Search Results (1,231)

Background: Lower limb malalignment is a hallmark of knee osteoarthritis, with surgical correction techniques evolving from traditional mechanical alignment (MA) to kinematic alignment (KA) approaches. Restrictive kinematic alignment (rKA) represents a hybrid strategy combining principles from both techniques. This study evaluated short-term functional outcomes following robotic-assisted total knee arthroplasty (RoTKA), comparing MA versus rKA alignment strategies. Methods: This prospective, randomized, single-center study enrolled 96 patients with grade 3–4 idiopathic knee osteoarthritis (Kellgren–Lawrence classification). Patients were randomized to MA (n = 49, mean age 67 ± 9 years) or rKA (n = 47, mean age 66 ± 7 years) groups. Preoperative hip–knee–ankle (HKA) angles were 172.6° ± 1.1° and 172.9° ± 0.9° for MA and rKA groups, respectively. Outcomes were assessed using Visual Analog Scale (VAS) pain scores, range of motion (ROM), Knee Society Score (KSS), Oxford Knee Score (OKS) (primary outcome), SF-36, and Forgotten Joint Score (FJS-12). Results: Postoperative HKA angles were 179.5° ± 1.2° (MA) and 176.0° ± 1.5° (rKA). At 14 days postoperatively, knee ROM increased by 20.5% in the MA group and 25.7% in the rKA group, with a statistically significant 5.2% intergroup difference, indicating faster postoperative recovery (p = 0.008). VAS pain scores decreased by 7% in the rKA group while increasing by 13% in the MA group (p < 0.001). At one-year follow-up, FJS-12 scores were significantly higher in the rKA group (94.8 ± 3.2 vs. 91.9 ± 2.2, p < 0.001). No significant differences were observed in KSS, OKS, or SF-36 score between groups. Conclusions: Restrictive kinematic alignment demonstrated superior early postoperative outcomes compared to mechanical alignment in RoTKA, with significantly reduced pain and improved ROM. While one-year functional outcomes were comparable between techniques, rKA may offer advantages in the immediate postoperative period, supporting its consideration as a viable alignment strategy in robotic-assisted knee arthroplasty. Full article

Swimming research has determined that rounded shoulders, forward head, and scapular dyskinesis are common imbalances that may lead to injury without correction. This case study aimed to evaluate a preventative exercise program designed to reduce injuries, correct postural deviations, and improve shoulder function over one collegiate swimming season. Twenty female NCAA Division I swimmers (average age = 21.6 ± 1.3 years) participated over 25 weeks, completing pre-, mid-, and post-season assessments of injury rates, shoulder range of motion, and stability using standardized tests. Injuries were included as diagnosed and reported by an athletic trainer. Testing included internal rotation, external rotation, the Hawkins-Kennedy test, Neer’s sign, Sulcus sign, and the Closed Kinetic Chain Upper-Extremity Stability Test (CKCUEST). Compared to the season prior with no intervention, swimmers who completed the program were 44% less likely to sustain an upper-extremity injury, as assessed from the CKCUEST scores (p < 0.01 for all metrics), shoulder internal rotation (p < 0.01 for both shoulders), and total range of motion (p < 0.01 for both shoulders). These findings suggest that a targeted corrective exercise program can effectively reduce injury rates and improve shoulder mobility and function in collegiate athletes. The interpretation of these results is limited by the study’s non-randomized design and absence of a control group. Full article

Introduction: 3D-printing is an emerging technology in the field of prosthetics, offering advantages such as cost-effectiveness, ease of customization, and improved accessibility. While previous reviews have focused on limited aspects, the aim of this systematic review is to provide a comprehensive evaluation of the clinical outcomes of 3D-printed prostheses for both upper and lower limbs. Methods: A search was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across six databases (PubMed, Web of Science, EBSCO, Scopus, Cochrane Library, and Sage). Studies on 3D-printed prostheses in human rehabilitation that focused on the clinical outcomes of the device were included, while studies lacking clinical data, 3D printing details, or focusing on traditional manufacturing methods were excluded. Finally, the risk of bias was assessed using the modified Downs & Black Checklist. Results: A total of 1420 studies were identified, with 11 meeting the inclusion criteria. The included studies assessed different 3D-printed prosthetic types and upper and lower limb prostheses. The main clinical outcomes analyzed were functional performance, design and material integrity, and overall effectiveness of 3D-printed prostheses. Studies on upper limb prostheses reported improved dexterity, range of motion (ROM), and user satisfaction, despite some durability limitations. Lower limb prostheses showed enhancements in comfort, gait parameters, and customization, particularly in amphibious and partial foot designs. Conclusions: 3D-printed prostheses show potential to improve functional performance, patient satisfaction, fit, and implementation feasibility compared to conventional methods. However, limitations such as small sample sizes, variability in assessment tools, and limited high-quality evidence highlight the need for further research to support broader clinical adoption. Full article

Background: Neuromuscular training is widely implemented in professional football to enhance performance and reduce injury risk. Although unstable surfaces are commonly used for proprioceptive and rehabilitation purposes, limited evidence supports their effectiveness in improving sport-specific force production and stability in elite athletes. This study aimed to compare the effects of multicomponent neuromuscular training performed on stable versus unstable surfaces on unilateral force production, mobility, and agility in elite male soccer players. Methods: Twenty-seven professional male soccer players from the Spanish first division were randomly assigned to either a stable surface group (SSG; n = 14) or an unstable surface group (USG; n = 13). Both groups completed a 10-week intervention in addition to their regular training routines. Pre- and post-intervention assessments included dorsiflexion range of motion (DFt), Y-Balance Test (YBT), single-leg countermovement jump (SLCMJ), single-leg hop for distance (SLH), side-hop (SH), Speedy Jump (SpJ), Agility T-test (TT), and the Lower Extremity Functional Test (LEFT). A two-way repeated-measures ANOVA and Hedges’ g effect sizes were used for statistical analysis. Results: The SSG showed significant improvements in most performance variables, including DFt, YBT, SLH, SH, SpJ, TT, and LEFT (percent change range: 1.6% to 9.8%; Hedges’ g ranging from 0.52 to 2.57). The USG showed limited improvements, with significant changes only in LEFT (percent change = 1.18%; Hedges’ g = 0.53). Notably, the stable surface group demonstrated enhanced force production and agility, particularly in the non-dominant limb. Conclusions: Multicomponent neuromuscular training on stable surfaces appears more effective than training on unstable surfaces for improving unilateral strength, mobility, and agility in elite soccer players. These findings suggest that stable surface training may provide superior performance benefits and should be considered a priority in high-performance environments. Full article

Scientific awareness is rising regarding fish and sea invertebrates’ sensitivity to the sound field’s particle motion component. The AquaVib, a distinctive laboratory setup, provides a practical methodology for controlled sound exposure experiments on small aquatic organisms, enabling a separate assessment of their acoustic pressure- and particle motion-elicited responses across a range of realistic scenarios. The chosen facility design permits the reproduction of realistic sound exposures at different kinetic-to-potential energy ratios, with characteristics similar to underwater-radiated noise from human activities such as shipping or offshore installations (<1 kHz). It provides a cost-efficient multimodal approach to investigate potential physiological, pathological, and ultrastructural effects on small aquatic organisms at any stage of maturity. This study details the vibroacoustic characterization of the AquaVib system, identifies key challenges, and outlines planned improvements. The ultimate goal of the presented approach is to contribute to the scientific community and competent authorities in covering the main gaps in current knowledge on the sensitivity of aquatic organisms to the particle motion component and to identify and quantify potential acute and long-term detrimental effects arising from human activities. Full article

Unaccustomed eccentric exercise is well established to induce exercise-induced muscle damage (EIMD), characterized by transient strength loss, delayed onset muscle soreness (DOMS), reduced range of motion, and proprioceptive disturbances. While limb dominance has been proposed as a potential modulator of susceptibility to EIMD, evidence remains inconclusive. This exploratory study aimed to compare alterations in muscle damage indices between dominant and non-dominant knee extensors 48 h after eccentric isokinetic exercise. Eighteen physically active young women (23 ± 2 years) completed two eccentric exercise sessions (5 × 15 maximal contractions at 60°/s), one per limb, with sessions separated by 24–30 days. For all participants, testing was conducted during the early follicular phase. Muscle strength (isometric and eccentric peak torque), DOMS (palpation and pain pressure threshold), range of motion, fatigue index, and position sense were assessed pre- and 48 h post-exercise. Significant reductions in isometric and eccentric peak torque, increased DOMS, impaired position sense, and altered fatigue index were observed 48 h post-exercise in the exercised limb (p < 0.001), with no differences between dominant and non-dominant limbs across all indices. These findings demonstrate that limb dominance does not influence the magnitude of EIMD in knee extensors of young women. Practical implications include equal consideration of both limbs in eccentric training, rehabilitation, and injury prevention programs. Full article

Background/Objectives: Meniscectomy is commonly performed to treat meniscal injury. Recovery of patients and restoration of functional capacity may be influenced by several factors, among which postoperative rehabilitation could play a significant role. The objective was to compare clinical and functional status in patients undergoing meniscectomy according to receipt of postoperative rehabilitation. Methods: An ambispective cohort study was conducted in 89 patients who underwent meniscectomy. The primary outcome was functional capacity, assessed using the Timed Up and Go (TUG) test. The primary exposure was receipt of postoperative rehabilitation. Secondary outcomes included knee range of motion (goniometry), pain intensity (visual analogue scale, VAS), and kinesiophobia (Tampa Scale of Kinesiophobia). Results: Functional capacity differed significantly between patients who received postoperative rehabilitation and those who did not (U = 490; p = 0.03), with lower (better) TUG times in the rehabilitation group. A significant difference was also observed between patients who did and did not engage in preoperative regular physical exercise (U = 680.0; p = 0.01), with better postoperative functional performance in those who had not exercised preoperatively. A sex difference was identified, with females demonstrating superior functional performances compared with males (U = 1187.0; p = 0.01). Older age was positively associated with functional impairment (β = 0.02; p = 0.02). Conclusions: Postoperative rehabilitation was associated with superior objective functional performance after meniscectomy, alongside improvements in pain, range of motion, and kinesiophobia. Female sex and younger age predicted better function; preoperative inactivity was associated with superior postoperative performance, while postoperative exercise showed no clear association. Findings should be interpreted cautiously in view of potential residual confounding and the small non-rehabilitation subgroup, and warrant validation in larger, preferably randomised, cohorts. Full article

Background: Breast cancer-related lymphedema (BCRL) is a common complication that impairs function and quality of life (QoL). The comparative effectiveness of physical therapy interventions (PTIs) remains unclear. This systematic review and network meta-analysis (NMA) was conducted to identify the most effective PTIs for BCRL management. Methods: A systematic search of Medline/PubMed, LILACS, CENTRAL, PEDro, and CINAHL was conducted up to July 2024. Eligible studies were randomized controlled trials (RCTs) involving women with BCRL, evaluating PTIs delivered alone or in combination. Primary outcomes were lymphedema volume, volume reduction, percentage reduction, QoL, and pain. Secondary outcomes included range of motion (ROM), grip strength, and adverse events. A frequentist NMA was performed, and certainty of evidence (CoE) was assessed using the GRADE approach. Results: Eighty-three RCTs were identified, of which twenty-six (1203 participants) were included in the NMA, assessing 23 PTIs. Based on moderate CoE, yoga was among the most effective interventions for improving QoL within 6 months compared to usual standard care (USC). The multimodal approach, with or without a home exercise program, showed intermediate benefits for external rotation and may also improve shoulder abduction (low to moderate CoE). No intervention demonstrated clear superiority over USC for other outcomes. Adverse events were reported with kinesiotaping and compression measures. Conclusions: The evidence supports yoga and multimodal programs as potential short-term strategies for improving QoL and shoulder mobility in women with BCRL. However, the predominance of low-to-very-low CoE underscores the need for individualized clinical decisions and future high-quality RCTs with standardized comparators, larger samples, and longer follow-up. The consistent use of standardized comparators will be crucial in improving network connectivity and enabling more robust and comprehensive comparisons across multiple interventions. Full article

Background/Objectives: Duchenne muscular dystrophy (DMD) leads to postural abnormalities and increased lumbar lordosis, which may affect gait and spinal load. This study aimed to assess the reliability of sagittal spinal curvature measurements using the Rippstein plurimeter and to analyze spinal curvature in ambulant boys with DMD compared to healthy peers. Additionally, the study examined the effect of lower limb positioning in standing on sagittal spinal alignment in boys with DMD and investigated the relationship between hip adduction and extension range and spinal alignment. Methods: The study included 42 boys with DMD and 36 healthy peers aged 5–14 years. In boys with DMD, spinal curvature was measured using the Rippstein plurimeter in two positions: feet in alignment with hip joints axis and with feet together. In healthy participants, measurements were taken in the first position only. Hip adduction and extension ranges were also assessed in both groups. Results: Plurimeter measurements demonstrated high reliability. Boys with DMD showed significantly increased cervical retraction, greater sternal deviation from the vertical, and increased lumbar lordosis compared to healthy peers. Lower limb positioning (adduction) altered sagittal spinal alignment. Hip adduction and extension ranges were decreased in the DMD group and showed a correlation with spinal alignment. Conclusions: The Rippstein plurimeter provides reliable measurements and is useful for monitoring posture in boys with DMD. Reduced hip mobility and lower limb positioning influence lumbar lordosis and should be considered in physiotherapy planning for DMD. Full article

Introduction. We hypothesized changes in the elasticity in quadriceps and patella tendon before and after total knee arthroplasty would be correlated with a post-operative range of motion after total knee arthroplasty. To prospectively assess the post-operative range of motion after total knee arthroplasty, logistic regression was adopted with elasticity in the quadriceps and patella tendons were measured using shear wave elastography (SWE). Materials and Methods. From March 2021 to June 2021, SWE was performed on 95 patients (86 women; aged 57–85, mean 70.62 ± 5.49 years) preoperatively and 2 days after total knee arthroplasty. Elasticity at quadriceps and patellar tendons were measured with full flexion and extension using SWE. Based on the range of motion after surgery at 56 days, we divided the patients into two groups (Group A > 120 degrees; group B < 120 degrees). Using a logistic regression algorithm, classification between groups was performed. For the input of algorithm, patient information, the elasticity of quadriceps and patella tendons preoperatively and two days after total knee arthroplasty were used. Results. The accuracy of predicting group using only patient information was 62%, whereas using only elasticity was 68%. Furthermore, combining information and elasticity before and after surgery at 2 days, accuracy, sensitivity, specificity was 79%, 92%, 56%. Conclusions. Combined with patient information, elasticity measured by SWE at pre-op and early post-op periods could be effective to predict the performance of postoperative ROM. This algorithm could provide direction for rehabilitation. Full article

This study constructed an integrated underwater pipeline monitoring system, which combines pipeline posture sensing modules and pipeline leakage detection modules. The proposed system can achieve the real-time monitoring of pipeline posture and the comprehensive assessment of pipeline damage. By deploying pipeline posture sensing and leakage detection modules in array configurations along an underwater pipeline, information related to pipeline posture and flow variations is continuously collected. An array of inertial sensor nodes that form the pipeline posture sensing system is used for real-time pipeline posture monitoring. The system measures underwater motion signals and obtains bending and buckling postures using posture algorithms. Pipeline leakage is evaluated using flow and water temperature data from Hall sensors deployed at each node, assessing pipeline health while estimating the location and area of pipeline damage based on the flow values along the nodes. The human–machine interface designed in this study for underwater pipelines supports automated monitoring and alert functions, so as to provide early warnings for pipeline postures and the analysis of damage locations before water supply abnormalities occur in the pipelines. Underwater experiments validated that this system can precisely capture real-time postures and damage locations of pipelines using sensing modules. By taking flow changes at these locations into consideration, the damage area with an error margin was estimated. In the experiments, the damage areas were 8.04 cm² to 25.96 cm², the estimated results were close to the actual area trends (R² = 0.9425), and the area error was within 5.16 cm² (with an error percentage ranging from −20% to 26%). The findings of this study contribute to the management efficiency of underwater pipelines, enabling more timely maintenance while effectively reducing the risk of water supply interruption due to pipeline damage. Full article

Potato above-ground biomass (AGB) and tuber yield estimation remain challenging due to the subjectivity of farmer-based assessments, the high data requirements of spectral analysis methods, and the sensitivity of traditional Structure from Motion (SfM) techniques to soil elevation variability. To address these challenges, this study proposes a novel UAV-based visible-light remote sensing framework to estimate the AGB and predict the tuber yield of potato crops. First, a new vegetation index, the Green-Red Combination Vegetation Index (GRCVI), was developed to improve the separability between vegetation and non-vegetation pixels. Second, an improved single-period SfM method was designed to mitigate errors in canopy height estimation caused by terrain variations. Fractional vegetation coverage (FVC) and plant height (PH) derived from UAV imagery were then integrated into a feedforward neural network (FNN) to predict AGB. Finally, potato tuber yield was predicted using polynomial regression based on AGB. Results showed that GRCVI combined with the numerical intersection method and SVM classification achieved FVC extraction accuracy exceeding 95%. The improved SfM method yielded canopy height estimates with R² values ranging from 0.8470 to 0.8554 and RMSE values below 2.3 cm. The AGB estimation model achieved an R² of 0.8341 and an RMSE of 19.9 g, while the yield prediction model obtained an R² of 0.7919 and an RMSE of 47.0 g. This study demonstrates the potential of UAV-based visible-light imagery for cost-effective, non-destructive, and scalable monitoring of potato growth and yield, providing methodological support for precision agriculture and high-throughput phenotyping. Full article

The Timed Up and Go (TUG) test is used to assess mobility in older adults, but its reliance on completion time limits its insight into detailed movement patterns that could serve as early indicators of functional decline. This study aimed to identify lower limb and trunk kinematic biomarkers during the TUG test that distinguish between older adults with and without functional disability, emphasizing the potential for wearable sensor applications. Sixty adults aged 60+ participated in this cross-sectional study. Three-dimensional lower limb and trunk range of motion (ROM), velocity, center of mass (CoM) displacement, and velocity were analyzed using an optoelectronic system across TUG subphases: sit-to-walk, walk-forward, turn, walk-back, and turn-to-sit. Principal component analysis identified eleven principal components (PCs), explaining 84.33% of the total variance. PCs included sagittal hip and knee motion and CoM velocity during turn-to-sit and walking (PC1); tri-dimensional trunk velocity during turning, walk-back, and sit-to-walk transitions (PC2, PC4, PC6); sagittal knee and hip velocity in sit-to-walk (PC3); and frontal and transverse plane knee ROM and velocity during turning (PC5). Significant differences between functional disability groups were found for PC1 and PC4. These findings provide benchmark data for developing and validating wearable biosensors aimed at monitoring kinematic biomarkers. Full article

Autonomous vehicles, submersible robotic systems and drones, and other human-carrying equipment consistently adhere to a safety perimeter, ensuring collision-free navigation amidst surrounding objects. In contrast, roller coaster vehicles, despite being constrained to a predetermined track, necessitate frequent safety distance detection owing to the variability introduced by trees and decorative installations. Passengers’ limbs may protrude beyond vehicle boundaries, posing a collision hazard. The motion range of limbs, influenced by vehicle-specific conditions, mismatches standardized safety volumes (cylindrical, cubic, and rectangular) designed for mobile entities. The roller coaster industry’s current practice involves a moving safety frame, which visually inspects for collisions to assess safety distances, which is cumbersome and prone to oversight in intricate settings. Therefore, this study introduces a novel safety envelope detector (SE-detector). It creates a customer-defined virtual safety envelope around the roller coaster vehicle and measures the safety distance based on LiDAR (Light Detection and Ranging) to detect the intrusions of obstacles. Meanwhile, this SE-detector also innovatively integrated an accelerometer to synchronously measure the acceleration of the vehicle. The measured acceleration will be aligned with simulated sequences by dynamic time warping (DTW) algorithms to pinpoint intrusion location. Additionally, a wide-angle camera is also deployed to enhance perception of the surrounding environment. The SE-detector developed in this study has the capability to record inspection results. It is expected to enhance the inspection capabilities of the safety envelope for roller coasters, thereby improving the efficiency of safety distance inspection. Full article

Background/Objectives: Back pain is increasingly prevalent during childhood and adolescence, often predicting adult spinal disorders. This study aimed to describe sex-specific anthropometric and “Postural Fitness” characteristics in school-aged children and adolescents and to introduce a standardized, field-based assessment protocol for early screening of postural and functional deficits. Methods: This cross-sectional study included a total of 494 students (8–17 years; 50% girls) from 14 schools in Murcia (Spain). Exclusion criteria included diagnosed spinal pathology or major physical injury, lack of signed informed consent, absence on the testing day, and incomplete Postural Fitness assessment. The “Postural Fitness” protocol included assessments of sagittal spinal alignment (inclinometer), hip range of motion (ROM) (inclinometer with an extendable telescopic arm), pelvic tilt (goniometer with a spirit level system), and trunk muscle endurance (chronometer). Tests were conducted in physical education sessions by trained sports scientists. Results: Significant sex-based differences were observed. Boys exhibited greater thoracic kyphosis (40.3 ± 9.6° vs. 36.7 ± 9.2°), reduced hip ROM (passive hip extension (PHE): 16.8 ± 8.1°, passive hip flexion with knee extension (PHFKE): 68.9 ± 8.6°), and more posterior pelvic tilt (104.9 ± 8.4° vs. 99.7 ± 8.1°), whereas girls demonstrated increased lumbar lordosis (35.7 ± 8.6° vs. 31.5 ± 8.5°), greater hip ROM (PHE: 18.5 ± 9°, PHFKE: 77.9 ± 13°), and superior trunk extensor endurance (123.2 ± 74.7 s vs. 106.2 ± 69.8 s). Lateral trunk muscle endurance was higher in boys (48.7 ± 31 s vs. 41.4 ± 24.9 s). Conclusions: The “Postural Fitness” protocol proved feasible in school settings and revealed key sex-based disparities in spinal and neuromuscular profiles. These findings highlight the need for individualized, sex-specific screening and preventive programs to enhance back health during growth. Implementing this protocol may support early identification of modifiable risk factors linked to spinal dysfunction and pain in youth. Full article