An examination of studies related to the sport of curling: a scoping review.

Introduction: There has been growth in research in the sport of curling over the past few decades. The need for a scoping review is warranted. This study's purpose was to identify and synthesize research evidence regarding quantitative variables for a series of components within the sport of curling. Methods: A scoping review of studies published and established within four databases was performed. One independent reviewer selected studies based on a systematic procedure. Inclusion criteria for studies were: (1) interventions that focused on the sport of curling; (2) quantitative in nature; (3) written in English; and (4) published within a peer-reviewed journal, a conference presentation, or a published thesis. Results: Searching identified 8,467 articles and 94 met the inclusion criteria. Data were organized and synthesized based on the devised research variables from the sport of curling: The curl mechanism of the curling stone; the impact of sweeping on stone trajectory; curling delivery mechanics; wheelchair curling; technology analysis; strategy and tactics; psychological factors; injury occurrences; facility and arena infrastructure; and assessment of curling training and ability. The findings confirm the strong knowledge base that exists across game variables and unveil controversy between the underlying physics that produces curl, as well as the mechanisms of sweeping responsible for manipulating the stone trajectory. Conclusions: Knowledge derived from this review can assist researchers, coaches, and curlers in addressing the specific variables of the sport that influence stone trajectory and game results. Such awareness will expose gaps in the current understanding and foster new research endeavors to further the knowledge of the sport.

A Violation of Fitts' Law is Maintained in Ecologically Valid Settings.

A 'violation' of Fitts' Law, or Fitts' Equation, occurs when each potential target location is outlined before and during a reaching movement. Past studies have measured the violation in highly controlled laboratory environments, limiting the generalizability of findings. The purpose of the study was to replicate the violation of Fitts' Equation in the homes of participants using a novel portable apparatus during the COVID-19 pandemic. Movements were measured independently with an accelerometer and touch screen, which allowed for kinematic, temporal, and spatial outcomes to be measured in remote environments. The violation of Fitts' Equation was found with the touch and acceleration measurements and was thus seen in ecologically valid environments. The apparatus used may be used as a model for future field research.

Dual muscle tendon vibration does not impede performance of a goal-directed aiming task.

AIMS: Application of muscle-tendon vibration within the frequency range of 70-120Hz has been studied as a tool to stimulate somatosensory afferents with both the goal of studying human sensorimotor control and of improving post-stroke motor performance. Specific to applications for rehabilitation, current evidence is mixed as to whether dual muscle-tendon vibration is detrimental to the performance of goal-directed upper-limb movements. The current study aimed to determine the effects of muscle-tendon vibration over the wrist flexors and extensors (dual vibration) on performance of a computer goal-directed aiming task. METHODS: Twenty healthy participants were assigned to the vibration or control group. An aiming task that involved acquiring targets by moving an unseen cursor on a screen was performed. Vision of the cursor and hand were unavailable throughout the four blocks of movement execution. Only the vibration group received dual vibration throughout four blocks. Task performance was assessed using measures of endpoint accuracy and timing. Perceived hand location was assessed using a set of questions and a computerised conscious perception task. RESULTS: The vibration group had significantly shorter reaction times, without any change in endpoint accuracy, indicating more efficient and effective movement planning. The vibration group did report illusory movement sensation, which was reduced by block 4. CONCLUSIONS: Dual vibration did not adversely affect aiming accuracy and showed some improvement in reaction time. The present findings support the potential for using dual vibration to stimulate the somatosensory system as participants improved their performance of a novel goal-directed movement. Notably, improvements were maintained when the vibration was removed.

Optimizing Movement Performance with Altered Sensation: An Examination of Multisensory Inputs.

Two experiments were conducted to assess the impact of induced paresthesia on movement parameters of goal-directed aiming movements to determine how visual and auditory feedback may enhance performance when somatosensory feedback is disrupted. In both experiments, neurotypical adults performed the goal-directed aiming task in four conditions: (i) paresthesia-full vision; (ii) paresthesia-no vision; (iii) no paresthesia-full vision; (iv) no paresthesia-no vision. Targets appeared on a computer screen, vision was obscured using visual occlusion spectacles, and paresthesia was induced with a constant current stimulator. The first and last 20% of trials (early and late performance) were compared to assess adaptability to altered somatosensory input. Experiment 2 added an auditory tone that confirmed successful target acquisitions. When compared to early performance in the no-paresthesia and no-vision conditions, induced paresthesia and no vision led to significantly larger endpoint error toward the body midline in both early and late performance. This finding reveals the importance of proprioceptive input for movement accuracy in the absence of visual feedback. The kinematic results indicated that vision could not fully compensate for the disrupted proprioceptive input when participants experienced induced paresthesia. However, when auditory feedback confirmed successful aiming movements in Experiment 2, participants were able to improve their endpoint variability when experiencing induced paresthesia through changes in movement preparation.

Adapting to Altered Sensory Input: Effects of Induced Paresthesia on Goal-Directed Movement Planning and Execution.

The current study investigated how temporarily induced paresthesia in the moving limb affects the performance of a goal-directed target aiming task. Three-dimensional displacement data of 14 neurotypical participants were recorded while they pointed to a target on a computer monitor in four conditions: (i) paresthesia-full-vision; (ii) paresthesia-without-target vision; (iii) no-paresthesia-full-vision; (iv) no paresthesia-without-target vision. The four conditions were blocked and counterbalanced such that participants performed the paresthesia and no-paresthesia conditions on two separate days. To assess how aiming performance changed in the presence of paresthesia, we compared early versus late performance (first and last 20% of trials). We found that endpoint accuracy and movement speed were reduced in the presence of paresthesia, but only without target vision. With repetition, participants adjusted their movement performance strategy, such that with induced paresthesia, they used a movement strategy that included more pre-planned movements that depended less on online control.

A violation of Fitts' Law occurs when a target range is presented before and during movement.

According to Fitts' Law, the time to reach a target (movement time, MT) increases with distance. A violation of Fitts' Law occurs when target positions are outlined before and during movement, as MTs are not different when reaching to the farthest and penultimate targets. One hypothesis posits that performers cognitively process the edges of a target array before the center, allowing for corrective movements to be completed more quickly when moving to edge targets compared to middle targets. The objective of this study was to test this hypothesis by displaying a target range rather than outlines of individual targets in an effort to identify the effects of array edges. Using a touch-screen laptop, participants (N = 24) were asked to reach to one of three targets which would appear within a presented range. Separately, targets were also presented without a range to determine if the display protocol could evoke Fitts' Law. Movements were assessed with the touch screen and optical position measurement. A main effect was found for relative position within a range (touch: F2,44 = 15.4, p < 0.001, η2p = 0.412; position: F2,40 = 15.6, p < 0.001, η2p = 0.439). As hypothesised, MT to the farthest target in a range was not significantly different than MT to the middle target (touch: p = 0.638, position: p = 0.449). No violation was found when a target range was not presented (touch: p = 0.003, position: p = 0.001). Thus, a target range reproduces the Fitts' Law violation previously documented with individually outlined targets, which supports and extends the discussed hypothesis.

Factors associated with non-pharmacological, non-operative treatment utilization prior to thoracolumbar spine surgery in Manitoba: A Canadian Spine Outcomes Research Network (CSORN) study.

BACKGROUND: Evidence for managing chronic low back pain suggests beginning with non-invasive treatments and having surgery as a last resort. Currently, no studies examine treatment engagement for back pain in the six-months preceding elective spine surgery assessment. OBJECTIVES: This study aims to: 1) determine the engagement in non-pharmacological, non-operative treatment before elective thoracolumbar spine surgery (ETSS) assessment in XXXXXXXX; and 2) investigate potential factors associated with engagement in this population. DESIGN: Retrospective cohort design. METHODS: Canadian Spine Outcomes Research Network (CSORN) registry data were analyzed to compare groups who reported minimal engagement in non-pharmacological, non-operative treatment before ETSS assessment to those who engaged. Binary logistic regression was used to identify factors associated with engagement. RESULTS: A total of 144 patients qualified, 41.7% reported minimal engagement with non-pharmacological, non-operative treatment in the six-months preceding ETSS assessment. Four statistically significant factors associated with minimal engagement were identified: 1) 61-90 years of age (odds ratio [OR] 4.6, 95% confidence interval [CI] 2.0-10.7, p < .001); 2) Oswestry disability index (ODI) score >60% (OR 3.5, 95% CI 1.4-9.2, p = .010; 3) body mass index (BMI) score 25-29.9 (OR 6.7, 95% CI 2.2-20.9, p < .001) and BMI ≥ 30 (OR 4.2, 95% CI 1.4-12.2, p = .009); and 4) female biological sex (OR 2.4, 95% CI 1.0-5.6, p = .039. CONCLUSIONS: In total, 41.7% of CSORN patients had minimal engagement with non-pharmacological, non-operative treatment in the six-months prior to ETSS assessment in XXXXXXXX. Factors associated with minimal engagement included: older age, high disability, increased BMI, and female biological sex.

Self-reported Measures of Function Compared to Lower Limb Motor Performance in People With and Without Imaging Evidence of Unilateral Lumbar Nerve Root Compression: A Cross-sectional Study.

OBJECTIVE: The primary objective of the present study was to determine if imaging findings of unilateral lumbar nerve root compression (ULNRC) impact performance on a coordinated motor performance task and to determine if there were correlations between motor performance and self-reported clinical measures. METHODS: People with back pain (N = 45) were stratified into 3 groups based on combinations of: lumbar imaging; and clinical presentation for ULNRC. Group 1 included people with imaging of lumbar nerve root compression, who presented with neurological deficit. Group 2 people demonstrated imaging evidence of nerve compression, without motor, sensory or reflex change. Group 3 participants possessed only degenerative changes on lumbar imaging films, and were neurologically intact. Performance measures included behavioral and kinematic variables from an established lower limb Fitts' Task requiring movements to targets of different difficulties. Self-reported measures of disability, function and pain were collected. Analysis of variance for between and within group variables were conducted, and Pearson correlation compared performance with self-reported measures. RESULTS: All groups yielded main effects for movement time with increasing task difficulty as predicted by Fitts' Law. A main effect revealed Group 1 participants performed less accurately than Group 3 participants. Positive correlations were predominantly found between self-report measures and motor performance for Group 2 and Group 3. CONCLUSION: Imaging, and self-reported measures alone did not predict function, however, Fitts' task performance accuracy effectively differentiated groups.

A retrospective analysis of pain changes and opioid use patterns temporally associated with a course of chiropractic care at a publicly funded inner-city facility.

Background: Non-pharmacologic treatment, including chiropractic care, is now recommended instead of opioid prescriptions as the initial management of chronic spine pain by clinical practice guidelines. Chiropractic care, commonly including spinal manipulation, has been temporally associated with reduced opioid prescription in veterans with spine pain. Purpose: To determine if chiropractic management including spinal manipulation was associated with decreased pain or opioid usage in financially disadvantaged individuals utilizing opioid medications and diagnosed with musculoskeletal conditions. Methods: A retrospective analysis of quality assurance data from a publicly funded healthcare facility was conducted. Measures included numeric pain scores of spine and extremity regions across three time points, opioid utilization, demographics, and care modalities. Results: Pain and opioid use significantly decreased concomitant with a course of chiropractic care. Conclusions: A publicly funded course of chiropractic care temporally coincided with statistically and clinically significant decreases in pain and opioid usage in a financially disadvantaged inner-city population.

Contexte: Conformément aux directives de pratique clinique, un traitement non pharmacologique, notamment des soins chiropratiques, à la place de prescriptions d'opioïdes est désormais recommandé dans le traitement initial de la douleur chronique à la colonne vertébrale. Les soins chiropratiques, qui comprennent habituellement la manipulation vertébrale, ont été liés de manière provisoire à une consommation réduite d'opioïdes sur ordonnance chez les vétérans souffrant de douleurs à la colonne vertébrale. Objectif: Déterminer si un traitement chiropratique, y compris la manipulation vertébrale, était lié à une diminution de la douleur ou de la consommation d'opioïdes chez les personnes défavorisées sur le plan financier utilisant des médicaments à base d'opioïdes et souffrant de problèmes musculosquelettiques. Méthodologie: Une analyse rétrospective des données sur l'assurance de la qualité provenant d'un établissement de soins de santé financé par l'État a été menée. Les mesures portaient sur des résultats numériques de la douleur à la colonne vertébrale et des extrémités des membres à trois moments différents, la consommation d'opioïdes, des données démographiques et les modes de soins. Résultats: La douleur et la consommation d'opioïdes ont sensiblement diminué dans le cadre de soins chiropratiques. Conclusions: Une diminution importante de la douleur et de la consommation d'opioïdes observée de façon statistique et clinique a coïncidé de manière provisoire avec des soins chiropratiques financés par l'État dans un groupe de personnes défavorisées sur le plan financier vivant au centre-ville.

Differing Characteristics of Human-Shaped Visual Stimuli Affect Clinicians' Dosage of a Spinal Manipulative Thrust on a Low-Fidelity Model: A Cross-Sectional Study.

OBJECTIVE: The purpose of this study was to determine whether chiropractic clinicians modulate spinal manipulation (SM) thrust characteristics based on visual perception of simulated human silhouette attributes. METHODS: We performed a cross-sectional within-participant design with 8 experienced chiropractors. During each trial, participants observed a human-shaped life-sized silhouette of a mock patient and delivered an SM thrust on a low-fidelity thoracic spine model based on their visual perception. Silhouettes varied on the following 3 factors: apparent sex (male or female silhouette), height (short, average, tall), and body mass index (BMI) (underweight, healthy, obese). Each combination was presented 6 times for a total of 108 trials in random order. Outcome measures included peak thrust force, thrust duration, peak preload force, peak acceleration, time to peak acceleration, and rate of force application. A 3-way repeated measures analysis of variance model was used to for each variable, followed by Tukey's honestly significant difference on significant interactions. RESULTS: Peak thrust force was reduced when apparent sex of the presented silhouette was female (F1,7 = 5.70, P = .048). Thrust duration was largely invariant, except that a BMI by height interaction revealed a longer duration occurred for healthy tall participants than healthy short participants (F4,28 = 4.34, P = .007). Compared to an image depicting obese BMI, an image appearing underweight lead to reduced peak acceleration (F2,5 = 6.756, P = .009). Clinician time to peak acceleration was reduced in short compared to tall silhouettes (t7 = 2.20, P = .032). CONCLUSION: Visual perception of simulated human silhouette attributes, including apparent sex, height, and BMI, influenced SM dose characteristics through both kinetic and kinematic measures. The results suggest that visual information from mock patients affects the decision-making of chiropractic clinicians delivering SM thrusts.

Utilization of chiropractic services in patients with osteoarthritis and spine pain at a publicly funded healthcare facility in Canada: A retrospective study.

BACKGROUND: Osteoarthritis (OA) is one of the most prevalent and disabling musculoskeletal diseases worldwide. There is preliminary evidence from experimental studies and consensus documents that chiropractic management may alleviate spine and/or extremity OA related pain in the short term. OBJECTIVE: This research explores the potential relationship of a pragmatic course of care, including soft tissue therapy, spinal manipulation, and other treatments commonly delivered by chiropractors, to spine and extremity pain in patients with OA. METHODS: A retrospective analysis of prospectively collected data from the chiropractic program at a publicly funded healthcare facility was conducted. The primary outcome measures for patients diagnosed with spine and/or extremity OA (n= 76) were numeric pain scores of each spinal and extremity region at baseline and discharge, and a change score was determined. RESULTS: Statistically significant improvements that exceed a clinically meaningful difference in pain numeric rating scale scores were demonstrated by point change reductions from baseline to discharge visits. Change scores exceeding a minimally clinically important difference of "2-points" were present in the sacroiliac (-2.91), extremity (-2.84), cervical (-2.73), thoracic (-2.61), and lumbar (-2.59) regions. CONCLUSION: Patients diagnosed with OA in a socioeconomically disadvantaged community demonstrated reductions in mean pain scores in both a clinically meaningful and statistically significant manner concurrent with a course of chiropractic care.

Patient Characteristics and Clinical Outcomes Associated With Conservative Treatment for Spine Pain in Women Experiencing Socioeconomic Challenges.

OBJECTIVE: The purpose of this study was to describe patient demographics and pain changes for women over the course of care in a chiropractic program. METHODS: We performed a retrospective cross-sectional analysis of a prospective quality assurance database from the Mount Carmel Clinic (MCC) in Winnipeg, Manitoba, Canada. Pain scores were reported on an 11-point Numeric Rating Scale. Baseline and discharge Numeric Rating Scale scores were compared for each spinal and extremity region through Wilcoxon signed rank tests to determine if clinically meaningful or statistically significant differences were present. RESULTS: The sample population attained was 348 primarily middle-aged (mean = 43.0, SD = 14.96) women with obesity (body mass index = 31.3 kg/m2, SD = 7.89) referred to the MCC chiropractic program by their primary care physician (65.2%) for an average of 15.6 (SD = 18.49) treatments. Clinically meaningful median baseline to discharge changes in pain by spine region were observed (Cervical = -2, Thoracic = -2, Lumbar = -3, Sacroiliac = -3), each of which yielded statistical significance (P < .001). CONCLUSION: This retrospective analysis found that the MCC chiropractic program serves middle-aged women with obesity experiencing socioeconomic challenges. Pain reductions were reported, regardless of the region of complaint, temporally associated with a course of chiropractic care.

Non-Surgical Interventions for Lumbar Spinal Stenosis Leading To Neurogenic Claudication: A Clinical Practice Guideline.

Lumbar spinal stenosis (LSS) causing neurogenic claudication (NC) is increasingly common with an aging population and can be associated with significant symptoms and functional limitations. We developed this guideline to present the evidence and provide clinical recommendations on nonsurgical management of patients with LSS causing NC. Using the GRADE approach, a multidisciplinary guidelines panel based recommendations on evidence from a systematic review of randomized controlled trials and systematic reviews published through June 2019, or expert consensus. The literature monitored up to October 2020. Clinical outcomes evaluated included pain, disability, quality of life, and walking capacity. The target audience for this guideline includes all clinicians, and the target patient population includes adults with LSS (congenital and/or acquired, lateral recess or central canal, with or without low back pain, with or without spondylolisthesis) causing NC. The guidelines panel developed 6 recommendations based on randomized controlled trials and 5 others based on professional consensus, summarized in 3 overarching recommendations: (Grade: statements are all conditional/weak recommendations) Recommendation 1. For patients with LSS causing NC, clinicians and patients may initially select multimodal care nonpharmacological therapies with education, advice and lifestyle changes, behavioral change techniques in conjunction with home exercise, manual therapy, and/or rehabilitation (moderate-quality evidence), traditional acupuncture on a trial basis (very low-quality evidence), and postoperative rehabilitation (supervised program of exercises and/or educational materials encouraging activity) with cognitive-behavioral therapy 12 weeks postsurgery (low-quality evidence). Recommendation 2. In patients LSS causing NC, clinicians and patients may consider a trial of serotonin-norepinephrine reuptake inhibitors or tricyclic antidepressants. (very low-quality evidence). Recommendation 3. For patients LSS causing NC, we recommend against the use of the following pharmacological therapies: nonsteroidal anti-inflammatory drugs, methylcobalamin, calcitonin, paracetamol, opioids, muscle relaxants, pregabalin (consensus-based), gabapentin (very low-quality), and epidural steroidal injections (high-quality evidence). PERSPECTIVE: This guideline, on the basis of a systematic review of the evidence on the nonsurgical management of lumbar spine stenosis, provides recommendations developed by a multidisciplinary expert panel. Safe and effective non-surgical management of lumbar spine stenosis should be on the basis of a plan of care tailored to the individual and the type of treatment involved, and multimodal care is recommended in most situations.

The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature.

BACKGROUND: A small proportion of chiropractors, osteopaths, and other manual medicine providers use spinal manipulative therapy (SMT) to manage non-musculoskeletal disorders. However, the efficacy and effectiveness of these interventions to prevent or treat non-musculoskeletal disorders remain controversial. OBJECTIVES: We convened a Global Summit of international scientists to conduct a systematic review of the literature to determine the efficacy and effectiveness of SMT for the primary, secondary and tertiary prevention of non-musculoskeletal disorders. GLOBAL SUMMIT: The Global Summit took place on September 14-15, 2019 in Toronto, Canada. It was attended by 50 researchers from 8 countries and 28 observers from 18 chiropractic organizations. At the summit, participants critically appraised the literature and synthesized the evidence. SYSTEMATIC REVIEW OF THE LITERATURE: We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health, and the Index to Chiropractic Literature from inception to May 15, 2019 using subject headings specific to each database and free text words relevant to manipulation/manual therapy, effectiveness, prevention, treatment, and non-musculoskeletal disorders. Eligible for review were randomized controlled trials published in English. The methodological quality of eligible studies was assessed independently by reviewers using the Scottish Intercollegiate Guidelines Network (SIGN) criteria for randomized controlled trials. We synthesized the evidence from articles with high or acceptable methodological quality according to the Synthesis without Meta-Analysis (SWiM) Guideline. The final risk of bias and evidence tables were reviewed by researchers who attended the Global Summit and 75% (38/50) had to approve the content to reach consensus. RESULTS: We retrieved 4997 citations, removed 1123 duplicates and screened 3874 citations. Of those, the eligibility of 32 articles was evaluated at the Global Summit and 16 articles were included in our systematic review. Our synthesis included six randomized controlled trials with acceptable or high methodological quality (reported in seven articles). These trials investigated the efficacy or effectiveness of SMT for the management of infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. None of the trials evaluated the effectiveness of SMT in preventing the occurrence of non-musculoskeletal disorders. Consensus was reached on the content of all risk of bias and evidence tables. All randomized controlled trials with high or acceptable quality found that SMT was not superior to sham interventions for the treatment of these non-musculoskeletal disorders. Six of 50 participants (12%) in the Global Summit did not approve the final report. CONCLUSION: Our systematic review included six randomized clinical trials (534 participants) of acceptable or high quality investigating the efficacy or effectiveness of SMT for the treatment of non-musculoskeletal disorders. We found no evidence of an effect of SMT for the management of non-musculoskeletal disorders including infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. This finding challenges the validity of the theory that treating spinal dysfunctions with SMT has a physiological effect on organs and their function. Governments, payers, regulators, educators, and clinicians should consider this evidence when developing policies about the use and reimbursement of SMT for non-musculoskeletal disorders.

Somatosensory Integration and Masking of Complex Tactile Information: Peripheral and Cortical Contributions.

Nerve paresthesia is a sensory impairment experienced in clinical conditions such as diabetes. Paresthesia may "mask" or "compete" with meaningful tactile information in the patient's sensory environment. The two objectives of the present study were: (1) to determine if radiating paresthesia produces a peripheral mask, a central mask, or a combination; (2) to determine if a response competition experimental design reveals changes in somatosensory integration similar to a masking design. Experiment 1 assessed the degree of masking caused by induced radiating ulnar nerve paresthesia (a concurrent non-target stimulus) on a vibrotactile Morse code letter acquisition task using both behavioral and neurophysiological measures. Experiment 2 used a response competition design by moving the radiating paresthesia to the median nerve. This move shifted the concurrent non-target stimulus to a location spatially removed from the target stimuli. The task, behavioral and neurophysiological measures remained consistent. The induced paresthesia impacted letter acquisition differentially depending on the relative location of meaningful and non-meaningful stimulation. Paresthesia acted as a peripheral mask when presented to overlapping anatomical stimulation areas, and a central mask when presented at separate anatomical areas. These findings are discussed as they relate to masking, subcortical, and centripetal gating.

An external focus of attention compared to an internal focus of attention improves anticipatory postural adjustments among people post-stroke.

BACKGROUND: People after stroke often have postural impairments that can increase their risk of falling. Anticipatory postural adjustments (APAs) are changes in the activity of postural muscles prior to a voluntary movement in order to maintain vertical equilibrium. Previous research suggests that improving APAs leads to better postural control and reduces the risk of falls. Despite the importance of APAs and their impairment among people post-stroke, studies that aim to investigate methods for improving APAs are limited. Consistent evidence supports that an external focus of attention compared to an internal focus of attention, yields superior performance of motor skills that include postural control. RESEARCH QUESTION: What are the effects of adopting different foci of attention on measures of APAs and movement parameters when performing a lower extremity Fitts' task among people post-stroke? METHODS: Twelve individuals post-stroke performed a lower extremity stepping movement (Fitts' task) while adopting an external focus or an internal focus of attention in a within-subject design. A motion capture system was used to record participants' movement data. Custom software derived movement time (MT), peak velocity (PV), time to peak velocity (ttPV) and variability at endpoint (SDT). Electromyography was used to measure muscle activity and determine APAs onset and magnitude. For all dependent variables separate repeated measures ANOVAs were conducted to compare performance between foci of attention. RESULTS: The results showed that an external focus of attention yielded significantly better performance on all outcome measures. The improvement in performance was seen in shorter MT, higher PV, shorter ttPV, smaller SDT, earlier APAs onset and more efficient APAs magnitude. SIGNIFICANCE: The changes in outcome measures suggest that adopting an external focus of attention during postural tasks could be an effective strategy for improving balance control among people post-stroke.

Both reaching and grasping are impacted by temporarily induced paresthesia.

Along with visual feedback, somatosensory feedback provides the nervous system with information regarding movement performance. Somatosensory system damage disrupts the normal feedback process, which can lead to a pins and needles sensation, or paresthaesia, and impaired movement control. The present study assessed the impact of temporarily induced median nerve paresthaesia, in individuals with otherwise intact sensorimotor function, on goal-directed reaching and grasping movements. Healthy, right-handed participants performed reach and grasp movements to five wooden Efron shapes, of which three were selected for analysis. Participants performed the task without online visual feedback and in two somatosensory conditions: 1) normal; and 2) disrupted somatosensory feedback. Disrupted somatosensory feedback was induced temporarily using a Digitimer (DS7AH) constant current stimulator. Participants' movements to shapes 15 or 30 cm to the right of the hand's start position were recorded using a 3 D motion analysis system at 300 Hz (Optotrak 3 D Investigator). Analyses revealed no significant differences for reaction time. Main effects for paresthaesia were observed for temporal and spatial aspects of the both the reach and grasp components of the movements. Although participants scaled their grip aperture to shape size under paresthaesia, the movements were smaller and more variable. Overall participants behaved as though they perceived they were performing larger and faster movements than they actually were. We suggest the presence of temporally induced paresthaesia affected online control by disrupting somatosensory feedback of the reach and grasp movements, ultimately leading to smaller forces and fewer corrective movements.

Comparing Two Moderate-to-Vigorous Physical Activity Accelerometer Cut Points in Older Adults With Neck and Back Disabilities Undergoing Exercise and Spinal Manipulation Interventions.

Different techniques used to analyze and reduce accelerometer data may impact its interpretation. To determine which variables were impacted by changing analysis parameters, the authors performed a secondary analysis of data gained from a clinical trial conducted on older adults (aged ≥65 years; M = 71.1 and SD = 5.3; n = 100) with neck and back disabilities and compared the effects of two different cut- point sets (Matthews and Freedson sets) commonly used to analyze older adult accelerometry data. The Matthews set was found to assign significantly greater moderate-to-vigorous physical activity per day than the Freedson set in all comparisons. This suggests that, if moderate-to-vigorous physical activity per unit time is a primary outcome measure, the choice of which analysis method is used should be carefully considered. Further results from analyses of dependent variables, time in moderate-to-vigorous physical activity bouts of >10 min/day, mean bout length, and number of bouts per day are discussed.