Rib index is a strong surrogate of scoliometric reading in idiopathic scoliosis.

INTRODUCTION AND AIM: Scoliometry is not always included in the examination protocol of IS patients. The aim of this report is to examine the degree of correlation of Segmental Rib Index (SRI) to scoliometry, in order for SRI to be used as a surrogate of scoliometric angle of trunk rotation (ATR). MATERIAL AND METHOD: 66 Idiopathic Scoliosis (IS) subjects were studied, with a mean age 12.2 ± 2.9 years, 18 boys and 48 girls: 20 thoracic, 22 thoracolumbar and 24 lumbar curves. The standing lateral spine radiographs (LSR) were obtained and the Segmental Rib Index (SRI) from T1 to T12 were assessed. The ATR was documented. RESULTS: In all 66 cases with IS the scoliometer readings (ATR) were significantly correlated to the SRI at the T6, T7 and T8 levels. In the thoracic curves SRI and ATR correlations were significant for the levels T6-T12. DISCUSSION: It was suggested that as long as the patients doesn't have scoliometer measurements, the SRI, could be used as a surrogate for scoliometry. It was also found that in thoracic, thoracolumbar and lumbar level, in both genders, changing from the flexed position to the standing position, the mean trunk asymmetry (TA) decreases. Therefore, if these patients had their TA measured using a scoliometer during the Adams test, their body asymmetry would have been greater than that measured using the SRI method on standing LSR. Consequently, it is evident that the significantly correlated SRI used as a surrogate for the scoliometric assessment of TA is reasonably a strong surrogate.

Effect of forearm positions on scapular movements and trunk rotation angles.

[Purpose] The study investigated the impact of distinct forearm positions on scapular movement and trunk rotation angles. [Participants and Methods] We enrolled 23 healthy young males. Measurements of trunk rotation and relative scapular segment angles were acquired under three conditions employing three-dimensional motion analysis, each executed in a seated posture: (1) both forearms in a neutral position, (2) the forearm on the rotational side adopted supination while the opposite forearm utilized pronation, and (3) the forearm on the rotational side employed pronation while the opposite forearm assumed supination. [Results] The scapular angles in all three scenarios reflected downward rotation, posterior tilt, and external rotation of the rotational-side scapula. Conversely, the contralateral scapula exhibited upward rotation, anterior tilt, and internal rotation. Although the scapular and trunk rotation angles corresponded with the three forearm positions, all three were significantly different and were significantly increased when the rotational-side forearm was in supination (opposite side pronation) and decreased when the rotational-side forearm was in pronation (opposite side supination). [Conclusion] During trunk rotation, regular scapular movements were observed, which varied depending on forearm position and influenced the range of trunk rotation.

Effects of physiotherapeutic scoliosis-specific exercise in patients with mild juvenile scoliosis.

STUDY DESIGN: A combined retrospective and prospective analysis on the therapeutic effect of physiotherapeutic scoliosis-specific exercise (PSSE) in mild juvenile idiopathic scoliosis (JIS) patients. BACKGROUND: At present, patients with mild JIS are generally treated by observation without any interventional treatment. This study analyzed the effects of PSSE on mild JIS, which provided a new approach for the treatment of JIS. METHOD: A total of 52 patients with mild JIS (Cobb angle 10-19°), aged 4-9 years, self-selected into an observation group and a PSSE group. Patients performed the corrective posture exercises daily based on the Scientific Exercise Approach to Scoliosis (SEAS) to the best of their ability, and performed the over-corrective training based on Schroth methods for 30 min each day. Before and one year after the treatment, the Cobb angle and the angle of trunk rotation (ATR) were evaluated, and the results were compared between the two groups. RESULTS: After one year of treatment, the Cobb angle in the PSSE group decreased from 15.0(11.0-17.0)° to 5.0(2.0-12.0)°(p ≤ 0.001), while the Cobb angle in the observation group increased from 13.5(11.0-17.3)° to 16.0(10.8-20.0)° (p = 0.010). The ATR in the PSSE group decreased from 5.0(2.0-7.0)° to 3.0(2.0-4.0)° (p = 0.009), while the change of ATR in the observation group was not significant. Compared with the observation group, 69.57% of patients in PSSE group had a decreased Cobb angle of more than 5 degrees, which was statistically significant(p ≤ 0.001). CONCLUSION: For mild JIS, PSSE decreased the Cobb angle and ATR.

Influence of sidestepping expertise and core stability on knee joint loading during change of direction.

The aims of this study were twofold: first, to compare core stability and knee joint loading between sidestepping experts and nonexperts; secondly, to determine core predictors of knee joint loading. Thirteen handball male players (experts) and 14 karatekas (nonexperts) performed six unanticipated 45° sidestepping manoeuvers, while trunk and pelvis 3D kinematics as well as ground reaction forces were measured, and peak knee abduction moment (PKAM) was determined. Student t-tests enabled a comparison of both groups and a linear mixed model approach was used to identify PKAM predictors. Sidestepping experts demonstrated significantly lower pelvis rotation towards the new movement direction at the initial contact than nonexperts (4.9° vs. 10.8°) and higher PKAM (0.539 vs. 0.321 Nm/kg-bwt). Trunk medial lean, trunk axial rotation and pelvis anterior tilt at the initial contact predicted PKAM, while trunk axial rotation, pelvis medial lean and posterior ground reaction force predicted PKAM during the weight acceptance phase. Despite higher PKAM, handball players might not be at a higher risk of anterior cruciate ligament injury as the knee joint loading remained at a relatively low level during this sidestepping task. Core stability, in its three dimensions, is a key determinant of knee joint loading.

Is early trunk rotation really hazardous for shoulder biomechanics in baseball throwing?

BACKGROUND AND HYPOTHESIS: Early trunk rotation (ETR), which is a unique kinematics of the trunk that occurs during baseball throwing, is thought to be related to shoulder injuries. Pelvic rotation is a confounder when studying the effects of trunk rotation on shoulder biomechanics. The purpose of this study was to understand the "pure" effects of trunk rotation on shoulder biomechanics, with pelvic rotation under control. Our hypotheses were as follows: (1) throwers with ETR have a different shoulder kinematics pattern compared with throwers without ETR; (2) throwers with ETR have a lower ball speed performance than do throwers without ETR; and (3) throwers with ETR have a greater value of shoulder forces and moments, which may increase risks of shoulder injury, than do throwers without ETR. METHODS: Fifty-seven elite throwers were enrolled and divided into 2 groups (non-ETR and ETR) using an outdoor motion analysis. Several kinematics and kinetics parameters of the shoulder were analyzed and compared between the 2 groups. RESULTS: Ball velocity was faster in the non-ETR group (127 km/h) compared with the ETR group (120 km/h). The shoulders of throwers in the ETR group showed pathokinematics of "horizontal adduction lag" and "dropped elbow." The increases in maximal posterior force, inferior force, horizontal abduction moment, and vertical adduction moment were 9.2%, 13.6%, 21.3%, and 24.3%, respectively, in the shoulders of throwers in the ETR group. These results indicate that ETR may be hazardous for the throwing shoulder. With lower ball velocity and higher shoulder joint loading, ETR is not a proper pitching pattern for kinetic energy transfer. CONCLUSION: Improper pitching mechanics among baseball throwers, such as ETR, may result in higher shoulder joint loading and increased risk of shoulder injuries. When treating throwers with shoulder injuries, it is important not only to address shoulder anatomy and pathology but also to understand the possible pathomechanics and pathogenesis of the shoulder caused by ETR. Furthermore, special training programs focusing on trunk flexibility and core muscle strengthening should be implemented to prevent ETR and decrease the risk of shoulder injuries. Motion analysis is useful for the screening and early detection of improper pitching mechanics in throwers.

3D trunk orientation measured using inertial measurement units during anatomical and dynamic sports motions.

Trunk motion is related to the performance and risk of injuries during dynamic sports motions. Optical motion capture is traditionally used to measure trunk motion during dynamic sports motions, but these systems are typically constrained to a laboratory environment. Inertial measurement units (IMUs) might provide a suitable alternative for measuring the trunk orientation during dynamic sports motions. The objective of the present study was to assess the accuracy of the three-dimensional trunk orientation measured using IMUs during dynamic sports motions and isolated anatomical trunk motions. The motions were recorded with two IMUs and an optical motion capture system (gold standard). Ten participants performed a total of 71 sports motions (19 golf swings, 15 one-handed ball throws, 19 tennis serves, and 18 baseball swings) and 125 anatomical trunk motions (42, 41, and 42 trials of lateral flexion, axial rotation, and flexion/extension, respectively). The root-mean-square differences between the IMU- and optical motion capture-based trunk angles were less than 5 degrees, and the similarity between the methods was on average across all trials "very good" to "excellent" (R ≥ 0.85; R2 ≥ 0.80). Across the dynamic sports motions, even higher measures of similarity were found (R ≥ 0.90; R2 ≥ 0.82). When aligned to the relevant segment, the current IMUs are a promising alternative to optical motion capture and previous presented IMU-based systems for the field-based measurement of the three-dimensional trunk orientation during dynamic sports motions and the anatomical trunk motions.

The association of stride length to ball velocity and elbow varus torque in professional pitchers.

Professional basebal pitchers (n =315) were divided into quartiles based on increasing stride length and random intercept linear mixed-effect models were used to correlate stride length with ball velocity, pelvis and trunk rotation at foot contact, and throwing arm kinetics. Average stride length among all pitchers was 78.3±5.3%body height (%BH). For every 10% increase in stride length, ball velocity increased by 0.9 m/s (B =0.089, ß =0.25, p <0.001) and trunk rotation initiation occurred 4.23 ms earlier (B =-0.42, ß =-0.14, p <0.001). When divided into quartiles pelvis rotation was less towards home plate in Q1 compared to Q3 and Q4 (70.0±10.7° vs. 60.9±8.9° and 58.6±9.1°, p <0.001). No significant differences in shoulder internal rotation torque (p =0.173) or elbow varus torque (p =0.072) were noted between quartiles. Professional baseball pitchers who reached stride lengths of 80%BH or greater achieved faster ball velocity without an increase in elbow varus torque. This may, be a byproduct of rotating the pelvis for a greater proportion of the pitching motion and thereby more effectively utilising the lower extremities in the kinetic chain. Encouraging players to achieve this threshold of stride length may enhance ball velocity outcomes.

Compensatory Trunk Movements in Naturalistic Reaching and Manipulation Tasks in Chronic Stroke Survivors.

Impairment of arm movements poststroke often results in the use of compensatory trunk movements to complete motor tasks. These compensatory movements have been mostly observed in tightly controlled conditions, with very few studies examining them in more naturalistic settings. In this study, the authors quantified the presence of compensatory movements during a set of continuous reaching and manipulation tasks performed with both the paretic and nonparetic arm (in 9 chronic stroke survivors) or the dominant arm (in 20 neurologically unimpaired control participants). Kinematic data were collected using motion capture to assess trunk and elbow movement. The authors found that trunk displacement and rotation were significantly higher when using the paretic versus nonparetic arm (P = .03). In contrast, elbow angular displacement was significantly lower in the paretic versus nonparetic arm (P = .01). The reaching tasks required significantly higher trunk compensation and elbow movement than the manipulation tasks. These results reflect increased reliance on compensatory trunk movements poststroke, even in everyday functional tasks, which may be a target for home rehabilitation programs. This study provides a novel contribution to the rehabilitation literature by examining the presence of compensatory movements in naturalistic reaching and manipulation tasks.

The Effect of an Innovative Biofeedback SKOL-AS® Treatment on the Body Posture and Trunk Rotation in Children with Idiopathic Scoliosis-Preliminary Study.

Background and Objectives: The deformity in idiopathic scoliosis (IS) is three dimensional and effective correction involves all three planes. Recently, the biofeedback method has been implemented in the treatment of scoliosis. The aim of this study was to evaluate the effectiveness of an innovative biofeedback SKOL-AS® postural training among children with scoliosis. Materials and Methods: The target population for this study was 28 patients (25 girls and 3 boys) aged between 5 and 16 years old diagnosed and treated with progressing low-grade scoliosis. The postural diagnosis consisted of anthropometric measurements, posterior-anterior X-ray imaging, SpinalMeter® postural assessment and the angle of trunk rotation (ATR) assessment. The SKOL-AS® treatment comprised of 24 sessions conducted in lying and sitting positions, two times a week. Results: It has been shown that the postural training resulted in the decrease in the ATR value (pre- vs. post-exercise in younger: 5.55 vs. 3.0 and older patients: 5.2 vs. 3.0). The increase in height of the subjects seemed to confirm a positive effect of SKOL-AS® elongation treatment. In the posterior view, a statistically significant decrease in shoulder asymmetry in the sitting position in younger children has been observed. In the anterior view, the changes in the head position (based on mouth and eye symmetry) have been observed. The statistically significant increase in acromion-heel, acromion-iliac crest and posterior superior iliac spine (PSIS)-heel length values has been shown in younger children on the left side of the body. After treatment, older subjects had higher acromion-iliac crest and PSIS-heel values on the left side of the body. On the right side only PSIS-heel length was higher. In a sitting position, only a small increase in acromion-iliac crest length value has been observed. Conclusions: The SKOL-AS® biofeedback method could teach good postural habits and teach patients the auto-correction of the spine.

Relationship between spinal range of motion and trunk muscle activity during trunk rotation.

[Purpose] The aim of this study was to clarify the relationship between spinal range of motion and trunk muscle activity during trunk rotation using a three-dimensional motion analysis system and surface electromyography. [Subjects and Methods] The subjects comprised 11 healthy men. A three-dimensional motion analysis system measured the trunk rotational angle of 4 segments of the thoracic vertebrae and 2 segments of the lumbar vertebrae. Surface electromyography measured the activities of the unilateral latissimus dorsi, lumbar multifidus, rectus abdominis, external oblique, internal oblique, and transversus abdominis muscles. [Results] During ipsilateral rotation at thoracic vertebral levels, the muscle activity of the latissimus dorsi and external oblique was significantly increased compared with the activity in the 0-10% range of trunk rotation. During early ipsilateral rotation at lumbar vertebral levels, the muscle activity of the internal oblique and transversus abdominis was significantly increased compared with that in the 0-10% range of trunk rotation. During contralateral rotation at both thoracic and lumbar vertebral levels, the muscle activity of the external oblique was significantly increased compared with that in the 0-10% range of trunk rotation. [Conclusion] This study indicates that it is important to consider vertebral segments and spinal range of motion during trunk rotation.

The effect of trunk rotation during shoulder exercises on the activity of the scapular muscle and scapular kinematics.

BACKGROUND: In patients with shoulder disease, kinetic chain exercises including hip or trunk movement are recommended. However, the actual muscle activation and scapular kinematics of these exercises are not known. The purpose of this study was to examine the effect of trunk rotation on shoulder exercises that are devised to improve scapular function. METHODS: Thirteen healthy young men participated in this study. Scaption, external rotation in the first and second positions, and prone scapular retraction at 45°, 90°, and 145° of shoulder abduction were performed with and without trunk rotation. Electromyography was used to assess the scapular muscle activity of the upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and serratus anterior (SA), and electromagnetic motion capture was used to assess scapular motion. The muscle activity ratio, which is the activity of the UT to the MT, LT, and SA, was calculated. These data were compared between 2 conditions (with and without trunk rotation) for each exercise. RESULTS: Adding trunk rotation to scaption, the first external rotation, and the second external rotation significantly increased scapular external rotation and posterior tilt, and all 3 exercises increased LT activation. In addition, trunk rotation with scapular retraction at 90° and 145° of shoulder abduction significantly decreased the UT/LT ratio. CONCLUSIONS: Our findings suggest that shoulder exercises with trunk rotation in this study may be effective in patients who have difficulty in enhancing LT activity and suppressing excessive activation of the UT or in cases in which a decreased scapular external rotation or posterior tilt is observed.

Movement of loads with trunk rotation.

Movements with participants standing at a bench and moving loads up to 6 kg were studied, with participants using two hands to hold the load and trunk rotation in order to move the loads to specified locations. Tasks were performed with rapid ballistic movements and also with ongoing visual control. Data for ballistic movements were modelled in terms of a modified form of the (Gan, K.-C. and Hoffmann, E.R. 1988. "Geometrical conditions for ballistic and visually controlled movements." Ergonomics 5 (31): 829-839) model for ballistic movements, taking into account the inertial properties of trunk rotation. Visually-controlled movements were modelled in terms of Fitts' law and a term that allowed for the ballistic form of the first submovement of the visually-controlled movement. Practitioner Summary: Movement times to move masses up to 6 kg, for workers at a bench using trunk rotation, are given. Theoretical models fit the experimental data very well and allow prediction of movement times.

A survey of expert opinion on the effects of occupational exposures to trunk rotation and whole-body vibration.

We present a review of current expert opinion on the effects of combined exposures to trunk rotation and whole-body vibration (WBV), commonly experienced by operators of agricultural machinery. We evaluate the level of agreement between academic experts in the field of ergonomics, human response to WBV and agricultural operators, on the effects of exposure to WBV and trunk rotation. A total of 83 individuals responded to the paper-based questionnaire, which included questions on risk levels from individual and combined exposures, discomfort development, exposure duration limits and tasks within agriculture. The results showed that all groups considered exposure to WBV and trunk rotation as risk factors for the development of back pain. The experts were not in consensus regarding acceptable exposure durations, areas of discomfort experienced or recommendations for cab developments.

Ultrasound evaluation of muscle thickness changes in the external oblique, internal oblique, and transversus abdominis muscles considering the influence of posture and muscle contraction.

[Purpose] The aim of this study was to investigate muscle thickness changes in the external oblique (EO), internal oblique (IO), and transversus abdominis (TrA) muscles between the neutral position and trunk rotation, under a state of rest without voluntary contractions, and isometric contractions to both sides with resistance of 50% of the maximum trunk rotation strength. [Subjects] The subjects of this study were 21 healthy young men. [Methods] Muscle thickness changes in the EO, IO, and TrA in each position and state were evaluated by ultrasound. The range of motion at maximum trunk rotation and the maximum strength of trunk rotation were measured using a hand-held dynamometer. [Results] In the neutral position and at 50% trunk rotation to the right side, the thicknesses of the IO and TrA significantly increased with resistance. In both states, the thicknesses of the IO and TrA significantly increased at 50% trunk rotation to the right side. [Conclusion] The muscular contractions of the IO and TrA were stronger during ipsilateral rotation than in the neutral position and with resistance than at rest. Moreover, the muscular contraction was strongest in the resistive state during ipsilateral rotation.

The Immediate Effect of Hanging Exercise and Muscle Cylinder Exercise on the Angle of Trunk Rotation in Adolescent Idiopathic Scoliosis.

(1) Background: Semi-hanging and muscle cylinder exercises have been defined as scoliosis-specific corrective exercises. The aim of this study was to evaluate the immediate effect of muscle cylinder and semi-hanging exercises on the angle of trunk rotation in patients with adolescent idiopathic scoliosis (AIS). (2) Methods: Twenty-seven patients with AIS with a mean age of 18.6 years were retrospectively analyzed. The angle of trunk rotation (ATR) values were measured before and after performing semi-hanging and standing muscle cylinder exercises. Both exercises were performed for three to five respiratory cycles. The semi-hanging exercise was performed first, followed by the muscle cylinder exercise, in this order, in all participants. For statistical analysis, the Wilcoxon signed-rank test was used to analyze ATR changes after the exercises, and the Kruskal-Wallis test was used to compare ATR changes according to the main curve location. (3) Results: The thoracic, thoracolumbar and lumbar maximum ATR values were significantly increased after the semi-hanging exercise (p < 0.001) and decreased after the muscle cylinder exercise (p < 0.001). The ATR change was greater in the lumbar region than in the thoracic and thoracolumbar regions. (4) Conclusion: The results of this study of a small group of patients emphasized that one of the scoliosis-specific corrective exercises, the standing muscle cylinder exercise, improved ATR, while the other, the semi-hanging exercise, worsened ATR in patients with AIS. It is recommended that each scoliosis-specific corrective exercise be evaluated and redesigned to maximize the three-dimensional corrective effect, considering the biomechanics of the spine and the pathomechanics of scoliosis.

The Superiority of Schroth Exercise Combined Brace Treatment for Mild-to-Moderate Adolescent Idiopathic Scoliosis: A Systematic Review and Network Meta-Analysis.

OBJECTIVE: The current study aimed to assess and rank the comparative efficacy of different nonoperative treatments on Cobb angle, angle of trunk rotation, and quality of life for mild-to-moderate adolescent idiopathic scoliosis. METHODS: A comprehensive search of databases, including Medline, The Cochrane Library, PubMed, EMBASE, and Web of Science spanning all previous years up to January 1, 2024. The included studies were evaluated for literature quality according to Cochrane Handbook criteria, and a network meta-analysis was performed using STATA 14.0 statistical software. RESULTS: Twenty randomized controlled trials met all inclusion criteria and were analyzed. Schroth exercise and scoliosis-specific exercise combined with brace treatments had a significant positive effect on Cobb angle and quality of life. For angle of trunk rotation, Schroth exercise and Schroth exercise combined with brace treatments prove more effective compared to the control group. On surface-under-the-cumulative-ranking-curve analysis, Schroth exercise combined with brace treatment had the highest likelihood for reducing Cobb angle (P-score = 0.899), angle of trunk rotation (0.82), and improving quality of life (0.828). CONCLUSIONS: Although most conservative treatments had benefits for mild-to-moderate adolescent idiopathic scoliosis, the most optimal programs were those that included (1) at least 10 weeks of approximately 60-minute Schroth exercise sessions twice a week and (2) wearing the brace for 23 hours every day throughout the treatment period.

Analysis of trunk rotation during baseball batting with lumbar disc degeneration.

Lower back pain (LBP) is common among baseball players, and the occurrence of lumbar intervertebral disc degeneration is high. The dynamic load on the lumbar spine due to the postures and movements characteristic of baseball is suspected of aggravating LBP caused by degeneration, but the difference in batting action between players with and without degeneration is not known. The purpose of this study was to investigate the difference in batting motion in the presence and absence of lumbar disc degeneration (LDD). The subjects were 18 male baseball players belonging to the University League Division I: seven with disc degeneration and 11 without. The motion task analyzed tee batting. The items examined were the angles of rotation of shoulder, pelvis, hip, and twisting motion; rotation angular velocity; time to maximum angular velocity; and muscle activity potentials of the bilateral latissimus dorsi, erector spinae, multifidus, external oblique, internal oblique, rectus abdominis, and gluteus medius muscles; at each stage of batting action. There were significant differences between the shoulder and pelvis in rotation angle, time to maximum angular velocity, and muscle activity in the presence and absence of LDD, and in the time to maximum angular velocity between the shoulder and pelvis. We infer that these differences are characteristic of batting motion due to LDD.

Assessment of reliability and validity of a handheld surface spine scanner for measuring trunk rotation in adolescent idiopathic scoliosis.

PURPOSE: To assess the reliability and validity of a handheld scanner (SpineScan3D) for trunk rotation measurement in adolescent idiopathic scoliosis (AIS) subjects, as compared with Scoliometer. METHODS: This was a cross-sectional study with AIS subjects recruited. Biplanar spine radiographs were performed using an EOS imaging system with coronal Cobb angle (CCA) determined. The angle of trunk rotation (ATR) was measured using Scoliometer. SpineScan3D was employed to assess the axial rotation of subjects' back at forward bending, recorded as surface tilt angle (STA). Intra- and inter-examiner repeats were conducted to evaluate the reliability of SpineScan3D. RESULTS: 97 AIS patients were recruited. Intra- and inter-examiner reliability of STA measures were good to excellent in major thoracic and lumbar curves (p < 0.001). A strong correlation was found between STA and ATR measures in both curve types (p < 0.001) with a standard error of the ATR estimate of between 1 and 2 degrees from linear regression models (R squared: 0.8-0.9, p < 0.001). A similar correlation with CCA was found for STA and ATR measures (r: 0.5-0.6, p < 0.002), which also demonstrated a similar sensitivity (72%-74%) and specificity (62%-77%) for diagnosing moderate to severe curves. CONCLUSION: SpineScan3D is a handheld surface scanner with a potential of wide applications in subjects with AIS. The current study indicated that SpineScan3D is reliable and valid for measuring trunk rotation in AIS subjects, comparable to Scoliometer. Further studies are planned to investigate its measurements in coronal and sagittal planes and the potential of this device as a screening and monitoring tool. TRIAL REGISTRATION NUMBER (DATE OF REGISTRATION): HKUCTR-2288 (06 Dec 2017). LEVEL OF EVIDENCE: Level III.

Lumbar and pelvis movement comparison between cross-court and long-line topspin forehand in table tennis: based on musculoskeletal model.

Introduction: Cross-court and the long-line topspin forehand is the common and basic stroke skill in table tennis. The purpose of this study was to investigate the differences in lumbar and pelvis movements between cross-court and long-line topspin forehand strokes in table tennis based on musculoskeletal demands using OpenSim. Materials and Methods: The eight-camera Vicon system and Kistler force platform were used to measure kinematics and kinetics in the lumbar and pelvis movement of sixteen participants (Weight: 69.89 ± 1.58 kg; Height: 1.73 ± 0.03 m; Age: 22.89 ± 2.03 years; BMI: 23.45 ± 0.69 kg/m2; Experience: 8.33 ± 0.71 years) during cross-court and long-line topspin forehand play. The data was imputed into OpenSim providing the establishment of the Giat2392 musculoskeletal model for simulation. One-dimensional statistical parametric mapping and independent samples t-test was performed in MATLAB and SPSS to analyze the kinematics and kinetics. Results: The results show that the range of motion, peak moment, and maximum angle of the lumbar and pelvis movement in cross-court play were significantly higher than in the long-line stroke play. The moment of long-line in the sagittal and frontal plane was significantly higher than cross-court play in the early stroke phase. Conclusion: The lumbar and pelvis embody greater weight transfer and greater energy production mechanisms when players performed cross-court compared to long-line topspin forehand. Beginners could enhance their motor control strategies in forehand topspin skills and master this skill more easily based on the results of this study.

Scoliosis Management through Apps and Software Tools.

Background: Scoliosis is curvature of the spine, often found in adolescents, which can impact on quality of life. Generally, scoliosis is diagnosed by measuring the Cobb angle, which represents the gold standard for scoliosis grade quantification. Commonly, scoliosis evaluation is conducted in person by medical professionals using traditional methods (i.e., involving a scoliometer and/or X-ray radiographs). In recent years, as has happened in various medicine disciplines, it is possible also in orthopedics to observe the spread of Information and Communications Technology (ICT) solutions (i.e., software-based approaches). As an example, smartphone applications (apps) and web-based applications may help the doctors in screening and monitoring scoliosis, thereby reducing the number of in-person visits. Objectives: This paper aims to provide an overview of the main features of the most popular scoliosis ICT tools, i.e., apps and web-based applications for scoliosis diagnosis, screening, and monitoring. Several apps are assessed and compared with the aim of providing a valid starting point for doctors and patients in their choice of software-based tools. Benefits for the patients may be: reducing the number of visits to the doctor, self-monitoring of scoliosis. Benefits for the doctors may be: monitoring the scoliosis progression over time, managing several patients in a remote way, mining the data of several patients for evaluating different therapeutic or exercise prescriptions. Materials and Methods: We first propose a methodology for the evaluation of scoliosis apps in which five macro-categories are considered: (i) technological aspects (e.g., available sensors, how angles are measured); (ii) the type of measurements (e.g., Cobb angle, angle of trunk rotation, axial vertebral rotation); (iii) availability (e.g., app store and eventual fee to pay); (iv) the functions offered to the user (e.g., posture monitoring, exercise prescription); (v) overall evaluation (e.g., pros and cons, usability). Then, six apps and one web-based application are described and evaluated using this methodology. Results: The results for assessment of scoliosis apps are shown in a tabular format for ease of understanding and intuitive comparison, which can help the doctors, specialists, and families in their choice of scoliosis apps. Conclusions: The use of ICT solutions for spinal curvature assessment and monitoring brings several advantages to both patients and orthopedics specialists. Six scoliosis apps and one web-based application are evaluated, and a guideline for their selection is provided.