Search Results (336)

Transcranial direct current stimulation (tDCS) over motor–premotor regions may modulate motor performance, though underlying mechanisms remain unclear. Twenty-four athletes (9 females, 15 males) were randomly assigned to receive anodal tDCS (2 mA, 20 min) over the left sensorimotor cortex (n = 12) or sham stimulation (n = 12). Participants performed a bimanual isometric force-matching task at 30% maximal voluntary contraction, with visual feedback initially provided and then removed. Force undershoot, root mean square error (RMSE), spectral power (1–3 Hz), and inter-hand coherence were analyzed. A computational model was developed to test whether enhanced proprioceptive feedback processing could account for observed effects. Following tDCS, force undershoot decreased significantly (p = 0.002, d = −1.15) and RMSE improved (p = 0.010, d = −0.91). Spectral power in the 1–3 Hz band increased (p = 0.012, d = 0.87), suggesting enhanced corrective oscillations. These within-group changes were absent in the sham group (all p > 0.20), although Group × Epoch interactions did not reach significance (all p > 0.05), likely due to limited statistical power. Inter-hand coherence remained unchanged. The computational model demonstrated that enhanced proprioceptive feedback gain qualitatively reproduces the observed behavioral pattern. Anodal tDCS over the left sensorimotor/premotor region may enhance bimanual force control under conditions requiring proprioceptive feedback. Replication with larger samples is needed to confirm between-group specificity. Full article

Flexor hallucis longus (FHL) tendon injuries, although rare, severely affect foot stability and mobility, particularly in individuals engaging in repetitive push-off actions. This case study examines a 27-year-old male who underwent surgical repair for FHL tendon rupture, followed by a structured, multi-modal rehabilitation program integrating advanced therapeutic techniques. The 12-week program was divided into three distinct phases to ensure a structured and progressive recovery process. The Early Phase (Weeks 1–4) focused on pain and edema control through interventions such as massage, electrotherapy, kinesiotaping, and the use of peritendinous ultrasonography to monitor recovery progress. The Intermediate Phase (Weeks 5–8) aimed to enhance strength and flexibility by incorporating Proprioceptive Neuromuscular Facilitation (PNF), weight-bearing exercises, dynamic stretching, and the progressive integration of Graston massage techniques. Finally, the Advanced Phase (Weeks 9–12) prioritized functional recovery, utilizing balance training, load transfer exercises, agility drills, and Theragun applications to prepare the individual for a return to optimal physical performance. Significant improvements were observed, including pain reduction (VAS score reduced by X%), increased dorsiflexion flexibility (from X° to X°), and enhanced muscle strength (e.g., tibialis anterior strength increased by X%). Functional assessments, such as the Y Balance Test, revealed improved endurance and mobility. This case study highlights the benefits of integrating innovative techniques like Graston massage and Theragun within a structured, evidence-based rehabilitation program to optimize recovery post-FHL tendon surgery. Full article

Purpose: To critically evaluate the role or effect of platelet-rich plasma (PRP) in anterior cruciate ligament (ACL) reconstruction in terms of clinical and radiological outcomes. Method: We conducted a systematic search of PubMed, Embase, the Cochrane Library, and Web of Science to identify relevant studies. Clinical outcomes included the Visual Analogue Scale (VAS), International Knee Documentation Committee (IKDC) subjective and objective evaluations, Lysholm score, Tegner score, anterior knee laxity, Knee Injury and Osteoarthritis Outcome Score (KOOS), Kujala score, Victorian Institute of Sport Assessment (VISA) scale, proprioception, isokinetic strength, and physical examination tests (anterior drawer, Lachman, and pivot-shift tests). Radiological outcomes encompassed measures obtained via magnetic resonance imaging (MRI), computed tomography (CT), X-ray, and ultrasound. Statistical significance was defined as a p value < 0.05, and all analyses were performed using R software (version 4.1.3). Results: A total of 23 studies, including 19 randomized controlled trials, met the inclusion criteria, encompassing 1072 patients overall. The meta-analysis showed significant differences between PRP group and non-PRP group with regard to VAS score at 6- and 12-month follow-up, Lysholm score at 6-month follow-up, and Tegner score at 6-month follow-up. Meta-regression showed that the two group differences in VAS score changed significantly with follow-up time (p < 0.01). In terms of radiological findings, about half of the assessments favored PRP to facilitate the graft maturation and integration at 6-month follow-up. Conclusions: PRP application in ACL reconstruction compared with non-PRP, may produce short-term but not long-term clinical outcomes such as VAS score, Lysholm score and Tegner score. While some short-term statistical differences exist, their magnitude and durability do not yet justify routine clinical adoption of PRP in ACL reconstruction. Larger samples and higher-quality studies are needed to support our results and further explore the advantages of PRP in other aspects. Level of evidence: Level II. Full article

Translating large-scale motion datasets into robust, deployable humanoid controllers is a critical challenge in engineering informatics, primarily due to the scarcity of high-quality annotations, the risk of mode collapse in conditional generation, and the strict constraints of onboard computing hardware. This paper presents a deployable two-stage learning system that maps clip-level motion datasets to a single-policy multi-skill controller and its deployable counterpart. We adopt coarse one-hot skill labels that can be assigned automatically at the clip level with negligible manual effort, enabling scalable dataset construction. To prevent conditional discriminators from ignoring skill conditions, we inject mismatched (transition, label) pairs and introduce a condition-aware loss that explicitly penalizes incorrect transition–label associations, improving controllability and mitigating mode collapse. For real-world deployment, we further propose a two-stage training strategy: a privileged teacher policy is first trained in simulation and then distilled into a student policy that relies on stacked historical proprioceptive observations, ensuring robustness against sensing noise and latency without relying on external state estimation. Extensive evaluations in simulation and on real hardware demonstrate improved skill coverage, transition coverage, realism, and training efficiency across heterogeneous embodiments. With the onboard computer of a Unitree G1 robot, the distilled policy runs at 100 Hz with 15–25 ms latency, confirming the system’s engineering feasibility. Full article

At the dawn of the 20th century, seminal studies revealed that muscle fibers produce less heat and generate greater force during elongation than during shortening actions, laying the foundation for contemporary research on eccentric exercise. Today, eccentric exercise is widely used by athletes to enhance strength and by older adults to maintain functional capacity, yet it may cause muscle damage, particularly in unaccustomed muscles. Despite more than a century of investigation, the precise mechanisms of eccentric exercise-induced muscle damage remain incompletely resolved. Nevertheless, eccentric exercise serves as a valuable model for studying muscle injury and repair and adaptation. This review organizes current evidence into nine key themes: (1) eccentric exercise-induced muscle damage and flawed biomarkers, (2) satellite cell-mediated and alternative repair pathways, (3) high-force, low-cost contractions and metabolic impact, (4) repeated bout effect and protective adaptations, (5) architectural remodeling of fascicles, sarcomeres and tendon, (6) distinct neural control, proprioception, and cross-education adaptations, (7) mitochondrial, sarcoplasmic reticulum, and cytoskeletal stress remodeling, (8) connective tissue perturbation, remodeling, and joint stability, and (9) targeted, cautious use of antioxidant supplementation. Rather than offering a comprehensive overview, this review highlights pivotal experiments, concepts, and controversies within these themes to guide readers to the most impactful discoveries in eccentric exercise and muscle damage. Full article

Background: Sensorimotor differences have frequently been reported in children with developmental dyslexia, but are often considered secondary or comorbid to phonological deficits. Within an embodied cognition perspective, reading acquisition emerges from dynamic interactions between bodily regulation, multisensory integration, and learning-related neural plasticity. Proprioception contributes to spatial orientation, motor coordination, and perceptual stabilization, while sleep-dependent processes play a critical role in the consolidation and automatization of cognitive and motor skills. Objectives: Building on early clinical observations, including the hypothesis proposed by Martins da Cunha, this review explores whether variations in proprioceptive processing and sensorimotor regulation may influence multisensory stability and the conditions under which reading skills develop in some individuals with dyslexia. Methods: This narrative synthesis integrates clinical observations and experimental paradigms examining proprioceptive function in children with dyslexia, including studies conducted in our laboratory over the past two decades. These investigations address postural regulation under varying attentional demands, laboratory measures of proprioceptive acuity, visuospatial localization tasks, multisensory interactions, and exploratory observations concerning sleep–wake regulation. Results: Across studies, children with dyslexia often show differences in proprioceptive processing associated with variations in postural regulation, visuospatial stability, and multisensory tasks. Laboratory measurements suggest reduced proprioceptive acuity in some individuals, with moderate correlations observed between proprioceptive sensitivity and reading-related measures. Additional observations suggest that nocturnal physiological regulation—including respiratory dynamics and sleep architecture—may interact with daytime sensorimotor stability and attentional functioning. Conclusions: Taken together, these findings support the hypothesis that variations in sensorimotor regulation across the sleep–wake cycle may influence the stability of multisensory processing and attentional conditions relevant for reading acquisition. Within this perspective, proprioception is not proposed as an alternative explanation for dyslexia but as a complementary dimension that may contribute to the heterogeneity of dyslexic profiles. Further longitudinal and controlled studies are required to clarify the relationships between sensorimotor regulation, sleep-dependent plasticity, and learning processes. Full article

Background: Adolescent idiopathic scoliosis (AIS) is often associated with central nervous system disorders and deficits in sensorimotor function. While the Schroth method is a common clinical intervention, research evidence regarding its effectiveness in enhancing sensorimotor control remains limited. This study aimed to evaluate the impact of the Schroth method on sensorimotor control and quality of life (QoL) in AIS patients. Methods: Sixty female participants (mean age 13.4 years) with Cobb angles between 10° and 45° were divided into an intervention group (n = 30), receiving Schroth exercises and bracing for 10 weeks, and a control group (n = 30), receiving bracing alone. Outcome measures included static and dynamic balance, spine lateral flexion joint position sense (JPS), upper-limb functional proprioception, and the GR-BSSQ Brace questionnaire. Results: Statistical analysis using two-way mixed ANOVA revealed significant Group × Time interactions across several parameters. The Schroth group showed significant improvements in static and dynamic balance, with ellipse area reduction (p = 0.005) and reduced Fukuda test distance (p = 0.007), respectively. Significant enhancements were noted in spine lateral flexion JPS (Bilateral p = 0.008) and upper-limb proprioception (Bilateral p = 0.000). Furthermore, the intervention group reported a significant improvement in QoL scores compared to the control (p = 0.000). Conclusions: The findings demonstrate that the Schroth method was associated with enhanced sensorimotor control, supporting its use as a targeted approach to improve functional outcomes in individuals with AIS. These results highlight the clinical value of the method, beyond spinal curve correction. Full article

Background: Upper-limb performance in handball depends on accurate shoulder sensorimotor control under high loads and fatigue. This study examined between-cohort differences associated with concentric versus eccentric exercise-induced fatigue in shoulder proprioception, kinesthesia, functional stability, and isometric force output in professional male handball players. Methods: This was a retrospective, quasi-experimental (non-randomized) between-cohort comparison of two previously collected cohorts who completed either a concentric (n = 46) or eccentric (n = 33) fatigue protocol, with pre- and post-fatigue assessments of joint repositioning sense (absolute angular error, AAE), threshold to detection of passive movement (TTDPM), Y Balance Test Upper Quarter (YBT-UQ), and the Athletic Shoulder (ASH) test. Results: Fatigue significantly increased AAE across all tested angles (Time: all p < 0.001), with a contraction-specific effect at end-range internal rotation (IR45°), where AAE increased more after concentric than eccentric fatigue (Time × Fatigue Type: p = 0.017; Δ = +1.34° (+61.8%) vs. +0.20° (+7.4%)). TTDPM increased after fatigue (p = 0.001) with no interaction (p = 0.968). YBT-UQ performance decreased after fatigue for all dominant-limb outcomes and for non-dominant inferolateral, superolateral, and composite scores (all p ≤ 0.018), but not for non-dominant anteromedial reach (p = 0.986); no Time × Fatigue Type interactions were detected for YBT-UQ outcomes (all p > 0.05). ASH force output decreased across all positions and both limbs (all p ≤ 0.002), with the dominant-limb Y position showing a greater decline following eccentric fatigue (Time × Fatigue Type: p = 0.030; e.g., ASH Y dominant Δ = −0.49 (−4.6%) vs. −1.43 N·kg⁻¹ (−13.3%)). Conclusions: Exercise-induced fatigue impairs shoulder sensorimotor function and upper-limb performance in handball. Contraction-mode differences were small and task-specific in this between-cohort comparison, emerging primarily at end-range proprioception and selected isometric strength positions. These findings may inform the design of training programs that emphasize fatigue-resistant sensorimotor control and end-range strength, while causal inferences regarding contraction mode are not warranted given the non-randomized design. Full article

While walking robots possess significantpotential for various real-world applications, the reliance on high-performance sensors and complex control architectures for precise gait control remains a significant barrier to commercialization and lightweight design. To overcome these engineering limitations and lay the groundwork for a sensing paradigm adaptable to complex terrains, this study proposes an AI-based sensorless feedback control framework that incorporates the biological principles of proprioception. To this end, a walking robot leveraging the morphological intelligence of the Klann linkage was developed. We constructed a time-series dataset by defining motor current signals as ‘interoceptive sensing’ information—analogous to biological muscle feedback—and synchronizing them with absolute angular data. This dataset was used to train an Attention-LSTM (A-LSTM) model, which predicts future motor states in real-time by decoding nonlinear physical information embedded within internal current data, independent of external environmental sensors. By integrating the proposed model into a PI controller, a stable biomimetic walking loop was successfully implemented without the need for additional position sensors. Full article

Background: Patellofemoral pain syndrome (PFPS) is a common musculoskeletal disorder that involves various biomechanical factors, including the altered positioning of the patella, weakness of the lower extremity muscles, delayed activation of the vastus medialis muscle, and excessive pronation of the foot. Although the short- and long-term effects of external support among the recommended conservative treatment methods for PFPS have been examined, there remains a lack of consensus regarding their impacts. This study was conducted to investigate the immediate effects of braces and rigid taping applied to control pain on proprioception, functional status, and balance in patients with PFPS, and to compare these outcomes with normative values obtained from healthy individuals. Methods: The study included 18 patients with PFPS and 18 healthy individuals who met the inclusion criteria. Through randomization of the intervention sequence, patients were evaluated under conditions of rigid taping, support, or without any support. Their pain levels before and after the application were assessed using the Visual Analog Scale; their functional status was evaluated with the Kujala Patellofemoral Scoring, the 10-Step Up Test, and the Squat; their balance performance was measured using the Y-Balance Test and the Single Leg Stance Test; and their proprioception was assessed with the Joint Position Sense Test. Results: It has been determined that rigid taping and bracing have similar effects in the immediate management of pain, proprioception, functional status, and balance issues in patients with PFPS. The interventions were observed to bring patients’ static balance and proprioception parameters closer to the values seen in healthy individuals. Conclusions: Rigid taping and bracing are both effective interventions in the management of PFPS, offering benefits such as pain relief, prevention of proprioceptive deficits, mitigation of balance impairments, and enhancement of functional outcomes. The selection of the most appropriate modality should be based on the individual patient’s characteristics and tolerance levels. Full article

Hemophilia is an X-linked inherited bleeding disorder characterized by joint hemorrhages and progressive arthropathy. While mutation type is known to influence disease severity, its impact on postural balance strategies has remained unclear. This cross-sectional study investigated the relationship between gene mutation type and postural control in hemophilia A patient using center of pressure (CoP) analysis and radiographic joint assessment with the Pettersson score. Thirty-five participants were divided into an INV group (intron 22 or intron 1 inversion of the F8 gene) and a NonINV group (other mutations). While the Pettersson scores and traditional time-domain CoP parameters (sway area, velocity) were comparable between groups, frequency domain analysis revealed a significant difference. INV group exhibited significantly higher energy content above 2 Hz in the anteroposterior direction compared to NonINV group. This genotype-specific spectral signature emerged despite comparable radiographic arthropathy and conventional CoP metrics, suggesting that frequency-domain CoP analysis can uncover subclinical postural adaptations in hemophilia A. These findings highlight the need for targeted proprioceptive training in this specific subpopulation to prevent subclinical instability and potential falls. Full article

(1) Background: Falls are a major public health concern in older adults, largely due to age-related declines in proprioception and postural control. Although knee braces are commonly prescribed to enhance joint stability and sensory feedback, their effects on plantar pressure distribution remain unclear; (2) Methods: Thirteen community-dwelling older adults (mean age: 79.6 ± 3.2 years) participated in a repeated-measures study under three conditions: no brace, knee brace A, and knee brace B. Plantar pressure variables were assessed barefoot during quiet standing using a baropodometric platform. Conditions were compared using non-parametric Friedman tests; (3) Results: Significant differences were observed for left foot total surface area (p = 0.041) and left rearfoot surface area (p = 0.020). Compared with no brace, brace A increased plantar contact area, whereas brace B reduced it. No significant differences were found for pressure magnitude, load distribution, or right foot variables; (4) Conclusions: Knee braces induce subtle, brace-specific and lateralized changes in plantar pressure distribution, potentially reflecting altered postural control strategies. Although limited to specific variables, these effects may be clinically relevant for fall risk assessment and individualized knee brace prescription in older adults. Full article

Background: Conservative treatment for adolescent idiopathic scoliosis (AIS) includes physiotherapeutic scoliosis-specific exercises (PSSE) and bracing. One PSSE-based approach is the Rigo Concept, which emphasizes three-dimensional (3D) postural correction, expansion techniques, muscle activation, and postural integration. Recently, increasing interest has been directed toward incorporating whole-body vibration (WBV) into physiotherapy. WBV is a reflex-based neuromuscular training method shown to improve muscle strength and power and enhance proprioception, which may be beneficial in the treatment of AIS. Objectives: This study aimed to assess the effects of physiotherapy based on the Rigo Concept combined with WBV on sagittal spinal curvatures, trunk symmetry, and the angle of trunk rotation (ATR) in girls with AIS. Methods: This prospective controlled experimental study included 45 girls (12.8 ± 1.7 years) with AIS who participated in a 5-day physiotherapy session based on the Rigo Concept. Of these, 22 participants additionally received WBV using a Galileo Med 35 platform (3 × 3 min/day, frequency 25 Hz, peak-to-peak displacement 2 mm), forming the Rigo–WBV group. The remaining participants received the Rigo Concept alone (Rigo–ONLY). Participants were allocated to the study groups using a quasi-random method based on the order of enrollment. ATR was defined as the primary endpoint, while thoracic kyphosis, lumbar lordosis, sacral slope, coronal balance, and scapular position were considered secondary outcomes. All outcomes were assessed before and after the intervention. Results: Neither the Rigo–WBV nor the Rigo–ONLY intervention affected sagittal spinal curvatures (p > 0.05). Coronal balance improved in both the Rigo–WBV (Δ 0.5 cm, p < 0.001) and Rigo–ONLY groups (Δ 0.4 cm, p = 0.005). In the Rigo–ONLY group, an improvement in scapular height asymmetry was observed (Δ 1.1°, p = 0.010). Following the Rigo–WBV intervention, ATR decreased in the main thoracic (Δ 1.9°, p < 0.001), thoracolumbar (Δ 1.9°, p < 0.001), lumbar curve (Δ 2.1°, p < 0.001), and pelvis (Δ 1.0°, p < 0.001). In the Rigo–ONLY group, a reduction in ATR was observed only in the thoracolumbar curve (Δ 1.9°, p < 0.001). Conclusions: In terms of clinical and postural changes, five-day physiotherapy based on the Rigo Concept, with or without WBV, does not influence sagittal spinal curvatures in girls with AIS. Both interventions may improve coronal balance. Moreover, the Rigo Concept combined with WBV may reduce ATR. Full article

The lack of reliable sensory input from prosthetic limbs limits transfemoral amputees’ ability to perceive limb movement without visual monitoring. This study evaluated design parameters of a proposed forearm-based vibrotactile system in a pre-clinical, design-level perceptual evaluation, conveying prosthetic joint positions through patterned vibrations to provide non-invasive proprioceptive feedback. Healthy participants completed two experiments assessing detection of tactile cues from dual-actuator bands on the wrist and elbow representing assumed ankle and knee positions. The effects of temporal structuring (sequential vs. simultaneous stimulation), actuator configuration, amplitude and frequency settings, and signal duration on response accuracy were examined. Sequential vibrations produced significantly higher recognition accuracy than simultaneous presentation (72.4% vs. 42.7%, p < 0.001) in a variety of vibration signal parameter values. Actuator placement also influenced performance: simultaneous stimulation on opposite forearm sides yielded significantly lower accuracy (p < 0.001) than same-side configurations, whereas this directional effect was not significant for sequential presentation. Accuracy did not differ significantly between equal and unequal amplitude or frequency levels across actuators. Longer stimulus durations improved accuracy, increasing from 82.3% at 60 ms to 92.5% at 240 ms, though the results indicated a saturation point, suggesting an optimal temporal window. These findings inform the design of forearm-based sensory feedback systems for improved prosthetic limb control. Full article

Background and Objectives: Postural instability is a key feature of Parkinson’s disease (PD), contributing to disability and increased risk of falls. Pharmacological treatments are important, but it is necessary to integrate them with rehabilitation programs that provide benefits for gait and balance. Focal muscle vibration (fMV) has been proposed as a proprioceptive-oriented intervention to enhance postural control, but evidence in PD remains heterogeneous. This observational, retrospective, and controlled pilot study aimed to evaluate whether the integration of fMV into a standardized rehabilitation program provides additional benefits for balance, gait, and fall risk compared to standardized exercise alone in patients with PD. Materials and Methods: Medical records of 35 outpatients with Parkinson’s disease (Hoehn & Yahr stage II–III) were reviewed. All practiced a standardized rehabilitation exercise group program. Of these, 18 patients agreed to undergo fMV before the exercise sessions (fMV group); 17 patients did not accept fMV due to personal organizational reasons (EG) and were considered a retrospective control group. In detail, (i) the fMV group receivdc focal muscle vibration during the first three weeks in addition to a standardized group rehabilitation exercise program, and (ii) the EG underwent a standardized rehabilitation program only. Both groups then completed an identical 16-week standardized rehabilitation program. Functional outcomes were assessed at baseline (T0) and after one month (T1). Results: Groups were homogeneous at baseline. The fMV group showed significant improvements in SPPB (from 8.16 ± 1.6 to 10.2 ± 1.6 p < 0.001) in the Tinetti total (from 18.38 ± 3.2 to 21.5 ± 2.9 p < 0.05). Stabilometric analysis revealed a significant improvement in the Romberg Quotient in the fMV group (p < 0.005). Conclusions: A short time-limited fMV intervention may act as a sensory primer, enhancing the effects of a subsequent standardized rehabilitation program in PD. Full article