Search Results (135)

Background: Osteoporosis is the most prevalent metabolic bone disease, characterized by decreased bone mineral density, which leads to increased bone fragility, back pain, impaired postural stability, and a heightened risk of fractures. Proprioceptive exercises have been identified as an effective approach for reducing the risk of falls and adverse events. Objective: Our aim was to conduct a pilot exploratory study evaluating the effectiveness of proprioceptive training in improving coordination and balance, and in reducing chronic thoracolumbar back pain in older women diagnosed with osteoporosis. Methods: Quantitative ultrasound bone densitometry was performed on 144 women over the age of 60, followed by the implementation of a proprioceptive training program. The One-Leg Stance balance test and the Visual Analog Scale for pain intensity were administered before and after a six-month training intervention. Results: ANOVA revealed significant improvements in balance, with the OLS duration increasing from 2.49 s at baseline to 7.31 s following the intervention. Participants aged over 70 years demonstrated a positive, though comparatively lower increase in stability and balance. Chi-squared (χ²) analysis indicated that 83.9% of the variance in OLS performance was attributable to proprioceptive training (Cramer’s V = 0.839, p = 0.001). A significant reduction in VAS pain scores was observed, with 48.1% of the variance explained by the moderate effect of proprioceptive training (Cramer’s V = 0.481, p = 0.001). Conclusions: Proprioceptive training has the potential to improve postural stability, balance, and coordination and stimulate pain intensity in the thoracolumbar region. Despite promising results, the absence of a control group limits our ability to draw definitive causal conclusions. Full article

Background/Objectives: Maintaining proper posture and preventing musculoskeletal pain are essential for the healthy development of young football players. Contemporary concepts of postural control emphasize the importance of the lumbopelvic-hip complex and the activation of deep trunk muscles. This study aimed to evaluate the effects of a structured core stabilization training program on postural parameters and pain reduction in young football players. Methods: A total of 182 male football players, aged 9–15 years, were enrolled and allocated to either the intervention or control group. The 12-week intervention consisted of exercises targeting both local and global trunk stabilizers. Assessments included measurements of spinal curvatures, trunk rotation angles, lower limb loading symmetry, and postural stability using the TMX-127 digital inclinometer (Saunders Group Inc., Chaska, MN, USA) and the Baseline scoliometer (Fabrication Enterprises, Inc. New York, USA). Pain intensity was measured using the Visual Analogue Scale (VAS). Repeated-measures statistical analyses were performed with a significance level set at p ≤ 0.05. Results: The intervention group showed significant improvements in trunk rotational parameters, with reductions in ATR values at C7/Th1 (−0.54°) and L5/S1 (−0.49°). SATR values decreased by −0.28° between the second and third assessments. Symmetry of lower limb loading under eyes-open conditions improved significantly (p < 0.00195). No significant changes were observed in dynamic balance, as assessed by the Y-Balance Test (p > 0.05). Pain intensity decreased from 3.33 to 2.55 on the VAS, reflecting a reduction of 0.78 points. Conclusions: Systematic core stabilization training enhances postural quality and reduces the occurrence and severity of musculoskeletal pain in young football players, with lasting effects—except for postural control under conditions of reduced visual input. This type of training represents an effective physioprophylactic strategy, supporting postural control and lowering the risk of injuries. To maintain these benefits, continued training that incorporates balance and proprioceptive exercises is recommended. Full article

This systematic review and meta-analysis was conducted to evaluate the effectiveness of the FIFA 11+ injury prevention programme, a neuromuscular training intervention involving muscular strength, proprioception, balance, and plyometric exercises, in reducing ankle injury incidence among football players. Included are randomised controlled trials (RCTs) involving players of any age, sex, or competition level, comparing the FIFA 11+ programme with standard warm-up routines. Studies were eligible if they had a minimum follow-up of five months and reported at least two of the following: number of ankle injuries, incidence rate, and exposure hours. Searches were conducted in PubMed, MEDLINE (via OVID), Scopus, and SPORTDiscus up to October 2024. Risk of bias was assessed using the revised Cochrane Risk of Bias tool (RoB 2), and a random-effects meta-analysis was conducted. Three RCTs, involving 3833 participants and 286,827 exposure hours, met the inclusion criteria. The pooled analysis showed that the FIFA 11+ programme significantly reduced ankle injury rates compared to control groups (rate ratio (RR) = 0.67, 95% confidence interval (CI): 0.46–0.96, p = 0.03, I² = 52%), reflecting a 33% lower risk. The certainty of the evidence was rated as moderate due to bias in two studies. In conclusion, the FIFA 11+ programme significantly reduces ankle injury incidence and supports implementation at all levels. However, further research is needed to examine long-term effects, optimal doses, and applicability across diverse football populations. Full article

Background: Despite outstanding clinical outcomes are routinely achieved after ACL reconstruction (ACLR), the major current issue is the failure rate (re-rupture or objective clinical instability). Reinjury rates have been reported to be about 6% for ipsilateral graft rupture and 8% for contralateral ACL rupture, with a cumulative reinjury rate of about 20%. Methods: A comprehensive review of the literature was performed to summarize the latest evidence on biological, surgical and rehabilitation aspects of ACLR. Results: It has been demonstrated that young age is a risk factor for ACL graft rupture and so is not passing return-to-play (RTP) testing following ACLR (those who pass the RTP test battery have a one-third reduction in the ACL re-rupture rate). Furthermore, up to 30% of reinjury occurs within two years from ACLR. These data can be explained by numerous pieces of evidence showing that the recovery of proprioception, proper neuromuscular activation and strength, as well as proper biomechanics, remains affected for a long time after surgery (up to two or three years in some cases) despite adequate rehabilitation programs. Conclusions: Clinical evidence, together with biological data on the ligamentization process and the remodeling phase, suggest that return to strenuous sports, especially in younger athletes, should be delayed by at least 18 months or 2 years after ACLR. Full article

In this study, the effects of walking speed on lower limb muscle activity and gait parameters during over-ground walking were investigated in individuals with chronic stroke. Twenty-four patients with chronic stroke participated in a cross-sectional repeated-measures study, walking 20 m at three different speeds: slow (80% of self-selected speed), self-selected, and maximal speed. Surface electromyography was used to measure muscle activity in five paretic-side muscles (rectus femoris, biceps femoris, tibialis anterior, gastrocnemius, and gluteus medius), while gait parameters, including stride length, stance and swing phases, single-limb support time, and the gait asymmetry index were assessed using a triaxial accelerometer. As walking speed increased, activity in the rectus femoris, biceps femoris, and gastrocnemius muscles significantly increased during the stance and swing phases (p < 0.05), whereas the gluteus medius activity tended to decrease. Stride length on the paretic and non-paretic sides significantly increased with faster walking speed (p < 0.05); however, no significant improvements were observed in other gait parameters or gait asymmetry. These findings suggest that although increasing walking speed enhances specific muscle activities, it does not necessarily improve overall gait quality or symmetry. Therefore, rehabilitation programs should incorporate multidimensional gait training that addresses speed and neuromuscular control factors such as balance and proprioception. Full article

This study aimed to investigate the differences in proprioceptive changes at different time points (Pre vs. Post vs. 90 min vs. 24 h) before and after ischemic preconditioning. It followed a within-subject, self-controlled design, and a total of 21 trained male participants were assessed using two-point discrimination threshold tests on thigh and knee joint position sense testing. The results demonstrated that ischemic preconditioning effectively improved proprioceptive accuracy (two-point discrimination, right lower limb, p < 0.001; two-point discrimination, left lower limb, p < 0.001; knee position sense, right lower limb, p = 0.001; knee position sense, left lower limb, p = 0.014) and stability (two-point discrimination, right lower limb, p < 0.001; two-point discrimination, left lower limb, p = 0.002; knee position sense, right lower limb, p < 0.001; knee position sense, left lower limb, p = 0.003), with the optimal time point for enhancement identified at 90 min. This research suggests administering IPC 90 min before warm-up or competition to enhance athletic performance. Full article

This survey provides a comprehensive review of the integration of large language models (LLMs) into autonomous robotic systems, organized around four key pillars: locomotion, navigation, manipulation, and voice-based interaction. We examine how LLMs enhance robotic autonomy by translating high-level natural language commands into low-level control signals, supporting semantic planning and enabling adaptive execution. Systems like SayTap improve gait stability through LLM-generated contact patterns, while TrustNavGPT achieves a 5.7% word error rate (WER) under noisy voice-guided conditions by modeling user uncertainty. Frameworks such as MapGPT, LLM-Planner, and 3D-LOTUS++ integrate multi-modal data—including vision, speech, and proprioception—for robust planning and real-time recovery. We also highlight the use of physics-informed neural networks (PINNs) to model object deformation and support precision in contact-rich manipulation tasks. To bridge the gap between simulation and real-world deployment, we synthesize best practices from benchmark datasets (e.g., RH20T, Open X-Embodiment) and training pipelines designed for one-shot imitation learning and cross-embodiment generalization. Additionally, we analyze deployment trade-offs across cloud, edge, and hybrid architectures, emphasizing latency, scalability, and privacy. The survey concludes with a multi-dimensional taxonomy and cross-domain synthesis, offering design insights and future directions for building intelligent, human-aligned robotic systems powered by LLMs. Full article

Hexapod robots that use external sensors to sense the environment are susceptible to factors such as light intensity or foggy weather. This effect leads to a drastic decrease in the motility of the hexapod robot. This paper proposes a motion control strategy for a blind hexapod robot. The hexapod robot is symmetrical and its environmental sensing capability is obtained by collecting proprioceptive signals from internal sensors, allowing it to pass through rugged terrain without the need for external sensors. The motion gait of the hexapod robot is generated by a central pattern generator (CPG) network constructed by Hopf oscillators. This gait is a periodic gait controlled by specific parameters given in advance. A policy network is trained in the target terrain using deep reinforcement learning (DRL). The trained policy network is able to fine-tune specific parameters by acquiring information about the current terrain. Thus, an adaptive gait is obtained. The experimental results show that the adaptive gait enables the hexapod robot to stably traverse various complex terrains. Full article

Diabetic peripheral neuropathy (DPN), a common complication of type 2 diabetes mellitus (T2DM), significantly impairs postural control and increases fall risk due to sensory and motor nerve dysfunction. While conventional rehabilitation is widely used, the effectiveness of technology-assisted balance training remains underexplored. This quasi-experimental study aimed to compare the impact of Biodex Balance System (BBS)-based training versus traditional exercises on balance and coordination in patients with DPN. Thirty patients with T2DM and clinically confirmed DPN were allocated into two groups (n = 15 per group): the intervention group (BBS training) and the control group (traditional exercises). Both groups trained for 8 weeks. Static balance was assessed using stability indices and clinical balance tests. Statistical analysis included paired and independent t-tests, Shapiro–Wilk tests for normality, and Cohen’s d for effect size. The BBS group demonstrated statistically significant improvements across all balance measures compared to the control group. For the most challenging condition (unstable surface, eyes closed), the mean balance index improved by 0.66° (p < 0.001; Cohen’s d = 14.25). Substantial improvements were also observed for the stable surface (eyes open: Δ = 0.34°, p < 0.001, d = 4.01) and unstable surface (eyes open: Δ = 0.23°, p < 0.001, d = 7.46). Control group gains were modest and less consistent. Balance training using the Biodex Balance System significantly enhances static balance and postural control in patients with diabetic neuropathy, outperforming traditional rehabilitation methods. These findings support integrating the BBS into structured diabetic care programs to reduce fall risk and improve functional stability. Full article

Background: Basketball carries a high risk of both chronic and acute musculoskeletal injuries, affecting various parts of the body. Additionally, stress is a critical factor that influences athletic performance, particularly in high-pressure sports like basketball. This study aimed to investigate the impact of a specific proprioceptive training protocol on professional basketball players. Methods: Thirty male basketball players (M = 21.93, SD = 3.75 years) were divided into two groups: an experimental group (n = 15) and a control group (n = 15). The experimental group completed an adapted proprioceptive training program designed to enhance position-specific skills, following their regular team training. The control group continued to follow their routine training program without any additional proprioceptive intervention. The parameters assessed included stress levels, longitudinal body axis alignment, spinal range of motion, and total plantar load distribution. These were measured at three time points: baseline (T₀), after 4 weeks of training (T₁), and after 8 weeks of training (T₂). Results: Data analysis showed a significant reduction in stress (p < 0.001), postural alignment (p < 0.001), and spinal range of motion (p < 0.001) in the experimental group compared to the control group. Conclusions: In conclusion, the findings highlight the effectiveness of specific and detailed training programs in injury prevention, offering valuable insights for coaches and sports psychologists. Full article

Background and Objectives: Brain-computer interface (BCI) technology is revolutionizing stroke rehabilitation by offering innovative neuroengineering solutions to address neurological deficits. By bypassing peripheral nerves and muscles, BCIs enable individuals with severe motor impairments to communicate their intentions directly through control signals derived from brain activity, opening new pathways for recovery and improving the quality of life. The aim of this study was to explore the beneficial effects of BCI system-based interventions on upper limb motor function and performance of activities of daily living (ADL) in stroke patients. We hypothesized that integrating BCI into occupational therapy would result in measurable improvements in hand strength, dexterity, independence in daily activities, and cognitive function compared to baseline. Materials and Methods: An observational study was conducted on 56 patients with subacute stroke. All patients received standard medical care and rehabilitation for 54 days, as part of the comprehensive treatment protocol. Patients underwent BCI training 2–3 times a week instead of some occupational therapy sessions, with each patient completing 15 sessions of BCI-based recoveriX treatment during rehabilitation. The occupational therapy program included bilateral exercises, grip-strengthening activities, fine motor/coordination tasks, tactile discrimination exercises, proprioceptive training, and mirror therapy to enhance motor recovery through visual feedback. Participants received ADL-related training aimed at improving their functional independence in everyday activities. Routine occupational therapy was provided five times a week for 50 min per session. Upper extremity function was evaluated using the Box and Block Test (BBT), Nine-Hole Peg Test (9HPT), and dynamometry to assess gross manual dexterity, fine motor skills, and grip strength. Independence in daily living was assessed using the Functional Independence Measure (FIM). Results: Statistically significant improvements were observed across all the outcome measures (p < 0.001). The strength of the stroke-affected hand improved from 5.0 kg to 6.7 kg, and that of the unaffected hand improved from 29.7 kg to 40.0 kg. Functional independence increased notably, with the FIM scores rising from 43.0 to 83.5. Cognitive function also improved, with MMSE scores increasing from 22.0 to 26.0. The effect sizes ranged from moderate to large, indicating clinically meaningful benefits. Conclusions: This study suggests that BCI-based occupational therapy interventions effectively improve upper extremity motor function and daily functions and have a positive impact on the cognition of patients with subacute stroke. Full article

Background: Recreational participation in Mixed Martial Arts (MMA) has rapidly increased. Despite consistent evidence of a high injury prevalence in MMA athletes, the neuromuscular implications of regular MMA training remain underexplored. The cervical spine is particularly vulnerable to trauma due to repetitive impacts and high mechanical demands in combat sports. Methods: This case-control study compared cervical spine function and self-reported symptoms between 25 recreational MMA athletes and 25 matched individuals who engaged in general fitness training. Outcome measures included Neck Disability Index (NDI), Post-Concussion Symptom Scale (PCSS), pain and headache reports, cervical range of motion (ROM), proprioception, isometric strength, and endurance. Multivariate logistic regression analysis was used to identify the predictors of group classification. Results: The MMA group exhibited significantly higher values for post-concussion symptoms (p = 0.012), cervical flexor endurance (p = 0.031), and the number of concussions (p = 0.001) but lower flexion ROM (p = 0.031). No significant differences were observed in strength, proprioception, or NDI scores. Logistic regression identified the number of concussions, age, total cervical ROM, and average rotation strength as significant predictors of group membership (model AUC = 0.96; Nagelkerke R² = 0.797). Conclusions: Recreational MMA athletes demonstrated higher rates of concussion-related symptoms and reduced cervical flexion ROM than noncontact exercisers despite no statistically significant differences in strength and proprioception. These findings suggest that cumulative exposure to amateur MMA is associated with alterations in cervical neuromuscular characteristics. These results support the implementation of targeted mobility, endurance, and injury prevention programs in recreational MMA training. Full article

Background/Objectives: Soccer players, particularly females, exhibit an increased risk of both concussions and Anterior Cruciate Ligament (ACL) injuries. Emerging evidence suggests that neurcognitive deficits following concussions may impair neuromuscular control, increasing ACL injury susceptibility. This study aims to explore the interplay between concussions, neuromuscular deficits, and ACL injury risk, while proposing targeted prevention strategies. Methods: A comprehensive review of current literature was conducted to analyze the biomechanical and neurophysiological impact of concussions on ACL injury risk. Key areas investigated include the effect of sub-concussive impacts on proprioception, reaction time, and postural stability, as well as sex-based differences in injury susceptibility. Results: Findings indicate that post-concussion neuromuscular impairments—such as altered proprioception, delayed reaction times, and compromised joint stability—heighten ACL injury risk. Female athletes, due to biomechanical and hormonal factors, are particularly vulnerable. Preventive measures, including neuromuscular training, cervical spine strengthening, and optimized return-to-play protocols, are essential to mitigate these risks. Conclusions: Longitudinal research is needed to further elucidate the connection between head trauma and ACL injuries. Implementing evidence-based interventions and policy changes, such as modifying heading exposure in youth athletes, may enhance player safety and reduce long-term injury burden in female soccer players. Full article

Background: Diabetic foot ulcers (DFUs) affect millions worldwide, significantly increasing the risk of amputation, mortality, and reduced quality of life. While conventional interventions such as specialized footwear and podiatric care can mitigate ulceration risks, they do not address the biomechanical factors contributing to ulcer recurrence. Emerging evidence suggests that lower limb exercises may play a role in secondary DFU prevention. This scoping review aims to synthesize available research on home-based lower limb exercise programs for individuals with diabetes mellitus, focusing on feasibility, adherence, and their impact on foot biomechanics and ulcer prevention. Methods: A search was conducted across six electronic databases (PubMed, Web of Science, Cochrane Library, EBSCO, Scopus, and ScienceDirect) for studies published between January 2014 and December 2024. Eligible studies included those assessing home-based lower limb exercises in diabetic individuals, with interventions lasting at least four weeks. Studies focusing on supervised exercises, pharmacological interventions, or non-diabetic populations were excluded. Results: Nine studies met the inclusion criteria, featuring a range of home-based exercise interventions, such as muscle strengthening, stretching routines, proprioceptive training, functional mobility exercises, and range-of-motion activities. These interventions demonstrated notable effectiveness, leading to improved foot biomechanics, more even plantar pressure distribution, enhanced balance, and reduced ulcer recurrence (in some cases). One study, for instance, reported a significant decrease in ulcer recurrence, with only 16% of participants in the intervention group experiencing relapse compared to 72% in the control group after 24 weeks. Adherence rates varied across studies but were generally higher when programs included structured guidance through educational booklets, mobile applications, or consistent phone follow-ups ranging from 41% to 92.5%. Nonetheless, the findings tend to be tempered by methodological differences between studies and a lack of robust long-term follow-up data. Conclusions: Home-based lower limb exercises show promise in improving foot function and preventing DFU recurrence. Further research is needed to standardize protocols, enhance adherence, and confirm long-term effectiveness. Full article

To enhance wrist impairment rehabilitation efficiency, self-rehabilitation training using healthy-side forearm sEMG was introduced, improving patient engagement and proprioception. A sEMG-based movement recognition and muscle force estimation algorithm was proposed to transmit the estimated results to a wrist rehabilitation robot. Dominant eigenvalues of raw forearm EMG signals were selected to construct a movement recognition model that included a BPNN, a voting decision, and an intensified algorithm. An experimental platform for muscle force estimation was established to measure sEMG under various loads. The linear fitting was performed between mean absolute values (MAVs) and external loads to derive static muscle force estimation models. A dynamic muscle force estimation model was established through linear fitting average MAVs. Volunteers wore EMG sensors and performed six typical movements to complete the verification experiment. The average accuracy of only BPNN was 90.7%, and after the addition of the voting decision and intensified algorithm, it was improved to 98.7%. In the resistance training, the measured and estimated muscle forces exhibited similar trends, with RMSE of 4.2 N for flexion/extension and 5.8 N for ulnar/radial deviation. Under two different speeds and loads, the theoretical and estimated values of dynamic muscle forces showed similar trends with almost no phase difference, and the estimation accuracy was better during flexion movements compared to radial deviations. The proposed algorithms had strong versatility and practicality, aiming to realize the self-rehabilitation trainings of patients. Full article