Passive Movement Research Articles

Assistance force-line of exosuit affects ankle multidimensional motion: a theoretical and experimental study

BackgroundThe talocrural joint and the subtalar joint are the two major joints of the ankle-joint complex. The position and direction of the exosuit force line relative to these two joint axes can influence ankle motion. We aimed to understand the effects of different force-lines on ankle multidimensional motion.MethodsIn this article, three assistance force line schemes for ankle exosuits were proposed: perpendicular to the talocrural joint axis (PT), intersecting with the subtalar joint axis (IS), and parallel to the triceps surae (PTS). A theoretical model was proposed to calculate the exosuit’s assistance moment. Seven participants completed four experimental tests of ankle plantarflexion, including three passive motions assisted by the PT, PTS and IS schemes, and one active motion without exosuit assistance (Active).ResultsThe simulation results demonstrated that all three exosuits were able to produce significant moments of ankle plantarflexion. Among these, the PT scheme exhibited the highest moments in all dimensions, followed by the PTS and IS schemes. The experimental findings confirmed the effectiveness of all three exosuit schemes in assisting ankle plantarflexion. Additionally, as the assistive force lines approached the subtalar joint, there was a decrease in ankle motion assisted by the exosuits in non-plantarflexion directions, along with a reduction in the average distance of ankle angle curves relative to active ankle motion. Furthermore, the linear correlation coefficients between inversion and plantarflexion, adduction and plantarflexion, and adduction and inversion gradually converged toward active ankle plantarflexion motion.ConclusionsOur research indicates that the position of the exosuit force line to the subtalar joint has a significant impact on ankle inversion and adduction. Among all three schemes, the IS, which has the closest distance to the subtalar joint axes, has the greatest kinematic similarity to active ankle plantarflexion and might be a better choice for ankle assistance and rehabilitation.

Short-Term Reproduction of Active Movement with Visual Feedback and Passive Movement with a Therapist’s Hands

Reproducing instructed movements is crucial for practice in motor learning. In this study, we compared the short-term reproduction of active pelvis movements with visual feedback and passive movement with the therapist’s hands in an upright stance. Sixteen healthy males (M age = 34.1; SD = 10.2 years) participated in this study. In one condition, healthy males maintained an upright stance while a physical therapist moved the participant’s pelvis (passive movement instruction), and in a second condition, the participant actively moved their pelvis with visual feedback of the target and the online trajectory of the center of pressure (active movement instruction). Reproduction errors (displacement of the center of pressure in the medial–lateral axis) 10 s after the passive movement instruction were significantly greater than after the active movement instruction (p < 0.001), but this difference disappeared 30 s after the instruction (p = 0.118). Error of movement reproduction in the anterior–posterior axis after the passive movement instruction was significantly greater than after the active movement instruction, no matter how long the retention interval was between the instruction and reproduction phases (p = 0.025). Taken together, active pelvis movements with visual feedback, rather than passive movement with the therapist’s hand, is better to be used for instructing pelvis movements.

Persistent Challenges: A Comprehensive Review of Persistent Postural-Perceptual Dizziness, Controversies, and Clinical Complexities.

Persistent postural-perceptual dizziness (PPPD) is a chronic and disabling disorder characterized by persistent dizziness, unsteadiness, and imbalance. It often arises without an identifiable cause and is exacerbated by upright posture, active or passive movement, and exposure to moving or complex visual stimuli. This complex pathophysiology and the psychological dimensions of its symptomatology pose a significant challenge to clinicians. PPPD presents diagnostic challenges and a lack of standardized treatment options, underscoring the need for multidisciplinary approaches encompassing pharmacotherapy, vestibular rehabilitation, and psychological interventions for effective management. Bridging the gaps in understanding PPPD requires collaborative efforts across disciplines, emphasizing integrated research approaches and patient support networks to enhance care and improve outcomes. This review explores the challenges, controversies, and clinical complexities of PPPD, highlighting the importance of a patient-centered approach.

Strain of the vertebral artery during passive neck movements and spinal manipulation of the cervical spine: An observational study

BackgroundNeck pain is a common condition, and a frequent treatment is chiropractic cervical spinal manipulation therapy (cSMT). However, cervical spinal manipulations have been associated with excessive cervical artery elongations, allegedly causing arterial dissection leading to stroke. PurposeThe primary purpose of this study was to quantify the total vertebral artery elongations during cSMT, and secondarily, quantify the vertebral artery elongations during the pre-manipulative orientation of the head and neck and the subsequent elongations during the actual thrust. MethodsVertebral artery strains were measured at the cervical levels C0–C1, C1–C2, and C2–C3 using piezoelectric crystals that were sutured to the wall of the left and right vertebral artery in three cadavers. Vertebral artery strains were measured continuously for a full set of passive range of motion testing and for the chiropractic spinal manipulation. FindingsFor the range of motion testing, the greatest average vertebral artery strains at the C0–C1 level were 6.9% for ipsilateral flexion-rotation, at the C1–C2 level 4.3% for contralateral rotation, and at the C2–C3 level 3.7% for contralateral flexion-rotation. For the chiropractic spinal manipulation, the average maximal strains at the C0–C1, C1–C2 and C2–C3 levels were 1.3%, 0.1%, and 1.0%, respectively. The maximal average vertebral artery strains in the pre-manipulative phase were 0.5% and the corresponding maximal vertebral artery strains during the manipulative thrust was 1.1%. InterpretationPassive range of motion testing produced strains in the vertebral artery were 5.3 times (C0–C1), 7.2 times (C1–C2), and 3.7 times (C2–C3) greater than the corresponding strains during chiropractic spinal manipulation, suggesting that strains in the vertebral artery during chiropractic spinal manipulation were much smaller than the strains that can occur during normal everyday movements of the head and neck. Furthermore, vertebral artery strains in the pre-manipulative phase did not contribute to the peak strains on the contralateral vertebral artery and helped reduce strains on the ipsilateral side.

A CLINICAL STUDY TO EVALUATE THE EFFECT OF MASHA TAILA AND PHYSIOTHERAPY IN THE MANAGEMENT OF AVABAHUKA W.S.R.TO FROZEN SHOULDER

Introduction : Paradoxically shoulder joint privileged as the most mobile joint in the body has its nemesis be-cause of this advantage i.e. it become more vulnerable to injuries. Frozen shoulder is a clinical syndrome char-acterized by painful restriction of both active and passive shoulder movements due to abnormalities within the shoulder joint or remote. Prevalence of this disease is around 2.1 - 5% and women suffer more than men be-tween age group of 40-60 years .According to Ayurvedic principles, frozen shoulder can be taken as“Avabahuka”(Frozen shoulder), as its clinical features are almost similar. Ayurvedic principles of manage-ment for these diseases are more effective than other pathies . In modern medicine the current management has many side effects and having success rate of 58% only.Even on surgical decompression recurrence is also there. Aim:- To determine the effect of Masha Taila(oil) and physiotherapy in the management of Avabahuka w.s.r.to Frozen Shoulder. Materials and method : The study was conducted on 30 patients in two groups with symp-toms of Frozen shoulder. Statistical Analysis used : Observations of the study were analyzed, and findings were evaluated by using statistical methods. Result: Group I:-Among15 patients,11patients (73%) had markedly im-proved .Group II:-Among 15 patients, 2 patients (13.33%)had markedly improved. Conclusion: In group I: -Masah Taila (Matar Vasti(Enema) and Sthanic Snehna(Oleation) along with physiotherapy gave better results ,in less duration of time then physiotherapy alone in group II.

Retained intracardiac air in cardiovascular surgery: a re-visited problem.

Intracardiac air remains an unsolved problem in the realm of cardiac surgery, leading to embolic events encompassing conduction disturbance, heart failure, and stroke. Transesophageal echocardiography allows the visualization of three distinct types of retained intracardiac air: pooled air, coarse bubbles, and microbubbles. The former two predominantly manifest in the right upper pulmonary vein, left atrium, and left ventricle, exhibiting passive movement along the vessel walls by buoyancy. De-airing, involving "eradication" of air from circulation and "expulsion" of air from the heart into the systemic circulation assumes paramount importance in averting embolic events. Optimal de-airing strategies necessitate the thorough elimination of air during the static phase before the resumption of cardiac activity, achieved through aspiration or guided exit leveraging buoyancy. While the dynamic phase, characterized by active cardiac beating, presents challenges for air eradication, the majority of air expulsion occurs towards the aorta during this period. In this latter phase, collaborative efforts among the surgeon, anesthesiologist, and clinical engineer are pivotal to mitigate the risk of bolus air embolism. The efficacy of carbon dioxide insufflation is limited, as it is rapidly aspirated by wall suction or absorbed into the bloodstream. Consequently, the "air" identified by TEE is acknowledged as conventional air. Understanding the distinctive properties of air as well as timely and judicious collaboration for detection and removal, with the ultimate goal of eradication, emerges as an essential prerequisite for successful de-airing in the evolving era of cardiac surgery.

СРАВНИТЕЛЬНЫЙ АНАЛИЗ РЕЗУЛЬТАТОВ ЛЕЧЕНИЯ ОСТЕОХОНДРАЛЬНЫХ ДЕФЕКТОВ СУСТАВНОЙ ПОВЕРХНОСТИ КОЛЕННОГО СУСТАВА, АССОЦИИРОВАННЫХ С ПОВРЕЖДЕНИЕМ ПЕРЕДНЕЙ КРЕСТООБРАЗНОЙ СВЯЗКИ

Purpose of work: to perform a comparative analysis of the results of treatment of patients with osteochondral defects of the articular surface associated with damage of the anterior cruciate ligament of the knee joint. Materials and Methods. Between 2015 and 2023 inclusive, 72 patients with anterior cruciate ligament injury accompanied by osteochondral defects of femoral condyles were treated. All patients were randomly divided into three groups: the first group - simultaneous ACL reconstruction and abrasive chondroplasty (ACh-ACL group) (n=24); the second group - ACL reconstruction and microfracturing (MF-ACL group) (n=24); the third group - ACL reconstruction and mosaic autochondroplasty (OAT-ACL group) (n=24). For the purpose of independent evaluation, a control group - anterior cruciate ligament reconstruction with intact articular cartilage (IAC-ACL group) (n=24) was introduced for comparison. Results and Discussion. Having analyzed the results of IKDC-2000 and Lysholm + Tegner questionnaires at 3, 6 and 12 months after the operation we noted the greatest positive dynamics in the early postoperative period (3 months) in all groups. From 6 to 12 months the dynamics changed its tendency and more pronouncedly passed into a "plateau" in groups 1 and 2, which was clinically determined by the restoration of passive movements with insufficient volume of active flexion-extension movements in the knee joint, as well as by the persistence of pain syndrome during loading. Conclusions. Simultaneous reconstruction of osteochondral lesions of the articular surface of the knee joint and reconstruction of the anterior cruciate ligament is the basis for full restoration of the function and bearing capacity of the knee joint. In this case, the use of organ-reconstructive methods of surgical intervention (bone-cartilage autochondroplasty and anterior cruciate ligament reconstruction (OAT-ACL)) allows achieving better clinical results compared to "mesenchymal stimulation" of the defect area, showing full functional recovery of the knee joint.

Humpback whale (Megaptera novaeangliae) social calls in southern British Columbia

AbstractHumpback whale (Megaptera novaeangliae) nonsong vocalizations, or social calls, are much more poorly understood than humpback song. We examined humpback whale social calls from a foraging ground in southern British Columbia (BC) and developed a catalog for humpback social calls in BC. We tagged four humpback whales on the eastern edge of Swiftsure Bank, BC, in early September 2020, with a passive acoustic and movement tag. We manually classified 32 call types in our data set based on comparisons with published classifications of humpback social calls. Many of the calls identified in our data set had similar characteristics to calls from other locations. We also used two statistical classification methods, a cluster analysis and a random forest. The cluster analysis grouped 20 of these call types into four categories, and the random forest classifier was able to accurately classify all 20 call types 87.6% of the time. This study fills a geographical gap of humpback whale social calls on foraging grounds and is a first step towards categorizing the social calls of humpback whales in BC.

Effectiveness of Mindfulness Based Cognitive Therapy Verses Conventional Physiotherapy on Kinesiophobia in Patients with Frozen Shoulder: A Comparative Study

Background: Frozen Shoulder is defined as a clinical syndrome characterized by painful restriction of both active and passive shoulder movements (1) . there is high degree of kinesiophobia among patients having shoulder pain(2). Mindfulness based cognitive therapy (MBCT) may be an effective intervention for the treatment of active depression in a population with chronic pain (3) . The treatment goal of MBCT program, is to find ways of managing the pain and the adverse consequences on mental health and quality of life (4). considering that in patients with frozen shoulder treatment of pain alone was not enough to reduce fear of movement , Hence this study aimed to find the effect of MBCT on pain and kinesiophobia in patients with frozen shoulder. Objective: To find the effect of mindfulness based cognitive therapy on pain and kinesiophobia in patients with frozen shoulder. Methodology: After designing the study Institutional Ethical Approval was taken. Consent was obtained from all the participants. 30 samples were screened based on eligibility criteria, 2 were excluded and 28 were further divided into Group A (experimental group) received MBCT and conventional therapy and Group B (control group) received conventional therapy. Pre-assessment was by Tampa scale for kinesiophobia and VAS scale for pain done at Week 0. The experimental group received the MBCT and regular exercise program for 8 sessions 2 hours per day for 8 weeks. The control group received regular exercise program. Post-assessment was done at week 8. Result: The (INSTAT) was used for comparison of mean of group A and group B. One participant from the experimental group and one from the control group did not complete the study. The comparison of mean post intervention scores for group A and B of TSK Scores was found to be Extremely significant which was calculated using un-paired t test with t value t= 3.922, p value p= <0.0006. Comparison of mean post intervention scores for group A and B of VAS Scores was found to be Not significant which was calculated using un-paired t test with t value t= 0.4583, p value p= 0.6505. Conclusion: The study concludes that MBCT along with conventional physiotherapy is effective in reducing kinesiophobia in patients with frozen shoulder.

Convolutional Neural Network in Motion Detection for Physiotherapy Exercise Movement

Physiotherapy focuses on movement and optimal utilization of the patient's potential. Exercise Therapy is a physiotherapy procedure that specifically focuses exercises on active and passive movements. Cerebral Palsy (CP) patients are one of the sufferers of motor disorders of the upper extremities. Cerebral Palsy (CP) patients suffer from disorders in motor functions of the upper extremities. Physiotherapy Exercise Movement has 4 categories of movement exercises for the therapy of people with upper extremity body disorders: Elbow flexor strengthening in sitting using free weights, lifting an object up, reaching diagonally in sitting, and reaching from a low surface to a high surface. By taking 4 categories of motion movements in exercise therapy, data were taken using normal child subjects as standard movements, which then became a reference for CP child therapy. The limitations of therapy in physical care prompted researchers to investigate the use of image processing as input to Human Computer Interaction (HCI) in the process of motion detection-based therapy. In research using Deep learning as a classifier, namely using the CNN Model (Inception V3, Resnet152, and VGG16 architectural models). The results obtained by the CNN (Inception V3) model have the best performance with an accuracy percentage of 98%.

The effects of prolonged sitting with a mild hypercapnic environment on vascular function in elderly adults: A pilot study

Introduction: Prolonged Sitting (PS), defined a sitting for 2+ hours at a time, has been identified as an independent risk factor for cardiovascular disease (CVD). We previously reported that an acute bout of PS can attenuate macrovascular function in healthy young adults. Additionally, we reported that PS in mild hypercapnic environments (elevated CO2 concentrations) can further exacerbate these impairments in healthy young adults, and these impairments can be partially prevented by intermittent bouts of passive and active leg movements. However, the effects of prolonged sitting with a mild hypercapnic environment in the elderly population have not been studied. Therefore, the purpose of this study was to examine the impact of prolonged sitting with a mild hypercapnic condition on macrovascular function, arterial stiffness, and leg muscle metabolism. Additionally, we have further examined the effects of passive and active movements to negate the negative effects of prolonged sitting in elderly adults. Hypothesis: We hypothesized that 1) prolonged sitting in a hypercapnic environment will attenuate vascular function and leg metabolism, 2) both passive and active leg movements will preserve endothelial function and leg metabolism. Methods: Healthy elderly adults (n=2, 2 males, 69 ± 2.83 yrs) participated in three experimental visits consisting of 2.5h of prolonged sitting in a mild hypercapnic condition (CO2 = 1500ppm): control (CON), passive (PASS, passive leg movement), and active (ACT, active leg movement). Popliteal and brachial artery endothelial function was measured using flow-mediated dilation (FMD). Peripheral and central arterial stiffness was assessed using pulse wave velocity. Leg muscle metabolism was assessed using near infrared spectroscopy and a thermal camera. All measurements were taken pre- and post-siting. Results: Popliteal FMD was reduced in the CON condition compared to both the PASS and ACT (Δ -3.559 ± 0.499 vs Δ -1.799 ± 0.824 vs Δ 0.601 ± 1.958, respectively). Brachial FMD was attenuated in the CON condition compared to both compared to both the PASS and ACT (Δ -2.368 ± 0.215 vs Δ -0.285 ± 1.578 vs Δ 1.116 ± 1.174, respectively). The CON condition showed a greater reduction in leg temperature compared to both the PASS and ACT (Δ -2.4 vs Δ -1.6 ± 0.599 vs Δ 0.1 ± 0.224, respectively). No changes in central or peripheral arterial stiffness were observed. Conclusion: This preliminary data shows that uninterrupted prolonged sitting induces impairments in both local and systemic vascular function, leg muscle metabolism, but not arterial stiffness. Additionally, intermittent bouts of passive and active movements can partially preserve leg vascular function and metabolism during PS. This research was supported by the UNO Graduate Research and Creative Activity Grant, National Institutes of Health (RO1HD106911) and the Great Plains IdeaA-CTR (U54 GM115448). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Ischemic Conditioning Improves the Microvascular Hyperemic Response to Passive Limb Movement in Young Adults

Background: Passive limb movement (PLM) of the lower extremity is a simple and clinically relevant approach to measure peripheral microvascular health. PLM causes an acute increase in hyperemic leg blood flow (LBF) without an increase in skeletal muscle metabolism, and the hyperemic response is ~80% nitric oxide-mediated. A known therapeutic stimulus to increase large conduit artery vascular health is ischemic conditioning (IC). Whether a single session of IC can improve the hyperemic response to PLM remains unknown. Objective: To quantify the microvascular response to PLM after a single session of IC in young adults. Hypothesis: The hyperemic response to PLM, measured as a change in peak femoral artery blood flow, will be greater following IC vs. sham-IC. Methods: This was a prospective, cross-over, blinded clinical trial (NCT05935670). Young adults aged 18-30 years who were free of cardiovascular disease were recruited, and study participants completed two study visits. Participants were seated in a Biodex dynamometer and superficial femoral artery resting blood flow and diameter were measured in the dominant leg using ultrasonography. The dynamometer then passively moved the knee 90 degrees at a frequency of 1 Hz for a single PLM while blood flow was continuously measured. The ΔLBF was calculated as the absolute (ml/min) and relative (% change) difference in LBF from rest to peak. Participants were then randomized to receive either IC or sham-IC, and the vascular assessor was blinded to the condition. For IC, the cuff was placed around the proximal dominant thigh and repetitively inflated to 225 mmHg for 5 min then deflated for 5 min, for a total of 5 cycles. For sham-IC, the thigh cuff was inflated to only 25 mmHg. Fifteen minutes after IC or sham-IC the hyperemic response to PLM was re-assessed. The pre-/post- change in the PLM hyperemic response was calculated as the difference from pre- vs. post-IC or sham-IC. Statistical analysis included one-sided paired t-tests. Results: Seven individuals (3 female, age 26 ± 4 years old) completed the study. Compared to pre-IC, the relative peak hyperemic response to PLM was augmented post-IC (%ΔLBF = 89 ± 42% pre- vs. 136 ± 49% post-IC, p=0.001). Conversely, there was no change in the relative peak hyperemic response in the sham-IC condition (%ΔLBF = 108 ± 61% pre- vs. 108 ± 77% post-sham-IC, p=0.50). The pre-/post- change score of absolute peak hyperemic response to PLM was also higher after IC vs. sham-IC (change in ΔLBF = 50 ± 78 IC ml/min vs. -44 ± 127 ml/min sham-IC, p = 0.03). Conclusion: These results show an improvement in the peripheral microvascular response to PLM following IC. Future studies should examine the mechanistic pathways responsible for an improved PLM response as well as the potential benefits of IC on microvascular health in clinical populations with underlying peripheral microvascular dysfunction. AAW was supported by the National Heart, Lung and Blood Institute (T32HL13464) and Cardiovascular Center’s A.O. Smith Fellowship Scholars Program. Research was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development R01-HD099340 (ASH and MJD) and R01-HD112258 (MJD and ASH). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

The effcacy of short-term tetrahydrobiopterin administration to improve locomotor muscle microvascular function in heart failure with preserved ejection fraction

Background: Patients with heart failure with preserved ejection fraction (HFpEF) exhibit locomotor muscle microvascular dysfunction due partly to reduced nitric oxide (NO) bioavailability. Tetrahydrobiopterin (BH4) is a requisite cofactor for the enzymatic production of NO by NO synthase (NOS). BH4 insuffciency promotes NOS uncoupling, which reduces NO production and augments cellular oxidative stress. Given the potential of BH4 to improve NO bioavailability, we tested the hypothesis that short-term BH4 administration would improve locomotor muscle microvascular function in patients with HFpEF. Methods: Eight patients with HFpEF (74±7 years; 31.3±4.9 kg/m2) participated in a randomized, double-blind, crossover study, having consumed either BH4 (Sapropterin, 10 mg/kg) or placebo for 10 days, separated by a 14-day washout period. Locomotor muscle microvascular function was assessed as leg blood flow (LBF) and leg vascular conductance (LVC) responses to passive leg movement (PLM) before (pre) and after (post) each treatment. PLM-induced LBF and LVC responses were expressed as peak change (Δpeak) or total hyperemic response (area under the curve above baseline; AUC). Results: LBFΔpeak did not change following BH4 (267 ± 136 mL/min vs. 250 ± 101 mL/min) or placebo (317 ± 119 mL/min vs. 269 ± 97 mL/min) administration (pre vs. post; p>0.05). Similarly, LVCΔpeak was unchanged following either BH4 (396 ± 165 mL/min/100mmHg vs. 465 ± 180 mL/min/100mmHg) or placebo (579 ± 238 mL/min/100mmHg vs. 496 ± 185 mL/min/100mmHg) administration (pre vs. post; p>0.05). The changes in LBFAUC and LVCAUC were not affected by either treatment (LBFAUC; BH4: Δ91 ± 103 mL vs. Δ82 ± 69 mL; placebo: Δ148 ± 119 mL vs. Δ87 ± 81 mL; LVCAUC; BH4: Δ65 ± 55 mL/100mmHg vs. Δ98 ± 78 mL/100mnHg; placebo: Δ182 ± 127 mL/100mmHg vs. Δ105 ± 94 mL/100mmHg) (pre vs. post; p>0.05). Conclusion: Short-term BH4 administration did not improve locomotor muscle microvascular function in patients with HFpEF. This project was funded, in part, by the National Institutes of Health (HL118313, D.W.W.; T32HL139451, K.B.; the U.S. Department of Veterans Affairs (I01RX001311, D.W.W.; IK2RX003670, to K.B.), and the American Heart Association (18POST33960192; K.B.). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Passive Heat Stress, Like Exercise Training, Leads to Improved Vascular Function

Epidemiological data indicate that repeated heat stress improves cardiovascular health, making passive heat therapy (PHT) a potential alternative for those unable to exercise. Few studies to date have examined the potential exercise mimetic effects in humans, and it is unclear how adaptations compare in magnitude to exercise training. OBJECTIVE: To examine the effects of 6 weeks of localized, muscle-focused PHT on resistance artery vascular function, exercise hemodynamics and performance, molecular regulators of vascular tone, and skeletal muscle capillarization relative to the adaptations observed following high-intensity aerobic exercise training focused on the same muscles. HYPOTHESIS: 6 weeks of PHT, applied to the knee extensor muscles through pulsed shortwave diathermy (2 hr, 3 days/week), would improve both resistance artery function and exercise hemodynamics, as well as increase vascular tone regulators more than a sham treatment, but less than single-leg knee extension (KE) exercise training (EX; 40 min, 3 days/week). Methods: We randomized 34 sedentary but otherwise healthy, young adults (ages 18–36; n = 17 female, 17 male) to receive PHT, EX, or sham heating sessions (SHAM; 2 hr, 3 days/week) over 6 weeks. Vascular function was determined through the blood flow response during both a passive leg movement (PLM) assessment and a knee extension graded exercise test (GXTmax). Muscle biopsies were taken from the vastus lateralis at baseline and after 6 weeks of intervention. Results: Peak blood flow during PLM increased to the same extent in both the EX (~10.5% increase, P=0.009) and PHT groups (~8.5% increase, P=0.044). KE peak flow increased in EX (~19%, P=0.005), but did not change in PHT (P=0.523) and decreased in SHAM (~7%, P=0.020). Peak vascular conductance during KE increased by ~25% in EX (P=0.030) and PHT (P=0.012). KE peak power increased in EX by ~27% (P=0.001) but did not significantly change in PHT (P=0.175) and SHAM groups (P=0.111). EX, but not PHT or SHAM, increased muscle capillary-to-fiber ratio (P = 0.0003), capillary density (P = 0.0428), and the Capillary to Fiber Perimeter Exchange Index (P = 0.0089). Protein expression of endothelial nitric oxide synthase (eNOS) increased significantly in both EX (P=0.0028) and PHT (P=0.0095), but only EX resulted in increased angiogenesis. CONCLUSIONS: 6 weeks of localized PHT, when applied to young healthy individuals, improved resistance artery function at rest and during exercise to the same extent as exercise training. Moreover, our data suggest that these PHT-induced improvements can be primarily attributed to increased expression of the regulators of vascular tone and not neo-angiogenesis. In conclusion, passive heat therapy mimics many, but not all the vascular benefits of exercise training. Funding for this study was provided by the Department of Exercise Sciences at Brigham Young University. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Establishment and evaluation of a rabbit model of frozen shoulder induced by persistent strain injuries and ice compression

To evaluate the rabbit modle of frozen shoulder induced by persistent strain injuries and ice compression. Twelve clean, healthy male New Zealand rabbits with a mass of (2 500±500) g were selected and randomly divided into a blank group and a control group with 6 rabbits in each group. In the control group, the rabbits were modeled with persistent strain injuries and ice compression, the general conditions of the rabbits and the active and passive activities of the shoulder joint were observed and their body weights were recorded. MRI was performed on the affected shoulder joints at 6 d and 29 d after modelling to observe the fluid and soft tissue;HE staining was used to observe the morphology of the rabbit biceps longus tendon and the synovial membrane of the joint capsule;Masson staining was used to observe the fibrous deposits of the rabbit biceps longus tendon and the synovial membrane of the joint capsule, and the fibrous deposits were analysed semi-quantitatively by Image J software. Six days after the end of modeling, the active movement of the shoulder joints in the control group was limited, the passive movement was not significantly limited, and they walked with a limp;29 days after the end of the modeling, the active and passive movements of the shoulder joints in the model group were severely limited. Compared with the blank group (2.50±0.14) kg, the body weight of the model group (2.20±0.17) kg was significantly reduced(P<0.01). MRI showed that 6 days after modelling, the muscles around the shoulder joint were not smooth in shape, the joint capsule structure was narrowed and a large amount of fluid was seen in the joint cavity;29 days after modelling, the muscles around the shoulder joint were rough in shape, structure of the joint capsule was unclear and the fluid in the joint cavity was reduced compared with 6 days after modelling. Pathological staining showed that the long-headed biceps tendon fibres in the control group were disorganised, curled or even broken, and the synovial tissue of the joint capsule was heavily vascularised, with collagen fibre deposits and severe inflammatory cell infiltration. The fiber deposition of the long head of biceps brachii in the model group [(23.58±3.41)%, (27.56±3.70)%] and synovial tissue [(41.78±5.59)%, (62.19±7.54)%] were significantly higher than those in the blank group [(1.79±1.03) %, (1.29±0.63) %] at 7 and 30 days after modeling and synovial tissue fiber deposition [(8.15±3.61) %, (11.29±7.10) %], as shown by the semi-quantitative analysis of Masson staining results by Image J software. And the longer the time, the more severe the fibrosis (P<0.01). The behavioral, imaging and pathological findings showed that the rabbit frozen shoulder model with persistent strain injuries and ice compression is consistent with the clinical manifestations and pathogenesis of periarthritis, making it an ideal method for periarthritis research.

ARE NEUROVASCULAR CHARTS APPROPRIATE FOR DIAGNOSING COMPARTMENT SYNDROME?

IntroductionCompartment syndrome can be a life changing consequence of injury to a limb. If not diagnosed and treated early it can lead to permanent disability. Neurovascular observations done on the ward by nursing staff, are often our early warning system to those developing compartment syndrome. But are these adequate for detecting the early signs of compartment syndrome? Our aim was to compare the quality and variability of charts across the UK major trauma network.Materials &amp; MethodsAll major trauma centres in England and Scotland were invited to supply a copy of the neurovascular chart routinely used. We assessed how such charts record relevant information. Specific primary data points included were pain scores, analgesia requirements, pain on passive stretch and decreased sensation in the first web space specifically. As secondary objectives, we assessed how late signs were recorded, whether clear instructions were included, quantitative scores and the use of regional blocks recorded.ResultsA response rate of 46% was achieved. Of the charts reviewed, 25% documented pain scores or pain on passive movement. Pain on movement and analgesia requirements were documented in 33% and 8% respectively. Specific sensation within the 1st webspace was recorded in 16%. No charts recorded use of regional block. All charts recorded global sensation, movement (unspecified), pulse and colour whilst 66% documented capillary refill and 83% temperature. Instructions were included in 41% of charts.ConclusionsIn 2016, the BOA supported publication of an observation chart for this purpose however, it is not widely used. In our study, late signs of compartment syndrome were generally well recorded. However, documentation of early signs and regional blocks was poor. This may lead to delays in diagnosis with significant clinical and medicolegal consequences. Standardisation of documentation by updating and promoting the use of the pre-existing chart would ensure highest quality care across the network.

The Effect of Therapeutic Approaches on Hallux Valgus Deformity.

Hallux valgus (HV) is a relatively frequent disease caused by a complicated structural malformation of the primary ray. The bunion or middle projection generated by the hallux's lateral displacement and pronation is merely one element of the three-dimensional abnormality. HV may trigger severe discomfort and affect joint kinematics. The specific kinematic cause is still unknown. Female age, gender, restrictive footwear, and heritage are risk indicators. HV frequently coexists along metatarsal adducts, equines contracture, hammertoe imperfection, and pes planus. HV is a frequent foot ailment with multiple, complicated, unknown etiology and course. HV has a preference for females. It is an ongoing condition for which there is no known treatment to reduce or prevent improvement.Fibrodysplasia ossificans progressiva (FOP) is distinguished by hereditary symmetrical HVdeformities or symptoms that begin heterotopic calcification that is either idiopathic or caused by trauma, such as subcutaneous immunizations. Localized heterotopic calcification may be preceded by aggravating, recurring soft-tissue enlargements (flare-ups). Heterotopic calcification may happen anywhere; however, it most commonly impacts locations near the axial bone structure during the early/mild phases until advancing to the appendicular skeleton. As an effect of calcification affecting the flexibility of the joints, it might cause limitations in motion.The initial line of therapy focuses on non-surgical methods including night splinting, orthotics, and larger shoes. The next suggested line of action is surgical intervention if conservative therapy fails. Patients have good postoperative tolerance, and bone union often happens six to seven weeks after surgery. Stretching exercises help to restore function by extending shortened soft tissue and restoring range of motion (ROM). The goal of joint mobilization, a form of manual treatment method, is to extend the ligament, the soft tissue surrounding the limited joint, and the restricting joint capsule by applying modest amplitude passive movement to the joint components.

Deviation of Root Canal Curvature Using Three Types of Rotary Instruments: An In Vitro Study

One of the essential requirements for a successful endodontic treatment is efficient cleaning and shaping. Since its introduction, the nickel-titanium rotary system has gained popularity due to its elasticity and suppleness in the creation of curved root canals. To assess the deviation in root canal curvature in severely curved root canals following three different rotary file system preparations. Thirty-six human permanent mandibular first molars were chosen and stored in regular saline after being newly extracted with the curve mesial root. To standardize length at 13 mm, the mesial roots were separated from the tooth and the crown was removed. The three groups of teeth were A, B, and C. Groups A, B, and C were equipped with rotary variable taper instruments, reciprocating variable taper instruments, and rotary constant taper control memory instruments, respectively, in their mesio buccal canals. The instruments were never pressed apically; instead, they were employed in the canal with a constant, gentle passive movement. With frequent and copious irrigation using 5.25% sodium hypochlorite solution and 17% ethylene diamine tetra acetic acid, all canals were shaped and cleansed. To assess the curvature deviation, periapical radiographs were taken both before and after preparation. By using the Schneider method to measure the pre- and post-instrument canal curvatures, the deviation was found. The Wilcoxon test was employed for numerous pairwise comparisons across distinct groups, and the Kruskal-Wallis test was used to conduct statistical analysis among three groups. The p-value of less than 0.05 was deemed statistically significant. Compared to groups A and B, group C had the least variation of canal curvature. The current study concludes that a 4% rotating constant taper control memory instrument works better than a rotary variable taper instrument or a reciprocating variable taper instrument for shaping a curved canal.

Safety and efficacy of the second-generation cryoballoon for left atrial appendage electrical isolation in canines.

Left atrial appendage electrical isolation (LAAEI) has demonstrated a significant enhancement in the success rate of atrial fibrillation (AF) ablation. Nevertheless, concerns persist about the safety of LAAEI, particularly regarding alterations in left atrial appendage (LAA) flow velocity and the potential risks of thrombus. This study aimed to assess the efficacy and safety of LAAEI, investigating changes in LAA flow velocity in canines. The study comprised a total of 10 canines. The LAAEI procedure used by a 23 mm cryoballoon of the second generation was conducted at least 180 s. Intracardiac ultrasonography (ICE) was employed to quantify the velocity flow of the LAA both prior to and following LAAEI. Following a 3-month period, subsequent evaluations were performed to assess the LAA velocity flow and the potential reconnection. Histopathological examination was conducted. Left atrial appendage electrical isolation was effectively accomplished in all canines, resulting in a 100% acute success rate (10/10). The flow velocity in the LAA showed a notable reduction during LAAEI as compared with the values before the ablation procedure (53.12 ± 5.89 vs. 42.01 ± 9.22 cm/s, P = 0.007). After the follow-up, reconnection was observed in four canines, leading to a success rate of LAAEI of 60% (6/10). The flow velocity in the LAA was consistently lower (53.12 ± 5.89 vs. 44.33 ± 10.49 cm/s, P = 0.006), and no blood clot development was observed. The histopathological study indicated that there was consistent and complete injury to the LAA, affecting all layers of its wall. The injured tissue was subsequently replaced by fibrous tissue. The feasibility of using cryoballoon ablation for LAAEI was confirmed in canines, leading to a significant reduction of LAA flow velocity after ablation. Some restoration of LAA flow velocity after ablation may be linked to the passive movement of the LAA and potential reconnecting. However, this conclusion is limited to animal study; more clinical data are needed to further illustrate the safety and accessibility of LAAEI in humans.

Fractional Amplitude of Low-Frequency Fluctuation and Voxel-Mirrored Homotopic Connectivity in Patients with Persistent Postural-Perceptual Dizziness: Resting-State Functional Magnetic Resonance Imaging Study.

Purpose: Persistent postural-perception dizziness (PPPD) is a chronic subjective form of dizziness characterized by the exacerbation of dizziness with active or passive movement, complex visual stimuli, and upright posture. Therefore, we aimed to analyze the resting-state functional magnetic resonance imaging (fMRI) in patients with PPPD using fractional amplitude of low-frequency fluctuation (fALFF) and voxel-mirrored homotopic connectivity (VMHC) and evaluate the correlation between abnormal regions in the brain and clinical features to investigate the pathogenesis of PPPD. Methods: Thirty patients with PPPD (19 females and 11 males) and 30 healthy controls (HCs; 18 females and 12 males) were closely matched for age and sex. The fALFF and VMHC methods were used to investigate differences in fMRI (BOLD sequences) between the PPPD and HC groups and to explore the associations between areas of functional abnormality and clinical characteristics (dizziness, anxiety, depression, and duration). Result: Compared to the HC group, patients with PPPD displayed different functional change patterns, with increased fALFF in the right precuneus and decreased VMHC in the bilateral precuneus. In addition, patients with PPPD had a positive correlation between precuneus fALFF values and dizziness handicap inventory (DHI) scores, and a negative correlation between VMHC values and the disease duration. Conclusions: Precuneus dysfunction was observed in patients with PPPD. The fALFF values correlated with the degree of dizziness in PPPD, and changes in VMHC values were associated with the duration of dizziness, suggesting that fMRI changes in the precuneus of patients could be used as a potential imaging marker for PPPD.