Functional Performance Tests Research Articles

OLDER ADULTS REPORTING FEAR OF FALLING PRESENT WITH REDUCED PHYSICAL FUNCTION

Abstract Falls pose a significant risk to older adults (OAs), often leading to fear of falling (FOF). This study investigated the prevalence and the impact of FOF on physical activity (PA), sedentary behavior (SB), and physical function in OAs living in a community-dwelling facility (CDF). Ninety-three OAs were included in the study. FOF was assessed using the following Yes/No question: “Are you afraid of falling”? PA and SB were self-reported, while physical function was assessed using a collection of objective tests. Data were analyzed using descriptive and inferential statistics with significance set at p< 0.05. The prevalence of FOF was found to be 47.3% (36.9%–57.9%), with no significant differences between sex (Female: 48.4% (35.8%–61.3%) vs. Male: 44.8% (26.4%–64.3%); χ2(1, N=93) = 0.104, p=0.747) or falls history (zero falls: 43.9% (30.7%–57.6%) vs. One or more falls: 52.8% (35.5%–69.6%); χ2(1, N=93) = 0.704, p=0.401). OAs reporting FOF presented with significant (p< 0.05) lower performance in all physical function tests compared to those reporting no FOF. However, after controlling for the use of assistive devices (i.e., cane), the performance in some tests (i.e., Timed Up and Go, Timed 25-foot Walk; Short Physical Performance Battery subcomponent gait) lost significance (p>0.05). No significant differences were observed for PA and SB between groups with and without FOF (p>0.05). These findings suggest a high prevalence of FOF among the studied sample, worse physical function for OAs reporting FOF, and similar levels of PA and SB between FOF groups of OAs living in a CDF.

Balance in children with chronic kidney disease: the relationship between skeletal muscle mass index, fatigue, and physical function.

The study evaluated the relationship between balance function and skeletal muscle mass index (ASMI), physical function, and fatigue in children with chronic kidney disease (CKD). A cross-sectional study of 83 children with CKD (stages 1-4, dialysis, transplant) and 71 healthy controls was conducted. Functional performance tests, including gait speed, 6-min walk distance (6MWD), five-repetition sit-to-stand (5RST), and timed up-and-go (TUG) tests, were administered. Quadriceps muscle strength (QMS) and hand grip strength (HGS) were assessed alongside bioelectrical impedance analysis (BIA) for muscle mass evaluation. Fatigue was measured using the Child Fatigue Scale, and balance was assessed using the Pediatric Balance Scale. Multivariate linear regression, performed exclusively on the CKD cohort, was used to determine factors influencing balance. Children with CKD exhibited significantly lower muscle strength, physical performance, and balance than controls. Specifically, QMS on the right side was 7.16 ± 5.36kg in the dialysis group versus 16.51 ± 8.66kg in the CKD stages 1-4 group and 18.58 ± 7.27kg in controls (p < 0.001). The 6MWD was 392 ± 50.34m in the dialysis group compared to 476 ± 49.67m in CKD stages 1-4 and 425 ± 68.94m in controls (p < 0.001). Fatigue levels were highest in the dialysis group (41.00 ± 11.51), and balance scores were lowest in this group (47.71 ± 8.55) (p = 0.001 for both). Regression analysis showed that QMS (β = 0.333, p = 0.042), ASMI (β = 0.259, p = 0.043), gait speed (β = -0.347, p = 0.012), TUG (β = -0.656, p = 0.001), GFR (β = 0.238, p = 0.033), and lean mass (β = 0.710, p = 0.028) were significant predictors of balance. The dialysis group presented the most significant reductions in ASMI, muscle strength, balance, and functional performance, alongside the highest fatigue levels. Balance was mainly influenced by fatigue, ASMI, QMS, and declining functional capabilities. Considering the negative impact of balance impairments on prognosis, early implementation of rehabilitation programs is essential for improving outcomes in CKD patients.

Should Femoral Nerve Blocks and Adductor Canal Blocks Be Used in Pediatric or Adolescent Anterior Cruciate Ligament Reconstruction?: A Systematic Review.

Achieving adequate pain control is vital for proper rehabilitation, satisfaction, and earlier discharge after anterior cruciate ligament reconstruction. Opioids have traditionally been used for this purpose, however, can be associated with various negative outcomes. As such, multimodal analgesia was introduced to reduce postoperative opioid use. Regional nerve blocks constitute one modality of multimodal analgesia, with femoral nerve blocks (FNBs) and adductor canal blocks (ACBs) being standard. This review sought to evaluate the utility and adverse effects of FNBs and ACBs relative to controls, alternative regional anesthesia options, and each other in pediatric or adolescent anterior cruciate ligament reconstruction (ACLR). Three databases were searched on January 31, 2024. The authors adhered to the PRISMA and R-AMSTAR guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The definition of pediatric was considered to be a mean age of 18 years or younger. Data on demographics, operative and anesthetic details, strength and functional outcomes, postoperative opioid consumption, revision rates and return to sport (RTS) rates, and Visual Analogue Scale (VAS) scores were extracted. Eleven studies (1 level I, 10 level III) comprising 5453 patients were included in this review (54.1% female), with a mean age of 16.3 (range of means: 15.0 to 16.9) years. Two studies compared FNB with and without a sciatic-nerve block (SNB), finding lower opioid consumption (P=0.007) and VAS scores (P<0.0001) in the postanesthesia care unit (PACU) in the FNB + SNB group. Three studies compared FNB or ACB with controls, with no studies reporting a benefit in rates of RTS, isokinetic quadriceps or hamstrings strength, or functional test performance. There were minimal differences when comparing continuous and single nerve blocks and FNB with ACB. There is inconclusive evidence investigating the role of FNB and ACB in pediatric or adolescent ACLR. The addition of a SNB to FNB may result in improvements in opioid consumption and VAS scores in the early postoperative period. There was minimal evidence in support of continuous blocks over single-shot blocks. Future studies should compare the use of ACB, FNB, and no blocks for pediatric or adolescent ACLR, with primary endpoints of acute pain control, postoperative opioid use, and the presence of longer-term motor deficits. Level III.

The Effectiveness of Therapeutic Exercise Interventions With Virtual Reality on Balance and Walking Among Persons With Chronic Stroke: Systematic Review, Meta-Analysis, and Meta-Regression of Randomized Controlled Trials.

Well-targeted balance, walking, and weight-shift training can improve balance capabilities in the chronic phase of stroke. There is an urgent need for a long-term approach to rehabilitation that extends beyond the acute and subacute phases, supporting participation without increasing the demand for health care staff. This study aims to evaluate the effectiveness of therapeutic exercise interventions with virtual reality (VR) training on balance and walking at the activity and participation levels in individuals with chronic stroke, compared with control groups receiving no treatment, conventional physical therapy, specific training, similar treatment, or identical treatment without VR. Studies were searched across 6 databases. The inclusion criteria were as follows: Adults aged 18 years or older with a stroke diagnosis for at least 6 months (population). Therapeutic exercises within a VR environment, using VR glasses or interactive games (intervention). Control groups without the use of VR (including no treatment, conventional physical therapy, specific training, similar treatment without VR, or identical treatment without the additional use of VR; comparison). We evaluated the Berg Balance Scale score, Functional Reach Test performance, Activities-specific Balance Confidence Scale score, Six-minute Walk Test, Two-minute Walk Test, 10-meter Walk Test results, and cadence (outcome measures). We investigated randomized controlled trials (study design). A meta-analysis and a meta-regression analysis were conducted to evaluate whether the content of VR interventions or control groups, as well as the level of VR immersion used, was related to balance or walking outcomes. A total of 43 randomized controlled trials involving 1136 participants were included in this review. The use of VR training in therapeutic exercise interventions had a large effect on balance (standardized mean difference 0.51, 95% CI 0.29-0.72; P<.001) and a moderate effect on walking (standardized mean difference 0.31, 95% CI 0.09-0.53; P=.006) in individuals with chronic stroke, compared with pooled control groups (no treatment, conventional physical therapy, specific training, similar treatment, or identical treatment without the use of VR). According to the meta-regression findings, the content of VR interventions (P=.52), the type of control groups (P=.79), and the level of VR immersion (P=.82) were not significantly related to the pooled balance or walking outcomes. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) was moderate for balance and low for walking. Therapeutic exercise training with VR had a positive, albeit moderate, effect on balance and a low impact on walking at the level of activity (capacity), even in the chronic phase of stroke, without serious side effects. The results are applicable to working-aged stroke rehabilitees who are able to walk without assistance. Further research is needed with defined VR methods and outcomes that assess performance at the level of real-life participation.

The effects of whole-body vibration exercises with and without conventional physical therapy modalities in patients with knee osteoarthritis: A prospective, randomized-controlled study

Objectives: This study aims to examine the effects of whole-body vibration (WBV) therapy + home-based exercise (HBE) therapy; physical therapy modalities (PTMs)+HBE; and WBV+PTM+HBE on pain severity, physical performance, and functional status in patients with knee osteoarthritis (OA). Patients and methods: This single-center, single-blind, three-armed, prospective, randomized-controlled study included a total of 65 patients (3 males, 62 females; mean age: 56.0±6.3 years; range, 45 to 70 years) who were diagnosed with knee OA between February 2014 and July 2014. The participants were randomly divided into three groups. Group 1 (n=22) received WBV+HBE, Group 2 (n=22) received WBV+PTM+HBE, and Group 3 (n=21) received PTM+HBE alone. The primary outcome measure was functional physical performance, while the secondary outcome measures were pain intensity and functional status. All the measurements were evaluated by a single blinded investigator before and after treatment. Results: All the functional physical performance tests (p&lt;0.01), pain intensity (p&lt;0.01), and functional status (p&lt;0.01) showed statistically significant effects in terms of time and group × time interaction, but no significant difference was observed among the groups (p&gt;0.05). We observed statistically and clinically significant improvement in all of the functional physical performance tests, pain, and functional status for Group 2. There was a statistically and clinically significant improvement only in the functional physical performance tests for Group 1. In Group 3, no clinical or statistical significance was achieved in any outcome measurements. Conclusion: Treatment program consisting of WBV+PTM+HBE can yield clinically and statistically favorable results by improving all of the pain, functional status and physical performance parameters of the patients with knee OA, while WBV+HBE can be clinically and statistically effective only in the physical performance parameters of the patients.

Anti-saccade can be used as a screening tool for early cognitive impairment: a correlation study based on anti-saccade parameters and cognitive function.

Eye movement tasks, especially anti-saccade tasks, have been used to assess cognitive function in patients with neuropsychiatric disorders. Although it has been shown that individuals with cognitive impairment perform worse on anti-saccades tasks, there is a lack of systematic evaluation of the sensitivity of parameters of anti-saccades to assess different subtypes of cognitive impairment. A total of 158 participants were enrolled in this study, consisting of 66 men and 92 women, with an average age of 50.2 ± 10 years. The comparison of pro-saccade reaction time, anti-saccade reaction time, and error rates in the saccade task between individuals with cognitive impairments and a normal group was conducted. Furthermore, we systematically analyzed the correlations between the performance in neurological function tests (Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Stroop) and these anti-saccade parameters. Especially, the correlation between these parameters and cognitive function in different domains of the MoCA task were also evaluated. The pro-saccade reaction time, anti-saccade reaction time and error rate were negatively correlated with the MMSE and MoCA scores (P < 0.001), and positively correlated with the time used in Stroop tasks. Among them, the error rate had the strongest correlation with the performance of MMSE, MoCA and Stroop tasks (MoCA: P < 0.0001, r2 = -0.608; MMSE: P < 0.0001, r2 = -0.344; Stroop: P < 0.0001, r2 = 0.455). Among the seven cognitive domains examined by the MoCA task, error rates had relatively high correlations with visuospatial/executive (P < 0.0001, r2 = -0.4660) and delayed recall (P < 0.0001, r2 = -0.4228) compared to naming, language (P = 0.0004, r2 = -0.0788), attention (P = 0.0004, r2 = -0.0780), abstraction (P < 0.0001, r2 = -0.1515), orientation (P < 0.0001, r2 = -0.1075). Moreover, pro-saccade reaction time, anti-saccade reaction time and error rate of people with high MoCA scores were significantly higher than those of people with low MoCA scores, which can be used to identify people with mild cognitive impairment. Our study's results provide valuable clinical evidence supporting the effectiveness of anti-saccades in assessing cognitive impairment, which is beneficial for screening and timely clinical intervention in individuals with specific cognitive impairment.

Effects of structured positive feedback intervention on standing reach ability among older adults admitted to a convalescent rehabilitation ward: a small-sample pilot randomized controlled trial.

Interventions to improve the standing reach ability of older adults are essential for full functional independence, and structured positive feedback (PF) may be an effective intervention strategy. The purposes of this pilot randomized controlled trial (RCT) are to investigate the preliminary efficacy of structured PF for improving the standing reach ability of older patients admitted to a convalescent rehabilitation ward and evaluate the feasibility of a future full-scale RCT. Thirty-two eligible older adults (83.3 ± 5.9years, 23 women) out of 587 potential participants were randomly assigned 1:1 to structured PF (experimental) and conventional rehabilitation (control) groups. Only the experimental group received PF intervention for standing reach ability once every 3days. Both groups engaged in conventional rehabilitation programs for 2-3h every day. The primary outcome was change in Functional Reach Test (FRT) performance after 5weeks of the indicated intervention compared to baseline. Secondary outcomes were change in Short Falls Efficacy Scale International (Short FES-I), a self-reported measure of fear of falling, and Functional Independence Measure (FIM) scores after the 5-week intervention. The estimated difference in mean FRT change (∆) between experimental and control groups was -4.1cm (P = 0.07) according to a linear mixed model, supporting the potential efficacy of PF for improving standing reach ability. Further, Hedge's g value was 0.71, consistent with a moderate effect size. However, the estimated mean change in Short FES-I between groups also indicated greater fear of falling in the experimental group (∆ = -4.5, P = 0.009, g = 1.0). In contrast, the intervention effect on FIM was negligible (∆ = 2.0, P = 0.66, g = -0.1). These results support the preliminary effectiveness of structured PF for improving the standing reach ability of older adults. A larger-sample RCT is warranted for validation and optimization of the structured PF protocol. The University Hospital Medical Information Network (UMIN) Registered 31 May 2022 (UMIN000047647).

Assembly of functional microbial ecosystems: from molecular circuits to communities.

Microbes compete and cooperate with each other via a variety of chemicals and circuits. Recently, to decipher, simulate, or reconstruct microbial communities, many researches have been engaged in engineering microbiomes with bottom-up synthetic biology approaches for diverse applications. However, they have been separately focused on individual perspectives including genetic circuits, communications tools, microbiome engineering, or promising applications. The strategies for coordinating microbial ecosystems based on different regulation circuits have not been systematically summarized, which calls for a more comprehensive framework for the assembly of microbial communities. In this review, we summarize diverse cross-talk and orthogonal regulation modules for de novo bottom-up assembling functional microbial ecosystems, thus promoting further consortia-based applications. First, we review the cross-talk communication-based regulations among various microbial communities from intra-species and inter-species aspects. Then, orthogonal regulations are summarized at metabolites, transcription, translation, and post-translation levels, respectively. Furthermore, to give more details for better design and optimize various microbial ecosystems, we propose a more comprehensive design-build-test-learn procedure including function specification, chassis selection, interaction design, system build, performance test, modeling analysis, and global optimization. Finally, current challenges and opportunities are discussed for the further development and application of microbial ecosystems.

Executive functioning in adults with attention deficit hyperactivity disorder: A systematic review

Introduction: Executive function deficits are associated with attention deficit hyperactivity disorder (ADHD) in both children and adults. The inattentive subtype is primary related to “cold” executive functions, while the hyperactive subtype is related to “warm” executive functions. Objective: To systematically review studies on executive functioning in adults with attention deficit hyperactivity disorder published during the last decade. Methodology: A documentary research was conducted, encompassing 33 articles retrieved from PubMed, Web of Science and EBSCO platforms. The analysis considered years and countries of publication, attention deficit hyperactivity disorder diagnostic criteria, participants, comorbidities, subtypes, medication use, assessment tools, and processes of executive functions evaluated. Results: It was evidenced that there is a high percentage of adults with attention deficit hyperactivity disorder who present a deficit or lower performance in executive function tests. However, the results varied depending on specific characteristics of the study and/or participants, which confirms the heterogeneity of the disorder. In addition, the main instruments for measuring executive functions and diagnostic criteria for adult attention deficit hyperactivity disorder were identified. Discussion: These results support the established links between attention deficit hyperactivity disorder , impaired executive functions, and major life activities found in the adult attention deficit hyperactivity disorder literature. However, some of the limitations were the poorly controlled variables such as comorbidities, attention deficit hyperactivity disorder subtypes that were not assessed, and usage of instruments that measure executive functions that can lead to reduced credibility of the results presented here. Conclusions: According to the results presented, there is a high percentage of adults with attention deficit hyperactivity disorder who present a deficit or lower performance in executive function tests, compared to both neurotypical adults and those with other psychiatric disorders. Further research is recommended to continue studies on the topic and to include other variables.

Functional performance profile of Under-20 soccer athletes from a Brazilian first division team during the COVID-19 pandemic: A descriptive study

BackgroundThe COVID-19 pandemic led to widespread social isolation and the suspension of sports activities, significantly impacting the physical and psychological performance of athletes worldwide, particularly soccer players. This study aims to evaluate the effects of pandemic-related training suspensions on the functional performance of U-20 soccer players from a first-division club in Rio de Janeiro. MethodsForty-one male U-20 soccer players were assessed during the preseason (PS) periods of 2020 and 2021. The following functional tests were performed: Single Leg Step Down (STEP DOWN), Ankle Mobility Test (LUNGE), Y-Balance Test (YBT), and Single Leg Bridge Test (BRIDGE). Comparisons were made between seasons and against established cutoff values. ResultsMost athletes demonstrated moderate-to-good performance in the functional tests during PS-20. However, in PS-21, the players showed significantly improved performance in the LUNGE test (P = 0.001) but a decline in YBT performance (P = 0.009). Specifically, 68% and 21% of the U-20 players exhibited moderate-to-good performance in LUNGE and YBT, respectively, in PS-21. ConclusionAfter a period of restricted social and sports activities due to the COVID-19 pandemic, most U-20 soccer players experienced changes in their functional test performance. These findings highlight the need for medical and health professionals working with soccer teams to carefully plan exercise and rehabilitation programs during periods of activity restrictions.

Physical Function, Self-Perceived Physical Fitness, Falls, Quality of Life and Degree of Disability According to Fear and Risk of Falling in Women with Fibromyalgia.

Background: People with fibromyalgia (FM) experience a range of symptoms (chronic widespread pain, fatigue, mood disorder, sleep problems, muscle stiffness) that promote deterioration of physical condition and function. With impaired physical function, fear of falling and risk of falling increases. This study evaluated physical function, self-perceived physical fitness, falls, quality of life, and the degree of disability caused by FM according to fear and risk of falling in Spanish adult women with FM. Methods: Cross-sectional study involving 84 Spanish adult women with FM. Participants completed tests to assess their physical function and completed questionnaires to evaluate self-perceived physical fitness, falls, the disabling effect of FM, quality of life, fear of falling, and risk of falling. Nonparametric statistical tests were used to analyze possible intergroup differences (Mann-Whitney U test) and correlations between variables (Spearman's Rho). Results: Women with a fear of falling and at risk of falling presented a worse performance in physical tests, worse self-perceived physical fitness, greater number of falls, lower quality of life, and greater degree of disability due to FM. Weak and moderate correlations were found for fear of falling and fall risk and the variables of interest. However, no intergroup differences were found, nor significant correlations in all variables. Conclusions: Women with FM who present fear of falling and risk of falling tend to have worse performance in physical function tests, in addition to worse self-perceived physical fitness, higher number of falls, poorer quality of life, and greater disabling effect of FM.

Evaluating environmental and economic benefits of using biochar in concrete: A life cycle assessment and multi-criteria decision-making framework

While several studies have assessed the applicability of using biochar in cement mortar and concrete preparation based on the best mechanical properties, this evaluation method should be improved to consider the techno-economic feasibility and the environmental impacts. To address this research gap, this study attempts to compare between the conventional concrete with 100 % cement as a control mixture (CM) and dumping of sludge into open sites (scenario_1), and biochar concrete using alum sludge biochar (ASB) as a partial cement replacement (scenario_2), regarding the project life cycle assessment (LCA) and economic feasibility. A multi-criteria decision-making (MCDM) framework was used to assign scores to the environmental LCA criteria, material functional performance tests, and cost considerations. The two scenarios were arranged in SimaPro LCA software, and then the different criteria were analyzed using the TOPSIS technique to choose the best alternative. The study demonstrated that the functional properties of the cement mixture containing 5 % of ASB were almost comparable to those of CM, owing to the presence of significant amounts of quartz (SiO2) that bonded strongly with cement molecules. This ASB mixture also enjoyed the least environmental impacts, reducing the global warming potential (GWP) by 32.2 % compared with the CM scenario. The scores of the “Cost” criterion, considering the price of raw materials, energy, production, and maintenance, for the two alternatives were almost comparable, depicting that scenario_2 achieved the highest closeness coefficient of 0.95 in the MCDM overall scoring. This study concluded that biochar could be incorporated into cementitious mixtures due to its lower impact on global warming to maintain a sustainable and economic concrete industrial strategy. Future studies should focus on studying the long-term durability of the biochar-based concrete mixtures and integrating into the MCDM strategy; in addition, determining the correlation between sustainable construction implementation and sustainable development goals achieved.

Intraoperative landmark-based genicular nerve block versus periarticular infiltration for postoperative analgesia in total knee arthroplasty: a randomized non-inferiority trial

IntroductionGenicular nerve blocks (GNBs) are an emerging technique that have been used as a part of multimodal analgesia for total knee arthroplasty. The efficacy of intraoperative landmark-based GNBs, a recently...

The Relationship Between Pre-Season Functional Screening Test Performance and Coaches' Perception of Soccer Performance in Adult Male Players

The Relationship Between Pre-Season Functional Screening Test Performance and Coaches' Perception of Soccer Performance in Adult Male Players

Minimal dose resistance training enhances strength without affecting cardiac autonomic modulation in menopausal women: a randomized clinical trial

The proposition of a minimal dose of resistance training (RT) to elicit health benefits, encompassing physiological and psychological aspects, has garnered attention. While empirical investigations have demonstrated the efficacy of low-volume RT protocols in inducing adaptations such as enhanced strength and functional capacity, further exploration of the effects of this paradigm across a broader spectrum of variables is warranted. Thus, this study aimed to investigate the effects of minimal dose RT on strength and functional capacity, cardiac autonomic modulation, and hemodynamic parameters in menopausal women. Twenty-six women were randomly assigned to the training (TG: 63.2 ± 9.3 years) or control group (CG: 59.3 ± 7.6 years). Anthropometric measurements, strength and functional performance tests, cardiac autonomic assessment, and hemodynamic parameters were performed before and after four weeks of intervention. The TG performed the minimum dose RT twice weekly for four weeks (2 sets of 8–12 repetitions in three dynamic exercises, plus three 1-min isometric planks), and the CG had a weekly meeting with lectures and stretching. Two-way ANOVA with repeated measures was applied to each variable. Regarding time comparisons, there was a significant increase for LniRR (F = 4.78; ω2 = 0.046; p = 0.04), one repetition maximum (1RM) bench press (F = 8.06; ω2 = 0,013; p = 0.01), and 1RM leg press (F = 17.3; ω2 = 0,098; p < 0.01). There was a group*time interaction only for the index LnRMSSD (F = 5.11; ω2 = 0.042; p = 0.03), and 1RM bench press (F = 9.52; ω2 = 0,016; p = 0.01). No between-group main effect for any variable was found. The minimal dose RT protocol improved muscle strength, while cardiac autonomic and hemodynamic variables, as well as functional capacity, remained stable over 4 weeks in menopausal women.

EFFECTS OF BALANCE TRAINING WITH STROBOSCOPIC GLASSES ON JOINT POSITION SENSE, POSTURAL STABILITY, AND FUNCTIONAL PERFORMANCE TESTING IN CHRONIC ANKLE INSTABILITY NATIONAL ATHLETES: A SINGLE-BLINDED RANDOMIZED CONTROLLED TRIAL

Chronic Ankle Instability (CAI) significantly affects athletic performance and increases the risk of recurrent ankle sprains. Stroboscopic Glasses (SG) may enhance proprioceptive feedback and postural control. We aimed to evaluate the augmented effects of Proprioceptive Feedback Training (PFT) combined with SG in athletes with CAI. We conducted a single-blinded randomized controlled trial with participants assigned to the PFT+SG or PFT alone groups. The interventions were administered over an eight-week period. Improvements in the Foot and Ankle Ability Measure Sport subscale (FAAM-S), Identification of Functional Ankle Instability (IdFAI) Questionnaire, Joint Position Sense (JPS) error value, postural stability via the Balance Velocity Test (BVT), Functional Performance Tests (FPTs), and giving-way episodes were assessed pre- and post-intervention. Substantial improvements in FAAM-S and IdFAI scores were observed in the PFT+SG group compared to those in the PFT group. JPS and BVT were significantly higher in the PFT+SG group than in the PFT group. FPTs and giving-way episodes were significantly higher in the PFT+SG group than in the PFT group. The inclusion of SG in PFT significantly enhanced rehabilitation outcomes in athletes with CAI. SG combined with PFT may address proprioceptive deficits and improve functional performance in patients with CAI.

Comparison of functional performance outcomes between oral patented crystalline glucosamine sulfate and platelet-rich plasma among knee osteoarthritis patients: a propensity score matching analysis

BackgroundAmong the medications used to treat knee osteoarthritis (OA), oral patented crystalline glucosamine sulfate (pCGS) and platelet-rich plasma (PRP) have become popular alternatives to painkillers or nonsteroidal anti-inflammatory drugs (NSAIDs). Although studies have shown that pCGS and PRP improve clinical outcomes, no study has compared outcomes between these optional treatments. We compared functional performance outcomes from baseline to the 1-year follow-up (FU) between oral pCGS and PRP in patients with knee OA.Materials and methodsThree hundred eighty-two patients receiving oral pCGS and 122 patients receiving PRP injections were enrolled for a review of functional performance outcomes, including a five-time sit-to-stand test (5xSST), time up-and-go test (TUGT), and 3-minute walk distance test (3MWDT). The patients were followed up for one year. The pCGS group received 1500 mg daily, whereas the PRP group received 2 cycles of intra-articular injections at week 0 and week 6. Using propensity score matching based on age, sex, height, weight, BMI, and Kellgren and Lawrence (KL) classification, all three functional performance outcomes were compared between the baseline (pretreatment), 6-week, 12-week, 24-week, and 1-year FUs.ResultsWith a ratio of 2:1 (pCGS: PRP), 204 patients in the pCGS group were matched with 102 patients in the PRP group. Compared with the baseline levels, the PRP group showed significant improvements in 5xSST and TUGT outcomes from 6 weeks and significant improvements in 3MWDT outcomes from 12 weeks, whereas the pCGS group showed significant improvements in TUGT outcomes from 6 weeks and significant improvements in 5xSST and 3MWDT outcomes from 12 weeks. At the 24-week and 1-year FU, both groups showed significant improvements in all three functional performance tests without adverse events.ConclusionsAlthough the PRP group showed faster improvements in 5xSST outcomes at six weeks, from the 12-week to 1-year FU, both the pCGS and PRP groups showed significant improvements in 5xSST, TUGT, and 3MWDT outcomes. As the use of PRP is more complicated and invasive than the use of oral pCGS, the benefits and drawbacks of selecting PRP over pCGS in knee OA treatment should be examined.

"If you cannot measure it, you cannot improve it". Outcome measures in Duchenne Muscular Dystrophy: current and future perspectives.

Duchenne Muscular Dystrophy (DMD) is an X-linked recessive neuromuscular disorder primarily affecting males, caused by mutations in the dystrophin gene. The absence of dystrophin protein leads to progressive skeletal muscle degeneration. Recent advances in the therapeutic landscape underscore the need to identify appropriate outcome measures to assess treatment efficacy in ambulant and non-ambulant DMD patients, across clinical and research settings. This is essential for accurately evaluating new treatments and attributing therapeutic benefits.It is crucial to establish a robust correlation between outcome scores and disease progression patterns. This task is challenging since functional test performance may be influenced by different patient's characteristics, including the physiological evolution of the neurodevelopment together with the disease progression. While widely used DMD outcomes such as the North Star Ambulatory Assessment, the 6-Minute Walking Test, the 4 stairs climbed, and the Performance of the Upper Limb exhibit reliability and validity, their clinical significance is influenced by the wide phenotype and progression variability of the disease.We present and discuss the features (relevance, quantifiability, validity, objectivity, reliability, sensitivity, specificity, precision) of available DMD outcome measures, including new potential measures that may be provided by digital tools and artificial intelligence.

New Approach to Personalizing Scenarios for a Single-Player 3D Soulslike Game

The results of an analysis of games in the Action/RPG genre and existing methods for personalizing their scenarios are presented, and the stages of developing a computer video game using methods for personalizing its scenarios are outlined. These include strengthening and weakening the player and opponents, as well as changing the environ­ment; approaches and technologies used to solve the problems of developing a system for gameplay personification of game scenarios and developing a software product are revealed. A description of the design stages by the authors of a Soulslike-style game application with the possibility of personalizing its scenarios, the results of functional testing and game performance in terms of the number of frames per second are presented.

Feasibility and preliminary effects of the Fit2ThriveMB pilot physical activity promotion intervention on physical activity and patient reported outcomes in individuals with metastatic breast cancer.

Physical activity research among patients with metastatic breast cancer (MBC) is limited. This study examined the feasibility and potential benefits of Fit2ThriveMB, a tailored mHealth intervention. Insufficiently active individuals with MBC (n = 49) were randomized 1:1 to Fit2ThriveMB (Fit2ThriveMB app, Fitbit, and weekly coaching calls) or Healthy Lifestyle attention control (Cancer.Net app and weekly calls) for 12weeks. Fit2ThriveMB aimed to increase daily steps via an algorithm tailored to daily symptom rating and step goal attainment. The primary outcome was feasibility defined as ≥ 80% completion rate. Secondary feasibility metrics included meeting daily step goal and wearing the Fitbit ≥ 70% of study days, fidelity, adherence to intervention features and safety. Secondary outcomes included physical activity, sedentary time, patient reported outcomes (PROs), health-related quality of life (QOL) and social cognitive theory constructs. A subsample (n = 25) completed functional performance tests via video conferencing. The completion rate was 98% (n = 1 died). No related adverse events were reported. Fit2ThriveMB participants (n = 24) wore the Fitbit 92.7%, met their step goal 53.1%, set a step goal 84.6% and used the app 94.1% of 84 study days. Intent-to-treat analyses indicated trends toward improvements in activity, QOL, and some PROs, social cognitive theory constructs, and functional performance tests favoring the Fit2ThriveMB group. Significant effects favoring Fit2ThriveMB were observed for self-efficacy and goal-setting. However, some PROs and functional performance improvements favored the control group (p-values > 0.05). Fit2ThriveMB is feasible and safe for patients with MBC and warrants further evaluation in randomized controlled trials with larger sample sizes. Registration Clinicaltrials.gov NCT04129346, https://clinicaltrials.gov/ct2/show/NCT04129346.