Balance Parameters Research Articles

Investigation of the Effects of Posture and Proprioception Sense on Balance and Gait

The aim of this research is to evaluate the effects of individual differences in head posture, balance parameters, and proprioception on balance and gait in asymptomatic individuals. The research was conducted with 111 participants. Balance and walking ability, range of motion of the cervical spine, body posture, proprioception sense, and both static and dynamic balance assessments were carried out. The relationship of the Timed Up and Go Test with various independent variables such as head forward tilt, proprioceptive error, Flamingo Test score, Functional Reach Test score, and Y Balance Test score was examined. There was a significant negative correlation between the Timed Up and Go Test score and the Functional Reaching Test score and the Y Balance Test score at p = 0.05 statistical significance level. Multiple regression analysis was used to identify variables predicting balance and gait performance. The results showed that there is no statistically significant relationship between the Timed Up and Go Test score and any of the predictive variables. The findings indicated that impairments in upper extremity reaching capacity and particular aspects of dynamic equilibrium could potentially be associated with the prolonged duration of the Timed Up and Go Test. The aforementioned discoveries hold significance for evaluating and restoring the physical abilities of people with mobility limitations.

Assessing POT Syndrome with Wearable Sensors and AI: A Case Study

Background:- POTS affects younger people between the ages of 15 and 45, with a clear female predominance (80%). Dizziness, weakness, a quick heartbeat, and palpitations upon standing are the most frequent complaints. Additionally, patients frequently describe headaches, "brain fog," dyspnea, gastrointestinal problems, and musculoskeletal pain in addition to physical deconditioning and decreased exercise ability. Objective:- fitnees assessment of neurological symptoms along with musculoskeletal symptoms. Results - fitknees assessment shows significant changes in static balance, dynamic balance and gait parameter.

PHYSICAL FITNESS AND BALANCE PERFORMANCE IN TABLE TENNIS PLAYERS WITH INTELLECTUAL DISABILITIES: A COMPARISON BETWEEN THE YEARS 2016 AND 2022

Training routine is beneficial for people with intellectual disabilities, increasing their physical fitness, improving the balance and consequently reducing the risk of falls. However, during the COVID-19 breakdown, training restrictions could impair these benefits. This is a two-fold study aimed to compare the physical fitness performance and balance in table tennis athletes with intellectual disability (ID) during 2016 and 2022; and to analyse the association between the fitness and balance parameters. Table tennis athletes with ID, from both sexes and members of the Special Olympics Czech Republic, were assessed in 2016 (n=33) or 2022 (n=32). The FUNfitness protocol was used to measure the physical fitness parameters and balance (e.g., functional shoulder rotation, timed sit-to-stand test, partial sit-up test, handgrip test, single leg stance eyes open, single leg stance eyes closed). Comparison and correlation statistical tests were used (p<0.05). The physical fitness parameters and balance presented no statistically significant between the years (2016 vs 2022) or better results in 2022 (single leg stance, partial sit-up test). The correlation of physical fitness parameters and balance demonstrated that balance is positively related to flexibility (single leg stance eyes closed: r=0.32 and 0.58 for males and females, respectively) and lower limb strength (single leg stance eyes open: r=-0.31 and -0.52 for males and females, respectively). In conclusion, the development of flexibility and low limb strength in ID population can help improve the balance, and consequently minimize the risk of falls.

Neuromuscular Electrical Stimulation of Peroneal Longus on Balance Control Ability in Young Adults with Chronic Ankle Instability: A Randomized Controlled Trial.

This study aimed to investigate the effects of six weeks of peroneal longus neuromuscular electrical stimulation (NMES) on the balance control ability in young adults with chronic ankle instability (CAI). This study is a double blind randomized controlled trial. Six weeks of NMES and placebo intervention were conducted in the NMES and control groups for 20 minutes, three times a week, respectively. Thirty-eight participants successfully completed the whole intervention and single-leg standing tests. The kinetics data of the center of pressure (COP) trajectory during static single-leg stance were measured using a Kistler force platform. Two-way repeated measures ANOVA was used to analyze the electrical stimulation effects. Significant interactions were detected in CAIT scores and all balance parameters including Displacement X (Dx), Displacement Y(Dy), 95% confidence ellipse area (95%AREA), root-mean-square (RMS) and COP mean displacement velocity (MV) (p < 0.05, 0.103 ≤ η2 ≤ 0.201). Significant between-group differences were found in CAIT scores (p = 0.003, Cohen's d = 0.215), Dx (p = 0.045, Cohen's d = 0.107), RMS-ml (p = 0.019, Cohen's d = 0.143) and 95%AREA (p = 0.031, Cohen's d = 0.123) after the six weeks interventions. Six weeks of NMES on the peroneus longus can improve static balance control ability in young adults with CAI, especially the stability of ankle frontal plane.

The Effect of Pilates Exercises on Mobility and Dynamic Balance in Former Athletes and Sedentary Individuals

Workout programmes have proven physiological benefits, and it is widely accepted that they can yield more positive health outcomes when parameters such as balance and mobility are at play. This study intends to examine the effects of a 12-week mat pilates workout program on mobility and dynamic balance parameters in the former athlete group (FAG) and the sedentary group (SG). The study was designed in an experimental design with pre-test and post-test in two groups. The study group consisted of 30 female participants, SG (n=15) and FAG (n = 15). Dynamic balance values were measured using the Star Excursion Balance Test, and lower extremity mobility was measured using the Sit and Reach Test. Both groups conducted mat pilates exercises twice a week for 12 weeks. At the end of the 12-week mat pilates workout programme, a significant difference of increase was obtained in the mobility values of the FAG (p&amp;lt;0,002) and the SG (p&amp;lt;0,001). The Y Balance Test identified a significant difference of increase with pre-test and post-test in anterior (p = 0.04), postero-lateral (p = 0.03), posteromedial (p = 0.04) directions balance in the FAG. In the difference between groups, SG showed a significant increase in posterolateral (p = 0.001) and posteromedial (p = 0.002) directions balance than FAG at post-test. At the end of the 12-week mat pilates workout programme, it was revealed out that the FAG scored better in post-test in dynamic balance than the SG although it scored lower in the dynamic balance pre-test than the SG.

Impaired Standing Balance in Older Adults with Cognitive Impairment after a Severe Fall

Introduction: Fall-related sequelae as well as balance and gait impairments are more pronounced in older adults who are cognitively impaired (OACI) compared to older adults who are cognitively healthy (OACH). Evidence is scarce about differences in standing balance and gait in OACH and OACI after a fall, even though these are major risks for recurrent falls. Thus, the aim of this study was to investigate early impairments in gait and balance, by adding inertial measurement units (IMUs) to a functional performance test in OACH and OACI after a severe fall with a presentation to the emergency department (ED) and immediate discharge. Methods: The study sample was stratified into participants with and without probable cognitive impairment using the result of the Montreal Cognitive Assessment total score (maximum of 30 points). The cutoff for probable cognitive impairment was set at ≤ 24. Standing balance and gait parameters were measured using three IMUs in n = 69 OACH (72.0 ± 8.2 years) and n = 76 OACI (78.7 ± 8.1 years). Data were collected at participants’ homes as part of a comprehensive geriatric assessment in the “SeFallED” study within 4 weeks after presentation to the ED after a severe fall (German Clinical Trials Register ID: 00025949). ANCOVA was used for statistical analysis, adjusted for age. Results: The data indicated significantly more sway for OACI compared to OACH during balance tasks, whereas no differences in gait behavior were found. In detail, differences in standing balance were revealed for mean velocity (m/s) during parallel stance with eyes open (ηp2 = 0.190, p < 0.001) and eyes closed on a balance cushion (ηp2 = 0.059, p = 0.029), as well as during tandem stance (ηp2 = 0.034, p = 0.044) between OACI and OACH. Further differences between the two groups were detected for path length (m/s2) during parallel stance with eyes open (ηp2 = 0.144, p < 0.001) and eyes closed (ηp2 = 0.044, p < 0.027) and for range (m/s2) during tandem (ηp2 = 0.036, p = 0.036) and parallel stance with eyes closed (ηp2 = 0.045, p = 0.032). Conclusion: Even though both groups have experienced a severe fall with presentation to the ED in the preceding 4 weeks, balance control among OACI indicated a higher fall risk than among OACH. Therefore, effective secondary fall prevention efforts have to be established, particularly for OACI.

Patients with chronic ankle instability exhibit increased sensorimotor cortex activation and correlation with poorer lateral balance control ability during single-leg stance: a FNIRS study.

Chronic Ankle Instability (CAI) is a musculoskeletal condition that evolves from acute ankle sprains, and its underlying mechanisms have yet to reach a consensus. Mounting evidence suggests that neuroplastic changes in the brain following ankle injuries play a pivotal role in the development of CAI. Balance deficits are a significant risk factor associated with CAI, yet there is a scarcity of evidence regarding the sensorimotor cortical plasticity related to balance control in affected individuals. This study aims to evaluate the differences in cortical activity and balance abilities between patients with CAI and uninjured individuals during a single-leg stance, as well as the correlation between these factors, in order to elucidate the neurophysiological alterations in balance control among patients with CAI. The study enrolled 24 patients with CAI and 24 uninjured participants. During single-leg stance, cortical activity was measured using a functional near-infrared spectroscopy (fNIRS) system, which included assessments of the pre-motor cortex (PMC), supplementary motor area (SMA), primary motor cortex (M1), and primary somatosensory cortex (S1). Concurrently, balance parameters were tested utilizing a three-dimensional force platform. Independent sample t-tests revealed that, compared with the uninjured individuals, the patients with CAI exhibited a significant increase in the changes of oxyhemoglobin concentration (ΔHbO) during single-leg stance within the left S1 at Channel 5 (t = 2.101, p = 0.041, Cohen's d = 0.607), left M1 at Channel 6 (t = 2.363, p = 0.022, Cohen's d = 0.682), right M1 at Channel 15 (t = 2.273, p = 0.029, Cohen's d = 0.656), and right PMC/SMA at Channel 11 (t = 2.467, p = 0.018, Cohen's d = 0.712). Additionally, the center of pressure root mean square (COP-RMS) in the mediolateral (ML) direction was significantly greater (t = 2.630, p = 0.012, Cohen's d = 0.759) in the patients with CAI. Furthermore, a moderate positive correlation was found between ML direction COP-RMS and ΔHbO2 in the M1 (r = 0.436; p = 0.033) and PMC/SMA (r = 0.488, p = 0.016), as well as between anteroposterior (AP) direction COP-RMS and ΔHbO in the M1 (r = 0.483, p = 0.017). Patients with CAI demonstrate increased cortical activation in the bilateral M1, ipsilateral PMC/SMA, and contralateral S1. This suggests that patients with CAI may require additional brain resources to maintain balance during single-leg stance, representing a compensatory mechanism to uphold task performance amidst diminished lateral balance ability in the ankle joint.

Comparative characteristics of cervical sagittal balance parameters and atlantoaxial instability criteria in normal and Down syndrome children

BACKGROUND: Sagittal balance of the spine has received considerable development in recent years. However, most studies focused on the assessment of vertebral–pelvic parameters. The cervical spine has long received insufficient attention from researchers, but this trend has been changing. The study of cervical sagittal balance in children with Down syndrome is beneficial in approaching the preconditions of atlantoaxial instability. AIM: To perform a comparative analysis of cervical sagittal balance parameters and atlantoaxial instability criteria in normal and Down syndrome children. MATERIALS AND METHODS: Radiographs of the cervical spine in the neutral position in lateral projection and postural radiographs of 110 pediatric patients were analyzed retrospectively. The patients were divided into two groups: group 1 (normal), 60 children aged 4–17 years without spinal pathology, and group 2 (Down syndrome), 50 children aged 4–17 years with Down syndrome. The parameters of cervical sagittal balance (Oc-C2, Oc-C7, C1-C2, C2-C7, C2-C7H, C7S, Th1S, TIA, NT) and criteria for atlantoaxial instability (Nakamura angle, ADI, SAC-C1, SAC-C1/SAC-C4) were obtained, and data was statistically analyzed. RESULTS: Significant differences in the parameters C7S, Th1S, and TIA increased in children with Down syndrome. These parameters are involved in cervical lordosis; however, no significant differences in cervical lordosis angles were found. Furthermore, significant differences were noted in the criteria of atlantoaxial instability ADI, SAC-C1, and SAC-C1/SAC-C4 toward their decreasing in children with Down syndrome. CONCLUSION: In patients with Down syndrome, the indices of cervical lordosis are statistically greater than those in normal children. Moreover, the parameters of cervical lordosis in patients with Down syndrome do not differ from those in normal children. Therefore, during flexion, subcompensation of the cervical spine is observed in children with Down syndrome. Given the statistically smaller indicators ADI, SAC-C1, SAC-C1/SAC-C4, low neck muscle tone, and ligamentous hypermobility, these abnormalities can be considered as congenital predisposition factors for atlantoaxial instability in children with Down syndrome.

GAIT- AND BALANCE-RELATED FACTORS AFFECTING PARTICIPATION IN SCHOOL-AGED CHILDREN WITH UNILATERAL CEREBRAL PALSY

Although gait and balance impairments are prevalent in children with unilateral cerebral palsy (UCP), their effects on participation are not completely elucidated. This study aims to explore factors affecting participation in children with UCP, particularly those related to gait and balance. This descriptive relation-seeker study was completed with 40 children with UCP at Gross Motor Function Classification System (GMFCS) levels I and II (50% female; median age = 11 (7-12)years). "The Gross Motor Function Measure (GMFM-66)", "The Pediatric Balance Scale (PBS)", "The Timed Up and Go test (TUG) and The Functional Mobility Scale (FMS)", and "The BTS G-Walk Spatiotemporal Gait Analysis System" were used to evaluate the gross motor function, balance, functional mobility, and quantitative gait parameters, respectively. "The Canadian Occupational Performance Measure (COPM)" was employed to evaluate participation. Variables affecting the COPM scores were analyzed by multivariate regression analysis.The factors affecting the COPM-performance score were cadence (B = 79.859, p = 0.001) and FMS (B = 0.352, p

Balance Changes Following a Controlled Whole-Body Vibration Training: A Pilot Analysis Addressing Balance Control in Adult Women with Obesity

Background: The prevalence of obesity among older individuals has significantly increased in recent years, potentially doubling the risk of postural imbalance and falls. Controlled whole-body vibration (CWBV) training is considered an alternative/complementary therapy for fall prevention, but its mechanisms still require further investigation. Objectives: This study aimed to investigate the effects of CWBV on balance and fall risk among older adult women with obesity. Methods: Fifteen adult women over the age of 60 (mean age 68.55 ± 4.86, BMI: 30.57 ± 2.97) participated in this quasi-experimental study. They underwent CWBV training three times weekly for six weeks. Gait stability and balance were assessed using a gait analysis system before and after the intervention. Results: The results indicated a significant decrease in both static and dynamic balance parameters, except for the variability of velocity index (P = 0.9) and fear of falling (FES-I score, P = 0.56), after the intervention. Conclusions: CWBV training appears to be an effective method for improving static and dynamic balance parameters in older adult women. However, further research is necessary to explore different dosages and protocols of vibration training, incorporating more challenging/specialized proprioceptive exercises to potentially improve the fear of falling in this population.

The immediate efficacy of the spinomed orthosis and biofeedback posture orthosis on balance and gait in older people with thoracic hyperkyphosis

BackgroundIncreased kyphosis is a common condition among older people that may, directly or indirectly, be a risk factor for poor balance and gait. Spinomed and Biofeedback Posture Trainer (BPT) orthoses is an effective treatment approach for hyperkyphosis. This study aimed to compare the immediate effects of the Spinomed and BPT orthoses on balance and gait in the older population. MethodsA total of 52 volunteer older people with hyperkyphosis (kyphosis angle>40°) participated in this study and were randomly allocated into two groups, to either the Spinomed orthosis (n = 26, mean age = 65.50 ± 5.50) or the BPT (n = 26, mean age = 65.38 ± 5.69) orthosis. All participants were asked to wear the orthoses for 1.5 h to get used to them. Balance parameters, which are Postural Stability Test (PST), Limits of Stability (LOS), and Clinical Test of Sensory Integration for Balance (m-CTSIB) were assessed using the Biodex Balance System, while walking parameters were assessed using the G-Walk with and without orthosis. ResultsThe Spinomed had a positive effect on balance parameters (p < 0.05) except for the closed eyes firm surface and the opened eyes foam surface conditions of the m-CTSIB (p > 0.05). BPT had a significant impact on the PST score, LOS, and the closed eyes firm surface condition of the m-CTSIB (p < 0.001). Spinomed had a significant effect on cadence, speed, gait cycle duration, elaborated steps, and symmetry index of pelvic angles (p < 0.05), while the BPT had a significant effect only on step length and rotation symmetry index. No significant difference was detected between the two types of orthoses in the balance and gait parameters (p > 0.05). ConclusionsSpinomed and BPT were both effective in improving balance performance, with similar improvements demonstrated by both orthoses. Additionally, Spinomed may provide significant improvements in cadence, speed, gait cycle duration, elaborated steps, and all symmetry indexes of pelvic angles in the short term.

Lower limb lymphedema disrupts both static and dynamic balance

BackgroundThe impact of lower-limb-lymphedema on quality of life of patients regarding balance is unclear due to the scarcity of literature. The aim of this study was to determine the static and dynamic balance of patients with lower-limb-lymphedema in comparison with healthy subjects. MethodsThis case-control designed study included 30 lymphedema patients and 30 healthy individuals, of whom were 52 female and 8 male with a mean age of 50.63 ± 9.72 years. Static balance stability and anterior-posterior with lateral sway parameters on four conditions (eyes-opened-stable-ground, eyes-closed-stable-ground, eyes-opened-unstable-ground, eyes-closed-unstable-ground) and dynamic stability of all participants were evaluated. FindingsThe demographic variables were similar between the groups. Majority of the patients had lymphedema due to cancer surgery with a stage of 2. Dynamic stability was significantly disrupted in lymphedema group in comparison with controls (P = 0.049). Static balance parameters were impaired on all conditions except the eyes opened-stable ground in lymphedema patients (P = 0.048,P = 0.043,P = 0.017). The dynamic with static balance and lateral sway parameters were correlated with the duration of lymphedema(P = 0.046,P = 0.002,P = 0.005). Anterior-posterior sway on eyes-closed-unstable-ground condition was correlated with functional status (P = 0.02). Static balance on eyes-opened-unstable-ground condition and anterior-posterior sway parameters were correlated with physical activity level (P = 0.015,P = 0.016,P < 0.05). InterpretationClosing eyes and the deterioration of ground caused significant alteration of the static and dynamic balance both separately and together in patients with lower-limb-lymphedema compared to healthy subjects. Regarding the static and dynamic imbalance, we suggest the evaluation of balance and inclusion of balance exercises in routine lymphedema rehabilitation program, especially in the early period of disease.

Investigation of the effect of chronic ankle instability on core stabilization, dynamic balance and agility among basketball players of a university

BackgroundChronic ankle instability (CAI) is frequently seen in basketball, where ankle sprains are common due to repetitive movements such as jumping, landing, deceleration and acceleration. ObjectiveThis study investigated the effects of CAI on core stabilization, dynamic balance, and agility in university-level basketball players. Materials and methodsThe study included 22 basketball players with CAI (8F, 3M; 20.09 ± 1.04 years) and without CAI (8F, 3M; 21.27 ± 2.24 years), registered as team players in the Yeditepe University basketball teams. Participants divided into two groups: the chronic ankle instability group (CAIG) and the control group (CG). The participants' core stabilization was evaluated using the McGill Core Endurance Test, dynamic balance was evaluated with the Y Balance Test and the T Test was used to evaluate agility. ResultsAccording to the results of an independent t-test, significant differences were observed between groups including posteromedial (p = 0.03) and posterolateral (p = 0.03) reach distances, trunk flexion (p = 0.04) and trunk extension (p = 0.03) tests. According to the logistic regression analysis, Y Balance Test posteromedial and posterolateral reach distances, trunk flexion and trunk extension tests in the McGill Core Endurance Test were found to be statistically significant on the presence of CAI (p < 0.05). ConclusionIncluding core stabilization and dynamic balance exercises in the training program may be beneficial to improve core stabilization and dynamic balance parameters and prevention of CAI in university-level basketball players with CAI.

Sagittal balance parameters measurement on cervical spine MR images based on superpixel segmentation.

Introduction: Magnetic Resonance Imaging (MRI) is essential in diagnosing cervical spondylosis, providing detailed visualization of osseous and soft tissue structures in the cervical spine. However, manual measurements hinder the assessment of cervical spine sagittal balance, leading to time-consuming and error-prone processes. This study presents the Pyramid DBSCAN Simple Linear Iterative Cluster (PDB-SLIC), an automated segmentation algorithm for vertebral bodies in T2-weighted MR images, aiming to streamline sagittal balance assessment for spinal surgeons. Method: PDB-SLIC combines the SLIC superpixel segmentation algorithm with DBSCAN clustering and underwent rigorous testing using an extensive dataset of T2-weighted mid-sagittal MR images from 4,258 patients across ten hospitals in China. The efficacy of PDB-SLIC was compared against other algorithms and networks in terms of superpixel segmentation quality and vertebral body segmentation accuracy. Validation included a comparative analysis of manual and automated measurements of cervical sagittal parameters and scrutiny of PDB-SLIC's measurement stability across diverse hospital settings and MR scanning machines. Result: PDB-SLIC outperforms other algorithms in vertebral body segmentation quality, with high accuracy, recall, and Jaccard index. Minimal error deviation was observed compared to manual measurements, with correlation coefficients exceeding 95%. PDB-SLIC demonstrated commendable performance in processing cervical spine T2-weighted MR images from various hospital settings, MRI machines, and patient demographics. Discussion: The PDB-SLIC algorithm emerges as an accurate, objective, and efficient tool for evaluating cervical spine sagittal balance, providing valuable assistance to spinal surgeons in preoperative assessment, surgical strategy formulation, and prognostic inference. Additionally, it facilitates comprehensive measurement of sagittal balance parameters across diverse patient cohorts, contributing to the establishment of normative standards for cervical spine MR imaging.

Detergents with Scalable Properties Identify Noncanonical Lipopolysaccharide Binding to Bacterial Inner Membrane Proteins.

Lipopolysaccharide (LPS) is vital for maintaining the outer membrane barrier in Gram-negative bacteria. LPS is also frequently obtained in complex with the inner membrane proteins after detergent purification. The question of whether or not LPS binding to inner membrane proteins not involved in outer membrane biogenesis reflects native lipid environments remains unclear. Here, we leverage the control of the hydrophilic-lipophilic balance and packing parameter concepts to chemically tune detergents that can be used to qualitatively differentiate the degree to which proteins copurify with phospholipids (PLs) and/or LPS. Given the scalable properties of these detergents, we demonstrate a detergent fine-tuning that enables the facile investigation of intact proteins and their complexes with lipids by native mass spectrometry (nMS). We conclude that LPS, a lipid that is believed to be important for outer membranes, can also affect the activity of membrane proteins that are currently not assigned to be involved in outer membrane biogenesis. Our results deliver a scalable detergent chemistry for a streamlined biophysical characterization of protein-lipid interactions, provide a rationale for the high affinity of LPS-protein binding, and identify noncanonical associations between LPS and inner membrane proteins with relevance for membrane biology and antibiotic research.

Weight loss in adult male Wistar rats by Roux-en-Y gastric bypass is primarily explained by caloric intake reduction and presurgery body weight.

Diets varying in macronutrient composition, energy density, and/or palatability may cause differences in outcome of bariatric surgery. In the present study, rats feeding a healthy low-fat (LF) diet or an obesogenic high-fat/sucrose diet (HF/S) were either subjected to Roux-en-Y gastric bypass surgery (RYGB) or sham surgery, and weight loss trajectories and various energy balance parameters were assessed. Before RYGB, rats eating an HF/S (n = 14) diet increased body weight relative to rats eating an LF diet (n = 20; P < 0.01). After RYGB, absolute weight loss was larger in HF/S (n = 6) relative to LF feeding (n = 6) rats, and this was associated with reduced cumulative energy intake (EI; P < 0.05) and increased locomotor activity (LA; P < 0.05-0.001), finally leading to similar levels of reduced body fat content in HF/S and LF rats 3 wk after surgery. Regression analysis revealed that variation in RYGB-induced body weight loss was best explained by models including 1) postoperative cumulative EI and preoperative body weight (R2 = 0.87) and 2) postoperative cumulative EI and diet (R2 = 0.79), each without significant contribution of LA. Particularly rats on the LF diet became transiently more hypothermic and circadianally arrhythmic following RYGB (i.e., indicators of surgery-associated malaise) than HF/S feeding rats. Our data suggest that relative to feeding an LF diet, continued feeding an HF/S diet does not negatively impact recovery from RYGB surgery, yet it promotes RYGB-induced weight loss. The RYGB-induced weight loss is primarily explained by reduced cumulative EI and higher preoperative body weight, leading to comparably low levels of body fat content in HF/S and LF feeding rats.NEW & NOTEWORTHY Relative to feeding an LF diet, continued feeding an HF/S diet does not negatively impact recovery from RYGB surgery in rats. Relative to feeding an LF diet, continued feeding an HF/S diet promotes RYGB-induced weight loss. The RYGB-induced weight loss is primarily explained by reduced cumulative EI and higher preoperative body weight, leading to comparably low levels of body fat content in HF/S and LF feeding rats.

Oxidative stress as one of the pathogenetic mechanisms of hepatopulmonary syndrome in patients with liver cirrhosis

Background. Hepatopulmonary syndrome is one of the most dangerous syntropies in case of liver cirrhosis. Consequently, it is important to determine the role of oxidative stress, acid-base balance and ventilation-perfusion disorders as factors of hepatopulmonary syndrome development in cirrhotic patients. Materials and methods. We included 44 cirrhotic patients with hepatopulmonary syndrome verified according to the patented Method for diagnosing degrees of hepatopulmonary syndrome severity in patients with liver cirrhosis. In addition to the traditional examinations, we determined the gas composition parameters in venous blood, acid-base balance parameters, catalase activity and malondialdehyde level in all the patients. The received material was processed on a personal computer using Excel 2010, Statistica 6.0, RStudio v. 1.1.442 and R Commander v. 2.4-4. Results. Analysis of blood gas parameters revealed the reliability of the difference for PCO2 (р = 0.03) depending on the class of liver cirrhosis severity. Also, with the liver cirrhosis severity increase, the malondialdehyde level increased, and catalase decreased. Moreover, significant inverse relationships between malondialdehyde content and PCO2 (p = 0.039), HCO3 (p = 0.039), TCO2 (p = 0.036), Beb (p = 0.049), BEecf (p = 0.043) were found resulting in hypocapnia and partially compensated metabolic acidosis. The found direct correlation between malondialdehyde level and AaDO2 (p = 0.044) indicates the arteriovenous pulmonary shunts, ventilation-perfusion disorders. The absence of catalase content changes can obviously be explained by the fact that its activity can be partially compensatory maintained. Conclusions. In patients with hepatopulmonary syndrome, the peroxidation activity enhances with an increase in the liver cirrhosis severity, resulting in the redox homeostasis imbalance, leading to the ventilation-perfusion disorders and partially compensated metabolic acidosis.

Fracturas vertebrales osteoporóticas: historia natural e impacto

Osteoporosis, and the consequences derived from it, such as fragility fractures, constitute a growing public health problem. Suffering from a fracture of this nature is the main risk factor for suffering a new fracture.It is documented that vertebral compression fractures lead to significant morbidity and mortality, in the short and long term, as well as other complications, such as sagittal imbalance and hyperkyphosis of the segment. However, we have not found documentation that analyzes the medium and long-term consequences of these injuries, assessing the type of treatment used, and the economic impact they represent.The purpose of this review is to analyze the main recent literature on the subject and make a breakdown of the consequences of these fractures in various spheres, such as economic, quality of life, sagittal balance and radiographic parameters, pain or mortality; as well as a brief analysis of epidemiology and natural history. ConclusionOsteoporotic fractures constitute an emerging problem, both in the medical and economic fields. The consequences and sequelae on the patient are multiple and although surgical options offer good long-term results, it is necessary to properly select the patient, through multidisciplinary teams, to try to minimize potential complications.

How robot-assisted gait training affects gait ability, balance and kinematic parameters after stroke: a systematic review and meta-analysis.

Gait ability is often cited by stroke survivors. Robot-assisted gait training (RAGT) can help stroke patients with lower limb motor impairment regain motor coordination. PubMed, Cochrane Library, Embase were systematically searched until September 2023, to identify randomized controlled trials presenting: stroke survivors as participants; RAGT as intervention; conventional rehabilitation as a comparator; gait assessment, through scales or quantitative parameters, as outcome measures. Twenty-seven publications involving 1167 patients met the inclusion criteria. Meta-analysis showed no significant differences in speed, cadence, spatial symmetry, and changes in joint mobility angles between the RAGT group and the control group. In addition, RAGT was associated with changes in affected side step length (SMD=0.02, 95% CI: 0.01, 0.03; P<0.0001), temporal symmetry (SMD=-0.38, 95% CI: -0.6, -0.16; P=0.0006], Six-Minute Walk Test (SMD=25.14, 95% CI: 10.19, 40.09; P=0.0010] and Functional Ambulation Categories (SMD=0.32, 95% CI: 0.01, 0.63; P=0.04). According to the PEDro scale, 19 (70.4%) studies were of high quality and eight were of moderate quality (29.6%). Taken together, the review synthesis showed that RAGT might have a potential role in the recovery of walking dysfunction after stroke. However, its superiority over conventional rehabilitation requires further research. Additionally, it may provide unexpected benefits that the effects of RAGT with different types or treatment protocols were further compared.

Enhancing water balance assessment in urban areas through high-resolution land cover mapping: Case study of Debrecen, Hungary

Land cover (LC) mapping in urban areas is one of the core applications in remote sensing (RS), and it plays an important role in modern urban planning and management. In order to support up-to-date simplified water balance calculation, LC modelling needs to be developed for precise and high-resolution operations to monitor rapidly expanding urban areas. This study provides a spatial decision support tool for urban water balance calculations considering hydrological parameters at pixel scale. The study is aimed to create a high-resolution LC map for more precise water balance calculations to identify and link the most important parameters, such as crop coefficient, for estimating crop evapotranspiration, runoff coefficients, and infiltration rate. Meteorological data from 2016 to 2019 were involved in evapotranspiration estimation. The study site is Debrecen, a city in northeast Hungary with a population of about 200,000. By integrating Landsat 8 imagery, Google Earth (GE), and Corine Land Cover (CLC), a LC map of 30 m resolution was created with 81.2 % overall accuracy (OA) and a coefficient of kappa greater than 0.78. For the classification of Landsat 8, seven classes were assigned (forests, sealed surfaces, areas with crop cover, grassland, semi-sealed surfaces, bare ground and surface water bodies). Classification results were validated by 101 ground truth samples using other satellite images and aerial photographs. Water balance parameters (i.e. surface runoff, infiltration and evapotranspiration) were then defined and calculated at a pixel scale and for larger areas. The technique developed in this study can also be utilized in other urban areas.