Smartphone-based evaluation of static balance and mobility in type 2 Diabetes.

It was compared smartphone-based measurements of static balance control and mobility of elderly population with and without type 2 diabetes mellitus (DM2). The present cross-sectional study investigated 73 participants grouped in a control group (n = 36) and a DM2 group (n = 37). Smartphone's built in inertial sensors were used to record inertial changes of the participants during static balance and mobility (Timed Up and Go test - TUG) tasks. The inertial variations as a function of the time were analyzed and compared between groups. Both groups were matched in age, body mass index, male-female proportion, but DM2 group had significant larger fasting glucose than control group. Additionally, DM2 group had worst static balance control with open and closed eyes than the controls (p < 0.05) as well as they also had longer duration to execute the different events of the mobility test than the controls (p < 0.05). DM2 patients had decline of motor functions compared to controls and the use of bult-in sensors of smartphones was feasible to identify these functional impairments. The easy access of smartphones could be improving the screening of functional impairments in DM2 patients.

Prevalence of urinary incontinence in Brazilian para athletes.

OBJECTIVE: To describe the prevalence of urinary incontinence (UI) in para athletes in Brazil. METHODS: This is a cross-sectional study with Brazilian para athletes with physical impairments from all para sports. The data from 86 participants of both sexes (60 males and 26 females) were collected through an online survey that gathered sociodemographic data and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form, from March to July 2023. RESULTS: The prevalence of UI was 45.3% (n=39), with the average impact on quality of life scored at 6.1±3.5 on a scale of 0-10. Most para athletes reported moderate (43.5%) or severe (38.4%) symptoms. The most common type was mixed UI (46.1%), with an average of 3±1.9 episodes of urinary loss per athlete in the last 4 weeks. Adjusted Poisson regression (controlling for sex, age and level of competition) revealed that para athletes with orthopaedic impairments had a 58% lower prevalence of UI (prevalence ratio=0.42; 95% CI 0.24, 0.83) compared with those with neurological impairments. Furthermore, ordinal regression indicated that para athletes with neurological impairments were 147% more likely to experience a progression from 'severe' to 'very severe' UI (OR=2.47; 95% CI 1.59, 3.93). CONCLUSIONS: UI is highly prevalent among para athletes, particularly those with neurological impairments, underscoring the need for specialised genitourinary healthcare and the need for further treatment and monitoring of the condition. There is a critical need to raise awareness among coaches, healthcare providers and the athletes themselves about UI and its impact to foster the comprehensive well-being of these athletes.

Intra and Inter-Device Reliabilities of the Instrumented Timed-Up and Go Test Using Smartphones in Young Adult Population.

The Timed-Up and Go (TUG) test is widely utilized by healthcare professionals for assessing fall risk and mobility due to its practicality. Currently, test results are based solely on execution time, but integrating technological devices into the test can provide additional information to enhance result accuracy. This study aimed to assess the reliability of smartphone-based instrumented TUG (iTUG) parameters. We conducted evaluations of intra- and inter-device reliabilities, hypothesizing that iTUG parameters would be replicable across all experiments. A total of 30 individuals participated in Experiment A to assess intra-device reliability, while Experiment B involved 15 individuals to evaluate inter-device reliability. The smartphone was securely attached to participants' bodies at the lumbar spine level between the L3 and L5 vertebrae. In Experiment A, subjects performed the TUG test three times using the same device, with a 5 min interval between each trial. Experiment B required participants to perform three trials using different devices, with the same time interval between trials. Comparing stopwatch and smartphone measurements in Experiment A, no significant differences in test duration were found between the two devices. A perfect correlation and Bland-Altman analysis indicated good agreement between devices. Intra-device reliability analysis in Experiment A revealed significant reliability in nine out of eleven variables, with four variables showing excellent reliability and five showing moderate to high reliability. In Experiment B, inter-device reliability was observed among different smartphone devices, with nine out of eleven variables demonstrating significant reliability. Notable differences were found in angular velocity peak at the first and second turns between specific devices, emphasizing the importance of considering device variations in inertial measurements. Hence, smartphone inertial sensors present a valid, applicable, and feasible alternative for TUG assessment.

Risk stratification for frailty, impairment and assessment of sleep disorders in community-dwelling older adults.

BACKGROUND: Frailty is associated with an increased susceptibility to functional decline, impairment, hospitalization, and mortality among the older adults. However, the potential reversibility of frailty lies in identifying modifiable factors that could prevent, mitigate, or interrupt its progression. While there is a suggestion that sleep disorders may increase the risk of frailty and impairment, the risk stratification of this relationship remains inconclusive. OBJECTIVE: Stratify the risk of frailty and impairment and investigate potential connections with sleep quality, excessive daytime sleepiness, and the risk of obstructive sleep apnea in older adults dwelling in the community. METHODS: This was a quantitative cross-sectional investigation. Frailty risk and impairment were stratified using the Frail Non-disabled Questionnaire (for impairment) and the FRAIL Scale (for Frailty). The assessment of excessive daytime sleepiness, sleep quality, and the risk of obstructive sleep apnea involved the employment of the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, and the STOP-BANG questionnaire, respectively. RESULTS: A total of 109 older adults living in the urban area (86 %, p = 0.010), females (61 %; p = 0.030), median age 68 (64-75) years, with overweight (36 %, p < 0.010) and self-identified as belonging to other racial or ethnic categories (71 %, p < 0.010). According to the impairment assessment, 32 % of participants were classified as disable (p < 0.01). Conversely, as per the frailty evaluation, 33 % were pre-frail and 25 % were identified as frail. Additionally, a substantial proportion experienced poor sleep quality (80 %, p = 0.010), exhibited a moderate risk of obstructive sleep apnea (49 %, p < 0.010), and showed no signs of excessive daytime sleepiness (62 %, p < 0.010). There was a modest correlation between frailty and impairment with poor sleep quality (rho = 0.39; p < 0.001) and the risk of obstructive sleep apnea (rho = 0.26; p = 0.000). However, the was no significant relationship was observed between frailty and impairment and excessive daytime sleepiness (rho = 0.04; p = 0.660). Similarly, a modest correlation was observed between sleep quality (rho = 0.33; p < 0.001), the risk of obstructive sleep apnea (rho = 0.27; p = 0.001), and frailty. Conversely, no correlation was found with excessive daytime sleepiness (rho = 0.05; p = 0.590). Also, the poor sleep quality and the risk of obstructive sleep apnea explain 14 % of the risk of frailty in the population of community-dwelling older adults (r2 = 0.14; p = 0.04). CONCLUSION: This study reveals a modest risk of frailty and impairment with sleep quality and the risk of obstructive sleep apnea, but not with excessive daytime sleepiness in community-dwelling older adults.

Smartphone-based evaluation of static balance and mobility in long-lasting COVID-19 patients.

Background: SARS-CoV-2 infection can lead to a variety of persistent sequelae, collectively known as long COVID-19. Deficits in postural balance have been reported in patients several months after COVID-19 infection. The purpose of this study was to evaluate the static balance and balance of individuals with long COVID-19 using inertial sensors in smartphones. Methods: A total of 73 participants were included in this study, of which 41 had long COVID-19 and 32 served as controls. All participants in the long COVID-19 group reported physical complaints for at least 7 months after SARS-CoV-2 infection. Participants were evaluated using a built-in inertial sensor of a smartphone attached to the low back, which recorded inertial signals during a static balance and mobility task (timed up and go test). The parameters of static balance and mobility obtained from both groups were compared. Results: The groups were matched for age and BMI. Of the 41 participants in the long COVID-19 group, 22 reported balance impairment and 33 had impaired balance in the Sharpened Romberg test. Static balance assessment revealed that the long COVID-19 group had greater postural instability with both eyes open and closed than the control group. In the TUG test, the long COVID-19 group showed greater acceleration during the sit-to-stand transition compared to the control group. Conclusion: The smartphone was feasible to identify losses in the balance motor control and mobility of patients with long-lasting symptomatic COVID-19 even after several months or years. Attention to the balance impairment experienced by these patients could help prevent falls and improve their quality of life, and the use of the smartphone can expand this monitoring for a broader population.

The role of sex and handedness in the performance of the smartphone-based Finger-Tapping Test.

The Finger Tapping Test (FTT) is a classical neuropsychological test that assesses motor functioning, and recently it has been employed using smartphones. For classical protocols, it has been observed that sex and handedness influence the performance during the test. By assessing the influence of sex and handedness on the test, it is possible to adjust the performance measurements to ensure the validity of test results and avoid sex- and handedness-related bias. The present study aimed to evaluate the influence of sex and handedness on smartphone-based FTT performance. We developed an Android application for the FTT and recruited 40 males and 40 females to carry out three spatial designs on it (protocols I, II, and III). Participants' performance was measured using the global, temporal, and spatial parameters of the FTT. We observed that for the performance in protocol I, handedness had a significant influence on global and temporal variables, while the interaction between handedness and sex had a greater influence on spatial variables. For protocols II and III, we observed that handedness had a significant influence on global, temporal, and spatial variables compared to the other factors. We concluded that the smartphone-based test is partly influenced by handedness and sex, and in clinical implications, these factors should be considered during the evaluation of the smartphone-based FTT.

Comparison of inertial records during anticipatory postural adjustments obtained with devices of different masses.

Background: Step initiation involves anticipatory postural adjustments (APAs) that can be measured using inertial measurement units (IMUs) such as accelerometers. However, previous research has shown heterogeneity in terms of the population studied, sensors used, and methods employed. Validity against gold standard measurements was only found in some studies, and the weight of the sensors varied from 10 to 110 g. The weight of the device is a crucial factor to consider when assessing APAs, as APAs exhibit significantly lower magnitudes and are characterized by discrete oscillations in acceleration paths. Objective: This study aims to validate the performance of a commercially available ultra-light sensor weighing only 5.6 g compared to a 168-g smartphone for measuring APAs during step initiation, using a video capture kinematics system as the gold standard. The hypothesis is that APA oscillation measurements obtained with the ultra-light sensor will exhibit greater similarity to those acquired using video capture than those obtained using a smartphone. Materials and Methods: Twenty subjects were evaluated using a commercial lightweight MetaMotionC accelerometer, a smartphone and a system of cameras-kinematics with a reflective marker on lumbar vertebrae. The subjects initiated 10 trials of gait after a randomized command from the experimenter and APA variables were extracted: APAonset, APAamp, PEAKtime. A repeated measures ANOVA with post-hoc test analyzed the effect of device on APA measurements. Bland-Altman plots were used to evaluate agreement between MetaMotionC, smartphone, and kinematics measurements. Pearson's correlation coefficients were used to assess device correlation. Percentage error was calculated for each inertial sensor against kinematics. A paired Student's t-test compared th devices percentage error. Results: The study found no significant difference in temporal variables APAonset and PEAKtime between MetaMotionC, smartphone, and kinematic instruments, but a significant difference for variable APAamp, with MetaMotionC yielding smaller measurements. The MetaMotionC had a near-perfect correlation with kinematic data in APAonset and APAamp, while the smartphone had a very large correlation in APAamp and a near-perfect correlation in APAonset and PEAKtime. Bland-Altman plots showed non-significant bias between smartphone and kinematics for all variables, while there was a significant bias between MetaMotionC and kinematics for APAamp. The percentage of relative error was not significantly different between the smartphone and MetaMotionC. Conclusions: The temporal analysis can be assessed using ultralight sensors and smartphones, as MetaMotionC and smartphone-based measurements have been found to be valid compared to kinematics. However, caution should be exercised when using ultralight sensors for amplitude measurements, as additional research is necessary to determine their effectiveness in this regard.

Atividade física e saúde mental em atletas brasileiros de basquetebol em cadeira de rodas durante o isolamento social na pandemia de Covid-19 / Physical activity and mental health levels in brazilian wheelchair basketball athletes during isolation social in the covid-19 pandemic / Actividad física y salud mental en deportistas brasileños de baloncesto en silla de ruedas durante el aislamiento social durante la pandemia de Covid-19

Introdução: Desde o início da Pandemia Covid-19 vários países adotaram o isolamento social (lockdown) como medida de contenção para diminuir a propagação do vírus e reduzir o risco de sobrecarga no sistema de saúde. A prática regular do exercício físico ao longo da pandemia poderia atenuar os prejuízos do isolamento e manter a saúde mental e bem-estar dos atletas. Objetivo: Avaliara associação entre os níveis de exercício físico e os níveis de saúde mental em atletas de basquete em cadeira de rodas durante o isolamento social. Métodos: Utilizamos um questionário online dividido em duas seções: avaliação da saúde mental e do nível de exercício físico. Resultados e Discussão: Pontuações mais baixas no questionário Short Form 36(SF-36)foram observadas nos domínios "vitalidade" com uma pontuação de 16, "limitação por aspectos emocionais" com pontuação de 55, "limitação por aspectos físicos" com pontuação de 62,5 seguido por "estado geral de saúde" com pontuação de 63.O questionário Physical Activity Scale for Individuals With Physical Disabilities (PASIPD) mostrou uma percepção baixa em relação ao nível de atividade física nas pessoas com deficiência. Conclusão: Os domínios de saúde geral com menor pontuações no lockdown foi "vitalidade" (16) e "aspectos emocionais" (55) e não foi observado associação forte entre os diferentes domínios da escala SF-36 e o nível de atividade física através da Escala PASIPD (p>0,005).

Introduction: Since the beginning of the Covid-19 pandemic, several countries have adopted social isolation (lockdown) as a containment measure to reduce the spread of the virus and the risk of overloading the health system. Regular physical exercise during the pandemic could mitigate the damage of isolation and maintain the mental health and well-being of wheelchair basketball athletes. Objective: To evaluate the association between physical exercise levels and mental health levels in wheelchair basketball athletes during social isolation. Methods: We used an online questionnaire divided into two sections: mental health assessment and physical exercise level assessment. Results and discussion: Lower scores on the Short Form 36 (SF-36) questionnaire were observed in the domains "vitality" with a score of 16, "limitation by emotional aspects" with a score of 55, "limitation by physical aspects" with a score of 62.5 followed by "general health status" with a score of 63. The Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) showed a low perception of physical activity level in people with disabilities. Conclusion: The general health domains with lower scores in lockdown were "vitality" (16) and "emotional aspects" (55) and no strong association was observed between the different domains of the SF-36 scale and the level of physical activity through the PASIPD Scale (p>0.005).

Introducción: Desde el inicio de la pandemia de Covid-19, varios países han adoptado el aislamiento social (confinamiento) como medida de contención para reducir la propagación del virus y el riesgo de sobrecargar el sistema de salud. El ejercicio físico regular durante la pandemia podría mitigar el daño del aislamiento y mantener la salud mental y el bien estar de los atletas de baloncesto en silla de ruedas. Objetivo: Evaluar la asociación entre los niveles de ejercicio físico y los niveles de salud mental en los atletas de baloncesto en silla de ruedas durante el aislamiento social. Métodos: Utilizamos um cuestionario en línea dividido en dos secciones: evaluación de la salud mental y evaluación del nivel de ejercicio físico. Resultados y discusión: Se observaron puntuaciones más bajas en el cuestionario Short Form 36 (SF-36) en los dominios "vitalidad" con una puntuación de 16, "limitación por aspectos emocionales" con una puntuación de 55, "limitación por aspectos físicos" con una puntuación de 62,5 seguido de "estado general de salud" con una puntuación de 63. La Escala de Actividad Física para Personas com Discapacidad Física (PASIPD) mostró una baja percepción del nivel de actividad física en las personas com discapacidad. Conclusión: Los domínios generales de salud com puntuaciones más bajas en el confinamento fueron "vitalidad" (16) y "aspectos emocionales" (55) y no se observó una Asociación fuerte entre los diferentes dominios de la escala SF-36 y el nivel de actividad física a través de la Escala PASIPD (p>0,005).

Wheelchair skill tests in wheelchair Basketball: A systematic review.

OBJECTIVES: The aim of this study was to identify, describe and synthesize the skill tests used in wheelchair basketball. METHOD: A systematic review was carried out in the databases: PubMed/Medline, ScienceDirect, Scopus, Web of science and Google Scholar from inception to January 2021 with up to date in January 2022. the eligibility criteria used were Inclusion: (i) evaluation of wheelchair basketball athletes; (ii) using skill tests (defined as agility, speed, ball maneuverability, slalom, etc.) and (iii) papers needed to be written in English and published in peer-reviewed journals. Exclusion: (i) papers with poor description of the test methodology, (ii) participants not classified as wheelchair basketball athletes (less than one year of practice) and (iii) Participants were not people without disabilities. RESULTS: Our main findings were: a) the most explored skills were pass and speed, and the most frequent test was the pass tests and sprint tests, b) Strong associations were found between sports classes and performance in field tests, c) The most used tests for each skill were: pass = pass accuracy and maximum pass; speed = 20m sprint test with and without the ball; agility = slalom test; dribbling = obstacle dribbling tests and throw = free throw and spot shot. CONCLUSION: The most explored skills were passing and speed, and to evaluate these skills we highlight the two-handed chest pass test, 20m sprint test with ball and the WMP test. The use of specific tests can facilitate the creation of reference standards and possible comparison of athletes and, thus, enable better training conditions, aiming to meet the specific demands of each athlete and team.

Wearable Inertial Sensor Approach for Postural Adjustment Assessments during Predictable Perturbations in Sport.

INTRODUCTION: Evidence supports the importance of efficient postural control to improve performance in sports. This involves the use of strategies such as anticipatory posture adjustments and compensatory adjustments. Technology makes analysis and assessments in sports cheaper, while being valid and reliable compared to the gold-standard assessment equipment. OBJECTIVES: This article aimed to test the validity and reliability of signals extracted from the sensor's accelerometer (Metamotion C), by comparing it to the data obtained from the gold-standard equipment (a three-dimensional video-motion-capture system). DESIGN: Observational, cross-sectional study. METHODS: We exposed 20 healthy young standing people to the pendulum impact paradigm, which consisted of predictable anteroposterior disturbances applied at the shoulder level. In order to measure this, we observed the acceleration of the center of mass in the anticipatory and compensatory phase of the disturbance and compared the signals of the two devices (Metamotion C and a motion-capture system). RESULTS: The validation results showed the significant linear correlation of all variables with a moderate to large correlation of r ≥ 0.5 between the devices. In contrast, the reliability results between sessions obtained by filming were all significant and above 0.75, indicating excellent reliability. The APAonset variable had a reasonable to high intra-class correlation in the anticipatory phase. In the compensatory phase, the CPAtime variable showed an excellent correlation. CONCLUSIONS: Metamotion C proved reasonably valid and highly reliable in measuring the center of mass acceleration compared to the camera system in both the anticipatory and compensatory phases.

Comparison of Static Balance Control in Infected Htlv-1 Subjects with Different Tsp/Ham Diagnosis.

(1) Background: Tropical spastic paraparesis (TSP/HAM) associated with the T cell lymphotropic virus in type I humans (HTLV-1) is a slow, chronic, and progressive disease that causes balance changes. TSP/HAM diagnosis can be classified as probable, possible, and definite. We compared the static balance control of HTLV-1-infected patients with different TSP/HAM diagnosis. (2) Methods: Our sample consisted of 13 participants infected with HTLV-1 and 16 healthy participants. The center of pressure was recorded using a force platform with open and closed eyes. We divided the recordings into three intervals, period T1 (corresponds to the first 10 s); period T2 (from 10 to 45 s); period T3 (from 45 to 55 s). (3) Results: Eight participants infected with HTLV-1 were classified as probable TSP/HAM and five participants infected with HTLV-1 were classified as definite TSP/HAM. There was a significant increase in postural instability in patients with definite PET/MAH considering the structural and global variables of body sway compared to the control and the probable TSP/HAM. (4) Conclusions: We concluded that the severity of balance is directly related to the degree of signs and symptoms of TSP/HAM.

Anticipatory postural adjustments in older versus young adults: a systematic review and meta-analysis.

BACKGROUND: Anticipatory postural adjustments (APAs) are a feedforward mechanism triggered in advance to a predictable perturbation, to help the individual counteract mechanical effects that the disturbance may cause. Whether or not this strategy is compromised in the elderly is not a consensus in the literature. METHODS: In this systematic review with meta-analysis, we investigated aging effects on postural control, based on anticipatory postural adjustments (APAs). We selected 11 eligible articles of the following databases: Lilacs, SciELO, PubMed, Cochrane Central, Embase, and CINAHL, involving 324 research participants, assessing their methodological quality and extracting electromyographic, posturographic, and kinematic measurements. We included studies that investigated the occurrence of APAs in healthy younger and older adults, published before 10th August 2022, in English. Studies involving participant with conditions that may affect balance or that did not report measures of onset or amplitude of electromyography (EMG), COP, or kinematics were excluded. To analyze the aggregated results from these studies, we performed the analysis based on the outcome measures (EMG, COP, or kinematic measures) used in individual studies. We calculated differences between younger and older adult groups as the mean differences between the groups and the estimated effect. Egger's test was conducted to evaluate whether this meta-analysis had publication bias. RESULTS: Through this review, older adults showed no significant difference in the velocity to perform a movement compared to the younger adults (MD 0.95, 95% CI -0.86, 2.76, I2 = 82%), but both muscle onset and center of pressure (COP) onset were significantly more delayed in older than in younger adults: erector spinae (MD -31.44, 95% CI -61.79, -1.09, I2 = 95%); rectus abdominis (RA) (MD -31.51, 95% CI -70.58, -3.57, I2 = 85%); tibialis anterior (TA) (MD -44.70, 95% CI -94.30, 4.91, I2 = 63%); soleus (SOL) (MD -37.74, 95% CI -65.43, -10.05, I2 = 91%); gastrocnemius (GAS) (MD -120.59, 95% CI -206.70, -34.49, I2 = 94%); quadriceps (Q) (MD -17.42, 95% CI -34.73, -0.12, I2 = 0%); biceps femoris (BF) (MD -117.47, 95% CI -192.55, -42.70, I2 = 97%); COP onset (MD -45.28, 95% CI -89.57, -0.98, I2 = 93%), and COP apa (COPapa) (MD 2.35, 95% CI -0.09, 4.79, I2 = 64%). These changes did not seem to be linked to the speed of movement but possibly to age-related physiological changes that indicated decreased motor control during APAs in older adults. CONCLUSIONS: Older adults use different postural strategies that aim to increase the safety margin and stabilize the body to perform the movement, according to the requirements imposed, and this should be considered in rehabilitation protocols. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD420119143198.

The hand tremor spectrum is modified by the inertial sensor mass during lightweight wearable and smartphone-based assessment in healthy young subjects.

Tremors are common disorders characterized by an involuntary and relatively rhythmic oscillation that can occur in any part of the body and may be physiological or associated with some pathological condition. It is known that the mass loading can change the power spectral distribution of the tremor. Nowadays, many instruments have been used in the evaluation of tremors with bult-in inertial sensors, such as smartphones and wearables, which can significantly differ in the device mass. The aim of this study was to compare the quantification of hand tremor using Fourier spectral techniques obtained from readings of accelerometers built-in a lightweight handheld device and a commercial smartphone in healthy young subjects. We recruited 28 healthy right-handed subjects with ages ranging from 18 to 40 years. We tested hand tremors at rest and postural conditions using lightweight wearable device (5.7 g) and smartphone (169 g). Comparing both devices at resting tremor, we found with smartphone the power distribution of peak ranging 5 and 12 Hz in both hands. With wearable, the result was similar but less evident. When comparing both devices in postural tremor, there were significant differences in both frequency ranges in peak frequency and peak amplitude in both hands. Our main findings show that in resting condition the hand tremor spectrum had a higher peak amplitude in the 5-12 Hz range when the tremor was recorded with smartphones, and in postural condition there was a significantly (p < 0.05) higher peak power spectrum and peak frequency in the dominant hand tremors recorded with smartphones compared to those obtained with lightweight wearable device. Devices having different masses can alter the features of the hand tremor spectrum and their mutual comparisons can be prejudiced.

Bioelectrical impedance vector analysis and body composition in cervical spinal cord injury: A pilot study.

Introduction: Body composition assessment in cervical spinal cord injury (c-SCI) individuals is important to monitor the fat free-mass (FFM) loss, due to immobilization, or gain, due to exercise practice. Single frequency bioelectrical impedance analysis (SF-BIA) is low in cost, simple and easy. Objectives: The aims of this study are: to evaluate the concordance between the FFM values obtained using dual X-ray absorptiometry (DXA) and the three SF-BIA previous predictive equations; and to test the applicability of the bioelectrical impedance vector analysis (BIVA). Methods: Twenty-three c-SCI males were divided into two groups: Physically active (PA; n = 13; at least 150 min/week) and non-active individuals (NPA) and were assessed by DXA and SF-BIA simultaneously. Results: FFM values were similar between groups PA and NPA. Considering all participants, FFM values obtained by Kocina and Heyward (>11%) and Sun (<15.4%) predictive equations were different when compared to DXA (p < 0.01). However, Buchholz's et al. predictive equation showed FFM values similar to DXA, but presented poor concordance (<7%, p = 0.99; concordance coefficient = 0.85). BIVA showed consistency in ellipse distribution using FFM obtained using Buchholz et al. predictive equation. Conclusions: The use of non-specific BIA equations can lead to misinterpretation in FFM values in male c-SCI individuals. Predictive equations for this group need to be developed.

Wearable Devices and Smartphone Inertial Sensors for Static Balance Assessment: A Concurrent Validity Study in Young Adult Population.

Falls represent a public health issue around the world and prevention is an important part of the politics of many countries. The standard method of evaluating balance is posturography using a force platform, which has high financial costs. Other instruments, such as portable devices and smartphones, have been evaluated as low-cost alternatives to the screening of balance control. Although smartphones and wearables have different sizes, shapes, and weights, they have been systematically validated for static balance control tasks. Different studies have applied different experimental configurations to validate the inertial measurements obtained by these devices. We aim to evaluate the concurrent validity of a smartphone and a portable device for the evaluation of static balance control in the same group of participants. Twenty-six healthy and young subjects comprised the sample. The validity for static balance control evaluation of built-in accelerometers inside portable smartphone and wearable devices was tested considering force platform recordings as a gold standard for comparisons. A linear correlation (r) between the quantitative variables obtained from the inertial sensors and the force platform was used as an indicator of the concurrent validity. Reliability of the measures was calculated using Intraclass correlation in a subsample (n = 14). Smartphones had 11 out of 12 variables with significant moderate to very high correlation (r > 0.5, p < 0.05) with force platform variables in open eyes, closed eyes, and unipedal conditions, while wearable devices had 8 out of 12 variables with moderate to very high correlation (r > 0.5, p < 0.05) with force platform variables under the same task conditions. Significant reliabilities were found in closed eye conditions for smartphones and wearables. The smartphone and wearable devices had concurrent validity for the static balance evaluation and the smartphone had better validity results than the wearables for the static balance evaluation.

Injuries in Wheelchair Basketball Players: A Systematic Review.

BACKGROUND: Sports injuries have physical and psychological effects that negatively affect sports performance. Although there are data available on sports injuries in wheelchair basketball, some aspects need to be clarified, such as the location, mechanisms and risk factors for injury, which are not well described due to variations and/or a lack of definition of injury. The aim of this study was to determine epidemiological information, primary injury characteristics and affected body regions in wheelchair basketball players; Methods: The PubMed, Science Direct, Scopus, Web of Science and Google Scholar databases were used; Results: eight articles were included in this review. The shoulder was the body region most affected (N = 60; 22.1%). When divided by body segments, the upper limbs were the most affected (N = 128; 47.2%), followed by the head and/or face (N = 53; 19.5%), trunk (included spine and ribs) (N = 48; 17.8%) and lower limbs (N = 42; 15.5%); Conclusions: wheelchair basketball players suffer a large number of injuries with different characteristics that are mainly linked to biomechanics and sport. These results can be used to guide coaches in structuring training to minimize recurring injuries, in addition to assisting in the organization of medical teams in competitions.

Validity and reliability of a smartphone-based assessment for anticipatory and compensatory postural adjustments during predictable perturbations.

BACKGROUND: Postural adjustments involve displacements of the center of mass (COM), controlled by the central nervous system (CNS), to maintain equilibrium whilst standing. Postural adjustments can be anticipatory (APAs) or compensatory (CPAs), and are triggered to counteract predictable perturbations. RESEARCH QUESTION: Is the new smartphone application, Momentum, a valid and reliable tool for the assessment of body balance, by measuring APAs and CPAs using accelerometer readings? METHODS: 20 young adults were exposed to external predictable perturbations induced at the shoulder level, whilst standing. COM linear acceleration was recorded by Momentum (extracting data from a smartphone's accelerometer) and a 3D motion capture system. RESULTS: The key results demonstrated a very high, significant correlation (r ≥ 0.7, p < 0.05) between the two device settings in the APA parameters, which obtained r = 0.65, denoting a high correlation. Considering the reliability, variables that are compensatory in nature are presented on a scale of good to excellent in measurement methods, kinematics, and Momentum. However, the anticipatory variables presented excellent reliability only for the kinematics. SIGNIFICANCE: These experiments show that Momentum is a valid method for measuring COM acceleration under predictable perturbations and is reliable for compensatory events.

Validity and Reliability of Smartphone App for Evaluating Postural Adjustments during Step Initiation.

The evaluation of anticipatory postural adjustments (APAs) requires high-cost and complex handling systems, only available at research laboratories. New alternative methods are being developed in this field, on the other hand, to solve this issue and allow applicability in clinic, sport and hospital environments. The objective of this study was to validate an app for mobile devices to measure the APAs during gait initiation by comparing the signals obtained from cell phones using the Momentum app with measurements made by a kinematic system. The center-of-mass accelerations of a total of 20 healthy subjects were measured by the above app, which read the inertial sensors of the smartphones, and by kinematics, with a reflective marker positioned on their lumbar spine. The subjects took a step forward after hearing a command from an experimenter. The variables of the anticipatory phase, prior to the heel-off and the step phase, were measured. In the anticipatory phase, the linear correlation of all variables measured by the two measurement techniques was significant and indicated a high correlation between the devices (APAonset: r = 0.95, p < 0.0001; APAamp: r = 0.71, p = 0.003, and PEAKtime: r = 0.95, p < 0.0001). The linear correlation between the two measurement techniques for the step phase variables measured by ques was also significant (STEPinterval: r = 0.56, p = 0.008; STEPpeak1: r = 0.79, p < 0.0001; and STEPpeak2: r = 0.64, p < 0.0001). The Bland−Altman graphs indicated agreement between instruments with similar behavior as well as subjects within confidence limits and low dispersion. Thus, using the Momentum cell phone application is valid for the assessment of APAs during gait initiation compared to the gold standard instrument (kinematics), proving to be a useful, less complex, and less costly alternative for the assessment of healthy individuals.

Supplementation and Performance for Wheelchair Athletes: A Systematic Review.

This systematic review aimed to identify nutritional interventions and supplements that improve the performance for wheelchair athletes. Intervention trials involving high-performance wheelchair athletes were analyzed, including those that comprised a nutritional intervention, defined as any intervention related to food, beverages, and supplementation aiming at evaluating the performance of wheelchair athletes. Of the included studies, four evaluated caffeine supplementation, of which one also evaluated sodium citrate supplementation; two studies evaluated vitamin D supplementation; one study assessed creatine monohydrate supplementation; and one assessed carbohydrate supplementation. Most studies were conducted on athletes with spinal cord injury. Athletes who consumed caffeine exhibited an improvement in performance, but this finding is not strong enough to become a recommendation.

Social Distancing, Physical Activity, and COVID-19: Implications for Type 1 Diabetes Mellitus in Brazil.

A lack of glycemic control and diabetes are risk factors for complications related to COVID-19, and social isolation can hinder adherence to physical activity. Thus, this study sought to assess the impacts of social distancing on the practice of physical activity of individuals with type 1 diabetes mellitus (T1DM). This was a transversal study carried out using an online form to collect sociodemographic, practice of physical activity, and social distancing data. Of the 472 participants, 85.6% reported that they were respecting the steps of social distancing. Social distancing affected the practice of physical activity in adherence to the habit of practicing in frequency, duration, and perception of change in intensity. An association was found between noticing a lot of stress in the home environment and stopping physical activity; lower levels of tolerance to social distancing were associated with less physical activity, and maintaining the habit of practicing physical activity was associated with decreasing the intensity of the practice. Hence, social distancing harmed the practice of physical activity as part of the treatment of individuals with T1DM, both in the habit of practicing and in the characteristics of these practices of physical activity, such as frequency, duration, and intensity.