Symmetry of the Neck Muscles' Activity in the Electromyography Signal during Basic Motion Patterns.

The activity of muscles during motion in one direction should be symmetrical when compared to the activity of the contralateral muscles during motion in the opposite direction, while symmetrical movements should result in symmetrical muscle activation. The literature lacks data on the symmetry of neck muscle activation. Therefore, this study aimed to analyse the activity of the upper trapezius (UT) and sternocleidomastoid (SCM) muscles at rest and during basic motions of the neck and to determine the symmetry of the muscle activation. Surface electromyography (sEMG) was collected from UT and SCM bilaterally during rest, maximum voluntary contraction (MVC) and six functional movements from 18 participants. The muscle activity was related to the MVC, and the Symmetry Index was calculated. The muscle activity at rest was 23.74% and 27.88% higher on the left side than on the right side for the UT and SCM, respectively. The highest asymmetries during motion were for the SCM for the right arc movement (116%) and for the UT in the lower arc movement (55%). The lowest asymmetry was recorded for extension-flexion movement for both muscles. It was concluded that this movement can be useful for assessing the symmetry of neck muscles' activation. Further studies are required to verify the above-presented results, determine muscle activation patterns and compare healthy people to patients with neck pain.

The Effect of the Weight and Type of Equipment on Shoulder and Back Muscle Activity in Surface Electromyography during the Overhead Press-Preliminary Report.

The overhead press is a multi-joint exercise that has the potential to use a high external load due to the cooperation of many muscle groups. The purpose of this study was to compare the activity of shoulder and back muscles during the overhead press with a kettlebell and a dumbbell. Surface electromyography (EMG) for the anterior and posterior deltoid, upper and lower trapezius, serratus anterior, and spinal erectors was analysed for 20 subjects. Participants performed the four trials of pressing kettlebell and dumbbell, weighted at 6 kg, and 70% of one maximum repetition (1RM) in the sitting position. Statistical analysis was performed using a non-parametric Friedman test and a post-hoc test of Dunn Bonferroni. No significant differences were found in the activation of assessed muscles when comparing dumbbell to kettlebell press trials with the same load (6 kg and 70% of 1RM). However, muscle activity of all muscles except the upper trapezius was always higher for kettlebell pressing. Different center of gravity locations in the kettlebell versus the dumbbell can increase shoulder muscle activity during the overhead press. However, more studies are required to confirm these results.

The Impact of Visual Input and Support Area Manipulation on Postural Control in Subjects after Osteoporotic Vertebral Fracture.

Osteoporosis is a prevalent health concern among older adults and is associated with an increased risk of falls that may result in fracture, injury, or even death. Identifying the risk factors for falls and assessing the complexity of postural control within this population is essential for developing effective regimes for fall prevention. The aim of this study was to assess postural control in individuals recovering from osteoporotic vertebral fractures while performing various stability tasks. Seventeen individuals with type II osteoporosis and 17 healthy subjects participated in this study. The study involved maintaining balance while standing barefoot on both feet for 20 s on an Advanced Mechanical Technology Inc. (AMTI) plate, with eyes open, eyes closed, and eyes closed in conjunction with a dual-task. Another three trials lasting 10 s each were undertaken during a single-leg stance under the same conditions. Fall risk was assessed using the Biodex Balance platform. Nonlinear measures were used to assess center of pressure (CoP) dynamics in all trials. Reducing the support area or elimination of the visual control led to increased sample entropy and fractal dimension. Results of the nonlinear measurements indicate that individuals recovering from osteoporotic vertebral fractures are characterized by decreased irregularity, mainly in the medio-lateral direction and reduced complexity.

Assessment of the Effectiveness of Rehabilitation after Total Knee Replacement Surgery Using Sample Entropy and Classical Measures of Body Balance.

Exercises in virtual reality (VR) have recently become a popular form of rehabilitation and are reported to be more effective than a standard rehabilitation protocol alone. The aim of this study was to assess the efficacy of adjunct VR training in improving postural control in patients after total knee replacement surgery (TKR). Forty-two patients within 7-14 days of TKR were enrolled and divided into a VR group and a control group (C). The C group underwent standard postoperative rehabilitation. The VR group additionally attended twelve 30-min exercise sessions using the Virtual Balance Clinic prototype system. Balance was assessed on the AMTI plate in bipedal standing with and without visual feedback before and after the four-week rehabilitation. Linear measures and sample entropy of CoP data were analyzed. After four weeks of rehabilitation, a significant reduction in parameters in the sagittal plane and ellipse area was noted while the eyes remained open. Regression analysis showed that sample entropy depended on sex, body weight, visual feedback and age. Based on the sample entropy results, it was concluded that the complexity of the body reaction had not improved. The standing-with-eyes-closed test activates automatic balance mechanisms and offers better possibilities as a diagnostic tool.

Effect of Annoying Sounds on Postural Control.

Objectives: This study aimed to explore the impact of irritating sounds on the postural control of healthy adults, considering both linear and nonlinear parameters, subjective assessments, and gender differences. Methods: Thirty-four young participants (17 females, 17 males) completed three 30 s bipedal standing stability tests on a balance platform: one with visual control (EO), another without visual control (EC), and a third without visual control but accompanied by irritating sounds (ECS). Additionally, participants filled out a questionnaire evaluating their sound sensitivity. Linear and nonlinear parameters from each balance test were considered for statistical analysis. Results: The findings reveal significant gender-based variations in sensitivity to sound, with women exhibiting higher sensitivity. No statistically significant differences in postural control were observed between males and females, except for a notable increase in irregularity (SampEn values) in the anterior-posterior direction for females in the ECS trial. Correlation analyses revealed a moderate and statistically significant correlation between SampEn values in the AP direction and SE scores. Conclusions: This study highlights the intricate relationship between sensory stimuli, attention, and the body's ability to maintain balance. The presence of irritating sounds led to increased irregularity in postural control, particularly in the absence of visual control.

Effect of wearing high-heeled shoes on postural control and foot loading symmetry.

Purpose: This study aimed to evaluate the effects of high-heeled shoes (HHS) and experience with such footwear on foot loading and standing balance using linear and nonlinear methods. Methods: Sixteen young female experts in wearing high-heeled shoes (HHE) and sixteen young females who occasionally wore high-heeled shoes (HHO) completed a Fall Risk Test (FRT) on the Biodex Balance System platform. They also underwent a both-leg standing test on the Zebris pressure mapping platform, both barefoot and while wearing 11 cm HHS. The study analyzed several parameters, including the FRT index, foot loading parameters, linear measures of postural stability (Center of Pressure (CoP) path length and velocity), and nonlinear postural control measures (sample entropy - SampEn, fractal dimension - FD, and the largest Lyapunov exponent - LyE). Results: HHS caused a significant increase the fall risk of more than 44%, but only in the HHE group. The presence of HHS caused a significant increase in CoP path length and CoP velocity by almost 78%. The values of these parameters increased by more than 67% in the HHO group and by more than 92% in the HHE group. HHS caused a significant increase in the values of nonlinear measures (FD and LyE) in the mediolateral direction. Higher FD and LyE values suggest the ability to react faster to destabilizing stimuli and better balance control related to plasticity and adaptability to new conditions. HHS also led to up to 70% loading on the supporting limb. Conclusions: High heels in the population of young women significantly worsen static balance.

Effect of hamstring tissue flossing during warm-up on sit and reach performance.

BACKGROUND: Tissue flossing, also called voodoo flossing, is becoming a popular adjunct to athletic training to improve joint range of motion and muscle strength. The authors of this technique believe that tissue flossing can be used during warm-up. This study investigated the effect of tissue flossing during warm-up on the range of motion in the sit and reach test. METHODS: The study enrolled 40 recreational athletes divided into an experimental and control group consisting of 20 participants each. The range of trunk flexion was assessed with the sit and reach test. Participants were tested before as well as immediately and 15, 30 and 45 minutes after completing the 9-minute warm-up. During the warm-up, athletes in the experimental group wore a floss band on the thigh muscles, while athletes in the control group exercised without wearing a floss band. RESULTS: The sit and reach test revealed an improved range of motion after the warm-up in both groups (P<0.05). The improvement was noted at all time points. Regression analysis showed no effect of any of the study parameters (group assignment, sex, age, body mass index, pain intensity on a visual analogue scale) on the improvement in the sit and reach test results. CONCLUSIONS: The similar results obtained in both groups indicate that there may not be a rationale for using tissue flossing during warm-up to improve trunk and hip flexibility.

Effect of smooth eye tracking in different patterns on results of the modified Clinical Balance Sensory Integration Test in healthy young adults.

PURPOSE: The aim of the study was to determine whether eye tracking of a point moving in different directions influences balance test performance in young healthy subjects. METHODS: The study enrolled 45 healthy young adults aged 19-26. Balance assessment was carried out according to the modified Clinical Balance Sensory Integration Test protocol using the Biodex Balance System with an additional 63" screen to present the eye-tracking task. Each participant repeated measurements in standing on a stable and foam surface in six test conditions: two without eye tracking with eyes open and eyes closed, and four with eye tracking: with vertical, horizontal, star, and circle moving point. Each trial lasted 30 sec. RESULTS: Regression analysis for the Sway Index showed that there was no impact of eye tracking on test results (p = 0.4326), although detailed analysis showed a significant impact of tracking a point moving in a circle in standing on a foam surface (p 〈 0.001). CONCLUSIONS: The presented results show that eye-tracking does not influence the results of the balance test with exception of eye-tracking of the circle movement in standing on a foam surface. It suggests that eye movements may affect the test results when performing more difficult balance tests.

Effectiveness of Warm-Up Exercises with Tissue Flossing in Increasing Muscle Strength.

Tissue flossing is an increasingly popular method in physiotherapy and sports. There is a belief that tissue flossing can improve range of motion and muscle strength, shorten muscle recovery time, and reduce the risk of injury. The aim of this study was to analyse the effectiveness of tissue flossing for immediately improving muscle strength in recreational athletes when it is performed during warm-up. All participants were randomly assigned to either an experimental group (n = 36) or a control group (n = 34) using a random number generator. The experimental group (n = 36) performed an intervention comprising exercises with muscle tissue flossing and exercises without flossing. The control group (n = 30) performed the same protocol without a floss band. Muscle strength was measured for knee flexion end extension at three speeds (60, 120, and 180 °/s) 3 times. Analysed parameters include peak torque, work, and power related to body weight, flexors−extensors ratio, and time to peak torque. There were no significant changes in the muscle strength parameters from before to after the warm-up in either group (p > 0.05). Significantly lower values of peak torque, work, and power were observed in the experimental group during the warm-up with the floss band applied to muscles (p < 0.05). No clinically significant changes in time to peak torque or flexors−extensors ratio were observed. A single application of flossing does not improve muscle strength or power and can even reduce individuals' maximum muscle strength capabilities.

Effectiveness of Early Rehabilitation with Exergaming in Virtual Reality on Gait in Patients after Total Knee Replacement.

Total knee replacement (TKR) is the treatment of choice for advanced stages of osteoarthritis but it requires good postoperative rehabilitation. This study aimed to assess the effectiveness of exercises using virtual reality to improve gait parameters in patients after TKR. Fifty-nine patients 7−14 days after TKR surgery were divided into a study group (VRG, n = 38) and a control group (CG, n = 21). Both groups underwent the same 4-week rehabilitation protocol. The VRG group had 12 additional nonimmersive virtual reality game sessions on the Virtual Balance Clinic prototype system at 30 min each, focusing on gait and balance improvement. Spatiotemporal, force and foot plantar pressure parameters were collected on an instrumented treadmill during a 30 s walk. The most significant improvement was in the symmetry indices of forefoot force, maximum forefoot force, loading response time, and preswing time (p < 0.05) in both groups. Gait speed increased by 31.25% and 44% in the VRG and CG groups, respectively (p < 0.005). However, the extra exergaming sessions did not significantly improve rehabilitation outcomes. Therefore, additional VR training does not improve gait better than standard rehabilitation alone, but the improvement of gait, especially its symmetry, is significant within the first six weeks after surgery.

Influence of force-time parameters of hip abductors on maintaining balance in frontal plane in young healthy females.

PURPOSE: The aim of this study was to determine the impact of isometric and isokinetic hip abductor muscle strength on the quality of maintaining static balance in healthy subjects. METHODS: The study enrolled 51 healthy women aged 18-25. Balance assessment was carried out according to the M-CTSIB protocol and Single Leg Stance Test (with eyes open and closed) using the Biodex Balance System. An isokinetic evaluation conducted at 30 °/s and an isometric evaluation of the hip abductors were performed with the Humac Norm system. RESULTS: Regression analysis for Sway Index (SW) and Stability Index (ST) in bipedal standing showed a significant importance of the presence of visual feedback (RSW EO = -0.922; p < 0.0001; RST EO = -0.613; p = 0.0493), and unstable surface (RSW US = 1.253; p < 0.0001; RSW US = 2.547; p < 0.0001). Regression analysis for single-leg stance showed correlations between the following indices: overall sway index (OR) in single-leg stance, the antero-posterior (AP) sway index and the medio-lateral (ML) sway index on the one hand and isometric abduction time to peak torque (ROR TPT = 0.769; p = 0.0005; RAP TPT = 0.565; p = 0.008; RML TPT = -1.74; p < 0.05, respectively) as well as the test conditions on the other. CONCLUSIONS: Physiological activation of the hip abductors may be important for physiological maintenance of postural balance in young people, in both leg standing as well as in single-leg stance. The present results warrant prospective, randomized studies of larger groups that are diversified with regard to age and gender of the participants.

Nonlinear and Linear Measures in the Differentiation of Postural Control in Patients after Total Hip or Knee Replacement and Healthy Controls.

Primary osteoarthritis treatments such as a total hip (THR) or knee (TKR) replacement lead to postural control changes reinforced by age. Balance tests such as standing with eyes open (EO) or closed (EC) give a possibility to calculate both linear and nonlinear indicators. This study aimed to find the group of linear and/or nonlinear measures that can differentiate healthy people and patients with TKR or THR from each other. This study enrolled 49 THR patients, 53 TKR patients, and 16 healthy controls. The center of pressure (CoP) path length, sample entropy (SampEn), fractal dimension (FD), and the largest Lyapunov exponent (LyE) were calculated separately for AP and ML directions from standing with EO/EC. Cluster analysis did not result in correct allocation to the groups according to all variables. The discriminant model included LyE (ML-EO, ML-EC, AP-EC), FD (AP-EO, ML-EC, AP-EC), CoP-path AP-EC, and SampEn AP-EC. Regression analysis showed that all nonlinear variables depend on the group. The CoP path length is different only in THR patients. It was concluded that standing with EC is a better way to assess the amount of regularity of CoP movement and attention paid to maintain balance. Nonlinear measures better differentiate TKR and THR patients from healthy controls.

Can the sleep quality of patients with chronic neck pain be improved by muscle energy techniques combined with Swedish massage?

BACKGROUND AND PURPOSE: Muscle energy techniques (METs) are used to reduce tension in neck muscles and therefore, can be used together with Swedish massage to enhance its effect. The aim of this study was to assess if using METs combined with massage could improve sleep quality. MATERIALS AND METHODS: In this prospective, randomised controlled trial forty patients with chronic cervical spine pain were divided into two equal groups. Both groups attended 10 sessions of Swedish massage, and the study group additionally attended MET-sessions. Sleep disturbances were assessed with the Pittsburgh Sleep Quality Index (PSQI). RESULTS: A significant improvement in terms of sleep disturbances was seen in both groups. The MET group demonstrated improvement in all PSQI components. In the control group, the improvement included only 4 components of the index. CONCLUSION: Massage therapy combined with relaxing METs may be more effective than massage therapy alone in this group of patients.

Effect of a Single Session of Facial Distortion Model Manual Physiotherapy and a Selected Foam Rolling Technique on Treatment Outcomes in Cervical Spine Overload. Pilot Study.

BACKGROUND: The prevalence of neck pain is on the increase. A sedentary life style, poor ergonomics in the workplace and in daily life, and stress all contribute to neck overload. The aim of this study was to assess the efficacy of a single session of a Fascial Distortion Model (FDM) intervention combined with foam rolling in patients with cervical spine overload. MATERIAL AND METHODS: The study enrolled 90 patients, who were randomized to an FDM group, a foam rolling group (who exercised with a Duoball against a wall) and a control group, of 30 patients each. Mobility was measured with a digital inclinometer, pain intensity was assessed with a VAS scale and (upper and middle) trapezius tone was evaluated by sEMG. These measurements were carried out twice in each group and analysed in Matlab and Statistica 13. RESULTS: Both groups subjected to a therapeutic intervention (FDM and foam rolling) reported a significant reduction in neck pain intensity and improved cervical spine mobility (p<0.01). The control group did not demonstrate changes in mobility or pain intensity. The resting trapezius tone did not change in any of the groups. Conclusions, 1. A single session of FDM therapy can effectively reduce and eliminate cervical spine pain, which may be of use in work-site rehabilitation. 2. Single sessions of FDM and foam rolling can effectively improve neck mobility in patients with cervical spine overload. 3. There is a rationale for conducting further prospective randomized studies of larger samples to assess the duration of the beneficial effects of both therapies and determine an optimum session frequency.

Standards of Virtual Reality Application in Balance Training Programs in Clinical Practice: A Systematic Review.

OBJECTIVE: To determine the effect of virtual reality (VR) games on improving balance in different groups of neurological patients with a particular focus on the study quality and to determine the gold standard in VR training in these groups. MATERIALS AND METHODS: A systematic review of controlled trials published between January 2009 and December 2017 was conducted. The PubMed, SCOPUS, SPORTDiscus, and Medline databases were searched. Studies involved patients with stroke or Parkinson's disease or children with cerebral palsy. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the included studies. RESULTS: A total of 20 studies met the inclusion criteria. The PEDro scores ranged from 4 to 8 points. Analysis of the rehabilitation programs revealed a very large discrepancy in the planned volume of exercises in different subgroups of patients. CONCLUSIONS: Overall, the comparison of VR interventions between conventional rehabilitation and no intervention exhibited significantly better results. However, these results should be interpreted with great caution due to the large diversity of the systems, games, and training volume used in the VR therapy. In all included studies, only several articles included objective methods to assess the effect of VR. In addition, most of the articles showed a high risk of bias, such as a lack of randomization and blinding or a small sample size. That is why further well-designed randomized control trials are required to evaluate the influence of VR on balance in different groups of neurological patients.

Assessment of the Impact of Kinesiology Taping Application Versus Placebo Taping on the Knee Joint Position Sense. Preliminary Report.

BACKGROUND: Kinesiology Taping is a very popular physiotherapy method. It is used in both healthy people and orthopaedic patients in order to relieve pain, increase range of motion and for other purposes. Many researchers claim that these applications will also improve proprioception and sensorimotor efficiency, which are important for recovery after injuries and orthopaedic surgeries, especially on the knee joint. The aim of this study was to determine the effect of the muscle application of Kinesiology Taping on knee joint position sense in active motion. MATERIAL AND METHODS: The study involved 50 healthy people (30 men and 20 women). Mean age was 23.2 years (range 18-30 years). The exclusion criteria were past knee injuries and knee surgery that could affect the test results. The participants were divided randomly into two equal groups. The first group (KT group) had a Kinesiology Taping muscle application placed, whereas a placebo application of an adhesive tape was used in the remaining participants (placebo group). Both applications were supposed to support quadriceps muscle activity. Joint position sense (JPS) was evaluated by measuring the error of active reproduction of the joint position (EARJP) of the knee in 45° flexion. The test was performed prior to applying the patch, after the patch was applied, then after 24 hours of wearing it and after removing the tape. The interval between trials before and after application of the patch was not less than 30 minutes. Statistical analysis was performed using Statistica 12.0. Distribution characteristics were calculated and the Wilcoxon test, Friedman's ANOVA and Mann-Whitney U test were performed. RESULTS: The average test scores of JPS in the KT group and the placebo group before applying the KT patch were 3.48° and 5.16° respectively, compared to 4.84° and 4.88°, respectively, with the patch on, 5.12° and 4.96°, respectively, after 24 hours of wearing the tape, and 3.84° and 5.12°, respectively, after removing the patch. Within-group differences at any two time points were not statistically significant. There were also no significant differences between the groups. CONCLUSIONS: 1. Kinesiology Taping application to the quadriceps muscle had no significant effect on knee joint proprioception. Its use in order to improve sensorimotor skills therefore seems unreasonable. 2. The results are the basis for future prospective, randomised trials of larger experimental groups and involving the use of other Kinesiology Taping applications as well as including individuals with lesions of knee joint structures.

Objective Assessment of Knee Proprioception and Sensorimotor Function in Patients with Primary Gonarthrosis before and after Knee Replacement.

The sensorimotor system is a complicated tool allowing for maintaining body balance and responding to changing environmental conditions to prevent injury. It is difficult to objectively assess the function of balance control mechanisms due to the multidimensional nature of the sensorimotor system and multitude of variables that may interfere with the measurement. The function of the sensorimotor system is considerably compromised in osteoarthritis, including gona-rthro-sis. The knee is the second most common location of osteoarthritis, after the hip, and total or partial replacement surgery of the knee joint represents the therapy of choice in advanced stages of the condition. As average life expectancy increases and state-of-the art medical technology develops, the number of total knee replacement surgeries is increasing dramatically and the re-education of the sensorimotor system is of fundamental impo-rtance for restoring function in the patients. This paper describes the current methods for objective assessment of proprioception, sensorimotor function and balance in the knee. The current literature is also reviewed to discuss the use of such examinations in pa-tients with gonarthrosis before and after knee replacement surgery.

Use of Functional Scores For Assessing Patients Following Total Knee Replacement.

This paper discusses key aspects of the use of functional scores, including their reliability conditions, differences between subjective and objective assessment and types. Functional scores used for assessing patients following total knee replacement, both objective and those including elements of patient-reported subjective evaluation, are discussed in detail, including scales that can be used in pre-operative assessment.

Use of Kinesiology Taping in Rehabilitation after Knee Arthroplasty: a Randomised Clinical Study.

BACKGROUND: Proprioception and body balance after knee arthroplasty have a considerable impact on restoration of joint function and a normal gait pattern. Kinesiology Taping (KT) is a method that may be able to influence these factors. The aim of this study was to assess the effects of KT application on sensorimotor efficiency, balance and gait in patients undergoing rehabili-ta--tion after knee replacement surgery. MATERIAL AND METHODS: The study involved 120 male and female patients (mean age was 69 years) after total knee repla-cement. The patients were randomly assigned to one of two groups: Experimental Group (n=51) and Control Group (n=60). Both groups underwent standard rehabilitation lasting 20 days. In addition, the Experimental Group received KT applications. Treat-ment outcomes were assessed based on tests evaluating balance, joint position sense and functional gait performance, conducted both before and after the therapy. RESULTS: Statistically significant improvements were noted across all the parameters assessed in the Experimental Group (p<0.005). Significant improvements were also seen in the Control Group (p<0.005), but, in percentage terms, the improvement was higher in the Experimental Group. The only exception was the right/left foot load distribution, whose symmetry improved proportionally in both groups. CONCLUSIONS: 1. Patients after knee replacement surgery have considerable proprioception deficits, impaired body balance and reduced functional performance, which may increase the risk of falls in this group of patients. 2. Both standard physiotherapy and combination therapy with Kinesiology Taping (modified by the present authors) used in patients after knee arthroplasty may considerably improve the level of proprioception, body balance and overall functional performance. 3. The technique of dynamic taping proposed in this paper may optimise standard physiotherapy used in patients after knee arthroplasty and increase its clinical efficacy. Further studies are required.

Effect of Sacroiliac Joint Manipulation on Selected Gait Parameters in Healthy Subjects.

BACKGROUND: The sacroiliac joints have complicated biomechanics. While the movements in the joints are small, they exert a significant effect on gait. This study aimed to assess how sacroiliac joint manipulation influences selected gait parameters. MATERIAL AND METHOD: The study enrolled 57 healthy subjects. The experimental group consisted of 26 participants diagnosed with dysfunction of one sacroiliac joint. The control group was composed of 31 persons. All subjects from the experimental group underwent sacroiliac joint manipulation. RESULTS: The experimental group showed significant lengthening of the step on both sides and the stride length in this group increased as well. Moreover, the duration of the stride increased (p=0.000826). The maximum midfoot pressure was higher and maximum heel pressure decreased. The differences were statistically significant. CONCLUSIONS: 1. Subclinical dysfunctions of the sacroiliac joints may cause functional gait disturbance. 2. Manipulation of the iliosacral joint exerts a significant effect on gait parameters, which may lead to improved gait economy and effec-tiveness. 3. Following manipulation of one iliosacral joint, altered gait parameters are noted on both the manipulated side and the contralateral side, which may translate into improved quality of locomotion.