"Balancing work and movement": barriers and enablers for being physically active at Indian workplaces - findings from SMART STEP trial.

BACKGROUND: Non-communicable diseases are rising rapidly in low- and middle-income countries, leading to increased morbidity and mortality. Reducing sedentary behavior (SB) and increasing physical activity (PA) offer numerous health benefits. Workplaces provide an ideal setting for promoting SB/PA interventions; however, understanding the barriers and enablers is crucial for optimizing these interventions in workplace environments. METHODS: Nested within a cluster randomised controlled trial (the SMART-STEP trial), the present study employed in-depth interviews with 16 office workers who have completed 24 weeks of two distinct (technology assisted and traditional) workplace SB/PA interventions. Using a deductive analysis, semi-structured interviews were administered to explore the barriers and enablers to the SB/PA interventions at individual, interpersonal and organisational level using the socio-ecological model. RESULTS: Several individual (poor goal setting, perceived health benefits & workload, attitude, intervention engagement), interpersonal (lack of peer support) and organisational (task prioritisation, lack of organisational norm and material or social reward) barriers were identified. Indian women engaged in desk-based office jobs often find themselves burdened with intense home and childcare responsibilities, often without sufficient support from their spouses. A primary concern among Indian office workers is the poor awareness and absence of cultural norms regarding the health risks associated with SB. CONCLUSIONS: Raising awareness among workplace stakeholders-including office workers, peers, and the organization-is crucial before designing and implementing SB/PA interventions in Indian workspaces. Personalized interventions for Indian female office workers engaged in desk-bound work are warranted.

Sedentary and physical activity time differs between self-reported ATLS-2 physical activity questionnaire and accelerometer measurements in adolescents and young adults in the United Arab Emirates.

BACKGROUND: Most young adults and adolescents in the United Arab Emirates (UAE) do not meet the established internationally recommended physical activity levels per day. The Arab Teen Lifestyle Study (ATLS) physical activity questionnaire has been recommended for measuring self-reported physical activity of Arab adolescents and young adults (aged 14 years to mid-twenties). The first version of the ATLS has been validated with accelerometers and pedometers (r ≤ 0.30). The revised version of the questionnaire (ATLS-2, 2021) needs further validation. The aim of this study was to validate the self-reported subjective sedentary and physical activity time of the ATLS-2 (revised version) physical activity questionnaire with that of Fibion accelerometer-measured data. METHODS: In this cross-sectional study, 131 healthy adolescents and young adults (aged 20.47 ± 2.16 [mean ± SD] years (range 14-25 years), body mass index 23.09 ± 4.45 (kg/m2) completed the ATLS-2 and wore the Fibion accelerometer for a maximum of 7 days. Participants (n = 131; 81% non-UAE Arabs (n = 106), 13% Asians (n = 17) and 6% Emiratis (n = 8)) with valid ATLS-2 data without missing scores and Fibion data of minimum 10 h/day for at least 3 weekdays and 1 weekend day were analyzed. Concurrent validity between the two methods was assessed by the Spearman rho correlation and Bland-Altman plots. RESULTS: The questionnaire underestimated sedentary and physical activity time compared to the accelerometer data. Only negligible to weak correlations (r ≤ 0.12; p > 0.05) were found for sitting, walking, cycling, moderate intensity activity, high intensity activity and total activity time. In addition, a proportional/systematic bias was evident in the plots for all but two (walking and moderate intensity activity time) of the outcome measures of interest. CONCLUSIONS: Overall, self-reported ATLS-2 sedentary and physical activity time had low correlation and agreement with objective Fibion accelerometer measurements in adolescents and young adults in the UAE. Therefore, sedentary and physical activity assessment for these groups should not be limited to self-reported measures.

Perception and knowledge of learners about the use of 3D technologies in manual therapy education - a qualitative study.

OBJECTIVES: Manual therapy is a specific hands-on approach used and taught by various professions such as physiotherapy and osteopathy. The current paradigm of teaching manual therapy incorporates the traditional 'See one, do one, teach one' approach. However, this 'teacher centred' approach may not enable learners to develop the complex clinical skills of manual therapy. In this context, 3D technologies such as virtual reality may facilitate the teaching and learning of manual therapy. Hence the aim of the current study was to investigate the perception, knowledge and attitude of manual therapy learners about the use of 3D technologies in manual therapy education. METHODS: An exploratory qualitative research design using semi-structured interviews was used in this study. A total of ten manual therapy (5 physiotherapy and 5 osteopathic) students (mean age = 32; 80% female) enrolled in an appropriate physiotherapy or osteopathic degree provided by a New Zealand recognized institution (e.g., university or polytechnic) participated in this study. Data saturation was achieved after 10 interviews (average duration: 35 min) that provided thick data. A thematic analysis was used for data analysis. RESULTS: Six factors were identified which appeared to influence participants' perception of role of technology in manual therapy education. These were (1) the sufficiency of current teaching method; (2) evolution as a learner (a novice to an expert); (3) need for objectivity; (4) tutor feedback; (5) knowledge and (6) barriers and enablers. These six factors influenced the participants' perception about the role of 3D technologies in manual therapy education with participants evidently taking two distinct/polarized positions ('no role' (techstatic) versus a 'complete role' (techsavvy)). CONCLUSION: Although 3D technology may not replace face-to-face teaching, it may be used to complement the traditional approach of learning/teaching to facilitate the learning of complex skills according to the perceptions of manual therapy learners in our study. The advantage of such an approach is an area of future research.

Do kinematic measures, added to clinical measures, better predict upper extremity motor impairments at three months post-stroke?

OBJECTIVE: Predicting post-stroke recovery through prediction models is crucial for choosing appropriate treatment options. However, the existing models predominantly incorporate clinical measures although measurement of movement quality using kinematic measures is essential for distinguishing various types of recovery. Thus, this study aimed at determining if, by considering varied aspects of recovery, adding kinematic measurements over clinical measures would better predict upper extremity (UE) motor impairments at three months post-stroke. MATERIALS AND METHODS: Eighty-nine stroke survivors (58.9 ± 11.8 years) were assessed for clinical predictors between 4 and 7 days, kinematic predictors within 1 month, and the impairment outcome of the Fugl Meyer Assessment of the UE (FM-UE) at three months post-stroke. Significant predictors (p<0.05) with a variation inflation factor (VIF) <10 were selected for model development. After performing further step-wise selection, three models incorporating clinical outcomes, kinematic measurements, and a combination of these two, respectively, were formulated. RESULTS: The clinical model (R2 = 0.70) included shoulder abduction finger extension (SAFE) scores, the National Institutes of Health Stroke Scale (NIHSS), and the Montreal Cognitive Assessment (MoCA). The kinematic model (R2 = 0.34) included total displacement, total time, and reaction time. The combined model (R2 = 0.72) comprised of SAFE score and shoulder flexion. All the models had a minimal mean squared error on cross validation, which indicated a good validity. CONCLUSION: The performance of clinical and combined prediction models for predicting three-month post-stroke UE motor recovery was nearly similar. However, in order to detect minimal changes over time and to understand all aspects of motor recovery, there is a need to add instrument-based kinematic measures.

Comparative effects of tensioning and sliding neural mobilization on peripheral and autonomic nervous system function: A randomized controlled trial.

Background: Although different types of neural mobilization (NM) exercises induce different amounts of longitudinal nerve excursion and strain, the question whether the increased longitudinal stress and nerve excursion from sliding or tensioning intervention may subtly affect the neural functions has not been answered yet. Objective: To compare the effects of tensioning NM versus sliding NM of the median nerve on peripheral and autonomic nervous system function. Methods: In this randomized controlled trial, 90 participants were randomly assigned to tensioning NM, sliding NM, or sham NM. The neurophysiological outcome measures included peak-to-peak amplitude of the dermatomal somatosensory evoked potential (DSSEP) for dermatomes C6, C7, C8, and T1. Secondary outcome measures included amplitude and latency of skin sympathetic response. All outcome measures were assessed pretreatment, immediately after the two weeks of treatment and one week after the last session of the treatment. Results: A 2-way repeated measures ANOVA revealed significant differences between the three groups. The post hoc analysis indicated that tensioning NM significantly decreased the dermatomal amplitude for C6, C7, C8, and T1 ( p < 0 . 005 ). Sympathetic skin responses in the gliding NM group showed lower amplitudes and prolonged latencies post-treatment when compared to tensioning NM group ( p < 0 . 05 ). In contrast, no significant changes were observed in the DSSEPs and skin sympathetic responses for participants in the sham treatment group ( p > 0 . 05 ). Conclusions: A tensioning NM on the median nerve had a possible adverse effect on the neurophysiology variables of the nerves involved in the neural mobilization. Thus, tensioning NM with the current parameters that place increased stress and strain on the peripheral nervous system should be avoided.

Does breaking up prolonged sitting improve cognitive functions in sedentary adults? A mapping review and hypothesis formulation on the potential physiological mechanisms.

BACKGROUND: Prolonged (excessive) sitting is detrimentally associated with cardiovascular, metabolic and mental health. Moreover, prolonged sitting has been associated with poor executive function, memory, attention and visuospatial skills, which are important cognitive aspects of work performance. Breaking up prolonged sitting with standing or light-intensity exercises at the workplace is recognized as a potential measure in improving cognition. However, preliminary evidence, primarily from acute laboratory experiments, has enabled formulating hypothesis on the possible mechanistic pathways. Hence, the aim of this mapping review is to gather preliminary evidence and substantiate possible physiological mechanisms underpinning the putative effects of breaking prolonged sitting on improving cognitive function among sedentary office workers. MAPPING METHOD: We searched four databases to identify relevant studies that explored the effects of uninterrupted sitting on cognitive function. First, we introduce how prolonged sitting increases the risks of hyperglycemia, autonomic stability, inflammation, adverse hormonal changes and restrictions in cerebral blood flow (CBF) and alters cognitive function. Second, we elucidate the direct and indirect effects of breaking up prolonged sitting time that may prevent a decline in cognitive performance by influencing glycaemic variability, autonomic stability, hormones (brain derived neurotrophic factor, dopamine, serotonin), vascular functions, and CBF. We highlight the importance of breaking up prolonged sitting on metabolic, vascular and endocrine functions, which in turn may improve cognitive functions and eventually foster work productivity. Improved synaptic transmission or neuroplasticity due to increased brain glucose and mitochondrial metabolism, increased endothelial shear and CBF, increased brain neurotrophic factors (dopamine) and accelerated anti-inflammatory functions are some of the hypothetical mechanisms underpinning improved cognitive functions. CONCLUSION: We postulate that improving cognitive function by breaking up prolonged sitting periods is biologically plausible with the myriad of (suggested) physiological mechanisms. Future experimental studies to ascertain the aforementioned hypothetical mechanisms and clinical trials to break sedentary behavior and improve cognitive functions in sedentary office workers are warranted.

Effect of robotic-assisted gait training on objective biomechanical measures of gait in persons post-stroke: a systematic review and meta-analysis.

BACKGROUND: Robotic-Assisted Gait Training (RAGT) may enable high-intensive and task-specific gait training post-stroke. The effect of RAGT on gait movement patterns has however not been comprehensively reviewed. The purpose of this review was to summarize the evidence for potentially superior effects of RAGT on biomechanical measures of gait post-stroke when compared with non-robotic gait training alone. METHODS: Nine databases were searched using database-specific search terms from their inception until January 2021. We included randomized controlled trials investigating the effects of RAGT (e.g., using exoskeletons or end-effectors) on spatiotemporal, kinematic and kinetic parameters among adults suffering from any stage of stroke. Screening, data extraction and judgement of risk of bias (using the Cochrane Risk of bias 2 tool) were performed by 2-3 independent reviewers. The Grading of Recommendations Assessment Development and Evaluation (GRADE) criteria were used to evaluate the certainty of evidence for the biomechanical gait measures of interest. RESULTS: Thirteen studies including a total of 412 individuals (mean age: 52-69 years; 264 males) met eligibility criteria and were included. RAGT was employed either as monotherapy or in combination with other therapies in a subacute or chronic phase post-stroke. The included studies showed a high risk of bias (n = 6), some concerns (n = 6) or a low risk of bias (n = 1). Meta-analyses using a random-effects model for gait speed, cadence, step length (non-affected side) and spatial asymmetry revealed no significant differences between the RAGT and comparator groups, while stride length (mean difference [MD] 2.86 cm), step length (affected side; MD 2.67 cm) and temporal asymmetry calculated in ratio-values (MD 0.09) improved slightly more in the RAGT groups. There were serious weaknesses with almost all GRADE domains (risk of bias, consistency, directness, or precision of the findings) for the included outcome measures (spatiotemporal and kinematic gait parameters). Kinetic parameters were not reported at all. CONCLUSION: There were few relevant studies and the review synthesis revealed a very low certainty in current evidence for employing RAGT to improve gait biomechanics post-stroke. Further high-quality, robust clinical trials on RAGT that complement clinical data with biomechanical data are thus warranted to disentangle the potential effects of such interventions on gait biomechanics post-stroke.

Down syndrome-A narrative review with a focus on anatomical features.

Down syndrome (DS) is the most common aneuploidy of chromosome 21, characterized by the presence of an extra copy of that chromosome (trisomy 21). Children with DS present with an abnormal phenotype, which is attributed to a loss of genetic balance or an excess dose of chromosome 21 genes. In recent years, advances in prenatal screening and diagnostic tests have aided in the early diagnosis and appropriate management of fetuses with DS. A myriad of clinical symptoms resulting from cognitive, physical, and physiological impairments caused by aberrations in various systems of the body occur in DS. However, despite these impairments, which range from trivial to fatal manifestations, the survival rate of individuals with DS has increased dramatically from less than 50% during the mid-1990s to 95% in the early 2000s, with a median life expectancy of 60 years reported recently. The aim of this narrative review is to review and summarize the etiopathology, prenatal screening and diagnostic tests, prognosis, clinical manifestations in various body systems, and comorbidities associated with DS. Clin. Anat. 29:568-577, 2016. © 2015 Wiley Periodicals, Inc.

Acute neuromuscular responses to whole-body vibration in healthy individuals: A systematic review.

Whole-body vibration (WBV) training has been employed alongside conventional exercise like resistance training to enhance skeletal muscle strength and performance. This systematic review examines the evidence regarding the effect of WBV on muscle activity, strength, and performance in healthy individuals. The Academic Search Ultimate, CINAHL, Cochrane CENTRAL, PubMed, ProQuest One Academic and SCOPUS databases were searched from 1990 to April 2023 to retrieve relevant studies. Methodological quality was assessed using the Modified Downs and Black checklist, while the level of evidence was evaluated through the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool. Even though the quality of the included studies was moderate to high, the level of evidence was very low owing to serious concerns with three or more GRADE domains (risk of bias, inconsistency, indirectness, imprecision, and publication bias) for each outcome of interest across studies. The review suggests that in WBV training, using moderate to high vibration frequencies (25-40 Hz) and high magnitudes (3-6 mm) can enhance muscle activation and strength in pelvis and lower limb muscles. However, findings regarding WBV effect on muscle performance measures were inconsistent. Future research with robust methodology is necessary in this area to validate and support these findings.

Transmission of fore-and-aft floor vibration to the spine and head of standing people.

Sixteen standing male participants were subjected to fore-and-aft sinusoidal vibration with peak magnitude and frequency in the range 0.44-4.431 ms-2 and 2-6 Hz, respectively. The fore-and-aft, lateral and vertical transmissibilities to the first dorsal vertebra (T1), eighth dorsal vertebra (T8), twelfth dorsal vertebra (T12), fourth lumbar vertebra (L4) and head were measured. Large inter-participant variability was observed in the transmissibilities at all locations. Nevertheless, peaks in the range 3-4.5 Hz were identified at all locations, implying a whole-body resonance in this frequency range. The response was found dominant in the mid-sagittal plane as the lateral transmissibility showed low values. Below 4.5 Hz, the fore-and-aft transmissibility increased with moving from caudal to cranial locations of the upper body. However, at higher frequencies, the opposite trend was observed. The results can be used for developing models that may help understand how vibration affects health and comfort.

Prevalence of peripheral arterial disease among individuals with type 2 diabetes mellitus in India - A systematic review and meta-analysis.

BACKGROUND: Peripheral arterial disease (PAD) is a prevalent complication of type 2 diabetes mellitus (T2DM). As India ranks second in the population afflicted by T2DM, and the objective of this systematic review was to estimate the pooled prevalence of PAD in individuals living with T2DM in India. METHODS: Five databases (Cochrane (CENTRAL), MEDLINE (via PubMed), CINAHL (via EBSCO), PEDro, and Scopus) were searched using database-specific search terms from inception to August 2023. Inclusion criteria included studies reporting the prevalence of PAD in Indian adults diagnosed with T2DM of either or both sexes, employing ankle brachial index measurements with a Doppler test or sphygmomanometer. The risk of bias was evaluated using the JBI checklist, and the certainty of evidence was determined via the GRADE approach. RESULTS: Twenty-three articles met the inclusion criteria which comprised of 196,883 individuals with T2DM aged between 30 and 70 years from nine states and one union territory. Utilizing a random effects model, the meta-analysis revealed that the pooled prevalence of PAD among individuals with T2DM in India was 18 % (95 % confidence interval: 10-28 %), with statistically significant heterogeneity observed between studies (I2 = 100 %, P < 0.001). Overall certainty in the evidence was low. CONCLUSION: The combined prevalence of PAD among individuals with T2DM in India is 18 %, indicating a significant portion of the Indian population has been affected. Epidemiological studies utilizing precise assessment tools can enhance the early detection and prevention of PAD in T2DM and improve the certainty of findings.

Are accelerometer-measured sitting and physical activity times associated with muscle mass and strength in healthy young adults in the UAE?

Background: A high prevalence of obesity, sedentary behavior, and physical inactivity could affect muscle mass and strength in young adults in the United Arab Emirates (UAE). Therefore, we investigated the association of sex, body mass index (BMI), and accelerometer-measured sitting and physical activity (PA) times with skeletal muscle mass index (SMI), hand grip, and thigh muscle strength in healthy young adults in the UAE. Methods: In this cross-sectional study, 156 healthy young adults (age 21.68 ± 3.01 years, BMI 25.40 ± 4.79 kg/m2, 52.6 % women) were included. BMI and muscle mass were recorded using a bioelectrical impedance analyzer. Maximum hand grip strength and thigh muscle torque were assessed using the Jamar-smart hand-dynamometer and Biodex System-4-Pro, respectively. Participants wore a triaxial Fibion accelerometer on their anterior thigh for >10 h per day for 4-7 days to measure their sitting and PA times. Multiple linear regression analyses were used. Results: Participants spent most of their time sitting (11.37 ± 1.10 h), followed by standing (2.92 ± 0.86 h), walking (1.58 ± 0.55 h), and vigorous intensity PA (4.79 ± 5.85 min) per 16-h day. Sex (p < 0.001) and BMI (p < 0.001) were negatively associated with all muscle mass and strength variables. Men had more muscle mass and strength than women. As BMI increased, muscle mass and muscle strength decreased. Accelerometer-measured sitting and walking times were negatively associated with concentric hamstrings (p = 0.044) and quadriceps torques (p = 0.031), respectively. Conclusion: Sex, BMI, and accelerometer-measured sitting and walking times were associated with muscle mass and/or muscle strength in healthy young adults. Women and those with a high BMI need interventions to improve their muscle mass and strength. The paradox regarding the association of PA with muscle mass and strength in younger adults may be due to possible influences from other factors (e.g., resistance training, dietary intakes, etc.) superseding that of accelerometer-measured PA.

Association of accelerometer measured sedentary behavior patterns with cognitive functions in sedentary office workers: Insights from SMART-STEP study.

BACKGROUND: High levels of sedentary behavior in workplaces are currently recognized as an independent risk factor for cognitive dysfunction and poor mental health. However, sedentary patterns vary between workdays and non-workdays, which may influence cognitive functions. OBJECTIVE: The present study aimed to quantify and compare work and nonwork device-measured sedentary time (ST) and its association with cognitive function in Indian office workers. METHODS: In an ongoing randomized controlled trial (SMART-STEP), the baseline data of 136 full-time office workers, including accelerometer-measured sedentary patterns and cognitive functions, were analyzed. The ST was measured using a hip-worn accelerometer (Actigraph wGT3X-BT) for seven days, and executive functions were measured using computer-based tests. Linear regression models were employed to analyze the relationships between ST and executive function measures. RESULTS: The median daily ST of Indian office workers was 11.41 hours. The ST was greater on both workdays (11.43 hrs.) and non-workdays (11.14 hrs.) though different (F = 6.76, p = 0.001, ηp2 = 0.032). Office workers accumulate more prolonged sitting bouts (+21.36 min) during work days than non-workdays. No associations between device-measured ST and executive functions were observed. CONCLUSION: Indian office workers exhibited high ST patterns, especially on workdays. Although lower than workdays, Indian office workers exhibited more ST patterns during non-workdays than did their Western counterparts. Culturally adaptable workplace and leisure time physical activity interventions are needed to address the high ST of Indian office workers.

Night Screen Time is Associated with Cognitive Function in Healthy Young Adults: A Cross-Sectional Study.

Background: In recent years, a significant shift toward remote work, virtual education, and social distancing measures was witnessed, thereby leading people to increasingly depend on digital devices for communication, work, and entertainment. This increased exposure to screens has raised concerns regarding its potential impact on cognitive function. Purpose: This study investigated the relationship between screen time and cognitive function among healthy young adults. Methods: One hundred forty-five healthy individuals (mean age 21.55 ± 2.84 years) participated in this cross-sectional study. Sociodemographic information including age, sex, height, weight, and level of education were obtained. Participants reported screen time using a screen time questionnaire. Cognitive function tests including, Paced Auditory Serial Addition Task (PASAT), Montreal Cognitive Assessment (MoCA) and Symbol Digit Modalities Test (SDMT) were conducted. Multilinear regression analyses were used to examine the associations between age, sex, level of education, screen time, and cognitive function. Results: One hundred thirty-nine participants (76 women) completed the study. Increased night screen time, bachelor's educational level, and women were associated with lower PASAT scores (R2=0.258; p≤0.047). Moreover, increased night screen time was associated with lower MoCA scores (R2=0.029; p=0.035). However, no associations were found between night screen time and SDMT scores. Conclusion: Participants who had higher night screen exposure had lower cognitive scores in the information speed processing, working memory, calculation, and attention domains. Considering these findings, this study emphasizes on the importance of setting a future recommended screen time guidelines for young adults as well as to promote healthy cognitive habits in order to preserve cognitive function and reduce the risk of developing neurodegenerative disease in the future. Future prospective cohort studies involving a more diverse age range is needed.

Health and fitness trends in the post-COVID-19 era in the United Arab Emirates: A cross-sectional study.

The health and fitness (H&F) sector is rapidly evolving and appears to be a vibrant space for industry stakeholders with a great potential globally. This observational study aimed to identify the most popular trends related to H&F services in the United Arab Emirates (UAE) for the first time, focused on the industry status after the coronavirus (COVID-19) pandemic, and aimed to detect potential differences with the recent results observed in other countries or regions. Additionally, a chi-square analysis was applied to determine the significant differences between trends and demographics, such as sex, age, experience, and work status. A national online survey was conducted, and applied the methodology of similar international surveys that have been carried out by the American College of Sports Medicine since 2006. In particular, simple random sampling was utilized through an online questionnaire sent to 2771 professionals involved in the UAE's H&F sector. In total, 322 responses were collected with a response rate of 11.6%. The 10 most popular H&F trends in the UAE during the post-COVID-19 era were exercise for weight loss, personal training, traditional strength training, employing certified exercise professionals, boxing, kickboxing, mixed martial arts, youth athletic development, high-intensity interval training, massage, bodyweight training, and wearable technologies. Exercise for weight loss (p = 0.001) and lifestyle medicine (p = 0.032) were more popular among females compared to males, while traditional strength training (p = 0.035) was reported more frequently by males. Going to health clubs and spas (p = 0.001) and practicing yoga (p = 0.011) were more popular trends among middle-aged (36-64 years) respondents compared to young ones (18-34 years). Athletic development (p = 0.042) was more frequently reported by non-practitioners (students) compared to practitioners (part- and full-time employees). The present results are partially in line with those reported in other recent national, regional, and global surveys, which investigated the top H&F trends after the COVID-19 pandemic. Importantly, the main outcomes of this study indicate that the industry stakeholders should focus on in-person H&F services since trends related to technology and digital services are not currently popular nationwide. Moreover, the majority of the top trends were more traditional and rooted activities, which showed that the current status of the H&F sector has established particular training services, programs, and products in the UAE.

Association of sociodemographic, anthropometric, and sleep quality factors with accelerometer-measured sitting and physical activity times among Emirati working women during the COVID-19 pandemic: A cross-sectional study.

BACKGROUND: Although a significant lack of physical activity has been linked to an increase in obesity among Emirati women, the factors associated with accelerometer-measured sitting and physical activity times in Emirati women remain unclear. OBJECTIVES: To explore the association of accelerometer-measured sitting and physical activity times with sociodemographic, anthropometric, and sleep quality factors among Emirati working women. DESIGN: A cross-sectional study. METHODS: A convenience sample of 163 healthy working Emirati women aged 18-45 years was used. Sedentary and physical activity times were measured using the Fibion accelerometers worn on the thighs for 4-7 days. General demographic information, anthropometric measurements, and self-reported sleep quality (Pittsburgh sleep quality index score) were collected. Only participants who had valid data (i.e. wear time of ⩾600 min (10 h) per day for a minimum of 4-7 days) were evaluated. All values were normalized to a 16-h day to mitigate differences in wear time among the participants. RESULTS: Overall, 110 Emirati women were included. The mean sitting time per 16-h day was 11.6 ± 1.1 h; mean moderate activity time per day, 40.88 ± 17.99 min; and mean vigorous activity time per day, 2.41 ± 1.21 min. Longer sitting time was associated with high body fat, secondary education, and divorce. Sitting time was reduced in those with good sleep quality. Moderate-to-vigorous physical activity time was increased in women with postgraduate education and was decreased in women with a longer work experience and with comorbidities. The total activity time increased with increasing age and good sleep quality, whereas it decreased with increasing body fat, presence of at least one comorbidity, secondary education, and divorce. CONCLUSION: Certain demographic, anthropometric, and sleep quality factors were associated with accelerometer-measured sitting and physical activity times among Emirati working women. Future longitudinal studies should consider these factors when investigating predictors of physical activity levels in this population.

'I Do Not Want to Share My Pain With Anyone'-Coping With the Invisible Burden. A Qualitative Description of the Lived Experiences of Individuals With Rotator Cuff Related Shoulder Pain in an Indian Setting.

BACKGROUND: Rotator cuff related shoulder pain (RCRSP) significantly impacts the physical, and psychosocial well-being of an individual. While studies of lived experiences with shoulder pain were conducted in Western (developed countries) contexts, understanding such experiences in low-to middle-income countries such as India remains limited. OBJECTIVE: This study explores and describes the lived experiences of individuals with RCRSP in Indian settings. METHODS: A phenomenological approach explored the lived experience of individuals with RCRSP in South India. Ten participants with RCRSP (7 men and 3 women) with mean duration of symptoms ranging between 3 and 24 months were interviewed individually using a semi-structured guide with inductive thematic analysis. Participants also completed the Disabilities of the Shoulder Arm and Hand (DASH) questionnaire for upper limb function. Interviews were audio recorded and transcribed verbatim. RESULTS: Three themes that emerged from the interviews were 'The multidimensional burden of RCRSP', 'Navigating the treatment journey between trust and uncertainties', and 'Pathway of healing: Coping with the invisible burden'. Shoulder pain significantly impacted activities, family, and volunteering roles. The majority of the suffering and expression of pain were hidden and influenced by cultural and societal norms. There was a strong belief in the body's ability to heal and acceptance of Eastern and Western treatment approaches. CONCLUSION: The findings highlight the need for a holistic management strategy that effectively addresses physical impairments, psychosocial support, and cultural beliefs to manage RCRSP in such settings.

Effectiveness of an Intensive, Functional, and Gamified Rehabilitation Program on Upper Limb Function in People With Stroke (EnteRtain): A Multicenter Randomized Clinical Trial.

BACKGROUND1: Despite a growing interest in gaming rehabilitation for upper limb (UL) recovery post-stroke, studies investigating the effects of game-based rehabilitation incorporating functional games are lacking. OBJECTIVE: To investigate the efficacy of an intensive, functional, gamified rehabilitation program compared to task-based training on UL motor function in acute/sub-acute stroke survivors. METHODS: This randomized, multicenter, single-blind, clinical trial comprises 120 participants with unilateral stroke who were randomized to receive either gamified training (n = 64) using the ArmAble™ [experimental group (EG)] or task-based training (n = 56) in conjunction with conventional therapy for 2 hours per day, 6 days per week for 2 weeks, followed by UL rehabilitation for another 4 weeks at home. Primary outcomes evaluated by a blinded assessor included the Fugl-Meyer Assessment-Upper Extremity (FM-UE), and Action Research Arm Test (ARAT). Data were analyzed using a linear mixed-effect regression model. RESULTS: The mean (standard deviation) age of the participants was 54.4 ± 11.7 years (78.1% men) in the EG and 57.7 ± 10.9 years (73.2% men) in the comparator group (CG). The median (interquartile range) time since stroke was 30.0 (54.0) days in the EG and 22.5 (45.0) days in the CG. Following the 2-week intervention, a statistically significant improvement was observed in the EG for the FM-UE [between-group mean differences (95% confidence interval): -3.9 (-6.5, -1.3); P = .003]; but not for the ARAT [-2.9 (-5.8, 0.0); P = .051]. Gains at 6 weeks were significantly greater in the EG for both FM-UE [-3.9 (-6.5, -1.3); P = .003]; and ARAT [-3.0 (-5.9, -0.0); P = .046]. CONCLUSION: Gamified rehabilitation using the ArmAble™ device has shown immediate and short-term improvement in UL function after acute/sub-acute stroke. CLINICAL TRIALS REGISTRY NUMBER: CTRI/2020/09/027651.

Concurrent validity between self-reported International Physical Activity Questionnaire Short Form and Fibion accelerometer data among young adults in the UAE.

Self-reported physical activity questionnaires (e.g., International Physical Activity Questionnaire, IPAQ) are a cost-effective, time-saving, and accessible method to assess sedentary behaviour and physical activity. There are conflicting findings regarding the validity of self-reported questionnaires in comparison to accelerometer-measured data in a free-living environment. This study aimed to investigate the concurrent validity between self-reported Arabic-English IPAQ short form (IPAQ-SF) and Fibion (Fibion Inc., Jyväskylä, Finland) accelerometer-measured sedentary and physical activity time among young adults. One hundred and one young healthy adults (mean age 20.8 ± 2.4 years) filled in the IPAQ short form (IPAQ-SF) and wore the Fibion device on the anterior thigh for ≥ 600 min per day for 4-7 days. Concurrent validity between the IPAQ-SF and Fibion accelerometer for sitting, walking, moderate activity, and vigorous activity time was assessed using the Spearman correlation coefficient ( ρ ) and Bland-Altman plots. Significant weak associations between IPAQ-SF and Fibion measurements were found for total activity time ( ρ = 0.4; P < 0.001) and for the duration of walking ( ρ = 0.3; P = 0.01), moderate ( ρ = 0.2; P = 0.02), and vigorous-intensity activities ( ρ = 0.4; P < 0.001). However, ρ was not significant ( ρ = - 0.2; P = 0.09) for sitting time. In addition, all the plots of the measured variables showed a proportional bias. A low association and agreement were found between self-reported IPAQ-SF scores and Fibion accelerometer measurements among young adults in the UAE. Adult sedentary and physical activity measurements should be obtained objectively with accelerometers rather than being limited to self-reported measures.

Test-Retest Reliability of a Passive Joint Position Sense Test After ACL Reconstruction: Influence of Direction, Target Angle, Limb, and Outcome Measures.

Background: The joint position sense (JPS) is an element of proprioception and defined as an individual's ability to recognize joint position in space. The JPS is assessed by measuring the acuity of reproducing a predetermined target angle. The quality of psychometric properties of knee JPS tests after anterior cruciate ligament reconstruction (ACLR) is uncertain. Purpose/Hypothesis: The purpose of this study was to evaluate the test-retest reliability of a passive knee JPS test in patients who underwent ACLR. We hypothesized that the passive JPS test would produce reliable absolute error, constant error, and variable error estimates after ACLR. Study Design: Descriptive laboratory study. Methods: Nineteen male participants (mean age, 26.3 ± 4.4 years) who had undergone unilateral ACLR within the previous 12 months completed 2 sessions of bilateral passive knee JPS evaluation. JPS testing was conducted in both the flexion (starting angle, 0°) and the extension (starting angle, 90°) directions in the sitting position. The absolute error, constant error, and variable error of the JPS test in both directions were calculated at 2 target angles (30° and 60° of flexion) by using the angle reproduction method for the ipsilateral knee. The standard error of measurement (SEM), smallest real difference (SRD), and intraclass correlation coefficients (ICCs) with 95% Cis were calculated. Results: ICCs were higher for the JPS constant error (operated and nonoperated knee, 0.43-0.86 and 0.32-0.91, respectively) compared with the absolute error (0.18-0.59 and 0.09-0.86, respectively) and the variable error (0.07-0.63 and 0.09-0.73, respectively). The constant error of the 90°-60° extension test showed moderate to excellent reliability for the operated knee (ICC, 0.86 [95% CI, 0.64-0.94]; SEM, 1.63°; SRD, 4.53°), and good to excellent reliability for the nonoperated knee (ICC, 0.91 [95% CI, 0.76-0.96]; SEM, 1.53°; SRD, 4.24°). Conclusion: The test-retest reliability of the passive knee JPS tests after ACLR varied depending on the test angle, direction, and outcome measure (absolute error, constant error, or variable error). The constant error appeared to be a more reliable outcome measure than the absolute error and the variable error, mainly during the 90°-60° extension test. Clinical Relevance: As constant errors have been found reliable during the 90°-60° extension test, investigating these errors-in addition to absolute and variable errors-to reflect bias in passive JPS scores after ACLR is warranted.