Impact of Loneliness on Training Gains with Heart Rate Variability Biofeedback in the Elderly: A Pilot Study.

The negative impact of loneliness on the health of the elderly is particularly noticeable because of the effects of central control on the autonomic nervous system. Such an impact can be assessed through heart rate variability (HRV) analysis and can be modified using HRV biofeedback training. This study aimed to investigate the impact of different levels of social interaction reported by the elderly on HRV before and after training with HRV biofeedback and after a follow-up period. The participants of this pilot study comprised 16 elderly people of both sexes with a mean age of 71.20 ± 4.92 years. The participants were divided into two groups, the loneliness group (N = 8) and the no-loneliness group (N = 8), based on a combination of both criteria: the institutionalization condition (institutionalized or not) and the score on the loneliness scale (high or low). All participants had their HRV components recorded at baseline, after 14 training sessions with HRV biofeedback (three times a week, 15 min each for 4.5 weeks), and after 4.5 weeks of follow-up without training. After HRV biofeedback training, HRV components increased in both groups. However, the gains lasted at follow-up only in the no-loneliness group. In conclusion, loneliness can influence the maintenance of HRV after interruption of training with HRV biofeedback in the elderly. HRV biofeedback training can be an innovative and effective tool for complementary treatment of elderly individuals, but its effects on lonely elderly individuals need to be further investigated.

Machine learning applied to fMRI patterns of brain activation in response to mutilation pictures predicts PTSD symptoms.

BACKGROUND: The present study aimed to apply multivariate pattern recognition methods to predict posttraumatic stress symptoms from whole-brain activation patterns during two contexts where the aversiveness of unpleasant pictures was manipulated by the presence or absence of safety cues. METHODS: Trauma-exposed participants were presented with neutral and mutilation pictures during functional magnetic resonance imaging (fMRI) collection. Before the presentation of pictures, a text informed the subjects that the pictures were fictitious ("safe context") or real-life scenes ("real context"). We trained machine learning regression models (Gaussian process regression (GPR)) to predict PTSD symptoms in real and safe contexts. RESULTS: The GPR model could predict PTSD symptoms from brain responses to mutilation pictures in the real context but not in the safe context. The brain regions with the highest contribution to the model were the occipito-parietal regions, including the superior parietal gyrus, inferior parietal gyrus, and supramarginal gyrus. Additional analysis showed that GPR regression models accurately predicted clusters of PTSD symptoms, nominal intrusion, avoidance, and alterations in cognition. As expected, we obtained very similar results as those obtained in a model predicting PTSD total symptoms. CONCLUSION: This study is the first to show that machine learning applied to fMRI data collected in an aversive context can predict not only PTSD total symptoms but also clusters of PTSD symptoms in a more aversive context. Furthermore, this approach was able to identify potential biomarkers for PTSD, especially in occipitoparietal regions.

Sex, cognitive state and falls as factors associated with malnutrition: a cross-sectional study of institutionalized older adults living in a rural area of Portugal.

BACKGROUND: Malnutrition is an underestimated geriatric problem, with a high prevalence in institutionalized older adults. The identification of risk factors for malnutrition in elderly individuals must be a priority for governmental organizations worldwide. METHODS: A total of 98 institutionalized seniors were enrolled in a cross-sectional study. For the assessment of risk factors, sociodemographic characteristics and health-related information were collected. The Mini-Nutritional Assessment Short-Form test was used to assess malnutrition in the sample population. RESULTS: A significantly greater proportion of women than men were malnourished or at risk of malnutrition. In addition, the comparative analysis revealed that comorbidity, arthritis, balance impairment, dementia and fall episodes with serious injuries were significantly more frequent in the older adults categorized as malnourished or at risk of malnutrition than in those categorized as well-nourished. CONCLUSIONS: Multivariable regression analysis revealed that being female, having a poor cognitive status and experiencing falls with injuries are the main independent factors influencing nutritional status in institutionalized older adults living in a rural area of Portugal.

Accuracy and Interpretation of the Acceleration from an Inertial Measurement Unit When Applied to the Sprint Performance of Track and Field Athletes.

In this study, we aimed to assess sprinting using a developed instrument encompassing an inertial measurement unit (IMU) in order to analyze athlete performance during the sprint, as well as to determine the number of steps, ground contact time, flight time, and step time using a high-speed camera as a reference. Furthermore, we correlated the acceleration components (XYZ) and acceleration ratio with the performance achieved in each split time obtained using photocells. Six athletes (four males and two females) ran 40 m with the IMU placed on their fifth lumbar vertebra. The accuracy was measured through the mean error (standard deviation), correlation (r), and comparison tests. The device could identify 88% to 98% of the number of steps. The GCT, flight time, and step time had mean error rates of 0.000 (0.012) s, 0.010 (0.011) s, and 0.009 (0.009) s when compared with the high-speed camera, respectively. The step time showed a correlation rate of r = 0.793 (p = 0.001) with no statistical differences, being the only parameter with high accuracy. Additionally, we showed probable symmetries, and through linear regression models identified that higher velocities result in the maximum anteroposterior acceleration, mainly over 0-40 m. Our device based on a Wi-Fi connection can determine the step time with accuracy and can show asymmetries, making it essential for coaches and medical teams. A new feature of this study was that the IMUs allowed us to understand that anteroposterior acceleration is associated with the best performance during the 40 m sprint test.

Effects of Motor Task Difficulty on Postural Control Complexity during Dual Tasks in Young Adults: A Nonlinear Approach.

Few studies have evaluated the effect of a secondary motor task on the standing posture based on nonlinear analysis. However, it is helpful to extract information related to the complexity, stability, and adaptability to the environment of the human postural system. This study aimed to analyze the effect of two motor tasks with different difficulty levels in motor performance complexity on the static standing posture in healthy young adults. Thirty-five healthy participants (23.08 ± 3.92 years) performed a postural single task (ST: keep a quiet standing posture) and two motor dual tasks (DT). i.e., mot-DT(A)­perform the ST while performing simultaneously an easy motor task (taking a smartphone out of a bag, bringing it to the ear, and putting it back in the bag)­and mot-DT(T)­perform the ST while performing a concurrent difficult motor task (typing on the smartphone keyboard). The approximate entropy (ApEn), Lyapunov exponent (LyE), correlation dimension (CoDim), and fractal dimension (detrending fluctuation analysis, DFA) for the mediolateral (ML) and anterior-posterior (AP) center-of-pressure (CoP) displacement were measured with a force plate while performing the tasks. A significant difference was found between the two motor dual tasks in ApEn, DFA, and CoDim-AP (p < 0.05). For the ML CoP direction, all nonlinear variables in the study were significantly different (p < 0.05) between ST and mot-DT(T), showing impairment in postural control during mot-DT(T) compared to ST. Differences were found across ST and mot-DT(A) in ApEn-AP and DFA (p < 0.05). The mot-DT(T) was associated with less effectiveness in postural control, a lower number of degrees of freedom, less complexity and adaptability of the dynamic system than the postural single task and the mot-DT(A).

The impact of a violent community on mental health and the benefits of a sport program for social development.

The aim of the present study was to evaluate the impact of a violent environment on mental health and the impact of a sport for social development (SSD) program on quality of life, mental distress symptoms, and heart rate variability (HRV). HRV and psychometric data were measured from 20 men professional athletes assisted by the SSD and 20 men living in the same violent community. The comparison of groups revealed greater sympathetic parameters of HRV, positive affect, and quality of life in the SSD group. Multiple regression analysis showed that the quality of life in the SSD group was positively predicted by positive affect, while in the control group the quality of life was negatively predicted by their history of traumatic events. Both groups reported high levels of exposure to traumatic events and posttraumatic stress symptoms. However, this study demonstrates the benefits of SSD programs in mental health.

Effects of an 11-Week Detraining, Imposed by the COVID-19 Confinement, on Handball Players' Shoulder Rotator Isokinetic Profile, Shoulder Range of Motion, and Ball Release Velocity.

Background and Objectives: The COVID-19 confinement significantly impacted the physical condition of athletes. However, the detraining impacts of this period on the shoulder rotator and range of motion in handball players have not been studied. Thus, the main aim of this study was to investigate the effect of this 11-week detraining period, imposed by the COVID-19 pandemic confinement, on the shoulder rotator isokinetic profile (peak torque, ratio, fatigue index), shoulder rotator and flexion range of motion, and ball release velocity in handball players. Materials and Methods: A total of 16 handball players, with a mean age of 22.38 (5.28) years, participated in this study. The isokinetic strength was assessed using two protocols (three repetitions at an angular velocity of 60°/s and 20 repetitions at an angular velocity of 180°/s). In addition, the range of motion and ball release (at jump and standing shots) were measured. All these measurements were assessed before and after the COVID-19 confinement. Results: The results showed a significant reduction in the peak torque of the external rotation of their dominant and non-dominant shoulders. In addition, confinement significantly increased the fatigue index of external rotation and internal rotation and reduced the range of motion of internal rotation. Additionally, the ball release velocity during standing and jump shots was significantly reduced. Conclusions: These results suggested that strengthening external and internal rotation as well as recovering the internal rotation range of motion may be necessary after a detraining period in order to prevent shoulder injuries.

Accuracy of Inertial Measurement Units When Applied to the Countermovement Jump of Track and Field Athletes.

In this study, we aimed to assess the countermovement jump (CMJ) using a developed instrument encompassing an off-the-shelf Inertial Measurement Unit (IMU) in order to analyze performance during the contraction phase, as well as to determine the jump height and the modified reactive strength index (RSImod), using force plate (FP) data as reference. Eight athletes (six males and two females) performed CMJs with the IMU placed on their fifth lumbar vertebra. Accuracy was measured through mean error (standard deviation), correlation, and comparison tests. The results indicated high accuracy, high correlation (r), and no statistical differences between the IMU and the FP for contraction time (r = 0.902; ρ < 0.001), negative impulse phase time (r = 0.773; ρ < 0.001), flight time (r = 0.737; ρ < 0.001), jump time (r = 0.708; ρ < 0.001), RSImod (r = 0.725; ρ < 0.001), nor minimum force (r = 0.758; ρ < 0.001). However, the values related to the positive impulse phase did not have the expected accuracy, as we used different devices and positions. Our results demonstrated that our developed instrument could be utilized to identify the contraction phase, jump height, RSImod, and minimum force in the negative impulse phase with high accuracy, obtaining a signal similar to that of an FP. This information can help coaches and athletes with training monitoring and control, as the device has simpler applicability making it more systematic.

The Validity of the Push Band 2.0 on the Reactive Strength Index Assessment in Drop Jump.

This study aims to verify the validity of the Push Band 2.0 (PB2.0) device on the reactive strength index (RSI) measurement, using a force plate (FP) and an optical sensor device, OptoJump (OPT), as a reference. Twenty trained athletes performed 60 drop jump trials with a height box of 30 cm. A randomized repeated measures study was conducted during a single session using the PB2.0, the OPT, and the plate force manually synchronized to obtain RSI data for each jump. Validity was analyzed by contrasting three measures: the intra-class correlation coefficient (ICC), the Bland-Altman test, and R2 coefficient of determination. Bland-Altman analysis showed that RSI and FP for PB2.0 (media = -0.047; IC 93.34%) of all data were within the confidence interval, indicating a statistically reliable result. The RSI measured by the OPT and PB2.0 also provided similar values (media = -0.047). These data are identical to other validity measures (ICC and linear correlation) but differ in the R2 values. The explained variation of PB2.0 measures attained only 29.3% of the FP (R2 = 0.293) and 29.5% (R2 = 0.295) of the OPT assessment, showing a very low determination coefficient. The results of this study point to caution in the use of PB2.0 when measuring RSI in scientific research.

Increasing tactical complexity to enhance the synchronisation of collective behaviours: An action-research study throughout a competitive volleyball season.

An Action-Research (AR) design was implemented throughout a competitive season in which Constraint-led and Step-Game approaches were combined. This intervention study investigated the impact of increased performance complexity on emergence of counterattacking synchronisation tendencies in team players (laterally and longitudinally on court) at different set moments. Fifteen youth volleyball team players were studied across three action-research cycles, with performance in one competitive match analysed per cycle. Team synchronisation tendencies were assessed using the cluster phase method, with a 3 (matches) x 2 (set moments) x 2 (court direction) repeated-measures ANOVA statistical procedure to calculate differences in cluster amplitude mean values. Results revealed a reduction in team synchrony levels when tactical complexity of counterattacking play increased (second AR-cycle). Nevertheless, similar levels of team synchrony emerged between the first and third AR-cycles. Results also revealed the final moments of a set as a significant environmental constraint that shaped synchronisation tendencies. Evidence suggested that the (re)achievement of functional synchrony was realised through integration of Constraint-led and Step-Game approaches during practices designed to enhance tactical awareness in players. Finally, an insider action-research design provided relevant contextualised insights on the development of a team's synchronisation tendencies.

Decoding negative affect personality trait from patterns of brain activation to threat stimuli.

INTRODUCTION: Pattern recognition analysis (PRA) applied to functional magnetic resonance imaging (fMRI) has been used to decode cognitive processes and identify possible biomarkers for mental illness. In the present study, we investigated whether the positive affect (PA) or negative affect (NA) personality traits could be decoded from patterns of brain activation in response to a human threat using a healthy sample. METHODS: fMRI data from 34 volunteers (15 women) were acquired during a simple motor task while the volunteers viewed a set of threat stimuli that were directed either toward them or away from them and matched neutral pictures. For each participant, contrast images from a General Linear Model (GLM) between the threat versus neutral stimuli defined the spatial patterns used as input to the regression model. We applied a multiple kernel learning (MKL) regression combining information from different brain regions hierarchically in a whole brain model to decode the NA and PA from patterns of brain activation in response to threat stimuli. RESULTS: The MKL model was able to decode NA but not PA from the contrast images between threat stimuli directed away versus neutral with a significance above chance. The correlation and the mean squared error (MSE) between predicted and actual NA were 0.52 (p-value=0.01) and 24.43 (p-value=0.01), respectively. The MKL pattern regression model identified a network with 37 regions that contributed to the predictions. Some of the regions were related to perception (e.g., occipital and temporal regions) while others were related to emotional evaluation (e.g., caudate and prefrontal regions). CONCLUSION: These results suggest that there was an interaction between the individuals' NA and the brain response to the threat stimuli directed away, which enabled the MKL model to decode NA from the brain patterns. To our knowledge, this is the first evidence that PRA can be used to decode a personality trait from patterns of brain activation during emotional contexts.

Effects of 10-week eccentric overload training on kinetic parameters during change of direction in football players.

The aim of the current study was to analyse the effect of 10-week eccentric overload training on kinetic parameters during change of direction (COD) in U-19 football players. The outcome measured included relative peak braking (rPB) and propulsive force (rPF), contact time (CT), time spent during braking (BT) and propulsive phase (PT), relative total (rTOT_IMP), braking (rB_IMP) and propulsive (rP_IMP) impulses. Between-group results showed a substantial better improvement (likely) in CT (ES: 0.72) and BT (ES: 0.74) during side-step cutting, and in rPB (ES: 0.84) and rB_IMP (ES: 0.72) during crossover cutting, in the experimental group (EXP) in comparison to control group (CON). Within-group analysis showed a substantially better performance (likely to almost certain) in CT (ES: 1.19), BT (ES: 1.24), PT (ES: 0.70), rPB (ES: 0.75), rPF (ES: 0.68), rTOT_IMP (ES: 0.48) and rB_IMP (ES: 0.50) in EXP during side-step cutting. Regarding crossover cutting, within-group analysis showed a substantial better performance (likely to almost certain) in CT (ES: 0.75), rPB (ES: 0.75), rPF (ES: 1.34), rTOT_IMP (ES: 0.61), rB_IMP (ES: 0.76) and rP_IMP (ES: 0.46) in EXP. In conclusion, the eccentric overload-based programme led to an improvement in kinetic parameters during COD football tasks.

Dynamic knee stability and ballistic knee movement after ACL reconstruction: an application on instep soccer kick.

PURPOSE: The instep soccer kick is a pre-programmed ballistic movement with a typical agonist-antagonist coordination pattern. The coordination pattern of the kick can provide insight into deficient neuromuscular control. The purpose of this study was to investigate knee kinematics and hamstrings/quadriceps coordination pattern during the knee ballistic extension phase of the instep kick in soccer players after anterior cruciate ligament reconstruction (ACL reconstruction). METHODS: Seventeen players from the Portuguese Soccer League participated in this study. Eight ACL-reconstructed athletes (experimental group) and 9 healthy individuals (control group) performed three instep kicks. Knee kinematics (flexion and extension angles at football contact and maximum velocity instants) were calculated during the kicks. Rectus femoris (RF), vastus lateralis, vastus medialis, biceps femoralis, and semitendinosus muscle activations were quantified during the knee extension phase. RESULTS: The ACL-reconstructed group had significantly lower knee extension angle (-1.2 ± 1.6, p < 0.021) and increased variability (1.1 ± 1.2, p < 0.012) when compared with the control group. Within the EMG variables, the RF had a significantly greater activity in the ACL-reconstructed group than in the control group (79.9 ± 27.7 % MVC vs. 49.2 ± 20.8 % MVC, respectively, p < 0.034). No other statistically significant differences were found. CONCLUSIONS: The findings of this study demonstrate that changes in ACL-reconstructed individuals were observed on knee extension angle and RF muscle activation while performing an instep kick. These findings are in accordance with the knee stability recovery process after ACL reconstruction. No differences were observed in the ballistic control movement pattern between normal and ACL-reconstructed subjects. Performing open kinetic chain exercises using ballistic movements can be beneficial when recovering from ACL reconstruction. The exercises should focus on achieving multi-joint coordination and full knee extension (range of motion). LEVEL OF EVIDENCE: III.

The effect of Ashtanga-Vinyasa Yoga method on air force pilots' operational performance.

Introduction: In today's military landscape, optimizing performance and bolstering physical health and mental resilience are critical objectives. Introducing a 12-week Ashtanga Vinyasa Yoga Supta Method (AVYSM) to the training protocol of military trained Airforce pilots, we aim to assesses the feasibility and impact of the method. Materials and equipment: Borg Scale assesses the intensity level of physical activity during the intervention. Flight simulator data gauges operational performance responses. Postural control responses are measured using a force platform, stress responses are monitored via heart monitor, and handgrip dynamometry will measure strength. Respiratory capacity is assessed using a spirometer, body composition is evaluated using impedance balance, and aviation-related questionnaires are administered before and after the intervention period. Methods: In a randomized controlled trial, the totality of pilots from the "Masters in Military Aeronautics: aviator pilot specialist" course at the Portuguese Air Force Academy (PAA) were randomly assigned to the yoga intervention or the waiting list control groups, with participants providing written informed consent. The control group followed protocolized course classes for 12 weeks, while the intervention group integrated two weekly one-hour yoga sessions into their course. Results: The PAA has approved the implementation of this intervention protocol at Airbase 11 in Beja, highlighting its significance for the organization's policy makers. We hypothesize that this method will enhance operational performance and, subsequently, elevate flight safety. Discussion: This research's potential extends beyond the PAA, as it can be adapted for use in Airforce departments of other nations and various military contexts. Clinical trial registration: Évora University research ethics committee-approval number 21050. Study registered on ClinicalTrials.gov under identifier NCT05821270, registered on April 19, 2023.

Unveiling the Chaos in Postural Control in Adults with Achondroplasia.

BACKGROUND: Achondroplasia is a rare genetic skeletal condition characterized by disproportionate short stature. There is limited evidence on postural control in adults with achondroplasia and how lower limb lengthening (intervention) interacts with body dynamics. This study investigated sway variability during quiet standing in adults with achondroplasia with natural growth (N) and with lower limb lengthening (LL). METHODS: Sixteen adults performed bilateral/unilateral standing tasks. Linear (total excursion, amplitude, and ellipse area) and nonlinear (sample entropy and correlation dimension) center of pressure sway metrics were analyzed in the anteroposterior/mediolateral directions. Relationships between posture metrics, strength, and physical activity were explored. Between-groups statistics were calculated. RESULTS: The LL group exhibited amplified linear sway, indicating larger postural deviations, and reduced sample entropy and correlation dimension, indicative of more rigid and repeated corrections. The N group exhibited more unpredictable and adaptive movement corrections. Numerous correlations emerged between strength and posture measures, with relationships altered by intervention. CONCLUSIONS: Adults with achondroplasia display distinct balance strategies influenced by intervention. The results indicate that LL is associated with altered variability and adaptability compared to natural development. Relationships with muscle strength spotlight a key role of muscle capacity in postural control modulation after growth alterations in this population.

Migraine aura discrimination using machine learning: an fMRI study during ictal and interictal periods.

Functional magnetic resonance imaging (fMRI) studies on migraine with aura are challenging due to the rarity of patients with triggered cases. This study optimized methodologies to explore differences in ictal and interictal spatiotemporal activation patterns based on visual stimuli using fMRI in two patients with unique aura triggers. Both patients underwent separate fMRI sessions during the ictal and interictal periods. The Gaussian Process Classifier (GPC) was used to differentiate these periods by employing a machine learning temporal embedding approach and spatiotemporal activation patterns based on visual stimuli. When restricted to visual and occipital regions, GPC had an improved performance, with accuracy rates for patients A and B of roughly 86-90% and 77-81%, respectively (p < 0.01). The algorithm effectively differentiated visual stimulation and rest periods and identified times when aura symptoms manifested, as evident from the varying predicted probabilities in the GPC models. These findings contribute to our understanding of the role of visual processing and brain activity patterns in migraine with aura and the significance of temporal embedding techniques in examining aura phenomena. This finding has implications for diagnostic tools and therapeutic techniques, especially for patients suffering from aura symptoms.

Effects of a 16-week High-Speed Resistance Training program on body composition in community-dwelling independent older adults: A clinical trial.

BACKGROUND & AIMS: Aging frequently causes changes in body composition, such as a loss of strength and muscular mass and an increase in fat mass. Exercise training programs have been suggested as effective strategies to mitigate or prevent age-related declines in body composition. Therefore, this study examined the effects of a sixteen-week High-Speed Resistance Training (HSRT) program on body composition parameters in community-dwelling independent older adults. METHODS: The present clinical trial included 79 older adults, who were divided into two groups: intervention group (IG, N = 40, age, 68.50 ± 3.54 years; weight, 68.65 ± 11.36 kg) and control group (CG, N = 39, age, 72.08 ± 5.89 years; weight, 67.04 ± 10.69 kg). IG performed the supervised HSRT for 16 weeks, with 3 sessions per week of 60-70min, each session of 5-6 exercises, 2-3 sets, and 6-10 reps/exercise, while CG did not perform any exercise training program. Body composition parameters were assessed using a multifrequency tetrapolar bioelectrical impedance analyzer (InBody® S10). The level of physical activity and the dietary intake were evaluated by the International Physical Activity Questionnaire (IPAQ-SF) and the Food Frequency Questionnaire, respectively. Statistical analyses were performed using the analysis of covariance (ANCOVA), and effect size (Cohen's dunbiased). RESULTS: The analysis showed significant effects of the group factor for IG on phase angle (F(1) = 14.39, p < 0.001, η2p = 0.159). Additionally, results from Δ changes (post-minus pre-values) revealed small and medium effects in favor to IG for body cell mass (t(77) = 1.21, p = 0.230, dunb = 0.27 [-0.17, 0.71]) and phase angle (t(77) = 2.82, p = 0.006, dunb = 0.63 [0.18, 1.08]), respectively. CONCLUSIONS: The HSRT could effectively prevent the decline in cellular health and cell integrity in older adults, as evidenced by the significant improvements in the phase angle. REGISTRATION: Clinicaltrial.gov (ID: NCT05586087).

Gait characterization in rare bone diseases in a real-world environment - A comparative controlled study.

BACKGROUND: Rare bone diseases (RBD) cause physical and sensory disability that affects quality of life. Mobility challenges are common for people with RBDs, and travelling to gait analysis labs can be very complex. Smartphone sensors could provide remote monitoring. RESEARCH QUESTION: This study aimed to search for and identify variables that can be used to discriminate between people with RBD and healthy people by using built-in smartphone sensors in a real-world setting. METHODS: In total, 18 participants (healthy: n=9; RBD: n=9), controlled by age and sex, were included in this cross-sectional study. A freely available App (Phyphox) was used to gather data from built-in smartphone sensors (accelerometer & gyroscope) at 60 Hz during a 15-min walk on a level surface without turns or stops. Temporal gait parameters like cadence, mean stride time and, coefficient variance (CoVSt) and nonlinear analyses, as the largest Lyapunov exponent (LLE) & sample entropy (SE) in the three accelerometer axes were used to distinguish between the groups and describe gait patterns. RESULTS: The LLE (p=0.04) and the SE of the z-axis (p=0.01), which are correlated with balance control during walking and regularity of the gait, are sufficiently sensitive to distinguish between RBD and controls. SIGNIFICANCE: The use of smartphone sensors to monitor gait in people with RBD allows for the identification of subtle changes in gait patterns, which can be used to inform assessment and management strategies in larger cohorts.

Effectiveness of the KC@H programme compared with clinic-based rehabilitation in patients recovering from ACL reconstruction: a study protocol for a single-centre, two-arm, single-blinded, randomised controlled superiority trial.

Patients who cannot fully comply with conventional clinic-based rehabilitation (CR) sessions after ACL reconstruction (ACLR) may find additional internet-based sessions beneficial. These remote sessions include therapeutic exercises that can be done at home, potentially extending the reach of rehabilitation services to underserved areas, prolonging the duration of care and providing improved supervision. The study's main purpose is to determine if the Knee Care at Home (KC@H) programme is more effective than conventional CR alone in improving patient-reported, clinician-reported and physical functional performance outcome measures after ACLR. Additionally, the trial assesses the significance of changes in outcome measures for clinical practice. This protocol outlines a randomised controlled trial for postoperative recovery following ACLR. Adult participants of both sexes who meet specific criteria will be randomly assigned to either the CR group or the KC@H group. Only the latter group will receive internet-based sessions of therapeutic exercises at home and CR sessions. A follow-up evaluation will be conducted for both groups 12 weeks after the intervention ends. The trial protocol was approved by the Ethics Committee of the Universidade de Évora and complies with the Code of Ethics of the World Medical Association. All recordings will be stored on a secure server with limited access and deleted as soon as they are no longer needed. The KC@H programme is expected to be superior to conventional CR for patients recovering from ACLR across multiple outcome measures. Also, the programme has the potential to promote superior recovery and extend the reach and duration of care. Trial registration number: NCT05828355.

Does pilates-based exercise improve postural alignment in adult women?

A randomized, controlled trial was conducted to determine the effect of Pilates-based exercise on postural alignment. Seventy-four adult women (mean age ± SD, 34.9 ± 16.4 years) were randomized to a Pilates-based mat class (n = 40) or a control group (n = 34). Pilates-based exercise participants were taught the Initial Mat of Body Control Pilates for 6 months, twice a week, for 60 minutes per session; the control group received no exercise intervention. Repeated measurements were performed at baseline, 3 months, and 6 months of the frontal alignment of the thoracolumbar spine, shoulder, and pelvis, and sagittal alignment of the head and pelvis. No differences were found in either group, over time, on frontal alignment of the thoracolumbar spine and pelvis. The experimental group showed significant improvements in frontal alignment of the shoulder and sagittal alignment of the head and pelvis at 6 months. The Pilates-based exercise enhanced some parameters of the postural alignment of women, as measured by frontal alignment of the shoulder and sagittal alignment of the head and pelvis. The significant improvement in sagittal alignment of the head may imply that 6 months of Pilates-based exercise enhances sagittal alignment of the cervical or thoracic spine.