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Sensors (Basel, Switzerland) Jun 2024For individuals with spinal cord injuries (SCIs) above the midthoracic level, a common complication is the partial or complete loss of trunk stability in the seated...
For individuals with spinal cord injuries (SCIs) above the midthoracic level, a common complication is the partial or complete loss of trunk stability in the seated position. Functional neuromuscular stimulation (FNS) can restore seated posture and other motor functions after paralysis by applying small electrical currents to the peripheral motor nerves. In particular, the Networked Neuroprosthesis (NNP) is a fully implanted, modular FNS system that is also capable of capturing information from embedded accelerometers for measuring trunk tilt for feedback control of stimulation. The NNP modules containing the accelerometers are located in the body based on surgical constraints. As such, their exact orientations are generally unknown and cannot be easily assessed. In this study, a method for estimating trunk tilt that employed the Gram-Schmidt method to reorient acceleration signals to the anatomical axes of the body was developed and deployed in individuals with SCI using the implanted NNP system. An anatomically realistic model of a human trunk and five accelerometer sensors was developed to verify the accuracy of the reorientation algorithm. Correlation coefficients and root mean square errors (RMSEs) were calculated to compare target trunk tilt estimates and tilt estimates derived from simulated accelerometer signals under a variety of conditions. Simulated trunk tilt estimates with correlation coefficients above 0.92 and RMSEs below 5° were achieved. The algorithm was then applied to accelerometer signals from implanted sensors installed in three NNP recipients. Error analysis was performed by comparing the correlation coefficients and RMSEs derived from trunk tilt estimates calculated from implanted sensor signals to those calculated via motion capture data, which served as the gold standard. NNP-derived trunk tilt estimates exhibited correlation coefficients between 0.80 and 0.95 and RMSEs below 13° for both pitch and roll in most cases. These findings suggest that the algorithm is effective at estimating trunk tilt with the implanted sensors of the NNP system, which implies that the method may be appropriate for extracting feedback signals for control systems for seated stability with NNP technology for individuals who have reduced control of their trunk due to paralysis.
Topics: Humans; Algorithms; Accelerometry; Torso; Spinal Cord Injuries; Neural Prostheses; Posture
PubMed: 38931600
DOI: 10.3390/s24123816 -
Journal of Clinical Medicine Jun 2024Shoulder pain is one of the most important musculoskeletal conditions affecting the upper extremities. Glenohumeral osteoarthritis (GHOA) and rotator cuff injuries...
Shoulder pain is one of the most important musculoskeletal conditions affecting the upper extremities. Glenohumeral osteoarthritis (GHOA) and rotator cuff injuries (RCIs) are notable for their high prevalence. The critical shoulder angle (CSA) is a significant radiological measure for determining the diagnosis and progression of patients with these conditions. Although there are reports in the international literature about this measure, in our country, guideline values considering these two pathologies are unknown. Our objective was to assess patients diagnosed with GHOA and RCI using an AP X-ray view and the CSA. To conduct this, we identified differences between sexes and age categories. Fifty-nine adult patients with GHOA and RCI were included. CSA grades varied depending on the age category and type of injury evaluated. Significant differences between the age ranges of 40 and 54 ( = 0.05), 55-69 ( = 0.001), and 70-84 ( = 0.017) were observed. Patients with RCI tended to be younger and have a higher CSA compared to those with GHOA. It is important to have more normative values and to continue monitoring the critical shoulder angle in these patients.
PubMed: 38929939
DOI: 10.3390/jcm13123408 -
Journal of Clinical Medicine Jun 2024The side hop test (SHT) measures the number of jumps performed over 30 s. Although this measure has demonstrated its value in clinical practice, the temporal parameters...
The side hop test (SHT) measures the number of jumps performed over 30 s. Although this measure has demonstrated its value in clinical practice, the temporal parameters of the SHT allow for a deeper analysis of the execution strategy. The aim of this study is to assess the reliability and construct validity of contact time parameters during the SHT recorded by a video analysis system in anterior cruciate ligament reconstructed (ACLR) patients. We investigated the reliability (intra-rater, standard error of measurement (SEM), and minimum detectable change (MDC)), discriminant validity (operated (OP) versus non-operated (NOP) side), and convergent validity (relationship with strength and psychological readiness) of SHT contact time parameters, number of valid hops and limb symmetry index (LSI) in 38 ACLR patients. Contact time parameters are presented as mean, standard deviation (SD), and coefficient of variation (CV) of contact time. Intra-tester reliability was good to excellent for all contact time parameters. For discriminant validity, the mean and SD contact times of the OP leg were significantly longer than those of the NOP leg, although the difference was smaller than the SEM and MDC values. The number of valid jumps and CV contact time parameters were not significantly different. Isokinetic quadriceps strength (60°/s) was strongly correlated with mean contact time for both legs. However, psychological readiness was not correlated with any of the contact time parameters. Temporal parameters of the SHT measured on video analysis are valid and reliable parameters to assess the performance strategy of the SHT. The results should be interpreted with caution regarding the SEM and MDC values. Further studies are needed to measure criterion validity, inter-rater reliability, and responsiveness.
PubMed: 38929938
DOI: 10.3390/jcm13123407 -
Animals : An Open Access Journal From... Jun 2024This literature review analyzes the historical development of polo, its organizational structure, the course of the game, as well as the breeding, rearing, and training... (Review)
Review
This literature review analyzes the historical development of polo, its organizational structure, the course of the game, as well as the breeding, rearing, and training practices of polo horses. Frequently occurring ailments, such as musculoskeletal injuries, respiratory diseases, and internal illnesses, are highlighted. Lameness is a major problem, with injuries to the superficial digital flexor tendon being the most common cause. Other notable diseases include exercise-induced pulmonary hemorrhage (EIPH), myositis, rhabdomyolysis, and equine infectious anemia (EIA). To ensure the welfare of polo horses, effective prevention and management strategies are crucial. These include proper training, the adaptation of the ground surface, appropriate shoeing, and compliance with animal welfare guidelines and association rules. Collaboration between associations, players, organizers, and veterinarians is crucial. Promoting responsible management practices and raising awareness among stakeholders can help ensure that polo continues to thrive while maintaining high animal welfare standards.
PubMed: 38929354
DOI: 10.3390/ani14121735 -
Emergency Medicine Clinics of North... Aug 2024Endurance sports encompass a broad range of events from marathons and triathlons to ultramarathons, long-distance cycling, skiing, and swimming. As these events have... (Review)
Review
Endurance sports encompass a broad range of events from marathons and triathlons to ultramarathons, long-distance cycling, skiing, and swimming. As these events have experienced a surge in popularity, we have a greater need to understand the associated medical risks. This article reviews the history of endurance races, reviews the most critical and common causes of cardiovascular, heat, electrolyte, and musculoskeletal injuries/illnesses, and discusses considerations for medical directors/personnel associated with such events.
Topics: Humans; Physical Endurance; Athletic Injuries; Swimming; Bicycling; Sports; Running; Skiing; Musculoskeletal Diseases
PubMed: 38925776
DOI: 10.1016/j.emc.2024.02.017 -
Journal of ISAKOS : Joint Disorders &... Jun 2024While previous investigations have demonstrated a positive correlation between previous concussion and risk of subsequent lower extremity musculoskeletal injury...
Playing Surface and Sport Contact Status Modulate Time to Lower Extremity Musculoskeletal Injury at a Greater Level than Concussion History Among Collegiate Student-Athletes.
OBJECTIVES
While previous investigations have demonstrated a positive correlation between previous concussion and risk of subsequent lower extremity musculoskeletal injury (LEMSKI), the effect of sport- and patient-specific factors on time to injury has not been thoroughly described. This study's main objective was to evaluate the relationship between prior concussion and time to LEMSKI among a population of collegiate student-athletes. Secondary objectives were to evaluate the relationship between playing surface, sport contact status, and biologic sex on time to LEMSKI. We hypothesized that those with previous concussion, those competing on synthetic surfaces, and those competing in collision sports would experience decreased latency to LEMSKI overall.
METHODS
A retrospective observational analysis of National Collegiate Athletic Association (NCAA) Division I student-athletes was conducted utilizing a mixed linear model analysis with contrasts. Inclusion criteria included participation in the Pac-12 Health Analytics Program with a documented LEMSKI between 2017 and 2020. Exclusion criteria included concurrent concussion and LEMSKI, injury resulting in serious morbidity or mortality, and incomplete medical record. Participants were classified by whether they sustained a concussion prior to LEMSKI in each athletic season.
RESULTS
Of 1179 athletes included, 1140 had no previous concussion and 37 had a previous concussion. There was no observed effect of previous concussion (F=0.038; p=0.846) on time to LEMSKI overall. Student-athletes competing on constructed surfaces sustained a subsequent LEMSKI 14.5 days sooner (SE=5.255; p=0.045), and those competing on organic surfaces sustained a subsequent LEMSKI 23.5 days sooner (SE=4.018; p<0.001) in the season than those competing on synthetic surfaces. Contact sport student-athletes sustained a subsequent LEMSKI 52.1 days sooner than collision sport student-athletes (SE=5.248; p<0.001), and limited contact sport student-athletes sustained a subsequent LEMSKI 42.29 days sooner than collision sport student-athletes (SE=4.463; p<0.001). There was no observed effect of biologic sex (F=0.602; p=0.438) on time to LEMSKI overall.
CONCLUSION
There was no observed impact of concussion on time to LEMSKI overall in this collegiate athletic population. Contact sports were associated with decreased time to LEMSK, while synthetic surfaces were associated with increased time to LEMSKI in this population. There was no observed impact of biologic sex on time to LEMSKI.
LEVEL OF EVIDENCE
Case-control, level of evidence III.
PubMed: 38925353
DOI: 10.1016/j.jisako.2024.06.008 -
Journal of Functional Morphology and... Jun 2024The fire service suffers from high rates of cardiovascular disease and poor overall health, and firefighters often suffer fatal and non-fatal injuries while on the job.... (Review)
Review
The fire service suffers from high rates of cardiovascular disease and poor overall health, and firefighters often suffer fatal and non-fatal injuries while on the job. Most fatal injuries result from sudden cardiac death, while non-fatal injuries are to the musculoskeletal system. Previous works suggest a mechanistic link between several health and performance variables and injury risk. In addition, studies have suggested physical activity and nutrition can improve overall health and occupational performance. This review offers practical applications for exercise via feasible training modalities as well as nutritional recommendations that can positively impact performance on the job. Time-efficient training modalities like high-intensity interval training and feasible modalities such as resistance training offer numerous benefits for firefighters. Also, modifying and supplementing the diet and can be advantageous for health and body composition in the fire service. Firefighters have various schedules, making it difficult for planned exercise and eating while on shift. The practical training and nutritional aspects discussed in this review can be implemented on-shift to improve the overall health and performance in firefighters.
PubMed: 38921641
DOI: 10.3390/jfmk9020105 -
Journal of Functional Biomaterials Jun 2024Treatment of volumetric muscle loss (VML) faces challenges due to its unique pathobiology and lower priority in severe musculoskeletal injury management. Consequently, a...
Treatment of volumetric muscle loss (VML) faces challenges due to its unique pathobiology and lower priority in severe musculoskeletal injury management. Consequently, a need exists for multi-stage VML treatment strategies to accommodate delayed interventions owing to comorbidity management or prolonged casualty care in combat settings. To this end, polyvinyl alcohol (PVA) was used at concentrations of 5%, 7.5%, and 10% to generate provisional muscle void fillers (MVFs) of varying stiffness values (1.125 kPa, 3.700 kPa, and 7.699 kPa) to stabilize VML injuries as part of a two-stage approach. These were implanted into a rat model for a duration of 4 weeks, then explanted and either left untreated (control) or treated through minced muscle grafting (MMG). Additional benchmarks included acute MMG and unrepaired groups. At the MVF explant, the 7.5% PVA group exhibited superior neuromuscular function compared to the 5% and 10% PVA groups, the least fibrosis, and the largest median myofiber size among all groups at the 12-week endpoint. Despite the 7.5% PVA's superiority amongst the two-stage treatment groups, neuromuscular function was neither improved nor impaired relative to acute treatment benchmarks. This suggests that the future success of a two-stage VML treatment strategy will necessitate a more effective definitive intervention.
PubMed: 38921533
DOI: 10.3390/jfb15060160 -
Military Medicine Jun 2024Musculoskeletal injuries (MSIs) occur frequently in military personnel. U.S. Marine Corps (USMC) recruits participate in an intense 13-week training program designed to...
INTRODUCTION
Musculoskeletal injuries (MSIs) occur frequently in military personnel. U.S. Marine Corps (USMC) recruits participate in an intense 13-week training program designed to transform civilians into basically trained Marines, during which they are susceptible to MSIs. Previous injury epidemiology research with USMC recruits was conducted in a non-gender-integrated training. Data for the current study were derived from a larger study, the USMC Gender-Integrated Recruit Training study, that was initiated to provide data-driven recommendations for gender integration during USMC recruit training. The purpose of the current analysis was to describe the unique profile of MSIs during USMC recruit training and compare MSIs between female and male recruits in gender-integrated training.
MATERIALS AND METHODS
Medical record-reviewed MSI data were obtained for recruits in three models of USMC recruit training: two models of gender-integrated recruit training at Marine Corps Recruit Depot (MCRD) Parris Island-the older Series Track (ST) model and the newer Integrated Company (IC) model, and a Male-Only (MO) cohort at MCRD San Diego. Incidence, anatomic region and subregion, event at the time of MSI, MSI type and onset, and disposition following MSI were described for each model. Group comparisons were conducted using Fisher's exact tests or independent samples t tests, as appropriate.
RESULTS
MSI data were available for 584 recruits (ST: 98 female recruits, 95 male recruits; IC: 85 female recruits, 106 male recruits; MO: 200 male recruits). The cumulative incidence of MSIs was significantly higher among female compared to male recruits in the ST (59.2% vs. 29.5%, P < .001) and in the IC (25.9% vs. 12.3%, P = .023) cohorts. The most frequent anatomic location for MSIs was the lower extremity (female recruits: ST: 76.5% of MSIs, IC: 88.6%; male recruits: ST: 81.1%, IC: 80.0%, MO: 83.8%). The most frequent body part affected was the hip among female recruits (ST: 26.5% of MSIs, IC: 37.1%). The most frequent body part affected by MSIs among the male recruits was the knee in the ST (32.4%) and IC (53.3%) cohorts and the lower leg (27.0%) in the MO cohort. A significantly greater percentage of female compared to male recruits sustained a hip MSI in the ST (23.5% vs. 2.1%, P < .001) and IC (12.9% vs. 0.0%, P < .001) cohorts. There was no significant difference in knee MSI incidence between sexes in the ST (P = .323) or IC (P = .757) cohorts. A large percentage of MSIs resulted in light duty (female recruits: ST: 69.4% of MSIs, IC: 74.3%; male recruits: ST: 64.9%, IC: 73.3%, MO: 94.6%).
CONCLUSIONS
This was the first study to assess the burden of MSIs concurrently among female and male USMC recruits in gender-integrated training. MSIs, especially those affecting the lower extremity, continue to occur frequently in this population. Female recruits are more susceptible to MSIs during USMC recruit training compared to male recruits and are especially prone to hip MSIs. Future research should focus on identifying modifiable risk factors for MSIs in this population, with a focus on reducing lower-extremity MSIs in all recruits and hip MSIs in female recruits.
Topics: Humans; Male; Female; Military Personnel; United States; Incidence; Musculoskeletal System; Adult; Young Adult; Sex Factors; Adolescent
PubMed: 38920037
DOI: 10.1093/milmed/usad206 -
Military Medicine Jun 2024Elevated rates of musculoskeletal injuries (MSIs) and attrition are documented in military recruit training. By identifying and addressing modifiable risk factors, the...
INTRODUCTION
Elevated rates of musculoskeletal injuries (MSIs) and attrition are documented in military recruit training. By identifying and addressing modifiable risk factors, the rate of successful training completion and military readiness can be enhanced. Despite their impact, the causes of MSIs and attrition among U.S. Marine Corps (USMC) recruits remain underexplored. This study investigates demographic, psychological, and physiological predictors of MSIs and attrition among USMC recruits.
MATERIALS AND METHODS
In this prospective cohort study, we evaluated USMC recruits at Marine Corps Recruit Depot, Parris Island and San Diego. Recruits were briefed and invited to volunteer. All recruits who were medically cleared to participate in recruit training were eligible to participate in the study. We gathered baseline data on potential predictors at the start of training, with follow-up data on MSIs and attrition collected post-training. Analyzed predictors encompassed dynamic and static strength measures from countermovement jumps, isometric mid-thigh pulls; and participant surveys. We employed multiple logistic regression to discern risk factors for MSI and attrition.
RESULTS
Our study comprised 584 USMC recruits (183 female recruits, 19.49 ± 1.88 years, 160.10 ± 7.17 cm, 61.19 ± 8.05 kg; 401 males, 18.94 ± 1.92 years, 172.97 ± 7.26 cm, 73.86 ± 11.04 kg). We observed 193 MSIs in 135 recruits, with 80.31% affecting the lower extremity (LE). Notably, lower relative peak power (odds ratio [OR] 0.91 [0.89, 0.94], P < .001) and shorter eccentric deceleration duration (OR 0.99 [0.99, 1.00], P = .005) were significant predictors of MSIs. Specifically, for LE MSIs, similar trends were noted for relative peak power and eccentric deceleration duration, with additional risks associated with lower body mass index (OR 0.93 [0.86, 0.99], P = .036) and previous LE MSIs (OR 2.25 [1.18, 4.27], P = .013). Attrition was more likely with a reduced eccentric deceleration impulse (OR 0.98 [0.97, 0.99], P < .001) and prolonged time to peak force (OR 1.36 [1.17, 1.59], P < .001) and cigarette use (OR 2.12 [1.01, 4.43], P = .046).
CONCLUSIONS
MSIs and attrition during USMC recruit training significantly undermine force readiness and escalate costs. Our research has pinpointed several modifiable risk factors, chiefly reduced muscular power and cigarette smoking. We advocate for neuromuscular training programs to bolster strength and power, integrated nutrition and exercise strategies for optimal body composition, and support for smoking cessation to alleviate the incidence of MSIs and curtail attrition. Initiating training with a gradual increase in activity intensity can provide a critical window to correct pre-existing neuromuscular imbalances and weaknesses, particularly those stemming from prior MSIs. Effectively addressing these risk factors is pivotal for diminishing the rates of MSIs and attrition among recruits, thereby enhancing overall military readiness and operational efficiency.
Topics: Humans; Male; Military Personnel; Female; Prospective Studies; Muscle Strength; Risk Factors; Cohort Studies; Adolescent; Young Adult; Logistic Models; Surveys and Questionnaires; United States
PubMed: 38920036
DOI: 10.1093/milmed/usae134