Leg Stance Research Articles

Push Recovery of a Biped in Different Stance Scenarios

Abstract Push recovery of a biped robot is challenging because of the complexity of biped locomotion contributed by its constraints. The present work proposes a novel optimized control methodology for push recovery against external disturbances utilizing “Centroidal Momentum” and “Momentum Jacobian Matrix” (MJM). The novelty of this work lies in the optimization framework of the control problem that includes an eigenanalysis of MJM. The optimization considers various constraints associated with the biped locomotion while minimizing the necessary cost function. Successful push recoveries of a biped from different stance scenarios (single leg stance, double leg stance, double leg stance at different heights) are demonstrated using the unique methodology proposed in this work. Such a unique methodology using eigenanalysis of MJM for push recovery under diverse stance scenarios has yet to be described in the literature. The balance stability of the robot after being pushed is evaluated by its Center of Mass (CoM) motion and Zero Moment Point (ZMP) criteria. It is also demonstrated that the proposed methodology in the present work can recover a biped from a greater impulse force normalized by biped weight compared to other existing push recovery methods. A new term called “Effective Disturbance Ratio” (EDR) is introduced to perform this comparison.

The effects of balance training in patients with total hip arthroplasty : Arandomized controlled pilot study.

Total hip arthroplasty (THA) causes damage to hip joint mechanoceptors, which in turn leads to decrease in proprioception and increase in balance disorders. Few research has focused on balance training in patients with arthroplasty and none investigated the long-term effect of balance training using objective balance assessment methods in THA patients. The purpose of our study was to investigate the effects of balance training in patients with THA until 26 weeks postoperatively. For this study 24 patients with hip osteoarthritis, who were candidates for THA were recruited. Of the patients with THA 16completed the study protocol and the patients were randomized to 2groups: conventional rehabilitation (CR, n = 8) or conventional rehabilitation plus balance training (CR + BT, n = 8). The CR group completed typical surgery-specific exercise programs, while the CR + BT group completed the CR plus balance exercises. The patients were evaluated by ahand-held dynamometer, single leg stance test (SLST), Tetrax balance system, Harris hip score, lower extremity function scale, 5times sit to stand test and 50-foot timed walk test preoperatively and 8, 14 and 26 weeks postoperatively. While the CR + BT group showed significant improvement for the right extremity eyes closed SLST score (p < 0.05), there was no significant difference for other assessment parameters between the CR and CR + BT groups (p > 0.05). There were significant improvements in both groups until 26 weeks following THA (p < 0.05). The results of our study indicate that there were similar improvements in the balance and functional parameters in the CR and CR + BT groups. There was no additional benefit after 26 weeks of controlled balance exercises following THA.

Improvements in clinical signs and symptoms of Parkinson’s disease using photobiomodulation: a five-year follow-up

BackgroundParkinson’s disease is a progressive neurodegenerative disease characterized by clinical motor signs and non-motor symptoms that severely impact quality of life. There is an urgent need for therapies that might slow, halt or even reverse the progression of existing symptoms or delay the onset of new symptoms. Photobiomodulation is a therapy that has shown potential to alleviate some symptoms of Parkinson’s disease in animal studies and in small clinical trials.ObjectiveTo assess long-term effectiveness of photobiomodulation therapy in a cohort of Parkinson’s disease individuals after five years of continuing therapy.MethodsEight participants of the initial 12 in a previously published study agreed to be reassessed after five years. Seven of these participants had continued home-based, self-applied photobiomodulation therapy three times per week for five years. One participant had discontinued treatment after one year. Participants were assessed for a range of clinical motor signs, including MDS-UPDRS-III, measures of mobility and balance. Cognition was assessed objectively, and quality of life and sleep quality were assessed using self-reported questionnaires. A Wilcoxon Signed Ranks test was used to evaluate change in outcome measures between baseline (before treatment) and after five years, with the alpha value set to 0.05.ResultsOf the seven participants who had continued photobiomodulation therapy, one had a preliminary diagnosis of multisystem atrophy and was excluded from the group analysis. For the remaining six participants, there was a significant improvement in walk speed, stride length, timed up-and-go tests, tests of dynamic balance, and cognition compared to baseline and nonsignificant improvements in all other measures, apart from MDS-UPDRS-III, which was unchanged and one measure of static balance (single leg stance, standing on the unaffected leg with eyes open) which declined. Five of six participants either improved or showed no decline in MDS-UPDRS-III score and most participants showed improvement or no decline in all other outcome measures. No adverse effects of the photobiomodulation therapy were reported.ConclusionsThis study provides a signal that photobiomodulation therapy might safely reduce important clinical motor signs and non-motor symptoms in some Parkinson’s disease patients, with improvements maintained over several years. Home-based photobiomodulation therapy has the potential to complement standard therapies to manage symptoms and potentially delay Parkinson’s symptom progression.Trial registrationAustralian New Zealand Clinical Trials Registry, registration number ACTRN12618000038291p, registered on 12/01/2018.

Effect of mediolateral leg perturbations on walking balance in people with chronic stroke: A randomized controlled trial.

Many people with chronic stroke (PwCS) exhibit deficits in step width modulation, an important strategy for walking balance. A single exposure to swing leg perturbations can temporarily strengthen this modulation. The objective of this parallel, double-blinded, randomized controlled trial was to investigate whether repeated perturbations cause sustained increases in step modulation (NCT02964039; funded by the VA). 54 PwCS at the Medical University of South Carolina were randomly assigned to one of three intervention groups: Control (n = 18), with minimal forces; Assistive (n = 18), pushing the swing leg toward a mechanically appropriate location; Perturbing (n = 18), pushing the swing leg away from a mechanically appropriate location. All intervention groups included 24 training sessions over 12-weeks with up to 30-minutes of treadmill walking while interfaced with a novel force-field and a 12-week follow-up period, with five interspersed assessment sessions. Our primary outcome measure was paretic step width modulation, the partial correlation between step width and pelvis displacement (ρSW). Secondarily, we quantified swing and stance leg contributions to step modulation, clinical assessments of walking balance and confidence, and real-world falls. Outcomes were analyzed for participants who completed all assessment sessions (n = 44). Only the Perturbing group exhibited significant increases in paretic ρSW, which were present after 4-weeks of training and sustained through follow-up (t = 2.42-3.17). These changes were due to improved control of paretic swing leg positioning. However, perturbation-induced changes in step modulation were not always significantly greater than those in the Control group, and clinical assessments were similar across intervention groups. Participants in the Perturbing group experienced a lower fall rate than those in the Control group (incidence rate ratio = 0.53), although our small sample size warrants caution. The present results indicate that perturbations can cause sustained modifications of targeted biomechanical characteristics of post-stroke gait, although such changes alone may be insufficient to change more complex clinical assessments.

Color-induced cognitive conflicts affect muscle activity prior to gait initiation in the Go/No-go task.

In traffic rule, green/blue means go, and red means stop. It has been shown that this prior knowledge about traffic signal colors can affect reaction times (RTs). For example, RTs are longer when responding to a red "Go" signal and withholding the response to a blue "No-go" signal (Red Go/Blue No-go task) than when responding to a blue "Go" signal and withholding the response to a red "No-go" signal (Blue Go/Red No-go task), when responses are provided by button press. However, it remains unknown whether this holds in different actions. The aim of this study was to investigate the effect of prior knowledge of color on gait initiation in a Go/No-go task. Seventeen participants performed Green Go/Red No-go and Red Go/Green No-go tasks, in which they stepped forward from a force plate in response to a green or red signal and withhold the response to red or green signal, respectively. We recorded the center of pressure (COP) and electromyogram (EMG) from the bilateral tibialis anterior muscles during gait initiation. The onset of COP movement and toe-off time as well as COP displacements did not differ between the Go/No-go tasks. The EMG onset for the stance leg was delayed in the Red Go/Green No-go than Green Go/Red No-go task. These findings suggest that the conflict between prior knowledge of color related to traffic rule and the meaning of the stimulus color affects muscle activity but not COP characteristics during gait initiation, highlighting two distinct motor control mechanisms, where the initial phase is influenced by cognitive load while the subsequent phase remains unaffected. This dissociation suggests that the later phase of gait initiation relies on robust spinal loops and central pattern generators, which are less influenced by cognitive factors such as prior knowledge.

Transcranial Direct-Current Stimulation Over the Primary Motor Cortex and Cerebellum Improves Balance and Shooting Accuracy in Elite Ice Hockey Players.

To investigate the effects of transcranial direct-current stimulation (tDCS) applied over the primary motor cortex (M1) and cerebellum on balance control and shooting accuracy in elite ice hockey players. Twenty-one elite ice hockey players underwent anodal tDCS over theM1 (a-tDCSM1), anodal tDCS over the cerebellum (a-tDCSCB), concurrent dual-site anodal tDCS over the M1 and the cerebellum (a-tDCSM1+CB), and sham stimulation (tDCSSHAM). Before and after receiving tDCS (2mA for 15min), participants completed an ice hockey shooting-accuracy test, Pro-Kin balance test (includes stance test and proprioceptive assessment), and Y-balance test in randomized order. For static balance performance, the ellipse area in the 2-legged stance with eyes open and the 1-legged stance with the dominant leg significantly improved following a-tDCSM1, a-tDCSCB, and concurrent dual-site a-tDCSM1+CB, compared with tDCSSHAM (all P < .05, Cohen d = 0.64-1.06). In dynamic balance performance, the average trace error of the proprioceptive assessment and the composite score of the Y-balance test with the dominant leg significantly improved following a-tDCSM1 and concurrent dual-site a-tDCSM1+CB (all P < .05, Cohen d = 0.77-1.00). For the ice hockey shooting-accuracy test, shooting-accuracy while standing on the unstable platform significantly increased following a-tDCSM1 (P = .010, Cohen d = 0.81) and a-tDCSCB (P = .010, Cohen d = 0.92) compared with tDCSSHAM. tDCS could potentially be a valuable tool in enhancing static and dynamic balance and shooting accuracy on unstable platforms in elite ice hockey players.

Effects of controlled supramaximal high-intensity interval training on muscle capacities and physical functions for older adults: analysis of secondary outcomes from the Umeå HIT study-a randomised controlled trial.

This study investigated the effectiveness of supramaximal high-intensity interval training (supramaximal HIT) on muscle capacities and physical function compared to moderate-intensity training (MIT) for older adults. Sixty-eight older adults (66-79years, 56% women), not engaged in regular exercise, were randomised to 3months of twice-weekly supramaximal HIT (20minutes including 10 × 6-second intervals) or MIT (40minutes including 3 × 8-minute intervals). Both groups performed the training on stationary bicycles in a group setting. Target intensity was watt-controlled, with standardised cadence and individualised resistance. Outcomes analysed with linear-mixed models included leg power (Nottingham Power Rig), hand grip strength (Jamar dynamometer), static and dynamic balance (One leg stance, 30-second step test), chair stand (30-second chair stand), and anaerobic cycling performance (modified Borg Cycle Strength Test). Baseline values were (supramaximal HIT/MIT, mean ± SD) leg power 198 ± 60/189 ± 53W, hand grip strength 4.2 ± 1.0/4.3 ± 1.1N/kg, static balance 64 ± 41/62 ± 41s, dynamic balance 39 ± 7/38 ± 5 steps, chair stands 22 ± 6/22 ± 6 and anaerobic cycling performance 224 ± 60/217 ± 55W. At 3-month follow-up, a between-group difference in favour of supramaximal HIT [95% CI] was observed in anaerobic cycling performance of 19[3;35] W. Within-group mean changes for supramaximal HIT/MIT were for leg power 8.4[0.9;15.8]/6.0[-1.3;13.3] W, hand grip strength 0.14[0.00;0.27]/0.13[-0.01;0.26] N/kg, static balance 11[3;20]/10[1;18] s, dynamic balance 1.6[0.3;2.8]/2.3[1.1;3.6] steps, 2.1[1.1;3.1]/1.4[0.4;2.3] chair stands and anaerobic cycling performance 31.3[19.6;43.0]/12.0[0.4;23.5] W. Supramaximal HIT showed superior effect on anaerobic cycling performance when compared to MIT. Additionally, the results indicate that supramaximal HIT is comparably beneficial as MIT in terms of effects on muscle capacity and physical function for older adults.

Robotic-Assisted Total Knee Arthroplasty Results in Shorter Navigation Working Time With Similar Clinical Outcomes Compared to Computer-Navigated Total Knee Arthroplasty

BackgroundEarly clinical data are important in the appraisal of newly introduced robotic-assisted surgery (RAS) systems in total knee arthroplasty (TKA). However, there are few studies to date comparing 1-year clinical outcomes between RAS and computer-assisted navigation (CAS), the forerunner in reducing alignment outliers. The aim of this study was to determine if there was a difference between these two groups in early clinical outcomes, including functional outcome and patient-reported outcome measures (PROMs). MethodsA total of 158 propensity score-matched patients who underwent primary TKA with either CAS or RAS were retrospectively analyzed. Perioperative outcomes (navigation time, length of stay, complications, readmissions, transfusions, and technical failure), as well as functional outcome measures (range of motion, sit to stand test, timed-up-and-go test, single-leg stance test, calf raises, and step count), and PROMs (Oxford Knee Score, Knee Injury and Osteoarthritis Outcome Score, 12-item Short Form Survey, Forgotten Joint Score-12, and satisfaction) were compared between those who underwent CAS and those who underwent RAS. ResultsNavigation time was shorter in the RAS group compared to the CAS group (mean difference, 15.4 minutes; P < 0.001). There were 2 complications reported in the CAS group (one patellar clunk, one periprosthetic joint infection), but none in the RAS group. There were no other readmissions, transfusions, or technical failures in either group. Postoperatively, there were no clinical differences in function between groups. Clinically meaningful improvement in PROMs was observed in both groups, with no differences. ConclusionsThe use of RAS resulted in shorter navigation time compared to CAS in TKA. No other differences were observed in early clinical outcomes between patients who underwent RAS and CAS.

Knee joint contact load associated by balance control for stance leg during taekwondo front kick: A musculoskeletal modeling approach

Knee joint contact load associated by balance control for stance leg during taekwondo front kick: A musculoskeletal modeling approach

A Randomized Study of Myostaal® Liniment as an Add-On Therapy for Muscle Strengthening in Cases of Knee Osteoarthritis.

Knee osteoarthritis (OA) is a prevalent degenerative musculoskeletal condition, affecting approximately 277 million people worldwide, with significant impacts on mobility, especially in women and obese patients, and an increasing incidence among Indians aged 30 to 50 years. The primary objective was to evaluate the knee muscle-strengthening effect of Myostaal® liniment (Solumiks Herbaceuticals Limited, Mumbai, India) as an add-on to physiotherapy for 90 days compared to physiotherapy alone in participants with knee OA. Secondary objectives included assessing changes in the total Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score, WOMAC Subscale scores, Six-Minute Walk Test(6MWT) distance, Single Leg Stance Test (SLST) duration, Visual Analogue Scale (VAS) score, and the number of adverse events from baseline to Day 90 between the two groups. Seventy participants were randomly allocated to Group A (Myostaal® liniment plus physiotherapy) or Group B (physiotherapy alone) for 90 days, with Myostaal® liniment applied twice daily in Group A. Data were recorded in Case Report Forms (CRFs) and analyzed using parametric tests for within-group comparisons (one-way ANOVA or Friedman test) and non-parametric tests (Mann-Whitney test) for between-group comparisons, with significance set at p<0.05. The knee muscle strength (index knee) in Group A (test medication group) was significantly greater compared to Group B (standard treatment group) at Visit 3 (p<0.05; Day 60±3) and Visit 4 (p<0.001; Day 90±3). For the non-index (other) knee, a statistically significant increase in knee muscle strength was observed (p<0.001 at Day 90±3) solely in Group A. A notable reduction in total WOMAC score was seen in Group A from Visit 2 (p<0.01; Day 30±3) onward, compared to Visit 1 (Day 0). The scores at Visit 3 (p<0.001; Day 60±3) and Visit 4 (p<0.001; Day 90±3) were significantly lower than those at Visit 2 (Day 30±3). The local application of Myostaal® liniment through massage as an adjunct to a physiotherapy regimen, improved knee muscle strength in participants with knee OA, leading to an enhancement in joint functionality. Additionally, Myostaal® linimentprovided superior pain relief as an add-on therapy.

Is Visual Reliance Increased in Athletes After ACL Injury? A Scoping Review.

Individuals with anterior cruciate ligament (ACL) injury often exhibit visual cognitive deficits during tasks that require neuromuscular control. In this paper, we present evidence of increased visual reliance after ACL injury during a range of clinically applicable cognitive-motor tasks. This information is essential to strengthen the scientific rationale for therapeutic interventions that target maladaptive neuroplasticity and may translate to improved return-to-sport (RTS) outcomes following ACL injury. The objectives of this study are (1) to determine if visual reliance is present during common rehabilitation-based assessments after ACL deficiency (ACL-D) or ACL reconstruction (ACL-R), (2) to describe how visual reliance is assessed during such tasks, and (3) to provide information to help clinicians and patients understand the clinical relevance of cognitive load in the assessment and intervention of visual reliance. Scoping review. We searched MEDLINE, EMBASE, CINAHL, SCOPUS, and PEDro databases. Only primary studies published in English were included without time limitations. Qualitative analysis of the included studies was performed. We synthesized the results of 23 studies. A total of 7 studies (31%) included patients with ACL-D, 15 studies (65%) included patients with ACL-R, and 1 study (4%) included patients with ACL-D and ACL-R. Evaluation of tasks, task evaluation setting, visual conditions, outcome measures, and presence of increased visual reliance were identified. Most studies investigating patients with ACL-D, contrary to those with ACL-R, exhibited worse postural stability during eyes-closed conditions than uninjured controls. Complete visual obstruction (i.e., eyes closed or blindfolded) was the most frequently reported method to disrupt vision (52%). The addition of a visual-cognitive challenge resulted in significantly worse postural stability in patients with ACL-R compared with controls. Visual reliance was most commonly assessed during single leg stance with complete visual obstruction. The majority of studies on patients with ACL-D indicate that they exhibit poorer postural stability in eyes-closed conditions when compared with uninjured controls, which suggests increased visual reliance. There is less evidence of visual reliance in patients who have undergone ACL-R compared with those with ACL-D. Adding a visual-cognitive load was found to be more effective in inducing postural stability deficits in individuals who have undergone ACL-R. IV. The protocol was a priori registered on Open Science Framework ( https://osf.io/p4j95/ ).

Inertial measurement unit-based real-time feedback gait immediately changes gait parameters in older inpatients: a pilot study.

The effect of gait feedback training for older people remains unclear, and such training methods have not been adapted in clinical settings. This study aimed to examine whether inertial measurement unit (IMU)-based real-time feedback gait for older inpatients immediately changes gait parameters. Seven older inpatients (mean age: 76.0years) performed three types of 60-s gait trials with real-time feedback in each of the following categories: walking spontaneously (no feedback trial); focused on increasing the ankle plantarflexion angle during late stance (ankle trial); and focused on increasing the leg extension angle, which is defined by the location of the ankle joint relative to the hip joint in the sagittal plane, during late stance (leg trial). Tilt angles and accelerations of the pelvis and lower limb segments were measured using seven IMUs in pre- and post-feedback trials. To examine the immediate effects of IMU-based real-time feedback gait, multiple comparisons of the change in gait parameters were conducted. Real-time feedback increased gait speed, but it did not significantly differ in the control (p = 0.176), ankle (p = 0.237), and leg trials (p = 0.398). Step length was significantly increased after the ankle trial (p = 0.043, r = 0.77: large effect size). Regarding changes in gait kinematics, the leg trial increased leg extension angle compared to the no feedback trial (p = 0.048, r = 0.77: large effect size). IMU-based real-time feedback gait changed gait kinematics immediately, and this suggests the feasibility of a clinical application for overground gait training in older people.

Balance Board or Motion Capture? A Meta-Analysis Exploring the Effectiveness of Commercially Available Virtual Reality Exergaming in Enhancing Balance and Functional Mobility Among the Elderly.

Force platforms and motion capture are commonly used as feedback mechanisms in exergaming; nevertheless, their therapeutic effectiveness may vary. Therefore, the primary objective of this study was to evaluate the effectiveness of commercially available virtual reality (VR) exergaming systems on balance and functional mobility, with a supplementary analysis considering the administered dose of exergaming. The search was conducted in five databases. Commercially available exergaming platforms were classified into two categories: VR exergaming with a balance board (including Wii Balance Board) and motion capture (including Xbox Kinect). Two categories of control interventions (treatment as usual [TAU] and no treatment [NT]) were extracted. The meta-analysis was performed separately for static, dynamic, and proactive balance outcomes and for the aggregated results of all included outcomes with subgroup analysis of lower, moderate, and higher doses. In total, 28 studies with 1457 participants were included. Both exergaming systems were particularly effective in improving the single leg stance outcome. VR exergaming with motion capture was found to be more effective than TAU with a standardized mean difference (SMD) of 0.48 (P = 0.006) and NT (SMD = 0.86; P = 0.02). In conclusion, commercially available VR exergaming with a motion capture feedback mechanism has demonstrated effectiveness as an intervention for balance training when compared with NT. Specifically, high doses (above 134 minutes per week) appear to be more beneficial for healthy older adults. Moreover, the findings provide some weak evidence supporting the effectiveness of VR exergaming with a balance board for improving functional mobility, particularly when compared with NT.

Association of fear of falling with performance-based physical function and low back pain in older adults: a cross-sectional study in Iran

ObjectivesThis study investigated the association of fear of falling with performance-based physical function and low back pain (LBP) among older adults.DesignCross-sectional study.SettingParticipants were selected via convenient sampling from Iran University...

Checks and balances: a meta-analysis on the known-groups validity of functional postural control tests in children.

Pediatric physical therapists commonly treat children with postural control deficits. Ideally, pediatric functional postural control tests should therefore be able to identify postural control deficits in children with various disorders. Despite a plethora of available tests, evidence for their validity - especially known-groups - remains scarce. This review aims to determine the known-group validity of available functional postural control tests to differentiate various pediatric pathological groups of different ages from their typically developing (TD) peers. PubMed, Web of Science and Scopus were systematically searched (last update: February 2023; PROSPERO: CRD42023408982). Forty case-control studies with a pathological pediatric sample (N.=1331) and TD peers (N.=1889) were included and selected for data-extraction and -analysis. Risk of bias was assessed using the SIGN checklist and level of evidence was scored using GRADE. Random-effect meta-analyses were performed to estimate pooled standardized mean differences (SMD) for the various test types and subclassified based on pathology and/or age. When compared with TD peers, children with underlying pathologies performed significantly worse on pediatric functional postural control test batteries (SMD=-2.21), the Timed Up and Go Test and variants (SMD=2.30), the One Leg Stance test and variants (SMD=-2.14), while the Reach tests showed a smaller difference (SMD=-1.19). Subclassification within the meta-analyses showed that pathology was an influencing factor for the test batteries and the one leg stance test and variants. Age was an influencing factor for the reach tests. None of the included functional postural control tests exceeded a low level of evidence. Pediatric functional postural control tests that assess multiple aspects of postural control (such as test batteries) seem to offer higher known-groups validity than single-task tests (e.g. reach tests). The underlying pathology has a larger impact on the validity of these tests than age. There remains an overall low level of evidence for the known-groups validity of pediatric functional postural control tests indicating the need for research with more homogenous groups and norm reference data.

An investigation into the influence of biological sex, anthropometrics, footwear, and dual tasking on balance

BACKGROUND: It remains unclear whether balance is influenced by biological sex, anthropometrics, wearing footwear, or dual tasking. Such information is important to aid clinical reasoning pertaining to assessment and rehabilitation. OBJECTIVE: To investigate the influence of biological sex, anthropometrics, footwear, physical activity and dual tasking (DT) on balance performance. METHODS: An observational study was performed on eighty-six healthy participants. Anthropometric assessment and static balance performance was evaluated, during double leg stance with eyes open (DLSEO) and eyes closed (DLSEC) and during single-leg-stance (SLS). All tasks were assessed with and without footwear and a cognitive task was introduced to assess the effect of DT on static balance performance. RESULTS: Generally, the static balance performance of females was better than males, across all balance tasks, with some large effect sizes (ES). In both sexes, without footwear tasks resulted in better balance during the DLSEC task but with footwear, static balance performance was better during SLS in males only. Overall minimal differences were observed between single and dual task with a large ES for SLS and DLSEO for females. Upper body size was moderately negatively correlated to static balance performance. CONCLUSION: Females outperformed males, footwear and DT had some, but minimal influence on static balance. Anthropometrics were moderately correlated with balance. Balance performance should be compared to unisex normative data sets and performed as a single task, with or without footwear.

The effect of upper trapezius trigger points dry needling on postural control in patients with chronic neck pain

ObjectiveMyofascial neck pain, which strongly affects the upper trapezius muscle, is treated by physiotherapists with dry needling. The purpose of this study was to investigate the effect of upper trapezius trigger points (TrPs) dry needling on postural control and balance in chronic neck pain. DesignRandomized controlled clinical trial. SubjectsThirty individuals with chronic neck pain (more than 3 months), aged 18–40 years, neck disability index (NDI) > 10, and pain intensity (PI) between 3 and 6 who have TrP in the upper trapezius. MethodThirty individuals were randomly assigned into 2 groups, (i) 15 receiving intervention (real dry needling), and (ii) 15 in the sham group (sham dry needling). Outcomes were range of neck movements, neck disability index, pain intensity, and the mean and standard deviation as well as maximum velocity of center of pressure displacement in the anterior-posterior and medio-lateral directions during balance task on the force plate (1 leg stance and closed eyes) before the intervention and after the fifth and fifteenth (follow-up) days. InterventionUpper trapezius dry needling was applied for 3 sessions occurring every other day in a week. ResultNo significant differences were seen between the 2 groups in mean displacement, standard deviation, or maximum velocity in the anterior-posterior and medial-lateral axis and range of motion (ROM) except for left lateral bending; however, a significant difference was observed between the 2 groups in pain intensity and neck disability index. ConclusionDry needling on the upper trapezius TrPs does not change postural control but decreases pain and disability.

Does Focused Gluteus Medius Muscle Stretching After Total Hip Arthroplasty Work? An Electromyographic Study

BackgroundThe hypothesis of this randomized prospective study was that focused stretching of the gluteus medius muscle, in addition to generalized physical therapy, is likely to improve muscle reaction time and positively impact the return to function of the patient after primary total hip arthroplasty. MethodsWe prospectively recruited 28 patients undergoing primary total hip arthroplasty from January 2021 to January 2023. The control group (13 patients) received a conventional rehabilitation protocol, while the intervention group (15 patients) received focused stretching exercises of the gluteus medius muscle in addition to the conventional rehabilitation protocol. Patients had preoperative and postoperative surface electromyography (sEMG) to assess muscle activity. ResultsPatients in the intervention group after surgery had better muscle activation according to sEMG during walking and during one leg stance compared to the control group. Also, patients from the intervention group had better strength of the gluteus medius muscle after surgery, but this did not reach statistical significance. ConclusionsThe present prospective study demonstrated that implementation of focused gluteus medius muscle stretching results in statistically significantly higher muscle activation as measured by sEMG. The strength of the gluteus medius muscle is also higher as measured using a dynamometer, albeit not reaching statistical significance. Based on the findings of this sEMG study, it appears that focused stretching and strengthening of abductors muscles are beneficial.

Immediate Effects of Wearing an Ankle Bandage on Fine Coordination, Proprioception, Balance and Gait in the Subacute Phase of Ankle Sprains.

Ankle sprains are the most frequently occurring musculoskeletal injuries among recreational athletes. Ankle support through bandages following the initial orthotic treatment might be beneficial for rehabilitation purposes. However, the literature is sparse regarding the use of an ankle support directly after the acute phase of an ankle sprain. Therefore, this study investigates the hypothesis that wearing an ankle bandage immediately after an acute ankle sprain improves motor performance, stability and reduces pain. In total, 70 subjects with acute unilateral supination trauma were tested. Subjects were tested five weeks post-injury to assess immediate effects of the ankle bandage. On the testing day, subjects completed rating questionnaires and underwent comprehensive biomechanical assessments. Biomechanical investigations included fine coordination and proprioception tests, single leg stances, the Y-Balance test, and gait analysis. All biomechanical investigations were conducted for the subject's injured leg with and without a bandage (MalleoTrain® Bauerfeind AG, Zeulenroda-Triebes, Germany) and the healthy leg. Results indicated moderate to strong improvements in ankle stability and pain relief while wearing the bandage. Wearing the bandage significantly normalized single leg stance performance (p < 0.001), stance phase duration (p < 0.001), and vertical ground reaction forces during walking (p < 0.05). However, the bandage did not have a clear effect on fine coordination and proprioception. The findings of our study suggest that ankle bandages may play a crucial role in early-stage rehabilitation by enhancing motor performance and reducing pain.

Acceptability, feasibility, and effectiveness of WE-SURF™: a virtual supervised group-based fall prevention exercise program among older adults

Conducted physically, supervised group-based falls prevention exercise programs have demonstrated effectiveness in reducing the risk of falls among older adults. In this study, we aimed to assess the acceptability, feasibility, and effectiveness of a virtual supervised group-based falls prevention exercise program (WE-SURF™) for community-dwelling older adults at risk of falls.MethodA preliminary study utilizing virtual discussions was conducted to assess the acceptability of the program among six older adults. Effectiveness was evaluated in a randomized controlled feasibility study design, comprising 52 participants (mean age: 66.54; SD: 5.16), divided into experimental (n = 26) and control (n = 26) groups. The experimental group engaged in a 6-month WE-SURF™ program, while the control group received standard care along with a fall’s prevention education session. Feasibility of the intervention was measured using attendance records, engagement rates from recorded videos, dropouts, attrition reasons, and adverse events.ResultsPreliminary findings suggested that WE-SURF™ was acceptable, with further refinements. The study revealed significant intervention effects on timed up and go (TUG) (η2p:0.08; p < 0.05), single leg stance (SLS) (η2p:0.10; p < 0.05), and lower limb muscle strength (η2p:0.09; p < 0.05) tests. No adverse events occurred during the program sessions, and both attendance and engagement rates were high (> 80% and 8/10, respectively) with minimal dropouts (4%). The WE-SURF™ program demonstrated effectiveness in reducing the risk of falls while enhancing muscle strength and balance.ConclusionIn conclusion, WE-SURF™ was demonstrated to be an acceptable, feasible, and effective virtual supervised group-based exercise program for fall prevention in community-dwelling older adults at risk of falls. With positive outcomes and favourable participant engagement, WE-SURF™ holds the potential for wider implementation. Further research and scaling-up efforts are recommended to explore its broader applicability.(Registration number: ACTRN 12621001620819).