Body Position Research Articles

Low back pain among college students in a public Saudi university: A cross-sectional study.

Low back pain (LBP) is the most prevalent orthopedic condition worldwide. University students are more likely to have this issue due to their demanding and time-consuming course load. This study aimed to investigate the prevalence of LBP and the factors that lead to it among students at the Imam Mohammad Ibn Saud Islamic University (IMSIU). This cross-sectional study targeted undergraduate students using an online self-administered questionnaire. A descriptive analysis method was conducted. Of the 830 students who completed the survey, 71.4% were females. About two-thirds were aged between 18 and 22 years. Our study shows that 68.2% had complained of recent LBP. The most significant prevalent factor associated with LBP among IMAMU students, 94.2%, was prolonged sitting. Heavy object lifting is 93.2%, and unhealthy seating/body position is 90.2%, which comes in second and third place. Those who complained about the discomfort of their lecture hall seats were shown to be dramatically more likely (5.549 times more) to develop LBP than students who did not. Students with a positive history of depression were significantly more prone (2.565-fold) to LBP. A positive family history of LBP and smoking cigarettes were found to increase the chance of developing LBP. LBP among IMSIU students is high, mainly because of prolonged sitting, heavy object lifting, and unhealthy sitting and/or body position. There is a strong association between LBP and a positive family history of LBP, smoking, and uncomfortable seats. Prevenive measures, such as an intervention program for university students, are required.

O20 CURRENT 24-HOUR AMBULATORY BLOOD PRESSURE TECHNOLOGIES SHOULD BE RECONSIDERED AS THE REFERENCE STANDARD FOR VALIDATION OF CUFFLESS BLOOD PRESSURE DEVICES

Background and Objective: Recommendations for the validation of cuffless blood pressure (BP) devices were recently released by the European Society of Hypertension (ESH). In this recommendation, 24-hour ambulatory BP monitoring (ABPM) is the reference standard for a newly proposed ‘awake-asleep’ accuracy test. However, this reference standard may be inappropriate because ABPM is subject to measurement insecurities, and it is unknown if it would pass the awake-asleep test. Therefore, the aim of this study was to determine if ABPM itself would pass the awake-asleep test recommended for validation of cuffless BP devices. Methods: Dual arm, simultaneous ABPM were recorded using two identical cuff-based devices (TM-2430, A&D, Japan) among 46 healthy adults (22±2.3 years; 54% female). The awake-asleep test was defined as the difference between the left arm ABPM minus right arm ABPM for assessing the change in BP between awake-asleep time (ESH recommendations: mean difference ± SD ≤5±8 mmHg, correlation r>0.7 for test and reference values; awake-asleep BP components calculated based on personalized sleeping times). Measurement artefacts were identified by analysis of the cuff deflation pressure curves and hydrostatic pressure differences (body position) between the cuffs. Results: ABPM did not pass the awake-asleep test due to higher than acceptable measurement variability for systolic BP, -0.1±8.6 mmHg, r=0.69 and partially met requirements for diastolic BP, -0.7±5.9 mmHg, r=0.63. After correction for measurement artefacts and hydrostatic pressure differences, ABPM passed the awake-asleep test for systolic BP (-1.7±5.0 mmHg, r=0.76) but still did not meet requirements for diastolic BP due to insufficient correlation (r=0.64). Conclusion: In this analysis, ABPM itself did not meet the awake-asleep test criteria recommended by the ESH. Using current ABPM technologies as a reference standard for cuffless BP validation protocols may need to be reconsidered and they need improvement before use for this purpose. Improving ABPM through better measurement artefact detection could be an initial solution which would also improve its value for clinical decision making.

Contact between leaked cement and adjacent vertebral endplate induces a greater risk of adjacent vertebral fracture with vertebral bone cement augmentation biomechanically

BACKGROUND CONTEXTAdjacent vertebral fracture (AVF) is a frequently observed complication after percutaneous vertebroplasty in patients with osteoporotic vertebral compressive fracture (OVCF). Studies have demonstrated that intervertebral cement leakage (ICL) can increase the incidence of AVF, but others have reached opposite conclusions. The stress concentration initially increases the risk of AVF, and dispersive concentrated stress is the main biomechanical function of the intervertebral disc (IVD). PURPOSEThis study was designed to validate the hypothesis that direct contact between the leaked cement and adjacent bony endplate (BEP) can inhibit this biomechanical function, trigger adjacent vertebral stress concentration and increase the risk of AVF. STUDY DESIGNA retrospective study and corresponding numerical mechanical simulations. PATIENT SAMPLEClinical data from 97 OVCF patients treated by bone cement augmentation operations were reviewed in this study. OUTCOME MEASURESClinical assessments involved measuring ICL and cement-BEP contact status in patients with and without AVF. Numerical simulations were conducted to compute stress values in adjacent vertebral body's BEP and cancellous bone under various body positions. MATERIALS AND METHODSRadiographic and demographic data of 97 OVCF patients (with an average follow-up period of 11.5 months) treated using bone cement augmentation operation were reviewed in the present study. The patients were divided into 2 groups: those with AVF and those without AVF. Bone cement leakage status was judged via 2 different methods: with or without IVD cement leakage and with and without adjacent vertebral endplate contact. The data from patients with and without AVF were compared, and the independent risk factors were identified through regression analysis. Patients without IVD cement leakage, with IVD cement leakage but without adjacent vertebral endplate cement contact, and with direct adjacent vertebral endplate cement contact were simulated using a previously constructed and validated lumbar finite element model, and the biomechanical indicators related to the AVF were computed and recorded in these surgical models. RESULTSRadiographic analysis revealed that the incidence of AVF was numerically higher, but was not significantly higher in patients with IVD cement leakage. In contrast, patients with direct adjacent vertebral endplate cement contact had a significantly greater incidence of AVF, which has also been proven to be an independent risk factor for AVF. In addition, numerical mechanical simulations revealed an obvious stress concentration tendency (the higher maximum equivalent stress value) in the adjacent vertebral body in the model with endplate cement contact. CONCLUSIONDirect adjacent vertebral endplate cement contact induces a greater risk of AVF through deterioration of the local biomechanical environment. Cement injection, therefore, should be terminated when IVD cement leakage occurs to reduce adjacent vertebral endplate cement contact and reduce the resulting risk of AVF biomechanics.

Fluid distribution during surgery in the flat recumbent, Trendelenburg, and the reverse Trendelenburg body positions.

The distribution and elimination of infused crystalloid fluid is known to be affected by general anesthesia, but it is unclear whether changes differ depending on whether the patient is operated in the flat recumbent position, the Trendelenburg ("legs up") position, or the reverse Trendelenburg ("head up") position. Retrospective data on hemodilution and urine output obtained during and after infusion of 1-2 L of Ringer's solution over 30-60 min were collected from 61 patients undergoing surgery under general anesthesia and 106 volunteers matched with respect to the infusion volume and infusion time. Parameters describing fluid distribution in the anesthetized and awake subjects were compared by population volume kinetic analysis. General anesthesia decreased the rate constant for urine output by 79% (flat recumbent), 91% (legs up) and 91% (head up), suggesting that laparoscopic surgery per se intensified the already strong anesthesia-induced fluid retention. General anesthesia also decreased the rate constant governing the return of the distributed fluid to the plasma by 32%, 15%, and 70%, respectively. These results agree with laboratory data showing a depressive effect of anesthetic drugs on lymphatic pumping, and further suggest that the "legs up" position facilitates lymphatic flow, whereas the "head up" position slows this flow. Both Trendelenburg positions increased swelling of the "third fluid space". General anesthesia caused retention of infused fluid with preferential distribution to the extravascular space. Both Trendelenburg positions had a modifying influence on the kinetic adaptations that agreed with the gravitational forces inflicted by tilting to body.

Comparison of Non-Surgical Methods for Treating Hemorrhoids

Introduction and purpose Hemorrhoidal disease is one of the most common proctological problems worldwide. The etiology of hemorrhoidal disease has not been fully explained. Authors note that lifestyle factors and dietary habits are primarily responsible for hemorrhoidal disease. These include: a low-fiber diet, constipation, a sedentary lifestyle, and suboptimal body position during defecation commonly observed in Western societies. Due to the high prevalence of the disease in the population and the associated decrease in quality of life, outpatient procedural treatments that are highly effective and allow for a quick return to normal activity are very popular among patients. The aim of this study is to discuss non-surgical methods of hemorrhoid treatment. Material and methods This paper was based on a review of materials available on PubMed, searched using the following keywords: “hemorrhoids”, “sclerotherapy”, “rubber band ligation”, „infrared coagulation”, „laser hemorrhoidoplasty”, „Doppler guides hemorrhoidal artery ligation”. Results In recent years, there has been a significant development in non-surgical techniques for treating hemorrhoids, which are widely used in patients with grade I-III hemorrhoids and can be performed in an outpatient setting or during short hospital stays with the use of regional anesthesia, such as: Sclerotherapy, rubber band ligation, Infrared coagulation, Laser hemorrhoidoplasty, Doppler Guides Hemorrhoidal Artery Ligation. Conclusion In conclusion, non-surgical methods for the treatment of hemorrhoids offer a range of effective alternatives to conventional surgery. The choice of treatment should be individualized, taking into account the severity of the hemorrhoidal disease, patient preferences, and the potential for complications.

Kinematic Analysis of the Final Release position of elite Archer

The purpose of the study was kinematical analysis of an Elite archers. In present study total sample five Indian International level male Recurve category Archers was selected by Purposive sampling technique from SAI Archery training Center Sonipat. The age of the subjects was between 24 (± 5) years, hight of the subjects 6.0` (± 5 Inch), participation year between 2016-2022, shooting FITA score between 650-720 in archery was selected as a subjects for the study. According to Casio EX-F1 high speed camera was used, which have frequency from 60-300 frames per second (f/s). The data were recorded from Superior view, Lateral view, Anterior view and Medial view. The distance between shooting line and target is 70 meter. Shooting line is passed horizontally through the Center of Gravity box, Center of Gravity box is a square box drown with the measurement of 1×1 m, Center of Gravity box is equally divided into 4 parts. A straight line is passed vertically on it and a horizontal line which is shooting line and is drawn 70 meter apart from the target. The distance between bull eye of the target and the floor surface is 5 feet. Siliconcoach Pro8 update motion analysis software and Tracker motion analysis software was used for kinematical analysis of at the time of final release position in archery. Descriptive statistic was used. To find out multi correlation between dependent variable performance on target 1-10 (bull eye) in points and independent variables (selected linear variables). The significant correlation was found between Height of body Center of Mass, Height of body Center of Gravity, Height of Projectile and obtained value (-.893), (.878), (-.945) is greater than tabulated value of (.878) therefore it shows significant relationship of this independent variable with performance in archery. Whereas, in case of Body force aliment right medial, Body force aliment left medial the obtained values (.360) and (.770) are lower than tabulated value of (.878) therefore it shows insignificant relationship of these independent variable with performance in archery. The significant correlations with height variables suggest that certain aspects of an archer's body positioning, such as the height of the center of mass, center of gravity, and projectile, play a crucial role in archery performance. The negative correlation with the height of the center of mass implies that a lower center of mass is associated with better performance. The insignificant correlations with body forced alignment variables suggest that, at least within the parameters measured, the lateral alignment of the body (right and left medial) does not significantly influence performance in archery. Since the significant relationship was found between Height of body Center of Mass and Height of body Center of Gravity, Height of Projectile and Body force aliment left medial of the subject among independent variables as calculated “r” (-.960), (.887), (-.959) is found greater than the required tabulated value of (.878) at .05 level of significance. In case be seen the significant relationship was found between Height of body Center of Gravity and Body force aliment left medial of the subject among independent variables as calculated “r” (.935), is found greater than the required tabulated value of (.878) at .05 level of significance. The strong correlations among these variables indicate a close relationship between the height-related kinematic variables (center of mass, center of gravity, and projectile) and the lateral alignment of the body (body forced alignment left medial). The negative correlations suggest that as the height of the center of mass decreases, the height of the center of gravity and the height of the projectile tend to decrease, and as the height of the projectile decreases, the body forced alignment left medial tends to increase. The study concludes that there is a statistically significant and positive relationship between the height of the center of gravity and body forced alignment on the left medial side in archery. This finding implies that variations in the height of the center of gravity are associated with corresponding changes in the lateral alignment of the body, specifically towards the left medial side.

The influence of breastfeeding factors on the prevalence of back and neck pain: data from an online survey

BackgroundSometimes during breastfeeding women adopt positions that may cause problems with musculoskeletal system, resulting in back pain. The aim of this study was to determine the prevalence of lower back, upper back and neck pain in breastfeeding women and how this may be related to the act of breastfeeding.MethodsAn online survey within Poland was conducted among 395 breastfeeding women who were 1 to 48 months postpartum and were divided into two groups; “no back pain” and “back pain present”. The measurement tools used included an original questionnaire, the International Physical Activity Questionnaire (IPAQ), a Numerical Pain Rating Scale (0–10), and the Roland-Morris Disability Questionnaire. Pearson’s chi-squared tests, Mann-Whitney U tests, Student’s t-tests, and Kruskal-Wallis ANOVA tests were used to compare the groups.ResultsIt was found that 84% of breastfeeding mothers suffered from back pain at least once a month. Pain was experienced at least once a week in the cervical, thoracic and lumbosacral regions in 48%, 36%, and 66% of the women, respectively. A dysfunctional state was present in 27.6% of breastfeeding mothers who suffered from back pain. Mothers experiencing back pain spent significantly more time on single breastfeeding episodes (p < 0.05) and had an increased total time breastfeeding per day (p < 0.01) compared to mothers with no back pain. Neck pain was significantly less intense in mothers preferring to breastfeed in a lying position as compared to mothers preferring a sitting position in a chair or an armchair (p < 0.05).ConclusionsThis survey of Polish breastfeeding mothers revealed a very high prevalence of lower back, upper back and neck pain. The amount of time spent on breastfeeding and the choice of body position for breastfeeding were important factors differentiating the prevalence and intensity of the pain. It is recommended that breastfeeding mothers do not extend the single-feeding time in the adopted position beyond the required time. It is of utmost importance to choose a breastfeeding position in which all parts of the mother’s body are supported. To prevent neck pain, lying and semi-lying positions with head support are recommended.

Benefits of postural sway to succeed in goal-directed visual tasks

When individuals stand, they sway and so have to maintain their balance. It is generally expected that task performance is worse when standing and swaying than when sitting and therefore not swaying. In contrast, we hypothesized that greater sway is associated with better task performance in the absence of external perturbations of posture. Twenty-four healthy, young adults performed two goal-directed, modified Stroop tasks (incongruent and reversed incongruent) in four body position conditions (standing against a vertical surface, and standing freely with a wide, standard or narrow stance). Centre of pressure (COP) sway, head sway, eye movements, visual attention, and task performance were recorded. Partial correlation analyses showed significant positive associations between task performance and some COP and head sway variables, after controlling for the level of visual attention. Analyses of variance with three factors (body position, task difficulty, target distance) also showed significant interaction effects between body position (and therefore postural sway) and the number of accurate target findings. The presence of these interactions showed that narrow stance was both the best body position for performing the incongruent task and the worst body position for performing the reversed incongruent task. Overall, COP sway and head sway can increase task performance. Hence, healthy, young adults in quiet stance appear to use sway to explore their environment more effectively. However, it should be borne in mind that our hypothesis was formulated solely with regard to healthy, young adults standing in quiet stance.

A Product Evaluation of Augmented Reality Equipment Coupled to Diagnostic Medical Sonography: A Potential Equipment and Ergonomic Innovation

Objective: The aim of this product evaluation was to investigate the workflow and occupational health benefits of implementing augmented reality (AR) technology (MediView XR Inc, Cleveland, OH) paired with a portable ultrasound equipment system. Materials and Method: A diverse sample of sonography users was consented and ranged in experience levels. They were asked to complete a video training session, a hands-on demonstration, and remote instruction while using the augmented reality ultrasound (AR US) system. The duration of participants’ tasks was assessed during the use of both AR US and the 2-dimensional ultrasound (2D US) system. Participants’ postures and positions were evaluated using the Rapid Upper Limb Assessment (RULA), which assessed ergonomic risk factors, linked to body position and muscle usage. Participants also completed the System Usability Scale (SUS). Finally, participants were invited to complete a qualitative interview session, regarding the use of the AR US system. Results: A total of 20 participants provided data after using both the AR US and 2D US systems. The assessment data revealed positive SUS scores, which reflected favorably on both the product, education, and the training provided. The time spent on simulated work (20 minutes), with both imaging systems, remained consistent. The Rapid Upper Limb Assessment tool (RULA) scores for the cohort indicated a lower (better) median upper body score when using the AR US system. The cohort also had a statistically significant lower median subscore for the neck, trunk, and legs, compared with 2D US ( p &lt; 0.00). Conclusion: Although larger studies are necessary to validate these findings, this cohort identified several opportunities for integrating the AR US system. Preliminary evidence suggests that an AR US system may offer occupational health benefits, as part of the imaging workflow.

Exploring the Psychological Effects and Physical Exertion of Using Different Movement Interactions in Casual Exergames That Promote Active Microbreaks: Quasi-Experimental Study.

Prolonged sedentary behavior, such as sitting or reclining, has consistently been identified as a stand-alone risk factor for heightened cardiometabolic risk and overall mortality. Conversely, interrupting sedentary periods by incorporating short, active microbreaks has been shown to mitigate the negative effects of sedentary behavior. Casual exergames, which mix elements of casual gaming with physical activity, are one prospective intervention to reduce sedentary behavior because they require physical exertion. Casual exergames have shown promise in fostering emotional and physical advantages when played in specific circumstances. However, little research exists on how different types of movement interactions impact the psychological effects as well as the physical exertion of playing casual exergames. The primary aim of this work was to explore the psychological effects and physical exertion of playing casual exergames lasting 2 minutes. More precisely, the investigation focused on comparing upper body and full body movement interactions. In addition, the work examined variations in body positions, considering both standing and seated positions during upper body movement interactions. Two casual exergames were developed and investigated through 2 quasi-experimental studies. In study 1, we investigated how players' perceptions of control, exertion, and immersion were affected by using upper body as opposed to full body exergame controllers when playing casual exergames. In study 2, we investigated differences in positive affect, performance, enjoyment, and exertion when playing casual exergames with upper body movement interactions in seated and standing positions. Study 1 showed that perceived control was significantly higher for upper body movement interactions than for full body movement interactions (P=.04), but there were no significant differences regarding perceived exertion (P=.15) or immersion (P=.66). Study 2 showed that positive affect increased significantly for both standing (P=.003) and seated (P=.001) gameplay. The participants in the standing gameplay group showed slightly higher actual exertion; however, there were no differences between the groups in terms of positive affect, perceived exertion, enjoyment, or performance. Casual exergames controlled by upper body movement interactions in seated gameplay can produce similar psychological effects and physical exertion as upper body movement interactions in standing gameplay and full body movement interactions. Therefore, upper body and seated casual exergames should not be overlooked as a suitable microbreak activity.

The Influence of Body Position on the Resting Motor Threshold of Posterior Root-Muscle Reflexes Evoked via Transcutaneous Spinal Cord Stimulation.

Background: Thoracolumbar transcutaneous spinal cord stimulation (tSCS) non-invasively evokes posterior root-muscle reflexes (PRMR) with the aim of neuromodulating sensorimotor function following spinal cord injury. Research is still in its infancy regarding the effect of body position on the nature of these spinally evoked responses. Therefore, the aim of this study was to investigate the influence of body position on the nature of PRMR responses during tSCS. Methods: A total of 11 (6M, 5F) participants completed a full PRMR recruitment curve from 10 ma up to 120 ma (10 ma increments) at the T11/12 intervertebral space using a singular 3.2 cm diameter cathode. At each intensity, three paired pulses (50 ms inter-pulse interval), followed by three singular pulses with a six-second delay were applied in each body position (supine, supine 90-90, sitting and standing) in a randomised order. The PRMR responses in lower limb muscles were recorded using wireless electromyographic sensors placed on the Soleus, Tibialis Anterior, Rectus Femoris and Bicep Femoris long head. A two-way (body position × muscle) repeated measures analysis of variance was used to investigate the effect of body position on PRMR-evoked responses. Results: There was a significant main effect of body position on PRMR resting motor threshold (RMT) (p < 0.001), first response peak-to-peak amplitude (p = 0.003) and percentage post-activation depression (%PAD) (p = 0.012). Sitting had significantly higher RMT and significantly lower first response peak-to-peak amplitudes compared to all other positions, but significant differences in %PAD were only detectible between supine and standing. Conclusions: Body position influences the nature of PRMR-evoked responses during tSCS.

Real-time observation of nasal cycle during sleep with polysomnography.

To investigate the nasal cycle (NC) during sleep in healthy individuals without nasal obstruction or obstructive sleep apnoea via a flexible wearable respiratory monitoring system in a continuous and real-time manner. NC during sleep was continuously measured in 30 healthy individuals (15 women, 15 men) via long-term sleep respiratory monitoring system, while sleep stage and body position were simultaneously recorded via polysomnography (PSG). The number of NC transitions and positional changes were documented each night. Additionally, time intervals between NC transitions and their closest positional changes during sleep were meticulously recorded to investigate potential correlations between them. A total of 86.7% of the participants displayed the classic NC, with a mean duration of 6.43 ± 2.33h. Nightly observations revealed an average occurrence of 2.19 ± 0.40 NC transitions, predominantly occurring during REM stage (68.4%), and 9.15 ± 7.77 postural changes. Analysis of the intervals between NC transitions and positional changes revealed an average absolute value of 27.72 ± 10.85min, with a substantial 56.4% exceeding 30min, indicating a non-obvious sequence order among them. NC can be measured in a continuous and real-time manner, the transitions occur mainly during the REM stage. However, we have not identified a clear correlation between NC transition and positional change.

24 h combined esophageal multichannel intraluminal impedance and pH monitoring in children with chronic cough

BackgroundChronic cough in children is closely related to gastroesophageal reflux (GER). However, this association has not been adequately studied due to a lack of diagnostic tools. Combined esophageal multichannel intraluminal impedance and pH (MII-pH) monitoring is considered the most accurate method for evaluating the association between symptoms and reflux, but data on its use in children with chronic cough are still lacking. We aimed to assess the association between chronic cough and GER in children through MII-pH monitoring.MethodsChildren with chronic cough (> 4 weeks) who were suspected gastroesophageal reflux disease(GERD) were selected to undergo 24 h MII-pH monitoring at our hospital. Patients were divided into groups according to their age, body position, reflux index (RI) or total reflux events, and the differences between the groups were analyzed. Then the significance and value of 24 h pH and impedance monitoring in chronic cough and the relationship between chronic cough and reflux were discussed.ResultsOverall, 426 patients were included. The median age was 12 months (interquartile range: 6–39.5 months), 129 (30.3%) patients had RI > 7% detected by pH-metry, and 290 (68.1%) patients had positive diagnosis based on the impedance data. GER predominantly occurred in the upright position and mostly involved weakly acidic reflux and mixed gas–liquid reflux. There were 14.1% of children in non-acid GER group were SAP positive showing no difference in acid GER group 13.2% (P = 0.88), whereas patients with SAP > 95% in MII positive group (47[16.2%]) is higher than in MII negative group (P < 0.05).ConclusionTwenty four hour MII-pH monitoring is safe, well tolerated in children, but also has a higher detection rate of gastroesophageal reflux. It can find identify weakly acidic reflux, weakly alkaline reflux and reflux events with different physical properties, which can explain the relationship between GER and chronic cough more comprehensively. It provides new approach for exploring the etiology, diagnosis and treatment of children with chronic cough.

Injury rates and mechanisms of starting and replacement players

ABSTRACT To examine injury rates, injury mechanisms and injury inciting tackle characteristics of both starting and replacement players. A prospective, cohort study of four male professional Welsh Rugby Union (WRU) teams. Injury surveillance and Global Positioning System (GPS) data were collected from league matches between the 1st of July 2017 to the 31st of August 2020. Video analysis included league matches from the 1st of July 2017 to the 31st of March 2021. Player-specific GPS exposure was used to calculate injury incidence. Generalised linear mixed models were used to analyse the effect of replacement players on injuries. Tackle injury propensity (injuries/100 tackle events) and descriptive characteristics for the tackle event were reported. A total of 290 injuries were sustained by 105 players. Starting players had a higher injury incidence than replacement players (80.8 vs 57.2 injuries/1000 match hours; rate ratio: 1.41 (95% CI 1.00 – 1.98)). For every replacement used there was a 12% increase in the number of injuries (p = 0.037). However, there was no increase in the number of injuries accounting for the replacement time-in-game (p = 0.099). The injury propensity was highest for starting versus opposition replacement players (RR: 4.08, 95% CI: 2.28 – 7.29). Injury inciting tackles for starting players showed higher body positions, whereas replacement players maintained a lower body position. Match injuries were influenced by the number of replacement players, but this was mitigated when accounting for the replacement player time-in-game. Starting and replacement players have differing injury inciting tackle characteristics, suggesting that injury risk mitigation associated with the tackle should be incorporated at a player-specific level.

Abstract thematic roles in infants’ representation of social events

Infants' thoughts are classically characterized as iconic, perceptual-like representations.1,2,3 Less clear is whether preverbal infants also possess a propositional language of thought, where mental symbols are combined according to syntactic rules, very much like words in sentences.4,5,6,7,8,9,10,11,12,13,14,15,16,17 Because it is rich, productive, and abstract, a language of thought would provide a key to explaining impressive achievements in early infancy, from logical inference to representation of false beliefs.18,19,20,21,22,23,24,25,26,27,28,29,30,31 A propositional language-including a language of thought5-implies thematic roles that, in a sentence, indicate the relation between noun and verb phrases, defining who acts on whom; i.e., who is the agent and who is the patient.32,33,34,35,36,37,38,39 Agent and patient roles are abstract in that they generally apply to different situations: whether A kicks, helps, or kisses B, A is the agent and B is the patient. Do preverbal infants represent abstract agent and patient roles? We presented 7-month-olds (n= 143) with sequences of scenes where the posture or relative positioning of two individuals indicated that, across different interactions, A acted on B. Results from habituation (experiment 1) and pupillometry paradigms (experiments 2 and 3) demonstrated that infants showed surprise when roles eventually switched (B acted on A). Thus, while encoding social interactions, infants fill in an abstract relational structure that marks the roles of agent and patient and that can be accessed via different event scenes and properties of the event participants (body postures or positioning). This mental process implies a combinatorial capacity that lays the foundations for productivity and compositionality in language and cognition.

Teleassessment using five times sit-to-stand test in older adults with and without Parkinson's disease: Guidelines and barriers.

Assessing lower limb strength, balance, and fall risk are crucial components of rehabilitation, especially for the older adult population. With the growing interest in telehealth, teleassessment has been investigated as an alternative when in-person assessments are not possible. The Five Times Sit-to-Stand test (5TSTS) provides a quick measure of balance during chair transfers, muscle power, endurance, and the hability to change and maintain body position, and is highly recommended by guidelines. However, the literature is unclear about the viability and safety of teleassessment using the 5TSTS in older adultswith and without Parkinson's disease (PD). This study aimed to evaluate the reliability of teleassessment using the 5TSTS and to determine its feasibility and safety for older adults with and without PD. This cross-sectional study included older adults with and without PD who were evaluated remotely through a videoconference platform. To ensure effective and comprehensive instructions for the test, we developed a guideline called OMPEPE (an acronym for: Objective; Materials; Position-Start; Execution; Position-End; Environment). We assessed the 5TSTS intra- and inter-rater reliability by comparing scores obtained from the same examiner and from different examiners, respectively. Participants and examiners completed online surveys to provide information about feasibility and safety. Twelve older adults with PD and 17 older adultswithout PD were included in this study (mean ages 69.0 and 67.6years, respectively). Based on the participants' perspectives and the absence of adverse effects, teleassessment using the 5TSTS is feasible and safe for older adults with and without PD. Excellent intra- and inter-rater reliability (intraclass correlation coefficient >0.90) was found for all measurements of the 5TSTS. This study demonstrated the feasibility, safety, and reliability of teleassessment using the 5TSTS. The guidelines developed may help health professionals minimize barriers and safely conduct an online assessment that includes a physical test such as the 5TSTS in older adults with or without PD. In addition to addressing technological barriers, the OMPEPE guideline might ensure the optimal execution of evaluations. Teleassessment using the 5TSTS for older adults with and without PD is feasible and safe. Both synchronous (i.e., live) and asynchronous (i.e., recorded) online 5TSTS tests demonstrate excellent intra- and inter-rate reliability.

Body position and cuff size influence lower limb arterial occlusion pressure and its predictors: implications for standardizing the pressure applied in training with blood flow restriction.

Background: Arterial occlusion pressure (AOP) is a relevant measurement for individualized prescription of exercise with blood flow restriction (BFRE). Therefore, it is important to consider factors that may influence this measure. Purpose: This study aimed to compare lower limb AOP (LL-AOP) measured with 11cm (medium) and 18cm (large) cuffs, in different body positions, and explore the predictors for each of the LL-AOP measurements performed. This information may be useful for future studies that seek to develop approaches to improve the standardization of pressure adopted in BFRE, including proposals for equations to estimate LL-AOP. Methods: This is a cross-sectional study. Fifty-one healthy volunteers (males, n = 25, females, n = 26; Age: 18-40years old) underwent measurement of thigh circumference (TC), brachial blood pressure, followed by assessments of LL-AOP with medium and large cuffs in positions supine, sitting and standing positions. Results: The large cuff required less external pressure (mmHg) to elicit arterial occlusion in all three-body positions when compared to the medium cuff (p < 0.001). The LL-AOP was significantly lower in the supine position, regardless of the cuff used (p < 0.001). Systolic blood pressure was the main predictor of LL-AOP in the large cuff, while TC was the main predictor of LL-AOP with the medium cuff. Body position influenced strength of the LL-AOP predictors. Conclusion: Our results indicate that LL-AOP and its predictors are substantially influenced by body position and cuff width. Therefore, these variables should be considered when standardizing the pressure prescribed in BFRE.

Analisis Strategi dan Teknik Tendangan Sabit Dalam Olahraga Pencak Silat: A Systematic Literature Review

Hook kick is a crucial technique in the Indonesian martial art of Pencak Silat that requires precise strategy for its effectiveness. This research employs a systematicliteraturereview method to explore relevant studies on hook kick strategies in Pencak Silat. The method involves searching scientific articles and other pertinent sources to identify commonly used strategies and the scientific evidence supporting them. Analysis of the literature reveals that hook kick strategies can be categorized into several key elements, including proper body positioning, correct foot techniques, utilization of body momentum, and effective distance management. These findings provide deeper insights into how this technique can be effectively applied in combat situations and training. The research outcomes are expected to offer profound insights applicable to training and skill development in Pencak Silat, contributing to the enhancement of overall standards in this martial art. Keywords: Sickle Kick Technique, Sports, and Pencak Silat

Влияние позы на эффективность мочеиспускания у мальчика с дисфункциональным мочеиспусканием

Dysfunctional voiding in children without organic pathology of the spinal cord in childhood is now becoming more common. Unproductive voiding with the presence of residual voiding of more than 30% of the functional bladder volume for a long time leads to inflammatory diseases of the lower urinary tract. The physiological process of emptying the bladder requires a certain concentration of the child's attention, controlled activation of voiding reflexes and correct body position, especially for boys. Dysfunctional voiding is often formed in physiologically healthy boys with systematic emptying of the bladder in a sitting position, which disrupts the natural configuration of the pelvic floor muscles. Article represents a clinical case of a child with recurrent urinary infection and ineffective urination at the age of 12 y/o, whose treatment was based on training pelvic reflexes and voiding in a standing position, which in its turn had allowed normalization of the miction parameters and stopped the recurrent low urinary tract infection.

The Great Communicator: Audrey Holland's Legacy and Lessons.

Audrey Holland's core beliefs of respect for people and the quality of their lives informed her life's work. This examination of the ways she managed the academic, research, and clinical parts of her illustrious career shows how Audrey leaves a rich legacy and serves as a model for navigating an impactful career path and enhancing clinical interactions. First, she mentored more than 30 doctoral students who then mentored further generations of students, ran clinics, or shaped policy. She also regularly taught classes, supervised student clinicians, and traveled the world doing lectures and workshops. Second, her scholarship spanned more than 50 years and a range of subjects, such as assessment and treatment, self-determination and self-advocacy, pragmatics, counseling, coaching, and communication strategies. Third, her collaborations with many colleagues within the field and in related fields extended her impact even further. Finally, a close analysis of her clinical communication style shows how Audrey's simple, nonverbal behaviors (e.g., eye contact, body position) brought out the best in the people with whom she worked. On all these levels-mentorship, scholarship, collaboration, and communication style-Audrey's legacy leaves a vast array of powerful lessons that can be studied, emulated, and appreciated for years to come.