Musculoskeletal System and Gait Characteristics in Patients with Osteogenesis imperfecta.

OBJECTIVES: The aim of the study was to assess the muscoloskeletal system and spatiotemporal gait parameters of patients in three types of osteogenesis imperfecta. DESIGN STUDY: Retrospective observational study. SETTINGS: The Department of Rehabilitation, Children's Memorial Health Institute in Warsaw, Poland. PARTICIPANTS: This study investigated individuals with various types of osteogenesis imperfecta: 33 with osteogenesis imperfecta I (aged 13.9), 16 with osteogenesis imperfecta III (aged 10.4), and 14 with osteogenesis imperfecta IV (aged, 15.8), as well as a reference group of 400 healthy individuals. MAIN MEASURES: The musculoskeletal assessment included: medical record review, clinical evaluation, functional tests, long bone deformity assessment via clinical and X-ray examination, and objective gait analysis with the Vicon Motion Systems (Ltd, Oxford, UK). RESULTS: The study revealed notable differences in clinical presentation, deformities within the musculoskeletal system, gait parameters across the various types of osteogenesis imperfecta (p < 0.001). The most affected gait parameters were: cadence, gait speed and step length. The greatest deformities of lower limbs and spine were presented in patients with osteogenesis imperfecta type III. CONCLUSIONS: These findings are significant for understanding gait abnormalities in osteogenesis imperfecta patients and designing customized physiotherapy programs to help them participate fully in daily life. Improvement of muscle strength is one of the key for easier engagement in activities like walking or stair-climbing.

The Impact of Resistance Training on Equilibrium Abilities and Quality of Life in Older Adults after SARS-CoV-2 Survival.

Background: The scientific literature on COVID-19 and its long-term impacts on all-body systems and their treatments is still limited. The aim of the study was to create a safe protocol-based intervention to improve functional and equilibrium abilities in older adults impacted by COVID-19. Methods: This study used a sample of 46 people (intervention group: n = 26; control group: n = 20). Resistance training (RT) was held twice a week, with 60 min per session for 8 weeks. The postural stability and quality of life questionnaire (WHQOOL) was completed during pre- and post-testing. Results: The results indicated significant differences in overall stability index (OSI) with eyes open (EO), anterior-posterior stability index (APSI) EO, fall-risk index 6-2 (FRI6-2) values in males (p < 0.05), and APSI EO (p < 0.05) values in females compared to control groups, respectively. In the training, a significant improvement was reported in OSI EO and APSI EO (p < 0.05) female groups compared to baseline results and in FRI6-2 values in both gender groups (p < 0.01-men, p < 0.05-women). The effect of the intervention was recorded in the intervention group in the OSI EO (Z = -3.12, p < 0.01, R = 0.533) and FRI6-2 (Z = -2.06, p < 0.05, R = 0.354). Additionally, significantly different reactions between the groups were observed in the psychological domain (DOM2) (Z = 2.194, p < 0.028, R = 0.389), social relationship domain (DOM3) (Z = 2.051, p < 0.0403, R = 0.361), and in question 2 concerning general health (Z = 3.309, p < 0.0009, R = 0.535). Conclusions: The findings indicate that RT had a positive effect on older adults affected by COVID-19, led to a significant improvement in their postural stability, and had a significant impact on elements of psychological well-being and quality of life.

The Impact of Normobaric Hypoxia and Intermittent Hypoxic Training on Cardiac Biomarkers in Endurance Athletes: A Pilot Study.

This study explores the effects of normobaric hypoxia and intermittent hypoxic training (IHT) on the physiological condition of the cardiac muscle in swimmers. Hypoxia has been reported to elicit both beneficial and adverse changes in the cardiovascular system, but its impact on the myocardium during acute exercise and altitude/hypoxic training remains less understood. We aimed to determine how a single bout of intense interval exercise and a four-week period of high-intensity endurance training under normobaric hypoxia affect cardiac marker activity in swimmers. Sixteen young male swimmers were divided into two groups: one undergoing training in hypoxia and the other in normoxia. Cardiac markers, including troponin I and T (cTnI and cTnT), heart-type fatty acid-binding protein (H-FABP), creatine kinase-MB isoenzyme (CK-MB), and myoglobin (Mb), were analyzed to assess the myocardium's response. We found no significant differences in the physiological response of the cardiac muscle to intense physical exertion between hypoxia and normoxia. Four weeks of IHT did not alter the resting levels of cTnT, cTnI, and H-FABP, but it resulted in a noteworthy decrease in the resting concentration of CK-MB, suggesting enhanced cardiac muscle adaptation to exercise. In contrast, a reduction in resting Mb levels was observed in the control group training in normoxia. These findings suggest that IHT at moderate altitudes does not adversely affect cardiac muscle condition and may support cardiac muscle adaptation, affirming the safety and efficacy of IHT as a training method for athletes.

Resistance Exercise Program Is Feasible and Effective in Improving Functional Strength in Post-COVID Survivors.

Background: Evidence suggests that COVID-19 infection can cause lasting health consequences. Multidisciplinary rehabilitation services have been recommended to reduce the sequalae. However, the effectiveness of physical exercise interventions remains insufficiently documented. The aim of this study was to develop and implement a specific and well-tolerated protocol-based intervention to reduce muscle weakness in older adults impacted by COVID-19. Methods: Forty-six older adults were randomized into intervention and control groups. Isometric and isokinetic strength assessments were conducted for selected muscle groups using a JBA Staniak® torquemeter and Biodex System 3 dynamometer. Functional abilities were evaluated with the Time Up and Go test and Chair Stand Tests. Results: Men in the intervention group demonstrated a significant improvement in static conditions for knee flexors (KFs), trunk extensors (TEs) and trunk flexors (TFs) and in dynamic conditions for knee extensors (KEs). Women in the intervention group showed a significant improvement in static conditions for EFs, KFs, TEs and TFs and in dynamic conditions for a KE and a KF. The interaction GROUP × TESTING SESSION was significant for the Chair Test (s) and Chair Test (n). Conclusions: Our results demonstrate the effectiveness of a well-tolerated, protocol-based approach that can be used to diminish long-lasting functional deficits in post-COVID survivors.

Biomechanical comparison of two surgical methods for Hallux Valgus deformity: Exploring the use of artificial neural networks as a decision-making tool for orthopedists.

Hallux Valgus foot deformity affects gait performance. Common treatment options include distal oblique metatarsal osteotomy and chevron osteotomy. Nonetheless, the current process of selecting the appropriate osteotomy method poses potential biases and risks, due to its reliance on subjective human judgment and interpretation. The inherent variability among clinicians, the potential influence of individual clinical experiences, or inherent measurement limitations may contribute to inconsistent evaluations. To address this, incorporating objective tools like neural networks, renowned for effective classification and decision-making support, holds promise in identifying optimal surgical approaches. The objective of this cross-sectional study was twofold. Firstly, it aimed to investigate the feasibility of classifying patients based on the type of surgery. Secondly, it sought to explore the development of a decision-making tool to assist orthopedists in selecting the optimal surgical approach. To achieve this, gait parameters of twenty-three women with moderate to severe Hallux Valgus were analyzed. These patients underwent either distal oblique metatarsal osteotomy or chevron osteotomy. The parameters exhibiting differences in preoperative and postoperative values were identified through various statistical tests such as normalization, Shapiro-Wilk, non-parametric Wilcoxon, Student t, and paired difference tests. Two artificial neural networks were constructed for patient classification based on the type of surgery and to simulate an optimal surgery type considering postoperative walking speed. The results of the analysis demonstrated a strong correlation between surgery type and postoperative gait parameters, with the first neural network achieving a remarkable 100% accuracy in classification. Additionally, cases were identified where there was a mismatch with the surgeon's decision. Our findings highlight the potential of artificial neural networks as a complementary tool for surgeons in making informed decisions. Addressing the study's limitations, future research may investigate a wider range of orthopedic procedures, examine additional gait parameters and use more diverse and extensive datasets to enhance statistical robustness.

Effect of Water-Based vs. Land-Based Exercise Intervention (postCOVIDkids) on Exercise Capacity, Fatigue, and Quality of Life in Children with Post COVID-19 Condition: A Randomized Controlled Trial.

Evidence suggests that COVID-19 can cause lasting health consequences called post-COVID-19 condition. We conducted a three-group, randomized controlled trial for children aged 10-12 years with post COVID-19 condition. Participants were randomized to AQUA, LAND, or CONTROL groups. The AQUA and LAND training sessions were conducted twice a week for eight weeks. The primary outcomes were exercise capacity, measured using the modified Balke treadmill protocol, and fatigue, measured using the Cumulative Fatigue Symptoms Questionnaire (CFSQ). The secondary outcome was health-related quality of life (HRQoL), measured with the Pediatric Quality of Life Inventory (PedsQL) for children and parents. A total of 74 of the 86 children completed the intervention and attended the post-intervention assessment. The absolute maximal oxygen uptake (VO2max) values increased after both AQUA (p = 0.001) and LAND (p = 0.004) interventions. No significant differences were found in the degree of total fatigue and individual fatigue symptoms. A significant improvement was found in the PedsQL reported by the parents in the LAND group. In conclusion, the applied eight-week water-based and land-based exercise training programs improved exercise capacity in children aged 10-12 years old with post COVID-19 condition. The parents of the children in the training groups also noted an improvement in HRQoL.

Methods for Spatiotemporal Analysis of Human Gait Based on Data from Depth Sensors.

Gait analysis may serve various purposes related to health care, such as the estimation of elderly people's risk of falling. This paper is devoted to gait analysis based on data from depth sensors which are suitable for use both at healthcare facilities and in monitoring systems dedicated to household environments. This paper is focused on the comparison of three methods for spatiotemporal gait analysis based on data from depth sensors, involving the analysis of the movement trajectories of the knees, feet, and centre of mass. The accuracy of the results obtained using those methods was assessed for different depth sensors' viewing angles and different types of subject clothing. Data were collected using a Kinect v2 device. Five people took part in the experiments. Data from a Zebris FDM platform were used as a reference. The obtained results indicate that the viewing angle and the subject's clothing affect the uncertainty of the estimates of spatiotemporal gait parameters, and that the method based on the trajectories of the feet yields the most information, while the method based on the trajectory of the centre of mass is the most robust.

Water-Based and Land-Based Exercise for Children with Post-COVID-19 Condition (postCOVIDkids)-Protocol for a Randomized Controlled Trial.

The most common symptoms of post-COVID-19 condition in children are fatigue, shortness of breath, exercise intolerance, and weakness. The post-COVID-19 condition in children can be very debilitating and lead to prolonged school absences, high morbidity, and limitations in daily functioning. The aim of this research project is to determine the effectiveness of land-based and water-based exercise interventions on exercise capacity, fatigue, health-related quality of life, and pulmonary function in children with post-COVID-19 condition. This study is a prospective randomized controlled study with pre- and post-intervention assessment. Participants will be recruited from Warsaw's primary schools and primary healthcare units according to the inclusion criteria: (i) symptoms of post-COVID-19 condition lasting more than one month following initial COVID-19 infection confirmed by the diagnosis by general practitioner (including obligatory fatigue and shortness of breath/respiratory problems); (ii) age 10-12 years old. Participants meeting the inclusion criteria will be randomized to one of three groups: water-based exercise, land-based exercise, or control (no exercise). We hope this study will provide guidance for long-COVID-19 rehabilitation in children.

Chronic Exposure to Normobaric Hypoxia Increases Testosterone Levels and Testosterone/Cortisol Ratio in Cyclists.

The aim of this study was to analyze the effects of the "live high, train low" method (LH−TL) and intermittent hypoxic training (IHT) on testosterone (T) and cortisol (C) levels in cyclists. Thirty cyclists participated in the experiment. The LH−TL group (n = 10) was exposed to normobaric hypoxia (FiO2 = 16.3%) for 11−12 h a day and trained in normoxia for 3 weeks. In the IHT group (n = 10), participants followed the IHT routine three times a week for 3 weeks in normobaric hypoxia (FiO2 = 16.3%). The control group (N; n = 10) followed the same training protocol in normoxia. The LH−TL training was found to significantly increase (p < 0.05) T levels and the testosterone/cortisol (T/C) ratio during the experiment. The area under the curve (AUC) calculated for T levels over 4 weeks was significantly (p < 0.05) higher in the LH−TL group, by 25.6%, compared to the N group. The results also indicated a significant correlation (r = 0.53; p < 0.05) between AUC for T levels over 4 weeks and ∆ values of hemoglobin (HGB) in the LH−TL group. Overall, the findings show that LH−TL training at a moderate simulated altitude contributes to an increase in T levels and T/C ratio in athletes, which is a beneficial change stimulating anabolic processes and erythropoiesis.

Using the TUG Test for the Functional Assessment of Patients with Selected Disorders.

One of the tests used for quantitative diagnostics is Timed Up-and-Go (TUG), however, no reports were found regarding the percentage share of individual test components, which seems to have a greater diagnostic value in differentiating the functional status of the patients. The aim of the study was to analyze the percentage of the individual components of the TUG test in functional assessment in a population of healthy children and in clinical trials patients with various diseases. MATERIAL AND METHODOLOGY: The material consisted of patients with orthopedic (n = 165), metabolic (n = 116) and neurological dysfunctions (n = 96). RESULTS: The components of the TUG test that differentiated the studied groups of patients to the greatest extent were in the order: relapse tug3%, initial transition tug2%, sitting tug5% and standing up tug1%, while during the final transition tug4% statistically significant differences were found only between healthy children and the studied groups of patients. CONCLUSIONS: The TUG test turned out to be a good diagnostic tool, differentiating the studied groups of patients. The analysis of the percentage of the components of the TUG test can help in assessing the mobility of children and adolescents, monitor the effects of physiotherapy or the effects of surgical procedures.

The influence of three different test positions and thigh asymmetry on measurements of isometric hip flexion strength in men and women.

PURPOSE: The aim of this study was to compare muscle strength at 90° hip and knee flexion as measured in three different positions and to investigate whether an internal or external deficit in the range of rotation in the hip joint affects flexor muscle strength. METHODS: We measured the peak muscle torque of rotation in the hip joint, using isometric torquemeter, and hip ROM in healthy participants N = 40, aged 21.6 ± 1.9, in three different measurement positions. We tested for differences between the positions, and for the potential influence of participant's sex and ROM asymmetry. RESULTS: The measured peak muscle torque was affected not only by sex and the value of hip flexion affect, but also by the position in which it is measured. Subjects with restricted external rotation of the hip joint (CERD) had significantly higher flexor peak muscle torque compared to subjects with restricted internal rotation (CIRD), in all but the supine position. For CERD, the results were: Supine (SuP) 1.02 ± 0.26; Sitting (StP) 1.32 ± 0.58; Standing (SP) 1.53 ± 0.47; and for CIRD, the results were: Supine (SuP) 1.05 ± 0.17; Sitting (StP) 1.05 ± 0.40; Standing (SP) 1.47 ± 0.53. CONCLUSIONS: Overall, measurement position and passive ROM significantly influence the peak muscle torque in isometric conditions. Moreover, an imbalance in thigh rotation movement significantly determines the magnitude of muscle torque of the hip flexion movement. Individuals with increased internal-toexternal rotation achieved significantly higher values for flexor muscle torque force moments. Overall, these findings are of importance for interpreting or comparing any reported values for muscle torque force moments.

Kinetic analysis of gait in adults with asymptomatic flatfoot.

PURPOSE: The aim of our study was to assess the influence of asymptomatic flatfoot on the kinetic parameters of the lower limb during gait. METHODS: Individuals of both sexes were studied: 15 women [age 25 ± 5 years] and 19 men [age 25 ± 4 years] with bilateral asymptomatic flatfoot, as well as 16 women [age 26±4 years] and 14 men [age 24 ± 3 years] with normal feet on both sides. A threedimensional VICON motion analysis system coupled with KISTLER dynamometric platforms was used to perform kinetic gait analysis. RESULTS: Women with flatfoot showed significantly lower maximal relative moments in the ankle in the sagittal plane ( p < 0.05) and significantly lower maximal relative moments in the knee in the sagittal plane in the Terminal Stance ( p < 0.001). In men, a significant difference was found in terms of hip rotation moment in the transverse plane in the Mid Stance ( p < 0.01): men with normal feet showed moments of external rotation, while men with flatfoot generated internal rotational moments. Moreover, men with flatfoot showed significantly lower ( p < 0.01) maximal relative moments in the knee in the transverse plane in the Mid Stance. CONCLUSIONS: Women with flatfoot have a weakened lower limb propulsion mechanism, whereas, in men with flatfoot, there is a change in the mechanics of the lower limb in the transverse plane. Our findings cast some doubt on flatfoot as a putative risk factor for stress injuries and degenerative changes in lower-limb structures, and suggest that gender differentiation should be taken into account in the analysis and therapy of flatfoot.

Hip joint mobility in relation to measurement position, gender and limb dominance.

PURPOSE: The purpose of this study was to determine whether three different measurement position yield divergent results in ROM using a goniometer, and how is it affected by anthropometrical factors. METHODS: We measured the range of rotation in the hip joint in healthy participants aged 21.6 ± 1.88, seeking to determine how the distribution of internal vs. external rotation (RI) within the total range of mobility (TR) was influenced by the measurement position used, the gender of the participant, and the dominant lower limb. RESULTS: We found that not only gender and limb dominance, but also the body position in which hip joint's range of motion is measured significantly affects the values of TR and RI. We found that TR achieves the highest values in the prone position - PrP (males: 95.35 ± 12.44 and 93.15 ± 12.49; females: 103.75 ± 14.87 and 106.25 ± 15.56) and the lowest values in supine position - SuP (male: 62.65 ± 8.51 and 57.85 ± 9.60; female: 59.5 ±12.27 and 55.85 ±8.54). The analysis shows that CERD occurs <0.42 RI in females (PrP) and <0.88 RI in men (PrP and sitting position - StP), and CIRD > 1.72 RI in women (StP), and > 2.08 RI in men (PrP). CONCLUSIONS: Due to the similarities between asymmetry of internal/external rotation in the hip joint and asymmetry in the rotation of the shoulder found in Glenohumeral Internal Rotation Deficit (GIRD), we propose the concepts of Coxal Internal Rotation Deficit (CIRD) and Coxal External Rotation Deficit (CERD) as tools to indicate the possibility for injury to the hip joint, and propose threshold rotation index values serving as indicators of these deficits.

Using nonlinear measures to evaluate postural control in healthy adults during bipedal standing on an unstable surface.

PURPOSE: This study examined the use of nonlinear measures - sample entropy (SampEn), fractal dimension (FD), and the Lyapunov exponent (LyE) - to evaluate postural control in adults during standing on an unstable surface, with and without visual feedback. METHODS: 14 healthy young adults (24.07 ± 7.32 years) completed bipedal standing trials on an unstable-plate Biodex Balance System (BBS) connected to a Vicon system, with eyes open and closed. Each trial lasted 20 sec. Analysis was performed based on the center of mass (CoM), for which the three nonlinear measures were calculated. RESULTS: Excluding visual feedback was found to cause a significant increase in linear and nonlinear parameters. Moreover, SampEn and FD values were found to be significantly higher in the PD direction, compared to AP or ML, whereas LyE values in this direction were minimal. CONCLUSIONS: Results show that the three nonlinear measures provide a useful way of evaluating postural control in healthy adults. Moreover, it seems that introducing an unstable surface meant that the projection of the CoM was not perpendicular to the surface, but rather set at a certain continually changing angle, forcing the whole system to adapt to chaotic and unpredictable conditions. Such refined changes in conditions can be evaluated in a precise way only by using nonlinear measures.

Women after Bilateral Surgical Correction of Hallux Valgus Do Not Show Improvement in Spatiotemporal Gait Parameters at 18 Weeks Postoperatively.

BACKGROUND: Hallux valgus (HV) is a gait-altering orthopedic deformity, somewhat more prevalent in women, which often affects both limbs. Although surgery is a commonly applied treatment, there is no consensus in the literature on how invasive HV correction affects spatiotemporal gait parameters, or how quickly improvement can be expected. We investigated gait parameters in female HV patients who underwent bilateral surgical correction of hallux valgus, both preoperatively and 18 weeks following surgery (a timeframe relevant from the perspective of physical therapy), and also in relation to a non-HV control group. METHODS: A total of 23 women aged 40-70 years, with moderate to severe HV deformity in both feet, were assessed preoperatively and 18 weeks postoperatively, and an age-matched control group of 76 healthy women was also assessed. A total of 22 spatiotemporal parameters were collected during 30 s walks over an electronic walkway (Zebris Medical System). RESULTS: Of the 22 parameters analyzed, significant differences between the preoperative experimental and control groups were found only in 4 parameters (Velocity, Right step time, Total double support and Stride time), but in 16 parameters between the postoperative experimental and control groups (the greatest impact being found for: Left and Right Step time, Stride time, Cadence, Right Foot rotation, Left Step length (%leg length) and Stride length (%leg length)). CONCLUSIONS: Women after bilateral HV correction did not exhibit improved (i.e., more normal) gait parameters at 18 weeks postoperatively; rather, they showed more gait abnormalities than preoperatively. These findings urge longer-term planning of postoperative rehabilitation, involving continual evaluation of gait improvement.

Does the Aquatic Breathing Program Improve Lung Function in Adolescents with Scoliosis?

Aim: To determine pulmonary parameters in adolescents with scoliosis after three weeks of intensive physiotherapeutic scoliosis-specific exercises based on the Aquatic Breathing Program (ABP) compared to corrective swimming (CS).Methods: A pretest-posttest control group design was used. The ABP group comprised 13 adolescents (age 14.2 ± 1.4) and the CS group 10 adolescents (age 14.1 ± 1.5) with mild to moderate scoliosis. Both groups participated in a threeweek intervention consisted of three types of exercises: corrective, general and aquatic. ABP group participated in the Aquatic Breathing Program and CS group took part in corrective swimming. Spirometric measurements were taken before and after the intervention.Results: ABP group demonstrated a greater increase (p = .05) in the predicted percentage values of forced expiratory volume in 1 s (FEV1) and maximal expiratory flow at 25% of forced vital capacity (MEF25), both in absolute terms and in percentage values (MEF25%pred) compared to the CS group. CS group exhibited lower values of all measured parameters in the second examination, and some of those differences were found to be statistically significant.Conclusions: The Aquatic Breathing Program can be used in adolescents with mild to moderate scoliosis to improve lung function.

Selected Tools for Assessing the Risk of Falls in Older Women.

METHODS: Fifty-five females were examined (May 2018-June 2019). Stabilographic examinations were performed with eyes open (EO) and closed (EC). An analysis of variance (ANOVA) and Spearman rank correlation were performed to determine the relationships and differences between the above tests. RESULTS: The results of the TUG correlate with the overall stability index (OSI) EO (r = 0.314), medial-lateral stability index (MLSI) EO (r = 0.297), and fall risk index (FRI6-2; r = 0.435) in stabilographic examinations and the FRT (r = -0.399). The results of the modified Unterberger test correlate with MLSI EO (r = 0.276), OSI EC (r = 0.310), and MLSI EC (r = 0.378). There are statistically significant differences between faller and nonfaller groups in TUG (p = 0.0068), FRT (p = 0.001), and MLSI EO (p = 0.0118). CONCLUSIONS: The modified Unterberger test and TUG can be considered effective in functional FR assessment in older women. Using at least two different functional tests may improve the assessment of FR.

Does cochlear implantation influence postural stability in patients with hearing loss?

BACKGROUND: Cochlear implantation (CI) procedure carries the potential risk for vestibular system insult or stimulation with resultant dysfunction due to its proximity to the cochlea. The vestibular system plays an essential role in crucial tasks such as postural control, gaze stabilization and spatial orientation. RESEARCH QUESTION: How does standard cochlear implantation influence postural stability in patients with hearing loss? METHODS: The study included 21 individuals (age 51 ± 18 years) qualified to undergo CI due to severe or profound hearing loss. Participants were qualified for both groups by a physician based on an interview, an otoneurological examination and vestibular tests. The first group included patients without vestibular dysfunction, whereas the other group consisted of persons with vestibular dysfunction. The research methodology included medical examinations, anthropometric measurements and stabilometry on the Biodex Balance System SD (BBS) platform. The examinations were carried out twice, i.e. prior to and 3 months post implantation. The recorded data was compared between the first and the second examination using a non-parametric Wilcoxon test. The analysis of variance (ANOVA) and Tukey's post-hoc HSD unequal sample sizes were performed for patients with and without vestibular dysfunction. RESULTS AND SIGNIFICANCE: Study showed that 52.4% of the participants obtained results within the norm, while 47.6% scored below it. The comparison of stability indices of the examined individuals, with and without vestibular dysfunction, did not reveal statistically significant differences. The only difference was the anterior-posterior stability index assessed in static conditions. Three months after the implantation, no changes in the majority of indices were noted, with the exception of anterior-posterior stability index, which improved following the implantation. CI does not affect postural stability changes in the study participants.

Assessing Gait Stability before and after Cochlear Implantation.

BACKGROUND: It is known that cochlear implantation may alter the inner ear and induce vestibular disorders. RESEARCH QUESTION: How does cochlear implantation influence gait stability? Material and Methods. An experimental group of twenty-one subjects scheduled for cochlear implantation underwent gait testing twice, on the day before cochlear implantation (BCI) and three months after cochlear implantation (ACI), using a motion capture system. A control group of 30 age-matched healthy individuals were also tested. RESULTS: In the experimental group, the gait stability ratio (GSR) was found to improve in 17 subjects after implantation, by an average of 6%. Certain other parameters also showed statistically significant improvement between the two experimental group tests: step time (p<0.001), single-support phase walking speed (p<0.05), and center of mass (CoM) (p<0.05). Using the CoM results of the control group, we devised a stability classification system and applied it to the pre- and postimplantation subjects. After implantation, increases were seen in the number of subjects classified in interval II (strong stability) and III (weak stability). The number of subjects in interval I (perfect stability) decreased by 1 and in interval IV (no stability) by 4. SIGNIFICANCE: (1) Although cochlear implantation intervenes in the vestibular area, we found evidence that gait stability improves in most subjects after the surgery, reducing the risk of falls. (2) We found statistically significant improvements in individual parameters (such as single-support phase time), in GSR, and in CoM. (3) Based on CoM results, we proposed a new rule-of-thumb way of classifying patients into gait stability intervals, for use in rehabilitation planning and monitoring.

Effects of anthropometric factors on postural stability in individuals with hearing impairment.

PURPOSE: Identification of factors that affect postural stability may help to improve diagnostic accuracy and enhance the quality of treatment and rehabilitation. This study sought to assess the relationship between postural stability parameters and anthropometric factors of persons with hearing impairment (HI). METHODS: The study included 128 individuals - 42 subjects with HI and 86 without HI (healthy controls). Research methodology included an interview and a medical examination, anthropometric measurements and stabilometric tests on platforms with stable and unstable surfaces. RESULTS: In the group of female study participants with HI, significant correlations were only noted between body height and the Fall Risk Index (FRI). In the group of male subjects with HI, the study revealed significant correlations between FRI and body mass, BMI, % MM (muscle mass percentage) and % FAT (fat percentage). Moreover, moderate correlation was found between COP path with eyes open and body mass, while high correlation was observed between COP path with eyes open and BMI, % MM and % FAT. No significant correlation was noted between FRI and body height in men with HI. CONCLUSIONS: The examination of correlations between postural stability and body build of persons with HI did not confirm the effects of body height on postural stability in the examined group of individuals with HI, but revealed a greater influence of somatic parameters (body mass, BMI, % MM, % FAT) on postural stability in hearing-impaired men.