Search Results (384)

Background/Objectives: Subacromial impingement syndrome (SIS) may be associated with altered kinetic-chain mechanics above and below the shoulder. The posterior oblique sling integrates the gluteus maximus and latissimus dorsi through established fascial and neuromuscular connections, yet empirical evidence examining its relevance in SIS remains limited. Therefore, this cross-sectional observational study aimed to investigate the surface electromyographic (sEMG) activity of the latissimus dorsi (LD) and contralateral gluteus maximus (GM) and evaluate their associations with pain, disability, and shoulder range of motion (ROM) in young adults with SIS. Methods: Sixty sedentary young adults with SIS and matched controls were assessed using the Numeric Pain Rating Scale, Arabic QuickDASH, twin-axis electrogoniometer, and sEMG of the gluteus maximus and latissimus dorsi. Results: The SIS group had significantly lower GM activity (23.96 ± 3.54% MVIC for SIS and 34.49 ± 4.16% MVIC for controls) and significantly higher LD activity (118.63 ± 24.87% MVIC for SIS and 75.52 ± 25.93% MVIC for controls) (p = 0.001). In addition to these differences, the SIS group exhibited significantly less ROM in all directions (flexion, extension, abduction, and rotation) and greater disability and pain intensity (both p = 0.001) than controls. Correlations between sEMG activity and clinical outcome measures in the SIS group were weak and not statistically significant. Discriminant logistic regression indicated that both GM and LD sEMG were significant discriminative variables of group membership, with GM underactivity showing the greater discriminative value. Conclusions: These results indicate an altered neuromuscular activation pattern observed in participants with SIS, characterized by decreased GM and increased LD sEMG activity. They may justify further investigation of kinetic-chain-informed rehabilitation, with attention to both hip/lumbopelvic function and shoulder-based treatment. Full article

Context: Different studies on football players with fifth metatarsal stress fractures have found that hip internal rotation (HIR)range of motion is significantly reduced, while lateral forefoot pressure is significantly increased; therefore, the purpose of this study was to determine whether HIR range of motion is related to lateral plantar pressure. Methods: The study included 120 college students (60 males and 60 females). HIR was measured using a smartphone inclinometer app in the prone position and a compass app in the supine position. Plantar pressure was assessed using the Gaitview AFA-50 system during standing and walking. Correlation analysis was performed using SPSS 27.0. Results: Among all subjects, HIR activity in the prone position was significantly negatively correlated with standing second through fourth metatarsophalangeal joints(MTPJ2-4), fifth metatarsophalangeal joint (MTPJ5), and midfoot (FM)pressures and significantly positively correlated with standing first toe (T1)pressure. During walking, there is a significant negative correlation between HIR in the prone position and MTPJ2-4, MTPJ5, FM, and lateral heel (LH). Similarly, in the supine position, HIR is significantly negatively correlated with MTPJ2-4, MTPJ5, FM, medial heel (MH), and LH. Conclusion: There is a significant negative correlation between HIR and lateral plantar pressure, indicating that reduced HIR is associated with increased lateral plantar pressure. Improving HIR through targeted rehabilitation may reduce lateral plantar pressure, offering new approaches for non-surgical treatment of little toe capsulitis and reducing the risk of fifth metatarsal stress fractures. Full article

Background/Objectives: Sciatica and hip osteoarthritis (OA) are common causes of lower extremity pain and functional impairment. Because both conditions may produce overlapping symptoms, distinguishing them can be challenging. Misdiagnosis may lead to inappropriate treatment, delayed intervention and unnecessary procedures. In addition, the frequent coexistence of hip and lumbar degenerative pathology, commonly referred to as hip–spine syndrome, further complicates diagnostic evaluation. This review aims to examine current diagnostic strategies used to differentiate lumbar radiculopathy from hip OA and to introduce the Athena Sign, which is presented as a preliminary, hypothesis-generating clinical observation requiring prospective validation. Methods: A narrative review of the literature was performed focusing on the pathophysiology, clinical presentation, differential diagnosis, physical examination and imaging evaluation of sciatica and hip OA. Particular emphasis was placed on clinical examination techniques and diagnostic injections used to identify the primary pain generator. Results: Both conditions share overlapping symptom patterns and inflammatory mechanisms, which may obscure the source of pain. Careful assessment of gait, hip range of motion, neurological findings and provocative maneuvers remains essential for accurate diagnosis. Imaging findings should be interpreted in conjunction with clinical examination due to the high prevalence of asymptomatic degenerative changes. The Athena Sign, observed with internal and external rotation of the hips in a prone position with the knee flexed, is associated with anterior intra-articular hip pathology and may provide an additional diagnostic indicator in patients with ambiguous hip–spine presentations. Conclusions: A systematic diagnostic approach integrating clinical examination, imaging and targeted diagnostic injections is essential for distinguishing between lumbar radiculopathy and hip OA. Recognition of dynamic clinical findings such as the Athena Sign may further improve diagnostic accuracy and guide appropriate management in patients presenting with overlapping hip and lumbar symptoms. Full article

Background/Objectives: Asymmetric acetabular liners used in Total Hip Arthroplasty (THA) are clinically successful in reducing revision associated with dislocation. The performance of an asymmetric liner is dependent on its positioning, although few studies have directly investigated the effects of variables such as cup orientation or extended rim position on outcomes such as impingement. Therefore, the aim of this study was to compare the incidence of impingement in THA with a standard and lipped liner. Methods: A THA was virtually implanted into a previously developed geometric model. Acetabular cups were placed in a range of clinically relevant orientations, and the model was moved through seven joint motions associated with dislocation-prone Activities of Daily Living (ADLs). The occurrence of implant–implant, implant–bone, and bone–bone impingement was assessed for the standard and lipped constructs across a total of 6,237 unique combinations of cup orientation and lipped liner apex rotations. Results/Conclusions: The model predicted that with both standard and lipped constructs, there were no component placement positions which avoided impingement for all ADLs. The number of impingement incidents was minimised when components were positioned at the higher end of the manufacturer’s recommendations for cup inclination and anteversion. The use of a lipped liner increased the frequency of impingement events compared with the standard construct. However, for anterior impingement leading to posterior dislocation, this increase may be minimised by rotating the lip apex to a posterior-inferior position. Anterior lip apex placement tended to minimise the increase in the less critical posterior impingement. Full article

Background: Total hip arthroplasty (THA) is an effective treatment for advanced hip osteoarthritis, yet the influence of the surgical approach on early biomechanical and neuromuscular recovery remains debated. The direct anterior approach (DAA) is considered muscle-sparing, whereas the lateral approach (LA) involves partial abductor detachment and may influence postoperative gait and muscle activation. As a first step, this pilot study was designed primarily to assess the feasibility of an integrated, multidomain assessment protocol to combine clinical and patient-reported outcomes, instrumented gait analysis, hip biomechanics, and surface electromyography (sEMG), and to delineate preliminary trajectories of recovery after DAA versus LA THA to inform a future, adequately powered trial. Methods: In this prospective, non-randomized pilot study, 12 patients undergoing primary unilateral THA were evaluated and allocated according to surgical approach (DAA, n = 6; LA, n = 6). Assessments were performed at three months (T3M) and six months (T6M) postoperatively. Outcomes included pain intensity, SF-12, the Hip disability and Osteoarthritis Outcome Score (HOOS), instrumented gait analysis, hip kinematics and kinetics, and sEMG activity of the gluteus medius, semitendinosus, and rectus femoris of the operated limb. Given the small sample, between-group differences, within-group changes, and change scores from T3M to T6M were analyzed using non-parametric tests, and all results were treated as exploratory and hypothesis-generating. Results: Recruitment, retention, and completion of the full multidomain protocol were feasible, with no missing primary outcomes. Preliminary findings suggested that at three months, the DAA group showed lower pain and higher PCS-12, HOOS Total and HOOS Function scores, together with faster gait speed, longer normalized stride length, and shorter cycle and stance times. At six months, spatiotemporal gait parameters no longer appeared to differ between groups, suggesting the convergence of global gait performance, whereas the DAA group tended to maintain higher HOOS Total and Function scores and lower pain. The LA group showed greater late-stance hip extension and higher semitendinosus and rectus femoris sEMG amplitudes at T6M. Change-score analysis suggested a possible catch-up phenomenon in the LA group for gait speed, stride length, stance time, cycle time, and hip flexion range of motion, whereas semitendinosus activation tended to decrease in the DAA group and increase in the LA group. Given the limited sample, these observations are preliminary and require confirmation. Conclusions: This pilot study supports the feasibility of an integrated protocol combining patient-reported measures, instrumented gait analysis, and sEMG to characterize early recovery after THA. Preliminary, hypothesis-generating data suggest that DAA may be associated with a more favorable early postoperative clinical and spatiotemporal gait profile, with global gait performance tending to converge between approaches by six months, while persistent differences in hip-specific patient-reported outcomes and sEMG activation patterns hint that a similar gait performance may be achieved through different neuromuscular strategies. These preliminary findings should be interpreted with caution and used primarily to inform the design of larger, adequately powered studies with longer follow-up. Full article

Background: Total knee arthroplasty (TKA) is a common procedure to relieve pain and restore function in osteoarthritis patients. Postoperative rehabilitation is essential to address pain, swelling, reduced range of motion, and functional limitations. Hydrotherapy, using water buoyancy and resistance, may enhance recovery, but evidence on its effectiveness after these surgeries remains limited. Methods: A systematic literature search was conducted across six databases: PubMed, ProQuest, Science Direct, Google Scholar, Scopus, the Cochrane Library, and PEDro, covering studies published up to 30 November 2025. Only prospective randomized controlled trials were considered for inclusion. Studies such as case reports, uncontrolled case series, and those focused on outcomes other than postoperative pain and decreased muscle strength in patients undergoing total knee arthroplasty were excluded. This review was registered in PROSPERO (CRD420251164054). Results: Pooled analysis showed no statistically significant difference between hydrotherapy and land-based or usual-care rehabilitation in Visual Analogue Scale (VAS)-measured pain (MD ≈ −0.35; 95% CI $[-1.06, 0.36]$; $p=0.34$) or in WOMAC pain (MD ≈ −0.46; 95% CI $[-8.50, 7.58]$; $p=0.89$). In contrast, hydrotherapy produced a moderate, statistically significant improvement in lower-limb muscle strength (Hedges’ $g=0.46$; 95% CI $[0.23, 0.69]$), particularly in knee extensor and hip abductor strength. Heterogeneity was low for VAS pain and muscle strength but substantial for WOMAC pain ($I^2\approx 71\%$), and no evidence of publication bias was identified. Conclusions: Hydrotherapy did not reduce postoperative pain more than land-based exercise or usual care; pain relief was comparable between approaches, whereas hydrotherapy yielded greater gains in muscle strength. Heterogeneity in treatment parameters and the limited number of high-quality trials preclude definitive conclusions; future research should standardize hydrotherapy protocols and investigate long-term outcomes. Full article

Background: The Mercer Universal Prosthesis (MUP), designed with a default “neutral” (vertical) socket alignment, was developed to simplify transtibial prosthetic fitting, reduce labor costs, and improve access to prosthetic care in low-resource settings. Methods: This present longitudinal study evaluated biomechanical and functional outcomes at baseline, 6 months, and 12 months in 20 transtibial amputees fitted with the MUP. Results: Functional outcomes, assessed using the SF-36, showed significant improvement in overall health scores at 12 months (p < 0.001), while physical function and energy/fatigue domains remained unchanged (p = 0.686 and p = 0.211, respectively). Biomechanically, sagittal kinematics, measured using inertial motion capture, revealed significant limb × time interactions for hip flexion, knee flexion, and ankle plantarflexion. At 6 months, maximum hip flexion (−7°, p = 0.008) and knee flexion (−11°, p = 0.005) of the prosthetic limb were decreased versus baseline. At 12 months, the only observed difference was increased maximum ankle plantarflexion of the intact limb (+5° vs. baseline, p = 0.016). Muscle effort, quantified via the integral of EMG throughout the gait cycle, did not differ significantly between prosthetic and intact limbs across time points. Gait symmetry index (GSI) scores for hip, knee, and ankle range of motion trended toward gradual improvement but without statistical significance (p > 0.05). Conclusions: The MUP performance was maintained over 12 months, with stable biomechanical performance and meaningful quality-of-life gains. These findings support its potential as a cost-effective solution to expand prosthetic accessibility in low- and middle-income countries. Full article

Background/Objectives: Standard plyometric, flexibility and balance drills are central to youth rhythmic gymnastics but can be limited by repetitive monotony and reduced engagement. This study evaluated whether embedding plyometric or flexibility exercises within traditional games improves physical performance and lower-limb flexibility in young female gymnasts. Methods: Forty-two female gymnasts (age 13.7 ± 1.5 years) were randomly assigned (1:1:1, permuted-block randomization with allocation concealment) to a game-based plyometric group (PECG), a game-based flexibility group (FECG), or a standard gymnastics control (GE). Over 8 weeks (five sessions per week) the experimental groups performed their protocols immediately before regular training, with load recalibrated every two weeks. Squat jump (SJ), countermovement jump (CMJ) and hip flexibility were pre-specified primary outcomes; agility, Stork balance and Y-Balance were exploratory. Linear mixed models tested Group × Time interactions, with within-group effect sizes expressed as Cohen’s d. Results: Significant Group × Time interactions emerged for the squat jump (F_2,39 = 6.09, p = 0.005) and countermovement jump (F_2,39 = 6.77, p = 0.003), favoring PECG (SJ β = 1.90; CMJ β = 1.86). FECG produced the largest flexibility gains, with significant Group × Time interactions for hip abduction and left hip flexion; a marked within-group increase in right hip extension (β = 2.65) was not accompanied by a significant interaction and is interpreted with caution. PECG also improved agility (p = 0.001), static balance and several Y-Balance directions. No injuries or dropouts were recorded. Conclusions: An 8-week game-based intervention enhanced physical performance in adolescent rhythmic gymnasts, with effects largely specific to the training modality: plyometric games improved explosive power, agility and dynamic balance, whereas flexibility games improved range of motion. Given the small sample, the findings should be regarded as preliminary and hypothesis-generating. Full article

Objective: Volleyball athletes require well-developed balance control during spiking, blocking, rapid movement, and landing. Joint range of motion (ROM) may also influence limb extension, support adjustment, and center-of-mass control. Previous studies have usually examined balance ability and joint ROM as separate factors related to volleyball performance. However, the associations between dynamic balance, static balance, and multi-joint ROM in the upper and lower limbs remain insufficiently understood. This study therefore aimed to examine the relationship between balance performance and upper- and lower-limb joint ROM in female college volleyball athletes. Methods: Thirty-five female college volleyball athletes were included. Dynamic balance of the upper and lower limbs was assessed using the Y-Balance Test, and static balance was evaluated under eyes-open and eyes-closed conditions using a static balance platform. Upper- and lower-limb ROM was measured using an electronic goniometer and the knee-to-wall test. Paired-sample t-tests were used to compare bilateral differences and differences between visual conditions. Pearson correlation analysis was performed to examine associations between joint ROM and balance performance, and false discovery rate (FDR) correction was applied to account for multiple comparisons. Results: (1) No significant bilateral difference was observed in upper-limb YBT-UQ performance (p > 0.05); for lower-limb YBT-LQ performance, a significant difference was found only in the anterior direction, with the right side showing higher values than the left side (p < 0.01). (2) Static balance parameters under the eyes-closed condition were significantly poorer than those under the eyes-open condition (p < 0.01); under the same visual condition, only the total sway path length of the right foot was significantly shorter than that of the left foot (p < 0.05). (3) The ranges of motion of right shoulder flexion, shoulder horizontal adduction, shoulder external rotation, elbow flexion, and knee-to-wall distance were significantly greater than that of the left side (all p < 0.05), and right hip internal rotation ROM was also significantly greater than that of the left side (p < 0.01). (4) Dynamic balance was correlated with selected joint ROM measures. Specifically, the anterior reach direction of the right YBT-LQ was positively correlated with hip flexion ROM (r = 0.593, p < 0.01) and knee-to-wall distance (r = 0.653, p < 0.01), and these correlations remained statistically significant after FDR correction. (5) Static balance parameters were correlated with selected lower-limb joint ROM measures in the original correlation analysis; however, these correlations did not remain significant after FDR correction. Conclusions: Female college volleyball athletes demonstrated a certain degree of bilateral asymmetry in dynamic balance and a pronounced dependence on visual input during static balance tasks. After FDR correction, the associations between the anterior reach direction of the right YBT-LQ and both hip flexion ROM and knee-to-wall distance remained stable, suggesting that these ROM measures may be related to anterior dynamic balance performance. These findings may provide a reference for postural control assessment and the development of sport-specific training programs for female volleyball athletes. Full article

Background and Objectives: Foot wedges are widely used to modulate ankle alignment in clinical and athletic settings, yet the effects of mediolateral wedge placement on multi-planar lower limb biomechanics during functional unilateral exercises remain poorly characterized. This study aimed to quantify the effects of medial and lateral foot wedge placement on lower limb joint kinematics, muscle activation, and ground reaction forces (GRFs) during the split squat. Materials and Methods: Thirty healthy young adults (12 males, 18 females; 24.5 ± 2.7 years) performed split squats under three randomized conditions using a rigid inclined platform rather than a custom foot orthosis: no wedge (NW), medial wedge (MW), and lateral wedge (LW). Three-dimensional kinematics (Qualisys, 100 Hz), bilateral GRFs (Bertec, 1000 Hz), and surface electromyography (sEMG, 1000 Hz) of the peroneus longus (PL), tibialis anterior (TA), vastus medialis (VM), and vastus lateralis (VL) were recorded synchronously. Repeated-measures ANOVA with Bonferroni post hoc tests and partial eta-squared (η²_p) were used (α = 0.05). Results: LW significantly increased PL and VM activation, sagittal-plane range of motion (ROM) at the ankle, knee, and pelvis, and vertical GRF, compared with MW and NW (p < 0.05). MW significantly increased TA and VL activation and reduced sagittal hip ROM (p < 0.05). No significant differences were observed for mediolateral or anteroposterior GRF. Conclusions: Mediolateral foot wedge placement acutely reorganizes lower limb neuromuscular recruitment, joint kinematics, and vertical ground reaction force during the split squat in healthy young adults. These preliminary findings indicate that wedge orientation, applied via a rigid inclined platform, can acutely and selectively modulate muscle activation patterns; any therapeutic or performance applications, however, were not evaluated here and should not be generalized to conventional clinical orthoses without further investigation. Full article

Patellofemoral pain (PFP) in athletes is associated with lower-limb kinetic-chain constraints, yet rehabilitation strategies targeting both hip and ankle mobility remain insufficiently examined. This assessor-blinded randomized controlled trial investigated the effects of a 6-week hip and ankle mobility-based rehabilitation program in male collegiate athletes with PFP. Forty-eight participants were assigned using computer-generated 1:1 randomization to an intervention group (n = 24) or a control group (n = 24). The intervention group completed supervised hip and ankle mobility rehabilitation three times weekly, whereas the control group maintained regular sport-specific training only. Co-primary outcomes were pain intensity assessed using a 10-cm visual analog scale (VAS) and knee-related function assessed using the Kujala score. Secondary outcomes included hip rotation range of motion, weight-bearing ankle dorsiflexion, vastus medialis–vastus lateralis (VM–VL) onset timing, Y-Balance Test (YBT) composite score, and countermovement jump (CMJ) height. Significant group × time interactions favored the intervention group for VAS (p < 0.0001; partial η² = 0.436; change difference: −1.54 cm; 95% CI: −2.06 to −1.02) and Kujala score (p < 0.0001; partial η² = 0.285; change difference: 8.00 points; 95% CI: 4.24 to 11.76). Significant interactions were also observed for hip internal and external rotation range of motion, weight-bearing ankle dorsiflexion, VM–VL onset timing during a controlled squat task, and YBT composite score (all p ≤ 0.0405; partial η² = 0.088–0.374). No significant group × time interaction was observed for CMJ height (p = 0.0511; partial η² = 0.080). These findings suggest that, compared with regular sport-specific training alone, adding a supervised hip and ankle mobility-based rehabilitation program may improve pain, knee-related function, targeted mobility outcomes, VM–VL onset timing during a controlled squat task, and dynamic balance in the short term. However, because the control group did not receive an active or attention-matched intervention, these findings should be interpreted as the added effect of the supervised rehabilitation program rather than as definitive evidence of mobility-specific treatment effects. In addition, because patellar tracking, knee kinematics, joint kinetics, and patellofemoral joint loading were not directly measured, the findings should be interpreted as clinical and functional outcome changes rather than direct evidence of a confirmed biomechanical mechanism. Trial registration: NCT07542236. Full article

Background: Robot-assisted total knee arthroplasty (raTKA) improves the precision of component positioning and coronal alignment restoration, but it remains uncertain whether that technical accuracy modifies the clinical effect of alignment strategy in different varus phenotypes. The present report evaluates alignment strategy and correction magnitude, explicitly as a post hoc exploratory deformity-subgroup analysis within a randomized raTKA cohort. Methods: This single-center, open-label, randomized study enrolled 296 patients with varus knee osteoarthritis who underwent raTKA between 2023 and 2025 using either mechanical alignment (MA; n = 149) or limited/restricted kinematic alignment (lim.-KA; n = 147). The parent randomized comparison was conducted at the whole-cohort level; the deformity-based subgroups reported here were defined after the whole-cohort analysis and are therefore post hoc and exploratory. Patients were stratified according to preoperative varus severity into a mild-deformity subgroup (≤10°; lim.-KA-I n = 99, MA-I n = 102) and a moderate-deformity subgroup (11–20°; lim.-KA-II n = 48, MA-II n = 47). Outcomes included hip–knee–ankle angle (HKA), correction angle, range of motion (ROM), visual analog scale (VAS; 0–10 points), Knee Society Score (KSS; knee and function), Oxford Knee Score (OKS), and Forgotten Joint Score-12 (FJS-12) over 12 months. Estimates are presented with 95% confidence intervals where applicable. Because multiple post hoc subgroup comparisons were performed without formal multiplicity adjustment, p-values are interpreted descriptively and in conjunction with effect sizes and 95% confidence intervals. Results: The primary whole-cohort randomized comparison did not demonstrate an overall between-group advantage of either alignment strategy. The post hoc moderate-varus subgroup showed favorable unadjusted 12-month differences for lim.-KA versus MA in KSS-knee (+6.8 points; 95% CI 5.3 to 8.3; nominal p < 0.001), KSS-function (+4.0 points; 95% CI 2.7 to 5.2; nominal p < 0.001), OKS (+6.4 points; 95% CI 4.5 to 8.3; nominal p < 0.001), and FJS-12 (+11.3 points; 95% CI 9.4 to 13.1; nominal p < 0.001). In contrast, ROM favored MA rather than lim.-KA in the moderate-varus subgroup (−11.8°; 95% CI −16.6 to −7.0; nominal p < 0.001), indicating greater 12-month ROM after MA, and VAS pain, reported on a 0–10 scale, did not support a lim.-KA pain advantage (+0.26 points; 95% CI 0.05 to 0.48; higher scores indicate worse pain; nominal p = 0.018). Exploratory, unadjusted, post hoc 12-month alignment-by-deformity interaction terms were significant for ROM, KSS-knee, KSS-function, OKS, and FJS-12, but not for VAS. Because multiple post hoc comparisons were performed without formal multiplicity adjustment, the results are interpreted descriptively, along with effect sizes and confidence intervals. Conclusions: The primary randomized comparison did not demonstrate a clinical advantage of lim.-KA over MA in the whole cohort. In post hoc exploratory analyses, mild varus deformity was associated with outcomes broadly similar to those after both alignment strategies. In the moderate-varus subgroup, patient-level analyses suggested a possible phenotype-dependent signal for KSS-knee, KSS-function, OKS, and FJS-12 after lim.-KA, whereas ROM favored MA, and VAS pain did not support a lim.-KA pain advantage. These subgroup findings should be interpreted separately from the primary randomized result, considered hypothesis-generating only, and not used in isolation to change clinical practice without prospective confirmation. Full article

Background: Traditional gait assessments in adult degenerative scoliosis (ADS) often rely on prohibitively expensive, laboratory-bound optoelectronic systems that lack clinical accessibility. This research aims to independently evaluate both lower limbs using a wearable Inertial Measurement Unit (IMU) system, in contrast to studies that employ a unilateral reference, thereby elucidating the unique bilateral asymmetries and dynamic stability patterns exhibited in ADS. Methods: Gait patterns of 20 ADS patients and 15 healthy controls were analyzed using the Rokoko Smartsuit Pro. Segmental kinematic data were integrated with anthropometric mass distribution models to calculate the total body center of mass (CoM). Spatiotemporal parameters, joint range of motion (RoM), and CoM excursions in three planes were statistically compared between the groups. Results: ADS patients exhibited a cautious gait strategy characterized by significantly reduced step speed, shortened step lengths, and increased step width ($p<0.05$). Temporal analysis showed prolonged stride, stance, and double support time ($p<0.001$), while cadence remained comparable to healthy controls. A triple-joint deficit, including hip, knee, and ankle, was identified in the sagittal plane, especially with peak flexion reductions reaching up to 55% in the left knee and 38% in the right knee, highlighting profound functional asymmetry ($p<0.001$). Additionally, the CoM analysis reflected these stability restrictions, showing increased horizontal excursion and reduced vertical oscillation. Conclusions: Our findings suggest that ADS is associated with distinct, bilateral alterations in the lower limb kinematic chain and notable adaptations in dynamic balance parameters, characterized by a cautious gait strategy and profound sagittal triple-joint asymmetries. These findings highlight the feasibility of full-body wearable IMU technology in capturing objective, bilateral gait alterations, providing a foundational baseline that could complement standard static radiography in future clinical evaluations. Full article

Many older residential toilet designs may pose substantial biomechanical demands for older adults with reduced lower-extremity strength, as standard seat heights often require increased joint range of motion (ROM) and compensatory upper-limb support during sit-to-stand (STS) transfer. This exploratory, repeated-measures biomechanical study evaluated the effects of a biomimetic Stand-assist Toilet Seat (BSTS) designed to facilitate STS movement through a forward-and-upward curvilinear lifting trajectory. Thirty community-dwelling older adults were stratified into high-, moderate-, and low-functioning groups according to normative 30 s Chair Stand Test performance. Participants completed repeated STS trials under conventional and BSTS-assisted seating conditions in randomized order. A synchronized multimodal assessment integrating MediaPipe Pose-based motion tracking for sagittal-plane kinematic analysis was used to quantify lower-limb kinematics and upper-limb kinetics. Mixed-design ANOVA revealed significant main effects of seating condition on hip and knee ROM (all p < 0.001, η²p > 0.70), indicating reduced lower-limb joint motion requirements under the BSTS condition. Significant reductions were also observed in peak arm-support force (F (1,27) = 14.57, p = 0.001, η²p = 0.35) and arm-support impulse (F (1,27) = 20.21, p < 0.001, η²p = 0.42), demonstrating decreased upper-limb loading during STS transfer. No significant interaction effects between seating condition and functional group were identified. These findings suggest that the BSTS modified STS movement patterns and reduced upper-limb loading demands in community-dwelling older adults. The combined kinematic and kinetic assessment approach may provide a practical method for biomechanical evaluation of assistive seating technologies in rehabilitation and aging-related applications. Full article

Background: Femoroacetabular impingement syndrome (FAIS) is a common cause of hip pain and functional limitation in young and physically active individuals. Although hip arthroscopy is an established treatment when conservative management fails, objective data on early postoperative changes in active hip range of motion (ROM) remain limited. This study aimed to evaluate changes in active hip ROM three months after arthroscopic treatment for FAIS using inertial measurement units (IMUs) and to investigate their relationship with patient-reported outcomes. Methods: A prospective cohort of forty-two patients (mean age 36 ± 9 years; 64% male) undergoing hip arthroscopy for FAIS was assessed preoperatively and at a three-month follow-up. Active hip ROM—including flexion, internal rotation, external rotation, and total rotation—was measured using IMU sensors, while subjective outcomes were evaluated using the Hip disability and Osteoarthritis Outcome Score (HOOS). Results: Significant improvements were observed across all HOOS subscales at follow-up (all p < 0.001). The HOOS Total score increased from 57 ± 15 to 83 ± 11. Clinical recovery, defined by the Minimal Important Change (MIC), was achieved by 74% of patients for Symptoms, 81% for Pain, 81% for ADL, 83% for Sport, and 67% for Quality of Life (QOL). Active hip ROM in the operated hip increased significantly for internal rotation (19.6° ± 11.9° to 26° ± 8°), external rotation (37° ± 10° to 40° ± 8°), and total rotation (57° ± 15° to 67° ± 12°). Changes in hip flexion were not clinically meaningful (98° to 100°), and no changes were observed in the non-operated hip. Spearman’s analysis showed weak and inconsistent correlations between active ROM and HOOSs (r ranging from −0.34 to 0.31). Conclusions: Hip arthroscopy for FAIS leads to early improvements in both patient-reported outcomes and active hip mobility, particularly in rotational movements, although the relationship between ROM and subjective outcomes appears weak. Full article