Single-leg Stance Research Articles

Slackline training and postural control in older adults: A systematic review and meta-analysis

BackgroundExercise can reduce the negative effects of aging on postural control. The slackline training could potentially be an activity to improve postural control in older adults. However, the effects of slackline on postural control in older adults are not clear. This systematic review aimed to investigate the effects of slackline on postural control in older adults. MethodsRandomized controlled trials were retrieved from ISI Web Knowledge, PubMed and Scopus using the descriptors "Slackline", "Slacklining", "Aged", "Aging", "Elderly", "Older adults", "Balance”, “Postural Balance” and “Postural Control”. Randomized controlled trials were selected. Postural control was evaluated through center of pressure (CoP), and slackline standing time during single leg stance. ResultsFour studies with 118 participants were included. The studies found that slackline improves slackline standing time in the tandem, and the single-legged postures, without differences in CoP displacement in single-leg position, results that were confirmed by the meta-analyses. ConclusionAlthough slackline training improves task-specific performance, this improvement is not transferable to other tasks. This conclusion should be interpreted with caution considering the small number of studies, inconsistent designs, and general study limitations. Further studies are required before recommending slackline training to optimize the postural control of older adults.

Living in turbulent times

Abstract Spoken metaphors such as “unstable situation” document a conceptual association between physical instability and difficult situations. Drawing on research in embodied cognition and conceptual metaphor, the present research examined whether people’s somatic experience can influence their attitudes toward the current COVID-19 pandemic. The hypothesis is that inducing a sensorimotor state such as physical instability can activate the associated abstract concepts such as the feelings of instability during a public health crisis. In Experiment 1, participants who sat at a wobbly table and chair believed more in and had greater concern about the coronavirus disease than participants in a stable workstation. Using a different manipulation of physical instability and a more diverse sample, Experiment 2 found that participants who stood on one foot rather than two were more likely to worry about the pandemic. Experiment 3 examined consequential behavior that might follow from respondents’ COVID-19-related attitudes. The results showed that participants who adopted a single-leg stance rather than a double-leg stance donated more money to the coronavirus treatment acceleration program aiming to stabilize the virus situation. Taken together, these findings indicate that seemingly irrelevant physical experiences can skew people’s opinions on the COVID-19 pandemic, exerting potential downstream effects on their actual behavior.

Impairment of Proprioception in Young Adult Nonradicular Patients with Lumbar Derangement Syndrome.

Maintaining body balance is a complex function based on the information deriving from the vestibular, visual, and proprioceptive systems. The aim of the study was to evaluate quiet single stance stability in young adults with lumbar derangement syndrome (LDS) and in the control group of the healthy subjects. The second aim of this study was to determine whether pain intensity, degree of disability, and the level of physical activity can influence postural control in patients with LDS. It is important to underline that selecting a homogeneous group of LBP patients using, for example, mechanical diagnosis and therapy method and Quebec Task Force Classification, can result in an increased sensitivity of the study. The study included 126 subjects: 70 patients with LDS (37 women, 33 men) and the control group 56 healthy volunteers (36 women, 20 men). In case of multiple group comparisons for variables with normal distribution, ANOVA post hoc test was used or, as the nonparametric equivalent, Kruskal-Wallis test. In all these calculations, the statistical significance level was set to p < 0.05. The stability index eyes open for the study group was 88.34 and for the control group 89.86. There was no significant difference in the level of postural control between the study and control groups (p > 0.05). The level of stability index eyes closed (SI EC) for the study group was 71.44 and for the control group 77.1. SI EC results showed significant differences in proprioceptive control during single leg stance between the study and control groups (p < 0.05). The level of pain intensity, the degree of disability, and physical activity level did not influence postural control in the study group with LDS. In summary, patients with LDS showed significantly worse proprioceptive control.

The effect of an infra-acetabular screw for anatomically shaped three-dimensional plate or standard plate designs in acetabulum fractures: a biomechanical analysis

BackgroundVarious plate shapes and implant configurations are used for stabilization of acetabulum fractures via anterior approaches. Little is known about the biomechanical stability of a two-dimensionally shaped “conventional” plate (“J-Plate”—JP) in comparison to three-dimensionally shaped plate configurations (3DP). In addition, the augmentary effect of an infra-acetabular lag-screw (IACS) fixation for anterior column and posterior hemi-transverse acetabulum fractures has not been clarified in comparison of JP and 3DP constructs. This study analyzed the difference between the biomechanical stability of JP compared to 3DP and the role of an IACS in a standardized acetabular fracture model in a single-leg stance loading configuration.MethodsIn an artificial bone substitute pelvis model (Synbone© Malans, Switzerland), a typical and standardized fracture pattern (anterior column and posterior hemi-transverse) was created with osteotomy jigs. After anatomic reduction the stabilization was performed using JP or 3DP. Eight pelvises per group were axially loaded in a single-leg stance model up to 400 N. After the load cycle, an additional infra-acetabular screw was placed and the measurement repeated. Fragment displacement was recorded by an optical tracking system (Optitrack Prime 13®, Corvallis, USA).ResultsIn the pure placement, 3DP provided significantly superior stability when compared to JP. Augmentation of JP by IACS increased the stability significantly, up to the level of 3DP alone, whereas augmentation of the 3DP did not result in further increase of overall stability.ConclusionThe anatomically shaped plate alone provides a superior biomechanical stability in fixation of an anterior column and posterior hemi-transverse fracture model. In a JP fixation the augmentation by IACS provides similar strength as the anatomically shaped 3DP. By use of the anatomically shaped 3DP the need of a clinically risky application of IACS might be avoidable.Level of evidenceIV, Experimental study.

Effects of virtual reality versus conventional balance training on balance of the elderly.

The aging population is growing in the world, and the reduction in physical function caused by this is an important issue that, particularly, causes a disorder of balance and an increased risk of falling. This study aimed at the comparison between the effects of virtual reality training (VRT) and Conventional balance training (CBT) on the balance of the elderly. The present study was conducted on 36 elderly (men and women) who are living in nursing homes. Participants were randomly divided into three groups: virtual reality training (6 males, 6 females; age=66.5±3.8years), Conventional balance training (6 males, 6 females; age=67.5±3.1years), and control (5 males, 7 females; age=66.7±3.2years). Each group participated in a 60-min session, 3 times per week, for 9weeks. To assess the participants' balance, the balance tests were used on single-leg stance (SLS) with open and closed eyes, Functional reach test (FRT), Timed up and Go Test (TUG), and Fullerton Advance Balance Scale (FABS). Data analysis was done using paired t-test and analysis of covariance by SPSS software version 24 at the significant level (P=0.05). In both groups (VRT, CBT), SLS with open and closed eyes, FRT, TUG, and FABS were significantly improved (P˂0.05). After the intervention, changes in both groups were similar (P>0.05), which indicates that neither VRT and CBT training methods were superior to the other. According to the results of this study, it seems that a virtual reality training program can be used as a new training method to improve the elderly's balance in daily programs of nursing homes.

The association between pain, balance, fall, and disability in patients with lumbar spinal stenosis with vascular claudication.

BackgroundThe effect of lumbar spinal stenosis (LSS) and peripheral vascular disease (PVD), which occurs with similar degenerative conditions, when seen together, has not been studied. The aim of this study is to examine and compare the relationship between pain, balance, disability, fear of falling, and kinesiophobia in LSS patients with intermittent vascular claudication (IVC).MethodsSeventy-two patients diagnosed with LSS using magnetic resonance imaging participated in this study. Thirty-five patients with IVC symptoms and showing vascular lesions by lower extremity venous and arterial Doppler ultrasonography imaging were included in the IVC-LSS group. The pain, static balance, dynamic balance, disability, fear of falling, and kinesiophobia were evaluated using the numeric rating scale, single leg stance test, Time Up and Go (TUG), the Oswestry Disability Index (ODI), Fall Efficacy Scale-International (FES-I), and Tampa Scale for Kinesiophobia (TSK), respectively.ResultsAge and female sex were found to be higher in the IVC-LSS group (P = 0.024; P = 0.012). The IVC-LSS group had a shorter single leg stance time and TUG test duration, pain intensity, ODI, FES-I, and TSK scores were higher than patients with LSS (P = 0.001). Pain, fear of falling, and kinesiophobia were moderately correlated with disability in the IVC-LSS group. No relationship was found between pain and dynamic balance. Also, the pain was not related to kinesiophobia.ConclusionsThe findings indicated that IVC causes loss of balance and an increase in pain, disability, fear of falling, and kinesophobia in patients with LSS.

Direction-Specific Signatures of Sport Participation in Center of Pressure Profiles of Division I Athletes.

BackgroundDescriptive and comparative studies of human postural control generally report effects for component or resultant dimensions of a measured signal, which may obscure potentially important information related to off-cardinal directionality. Recent work has demonstrated highly specific balance behavior that is often not easily reconciled with conventional theories of postural control.PurposeThe purpose of this study was to quantify the effects of sport-specific training history on directional profiles of center of pressure (COP) displacement and velocity among collegiate athletes.Study DesignCross-Sectional Study.MethodsOne-hundred sixty-seven NCAA Division-I varsity athletes (80 female: 19.12±1.08 years, 169.79±7.03 cm, 65.69±10.43 kg; 87 male: 19.59±1.33 years, 181.25±9.06 cm, 76.40±12.73 kg) representing four sports (basketball, soccer, tennis, and cross county) participated in this study. Participants balanced barefoot with eyes closed on a force plate for 10-s. in double leg and single leg stance. Effects of sport on mean COP velocity and total displacement were assessed within eight non-overlapping directions (i.e. heading bins).ResultsGreater double leg COP displacement and velocity were observed within specific heading bins in cross country athletes when compared to soccer athletes. Greater double leg COP velocity was also observed in multiple heading bins in basketball athletes when compared to soccer athletes. Greater single leg (non-dominant limb) COP displacement was observed in the 135° heading bin in basketball athletes when compared to soccer athletes.ConclusionsThe observed effects are likely attributable to sport-specific sensorimotor adaptations, including lower extremity strength/power, proprioceptive acuity, and efficiency of integrating vestibular information. Other potential mechanism—namely the involvement of cutaneous feedback and/or muscle synergies—deserve consideration. Directional profiling of spontaneous COP motion may improve understanding of sport-related balance behavior, enhancing its application in therapeutic and performance monitoring contexts.Level of evidence3b

Prevalence and Risk Factors of Falls among Egyptian Elderly Attending Primary Health Centers in Suez Governorate

Abstract Objectives To estimate the prevalence and probable risk factors of falls among a sample of community-dwelling older adults in Suez Governorate, Egypt. Design A cross-sectional comparative study. Setting and Participants Study included 300 older adults (both men and women) recruited from 3 primary healthcare centers, all located in Suez Governorate, Egypt (Alsalam medical center, Mubarak medical center and Alsabbah medical center). Methods All participants were questioned about their fall history in the precedent year and were assessed using: Structured interview questionnaire and physical examination, Fall Risk Assessment Tool, Basic and instrumental activities of daily living, Timed Up and Go test, Single leg stance test, handgrip strength measurement, Mini-Mental Status Examination and Geriatric Depression Scale-15. Participants were categorized as faller and non-faller groups according to their fall history in the precedent year and were then compared as regard common fall risk factors (intrinsic and extrinsic). Results Prevalence of falls among the studied populations was 29%. Women fell more frequently than men (accounting for 64.4% and 35.6% of fallers, p = 0.01). Most falls occurred indoors (58.3%). A significant association was found between fall history and age, sex, muscle weakness, depression, urinary incontinence, IHD, visual impairment, fear of falling, use of assistive device, postural hypotension, and polypharmacy. Conclusion Prevalence of falls in community-dwelling elderly in Suez Governorate is 29%. Identification of factors significantly affecting elderly falls can help in planning public health policies and programs for prevention of falls.

A comparison of balance and leg muscle strength between tai chi and yoga in older adults: A cross-sectional study

Background: There is increasing evidence that practicing tai chi or yoga can improve the elderly’s physical performance. This study aimed to compare the effects of tai chi and yoga on balance and leg muscle strength in the elderly. Material &amp; Methods: This cross-sectional study involved 90 elderly persons who practice tai chi (n = 36), yoga (n = 23), and a control group (n = 31). The balance function was assessed using the single-leg stance (SLS) test, while leg muscle strength (LMS) was assessed using a leg-back dynamometer. A Chi-square, Spearman rank test, one-way ANOVA with LSD post hoc were applied. The significance was set at p&lt;0.05. Results: One-way ANOVA showed a difference in LMS and SLS between groups (p&lt;0.01). LSD post hoc analysis found the difference in LMS between tai chi and yoga (64.3 vs. 41.5, p&lt;0.01) and tai chi and control (64.3 vs. 30.4, p&lt;0.01). The difference was also found in SLS between tai chi and control (36.7 vs. 6.2, p&lt;0.01) and between yoga and control (41.4 vs. 6.2, p&lt;0.01). Conclusion: Elderly persons who participated in tai chi and yoga demonstrated higher LMS and SLS performance than the sedentary participants. The tai chi group showed better muscle strength than the yoga group.

The Influence of Nordic Walking on Spinal Posture, Physical Function, and Back Pain in Community-Dwelling Older Adults: A Pilot Study.

Nordic walking is an increasingly popular form of exercise among the elderly. Using poles is thought to facilitate a more upright posture; however, previous studies primarily investigated the effects of Nordic walking on respiratory function and physical fitness. The aims of this study were to investigate the influence of Nordic walking on spinal posture, physical functions, and back pain in community-dwelling older adults. Thirty-one community-dwelling older adults aged ≥ 60 years participated in a twice weekly Nordic walking training program for 12 weeks. The outcome measures, including spinal posture, physical functions, back pain, and the strength and endurance of back extensor muscles were assessed before and after a 12-week program. After training, spinal posture, back pain, and the strength and endurance of back extensor muscles did not show any statistically significant changes. Among the seven clinical tests of physical function, only the 30 s arm curl test, the 30 s chair stand test, and the single leg stance test showed significant improvements. Nordic walking has limited influence on age-related hyperkyphosis and back pain, but may be effective for physical function. The results of this study can provide useful information for people involved in the prevention and treatment of physical dysfunction in community-dwelling older adults.

The effectiveness of functional training on static balance, dynamic balance and flexibility of females with intellectual disability

Background: Children with intellectual disability (ID) have less balance and flexibility than typically developing peers. The aim of this study was to determine the effectiveness of functional training on static balance, dynamic balance and flexibility of female students with intellectual disability. Material/Methods: The research method was pre-test – post-test with a control group. The statistical population consisted of all female students with ID in elementary school of Shiraz studying under the auspices of the Special Education Organization in 2018–2019. The participants included 30 female students with ID selected through convenience sampling and randomly assigned to the experimental (n = 15) and control (n = 15) groups. The experimental group received functional training for 15 sessions, while the control group did not receive any intervention. The Single leg stance test was used for measuring static balance; the Tandem gait test was used for measuring dynamic balance, and the Sit and Reach test was used for measuring flexibility. The collected data were analyzed using ANCOVA. Results: The results showed that functional training had a significant effect on static and dynamic balance and flexibility of female students with intellectual disability (p&lt;0.05). Conclusions: It is recommended that functional training be given special attention by educators, teachers and child education experts.

Predictive Relationships Between Parkinson's Disease Outcome Measures and Participation in Long-Term HIIT Exercise

Research Objectives Although evidence suggests that High-Intensity-Interval-Training (HIIT) has benefits for persons with Parkinson Disease (PwPD), limited studies have assessed the relationship between standardized motoric assessments for PwPD and exercise levels in long-term HIIT including boxing activities. We proposed an exploration of relationship trends over time Design Longitudinal Repeated Measures. Setting University Outpatient Clinic. Participants 42 adults recruited from gyms specialized in HIIT, including boxing activities. Inclusion criteria: Hoehn and Yahr stages 1-3, ≥ 18 years old, walk ≥ 10m with/without assistive device. Interventions Participants engaged in 2-3 classes/week for 6-12 months. ACSM-certified instructor taught classes including 45-60 minutes of total-body HIIT with boxing activities. Participants completed assessments every 6-8 weeks and were given activity trackers (Garmin VivoFit-3) which documented steps/sleep. Microsoft Excel (vs. 2101) and SPSS (vs. 27) were used for Pearson's correlation and longitudinal regression analysis with p = 0.05. Main Outcome Measures Motor and non-motor standardized assessments were conducted over six sessions including: PDQ-8, UPDRS, step activity, sleep, Single-Leg-Stance (SLS), gait speed, Grip Strength (GS), Five-Times-Sit-to-Stand (5xSTS), cardiovascular health, Timed-Up-and-Go-Test (TUG), Four-Square-Step-Test (4SST). Results Trends for outcomes over time indicated, Right GS increased from 78.32(+/- 20.69) to 88.58(+/- 14.87) kg, Left GS increased from 77.20(+/- 25.40) kg to 84.83(+/- 17.24) kg. 5xSTS remained stable and varied from 10.56 (+/- 2.68) sec to 9.98(+/- 3.99) sec, 5xSTS and SLS were found to be weakly correlated(r=0.189). An inverse relationship was found between 5xSTS and average daily step count (r= -0.38). A moderate inverse relationship was also found between the timed 4SST and average daily step count (r= -0.55). Conclusions Preliminary data analysis suggests a notable predictive inverse relationship between higher doses of daily activity and motor function such as balance and coordination. Results indicate that further research is warranted to identify important needed changes in prescribed exercise dosage over time. Author(s) Disclosures All listed authors named declare that there are no conflicts of interest related to this project. Although evidence suggests that High-Intensity-Interval-Training (HIIT) has benefits for persons with Parkinson Disease (PwPD), limited studies have assessed the relationship between standardized motoric assessments for PwPD and exercise levels in long-term HIIT including boxing activities. We proposed an exploration of relationship trends over time Longitudinal Repeated Measures. University Outpatient Clinic. 42 adults recruited from gyms specialized in HIIT, including boxing activities. Inclusion criteria: Hoehn and Yahr stages 1-3, ≥ 18 years old, walk ≥ 10m with/without assistive device. Participants engaged in 2-3 classes/week for 6-12 months. ACSM-certified instructor taught classes including 45-60 minutes of total-body HIIT with boxing activities. Participants completed assessments every 6-8 weeks and were given activity trackers (Garmin VivoFit-3) which documented steps/sleep. Microsoft Excel (vs. 2101) and SPSS (vs. 27) were used for Pearson's correlation and longitudinal regression analysis with p = 0.05. Motor and non-motor standardized assessments were conducted over six sessions including: PDQ-8, UPDRS, step activity, sleep, Single-Leg-Stance (SLS), gait speed, Grip Strength (GS), Five-Times-Sit-to-Stand (5xSTS), cardiovascular health, Timed-Up-and-Go-Test (TUG), Four-Square-Step-Test (4SST). Trends for outcomes over time indicated, Right GS increased from 78.32(+/- 20.69) to 88.58(+/- 14.87) kg, Left GS increased from 77.20(+/- 25.40) kg to 84.83(+/- 17.24) kg. 5xSTS remained stable and varied from 10.56 (+/- 2.68) sec to 9.98(+/- 3.99) sec, 5xSTS and SLS were found to be weakly correlated(r=0.189). An inverse relationship was found between 5xSTS and average daily step count (r= -0.38). A moderate inverse relationship was also found between the timed 4SST and average daily step count (r= -0.55). Preliminary data analysis suggests a notable predictive inverse relationship between higher doses of daily activity and motor function such as balance and coordination. Results indicate that further research is warranted to identify important needed changes in prescribed exercise dosage over time.

Synergistic associations of cognitive and motor impairments with functional outcome in covert cerebral small vessel disease.

Cognitive and motor impairments are the key clinical manifestations of cerebral small vessel disease (SVD), but their combined effects on functional outcome have not been elucidated. This study investigated the interactions and mediating effects of cognitive and motor functions on instrumental activities of daily living (IADL) and quality of life in older individuals with various degrees of white matter hyperintensities (WMH). Participants of the Helsinki Small Vessel Disease Study (n=152) were assessed according to an extensive clinical, physical, neuropsychological and MRI protocol. Volumes of WMH and gray matter (GM) were obtained with automated segmentation. Cognitive (global cognition, executive functions, processing speed, memory) and motor functions (gait speed, single-leg stance, timed up-and-go) had strong interrelations with each other, and they were significantly associated with IADL, quality of life as well as WMH and GM volumes. A consistent pattern on significant interactions between cognitive and motor functions was found on informant-evaluated IADL, but not on self-evaluated quality of life. The association of WMH volume with IADL was mediated by global cognition, whereas the association of GM volume with IADL was mediated by global cognition and timed up-and-go performance. The results highlight the complex interplay and synergism between motor and cognitive abilities on functional outcome in SVD. The combined effect of motor and cognitive disturbances on IADL is likely to be greater than their individual effects. Patients with both impairments are at disproportionate risk for poor outcome. WMH and brain atrophy contribute to disability through cognitive and motor impairment.

Effects of specific inspiratory muscle training combined with whole-body endurance training program on balance in COPD patients: Randomized controlled trial.

PurposeThis study aims to assess the effect of inspiratory muscle training (IMT) combined with endurance training (ET) on balance in patients with chronic obstructive pulmonary disease (COPD).MethodsWe studied 32 male patients (62 ± 6 years) with moderate to very severe COPD. They were randomly assigned to an experimental group (IMT+ET) n = 16 or a control group (ET) n = 16 with similar characteristics. The evaluations were carried out at inclusion and after eight weeks of the training period. Functional balance was assessed by the Berg Balance Scale (BBS), the Timed-up and Go (TUG), the Single Leg Stance test (SLS), and the Activities-specific Balance Confidence (ABC) scale. The strength of the inspiratory muscles (PImax) was assessed by maximal inspiratory mouth pressure. Functional exercise performance was assessed by the 6 minutes walking test (6MWT). IMT program consists in performing two daily sets of 30 inspirations with 50% of PImax increased by 10% every two weeks. ET program consists in performing 30 min treadmill exercise at 60% to 80% of the average speed achieved during the 6MWT three days per week.ResultsAfter the training period, the experimental group demonstrated greater improvements in BBS (IMT+ET vs. ET; p = 0.019), and in ABC (IMT+ET vs. ET; p = 0.014). However, no significant differences between groups were observed for TUG, SLS, and 6MWT. There was a significant difference between groups in PImax (IMT+ET vs. ET; p = 0.030). Significant moderate correlations were obtained between ΔPImax and ΔBBS for both groups (IMT+ET: r = 0.624, p = 0.010; ET r = 0.550, p = 0.027) as well as for ΔABC but only in the experimental group (IMT+ET: r = 0.550, p = 0.027).ConclusionCompared to ET alone, the results suggest that IMT combined with ET enhances inspiratory muscle function and functional balance according to BBS and ABC in patients with COPD. We suggest that inspiratory muscle training might be introduced as additional training to pulmonary rehabilitation programs aimed at improving balance in COPD patients.Trial registrationThe trial registry name: Clinical Trials; Registration number: NCT04084405; URL: https://clinicaltrials.gov/ct2/show/NCT04084405.

Prediction of the Risk Factors of Knee Injury During Drop-Jump Landing With Core-related Measurements in Amature Basketball Players.

Purpose: To evaluate the relationship between specific aspects of core stability and knee injury risk factors during drop-jump (DJ) landing.Methods: Eighteen college-aged male amateur basketball players participated in the project. Kinetic and kinematic data for DJ tasks were collected with force plates and infrared cameras. Raw data were processed to calculate knee joint angles and joint moments during DJ landing. Different components of core stability were represented by the sit-ups in 20 s (SU), trunk extensor endurance, trunk flexion and extension range of motion, dominant extremity single-leg stance time (DLS), and dominant extremity single-leg hop distance, respectively.Methods: Correlation and regression were used to determine the relationship between jumping-related biomechanical parameters and core stability components.Results: SU shared significant variance with the peak moment of knee extension (PMKE, p < 0.05), the peak moment of knee abduction (PMKA, p < 0.05), and the angle of knee internal rotation at initial contact (AKRI, p < 0.05). DLS shared significant variance with the angular motion of knee internal rotation (AMKR, p < 0.05) and the AKRI (p < 0.01). SU and DLS together could explain 52% of the variance observed in the AKRI, and the result was significant.Conclusion: Core stability’s strength and motor control aspects played an essential role in preventing knee injury during DJ landing. An integrative training program addressing core strength and motor control could be considered for coaches and athletes to prevent knee injury through core training and conditioning.

Functional Outcomes and Physical Performance of Knee Osteoarthritis Patients After Ultrasound-Guided Genicular Nerve Radiofrequency Ablation.

To elucidate the effectiveness of ultrasound-guided genicular nerve radiofrequency ablation in alleviating pain as well as its effects on functional outcomes, quality of life and physical performance in knee osteoarthritis patients. Prospective observational study. Patients were recruited within one community hospital. Patients with knee osteoarthritis. The subjects underwent ultrasound-guided radiofrequency ablation of genicular nerves after showing a positive response to a diagnostic block. Outcome assessments were performed at baseline and at 2 and 12 weeks posttreatments using the 36-item Short Form Health Survey (SF-36), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and a physical performance evaluation including balance tests, quadriceps muscle strength test, two-minute walking test and knee joint proprioception test. Thirteen out of 38 patients were eligible for genicular nerve radiofrequency ablation. There were significant improvements from baseline to posttreatment in the numeric rating scale score, physical health domain score of SF-36, and pain and stiffness domain scores of the WOMAC. Regarding physical performance, the step test result significantly improved over the 12 weeks of follow-up. On the other hand, no significant deteriorations in the single leg stance test, isokinetic quadriceps muscle strength test, knee joint proprioception test or two-minute walking test results were observed after radiofrequency ablation of genicular nerves. Radiofrequency ablation of genicular nerves may significantly alleviate pain and improve functional outcomes in knee osteoarthritis patients. More importantly, static balance control and quadriceps muscle strength were preserved and there was a change of proprioception in the good direction.

Physical Characteristics and Physical Fitness Profiles of Korean Taekwondo Athletes: A Systematic Review.

This study aimed to present a standard and normal distribution of Taekwondo athletes’ physical characteristics and physical fitness profiles using a systematic review. A systematic search was conducted using four Korean databases (Research Information Sharing Service, National Digital Science Library, DBpia, and Korean Studies Information Service System). From 2010 to 2020, we reviewed 838 papers on Taekwondo athletes’ physical characteristics and physical fitness factors (e.g., body composition, muscle strength, muscular endurance, flexibility, cardiorespiratory fitness, power, agility, balance, speed, and reaction time). Of them, 24 papers were selected and analyzed. The criteria for selecting the physical characteristics and physical fitness factors for data extraction were set to have a total sample size of more than 30 individuals and included two or more studies. The sample size and average and standard deviation of physical characteristics and physical fitness factors were extracted from each selected study. In this study, the estimation error of all variables, except for the eyes-closed single-leg stance (15.71%), was less than 8%. Therefore, it was confirmed that there was no problem with the validity of the estimated values. These results could be used as an essential objective basis for evaluating the physical characteristics and physical fitness profiles of Taekwondo athletes in most countries worldwide and setting training goals.

Long-Term Outcomes of Gastrocnemius V-Y Plasty Gastrosoleus Fascial Turndown Flap for Chronic Tendo-achilles Injuries with Complex Gap (Kuwada Type IV Injuries).

The Achilles tendon is one of the strongest and most ruptured tendons; with no appropriate treatment it either heals in elongation or gap nonunion. Management of such chronic tears is critical and several procedures have been described. Complex gaps of over 6-8cm need a combination technique. To assess the long-term functional outcome of surgical technique of combined gastrosoleus turndown flap augmented with V-Y plasty for chronic tendoachilles tear with a complex gap of over 8cm. We retrospectively analyzed all the patients who were operated for tendoachilles tears from 2013 to 2018 and selected 12 patients who had a gap of 8cm. Demographic details, history, clinical and radiological findings, post-op follow-up were collected from hospital database. The acute, open, chronic tears with gap of < 8cm, peripheral vascular diseases were excluded. All the procedures were done by senior surgeon using combined technique of gastrosoleus turndown flap with V-Y plasty. Functional outcome was assessed using modified Rupp score, calf diameter and VAS scoring system at latest follow-up of the patient. Assessing increase in calf diameter did objective analysis, average of 2.2cm was regained which was statistically significant using paired T test. Each patient regained average 10° of dorsiflexion. Two patients had terminal 10° restriction of plantar flexion. All patients were able to do heel raise and single leg stance for at least 30s. Subjective assessments done using modified Rupp score, five patients had excellent and seven patients had good outcome. Mean VAS for pain was 1.5 (1-3) and VAS for satisfaction was 7.5 (6-9). All patients returned to their pre-injury functional status. Combined surgical technique of gastrosoleus turndown flap augmentation with V-Y plasty for repairing complex defects in chronic achilles tendon tears is a fair option with satisfactory functional outcome and fewer complications. The online version contains supplementary material available at 10.1007/s43465-021-00475-6.

Disease-inclusive exercise classes improve physical fitness and reduce depressive symptoms in individuals with and without Parkinson's disease-A feasibility study.

Background and purposeExercise is an adjunctive treatment in the management of Parkinson's disease (PD), but barriers such as health status, fear of overexertion, and lack of transportation to the location prevent regular exercise participation. Disease‐inclusive exercise classes may offer an opportunity to make exercise more accessible for older adults with and without diseases. However, the efficacy of such heterogenous exercise classes is still widely unknown. Therefore, it was the aim of this study to analyze the feasibility of disease‐inclusive exercise classes in older adults with and without PD.MethodsTwenty‐one older adults (healthy older adults (HOA): n = 13; PD: n = 8) completed an 8‐week multimodal exercise intervention in supervised group sessions. Exercise classes lasted 60 min with the goal of two participations a week. We assessed physical fitness (timed up and go test [TUG], 6‐minute walking test [6MWT], single leg stance), depressive symptoms and cognitive functions, and we determined growth factors (BDNF & IGF‐1) before and after the intervention to determine the effects and by that, the feasibility of a disease‐inclusive exercise program. Repeated measures ANOVA were used to establish changes.ResultsTUG and 6MWT improved significantly after the training in both HOA (p = .008; p < .001) and individuals with PD (p = .024; p < .001). Furthermore, individuals with PD increased single leg stance left (p = .003). HOA (p = .003) and individuals with PD (p = .001) decreased their depressive symptoms between pre‐ and post‐test significantly. Whereas growth factors tended to improve, no differences in cognitive functions were revealed.ConclusionDisease‐inclusive multicomponent exercise improved physical functions and reduced depressive symptoms independent of health status. This should encourage exercise providers, researchers, and clinicians to further investigate disease‐inclusive exercise, because they may have an important social impact and represent a more inclusive society.

Validity and reliability of smartphone-based application for chronic ankle instability

Background/aims Ankle instability is one of the most common injuries that can occur during everyday life, sports and exercise. Recently, smartphone accelerometers have been used to measure single leg balance associated with ankle instability, because they are easy to use, inexpensive and can be used in small spaces. Thus, the purpose of this study was to introduce and investigate the intra- and inter-rater reliability of the smartphone accelerometer when assessing ankle instability. Methods A total of 26 individuals who had ankle instability were recruited. The single leg stance balance was measured using a smartphone accelerometer (Accelerometer application) and a force platform (I-Balance) for 5 seconds with their eyes open or their eyes closed. Results In the eyes open position, intra-rater reliability of the smartphone accelerometer was excellent for both raters (intraclass correlation coefficient: 0.87–0.90); and the inter-rater reliability was moderate (intraclass correlation coefficient: 0.71). In the eyes closed position, the intra-rater reliability of the smartphone accelerometer was excellent for both raters (intraclass correlation coefficient: 0.90–0.93); the inter-rater reliability was good (intraclass correlation coefficient: 0.82). Additionally, there were fair positive correlations between the smartphone accelerometer and the Cumberland Ankle Instability Tool, and between the smartphone accelerometer and I-Balance (r=0.33, 0.30 respectively). Conclusions The present study demonstrated excellent intra-rater reliabilities of two raters and moderate to good inter-rater reliabilities. The smartphone accelerometer offers several important advantages as a potential portable medical device to assess ankle instability accurately. Although there was a positive correlation, the relationships between the smartphone accelerometer and Cumberland Ankle Instability Tool and that between the smartphone accelerometer and I-Balance were fair. Future studies should investigate the validity of the smartphone accelerometer as a portable medical device for determining ankle instability.