High-Density Electromyography Excitation in Front vs. Back Lat Pull-Down Prime Movers.

The current study compared the spatial excitation of the primary muscles during the lat pull-down exercise with the bar passing in front (front-LPD) or behind the neck (back-LPD) using high-density electromyography. Fourteen resistance trained men performed a front-LPD or a back-LPD within a non-fatiguing set with 8-RM as the external load. The muscle excitation centroid of latissimus dorsi, middle trapezius, pectoralis major, biceps brachii, triceps brachii and posterior deltoid muscles were recorded during the ascending and the descending phase. During the descending phase, the front-LPD showed superior excitation of the latissimus dorsi (ES = 0.97) and the pectoralis major (ES = 1.17), while in the ascending phase, the back-LPD exhibited superior excitation of the latissimus dorsi (ES = 0.63), and the front-LPD showed superior excitation of the biceps brachii (ES = 0.41) and the posterior deltoid (ES = 1.77). During the descending phase, the front-LPD showed a more lateral centroid of the latissimus dorsi (ES = 0.60), the biceps brachii (ES = 0.63) and the triceps brachii (ES = 0.98), while the centroid was more medial for the middle trapezius (ES = 0.58). The centroid of the middle trapezius was also more medial in the front-LPD during the ascending phase (ES = 0.85). The pectoralis major centroid was more cranial in the front-LPD for both the descending (ES = 1.58) and the ascending phase (ES = 0.88). The front-LPD appears to provide overall greater excitation in the prime movers. However, distinct spatial excitation patterns were observed, making exercise suitable for the training routine.

Towards a Distributed Digital Twin Framework for Predictive Maintenance in Industrial Internet of Things (IIoT).

This study uses a wind turbine case study as a subdomain of Industrial Internet of Things (IIoT) to showcase an architecture for implementing a distributed digital twin in which all important aspects of a predictive maintenance solution in a DT use a fog computing paradigm, and the typical predictive maintenance DT is improved to offer better asset utilization and management through real-time condition monitoring, predictive analytics, and health management of selected components of wind turbines in a wind farm. Digital twin (DT) is a technology that sits at the intersection of Internet of Things, Cloud Computing, and Software Engineering to provide a suitable tool for replicating physical objects in the digital space. This can facilitate the implementation of asset management in manufacturing systems through predictive maintenance solutions leveraged by machine learning (ML). With DTs, a solution architecture can easily use data and software to implement asset management solutions such as condition monitoring and predictive maintenance using acquired sensor data from physical objects and computing capabilities in the digital space. While DT offers a good solution, it is an emerging technology that could be improved with better standards, architectural framework, and implementation methodologies. Researchers in both academia and industry have showcased DT implementations with different levels of success. However, DTs remain limited in standards and architectures that offer efficient predictive maintenance solutions with real-time sensor data and intelligent DT capabilities. An appropriate feedback mechanism is also needed to improve asset management operations.

Predictive Path-Tracking Control of an Autonomous Electric Vehicle with Various Multi-Actuation Topologies.

This paper presents the development of path-tracking control strategies for an over-actuated autonomous electric vehicle. The vehicle platform is equipped with four-wheel steering (4WS) as well as torque vectoring (TV) capabilities, which enable the control of vehicle dynamics to be enhanced. A nonlinear model predictive controller is proposed taking into account the nonlinearities in vehicle dynamics at the limits of handling as well as the crucial actuator constraints. Controllers with different actuation formulations are presented and compared to study the path-tracking performance of the vehicle with different levels of actuation. The controllers are implemented in a high-fidelity simulation environment considering scenarios of vehicle handling limits. According to the simulation results, the vehicle achieves the best overall path-tracking performance with combined 4WS and TV, which illustrates that the over-actuation topology can enhance the path-tracking performance during conditions under the limits of handling. In addition, the performance of the over-actuation controller is further assessed with different sampling times as well as prediction horizons in order to investigate the effect of such parameters on the control performance, and its capability for real-time execution. In the end, the over-actuation control strategy is implemented on a target machine for real-time validation. The control formulation proposed in this paper is proven to be compatible with different levels of actuation, and it is also demonstrated in this work that it is possible to include the particular over-actuation formulation and specific nonlinear vehicle dynamics in real-time operation, with the sampling time and prediction time providing a compromise between path-tracking performance and computational time.

Synergistic difference in the effect of stretching on electromechanical delay components.

This study investigated the synergistic difference in the effect of stretching on electromechanical delay (EMD) and its components, using a simultaneous recording of electromyographic, mechanomyographic, and force signals. Twenty-six healthy men underwent plantar flexors passive stretching. Before and after stretching, the electrochemical and mechanical components of the EMD and the relaxation EMD (R-EMD) were calculated in gastrocnemius medialis (GM), lateralis (GL) and soleus (SOL) during a supramaximal motor point stimulation. Additionally, joint passive stiffness was assessed. At baseline, the mechanical components of EMD and R-EMD were longer in GM and GL than SOL (Cohen's d from 1.78 to 3.67). Stretching decreased joint passive stiffness [-22(8)%, d = -1.96] while overall lengthened the electrochemical and mechanical EMD. The mechanical R-EMD components were affected more in GM [21(2)%] and GL [22(2)%] than SOL [12(1)%], with d ranging from 0.63 to 1.81. Negative correlations between joint passive stiffness with EMD and R-EMD mechanical components were found before and after stretching in all muscles (r from -0.477 to -0.926; P from 0.007 to <0.001). These results suggest that stretching plantar flexors affected GM and GL more than SOL. Future research should calculate EMD and R-EMD to further investigate the mechanical adaptations induced by passive stretching in synergistic muscles.

Shear-wave elastography for the evaluation of tendinopathies: a systematic review and meta-analysis.

PURPOSE: To compare pathologic and healthy tendons using shear-wave elastography (SWE). METHODS: A systematic review with meta-analysis was done searching Pubmed and EMBASE up to September 2022. Prospective, retrospective and cross-sectional studies that used SWE in the assessment of pathologic tendons versus control were included. Our primary outcome were SWE velocity (m/s) and stiffness (kPa). Methodological quality was assessed by the methodological index for non-randomized studies (MINORS). We used the mean difference (MD) with corresponding 95% confidence intervals (CIs) to quantify effects between groups. We performed sensitivity analysis in case of high heterogeneity, after excluding poor quality studies according to MINORS assessment. We used Grades of Recommendation, Assessment, Development and Evaluation to evaluate the certainty of evidence (CoE). RESULTS: Overall, 16 studies with 676 pathologic tendons (188 Achilles, 142 patellar, 96 supraspinatus, 250 mixed) and 723 control tendons (484 healthy; 239 contralateral tendon) were included. Five studies (31.3%) were judged as poor methodological quality. Shear-wave velocity and stiffness meta-analyses showed high heterogeneity. According to a sensitivity analysis, pathologic tendons had a lower shear wave velocity (MD of - 1.69 m/s; 95% CI 1.85; - 1.52; n = 274; I2 50%) compared to healthy tendons with very low CoE. Sensitivity analysis on stiffness still showed high heterogeneity. CONCLUSION: Pathological tendons may have reduced SWE velocity compared to controls, but the evidence is very uncertain. Future robust high-quality longitudinal studies and clear technical indications on the use of this tool are needed. PROTOCOL: PROSPERO identifier: CRD42023405410 CLINICAL RELEVANCE STATEMENT: SWE is a relatively recent modality that may increase sensitivity and diagnostic accuracy of conventional ultrasound imaging promoting early detection of tendinopathy. Non-negligible heterogeneity has been observed in included studies, so our findings may encourage the conduct of future high-quality longitudinal studies which can provide clear technical indications on the use of this promising tool in tendon imaging.

Application of micro capillary blood sampling in an anti-doping setting.

Blood collection is an important facet of anti-doping testing, forming the basis of the Athlete Biological Passport (ABP). Traditional blood collection via venipuncture can be uncomfortable for athletes, especially those who are tested frequently or close to competition. Athletes may also have negative perceptions of venipuncture due to past experiences or the risks of adverse health events such as bruising, hematomas, syncope, and general discomfort that has the potential to affect performance. Advances in capillary whole blood collection technology now affords the ability to collect micro-volumetric capillary whole blood from the upper arm (or other suitable vascular location such as the abdomen) that is "needle-free" and virtually painless using devices such as the Tasso+. The present study extends previous work, by collecting microliter capillary whole blood samples via the Tasso+ EDTA device in an official anti-doping setting prior to competition, as well as requiring temperature-monitored cold chain shipping by air to the laboratory before analysis. Fifty-eight matched capillary and venous blood samples were collected under official doping control conditions by certified Doping Control Officers. No impact of sample shipment by air under cool conditions was observed on sample integrity. Provided that no visible clots were identified prior to analysis, capillary and venous blood samples showed excellent laboratory agreement for all CBC parameters, with the exception of platelets. Micro capillary blood collection provides a valid alternative to venous blood collection for ABP purposes, with the advantage of providing a more athlete-friendly experience, particularly close to competition.

Energy efficiency in wastewater treatment plants: A framework for benchmarking method selection and application.

Utilities produce and store vast amount of data related to urban wastewater management. Not yet fully exploited, proper data analysis would provide relevant process information and represents a great opportunity to improve the process performance. In the last years, several statistical tools and benchmarking methods that can extract useful information from data have been described to analyse wastewater treatment plant (WWTP) energy efficiency. Improving energy efficiency at WWTPs is however a complex task which involves several actors (both internal and external to the water utility), requires an exchange of different types of information which can be analysed by a broad selection of methods. Benchmarking method therefore must not only be selected based on whether they provide a clear identification of inefficient processes; it must also match the available data and the skills of those performing the assessment and objectives of stakeholders interpreting the results. Here, we have identified the requirements of the most common benchmarking methods in terms of data, resources, complexity of use, and information provided. To do that, inefficiency is decomposed so that the analyst, considering the objective of the study and the available data, can link each element to the appropriate method for quantification and benchmarking, and relate inefficiency components with root-causes in wastewater treatment. Finally, a framework for selecting the most suitable benchmarking method to improve energy efficiency in WWTPs is proposed to assist water sector stakeholders. By offering guidelines on how integrates and links data, methods and actors in the water sector, the outcomes of this article are expected to move WWTPs towards increasing energy efficiency.

Biceps Brachii and Brachioradialis Excitation in Biceps Curl Exercise: Different Handgrips, Different Synergy.

The current study analyzed the excitation of biceps brachii, brachioradialis, and anterior deltoid during bilateral biceps curl performed with different handgrips. Ten competitive bodybuilders performed bilateral biceps curl in non-exhaustive 6-rep sets using 8-RM with the forearm in supinated, pronated, and neutral positions. The ascending and descending phase of each variation was separately analyzed using the normalized root mean square collected using surface electromyography. During the ascending phase, (i) biceps brachii excitation was greater with the supinated compared to the pronated [+19(7)%, ES: 2.60] and neutral handgrip [+12(9)%, ES: 1.24], (ii) the brachioradialis showed greater excitation with the supinated compared to the pronated [+5(4)%, ES: 1.01] and neutral handgrip [+6(5)%, ES: 1.10], (iii) the anterior deltoid excitation was greater with the pronated and neutral handgrip compared to the supinated condition [+6(3)% and +9(2)%, ES: 2.07 and 3.18, respectively]. During the descending phase, the anterior deltoid showed greater excitation in the pronated compared to the supinated handgrip [+5(4)%, ES: 1.02]. Changing the handgrips when performing biceps curl induces specific variations in biceps brachii and brachioradialis excitation and requires different anterior deltoid interventions for stabilizing the humeral head. Practitioners should consider including different handgrips in the biceps curl routine to vary the neural and mechanical stimuli.

Bilateral Biceps Curl Shows Distinct Biceps Brachii and Anterior Deltoid Excitation Comparing Straight vs. EZ Barbell Coupled with Arms Flexion/No-Flexion.

The present study investigated the excitation of the biceps brachii and anterior deltoid during bilateral biceps curl performed using the straight vs. EZ barbell and with or without flexing the arms. Ten competitive bodybuilders performed bilateral biceps curl in non-exhaustive 6-rep sets using 8-RM in four variations: using the straight barbell flexing (STflex) or not flexing the arms (STno-flex) or the EZ barbell flexing (EZflex) or not flexing the arms (EZno-flex). The ascending and descending phases were separately analyzed using the normalized root mean square (nRMS) collected using surface electro-myography. For the biceps brachii, during the ascending phase, a greater nRMS was observed in STno-flex vs. EZno-flex (+1.8%, effect size [ES]: 0.74), in STflex vs. STno-flex (+17.7%, ES: 3.93) and in EZflex vs. EZno-flex (+20.3%, ES: 5.87). During the descending phase, a greater nRMS was observed in STflex vs. EZflex (+3.8%, ES: 1.15), in STno-flex vs. STflex (+2.8%, ES: 0.86) and in EZno-flex vs. EZflex (+8.1%, ES: 1.81). The anterior deltoid showed distinct excitation based on the arm flexion/no-flexion. A slight advantage in biceps brachii excitation appears when using the straight vs. EZ barbell. Flexing or not flexing the arms seems to uniquely excite the biceps brachii and anterior deltoid. Practitioners should consider including different bilateral biceps barbell curls in their routine to vary the neural and mechanical stimuli.

Is the Interpolated-Twitch Technique-Derived Voluntary Activation Just Neural? Novel Perspectives from Mechanomyographic Data.

PURPOSE: Voluntary activation (VA) determined by interpolation-twitch technique could be affected by the characteristics of the in-series elastic components. To overcome this possible bias, a novel approach based on the mechanomyographic (MMG) signal to detect voluntary activation (VA MMG ) has been proposed. We examined the changes in VA and VA MMG after passive stretching to check the influence of neural and mechanical factors in the force output. METHODS: Twenty-six healthy men underwent VA assessment using the interpolated-twitch technique before and after unilateral passive stretching of the plantarflexors (five 45-s on + 15-s off). In addition to the force signal, the MMG signal was detected on gastrocnemius medialis, gastrocnemius lateralis, and soleus. From the force and MMG signal analysis, VA and VA MMG were calculated in the stretched and contralateral nonstretched limbs. Joint passive stiffness was also defined. RESULTS: In the stretched limb, passive stretching increased dorsiflexion range (mean ± SD = +18% ± 10%, P < 0.001, ES = 1.54) but reduced joint passive stiffness (-22% ± 8%, P < 0.001, ES = -1.75), maximum voluntary contraction (-15% ± 7%, P < 0.001, ES = -0.87), VA (-7% ± 3%, P < 0.001, ES = -2.32), and VA MMG (~-5% ± 2%, P < 0.001, ES = -1.26/-1.14). In the contralateral nonstretched limb, passive stretching increased dorsiflexion range (+10% ± 6%, P < 0.001, ES = 0.80) but reduced joint passive stiffness (-3% ± 2%, P = 0.041, ES = -0.27), maximum voluntary contraction (-4% ± 3%, P = 0.035, ES = -0.24), VA (-4% ± 2%, P < 0.001, ES = -1.77), and VA MMG (~- 2% ± 1%, P < 0.05, ES = -0.54/-0.46). The stretch-induced changes in VA correlated with VA MMG ( R ranging from 0.447 to 0.583 considering all muscles) and with joint passive stiffness (stretched limb: R = 0.503; contralateral nonstretched limb: R = 0.530). CONCLUSIONS: VA output is overall influenced by both neural and mechanical factors, not distinguishable using the interpolated-twitch technique. VA MMG is a complementary index to assess the changes in VA not influenced by mechanical factors and to examine synergistic muscles.

Neuromuscular Aging: A Case for the Neuroprotective Effects of Dancing.

AIM: We planned a cross-sectional investigation (study 1) and a longitudinal training intervention (study 2) to investigate whether recreational dancing affords greater neuroprotective effects against age-related neuromuscular junction (NMJ) degeneration compared to general fitness exercise training. METHODS: In study 1, we recruited 19 older volunteers regularly practising dancing (older dancers [OD]) and 15 recreationally physically active older individuals (OA) and physical performance, muscle morphology, muscle function, and NMJ stability (from serum C-terminal agrin fragment [CAF] concentration) were assessed. In study 2, employing a longitudinal study design in a different cohort (composed of 37 older adults), we aimed to study whether a 6-month dancing intervention decreased CAF concentration compared to general fitness exercise training in older adults. RESULTS: Our findings show that OD had a lower CAF concentration (suggesting an increased NMJ stability) compared to OA. This result was accompanied by superior functional performance despite no differences in muscle size. In study 2, we observed a reduction in CAF concentration only in the dancing group. CONCLUSION: Overall, these findings suggest that dancing is an effective training modality to promote neuroprotection and increase muscle function in healthy older individuals.

Front vs Back and Barbell vs Machine Overhead Press: An Electromyographic Analysis and Implications For Resistance Training.

Overhead press is commonly performed to reinforce the muscles surrounding the shoulders. However, many overhead press variations can be executed, thus varying the stimuli to each muscle. Therefore, the current study compared the muscles excitation during overhead press performed with the barbell passing in front or behind the head or using a shoulder press machine. Eight competitive bodybuilders performed in random order front (front-BMP) or back barbell military press (back-BMP), and front (front-MSP) with neutral handgrip or back machine shoulder press (back-MSP). Normalized surface electromyographic root mean square (RMS) of anterior, medial and posterior deltoid, upper trapezius, pectoralis major and triceps brachii was recorded during both the ascending and descending phases. During the ascending phase, anterior deltoid showed greater RMS in back-BMP than back-MSP [ES: 1.42, (95% confidence interval 0.32/2.51)]. Medial deltoid showed greater RMS in back-BMP than front-BMP [ES: 3.68 (2.07/5.29)], and back-MSP [ES: 7.51 (4.73/10.29)]. Posterior deltoid showed greater RMS in back-BMP than front-BMP [ES: 9.00 (5.73/12.27)]. Pectoralis major showed greater RMS in front-BMP than back-BMP [ES: 3.11 (1.65-4.56)] and in front-MSP than back-MSP [ES: 20.52 (13.34/27.70)]. During the descending phase, anterior deltoid was more excited in back-BMP compared to front-BMP [ES: 7.66 (4.83/10.49). Medial deltoid showed greater RMS in back-BMP than front-BMP [ES: 4.56 (2.70/6.42)]. Posterior deltoid showed greater RMS in back-BMP than front-BMP [ES: 8.65 (5.50/11.80)]. Pectoralis major showed greater RMS in front-BMP than back-BMP [ES: 4.20 (2.44/5.95)]. No between-exercise difference was observed for upper trapezius. Performing back overhead press enhances the excitation of medial and posterior and partly anterior deltoid, while front overhead favors pectoralis major. Overhead press performed using barbell excites muscles more than using machine to stabilize the trajectory of the external load. Different variations of overhead press appear to provide different stimuli to the shoulder muscles and may be used accordingly during the training routine.

Multi-Criteria Evaluation for Sorting Motion Planner Alternatives.

Automated vehicles are expected to push towards the evolution of the mobility environment in the near future by increasing vehicle stability and decreasing commute time and vehicle fuel consumption. One of the main limitations they face is motion sickness (MS), which can put their wide impact at risk, as well as their acceptance by the public. In this direction, this paper presents the application of motion planning in order to minimise motion sickness in automated vehicles. Thus, an optimal control problem is formulated through which we seek the optimum velocity profile for a predefined road path for multiple fixed journey time (JT) solutions. In this way, a Pareto Front will be generated for the conflicting objectives of MS and JT. Despite the importance of optimising both of these, the optimum velocity profile should be selected after taking into consideration additional objectives. Therefore, as the optimal control is focused on the MS minimisation, a sorting algorithm is applied to seek the optimum solution among the pareto alternatives of the fixed time solutions. The aim is that this solution will correspond to the best velocity profile that also ensures the optimum compromise between motion comfort, safety and driving behaviour, energy efficiency, journey time and riding confidence.

Determining voluntary activation in synergistic muscles: a novel mechanomyographic approach.

PURPOSE: Drawing on correlations between the mechanomyographic (MMG) and the force signal, we devised a novel approach based on MMG signal analysis to detect voluntary activation (VA) of the synergistic superficial heads of the quadriceps muscle. We hypothesized that, after a fatiguing exercise, the changes in the evoked MMG signal of each quadriceps head would correlate with the changes in the level of VA in the whole quadriceps. METHODS: Twenty-five men underwent a unilateral single-leg quadriceps exercise to failure. Before and after exercise, VA was assessed by interpolated-twitch-technique via nerve stimulation during and after maximum voluntary contraction (MVC). The force and MMG signal were recorded from vastus lateralis, vastus medialis, and rectus femoris. The MMG peak-to-peak was calculated and the voluntary activation index (VAMMG), defined as the superimposed/potentiated MMG peak-to-peak ratio, was determined from the MMG signal for each head. RESULTS: VAMMG presented a very high intraclass correlation coefficient (0.981-0.998) and sensitivity (MDC95%: 0.42-6.97%). MVC and VA were decreased after exercise in both the exercising [MVC:-17(5)%, ES -0.92; VA: -7(3)%, ES -1.90] and the contralateral limb [MVC: -9(4)%, ES -0.48; VA: -4(1)%, ES -1.51]. VAMMG was decreased in both the exercising [~ -9(6)%, ES -1.77] and contralateral limb [~ -3(2)%, ES -0.57], with a greater decrease in VAMMG noted only in the vastus medialis of the exercising limb. Moderate-to-very high correlations were found between VAMMG and VA (R-range: 0.503-0.886) before and after exercise. CONCLUSION: VAMMG may be implemented to assess VA and provide further information when multiple synergistic muscle heads are involved in fatiguing exercises.

An Electromyographic Analysis of Romanian, Step-Romanian, and Stiff-Leg Deadlift: Implication for Resistance Training.

The present study examined the posterior chain muscle excitation in different deadlift variations. Ten competitive bodybuilders (training seniority of 10.6 ± 1.8 years) performed the Romanian (RD), Romanian standing on a step (step-RD), and stiff-leg deadlift (SD) with an 80% 1-RM. The excitation of the gluteus maximus, gluteus medius, biceps femoris, semitendinosus, erector spinae longissimus, and iliocostalis was assessed during both the ascending and descending phases. During the ascending phase, the RMS of the gluteus maximus was greater in the step-RD than in the RD (effect size (ES): 1.70, 0.55/2.84) and SD (ES: 1.18, 0.11/2.24). Moreover, a greater RMS was found in the SD than in the RD (ES: 0.99, 0.04/1.95). The RMS of the semitendinosus was greater in the step-RD than in the RD (ES: 0.82, 0.20/1.44) and SD (ES: 3.13, 1.67/4.59). Moreover, a greater RMS was found in the RD than in the SD (ES: 1.38, 0.29/2.48). The RMS of the longissimus was greater in the step-RD than in the RD (ES: 2.12, 0.89/3.34) and SD (ES: 3.28, 1.78/4.78). The descending phase had fewer differences between the exercises. No further differences between the exercises were found. The step-RD increased the overall excitation of the posterior chain muscles, possibly because of the greater range of movement and posterior muscle elongation during the anterior flexion. Moreover, the RD appeared to target the semitendinosus more than the SD, while the latter excited the gluteus maximus more.

Long-Term Passive Leg Stretch Improves Systemic Vascular Responsiveness as Much as Single-Leg Exercise Training.

PURPOSE: The current study compared the local and systemic vascular responsiveness after small muscle mass endurance training or passive stretching training (PST). METHODS: Thirty-six sex-matched healthy participants underwent 8-wk single-leg knee extension (SLKE) (n = 12) training or PST (n = 12), or no intervention (control, n = 12). Before and after the intervention, local and systemic vascular responsiveness was assessed by Doppler ultrasound at the femoral (local effect) and brachial artery (systemic effect) during single passive leg movement and brachial flow-mediated dilation (FMD) test, respectively. RESULTS: After training, delta femoral blood flow (representing the local vascular responsiveness) increased after SLKE and PST by +54 (7)% (effect size, 2.72; P < 0.001) and +20 (2)% (effect size, 2.43; P < 0.001), respectively, albeit with a greater extent in SLKE (post-SLKE vs post-PST: +56 [8]% [effect size, 2.92; P < 0.001]). Interestingly, the %FMD (standing for the systemic effect) increased after SLKE and PST by +12 (2)% (effect size, 0.68; P < 0.001) and +11 (1)% (effect size, 0.83; P < 0.001), respectively, without any between-groups difference (P > 0.05). No changes occurred in control. CONCLUSIONS: The present findings revealed that both active and passive training modalities induced similar improvements in the brachial artery dilatation capacity, whereas the former was more effective in improving femoral artery blood flow. Passive stretching could be used in people with limited mobility to improve vascular responsiveness both at the local and systemic level and in this latter case has similar effects as small muscle mass endurance training.

Repeated Passive Mobilization to Stimulate Vascular Function in Individuals of Advanced Age Who Are Chronically Bedridden: A Randomized Controlled Trial.

BACKGROUND: Vascular dysfunction and associated disorders are major side effects of chronic bed rest, yet passive mobilization as a potential treatment has only been theorized so far. This study investigated the effects of passive mobilization treatment on vascular function in older, chronically bedridden people. METHOD: The study sample was 45 chronically bedridden people of advanced age (mean age: 87 years; 56% female; mean bed rest: 4 years) randomly assigned to a treatment (n = 23) or a control group (CTRL, n = 22). The treatment group received passive mobilization twice daily (30 minutes, 5 times/wk) for 4 weeks. A kinesiologist performed passive mobilization by passive knee flexion/extension at 1 Hz in one leg (treated leg [T-leg] vs control leg [Ctrl-leg]). The CTRL group received routine treatment. The primary outcome was changes in peak blood flow (∆peak) as measured with the single passive leg movement test at the common femoral artery. RESULTS: ∆Peak was increased in both legs in the Treatment group (+90.9 mL/min, p < .001, in T-leg and +25.7 mL/min, p = .039 in Ctrl-leg). No difference in peak blood flow after routine treatment was found in the CTRL group. CONCLUSION: Improvement in vascular function after 4 weeks of passive mobilization was recorded in the treatment group. Passive mobilization may be advantageously included in standard clinical practice as an effective strategy to treat vascular dysfunction in persons with severely limited mobility.

The Effects of Verbal Instructions on Lower Limb Muscles' Excitation in Back-Squat.

The present study investigated whether or not verbal instruction affects the electromyographic (EMG) amplitude of back-squat prime movers. Fifteen resistance-trained men performed back-squat at 50%1-RM and 80%1-RM and received external (EF) or internal focus (IF) on lower-limb posterior muscles. EMG amplitude of gluteus maximus, biceps femoris, gastrocnemius medialis, vastus lateralis, and tibialis anterior was recorded during both concentric and eccentric phases. During the concentric phase, the gluteus maximus and biceps femoris EMG amplitude was greater in IF vs EF at 50% [effect size (ES): 0.63 (95%CI 0.09/1.17) and 0.49 (0.10/0.78), respectively] and 80% [ES: 1.30 (0.29/2.21) and 0.59 (0.08/1.10)]. The gastrocnemius medialis EMG amplitude was greater in IF vs EF during the eccentric phase at 50% [ES: 0.73 (0.13/1.33)] and at 80% [ES: 0.72 (0.10/1.34)]. Concomitantly, vastus lateralis EMG amplitude was lower at 50% [ES: -0.71 (-1.38/-0.04)] and 80% [ES: -0.68 (-1.33/-0.03)]. During the eccentric phase, the tibialis anterior EMG amplitude was greater in IF vs EF at 50% [ES: 0.90 (0.12 to 1.68)] and 80% [ES: 0.74 (0.13/1.45)]. Irrespective of the load, in the thigh muscles the internal focus promoted a different motor pattern, increasing the hip extensors and reducing the knee extensor excitation during the concentric phase. Concomitantly, both ankle muscles were more excited during the eccentric phase, possibly to increase the anterior-posterior balance control. The internal focus in back-squat seems to have phase-dependent effects, and it is visible at both moderate and high loads.

Passive stretching decreases muscle efficiency in balance tasks.

The current study aimed to verify whether or not passive static stretching affects balance control capacity. Thirty-eight participants (19 women and 19 men) underwent a passive static stretching session, involving the knee extensor/flexor and dorsi/plantarflexor muscles, and a control session (no stretching, CTRL). Before (PRE), immediately after (POST), after 15 (POST15) and 30 min (POST30) from stretching (or rest in CTRL), balance control was evaluated under static and dynamic conditions, with open/closed eyes, and with/without somatosensory perturbation (foam under the feet). During tests, centre of pressure (CoP) sway area and perimeter and antero-posterior and medio-lateral sway mean speed were computed. Surface electromyography root mean square (sEMG RMS) was calculated from the vastus lateralis, biceps femoris, gastrocnemius medialis, and tibialis anterior muscles during MVC and during the balance tests. Hip flexion/extension and dorsi/plantarflexion range of motion (ROM), maximum voluntary contraction (MVC) and sEMG RMS during MVC were measured at the same time points. After stretching, ROM increased (≈6.5%; P<0.05), while MVC and sEMG RMS decreased (≈9% and ≈7.5%, respectively; P<0.05). Regardless of the testing condition, CoP sway area and the perimeter remained similar, while antero-posterior and medio-lateral sway mean speed decreased by ≈8% and ≈12%, respectively (P<0.05). sEMG RMS during the balance tests increased in all muscles in POST (≈7%, P<0.05). All variables recovered in POST30. No changes occurred in CTRL. Passive static stretching did not affect the overall balance control ability. However, greater muscle activation was required to maintain similar CoP sway, thus suggesting a decrease in muscle efficiency.