Single-leg Stance Research Articles

Age-Related Influence on Static and Dynamic Balance Abilities: An Inertial Measurement Unit-Based Evaluation

Balance control, a complex sensorimotor skill, declines with age. Assessing balance is crucial for identifying fall risk and implementing interventions in the older population. This study aimed to measure age-dependent changes in static and dynamic balance using inertial measurement units in a clinical setting. This study included 82 healthy participants aged 20–85 years. For the dynamic balance test, participants stood on a horizontally swaying balance board. For the static balance test, they stood on one leg. Inertial measurement units attached to their bodies recorded kinematic data, with average absolute angular velocities assessing balance capabilities. In the dynamic test, the younger participants had smaller average absolute angular velocities in most body parts than those of the middle-aged and older groups, with no significant differences between the middle-aged and older groups. Conversely, in the single-leg stance tests, the young and middle-aged groups outperformed the older group, with no significant differences between the young and middle-aged groups. Thus, dynamic and static balance decline at different stages with age. These results highlight the complementary role of inertial measurement unit-based evaluation in understanding the effect of age on postural control mechanisms, offering valuable insights for tailoring rehabilitation protocols in clinical settings.

Correlation between functional tests and biomarker in return to sport tests of athletes with injuries to the knee region

A sports injury is a condition where damage occurs to the body tissue caused by sports activities. Data in the United States shows a high incidence rate of sports injuries which reaches 1.5 million per year, with half being serious injuries. Injuries to the lower limbs can generally lead to decreased performance, often preventing athletes from continuing as professionals. The Sports Physiotherapist is responsible for aiding recovery and improving the athlete’s performance so that they can return to their sport. Assessing an athlete’s ability to return to sport (RTS) requires tests that can predict their ability after injury. There is currently no consensus from the literature on the decision to return to sport given the lack of standardization and objective criteria. This research is a quantitative descriptive research in the form of a correlation study to analyze the relationship between the functional test model and the bilogical test of the success of the post-injury sports therapy program. Bivariate analysis shows that that the sit and reach test, and the hexagonal test are correlated with TGF Beta 1 results. Where the value r = 0,194 p = 0,160 yng means that there is no meaningful relationship between the Single Leg stance and the Beta 1 TGF.

Efficacy of Otago versus Bosu ball exercise protocol on core stabilization, static and dynamic balance in non-specific chronic low back pain: a randomized parallel arm clinical trial

Abstract Chronic non-specific low back pain (NSLBP) is a pain and stiffness in the lower back region for which specific cause of the pain is unknown. Otago exercises and Bosu ball exercises aim to improve balance and reduce pain and disability. There is a lack of literature where these approaches are not compared and hence the need arises to evaluate their efficacy in the management of NSLBP. A randomized parallel arm clinical trial was conducted in physiotherapy outpatient department at tertiary care center located in Belagavi city, India. 36 individuals with NSLBP, where 18 individuals were randomly allocated into two groups, i.e. Group A (Otago exercise) and Group B (both sides utilized (Bosu) ball exercise). Both the groups received conventional therapy (hot moist pack and interferential current therapy) 3 times/ week for 4 weeks. Outcome measures like plank holding test, star excursion balance test (SEBT), single-leg stance test (SLST), visual analogue scale (VAS) and Oswestry disability index (ODI) were assessed at baseline and on day 12 post-treatment. A within-group analysis using the Wilcoxon matched-pairs test and the dependent t-test showed statistically significant improvements in all outcome measures (). Between group analysis has shown both interventions to be equally effective in ODI () in individuals with NSLBP. In conclusion both Otago and Bosu ball exercises were effective, Bosu ball exercise demonstrated greater efficacy in enhancing core stability, static and dynamic balance, as well as reducing disability and pain in individuals with chronic NSLBP. Clinical trial registry of India: registration number CTRI/2023/11/059489

Kinetic changes of gait initiation in individuals with chronic ankle instability: A systematic review.

Gait initiation (GI) in individuals with chronic ankle instability (CAI) has shown differences in the center of pressure (COP) and muscular measures compared to healthy controls. Some studies reported that these alterations appeared when GI was with the affected leg, while others indicated that they occurred when GI was with the non-affected leg. This systematic review aimed to understand kinetic and muscular differences between individuals with CAI, healthy controls, and the affected and non-affected legs of individuals with CAI. PubMed, Science Direct, Web of Science, Google Scholar, and Scopus databases (1990-2023) were searched using the Population, Exposure, Comparator, and Outcome measure. The PRISMA guidelines were followed. The outcome measures were the peak and rate of COP displacement in the medial-lateral and anterior-posterior directions, and resultant plane during phases 1, 2, and 3 of COP trace during GI and the duration of each phase. The other measures included the onset time of the tibialis anterior and soleus muscle activity between individuals with CAI, healthy controls, and the affected and non-affected legs of the individuals with CAI. The studies' quality assessment was conducted based on the Strengthening the Reporting of Observational Studies in Epidemiology checklist. Five studies were included in the final evaluation. The results of included studies showed, individuals with CAI spent less time during phases 1 and 2, as well as a shorter peak of COP displacement in the lateral direction during phase 1 compared to healthy controls, regardless of whether the GI was with the affected or non-affected leg. Individuals with CAI have probably adopted a strategy involving adjusting the peak of COP displacement to manage internal sway while in a single-leg stance. Overall, there was no comprehensive conclusion about differences between the two legs in individuals with CAI.

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.

A Computer Modeling-Based Target Zone for Transposition Osteotomy of the Acetabulum in Patients with Hip Dysplasia.

This study aimed to determine the acetabular position to optimize hip biomechanics after transposition osteotomy of the acetabulum (TOA), a specific form of periacetabular osteotomy, in patients with hip dysplasia. We created patient-specific finite-element models of 46 patients with hip dysplasia to simulate 12 virtual TOA scenarios: lateral rotation to achieve a lateral center-edge angle (LCEA) of 30°, 35°, and 40° combined with anterior rotation of 0°, 5°, 10°, and 15°. Joint contact pressure (CP) on the acetabular cartilage during a single-leg stance and simulated hip range of motion without osseous impingement were calculated. The optimal acetabular position was defined as satisfying both normal joint CP and the required range of motion for activities of daily living. Multivariable logistic regression analysis was used to identify preoperative morphological predictors of osseous impingement after virtual TOA with adequate acetabular correction. The prevalence of hips in the optimal position was highest (65.2%) at an LCEA of 30°, regardless of the amount of anterior rotation. While the acetabular position minimizing peak CP varied among patients, approximately 80% exhibited normalized peak CP at an LCEA of 30° and 35° with 15° of anterior rotation, which were the 2 most favorable configurations among the 12 simulated scenarios. In this context, the preoperative head-neck offset ratio (HNOR) at the 1:30 clock position (p = 0.018) was an independent predictor of postoperative osseous impingement within the required range of motion. Specifically, an HNOR of <0.14 at the 1:30 clock position predicted limitation of required range of motion after virtual TOA (sensitivity, 57%; specificity, 81%; and area under the receiver operating characteristic curve, 0.70). Acetabular reorientation to an LCEA of between 30° and 35° with an additional 15° of anterior rotation may serve as a biomechanics-based target zone for surgeons performing TOA in most patients with hip dysplasia. However, patients with a reduced HNOR at the 1:30 clock position may experience limited range of motion in activities of daily living postoperatively. This study provides a biomechanics-based target for refining acetabular reorientation strategies during TOA while considering morphological factors that may limit the required range of motion.

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.

Relationship between Climacteric Symptom Intensity, Physical Activity Level, Spine Mobility, Balance, and Quality of Life in Women

Objective: The climacteric period contains more than 1/3 of a woman's life and causes various symptoms stemming from physiological and hormonal changes. Our study investigated the relationship of climacteric symptom intensity with physical activity level, spine mobility, balance, and quality of life. Methods: 64 women (49,5 ± 4,24 years) in the climacteric period were included in the study. Climacteric symptom severity was assessed with the Blatt-Kupperman Index, physical activity levels with the International Physical Activity Questionnaire, quality of life with the Menopause-Specific Quality of Life Questionnaire, and balance with the single-leg stance test. The correlations between the variables were analyzed with the Pearson and Spearman Correlation analysis. Results: Of the participants, 15.6% had minor severe symptoms, 59.4% had mild severe symptoms, 18.8% had moderately severe symptoms and 6.3% had severe climacteric symptoms. The climacteric duration was negatively correlated to spinal mobility measures (r= -0.26 - -0.30) and the quality of life (r= 0.26) (p

Assessing postural stability in flatfoot using a time-in-boundary method during single-leg standing.

Flatfoot, a foot deformity characterized by the collapse of the arch, significantly impacts an individual's balance and stability. This study explored postural adjustments and sway excursions in individuals with and without flatfoot using the Time-in-Boundary method. This method assessed relative stability by exploring various center of pressure radius thresholds during three trials of single-leg stance. We observed significant interactions in threshold levels (F = 4.37, p = 0.04) and normalized relative stable times (F = 7.64, p = 0.01), particularly in the initial trials. Initially, the flatfoot group showed marked decreases in stable times at 10 mm, 15 mm, and 20 mm thresholds, which expanded to 25 mm and 30 mm in subsequent trials. Despite a significant decrease in stability at the 30 mm threshold in early trials, participants exhibited improved stability control as trials progressed. This enhancement likely reflects a combination of a learning effect and an increased understanding of the task requirements, underscoring the adaptability of postural control systems to the biomechanical challenges posed by flatfoot. The Time-in-Boundary method has proven to be an effective tool for clinicians to assess postural control, playing a vital role in developing customized rehabilitation strategies for individuals with flatfoot.

Positive effects of lower extremity constraint-induced movement therapy on balance, leg strength and dual-task ability in stroke patients: a longitudinal cohort study.

To investigate whether high-intensity lower extremity constraint-induced movement therapy can improve balance, leg strength, and dual-task ability. A longitudinal cohort study in a real-world outpatient clinic. 147 community-dwelling participants in the subacute and chronic poststroke phases. Participants received lower extremity constraint-induced movement therapy for 6 hours/day during 2 consecutive weeks, including balance, strength, and functional training. The Berg Balance Scale (BBS), Single-Leg-Stance (SLS) bilaterally, one Repetition Maximum (1RM) in a leg press, symmetry of leg strength (Diff-1RM), Timed Up and Go (TUG), and the TUG Manual test were assessed before, after, and 3 months after lower extremity constraint-induced movement therapy. Compared with preintervention data, statistically significant improvements after lower extremity constraint-induced movement therapy (p < 0.001) were demonstrated for balance with an absolute value in BBS at 1.9 points (effect size 0.38) and SLS at 2.4 s (effect size 0.24), and for leg strength at 10.2 kg (effect size 0.54) for the affected leg. Diff 1RM decreased significantly at 5.8 kg (effect size 0.39) and improvements on dual-task ability at 2.7 s were significant (effect size 0.14). The effects persisted at the 3-month follow-up. High-intensity lower extremity constraint-induced movement therapy may be a feasible treatment option for middle-aged stroke patients to affect balance, leg strength, and dual-task ability positively in an out-patient clinical setting.

Comparison of a Novel Posterior Integrated Transfixation Sacroiliac Joint Fusion Approach to the Posterolateral and Lateral Approaches: A Cadaveric Biomechanical and Computational Analysis of the Fixation, Invasiveness, and Fusion Area.

To concurrently assess and compare the fixation efficacy, invasiveness, and fusion potential of a posterior integrated transfixation cage system to the posterolateral threaded implant and lateral triangular rod systems, in a cadaveric model. Twelve (12) cadaveric sacroiliac joint specimens were utilized and tested within the single-leg stance multidirectional pure moment bending model. Each specimen was tested in the intact, destabilized, treated (using posterior, posterolateral, and lateral systems), and post-fatigue conditions by applying 0 to ± 7.5 Nm of moment in flexion-extension, axial rotation, and lateral bending while measuring the angular range of motion between the sacrum and ilium. Computational models were reconstructed from Computed Tomography (CT) scans and manufacturer surgical technique guides. The models were utilized to quantify the volume of bone removed during implantation and the surface area available for fusion. The posterior integrated transfixation cage system and the lateral triangular rods produced equivalent motion reduction in all motion planes (P > 0.583). The posterolateral cylindrical threaded implant produced less motion reductions than the posterior and lateral implants in flexion-extension (6% ± 3% vs 37% ± 10% and 33% ± 11%, respectively, P <0.05). The posterior system removed 22%-60% less bone volume from the sacrum and ilium (P<0.10), introduced 200%-270% more implant surface to the joint space (P<0.01) and decorticated 75%-375% more joint surface area (P<0.01). The posterior integrated transfixation single-implant cage system is superior to the posterolateral cylindrical threaded single-implant system. Its performance in osteopenic bone is equivalent to the lateral triangular rod system in healthy bone; however, the posterior integrated transfixation cage system requires a single implant, while the lateral triangular rod system requires three. The posterior implant removes the least bone volume and has the most surface area for fusion, providing a significantly better opportunity for robust sacroiliac joint arthrodesis.

Comparison of Measurements for Recording Postural Control in Standing and Seated Position in Healthy Individuals.

Background: A standard method of assessing postural control is to measure while standing. However, its implementation is usually limited. Recording postural control directly on the trunk in a seated position could provide an alternative diagnostic method for quantifying neuromuscular control. Methods: A comparison of center of pressure (CoP) measurements in the standing and sitting positions was performed on 66 healthy adult subjects. The reliability of the measurements in the sitting position was tested in 23 subjects. In addition, the extension force of all test subjects was recorded. Results: The assessments of CoP fluctuations in standing and seated positions showed adequate agreement (deviation 9.1%). Furthermore, good internal consistencies with a sufficient test-retest reliability could be demonstrated for the measurements in seated position. Both CoP measurement methods showed a comparable Spearman correlation to obtained extension force measurements (standing: 0.24, seated: 0.23). Conclusions: Our results show that recording CoP fluctuations in the sitting position is a reliable and valid adjunct to single-leg stance measurements. It could serve as an additional alternative to quantify neuromuscular control in impaired patients who cannot adequately perform the single-leg stance. In addition, measurement in the seated position allows direct recording of neuromuscular control at the trunk.

Local and non-local effects (on the posterior chain) of four weeks of foot exercises: a randomized controlled trial

This study investigated the local, remote, and contralateral effects of a four-week intrinsic foot muscle exercise intervention in recreationally active participants on foot parameters, flexibility, and performance of the posterior chain (PC). Twenty-eight healthy participants (12f, 16m) were randomly assigned to a control group or performed 2 × 6 min of foot exercises twice daily unilaterally at least five days/week for four weeks. At baseline (M1), after the intervention (M2), and after a four-week wash-out period (M3), we assessed bilateral Foot Posture Index-6, medial longitudinal arch mobility, single-leg stance balance, range of motion (ROM) (first metatarsophalangeal joint and ankle), and flexibility and performance of the PC. The FPI-6 score changes over time differed significantly between groups for both legs, improving by 26% in the trained- (p < .001) and 11% in the untrained leg (p = .02) in the intervention group from M1 to M2. Improvements were maintained at M3 for the trained leg (p = .02). Ankle range of motion and balance of the trained leg improved from M1 to M2, yet only became significant at M3 (ROM: p = .02; balance: p = .007). The other parameters did not change significantly. A four-week foot exercise intervention might have local but no remote effects in healthy young adults.German Clinical Trial Register (DRKS00027923) (24/08/2022).

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.

The Impact of Ankle Mobilization Techniques on Static Stability in Individuals With Acute Inversion Ankle Sprain: A Randomized Clinical Trial

ObjectiveThe purpose of the study was to compare the impact of the mobilization techniques and mobilization with movement techniques on static balance in individuals with acute inversion ankle sprain. MethodsVolunteers with acute inversion ankle sprain (N = 40) were equally and randomly assigned to 2 groups. Participants in intervention group I received the Mulligan mobilization with movement techniques, whereas participants in intervention group II underwent the Maitland mobilization techniques. Each participant received the intervention every other day for 2 consecutive weeks. To assess static balance, participants assumed a single-leg stance on the affected leg at the center of a force plate with eyes open or closed plate for 20 seconds. The displacement, velocity, and area of the center of pressure were recorded 1 day before and after the intervention. ResultsThe velocity of the center of pressure in the anterior-posterior direction was significantly reduced only in group I during eyes open (P = .043) and closed (P = .004). However, the displacement of the center of pressure in the anterior-posterior direction was significantly decreased in both group I (P = .024) and group II (P = .028) with eyes open. No significant changes were found in the area of the center of pressure in either group during eyes open or closed (P > .053). ConclusionsBoth Mulligan's and Maitland's approaches significantly improved sway displacement. For the individuals with acute inversion ankle sprain who were included in this study, the Mulligan technique were more effective in improving static balance indicators compared to the Maitland technique. Clinical TrialThe study was then registered in the Iranian Registry of Clinical Trials (17/02/2019) (IRCT20190108042292N2).

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/ ).

Exploring the Relationship between Fundamental Movement Skills and Health-Related Fitness among First and Second Graders in Korea: Implications for Healthy Childhood Development.

This study investigated the relationship between fundamental movement skills (FMSs) and health-related fitness (HRF) among first and second graders in South Korean elementary schools. It aimed to provide foundational data for developing physical education programs tailored to the motor development stages and fitness levels of younger elementary school students. This study utilized secondary data from the physical activity competence evaluation conducted by the Health Physical Activity Institute (HPAI). In October 2023, the HPAI evaluated the fundamental movement skills (jumping, running, hopping, static balance, dynamic balance, overhand throwing, and kicking) and health-related fitness (muscular strength, cardiorespiratory endurance, and flexibility) of 291 first and second-grade students. The collected data were analyzed through frequency and multiple regression analyses performed using SPSS software. The results revealed that higher scores in jumping and hopping are associated with greater muscular strength, cardiorespiratory endurance, and flexibility. Running had no significant effect on HRF elements. Higher scores in static balance (i.e., that used in single-leg stance) were associated with increased muscular strength, cardiorespiratory endurance, and flexibility, but dynamic balance (balance beam walking) did not have a significant effect. Higher scores in overhand throwing were associated with greater muscular strength and cardiorespiratory endurance, but kicking did not show a significant association. Overall, these findings emphasize the importance of prioritizing jumping and static balance in physical education for the well-rounded health development of first and second graders. Based on the results derived from this study, it is expected to serve as a theoretical basis for including "jumping" and "static balance" in the first and second grade curriculum of elementary schools, thereby providing essential guidance.

Comparison Between Balance Ability and Muscle Endurance Among Patient with Shoulder Impingement

Abstract Aim; Chronic pain has been theorized to hinder balance control by compromising muscle endurance. Despite this theoretical connection, there is limited empirical evidence on this phenomenon, especially in patients diagnosed with shoulder impingement. This study aims to investigate muscle endurance, balance measures, and indicators of shoulder dysfunction in patients with impingement, comparing them with age- and sex-matched healthy controls. Method; In this cross-sectional study, patients (n=31) with shoulder impingement and healthy controls (n=23) matched for age and gender were compared with regard to their balance ability and physical performance. Functional questionnaires (Disabilities of the Arm, Shoulder, and Hand (DASH) as well as Single-Leg Stance Balance Test (SLBT), Y Balance test, Scapular Endurance Test, Trunk muscle flexor and extensor test, grip strength and Nine-Hole Peg Test (NHPT) were completed in a randomized order with consistent raters. Results; Patients with shoulder pain showed significantly worse results in measurements of shoulder function (p