Search Results (378)

During the coronavirus 2019 pandemic, sports activities were restricted, raising concerns about their impact on the physical condition of adolescent athletes, which remained largely unquantified. This study was designed with two primary objectives: first, to precisely quantify and elucidate the differences in the physical condition of adolescent athletes before and after activity restrictions due to the pandemic; and second, to innovatively develop and validate a non-contact medical checkup application. Medical checks were conducted on 563 athletes designated for sports enhancement. Participants were junior high school students aged 13 to 15, and the sample consisted of 315 boys and 248 girls. Furthermore, we developed a smartphone application and compared self-checks using the application with in-person checks by orthopedic surgeons to determine the challenges associated with self-checks. Statistical tests were conducted to determine whether there were statistically significant differences in range of motion and flexibility parameters before and after the pandemic. Additionally, items with discrepancies between values self-entered by athletes using the smartphone application and values measured by specialists were detected, and application updates were performed. Student’s t-test was used for continuous variables, whereas the chi-square test was used for other variables. Following the coronavirus 2019 pandemic, athletes were stiffer than during the pre-pandemic period in terms of hip and shoulder joint rotation range of motion and heel–buttock distance. The dominant hip external rotation decreased from 53.8° to 46.8° (p = 0.0062); the non-dominant hip external rotation decreased from 53.5° to 48.0° (p = 0.0252); the dominant shoulder internal rotation decreased from 62.5° to 54.7° (p = 0.0042); external rotation decreased from 97.6° to 93.5° (p = 0.0282), and the heel–buttock distance increased from 4.0 cm to 10.4 cm (p < 0.0001). The heel–buttock distance and straight leg raising angle measurements differed between the self-check and face-to-face check. Although there are items that cannot be accurately evaluated by self-check, physical condition can be improved with less contact by first conducting a face-to-face evaluation under appropriate guidance and then conducting a self-check. These findings successfully address our primary objectives. Specifically, we demonstrated a significant decline in the physical condition of adolescent athletes following pandemic-related activity restrictions, thereby quantifying their impact. Furthermore, our developed non-contact medical checkup application proved to be a viable tool for monitoring physical condition with reduced contact, although careful consideration of measurable parameters is crucial. This study provides critical insights into the long-term effects of activity restrictions on young athletes and offers a practical solution for health monitoring during infectious disease outbreaks, highlighting the potential for hybrid checkup approaches. Full article

Spontaneous quadriceps tendon rupture is a very rare occurrence, notably for bilateral simultaneous ruptures. Its occurrence is commonly linked to an underlying condition that may weaken the tendons leading to rupture. We report the case of a 68-year-old Caucasian male afflicted with long-term gout who presented a bilateral simultaneous quadriceps tendon rupture (BSQTR). We showcase the clinical presentation, the surgical intervention, rehabilitation program, dynamic sonographic monitoring, and home-based rehabilitation techniques of this injury, which aimed to improve activities of daily living (ADL) and quality of life (QoL). The patient was included in a 9-week post-surgical rehabilitation program and a home-based rehabilitation program with subsequent pain management and gait reacquisition. The outcome measures included right and left knee active range of motion (AROM), pain intensity measured on Visual Analogue Scale (VAS), functioning measured through ADL score, and gait assessment on Functional Ambulation Categories (FAC). All endpoints were measured at different time points, scoring significant improvement at discharge compared to baseline (e.g., AROM increased from 0 degrees to 95 degrees, while VAS decreased from 7 to 1, ADL score increased from 6 to 10, and FAC increased from 1 to 5). Moreover, some of these outcomes continued to improve after discharge, and the effects of home-based rehabilitation program and a single hip joint manipulation were assessed at 6-month follow-up. Musculoskeletal ultrasound findings showed mature tendon structure, consistent dynamic glide, and no scarring. Full article

Exercise is an important component in the treatment and improvement of function in populations with or at risk of lower limb injury. Cycling is the most common exercise modality used by these populations. However, reduced lower limb joint excursion and/or range of motion (ROM) during cycling might limit the optimization of functional improvements. Increased hip flexion gait (HFgait) is a new exercise modality that might result in larger lower limb joint excursions compared to cycling. The purpose of this study was to compare lower limb kinematics between HFgait and cycling. Twelve healthy individuals participated in the study. Each participant performed cycling and HFgait. Hip, knee, and ankle kinematics in the sagittal, frontal, and transverse planes were analyzed with and without phase offset reduction (POR). Discrete and continuous analyses were performed. Discrete analysis indicated differences for at least one of the variables analyzed (maximum, minimum, and ROM) for the hip (p ≤ 0.041), knee (p ≤ 0.008), and ankle (p ≤ 0.040) across all planes. For the continuous analysis, differences between HFgait and cycling kinematics were observed during the cycles for the hip, knee, and ankle sagittal (hip: original: 85%; with POR: 77%; knee: original: 93%; with POR: 76%; ankle: original: 14%; with POR: 14%), frontal (hip: original: 93%; with POR: 98%; knee: original: 41%; with POR: 12%; ankle: original: 4%; with POR: 5%), and transverse (hip: original: 66%; with POR: 0%; knee: original: 14%; with POR: 0%; ankle: original: 3%; with POR: 0%) planes. HFgait resulted in larger hip (+60.2°) and knee (+38.2°) sagittal plane ROM while maintaining the hip in a more neutral position in the frontal plane compared with cycling. These findings can support the development of rehabilitation strategies with the goal of improving function and joint range of motion while also receiving the health benefits of exercise. Full article

Background/Objectives: Dyskinetic cerebral palsy (DCP) often implies severe motor impairment and risk of health problems. Our aim was to follow up a group of young adults with DCP that we previously examined as children, to describe health, function, and living conditions. Methods: Interviews regarding health issues, treatments, and living conditions, and quality of life (RAND-36) and fatigue questionnaires were completed. Gross and fine motor function, communication, and speech ability were classified, and weight, height, spasticity, and dystonia were assessed and compared to previous data. Joint range of motion (ROM) was compared to older adults with DCP. Results: Dystonia was present in all fifteen participants, and spasticity in all but two. A decrease was found mainly in those who received intrathecal baclofen (ITB). ROM limitations were most pronounced in shoulder flexion, abduction and inward rotation (while outward rotation was hypermobile), hip abduction, hamstrings, and knee extension. The majority had frequent contact with primary and specialist healthcare. Seven participants were underweight, eight had a gastrostomy, and seven had ITB. Upper gastrointestinal and respiratory problems were frequent. Orthopedic surgery for scoliosis was reported in five, and lower extremity in nine, while fractures were reported in six participants. RAND-36 revealed physical functioning, general health, and vitality as the greatest problem areas. Fatigue was significant in 64%. Eight participants lived with their parents. Participants at more functional levels completed tertiary education and lived independently. Conclusions: Most participants had severe impairment and many health issues, despite decreased dystonia and spasticity due to ITB. Sleep problems and pain were uncommon. Full article

Background: Compression garments (CG) may influence countermovement jump (CMJ) performance by altering hip and knee biomechanics, but existing evidence remains controversial. This study aimed to compare the effects of compression tights (CTs), compression shorts (CSs), and control shorts (CCs) on CMJ performance and lower-limb biomechanics. Methods: Nine physically active men from a university were recruited to perform CMJ while wearing CTs, CSs, and CCs in a randomized sequence for a within-subjects repeated-measures design. A Vicon 3D motion capture system and an AMTI 3D force plate were used to collect biomechanical data. Visual3D software was used to calculate the joint angle, moment, and force of the lower limbs. Results: Statistical parametric mapping analysis with repeated measures analysis of variance (ANOVA) revealed that during the propulsion phase of the CMJ, wearing CSs significantly reduced the hip flexion angle compared to wearing CCs (25–36%); meanwhile, wearing CTs significantly reduced the knee extension and flexion moment (34–35%) and decreased the hip extension moment during the propulsion phase (36–37%). In addition, CTs significantly reduced the hip abduction angle during the flight phase (37–39%), and CSs significantly reduced the hip anterior force during the landing phase (59–60%). Conclusions: Compression legwear significantly affected the hip and knee biomechanics in propulsion, but these differences were not sufficient to improve the CMJ height. Due to the improvement in hip biomechanics in the flight and landing phases, there may be potential benefits for movement transitions and landing performance in CMJ. Full article

This paper explores the application of deep learning techniques for evaluating and classifying deadlift weightlifting techniques from video input. The increasing popularity of weightlifting, coupled with the injury risks associated with improper form, has heightened interest in this area of research. To address these concerns, we developed an application designed to classify three distinct styles of deadlifts: conventional, Romanian, and sumo. In addition to style classification, our application identifies common mistakes such as a rounded back, overextension at the top of the lift, and premature lifting of the hips in relation to the back. To build our model, we created a comprehensive custom dataset comprising lateral-view videos of lifters performing deadlifts, which we meticulously annotated to ensure accuracy. We adapted the MoveNet model to track keypoints on the lifter’s joints, which effectively represented their motion patterns. These keypoints not only served as visualization aids in the training of Convolutional Neural Networks (CNNs) but also acted as the primary features for Long Short-Term Memory (LSTM) models, both of which we employed to classify the various deadlift techniques. Our experimental results showed that both models achieved impressive F1-scores, reaching up to 0.99 for style and 1.00 for execution form classifications on the test dataset. Furthermore, we designed an application that integrates keypoint visualizations with motion pattern classifications. This tool provides users with valuable feedback on their performance and includes a replay feature for self-assessment, helping lifters refine their technique and reduce the risk of injury. Full article

Osteoarthritis (OA) is a leading cause of disability worldwide and is characterized by the gradual degradation of articular cartilage in weight-bearing joints, notably the knees and hips. However, the primary morphological and anatomical determinants of the disease onset and progression remain unclear. This narrative overview examines how variations in cartilage thickness—traditionally viewed as a biomechanical protective feature—can paradoxically compromise metabolic homeostasis during prolonged sedentary behavior. Intriguingly, compelling evidence suggests that despite its superior load-bearing capacity, thicker cartilage faces greater challenges in solute transport, a limitation further exacerbated by the formation of diffusion-resistant boundary layers at the cartilage–fluid interface during immobilization. This phenomenon restricts nutrient influx and impedes waste clearance, leading to the accumulation of catabolic byproducts in deep cartilage zones and accelerated extracellular matrix breakdown, potentially influencing OA pathogenesis. By critically synthesizing current debates on mechanical loading with emerging data on metabolic dysregulation, particularly nutrient diffusion limitations, this analysis underscores the urgent need for targeted investigation of synovial–cartilage interface dynamics and chondrocyte metabolism under low-motion conditions. This study further advocates for strategic research focusing on often-overlooked, silent metabolic imbalances among sedentary populations and recommends early-intervention strategies, such as periodic joint mobilization, ergonomic adaptations, and public-health campaigns, to reduce prolonged sitting, preserve joint function, and guide more effective prevention and management approaches for non-traumatic OA in contemporary contexts. Full article

Background/Objectives: Vibration foam rolling (VFR) has emerged as a popular intervention in sports and rehabilitation settings to enhance recovery and flexibility. This systematic review aimed to evaluate the effects of VFR on pain, fatigue, and range of motion (ROM) in individuals experiencing exercise-induced muscle fatigue and to assess its clinical applicability. Methods: A systematic literature search was conducted across five databases: PubMed, Cochrane Library, Embase, Web of Science, and CINAHL. Studies were included if they involved participants with muscle fatigue, applied VFR as an intervention, and measured outcomes related to pain, fatigue, or ROM. Methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools. Results: Eight studies published between 2019 and 2024 met the inclusion criteria. VFR showed beneficial effects in reducing delayed onset muscle soreness, improving pressure pain threshold, and lowering subjective fatigue. Several studies also reported increased ROM in specific joints, including the hip and knee. However, findings across studies were inconsistent, particularly in physiological markers such as muscle oxygen saturation and blood flow parameters, where statistically significant differences were not always observed. Conclusions: VFR may offer potential benefits for pain relief, fatigue recovery, and ROM improvement in fatigued individuals. Nonetheless, its effects remain difficult to isolate from those of mechanical pressure and friction associated with foam rolling. Future studies with standardized intervention protocols and long-term follow-up are needed to clarify the independent role of vibration in recovery outcomes. Full article

This study aims to develop and evaluate a cycling-specific marker protocol that minimises the number of markers while accounting for the unique biomechanics of cycling. Although movements in the frontal and transverse planes during cycling are limited, they are clinically relevant due to their association with overuse injuries. Existing gait-based marker protocols often fail to consider cycling-specific factors such as posture, range of motion, marker occlusion, and muscle-induced artifacts. The proposed protocol (PP) uses 15 physical and 8 virtual markers. In the absence of a gold standard for 3D pedalling kinematics, the PP was evaluated by comparing it with established gait analysis protocols. The protocol demonstrated high correlation in gait (CCC > 0.98 for hip and knee in the sagittal plane), low intra-subject variability (CV < 15% for hip, knee, and ankle), and high repeatability. During pedalling, position, velocity, and acceleration were measured in all three spatial directions. Notably, angular velocity and linear acceleration showed significant components outside the sagittal plane, particularly for angular velocity. These findings highlight the importance of considering 3D motion when estimating forces, joint moments, and joint-specific powers in cycling biomechanics. Full article

Blocked or narrowed arteries restrict blood flow to the lower limbs, commonly leading to peripheral artery disease (PAD). Patients with PAD have been shown to have increased gait variability, which may contribute to higher rates of falls and worsen functional outcomes. Surgical revascularization seeks to restore blood flow to the legs, but it is unknown if this restoration enhances limb function. This study investigated whether gait variability changes in patients with PAD after revascularization surgery. Thirty-three patients with PAD exhibiting claudication symptoms were recruited for the study. Kinematic data were recorded using a motion capture system while the patients walked on a treadmill following a progressive treadmill protocol, both before and after undergoing revascularization surgery. Angular sagittal movements’ linear and nonlinear variability in the lower limbs were measured and compared before and after surgery across the ankle, knee, and hip joints. Following revascularization surgery, knee joint sample entropy (SampEn) decreased, suggesting improved gait regularity. Furthermore, the hip range of motion (ROM) significantly decreased, whereas the knee ROM significantly increased. The ankle joint showed significantly greater changes in the Lyapunov Exponent (LyE) relative to the pre-exercise condition compared with the hip and knee joints. No significant differences existed in the linear variability (standard deviation) of the ROM between joints. In individuals with PAD, revascularization surgery considerably increased knee ROM and gait regularity, indicating improved limb function and motor control. However, the ankle ROM remained unchanged, indicating the need for targeted strengthening exercises post-surgery. Full article

This study addresses gait reference trajectory tracking control in a 13-degree-of-freedom lower-limb rehabilitation robot, where patients exhibit nonlinear perturbations in lower-limb muscle groups and gait irregularities during exoskeleton-assisted walking. We propose a novel control strategy integrating iterative learning with RBF neural network-based sliding mode control, featuring a single hidden-layer pre-feedback architecture. The RBF neural network effectively approximates uncertainties arising from lower-limb muscle perturbations, while adaptive regulation through parameter simplification ensures precise torque tracking at each joint, meeting real-time rehabilitation requirements. MATLAB 2021 simulations demonstrate the proposed algorithm’s superior trajectory tracking performance compared to conventional sliding mode control, effectively eliminating control chattering. Experimental results show maximum angular errors of 1.77° (hip flexion/extension), 1.87° (knee flexion/extension), and 0.72° (ankle dorsiflexion/plantarflexion). The integrated motion capture system enables the development of patient-specific skeletal muscle models and optimized gait trajectories, ensuring both training efficacy and safety for spasticity patients. Full article

Background/Objectives: The stability of dual mobility (DM) total hip arthroplasty (THA) is often attributed to reduced impingement incidence and a superior range of motion (ROM) compared to the corresponding values when standard implants are used. However, few studies have directly explored this. Thus, the purpose of the present study was to compare the incidence of impingement and the range of motion between standard and DM acetabular cups, whose diameters are suited to the same patient anatomy. Methods: One standard and two DM implants were virtually implanted into a pelvis using a previously developed geometric model. Joint motions, which were representative of seven dislocation-prone activities of daily living (ADLs), as well as walking, were applied to each device type at a range of cup orientations (inclination/anteversion). Conclusions: There were no placement positions that avoided impingement across all seven ADLs, regardless of cup construct type. A similar impingement incidence and ROM were observed for standard and DM constructs, although the consequences of impingement are potentially more serious for DM devices (metal–metal contact) than for standard constructs (metal–polyethylene contact). This finding contradicts the common notion that DM-THAs have a reduced impingement incidence and superior ROM, instead suggesting that their stability may be attributed to alternative mechanisms, such as increased jump distance. Full article

Background/Objectives: Total hip joint arthroplasty (THA) is a common procedure aimed at alleviating pain and restoring mobility in patients with severe hip joint conditions, particularly osteoarthritis. While the surgery itself is effective, postoperative rehabilitation is crucial for long-term functional recovery. This study investigates the role of muscle deflection as an indicator of rehabilitation quality, focusing on hip movement improvements (abduction, extension, and flexion) over an 8-week recovery period. The objective is to assess whether muscle deflection measurements can serve as reliable metrics for evaluating recovery progress and functional outcomes. Methods: The study involved post-THA patients from Euroclinic Hospital S.A. and Bucharest Emergency Clinical Hospital, who were divided into an experimental group (undergoing a specialized rehabilitation program) and a control group (receiving standard recovery protocols). Measurements of active range of motion (AROM), passive range of motion (PROM), and muscle deflection were taken using a handheld digital dynamometer (ActivForce 2) at different time points (2, 4, 6, and 8 weeks post-surgery). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was also used to assess pain, physical difficulties, and joint stiffness. Results: The study found progressive improvements in AROM, PROM, and muscle deflection across all movements over the 8-week period. Conclusions: The findings highlight the importance of structured physiotherapy in post-THA rehabilitation. The use of muscle deflection measurements provides an objective and quantifiable method for tracking patient progress. Future rehabilitation protocols could benefit from incorporating muscle deflection monitoring to tailor recovery programs and optimize patient outcomes. Standardizing rehabilitation exercises, including balance training and resistance exercises, may further enhance recovery and reduce long-term functional impairments. Full article

Aging often leads to a decline in intersegmental coordination, particularly in the lower limbs, which can negatively impact gait stability and symmetry. While fear of falling (FoF) and a history of falls (HoF) increase fall risk in older adults, their relationship with intra- and intersegmental coordination during gait remains understudied. This cross-sectional observational study involved 60 participants aged 60 and older. The three-dimensional range of motion of lower limb joints during gait was assessed using an optoelectronic system. Intra- and intersegmental coordination were evaluated via the Continuous Relative Phase (CRP) variable, including its mean, standard deviation, and coefficient of variation. The results showed that the HoF and FoF groups had higher mean CRP values in the left hip-knee (HOF, p = 0.004) and hip-ankle (FOF, p = 0.030) in the sagittal plane, as well as higher standard deviation values in the left knee-ankle (HOF, p = 0.006) and right hip-ankle (HOF, p = 0.004). Inter-segmental coordination differences were also observed, with higher mean CRP values between the knee joints in the sagittal plane (HOF, p = 0.046) and lower mean and standard deviation values between the ankle joints (FOF, p = 0.048 and p = 0.038, respectively). This study concludes that fear of falling and history of falling are significantly associated with altered intra- and intersegmental coordination in older adults, which may contribute to fall risk. Understanding these altered coordination patterns is crucial, as it underscores the therapeutic significance of targeting these changes, which could lead to interventions aimed at improving gait stability and reducing fall risk in elderly individuals. Full article

The analysis of human movement is crucial in biomechanical research and clinical practice. Quantitative movement analysis evaluates sports performance by tracking joint angles, segmental velocities, and body positions. There are high-accuracy motion-tracking systems like Vicon Motion Systems (Oxford, UK) or OptiTrack (Corvallis, OR, USA), but they are expensive, require expertise, and lack portability. This study assessed a low-cost virtual reality-based motion-tracking system with a customized eMotion data acquisition and analysis application to describe joint movements during squatting. The system, which utilizes commonly available virtual reality accessories, successfully collected kinematic data and continuous tracker trajectories. The results showed high repeatability comparable to advanced optoelectronic motion-capture systems. The eMotion system protocols exhibited low variability for most rotations, with inter-trial values ranging from 0.65° to 2.20° except for hip and knee flexion, which reached 3.09° and 4.01°. The motion-tracking technology that is part of VR headsets has great potential in supporting training and rehabilitation by enabling quantitative assessment of any activity in both the real and virtual worlds. The use of low-cost solutions can increase the potential for human motion measurements in clinical practice and biomechanical research. Full article