Extremity Strength Research Articles

Effects of high-intensity interval robot-assisted gait training on cardiopulmonary function and walking ability in chronic stroke survivors: A multicenter single-blind randomized controlled trial.

Chronic stroke can impair cardiopulmonary function, mobility, and daily activities. This study assessed the impact of robot-assisted gait training (RAGT) on such impairments. To investigate the effects of robot-assisted gait training on cardiopulmonary function, walking ability, lower extremity function and strength, activities of daily living (ADLs), and blood test results among individuals with chronic stroke. A multicenter, prospective, single-blinded, randomized controlled trial with 22 chronic stroke participants compared RAGT against a control exercise regimen. RAGT involved three days weekly sessions of high-intensity interval training for 8 weeks (24 sessions) with a Morning Walk® device. The control group also performed home exercises. (24 sessions) Measures included VO2max, Functional Ambulatory Category, 2-minute walk test, 10-meter walk test, Motricity Index-Lower, Korean version of the Fugl-Meyer Assessment Scale, Modified Barthel Index, Berg Balance Scale, muscle strength, InBody body composition, and blood tests (cholesterol, lipid, glucose). RAGT significantly improved VO2max, gait, balance, and lower limb strength compared with controls, with significant improvements in 2-minute walk test, 10-meter walk test, Motricity Index-Lower, and Fugl-Meyer Assessment outcomes. No changes were seen in muscle mass or blood markers. RAGT enhances cardiopulmonary function and ambulatory capacity in chronic stroke patients, underscoring its potential in stroke rehabilitation.

Hip Strength, Change of Direction, and Falls in Recreational Pickleball Players.

While a high incidence of pickleball-related falls is reported, little is known regarding factors differentiating persons with and without a fall history during play. This study aimed to determine differences between recreational pickleball players who fell while playing and those who did not. Additional aims were to determine reasons for falling and to investigate associations among assessed factors. Cross-sectional study. Participants completed a survey reporting age, fall history, and reasons for falling during play. Hip abduction strength, single leg squat form, ankle dorsiflexion, and change of direction time using a modified T-test on a pickleball court (i.e.pickleball T-test) were assessed. Among the 92 individuals participating in the study, 42% reported a fall while playing and 30% reported falling more than once. Leading reasons for reported falls were lunging and moving backward. Participants who reported falling were significantly older (z = -2.60, p = 0.009) and slower on the pickleball T-test (z = -2.10, p = 0.036) than those who did not report falling. Hip abduction strength was not associated with fall history but was associated with faster time on the pickleball T-test (left rs = -.41, p < 0.001, right rs = -.48, p < 0.001). Single leg squat form and dorsiflexion were not related to fall history. Falls are common among recreational pickleball players, particularly older players. Fall prevention programs for pickleball players should be considered including multi-directional lunging, lower extremity strength and power development, and change of direction training that includes moving backward. 2.

Comparison of Core Endurance, Strength, Power, Balance and Flexibility in Young Elite Sailors

Aim: This study examines and compares the core endurance levels, balance performance, muscle strength, and flexibility among young elite saiflors in different sailing classes. Method: Athletes were randomly selected from the Galatasaray Sailing Club and divided into three groups: windsurfing (n=14), optimist (n=13), and laser class (n=13). Demographic features, body mass index, and dominant side of the body were recorded. Upper extremity strength was assessed using a hand dynamometer, while lower extremity power was evaluated through vertical jump, standing long jump, and single-leg jump tests. Core endurance was evaluated with sit-up, plank, and rotary stability tests. Balance and flexibility were assessed using Y balance, straight leg raise, shoulder flexibility, sit and reach, shoulder elevation, and total body rotation tests. The data from the three groups were analyzed using the Kruskal-Wallis H test, and inter-group comparisons were performed with the Mann-Whitney U test. Results: Significant differences were observed among the groups in the hand grip test for both right and left hands (p&amp;lt;0.001). The laser group displayed the highest mean value. The standing long jump test also showed a significant difference between the groups (p&amp;lt;0.05), with the laser group exhibiting the highest mean value. The single-leg jump test revealed a significant difference among the groups (p&amp;lt;0.05), with the windsurfing group having the highest average. The Y balance test indicated a significant difference among the groups (p&amp;lt;0.05), with the optimist group displaying the highest average values. Conclusion: These findings demonstrate that each sailing class necessitates distinct physical attributes and specific performance parameters, particularly in terms of strength and balance.

Predicting physical functioning status in older adults: insights from wrist accelerometer sensors and derived digital biomarkers of physical activity.

Conventional physical activity (PA) metrics derived from wearable sensors may not capture the cumulative, transitions from sedentary to active, and multidimensional patterns of PA, limiting the ability to predict physical function impairment (PFI) in older adults. This study aims to identify unique temporal patterns and develop novel digital biomarkers from wrist accelerometer data for predicting PFI and its subtypes using explainable artificial intelligence techniques. Wrist accelerometer streaming data from 747 participants in the National Health and Aging Trends Study (NHATS) were used to calculate 231 PA features through time-series analysis techniques-Tsfresh. Predictive models for PFI and its subtypes (walking, balance, and extremity strength) were developed using 6 machine learning (ML) algorithms with hyperparameter optimization. The SHapley Additive exPlanations method was employed to interpret the ML models and rank the importance of input features. Temporal analysis revealed peak PA differences between PFI and healthy controls from 9:00 to 11:00 am. The best-performing model (Gradient boosting Tree) achieved an area under the curve score of 85.93%, accuracy of 81.52%, sensitivity of 77.03%, and specificity of 87.50% when combining wrist accelerometer streaming data (WAPAS) features with demographic data. The novel digital biomarkers, including change quantiles, Fourier transform (FFT) coefficients, and Aggregated (AGG) Linear Trend, outperformed traditional PA metrics in predicting PFI. These findings highlight the importance of capturing the multidimensional nature of PA patterns for PFI. This study investigates the potential of wrist accelerometer digital biomarkers in predicting PFI and its subtypes in older adults. Integrated PFI monitoring systems with digital biomarkers would improve the current state of remote PFI surveillance.

Evaluation of the strength of the upper extremity and the balance in pediatric population with hemiplegia after stroke

Evaluation of the strength of the upper extremity and the balance in pediatric population with hemiplegia after stroke

Electromyography-Triggered Constraint-Induced Movement Cycling Therapy for Enhancing Motor Function in Chronic Stroke Patients: A Randomized Controlled Trial.

This single-blind randomized controlled trial investigated the effectiveness of surface electromyography (sEMG)-triggered constraint-induced movement cycling therapy (CIMCT) in improving balance, lower extremity strength, and activities of daily living in patients with chronic stroke. The participants included patients with chronic stroke-induced hemiplegia who had been diagnosed for more than 6 months, with a minimum score of 24 points on the Mini-Mental State Examination and above level 3 on the Brunnstrom stages. The trial lasted 4 weeks and participants were divided into a CIMCT group and a general cycling training (GCT) group. The CIMCT group (n = 20) used an sEMG-triggered constrained-induced movement therapy device, whereas the GCT group (n = 19) used a standard stationary bicycle. The primary outcome measures showed a significant increase in muscle strength on the affected side in the CIMCT group, as assessed by a manual muscle tester (p < 0.05), with a large effect size (d = 1.86), while no meaningful improvement was observed in the GCT group. Both groups demonstrated significant improvements in dynamic balance, as measured by the Timed Up and Go (TUG) test (p < 0.05), with the CIMCT group showing superior results compared to the GCT group, reflected by a large effect size (d = 0.96). Additionally, both groups showed significant improvements in balance as assessed by the Berg Balance Scale (BBS) and the Functional Reach Test (FRT). The CIMCT group exhibited more pronounced improvements than the GCT group, with large effect sizes of 0.83 for the BBS and 1.25 for the FRT. The secondary outcome measures revealed significant improvements in activities of daily living in both groups, as assessed by the modified Barthel index (MBI), with the CIMCT group achieving a substantial improvement (p < 0.05), accompanied by a large effect size (d = 0.87). This study concludes that sEMG-triggered CIMCT effectively improved muscle strength, postural balance, and activities of daily living in patients with chronic stroke.

Validity and reliability of the Six-Minute Pegboard Ring Test for assessing functional capacity and upper limb function in persons with multiple sclerosis

BackgroundThe timed walk test is essential for assessing the functional capacity of persons with multiple sclerosis (MS). When a decline in ambulation ability and loss of function in the later stages of MS is observed, it is imperative to utilize alternative methods for measuring functional capacity. ObjectiveTo investigate the validity and reliability of the Six-Minute Pegboard Ring Test (6PBRT) in persons with MS. MethodsForty-three persons with MS were included in this study. Disease severity was quantified using the Expanded Disability Status Scale (EDSS). The 6PBRT was employed to assess upper extremity function during exercise stress, and vital signs were monitored pre- and post-test. Muscle strength was measured using a digital dynamometer for shoulder flexor, shoulder abductor, and grip strength, in addition to a hand dynamometer. Manual dexterity was evaluated through the 9-Hole Peg Test (9HPT), and walking endurance was assessed using the 2-Minute Walk Test (2MWT). Test-retest reliability was computed using the intraclass correlation coefficient (ICC). ResultsThe ICC value for the 6PBRT was 0.96 (95% CI 0.92–0.97), indicating excellent test-retest reliability. Significant differences in vital signs were observed before and after conducting the 6PBRT (p < 0.05). A strong negative correlation was found between the 6PBRT score and EDSS (r = -0.650, p < 0.001). The 9HPT of the dominant side demonstrated a moderate correlation with the 6PBRT score (r = -0.502, p = 0.001), whereas no significant correlation was shown between the non-dominant side 9HPT and the 6PBRT score (p > 0.05). Moreover, a positive moderate correlation was shown between the performance on the 2MWT and the 6PBRT score (r = 0.413, p = 0.006). However, no significant correlation was detected between the proximal muscle strength of the upper extremity, handgrip strength, and the 6PBRT score in individuals with multiple sclerosis (p > 0.05). ConclusionThe 6PBRT is a reliable and valid tool to evaluate upper extremity function and exercise capacity in persons with MS.

A case of MERS presenting with acute motor aphasia and tetraparesis and literature review

BackgroundMild encephalopathy wıth reversible splenial lesions (MERS) are a clinical–radiological diagnosis that can be diagnosed with radiological imaging and can be accompanied by impaired consciousness, aphasia, headache, and paralysis. MERS can be divided into two different types based on radiological findings; Involvement of the splenium is seen in type 1, and involvement of the splenium and deep white matter is seen in type 2. MERS Type 2 is very rare in adults. Here, we describe a patient diagnosed with MERS Type 2 and our therapeutic intervention.Case presentationA 22-year-old woman presented with slurred speech, weakness in the extremities and headache that started 14 h ago. The patient had sore throat and fever of 37.6 °C for 2 days, and medical history or family history were unremarkable. Neurological examination revealed that she was conscious, cooperative, with no signs of meningeal irritation. Speech comprehension, naming, and repetition were preserved, motor examination revealed 5/5 left upper extremity strength, 4/5 right upper extremity strength, and 2/5 bilateral lower extremity strength. Diffusion-weighted magnetic resonance imaging (MRI-DWI) revealed bilateral deep white matter and splenium symmetrical diffusion restriction. Blood tests showed high C-reactive protein (CRP) and no leukocytosis. No cells were detected in the cerebrospinal fluid (CSF), protein was 151 mg/dl, glucose was within normal limits. The patient, who developed quadriparesis during follow-up, was started on pulse dose steroids. Neurological examination improved to patient’s baseline at the 12th hour of treatment. In the 72nd hour control MRI-DWI, it was seen that the lesions had regressed. Culture/Polymerase chain reaction (PCR) for bacterial/viral infection agents came back negative. After steroids were given for 5 days, patient was discharged at her baseline.ConclusionsMERS is a rare diagnosis in adults and can be radiologically confused with acute toxic leukoencephalopathy. It can be distinguished clinically by the absence of prior infection, fever, and toxic agent exposure. Although there is no consensus in the literature regarding the treatment, the clinical picture improved rapidly after steroid in our case. Despite being rare, it should be considered in the differential diagnosis of patients with deep white matter lesions in adults.

Improving neurological deficits secondary to transverse myelitis using epidural spinal cord stimulation: illustrative cases.

Epidural spinal cord stimulation (eSCS) is canonically used for the treatment of intractable, chronic pain. Recent efforts have successfully utilized eSCS to improve neurological deficits in patients with spinal cord injury. However, there is a paucity of literature on the use of eSCS for demyelinating conditions, with no prior case reports examining eSCS among patients with transverse myelitis (TM). Two patients with TM underwent eSCS and experienced improvements in motor function and bladder symptoms. The first patient exhibited enhanced motor strength in both lower extremities and no longer experienced leg spasms, increasing exercise capacity and decreasing their fall risk. The patient had reduced incontinence pad usage due to a regained ability to sense bladder fullness. The second patient also experienced improved motor scores, leading to enhanced motor functionality and independence. Furthermore, the patient observed reductions in urinary tract infections post-eSCS. Neither patient reported substantial improvement in bowel function following stimulation. Improvements in motor functionality and bladder functioning are well-documented as factors that improve quality of life among paraplegic patients. Given the findings of the present case report, larger cohort studies examining the use of eSCS for demyelinating conditions, including TM, are warranted. https://thejns.org/doi/10.3171/CASE24152.

A protocol for the longitudinal investigation of cancer related fatigue in head and neck cancer with an emphasis on the role of physical activity.

Cancer related fatigue significantly impairs the ability to undertake sustained physical activity across the domains of daily living, work and recreation. The purpose of this study is to monitor cancer related fatigue and the factors affected or caused by it for 12 months in head and neck cancer patients following their diagnosis. Their perceptions of how fatigue might affect their activity levels in addition to identifying avenues to improve engagement with physical activity will be also explored. A single centre longitudinal mixed-methods study will be conducted. Forty head and neck cancer patients will be recruited over 6 months following the confirmation of their treatment plan, after which fatigue and physical activity will be assessed at four time points over 12 months. Additionally, other factors which influence fatigue such as body composition, blood counts, systemic inflammation levels, haemoglobin concentration, thyroid function, sleep quality, cardiorespiratory fitness and upper and lower extremity strength will be measured to understand how the multifactorial problem of fatigue may evolve over time and influence physical activity levels. Semi-structured interviews will be conducted after treatment completion and at end of twelve months which will analyse the participants fatigue experiences, understand how their perceived fatigue may have impacted physical activity and report the factors which may improve engagement with physical activity during cancer. Quantitative data will be analysed and reported using standard descriptive statistics and post-hoc pairwise comparisons. The changes in outcome measures across time will be analysed using the MIXED procedure in SPSS software. Statistical significance will be accepted at p<0.05. Qualitative data will be analysed using the Interpretative Phenomenological Approach using the NVivo software. The results from this study may help inform the planning and delivery of appropriately timed interventions for the management of cancer related fatigue.

Barriers and Facilitators to the Use of Wearable Robots as Assistive Devices: Qualitative Study With Older Adults and Physiotherapists.

Light wearable robots have the potential to assist older adults with mobility impairments in daily life by compensating for age-related decline in lower extremity strength. Physiotherapists may be the first point of contact for older adults with these devices. The aims of this study were to explore views of older adults and physiotherapists on wearable robots as assistive devices for daily living and to identify the barriers and facilitators to their use. Six older adults (aged 72-88 years) tested a wearable robot (Myosuit) and participated in semistructured interviews. A focus group with 6 physiotherapists who had a minimum of 5 years of professional experience and specialized in geriatrics was conducted. Data were analyzed using thematic qualitative text analysis. Older adults perceived benefits and had positive use experiences, yet many saw no need to use the technology for themselves. Main barriers and facilitators to its use were the perception of usefulness, attitudes toward technology, ease of use, and environmental factors such as the support received. Physiotherapists named costs, reimbursement schemes, and complexity of the technology as limiting factors. A light wearable robot-the Myosuit-was found to be acceptable to study participants as an assistive device. Although characteristics of the technology are important, the use and acceptance by older adults heavily depend on perceived usefulness and need.

Predictive Validity of Lower Extremity Muscle Strength, Strength Asymmetry, and Soccer-Specific Fitness for Talent Identification in Elite Male Youth Soccer Players: A Retrospective Cohort Study

ABSTRACT This study investigates the predictive validity of lower extremity strength, strength asymmetry, and soccer-specific fitness in talent identification among elite male youth soccer players. Employing a Retrospective Cohort design, we established a cohort consisting of K-League registered youth players, totaling 219 individuals (all males, aged 16 ~ 17 years, in grade 2 of high school; equivalent to grade 11 in the US), with 38 progressing to the professional level and 181 not. Results from t-tests revealed significant differences between professional and nonprofessional groups for countermovement jump (CMJ; t = −2.423, Cohen’s d = −.448, p = .019) and change of direction with a ball (CODB; t = 2.202, Cohen’s d = .398, p = .032). CMJ demonstrated a significant correlation with the 30 m sprint (r = −.53, p < .001), and change of direction without a ball (COD) correlated with CODB (r = .52, p < .001). The robust Poisson regression, encompassing the interaction term of COD and CODB, produced an AUC of .73 (95% CI: .65 ~ .82).

Muscle quality index comparisons between Hispanics and non-Hispanic Caucasians using dual energy X-ray absorptiometry and handgrip strength.

Muscle quality index (MQI) can be computed in various ways. Also, many studies have evaluated MQI in older adults and non-Hispanic populations. The aim of this study was to compare various muscle quality indexes between Hispanics and non-Hispanic Caucasians when stratifying grip strength and appendicular lean mass measurements. 235 participants (aged 25.5 ± 9.5 for males and 26.4 ± 9.9 for females) completed a dual energy X-ray absorptiometry (DXA) scan to assess appendicular lean mass (ALM). Handgrip strength (HGS) was assessed using a handheld dynamometer. MQI was computed using four different models: 1). MQIRA: ALM and HGS of right arm and hand, respectively; 2). MQILA: ALM and HGS of left arm and hand, respectively; 3). MQIARMS: ALM and HGS of both arms and hands, respectively; and 4). MQITOTAL: ALM of upper and lower-limbs and HGS of left and right hand. Hispanic males and females exhibited lower HGS compared to Caucasians with effect sizes ranging from trivial (d = 0.17) to moderate (d = 0.80). Females demonstrated higher MQI values compared to males for MQIARMS (d = 0.70), MQIRA (d = 0.75), and MQILA (d = 0.57). However, MQITOTAL yielded a small practical effect (d = 0.33) in favor of males (3.2 ± 0.5 kg/kg vs. 3.1 ± 0.5 kg/kg). After factoring by sex and ethnicity, Hispanic males and females, compared to non-Hispanic Caucasians males and females, showed trivial-to-small practical differences (d values ranging from 0.03 to 0.39). These results demonstrate MQI models vary across sex, particularly when utilizing models that account for upper extremity strength and ALM (i.e., MQIARMS, MQIRA, and MQILA). Lastly, to establish consistency in future research, the present study recommends using MQI models that account for ALM of upper- and lower-limbs (i.e., MQITOTAL). However, research measuring muscular strength via one upper-limb (e.g., left hand) might consider measuring ALM of the corresponding arm (e.g., left arm) when computing muscle quality (e.g., MQILA).

Estimating highest capacity propulsion performance using backward-directed force during walking evaluation for individuals with acquired brain injury

There are over 5.3 million Americans who face acquired brain injury (ABI)-related disability as well as almost 800,000 who suffer from stroke each year. To improve mobility and quality of life, rehabilitation professionals often focus on walking recovery soon after hospital discharge for ABI. Reduced propulsion capacity (force output of the lower limbs to counteract ground reaction forces) negatively impacts walking ability and complicates recovery during rehabilitation for brain injured people. We describe a method, using backward-directed resistance (BDR) in a robotic-based treadmill device, to allow measurement of maximum walking propulsion force (MWPF) that is not otherwise possible during overground walking assessment. Our objective was to test the construct validity of a maximum walking propulsion force (MWPF) measure that reflects a person’s propulsive strength against applied BDR, while walking on a robotic treadmill-based device for participants with acquired brain injury (ABI). Our study enrolled 14 participants with ABI at an in inpatient rehabilitation in Galveston, TX from 8/1/21 − 4/31/22. The range of weight-adjusted MWPF was 2.6–27.1% body weight (%BW), mean 16.5 ± 8.4%BW, reflecting a wide range of propulsive force capability. The strongest correlation with overground tests was between the 6-minute walk test (6-MWT) distance and the MWPF values (r = 0.83, p < 0.001) with moderate correlations between the 10-meter walk tests at comfortable (CWS) and fast speeds (FWS). The Five Times Sit-to-Stand (used as a standard clinical measure of functional lower extremity strength) and MWPF tests were poorly correlated (r = 0.26, p = 0.4). Forward model selection included 6-MWT distance, age, and overground CWS as significant partial predictors of MWPF. We conclude that this novel MWPF measure is a valid representation of maximum propulsive force effort during walking for people post-ABI. Additional research could help determine the impact of interventions designed to increase propulsive force generation during rehabilitation training to improve overground walking performance.

Gastrocnemius electrical stimulation increases ankle dorsiflexion strength in patients with post-acute sequelae of SARS-COV-2 (PASC): a double-blind randomized controlled trial

Post-Acute sequelae of SARS-CoV-2 (PASC) is a multisystem disorder causing persistent musculoskeletal deconditioning and reduced lower extremity strength. Electrical stimulation (E-Stim) to the gastrocnemius muscle can enhance strength outcomes by increasing the frequency of muscle fiber activation. We investigated its effect on individuals with PASC. Participants were randomized into intervention (IG) or control (CG) groups. The IG self-administered daily one-hour E-Stim to both their gastrocnemius muscles using a functional device over 4-week, while the CG used a sham device. Primary outcomes were ankle dorsiflexion strength assessed via dynamometry during maximum voluntary contractions, and gastrocnemius voluntary activation (GVA) via surface electromyography. The secondary outcome assessed activities of daily living (ADL), instrumental ADL, and mobility queries. Percentage improvement was calculated. Eighteen patients were analyzed (IG = 10; CG = 8). After 4 week, the IG showed a significantly higher improvement in ankle dorsiflexion strength (222.64%) compared to the CG (51.27%, p = 0.002). Additionally, the IG’s ankle dorsiflexion strength improvement significantly correlated with GVA improvement (rho = 0.782) at 4 week. The secondary outcomes did not reveal significant changes in neither group. Self-administered gastrocnemius E-Stim improves ankle dorsiflexion strength in individuals with PASC. However, larger sample sizes and longer interventions are needed to validate these findings.

ASSESSMENT OF 16-YEAR-OLD FEMALE BASKETBALL PLAYERS WITH CHRONOJUMP SYSTEM

In the basketball game, lower extremity strength plays a key role in various game actions. The jumping mat (Chronojump), an open-source (free software and open hardware), is available to the public on official servers, emphasizing peer review and corrections by the user community. The aim of this study was to establish the explosive power of the lower limbs of 16-year-old female basketball players from the Bulgarian National Basketball Team. We used specialized software, a signal transducer, and an electro-contact mat Chronojump. The subject of the study was the explosive power of the lower limbs of 16-year-old female basketball players from the national team of Bulgaria. The object of the study was the performance of the Chronojump platform tests to establish the explosive strength of the lower limbs. The study was conducted among 16 active female basketball players selected for the Bulgarian national team. Each participant performed all jumps at the same time of day. They performed CMJ - 90-degree squat jump; SJ - Squat, two-second hold, and jump; CMJAT - Jump with arms extended forward and up; RCMJ - Manipulative 90-degree squat jump; Stiff ness - Manipulative ankle jump. The test’s mathematical-statistical results were processed with variance analysis and One-way ANOVA, with a critical value of the F-criterion (F = 2.38) and high statistical reliability (Pt ≥ 95%). Results showed that hand involvement is key in rebounding. In terms of jumping endurance and explosiveness quotient, female athletes had a lower level of development. This research has the potential to significantly impact the training and performance of female basketball players.

Utilization Community-Based Rehabilitation Methods to Improve Independence and Quality of Life for Patients with Disabilities in Nara Phirom Health Promoting Hospital, Thailand

The disability community activity, Nara Phirom Health Promoting Hospital in Banglen District, Nakhon Pathom, Thailand, collaborated with the Faculty of Physiotherapy, Mahidol University to support the disability community. Using the Community-based rehabilitation (CBR) method, the aim to enhance independence and quality of life. Evaluation includes IADL for independence and WHOQoL Bref-100 for quality of life. Education on health, immobilization, and exercise was provided to patients, families, and caregivers. Therapists teached physical exercises, to be repeated 2-3 times daily by caregivers and family. The 1-month program, supervised by therapists, includes standing and walking for patients with lower extremity strength of 3/5 (measured by manual muscle testing). Rehabilitation involves crafting items like wallets and bags, stamps, and flowers from bottles. Results, patients with low function status (very dependent on other people) decreased by 64.3%, moderate function increased by 116.7% and independence increased by 111.1%. There was a significant improvement in quality of life (WHOQoL) and all domains after CBR program.

Effects of a circuit training program in improving cardiorespiratory fitness, upper extremity strength, and agility in paraplegic subjects

Exercise and sports may play a crucial role for individuals with disabilities due to their restricted levels of physical activity. Among people with disabilities, engaging in sports and exercise has the potential to notably enhance their physical and physiological functioning. Consequently, the aim of this research was to investigate the effects of a circuit training program on the cardiorespiratory fitness, musculoskeletal strength, and agility of wheelchair users. The study involved 28 participants with paraplegia as a result of spinal cord injury, aged between 19 and 40 years, who were divided into two groups: an experimental group (EG, n = 14) participating in circuit training, and a control group (CG, n = 14) undergoing aerobic upper-body exercise exclusively. All subjects took part in the wheelchair yo-yo test and hand grip test, both conducted at the commencement and conclusion of the training period. The results displayed a significant Time x Group interaction for both variables, indicating a substantial improvement in the intervention group (p &lt; 0.001), while no significant changes were observed in the control group. Therefore, the findings suggest that incorporating circuit training into the daily routine of wheelchair users has a positive impact on their overall well-being, ultimately enhancing their quality of life. Key words: physiology; exercise; sport; spinal cord injuries; cardiorespiratory fitness.

Changes in Physical Fitness in Youth Padel Players during One Season: A Cohort Study.

The aim of this study was to investigate how physical fitness performance, which is related to the strength and power of the lower extremities and core, as well as lateral agility, changes across 20 weeks of in-season training in youth female and male padel players. This study was conducted using a prospective cohort design on 16 Swedish high school padel players aged between 15 and 18 years old. The players were assessed at baseline with five tests of their physical fitness and followed prospectively, with the registration of their training load for 20 weeks, and then assessed at a follow-up, approximately five months later. The players increased their performance in all tests (p ≤ 0.02). The mean improvement in their Isometric squat test performance was 20% for peak force, 18% for relative strength value and 69% for average rate of force development. Their improvement in the squat jump test performance was 9%, whereas the improvement in their countermovement jump test was 6%. For the 30 second sit-up test, an improvement of 14% was observed. Improvements were also noted for the 30 second side hop test performance on both the right (9%) and left leg (11%). The effect size ranged from 0.31 to 1, respectively, for the tests, representing a small to large effect. The data from this study suggest that an improvement in physical fitness performance can be obtained during 20 weeks of padel training.

Postural instability and lower extremity dysfunction in upper motor neuron-dominant amyotrophic lateral sclerosis.

Upper motor neuron-dominant ALS (UMND ALS) is recognized to have early onset and good prognosis, but may have a rapid decline in motor function due to gait instability in the early stage. We investigated changes in lower extremity function in UMND ALS, particularly UMND ALS patients accompanied with postural instability or repeated falls (UMND ALS plus). Among the 2,353 ALS patients reviewed, 211 (9.0%) had UMND ALS. UMND ALS had a longer diagnosis delay and restricted symptoms. Although UMND ALS patients had better lower extremity function and strength than matched classic ALS patients on first evaluation, there was no difference in the time of needing assistance or not being able to walk after disease onset. In contrast, UMND ALS plus has severe UMN symptoms and a more rapid decline in motor function. The lower extremity function was no better than that in the matched classic ALS. The prognosis of UMND ALS and UMND ALS plus were significantly better than those of overall ALS. UMND ALS has restricted symptoms but has a rapid decline in lower extremity function in the early stage of the disease. The motor function decline of UMND ALS plus is as fast as classic ALS. Whether these patients represent a distinct subgroup of ALS deserves further investigation.