Present but Ignored: Physical Condition and Health-Related Quality of Life in College-Aged Females with Generalized Joint Hypermobility.

BACKGROUND: Generalized joint hypermobility (GJH) is prevalent among young adults, necessitating effective monitoring of musculoskeletal health, particularly among college-aged females. This study aimed to identify physical fitness and health-related quality of life (HR-QoL) characteristics associated with GJH. METHODS: A total of 67 participants were assessed: 26 with GJH (mean age 20.06, SD 1.2 years), and 41 without (mean age 20.15, SD 2.2 years). Assessments included hypermobility, anthropometric data, foot posture, balance, flexibility, strength, and HR-QoL. We used the Mann-Whitney test for two independent samples, categorical variables were analyzed with Cramer's V test. The results indicated that participants with GJH exhibited inferior balance and back muscle static strength endurance but greater flexibility compared to those without GJH. Significant differences were observed in foot posture. However, handgrip strength, explosive strength, and abdominal muscle static strength endurance did not differ significantly between groups. No significant differences were observed in HR-QoL components between the two groups. In conclusion, there appears to be a link between GJH and increased flexibility, impaired balance, reduced back muscle static strength endurance, and altered posture of both feet.

Caesarean Section Scar and Placental Location at the First Trimester of Pregnancy-A Prospective Longitudinal Study.

Background and Objectives: This study aims to report the location of the placenta in the first trimester of pregnancy in groups of women according to the number of previous caesarean deliveries and the visibility of the caesarean scar niche. Materials and Methods: The prospective observational research included adult women aged 18 to 41 years during pregnancy after one or more previous caesarean sections (CSs). Transvaginal (TVS) and transabdominal sonography (TAS) was used to examine the uterine scar and placental location during 11-14 weeks. The CS scar niche ("defect") was bordered in the sagittal plane as a notch at the previous CS scar's site with a depth of 2.0 mm or more. A comparative analysis of the placental location (high or low and anterior or posterior) was performed between groups of women according to the CS number and the CS scar niche. Results: A total of 122 participants were enrolled during the first-trimester screening. The CS scar defect ("niche") was visible in 40.2% of cases. In cases after one previous CS, the placenta was low in the uterine cavity (anterior or posterior) at 77.4%, and after two or more CSs, it was at 67.9%. Comparing the two groups according to the CS scar niche, the placenta was low in 75.5% of cases in the participant group with a CS scar niche and in 75% of cases without a CS scar niche (p = 0.949). Conclusions: The number of previous caesarean deliveries has no effect on the incidence rate of low-lying placentas in the first trimester. Moreover, the presence of the CS scar niche is not associated with anterior low-lying placentas.

Cross-cultural adaptation and validation of the Lithuanian version of the Spine Functional Index.

BACKGROUND: Low back pain is one of the most frequent medical problems caused by different factors. It is important to evaluate low back pain by choosing the best suited tool for the specific spine condition and pain severity. The Spine Functional Index (SFI) is a relatively new physical functioning-related questionnaire that can be used to assess different aspects of daily activities and movements. The purpose of this study was to cross-culturally adapt the SFI for the Lithuanian language and to determine its psychometric properties of validity, reliability, construct stability, internal consistency and factor structure. METHODS: The study was designed as a two-stage observational study. Double forward and backward translations of SFI were performed for cultural adaptation for the Lithuanian language. For evaluation of psychometric properties, 125 participants with non-specific low back pain (duration of symptoms ≥ 6 weeks) rated their pain using Numeric Rating Scale, completed the Lithuanian version of SFI and Oswestry Disability Index. In 3 to 7 days all participants completed Lithuanian version SFI for the second time. The full sample was employed to determine internal consistency, test-retest reliability, construct stability, measurement error, construct validity and factor structure. RESULTS: There was good internal consistency and reliability with Lithuanian version of SFI as Cronbach's α = 0.92 and r = 0.82. Spearman-Brown coefficient was 0.97 representing good construct stability. Measurement error from standard error of the mean (SEM) was 6.96, from Minimal Detectable Change (MDC) was 16.24. Construct validity between the Lithuanian version of SFI and Oswestry Disability Index was excellent (ρ = 0.83), and good between the SFI and Numeric Rating Scale (ρ = 0.55). The factor analysis demonstrated a one-factor solution explaining 35.04% of total variance. CONCLUSION: Lithuanian version of SFI is a new reliable and valid instrument for functional evaluation of back pain in Lithuanian speaking patients.

Feasibility of the optimal cerebral perfusion pressure value identification without a delay that is too long.

Optimal cerebral perfusion pressure (CPPopt)-targeted treatment of traumatic brain injury (TBI) patients requires 2-8 h multi-modal monitoring data accumulation to identify CPPopt value for individual patient. Minimizing the time required for monitoring data accumulation is needed to improve the efficacy of CPPopt-targeted therapy. A retrospective analysis of multimodal physiological monitoring data from 87 severe TBI patients was performed by separately representing cerebrovascular autoregulation (CA) indices in relation to CPP, arterial blood pressure (ABP), and intracranial pressure (ICP) to improve the existing CPPopt identification algorithms. Machine learning (ML)-based algorithms were developed for automatic identification of informative data segments that were used for reliable CPPopt, ABPopt, ICPopt and the lower/upper limits of CA (LLCA/ULCA) identification. The reference datasets of the informative data segments and, artifact-distorted segments, and the datasets of different clinical situations were used for training the ML-based algorithms, allowing us to choose the appropriate individualized CPP-, ABP- or ICP-guided management for 79% of the full monitoring time for the studied population. The developed ML-based algorithms allow us to recognize informative physiological ABP/ICP variations within 24 min intervals with an accuracy up to 79% (compared to the initial accuracy of 74%) and use these segments for timely optimal value identification or CA limits determination in CPP, ABP or ICP data. Prospective clinical studies are needed to prove the efficiency of the developed algorithms.

Sexual behavior of Lithuanian high school students.

OBJECTIVE: To evaluate the sexual behavior of Lithuanian high school students. STUDY DESIGN: School-based anonymous self-administered survey of high school students, conducted from February to June 2017. RESULTS: Of 167 invited schools, 113 (67.7%) agreed to participate in the survey with a response rate of 75% among invited students (8143/10,811). Respondents' median age was 18 (range 16-20) years. Nearly one-third of students (31.3%) reported sexual intercourse with a median age at coitarche of 17 years. Most (82.9%) used contraception at coitarche. Contraception at coitarche was more common among those who were sober at coitarche (aOR 2.2, 95% CI 1.5-3.2). Students whose parents had discussed sex with them were more likely to plan coitarche (aOR 1.3, 95% CI 1.1-1.5). Students searching for information about sexual life more often had their coitarche sober than those not searching for information (29.7% (n = 60) vs 21.1% (n = 497, p = 0.006). CONCLUSIONS: Every fifth high school student reported contraceptive nonuse; however, only 6% indicated the use of reliable dual contraception during the first sexual intercourse. IMPLICATIONS: Efforts are needed to improve the sexual education offered to Lithuanian adolescents to ensure the many sexually active adolescents are aware of how to protect themselves from infection and undesired pregnancy.

Yoga's Effects on the Cardiovascular System of Healthy Women: Implications for Best Practices.

CONTEXT: Yoga as a form of physical activity is growing in popularity. During yoga, individuals interrupt the stress response, which is typically associated with high blood pressure (BP), impaired focus, and high levels of anxiety. Consequently, research into yoga's effects on stress should place a special emphasis upon the interplay of the nervous and cardiovascular systems during yoga practice. OBJECTIVE: The purpose of this study was to delineate the immediate cardiovascular effects of 12 Hatha yoga poses by means of RR (beat-to-beat) intervals and JT (cardiac repolarization) intervals. DESIGN: The research team designed controlled pilot studies based on half-year periods. SETTING: The study took place at the Lithuanian University of Health Sciences in Kaunas, Lithuania. PARTICIPANTS: Participants were women who were long-term yoga practitioners. Three studies occurred: (1) Study 1-10 women with a mean age of 30.1 ± 1.9 years, (2) Study 2-10 women with a mean age of 29.9 ± 1.9 years, and (3) Study 3-22 women with a mean age of 32.9 ± 1.8 years. INTERVENTION: The study examined the acute cardiovascular effects of 12 Hatha yoga poses by means of electrocardiogram parameters. OUTCOME MEASURES: Anthropometrical and physiological parameters were measured: (1) height and weight; (2) body mass index (BMI); (3) heart rate (HR); (4) systolic and diastolic blood pressure (DBP); and (5) electrocardiogram (ECG) RR and JT intervals. RESULTS: The lowest RR interval value was recorded during the Chaturanga Dandasana, at 456.0 ± 16.5 ms in Study 3, with P < .001 compared to the intervals for all the other poses. Significant differences in the JT interval also emerged during the Chaturanga Dandasana, at 177.3 ± 6.0 ms in Study 3 with P < .001 compared to all the other poses. The next lowest RR interval value was recorded in Study 3 during the Utkatasana, at 569.4 ± 17.6 ms. In the Savasana prior to the program, the RR interval increased in study 1 and decreased in studies 2 and 3. The JT interval in the Savasana prior to the program increased in studies 1 and 2 but decreased in study 3. CONCLUSIONS: Healthy women can practice a modified and/or a shorter duration of the Chaturanga Dandasana. Adjustments in the Utkatasana, including having the arms in the prayer position, may help prevent strain to the cardiovascular system. Also, practicing poses with a longer RR interval may aid stress-related health problems.

Change of Cognitive Functions after Stroke with Rehabilitation Systems.

The objective of this study is to assess and compare the effect of applying a computerised cognitive training programme and virtual environment rehabilitation system on cognitive functions in patients after a stroke. METHODS: A controlled trial included 121 persons referred to second stage rehabilitation. The subjects were differentiated into three impact groups by a single blinded trial. RESULTS: The trial revealed that cognitive functions improved in all patient groups (p<0.001). A paired comparison analysis of all groups demonstrated a tendency for cognitive functions, evaluated by the MoCA-LT test, to be more strongly improved in patients who practised a computerised cognitive training programme during their OT sessions than those who did not (p=0.054). CONCLUSIONS: The final outcome of the trial was that cognitive functions significantly improved in patients who practised computerised cognitive training programmes or virtual environment rehabilitation systems, compared to those participants who only had occupational therapy sessions.

Exploring the Aortic Root Diameter and Left Ventricle Size Among Lithuanian Athletes.

Background and objectives: Aortic rupture is known as one of the potential causes of sudden cardiac death in athletes. Nevertheless, adaptation strategies for aortic root dilation in athletes vary. The purpose of this study was to investigate aortic root adaptation to physical workload and to determine if aortic roots and left ventricle sizes are contingent upon the physical workload. Materials and Methods: Echocardiography was applied to 151 subjects to measure the aortic root at aortic valve annulus (AA) and at sinus of Valsalva (VS). 122 were athletes (41 females and 81 males) and 29 were non-athletes (14 females and 15 males). Of the 41 female athletes, 32 were endurance athletes, and 9 were strength athletes. From 81 male athletes, 56 were endurance athletes, and 25 were strength athletes. AA and VS mean values for the body surface area were presented as AA relative index with body surface area (rAA) and VS relative index with body surface area (rVS). Left ventricle (LV) measures included LV end-diastolic diameter (LVEDD), interventricular septum thickness in diastole (IVSTd), LV posterior wall thickness in diastole (LVPWTd), LV mass (LVM), LV mass index, and LV end-diastolic diameter index (LVEDDI). Results: Results indicated that VS was higher in female athletes (28.9 ± 2.36 mm) than in non-athletes (27.19 ± 2.87 mm, p = 0.03). On the other hand, rAA was higher in strength athletes (12.19 ± 1.48 mm/m2) than in endurance athletes (11.12 ± 0.99 mm/m2, p = 0.04). Additionally, rVS and rAA were higher in female strength athletes (17.19 ± 1.78 mm/m2, 12.19 ± 1.48 mm/m2) than female basketball players (15.49 ± 1.08 mm/m2, p = 0.03, 10.75 ± 1.06 mm/m2, p = 0.02). No significant differences regarding aortic root were found between male athletes and non-athletes. Statistically significant positive moderate correlations were found between VS and LVEDD, LVM, IVSTd, LVPWTd, rVS, and LVEDDI parameters in all athletes. Conclusion: The diameter of Valsalva sinus was greater in female athletes compared to non-athletes. The rAA mean value for body surface area was greater in female athletes practising strength sports as compared to their counterparts who were practising endurance sports. The diameter of the aortic root at sinuses positively correlated with the LV size in all athletes.

Not only static: Stabilization manoeuvres in dynamic exercises - A pilot study.

This study examined characteristics of trunk muscles electrical activity in young adults performed in the course of static and dynamic trunk muscles strengthening exercises using different lumbar spine stabilization manoeuvres. Twenty young adults (Mage = 25.5 SD = 2.91) participated in this study. Of the 20, 11 subjects (5 males and 6 females) reported no history of pain, 9 subjects (5 males and 4 females) reported lower back pain (LBP) within the last three months. Subjects performed lumbar spine stabilization manoeuvres (abdominal bracing (AB) and abdominal hollowing (AH)) with static and dynamic abdominal muscles strengthening exercises (i.e., plank, side-bridges, and curl-ups). Noraxon Telemyo twelve channel electromyography device (Noraxon USA, Inc.) was used to record EMG data from rectus abdominal muscle (RA), external oblique muscles (EO), internal oblique muscles (IO), and erector spine muscles (ES). In static exercises such as side-bridge exercise, significantly higher RA muscle electrical activity was recorded with AB manoeuvre compared to AH manoeuvre both on the right side and left side respectively (Z = -2.17; p = 0.03; Z = 3.40; p = 0.001). In dynamic exercises such as curl-up exercise, during the lifting phase, median value of RA muscle activity with AB was significantly higher than with AH (Z = -2.315; p = 0.021). Median value of IO muscles activity with AH was significantly higher than with AB (Z = -3.230; p = 0.001). Our findings indicated that although surface muscles are more activated with AB manoeuvre exercises, deep abdominal muscles are more activated in exercises with AH manoeuvre. These findings can help practitioners design interventions to integrate AH manoeuvre for benefiting persons with lumbar instability.

Graphical and statistical analyses of the oculocardiac reflex during a non-invasive intracranial pressure measurement.

PURPOSE: This study aimed to examine the incidence of the oculocardiac reflex during a non-invasive intracranial pressure measurement when gradual external pressure was applied to the orbital tissues and eye. METHODS: Patients (n = 101) and healthy volunteers (n = 56) aged 20-75 years who underwent a non-invasive intracranial pressure measurement were included in this retrospective oculocardiac reflex analysis. Prespecified thresholds greater than a 10% or 20% decrease in the heart rate from baseline were used to determine the incidence of the oculocardiac reflex. RESULTS: None of the subjects had a greater than 20% decrease in heart rate from baseline. Four subjects had a greater than 10% decrease in heart rate from baseline, representing 0.9% of the total pressure steps. Three of these subjects were healthy volunteers, and one was a glaucoma patient. CONCLUSION: The incidence of the oculocardiac reflex during a non-invasive intracranial pressure measurement procedure was very low and not associated with any clinically relevant effects.

Correlation between Changes in Local Earth's Magnetic Field and Cases of Acute Myocardial Infarction.

The impact of changes in the geomagnetic field on the human body remains the subject of studies across the world, yet there is no consensus. Current studies are observing effects that require further work by researchers in order to find out the mechanisms that would allow a proper assessment of the correlations between the Earth's magnetic field variations and changes in human organisms. The main purpose of this study was to investigate possible correlations between the strength of time-varying aspects of the local Earth's magnetic field and incidence of myocardial infarctions. Study participants included 435 males and 268 females who had diagnosis of myocardial infarction during the period of 1 January 2016 to 31 December 2016 and attended the Department of Cardiology at the Hospital of Lithuanian University of Health Sciences (LUHS), Kauno klinikos. Time varying magnetic field data was collected at the magnetometer site located in Lithuania. After mathematical analysis, the results support the hypothesis that the Earth's magnetic field has a relationship between the number of acute myocardial infarction with ST segment elevation (STEMI) cases per week and the average weekly geomagnetic field strength in different frequency ranges. Correlations varied in different age groups as well as in males and females, which may indicate diverse organism sensitivity to the Earth's magnetic field.

The effect of differential training-based occupational therapy on hand and arm function in patients after stroke: Results of the pilot study.

OBJECTIVE: The aim of this study was to evaluate the effect of differential training-based occupational therapy on the recovery of arm function and to compare these data with the results obtained after conventional occupational therapy. METHODS: A total of 27 patients who had suffered a cerebral infarction in the left brain hemisphere were recruited for the study. There were 9 men (33.33%) and 18 women (66.67%). All the patients had paresis of the right arm. The patients were divided into 2 groups: the control group comprised 15 patients who were given conventional occupational therapy (5 times per week) and the study group consisted of 12 patients who underwent conventional occupational therapy (3 times per week) along with occupational therapy based on differential training (2 times per week). RESULTS: In the control group, the mean performance time of only 2 tasks, i.e., flip cards and fold towel, improved significantly (P<0.05), while significant deterioration in the mean performance time of the task "lift can" was observed (P<0.05). In the study group, the mean performance time of all the tasks except for forearm to box (side), hand to box (front), and lift paperclip improved significantly (P<0.05), and no deterioration in arm function was observed. CONCLUSION: Both patients' groups improved arm function after occupational therapy sessions, but the patients who underwent conventional occupational therapy along with differential training-based occupational therapy recovered their arm function more effectively than their counterparts after conventional occupational therapy.

Assessment of the effect of anthropometric data on the alterations of cardiovascular parameters in Lithuanian elite male basketball players during physical load.

OBJECTIVES. The aim of the study was to assess the effect of the anthropometric data of basketball players on the alterations of cardiovascular parameters during the physical load applying the model of integrated evaluation. MATERIAL AND METHODS. The research sample consisted of 113 healthy Caucasian male basketball players, candidates of the Lithuanian National men's basketball teams. Basketball players were divided into 2 groups: 69 taller and heavier male basketball players (with a higher percentage of body fat) (TMB) and 44 shorter and less heavy male basketball players (with a lower percentage of body fat) (SMB). The amount of fat, expressed in percentage, was measured using the body composition analyzer TBF-300. "Kaunas-Load," a computerized ECG analysis system, was used to evaluate the functional condition of the cardiovascular system during the load. RESULTS. The TMB group had a lower heart rate during the warming-up phase and the steady state of the load as compared with the SMB group (P<0.05). The JT interval in the TMB group was greater during the warming-up and the steady state as compared with the SMB group (P<0.05). The JT/RR ratio index in the TMB group was found to be lower in the warming-up phase and in the steady state compared with the respective parameter in the SMB group (P<0.05). CONCLUSIONS. The cardiovascular system of taller and heavier male basketball players with a greater relative amount of body fat functioned more economically.

Assessment of functional conditions of basketball and football players during the load by applying the model of integrated evaluation.

UNLABELLED: We consider the human body as an adaptable, complex, and dynamic system capable of organizing itself, though there is none, the only one, factor inside the system capable of doing this job. Making use of the computerized ECG analysis system "Kaunas-load" with parallel registration of ECG carrying out body motor characteristics, ABP, or other processes characterizing hemodynamics enable one to reveal and evaluate the synergistic aspects of essential systems of the human body what particularly extends the possibilities of functional diagnostics. The aim of the study was to determine the features of alterations in the functional condition of basketball and football players and nonathletes during the bicycle ergometry test by applying the model of evaluation of the functional condition of the human body. MATERIAL AND METHODS: The study population consisted of 266 healthy athletes and nonathletes. Groups of male basketball players, male football players, male nonathletes, female basketball players, and female nonathletes were studied. A computerized ECG analysis system "Kaunas-load" that is capable of both registering and analyzing the power developed by the subject and 12-lead ECG synchronically were used for evaluating the functional condition of the CVS. The subject did a computer-based bicycle ergometry test. The following ECG parameters at rest and throughout the load - HR, JT interval, and the deduced JT/RR ratio index that reflects the condition between regulatory and supplying systems - were evaluated. After measuring ABP, the pulse amplitude (S-D) was evaluated. The pulse blood pressure ratio amplitude (S-D)/S that depicts the connection between the periphery and regulatory systems was also evaluated. Speeds of changes in physiological parameters during physical load were evaluated too. RESULTS: Heart rate and JT/RR ratio of athletes at the rest and during load were lower, and JT interval of rest was longer and became shorter more slowly during load, compared to that of healthy nonathletes. The pulse arterial blood pressure amplitude of men at rest and during load was higher than that of women. The pulse ABP amplitude of athletes was higher than that of nonathletes. The relative pulse ABP amplitude in the state of rest in the groups of men was higher than in groups of women. The relative pulse amplitude of female basketball players at rest and during load was higher than that of female nonathletes. Significant differences in the dynamics of speed of changes in HR, the pulse ABP amplitude, and the relative pulse ABP amplitude of male and female basketball players, male football players, as well as male and female nonathletes were observed. CONCLUSIONS: The newly deduced parameters, namely, speeds of changes in the parameters with changes in the phase of the load reflect very well peculiarities of functional condition of the human body during bicycle ergometry test. The sum total of those newly deduced parameters and customary parameters reveals new functional peculiarities of the human body.