Influence of a Three-Month Mixed Reality Training on Gait Speed and Cognitive Functions in Adults with Intellectual Disability: A Pilot Study.

People with intellectual disability (ID) are often subject to motor impairments such as altered gait. As gait is a task involving motor and perceptive dimensions, perceptual-motor training is an efficient rehabilitation approach to reduce the risk of falls which grows with age. Virtual, augmented, and mixed reality are recent tools which enable interaction with 3D elements at different levels of immersion and interaction. In view of the countless possibilities that this opens, their use for therapeutic purposes is constantly increasing. Therefore, the aim of this study was to investigate the influence a mixed reality activity could have on motor and cognitive abilities in eighteen adults with intellectual disability. For three months, once a week, they had around 20 min to pop virtual balloons with a finger using a Microsoft HoloLens2® head-mounted mixed-reality device. Motor skills were assessed through gait analysis and cognitive abilities were measured with the Montréal Cognitive Assessment. Both walking speed and cognitive score increased after training. In conclusion, this study demonstrates that mixed reality holds potential to get used for therapeutic purposes in adults with ID.

Contribution of segmental kinetic energy to forward propulsion of the centre of mass: Analysis of sprint acceleration.

This study aimed to measure the contribution of each body segment to the production of total body kinetic energy (KE) during a 40-m sprint. Nine recreational sprinters performed two 40-m sprints wearing a MVN Biomech suit (Xsens). Data recorded were used to calculate total body KE, and the KE of each segment. The KE of each segment was then expressed as a percentage of the total body KE. We divided the sprint into three phases: 1 - start to maximal power (Pmax), 2 - Pmax to maximal velocity (Vmax), and 3 - Vmax to the end of the 40 m. Total body KE increased from the start to the end of the 40-m sprint (from 331.3 ± 68.4 J in phase 1 to 2378.8 ± 233.0 J in phase 3; p ≤ 0.001). The contribution of the head-trunk increased (from 39.5 ± 2.4% to 46.3 ± 1.1%; p ≤ 0.05). Contribution of the upper and lower limbs decreased over the three phases (respectively from 15.7 ± 2.5% to 10.6 ± 0.6% and from 44.8 ± 2.1% to 43.1 ± 1.5%; p ≤ 0.05). This study revealed the important contribution of the trunk to forward propulsion throughout the entire acceleration phase.

Mechanics of standing and crouching sprint starts.

The aim of this study was to compare the kinetic and kinematic parameters of standing and crouch sprint starts. Parallel starts (PS), false starts (FS), jump starts (JS) and crouch starts (3PS) were compared. Eighteen participants performed each start on a force plate and six infrared cameras captured the three-dimensional coordinates of 36 retro-reflective markers. Performance during a five-metre sprint (T5m) was analysed. Duration of the start phase (Tstart), mean values of horizontal and total ground reaction forces (GRFs) (Fx_mean and Ftot_mean), ratio of force (RF), maximal power (Pmax) and kinetic energy (KE) of each limb were calculated. Significant differences were found for T5m, Tstart, KE, Pmax, Fx_mean, Ftot_mean and RF for the crouch start compared to the other starts (P ≤ 0.05). Significant correlations were found between T5m and Tstart (r = 0.59; P ≤ 0.001), and T5m and Pmax, Fx_mean and RF (-0.73 ≤ r ≤ -0.61; P ≤ 0.001). To conclude, the crouch start resulted in the best performance because Tstart was shorter, producing greater Pmax, Fx_mean with a more forward orientation of the resultant force. Greater KE of the trunk in each start condition demonstrated the role of the trunk in generating forward translation of the centre of mass (CM).

Post-operative osteopathic manipulative treatment of Morel-Lavallee syndrome assessed using infrared thermal imaging: A case report.

INTRODUCTION: The Morel-Lavallee lesion (MLL) is a closed, degloving soft-tissue injury, wherein the skin and subcutaneous tissue are separated from the underlying fascia. This syndrome causes disruption of wound healing. Infrared thermography is a noninvasive and pain-free tool that can be used to evaluate scar and the influence of osteopathic manipulative treatment. OBJECTIVE: To evaluate the influence of post-operative osteopathic manipulative treatment (OMT) of Morel-Lavallee lesions (MLL). METHODS: During four osteopathic sessions on one volunteer patient, 28-year-old male, resulting in MLL of the left knee after motorcycle accident. The effects of OMT were assessed using an infrared thermal imaging camera and qualitative palpation examination of osteopathic dysfunction, scored on a scale of 1-4. RESULTS: and discussion: Both scar and peri-scar area temperatures increased after OMT. The difference in temperature between the scar and the peri-scar area decreased after OMT. Increase in temperature was greater when the OMT was applied around the scar than when applied at a distance from the scar site. The palpation score for dysfunction of the MLL scar site decreased from 4/4 to 2/4 after the final session. CONCLUSION: Several OMT sessions focusing on the MLL scar site appear necessary to obtain noteworthy results. OMT improved mobility and increased the temperature of the scar and the peri-scar area.

Influence of angles of attack, frequency and kick amplitude on swimmer's horizontal velocity during underwater phase of a grab start.

The underwater phase of starts represents an important part of the performance in sprint swimming's events. Kinematics variables that swimmers have to take into account to improve their underwater phase of starts are unknown. The aim of this study was to determine the kinematics variables that improve performance during the underwater phase of grab starts. A three-dimensional analysis of the underwater phase of ten swimmers of national level was conducted. Stepwise multiple linear regressions identified the main kinematics variables that influence the horizontal velocity of the swimmer each 0.5 m in the range of 5 to 7.5 m. The results show that the kinematics parameters change during the range of 5 to 7.5 m of the underwater phase of the starts. For this population of swimmers, the results enable proposals of four principles to improve the underwater phase: i) to be streamlined at the beginning of the underwater gliding phase, ii) to start the dolphin kicking after 6 m, iii) to generate propulsive forces using only feet and legs during underwater undulatory swimming, iv) to improve the frequency of underwater undulatory swimming.

Accuracy and reliability of the optoelectronic plethysmography and the heart rate systems for measuring breathing rates compared with the spirometer.

Measuring breathing rates without a mouthpiece is of interest in clinical settings. Electrocardiogram devices and, more recently, optoelectronic plethysmography (OEP) methods can estimate breathing rates with only a few electrodes or motion-capture markers placed on the patient. This study estimated and compared the accuracy and reliability of three non-invasive devices: an OEP system with 12 markers, an electrocardiogram device and the conventional spirometer. Using the three devices simultaneously, we recorded 72 six-minute epochs on supine subjects. Our results show that the OEP system has a very low limit of agreement and a bias lower than 0.4% compared with the spirometer, indicating that these devices can be used interchangeably. We observed comparable results for electrocardiogram devices. The OEP system facilitates breathing rate measurements and offers a more complete chest-lung volume analysis that can be easily associated with heart rate analysis without any synchronisation process, for useful features for clinical applications and intensive care.

EFFECTS OF A LIGHTER DISCUS ON SHOULDER MUSCLE ACTIVITY IN ELITE THROWERS, IMPLICATIONS FOR INJURY PREVENTION.

BACKGROUND: Performance in the discus throw requires high forces and torques generated from the shoulder of the throwing arm, making shoulder muscles at risk of overuse injury. Little is known on muscle activation patterns in elite discus throw. HYPOTHESIS/PURPOSE: The purpose of this study was to compare the body kinematics and muscle activation patterns of arm and shoulder muscles involved in discus throwing when using discs of different mass (1.7 kg vs 2.0 kg). It was hypothesized that the use of a lighter discus would modify the activation of the shoulder musculature compared to a standard discus. STUDY DESIGN: Case-control laboratory study. METHODS: Seven male elite discus throwers performed five throws using a standard discus (STD, 2.0 kg) and five throws using a lighter weight discus (LGT, 1.7 kg). Surface EMG was recorded for the biceps brachii (BB), deltoideus anterior (DA), deltoideus medialis (DM), clavicular head of the pectoralis major (PM), latissimus dorsi (LD), and trapezius medialis (TM). Three-dimensional high-speed video analysis was utilized to record discus speed and identify the different temporal phases of each throw from the preparation phase (P1) to the delivery phase (P5). RESULTS: The EMG activation of LD lasted longer (p < 0.01) in P1 and was initiated later in P5 with the LGT discus compared to STD. In P5, the EMG intensity of BB decreased (p = 0.02) with LGT (%EMGmax = 50.4 ± 49.6%) compared to STD (64.8 ± 77.9%) and the activation of PM increased (p < 0.01) with LGT (86.2 ± 40.3%) compared to STD (66.2 ± 26.9%). The discus speed at release was increased (p = 0.04) by using the LGT discus (20.62 ± 0.75m.s-1) compared to STD (19.61 ± 0.57m.s-1). The throwing distance was also increased (P < 0.01) with the LGT (43.1 ± 4.3m) discus compared to STD (39.4 ± 3.4m). CONCLUSION: /Clinical relevance: A lighter discus could be used by elite athletes in training to add variability in muscle solicitation and thus limit the overload on certain muscles of the shoulder region. These results may have implications regarding lowering the risk of injury in discus throw. LEVEL OF EVIDENCE: Level 3.

Effect of osteopathic treatment on a scar assessed by thermal infrared camera, pilot study.

BACKGROUND: Scar formation is influenced by mechanical forces and may generate mechanical tension. Scars induce a temperature difference in the body objectified by thermal imaging camera. The osteopath's task is to ensure the tissue good mobility in the body. The aim of this study was to measure the influence of osteopathic treatment on a scar by thermal camera. METHOD: 12 subjects were analyzed: 4 scars by wounds and 8 by operations. A thermal camera was used to measure the temperature variations of the scars and peri-scar area after cooled stimulation. Measurements were made before and after osteopathic treatment. RESULTS/FINDINGS: A significant difference was found between the scar and the peri-scar area before osteopathic treatment (p = 0.044) and no significant difference after osteopathic treatment (p = 0.069). Results showed that osteopathic treatment on a scar induces a more homogeneous local warming temperature. CONCLUSION: The osteopathic treatment allows different warming between scar and peri-scar area; this suggests a modification of the connective tissue function after osteopathic treatment. Further studies are required to better understand the function of connective tissue and the mechanism of healing.

Auditory cues behind congenitally blind subjects improve their balance control in bipedal upright posture.

BACKGROUND: Congenitally blind subjects developed postural adaptations improving somatosensory and vestibular systems to maintain upright stability and auditory skills to orient them in environment. However, the influence of auditory cues on upright stability in congenitally blind subjects stays unknown. RESEARCH QUESTION: The aim of this study is to define the influence of an auditory cue in congenitally blind subjects back space on their balance posture. METHODS: Eleven sighted subjects and eleven congenitally blind subjects performed upright bipedal and unipedal quiet stances on a force plate with two conditions of auditory cue played by a loudspeaker placed 2 m behind them. Mean CoP velocity were recorded. Student test was used to compare significant difference between blind and sighted subjects bipedal and unipedal postures stability in both conditions of auditory cue. RESULTS AND SIGNIFICANCE: Results showed that congenitally blind subjects had no significant difference in mean sway velocity compared to sighted subjects in bipedal upright posture in auditory signal condition. However, blind subjects had significant lower mean sway velocity than sighted subjects in bipedal upright posture without sound. Blind subjects had significant increased mean sway velocity during unipedal quiet standing in both auditory cue conditions (with and without sound). The results showed that congenitally blind subjects used auditory cues placed behind them in order to improve their balance control in bipedal upright posture. In this case, blind subjects could better use compensatory mechanisms to perform quiet standing as sighted subjects. Without sound or in unipedal upright posture, congenitally blind subjects probably have sensory perturbations or limitations that impose them adaptations in order to avoid falling risk. Auditory cues should be study in the aim to better understand the compensatory mechanisms used by congenitally blind subjects to perform postural balance in usual environment.

Relationships between each part of the spinal curves and upright posture using Multiple stepwise linear regression analysis.

Back pain is a common reason for consultation in primary healthcare clinical practice, and has effects on daily activities and posture. Relationships between the whole spine and upright posture, however, remain unknown. The aim of this study was to identify the relationship between each spinal curve and centre of pressure position as well as velocity for healthy subjects. Twenty-one male subjects performed quiet stance in natural position. Each upright posture was then recorded using an optoelectronics system (Vicon Nexus) synchronized with two force plates. At each moment, polynomial interpolations of markers attached on the spine segment were used to compute cervical lordosis, thoracic kyphosis and lumbar lordosis angle curves. Mean of centre of pressure position and velocity was then computed. Multiple stepwise linear regression analysis showed that the position and velocity of centre of pressure associated with each part of the spinal curves were defined as best predictors of the lumbar lordosis angle (R(2)=0.45; p=1.65*10-10) and the thoracic kyphosis angle (R(2)=0.54; p=4.89*10-13) of healthy subjects in quiet stance. This study showed the relationships between each of cervical, thoracic, lumbar curvatures, and centre of pressure's fluctuation during free quiet standing using non-invasive full spinal curve exploration.

Stimulated infrared thermography applied to differentiate scar tissue from peri-scar tissue: a preliminary study.

Every human injury leads to a scar formation. The healing process leads to the formation of new tissue: the scar, which is different from the original tissue. This process is influenced by mechanical strength and the local vasculature is modified. The purpose of this study is to show that there are various temperatures between the scar and the peri-scar area associated with the healing process that can be estimated using the thermal infrared camera. In the study, 12 scars were stimulated by cold. Several changes of temperature were observed between scar and peri-scar area for 10 min. Scars appeared significantly colder with a Wilcoxon test (p = 0.01). Results showed that stimulated infrared thermography can be used to monitor the temperature difference between the scar and peri-scar tissue.

Modeling the association between HR variability and illness in elite swimmers.

PURPOSE: To determine whether HR variability (HRV), an indirect measure of autonomic control, is associated with upper respiratory tract and pulmonary infections, muscular affections, and all-type pathologies in elite swimmers. METHODS: For this study, 7 elite international and 11 national swimmers were observed weekly for 2 yr. The indexes of cardiac autonomic regulation in supine and orthostatic position were assessed as explanatory variables by time domain (SD1, SD2) and spectral analyses (high frequency [HF] = 0.15-0.40 Hz, low frequency [LF] = 0.04-0.15 Hz, and HF/LF ratio) of HRV. Logistic mixed models described the relationship between the explanatory variables and the risk of upper respiratory tract and pulmonary infections, muscular affections, and all-type pathologies. RESULTS: The risk of all-type pathologies was higher for national swimmers and in winter (P < 0.01). An increase in the parasympathetic indexes (HF, SD1) in the supine position assessed 1 wk earlier was linked to a higher risk of upper respiratory tract and pulmonary infections (P < 0.05) and to a higher risk of muscular affections (increase in HF, P < 0.05). Multivariate analyses showed (1) a higher all-type pathologies risk in winter and for an increase in the total power of HRV associated with a decline SD1 in supine position, (2) a higher all-type pathologies risk in winter associated with a decline in HF assessed 1 wk earlier in orthostatic position, and (3) a higher risk of muscular affections in winter associated with a decrease SD1 and an increase LF in orthostatic position. CONCLUSIONS: Swimmers' health maintenance requires particular attention when autonomic balance shows a sudden increase in parasympathetic indices in the supine position assessed 1 wk earlier evolving toward sympathetic predominance in supine and orthostatic positions.

High-level swimmers' kinetic efficiency during the underwater phase of a grab start.

The purpose of the present work was to study swimmers' efficiency during the underwater phase of the grab start. Eight high-level swimmers participated in this study. They performed two types of start: a regular grab start (with underwater leg propulsion after the glide) and a grab start with no underwater movement (swimmers had to remain in a streamlined position). Four cameras filmed the entire underwater phase of all starts. Nine anatomic landmarks were identified on the swimmers' bodies and their positions were calculated using a modified double plan DLT technique. From these positions and Dempster's anthropometric data, the center of mass position and velocity were also determined. Kinetic energies were also calculated. This velocity and kinetic energies for the two types of start were compared. Swimmers began underwater leg propulsion 1.69 m too soon. The global and internal energies were significantly higher for the start with underwater leg propulsion. Nevertheless, swimmers' velocities were equivalent for both starts. These results suggest that the swimmers did not use the underwater phase of the start efficiently: By kicking too soon, they did not succeed in producing higher velocities and thus wasted energy.