more than half of the empirical papers (53.2%) studied implementation of PCR approaches, including its effect. Conclusion: This scoping review synthesizes key characteristics and publication trends in the PCR literature, which is mainly empirical and growing exponentially over time. Stakeholders can use the identified trends, gaps, and literature map to guide further PCR research, and both clinical and organizational practices. The high prevalence of papers focused on multiple professions, settings-type, or health conditions reinforces the need for developing a transdisciplinary, trans-service model of PCR, which will be derived from a thematic analysis of this body of literature.

Background: To inform global health policies and resources planning, this paper analyzes evolving trends in physical rehabilitation needs, using data on Years Lived with Disability (YLDs) from the Global Burden of Disease Study (GBD) 2017. Methods: Secondary analysis of how YLDs from conditions amenable to physical rehabilitation have evolved from 1990 to 2017, for the world and across countries of varying income levels. Linear regression analyses were used. Results: A 66.2% growth was found in estimated YLD Counts amenable to physical rehabilitation: a significant and linear growth of more than 5.1 billion YLDs per year (99%CI: 4.8–5.4; r² = 0.99). Low-income countries more than doubled (111.5% growth) their YLD Counts amenable to physical rehabilitation since 1990. YLD Rates per 100,000 people and the percentage of YLDs amenable to physical rehabilitation also grew significantly over time, across locations (all p > 0.05). Finally, only in high-income countries Age-standardized YLD Rates significantly decreased (p < 0.01; r² = 0.86). Conclusions: Physical rehabilitation needs have been growing significantly in absolute, per-capita and in percentage of total YLDs, globally and across countries of varying income level. In absolute terms, growths were higher in lower income countries, wherein rehabilitation is under-resourced.

Purposely slow velocity resistance exercise (i.e., 10 s concentric and eccentric phases) is a popular training method, but limits the loads that can be lifted (e.g., <50% 1 RM). This study compared the biomechanical properties of purposely slow velocity (SLOW) and traditional resistance exercise (TRAD) that uses maximal lifting velocities. Healthy resistance-trained men (n=5) performed two testing sessions (barbell squat and bench press) in random-order; a SLOW session (1 set x 10 repetitions at 28% 1 RM, 10 s concentric & eccentric), and a TRAD session (3 x 10 at 70% 1 RM, controlled eccentric and maximal concentric). A force plate and linear position transducer were used to collect kinetic and kinematic data for every repetition of both protocols (α = 0.05). For both exercises, both concentric and eccentric mean force (N) and power (W) for each repetition was greater for TRAD. When the entire training session (squat + bench press) was examined, SLOW exhibited greater time under tension, while TRAD produced greater work (J) and impulse (N·s). Contrary to suggestions in both the lay and scientific literature, purposely slow resistance exercise produced less force, power, and work than traditional velocity resistance exercise.

Purpose: This paper extends previous works to include the role of therapeutic gardens in the healing environment as an intervention for bettering the clinical outcomes of Alzheimer’s and dementia patients, the positive impact of healing gardens and the innovative application of technologies with nature, for promoting cognitive rehabilitation in this particular patient population.Methods: Using ISI Web of Science, PubMed, ProQuest Central, MEDLIN, Scopus and Google Scholar, a relevant literature search on the positive health implications of therapeutic gardens on Alzheimer’s and dementia patients’ in the healthcare milieu was conducted.Results: Health implication of therapeutic gardens on Alzheimer’s and dementia patients’ spans across physical, social, psychological and cognitive effects. Virtual reality (VR) technologies offer positive cognitive outcomes to Alzheimer's disease (AD) and dementia patients.Conclusion: Therapeutic gardens should be extended for speedier recovery of other patient populations. Future directions in the design of healthcare gardens with a focus on patient experience are inferred.

Abstract: This study evaluates the effect of paravertebral spinal injection (PSI), utilizing both subjective and objective assessments in chronic low back pain (LBP) associated with facet joint arthrosis over a one-month duration. Subjective questionnaires included the Visual Analogue Scale (VAS) for pain, Oswestry Disability Index, Health Survey SF-12, and the short Falls Efficacy Scale International (FES-I). Objective assessments included in-clinic gait and timed-up-and-go (TUG) tests using wearable sensors, as well as 48-hour daily physical activity (DPA) monitored using a chest-worn tri-axial accelerometer. Subjective and objective measures were performed prior to treatment, immediately after the treatment, and one-month afterthe treatment. Eight LBP patients were recruited for this study (mean age = 54±13 years, body mass index = 31.41±6.52 kg/m2, 50% males). Results show significant decrease in pain (~55%, p<0.05) and disability (Oswestry scores, ~21%, p<0.05). In-clinic gait and TUG were also significantly improved (~16% and ~18% faster walking and shorter TUG, p<0.05); however, DPA (including percentage of physical activities (walking and standing) and the number of steps) showed no significant change after PSI (p>0.25; effect size≤0.44). We hypothesize that DPA may continue to be truncated by conditioned fear-avoidance, a psychological state that may prevent increase in daily physical activity to avoid pain.

A high-level control algorithm capable of generating position and torque references from surface electromyography signals (sEMG) has been designed. It is applied to a shape memory alloy (SMA) actuated exoskeleton used in active rehabilitation therapies for elbow joints. The sEMG signals are filtered and normalized according data collected online during the first seconds of~therapy sessions. The control algorithm uses the sEMG signals to promote active participation of patients during the therapy session. In order to generate the position reference pattern with good precision, the sEMG normalized signal is compared with a pressure sensor signal to detect the intention of each movement. The algorithm has been tested in simulations and with healthy people for control of an elbow exoskeleton in flexion–extension movements. The results indicate that sEMG signals from elbow muscles in combination with pressure sensors that measure arm–exoskeleton interaction can be used as inputs for the control algorithm, which adapts the reference for exoskeleton movements according a patient's intention.

Background: Access to rehabilitation is crucial for the realization of the right to health and a proper concern of global health. Yet, reliable information to guide rehabilitation service planning is unavailable in many countries in part due to the lack of appropriate indicators. To ensure universal health coverage and meet the central imperative of “leaving no one behind” countries must be able to assess key aspects of rehabilitation policy and provision and monitor how they have discharged their human rights responsibilities towards those most disadvantaged, including people with disability. This article describes the process of developing an expert guided indicator framework to assess governments’ efforts and progress in strengthening rehabilitation in line with the Convention on the Rights of Persons with Disabilities. Methods: A systems methodology - concept mapping - was used to capture, aggregate and confirm the knowledge of diverse stakeholders on measures thought to be useful for monitoring the implementation of the Convention with respect to health related rehabilitation. 56 individuals generated a list of 107 indicators through online brainstorming which were subsequently sorted by 37 experts from the original panel into non overlapping categories. 41 participants rated the indicators for importance and feasibility. Multivariate statistical techniques where used to explore patterns and themes in the data and create the indicators’ organizing framework which was verified and interpreted by participants. Results: A concept map of 11 clusters of indicators emerged from the analysis grouped into three broader themes: Governance and Leadership (3 clusters); Service Delivery, Financing and Oversight (6 clusters); and Human Resources (2 clusters). The RESYST was comprehensive and well aligned with the Convention. On average, there was a moderately positive correlation between importance and feasibility of the indicators (r=.58) with experts prioritizing the indicators contained in the clusters of the Governance and Leadership domain. Two of the most important indicators arose from the Service Delivery, Financing and Oversight domain and reflect the need to monitor unmet needs and barriers in access to rehabilitation. In total, 59 indicators achieved above average score for importance and comprised the two–tiered priority set of indicators. Conclusion: Concept mapping was successful in generating a shared model that enables a system’s view of the most critical legal, policy and programmatic factors that must be addressed when assessing country efforts to reform, upscale and improve rehabilitation services. The RESYST provides a data driven basis for the development of standardized data collection tools to facilitate comparative analysis of rehabilitation systems.

The importance of vertical jump in sport fields and rehabilitation is widely recognized. Furthermore, Force-Time variables of vertical jump are factors affecting jumping height. Exclusive review of each of this variables, in eccentric and concentric phases, can lead to a specific focus on them during jumping exercises. So, the aims of his study were to a) reviewing the relationship between force-time curve variables of eccentric and concentric phases with jump height and b) description of this variables in Iran national youth volleyball players society. This is an observational study. 12 elite volleyball player (Male, Iran national youth volleyball players, 17±0.7 years) have participated in this study. Correlation between Force-Time variables - included peak force (PF), relative peak force (RPP), peak power (PP), average power (AP), relative peak power (RPP), and Modified Reactive Strength Index (MRSI) - in eccentric and concentric phases and ultimate jump height has been studied. Results showed that the average power (r=0.7) and relative peak force (r=0.75) of concentric phase and MRSI (r=0.83) have significant correlation with ultimate jump height (JH). Relative peak power and average power of concentric phase can massively effect Jump Height in sports like volleyball, which vertical jump is an integral part of them. Focus on both of these factors, which has been studied in this research, in training programs, can improve athlete jump performance significantly.