Toe Box Shape of Running Shoes Affects In-Shoe Foot Displacement and Deformation: A Randomized Crossover Study.

BACKGROUND: Long-distance running is popular but associated with a high risk of injuries, particularly toe-related injuries. Limited research has focused on preventive measures, prompting exploration into the efficacy of raised toe box running shoes. PURPOSE: This study aimed to investigate the effect of running shoes with raised toe boxes on preventing toe injuries caused by distance running. METHODS: A randomized crossover design involved 25 male marathon runners (height: 1.70 ± 0.02 m, weight: 62.6 + 4.5 kg) wearing both raised toe box (extended by 8 mm along the vertical axis and 3 mm along the sagittal axis) and regular toe box running shoes. Ground reaction force (GRF), in-shoe displacement, and degree of toe deformation (based on the distance change between the toe and the metatarsal head) were collected. RESULTS: Wearing raised toe box shoes resulted in a significant reduction in vertical (p = 0.001) and antero-posterior (p = 0.015) ground reaction forces during the loading phase, with a notable increase in vertical ground reaction force during the toe-off phase (p < 0.001). In-shoe displacement showed significant decreased movement in the forefoot medial (p < 0.001) and rearfoot (medial: p < 0.001, lateral: p < 0.001) and significant increased displacement in the midfoot (medial: p = 0.002, lateral: p < 0.001). Impact severity on the hallux significantly decreased (p < 0.001), while impact on the small toes showed no significant reduction (p = 0.067). CONCLUSIONS: Raised toe box running shoes offer an effective means of reducing toe injuries caused by long-distance running.

Structural and Organizational Strategies of Locomotor Modules during Landing in Patients with Chronic Ankle Instability.

BACKGROUND: Human locomotion involves the coordinated activation of a finite set of modules, known as muscle synergy, which represent the motor control strategy of the central nervous system. However, most prior studies have focused on isolated muscle activation, overlooking the modular organization of motor behavior. Therefore, to enhance comprehension of muscle coordination dynamics during multi-joint movements in chronic ankle instability (CAI), exploring muscle synergies during landing in CAI patients is imperative. METHODS: A total of 22 patients with unilateral CAI and 22 healthy participants were recruited for this research. We employed a recursive model for second-order differential equations to process electromyographic (EMG) data after filtering preprocessing, generating the muscle activation matrix, which was subsequently inputted into the non-negative matrix factorization model for extraction of the muscle synergy. Muscle synergies were classified utilizing the K-means clustering algorithm and Pearson correlation coefficients. Statistical parameter mapping (SPM) was employed for temporal modular parameter analyses. RESULTS: Four muscle synergies were identified in both the CAI and healthy groups. In Synergy 1, only the gluteus maximus showed significantly higher relative weight in CAI compared to healthy controls (p = 0.0035). Synergy 2 showed significantly higher relative weights for the vastus lateralis in the healthy group compared to CAI (p = 0.018), while in Synergy 4, CAI demonstrated significantly higher relative weights of the vastus lateralis compared to healthy controls (p = 0.030). Furthermore, in Synergy 2, the CAI group exhibited higher weights of the tibialis anterior compared to the healthy group (p = 0.042). CONCLUSIONS: The study suggested that patients with CAI exhibit a comparable modular organizational framework to the healthy group. Investigation of amplitude adjustments within the synergy spatial module shed light on the adaptive strategies employed by the tibialis anterior and gluteus maximus muscles to optimize control strategies during landing in patients with CAI. Variances in the muscle-specific weights of the vastus lateralis across movement modules reveal novel biomechanical adaptations in CAI, offering valuable insights for refining rehabilitation protocols.

New Insights Optimize Landing Strategies to Reduce Lower Limb Injury Risk.

Single-leg landing (SL) is often associated with a high injury risk, especially anterior cruciate ligament (ACL) injuries and lateral ankle sprain. This work investigates the relationship between ankle motion patterns (ankle initial contact angle [AICA] and ankle range of motion [AROM]) and the lower limb injury risk during SL, and proposes an optimized landing strategy that can reduce the injury risk. To more realistically revert and simulate the ACL injury mechanics, we developed a knee musculoskeletal model that reverts the ACL ligament to a nonlinear short-term viscoelastic mechanical mechanism (strain rate-dependent) generated by the dense connective tissue as a function of strain. Sixty healthy male subjects were recruited to collect biomechanics data during SL. The correlation analysis was conducted to explore the relationship between AICA, AROM, and peak vertical ground reaction force (PVGRF), joint total energy dissipation (TED), peak ankle knee hip sagittal moment, peak ankle inversion angle (PAIA), and peak ACL force (PAF). AICA exhibits a negative correlation with PVGRF (r = -0.591) and PAF (r = -0.554), and a positive correlation with TED (r = 0.490) and PAIA (r = 0.502). AROM exhibits a positive correlation with TED (r = 0.687) and PAIA (r = 0.600). The results suggested that the appropriate increases in AICA (30° to 40°) and AROM (50° to 70°) may reduce the lower limb injury risk. This study has the potential to offer novel perspectives on the optimized application of landing strategies, thus giving the crucial theoretical basis for decreasing injury risk.

In-classroom physical activity breaks program among school children in Sri Lanka: study protocol for a randomized controlled trial.

Background: The problem of sedentary behavior among primary school children is alarming, with numbers gradually increasing worldwide, including Sri Lanka. Physical activity interventions within classroom settings have been acknowledged as a critical strategy to increase students' movement behaviors while enhancing their academic achievement and health. Yet, the busy curriculum and challenging educational demands encourage more sedentary classroom behavior. Hence, this study aims to develop and evaluate an in-classroom physical activity breaks (IcPAB) intervention among fifth graders in Sri Lanka. Methods: The study will adopt a randomized controlled trial (RCT), comprising an in-classroom physical activity breaks program group and a control group to evaluate the effects of IcPAB on academic achievement, movement behaviors and health outcomes. The intervention design is based on the capability (C), opportunity (O) and motivation (M) behavior (B) (COM-B) model. A least 198 fifth graders will be recruited from two schools in Uva province, Sri Lanka. The recruitment process will start in late 2022. Class teachers of the intervention group will implement 5-min activity breaks at least three times a day after completing a training session. The primary variables include mathematics and reading achievement. The secondary variables include physical activity levels, steps count, sedentary behavior, body mass index, aerobic fitness, and perceived stress. Data collection will be implemented at pre-test and post-test, respectively. Intervention fidelity and the process will also be evaluated. Discussion: The IcPAB is designed to prevent pure educational time loss by introducing curriculum-integrated short bouts of physical active breaks into the classroom routine. If the IcPAB is effective, it can (1) improve the mathematics and reading achievement of fifth-grade girls and boys, which is a significant factor determining the performance at the Grade Five National Scholarship Examination in Sri Lanka; (2) improve movement behaviors as well as physical and mental health outcomes among primary school students. Sequentially, the IcPAB will enrich school-based physical activity intervention approaches which can in turn bring academic and health benefits to primary school children in Sri Lanka. Trial registration: The first version of the trial was registered with the ISRCTN registry (Ref: ISRCTN52180050) on 20/07/2022.

Tirzepatide and exercise training in obesity.

OBJECTIVES: The purpose of this study was to investigate the effects of 6 weeks of resistance training (RT) combined with aerobic training (AT) and Tirzepatide supplementation on lipid profiles, insulin resistance, anthropometric characteristics and physical fitness in prediabetic obese soldiers. METHODS: 61 obese men were randomly divided into six groups: Placebo; Tirzepatide 5 mg (T5); Tirzepatide 2.5 mg (T2.5); Hypertrophy, Strength, Power-Circuit Training+Placebo (Ex+P); Hypertrophy, Strength, Power-Circuit Training+Tirzepatide 5 mg (Ex+T5); Hypertrophy, Strength, Power-Circuit Training+Tirzepatide 2.5 mg (Ex+T2.5). All training groups performed aerobic training (AT) after resistance training. Subjects trained for six weeks, three sessions per week. Before and after the intervention period, the participants were evaluated for anthropometric measures, body composition [body weight, body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and fat mass (FM)], cardiorespiratory fitness (VO2max), and muscle strength (chest press 1RM and leg press 1RM). Blood biochemistry evaluations included triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), insulin level and insulin resistance (HOMA-IR). To evaluate the differences between the groups, ANCOVA statistical method was used along with Bonferroni's post hoc test, and the significance level was P <  0.05. RESULTS: Body weight, BMI, WC, FM, FBG, LDL-C, TC, TG and HOMA-IR were significantly decreased in Ex+P, Ex+T5 and Ex+T2.5 groups compared to Placebo, T5 and T2.5 groups. WHR significantly decreased in Ex+P, Ex+T5 and Ex+T2.5 groups compared to Placebo group. HDL-C, chest press and leg press significantly increased in Ex+P, Ex+T5 and Ex+T2.5 groups compared to Placebo, T5 and T2.5 groups. VO2max significantly increased and insulin significantly decreased in Ex+P group compared to Placebo, T5 and T2.5 groups. FM, FBG and TG were significantly decreased in both the T2.5 and T5 groups compared to Placebo group. HOMA-IR, LDL-C and TC significantly decreased in the T5 group compared to Placebo group. Also, leg press significantly increased in Ex+P group compared to all other groups. CONCLUSIONS: Performing six weeks of combined resistance and aerobic training in the form of RT+AT alone is more effective than the simultaneous use of Tirzepatide on cardiorespiratory fitness, strength, and modulating insulin levels. Taking Tirzepatide in doses of 5 mg and 2.5 mg in combination with exercise training did not have a significant advantage over exercise training alone. Finally, taking Tirzepatide in doses of 5 mg or 2.5 mg in combination with exercise training is not significantly superior to each other.

Redox signaling and skeletal muscle adaptation during aerobic exercise.

Redox regulation is a fundamental physiological phenomenon related to oxygen-dependent metabolism, and skeletal muscle is mainly regarded as a primary site for oxidative phosphorylation. Several studies have revealed the importance of reactive oxygen and nitrogen species (RONS) in the signaling process relating to muscle adaptation during exercise. To date, improving knowledge of redox signaling in modulating exercise adaptation has been the subject of comprehensive work and scientific inquiry. The primary aim of this review is to elucidate the molecular and biochemical pathways aligned to RONS as activators of skeletal muscle adaptation and to further identify the interconnecting mechanisms controlling redox balance. We also discuss the RONS-mediated pathways during the muscle adaptive process, including mitochondrial biogenesis, muscle remodeling, vascular angiogenesis, neuron regeneration, and the role of exogenous antioxidants.

Exploring biomechanical variations in ankle joint injuries among Latin dancers with different stance patterns: utilizing OpenSim musculoskeletal models.

Background: Dancers represent the primary demographic affected by ankle joint injuries. In certain movements, some Latin dancers prefer landing on the Forefoot (FT), while others prefer landing on the Entire foot (ET). Different stance patterns can have varying impacts on dancers' risk of ankle joint injuries. The purpose of this study is to investigate the differences in lower limb biomechanics between Forefoot (FT) dancers and Entire foot (ET) dancers. Method: A group of 21 FT dancers (mean age 23.50 (S.D. 1.12) years) was compared to a group of 21 ET dancers (mean age 23.33 (S.D. 0.94) years), performing the kicking movements of the Jive in response to the corresponding music. We import data collected from Vicon and force plates into OpenSim to establish musculoskeletal models for computing kinematics, dynamics, muscle forces, and muscle co-activation. Result: In the sagittal plane: ankle angle (0%-100%, p < 0.001), In the coronal plane: ankle angle (0%-9.83%, p = 0.001) (44.34%-79.52%, p = 0.003), (88.56%-100%, p = 0.037), ankle velocity (3.73%-11.65%, p = 0.017) (94.72-100%, p = 0.031); SPM analysis revealed that FT dancers exhibited significantly smaller muscle force than ET dancers around the ankle joint during the stance phase. Furthermore, FT dancers displayed reduced co-activation compared to ET dancers around the ankle joint during the descending phase, while demonstrating higher co-activation around the knee joint than ET dancers. Conclusion: This study biomechanically demonstrates that in various stance patterns within Latin dance, a reduction in lower limb stance area leads to weakened muscle strength and reduced co-activation around the ankle joint, and results in increased ankle inversion angles and velocities, thereby heightening the risk of ankle sprains. Nevertheless, the increased co-activation around the knee joint in FT dancers may be a compensatory response for reducing the lower limb stance area in order to maintain stability.

Impact of 24 h shifts on urinary catecholamine in emergency physicians: a cross-over randomized trial.

24-h shift (24 hS) exposed emergency physicians to a higher stress level than 14-h night shift (14 hS), with an impact spreading on several days. Catecholamines are supposed to be chronic stress biomarker. However, no study has used catecholamines to assess short-term residual stress or measured them over multiple shifts. A shift-randomized trial was conducted to study urinary catecholamines levels of 17 emergency physicians during a control day (clerical work on return from leave) and two working day (14 hS and 24 hS). The Wilcoxon matched-pairs test was utilized to compare the mean catecholamine levels. Additionally, a multivariable generalized estimating equations model was employed to further analyze the independent relationships between key factors such as shifts (compared to control day), perceived stress, and age with catecholamine levels. Dopamine levels were lower during 24 hS than 14 hS and the control day. Norepinephrine levels increased two-fold during both night shifts. Epinephrine levels were higher during the day period of both shifts than on the control day. Despite having a rest day, the dopamine levels did not return to their normal values by the end of the third day after the 24 hS. The generalized estimating equations model confirmed relationships of catecholamines with workload and fatigue. To conclude, urinary catecholamine biomarkers are a convenient and non-invasive strong measure of stress during night shifts, both acutely and over time. Dopamine levels are the strongest biomarker with a prolonged alteration of its circadian rhythm. Due to the relation between increased catecholamine levels and both adverse psychological effects and cardiovascular disease, we suggest that emergency physicians restrict their exposure to 24 hS to mitigate these risks.

Associations of bisphenol A exposure with metabolic syndrome and its components: A systematic review and meta-analysis.

Mounting evidence shows that bisphenol A (BPA) is associated with metabolic risk factors. The aim of this study was to review related epidemiologic studies and conduct a meta-analysis to quantitatively estimate the association between BPA and metabolic syndrome. Four electronic databases were systematically searched to identify suitable articles. A total of 47 published studies were finally included. Two studies involved metabolic syndrome. Of the 17, 17, 14, and 13 studies on the relationship between BPA with abdominal obesity, blood pressure, fasting plasma glucose, and dyslipidemia, 10, 6, 3, and 4 studies were included in the meta-analysis, respectively. The results showed that the risk of abdominal obesity increased with the increase of BPA exposure, especially in the group with higher BPA exposure levels (Quartile 2 vs. Quartile 1, pooled OR = 1.16, 95%CI: 1.01, 1.33; Q3 vs. Q1, pooled OR = 1.31, 95%CI: 1.13, 1.51; Q4 vs. Q1, pooled OR = 1.40, 95%CI: 1.21, 1.61). However, there was no significant correlation between BPA exposure and metabolic syndrome components including hypertension, abnormal fasting plasma glucose, and dyslipidemia. The present study found that BPA exposure is significantly associated with a higher risk of abdominal obesity. However, the relationship between BPA with metabolic syndrome and its other components needs further longitudinal studies to verify.

The influence of burnout on cardiovascular disease: a systematic review and meta-analysis.

Background: Burnout is a public health problem with various health consequences, among which cardiovascular disease is the most investigated but still under debate. Our objective was to conduct a systematic review and meta-analysis on the influence of burnout on cardiovascular disease. Methods: Studies reporting risk (odds ratio, relative risk, and hazard ratio) of cardiovascular disease following burnout were searched in PubMed, PsycINFO, Cochrane, Embase, and ScienceDirect. We performed a random-effect meta-analysis stratified by type of cardiovascular disease and searched for putative influencing variables. We performed sensitivity analyses using the most adjusted models and crude risks. Results: We included 25 studies in the systematic review and 9 studies in the meta-analysis (4 cross-sectional, 4 cohort, and 1 case-control study) for a total of 26,916 participants. Burnout increased the risk of cardiovascular disease by 21% (OR = 1.21, 95% CI 1.03 to 1.39) using the most adjusted risks and by 27% (OR = 1.27, 95% CI 1.10 to 1.43) using crude risks. Using stratification by type of cardiovascular disease and the most adjusted risks, having experienced burnout significantly increased the risk of prehypertension by 85% (OR = 1.85, 95% CI 1.00 to 2.70) and cardiovascular disease-related hospitalization by 10% (OR = 1.10, 95% CI 1.02 to 1.18), whereas the risk increase for coronary heart disease (OR = 1.79, 95% CI 0.79 to 2.79) and myocardial infarction (OR = 1.78, 95% CI 0.85 to 2.71) was not significant. Results were also similar using crude odds ratio. The risk of cardiovascular disease after a burnout was not influenced by gender. Insufficient data precluded other meta-regressions. Conclusions: Burnout seems to increase the risk of cardiovascular disease, despite the few retrieved studies and a causality weakened by cross-sectional studies. However, numerous studies focused on the pathophysiology of cardiovascular risk linked to burnout, which may help to build a preventive strategy in the workplace.

Resistance training modifies of serum levels of matrix metalloproteinase 2 and tissue inhibitor of matrix metalloproteinases in multiple sclerosis women - a randomized controlled trail.

The objectives of the present study was to investigate the effects of resistance training (RT) on serum levels of controlling blood-brain barrier (BBB) permeability indices and cognitive performance in MS women (MS-W). In this randomized control trail study (IRCT registration code: IRCT20120912010824N3, 07.09.2023), twenty-five MS-W were randomly divided into sedentary (MS) and resistance exercise (12 weeks/3 times per week/ 60-80% of 1RM) (MS + RT) groups. Fifteen healthy aged-matched women participated as a control group (HCON). The serum level of matrix metalloproteinase-2 (MMP-2), matrix metallopeptidase-9 (MMP-9), tissue metalloproteinase inhibitors-1 (TIMP-1), tissue metalloproteinase inhibitors-2 (TIMP-2), and S100 calcium-binding protein B (S100B) were assessed. In addition, cognitive performance was assessed pre- and post- intervention with the Brief International Cognitive Assessment for MS (BICAMS). A significant reduction in MMP-2, TIMP-2 serum levels, and MMP-2/TIMP-2 ratio were observed in post-test for MS + RT group (p < 0.01) in comparison to the HCON and MS groups; however, no changes were observed in MMP-9, TIMP-1, S100B and MMP-9/TIMP-1 ratio after RT (p > 0.05). The verbal learning was improved in post-test for MS + RT group (p < 0.01), although no change were observed for visuospatial memory and information processing speed (p > 0.05). These findings suggest that resistance training can modify some indices of BBB permeability and improve verbal learning in MS-W. The findings may also be beneficial as a non-pharmacological intervention to reduce inflammation.

Strength training improves heart function, collagen and strength in rats with heart failure.

BACKGROUND/OBJECTIVES: Myocardial infarction (MI) frequently leads to cardiac remodeling and failure with impaired life quality, playing an important role in cardiovascular deaths. Although physical exercise is a well-recognized effective non-pharmacological therapy for cardiovascular diseases, the effects of strength training (ST) on the structural and functional aspects of cardiac remodeling need to be further documented. In this study, we aimed to investigate the role of a linear block ST protocol in the rat model of MI. METHODS AND RESULTS: After 6 weeks of MI induction or sham surgery, male adult rats performed ST for the following 12 weeks. The ladder-based ST program was organized in three mesocycles of 4 weeks, with one load increment for each block according to the maximal carrying load test. After 12 weeks, the infarcted-trained rats exhibited an increase in performance, associated with reduced cardiac hypertrophy and pulmonary congestion compared with the untrained group. Despite not changing MI size, the ST program partially prevented cardiac dilatation and ventricular dysfunction assessed by echocardiography and hemodynamics, and interstitial fibrosis evaluated by histology. In addition, isolated cardiac muscles from infarcted-trained rats had improved contractility parameters in a steady state, and in response to calcium or stimuli pauses. CONCLUSIONS: The ST in infarcted rats increased the capacity to carry mass, associated with attenuation of cardiac remodeling and pulmonary congestion with improving cardiac function that could be attributed, at least in part, to the improvement of myocardial contractility.

A new method proposed for realizing human gait pattern recognition: Inspirations for the application of sports and clinical gait analysis.

BACKGROUND: Finding the best subset of gait features among biomechanical variables is considered very important because of its ability to identify relevant sports and clinical gait pattern differences to be explored under specific study conditions. This study proposes a new method of metaheuristic optimization-based selection of optimal gait features, and then investigates how much contribution the selected gait features can achieve in gait pattern recognition. METHODS: Firstly, 800 group gait datasets performed feature extraction to initially eliminate redundant variables. Then, the metaheuristic optimization algorithm model was performed to select the optimal gait feature, and four classification algorithm models were used to recognize the selected gait feature. Meanwhile, the accuracy results were compared with two widely used feature selection methods and previous studies to verify the validity of the new method. Finally, the final selected features were used to reconstruct the data waveform to interpret the biomechanical meaning of the gait feature. RESULTS: The new method finalized 10 optimal gait features (6 ankle-related and 4-related knee features) based on the extracted 36 gait features (85 % variable explanation) by feature extraction. The accuracy in gait pattern recognition among the optimal gait features selected by the new method (99.81 % ± 0.53 %) was significantly higher than that of the feature-based sorting of effect size (94.69 % ± 2.68 %), the sequential forward selection (95.59 % ± 2.38 %), and the results of previous study. The interval between reconstructed waveform-high and reconstructed waveform-low curves based on the selected feature was larger during the whole stance phase. SIGNIFICANCE: The selected gait feature based on the proposed new method (metaheuristic optimization-based selection) has a great contribution to gait pattern recognition. Sports and clinical gait pattern recognition can benefit from population-based metaheuristic optimization techniques. The metaheuristic optimization algorithms are expected to provide a practical and elegant solution for sports and clinical biomechanical feature selection with better economy and accuracy.

The effects of non-Newtonian fluid material midsole footwear on tibial shock acceleration and attenuation.

Introduction: Given the possibility of higher ground temperatures in the future, the pursuit of a cushioning material that can effectively reduce sports injuries during exercise, particularly one that retains its properties at elevated temperatures, has emerged as a serious concern. Methods: A total of 18 man recreational runners were recruited from Ningbo University and local clubs for participation in this study. Frequency analysis was employed to investigate whether there is a distinction between non-Newtonian (NN) shoes and ethylene vinyl acetate (EVA) shoes. Results: The outcomes indicated that the utilization of NN shoes furnished participants with superior cushioning when engaging in a 90° cutting maneuver subsequent to an outdoor exercise, as opposed to the EVA material. Specifically, participants wearing NN shoes exhibited significantly lower peak resultant acceleration (p = 0.022) and power spectral density (p = 0.010) values at the distal tibia compared to those wearing EVA shoes. Moreover, shock attenuation was significantly greater in subjects wearing NN shoes (p = 0.023) in comparison to EVA shoes. Performing 90° cutting maneuver in NN shoes resulted in significantly lower peak ground reaction force (p = 0.010), vertical average loading rate (p < 0.010), and vertical instantaneous loading rate (p = 0.030) values compared to performing the same maneuvers in EVA shoes. Conclusion: The study found that the PRA and PSD of the distal tibia in NN footwear were significantly lower compared to EVA footwear. Additionally, participants exhibited more positive SA while using NN footwear compared to EVA. Furthermore, during the 90° CM, participants wearing NN shoes showed lower PGRF, VAIL, and VILR compared to those in EVA shoes. All these promising results support the capability of NN footwear to offer additional reductions in potential injury risk to runners, especially in high-temperature conditions.

Psychosocial interventions seem redact kinesiophobia after anterior cruciate ligament reconstruction but higher level of evidence is needed: a systematic review and meta-analysis.

PURPOSE: Psychosocial interventions have shown potential in reducing the fear of re-injury after anterior cruciate ligament reconstruction (ACLR), but this has not been systematically reviewed. The aim of this study was to assess the available evidence on the effect of psychosocial interventions on kinesiophobia after ACLR. METHODS: Two independent researchers conducted a systematic search in the electronic databases including Scopus, PubMed, Web of Science (WOS), SPORTDiscus, PsycINFO, and CINAHL from their inception until May 2022. They included studies that utilised a randomised controlled study design with a control group, and measured kinesiophobia using the Tampa Scale for kinesiophobia in patients who underwent primary ACLR. The outcome of interest was the mean and standard deviation of kinesiophobia. Extracted data were analysed using Comprehensive Meta-Analysis software, version 3.0 (CMA.V2), employing a random-effects model to calculate the overall effect estimates of psychosocial interventions on Kinesiophobia. The standardised mean difference with 95% confidence intervals (CIs) was computed based on the mean and standard deviation in each group. RESULTS: This systematic review and meta-analysis included 5 randomised controlled trials with a total of 213 patients who underwent ACLR. The results of the meta-analysis showed that psychosocial intervention was more effective than non-psychosocial comparators in reducing kinesiophobia among patients who underwent a primary ACLR (5 trials, MD 0.56, 95% CI 0.28-0.83, p < 0.001). The heterogeneity score was zero (I2 = 0%; n.s. for Cochran's Q test), indicating no significant variation among the studies. CONCLUSIONS: Psychosocial interventions can alleviate kinesiophobia in patients with primary ACLR. Although the limited number of reviewed studies and their methodological limitations precludes drawing a definitive conclusion regarding the effectiveness of psychosocial interventions on kinesiophobia, these promising findings can serve as a basis for developing psychological strategies to manage kinesiophobia in patients with primary ACLR and can also guide future research this issue. LEVEL OF EVIDENCE: II. TRIAL REGISTRATION: This trial is registered in PROSPERO on December 2021 (CRD42021282413).

Effect of Supervised and Unsupervised Exercise Training in Outdoor Gym on the Lifestyle of Elderly People.

The aim of this study was to investigate the effectiveness of supervised and unsupervised physical training programs using outdoor gym equipment on the lifestyles of elderly people. METHODS: physically independent elderly people were randomly distributed into three groups: supervised training (n: 20; ST), unsupervised training (n: 20; UT) and control (n: 20; C). The ST and UT groups completed a 12-week program, with exercises performed three times a week. The ST group underwent weekly 30 min sessions consisting of a 5 min warm-up (walking at 60% of HRmax), followed by 20 sets of 30, "monitored by a metronome with 30" of passive recovery between sets and a five-minute cool-down. The following equipment was used: elliptical, rowing, surfing and leg press. The UT group was instructed to freely attend the gym and train spontaneously using the same equipment used by ST. Lifestyle changes were evaluated using a questionnaire containing specific domains. RESULTS: no significant differences were identified in the domains for family, physical activity, nutrition, smoking, sleep, behavior, introspection, work and overall score; however, the values corresponding to the alcohol domain for the ST and UT groups were lower (p < 0.05) than the C group, remaining even lower after the 12 weeks of intervention. Time effect (p < 0.05) was found only in the ST group for the physical domains, sleep, behavior and overall score. CONCLUSION: elderly people submitted to supervised and unsupervised physical exercise programs using outdoor gym equipment present positive changes in lifestyle parameters compared to physical inactive elderly people.

The effectiveness of dance movement interventions for older adults with mild cognitive impairment, Alzheimer's disease, and dementia: A systematic scoping review and meta-analysis.

OBJECTIVES: To synthesize evidence and summarize research findings related to the effectiveness and feasibility of dance movement intervention (DMI) in older adults with mild cognitive impairment (MCI), Alzheimer's disease (AD), and dementia; to systemically map existing research gaps and research directions for future practice. METHODS: A systematic search was conducted using six electronic databases: Web of Science, PubMed, PsycINFO, MEDLINE, ScienceDirect, and Cochrane Central Register of Controlled Trials. The methodological quality of included studies was assessed using the Cochrane Risk of Bias Tool for Randomized Trials (RoB 2) and The Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I). RESULTS: 29 dance intervention studies (13 RCT studies) were included in the scoping review: 62% of MCI, 10% of AD, and 28% of dementia; a total of 1708 participants (Female=1247; Male=461) aged from 63.8 ( ± 5.24) to 85.8 ( ± 5.27) years old. Eight RCT studies were included in the meta-analysis; results indicated that dance interventions had a significant effect on global cognition, memory, balance, and significantly decreased depression. No significant effects were found for executive function. CONCLUSIONS: Dance is a non-pharmacological, effective, affordable, and engaging intervention that can be used as a complementary treatment for older adults with MCI, AD, and dementia.

A Systematic Review and Meta-Analysis Investigating Head Trauma in Boxing.

OBJECTIVES: Although physical trauma has been reported in boxing since its inception, boxing still appeals to athletes and spectators. This systematic review and meta-analysis assess both acute and chronic neurological and neuropsychological effects that boxing has on the brain. Further assessments in terms of comparisons of the concussion ratio in boxing to other combat sports, as well as the efficiency of wearing headguards, are also performed. DATA SOURCES: This systematic review and meta-analysis used the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. The outcomes incorporated included physical chronic abnormalities of the brain, neuropsychiatric, and neurological disorders sustained in amateur or professional boxing, in addition to the safety benefits of boxing headguards. Odds ratios, descriptive statistics, and inferential statistics are also reported. MAIN RESULTS: From the 84 articles reviewed, the 35 included articles suggested that boxers have a significantly elevated risk of sustaining a concussion compared with other combat sports (risk ratio [RR]: 0.253 vs RR: 0.065, P < 0.001). From the 631 amateur and professional boxers analyzed, 147 (23.30%) had cavum septum pellucidum, whereas 125 of 411 amateur and professional boxers (30.41%) presented with some form of brain atrophy. Dementia or amnesia was observed in 46 of 71 boxers (61.79%), 36 of 70 (51.43%) had various forms and severities of cognitive disorders, and 57 of 109 (52.29%) displayed abnormal computed tomography or electroencephalogram scan results. Utilization of headguards significantly increased the risk for stoppages in amateur bouts, compared with boxers not wearing a headguard (OR: 1.75 vs 0.53, P < 0.050). CONCLUSIONS: Boxing is a hazardous sport that has the potential to have fatal and negative life-changing results. Because of the limited reliable data regarding the efficiency of boxing headguards, future research should focus on the overall significance that headguards may have for reducing head trauma.

Adaptive neuro-fuzzy inference system model driven by the non-negative matrix factorization-extracted muscle synergy patterns to estimate lower limb joint movements.

BACKGROUND AND OBJECTIVE: For patients with movement disorders, the main clinical focus is on exercise rehabilitation to help recover lost motor function, which is achieved by relevant assisted equipment. The basis for seamless control of the assisted equipment is to achieve accurate inference of the user's movement intentions in the human-machine interface. This study proposed a novel movement intention detection technology for estimating lower limb joint continuous kinematic variables following muscle synergy patterns, to develop applications for more efficient assisted rehabilitation training. METHODS: This study recruited 16 healthy males and 16 male patients with symptomatic patellar tendinopathy (VISA-P: 59.1 ± 8.7). The surface electromyography of 12 muscles and lower limb joint kinematic and kinetic data from healthy subjects and patients during step-off landings from 30 cm-high stair steps were collected. We subsequently solved the preprocessed data based on the established recursive model of second-order differential equation to obtain the muscle activation matrix, and then imported it into the non-negative matrix factorization model to obtain the muscle synergy matrix. Finally, the lower limb neuromuscular synergy pattern was then imported into the developed adaptive neuro-fuzzy inference system non-linear regression model to estimate the human movement intention during this movement pattern. RESULTS: Six muscle synergies were determined to construct the muscle synergy pattern driven ANFIS model. Three fuzzy rules were determined in most estimation cases. Combining the results of the four error indicators across the estimated variables indicates that the current model has excellent estimated performance in estimating lower limb joint movement. The estimation errors between the healthy (Angle: R2=0.98±0.03; Torque: R2=0.96±0.04) and patient (Angle: R2=0.98±0.02; Torque: R2=0.96±0.03) groups are consistent. CONCLUSION: The proposed model of this study can accurately and reliably estimate lower limb joint movements, and the effectiveness will also be radiated to the patient group. This revealed that our models also have certain advantages in the recognition of motor intentions in patients with relevant movement disorders. Future work from this study can be focused on sports rehabilitation in the clinical field by achieving more flexible and precise movement control of the lower limb assisted equipment to help the rehabilitation of patients.

A Data-Driven Approach for Fatigue Detection during Running Using Pedobarographic Measurements.

Background: Detecting fatigue at the early stages of a run could aid training programs in making adjustments, thereby reducing the heightened risk of injuries from overuse. The study aimed to investigate the effects of running fatigue on plantar force distribution in the dominant and nondominant feet of amateur runners. Methods: Thirty amateur runners were recruited for this study. Bilateral time-series plantar forces were employed to facilitate automatic fatigue gait recognition using convolutional neural network (CNN) and CNN-based long short-term memory network (ConvLSTM) models. Plantar force data collection was conducted both before and after a running-induced fatigue protocol using a FootScan force plate. The Keras library in Python 3.8.8 was used to train and tune deep learning models. Results: The results demonstrated that more mid-forefoot and heel force occurs during bilateral plantar and less midfoot fore force occurs in the dominant limb after fatigue (p < 0.001). The time of peak forces was significantly shortened at the midfoot and sum region of the nondominant foot, while it was delayed at the hallux region of the dominant foot (p < 0.001). In addition, the ConvLSTM model showed higher performance (Accuracy = 0.867, Sensitivity = 0.874, and Specificity = 0.859) in detecting fatigue gait than CNN (Accuracy = 0.800, Sensitivity = 0.874, and Specificity = 0.718). Conclusions: The findings of this study could offer empirical data for evaluating risk factors linked to overuse injuries in a single limb, as well as facilitate early detection of fatigued gait.