Upper-extremity Strength Research Articles

Cardiovascular safety of transcutaneous spinal cord stimulation in cervical spinal cord injury.

This study evaluated whether cervical transcutaneous spinal cord stimulation (tSCS) in conjunction with rehabilitation on upper extremity function alters blood pressure regulation in individuals with cervical spinal cord injury. This study is a secondary analysis of the Up-LIFT trial, a prospective single-arm multicenter trial designed to evaluate the safety and efficacy of tSCS in conjunction with rehabilitation (tSCS​+​rehab) on upper extremity function in individuals with chronic cervical spinal cord injury. Utilizing this large data set obtained from 60 individuals across 14 international sites, we compared blood pressure and heart rate measurements obtained before, during and after each training session during both the wash-in Rehab alone period and the tSCS​+​rehab period of the trial. Blood pressure and heart rate were recorded during each session throughout the protocol in all participants. Sessions of tSCS​+​rehab did not cause significant changes in blood pressure or heart rate compared to Rehab alone (p​>​0.05). Further, blood pressure medications did not have an effect on these cardiovascular responses to tSCS (p​>​0.05). This study supports the safety profile of cervical tSCS paired with rehabilitation in individuals with cervical spinal cord injury. The lack of adverse effects on blood pressure and heart rate during the intervention, together with the previously reported clinically meaningful improvements in upper extremity strength and function strongly supports the utility of tSCS in this patient population. Further work is required to elucidate potential long-term effects of targeted tSCS on cardiovascular function in people with spinal cord injury.

RETRACTION Tafuri, F., Martinez-Roig, R., Anam, K., Susanto, N. ., Setyawan, H. ., Saraiello, E., & Latino, F. (2024). Efectos de un programa de entrenamiento en circuito en la mejora de la aptitud cardiorrespiratoria, la fuerza de las extremidades superiores y la agilidad en sujetos parapléjicos (Effects of a circuit training program in improving cardiorespiratory fitness, upper extremity strength, and

Tafuri, F., Martinez-Roig, R., Anam, K., Susanto, N. ., Setyawan, H. ., Saraiello, E., & Latino, F. (2024). Efectos de un programa de entrenamiento en circuito en la mejora de la aptitud cardiorrespiratoria, la fuerza de las extremidades superiores y la agilidad en sujetos parapléjicos (Effects of a circuit training program in improving cardiorespiratory fitness, upper extremity strength, and agility in paraplegic subjects). Retos, 58, 552–559. https://doi.org/10.47197/retos.v58.107488 Retraction of the article by the editor of the journal. There has been a number of clear and conclusive pieces of evidence that they include references that are not related to the topic of the article or the context in which they are cited. The pattern discovered is that the authors have been self-citing their work, in all the articles that are retracted, without any relation to the content of the article in question, introducing citations that are not related to the text and then adding the corresponding references to these citations in the reference list.

Yoga Practice as a Potential Sarcopenia Prevention Strategy in Indonesian Older Adults: A Cross-Sectional Study.

Sarcopenia is characterized by the progressive loss of skeletal muscle mass and poses a significant health challenge for older adults by increasing the risk of disability and decreasing quality of life. Yoga considers as a low-risk and beneficial exercise for older adults. This research aims to evaluate the potential of yoga practice as a preventive strategy against sarcopenia in Indonesian older adults. An observational cross-sectional research was conducted including 41 older adults aged 60-87 years. The research focused on key biomarkers and functional assessments, including serum insulin-like growth factor 1 (IGF-1) levels, telomere length, gait speed, hand grip strength, and SARC-F questionnaire scores. The results showed that participants aged 71-80 years who practiced yoga for more than a year had significantly higher IGF-1 levels (p=0.04). While improvements in gait speed, hand grip strength, and SARC-F scores were observed, these changes were not statistically significant, and no significant differences were found in telomere length. Yoga in older adults was associated with higher IGF-1 levels and potential improvements in upper and lower extremity strength, though these findings were not statistically significant and did not influence telomere length. Yoga practice shows potential as an emerging adjuvant option but can not be applied as a single strategy for sarcopenia prevention in older adults.

The effect of strength training on upper extremities strength and ball throwing velocity in blind goalball athletes

Throwing technique in goalball game is the main attack to score a goal. The study aims to determine the effect of strength training on upper extremity strength and ball throwing velocity in blind goalball athletes. This study was used experimental study. Twenty goalball athletes aged 22.15±1.39 years, height 155.75±4.90 cm, and weight 56.67±5.96 kg participated in this study to evaluate the applied training, undergoing treatment for 8 weeks. Participants underwent upper extremities strength and ball throwing velocity testing before and after treatment. Parametric paired t test was used for data analysis with a significance of 0.05. Paired t-test showed tcount = 17.178 (p-value = 0.000) for TW_5s, tcount = 37.338 (p-value = 0.000) for TW_15s, and tcount = 9.303 (p-value = 0.000) for BTV, which showed an increase in upper extremities strength and ball throwing velocity after blind goalball athletes underwent strength training for 8 weeks. Strength training can be a choice for coaches as an optimal training strategy to increase upper extremity strength and ball throwing velocity in blind goalball athletes.

Effects of a multicomponent exercise program on upper extremity strength, range of motion, cardiovascular endurance, and adherence in adults with spinal cord injury

Effects of a multicomponent exercise program on upper extremity strength, range of motion, cardiovascular endurance, and adherence in adults with spinal cord injury

A162: Meta-Analysis on the Association Between Echo Intensity, Muscle Strength, and Physical Function in Older Individuals

Background/Purpose: Ultrasonographic echo intensity (EI) has been used to indicate skeletal muscle quality. Although lower extremity strength decreases significantly more than upper extremity strength during muscle decay with aging, it has yet to be demonstrated whether EI of the whole thigh muscle affects strength, explosive power, and physical function (PF) in older persons. Through a meta-analysis, this study aimed to systematically assess the association of EI, MS, and PF in older adults. Methods: A systematic approach to searching was performed using Boolean operators on PubMed, Embase, Web of Science, SPORTDiscus, and CINAHL up to October 2022. Studies of any design were included if the association between EI with MS and PF (strength, balance, and mobility) was investigated in healthy older persons. Study-related characteristics and Pearson's correlation coefficients were extracted. Fisher's z was used to convert Pearson r aggregation to a weighted average rz value, which was then back-transformed to r values. The random effects model was used to estimate the combined effect size and 95% confidence intervals, and heterogeneity was assessed using I2 statistics. Results: Twenty-four studies (2,491 individuals, mean age of the study population 71.3 ± 5.5 years) were included in the meta-analysis. Among healthy older persons, EI was negatively associated with lower extremity maximal strength (r = -0.351, 95% CI: -0.411 to -0.288, P < 0.001) and explosive power (r = -0.342, 95% CI: -0.517 to -0.139, P = 0.001). Subgroup analysis revealed there was a significant negative correlation between EI and handgrip strength (r = -0.361, 95% CI: -0.463 to -0.249, P < 0.001). In contrast, there was only a small-scale and non-significant negative association between EI and gait speed (r = -0.003, 95% CI: -0.083 to -0.077, P = 0.943), whereas a weak non-significant correlation was observed with the chair stand test (r = 0.072, 95% CI: -0.045 to 0.187, P = 0.227). Conclusion/Discussion: Enhanced EI in thigh muscles was found to be associated with lower strength and power, but not with balance and mobility in older persons. More well-designed large-sample studies and long-term follow-ups are warranted to provide applied value for this population's frailty prediction and risk assessment.

Physical Performance Effects Associated with a 16-Week Therapeutic Yoga Intervention in Survivors of Cancers in the South Texas Region: A Pilot Study.

Yoga is recognized as a complementary practice that improves physical, mental, and spiritual health in survivors of cancer. The present study assessed associations between a holistic approach and physical function for 30 survivors of cancer in south Texas. Cancer survivors (86% female) of diverse backgrounds (62% underrepresented minorities) performed a battery of physical function tests, including a 6-minute walk test, to assess cardiorespiratory function, isometric shoulder and elbow-flexor strength, dominant-arm grip strength, dominant-arm shoulder range of motion via inclinometer, sit-and-reach test to assess trunk and lower-extremity flexibility, and a 30-second sit-to-stand test to assess lower-extremity endurance. Participants were reassessed 16 weeks after starting the intervention. The intervention involved a 75-minute live-streamed therapeutic yoga program, including meditation, three times a week and daily psychosocial support text messaging through a telehealth platform to increase efficacy in promoting health-enhancing behaviors. Repeated-measures analysis of variance was used to assess changes in physical performance between sessions. Statistically significant improvements were observed for the 6-minute walk test (+35.68 m; p = 0.020), elbow-flexor strength (+7.44 kg; p < 0.001), dominant-hand grip strength (+3.19 kg; p < 0.004), sit-and-reach test (+5.25 cm; p = 0.010), and dominant-arm shoulder range of motion in flexion (+11.18 degrees, p = 0.012) and abduction (+17.06 degrees, p = 0.036). A 16-week live-streamed therapeutic yoga intervention performed three times a week, coupled with daily psychosocial support messaging, was associated with improved cardiorespiratory endurance by increasing the distance walked in 6 minutes, improving upper-extremity strength and range of motion, and increasing the flexibility of back and hamstring muscles.

Sarcopenia in older people with multiple sclerosis: A cross-sectional study

BackgroundOlder people with multiple sclerosis (pwMS) make up over one-third of the MS population. Ageing increases the risk of sarcopenia, characterised by reduced muscle mass, strength, and function. MS symptoms likely exacerbate sarcopenia, but its impact on older pwMS remains largely unexplored ObjectivesThe primary aim of this study was to investigate how the diagnosis of sarcopenia using the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) diagnostic tool in older pwMS is influenced by using upper extremity-based or lower extremity-based tests. MethodsThe present cross-sectional study analysed baseline data from the PoTOMS trial. A total of n = 41 older pwMS and n = 27 healthy controls (HC) were included. Participants were assessed for sarcopenia using the EWGSOP2 diagnostic tools and a lower extremity muscle strength test. ResultsOlder pwMS had a preferentially lower muscle mass and strength in the lower extremities compared to HC. According to EWGSOP2 criteria, 5 % of older pwMS had reduced upper extremity strength, 7 % had reduced lower extremity strength, and 15 % had sarcopenic muscle mass. However, only 5 % were diagnosed with sarcopenia despite these reductions. ConclusionThe present study shows that the sarcopenia diagnosis in older pwMS is more sensitive when using a lower extremity test, underlined by the preferentially lower muscle mass and strength in older pwMS compared to HC. Hence, when evaluating sarcopenia in older pwMS the diagnostics test should rely on the lower extremity test.

Test-Retest Reliability and Minimal Detectable Change of Body Function Impairment and Activity Limitation Outcomes Using a Mechatronic Evaluation Designed for Inpatient Stroke Research

ObjectiveTo determine the test-retest reliability and minimal detectable change (MDC) scores for 7 precision measures examining upper extremity strength, reaching ability, and the expression of flexion synergy after stroke. The measurements relied on a mechatronic evaluation designed for time efficiency facilitating implementation in inpatient translational research. DesignObservational, analytical, cross-sectional study. SettingUniversity research laboratory. ParticipantsTwenty-five participants (N=25) >6 months poststroke with persistent upper extremity body function impairment and activity limitation were recruited using convenience sampling. InterventionsNot applicable. Main Outcome MeasuresShoulder abduction and elbow extension strength measured as a unit of torque (Nm); normalized reaching distance with the arm under 3 conditions: supported, against gravity, and against 50% of shoulder abduction strength; flexion synergy takeover; and emergence thresholds. ResultsThe participants were 12 men and 13 women aged 56.4 ± 17.8 years with mean time poststroke 5.37 ± 7.55 years. The intraclass correlation coefficients for the outcome measures were as follows: shoulder abduction strength (0.963), elbow extension strength (0.983), supported reaching (0.982), reaching against gravity (0.968), reaching against 50% abduction strength (0.974), flexion synergy takeover (0.919), and flexion synergy emergence (0.949) thresholds. The MDC, overall mean, and standard deviation were calculated as follows: shoulder abduction strength (5.69 Nm, 24.44±10.67 Nm), elbow extension strength (5.66 Nm, 18.53±15.66 Nm), supported reaching (0.07, 0.91±0.20), reaching against gravity (0.15, 0.73±0.30), reaching against 50% abduction strength (0.13, 0.69±0.29), flexion synergy takeover (0.14, 0.91±0.17), and flexion synergy emergence (0.17, 0.56±0.27) thresholds. ConclusionsThe mechatronic evaluation, although streamlined from more labor-intensive laboratory evaluations, demonstrates excellent (>0.90) test-retest reliability and MDC scores for 7 precision measures of upper extremity body function impairment (weakness and synergy) and activity limitation (reaching).

Patient Improvement Following Acupuncture in the Treatment of Locked-In Syndrome Caused by Bilateral Pontine Infarction - A Case Report

Introduction: This report describes a case of locked-in syndrome (LIS) due to a bilateral pontine infarction.Case Presentation: A patient with LIS showed worsening despite treatment with thrombolytics, anticoagulants, and antiplatelet agents for acute pontine infarction. On the 8th day post-infarction, the patient was referred to the Internal Korean Medicine Department and received 83 days of acupuncture therapy. Treatments were conducted daily, excluding holidays and Sundays, for 15 minutes at various acupoints, including Baihui (GV20), Qubin (GB7), Jianyu (LI15), and Hegu (LI4). Muscle strength was assessed using manual muscle testing (MMT). Post-treatment, improvements were observed: right upper extremity strength increased from grades 0 and 1 to 2 and 4, while right lower extremity strength increased from 0 and 0 to 2 and 3; the results were similar for both left extremities.Conclusion: Acupuncture therapy led to a noticeable improvement in muscle strength in the LIS patient.

Age-related changes in gait, balance, and strength parameters: A cross-sectional study.

Longevity is increasing worldwide due to improvements in healthcare and living standards. Aging is often associated with disability and multiple health concerns. To address these challenges, effective interventions are essential. This study investigated potential age-related declines in gait, balance, and strength. We also sought to assess any relationships between these three parameters and explore potential differences between women and men. Healthy individuals over 50 years of age were recruited for this cross-sectional study. Upper extremity (grip) strength and lower extremity (knee) strength of the dominant side were measured. Static balance was performed on the force plate in different situations each for 30 seconds: bilateral stance with eyes open, bilateral stance with eyes closed, as well as dominant leg and non-dominant leg unilateral stance with eyes open. Gait was measured during level walking using an optical motion capture system. Additionally, the dynamic stability margin (DSM) was calculated for the level walking trials. The study results indicated that gait parameters were not significantly affected by age (p≥0.12), while knee and grip strength, along with several balance parameters, showed a significant decline with age. All individuals were able to maintain their bipedal balance, but their center of pressure movement increased significantly by age (p≤0.028). Z-scores were calculated to compare significant age parameters. Unipedal stance time was found to be the most affected by age compared to other contributing factors (p≤0.001). The duration of unipedal balance showed the most significant change per decade (non-dominant: -0.62 SDs; dominant: -0.53 SDs), while strength measures exhibited the lowest amount of change per decade (grip strength: -0.34 SDs; knee strength: -0.26 SDs). Sex differences were observed exclusively in strength parameters, with no discernible impact on the decline in balance parameters. These findings suggest that the duration of unipedal stance can serve as a reliable and gender-independent measure of neuromuscular aging for both elderly male and female subjects.

A 24-Week Combined Resistance and Balance Training Program Improves Physical Function in Older Adults: A Randomized Controlled Trial.

Jiang, G, Tan, X, Zou, J, and Wu, X. A 24-week combined resistance and balance training program improves physical function in older adults: a randomized controlled trial. J Strength Cond Res 39(1): e62-e69, 2025-This randomized controlled trial assessed the feasibility of older adults performing combined resistance and balance training (RBT) and compared the effects of RBT on physical function with those of resistance training (RT) alone and with no exercise training in older adults. In total, 65 community-dwelling adults aged 60-74 years were randomly assigned to an RT (n = 22), RBT (n = 22), or control (n = 21) group. The exercise intervention consisted of RT or RBT for 45 minutes, 3 times per week for 24 weeks. The control group engaged in no exercise training. The compliance rates were 93% in the RT group and 92% in the RBT group. No training-related adverse effect was observed. In the RT and RBT groups, dynamic balance (p = 0.017; p < 0.001, respectively), maximum walking speed (p = 0.014; p < 0.001), upper extremity (p = 0.013; p = 0.009) and lower extremity (p = 0.009; p < 0.001) muscle strength, and spirometry (p = 0.043; p = 0.018) were significantly improved at 24 weeks compared with the control group. Only the RBT group showed significant improvement in normal walking speed (p = 0.002). Compared with the RT group, the RBT group showed additional significant improvements in dynamic balance (p = 0.001) and lower limb muscle strength (p = 0.027). The findings of this randomized controlled trial indicated that RBT was safe and feasible for older adults. Long-term RBT had better effects than either no exercise training or RT alone on improving physical function in older adults. Compared with RT, RBT additionally benefited dynamic balance and lower limb muscle function, which are clinically important factors in preventing falls, frailty, disability, and other geriatric syndromes.

Comparison of Core Endurance, Strength, Power, Balance and Flexibility in Young Elite Sailors

Aim: This study examines and compares the core endurance levels, balance performance, muscle strength, and flexibility among young elite saiflors in different sailing classes. Method: Athletes were randomly selected from the Galatasaray Sailing Club and divided into three groups: windsurfing (n=14), optimist (n=13), and laser class (n=13). Demographic features, body mass index, and dominant side of the body were recorded. Upper extremity strength was assessed using a hand dynamometer, while lower extremity power was evaluated through vertical jump, standing long jump, and single-leg jump tests. Core endurance was evaluated with sit-up, plank, and rotary stability tests. Balance and flexibility were assessed using Y balance, straight leg raise, shoulder flexibility, sit and reach, shoulder elevation, and total body rotation tests. The data from the three groups were analyzed using the Kruskal-Wallis H test, and inter-group comparisons were performed with the Mann-Whitney U test. Results: Significant differences were observed among the groups in the hand grip test for both right and left hands (p&amp;lt;0.001). The laser group displayed the highest mean value. The standing long jump test also showed a significant difference between the groups (p&amp;lt;0.05), with the laser group exhibiting the highest mean value. The single-leg jump test revealed a significant difference among the groups (p&amp;lt;0.05), with the windsurfing group having the highest average. The Y balance test indicated a significant difference among the groups (p&amp;lt;0.05), with the optimist group displaying the highest average values. Conclusion: These findings demonstrate that each sailing class necessitates distinct physical attributes and specific performance parameters, particularly in terms of strength and balance.

A case of MERS presenting with acute motor aphasia and tetraparesis and literature review

BackgroundMild encephalopathy wıth reversible splenial lesions (MERS) are a clinical–radiological diagnosis that can be diagnosed with radiological imaging and can be accompanied by impaired consciousness, aphasia, headache, and paralysis. MERS can be divided into two different types based on radiological findings; Involvement of the splenium is seen in type 1, and involvement of the splenium and deep white matter is seen in type 2. MERS Type 2 is very rare in adults. Here, we describe a patient diagnosed with MERS Type 2 and our therapeutic intervention.Case presentationA 22-year-old woman presented with slurred speech, weakness in the extremities and headache that started 14 h ago. The patient had sore throat and fever of 37.6 °C for 2 days, and medical history or family history were unremarkable. Neurological examination revealed that she was conscious, cooperative, with no signs of meningeal irritation. Speech comprehension, naming, and repetition were preserved, motor examination revealed 5/5 left upper extremity strength, 4/5 right upper extremity strength, and 2/5 bilateral lower extremity strength. Diffusion-weighted magnetic resonance imaging (MRI-DWI) revealed bilateral deep white matter and splenium symmetrical diffusion restriction. Blood tests showed high C-reactive protein (CRP) and no leukocytosis. No cells were detected in the cerebrospinal fluid (CSF), protein was 151 mg/dl, glucose was within normal limits. The patient, who developed quadriparesis during follow-up, was started on pulse dose steroids. Neurological examination improved to patient’s baseline at the 12th hour of treatment. In the 72nd hour control MRI-DWI, it was seen that the lesions had regressed. Culture/Polymerase chain reaction (PCR) for bacterial/viral infection agents came back negative. After steroids were given for 5 days, patient was discharged at her baseline.ConclusionsMERS is a rare diagnosis in adults and can be radiologically confused with acute toxic leukoencephalopathy. It can be distinguished clinically by the absence of prior infection, fever, and toxic agent exposure. Although there is no consensus in the literature regarding the treatment, the clinical picture improved rapidly after steroid in our case. Despite being rare, it should be considered in the differential diagnosis of patients with deep white matter lesions in adults.

Muscle quality index comparisons between Hispanics and non-Hispanic Caucasians using dual energy X-ray absorptiometry and handgrip strength

Background & AimsMuscle quality index (MQI) can be computed in various ways. Also, many studies have evaluated MQI in older adults and non-Hispanic populations. The aim of this study was to compare various muscle quality indexes between Hispanics and non-Hispanic Caucasians when stratifying grip strength and appendicular lean mass measurements.Methods235 participants (aged 25.5 ± 9.5 for males and 26.4 ± 9.9 for females) completed a dual energy X-ray absorptiometry (DXA) scan to assess appendicular lean mass (ALM). Handgrip strength (HGS) was assessed using a handheld dynamometer. MQI was computed using four different models: 1). MQIRA: ALM and HGS of right arm and hand, respectively; 2). MQILA: ALM and HGS of left arm and hand, respectively; 3). MQIARMS: ALM and HGS of both arms and hands, respectively; and 4). MQITOTAL: ALM of upper and lower-limbs and HGS of left and right hand.ResultsHispanic males and females exhibited lower HGS compared to Caucasians with effect sizes ranging from trivial (d = 0.17) to moderate (d = 0.80). Females demonstrated higher MQI values compared to males for MQIARMS (d = 0.70), MQIRA (d = 0.75), and MQILA (d = 0.57). However, MQITOTAL yielded a small practical effect (d = 0.33) in favor of males (3.2 ± 0.5 kg/kg vs. 3.1 ± 0.5 kg/kg). After factoring by sex and ethnicity, Hispanic males and females, compared to non-Hispanic Caucasians males and females, showed trivial-to-small practical differences (d values ranging from 0.03 to 0.39).ConclusionsThese results demonstrate MQI models vary across sex, particularly when utilizing models that account for upper extremity strength and ALM (i.e., MQIARMS, MQIRA, and MQILA). Lastly, to establish consistency in future research, the present study recommends using MQI models that account for ALM of upper- and lower-limbs (i.e., MQITOTAL). However, research measuring muscular strength via one upper-limb (e.g., left hand) might consider measuring ALM of the corresponding arm (e.g., left arm) when computing muscle quality (e.g., MQILA).

Effects of a circuit training program in improving cardiorespiratory fitness, upper extremity strength, and agility in paraplegic subjects

Exercise and sports may play a crucial role for individuals with disabilities due to their restricted levels of physical activity. Among people with disabilities, engaging in sports and exercise has the potential to notably enhance their physical and physiological functioning. Consequently, the aim of this research was to investigate the effects of a circuit training program on the cardiorespiratory fitness, musculoskeletal strength, and agility of wheelchair users. The study involved 28 participants with paraplegia as a result of spinal cord injury, aged between 19 and 40 years, who were divided into two groups: an experimental group (EG, n = 14) participating in circuit training, and a control group (CG, n = 14) undergoing aerobic upper-body exercise exclusively. All subjects took part in the wheelchair yo-yo test and hand grip test, both conducted at the commencement and conclusion of the training period. The results displayed a significant Time x Group interaction for both variables, indicating a substantial improvement in the intervention group (p &lt; 0.001), while no significant changes were observed in the control group. Therefore, the findings suggest that incorporating circuit training into the daily routine of wheelchair users has a positive impact on their overall well-being, ultimately enhancing their quality of life. Key words: physiology; exercise; sport; spinal cord injuries; cardiorespiratory fitness.

Use of cortical hemodynamic responses in digital therapeutics for upper limb rehabilitation in patients with stroke

BackgroundStroke causes long-term disabilities, highlighting the need for innovative rehabilitation strategies for reducing residual impairments. This study explored the potential of functional near-infrared spectroscopy (fNIRS) for monitoring cortical activation during rehabilitation using digital therapeutics.MethodsThis cross-sectional study included 18 patients with chronic stroke, of whom 13 were men. The mean age of the patients was 67.0 ± 7.1 years. Motor function was evaluated through various tests, including the Fugl–Meyer assessment for upper extremity (FMA-UE), grip and pinch strength test, and box and block test. All the patients completed the digital rehabilitation program (MotoCog®, Cybermedic Co., Ltd., Republic of Korea) while being monitored using fNIRS (NIRScout®, NIRx Inc., Germany). Statistical parametric mapping (SPM) was employed to analyze the cortical activation patterns from the fNIRS data. Furthermore, the K-nearest neighbor (K-NN) algorithm was used to analyze task performance and fNIRS data to classify the severity of motor impairment.ResultsThe participants showed diverse task performances in the digital rehabilitation program, demonstrating distinct patterns of cortical activation that correlated with different motor function levels. Significant activation was observed in the ipsilesional primary motor area (M1), primary somatosensory area (S1), and contralateral prefrontal cortex. The activation patterns varied according to the FMA-UE scores. Positive correlations were observed between the FMA-UE scores and SPM t-values in the ipsilesional M1, whereas negative correlations were observed in the ipsilesional S1, frontal lobe, and parietal lobe. The incorporation of cortical hemodynamic responses with task scores in a digital rehabilitation program substantially improves the accuracy of the K-NN algorithm in classifying upper limb functional levels in patients with stroke. The accuracy for tasks, such as the gas stove-operation task, increased from 44.4% using only task scores to 83.3% when these scores were combined with oxy-Hb t-values from the ipsilesional M1.ConclusionsThe results advocated the development of tailored digital rehabilitation strategies by combining the behavioral and cerebral hemodynamic data of patients with stroke. This approach aligns with the evolving paradigm of personalized rehabilitation in stroke recovery, highlighting the need for further extensive research to optimize rehabilitation outcomes.

Effects of Electro-Muscle Stimulation Exercise Combined with Mat Pilates on Pain, Anxiety, and Strength in Sedentary Females with Fibromyalgia: A Single-Blind Randomized Controlled Trial.

Fibromyalgia syndrome (FM) is a chronic pain disorder that is ranked as one of the four most common rheumatological diseases in the world. This study aims to investigate the effects of an eight-week mat Pilates and electro-muscle stimulation (EMS) with combined mat Pilates exercises on pain, depression, anxiety, and strength in sedentary women. This study is a single-blind randomized controlled trial. A total of 30 sedentary female patients (Pilates (n = 15), EMS (n = 15)) diagnosed with FM were included in the study. The patients were subjected to Beck Depression (BDIs) and Anxiety Inventories (BAIs); a Fibromyalgia Impact Questionnaire (FIQ); five different Single-Leg Hop Tests (SLHTs); modified push-up (MPU), Handgrip Strength (HGS), Deep Squat (DSQ), V-Sit Flexor, bent-arm hang (BA), sit-up and Biering-Sørensen tests; and anthropometric tests before and after the 8-week exercise program. The eight weeks of mat Pilates exercises combined with mat Pilates and EMS revealed significant results (p < 0.05) in anthropometric data (abdomen, lower abdomen, hips) (p < 0.05) except for the results of chest circumference measurements (p > 0.05). In addition, there were statistically significant positive results in BDIs, BAIs, FIQs, lower extremity (all SLHTs and DSQ), upper extremity (MPU, HGS, BA), and core (V-SIT, sit-up, Biering-Sørensen test) strength test findings (p < 0.05). Combining the mat Pilates exercises with EMS is an effective and reliable method to improve the pain, anxiety, depression, and strength of female patients diagnosed with FM.

The strength of balance: Strength and dynamic balance in children with and without hypermobility.

Generalized Joint hypermobility (GJH) is predominantly non-symptomatic. In fact, individuals with joint flexibility usually perform better than their non-hypermobile counterparts during physical activities. Notwithstanding, strength and balance are essential to maintain the control of the extra range of motion during activities and to prevent musculoskeletal complications. There are limited and conflicting pieces of evidence in literature regarding the association between strength and balance in children with GJH. The purpose of this study was to examine differences in functional strength, dynamic balance, proprioception, and isometric strength in children with and without joint hypermobility and determine the association between strength outcomes and dynamic balance. A cross-sectional study was conducted among children aged 6 to 11. Hypermobility was determined using the Beighton Score, with scores ≥6 representing hypermobility. Functional strength was assessed with the Functional Strength Measure (FSM), isometric strength was determined with a handheld dynamometer (HHD), the Y-Balance Test (YBT) was used to assess dynamic balance and the Wedges test to measure proprioception. This study included 588 participants (age: 7.97 ± 1.3 years; height: 128±10.1 cm; mass: 27.18 ± 7.98 kg). 402 children were classified as having normal mobility and 186 as being hypermobile. Hypermobile children had better functional strength in the lower extremities than children with normal range mobility but lower reach distance in the YBT. No differences in proprioception, functional strength of the upper extremity or isometric strength in the hands were found. However, isometric lower extremity force was less in hypermobile children than children with normal range mobility. Irrespective of their joint mobility, a fair significant correlation existed between total Y-balance distance and FSM items r = 0.16-0.37, p = 0.01. Correlations between total Y-balance distance and isometric strength of knee and ankle muscles ranged between r = 0.26-0.42, p = 0.001. Hypermobile joints seem to co-occur with lower extremity isometric strength, more functional strength in the lower extremities and less reaching distance in dynamic balance. The opposing direction of the results on functional and isometric strength tests highlights the importance of the type of outcome measures used to describe the association of strength and the range of motion.

Effects of a strength program on physical performance in amateur female padel players

The aim of this study was to determine the effects of an explosive strength training program on the physical performance of amateur padel players. Eight females amateur padel players, aged between 25 and 40, were randomly split up in two groups: a control group (CG, n=4) and an experimental group (EG, n=4). The experimental group performed a 6-week explosive strength training program. Physical performance variables were measured before and after the intervention using several assessments: Change of direction was gauged using a modified padel-specific test (Test 505) with the "COD Timer" application. Bilateral and unilateral horizontal jumps, along with the countermovement jump (CMJ), were measured using the "Myjump" application. Upper extremity strength was evaluated through overhead medicine ball throwing. The experimental group showed significant improvements in all analyzed variables except for the bilateral horizontal jump, dis-playing an overall enhancement in their performance following the intervention. These findings contribute to shedding light on this sport, especially within the amateur domain, as most social clubs rely on it for sustenance despite the limited available information.