Acute intense exercise causes significant oxidative stress and consequently an increase in total antioxidant capacity; however, the mechanisms and combined effects of intense exercise and smoking on oxidative stress among active and non-active smokers are not clear. The aim of this study was to investigate the effect of acute intense exercise on antioxidant enzyme activity responses in active and non-active individuals exposed to cigarette smoke. The study included 40 subjects who were equally classified as: smokers that did exercise (SE), smokers that did not do exercise (SnE), non-smokers that did exercise (NSE), and non-smokers that did not do exercise (NSnE). The adjusted Astrand test was used to exhaust the subjects. Salivary enzymes of peroxidase (POX), catalase (CAT), and superoxide dismutase (SOD) were measured, by spectrophotometry methods, at 3 different time points: pre-test (TP1), post-test (TP2), and one hour after finishing the test (TP3). Significant (p<0.05) group x time interactions were found for the three enzymes. Salivary POX, CAT and SOD increased in all groups from TP1 to TP2 and decreased from TP2 to TP3. Only the NSE showed a significant difference between TP1 to TP3 in POX and SOD by +0.011 ± 0.007 and +0.075 ± 0.02 (U/ml), respectively. The NSE showed significantly higher levels of POX, CAT and SOD in TP2 compared to the other groups. Furthermore, NSE and NSnE had higher levels of POX, CAT and SOD in TP1 and TP3 (p<0.05) compared with SE and SnE. Only in the NSnE, were no differences observed in CAT compared with SE and SnE in TP3. These results showed that the antioxidant level at rest and in the recovery time after the acute intense exercise was lower in SE and SnE compared with NSE and NSnE, suggesting that smoking habit may reduce the ameliorating effect of regular physical activity on acute exercise-induced oxidative stress.

The aim of this study was to determine whether a rowing training program improved the quantity and quality of physical activity and quality of life in female breast cancer survivors (stage I - 4.35%; II - 30.43%; III - 52.17%; and IV - 8.7%) diagnosed 6.57 ± 5.02 years previously, who had undergone a subsequent intervention (preservation 53.52%; total mastectomy 39.13% and double mastectomy 4.35%) and had a current mean age of 53.70 ± 7.88 years. The participants (N = 30) engaged in a 12-week training program, each week comprising three sessions and each session lasting 60-90 minutes. An anthropometric evaluation was performed before and after the program. The short form of the International Physical Activity Questionnaire (IPAQ-SF) and the Short Form 36 Health Survey (SF-36) were also administered. The results showed statistically significant improvements in levels of physical activity and in the dimensions of quality of life. We can conclude that a 12-week rowing training program tailored to women who have had breast cancer increases physical activity levels, leading to improved health status and quality of life.

Back pain is a common symptom that affects all age groups across the globe, when left untreated may eventually lead to disability. A convenient sample selection method was used in this study due to the global Covid-19 pandemic lockdown which was effective in Turkey during the investigation period. Thus, virtual data collection and health education including some health risks were employed. A total population of two hundred adult women was involved in the study but one hundred and twenty-one responses were collected. Findings show that, for socio-demographic characteristics, the pain was found highest in women between the ages of 41-50 and obese/overweight individuals. Although, there was no significant difference recorded in the marital status category. Moreover, statistical mean differences were detected between the scales for ODI (4.18) and BPFS (6.09). Also, p<0.05, paired sample t-test was 0.001 ODI and 0.001 BPFS after the training exercise. This suggests that exercise training is inversely correlated with pain severity which implies that training has a significant influence on pain intensity. Thus, it could be concluded that there is a relationship between the training exercise and ODI/BPFS.

(1) Background: Although manual therapy for pain relief has been used as an adjunct in treatments for chronic low back pain (CLBP), there is still the belief that a single session of myofascial release would be effective. This study aimed to investigate whether a single session of a specific technique reduces pain and disability. (2) Methods: This was a crossover clinical trial in which 41 participants over 18 years old with CLBP were randomly enrolled into 3 situations - experimental, placebo, control, in a balanced and cross-over manner. The subjects underwent a single session of myofascial release on thoracolumbar fascia and compare it with the control and placebo. Outcome were pain and functionality, evaluated using the numerical pain rating scale (NPRS), pressure pain threshold (PPT) and Oswestry (ODI). (3) Results: There was no effects between-, within-tests, and interaction for all the outcomes, i.e., NPRS (η 2 = 0.32, F = 0.48, p = 0.61), PPT (η2 = 0.73, F = 2.80, p = 0.06), ODI (η 2 = 0.02, F = 0.02, p = 0.97). (4) Conclusion: A single trial of thoracolumbar myofascial release technique was not enough to reduce pain and disability in subjects with CLBP.

Mandibular critical size defect (CSD) due to pathological conditions, trauma, and congenital disease can not heal spontaneously and predominantly filled with fibrous tissue. Therefore, a Guided Bone Regeneration (GBR) combined with bone grafting can be performed. The researchers considered using Demineralized Dentin Material Membrane (DDMM) from bovine dentine as an alternative GBR. This study aimed to determine the amount of fibroblast and collagen density after DDMM and bone graft implantation on CSD. Thirty-six Rattus norvegicus rats were used as samples. Mandibular bone defect 5x5 mm was made, then filled with bone graft and covered with Bovine Pericardium Collagen Membrane (BPCM) in the control group and DDMM in the treatment group. Six samples were sacrificed on 7, 14, and 21 days post-surgical for histology examination. There were no significant differences in the amount of fibroblast and collagen density (p-value > 0,05). The amount of fibroblast is lower and the collagen density is higher in treatment group. DDMM has microporosity to prevent connective tissue ingrowth and dentine tubules to allow growth factors release. DDMM and bone graft implantation can reduce the amount of fibroblasts and increase collagen density of CSD which potentially being used as a CSD alternative treatment for bone regeneration.

Knee Osteoarthritis (KOA) is a chronic disease characterized by progressive disability and joint pain. Meniscus chondrocytes apoptosis is the main cause of reduced chondrocyte number and self-repair function. The purpose of this study was to investigate the role of miR-27b-3p in KOA.In this study, we found that the expression of miR-27b-3p was downregulated in cultured IL-1β treated chondrocyte and cartilage tissues in KOA. KOA overexpression evidently reduced IL-1β induced chondrocyte apoptosis and caspase-3 and caspase-9 expression.The upregulated iNOS and COX-2 mRNA and proteins expression was also inhibited by miR-27b-3p mimics. The expression of nitric oxide, PGE2, TNF-α and IL-6 was also inhibited by miR-27b-3p mimics. The target gene of miR-27b-3p was confirmed to be BDNF. TrkB/CREB pathway was proved to be the downstream pathway of miR-27b-3p/BDNF axis.The apoptotic cell percentage and nitric oxide, PGE2, TNF-α and IL-6 expression was induced by BDNF+IL-1β. This induction was inhibited by miR-27b-3p mimics. The cartilage tissues stained with safranin O results showed miR-27b-3p greatly decreased KOA induced cartilage degradation. The expression of BDNF、TrkB and p-CREB was inhibited by len-miR-27b-3p. MiR-27b-3p also reduced the expression of TNF-α、IL-6 and Bax, and increased Bcl-2 expression. These results indicated miR-27b-3p could applied to inhibit the development of KOA and miR-27b-3p/BDNF/TrkB/CREB pathway could serve as novel treatment target to handle KOA.

Tissue engineering and regenerative medicine has gradually evolved as a promising therapeutic strategy to the modern healthcare of the aging and diseased population. In this study, we developed a novel nano-fibrous scaffold and verified its application in the critical bone defect regeneration. The metformin-incorporated nano-gelatin/hydroxyapatite fibers (NGF) was produced by electrospinning, cross-linked, and then characterized by XRD and FTIR. Cytotoxicity, cells adhesion, cell differentiation, and quantitative osteogenic gene and protein expression were analyzed by bone marrow stem cells from rat. Rat forearm critical bone defect model was performed for the in vivo study. The nano-gelatin/hydroxyapatite fibers (NGF) were characterized by their porous structures with proper interconnectivity without significant cytotoxic effects; the adhesion of bone marrow stem cells on the nano-gelatin/hydroxyapatite fibers (NGF) could be enhanced. The osteogenic gene and protein expression were upregulated. Post implantation, the new regenerated bone in bone defect was well demonstrated in the NGF samples. We demonstrated that the metformin-incorporated nano-gelatin-hydroxyapatite fibers greatly improved healing potential on the critical sized bone defect. Although metformin-incorporated nano-gelatin/hydroxyapatite fibers had advantageous effectiveness during bone regeneration, further validation is required before it can be applied to clinical applications.

The aim of this study was to determine whether a rowing training program improved the quantity and quality of physical activity and quality of life in female breast cancer survivors (stage I - 4.35%; II - 30.43%; III - 52.17%; and IV - 8.7%) diagnosed 6.57 ± 5.02 years previously, who had undergone a subsequent intervention (preservation 53.52%; total mastectomy 39.13% and double mastectomy 4.35%) and had a current mean age of 53.70 ± 7.88 years. The participants (N = 30) engaged in a 12-week training program, each week comprising three sessions and each session lasting 60-90 minutes. An anthropometric evaluation was performed before and after the program. The short form of the International Physical Activity Questionnaire (IPAQ-SF) and the Short Form 36 Health Survey (SF-36) were also administered. The results showed statistically significant improvements in levels of physical activity and in the dimensions of quality of life. We can conclude that a 12-week rowing training program tailored to women who have had breast cancer increases physical activity levels, leading to improved health status and quality of life.

Despite the well-documented health benefits of recreational sports, few opportunities exist in lower- and middle-income countries for adult women to participate in recreational physical activities. An explanatory sequential mixed methods approach was used to explore associations between an innovative soccer program for adult women and self-reported health status. Cross-sectional survey data were collected in 2018-2019 from 702 women in the Nikumbuke Project, a health and literacy program in southeastern rural Kenya, followed by focus group discussions with 225 women who also participated in the Project's soccer program. Quantitative findings suggest that women who participated in soccer had 67% greater odds of reporting good or excellent health than their non-soccer playing peers. Thematic analysis of qualitative data indicated that women credited soccer with less pain, fatigue, and stress, as well as weight loss and reduced dependence on medicine for hypertension, pain, and sleep problems. Women equated health benefits with greater ease and efficiency in completing chores, reduced worries, youthful energy, male-like strength, and pleased husbands. Soccer programs for adult women may be particularly effective interventions in settings where access to health care is limited and where lack of opportunity to engage in physical aerobic activity increases women's risks for poor health outcomes. .

Objective: To explore the inter-rater reliability of the Measurement Of adherence Via Exercise Demonstration (MOVED) adherence tool. Design: Reliability study of a patient adherence measurement tool.Setting: Simulated physiotherapist-patient consultations. Participants: Sixteen experienced physiotherapists rated patient adherence to exercise. Interventions: N/A Main Outcome Measure: Inter-rater reliability of MOVED.Methods: The MOVED tool consists of two parts. Part one asks patients to self-report their adherence to exercise dose (including number of completed sessions, sets and repetitions in the last seven days). Part two asks patients to demonstrate each exercise. Component scores are totalled to give an overall level of patient adherence to each exercise.Participants were provided with a copy of five physiotherapist-prescribed exercises. Participants were then shown five corresponding video vignettes of simulated physiotherapist-patient consultations where patients were asked to self-report exercise frequency, sets and repetitions and demonstrate each exercise within the context of a consultation. Participants were asked to rate the level of patient adherence to each of the five exercises using the MOVED tool. Inter-rater reliability of MOVED scores was assessed using Intraclass Correlation Coefficient (ICC) and 95% Confidence Intervals. Results: The ICC of part one (self-report) was .90 (95%CI .74-.98), part two (demonstration) was .98 (95%CI .94-.99) and total score was .96 (95%CI .88-.99), demonstrating excellent inter-rater reliability. Conclusion: The MOVED tool, which can highlight whether patients are adhering to exercise technique as well as exercise dose, may provide clinicians and researchers with a more robust measure of exercise adherence when compared with other measures currently available.

Background: The optimisation of this return to athletic activity pass by a better understanding of the behaviour of the muscle involved in knee function.In this study, we focused on the muscular activity of the muscle involved in the flexion of the knee. Preciseley on the relation between the muscular activity of the gastrocnemius and the hamstring among the patient that underwent an anterior cruciate ligament reconstruction with hamstring graft.Objective : The objective of the study is to compare, the muscular activity of the flexor knee muscle in patient that underwent an anterior cruciate ligament reconstruction with hamstring autograft and the individuals that have not undergone surgery.Methods : The participants have been divided into two groups : an healthy group and an experimental group that underwent an anterior cruciate ligament recontruction with hamstring graft. The participants had to performe a strenght test on a isocinetik dynamometer. The activity of the medial gastrocnemius, lateral gastrocnemius, femoral biceps and the semitendinosus were mesured during this test.The muscular activity of the muscle mentioned of the individuals in the first group were compared to the ones in the second group via a statistical analysis. Then, a ratio of the activity of the gastrocnemius muscle on the activity of the hamstring was calculated The results of the experimental group were then compared to the results of the control groupResults : The results showed a significative difference activity of the medial gastrocnemius, the femoral biceps and the semitendinosus muscles : the experimental group results were superior to the control group results However the evaluation of the activity reporting has shown significant differences in the two groupsConclusion : This study has allowed us to show a difference in muscular activity of the gastrocnemius and hamstring muscle between patient that underwent an anterior cruciate ligament reconstruction surgery and the heathy participants. However our approch has not allowed us to identify the relation between a heihtened gastrocnemius activity and a diminished hamstring activity following an anterior cruciate ligament reconstruction with hamstring graft. Quite on the contrary, we observed a higher activity of the two muscle groups. Nevertheless, it seem to be necessary to have a variation in situations during the analysis of the gastrocnemius muscle to fully understans its purpose in the functional activity of the knee of patient that have undergone an anterior cruciate ligament reconstruction.

Today, rupture of the anterior cruciate ligament is the most common heavy injury in athletes, but it can also occur in sedentary subjects. Its treatment, always adapted to the lifestyle, age and will of the patient, often remains surgical. However, despite its frequency and universality, there are still walking disorders following the operation. These disorders sometimes persist for several months, or even several years after surgery. The present study is therefore interested in determining the risk factors linked to walking disorders following reconstruction of the anterior cruciate ligament. The objective of this study is to determine what risk factors associated with walking disorders are after reconstruction of the anterior cruciate ligament by hamstring graft. This study focused on factors that may exist at 3 and 6 months postoperatively. Two populations participated in this study, a healthy population and a population having benefited from reconstruction of the anterior cruciate ligament. The operated test group is divided into two subgroups, one with a postoperative period of 3 months and the second at 6 months. All subjects were subjected to the same protocol, their gait on the treadmill was analyzed and evaluated with an Optogait® analysis system. A univariate analysis was carried out first. Then, a multivariate analysis by adjustment method was carried out in order to eliminate the potential confounding factors. The comparison of the results between the populations in the univariate analysis shows an absence of significant results however there are trends. The statistical results of the multivariate analysis showed interactions in the two subgroups of the operated population.In fact, it turns out that at 3 months there is a tendency to worse gait disorders in subjects with a high BMI reflecting overweight, when an associated surgical procedure has taken place on the meniscus, in subjects over 35 years of age and males. On the other hand, at 6 months, the tendency to worsening is visible only in the strata represented by subjects with a BMI corresponding to overweight, as well as in subjects having benefited from a meniscal suture associated with ACL reconstruction. .The results of the present study show that there are certain factors which tend to increase the risk of these walking disorders after reconstruction of the anterior cruciate ligament by hamstring graft, these factors are different depending on the time postoperative.

Rehabilitation following anterior cruciate ligament reconstruction with hamstring graft allows the patient to regain his functional capacities and to support him in the resumption of sports activities. Rehabilitation also aims to minimize the risk of recurrence, which is why it ensures that the patient's muscular capacities develop properly until they return to sport. Isokinetics helps strengthen and assess the strength of muscle groups in the thigh, but controversy exists as to its use by resistance to the open kinetic chain knee extension that would cause the transplant to distend. The objective of this study is to determine the influence of isokinetic muscle strengthening on the possible laxity of the anterior cruciate ligament and to be able to determine risk factors. The study relates to a population having benefited from anterior cruciate ligament reconstruction with hamstring graft from 3 to 6 months after surgery. Two groups are differentiated, one group exposed to isokinetism during rehabilitation, the other group, named unexposed, undergoes rehabilitation without the use of isokinetism. An anterior knee laxity test is performed 6 months postoperatively using the GNRB® machine for all subjects according to the same protocol. The test results were statistically analyzed to determine a relative risk of transplant distension for each group in the study. Comparison of the results of each group by univariate analysis did not reveal any significant result. Multivariate analysis showed interactions in the two strata of the study. It was argued that the use of isokinetics seems to have no effect on the risk of developing distension for the majority of subjects in the exposed group. A tendency towards transplant protection was perceived for each variable except the age under 25 years (RRa = 1.07). The use of isokinetics does not appear to be a cause of transplant distension in patients undergoing an anterior cruciate ligament reconstruction when this method is introduced 3 months postoperatively.

Current pharmacological treatments of Fibromyalgia (FM) are merely symptom palliative, as clinical trials have so far failed to provide overall benefits without associated harms. Polypharmacy often leads to patient´s health deterioration and chronic drug use to an eventual lack of patient´s response. Emerging evidence support that physiotherapy treatments based on mechanical triggers improve FM symptoms and therefore could be used for therapeutic purposes by themselves, or in combination with current pharmacological treatments, as part of integrative medicine programs. However, a paucity of studies rigorously and systematically evaluating this possibility exists. This study uses scores from validated standardized questionnaires, algometer pressure point threshold (PPT) readings and responses from a custom self-developed questionnaire to determine the impact of a pressure-controlled manual protocol on FM hyperalgesia/allodynia, fatigue and patient´s quality of life. The results show that patient´s baseline sensitivity to pain inversely correlates with treatment response in FM. Moreover, patients presenting comorbid ME/CFS do not seem to respond to the applied therapy as those presenting FM only. Thus, pre-treatment PPTs and ME/CFS comorbidity may serve as indicators to predict patient´s response to physiotherapy programs based on mechanical triggers, as the one evaluated here. These unexpected findings grant further explorations including the study of gene expression profiles associating to patient´s treatment response in the blood collection of samples generated by this study.

Technological advances in game-mediated robotics provide an opportunity to engage children with CP and other neuromotor disabilities in more frequent and intensive therapy by making personalized, programmed interventions available 24/7 in children’s homes. Though shown to be clinically effective and feasible to produce, little is known of the subjective factors impacting acceptance and of such assistive/rehabilitative gamebots by their target populations and their families. This research describes the conceptualization phase of an effort to develop a valid and reliable instrument to guide the design of A/R gamebots. We conducted in-depth interviews with 8 children with CP and their families who had trialed an A/R gamebot for 28 days in their homes to understand how existing theories and instruments were either appropriate or inappropriate to measuring the subjective experience of A/R gamebots. Key findings were the importance of differentiating the paradigm of rehabilitative from that of assistive technology, the need to incorporate the differing perspectives of children with CP and those of their parents into A/R gamebot evaluation, and the potential conflict between the goals of preserving the quality of the experience of game play for the child while also optimizing the intensity and duration of therapy provided during play.

Studies on the gait's parameters have been identified on the patients population. Most researchers confirm that the patients walk differently than normal people and they may have a risk for falls. Consistent finding and description of gender, age, and body mass index differences in gait studies is rare in healthy subjects. A cross-sectional study with forty-five young adult (F = 20, M = 25) was conducted. Stadiometer and Physilog 4 inertial sensors were used for data collection. A gait analyser 5.2 software (GaitUp, S.A. Lausanne, Switzerland) was used to determine spatiotemporal parameters. No statistically significant differences were found in any bilateral foot gait parameters with respect to gender, age, and body mass index. Females are found with higher total double support and cadence than males. Cadence also increases with age. Obese people showed lower gait speed, cadence, and total double support. These findings may be beneficial to those who have abnormal gait pattern due to age, body mass index differences, decreased muscle strength, spasticity, and joint mobility. This important informations should be considered to rehabilitate patients with abnormal gait patterns to controlling dynamic balance and riks to falling.

This case study examined changes in body composition, resting metabolic rate (RMR), aerobic capacity, and daily physical activity in a patient who had ulcerative colitis who underwent ileal pouch‒anal anastomosis (IPAA) surgery. Body composition, RMR, and VO2 peak were assessed prior to, 4, 8, and 16 weeks after IPAA surgery. Daily physical activity data was extracted from a wrist-worn activity tracker preoperatively and 16 months postoperatively. At baseline, total body mass was 95.3 kg; body fat, 11.6 %; lean body mass, 81.1 kg; RMR, 2,416 kcal/d; and V̇O2peak, 42.7 mL/kg/min. All values decreased from baseline at 4 weeks postoperatively, body mass was 85.2 kg (-10.5%); body fat, 10.9% (-6.0%); lean body mass, 73.1 kg (-9.9%); RMR 2,210 kcal/d (-8.5%) and V̇O2peak, 25.5 mL/kg/min (-40.3%). At 16 weeks postoperatively, most parameters were near their baseline levels (within 1%-7%); exceptions were V̇O2peak, which was 20.4% below baseline, and RMR, which increased to nearly 20% above baseline. After the patient had an IPAA surgery, his total and lean body masses, RMR, and aerobic capacity were markedly decreased. Daily physical activity decreased postoperatively and likely contributed to the decreased aerobic capacity, which may take longer to recover compared to body composition and RMR parameters.

The soccer injury rate is distinctly higher during matches than the training sessions. Rules determine how to play, generating specific kinds of fatigue which is associated with the injury incidence. No research has evaluated the impact of potential rule-induced physical demands in soccer or comparing sports. Understanding the differences might be useful for enhancing rules (e.g., safer sport). Therefore, the aims of this study were: a) to described the differences in the rule-induced physical demands of soccer, futsal, basketball, and handball; and b) to evaluate whether soccer rule-induced physical demands are different than the other invasion intermittent team sports, focusing the impact of the substitutions rules. Data were collected from different sports rules (i.e., soccer, futsal, basketball, and handball), and performed hypothetical corrections to equate the other team sports to the soccer (i.e., court dimensions/number of players). The data showed that soccer has higher rule-induced physical demands: lower substitutions, higher dimensions in absolute (eight to 15 times), and relative (four to eight times) values. Hypothetical corrections showed that soccer has remarkably large differences. Therefore, we conclude that soccer has remarkably higher rule-induced physical demands than other team sports, and allowing unlimited substitutions in soccer is a must.

It is not established whether SARS-CoV-2 (COVID-19) patients with movement disorders, are at greater risk for more serious outcomes than the larger COVID-19 population beyond the susceptibility associated with greater age. We reviewed electronic health records and conducted telephone interviews to collect the demographics and clinical outcomes of patients seen at our Movement Disorders Center who tested positive for COVID-19 from 8 March 2020 through 6 June 2020. Thirty-six patients were identified, 23 men and 13 women, median age of 74.5 years. They primarily carried diagnoses of idiopathic Parkinson disease (n=22; 61%) and atypical parkinsonism (n=7; 19%) with the balance having other diagnoses. Twenty-seven patients (75%) exhibited alteration in mental status and fifteen (42%) had abnormalities of movement as common manifestations of COVID-19; in 61% and 31%, these were the presenting symptoms of the disease. 67% of patients in our cohort required hospitalization, and the mortality rate was 39%.. These data demonstrate that in patients with movement disorders, the likelihood of hospitalization and death after contracting COVID-19 was substantially greater than in the general population. Patients with movement disorders frequently presented with altered mental status, generalized weakness, or worsening mobility but not anosmia.

Exercise induced bronchoconstriction (EIB) is a common complication of athletes and individuals who exercise regularly. It is estimated that about 90% of patients with underlying asthma experience EIB. Sex differences in the prevalence of asthma have been widely reported, with higher rates in boys vs. girls before puberty, and higher rates in women than men after puberty. Because atopy has been reported to occur at higher rates in athletes than in non-athletes, in this study we investigated sex differences in EIB and atopy in athletes. A systematic literature review identified 60 studies evaluating EIB and/or atopy in post-pubertal adult athletes (n=7501). Collectively, these studies reported: 1) a 23% prevalence of EIB in athletes; 2) a higher prevalence of atopy in male athletes vs. females; 3) a higher prevalence of atopy in athletes with EIB; and 4) a significantly higher rate of atopic EIB in male vs. female athletes. Our analysis indicates that the physiological changes that occur during exercise may differentially affect male and female athletes, and suggest an interaction between male sex, exercise, and atopic status in the course of EIB. Understanding these sex differences is important to provide personalized management plans to athletes with underlying asthma and/or atopy.

Heart Rate Monitors (HRMs) are an indispensable tool for controlling training parameters of healthy athletes. They became a source of information about stress heart rhythm disturbances, recognized as unexpected increases in heart rate (HR), which can be life-threatening for athletes. Most HRMs do not recognize the type of arrhythmia, confusing them with artifacts. The aim of the study was to assess the usefulness of ECG recording functions by sports HRMs among endurance athletes, coaches, and physicians in comparison with other basic and hypothetical functions. We conducted 3 surveys among endurance athletes (76 runners, 14 cyclists, and 10 triathletes), as well as 10 coaches and 10 sports doctors to obtain information on how important ECG recording is, and what functions of HRMs should be improved to meet their expectations in the future. The respondents were asked questions regarding use and hypothetical functions, as well as preference for HRM type (optical/strap). For athletes, the 4 most important functions were distance traveled, pace, instant heart rate, and information about reaching the oxygen threshold. ECG recording was the 8th and 9th most important for momentary and continuous, respectively. Coaches opined more importance to ECG recording. Doctors placed ECG recording as most important. All participants preferred optical HRMs to strap HRMs. Research on the improvement and implementation of HRM functions shows slightly different preferences of athletes compared to coaches and doctors. Suspected arrhythmia increases the value of the HRM’s ability to record ECGs during training by athletes and coaches. For doctors, this is the most desirable feature in any situation. Considering the expectations of all groups continuous ECG recording during training will significantly improve the safety of athletes.

The performance of choice-reaction tasks during athletic movement has been demonstrated to evoke unfavorable lower limb biomechanics. However, the mechanism of this observation is unknown. We conducted a systematic review examining the association between 1) the biomechanical and functional safety of unplanned sports-related movements (e.g. jumps/runs with spontaneously indicated landing leg/cutting direction) and 2) markers of perceptual-cognitive function (PGF). A literature search in three databases (Pubmed, ScienceDirect, Google Scholar) identified five relevant articles. Study quality, rated by means of a modified Downs & Black checklist, was moderate to high (average: 13.5/16 points). Four of five papers, in at least one parameter, found either an association of lower PGF and reduced task safety or significantly reduced task safety in low vs. high PGF performers. Yet, as a) the outcomes, populations and statistical methods of the included trials were highly heterogeneous and b) only two out of five studies had an adequate control condition (pre-planned movement task), evidence was classified as conflicting. In sum, PGF may represent a factor increasing injury risk during unplanned sports-related movements but future research strengthening the evidence of this association is warranted.

The Body Mass Index (BMI) formula has been developed by Belgian mathematician Adolphe Quetelet and published in 1840 [1] as a law of nature and society, based on statistics about the weight and height of the population of that time, the first part of the 19^th century. He called it “social physics”. From then, for nearly two centuries, the BMI had been the most important formula describing the normal relations and ratio of weight to the square of the height for humans. The problem arises if the BMI formula, developed in the first part of the 19^th century is still good today when the type of work people perform is very different? In modern times, most people are less muscular than at the time when the BMI was developed because they do not work physically as heavy as at that time. In many cases, the Body Mass index can predict mortality, morbidity and illness but not always, for example cases such as (a) the obesity paradox for some cardiovascular problems and (b) the U shape mortality paradox as well as (c) false positive obesity diagnostic in regard to people who are strong and muscular, have low body fat percentage but are classified as obese by the BMI and (d) cases where BMI is normal but people have an “obese metabolism” (e) BMI normal but high fat percentage. The objective is to develop a formula good for all body types, a formula that makes the difference between fat and non-fat body weight such as muscle and body frame and quantifies the effect of strength and fitness, which BMI does not. Another objective is to develop a formula to predict the health risks and fitness status of people, better than BMI. The first generalizations of BMI using anthropometric metrics could be found in [2], where I discuss and analyze many formulae, developed, tested, and simulated by me, using similar new methods, accounting for body shape, physical shape and body function, making the difference between muscle mass and fat, fat and non fat body weight. Nearly all formulae and methods developed and proposed in this new model are new, never published before. Many experiments published before, in highly cited papers show that grip strength and muscle strength is a predictor of health, mortality, morbidity, endocrine and metabolic disease outside the BMI and anthropometric measures. The purpose of my formula is to explain the outcome of those experiments and create a formula which predicts these experiments [21-41].

This review and meta-analysis (PROSPERO registration number: CRD42020138845) critically evaluates test-retest reliability, concurrent validity and criterion validity of different physical activity (PA) levels of three most-common used international PA questionnaires (PAQs) in national language versions of EU-28: IPAQ-SF, GPAQ, and EHIS-PAQ. In total, 4969 abstracts were read, 287 full-text articles were identified as relvant to the study objectives, and 19 studies were included in the final meta-analysis. The studies’ results and quality were evaluated using the Quality Assessment of Physical Activity Questionnaires (QAPAQ) checklist. Results indicate that only five EU-28 countries validated national language versions of selected PAQs. Meta analysis revealed that assessment of moderate-to-vigourus PA (MVPA) is the most relevant PA level outcome, since no publication bias in any of measurement properties was detected while test-retest reliability was the moderately-high (rw=0.74), and moderate for both criterion (rw=0.41) and concurrent validity (rw=0.72). Reporting of methods and results of the studies was poor with overall moderate risk of bias with total score of 0.43. In conclusion, where only self-reporting is feasible, assessment of MVPA with selected PAQs in EU-28 adult population is recommended for policymaking.

Studies have demonstrated the positive effects of acupuncture on athletic performance. The aim of this study was to determine the acute effects of acupuncture on heart rate, the perceived exertion scale and lactate levels in recreational athletes. Fifteen competitive males engaged in HIIT. The characteristic was 29.86±2.51 years old, heart rate reserve 59.00±3.33, lactate 3.17±0.50 mM/DL. The subjects were submitted to two exercise sessions. Both training sessions consisted of 10 burpees, 12 thrusters and 14 box jumps (75 cm high) for 12 minutes. Activity intensity was between 85 and 95% of maximum heart rate. Acupuncture points: ST36, L3, LI11. The student’s t-test was adopted, Shapiro-Wilk test was applied for normality, and Pearson correlation. There was a positive correlation of r = 0.69 between lactate levels and heart rate. Lactate: Lac1 15.00±1.18 – Lac2 19.59± 1.46 p= 0.0001*; Heart 1rate: HRF 163.71±7.27 – HRF2 177.60±6.99 p=0.0001*; Blood pressure: SBP1 174.86±1.57 – SBP2 180.86±1.77 p= 0.0001*; PES1: 19.4±1.14; PES2 16.8±0.84 p= 0.0001*; weight1 – 182,57±12,05; weight 2 206,43±11,39 p=0.0325*. Acupuncture increased lactate accumulation, heart rate and blood pressure, suggesting that the exertion reached after acupuncture is higher than without acupuncture. The acupuncture technics improved the athlete performance.

Kinesio tape is considered one of the most common techniques which using recently, where it is used as a therapeutic technique for pain relief, correction of joint position, prevention of oedema and injuries, improve range of motion and muscular activity for the individual. This study is a descriptive research design and aims to identify the effect of using Kinesio tape on the neuromuscular activity of quadriceps muscle after the rehabilitation program of the knee joint. The study sample consists of (10) players from different sports (football, basketball …etc.) and suffering from knee joint injuries. This sample was taken from Kafr-El sheikh and Kaleen club. Results showed that Kinesio tape doesn’t have any explicit effect on the neuromuscular activity of muscle but acts as a catalyst for muscle and promote a person’s feeling of psychological wellbeing and reassurance.When comparing results of using Kinesio tape during performing leg squatting and balance test with not using tape, founded that when performing leg squatting and balance test with using Kinesio tape, there were significant effects on muscle activity compared to not using it.

The classic Body Mass Index, (BMI), developed in the 19^th century by the Belgian mathematician Adolphe Quetelet [1] is an important indicator of the risk of death, of obesity, of negative health consequences, body fat percentage and of the shape of the body. While he BMI is assumed to indicate obesity in sedentary people and in people who do not practice sports, it is undisputed and a consensus among researchers [2][3][4][5][9][25] that Body Mass Index (BMI) is not a good indicator for obesity in people who developed their body through heavy physical work or sport but also in other segments of population such as those who appear to have a normal weight but in fact have a high body fat percentage and obese methabolism. The BMI also does not include all the variables essential for a health predictor. The BMI is not always a good predictor of metabolic disease, people who appear of healthy weight according to BMI have in some cases an obese metabolic syndrome. The BMI was developed as a law of natural sciences and “social physics” [1], as it was called then, before the middle of the 19^th century, and it had been used from the 70s for medical purposes, to detect obesity and the risk of mortality [6][7]. The BMI has a huge importance for modern society, affected by an obesity epidemic [8]. BMI has applications in medicine, sport medicine, sport, fitness, bodybuilding, insurance, nutrition, pharmacology. The main limitation of the BMI is that it does not account for body composition including non fat body mass such as muscles, joints, body frame and makes no difference between fat and non fat components of the body weight. The body composition and the proportion of fat and muscles make a difference in health outcomes [12][13][14][25][26][27][35][36][37] [38][39][40][41][42][43][44]…[100]. Body composition makes a difference also in the level of sport performance for athletes of every level. In nearly two centuries since the Body Mass Index was developed, no formula had been successfully developed to account for body composition and make the difference between muscle and fat in a consistent way. This can be considered a longstanding open problem of major importance for society. The objective of this analysis is to develop new formulae taking into account the health implication of body composition measured through indirect, simple indicators and making the difference between muscles and fat, healthy and non healthy metabolism. The formulae developed in this article are the only formula to successfully generalize BMI and make this difference. I develop a direct generalization of BMI, in the mathematical and physiological sense to account for fat and fat free mass and muscles, small and large body frames. It is the first such generalization because the classic BMI can be determined as a particular case of my formulae in the strict mathematical and practical physiologic sense. No other formula generalized the BMI to make the difference between fat and a large frame and muscles has ever been published in nearly two centuries since the BMI formula had been developed. The formulae I developed explain and generalize the conclusions of a large number of highly cited empirical experiments cited in the reference section. [35][36][37][38][38][39] [40][42][43][44]..[100] Most of the experimental proof I bring in support of my formulae and bodyweight quantification theory comes from many highly cited experimental research publications in medicine, sports medicine, sport science and physiology. My formulae explain also performance in decades of competitive sports and athletics

Workloads may be classified as either internal or external. Internal workloads (heart rate, blood lactate, session rate of perceived exertion (sRPE) are categorised as the individual’s response to an external workload (volume, intensity). sRPE is an easily monitored variable which has been shown to have possible associations with other internal (1) and injury rates (2, 3) in contact sports. This case study describes the internal workload monitoring of a schoolboy rugby player during the entirety of his season (September to March) with the subsequent relationships between workload and time loss injuries being explored. Time loss injuries are defined as injuries which caused the individual to miss training or match play time (4). Acute to chronic workload ratio (ACWR) and exponentially weighted moving average (EWMA) were monitored, a novel ACWR:EWMA ratio was also calculated. High ACWR and low EWMA values were associated with injury occurrence, the ACWR:EWMA ratio may account for this. EWMA may be a better predictor of “time loss” injuries than ACWR. The ACWR:EWMA ratio may merit further scientific exploration in the future.

Conventional locomotor exercise, such as cycling or walking, induces motor learning-like neuroplastic changes (i.e., decreased cortical inhibition and/or increased facilitation, assessed in a muscle using transcranial magnetic stimulation). These effects seem to be a consequence of humoral processes notably resulting from hemodynamic solicitation. Unfortunately, pathological populations may not be capable of exercising at sufficient intensities to trigger these beneficial neuroplastic modulations and an alternative method is needed. As it can be inferred from non-invasive brain and peripheral stimulation studies, a high neural activity can directly result in neuroplastic changes. Similarly, eccentric exercise (i.e., active lengthening of the muscle), during which individuals develop the same force or power as conventional exercise at lower cardiorespiratory intensities, requires a high brain neural activity. As single-joint eccentric exercise was decreased cortical inhibition and increased cortical facilitation, locomotor eccentric exercise may be even more potent by pooling neural and, maybe, hemodynamic neuroplastic processes. Further studies are required to understand the influence of locomotor exercise characteristics (e.g., intensity, duration) on exercise-induced neuroplasticity.

Introduction: Osteoarthritis (OA) and age-related degeneration (ARD) are stimulants for the development of the fabella in the knee joint. This meta-analysis updates previous studies and reviews on the prevalence of the fabella in OA or ARD knee joints. In addition, it provides a quantitative estimation of the fabellar prevalence in knees having OA and ARD. Methodology: Twenty studies comprising of data from 11,056 knee joints were included in the analysis, consisting of 6,819 Knees of OA subjects (including those with age more than 40 years) and 4,237 knees of non-OA subjects (including less than 40years) knees, respectively. 2,434 knees had fabellae present in OA subjects (including more than 40years), and 844 fabellae were present in non-OA subjects (including less than 40years). The Odds and Risk Ratios were calculated. Sensitivity analysis and cumulative analysis were conducted to assess the robustness of the findings. Results: Prevalence of fabella was found to be higher in OA knees, where the Risk Ratio of developing fabella was 2.50 (2.07-3.01). Compared with this, the Risk Ratio for the incidence of fabella in OA with ARD knee was 1.84 (1.66-2.03). The bilateral occurrence of fabella was more common than unilateral. The risk of developing fabella in individuals aged less than forty-year was 63% less than individuals aged more than forty years. Conclusion: OA and ARD would increase the prevalence of fabella by 84%, thus acting as stimulants and risk factors for ossified fabella.

Safely resuming sporting events while the coronavirus is spreading is challenging – yet possible – if the science is taken into account. Two main ways the coronavirus can spread among football players is through air-suspended microdroplets (and possibly aerosols), and via contact with contaminated surfaces. Here we estimated virus survival in dried saliva droplets on a football pitch (i.e., on the grass) and on the ball itself, and compared these measures between mid-day and nighttime matches. We find, based on experiments with the enveloped phage Phi6 – a surrogate for SARS-Cov-2 – that while the virus survives reasonably well on both pitch and ball during a nighttime match (~10% survival), virtually no viruses survived the 90-minute duration of a mid-day match on a hot, sunny day. These results, taken together with studies reporting rapid deactivation of coronavirus in aerosols by sunlight, suggest that playing football in mid-day reduces the likelihood of transmission between players, and thus increases players’ safety.

Purpose: To explore the influence of education and other factors on an athlete’s decision to return to sport post-concussion injury, and whether general risk-taking tendencies are related to return to sport post-concussion decisions in these athletes. Participants and Methods: A self-administered electronic survey was designed to examine their decision-making process when faced with scenario-based questions regarding returning to sport post-concussion injury. Students from the Health Sciences and Medicine Faculty at Bond University were invited to participate. Participants were allocated to a concussion education or non-education group prior to commencement of questionnaire via the random generator on Qualtrics software function. The risk propensity scale was used to assess the risk aversion of each participant. Results: Sixteen respondents were randomized evenly to education and non-education groups. Seven (43.8%) had previously received concussion education training prior to completing the questionnaire, with one (14%) choosing to return to sport in the scenario-based questions. The education group reported two (25%) respondents return to sport, while three (75%) respondents out of four returned to sport with no education or previous concussion training. Influential factors that impacted the decision whether to return to sport or not included: game importance, concussion severity and symptoms, and various internal and external factors. Finally, there was a divergence in results from the risk propensity scale when deciding to return to sport and general risk-taking propensities. Conclusion: This study identified several influential factors including game importance, concussion severity and symptoms which play a significant role in the return to sport decisions post-concussion injury.

The aim of this study was to introduce a new activity-based balance index by using accelerometer data. Twenty-seven junior soccer players from the Iranian premier league were selected. Four functional tests, consisting of one leg stance, dynamic Y balance, running and dribbling tests, were conducted to assess the players’ balance, activity and skill. During these four tests, besides their relative scores, the acceleration of their body center was also recorded. Activity-based balance index (ABI) was calculated using these acceleration data. The results showed positive correlations between ABI and both static and dynamic balance scores. Additionally, negative correlations were found between ABI and dribbling scores, which demonstrate the agility required for this skill. It seems that this new index achieves the evaluation of both the balance and the skill level of soccer players. Perhaps this is a new way of talent identification and also a re-development of balance tests from traditional to modern.

This study investigated the relationship between wrist flexion and the dynamics of the swing of a croquet mallet. Twenty seven subjects participated in a study which used 3D motion capture equipment and high speed and high-definition video to determine if there is a correlation between the lateral twist of a croquet player’s swing and the flexion of the wrist during that swing. The study found a significant correlation between the amount of flexion of the wrist from the start of the stroke to the top of the backswing and the twist of the mallet head at the top of the backswing (r=0.330, p<0.01). The methodology and findings are relevant to all sports where minimising wrist flexion is favourable for improving consistency of stroke making. Additionally, reducing wrist motion in stroke-making may reduce the incidence of wrist pain and injury in croquet, further supporting recommendations to reduce the amount of wrist flexion during the croquet swing.

Introduction: Musculoskeletal dysfunctions happen to be the most common reason for referral to physiotherapy and manual therapy services. Therapists may use several articular and/or soft tissue concepts/approaches to evaluate and treat such dysfunctions that may include integration of myofascial system. Despite the research in this area spanning more than three decades, the role played by fascia has not received its duly deserved attention, owing to the lack of definitive research evidence. The concept of ‘fascial connectivity’ evolved two decades ago from a simple anatomical hypothesis called ‘myofascial meridians’. Since then it has been widely researched, as conceptually it makes more sense for functional movements than ‘single-muscle’ theory. Researchers have been exploring its existence and role in musculoskeletal dysfunctions and clinicians continue to practice based on anecdotal evidence. This narrative review attempts to gather available evidence, in order to support and facilitate further research that can enhance evidence based practice in this field. Methods: A search of most major databases was conducted with relevant keywords that yielded 272 articles as of December 2019. Thirty five articles were included for final review with level of evidence ranging from 3b to 2a (as per Center of Evidence Based Medicine’s scoring). Results: Findings from cadaveric, animal and human studies supports the claim of fascial connectivity to neighboring structures in the course of specific muscle-fascia chains that may have significant clinical implications. Current research (level 2) supports the existence of certain myofascial connections and their potential role in the manifestation of musculoskeletal dysfunctions and their treatment. Conclusion: Although these reviews and trials yield positive evidence for the objective reality/existence of fascial connectivity and continuity, several aspects need further exploration and in-depth analysis, which could not be evidenced entirely in this review. Manual and physical therapists may utilize the concept of fascial connectivity as a convincing justification to deal with clinical problems, but need to remain vigilant that functional implications are still being investigated.

Abstract The aim of this research is to conduct a systematic review analysing the role of the physiotherapy interventions in palliative care. PRISMA as a critical appraisal tool was utilised for the selection of the research articles. The inclusion criteria were based on the year of publication, ease of availability, language, geographical location, and study type. To ensure the credibility, databases such as Elsevier, Proquest, and EBSCO Host were used to filter the grey content. Data published in the past ten years (2009-onwards) was only included to ensure the selection of the most recent interventions used by the physiotherapists. A total of 11 articles were selected which determined that physiotherapy interventions involving breathing exercises, aerobic exercises, manual therapies, and educational awareness were critical to promoting the functional capability and empower the patients.

MicroRNAs (miRNAs) play crucial roles in the regulation of the transcriptome and development of diseases including cancer and autoimmune diseases, such as rheumatoid arthritis (RA). Currently, a comprehensive map, illustrating how miRNAs regulate transcripts, pathways, immune system differentiation, and their interaction with terminal cells, such as T cells, fibroblast-like synoviocytes (FLS), osteoblasts, and osteoclasts, is still missing. In this review, we provide a thorough summary of the roles of miRNAs in the susceptibility to pathogenesis, diagnosis, therapeutic intervention, and prognosis of RA. Numerous miRNAs are abnormally expressed in cells involved in RA, and regulate target genes and pathways including the NF-κB, Fas-FasL, JAK-STAT, IRE1-RIDD, and mTOR pathways. By regulating gene expression, miRNAs affect T cell differentiation to diverse cell types, including Th17 and T-reg cells, and thus constitute promising gene therapy targets to modulate the immune system in RA. We summarize the diagnostic and prognostic potential of blood-circulating and cell-free miRNAs, highlighting the novel opportunities to combine these with rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) to provide accurate diagnosis and prognosis, especially for seronegative patients. Furthermore, we outline how functional genetic variants of miR-499 and miR-146a partly explain the unmet susceptibility to RA. Additionally, we review the evidence implicating miRNAs as promising biomarkers of efficiency, response, and resistance to disease-modifying anti-rheumatic drugs (DMRDs) and immunotherapy. Finally, we discuss the autotherapeutic effect of miRNA intervention as a step toward the development of miRNA-based anti-RA drugs. Collectively, the current evidence supports miRNAs as interesting targets to better understand the pathogenetic mechanisms of RA and design more efficient therapeutic interventions.

Rheumatoid arthritis (RA) as a complex disease is thought triggered by interaction between genetics and environment, especially the shared epitope (SE) and cell surface calreticulin (CSC) theory. However, all the evidence shows genetic diversity and environment exposure cannot explain all the clinical characteristics heterogeneity of rheumatoid arthritis. In contrast, recent studies demonstrate that epigenetics play important roles in the pathogenesis of rheumatoid arthritis, especially DNA methylation and histone modification. DNA methylation and histone methylation are involved in innate and adoptive immune cell differentiation and the migration, proliferation, apoptosis, and mesenchymal characteristics of fibroblast-like synoviocytes (FLS). Epigenetic mediated regulation to immune genes and inflammation pathway provides well explanation to dynamic expression network of rheumatoid arthritis. In this review, we summarized the comprehensive evidence to show methylation modification occurred in DNA and histone are significantly involved in the pathogenesis of rheumatoid arthritis and could be applied as the promising biomarker in the disease activity and drug response prediction. We also explained the opportunity and challenge of the current epigenetics research in rheumatoid arthritis. In summary, epigenetic modules provide possible interface through which genetic and environmental risk factors connect together to contribute to the susceptibility and pathogenesis of RA. Meanwhile epigenetic regulators provided promising drug targets to develop novel therapeutic drugs for rheumatoid arthritis. Finally, DNA methylation and histone modification will be important features to provide better rheumatoid arthritis subtype identification to accelerate personalized treatment and precision medicine.

Background and Objectives: The techniques directed to the cranial field in osteopathy are the most questioned due to the lack of scientific evidence. In osteopathic practice, manual palpation is essential and, therefore, measuring reliability is fundamental. The objective of study is to assess the reliability and validity of osteopathic treatment depending on experience. Materials and Methods: A cross-sectional study of reliability and validity was conducted. For measurements, a strain gauge was placed on the sphenobasilar synchondrosis of the skull base, and three maneuvers (lateral compression, anteroposterior compression and compression maneuver of the mastoids) were repeated 25 times each by osteopaths with different time of experience (5-10 years, 1-5 years, <1 year). Measurement averages were computed for each of the three maneuvers to verify the average effect of each group in comparison to that of the Gold Standard (GS) (>10 years of experience). Data were analyzed to check for inter- and intra-observer reliability using intra-class correlation coefficients (ICC). Results: Reliability and validity in 5-10 experience of observer 1 and observer 2 in the tree maneuvers was excellent (p<0.001) against GS. Poor or enough reproducibility and concordance were observed in osteopaths with less experience. Conclusion: Experience of osteopaths determines the efficacy of cranial maneuvers in osteopathic treatment for patients’ rehabilitation.

The prevention, mitigation and treatment of movement impairments, ideally, requires early diagnosis or identification. As the human movement system has physiological and functional redundancy, movement limitations do not promptly arise at the onset of physical decline. A such, prediction of movement limitations is complex: it is unclear how much decline can be tolerated before movement limitations start and how humans select compensatory movement strategies for a task. Adding to the challenge is the lack of general applicable and consensus terminology on movement limitations. Currently, the term ‘homeostatic reserve’ or ‘physiological reserve’ is used to refer to the redundancy of the human biological system, but this does not describe the redundancy in the muscle architecture of the human body. This article therefore proposes CaReMoOC, a framework incorporating neuromusculoskeletal capacity (accumulation of neuromusculoskeletal resources over the lifespan), reserve (task-specific difference between capacity and task demand), movement objectives (considerations made to plan a movement), and compensation (use of NMSK resources to respond to the task demand). Two forms of compensation are Compensation for Capacity, when capacity does not meet the task demands, and Compensation for Movement Objectives, when the movement is changed due to for example a fear of falling. This article demonstrates the framework for healthy ageing, providing an overview of age-related capacity decline (neural, skeletal, muscular system) and shifted weighting of movement objectives (energy, pain, stability, speed) relevant for experimental and modelling research in biomechanics and motor control. CaReMoOC provides a means to communicate hypotheses and theories on movement impairments and limitations. To predict movement limitations, we need to find ways to quantify NMSK reserve.

Background: This study tested the hypothesis that treatment of symptomatic, partial-thickness rotator cuff tear (sPTRCT) with fresh, uncultured, unmodified, autologous adipose derived regenerative cells (UA-ADRCs) isolated from lipoaspirate at the point of care is safe and more effective than corticosteroid injection. Methods: Subjects aged between 30 and 75 years with sPTRCT who did not respond to physical therapy treatments for at least six weeks were randomly assigned to receive a single injection of an average 11.4×10⁶ UA-ADRCs (in 5 mL liquid; mean cell viability: 88%) (n=11; modified intention-to-treat (mITT) population) or a single injection of 80 mg of methylprednisolone (40 mg/ml; 2 mL) plus 3 mL of 0.25% bupivacaine (n=5; mITT population), respectively. Safety and efficacy were assessed using the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), RAND Short Form-36 Health Survey and pain visual analogue scale (VAS) at baseline (BL) as well as three weeks (W3), W6, W9, W12, W24, W32, W40 and W52 post treatment. Fat-saturated T2 weighted magnetic resonance imaging of the shoulder was performed at BL as well as at W24 and W52 post treatment. Results: No severe adverse events related to the injection of UA-ADRCs were observed in the 12 months post treatment. The risks connected with treatment of sPTRCT with UA-ADRCs were not greater than those connected with treatment of sPTRCT with corticosteroid injection. However, one subject in the corticosteroid group developed a full rotator cuff tear during the course of this pilot study. Despite the small number of subjects in this pilot study, those in the UA-ADRCs group showed statistically significantly higher mean ASES total scores at W24 and W52 post treatment than those in the corticosteroid group (p < 0.05). Discussion: This pilot study suggests that the use of UA-ADRCs in subjects with sPTRCT is safe and leads to improved shoulder function without adverse effects. To verify the results of this initial safety and feasibility pilot study in a larger patient population, a randomized controlled trial on 246 patients suffering from sPTRCT is currently ongoing.

Osteoarthritis and rheumatoid arthritis are common cartilage and joint diseases that globally affect more than 200 and 20 million people, respectively. Several transcription factors have been implicated in the onset and progression of osteoarthritis, including Runx2, C/EBPβ, HIF2α, Sox4, and Sox11. IL-1β also leads to osteoarthritis through NF-ĸB, IκBζ, and Zn²⁺-ZIP8-MTF1 axis. IL-1, IL-6, and TNFα play a major pathological role in rheumatoid arthritis through NF-ĸB and JAK/STAT pathways. Indeed, inhibitory reagents for IL-1, IL-6, and TNFα provide clinical benefits for rheumatoid arthritis patients. Several growth factors, such as BMP, FGF, PTHrP, and Indian hedgehog, play roles regulating chondrocyte proliferation and differentiation. Disruption and excess of these signaling cause genetic disorders in cartilage and skeletal tissues. FOP, an autosomal genetic disorder characterized by ectopic ossification, is induced by mutant ACVR1. mTOR inhibitors were found to prevent ectopic ossification by ACVR1 mutations. ACH and related diseases are autosomal genetic diseases, which manifest severe dwarfism. CNP is currently the most promising therapy for ACH. In these ways, investigation of cartilage and chondrocyte diseases at molecular and cellular levels sheds light on the development of effective therapies. Thus, identification of signaling pathways and transcription factors implicated in these diseases is important.

Background: Sex differences in blood pressure (BP) exist during all reproductive life between women and men whereas a sharper increase in BP occurs after menopause which is associated with increased prevalence of cardiovascular diseases. This study examined cardiovascular and biochemical parameters in perimenopausal women (PW) aiming to investigate the influence of sex on a) office BP and for 24 hours; b) cardiac autonomic modulation; c) redox state by measuring MDA, SOD, and catalase; d) NO_x^- concentration. In addition, aerobic exercise training (AET) was applied for detecting changes in cardiovascular responsiveness during the menopausal transition. Methods: Thirty-one participants were enrolled, healthy PW and age-matched men. Cardiovascular and biochemical biomarkers were evaluated at baseline and after AET (8 weeks of exercise on a treadmill, three sessions/week, duration of 30-40 minutes). Results: At rest, PW presented: a) a lower diastolic BP during daytime; b) a lower absolute and normalized LF component as well as a higher HF normalized component; d) no sex differences for redox biomarkers and NO_x^- concentration. After AET, only PW was responsive in lowering systolic BP that was accompanied by an increase in NO_x^- concentration and SOD activity. Regarding HRV, both groups were responsive to the AET. Conclusions: During the menopausal transition, systolic BP was similar to men whereas cardiac autonomic modulation remained unaltered showing the influence of sex steroids on BP. In Addition, AET was fundamental during the menopause transition by preventing an elevation in BP, minimizing the effects of aging associated with estrogen deficiency on women's cardiovascular health.

Over the past five years, the popularity of dietary nitrates as an ergogenic device among athletes has increased significantly. Hypoxic and acidic conditions that occur during exercise facilitate the conversion of nitrite to nitric oxide (NO) and increase the physiological efficiency of exogenously produced nitrite. After a few years of our team predicted experiments, as a nitric oxide precursor, amaranth (Amaranthus hypochondriacus) was identified as a source of dietary nitrates (concentrations 9-11%). The aim of this study was to evaluate the effect of single-dose and long- term doses of dietary nitrates from amaranth concentrate on the aerobic capacity of physically active young persons. Thirteen healthy and physically active young participants were randomized to experimental and placebo groups using a increasing cycling exercise (ICE) and placebo- controlled design. Pulmonary gas exchange recording (oxygen uptake (VO 2 ), pulmonary ventilation (VE), respiratory exchange ratio (RER)) and analysis of blood lactate samples were obtained. Our findings indicate that the single dose of dietary amaranth (400 mg) significantly improved only the power of the test performance. Long-term (6 days) intake significantly increased the power of the test performance, the maximum oxygen consumption and the power of the test for the first ventilation threshold value (from 37.7±2.7 mL/kg/min during the first test to 41.2±5.4 mL/kg/min during the third test, p &lt;0.05).

Objective: Rheumatoid Arthritis (RA) is a chronic inflammatory disease affecting the synovium and articular cartilage that initiates joint damage. RA associates with a change in many inflammatory biomarkers. The present study aims to measure the levels of inflammatory adipocytokines (chemerin and visfatin) and their ratio in addition to some related biomarkers in RA patients group in comparison to healthy control group and find out their efficacy in diagnosis of RA.Methods: The study included 60 RA patients and 30 healthy control group. Serum visfatin and chemerin were measured by using ELISA technique, while other biomarkers were determined spectrophotometrically. Multivariate general linear model analysis and Receiver operating curve was used to study the opportunity of using chemerin and visfatin as diagnostic tools for RA.Results: The results indicated that there was a significant increase (p<0.05) in all lipid profile components, except HDLc that decreased, in RA patients in comparison with healthy control group; while significant decrease (p<0.001) in high density lipoprotein-cholesterol of RA patients in comparison with control group. Serum chemerin, visfatin, C-reactive protein, and uric acid levels were significantly higher (p<0.05) in RA patients than those of control group. The results showed a relatively good sensitivity and specificity of chemerin (sensitivity=88.1, specificity=75.9) at a concentration=187.88ng in diagnosis of RA.Conclusions: chemerin is able to diagnose RA efficiently but this diagnoses, due to relatively small specificity, may interfere with other inflammatory disorders. However, with adjuvant with other diagnostic parameters, chemerin may represent a useful addition in diagnosis of RA.

The aim of this study was to investigate the size of the change in fatigability of gluteus maximus muscles during difficult endurance training in dynamic conditions. The research covered involved eight female athletes of the Polish National Team in short track, which had been prepared to the Olympic Games in PyeongChang. The sEMG system was used to measure fatigue of right and left gluteus maximus muscles, in the modified Biering-Sorensen test. The test was conducted five times during the training: before training, after warmup, and after each of 3 series of the endurance training. Comparing the mean frequency of the surface electromyography power spectrum of the first and the last seconds of the test, statistically significant reduction (p<0.05) of the average frequency value of the right muscle from 55.61±7.08 Hz to 48.64±4.48 Hz and left muscle from 58.78±4.98 Hz to 53.18±4.62 Hz was reported. In the conducted Biering-Sorensen test, the value of the muscle signal frequency measured by surface electromyography decreases, which may prove the muscle fatigue. Reductions in the frequency measured in the first and the last second of the test, was higher of the right lower limb. The size of the d Cohen effect in fatigue drops along with subsequent five tests during the training.

This study aimed to examine the vitamin D status of professional volleyball athletes and to determine its correlation with shoulder muscle strength. We finally included 52 healthy male professional volleyball players (23.2 ± 4.5 years), who were categorized by vitamin D status (<20 ng/mL: deficiency, 20-30 ng/mL: insufficiency, and >30 ng/mL: sufficiency). We examined the strength of the internal rotator (IR) and external rotator (ER) muscles of the shoulder by using isokinetic dynamometer. Fourteen players (26.9%) had vitamin D deficiency, 24 players (46.2%) were vitamin D insufficient, and 14 players (26.9%) were vitamin D sufficient. There was no significant correlation between the vitamin D level and shoulder muscle strength at 60°/s (IR, r = 0.159, p = 0.26; ER, r = 0.245, p = 0.08), and at 180°/s (IR, r = - 0.093, p = 0.51; ER, r = - 0.037, p = 0.79). Moreover, the isokinetic shoulder strengths were not significantly different across the three groups in all settings. In conclusion, vitamin D insufficiency was common in elite volleyball players. Though not being associated with isokinetic muscle weakness, vitamin D should be regularly monitored and supplemented in young elite athletes, considering its importance on musculoskeletal health.

The aim of the study is to assess enjoyment and intensity of physical exercise while practicing physical activity (PA) in immersive virtual reality (IVR) using innovative training devices (omni-directional Omni treadmill and Icaros Pro flight simulator). The study also contains the results of subjective research on the usefulness of such a form of PA in the opinion of users. In total, 61 adults (10 women and 50 men) took part in the study. To assess the enjoyment level (EL) Interest/Enjoyment subscale of Intrinsic Motivation Inventory (IMI) was used. Exercise intensity was assessed during 10-minute sessions of active video games (AVGs) in IVR based on heart rate (HR). The average enjoyment level during physical exercise in IVR on the tested training devices was relatively high (Omni 5.74 points, Icaros 5.60 points). In the opinion of the majority of participants, AVGs on IVR training devices constitute a sufficiently useful form of movement to meet the needs of PA practiced in free time, and they can even replace some of the classic forms of movement. Intensity of PA during games on training devices was at the level recommended for health benefits for 92% (Omni) and 84% (Icaros Pro) of its duration. Based on the conducted research, it can be assumed that AVGs in IVR using a multi-directional treadmill and a flight simulator can be an effective tool for increasing participation in health-oriented PA.

Titanium micro-scale topography results in excellent osteoconductivity and bone-implant integration. However, the biological effects of sub-micron topography are unknown. We compared osteoblastic phenotypes and in vivo bone and implant integration abilities between titanium surfaces with micro- (1–5 µm) and sub-micro-scale (0.1–0.5 µm) topographies and machined titanium. Average roughness was 12.5 ± 0.65 nm, 123 ± 6.15 nm, and 24 ± 1.2 nm for machined, micro-rough, and sub-micro-rough surfaces, respectively. The micro-rough surface showed the fewest cells attaching during the initial stage and the lowest proliferation. Calcium deposition and expression of osteoblastic genes were highest on the sub-micro-rough surface and lowest on the machined surface. Bone-to-implant integration was strongest for the micro-rough surface, consistent with it having the greatest ability to retain cells in vitro. Thus, the biological effects of titanium surfaces are not necessarily proportional to the degree of roughness in osteoblastic cultures or in vivo. Sub-micro-rough titanium ameliorates the disadvantage of micro-rough titanium by restoring cell attachment and proliferation and enhances the rate of osteoblastic differentiation over that of micro-rough titanium; however, bone integration and the ability to retain cells are compromised due to its lower interfacial mechanical locking compared to that of micro-rough titanium.

Background: Acute injuries of the hamstring muscle complex (HMC) Type 3b (interfascicle / bundle-tear) are frequently observed in various sports disciplines both in elite and recreational sport. The treatment of choice of acute HMC injuries Type 3b is a progressive physiotherapeutic exercise program. Besides this, there is currently only insufficient scientific evidence to support other treatment methods, including local infiltrations and injections of platelet-rich-plasma. Very recently it was demonstrated that extracorporeal shock wave therapy (ESWT) may accelerate regeneration after acute skeletal muscle injury. The aim of the present study is to test the hypothesis that the combination of radial ESWT (rESWT) and a specific rehabilitation program (RP) is effective and safe in treatment of acute HMC injury Type 3b in athletes, and is statistically significantly more effective than the combination of sham-rESWT and RP. Methods/Design: We will perform a double blind, randomized, sham-controlled clinical trial at the clinic KinEf Kinesiología Deportiva, Ciudad Autónoma de Buenos Aires, Argentina. Fourty patients with acute HMC injury Type 3b will be randomly allocated to receive either rESWT (nine rESWT sessions; three sessions per week; 2500 radial extracorporeal shock waves (rESWs) per session; energy density depending on what the patient tolerates) or sham-rESWT. In addition, all patients will receive a specific rehabilitation program that will last for eight weeks. The primary outcome measure will be the individual time (days) necessary to return to play. Secondary outcomes will include the presence or absence of reinjury during a time period of six months after inclusion into the study. Discussion: Because of the lack of adequate treatment options for acute HMC injury Type 3b in athletes and particularly the high reinjury rate, we hypothesize that the results of this trial will be of importance and have impact on clinical practice. Trial registration: ClinicalTrials.gov ID NCT03473899. Registered March 22, 2018.

The purpose of this study was to assess if self-regulation of intensity based on rating of perceived exertion (RPE) is a reliable method to control the intensity of metabolic conditioning of functional-fitness session. In addition, the relationship between RPE and changes in heart rate and lactate responses was also analyzed. Eight male participants (age 28.1 ± 5.4 years; body mass 77.2 ± 4.4kg; VO₂max: 52.6 ± 4.6 mL·(kg·min)⁻¹) completed three randomly sessions (5 to 7 days apart) under different conditions: (1) all-out (ALL); (2) self-regulation of intensity based on a RPE of 6 (hard) on the Borg CR-10 scale (RPE6); and (3) a control session. Rate of perceived exertion, LAC and HR response were measured pre, during and immediately after the sessions. The RPE and LAC during the ALL-OUT sessions were higher (p ≤ 0.05) than the RPE6 and control sessions for all the analyzed time points during the sessions. Regarding HR, the 22 min area under the curve of HR during ALL-OUT and RPE6 sessions were significantly higher (p ≤ 0.05) than the control session. The average number of repetitions was lower (p ≤ 0.05) for the RPE6 session (190.5 ± 12.5 repetitions) when compared to the ALL session (214.4 ± 18.6 repetitions). There was a significant correlation between RPE and LAC (p = 0.001; r = 0.76; very large) and number of repetitions during the session (p = 0.026; r = 0.55; large). No correlation was observed between RPE and HR (p = 0.147; r = 0.380). These results indicate that self-regulation of intensity of effort based on RPE may be a useful tool to control exercise intensity during a metabolic conditioning session of functional-fitness.

Functional mobility assessments (i.e., Timed Up and Go) are commonly used clinical tools for mobility and fall risk screening in the aging population. In this work, we proposed a new Mixed Reality (MR)-based assessment that utilized a Microsoft HoloLens^TM headset to automatically lead and track the performance of functional mobility tests, and subsequently evaluated its validity in comparison with reference inertial sensors. Twenty-two healthy adults (10 older, 12 young) participated in this study. An automated functional mobility assessment app was developed based on the HoloLens platform. Mobility performance was recorded with the headset built-in sensor and validated with reference inertial sensor (Opal, APDM) taped on the headset and lower back. Results indicate vertical kinematic measures by HoloLens was in good agreement with the reference sensor (Normalized RMSE ~ 10%). Additionally, the HoloLens-based test completion time was in perfect agreement with clinical standard stopwatch measure. Overall, our preliminary investigation indicates that it is possible to use an MR headset to automatically guide users to complete common mobility tests with good measurement accuracy, thus it has great potential to provide objective and efficient sensor-based mobility assessment.

BACKGROUND: Knee osteoarthritis (OA) commonly causes increase in the patients’ disability and reduce their function because it causes pain, limitation in knee range of motion and decrease in muscle power.AIM: This study investigated the effect of three different physical therapy programs on knee range of motion , pain level, muscle strength and functional condition in patients with knee OA. DESIGN: Randomized comparative study.SETTING: Outpatient Rehabilitation clinic of Tongji Hospital (Wuhan, China).POPULATION: Seventy-two patients of Knee OA (aged 40-70) enrolled and randomly allocated into three groups. Group A (n=24) received physical agents and isometric quadriceps exercises, group B (n=24) received same physical agents as group A in addition to open kinetic chain exercises and group C (n=24) received physical agents as group A in addition to closed kinetic chain exercises.METHODS: knee range of motion (by electro goniometer), knee pain level (by VAS), quadriceps muscle strength (by isokinetic dynamometer) and functional condition (by WOMAC) were assessed before and after 5 weeks of treatment.RESULTS: In between group analysis, there were significant differences (P<0.05) between the three groups for all outcome measure. In within-group analysis, group C was the only group that showed significant differences (P<0.05) in all the outcomes. Group A and B showed significant differences (P<0.05) in quadriceps muscle strength and knee pain and no significant differences (P>0.05) in knee ROM and functional condition.CONCLUSIONS: After the study, our solid conclusion is that in physical therapy programs or protocols, closed kinematic chain exercise is very effective, it improves knee ROM, and help in reducing knee pain, muscle strength, function and disability for patients with knee osteoarthritis.CLINICAL REHABILITATION IMPACT: Comparison between different physical therapy programs provides the rehabilitation team with the best treatment intervention that is more effective in treating the problems associated with knee osteoarthritis.

Despite the continued growth of the sport, particularly among recreational athletes, very little is known about how triathletes prepare for an event. The aim of this study was to identify the training characteristics of recreational-level triathletes and assess how their preparation for a triathlon influences their health and fatigue. During the 6 weeks prior to an Olympic distance triathlon, and the 2 weeks after the event, ten (5 males, 5 females) recreational athletes completed a daily training log to provide information on every training session. In addition, participants answered the Daily Analysis of Life Demands Questionnaire (DALDA), the Training Distress Scale (TDS), and the Alberta Swim Health Questionnaire weekly. Training loads were calculated using session-based rating of perceived exertion (sRPE) and training impulse (TRIMP). Every week of training was compared to week 1 to determine how athletes’ training and health changed throughout the study. In the 6 weeks leading up to the event, training loads, total minutes trained, and time spent in each training zone did not differ significantly. Significant reductions in training duration (Z=2.39, p=0.017, ES = 0.90), training strain (Z=2.59, p=0.009, 0.98), and number of sessions (Z=2.49, p=0.012, ES = 0.94) were seen on week 6. Training intensity distribution favored a threshold approach with athletes spending 56% of their training time at zone 1, 40% at zone 2, and 4% at zone 3. No significant changes were seen in the DALDA or TDS questionnaires. The results show that while the training intensity distribution of recreational-level triathletes does not follow a polarized model, these athletes were able to maintain their health while preparing for an Olympic distance triathlon.

The aim of this study was to identify the differences in functional fitness and quality of life among women over 60 years of age depending on their level of objectively measured physical activity (PA) according to Global Recommendations on Physical Activity for health. The study used cross-sectional design with 213 volunteered women over 60 years of age. Physical activity was monitored for 7 days of the week using Actigraph Gt3x monitor. The Senior Fitness Test battery and Hand-grip strength tests were performed to assess functional fitness. Quality of life was self-reported using short version of WHOQOL-brief questionnaire. Women who met the PA recommendations achieved slightly better results in most functional tests and all domain of quality of life. The significant differences were found in upper body strength, dynamic balance and social relationships domain of quality of life. Physical activity programs developed on the basis of WHO recommendations have the potential to improve functional capacity and quality of life. However, further experimental studies in this area are required.

Lower back musculoskeletal disorders (MSD) are an important public health problem and the leading cause of disability worldwide, but with prevalence yet unknown among shellfish gatherers. To investigate the prevalence and work-related factors associated with lower back MSD in a population of female shellfish gatherers, an epidemiological cross-sectional study was carried out in Saubara, Bahia – Brazil, in 2013. The Brazilian version of the Job Content Questionnaire (JCQ) and the Nordic Musculoskeletal Questionnaire (NMQ), in addition to a questionnaire containing the physical demands adapted to the artisanal work, were applied to a random sample of 209 female shellfish gatherers. The prevalence of lower back MSD was 72.7%. Using multivariate logistic regression, the shellfish gatherers who had worked for more than 26 years in the activity showed a prevalence of 1.22 (95% CI: 1.04-1.44) times higher compared to those unexposed. Lower back MSD was 1.24 (95%CI: 1.08-1.42) times higher among those more exposed to work sitting with trunk flexion. Those performed manual handling and muscle force with the arms had a prevalence ratio of 1.18 (95%CI: 1.01-1.39). These results show the need for greater awareness of health and social welfare factors impacting workers in small-scale fisheries and will promote the elaboration of health care policies for this occupational class.

Background: The maximal one-repetition test (1-RM) is widely used in scientific research; however, there are conflict results regarding its reproducibility in elderly population. The present study aimed to analyze the reproducibility the test both before and after a 12 week training period by using the bench press and leg press 45° 1-RM tests in the elderly taking into consideration the training experience and strength level of the women. Methods: Elderly women (n = 376; age, 68.5 ± 14.1 years; height, 162.7 ± 5.5 cm; body mass, 71.2 ± 16.0 kg) who underwent ≥3 months of resistance training performed an initial week of familiarization and a second week of testing and retest, with a 48–72 hour interval. Results: The results showed maximal and relative load strength of 39.3 kg and 0.59 kg/body mass for lower limbs and 20.9 kg and 0.31 kg/body mass for upper limbs. The Kappa indices were 0.93 and 0.95, and the intraclass correlation coefficients were 0.99 and 0.99 for the lower and upper limbs, respectively. Conclusion: Therefore, the present study confirms that the 1-RM test has high reliability and reproducibility in the elderly, for both upper and lower limbs.

Athletes are exposed to high-intensity loads to promote athletic performance, however without appropriate evaluation for its effects. This study investigates the effects of four types of exhaustion exercises on Heart Rate Variability (HRV) and Poincaré features as markers of central fatigue; Creatine Kinase (CK) and blood lactate concentrations ([LA-]b) as biomarkers of peripheral fatigue. To achieve this purpose, ten healthy volunteers were exposed to exhaustive exercise using isotonic-, isometric-, aerobic-, and anaerobic-fatigue protocols. HRV Poincaré features, standard deviation of instantaneous beat-to-beat R-R interval variability (SD1) and standard deviation of continuous long-term R-R interval variability (SD2) variables were collected. Central fatigue was tested through the sympathetic stress index (SS) and the sympathetic and parasympathetic index (SS/SD1). Blood samples were collected at the beginning and at the end of the exercises to determine CK and [LA-]b. The SD1 decreased in each exercise protocol, while the SS and SS/SD1 increased. [LA-]b and CK increased at the end of each protocol and correlated with SD1 and SS/SD1. HRV, CK, and [LA^-]_b are acute markers to detect, both central and peripheral fatigue; sensitive to the type, duration, and intensity of exercise, being HRV a novel noninvasive marker, simple and useful for sports coaches and athletes.

We asked whether the level of peripheral fatigue would differ when three consecutive exercise trials were completed to task failure, and whether there would be delayed recovery in maximal voluntary contraction (MVC) force, neuromuscular activation and peripheral fatigue following task failure. Ten trained sport students performed three consecutive knee extension isometric trials (T1, T2, T3) to task failure without breaks between trials. T1 and T2 consisted of repeated 5-s contractions followed by 5-s rest. In T1, contractions were performed at a target force at 60% pre-exercise MVC. In T2, all contractions were MVCs, and task failure occurred at 50% MVC. T3 was a sustained MVC performed until force fell below 15% MVC. Evoked force responses to supramaximal electrical femoral nerve stimulation were recorded to assess peripheral fatigue. Electromyography signals were normalized to M-wave amplitude to assess neuromuscular activation. Lower levels of evoked peak forces were observed at T3 compared to T2 and T1. Within 5 s of task failure in T3, MVC force and neuromuscular activation recovered substantially without any recovery in evoked peak force. Neuromuscular activation 5-10 s after T3 was unchanged from pre-exercise values, but evoked peak forces were substantially reduced. These results challenge the existence of a critical peripheral fatigue threshold that reduces neuromuscular activation. Since neuromuscular activation changed independently of any change in evoked peak force, immediate recovery in force production after exercise is due to increased central recruitment and not to peripheral mechanisms.

The results of this study offer a potential to gain a better understanding of the mechanisms underlying the falls in the elderly. The results were recorded for a group of 27 women in a control group (CON) and 16 women in an experimental group (EXP), aged 60-70. Participants took part in the six-weeks Elderly Recreation Movement Program (ERMP) with the difference, that the EXP group practiced twice as often as the CON group. The measurement of variations in the index called limits of stability (LOS) was performed by application of Kistler force plate and the coactivation index (CI) was registered by means of sEMG. The results demonstrate the existence of statistically significant differences in terms of the principal outcome of the exercise time in the measurements of LOS (F (1.42) = 10.0, p = 0.003), and CI (F (1.42) = 10.5, p = 0.002). The effect of the program was associated with an increase the level of the maximum LOS, and a decrease of the CI level, especially in the experimental group. Hence, the implementation of an innovative ERMP exercise program results in the improvement of the physical capabilities of senior subjects and a reduction of the risk of falls.

Reducing sedentary behaviours can help prevent non-communicable diseases, particularly among young adolescents with long term illnesses or disabilities (LTID). Much of young people’s voluntary sedentary time is related to screen-time behaviours (STBs) such as TV viewing, playing computer games, and using the computer for other activities. Although public health data on adolescents’ STB is growing, information about adolescents with LTID is currently lacking in a European context. The purpose of this study is to compare time on STBs between adolescents with and without LTID in European Countries through the HBSC 2013/14 study. Young adolescents (n = 61,329; boys 47.8%) from 15 European countries reported the time spent on TV viewing, playing computer games, and using the computer for other purposes on weekdays and the weekend. STBs were dichotomised based on international recommendations of less than 2 h per day, and Chi-square tests of independence were performed to investigate differences. STB time was combined to produce a sum score as dependent variable in multiple analysis of covariance with age and family affluence as covariates. There were statistically significant differences in computer gaming among boys and other computer use among girls for both weekdays and weekends, whereby adolescents with LTID reported higher use. In addition, both boys and girls with LTID spent more time on STBs than their same sex peers without LTID (Boys, F = 28.17, p < 0.001; Girls, F = 9.60, p = 0.002). The results of this study indicate a need for preventive strategies to address high levels of STB among young adolescents with LTID and reduce the risk of poor health outcomes associated with higher levels of sedentary behaviour.

This study investigated the effects of two plyometric training protocols on sprint and change of direction (COD) performance in elite hockey players. A parallel-group randomized controlled trial design was used and seventeen elite male and female field hockey players were randomly allocated into either low-to-high (L-H, n = 8) or high-to-low (H-L, n = 9) training groups. Each group performed separate variations of the drop jump exercise twice weekly for six weeks, with an emphasis on either jump height (L-H) or drop height (H-L). Performance variables assessed included sprint times over 10 m and 20 m, as well as 505 time. A two-way repeated measures analysis of variance was performed and Cohen’s d effect sizes were calculated. The H-L group displayed significant small ES improvement from baseline to post-training in the 10 m sprint (1.893 ± 0.08 s pre vs 1.851 ± 0.06 s post) (ES = −0.44) (P = <0.05). Small but not statistically significant differences between groups were observed for 10 m and 20 m sprint performance, and no significant differences were observed within or between groups for 505 time. These findings highlight the difficulty in substantially enhancing speed and COD ability in highly trained athletic populations through the addition of a low volume, short duration plyometric training protocol.

Background: Knee joint is a common site for injury among younger people, the purpose of this study is to measure the skeletal muscle endurance and strength on people with prior knee reconstruction surgery. Methods: Young healthy female subjects were tested who reported having knee reconstruction surgery of over one year prior to testing. The skeletal muscle endurance index of the hamstring and quadriceps muscles was determined as the decline in the specific muscle acceleration in response to 2, 4, and 6 Hz electrical stimulation. Maximal isometric muscle strength (MVC) was measured in the hamstring and quadriceps muscles. Results: The hamstring muscles in the affected leg had less endurance than the non-affected leg at 6 Hz stimulation (55.5 ± 13.2% versus 78.0 ± 13.3%, P = 0.01). Muscle endurance was not reduced in the quadriceps muscles in the affected leg compared to the non-affected leg at 6 Hz stimulation (78.0 ± 13.3% versus 80.3 ± 10.0%, P = 0.69). There were no differences in MVC between the affected and non-affected legs for either the hamstring (P= 0.20) or quadriceps muscles (p = 0.67). Conclusions: Muscle endurance is reduced in the hamstring muscles at least one-year post injury, while hamstring strength is not. Reduced hamstring muscle endurance could be a result of a lack of focus on muscle endurance during rehabilitation after injury and may contribute to re-injury in the particular muscle even in people who have recovered muscle strength.

Intense physical efforts performed at maximal or near-maximal speeds and the ability to recover among sprint are important characteristics of soccer player. Considering that women's soccer is a markedly growing sport, the aim of the study was to analyse the performance (total time –TT-; fatigue index percentage -IF%) and physiological (aerobic and anaerobic) responses to Repeated Sprint Ability Test (RSA, 7×30 m sprints with 25 s of active recovery among sprints) in an elite female player (age: 30 yrs; BMI: 20.3 kg/m²). A repeated measure MANOVA over the 7 sprints time series was applied (p < 0.05). Results showed that TT was 58.71 s (Ideal Time: 56.98 s) with IF% of 3.0%. Energy contributions were given for 80.3% by aerobic, 19.2% by anaerobic lactid, and 0.5% by anaerobic alactid sources. Considering that 1) we have different kinetics in heart rate (HR) and maximum oxygen uptake with oxygen uptake that reach the peak when HR is still rising, and 2) the energy consumption during intermittent exercises requires different metabolism as a result of physiological stimuli proposed, the present findings substantiate the need to choose specific and adequate training methods for female soccer players that aim at increasing their RSA performances.

The aim of this study was to clarify effects of 3-week work-matched high-intensity intermittent cycling training (HIICT) with different cadences on VO2max in university athletes. Eighteen university athletes performed HIICT with either 60 rpm (n = 9) or 120 rpm (n = 9). HIICT consisted of eight sets of 20-s exercise with a 10-s passive rest between each sets. The initial training intensity was set at 135% of VO2 max and was decreased by 5% every two sets. Athletes in both groups performed 9 sessions of HIICT during 3-week. The total work-load and achievement rate of the work load calculated before experiments in each group were used for analysis. VO2max was measured pre and post-training. After 3-week of training, no significant differences in the total work-load and achievement rate of the work load were found between the two groups. VO2max similarly increased in both groups from pre to post training (p = 0.016), with no significant differences between the groups (p = 0.680). These results suggest that cadence during HIICT is not training variable affecting effect of VO2max.

Background: Aging is commonly accepted as a time period of declining heath. Aims: This review aimed to examine the research base concerning the use of term ‘successful aging’, a process and outcome deemed desirable, but challenging to attain. A second was to provide related information to demonstrate how health professionals as well as individuals can aim for a ‘successful aging’ process and outcome, despite the presence of disabling osteoarthritis. Methods: Information specifically focusing on ‘successful aging’ and the concept of improving opportunities for advancing ‘successful aging’ despite osteoarthritis was sought. Results: Among the many articles on ‘successful aging’, several authors highlight the need to include, a broader array of older adults into the conceptual framework. Moreover, conditions such as osteoarthritis should not necessarily preclude the individual from attaining a personally valued successful aging outcome. Conclusion: Pursuing more inclusive research and research designs, and not neglecting to include people with chronic osteoarthritis can potentially heighten the life quality of all aging individuals, while reducing pain and depression, among other adverse aging and disability correlates among those with osteoarthritis

Baduanjin exercise is a traditional Chinese health-Qigong routine, created by an ancient physician for health promotion. Its mild-to-moderate exercise intensity is suitable for individuals with medical conditions. Recently, a large number of trials were conducted to investigate the effects of Baduanjin exercise in patients with chronic obstructive pulmonary disease (COPD). It needs to be determined whether Baduanjin exercise prescription is beneficial for the management of COPD patients. Thus, we conducted a systematic review to objectively evaluate the existing literature on this topic. We searched six databases (PubMed, Web of Science, Cochrane Library, Scopus, CNKI, and Wanfang) from its inception till early May, 2018. The adapted PEDro scale was used for study quality assessment of all randomized controlled trials (RCT). The pooled effect size (Hedge’s g) of exercise capability (6-Minute Walking Test, 6-MWT), lung function parameters (forced expiratory volume in first second, FEV1; forced volume vital capacity, FVC; FEV1/FVC ratio), and quality of life were calculated based on the random-effects model. Twenty RCTs (n = 1975 COPD patients) were included in this review, with sum scores of the adapted PEDro scale between 5 and 9. Study results of meta-analysis indicate that Baduanjin is effective in improving exercise capability (Hedge’s g = 0.69, CI 0.44 to 0.94, p < 0.001, I2 = 66%), FEV1 (Hedge’s g = 0.47, CI 0.22 to 0.73, p < 0.001, I2 = 68.01%), FEV1% (Hedge’s g = 0.38, CI 0.21 to 0.56, p < 0.001, I2 = 54.74%), FVC (Hedge’s g = 0.39, CI 0.22 to 0.56, p < 0.001, I2 = 14.57%), FEV1/FVC (Hedge’s g = 0.5, CI 0.33 to 0.68, p < 0.001, I2 = 53.49%), and the quality of life of COPD patients (Hedge’ s g = - 0.45, CI -0.77 to - 0.12, p < 0.05, I2 = 77.02%), as compared to control groups. Baduanjin exercise as an adjunctive treatment may potentially improve exercise capability and pulmonary function of COPD patients as well as quality of life. Baduanjin exercise could be tentatively prescribed for COPD in combination with the conventional rehabilitation program to quicken the process of recovery. To confirm the positive effects of Baduanjin exercise for COPD patients, future researchers need to consider our suggestions mentioned in this article.

In table tennis competitions the rule violation judgment with the greatest controversy is the height of the ball serve. This is because inaccuracy in the ball height judgment, which results in erroneous judgment, is unavoidable. Thus, we designed an automatic image judgment auxiliary system for table tennis ball height during service in this study. We used a high-speed camera to record the ball toss in the table tennis service. The designed algorithm architecture can automatically search for the ball and the position of the hand action under low light source conditions. The algorithm is mainly divided into hue-saturation-value color space processing and morphology processing using Hough transform to search for the circular ball. Experiment result shows that color segmentation can successfully and accurately determine the ball position under low light conditions. The morphology method can find the position of the hand and help determine the moment when the ball leaves the hand during the service ball toss. Finally, the actual size of the target is used to estimate the actual distance unit represented by the image pixel.

Application of protocols without parameter standardization and rigorous controls has led manual therapy (MT) and other physiotherapy approaches to controversial outcomes. Thus, there is an urgency to carefully define standard protocols that elevate physiotherapy treatments to rigorous scientific demands. One way this can be achieved is by studying gene expression and additional physiological changes that associate to particular, parameter-controlled, treatments in animal models and translating this knowledge to properly design objective, quantitatively-monitored clinical trials. Here, we propose a Molecular Physiotherapy Approach (MPTA), requiring multidisciplinary teams, to uncover the scientific reasons behind the numerous reports of MT that historically attribute benefits to these treatments. The review focuses in the identification of MT-induced physiological and molecular responses that could be used for the treatment of fibromyalgia (FM) and CFS/ME. The systemic effect associated to mechanical-load responses is considered of particular relevance as it suggests that defined, low-pain areas could be selected for treatments with overall benefits, an aspect that might result essential to treat FM. Additionally, MT can provide muscle conditioning to sedentary patients without demanding strenuous physical effort, detrimental for CFS/ME patients, placing MT as a real option for integrative medicine programs to treat FM and CFS/ME.

Soccer is the most played sport worldwide, with over 265 million participants. It is an incredibly demanding sport, with many different technical skills and physical loads placed on the body. This makes post-match recovery strategies amongst high level soccer players of great importance. The aim of this review is to summarize the existing literature on stretching for post-match recovery, examining its relation to injury prevention, Delayed Onset Muscle Soreness (DOMS), and performance. Scientific evidence of the highest quality and relevance was extracted and reviewed. Despite its common practice, evidence does not support static stretching as a modality to improve recovery post-match amongst soccer players. Larger trials with important outcome measures are needed to determine if a post-match stretching regimen to facilitate recovery exists.

Running on a non-motorized, curved-deck treadmill is thought to improve gait mechanics. It is not known, though, if the change in gait carries over to running on a motorized treadmill or level ground. To determine the effect of running on a curved non-motorized treadmill (CNT) on gait characteristics measured during a subsequent bout of running on a traditional motorized treadmill (TMT). Sixteen healthy college-aged participants, age (mean±SD) 20.4±1.6 years volunteered to have their gait analyzed while running on a TMT and CNT. After familiarization and warm-up on both treadmills, each subject completed five, 4-minute bouts of running alternating between traditional motorized and curved non-motorized treadmills: TMT-1, CNT-1, TMT-2, CNT-2, and TMT-3. Variables of interest included step length (m), stride length (m), imbalance score (%), and step angle (°) and were measured using Optogait gait analysis equipment. Differences in gait char acteristics among TMT-1, TMT-2, and TMT-3 can be attributed to running on the CNT. The results show that running on a CNT resulted in significant changes in gait characteristics. These findings suggest that running on a CNT can significantly alter gait characteristics may result in improvements in running gait that persist to subsequent running on a TMT.

Following an initial mechanical insult, traumatic spinal cord injury (SCI) induces a secondary wave of injury, resulting in a toxic lesion environment inhibitory to axonal regeneration. This review focuses on the glial cell line-derived neurotrophic factor (GDNF) and its application, also in combination with other factors and cell transplantations, for repairing the injured spinal cord. As recent decades of studies strongly suggest combinational treatment approaches hold the greatest therapeutic potential for the central nervous system (CNS) trauma, future directions of combinational therapies will also be discussed.

Introduction: We undertook the present study to analyze morphological features of a skull supposed to be that of Alum Bheg, a martyr from 1857 Indian Freedom Struggle (also called Sepoy Mutiny), using established methods to validate identity with regards to age and height as available in the note found with the skull (about 32 year and 5 feet 7½ inch). Methods: Identification of sex of the skull was done based on established criteria. Analysis for closure of skull sutures (cranial and facial) and measurement of orbitomedial (OM) & maxillomedial (MM) facial anthropometric lines were undertaken to provide an estimated age against each examined suture as well as group of sutures through established scoring systems. Further, approximate height of individual was estimated from skull length using regression equations from a reference adult Indian male population. Results: Established criteria confirmed that the skull was of a male individual and skull sutures and age related morphological changes in bones indicate that it belonged to an individual in age range 20 -50 years with an average of 30 years and approximate height between 5 feet 8.2 inch to 6 feet 1 inch. Discussion: Based on our observations we suggest that the skull belonged to a male individual around 30 years of age and height 5 feet 8.2 inch to 6 feet 1 inch. The observed values are in approximation with that mentioned in the historical note and slight differences may be attributed either to gross reporting of original values or limitations of anthropometric analysis.

The shoulder region has the highest incidence of acute injuries in the sport of surfing. Little is known about the strength profile at the shoulder in a surfing cohort. The primary aim of this study was to establish the reliability of a rotator cuff strength testing procedure for surfers with a secondary aim of providing a profile of internal (IR) and external rotation (ER) strength in a competitive surfing cohort. Shoulder IR and ER isometric strength was measured using a hand-held dynamometer in 13 competitive surfers. Intra-class coefficient values ranged from 0.97 to 0.98 for intra rater reliability and were lower for inter rater reliability ranging from 0.80 to 0.91. Normalised force (N/Kg) for IR strength was significantly greater than ER strength bilaterally (dominant, p= 0.007, non-dominant, p<0.001). No significant differences (p< 0.79) were found in IR strength (N/Kg) between the dominant and non-dominant arms. ER strength (N/Kg) was significantly weaker on the non-dominant arm compared with the dominant arm (p<0.02). The non-dominant arm ER to IR ratio (0.82 ± 0.15) was significantly (p=0.025) lower than the dominant (0.88 ± 0.14) The current procedure is reliable with the same clinician, results indicate musculature asymmetry specific to the external rotators.

The Combined Elevation Test (CET) is a musculoskeletal screening technique (MST) replicates the streamline position in swimming and is commonly used in various sports. Although the CET is widely used, no normative data exist within an adolescent population. Therefore, the purpose of this study was to develop a normative data set for the CET within an adolescent population and to evaluate the influence various demographic and anthropometric variables. Data was collected for 416 participants aged between 8 and 18 years old. Age and arm span showed a significant correlation with CET scores (arm span r_s (105) = .478, p = .000, age r_s (416) = .238 p = .000). Regression analysis further quantified the influence of arm span and age on CET scores accounting for 23.1% and 5.3% of variability respectively. These results can be used as a reference point for clinicians and coaches who are using the CET within their assessment.

Literature on the use of nutritional supplements (NS) in tennis players is scarce. The objective of the present study was to evaluate NS consumption in a group of men's tennis players who participated in the 2016 Andalusian team championship. A total of 70 questionnaires from 7 different clubs were registered. The questionnaire was previously designed and evaluated through piloting in which the validity of the content, its application, its structure and its presentation were observed. The results showed that 100% of the sample group was in favor of NS consumption within the law, 88.6% claimed to have consumed them at some time and 61.4% presently consume them. The NS most consumed by study participants were sports drinks (69.35%), energy bars (29%), a vitamin complex (19.35%), protein (serum) (17.74%) and creatine (14.51%). A high percentage of NS consumers thought that they had obtained positive results from NS consumption. The percentages and the findings regarding NS consumption in the present study were similar to the contributions made by other studies which evaluated supplementation in athletes, although with some subtle differences.

Rhizophora mangle L. is a well-known medicinal plant found in mangroves worldwide used to treatment diabetes. This study evaluated the chemical composition of the acetonic extract from Rhizophora mangle barks (AERM), by HPLC-PDA and FIA-ESI-IT-MS/MS and the effects on high-fat diet induced obesity in mice and its mechanism of action by gene expression of inflammatory markers (Pparg, Ppara, Srebf1, Cd36, Tnf, Ccl2, Lep, Il10, Il6, Fasn, 18s). High-fat diet fed mice during 12 weeks was used as model of obesity and associated alterations. The results were very satisfactory, the extract, rich in polyphenolic compounds, flavonoids and phenolic acids, displayed intense antioxidant activity in vitro (608 µmol Trolox/g), and showed excellent activity against non-alcoholic fatty liver disease (NAFLD) and reverse insulin resistance in a model of diet-induced obesity. We can registered a modulatory effect of AERM in liver PPAR-γ mRNA expression associated to an important inhibition of CD36 mRNA expression suggesting that AERM induces the down regulation of CD36 mRNA via PPAR-gamma inhibition. These results support the traditional knowledge about the use of R. mangle for the treatment of type 2 diabetes and reveal the potential of AERM for the treatment of NAFLD and management of obesity and comorbidities.

In 2011 over 1.7 million people were hospitalized because of a fragility fracture, and direct costs associated with osteoporosis treatment exceeded 70 billion dollars in the United States. Failure to reach and maintain optimal peak bone mass during adulthood is a critical factor in determining fragility fracture risk later in life. Physical activity is a widely accessible, low cost, and highly modifiable contributor to bone health. Here, we will review the evidence linking exercise and physical activity to bone health in women. Bone structure and quality will be discussed, especially in the context of clinical diagnosis of osteoporosis. We will review the mechanisms governing bone metabolism in the context of physical activity and exercise. Questions such as, when during life is exercise most effective, and what specific types of exercises improve bone health, will be addressed. Finally, we will discuss some emerging areas of research on this topic, and will summarize areas of need and opportunity.

Stand Up Paddleboard (SUP) surfing entails riding breaking waves and maneuvering the board on the wave face in a similar manner to traditional surfing. Despite some scientific investigations on SUP, little is known about SUP surfing. The aim of this study was to investigate the physiological response during SUP surfing sessions and to determine how various environmental conditions can influence this response. Heart rate (HR) of an experienced male SUP surfer aged 43 was recorded for 14.9 hours during ten surfing session and synced with on board video footage to enable the examination of the effect of different surfing modes and weather conditions on exercise intensity. Results indicated the SUP surfer's HR was above 70% of HR_max during 85% of each session, with the greatest heart rates were found during falls off the board (~85%HR_max) and while paddling back to the peak (~83%HR_max). Total time surfing a wave was less than 5% with the majority of time spend paddling back into position. Wind speed positively correlated with HR (r² = 0.062, p = 0.012) and wave height negatively correlated wave caching frequency (r² = 0.54, p = 0.025). The results highlight the aerobic fitness for SUP surfing, that wave riding, paddling back to the peak and falls appear to be associated with the greatest cardiovascular demand and that environmental conditions can have an effect of physiological response during SUP surfing sessions.

Then the purposes of this study were to compare and correlate the aerobic threshold (TH_aer) and anaerobic threshold (TH_anaer) measured during a new single judo specific incremental test and Treadmill Test for aerobic demand evaluation. Eight well-trained male competitive judo players (24.3±7.9 years; height of 169.3±6.7cm; fat mass of 12.7±3.9%) performed a maximal incremental specific test for judo mimicking the UchiKomi drills and on treadmill in different days. There was difference between specific and general TH_aer (P=0.0006) as well as weak correlation for TH_aer (r=0.32; R²=0.1; P=0.2) and TH_anaer (rs=-0.31; R²=0.1; P=0.12). When correlation was applied with normalized data (percentage of peak load) we observed moderate correlation for TH_aer (r=0.76; R²=0.58; P=0.027), but the same was not observed for TH_anaer. We conclude that there is a need of TH_aer and TH_anaer evaluation through a specific test for Judo.

Clinical rehabilitation and sports performance analysis both require the objectification of movement. Kinovea^© is a free 2D motion analysis software that enables the establishment of kinematics parameters. This low-cost technology has been used in sports sciences, as well as clinical field and research work. Although it has been validated as a tool with which to assess time-related variables, this is not yet the case regarding angular and distance variables. The main objective of this study was to determine the validity and reliability of the Kinovea software in obtaining angular and distance data at different perspectives of 90°, 75°, 60° and 45°. For this purpose, a figure with 29 points was designed (in AutoCAD) and 24 frames analysed. Each frame was examined by three observers who each made two attempts. For each export data item, 20 angles and 20 distance variables were calculated, with intra- and inter-observer reliability also analysed. To evaluate Kinovea reliability and validity a multiple approach was applied involving the following analysis: -systematic error with a two-way ANOVA 2x4; -relative reliability with ICC and CV (95% confidence interval); -absolute reliability with Standard Error. The results thus obtained indicate that the Kinovea software is a valid and reliable tool that is able to measure accurately at distances up to 5 m from the object and at an angle range of 90°–45°. Nevertheless, for optimum results an angle of 90° is suggested.

Background: We aimed to evaluate the effect of early pelvic binder use in emergency management of suspected pelvic trauma, compared with the conventional stepwise approach. Methods: We enrolled trauma patients with initial stabilization using a pelvic binder for suspecting pelvic injury. Inclusion criteria were traumatic injury requiring a trauma team and at least one of the following: loss of consciousness or Glasgow coma score (GCS) < 13; systolic blood pressure < 90 mmHg; falling from ≥6 m; injury to multiple vital organs; and suspected pelvic injury. Various parameters, including gender, age, mechanism of injury, GCS, mortality, hospital stay, initial vital sign, revised trauma score, injury severity score, and outcome, were assessed and compared with historical controls. Results: A total of 204 patients with high-energy multiple-trauma from single level I trauma center in North Taiwan were enrolled in the study from August 2013 to July 2014. The two group baseline patient characteristics were all collected and compared. The trauma patients with suspected pelvic fractures initially stabilized with a pelvic binder had shorter hospital and ICU stays. The study group achieved statistically significantly improved survival and lower mean blood transfusion volume and mortality rate although they were more severe in the trauma score. Conclusions: We recommend prompt pelvic binder use for suspected pelvic injury before definitive imaging is available, as a cervical spine collar is used to protect the cervical spine from further injury prior to definitive identification and characterization of an injury.

An alleged association of chronic use of thiazide diuretics with an increased risk of bone fragility fractures has been highlighted by a relatively recent prospective cohort study (Am J Med. 2016 Dec; 129(12):1299-1306). However, the concept that thiazides exert a beneficial effect on osteoporosis is still a predominant view. This effect would be mediated by the decrease in renal clearance of calcium ions, a pharmacological feature recognized for a long time now to this class of drugs , as opposed to the increase in calcium urinary excretion attributed instead to loop diuretics, i.e. furosemide and similar drugs . The purpose of this retrospective study is to attempt to clarify whether regular use of thiazide diuretics as antihypertensive therapeutics is associated with a significantly increased risk of osteoporotic fractures in female patients, aged over 70 years.

The cause-effect relationship between iron deficiency anemia (IDA) and osteoporosis has not been established in the general population. Thus, the current longitudinal study determined the role of IDA as a risk factor for osteoporosis by analyzing a large nationwide population-based sample. In a sample of 1,000,000 randomly sampled individuals from the 1998-2012 Taiwan National Health Insurance Research Database, patients with IDA (case group [n=35,751]) and individuals without IDA (control group [n=178,755]) were compared. Patients who were <20 years of age and who had pre-existing osteoporosis prior to the diagnosis of IDA were excluded. Each patient with IDA was age- and gender-matched to 5 individuals without IDA. The diagnoses of IDA and osteoporosis (coded using ICD-9CM) were further confirmed with blood test results and X-ray bone densitometry to ensure the accuracy of the diagnoses. Osteoporosis occurred more often among patients with IDA compared to individuals without IDA (2.27% vs. 1.32%, p<0.001). Cox proportional hazard analysis revealed that the risk for osteoporosis was significantly higher in the case than the control group (hazard ratio [HR]=1.74; 95% CI=1.61-1.88) and remained similar after adjustment for covariates (adjusted HR=1.81; 95% CI=1.67-1.97). Compared with individuals without IDA, the risk for osteoporosis was even higher for patients with IDA who received intravenous ferrum therapy (adjusted HR=2.21; 95% CI=1.85-2.63). In contrast, the risk for osteoporosis was reduced for patients with IDA who received a blood transfusion (adjusted HR=1.47; 95% CI=1.20-1.80). As a predictor, prior IDA is a significant and independent risk factor for development of osteoporosis. In contrast to blood transfusion treatment, the use of intravenous ferrum may further increase the risk for future osteoporosis.

To study the influence of Latin dance and Tai Chi on knee joint proprioception and balance. Method: All experiments were performed in the Beijing Normal University School of Physical Education and Sport Biomechanics Laboratory. An isokinetic test system (Biodex system 4, BS4) and a balance testing system (Biodex Balance System, BBS)from the United States Biodex medical system were used to test related indexes. Results: In the LOS test, the overall score of Latin group is much better than sedentary group. In the ASL test, Latin group have a better balance ability in anterior and posterior direction and overall score than sedentary group(p＜0.05); TAI CHI group have a better balance ability than sedentary group in anterior and posterior direction(p＜0.05)and right and left direction (p＜0.01). When the knee joint was at 15, 30, and 45degree positions, the Tai Chi exercise group was much better than sedentary group (P < 0.05), and the 45 degree position in the Tai Chi group was much better than that in the Latin dance group (P < 0.01).When the knee joint was at the 30 degree position, the quadriceps force sense was significantly better in the Tai Chi group than in the Latin dance and sedentary groups. In a test of the four angles, the hamstring force sense in the Tai Chi exercise group was obviously better than that in the sedentary group (P < 0.05); at the 15 degree position, the Tai Chi group was significantly better than the Latin group (P < 0.05); and at 30 degree position, the hamstring force sense of the Latin group was obviously better than that of the sedentary group (P < 0.05).

The main goal of the study was to obtain objective measures of the impact of a complete pre-season of amateur football on the players’ physical activity parameters. 17 amateur football players (24.47 ± 4.53 years) enrolled in the same team agreed to participate. They were asked to wear one accelerometer on the right hip during each training practice. Moderate-to-Vigorous physical activity (MVPA), steps and metabolic-equivalent (METs), among other parameters, were obtained and analyzed. Results showed that players spent an average 54.86% of each training session in MVPA levels, for a total of 100.33 minutes every week (3 training sessions per week). Therefore, this group of amateur football players did not meet the requirements to obtain health benefits from their physical activity program: amateur football. This finding could be considered noteworthy because there are thousands of adults worldwide who play amateur football to maintain a healthy lifestyle. They should be aware that their weekly training load is not enough to help them meet the necessary requirements. They either need more practice time (90-minute sessions) or more sessions. The pre-season training program was rated as “somewhat hard” by the participants, and quadriceps and hamstrings were mentioned as the most exerted muscles

Dysregulation of cartilage homeostasis and the changes in the density and the architecture of the subchondral bone were postulated as a potent mechanically pathological activity contributing to osteoarthritis (OA) pathogenesis. Extracorporeal shockwave therapy (ESWT) is a new, none invasive and effective method in the treatment of animal OA model. In the current study, we demonstrated that shockwave induced the expression of protein-disulfide isomerase-associated 3 (Pdia-3) which is a multifunctional protein hypothesized to be a significant mediator for 1α,25-Dihydroxyvitamin D3 (1α,25(OH)₂D₃) signaling pathway using two-dimensional electrophoresis. Histological analysis and quantitative polymerase chain reaction (qPCR) were verified and observed that the expression of Pdia-3 at 2 weeks was significantly higher than that of any other group at 4 weeks, 8 weeks, and 12 weeks post-shockwave treatment in early OA knee of rat. The other factors of the 1α,25(OH)₂D₃ rapid membrane signaling pathway including extracellular signal-regulated protein kinases 1 (ERK1), osteopontin (OPG), alkaline phosphatase (ALP), and matrix metallopeptidase 13 (MMP13) were measured and significantly increased by qPCR at 2 weeks post-shockwave treatment in early OA knee. Our proteomic data revealed significant Pdia-3 expression in microenvironments of joint tissue that could be actively responded to ESWT, which may potentially regulate biological function of chondrocytes and osteoblasts in the treatment of OA knee.

Aim: The aim of this study was to investigate if tests used to assess core stability could be used to determine success in physiological tests applied to assess dynamic balance and agility for a young active population. Methods: Pearson's r correlation coefficient was used to assess the relationship between the core stability tests and the dynamic balance and agility tests. Evaluation of the tests was established using Cronbach's coefficient of variance as part of intra-rater reliability tests. An analysis of 18 active college aged students was conducted (males: n= 13, females: n= 5). The mean ± SD age for males was 19.2 years ± 3.22 years and for females was 19.4 years ± 1.14 years. Conclusion: The results indicate that there is no significant relationship between tests that assess core stability and tests conducted to assess dynamic balance in active young adults. With the exception of the abdominal flexion test, no significant relationship exists between the remaining core stability tests and agility T-Test. Core stability is not a determinant of balance and agility.