Speech production and perception data collection in R: A tutorial for web-based methods using speechcollectr.

This tutorial is designed for speech scientists familiar with the R programming language who wish to construct experiment interfaces in R. We begin by discussing some of the benefits of building experiment interfaces in R-including R's existing tools for speech data analysis, platform independence, suitability for web-based testing, and the fact that R is open source. We explain basic concepts of reactive programming in R, and we apply these principles by detailing the development of two sample experiments. The first of these experiments comprises a speech production task in which participants are asked to read words with different emotions. The second sample experiment involves a speech perception task, in which participants listen to recorded speech and identify the emotion the talker expressed with forced-choice questions and confidence ratings. Throughout this tutorial, we introduce the new R package speechcollectr, which provides functions uniquely suited to web-based speech data collection. The package streamlines the code required for speech experiments by providing functions for common tasks like documenting participant consent, collecting participant demographic information, recording audio, checking the adequacy of a participant's microphone or headphones, and presenting audio stimuli. Finally, we describe some of the difficulties of remote speech data collection, along with the solutions we have incorporated into speechcollectr to meet these challenges.

Dual career through the eyes of university student-athletes in the Republic of Kosovo.

Introduction: The successful combination of a sports career and education, known as the dual career, requires cooperation and a multi-dimensional approach. Although extensive research has been conducted on dual career programs and services in developed countries, there is limited information available on the dual-career phenomenon in developing countries. This study aimed to explore the dual career experiences of university student-athletes in the Republic of Kosovo. Materials and methods: A 30-item online survey was distributed to student-athletes, addressing various aspects of the dual career. A total of 121 student-athletes (males: 63.6%; females: 36.4%) voluntarily participated in the survey. Results: These student-athletes represented 13 different sports, with 102 (84.3%) participating in team and 19 (15.7%) in individual sports. Between individual and team sports no significant differences were found regarding university and sports engagement, and the time required to travel from the university to the training venue, whereas a significant difference (p = 0.019) emerged for the time needed to travel from home to the training venue. Significant differences (p < 0.05) were found between university majors in terms of sports engagement. The present findings highlight a lack of familiarity with dual career programs among student-athletes (89.3%) and the need for dual-career policies at the university (16.5%), sport (9.9%), and national (13.2%) levels. Student-athletes faced various challenges, mainly related to limited leisure time (62.8%), academic overload (60.3%), frequent absence from classes (59.6%), and financial uncertainty (35.5%). Recommended improvements included increased financial support (66.1%), the availability of sports facilities at or near the university (48.8%), greater educational flexibility (26.4%), tutoring services at the university (25.6%), and sports clubs (19%) levels, as well as improved communication regarding existing initiatives and legal aspects (53.7% and 47.1%, respectively). The study also identified parents (98.3%), coaches (86%), and siblings (60.3%) as important sources of support for student-athletes at personal, sports, and university levels. Conclusions: In conclusion, to enhance the potential of future student-athletes in the Republic of Kosovo, relevant stakeholders in sports and higher education should collaborate closely and implement programs and services based on international best practices for dual-career support.

Lower limb muscle activation pattern in male soccer players with lumbar hyperlordosis.

OBJECTIVE: the aim of the current study was to compare the lower limb muscle activation pattern in soccer players with and without lumbar hyperlordosis during single-leg squat performance. METHODS: thirty male collegiate soccer players (15 with and 15 without lumbar hyperlordosis) performed the SLS task. Surface EMG was used to record the activation of eleven lower limb muscles. The activation of these muscles reduces to 100 points during the SLS cycle, where 50% demonstrates the maximum knee flexion, and 0% and 99% demonstrate the maximum knee extension. RESULTS: soccer players with lumbar hyperlordosis had higher muscle activation than those with normal lumbar lordosis in gluteus maximus, biceps femoris, and medial gastrocnemius. By contrast, they had lower gluteus medius, vastus medialis oblique, rectus femoris, soleus, and medial gastrocnemius (only in the final ascent phase of the SLS) muscle activity than the normal group during the SLS. CONCLUSION: this alteration may negatively affect targeted muscle performance during the SLS. Subsequent study is required to specify whether such an alteration in the lower limb muscle could be accompanied by injury in soccer players and change in their athletic performance.

Breastfeeding and Antepartum Breast Milk Expression (BABE): A Randomized Control Trial Utilizing an Electric Breast Pump and its Effect on Postpartum Breastfeeding.

Objective: To evaluate the effect of antenatal breast milk expression (ABE) on exclusive breastfeeding. Materials and Methods: A randomized control study was performed with the primary outcome being formula use during the postpartum hospital stay. Secondary outcomes were the exclusive breastfeeding rate at 6 months postpartum and peripartum safety outcomes. Participants included multiparous and nulliparous patients who planned to breastfeed. Exclusion criteria included exclusively breastfeeding in prior pregnancies for greater than 6 months, medical contraindications for breastfeeding, multiple gestation, history of preterm delivery, or any contraindication to vaginal delivery. ABE group participants were instructed to pump for 20 minutes, three times daily, starting at 37 weeks of gestation. Results: Three-hundred four participants from two clinics were enrolled. There was no significant difference in formula use during hospital admission (odds ratio [OR] 0.64, 95% confidence interval [CI] 0.34-1.22) or in exclusive breastfeeding at 6 months postpartum (OR 0.66, 95% CI 0.34-1.29). Colostrum use was more prevalent in the ABE group (OR 5.31, 95% CI 2.63-10.76). ABE participants were more likely to present in spontaneous labor (OR 2.09, 95% CI 1.05-4.14). Conclusion: ABE did not significantly improve exclusive breastfeeding rates, but safely provides women opportunities to become familiar with breastfeeding before delivery and can provide readily available colostrum. There was no negative secondary safety outcome related to ABE identified. Prenatal care providers can consider recommending ABE to patients with minimal to no experience with breastfeeding.

Comparing kinematic asymmetry and lateral step-down test scores in healthy, chronic ankle instability, and patellofemoral pain syndrome female basketball players: a cross-sectional study.

We aimed to understand whether ankle dorsiflexion range of motion (ROM) and dynamic knee valgus (DKV) kinematic inter-limb asymmetries would be associated with the Lateral Step-Down Test (LSD) in basketball players with chronic ankle instability (CAI), patellofemoral pain (PFP) and healthy controls (HC). An observational cross-sectional study with a between-subject design was employed. Female basketball athletes with CAI (n = 20), PFP (n = 20) and HC (n = 20) were recruited. Ankle dorsiflexion-ROM, DKV angle during a single-limb squat, and LSD quality were measured bilaterally. The Asymmetry index (ASI) was calculated to identify between-limb percentage imbalances. The correlation matrix between the tasks was calculated. Ankle dorsiflexion-ROM was less in the CAI and PFP than in the HC group regardless of limb (p < 0.001). DKV angle was greater in the CAI and PFP than in the HC group bilaterally (p < 0.001). LSDs were similar between the PFP and CAI groups (p = 0.698) but worse than the HC group (p = 0.001). The ASI showed asymmetry across all tasks (p < 0.001), with the greatest asymmetry for the DKV angle. The correlation matrix between tasks on both limbs was significant (p < 0.05). Our findings suggest significant asymmetries in ankle dorsiflexion-ROM and frontal plane knee control are present in female basketball athletes with CAI and PFP, and thus, highlights need to evaluate and reduce limb asymmetries in these populations.

Within-session and between-session effects of auditory biofeedback training on center of pressure location during gait in patients with chronic ankle instability.

OBJECTIVES: To establish preliminary gait training dosage parameters for patients with chronic ankle instability (CAI) by determining the within-session and between-session effects of auditory biofeedback training on center of pressure (COP) location during gait. DESIGN: Observational Longitudinal. SETTING: Laboratory. PARTICIPANTS: 19 participants with CAI, 8 participants who did not receive auditory biofeedback (NoFeedback group) and 11 participants who did receive auditory biofeedback (AuditoryFeedback group) over an 8-session 2-week intervention. MAIN OUTCOME MEASURES: COP location was measured at the start and at each 5-min interval during treadmill walking across all eight 30-min training sessions. RESULTS: The AuditoryFeedback group had significant within-session lateral-to-medial shifts in COP location during only session-1 at the 15-min (45% of stance; peak mean difference = 4.6 mm), 20-min (35% and 45%; 4.2 mm), and 30-min time intervals (35% and 45%; 4.1 mm). Furthermore, the AuditoryFeedback group had significant between-session lateral-to-medial shifts in COP location at session-5 (35-55% of stance; 4.2 mm), session-7 (35%-95%; 6.7 mm), and session-8 (35%-95%; 7.7 mm). The NoFeedback group had no significant changes in COP location within-sessions or between-sessions. CONCLUSIONS: Participants with CAI who received auditory biofeedback during gait needed an average of 15-min during session-1 to meaningfully shift their COP location medially and 4-sessions before retaining the adapted gait pattern.

Exercise-Induced Changes in Femoral Cartilage Thickness in Patients With Patellofemoral Pain.

CONTEXT: Rehabilitative exercises alleviate pain in patients with patellofemoral pain (PFP); however, no researchers have analyzed the cartilage response after a bout of those athletic activities in patients with PFP. OBJECTIVE: To determine if a single session of rehabilitative exercises alters femoral cartilage morphology. DESIGN: Crossover study. SETTING: Research laboratory. PATIENTS OR OTHER PARTICIPANTS: Twelve participants with PFP (age = 21.0 ± 2.0 years, height = 1.72 ± 0.1 m, mass = 68.7 ± 12.6 kg) and 12 matched healthy participants (age = 21.3 ± 2.8 years, height = 1.71 ± 0.1 m, mass = 65.9 ± 12.2 kg) were enrolled. INTERVENTION(S): Participants completed treadmill running, lower extremity strengthening exercises, and plyometric exercises for 30 minutes each. MAIN OUTCOME MEASURE(S): Patient-reported outcomes on the visual analog scale, Anterior Knee Pain Scale (AKPS), Knee injury and Osteoarthritis Outcome Score (KOOS), and Knee Injury and Osteoarthritis Outcome Score for Patellofemoral Pain and Osteoarthritis were collected. Femoral cartilage ultrasonographic images were obtained at 140° of knee flexion. Ultrasound images were segmented into medial and lateral images using the intercondylar notch. Medial and lateral cartilage cross-sectional area (mm2) and echo intensity (EI), defined as the average grayscale from 0 to 255, were analyzed by ImageJ software. The difference between loading conditions was calculated using repeated-measures analysis of variance. The Spearman correlation was calculated to find the association between the cartilage percentage change (Δ%) and patient-reported outcomes. RESULTS: Pain increased in the PFP group after all loading conditions (P values < .007). No differences were found in cartilage cross-sectional area or EI alteration between or within groups (P values > .06). The KOOS was negatively associated with the Δ% of the lateral femoral cartilage EI after plyometric loading (ρ = -0.87, P = .001), and the AKPS score was positively correlated with the Δ% of lateral femoral cartilage EI (ρ = 0.57, P = .05). CONCLUSIONS: Ultrasound imaging did not identify cartilaginous deformation after all loading conditions. However, because lateral cartilaginous EI changes were associated with the AKPS and KOOS score, those questionnaires may be useful for monitoring changes in femoral cartilage health.

The challenge point framework to improve stepping reaction and balance in children with hemiplegic cerebral palsy: A case series study.

PURPOSE: This study investigated the effects of the challenge point framework (CPF) to improve stepping reactions and enhance balance in children with hemiplegic cerebral palsy (HCP). The CPF relates practice variables to the skill level of the individual and task difficulty. METHODS: Nine children with HCP (age: 7.7±2.4 years) completed six weeks (12 sessions) of a CPF intervention which consisted of progressively fewer sets and repetitions of a stepping reaction task wherein participants sought to improve both step length and reaction rate. Stepping reaction (step length and reaction rate) to a balance perturbation in the anterior, posterior, and lateral directions and static and dynamic balance (via the Pediatric Balance Scale) were measured at baseline, a second baseline 3 weeks later, and post-intervention. Repeated measures ANOVAs determined within-group changes. Cohen's d effect sizes were calculated. RESULTS: Participants improved balance (d = 0.948, p = 0.010), step length (forward d = 0.938, p = 0.002; backward d = 0.839, p = 0.001; and lateral d = 0.876, p = 0.002), and reaction rate (forward d = 0.249, p = 0.042; backward d = 0.21, p = 0.047; and lateral d = 0.198, p = 0.049). CONCLUSION: These findings indicate that children with HCP may benefit from completing a CPF program with a motor learning approach. This approach of retraining stepping reactions helped to improve static and dynamic balance. The CPF may aid progression of functional task training in children with HCP aged 4-12, though more studies with a long-term follow-up analysis are needed to confirm this result.

Differences in health-related quality of life among patients after ankle injury.

Ankle sprains are the most common injuries sustained in the physically active, often associated with pain and functional limitations long after initial recovery. In recent years, the impact of ankle sprains on general health and health-related quality of life (HRQoL) has been noted in athletes, but is not well-documented in the general population. We examined differences in HRQoL and general health between individuals with ankle sprain history and healthy controls. Those with ankle sprain reported significantly higher body mass index and general body pain, and lower SF-8 physical component scores than healthy controls. Additionally, there is some indication that physical activity is lower in those with ankle sprain history. This is an important step in illustrating the adverse sequelae of ankle sprains on population health and HRQoL.

The effect of time-of-day and sleep deprivation on postural control: A systematic review.

BACKGROUND: Postural control (PC) can be affected by circadian rhythm and sleep deprivation, whereby it has been reported the result of PC measurement in clinical and experimental situations can be influenced by both factors. It has been suggested sleepiness can result in deficiency in PC, which in turn can lead to occupational accidents and subsequent injuries. This is while no study critically reviews or summarizes findings surrounding this topic in the literature. RESEARCH QUESTION: Is there any significant effect of sleep deprivation and circadian rhythm on PC variables among healthy individuals? METHODS: PubMed, Web of Science, Scopus, and Embase were used to detect relevant studies. Only studies that examined the effect of time of day and/or sleep loss on PC among healthy individuals were included in this systematic review. RESULTS: Forty-nine studies were included based on the inclusion criteria. Both circadian rhythm and sleep loss had a significant effect on PC, whereas there are inconsistent findings for optimal postural control regarding time of day. In terms of sleep deprivation, all investigations indicated that sleep loss deteriorates PC. SIGNIFICANCE: The current systematic review represents a significant effect of circadian rhythm and sleep deprivation on PC, whereby it is suggested that clinicians and researchers consider these factors when measuring PC since it may affect the result of research and clinical test. Moreover, PC may be worsened through sleeplessness; however, some studies revealed there is no linear relationship between time of wakefulness and deteriorating PC due to the influence of circadian rhythm. Hence, while PC, as an objective tool, can help to detect those who are sleep deprived, which in turn can lead to prevent possible musculoskeletal injuries, further studies are needed to reveal more understanding about the effect of sleep loss and circadian rhythm on PC.

Does core stability training improve hopping performance and kinetic asymmetries during single-leg landing in anterior cruciate ligament reconstructed patients?

Safe return to sport (RTS) after anterior cruciate ligament reconstruction (ACLR) surgery is important. Core stabilization is common within rehabilitation, but its influence on hopping performance and single-leg landing kinetics among athletes post-ACLR is unclear. Twenty-four male professional athletes who had ACL reconstruction surgery (time since surgery = 11.47 ± 1.55 months) were recruited and randomly assigned to exercise (n = 12) and control (n = 12) groups. Exercise group received an 8-week core stability exercise program. Limb symmetry index (LSI) for single-leg hop for distance (SLH) and triple hop (TRH) tests, and single-leg landing kinetics (multidirectional ground reaction forces) were measured pre- and post-intervention. In post-test, the participants in exercise group were more symmetrical in SLH (P = .04, CI = 0.01-7.68) and TRH (P = .01, CI = 0.28-11.1) distances. They also improved their LSI values for vertical ground reaction force (vGRF), though not significantly (P < .05). LSI for anteroposterior (a-p) and mediolateral (m-l) GRFs remained unchanged for participants of both groups. Our findings indicate the positive effect of core exercise on decreasing between-limb asymmetries during SLH and TRH tests. Our results demonstrate that despite lack of change in kinetics, functional performance is more symmetrical following core stability training.

Plantar pressure profile during walking is associated with talar cartilage characteristics in individuals with chronic ankle instability.

BACKGROUND: Individuals with chronic ankle instability typically present with abnormal gait patterns favoring the lateral foot. This gait pattern may alter cartilage stress potentially increasing the risk of osteoarthritis development, thus exploring this relationship may provide insights for early interventions. The purpose of this study was to examine the relationship gait biomechanics and talar articular cartilage characteristics. METHODS: Talar articular cartilage was assessed with ultrasound at rest and after walking for 30-min in twenty-five adults (14 females, 22.6 ± 3.12 years, 168.12 ± 9.83 cm, 76.00 ± 15.47 kg) with chronic ankle instability. Cartilage was segmented into Total, Medial, and Lateral regions. During the 30-min walking period, plantar pressure of the entire foot was recorded every 5-min and condensed to create a biomechanical loading pattern and center of pressure gait line. Relationships between resting cartilage thickness and echo intensity, changes in thickness and echo intensity, and plantar pressure profiles were assessed with correlation coefficients. FINDINGS: There was a significant relationship between plantar pressure in the lateral forefoot and medial talar cartilage deformation (r = 0.408, p < .05). Early stance center of pressure was correlated with deformation in the total (r = 0.439-0.524) and lateral (r = 0.443-0.550) regions (p < .05). There were no significant correlations between echo intensity and biomechanics. INTERPRETATION: This study contributes to the growing evidence that talar cartilage strain patterns are associated with biomechanics during walking. Further validation is needed to determine a causal relationship between biomechanics and ultrasound cartilage characteristics after ankle sprains. In addition, research should continue determining the utility of ultrasound to monitor joint health after musculoskeletal injuries.

Effects of gait training with auditory biofeedback on biomechanics and talar cartilage characteristics in individuals with chronic ankle instability: A randomized controlled trial.

BACKGROUND: Altered walking gait is a typical impairment following ankle sprains which may increase susceptibility to recurring injuries and development of posttraumatic osteoarthritis at the ankle. There is a lack of targeted gait training interventions focusing on specific modifications in individuals with chronic ankle instability (CAI). Additionally, there is a need to focus on cartilage health changes following gait training to mitigate osteoarthritis progression. RESEARCH QUESTION: To determine the immediate and retention effects of gait training using auditory biofeedback (AudFB) in patients with chronic ankle instability (CAI) on biomechanics and talar cartilage characteristics. METHODS: Eighteen participants with CAI were randomly assigned into Control (n = 7) or AudFB (n = 11) groups. Each group completed 8-sessions of 30-minute treadmill walking. The AudFB group received biofeedback through a pressure sensor fashioned to the lateral foot and instructions to walk while avoiding noise from the sensor. The Control group did not receive instructions during sessions. An in-shoe insole system measured peak pressure, maximum force, and center of the pressure gait line (COP) during walking. Ultrasonography captured talar cartilage thickness and echo intensity before and after walking. Biomechanics and ultrasound were measured at baseline, immediately, and 1-week after the intervention. Repeated measures mixed-methods analysis of variance assessed changes within groups across time. RESULTS: The AudFB group significantly reduced pressure and force in the lateral foot and medially shifted their COP at Immediate and 1-week Post. There were no observed changes in the Control group. In addition, neither group demonstrated changes in ultrasound measures at follow-up. SIGNIFICANCE: Implementation of auditory biofeedback during gait training can be a valuable tool for clinicians treating patients with CAI.

Inter-limb asymmetry of kinetic and electromyographic during walking in patients with chronic ankle instability.

After an initial ankle sprain, a relevant number of participants develop chronic ankle instability (CAI). Compensatory strategies in patients with CAI may change the inter-limb symmetry needed for absorbing movement-related forces. Accordingly, an increased risk of injury can occur. The present study aimed to compare the inter-limb asymmetry of kinetic and electromyography between individuals with CAI and without a history of an ankle sprain (Non-CAI) during walking. In this cross-sectional study, fifty-six athletes (28 CAI; 28 Non-CAI) participated. Participants walked at a comfortable pace over level ground while vertical ground reaction force (vGRF) and muscle activity of the tibialis anterior, peroneus longus, medial gastrocnemius, and gluteus medius were recorded. Inter-limb asymmetry during walking was calculated for each of the variables. Patients with CAI exhibited a greater inter-limb asymmetry of the first peak of vGRF, time to peak vGRF, and loading rate (P < 0.001), as well as presenting a greater inter-limb asymmetry of peroneus longus activity (contact phase) (P = 0.003) and gluteus medius activity (midstance/propulsion phase) (P = 0.010) compared to the Non-CAI group. No other differences in vGRF or muscles activity were observed between the groups. Our findings indicate that patients with CAI walk with greater inter-limb asymmetry in vGRF and muscle activity in different phases of the gait cycle compared to Non-CAI group. Our results could inform future studies on gait training aimed to reduce asymmetry during walking in patients with CAI.

The Effects of Increasing Cognitive Load on Support Limb Kicking Mechanics in Male Futsal Players.

Our objective was to examine the effects of cognitive load on support limb mechanics during a futsal kicking task. Twenty-one male futsal players completed kicks of a stationary ball without a secondary task (baseline), as well as kicks where cognitive load was increased by including a secondary cognitive task (dual-task) and requiring tracking of ball movement before the kick (pass). The athletes demonstrated less hip and knee flexion, higher loading rates, greater frontal and sagittal plane knee loading, and greater knee abduction for the dual-task condition, vs. baseline. They also demonstrated less knee flexion, higher loading rates, greater sagittal plane knee loading, and greater knee abduction for the pass condition, vs. baseline. It appears that cognitive load influences kicking mechanics.

Multi-axis destabilisation device influences plantar pressure distribution in adults with chronic ankle instability.

Patients with chronic ankle instability (CAI) walk with increased lateral plantar pressure, precipitating future injuries. Gait retraining to medially shift plantar pressure may prevent recurrent injury. We assessed if a multi-axis destabilisation device changed plantar pressure and muscle activity in patients with CAI during walking. Twelve adults with CAI (age: 23.6 ± 5.0 years; body mass index: 26.7 ± 4.5 kg/m2) participated. Insole plantar pressure and electro-myography were collected synchronously during treadmill walking. The destabilisation device had a half-sphere under both the rearfoot and forefoot. Two 30s walking trials were recorded at baseline, first without and second with the destabilisation device. After 20 min of walking with the destabilisation device, two 30s post-walking trials were collected, first with and second without the destabilisation device. The middle 10 steps of each trial were extracted, plantar pressure quantified, and data averaged across steps for repeated measures ANOVA analysis. Electromyographic data wereextracted from 50 ms pre- through 200 ms post-initial contact. The centre of pressure shifted medially during destabilisation device use (P < 0.002) versus baseline. This shift was notretained upon device removal. Thus, the device capably shifts plantar pressure while worn. Its effects beyond a single sessionare unknown.

Hip and Core Muscle Activation During High-Load Core Stabilization Exercises.

BACKGROUND: There is some evidence that high-load lumbar stabilization exercises, such as back bridge, can recruit both local and global muscles. HYPOTHESIS: Therapeutic exercises would optimize gluteus maximus (GMax), gluteus medius (GMed), multifidus (MF), and transversus abdominis (TrA) activation, while minimizing the activation of the tensor fascia latae (TFL) and erector spinae (ES) muscles in healthy individuals. DESIGN: Cross-sectional study. SETTING: Research laboratory. LEVEL OF EVIDENCE: Level 4. METHODS: In this cross-sectional study, surface electromyography (EMG) of GMax, GMed, TFL, TrA, MF, and ES was used to quantify the gluteal-to-TFL muscle activation (GTA) index and a ratio of local to global (L/G) lumbar muscles during (1) the elbow-toe exercise in the prone position, (2) the elbow-toe with right left lifted, (3) the hand-knee with left arm and right leg lifted, (4) the back bridge, (5) the back bridge with right leg lifted, (6) the back bridge with left leg lifted, (7) the side bridge with left leg lifted, (8) the side bridge with right leg lifted, and (9) the elbow-toe with right leg horizontally lifted exercises in healthy individuals (20 men, 20 women; age, 25 ± 4 years). RESULTS: The back bridge exercise with left leg lift generated the highest L/G muscles activity ratio (L/G = 3.35) while the hand-knee exercise yielded the lowest L/G muscles activity ratio (L/G = 1.21). The side bridge exercise with left elbow and foot and lifting the right leg (GTA = 63.78), hand-knee exercise (GTA = 49.62), back bridge (GTA = 28.05), and elbow-toe exercise with left leg horizontally lifted (GTA = 23.02) generated the highest GTA indices, respectively. Meanwhile, the normalized EMG amplitude for GMax was significantly less than the TFL, for elbow-toe exercise (P < 0.001), back bridge with left leg lift (P = 0.001), side bridge exercise with the right elbow and foot and lifting the left leg (P = 0.002), and elbow-toe exercise with right leg horizontally lifted (P < 0.001). CONCLUSION: The highest GTA indexes were observed during (1) the side bridge lifting the dominant leg and (2) the hand-knee horizontally lifting dominant leg, respectively. The L/G ratio was highest during (1) the back bridge lifting nondominant leg, (2) back bridge, and (3) back bridge lifting dominant leg, respectively. This study supports the use of back bridge exercises to strengthen the MF and side bridges to improve gluteal muscle activation. CLINICAL RELEVANCE: The highest GTA index was observed in the side bridge lifting the right leg. Highest L/G ratio was in the back bridge with nondominant leg lifted. This study supports the use of back bridge exercises to strengthen the MF. This study supports the use of side bridges to improve gluteal muscle activation.

Altered trunk and lower extremity movement coordination after neuromuscular training with and without external focus instruction: a randomized controlled trial.

BACKGROUND: This study sought to determine the effects of a 6-week neuromuscular training (NMT) and NMT plus external focus (NMT plus EF) programs on trunk and lower extremity inter-segmental movement coordination in active individuals at risk of injury. METHODS: Forty-six active male athletes (controls = 15, NMT = 16, NMT plus EF = 15) participated (age = 23.26 ± 2.31 years) in this controlled, laboratory study. Three-dimensional kinematics were collected during a drop vertical jump (DVJ). A continuous relative phase (CRP) analysis quantified inter-segmental coordination of the: (1) thigh (flexion/extension)-shank (flexion/extension), (2) thigh (abduction/adduction)-shank (flexion/extension), (3) thigh (abduction/adduction)-trunk (flexion/extension), and (4) trunk (flexion/extension)-pelvis (posterior tilt/anterior tilt). Analysis of covariance compared biomechanical data between groups. RESULTS: After 6 weeks, inter-segmental coordination patterns were significantly different between the NMT and NMT plus EF groups (p < 0.05). No significant differences were observed in CRP for trunk-pelvis coupling comparing between NMT and NMT plus EF groups (p = 0.134), while significant differences were observed CRP angle of the thigh-shank, thigh-trunk couplings (p < 0.05). CONCLUSIONS: Trunk and lower extremity movement coordination were more in-phase during DVJ in the NMT plus EF compared to NMT in active individuals at risk of anterior cruciate ligament injury. TRIAL REGISTRATION: The protocol was prospectively registered at UMIN_RCT website with ID number: UMIN000035050, Date of provisional registration 2018/11/27.

A comparison of functional movement patterns between female low back pain developers and non-pain developers.

BACKGROUND: Distinctive features of low back pain-developers (LBPDs) as pre-clinical low back pain (LBP) population have been evidenced in three areas of alignment, muscle activation, and movement patterns. To clarify whether the reported altered functional movement patterns in chronic LBP patients result from or result in LBP disorders, LBPDs' functional movement patterns should be investigated. OBJECTIVES: This study aimed to compare female LBPDs' functional movement patterns with non-pain developers' (NPDs). METHODS: Sixty female LBPDs and NPDs were recruited based on the research requirements. The Functional Movement Screen (FMS) was used to investigate movement quality. Data were compared between groups via Mann-Whitney U tests and correlation analyses examined association between pain intensity and onset during prolonged standing and the FMS score. Receiver Operating Characteristic Curves and Chi Squares were conducted to find the best cutoff points. An alpha level of p≤0.05 was used to establish statistical significance. RESULTS: LBPDs scored significantly lower, or rather worse than NPDs in the FMS composite score (12.06±1.33 vs. 16.43±1.59, U = 3, P < 0.001). Moreover, the optimal cutoff scores of≤14 on the FMS, 2 on the push-up, and 1 on the deep squat discriminated between female LBPDs and NPDs. The FMS composite score was correlated negatively with LBP intensity (r (60) = -0.724, p < 0.001) and positively with LBP onset (r (60) = 0.277, p = 0.032) during prolonged standing. Finally, the results indicated that female LBPDs presented with at least one bilateral asymmetry on the FMS had 10 times (95% CI, 2.941-34.008) and with at least two bilateral asymmetries on the FMS had 15.5 times (95% CI, 3.814-63.359) higher odds of developing LBP during prolonged standing than NPDs. CONCLUSIONS: Female LBPDs, who are at higher risk for developing LBP in the future, have significantly lower quality of functional movement patterns compared to NPDs. Moreover, the FMS appears to show promise for predicting individuals who are at risk for LBP development during prolonged standing.

Comparing myofascial meridian activation during single leg vertical drop jump in patients with anterior cruciate ligament reconstruction and healthy participants.

BACKGROUND: Muscles work synergistically to support the body during landing. Myofascial meridians have been described to classify muscles into functional synergies. The role that these functional lines plays in positioning the trunk and lower extremity of patients with anterior cruciate ligament reconstruction (ACLR) and healthy athletes during drop landing tasks remains unclear. RESEARCH QUESTION: The purpose of this study was to compare the front and back functional lines (FFL and BFL) muscle activation in patients with ACLR and healthy participants during single leg vertical drop jump (SLVDJ). METHODS: Thirty-two male athletes (post-ACLR = 16, healthy = 16) participated (age = 23.3 ± 2.3 years). Superficial electromyography of FFL (adductor longus [AL], rectus abdominis [RA], pectoralis major) and BFL (vastus lateralis [VL], gluteus maximus [GMax], latissimus dorsi [LD]) was collected during the SLVDJ and compared at initial contact and maximum knee flexion between groups using t-tests and limbs using paired-samples t-tests. RESULTS: In the FFL, the AL (p < 0.05) and RA (p < 0.05) muscles were more active in the healthy group compared to the ACLR group at initial contact and maximum knee flexion. PM demonstrated greater activation in the healthy group only at maximum knee flexion (p < 0.05). In the BFL, the VL (p < 0.05) and GMax (p < 0.05) muscles were more active in the ACLR group, whereas the LD (p < 0.05) muscles demonstrated greater activation in the healthy group at initial contact and maximum knee flexion. There were no healthy group inter-limb differences in FFL and BFL activation. ACLR participants demonstrated greater non-injured limb VL, AL, GMax and LD activation (p < 0.05) and greater injured limb PM and RA activation (p < 0.05). SIGNIFICANCE: Based on the present data, patients after ACLR may present with an alteration in BFL and FFL muscles activation during a drop jump task. Functional line muscles during dynamic activities may change lower extremity positioning and lead to increase ACL injury risk.