Lower Extremity Strength Research Articles

Effects of vitamin D3 supplementation on strength of lower and upper extremities in athletes: an updated systematic review and meta-analysis of randomized controlled trials.

Coaches and athletes are increasingly interested in understanding athletes' serum vitamin D levels, their impact on strength, physical performance, and athletic outcomes. Previous meta-analyses were reported with limited sample size and no significant overall effect was found. Hence, it is crucial to conduct a thorough and up-to-date systematic examination and meta-analysis to elucidate the potential advantages of supplementing with vitamin D3 in enhancing muscle strength for athletes. We performed a thorough investigation, spanning three databases (PubMed, EBSCO, and Cochrane Library), seeking randomized controlled trials (RCTs) in all languages. These trials delved into the influence of vitamin D3 supplementation on the changes of pre- and post-intervention muscle strength in healthy athletes. Our systematic examination and meta-analysis took into account serum 25(OH)D levels exceeding 30 ng/mL as a marker of adequacy. Ten RCTs, comprising 354 athletes (185 in the vitamin D3 group and 169 in the placebo group), fulfilled the inclusion criteria. During the study, 36 athletes were lost to follow-up, leaving 318 athletes (166 in the vitamin D3 group and 152 in the placebo group) with documented complete results. In comparison with the placebo group, there is a significant increase between the changes of pre- and post-intervention serum 25(OH)D levels among athletes following a period of vitamin D3 supplementation (MD 14.76, 95% CI: 8.74 to 20.77, p < 0.0001). Overall effect of four strength measurements including handgrip, one repetition maximum Bench Press (1-RM BP), vertical jump, and quadriceps contraction was not significantly improved (SMD 0.18, 95% CI: -0.02 to 0.37, p = 0.08), but there was a significant increase in quadriceps contraction (SMD 0.57, 95% CI: 0.04 to 1.11, p = 0.04). This updated meta-analysis indicates the potential benefits of vitamin D supplementation for enhancing muscle strength in athletes when analyzing its quantitatively synthesized effects. With limited available studies for the quantitative synthesis, it cannot warrant significant overall enhancements in muscle strength when athletes attain adequate serum 25(OH)D levels through supplementation.

The relationship between ankle landing kinematics, isokinetic strength, muscle activity, and the prevalence of lower extremity injuries in university-level netball players during a single season.

Safe landing in netball is fundamental. Research on the biomechanics of multidirectional landings is lacking, especially among netball players. Furthermore, few studies reporting the associations between ankle kinematics, isokinetic ankle muscle strength, muscle activities, and injury prevalence in South African netball have been undertaken. To determine the relationships between ankle kinematics, kinetics, isokinetic strength, and muscle activity during jump-landing tasks, as well as the prevalence of lower extremity injuries in university-level netball players during a single season. This cross-sectional repeated-measure study consisted of ten university-level female netball players. The injury prevalence data was collected during the 2022 netball season. The ankle muscle activity, kinematic, and kinetic data were collected during multidirectional single-leg landing and muscle strength was collected from plantar- and dorsiflexion trials. Netball players' ankle strength was generally below average. There was evidence of negative correlations between the ankle range of motion (ROM), isokinetic strength, and muscle activity amplitudes. A lack of evidence prevented the conclusion that lower extremity dominance predisposed players to injury, and that any specific body part was more likely to be injured among netball players. Landing forces and muscle activity are direction-dependent, especially for the dominant limb. Lower extremity strength and neuromuscular control (NMC) across multiple jump-landing directions should be an area of focus for female netball players.

The Effects of Different Stretching Techniques Used in Warm-Up on the Triggering of Post-Activation Performance Enhancement in Soccer Players

The aim of this research was to investigate the effects of different stretching techniques used during warm-up exercises prior to post-activation performance enhancement (PAPE) on the explosive lower extremity strength performance of soccer players. This cross-sectional study involved the participation of 13 male soccer players with an average age of 22.38 ± 1.75, body height of 174.38 ± 3.94, and body mass of 72.30 ± 4.13. To determine the participants’ maximal strength performance, one repeated maximal strength (1-RM) squat exercise was applied. The PAPE protocol was then implemented with a squat exercise consisting of three repetitions at 80% of 1-RM. The warm-up protocols consisted of 5 min of cycling, followed by dynamic stretching, static stretching, or proprioceptive neuromuscular facilitation (PNF) stretching exercises. These protocols were applied on four different days with a 72 h interval. A vertical jump test was conducted to measure the participants’ explosive strength performance. The research data were analyzed using IBM Statistics (SPSS version 26.0, Armonk, NY, USA) software. The findings of this study revealed statistically significant differences in vertical jump performance values after PAPE among participants based on the different stretching techniques used during warm-up (p = 0.00). In this context, the research concluded that dynamic stretching is the optimal stretching technique during warm-up exercises before PAPE to maximize its effects. On the other hand, static stretching was found to negatively affect performance by absorbing the PAPE effect.

Free-Living Sit-to-Stand Characteristics as Predictors of Lower Extremity Functional Decline among Older Adults.

Habitual strength and power-demanding activities of daily life may support the maintenance of adequate lower extremity functioning with aging, but this has been sparingly explored. Hence, we examined whether the characteristics of free-living sit-to-stand (STS) transitions predict a decline in lower extremity functioning over a 4-yr follow-up. A total of 340 community-dwelling older adults (60% women; age 75, 80, or 85 yr) participated in this prospective cohort study. At baseline, a thigh-worn accelerometer was used continuously (3-7 d) to monitor the number and intensity of free-living STS transitions. A decline in lower extremity functioning was defined as a drop of ≥2 points in the Short Physical Performance Battery (SPPB) from baseline to follow-up. Maximal isometric knee extension strength was measured in the laboratory. Eighty-five participants (75% women) declined in SPPB over 4 yr. After adjusting for age, sex, and baseline SPPB points, higher free-living peak STS angular velocity (odds ratio (OR), 0.70; 95% confidence interval (CI), 0.52-0.92, per 20°·s -1 increase) protected against a future decline. When adjusting the model for maximal isometric knee extension strength, the statistical significance was attenuated (OR = 0.72; 95% CI = 0.54-0.96, per 20°·s -1 increase). Performing STS transitions at higher velocities in the free-living environment can prevent a future decline in lower extremity function. This indicates that changes in daily STS behavior may be useful in the early identification of functional loss. Free-living peak STS angular velocity may be a factor underlying the longitudinal association of lower extremity strength and performance.

An almost forgotten neurological entity: man in a barrel syndrome

Man in a barrel syndrome (MIBS) presents with bilateral upper extremity weakness but preserved strength in face, neck, and lower extremities. In this case report, two cases of MIBS were admitted to the emergency department (ED) presented. The first patient injured his neck after falling off a ladder. The second patient was a victim of a traffic accident. Bilateral upper extremity weakness was examined in the first patient at first admission to the ED. On the other hand, progressive weakness was shown in the second patient during ED follow-up. The cervical imaging findings consisted with MIBS. This case report and review of literature highlights that physicians should consider every possible cause, even the rarest ones when a patient complains of neck trauma with non-specific symptoms. Rapid identification and treatment of treatable causes such as cerebral hypoperfusion are vital for patient prognosis.

Online dance versus online therapeutic exercise on quality of life - a study protocol for a randomized controlled trial investigating social telerehabilitation efficacy in Parkinson disease

Background Social telerehabilitation delivers rehabilitation services over online video conferencing within a social context. The modality of multimodal therapeutic exercises is the most recommended rehabilitation for individuals with PD, although other modalities, such as dance, have shown potential benefits. The investigation of the feasibility and efficacy of these therapeutic strategies in a remote online format is unknown. Methods This is a prospectively registered two-arm randomised controlled trial investigating the efficacy of online dance compared to online multimodal therapeutic exercise by looking at the biopsychosocial PD aspects. Individuals diagnosed with idiopathic PD between 40 and 90 years old, at any stage of disease severity, and without cognitive impairment will be recruited from the community. Participants will be randomly allocated to one of the two social telerehabilitation groups: (1) dance and music or (2) multimodal therapeutic exercise and music. Interventions will occur twice a week for twelve weeks. Each session will last 60 min. Tele-assessments will be conducted pre-, post-, and one-month follow-up through a videoconference platform. Results For feasibility, primary outcomes will include adherence, attendance, adverse events, and participants’ perceptions of enjoyment and socialisation. For efficacy, primary outcomes will investigate well-being by positive affect (by the Positive Affect and Negative Affect Schedule) and persistent anxiety, episodic anxiety, and avoidance behaviour (by the Parkinson Anxiety Scale). Secondary outcomes will include motor severity (by the UPDRS III), functional lower extremity strength (by the Five Times Sit to Stand Test), memory and attention (by the Attention and Recognition Memory Test), and quality of life (by the Parkinson’s Disease Questionnaire 39). Conclusion We hypothesise that both interventions would effectively ameliorate motor symptoms. However, we expect dance to be more enjoyable and improve well-being by increasing positive affect and reducing anxiety signs.

ENHANCING FUNCTIONAL CAPACITY AND QUALITY OF LIFE WITH ECCENTRIC CYCLING TRAINING IN HEART FAILURE PATIENTS: A RANDOMIZED CONTROLLED TRIAL

INTRODUCTION Exercise training is recommended for comprehensive management of patients with heart failure and reduced ejection fraction (HFrEF). However, limited exercise capacity prevents many patients from gaining optimal training benefit. Given eccentric cycling is well tolerated in HFrEF, and enables greater power output, we hypothesized that eccentric cycling training would result in superior functional outcomes than concentric cycling training when the interventions were matched for heart rate (HR). METHODS Forty-five participants (9♀, 57±13 y; BMI 27±5 kg/m2) with HFrEF (ejection fraction 33±10%, New York Heart Association class II) were randomized in a 1:1 superiority clinical trial to either eccentric cycling training (ET, n = 25) or concentric cycling training (CT, n = 20). Each intervention involved 2-weeks of familiarization and 12-weeks of training at matched relative intensity (40-80% of HR reserve), twice weekly. Primary outcome was peak oxygen consumption (V̇O2peak), secondary outcomes included 6-minute walk, functional lower extremity strength and health-related quality of life (Minnesota Living with Heart Failure, MLHF). RESULTS Repeated measures ANOVA revealed significant interaction effects for 6-min walk (ET 476±77 to 547±80 m vs CT 485±106 to 516±113 m, P=0.015), 30s sit-to-stand (ET 12±3 to 16±3 repetitions vs CT 13±4 to 14±3 repetitions, P=0.002), and timed up-and-go (ET 7.2±1.2 to 6.2±1.1 s vs CT 7.6±1.5 to 7.3±1.9 s, P=0.019). There were significant time effects for V̇O2peak (ET: 17.7±4.8 to 19.1±5.2 ml/kg/min and CT 17.4±6.0 to 19.8±6.0 ml/kg/min, P&amp;lt;0.001), and MLWHF (ET 31±24 to 23±16 and CT 32±19 to 27±16, P=0.003). CONCLUSION When matched for heart rate to control cardiovascular burden, ET demonstrated superior effect in functional capacity, and similar benefits in aerobic capacity (V̇O2peak) and health-related quality of life, when compared to CT. ET is a novel and efficacious approach for clinical benefit in highly compromised HFrEF patients, who represent a challenge in terms of exercise prescription.

Residual Effects of Same Day Lower Extremity Strength Training on Countermovement Jump Performance in Collegiate Women Athletes.

Balancing of strength programming intensity with sport demands is necessary to avoid excessive workloads that could inhibit performance. To expand previous jump height focused literature, this study evaluated whether countermovement jump (CMJ) movement strategies, including eccentric characteristics, might reveal CMJ execution strategy shifts to achieve similar afternoon CMJ height following a morning resistance training session (RTS). Fifteen collegiate women's soccer and volleyball athletes (18-24 years, 73.6 ± 8.4 kg, 1.74 ± 0.19 m) participating in an offseason RTS completed five CMJs during two afternoon sessions (48 h apart), one 4-6 h post morning RTS, and one on a rest day. The RTS consisted of 2 sets of 10 repetitions at 70-80% 1RM for the back squat, the front squat, and the forward lunge. Vertical ground reaction forces were recorded from which 13 outcome measures describing elements of the eccentric and concentric CMJ phases were computed. No significant differences in jump height (p = 0.427, d = 0.17) or outcome measures (p = 0.091-0.777, d = -0.07-0.21) between sessions with exception of a significant concentric phase time decrease (p = 0.026, d = 0.23) following the RTS were identified. Given the magnitude of the mean concentric phase time change (0.01 s), the result likely has limited practical meaning. As these results confirm previous CMJ height literature, practitioners have further evidence that a morning RTS does not interfere or enhance afternoon CMJ performance in athletic women.

The association of range of motion, lower limb strength, and load during jump landings in professional ballet dancers

This study aimed to investigate the associations between peak plantarflexion ankle joint moments and vertical ground reaction forces (vGRF) during jump landings, and static ankle dorsiflexion range of motion (ROM), three-dimensional ankle excursions, and lower extremity strength in professional ballet dancers. Twenty-seven professional ballet dancers volunteered to participate (men = 14, women = 13). Participants attended one data collection session to measure dorsiflexion ROM and isometric lower extremity strength. Two further sessions were used to establish ankle mechanics and vGRFs during countermovement jump landings in seven foot positions, via a seven-camera motion capture system and piezoelectric force platform. Two linear mixed-effects models were used to investigate associations between the target variables and strength, dorsiflexion ROM, and ankle excursions. Dancer identification, sex, and foot position were entered as random effects. Model fit, when considered independent of random effects, was generally poor with the predictor variables explaining little of the variance of peak plantarflexion ankle joint moments (R2 = 0.02) or vGRF (R2 = 0.01). Model fit improved when random effects were considered (R2 = 0.65 & 0.34). Frontal plane ankle excursion was the only predictor variable with a significant negative association with peak plantarflexion ankle joint moments (p = .016), although coefficient estimates were small. Strength, static ankle dorsiflexion ROM, and three-dimensional ankle excursions are poor predictors of load experienced at a joint and system level in professional ballet dancers. Differences between individuals, sex, and foot position may be better indicators of the load experienced during jump landings.

A 12-week multicomponent exercise program enhances frailty by increasing robustness, improves physical performance, and preserves muscle mass in older adults with HIV: MOVIhNG study.

Our aim was to analyze the effects of a multicomponent exercise program (MEP) on frailty and physical performance in older adults with HIV (OAWH) since exercise can reverse frailty in the older population overall, but there is no data for OAWH. A prospective longitudinal study with intervention and control group was designed. Sedentary adults 50 or over with and without HIV were included. The intervention was a 12-week home-based MEP. Dependent variables were frailty (frailty phenotype), physical performance (Senior Fitness Test), muscle mass (ASMI) by bioimpedance. Pre- and postintervention measurements were analyzed using McNemar's test for categorical variables and the Wilcoxon signed-rank test for quantitative variables. 40 OAWH and 20 OA without HIV. The median age was 56.5 years. 23.3% were women. The prevalence of frailty was 6.6% with no frail HIV-negative participants. Three of the four frail HIV-participants transitioned two (50%) from frail to prefrail and one (25%) to robust after the MEP. In participants with an adherence ≥50%, physical performance was significantly improved [basal vs. 12 week]: upper extremity strength [13 (13-15) vs. 16 (15-19), p = 0.0001], lower extremity strength [13 (11-16) vs. 15 (13-16), p = 0.004], aerobic endurance [62 (55-71) vs. 66 (58-80), p = 0.005]. Participants with low adherence experienced a significant worsening in ASMI [8.35 (7.44-9.26) vs. 7.09 (6.08-8.62), p = 0.03]. A 12-week MEP enhances frailty by increasing robustness in OAWH, and improves physical performance, and preserves muscle mass in older adults with good adherence to the MEP independently of HIV status.

Running Biomechanics and Clinical Features Among Adolescent Athletes With Lower Leg Chronic Exertional Compartment Syndrome.

To compare clinical measures between patients with chronic exertional compartment syndrome (CECS) and healthy controls and evaluate running biomechanics, physical measurements, and exertional intracompartmental (ICP) changes in adolescent athletes with lower leg CECS. Cross-sectional case-control study. Large tertiary care hospital and affiliated injury prevention center. Forty-nine adolescents with CECS (39 F, 10 M; age: 16.9 ± 0.8 years; body mass index (BMI): 23.1 ± 2.9 kg/m 2 ; symptom duration: 8 ± 12 months) were compared with 49 healthy controls (39 F, 10 M; age: 6.9 ± 0.8 years; BMI: 20.4 ± 3.7 kg/m 2 ). All participants underwent gait analyses on a force plate treadmill and clinical lower extremity strength and range of motion testing. Patients with chronic exertional compartment syndrome underwent Stryker monitor ICP testing. Symptoms, menstrual history, and ICP pressures of the patients with CECS using descriptive statistics. Mann-Whitney U and χ 2 analyses were used to compare CECS with healthy patients for demographics, clinical measures, and gait biomechanics continuous and categorical outcomes, respectively. For patients with CECS, multiple linear regressions analyses were used to assess associations between gait biomechanics, lower extremity strength and range of motion, and with ICP measures. The CECS group demonstrated higher mass-normalized peak ground reaction force measures (xBW) compared with controls (0.21 ± 0.05 xBW ( P < 0.001) and were more likely to have impact peak at initial contact ( P = 0.04). Menstrual dysfunction was independently associated with higher postexertion ICP (ß = 14.6; P = 0.02). The CECS group demonstrated increased total force magnitude and vertical impact transient peaks. In women with CECS, menstrual dysfunction was independently associated with increased postexertion ICP. These biomechanical and physiological attributes may play a role in the development of CECS.

Transference of outdoor gait-training to treadmill running biomechanics and strength measures: A randomized controlled trial

Outdoor gait-training has been successful in improving pain and reducing contact time during outdoor running for runners with exercise-related lower leg pain (ERLLP). However, it is unclear if these adaptations translate to gold standard treadmill running and clinical strength assessments. The study purpose was to assess the influence of a 4-week outdoor gait-training intervention with home exercises (FBHE) on treadmill running biomechanics and lower extremity strength compared to home exercises alone (HE) among runners with ERLLP. Seventeen runners with ERLLP were randomly allocated to FBHE and HE groups (FBHE: 3 M, 6F, 23 ± 4 years, 22.0 ± 4.6 kg/m2; HE: 3 M, 5F, 25 ± 5 years, 24.0 ± 4.0 kg/m2). Both groups completed eight sessions of home exercises over 4 weeks. The FBHE group received gait-training through wearable sensors to reduce contact time. Treadmill running gait and clinical strength assessments were conducted at baseline and 4-weeks. Multivariate repeated measures analyses of variance were used to assess the influence of group and timepoint for all outcomes. The FBHE group demonstrated significantly decreased contact time at 4-weeks compared to baseline and the HE group (Mean Difference [MD] range: −42 ms – −39 ms; p-range: <0.001–0.02). The FBHE group had significantly increased cadence (MD: +21 steps/min; p = 0.003) and decreased loading impulse (MD: −51, p < 0.001) during treadmill running at 4-weeks compared to the HE group. Strength did not significantly differ adjusting for multiple comparisons (p > 0.007). The outdoor FBHE intervention transferred to favorable changes in treadmill running biomechanics. Clinicians treating runners with ERLLP patients should implement data-driven outdoor gait-training to maximize patient benefits across running locations.

A Novel Rat Model of Venous Hypertensive Myelopathy Produced by Arteriovenous Bypass Plus Venous Stenosis.

Venous hypertensive myelopathy (VHM), mainly induced by the spinal dural arteriovenous fistula, is a congestive spinal cord injury that currently has no appropriate animal model available in preclinical research. Sprague Dawley rats (280-320 g) were used. The rats were divided into 3 groups: (1) Group 1, which underwent renal artery-dorsal spinal venous bypass (AVB group); (2) Group 2, which underwent renal artery-dorsal spinal venous bypass and drainage vein stenosis (AVB/VS group); and (3) Control group, with T13 dorsal vein ligation. The success of the model was assessed using Doppler ultrasound and 7.0-T magnetic resonance imaging. Transmission electron microscopy, histochemistry, proteomics, and western blot analysis were used to evaluate ultrastructural, pathological, and molecular features in the spinal cord and cerebrospinal fluid (CSF). The success rate of the arteriovenous bypass was 100% at 5 days and 83% at 2 weeks. The locomotor assessment showed decreased lower extremity strength in the AVB/VS group ( P = .0067), whereas unremarkable changes were found in the AVB and Control groups. Histochemical staining suggested a 2-fold expansion of the dorsal spinal vein in the AVB/VS group, which was lower than that in the AVB group ( P < .05); however, the former displayed greater myelin and neuronal damage ( P < .05) and slight dilatation of the central canal ( P > .05). Proteomics analysis revealed that the complement and coagulation cascade pathways were upregulated in the CSF of AVB/VS rats, whereas the C3 level was elevated both in the CSF and bilateral spinal cord. Furthermore, overexpression of C3, ITGB2, and CD9 in the spinal cord was confirmed by immunoblotting. These findings suggest that the AVB/VS model can effectively mimic the clinical and molecular characteristics of VHM. Furthermore, they suggest that impaired deep intramedullary venous drainage is the key reason for the VHM.

APPLICATION OF DIFFERENT EXERCISE PROGRAMS IN THE PREVENTION OF FALLS IN PEOPLE OF THE THIRD AGE

Introduction: Various exercise programs have a positive effect on reducing the risk of falls in elderly people. Consequences of falls include fractures and injuries, reduced quality of life, fear of falling, loss of selfconfidence, and self-limited activity leading to reduced physical function and social interactions. Activity limitation impairs physical capacity and increases the risk of further falls. Falls are the primary cause of injury of the elderly, which can result in serious consequences such as fractures, head injuries, and even death, placing a significant burden on the public health system. Annually, between 28 and 35% of individuals aged 65 and over experience a fall worldwide, with rates reaching 32% - 42% among those aged 70 and over. Therefore, preventing falls has become a key global goal for the older adult population. Objective: To determine the effectiveness of different exercise programs in preventing falls in people of the third age. Methods: The search included an overview of the relevant databases: Medline, PubMed, Google Scholar, Research Gate. The systematic literature review included 12 different types of research. Results: Through a scientific review of the literature, the results of the significance and effectiveness of various programs of Otago exercises, Tai Chi, and Frenkle exercises in the prevention of falls in people of the third age are presented. The greatest effect is realized in the improvement of static and dynamic balance and the fear of falling. Conclusion: These studies show that different exercise programs have a huge and significant impact on reducing the risk of falls in older people. It is a long-term and continuous method of reducing the risk of falls in the elderly through exercise. Physical exercise is effective in improving components of balance, lower extremity strength, mobility, and reducing falls and fall-related injuries.

The Effects of Different Exercise Types on Cognitive and Physical Functions in Dementia Patients: A Randomized Comparative Study

Purpose: The physical and cognitive effects of aerobic exercise on dementia have been extensively studied. Further investigation of other types of exercise with different physiological effects is still needed. This study aimed to determine cognitive and physical effects of 6-week aerobic, balance, and combined (aerobic-balance) exercise programs on dementia. Materials and Methods: A total of 31 mild to moderate dementia patients aged 65-90 years were divided into three exercise groups. Before and after the 6-week exercise program, mental rotation, spatial orientation, visual memory, and mental status were assessed for cognitive functions, while fall risk, reaction time, lower limb strength, and frailty were assessed for physical functions. Comprehensive cognitive and physical assessments were performed to provide a holistic approach to dementia. Results: When post-exercise values were compared with pre-exercise values, only frailty decreased significantly in the aerobic exercise group (p=0.017). After exercise program in balance and combined exercise groups, mental rotation (p=0.005, p=0.032), spatial orientation (p=0.020, p=0.035), mental status (p=0.007, p=0.014), and lower extremity strength (p=0. 010, p=0.005) increased significantly, while fall risk (p=0.005, p=0.005), reaction time (p=0.028, p=0.016), and frailty (p=0.020, p=0.009) decreased significantly. Moreover, in contrast to combined and aerobic exercise, improvement in visual memory was also observed in the balance exercise group (p=0.016). Conclusions: These findings suggest that balance and combined exercises may have broader effects on dementia than aerobic exercise. It emphasizes the importance of designing exercise programs for dementia patients, considering the cognitive and physical deficits of the patients, and creating a multidimensional treatment approach.

The Impact of Regular Diet Recovery on Postoperative Rehabilitation After Elective Cesarean Section

Abstract Objective To determine the role of regular diet recovery after restoration of normal muscle strength of both lower extremities in promoting postoperative recovery in women undergoing elective cesarean section. Methods This was a prospective observational cohort study. Patients who underwent elective cesarean section at Xiangya Hospital, Central South University, from October 2022 to December 2022, were categorized into two groups based on the duration of postoperative fasting: the observation group resumed eating after regaining lower extremity muscle strength, while the control group adhered to traditional postoperative fasting guidelines, waiting 6 hours before eating. Primary outcomes included postoperative pain levels assessed by visual analog scale (VAS) pain scores and time to first flatus. Demographic characteristics, time to first lactation, hospital stay length, and patient satisfaction were also assessed. Statistical analysis was conducted using Student’s t test and Chi-squared test, with significance set at P &lt; 0.05. Results Out of a total of 300 patients, 240 were included in the analysis, comprising 112 in the control group and 128 in the observation group. There were no significant differences in baseline demographic characteristics. The median values of the first flatus time and the first lactation time were 33.37 ± 1.22 vs. 18.06 ± 6.34 hours (P = 0.003) and 26.34 ± 8.21 vs. 7.05 ± 1.26 hours (P = 0.001) in the control and observation groups, respectively. The median hospital stay duration in the control and observation groups was 6.54 ± 0.53 vs. 4.84 ± 0.18 days (P = 0.000), respectively. Median postoperative VAS pain scores and patient satisfaction values were 8.57 ± 0.11 vs. 4.91 ± 0.27 (P = 0.000) and 9.36 ± 0.16 vs. 9.72 ± 0.08 (P = 0.005) in the control and observation groups, respectively. There were no statistically significant differences in other postoperative outcomes, such as intestinal obstruction, infection, and readmission within 42 days (P &gt; 0.05). Conclusion Food intake after restoration of lower extremity muscle strength improves first flatus, relieves postoperative pain, shortens hospital stay, and enhances satisfaction after elective cesarean section, without adverse effects. It is crucial for postoperative rehabilitation and should be encouraged.

Efektifitas Home Program untuk Meningkatkan Kekuatan Otot Ekstremitas Bawah dan Resiko Jatuh Bagi Lanjut Usia di Posyandu Lanjut Usia Dusun Plosokerep, Bendosari, Sukoharjo

Efektifitas Home Program untuk Meningkatkan Kekuatan Otot Ekstremitas Bawah dan Resiko Jatuh Bagi Lanjut Usia di Posyandu Lanjut Usia Dusun Plosokerep, Bendosari, Sukoharjo

Body composition, anaerobic power, lower extremity strength in football players: Acute effect on different leagues

The aim of the study was to compare differences in body composition, lower extremity strength, and anaerobic power characteristics among professional football players at different league levels. A total of seventy-one volunteer players aged between eighteen and thirty-five years (mean age: 23.14 ± 4.23 years) participated in the study, representing the Super League, 1st League, and 2nd League. The participants' body compositions were measured using the DXA (Hologic QDR Series, Delphi A model, Bedford, MA, USA) bioelectrical impedance analyzer, CounterMovement Jump (CMJ) strength with the ChronoJump Smartspeed Mat (INEFC, Barcelona), and Running Anaerobic Sprint Test (RAST) tests were conducted. ANOVA was used to compare multiple groups, and the Duncan multiple comparison tests were conducted in cases where differences were observed to determine which group the difference favored. The results revealed that Super League players statistically possessed more significant values in body composition compared to 1st and 2nd League players and demonstrated significantly higher values in terms of jump height, maximum force output, and anaerobic power compared to 1st and 2nd League players (p

Voleybolcularda Addüktör Kas Grubuna Uygulanan Kinezyolojik Bantlamanın Endurans, Güç ve Çeviklik Üzerine Akut Etkisi

Objective: This study was conducted to investigate the acute effect of kinesiology taping (KT) to the hip adductor muscle group (AMG) on endurance, strength and agility in female volleyball players (VP). Materials and Methods: Thirty female VP, with an average age of 17.53±2.55 years, who played licensed volleyball for at least two years were included in our study. KT was applied longitudinally to the athletes between the pubis and lower border of the tuberositas tibia, including the AMG using the facilitation technique (25% stretching). Evaluations were repeated before taping and 20 minutes after taping. The athletes' Adductor muscle endurance was evaluated using the Copenhagen adduction exercise, vertical jump test for lower extremity strength, and Edgren side step test for agility. Results: When the results of the study were evaluated, it was found that there was a statistically significant increase in the endurance (p&amp;lt;0.001), strength (p&amp;lt;0.001) and agility (p&amp;lt;0.001) values of the athletes after KT application. Conclusions: KT applied to the adductor area can be used by physiotherapists during competitions or training due to its positive effects on the performance of VP.

Deep Learning-Based Prediction Model for Gait Recovery after a Spinal Cord Injury.

Predicting gait recovery after a spinal cord injury (SCI) during an acute rehabilitation phase is important for planning rehabilitation strategies. However, few studies have been conducted on this topic to date. In this study, we developed a deep learning-based prediction model for gait recovery after SCI upon discharge from an acute rehabilitation facility. Data were collected from 405 patients with acute SCI admitted to the acute rehabilitation facility of Korea University Anam Hospital between June 2008 and December 2022. The dependent variable was Functional Ambulation Category at the time of discharge (FAC-DC). Seventy-one independent variables were selected from the existing literature: basic information, International Standards for Neurological Classification of SCI scores, neurogenic bladders, initial FAC, and somatosensory-evoked potentials of the lower extremity. Recurrent neural network (RNN), linear regression (LR), Ridge, and Lasso methods were compared for FAC-DC prediction in terms of the root-mean-squared error (RMSE). RNN variable importance, which is the RMSE gap between a complete RNN model and an RNN model excluding a certain variable, was used to evaluate the contribution of this variable. Based on the results of this study, the performance of the RNN was far better than that of LR, Ridge, and Lasso. The respective RMSEs were 0.3738, 2.2831, 1.3161, and 1.0246 for all the participants; 0.3727, 1.7176, 1.3914, and 1.3524 for those with trauma; and 0.3728, 1.7516, 1.1012, and 0.8889 for those without trauma. In terms of RNN variable importance, lower-extremity motor strength (right and left ankle dorsiflexors, right knee extensors, and left long toe extensors) and the neurological level of injury were ranked among the top five across the boards. Therefore, initial FAC was the seventh, third, and ninth most important predictor for all participants, those with trauma, and those without trauma, respectively. In conclusion, this study developed a deep learning-based prediction model with excellent performance for gait recovery after SCI at the time of discharge from an acute rehabilitation facility. This study also demonstrated the strength of deep learning as an explainable artificial intelligence method for identifying the most important predictors.