Quantitative Ultrasound Examination (QUS) of the Calcaneus in Long-Term Martial Arts Training on the Example of Long-Time Practitioners of Okinawa Kobudo/Karate Shorin-Ryu.

Quantitative research of bone tissue related to physical activity (PA) and sport has a preventive dimension. Increasing the parameters of bone tissue strength, especially reaching the maximum value of peak bone strength in childhood, adolescence, and early adulthood due to practicing sports can contribute to maintaining bone health throughout life. Practicing martial arts (tai chi, traditional karate, judo, and boxing) can effectively improve the quality of bone and reduce the risk of falls and fractures. The study aimed to evaluate the calcaneus bones among Okinawa Kobudo/Karate Shorin-Ryu practitioners using the quantitative ultrasound method as an indicator for assessing bone fracture risk. Forty-four adult martial arts practitioners with a mean age of 36.4 participated in this study. Quantitative ultrasound (QUS) with a portable Bone Ultrasonometer was used in this study. Speed of sound (SOS), broadband ultrasound attenuation (BUA), and the stiffness index (SI) were measured. Subjects were assigned to two groups of black and color belts, according to the advancement in Kobudo/karate practice. The measurements of the SI, BUA, SOS, T-score, and Z-score were significantly higher in subjects from the advanced, long-term practice (black belts) (p < 0.05). The long-term martial arts training in traditional karate and Kobudo significantly impacts the parameters of the calcaneus quantitative ultrasound measurements. Significantly higher bone density was observed among the black belt holders. Long-term practice subjects achieved results far beyond the norm for their age groups. Further studies using non-invasive methods of bone quantification are needed to determine the specific conditions for preventing osteoporosis through physical activity, sports, and martial arts, particularly the duration of the activity, the magnitude of loads, and other related factors.

Decreased Vertical Trunk Inclination Angle and Pelvic Inclination as the Result of Mid-High-Heeled Footwear on Static Posture Parameters in Asymptomatic Young Adult Women.

The influence of high-heel footwear on the lumbar lordosis angle, anterior pelvic tilt, and sacral tilt are inconsistently described in the literature. This study aimed to investigate the impact of medium-height heeled footwear on the static posture parameters of homogeneous young adult standing women. Heel geometry, data acquisition process, as well as data analysis and parameter extraction stage, were controlled. Seventy-six healthy young adult women with experience in wearing high-heeled shoes were enrolled. Data of fifty-three subjects were used for analysis due to exclusion criteria (scoliotic posture or missing measurement data). A custom structured light surface topography measurement system was used for posture parameters assessment. Three barefoot measurements were taken as a reference and tested for the reliability of the posture parameters. Two 30-degree wedges were used to imitate high-heel shoes to achieve a repeatable foot position. Our study confirmed the significant (p < 0.001) reduced vertical balance angle and pelvis inclination angle with large and medium-to-large effects, respectively, due to high-heel shoes. No significant differences were found in the kyphosis or lordosis angles. High-heeled shoes of medium height in young asymptomatic women can lead to a straightening effect associated with a reduced vertical balance angle and decreased pelvic inclination.

Translation, Cross-Cultural Adaptation, and Psychometric Properties of the Polish Version of the Hip Disability and Osteoarthritis Outcome Score (HOOS).

Background and Objectives: This study aimed to translate the Hip disability and Osteoarthritis Outcome Score (HOOS) into the Polish language, to determine its validity and reliability, and to assess its main psychometric properties. Materials and Methods: A total of 332 hip osteoarthritis (OA) subjects were recruited to the study group and 90 healthy subjects to the control group. The study consisted of the HOOS translation and the assessment of the discriminative power, internal consistency, and the potential floor and ceiling effects followed by the determination of the construct validity and test-retest reliability. The analysis was performed using Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and SF-36 questionnaires. Results: The translation process consisted of forward translation, reconciliation, backward translation, review, harmonization, and proofreading. The hip OA patients reported a reduced HOOS score when compared to the control subjects. The discriminant validity of the questionnaire was confirmed. A Cronbach's alpha of 0.97 was found, indicating a high internal consistency. The HOOS showed a significant correlation with the SF-36 and WOMAC, which ranged from r = -0.93, p-value < 0.05 for WOMAC total score to r = 0.92, and p-value < 0.05 for WOMAC daily living. No floor or ceiling effects were found. A very high intraclass correlation coefficient (ICC) was found (0.93-0.97) for the total score and the individual domains of the HOOS. Conclusions: The Polish HOOS is valid and reliable for evaluating the outcomes of hip OA patients in Poland. This questionnaire may be used with confidence for clinical and research purposes.

Association of sports and physical activity with obesity among teenagers in Poland.

OBJECTIVES: The purpose of the study was to assess the relationship between the body mass index and sports and physical activities in an unbiased, simple, random sample of teenagers from mid-northeastern Poland. MATERIAL AND METHODS: Children and adolescents aged 10-19 years old were surveyed. The Internet-based survey was conducted to collect information on physical activity, leisure time, studying hours, weight, and height. RESULTS: Obesity was found to be low in the study population. The overall prevalence of overweight was not higher than 8%. Only 0.6% of participants were underweight. Overall, 68% of them confirmed participating in sports. Boys were frequently more active than girls (> 70% boys and > 60% girls). Participants mostly played soccer, volleyball, handball, or basketball (30.5%); 7% of them practiced martial arts and 16.5% of them participated in swimming. Sports activity significantly influenced body mass index. Obesity was not related to the lack of participation for physical activity in girls but a significant relationship was observed in boys (p < 0.02). The risk of obesity or overweight for inactive teenagers increased 2-fold (p < 0.01). CONCLUSIONS: We report the overall participation of teenagers from 2 cities in mid-northeastern Poland in sports and physical activities and demonstrate that the lack of statistically significant differences in the body mass index and obesity and overweight is prevalent among boys and girls. Obesity was significantly related to less physical activity in boys, and the likelihood of obesity or overweight increased in inactive teenagers. Thus, we suggest that the importance of overweight and obesity prevention programs should be emphasized. Int J Occup Med Environ Health 2018;31(6):771-782.

Evaluation of the validity of treatment decisions based on surrogate country models before introduction of the Polish FRAX and recommendations in comparison to current practice.

INTRODUCTION: Patients diagnosed before the Polish FRAX was introduced may require re-evaluation and treatment changes if the diagnosis was established according to a surrogate country FRAX score. The aim of the study was to evaluate the validity of treatment decisions based on the surrogate country model before introduction of the Polish FRAX and to provide recommendations based on the current practice. MATERIAL AND METHODS: We evaluated a group of 142 postmenopausal women (70.7 ±8.9 years) who underwent bone mineral density measurements. We used 22 country-specific FRAX models and compared these to the Polish model. RESULTS: The mean risk values for hip and major osteoporotic fractures within 10 years were 4.575 (from 0.82 to 8.46) and 12.47% (from 2.18 to 21.65), respectively. In the case of a major fracture, 94.4% of women would receive lifestyle advice, and 5.6% would receive treatment according to the Polish FRAX using the guidelines of the National Osteoporosis Foundation (NOF). Polish treatment thresholds would implement pharmacotherapy in 32.4% of the study group. In the case of hip fractures, 45% of women according to the NOF would require pharmacotherapy but only 9.8% of women would qualify according to Polish guidelines. Nearly all surrogate FRAX calculator scores proved significantly different form Polish (p > 0.05). CONCLUSIONS: More patients might have received antiresorptive medication before the Polish FRAX. This study recommends re-evaluation of patients who received medical therapy before the Polish FRAX was introduced and a review of the recommendations, considering the side effects of antiresorptive medication.

The time effectiveness of three-dimensional telediagnostic postural screening of back curvatures and scoliosis.

BACKGROUND: Postural screening remains a powerful tool that can be used to identify children and adolescents with scoliosis or sagittal plane deformities. The aim of this study was to assess the time effectiveness of implemented telediagnostic screening procedures. MATERIALS AND METHODS: Medical images (virtual objects) of acquired clouds of points of 100 subjects of both sexes were chosen at random from the database and used for parametric evaluation for this study. This study was performed using a newly developed three-dimensional (3D) back surface topography measurement system for posture and scoliosis using a structured light method. The duration of each step of therapist/nurse/physician-assisted 3D assessment was measured independently with a stopwatch. Two configurations of PC computers and Internet connections were used to test the time effectiveness. Scoliotic postures were detected using cutoff values of angle of trunk rotation, Posterior Trunk Symmetry Index, and Deformity in the Axial Plane Index indices. RESULTS: The overall assessment of all subjects consumed from 2 h 55 min 55 s to 3 h 18 min 59 s dependent on PC and Internet connection configuration. Average examination time per subject ranged from 2 min 43 s to 4 min 51 s, respectively. The virtual landmarking and report generation times were dependent on the PC configuration (p<0.001). Our study confirmed satisfactory time effectiveness of the implemented telediagnostic postural screening procedure. We assume that it may influence the cost-effectiveness of the screening, which is usually mentioned as an important factor for recommendations against postural school screening. Relatively fast Internet connection and a medium-level PC configuration are sufficient for achieving a reasonably short time of 3D posture assessment of a virtual object representing a real subject's back surface. CONCLUSIONS: The efficiency of remote assessment of exact 3D surface topography can be used in large-scale studies for posture and scoliosis epidemiology.

Telediagnostic 3D school screening of back curvatures and posture using structured light method - pilot study.

BACKGROUND: Several studies consider the school scoliosis screening as controversial. Many authors postulate to improve its clinical effectiveness. AIM: Authors assumed that three dimensional telediagnostic surface topography measurements allowing measuring several postural deformity indexes and angles of curvatures in sagittal plane may enhance current practice. The study was designed to determine usefulness of school screening back evaluation performed utilizing the three dimensional telediagnostic measurement system. METHODS: The measurement module is based on structured light method using "3D Orthoscreen" system. The technique for 3D image acquisition of back shape is based on temporal phase shifting and Gray codes. Measurement data was securely archived for remote access by investigator over the secure Internet connection. Acquired "images" were transferred to Telediagnostic Center for clinical evaluation. Spine parameters and deformation indexes like Posterior Trunk Symmetry Index (POTSI), Deformity in the Axial Plane Index (DAPI), kyphosis and lordosis angle were measured. The preliminary study was performed in 2 selected schools (basic and middle schools). The study was approved by Bioethical Committee. Clouds of points representing back topography of assessed subjects were acquired at schools in March and May 2011 and stored for remote evaluation and analysis. RESULTS: 758 children averagely aged 11.1 years (from 5 to 16), 387 females and 371 males, were examined. Their average body mass was 45.13 kg [16-105; STD 16.4] and average height was 151.43 cm, [110-192; STD 18.3]. The average values of back assessment parameters were as follows: POTSI 15.97% [0-73.4; STD 10.3]; DAPI 0.88% [0-5.9; STD 0.76]; kyphosis angle 10.19° [0-32; STD 5.82]; and lordosis angle 32,82° [0-56; STD 9.86]. CONCLUSION: Technical and clinical issues of the practical implementation allowed to elaborate preliminary protocol for cohort studies addressed to subject (i.e. parents acceptance of examination of undressed back) and technical issues (i.e. upload data and retrieval, network transfer velocity). Postural telediagnostics was found sufficiently feasible for further implementation of remote, cohort 3D back shape evaluations including school screening. Permanently saved 3D data allow monitoring back surface of the individual subjects.