Body posture can modulate liver stiffness measured by transient elastography: a prospective observational study.

BACKGROUND: Non-invasive measurement of liver stiffness (LS), traditionally performed in the supine position, has been established to assess liver fibrosis. However, fibrosis degree is not the sole determinant of LS, necessitating the identification of relevant confounders. One often-overlooked factor is body posture, and it remains unclear whether normal daily postures interfere with LS irrespective of fibrosis. A prospective two-group comparison study was conducted to investigate the relationship between posture and LS. METHODS: Sixty-two adults participated, divided into two groups: patients with chronic liver disease and healthy controls. Both groups were assessed using transient elastography (TE) under the supine, seated, and standing postures. Randomization was applied to the order of the two upright postures. A two-way mixed ANOVA was conducted to assess the posture-dependence of LS and its variations between two groups. RESULTS: Results showed that posture differentially affected LS depending on the presence of liver fibrosis. In 31 healthy individuals (baseline LS range: 3.5-6.8 kPa), a transition from the supine (5.0 ± 1.0 kPa) to seated (5.7 ± 1.4 kPa; p = 0.036) or standing (6.2 ± 1.7 kPa; p = 0.002) positions increased LS, indicating liver stiffening. Conversely, in 31 patients with varying fibrosis stages (baseline LS range: 8.8-38.2 kPa), posture decreased LS from the supine (15.9 ± 7.3 kPa) to seated (13.8 ± 6.2 kPa; p < 0.001) or standing (13.9 ± 6.2 kPa; p = 0.001) positions. No significant difference in LS was observed between the seated and standing positions in both groups (control group: 5.7 vs. 6.2 kPa, p = 0.305; patient group: 13.8 vs. 13.9 kPa, p = 1). Additionally, different postures did not elicit significant changes in the success rate (supine, 98.6 ± 4%; seated, 97.6 ± 6%; standing, 99.1 ± 3%; p = 0.258) and IQR/median value (supine, 25 ± 8%; seated, 29 ± 15%; standing, 29 ± 12%; p = 0.117), implying no impact on both measurement feasibility and reliability. CONCLUSIONS: We demonstrated, for the first time, the feasibility of utilizing upright postures as an alternative measurement protocol for TE. We further unravel a previously unrecognized role of transitioning between different postures to assist the diagnosis of cirrhosis. The findings suggested that daily physiological activity of postural changes suffices to alter LS. Therefore, body positioning should be standardized and carefully considered when interpreting LS.

Impact of physical exercise (strength and stretching) on repairing craniovertebral and reducing neck pain: A systematic review and meta-analysis.

Background: The craniovertebral (CV) junction is crucial for head support, mobility, and protecting the upper spinal cord and vital nerve structures. Disorders in this area can cause severe symptoms such as neck pain, restricted movement, and neurological issues such as headaches and balance problems. Exercise and physical activity improves muscle strength, flexibility, joint stability, reducing pain, and enhancing joint function, while specifically for the CV junction, exercise can relieve muscle tension, boost blood flow, and improve posture, although the specific impact on CV junction health remains underexplored. Methods: A comprehensive literature search was conducted using databases MEDLINE, Cochrane, Lilacs, and ScienceDirect, alongside manual searches through reference lists. The review focuses on exercise and CV junction issues and includes randomized controlled trials, cohort or case-control studies, and systematic reviews. Primary outcomes include pain levels, joint mobility, function, and quality of life. Results: Results yield four meta-analyses with corrective exercise and conventional exercise in improving forward head posture risk difference 0.00 (-0.09, 0.09) 95% confidence interval (CI), between cervical and thoracic exercises odds ratio 1.04 (0.59, 1.84) 95% CI. Comparing exercise treatment and physiotherapy showed risk difference 0.11 (-0.10, 0.32) 95% CI and the comparative analysis between training and no treatment showed risk difference 0.09 (-0.01, 0.20) 95% CI. Conclusion: Exercise-based rehabilitation programs tailored to patients with CV junction problems offer robust evidence, benefiting clinical management, and prevention efforts.

Characteristics of clinical descriptive variables and polysomnographic findings of catathrenia.

STUDY OBJECTIVES: Catathrenia has been classified as a sleep-related breathing disorder variant in the third edition of the International Classification of Sleep Disorders, but its validity remains unverified. We analyzed the clinical descriptive variables and polysomnographic findings of catathrenia and discussed the similarities and differences to those of obstructive sleep apnea (OSA), non-REM parasomnias, and sleep bruxism (SB). METHODS: A retrospective analysis was conducted on 47 patients diagnosed with nocturnal groaning through polysomnography. We examined sex, body mass index, age at symptom onset, weekly symptom frequency, and presence/absence of comorbidities, including OSA, periodic limb movement disorder, non-REM parasomnia, and SB. The groaning event (GE) index was calculated according to sleep position and sleep stage. RESULTS: The distribution of patients with catathrenia did not show sex difference (male/female = 20:27), body mass index was 20.6 ± 3.0 kg/m2, and age of onset was 18.2 ± 7.4 years. The GE index was higher in stages N1 and R than in stage N3 and in the supine position than in the lateral position. There were no cases complicated with non-REM parasomnia, but the complication of SB was observed in 30% of the participants, and SB events appeared immediately before or during the interictal period of the GE episodes in these cases. CONCLUSIONS: Given the clinical background, posture- and sleep stage-dependent appearance of GEs, and the relatively high complication rate of SB, catathrenia pathogenesis may be heterogeneous or comprise elements of different sleep disorders.

Evaluation of the sagittal vertical axis with postural and 3D motion analyses in lumbar spinal stenosis.

BACKGROUND: Sagittal balance, commonly impaired in lumbar spinal stenosis (LSS) patients, is typically assessed using the sagittal vertical axis (SVA) with EOS imaging. However, to limit X-ray exposure and medical costs, it could be interesting to evaluate the capacity of quantified motion analysis to estimate the 3D modeling of SVA in patients with symptomatic LSS. METHODS: An estimation of the SVA in patients with LSS was performed with 3D motion analysis. SVA and "C7_PSI" (orthogonal horizontal distance between the vertical lines through the markers of the C7 vertebra and the middle of the posterosuperior iliac spine) were measured on 37 LSS patients using EOS radiography and postural and 3D motion analysis, respectively. Multiple stepwise linear regressions were performed with EOS SVA according to age, body mass index, C7_PSI and/or postural variables. RESULTS: A highly significant relationship was found between SVA and C7_PSI, mediolateral amplitude of CoP displacements and age (adjusted R²=0.69, p < 0.0001). While the postural analysis did not reveal significant relationships, the model using 3D parameters revealed significant relationships between radiographic SVA and C7_PSI and age (adjusted R²=0.65, p < 0.0001). 3D motion parameters with or without postural parameters may explain more than 65% of the variance seen in EOS imaging performed on LSS patients. CONCLUSIONS: These promising results in LSS patients suggest that the estimation of SVA with 3D motion analysis offers an alternative to EOS. In addition, SVA could be assessed at rest and during dynamic tasks. TRIAL REGISTRATION: This study has been published in Clinical Trial registration (reference NCT03194607).

Frequency-domain patterns in foot-force line-of-action: an emergent property of standing balance control.

A recent line of work suggests that the net behavior of the foot-ground interaction force provides insight into quiet-standing-balance dynamics and control. Through human subject experiments, Boehm et al. found that the relative variations of the center of pressure and force orientation emerge as a distinct pattern in the frequency domain, termed the "intersection-point height." Subsequent empirical and simulation-based studies showed that different control strategies are reflected in the distribution of intersection-point height across frequency. To facilitate understanding of the strengths and limitations of the intersection-point height in describing the dynamics and control of standing, the present work establishes a spectral-based method that also enables derivation of a closed-form estimate of the intersection-point height from any linear model of quiet stance. This new method explained observations from prior work, including how the measure captures aspects of control and physiological noise. The analysis presented herein highlights the utility of the frequency-dependent foot-force dynamics in probing the balance controller and provides a tool for model development and validation to further our understanding of the neuromotor control of natural upright posture in humans.

Brain activation in older adults with hypertension and normotension during standing balance task: an fNIRS study.

Background: Hypertension (HT) is a common chronic disease in older adults. It not only leads to dizziness and other symptoms affecting balance in older adults with HT but also affects the hemodynamics of the cerebral cortex. At present, potential neural mechanisms of balance control in older adults with HT are still unclear. Therefore, this study aimed to explore the differences in the center of pressure (COP) and cerebral cortex activation between older adults with HT and normotension (NT) during standing balance tasks. This study May provide guidance for the early detection of the risk of falls among older adults with HT and the development of clinical rehabilitation strategies. Methods: In this cross-sectional study, 30 older adults with NT (NT group) and 27 older adults with HT (HT group) were subjected to three conditions: task 1, standing with eyes open on a stable surface; task 2, standing with eyes closed on a stable surface; and task 3, standing with eyes open on the surface of the foam pad. Cortical hemodynamic reactions were measured using functional near-infrared spectroscopy, and COP parameters were measured using a force plate. Results: The mean velocity of the COP in the medial-lateral direction in the NT group was significantly higher than that in the HT group (F = 5.955, p = 0.018) during task 3. When proprioception was disturbed, the activation of the left premotor cortex and supplementary motor cortex in the HT group was significantly lower than that in the NT group (F = 14.381, p < 0.001). Conclusion: The standing balance function of older adults with HT does not appear to be worse based on COP parameters than those of older adults with NT. This study revealed that the changes in the central cortex related to standing balance appear to be more indicative of balance control deficits in older adults with HT than changes in peripheral COP parameters, suggesting the importance of the early evaluation of cortical activation in older adults with HT at risk of falls.

YOLOv5-POS: research on cabbage pose prediction method based on multi-task perception technology.

Introduction: Accurate and rapid identification of cabbage posture is crucial for minimizing damage to cabbage heads during mechanical harvesting. However, due to the structural complexity of cabbages, current methods encounter challenges in detecting and segmenting the heads and roots. Therefore, exploring efficient cabbage posture prediction methods is of great significance. Methods: This study introduces YOLOv5-POS, an innovative cabbage posture prediction approach. Building on the YOLOv5s backbone, this method enhances detection and segmentation capabilities for cabbage heads and roots by incorporating C-RepGFPN to replace the traditional Neck layer, optimizing feature extraction and upsampling strategies, and refining the C-Seg segmentation head. Additionally, a cabbage root growth prediction model based on Bézier curves is proposed, using the geometric moment method for key point identification and the anti-gravity stem-seeking principle to determine root-head junctions. It performs precision root growth curve fitting and prediction, effectively overcoming the challenge posed by the outer leaves completely enclosing the cabbage root stem. Results and discussion: YOLOv5-POS was tested on a multi-variety cabbage dataset, achieving an F1 score of 98.8% for head and root detection, with an instance segmentation accuracy of 93.5%. The posture recognition model demonstrated an average absolute error of 1.38° and an average relative error of 2.32%, while the root growth prediction model reached an accuracy of 98%. Cabbage posture recognition was completed within 28 milliseconds, enabling real-time harvesting. The enhanced model effectively addresses the challenges of cabbage segmentation and posture prediction, providing a highly accurate and efficient solution for automated harvesting, minimizing crop damage, and improving operational efficiency.

Vertical back movement of cows during locomotion: detecting lameness with a simple image processing technique.

This research paper proposes a simple image processing technique for automatic lameness detection in dairy cows under farm conditions. Seventy-five cows were selected from a dairy farm and visually assessed for a reference/real lameness score (RLS) as they left the milking parlor, while simultaneously being video-captured. The method employed a designated walking path and video recordings processed through image analysis to derive a new computerized automatic lameness score (ALDS) based on calculated factors from back arch posture. The proposed automatic lameness detection system was calibrated using 12 cows, and the remaining 63 were used to evaluate the diagnostic characteristics of the ALDS. The agreement and correlation between ALDS and RLS were investigated. ALDS demonstrated high diagnostic accuracy with 100% sensitivity and specificity and was found to be 100% accurate with a perfect agreement (ρc = 1) and strong correlation (r = 1, P < 0.001) for lameness detection in binary scores (lame/non-lame). Moreover, the ALDS had a strong agreement (ρc = 0.885) and was highly correlated (r = 0.840; 0.796-1.000 95% confidence interval, P < 0.001) with RLS in ordinal scores (lameness severity; LS1 to LS5). Our findings suggest that the proposed method has the potential to compete with vision-based lameness detection methods in dairy cows in farm conditions.

Effect of operation table height on ease of mask ventilation, laryngeal view, and endotracheal intubation success.

Background and Aims: Optimal patient positioning and operating table height are essential for an ergonomic posture of an anesthesiologist in which there is minimal or no strain on thewrist during mask ventilation. It also avoids flexion of the neck, lower back, and knee bending at the time of laryngoscopy and intubation. Material and Methods: One hundred eighty patients were randomly allocated to three groups based on different table heights. The height of the table is kept at the mid-sternum level of an anesthesiologist in group 1, at the xiphoid process in group 2, and at the level of umbilicus in group 3. Laryngoscopic view with or without postural changes (exertion at wrist joint, flexion of the neck, lower back, or knee bending) was graded as per Cormack Lehane's (CL) grading. The degree of discomfort experienced by the anesthesiologist during mask ventilation or tracheal intubation was graded subjectively (1 = no discomfort, 2 = mild discomfort, 3 = moderate discomfort, and 4 = severe discomfort) at different table heights. Postural changes required to obtain the best glottic view and quality of endotracheal (ET) intubation (intubation time and attempts required) were also noted. For analysis, quantitative variables were expressed as mean ± SD and compared using unpaired t or analysis of variance test. Qualitative variables were expressed as frequencies/percentages and compared using the Chi-square test. Results with P value <0.05 were considered significant statistically. Results: Moderate discomfort (strain at wrist joint) during bag-mask ventilation was experienced by the anesthesiologist in a maximum number of patients in group 1 (81.7%). Significant improvement was seen in CL grade after the use of postural modifications in groups 1 and 2 (P value ≤0.05). Greater postural modifications were required during ET intubation at lower table heights (group 3). Conclusions: It is advisable to adopt higher table positioning in relation to anesthesiologist performing the laryngoscopy for smooth and single-attempt ET intubation since the best laryngoscopic view and intubation with minimal postural modifications was seen at higher table heights (at the mid-sternum level of an anesthesiologist).

Clinical Significance of Pose Estimation Methods Compared with Radiographic Parameters in Adolescent Patients with Idiopathic Scoliosis.

Introduction: Human pose estimation, a computer vision technique that identifies body parts and constructs human body representations from images and videos, has recently demonstrated high performance through deep learning. However, its potential application in clinical photography remains underexplored. This study aimed to establish photographic parameters for patients with adolescent idiopathic scoliosis (AIS) using pose estimation and to determine correlations between these photographic parameters and corresponding radiographic measures. Methods: We conducted a study involving 42 patients with AIS who had undergone spinal correction surgery and conservative treatment. Preoperative photographs were captured using an iPhone 13 Pro mounted on a tripod positioned at the head of an X-ray tube. From the outputs of pose estimation, we derived five photographic parameters and subsequently conducted a statistical analysis to assess their correlations with relevant conventional radiographic parameters. Results: In the sagittal plane, we identified significant correlations between photographic and radiographic parameters measuring trunk tilt angles. In the coronal plane, significant correlations were found between photographic parameters measuring shoulder height and trunk tilt and corresponding radiographic measurements. Conclusions: The results suggest that pose estimation, achievable with common mobile devices, offers potential for AIS screening, early detection, and continuous posture monitoring, effectively mitigating the need for X-ray radiation exposure. Level of Evidence: 3.

Foot Posture and Ankle Dorsiflexion as Risk Factors for Developing Achilles Tendinopathy and Plantar Fasciitis: A Case-Control Study.

BACKGROUND: Plantar fasciitis (PF) and Achilles tendinopathy (AT) are common injuries that primarily affect people engaged in sport or occupational weightbearing activities. Identifying modifiable risk factors is important for the treatment and prevention of these injuries. The purpose of this study was to evaluate whether foot posture or ankle dorsiflexion are risk factors for developing AT or PF, and if there were any differences between PF and AT patients. METHODS: This was a case-control study of 108 patients with PF and 114 patients with AT, compared to the same number of referred patients in 2 control groups never having had these injuries, matched for sex, age, body mass index (BMI), sport, and occupational weightbearing activities. Included patients were 20-65 years with ultrasonographic-verified PF or midsubstance AT. Foot posture was assessed using Foot Posture Index (FPI) classifying the feet into 3 categories: FPI 0-5 normal foot, 6-12 hyperpronated, <0 hypopronated. Ankle dorsiflexion was measured with a goniometer in weightbearing with straight and bent knee. RESULTS: Abnormal foot posture was associated with an increased risk for sustaining both AT (odds ratio [OR] 3.4-4.1) and PF (OR 3.2-3.8). Hyperpronation being the major reason for this association with ORs 5.4-5.5 compared with hypopronation with ORs 2.6-2.9. However, decreased dorsiflexion was not a risk factor: instead, there was an increased ankle dorsiflexion in patients with AT or PF compared with their control groups. Comparison between PF and AT patients demonstrated that PF affected mostly women, and AT mostly men, PF patients were 2.4 years (CI 0.2-4.5) younger, and had 25% more occupational weightbearing than AT patients. However, no differences in BMI or weightbearing physical activity was demonstrated. CONCLUSION: Hypopronation and hyperpronation but not limited ankle dorsiflexion was associated with increased risk for AT or PF.

Artificial Intelligence for the Evaluation of Postures Using Radar Technology: A Case Study.

In the last few decades, major progress has been made in the medical field; in particular, new treatments and advanced health technologies allow for considerable improvements in life expectancy and, more broadly, in quality of life. As a consequence, the number of elderly people is expected to increase in the following years. This trend, along with the need to improve the independence of frail people, has led to the development of unobtrusive solutions to monitor daily activities and provide feedback in case of risky situations and falls. Monitoring devices based on radar sensors represent a possible approach to tackle postural analysis while preserving the person's privacy and are especially useful in domestic environments. This work presents an innovative solution that combines millimeter-wave radar technology with artificial intelligence (AI) to detect different types of postures: a series of algorithms and neural network methodologies are evaluated using experimental acquisitions with healthy subjects. All methods produce very good results according to the main parameters evaluating performance; the long short-term memory (LSTM) and GRU show the most consistent results while, at the same time, maintaining reduced computational complexity, thus providing a very good candidate to be implemented in a dedicated embedded system designed to monitor postures.

Postural Risks in Dental Practice: An Assessment of Musculoskeletal Health.

In recent years, Romania's stomatology private practice sector has seen substantial growth, with many dentists fully committing to building and expanding their own practices, often funded by their personal income. This study aimed to explore how various postures affect the muscle groups of dentists (380), particularly focusing on identifying positions that may jeopardize their musculoskeletal health. A group of dentists effectively participated in this study (10), adhering to their regular work routines while wearing wearable sensors on their backs to monitor posture and activity. The data gathered from these sensors were analyzed using the RULA (rapid upper-limb assessment) and REBA (rapid entire-body assessment) tools. The findings indicated that the head and shoulder movements during dental procedures involved considerable and repetitive angular shifts, which could strain the neck and back muscles and heighten the risk of musculoskeletal problems. Additionally, the standing postures adopted by the dentists were associated with an increased risk of postural issues and greater overall fatigue. Extended periods of trunk and head tilting were also identified as contributing factors to posture-related challenges.

Assessing Static Balance, Balance Confidence, and Fall Rate in Patients with Heart Failure and Preserved Ejection Fraction: A Comprehensive Analysis.

Chronic heart failure (CHF) is a complex clinical syndrome, associated with frailty, higher fall rates, and frequent hospitalizations. Heart Failure (HF) and preserved ejection fraction (HFpEF) is defined as a condition where a patient with HF have a diagnosis of left ventricular ejection fraction (LVEF) of ≥ 50%. The risk of HFpEF increases with age and is related to higher non-cardiovascular mortality. The aim of this study was to evaluate static balance and examine the effect of task difficulty on the discriminating power of balance control between patients with HFpEF (Patients with HFpEF) and their healthy controls. Moreover, the associations between static balance parameters, balance confidence, falls, lean muscle mass, and strength were assessed. Seventy two patients with HFpEF (mean age: 66.0 ± 11.6 years) and seventy two age- and gender-matched healthy individuals (mean age: 65.3 ± 9.5 years) participated in this study. Participants underwent a 30 s bilateral stance (BS) test and a 20 s Tandem-Romberg stance (TRS) on a force platform, evaluating the Range and Standard Deviation of Center of Pressure (COP) displacement parameters in both axes. Balance confidence was evaluated by the Activities-Specific Balance Confidence (ABC) Scale, and the number of falls during the last year was recorded. Lower limb strength was measured using an isokinetic dynamometer, isometric leg strength, and a Sit-to-Stand test. Bioelectrical impedance analysis was conducted to assess lean fat mass, lean fat mass index, and lean%. Patients with HFpEF presented with lower static balance in BS and TRS compared to healthy controls (p < 0.05), lower balance confidence by 21.5% (p < 0.05), and a higher incidence of falls by 72.9% (p < 0.05). BS was a better descriptor of the between-group difference. Furthermore, static balance, assessed in controlled lab conditions, was found to have little if no relationship to falls, strength, lean muscle mass, and balance confidence. Although no correlation was noted between the static balance parameters and falls, the fall rate was related to balance confidence, age, muscle strength, and lean fat.

The effect of posture regulation training on musculoskeletal disorders, fatigue level and job performance in intensive care nurses.

BACKGROUND: Intensive care units (ICUs) are one of the high-risk working areas in terms of musculoskeletal disability and ergonomic risks including the environment and posture factors. Correct posture technique is often ignored by nurses working in these units. This study was conducted to determine the effect of posture regulation training on work-related musculoskeletal disorders, fatigue level and job performance in nurses working in ICUs. METHODS: This quasi-experimental study with one-group pretest-posttest design included 64 intensive care nurses. The nurses received posture regulation training in three different sessions. The post-test was administered four months after the posture regulation training. RESULTS: The nurses reported to frequently have aches, pains and discomfort in the neck, upper back and lumbar regions. After the posture regulation training, their level of pain, ache and discomfort in the neck, right and left shoulder, upper back, lower back and right/left foot areas decreased significantly (p < 0.05). The posture regulation training reduced the levels of behavior/severity and affect, which are sub-dimensions of fatigue, and increased the level of contribution to work, which is a sub-dimension of job performance (p < 0.05). CONCLUSION: The posture regulation training decreased the level of symptoms in the neck, shoulder, upper back, lower back and foot regions of intensive care nurses and partially improved their fatigue level and job performance. Therefore, posture regulation training should be added to in-service training programs and permanent measures should be taken for ergonomic risks in ICUs.

Changes in shoulder function and muscle strength following rehabilitation exercise program in male patients with forward shoulder posture undergoing rotator cuff repair.

BACKGROUND: Abnormal posture is known to affect the efficacy of exercise therapy for musculoskeletal diseases. However, no studies to date have examined the effect of exercise programs should take into account the posture of the upper body in patients with rotator cuff disease. This study aimed to assess how rotator cuff and corrective exercises impact shoulder function and muscle strength post-arthroscopic rotator cuff repair surgery, providing tailored rehabilitation programs for patients with forward posture. METHODS: Ninety male patients who underwent arthroscopic rotator cuff repair participated in this study. The patients were randomly divided into three groups corrective exercise group (CEG, n = 29), rotator cuff exercise group (REG, n = 27), and control group (CG, n = 28). Each group was instructed to apply different exercise programs to correct posture and enhance rotator cuff strength. All patients were checked by the American Shoulder and Elbow Surgeons (ASES) score, Constant score and muscle strength, and range of motion preoperatively and postoperatively at 6 months and 1 year. RESULTS: ASES shoulder function scores showed significant difference between the three groups (p = 0.002, F = 7.03), indicating that the corrective exercise program was more beneficial than rotator cuff exercises (p = 0.009, F = 3.78). A significant intergroup difference in mean Constant score was also noted (p = 0.025, F = 3.86), while a statistically significant interaction between time and group was observed (p = 0.032, F = 2.96). CONCLUSIONS: These results suggested that a corrective exercise program can improve shoulder muscle strength and function after rotator cuff repair in male patients with a forward shoulder posture.

Assessment of Cervical Joint Position Sense and Head Posture in Individuals With Myogenic Temporomandibular Dysfunctions and Identifying Related Factors: A Case-Control Study.

BACKGROUND: Temporomandibular dysfunctions (TMDs) have the potential to cause changes in cervical muscle strength, muscle endurance and position sense by changing muscle activation patterns, especially as a result of forward head posture. The effects of TMDs on cervical joint position sense (CJPS) and head posture remain controversial. OBJECTIVE: The aim of this study was to evaluate the head posture and CJPS of individuals with TMDs and compare them with healthy individuals. METHODS: This research, which was designed as a case-control study, was concluded with the inclusion of total of 84 participants (42 individuals diagnosed with myogenic TMDs, 42 controls). The assessment of participants included pain severity, neck and jaw functionality and disability, CJPS, head posture and temporomandibular joint (TMJ) range of motion (ROM). RESULTS: Individuals with TMDs exhibited higher angular deviation in CJPS during flexion and extension (p < 0.001). Additionally, individuals with TMDs demonstrated higher TMJ pain, limitation and dysfunction severity, as well as a more limited TMJ ROM (p < 0.001). Head posture was similar between groups (p > 0.05). There is a significant relationship between VAS-TMJ with VAS-cervical, FAI, NDI, JFLS-8 and TMJ ROM (p < 0.05). Moreover, a significant correlation was observed between NDI with FAI and TMJ ROM (p < 0.05). CONCLUSION: These results indicate that in addition to higher pain severity, disability and lower jaw ROM, CJPS of individuals with TMDs is also negatively affected. Also, parameters related to disability and functionality of cervical and TMJ were significantly correlated. Further studies are needed to determine the factors contributing to these results.

Upper extremity functions, spinal posture, and axial rigidity in patients with parkinson's disease.

OBJECTIVE: Upper extremity dysfunction is frequently seen in Parkinson's disease (PD). Existing research has shown that bradykinesia, which is main symptom of PD, is primarily responsible but the combined effects of spinal posture and axial rigidity on upper extremity functions were not investigated yet. The aim of this study was to investigate upper extremity functions in patients with PD and to evaluate relationship of these with spinal posture and axial rigidity. METHODS: This prospective controlled study included 40 patients with PD and 40 healthy controls. Upper extremity function was measured with the 9-Hole Peg Test. Spinal posture and axial rigidity were measured with a Spinal Mouse. RESULTS: Compared with the control group, a decrease in upper extremity functions (p < 0.001), decreased lumbar lordosis (p = 0.003), and posterior sacral tilt (p = 0.021) were determined in patients' group. Thoracic and lumbar mobility in the sagittal (all p < 0.001) and frontal planes (p = 0.004, p < 0.001) was found to be reduced in the patient group. A correlation was determined between upper extremity functions and lumbar mobility in the sagittal (p = 0.022, r= -0.362) and frontal planes (p = 0.045, r= -0.319) and lumbar lordosis (p = 0.048, r = 0.302). CONCLUSIONS: The results of this study demonstrated that altered spinal posture and increased axial rigidity were related with decreased upper extremity functions in patients with PD. There is a need for further studies to investigate effect of trunk-based therapies on upper extremity function in patients with PD.

Wearable technology mediated biofeedback to modulate spine motor control: a scoping review.

BACKGROUND: Lower back pain (LBP) is a disability that affects a large proportion of the population and treatment for this condition has been shifting towards a more individualized, patient-centered approach. There has been a recent uptake in the utilization and implementation of wearable sensors that can administer biofeedback in various industrial, clinical, and performance-based settings. Despite this, there is a strong need to investigate how wearable sensors can be used in a sensorimotor (re)training approach, including how sensory biofeedback from wearable sensors can be used to improve measures of spinal motor control and proprioception. RESEARCH QUESTION: The purpose of this scoping review was to examine the wide range of wearable sensor-mediated biofeedback frameworks currently being utilized to enhance spine posture and motor function. METHODS: A comprehensive scoping review was conducted in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines extension for Scoping Reviews (PRISMA-ScR) across the following databases: Embase, PubMed, Scopus, Cochrane, and IEEEXplore. Articles related to wearable biofeedback and spine movement were reviewed dated from 1980 - 2020. Extracted data was collected as per a predetermined checklist including the type, timing, trigger, location, and magnitude of sensory feedback being applied to the body. RESULTS: A total of 23 articles were reviewed and analysed. The most used wearable sensor to inform biofeedback were inertial measurement units (IMUs). Haptic (vibrotactile) feedback was the most common sensory stimulus. Most studies used an instantaneous online trigger to initiate sensory feedback derived from information pertaining to gross lumbar angles or the absolute orientations of the thorax or pelvis. CONCLUSIONS: This is the first study to review wearable sensor-derived sensory biofeedback to modulate spine motor control. Although the type of wearable sensor and feedback were common, this study highlights the lack of consensus regarding the timing and structure of sensory feedback, suggesting the need to optimize any sensory feedback to a specific use case. The findings from this study help to improve the understanding surrounding the ecological utility of wearable sensor-mediated biofeedback in industrial, clinical, and performance settings to enhance the sensorimotor control of the lumbar spine.

Transiently worse postural effects after vestibulo-ocular reflex gain-down adaptation in healthy adults.

Suffering an acute asymmetry in vestibular function (i.e., vestibular neuritis) causes increased sway. Non-causal studies report associations between lateral semicircular canal function and balance ability, but direct links remain controversial. We investigate the immediate effect on body sway after unilateral vestibulo-ocular reflex (VOR) gain down adaptation simulating acute peripheral vestibular hypofunction. Eighteen healthy adults, mean age 27.4 (± 12.4), stood wearing an inertial measurement device with their eyes closed on foam before and after incremental VOR gain down adaptation to simulate mild unilateral vestibular neuritis. Active head impulse VOR gain was measured before and after the adaptation to ensure VOR gain adaptation. Percentage change for VOR gain was determined. Sway area was compared before and after VOR adaptation. VOR gain decreased unilaterally exceeding meaningful change values. Sway area was significantly greater immediately after VOR gain down adaptation, but quickly returned to baseline. In a subset of subjects VOR gain was re-assessed and found to remain adapted despite sway normalization. These results indicate that oculomotor adaptation targeting the lateral semicircular canal VOR pathway has an immediate, albeit transient increase in body sway. Rapid return of body sway to baseline levels suggests dynamic sensory reweighting between vestibular and somatosensory inputs to resolve the undesirable increased body sway.