Reliability and validity of an app-assisted tissue compliance meter in measuring tissue stiffness on a phantom model.

Background: Most methods for soft tissue stiffness assessment require high financial resources, significant technical effort, or extensive therapist training. The PACT Sense device was developed to be used in a wide range of applications and user groups. However, to date, there are no data on its validity and reliability. The aim of this study was to investigate the validity and reliability of the PACT device. Methods: A polyurethane phantom tissue model (PTM) mimicking the mechanical properties of the fascia profunda and the erector spinae muscle was used. Stiffness measurements with PACT were conducted by two independent investigators. For construct validity, correlations were calculated between the known stiffness of the PTM and values obtained with PACT. For concurrent validity, we determined the association between the PACT values and additional measurements with the established MyotonPRO device. To estimate interrater and intrarater (two measurements with an interval of 7 days) reliability, we used the intraclass correlation coefficient (ICC). Results: Correlation analysis (PTM/PACT) revealed very high concurrent validity (r = 0.99; p < 0.001), construct validity (PACT/MyotonPRO) was 0.87, p < 0.001. Both, interrater reliability (ICC = 0.85; p = 0.036) and intrarater reliability were good (ICC = 0.89; p < 0.001). Conclusions: The PACT provides valid and reliable stiffness measurements in tissue phantoms. Further studies in humans are needed to confirm its physiometric properties under in vivo conditions.

Assessing reliability and validity of different stiffness measurement tools on a multi-layered phantom tissue model.

Changes in the mechanical properties (i.e., stiffness) of soft tissues have been linked to musculoskeletal disorders, pain conditions, and cancer biology, leading to a rising demand for diagnostic methods. Despite the general availability of different stiffness measurement tools, it is unclear as to which are best suited for different tissue types and the related measurement depths. The study aimed to compare different stiffness measurement tools' (SMT) reliability on a multi-layered phantom tissue model (MPTM). A polyurethane MPTM simulated the four layers of the thoracolumbar region: cutis (CUT), subcutaneous connective tissue (SCT), fascia profunda (FPR), and erector spinae (ERS), with varying stiffness parameters. Evaluated stiffness measurement tools included Shore Durometer, Semi-Electronic Tissue Compliance Meter (STCM), IndentoPRO, MyotonPRO, and ultrasound imaging. Measurements were made by two independent, blinded examiners. Shore Durometer, STCM, IndentoPRO, and MyotonPRO reliably detected stiffness changes in three of the four MPTM layers, but not in the thin (1 mm thick) layer simulating FPR. With ultrasound imaging, only stiffness changes in layers thicker than 3 mm could be measured reliably. Significant correlations ranging from 0.70 to 0.98 (all p < 0.01) were found. The interrater reliability ranged from good to excellent (ICC(2,2) = 0.75-0.98). The results are encouraging for researchers and clinical practitioners as the investigated stiffness measurement tools are easy-to-use and comparatively affordable.

Influence of Rolfing Structural Integration on Active Range of Motion: A Retrospective Cohort Study.

Background: Recent work has investigated significant force transmission between the components of myofascial chains. Misalignments in the body due to fascial thickening and shortening can therefore lead to complex compensatory patterns. For the treatment of such nonlinear cause−effect pathology, comprehensive neuromusculoskeletal therapy such as the Rolf Method of Structural Integration (SI) could be targeted. Methods: A total of 727 subjects were retrospectively screened from the medical records of an SI practice over a 23-year period. A total of 383 subjects who had completed 10 basic SI sessions met eligibility criteria and were assessed for active range of motion (AROM) of the shoulder and hip before and after SI treatment. Results: Shoulder flexion, external and internal rotation, and hip flexion improved significantly (all p < 0.0001) after 10 SI sessions. Left shoulder flexion and external rotation of both shoulders increased more in men than in women (p < 0.0001) but were not affected by age. Conclusions: An SI intervention could produce multiple changes in the components of myofascial chains that could help maintain upright posture in humans and reduce inadequate compensatory patterns. SI may also affect differently the outcome of some AROM parameters in women and men.

Expert Consensus on the Contraindications and Cautions of Foam Rolling-An International Delphi Study.

BACKGROUND: Foam rolling is a type of self-massage using tools such as foam or roller sticks. However, to date, there is no consensus on contraindications and cautions of foam rolling. A methodological approach to narrow that research gap is to obtain reliable opinions of expert groups. The aim of the study was to develop experts' consensus on contraindications and cautions of foam rolling by means of a Delphi process. METHODS: An international three-round Delphi study was conducted. Academic experts, defined as having (co-) authored at least one PubMed-listed paper on foam rolling, were invited to participate. Rounds 1 and 2 involved generation and rating of a list of possible contraindications and cautions of foam rolling. In round 3, participants indicated their agreement on contraindications and cautions for a final set of conditions. Consensus was evaluated using a priori defined criteria. Consensus on contraindications and cautions was considered as reached if more than 70% of participating experts labeled the respective item as contraindication and contraindication or caution, respectively, in round 3. RESULTS: In the final Delphi process round, responses were received from 37 participants. Panel participants were predominantly sports scientists (n = 21), physiotherapists (n = 6), and medical professionals (n = 5). Consensus on contraindications was reached for open wounds (73% agreement) and bone fractures (84%). Consensus on cautions was achieved for local tissue inflammation (97%), deep vein thrombosis (97%), osteomyelitis (94%), and myositis ossificans (92%). The highest impact/severity of an adverse event caused by contraindication/cautions was estimated for bone fractures, deep vein thrombosis, and osteomyelitis. DISCUSSION: The mechanical forces applied through foam rolling can be considered as potential threats leading to adverse events in the context of the identified contraindications and cautions. Further evaluations by medical professionals as well as the collection of clinical data are needed to assess the risks of foam rolling and to generate guidance for different applications and professional backgrounds.

The Stiffness Comparison Test: A pilot study to determine inter-individual differences in palpatory skill related to gender, age, and occupation-related experience.

BACKGROUND: Manual palpation is a core skill in physical examination. Assessing elastic properties such as tissue stiffness has the potential for being an important diagnostics tool in the detection of cancer and other diseases. OBJECTIVE: The study describes the newly developed Stiffness Comparison Test (SCT). The aim of our study was to test the SCT as a tool to detect interindividual differences in palpation skill related to gender, age and occupational experience. METHODS: We used eight pairs of polyuterhane gel pads with the stiffness difference decreasing from the first to the last pair. Test subjects were asked to palpate each pair and determine stiffness differences. PARTICIPANTS: We recruited 25 osteopaths, 48 other manual therapists and 50 participants from other non-manual professions. RESULTS: As hypothesized there was no significant difference in SCT performance between the sexes (t(121) = 0.288, p = .774). To investigate if an age-related decline would have an effect on palpation skill, we carried out a linear regression. As hypothesized, the model did not predict any significant associations (F(1, 121) = 2.733, b = -0.149, p = .101, R2 = 0.022). To compare the effect of occupational groups on SCT performance a one-way ANOVA was conducted. There were no statistically significant differences between group means (F(2, 120) = 0.598, p = .552). CONCLUSIONS: The SCT can be used as simple and affordable tool for assessment, teaching and training in all disciplines of manual medicine. Further refinements of the tool are suggested to advance its discrimination power.

Chromatographic property classification of narrowly distributed ZnS quantum dots.

Although optimized synthesis methods for nanoparticles (NPs) on small scale can lead to narrow particle size distributions (PSDs) and thus defined optical properties, in particular during scale-up, an additional classification step must be applied to adjust the particle properties according to the needs of the later application. NP chromatography is a promising separation method, which can be potentially transferred to preparative and industrial scale. Herein, we demonstrate that remarkable classification of ZnS quantum dots (QDs) with respect to the fundamental band gap energy is achieved by chromatography although the PSD of the feed material is already very narrow (1.5-3.0 nm). We investigated the interactions of ZnS QDs with stationary and mobile phase materials in order to select a proper material couple so that irreversible NP adhesion, agglomeration, decomposition or dissolution of the ZnS QDs during the chromatographic experiments are avoided and highly reproducible chromatograms are obtained. Using a fraction collector, the already narrowly size distributed feed material was separated into coarse and fine fractions with distinct band gap energies. For characterization of the chromatographic fractionation, quantities known from particle technology, i.e. separation efficiency, cut size and yield, were adapted to the band gap energy distributions accessible from UV/Vis spectroscopy. The optimization of process conditions (flow rate, temperature, switching time of the fraction collector) allows fine-tuning of the property classification and therefore of the optical properties within the narrow distribution of the ZnS QDs. Our study shows the strength and high potential of chromatography for preparative and continuous separation of NPs even in case of narrow size-distributed sub-10 nm semiconductor QDs.

Dose-response relationship between physical activity and mortality in people with non-communicable diseases: a study protocol for the systematic review and meta-analysis of cohort studies.

INTRODUCTION: This study protocol outlines our planned systematic review and dose-response meta-analysis of postdiagnosis physical activity and mortality in people with non-communicable diseases (NCDs). METHODS AND ANALYSIS: This study is based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis for Protocols. A systematic literature search will be conducted in various databases-namely, PubMed, Scopus and Web of Science-by two researchers in order to identify prospective observational studies that investigate postdiagnosis physical activity or activity-related energy expenditure and mortality in individuals with NCDs. The target population is adults (≥18 years of age) with one of the following nine NCDs: low back pain, type 2 diabetes mellitus, osteoarthritis, depressive disorder, chronic obstructive pulmonary disease, breast cancer, lung cancer, stroke or ischaemic heart disease. We will focus on all-cause mortality as the primary outcome and investigate indication-specific mortality as the secondary outcome. For each study identified as a result of the literature search, we will conduct graphical dose-response analyses of mortality as a function of activity-related energy consumption. If more than two studies are available for one disease, we will perform linear and non-linear dose-response meta-analyses for said disease using random-effects models. We will investigate the heterogeneity of the studies and publication bias. To assess the risk of bias and the quality of the included studies, we will use the Risk Of Bias In Non-randomised Studies - of Interventions tool, which is a Cochrane tool. ETHICS AND DISSEMINATION: This systematic review will be conducted in compliance with ethical precepts. As the systematic review is based on published studies, approval from an ethics committee is not required. The systematic review and meta-analysis will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42018103357.

Labeling exercise fat-burning increases post-exercise food consumption in self-imposed exercisers.

The goal of the study was to determine whether the label given to an exercise bout affects immediate post-exercise food intake. The authors hypothesized that explicitly labeling an exercise bout 'fat-burning' (vs. labeling an exercise bout 'endurance' exercise) would increase post-exercise food intake in individuals who self-impose physical activity, because they are more likely to see the label as signal of activated fat metabolism and license to reward oneself. No such effect was expected for individuals who do not self-impose physical activity but consider exercise enjoyable. Ninety-six participants took part in an experiment manipulating the label given to an exercise bout (fat-burning exercise or endurance exercise) between participants. They cycled on an ergometer for 20 minutes at a consistent work rate (55-65% of predicted VO2 max) and were offered ad libitum food (i.e., pretzel pieces) after the exercise bout. The results showed that self-imposed exercisers, that is, individuals with low behavioral regulation and individuals with high psychological distress, high fatigue levels, and low positive well-being when exercising, ate more food after exercise when the bout was labeled fat-burning exercise rather than endurance exercise. The results help develop health interventions, indicating that the tendency to compensate for energy expended following physical activity depends on both the label given to the exercise bout and the degree to which individuals self-impose physical activity.