Three-dimensional kinematic analysis of upper limb movements between individuals with and without subacromial shoulder pain exploring the statistical parametric mapping.

Subacromial shoulder pain (SSP) accounts for 44-65% of all cases of shoulder pain. Kinematic alterations in the upper limbs have been observed in individuals with SSP, although there is no consensus on such alterations in the literature. Therefore, the present study aimed to compare the three-dimensional kinematics of the scapula, trunk, and arm during shoulder flexion-extension and abduction-adduction movements in individuals with SSP and a control group using statistical parametric mapping (SPM). We evaluated 117 participants [61 with SSP and 56 in the control group (CG)]. The three-dimensional kinematic analysis was performed starting from arm extension/adduction (0%), moving to flexion/abduction, and ending returning to extension/adduction, respectively (100%) in both groups. SSP group flexed more their trunk (0-100%, p < 0.001) and rotated scapula internally (0-20%, p < 0.001 and 75-100%, p < 0.001); rotated upwards (17-32%, p < 0.005 and 58-87%, p < 0.003) and posteriorly tilted (28-79%,p < 0.001 and 81-95%,p < 0.006) less than CG group during arm abduction-adduction. Through arm flexion-extension, the SSP group flexed (38-82% p < 0.009) less their trunk, rotated upwards (5-10% p = 0.021) less their scapula, and posteriorly tilted scapula (0-100% p < 0.001) more than CG. Combining conventional variables used to describe motion in individuals with SSP, such as minimum and maximum values, range of motion, and results provided by SPM can furnish a detailed description of the compensations and limitations of the patient, enabling a better understanding of the function of the scapular girdle as well as improvements in the evaluation process and clinical decision making.

The effects of strength training upon front foot contact ground reaction forces and ball release speed among high-level cricket pace bowlers.

The effects of an eight-week off-season strength training program upon lower-body strength, power, eccentric capacity, front foot contact (FFC) kinetics, and ball release speed (BRS) in pace bowlers were investigated. Ten elite-academy pace bowlers completed the intervention, and pre- and post-testing. Pre- and post-testing included: double (DLDL) and single leg (SLDL) drop landings; isometric mid-thigh pull (IMTP); countermovement jump; and pace bowling performance (two-over bowling spell measuring BRS and FFC kinetics). Changes from pre- to post-testing were assessed with paired sample t tests (p≤ 0.01), effects sizes and statistical parametrical mapping. Post-testing revealed a significant decrease in peak normalised vertical force during DLDL and SLDL with large effects and a significant, moderate effect increase in IMTP. There was no significant changes in BRS. Concomitantly, neither discrete scalar (p= 0.15-0.58) nor vector field analysis kinetics during FFC indicated significant changes. No significant alterations in FFC kinetics may explain the lack of improvement in BRS (pre = 31.55 ± 1.44 m/s; post = 31.79 ± 1.33 m/s). This study indicated an eight-week strength training program can improve strength and eccentric capacity in pace bowlers, and these changes when developed in the absence of skills training neither improved nor decreased pace bowling performance.

The relationship between inertial measurement unit-derived 'force signatures' and ground reaction forces during cricket pace bowling.

This study assessed the reliability and validity of segment measured accelerations in comparison to front foot contact (FFC) ground reaction force (GRF) during the delivery stride for cricket pace bowlers. Eleven recreational bowlers completed a 30-delivery bowling spell. Trunk- and tibia-mounted inertial measurement units (IMUs) were used to measure accelerations, converted to force, for comparisons to force plate GRF discrete measures. These measures included peak force, impulse and the continuous force-time curve in the vertical and braking (horizontal) planes. Reliability and validity was determined by intra-class correlation coefficients (ICC), coefficient of variation (CV), Bland-Altman plots, paired sample t-tests, Pearson's correlation and one-dimensional (1D) statistical parametrical mapping (SPM). All ICC (0.90-0.98) and CV (4.23-7.41%) were acceptable, except for tibia-mounted IMU braking peak force (CV = 12.44%) and impulse (CV = 18.17%) and trunk vertical impulse (CV = 17.93%). Bland-Altman plots revealed wide limits of agreement between discrete IMU force signatures and force plate GRF. The 1D SPM outlined numerous significant (p < 0.01) differences between trunk- and tibia-located IMU-derived measures and force plate GRF traces in vertical and braking (horizontal) planes. The trunk- and tibia-mounted IMUs appeared to not represent the GRF experienced during pace bowling FFC when compared to a gold-standard force plate.

The Effects of an Eight over Cricket Bowling Spell upon Pace Bowling Biomechanics and Performance within Different Delivery Lengths.

Pace bowlers must often perform extended bowling spells with maximal ball release speed (BRS) while targeting different delivery lengths when playing a multi-day match. This study investigated the effect of an eight over spell upon pace bowling biomechanics and performance at different delivery lengths. Nine male bowlers (age = 18.8 ± 1.7 years) completed an eight over spell, while targeting different lengths (short: 7-10 m, good: 4-7 m, full: 0-4 m from the batter's stumps, respectively) in a randomized order. Trunk, knee and shoulder kinematics and ground reaction forces at front foot contact (FFC), as well as run-up velocity and BRS were measured. Paired sample t-tests (p ≤ 0.01), Hedges' g effect sizes, and statistical parametrical mapping were used to assess differences between mean variables from the first and last three overs. No significant differences (p = 0.05-0.98) were found in any discrete or continuous variables, with the magnitude of difference being trivial-to-medium (g = 0.00-0.73) across all variables. Results suggest pace bowlers sustain BRS through a single eight over spell while tolerating the repeatedly high whole-body biomechanical loads as suggested by maintaining the kinematics or technique at the assessed joints during FFC. Practically, the findings are advantageous for bowling performance and support current bowling load monitoring practices.

Which of the branched-chain amino acids increases cerebral blood flow in hepatic encephalopathy? A double-blind randomized trial.

Branched-chain amino acids increase the brain perfusion of patients with hepatic encephalopathy (HE), but the amino acid and the mechanisms involved are still unknown. This study compared brain perfusion and clinical improvement during leucine or isoleucine supplementation. After randomization, 27 subjects with cirrhosis and HE received leucine or isoleucine supplements for one year. Brain single Photon Emission Computed Tomography (SPECT) and dynamic brain scintigraphy (DBS) were performed pretreatment and at 1, 8 and 12 months of supplementation. Brain perfusion was increased only in the isoleucine group at 8 months of treatment by both SPECT and DBS (p < 0.001 and p = 0.05, respectively) and by SPECT at the 12th month (p < 0.05). This was associated with hepatic encephalopathy improvement at 8 and 12 months (p = 0.008 and 0.004, respectively), which was not observed in the leucine group (p = 0.313 and 0.055, respectively). Isoleucine supplementation achieved a better impact on brain perfusion restoration in HE.

Validation of an optimized SPM procedure for FDG-PET in dementia diagnosis in a clinical setting.

Diagnostic accuracy in FDG-PET imaging highly depends on the operating procedures. In this clinical study on dementia, we compared the diagnostic accuracy at a single-subject level of a) Clinical Scenarios, b) Standard FDG Images and c) Statistical Parametrical (SPM) Maps generated via a new optimized SPM procedure. We evaluated the added value of FDG-PET, either Standard FDG Images or SPM Maps, to Clinical Scenarios. In 88 patients with neurodegenerative diseases (Alzheimer's Disease-AD, Frontotemporal Lobar Degeneration-FTLD, Dementia with Lewy bodies-DLB and Mild Cognitive Impairment-MCI), 9 neuroimaging experts made a forced diagnostic decision on the basis of the evaluation of the three types of information. There was also the possibility of a decision of normality on the FDG-PET images. The clinical diagnosis confirmed at a long-term follow-up was used as the gold standard. SPM Maps showed higher sensitivity and specificity (96% and 84%), and better diagnostic positive (6.8) and negative (0.05) likelihood ratios compared to Clinical Scenarios and Standard FDG Images. SPM Maps increased diagnostic accuracy for differential diagnosis (AD vs. FTD; beta 1.414, p = 0.019). The AUC of the ROC curve was 0.67 for SPM Maps, 0.57 for Clinical Scenarios and 0.50 for Standard FDG Images. In the MCI group, SPM Maps showed the highest predictive prognostic value (mean LOC = 2.46), by identifying either normal brain metabolism (exclusionary role) or hypometabolic patterns typical of different neurodegenerative conditions.

Psychosis effect on hippocampal reduction in schizophrenia.

INTRODUCTION: In schizophrenia, disruption of the neurodevelopmental processes may lead to brain changes and subsequent clinical manifestations of the illness. Reports of the progressive nature of these morphological brain changes raise questions about their causes. The possible toxic effects of repeated stressful psychotic episodes may contribute to the disease progression. OBJECTIVES: To analyze the influence of illness duration and previous psychotic episodes on hippocampal gray matter volume (GMV) in schizophrenia. METHODS: We performed an analysis of hippocampal GMV correlations with illness duration, number of previous psychotic episodes, and age in 24 schizophrenia patients and 24 matched healthy controls. RESULTS: We found a cluster of GMV voxels in the left hippocampal tail that negatively correlated with the number of previous psychotic episodes, independent from the effect of age. On the other hand we found no effect of illness duration independent of age on the hippocampal GMV. Finally, we found a cluster of significant group-by-age interaction in the left hippocampal head. CONCLUSIONS: We found an additive adverse effect of psychotic episodes on hippocampal morphology in schizophrenia. Our findings support toxicity of psychosis concept, together with etiological heterogeneity of brain changes in schizophrenia.

Altered phospholipid metabolism in schizophrenia: a phosphorus 31 nuclear magnetic resonance spectroscopy study.

Phospholipid (PL) metabolism is investigated by in vivo 31P magnetic resonance spectroscopy (MRS). Inconsistent alterations of phosphocholine (PC), phosphoethanolamine (PE), glycerophosphocholine (GPC) and glycerophosphoethanolamine (GPE) have been described in schizophrenia, which might be overcome by specific editing techniques. The selective refocused insensitive nuclei-enhanced polarization transfer (RINEPT) technique was applied in a cross-sectional study involving 11 schizophrenia spectrum disorder patients (SZP) on stable antipsychotic monotherapy and 15 matched control subjects. Metabolite signals were found to be modulated by cerebrospinal fluid (CSF) content and gray matter/brain matter ratio. Corrected metabolite concentrations of PC, GPC and PE differed between patients and controls in both subcortical and cortical regions, whereas antipsychotic medication exerted only small effects. Significant correlations were found between the severity of clinical symptoms and the assessed signals. In particular, psychotic symptoms correlated with PC levels in the cerebral cortex, depression with PC levels in the cerebellum and executive functioning with GPC in the insular and temporal cortices. In conclusion, after controlling for age and tissue composition, this investigation revealed alterations of metabolite levels in SZP and correlations with clinical properties. RINEPT 31P MRS should also be applied to at-risk-mental-state patients as well as drug-naïve and chronically treated schizophrenic patients in order to enhance the understanding of longitudinal alterations of PL metabolism in schizophrenia.