Establishment of hypertension risk nomograms based on physical fitness parameters for men and women: a cross-sectional study.

Objective: This study aims to establish hypertension risk nomograms for Chinese male and female adults, respectively. Method: A series of questionnaire surveys, physical assessments, and biochemical indicator tests were performed on 18,367 adult participants in China. The optimization of variable selection was conducted by running cyclic coordinate descent with 10-fold cross-validation through the least absolute shrinkage and selection operator (LASSO) regression. The nomograms were built by including the predictors selected through multivariable logistic regression. Calibration plots, receiver operating characteristic curves (ROC), decision curve analysis (DCA), clinical impact curves (CIC), and net reduction curve plots (NRC) were used to validate the models. Results: Out of a total of 18 variables, 5 predictors-namely age, body mass index, waistline, hipline, and resting heart rate-were identified for the hypertension risk predictive model for men with an area under the ROC of 0.693 in the training set and 0.707 in the validation set. Seven predictors-namely age, body mass index, body weight, cardiovascular disease history, waistline, resting heart rate, and daily activity level-were identified for the hypertension risk predictive model for women with an area under the ROC of 0.720 in the training set and 0.748 in the validation set. The nomograms for both men and women were externally well-validated. Conclusion: Gender differences may induce heterogeneity in hypertension risk prediction between men and women. Besides basic demographic and anthropometric parameters, information related to the functional status of the cardiovascular system and physical activity appears to be necessary.

Biomechanics of Topspin Forehand Loop in Table Tennis: An Application of OpenSim Musculoskeletal Modelling.

Topspin is one of the most attacking strokes in table tennis, and topspin forehand loop is an effective way to score. The aim of this study was to investigate the kinematics of the lower extremities in topspin forehand loop between different levels via OpenSim Musculoskeletal Modelling. Ten elite athletes (NL1) and ten medium athletes (NL2) performed the topspin forehand loop without muscle and joint injuries. An eight-camera Vicon motion capture system was used to measure the kinematics data. During the topspin forehand loop, the forward phase (FP) and the entire phase (EP) of the NL1 were significantly shorter than that of the NL2. In the sagittal plane, NL1 significantly had greater hip and ankle flexion and extension at range of motion (ROM) but less hip flexion and knee flexion at FP and less ankle flexion at BP than NL2. In the frontal plane, NL1 displayed less ROM in the hip joint and significantly less hip abduction ROM at the backward phase (BP). In the transverse plane, NL1 had a significantly greater ROM in the hip joint and displayed significantly less hip ROM at the BP. The level differences presented in this study could help table tennis athletes to improve performance and coaches to develop technical training.

Sex-specific differences in biomechanics among runners: A systematic review with meta-analysis.

Patellofemoral disorders are more common in female runners compared to their male counterparts. Differences in biomechanical characteristics between groups of runners could provide insight into the causes of higher rates of injury in female versus male runners, which would be useful to physical therapists and athletic trainers in development of individualized injury prevention programs. This review compares the differences in biomechanical characteristics between female and male runners. Electronic databases, including PubMed, Scopus, Web of Science, and Embase were searched in December 2021 for studies evaluating sex-specific differences in lower limb mechanics of healthy participants during running. Two independent reviewers determined the inclusion and quality of each research paper. Meta-analyses were used where possible. A total of 13 studies were selected. Means and standard deviations of reported data were retrieved from each selected paper for comparison of results. Three biomechanical variables, including dynamics, muscle activation, and kinematics, were compared between female and male runners. However, no differences were found in kinetic variables or muscle activation between groups due to insufficient data available from the selected studies. Meta-analyses of kinematic variables revealed that female runners exhibited significantly greater hip flexion angle, hip adduction angle, and hip internal rotation angle, but smaller knee flexion angle compared to male runners during running. We found significant differences in kinematic variables between female and male runners, which could influence the training advice of physical therapists and athletic trainers who work with runners, and inform the development of injury prevention programs.

Mixed Comparison of Different Exercise Interventions for Function, Respiratory, Fatigue, and Quality of Life in Adults With Amyotrophic Lateral Sclerosis: Systematic Review and Network Meta-Analysis.

Background: Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease whose primary hallmark is the progressive degeneration of motor neurons in the brainstem, spinal cord, and cerebral cortex that leads to weakness, spasticity, fatigue, skeletal muscle atrophy, paralysis, and even death. Exercise, as a non-pharmacological tool, may generally improve muscle strength, cardiovascular function, and quality of life. However, there are conflicting reports about the effect of exercise training in adults with ALS. Aims: This systematic review and network meta-analysis aim to conduct a mixed comparison of different exercise interventions for function, respiratory, fatigue, and quality of life in adults with ALS. Methods: Randomized controlled trials with ALS participants were screened and included from the databases of PubMed, Medline, and Web of Science. Physical exercise interventions were reclassified into aerobic exercise, resistance training, passive exercise, expiratory muscle exercise, and standard rehabilitation. Patient-reported outcome measures would be reclassified from perspectives of function, respiratory, fatigue, and quality of life. The effect size would be transferred into the percentage change of the total score. Result: There were 10 studies included, with the agreement between authors reaching a kappa-value of 0.73. The network meta-analysis, which was conducted under the consistency model, identified that a combined program of aerobic exercise, resistance exercise, and standard rehabilitation showed the highest potential to improve quality of life (0.64 to be the best) and reduce the fatigue (0.39 to be the best) for ALS patients, while exercise program of aerobic and resistance training showed the highest potential (0.51 to be the best) to improve ALS patients' physical function. The effect of exercise on the respiratory was still unclear. Conclusion: A multi-modal exercise and rehabilitation program would be more beneficial to ALS patients. However, the safety and guide for practice remain unclear, and further high-quality randomized controlled trials (RCTs) with a larger sample are still needed. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021253442, CRD42021253442.

Biomechanical Characteristics of the Typically Developing Toddler Gait: A Narrative Review.

Independent ambulation is one of the most important motor skills in typically developing toddlers. Gait analysis is a key evaluation method in basic and clinical research. A narrative review on the literature of toddler gait development was conducted following inclusion criteria, explicitly including the factors of English article, age range, no external intervention during the experimental process of studies involved, the non-symptomatic toddler, and no pathological gait. Studies about toddlers' morphological, physiological, and biomechanical aspects at this developmental stage were identified. Remarkable gait characteristics and specific development rules of toddlers at different ages were reported. Changes in gait biomechanics are age and walking experience-dependent. Gait patterns are related to the maturation of the neuro and musculoskeletal systems. This review thus provides critical and theoretical information and the nature of toddler walking development for clinicians and other scientific researchers. Future studies may systematically recruit subjects with more explicit criteria with larger samples for longitudinal studies. A particular design could be conducted to analyze empirically before practical application. Additionally, the influence of external interventions on the development of toddler gait may need consideration for gait development in the toddler cohort.

The Relationship between Patellofemoral Pain Syndrome and Hip Biomechanics: A Systematic Review with Meta-Analysis.

(1) Background and purpose: Muscular control and motor function in a patient with Patellofemoral pain syndrome (PFPS) have not yet been investigated systematically. Therefore, this review synthesis the previous results about the association of PFPS with gluteus muscle activation, hip strength, and kinematic characteristic of the hip and knee joint, to deepen understanding of the PFPS etiology and promote the establishment of an effective treatment strategy. (2) Methods: A literature search was conducted from January 2000 to July 2022 in four electronic databases: Medline, Embase, Google scholar, and Scopus. A total of 846 articles were initially identified, and after the screening process based on the inclusion criteria, 12 articles were eventually included. Means and SDs of gluteus medius (GMed), gluteus maximus (GMax), hip strength, and kinematic variation of hip and knee were retrieved from the present study. (3) Results and conclusion: Regarding kinematic variation, moderate evidence indicates that an increased peak hip adduction was found in PFPS groups during running and single leg (SL) squat activities. There is no difference in the GMed and GMax activation levels between the two groups among the vast majority of functional activities. Most importantly, strong evidence suggests that hip strength is weaker in individuals with PFPS, showing less strength of hip external rotation and hip abduction compared to the control group. However, without prospective studies, it is difficult to determine whether hip strength weakness is a cause or a result of PFPS. Therefore, further research is needed to evaluate the hip strength level in identifying individuals most likely to associated with PFPS development is needed.

An Investigation of Differences in Lower Extremity Biomechanics During Single-Leg Landing From Height Using Bionic Shoes and Normal Shoes.

Bionic shoes utilizing an actual foot shape sole structure can alter lower limb's biomechanics, which may help in the development of specific training or rehabilitation programs. The purpose of this study was to investigate the biomechanical differences in the lower limb during a single-leg landing task using bionic shoes (BS) and normal shoes (NS). Fifteen healthy male subjects participated in this study, sagittal, and frontal plane data were collected during the landing phase (drop landing from 35 cm platform). Our study showed that BS depicted a significantly greater minimum knee flexion angle at initial contact (p = 0.000), a significantly greater minimum (initial contact) hip flexion angle at initial contact (p = 0.009), a significantly smaller sagittal plane total energy dissipation (p = 0.028), a significantly smaller frontal plane total energy dissipation (p = 0.008), a significantly smaller lower limb total energy dissipation (p = 0.017) than NS during the landing phase. SPM analysis revealed that BS depicted a significantly smaller knee joint vertical reaction force during the 13.8-19.8% landing phase (p = 0.01), a significantly smaller anterior tibia shear force during the 14.2-17.5% landing phase (p = 0.024) than NS. BS appears to change lower limb kinematics at initial contact and then readjust the landing strategies for joint work and joint reaction force, thereby reducing the risk of lower limb skeletal muscle injury. BS have great potential for future development and application uses, which may help athletes to reduce lower limb injury risk.

Gender Differences in Kinematic Analysis of the Lower Limbs during the Chasse Step in Table Tennis Athletes.

The chasse step is one of the most important footwork maneuvers used in table tennis. The purpose of this study was to investigate the lower limb kinematic differences of table tennis athletes of different genders when using the chasse step. The 3D VICON motion analysis system was used to capture related kinematics data. The main finding of this study was that the step times for male athletes (MA) were shorter in the backward phase (BP) and significantly longer in the forward phase (FP) than for female athletes (FA) during the chasse step. Compared with FA, knee external rotation for MA was larger during the BP. MA showed a smaller knee flexion range of motion (ROM) in the BP and larger knee extension ROM in the FP. Moreover, hip flexion and adduction for MA were significantly greater than for FA. In the FP, the internal rotational velocity of the hip joint was significantly greater. MA showed larger hip internal rotation ROM in the FP but smaller hip external rotation ROM in the BP. The differences between genders can help coaches personalize their training programs and improve the performance of both male and female table tennis athletes.

Principal Component Analysis of the Running Ground Reaction Forces With Different Speeds.

Ground reaction force (GRF) is a key metric in biomechanical research, including parameters of loading rate (LR), first impact peak, second impact peak, and transient between first and second impact peaks in heel strike runners. The GRFs vary over time during stance. This study was aimed to investigate the variances of GRFs in rearfoot striking runners across incremental speeds. Thirty female and male runners joined the running tests on the instrumented treadmill with speeds of 2.7, 3.0, 3.3, and 3.7 m/s. The discrete parameters of vertical average loading rate in the current study are consistent with the literature findings. The principal component analysis was modeled to investigate the main variances (95%) in the GRFs over stance. The females varied in the magnitude of braking and propulsive forces (PC1, 84.93%), whereas the male runners varied in the timing of propulsion (PC1, 53.38%). The female runners dominantly varied in the transient between the first and second peaks of vertical GRF (PC1, 36.52%) and LR (PC2, 33.76%), whereas the males variated in the LR and second peak of vertical GRF (PC1, 78.69%). Knowledge reported in the current study suggested the difference of the magnitude and patterns of GRF between male and female runners across different speeds. These findings may have implications for the prevention of sex-specific running-related injuries and could be integrated with wearable signals for the in-field prediction and estimation of impact loadings and GRFs.

Adjusted Indirect and Mixed Comparisons of Conservative Treatments for Hallux Valgus: A Systematic Review and Network Meta-Analysis.

Background: Hallux valgus (HV) deformity is a common, potentially debilitating deformity. And evidence with high-quality for the conservative treatments of HV deformity is still required.; AIMS: To compare the effects of different conservative treatments for hallux valgus deformity by using the method of network meta-analysis.; Study Design: A systematic review and network meta-analysis of randomized controlled trials identified by searching PubMed, EMBASE, MEDLINE, OVID, and CINAHL. The included studies should have the characteristics that: (1) participants with hallux valgus deformity of any age (2) conservative treatments (3) Reported the hallux valgus (HVA), the intermetatarsal angle (IMA), the score of the Visual Analog Scale, and the score of Foot Function Index.; Results: 11 studies were included in this review. The agreement between reviewers reached a kappa value of 0.75. The results of the network meta-analysis showed that a combination of exercise and toe separator, night splints, and dry needling are most likely to be the best choice for reducing the hallux valgus angle (HVA) and intermetatarsal angle, and toe separators (with or without exercise), dry needling, and manipulation (with or without ice treatment) have advantages in improving the subjective feeling of patients.; Conclusions: Multi-disciplinary conservative treatments have a great potential for hallux valgus deformity. More research with high-quality is needed to give a comprehensive and reasonable scheme of a holistic and long-term treatment protocol.

Effect of Different Exercise Modalities on Oxidative Stress: A Systematic Review.

Exercise-induced benefits are being increasingly recognized in promoting health and preventing diseases. However, initial adaption to exercise response can have different effects on cells, including an increase in the formation of oxidants and inflammatory mediators that ultimately leads to oxidative stress, but this scenario depends on the exercise type and intensity and training status of the individual. Therefore, we aimed to understand the effect of different types of exercise on oxidative stress. Indeed, exercise-induced minimum oxidative stress is required for regulating signaling pathways. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, a search for relevant articles was carried out on PubMed/Medline, ISI Web of Science, and Google Scholar using a broad range of synonyms such as oxidants, reactive oxygen species (ROS), oxidative stress, exercise, physical training, aerobic exercise, and strength exercise until 2019. This study selected a total of 18 articles for assessing the oxidative damage using various parameters such as malondialdehyde (MDA), protein carbonyl (PCO), and F1-isoprostanes and enzymatic antioxidants. We observed that any type of exercise can increase the oxidative damage in an exercise type and intensity manner. Further, the training status of the individual and specific oxidative damage marker plays a crucial role in predicting earlier oxidative damage in the exercise condition. However, some of the studies that we included for review did not perform follow-up evaluations. Therefore, follow-up programs using larger numbers need to be performed to confirm our findings.

Taurine Reverses Oxidative Damages and Restores the Muscle Function in Overuse of Exercised Muscle.

Exercise-induced oxidative stress is linked with the expression level of endogenous antioxidants, but these antioxidants cannot overcome all oxidative stress-related damages in the cells, particularly when cells are under physiological stress. Sometimes, compounds are needed for cellular function, which are produced/activated within the cells, and these compounds can be synthesized by performing exercise, especially high-performance exercise. Taurine is a sulfur-containing amino acid used for various physiological functions. However, its synthesis and accumulation under the oxidative environment may be compromised. Recently, we have shown that taurine level is increased during exercise performance with a decrease in oxidative damage in overused muscles. Other studies have also shown that short-term supplementation with taurine increased physiological performance during severe work intensities, suggesting the role of taurine in improving muscle performance during exercise. However, its precursor cysteine is used in the synthesis of other compounds like GSH and Coenzyme A, which are important for regulating the redox system and energy homeostasis. It is, therefore, important to understand whether taurine synthesis within the cells can blunt the activity of other compounds that are beneficial in preventing oxidative damage during intense exercise. Furthermore, it is important to understand whether taurine supplementation can prevent the conditions observed in the physiological stress of muscles. This review discusses how taurine synthesis could alter exercise-induced ROS generation and the relationship between the physiological stress of muscle and subsequent improvements in exercise performance.

Relationship between Firefighter Physical Fitness and Special Ability Performance: Predictive Research Based on Machine Learning Algorithms.

Firefighters require a high level of physical fitness to meet the demands of their job. The correlations and contributions of individual physical health parameters to the tasks of firefighting would enable firefighters to focus on the effects of specific physical conditions during their physical training programs. Therefore, the purpose of the present study was to identify the relationships between various physical health parameters (weight, maximum oxygen uptake, body fat percentage, upper body muscular power and lower body muscular power) and performance on simulated firefighting ability tasks, which included a set of seven tasks (rope climb, run 200 m round trip with load, 60 m carrying a ladder, climb stairs with load, evacuation of 400 m with supplies, run 5 km with an air respirator, run 100 m with the water hose). Through use of a partial least-squares regression (PLSR) algorithm to analyze the linear correlation, we revealed the change in various training performances of specific ability tests with physical fitness parameters. The present study demonstrated significant relationships among physical health parameters and performance on simulated firefighting ability tasks, which also represent that those parameters contributed significantly to the model's predictive power and were suitable predictors of the simulated firefighting tasks score.

Temporal Kinematic Differences between Forward and Backward Jump-Landing.

Backward jump-landing during sports performance will result in dynamic postural instability with a greater risk of injury, and most research studies have focused on forward landing. Differences in kinematic temporal characteristics between single-leg and double-leg backward jump-landing are seldom researched and understood. The purpose of this study was to compare and analyze lower extremity kinematic differences throughout the landing phases of forward and backward jumping using single-leg and double-leg landings (FS and BS, FD and BD). Kinematic data were collected during the landing phases of FS and BS, FD and BD in 45 participants. Through statistical parametric mapping (SPM) analysis, we found that the BS showed smaller hip and knee flexion and greater vertical ground reactive force (VGRF) than the FS during 0-37.42% (p = 0.031), 16.07-32.11% (p = 0.045), and 23.03-17.32% (p = 0.041) landing phases. The BD showed smaller hip and knee flexion than the FD during 0-20.66% (p = 0.047) and 0-100% (p < 0.001) landing phases. Most differences appeared within a time frame during the landing phase at 30-50 ms in which non-contact anterior cruciate ligament (ACL) injuries are thought to occur and are consistent with the identification of risk in biomechanical analysis. A landing strategy that consciously increases the knee and hip flexion angles during backward landing should be considered for people as a measure to avoid injury during the performance of this type of physical activity.

A Pilot Study of Musculoskeletal Abnormalities in Patients in Recovery from a Unilateral Rupture-Repaired Achilles Tendon.

The purpose of this study was to compare the inter-limb joint kinematics, joint moments, muscle forces, and joint reaction forces in patients after an Achilles tendon rupture (ATR) via subject-specific musculoskeletal modeling. Six patients recovering from a surgically repaired unilateral ATR were included in this study. The bilateral Achilles tendon (AT) lengths were evaluated using ultrasound imaging. The three-dimensional marker trajectories, ground reaction forces, and surface electromyography (sEMG) were collected on both sides during self-selected speed during walking, jogging and running. Subject-specific musculoskeletal models were developed to compute joint kinematics, joint moments, muscle forces and joint reaction forces. AT lengths were significantly longer in the involved side. The side-to-side triceps surae muscle strength deficits were combined with decreased plantarflexion angles and moments in the injured leg during walking, jogging and running. However, the increased knee extensor femur muscle forces were associated with greater knee extension degrees and moments in the involved limb during all tasks. Greater knee joint moments and joint reaction forces versus decreased ankle joint moments and joint reaction forces in the involved side indicate elevated knee joint loads compared with reduced ankle joint loads that are present during normal activities after an ATR. In the frontal plane, increased subtalar eversion angles and eversion moments in the involved side were demonstrated only during jogging and running, which were regarded as an indicator for greater medial knee joint loading. It seems after an ATR, the elongated AT accompanied by decreased plantarflexion degrees and calf muscle strength deficits indicates ankle joint function impairment in the injured leg. In addition, increased knee extensor muscle strength and knee joint loads may be a possible compensatory mechanism for decreased ankle function. These data suggest patients after an ATR may suffer from increased knee overuse injury risk.

Current Evidence on Traditional Chinese Exercise for Cancers: A Systematic Review of Randomized Controlled Trials.

Traditional Chinese exercise (TCE) has gradually become one of the widespread complementary therapies for treatment and recovery of cancers. However, evidence based on the systematic evaluation of its efficacy is lacking, and there appears to be no conclusion regarding the setting of TCE interventions. The purpose of this systematic review is to summarize the current randomized controlled trials (RCTs) that outline the effects of TCE on cancer patients. Relevant studies were searched by GOOGLE SCHOLAR, SCIENCEDIRECT, and WEB OF SCIENCE using "traditional Chinese exercise" and "cancer." Only RCTs published in peer-reviewed English journals were included. A total of 27 studies covering 1616 cancer patients satisfied the eligibility criteria for this review. Despite the methodological limitation and relatively high risk of bias possessed by some included studies, positive evidence was still detected on the effects of TCE on these cancer-related health outcomes in physical, psychological, and physiological parameters. The 60-min or 90-min course of TCE intervention for two to three times per week for 10 to 12 weeks was found to be the most common setting in these studies and has effectively benefited cancer patients. These findings add scientific support to encourage cancer patients to practice TCE during or after conventional medical treatment. Nevertheless, future well-designed RCTs with improved methodology and larger sample size on this field are much warranted for further verification.

Benefits of Exercise on Influenza or Pneumonia in Older Adults: A Systematic Review.

A coronavirus pandemic has recently become one of the greatest threats the world is facing. Older adults are under a high risk of infection because of weaker immune systems. Therefore, the purpose of this review is to summarize the recent scientific evidence that outlines the effects of exercise on influenza or pneumonia in older adults. An electronic literature search was conducted using the WEB OF SCIENCE, SCIENCEDIRECT and GOOGLE SCHOLAR databases using the following keywords, "Exercise," "Older adult," "Influenza," and "Pneumonia." Any randomized control trials, cross-sectional and observational studies that related to this topic were all included. Twenty studies met the eligibility criteria for this review. Thirteen randomized control trials investigated the effects of exercise on the immune responses to influenza or pneumonia vaccination: seven trials employed moderate aerobic exercise, three employed resistance exercise, and the remaining three used Asian martial arts or special home-based exercises. Five cross-sectional and two observational studies examined the associations between exercise/physical condition and influenza/pneumonia. Most of the current studies suggested that prolonged moderate aerobic exercise may help to reduce the risk of influenza-related infection and improve the immune responses to influenza or pneumonia vaccination in older adults. In addition, training in traditional Asian martial arts was also found to be beneficial. Future research should focus on the different effects of moderate and vigorous exercise on influenza-related diseases.

Current Evidence on Traditional Chinese Exercises for Quality of Life in Patients With Essential Hypertension: A Systematic Review and Meta-Analysis.

Essential hypertension is one of the most common chronic diseases seen in primary human health care that could lead to various health problems and reduce the quality of life (QOL). This study was performed to evaluate the effects of traditional Chinese exercises (TCE) on QOL in patients with essential hypertension. Three English databases and one Chinese database were searched for randomized controlled trials (RCTs) until August 2020. A total of 13 RCTs with 1,361 hypertensive patients met the inclusion criteria, 10 trials employed Tai Chi and 3 trials employed Qigong, including Dongeui Qinggong, Yijinjing, and Wuqinxi. Despite a large heterogeneity within studies, it is demonstrated that TCE may be an effective therapy to improve the QOL of hypertensive patients. More specific, compared with no intervention, the meta-analysis presented that Tai Chi significantly improved both the physical and mental component of the 36-item short-form health survey (SF-36) QOL scale, and it was found that the simplified 24-form Tai Chi with a frequency of 30-50 min per session at five to eight sessions per week was the most commonly used setting. The pooling also revealed that Tai Chi and Qigong had some significantly positive effects on QOL based on other scales. However, more rigorously designed RCTs are warranted for further verification. This systematic review and meta-analysis of RCTs demonstrated that Tai Chi may be an effective therapy to improve the QOL of patients with essential hypertension. All these findings provide helpful information for hypertensive patients and medical personnel.