The Effect of Real-Time Tibial Acceleration Feedback on Running Biomechanics During Gait Retraining: A Systematic Review and Meta-Analysis.

OBJECTIVES: To explore the immediate and retention effect of real-time tibial acceleration feedback on running biomechanics during gait retraining. METHODS: Five electronic databases were searched to identify relevant studies published before May 2022. The included studies were evaluated for methodological quality and bias risk, and data were extracted. A meta-analysis was conducted on the primary outcomes, including peak tibial acceleration (PTA) and vertical ground reaction force. Subgroup analysis was performed by gender, feedback criterion, mode, dosage, fading, retention period, and running environment to evaluate the source of heterogeneity. Qualitative analysis was performed to describe other variables. RESULTS: Fourteen studies (174 participants) were eligible. Meta-analysis showed that real-time tibial acceleration feedback reduced PTA (P < .01, P < .01), vertical impact peak (P = .004, P < .01), vertical average loading rate (P < .01, P < .01), and vertical instantaneous loading rate (P < .01, P < .01) after feedback and during retention period (5 min-12 mo). Subgroup analysis showed that the immediate effect of vertical impact peak was more noticeable with mixed gender (P = .005) and fading feedback (P = .005) conditions, and the retention effect of PTA was more noticeable with high feedback dosage (P < .01) and fading feedback (P < .01) conditions. CONCLUSIONS: Real-time tibial acceleration feedback can reduce PTA and vertical ground reaction force during gait retraining, and for periods of 5 minutes to 12 months when the feedback is removed.

Interaction Between Obesity and Hypertension on Arteriosclerosis in Chinese Urban Adults: A Population-Based Cross-Sectional Study.

This study recruited 9,830 participants to identify whether the interaction between obesity and hypertension affects the occurrence of arteriosclerosis in Chinese adults. Brachial-ankle pulse wave velocity (baPWV) was measured to diagnose arteriosclerosis. Unconditional logistic regression was used for multiplicative interaction. The additive interaction was represented by relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy (S). Hypertension was an independent risk factor for baPWV (p < .01), but obesity was not (p = .08). The interaction between obesity and hypertension on arteriosclerosis was not multiplicative (adjusted odds ratio = 0.89 (0.79-1.01), p = .07), but a negative additive interaction (RERI = -4.33, AP = -2.91, S = 0.10; p < .01) exists. Therefore, obesity may reduce the risk of arteriosclerosis caused by hypertension when hypertension and obesity coexist, especially in women and middle-aged people, which supports the obesity paradox.

Observations on the kinematic characteristics of the healthy side of the knee in stroke patients: A cross-sectional study.

The abnormal gait of stroke patients not only severely limits the recovery of their walking ability, but also seriously affects their quality of daily life. Previous observational studies have focused too much on the observation of single degree of freedom and axial knee motion angles in stroke patients. Changes in the multi-degree of freedom and multi-axial joint angles of the knee have been less frequently observed, leading to somewhat limited conclusions. Therefore, the aim of this study was to use the Opti-knee motion test to analyze in real time the motion of the knee in all directions on the healthy side of stroke patients and to compare it with normal gait to provide a clinical basis for subsequent rehabilitation. In a cross-sectional study, 120 subjects (60 stroke patients were as the observation group and 60 healthy subjects as the control group) were studied. Both groups of subjects were tested for Opti-Knee tri-axial angles of motion of the healthy side of the knee, including flexion and extension, internal and external rotation, internal and external turning, anterior and posterior displacement, superior and inferior displacement, left and right displacement, maximum extension angle and maximum flexion angle. Compared with the control group, there were significant changes in the joint angles of flexion and extension, internal and external rotation, internal and external turning, maximum extension and maximum flexion of the knee on the healthy side in the observation group, and the differences were statistically significant [95%(37.22, 45.13), P = .01], [95%(9.51,13.67), P = .018], [95%(4.82,7.57), P = .049], [95%(4.12, 8.63), P = .019], [95%(51.68, 57.28), P = .0001]. However, there was no significant change in the angle of motion of the healthy side of the knee for anterior-posterior displacement, superior-inferior displacement and internal-external displacement in either group and the differences were not statistically significant [95%(1.16, 1.78), P = .72], [95%(0.85,1.32), P = .32], [95%(0.57, 0.88), P = .36]. This study confirms the importance of changes in the angle of motion of the knee on the side of the stroke patient in maintaining the stability of the knee joint. Therefore, their bilateral lower limb symmetry training should be paid attention to in the subsequent rehabilitation treatment.

Pulmonary Rehabilitation in Patients with COVID-19-A Protocol for Systematic Review and Meta-Analysis.

INTRODUCTION: Pulmonary rehabilitation (PR) is a well-established treatment for patients with chronic lung disease; however, its role in patients with COVID-19 has not been systematically studied. We provide a protocol outlining the methods and analyses that will be used in the systematic review. METHODS: The methodology of this systematic review protocol has been filed in PROSPERO under the registration number CRD42022301418. Five electronic databases (PubMed, Web of Science, Cochrane Library, EBSCO, and CNKI databases) will be searched from 2019 to 28 July 2022, using pre-determined search terms. Eligibility criteria will be defined using a PICOS framework. Pulmonary function, exercise capacity, and health-related quality of life will be the primary outcomes. Quantitative findings will be narratively synthesized, whilst argument synthesis combined with refutational analysis will be employed to synthesize qualitative data. RESULTS: The results will be presented by both meta-analysis and qualitative analysis. CONCLUSION: This protocol describes what will be the first systematic review to conduct a worldwide assessment of the effect of PR in patients with COVID-19. Because this is a systematic review and meta-analysis, no ethical approval is needed. The systematic review and meta-analysis will be published in a peer-reviewed journal and disseminated both electronically and in print.

The Effects of Breastfeeding for Four Months on Thinness, Overweight, and Obesity in Children Aged 3 to 6 Years: A Retrospective Cohort Study from National Physical Fitness Surveillance of Jiangsu Province, China.

Objective: To explore the effects of breastfeeding during the first four months of life on thinness, overweight, and obesity and to analyze the influential factors in children aged three to six years in eastern China. Methods: This study was designed as a retrospective cohort study, and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were followed. A total of 8053 subjects were included in this secondary analysis of data from the 2015 "Physical Fitness Surveillance data of Jiangsu, China". The subjects were classified into three groups on the basis of feeding patterns: breastfeeding, mixed feeding, and formula feeding. The International Obesity Task Force (IOTF) definitions of BMI were used to define thinness, overweight, and obesity. Multivariate logistic regression models and subgroup analysis were used to assess the association between feeding patterns and childhood thinness, overweight, obesity, and overweight/obesity, adjusted for potential confounders (sex, age grade, area, region/economy, gestational age, birthweight, childbearing age, mother's education, and caretaker). Results: The prevalence of breastfeeding was 63.8%, and the prevalence of thinness, overweight, obesity, and overweight/obesity reached 2.7%, 11.2%, 4.7%, and 15.9%, respectively. Breastfeeding participants had a lower risk of overweight and overweight/obesity with adjusted ORs of 0.652 (95% CI: 0.533, 0.797; p < 0.001) and 0.721 (95% CI: 0.602, 0.862; p < 0.001), respectively; however, there was no difference in thinness and obesity (both p > 0.05) compared with formula feeding. There was no statistical difference between mixed and formula feeding, in terms of thinness, overweight, obesity, or overweight/obesity (all p > 0.05). Subgroup analysis showed that breastfeeding for three years, preterm, and a childbearing age of 25−29 years had higher adjusted ORs for thinness, and in 5−6 years, urban areas, southern/developed economy regions, post-mature, childbearing age ≥ 25 years, and other caretakers had higher and invalid breastfeeding-adjusted ORs (all p > 0.05 except overweight in the urban grade) for both overweight and overweight/obesity. Conclusions: Breastfeeding during the first four months was not associated with the thinness of children aged 3−6 years in eastern China, and the protective effect of breastfeeding against overweight or overweight/obesity could be confirmed. However, the effects of breastfeeding on thinness, overweight, and obesity may change or become invalid in some subgroups, suggesting that there may be potential interactions between feeding patterns and influential factors.

Comparison of Five Expressions of Handgrip Strength for Predicting Cardiovascular Disease Risk Factors in Chinese Middle-Aged Community Residents.

Objective: To compare the predictive performance of five handgrip strengths for cardiovascular disease (CVD) risk factors. Methods: A total of 804 Chinese middle-aged community residents' health medical examinations were collected. The absolute handgrip strength was denoted as HGS. HGS/body weight (HGS/BW), HGS/body mass index (HGS/BMI), HGS/lean body mass (HGS/LBM), and HGS/muscle mass (HGS/MM) represented relative handgrip strength (RHGS). To assess predictive performance, receiver operating characteristic (ROC) curves and the area under the curve (AUC) were constructed. Results: HGS was not associated with most CVD risk biomarkers; however, RHGS showed a negative correlation trend after controlling for covariates (sex, age, smoking, and exercise). HGS/BMI and HGS/BW had better AUCs for predicting CVD risk factors than HGS/LBM or HGS/MM. HGS/BMI and HGS/BW can successfully predict all CVD risk factors in men with AUCs 0.55-0.65; similarly, women may effectively predict arteriosclerosis, hyperglycemia, hyperuricemia, and metabolic syndrome with AUCs 0.59-0.64, all p < 0.05. The optimal HGS/BW cut-off points for identifying different CVD risk factors were 0.59-0.61 in men and 0.41-0.45 in women, while the HGS/BMI were 1.75-1.79 in men and 1.11-1.15 in women. Conclusions: Almost all CVD risk biomarkers and CVD risk factors were unrelated to HGS. There is, however, a significant inverse relationship between RHGS and CVD risk factors. HGS/BMI or HGS/BW should be recommended to be the best choice for predicting the risk of CVD risk factors in five expressions of handgrip strength. We also acquired the recommended optimal cut-off points of HGS/BMI and HGS/BW for predicting CVD risk factors.

Clinical observation of Long chiropractic treatment on patients with neurogenic cervical spondylosis: Study protocol for a randomized controlled trial.

ABSTRACT: Neurogenic cervical spondylosis is the most common type of cervical spondylosis, accounting for approximately 60% percent of the incidence of cervical spondylosis. Cervical spine Long manipulation and sling exercise training (SET) have obtained good therapeutic results in clinical rehabilitation. The aim of this study was to evaluate the effect of Long manipulation combined with SET on neurogenic cervical spondylosis. In this assessor-blind, randomized controlled trial, 90 eligible patients will be randomized into a combination treatment group (Long manipulation combined with SET), a Long manipulation group and a conventional massage group. The visual analogue score, the Neck Disability Index score, and muscle fatigue in the bilateral upper oblique and Musculus sternocleidomastoideus, using mean power frequency and median frequency from the surface electromyography frequency domain index, will be assessed before and after the intervention at 0 and 4 weeks, respectively.Trial registration: Registered in the Chinese Clinical Trial Registration Center with the number ChiCTR2100054978. Registered December 30, 2021.

A new non-randomized model for analysing sensitive questions with binary outcomes.

We propose a new non-randomized model for assessing the association of two sensitive questions with binary outcomes. Under the new model, respondents only need to answer a non-sensitive question instead of the original two sensitive questions. As a result, it can protect a respondent's privacy, avoid the usage of any randomizing device, and be applied to both the face-to-face interview and mail questionnaire. We derive the constrained maximum likelihood estimates of the cell probabilities and the odds ratio for two binary variables associated with the sensitive questions via the EM algorithm. The corresponding standard error estimates are then obtained by bootstrap approach. A likelihood ratio test and a chi-squared test are developed for testing association between the two binary variables. We discuss the loss of information due to the introduction of the non-sensitive question, and the design of the co-operative parameters. Simulations are performed to evaluate the empirical type I error rates and powers for the two tests. In addition, a simulation is conducted to study the relationship between the probability of obtaining valid estimates and the sample size for any given cell probability vector. A real data set from an AIDS study is used to illustrate the proposed methodologies.