Chronic low back pain (CLBP) is associated with postural control impairments and is highly prevalent in elderly people. The objective of this study is to verify whether anticipatory postural ...adjustments (APAs) and compensatory postural adjustments (CPAs) are affected by CLBP in elderly people by assessing their postural control during a self-initiated perturbation paradigm induced by rapid upper arm movement when pointing to a target. The participants' lower limb muscle onset and center of pressure (COP) displacements were assessed prior to perturbation and throughout the entire movement. T
moment (i.e., the beginning of the movement) was defined as the anterior deltoid (DEL) onset, and all parameters were calculated with respect to it. The rectus femoris (RT), semitendinosus (ST), and soleous (SOL) showed delayed onset in the CLBP group compared with the control group: RF (control: - 0.094 ± 0.017 s; CLBP: - 0.026 ± 0.012 s, t = 12, p < 0.0001); ST (control: - 0.093 ± 0.013 s; CLBP: - 0.018 ± 0.019 s, t = 12, p < 0.0001); and SOL (control: - 0.086 ± 0.018 s; CLBP: - 0.029 ± 0.015 s, t = 8.98, p < 0.0001). In addition, COP displacement was delayed in the CLBP group (control: - 0.035 ± 0.021 s; CLBP: - 0.015 ± 0.009 s, t = 3; p = 0.003) and presented a smaller amplitude during APA COP
control: 0.444 cm (0.187; 0.648); CLBP: 0.228 cm (0.096; 0.310), U = 53, p = 0.012. The CLBP group required a longer time to reach the maximum displacement after the perturbation (control: 0.211 ± 0.047 s; CLBP 0.296 ± 0.078 s, t = 3.582, p = 0.0013). This indicates that CLBP elderly patients have impairments to recover their postural control and less efficient anticipatory adjustments during the compensatory phase. Our results suggest that people with CLBP have altered feedforward hip and ankle muscle control, as shown from the SOL, ST, and RT muscle onset. This study is the first study in the field of aging that investigates the postural adjustments of an elderly population with CLBP. Clinical assessment of this population should consider postural stability as part of a rehabilitation program.
Introduction: Evidence supports the importance of efficient postural control to improve performance in sports. This involves the use of strategies such as anticipatory posture adjustments and ...compensatory adjustments. Technology makes analysis and assessments in sports cheaper, while being valid and reliable compared to the gold-standard assessment equipment. Objectives: This article aimed to test the validity and reliability of signals extracted from the sensor’s accelerometer (Metamotion C), by comparing it to the data obtained from the gold-standard equipment (a three-dimensional video-motion-capture system). Design: Observational, cross-sectional study. Methods: We exposed 20 healthy young standing people to the pendulum impact paradigm, which consisted of predictable anteroposterior disturbances applied at the shoulder level. In order to measure this, we observed the acceleration of the center of mass in the anticipatory and compensatory phase of the disturbance and compared the signals of the two devices (Metamotion C and a motion-capture system). Results: The validation results showed the significant linear correlation of all variables with a moderate to large correlation of r ≥ 0.5 between the devices. In contrast, the reliability results between sessions obtained by filming were all significant and above 0.75, indicating excellent reliability. The APAonset variable had a reasonable to high intra-class correlation in the anticipatory phase. In the compensatory phase, the CPAtime variable showed an excellent correlation. Conclusions: Metamotion C proved reasonably valid and highly reliable in measuring the center of mass acceleration compared to the camera system in both the anticipatory and compensatory phases.
Objective assessment of pre-operative functional capacity in cancer patients using the smartphone gyroscope during the Chester step (CST) test may allow greater sensitivity of test results. This ...study has investigated whether the CST is a postoperative hospital permanence predictor in cancer patients undergoing abdominopelvic surgery through work, VO2MAX and gyroscopic movement analysis.
Prospective, quantitative, descriptive and inferential observational cohort study. Fifty-one patients were evaluated using CST in conjunction with a smartphone gyroscope. Multivariate linear regression analysis was used to examine the predictive value of the CST.
The duration of hospital permanence 30 days after surgery was longer when patients who performed stage 1 showed lower RMS amplitude and higher peak power. The work increased as the test progressed in stage 3. High VO2MAX seemed to be a predictor of hospital permanence in those who completed levels 3 and 4 of the test.
The use of the gyroscope was more accurate in detecting mobility changes, which predicted a less favorable result for those who met at level 1 of the CST. VO2MAX was a predictor of prolonged hospitalization from level 3 of the test. The work was less accurate to determine the patient's true functional capacity.
Anticipatory postural adjustments (APAs) are a feedforward mechanism triggered in advance to a predictable perturbation, to help the individual counteract mechanical effects that the disturbance may ...cause. Whether or not this strategy is compromised in the elderly is not a consensus in the literature.
In this systematic review with meta-analysis, we investigated aging effects on postural control, based on anticipatory postural adjustments (APAs). We selected 11 eligible articles of the following databases: Lilacs, SciELO, PubMed, Cochrane Central, Embase, and CINAHL, involving 324 research participants, assessing their methodological quality and extracting electromyographic, posturographic, and kinematic measurements. We included studies that investigated the occurrence of APAs in healthy younger and older adults, published before 10th August 2022, in English. Studies involving participant with conditions that may affect balance or that did not report measures of onset or amplitude of electromyography (EMG), COP, or kinematics were excluded. To analyze the aggregated results from these studies, we performed the analysis based on the outcome measures (EMG, COP, or kinematic measures) used in individual studies. We calculated differences between younger and older adult groups as the mean differences between the groups and the estimated effect. Egger's test was conducted to evaluate whether this meta-analysis had publication bias.
Through this review, older adults showed no significant difference in the velocity to perform a movement compared to the younger adults (MD 0.95, 95% CI -0.86, 2.76, I
= 82%), but both muscle onset and center of pressure (COP) onset were significantly more delayed in older than in younger adults: erector spinae (MD -31.44, 95% CI -61.79, -1.09, I
= 95%); rectus abdominis (RA) (MD -31.51, 95% CI -70.58, -3.57, I
= 85%); tibialis anterior (TA) (MD -44.70, 95% CI -94.30, 4.91, I
= 63%); soleus (SOL) (MD -37.74, 95% CI -65.43, -10.05, I
= 91%); gastrocnemius (GAS) (MD -120.59, 95% CI -206.70, -34.49, I
= 94%); quadriceps (Q) (MD -17.42, 95% CI -34.73, -0.12, I
= 0%); biceps femoris (BF) (MD -117.47, 95% CI -192.55, -42.70, I
= 97%); COP onset (MD -45.28, 95% CI -89.57, -0.98, I
= 93%), and COP apa (COPapa) (MD 2.35, 95% CI -0.09, 4.79, I
= 64%). These changes did not seem to be linked to the speed of movement but possibly to age-related physiological changes that indicated decreased motor control during APAs in older adults.
Older adults use different postural strategies that aim to increase the safety margin and stabilize the body to perform the movement, according to the requirements imposed, and this should be considered in rehabilitation protocols.
PROSPERO CRD420119143198.
Step initiation involves anticipatory postural adjustments (APAs) that can be measured using inertial measurement units (IMUs) such as accelerometers. However, previous research has shown ...heterogeneity in terms of the population studied, sensors used, and methods employed. Validity against gold standard measurements was only found in some studies, and the weight of the sensors varied from 10 to 110 g. The weight of the device is a crucial factor to consider when assessing APAs, as APAs exhibit significantly lower magnitudes and are characterized by discrete oscillations in acceleration paths.
This study aims to validate the performance of a commercially available ultra-light sensor weighing only 5.6 g compared to a 168-g smartphone for measuring APAs during step initiation, using a video capture kinematics system as the gold standard. The hypothesis is that APA oscillation measurements obtained with the ultra-light sensor will exhibit greater similarity to those acquired using video capture than those obtained using a smartphone.
Twenty subjects were evaluated using a commercial lightweight MetaMotionC accelerometer, a smartphone and a system of cameras-kinematics with a reflective marker on lumbar vertebrae. The subjects initiated 10 trials of gait after a randomized command from the experimenter and APA variables were extracted: APAonset, APAamp, PEAKtime. A repeated measures ANOVA with
test analyzed the effect of device on APA measurements. Bland-Altman plots were used to evaluate agreement between MetaMotionC, smartphone, and kinematics measurements. Pearson's correlation coefficients were used to assess device correlation. Percentage error was calculated for each inertial sensor against kinematics. A paired Student's t-test compared th devices percentage error.
The study found no significant difference in temporal variables APAonset and PEAKtime between MetaMotionC, smartphone, and kinematic instruments, but a significant difference for variable APAamp, with MetaMotionC yielding smaller measurements. The MetaMotionC had a near-perfect correlation with kinematic data in APAonset and APAamp, while the smartphone had a very large correlation in APAamp and a near-perfect correlation in APAonset and PEAKtime. Bland-Altman plots showed non-significant bias between smartphone and kinematics for all variables, while there was a significant bias between MetaMotionC and kinematics for APAamp. The percentage of relative error was not significantly different between the smartphone and MetaMotionC.
The temporal analysis can be assessed using ultralight sensors and smartphones, as MetaMotionC and smartphone-based measurements have been found to be valid compared to kinematics. However, caution should be exercised when using ultralight sensors for amplitude measurements, as additional research is necessary to determine their effectiveness in this regard.
Cervical cancer (CC) is the most common type of cancer in women and is the third leading cause of death in most developing countries, causing more than 288,000 deaths in women worldwide each year. ...The most favourable survival rate is in developed countries, since CC mortality has recently declined in those countries. The purpose of this study was to determine the survival rate and associated factors of CC patients at a reference hospital in the Amazon region. The patient sample included records of 339 patients with cervical cancer who had been hospitalized in Belém, Pará, Brazil from January 2005 to December 2010; the socioeconomic and clinical data were collected between June and September 2016. A survival rate of approximately 84% was observed, and it was found that disease stage (p <0.01), metastasis (p <0.01) and readmission (p <0.01) had significant influences on patient outcome. The impact of these factors on the general survival rate was higher in the Amazon region compared with other regions of Brazil, and the primary survival factors were associated with earlier stages of the disease. However, more national studies are needed on this subject. Our findings may contribute to the development of regional strategies for the prevention of cervical cancer, a reduction in its incidence and mortality rate, an increase in survival time and an improvement in the quality of life of these women.
The Timed-Up and Go (TUG) test is widely utilized by healthcare professionals for assessing fall risk and mobility due to its practicality. Currently, test results are based solely on execution time, ...but integrating technological devices into the test can provide additional information to enhance result accuracy. This study aimed to assess the reliability of smartphone-based instrumented TUG (iTUG) parameters. We conducted evaluations of intra- and inter-device reliabilities, hypothesizing that iTUG parameters would be replicable across all experiments. A total of 30 individuals participated in Experiment A to assess intra-device reliability, while Experiment B involved 15 individuals to evaluate inter-device reliability. The smartphone was securely attached to participants' bodies at the lumbar spine level between the L3 and L5 vertebrae. In Experiment A, subjects performed the TUG test three times using the same device, with a 5 min interval between each trial. Experiment B required participants to perform three trials using different devices, with the same time interval between trials. Comparing stopwatch and smartphone measurements in Experiment A, no significant differences in test duration were found between the two devices. A perfect correlation and Bland-Altman analysis indicated good agreement between devices. Intra-device reliability analysis in Experiment A revealed significant reliability in nine out of eleven variables, with four variables showing excellent reliability and five showing moderate to high reliability. In Experiment B, inter-device reliability was observed among different smartphone devices, with nine out of eleven variables demonstrating significant reliability. Notable differences were found in angular velocity peak at the first and second turns between specific devices, emphasizing the importance of considering device variations in inertial measurements. Hence, smartphone inertial sensors present a valid, applicable, and feasible alternative for TUG assessment.
Jumps are important evaluation tools for muscle strength and power and for interlimb asymmetries. Different jump tests are well related to athletic performance, prediction of injury risk, and common ...motor gestures of several sports such as soccer. Low-cost mobile applications (apps) have gained popularity for this measure. The authors hypothesized that the My Jump 2 app would be a valid tool to assess drop-jump performance and interlimb asymmetry in soccer players.
Eleven male soccer players took part in this study (18.2 1.3 y, 69.9 9.5 kg, 174 6.6 cm). The athletes performed each test twice on a force plate (gold-standard method), while the jumps were recorded through the mobile app. Measures with the My Jump 2 app were applied by 2 evaluators, independently and in duplicate (interrater and intrarater reliability). The agreement analysis between both evaluations was done using an intraclass correlation coefficient and Bland-Altman plots.
Compared with the force platform, the app tested showed excellent reliability for the drop jump's flight time and interlimb asymmetry (intraclass correlation coefficient > .98). For interlimb contact-time asymmetry, the values were 18.4 (9.9) and 19.1 (9.9) milliseconds for the My Jump 2 app and the force platform, respectively (P = .88). For flight-time asymmetries, the values were 389.7 (114.3) and 396.8 (112.5) milliseconds for the My Jump 2 app and the force platform, respectively (P = .88).
The My Jump 2 app is a valid tool to assess drop-jump and interlimb asymmetry in soccer players.
Balance disorders have been poorly investigated and somewhat neglected in people infected with the human immunodeficiency virus, especially in children, whose have intrinsic and extrinsic risk ...factors that may compromise the balance. To evaluate the foot plantar pressures and the balance in children with acquired immunodeficiency. We recruited 53 children aged between 6 and 15 years: 33 healthy children, and 20 children with positive serology for the human immunodeficiency virus. A physical examination included anthropometric, reflexes, tactile sensitivity of the foot and orthopedic evaluation. We also collected data of them using Pediatric Equilibrium Scale, baropodometry, and stabilometry. We considered significance level of 0.05 for statistics. Both groups were aged-, sex-matched and similar body mass index and scores of the Pediatric Equilibrium Scale. Three infected children had altered tactile sensitivity, and none had orthopedic or reflex alteration. Infected children had higher mean plantar pressure in the hindfoot than of the control group (p = 0.02). There was higher maximum plantar pressure in the hindfoot of the infected children than of the controls (p = 0.04). Controls had lower maximum plantar pressure in the forefoot than the infected children (p = 0.04). Infected children had larger displacement of the center of pressure (p = 0.006), larger mean velocity of displacement (p = 0.006), and longer duration between successive peaks of displacement than the controls (p = 0.02). Children living with the human immunodeficiency virus discharges great plantar pressures in the hindfoot and to present balance disturbances in the absence of neurological symptomatology.
PDF
