Musculoskeletal System and Gait Characteristics in Patients with Osteogenesis imperfecta.

OBJECTIVES: The aim of the study was to assess the muscoloskeletal system and spatiotemporal gait parameters of patients in three types of osteogenesis imperfecta. DESIGN STUDY: Retrospective observational study. SETTINGS: The Department of Rehabilitation, Children's Memorial Health Institute in Warsaw, Poland. PARTICIPANTS: This study investigated individuals with various types of osteogenesis imperfecta: 33 with osteogenesis imperfecta I (aged 13.9), 16 with osteogenesis imperfecta III (aged 10.4), and 14 with osteogenesis imperfecta IV (aged, 15.8), as well as a reference group of 400 healthy individuals. MAIN MEASURES: The musculoskeletal assessment included: medical record review, clinical evaluation, functional tests, long bone deformity assessment via clinical and X-ray examination, and objective gait analysis with the Vicon Motion Systems (Ltd, Oxford, UK). RESULTS: The study revealed notable differences in clinical presentation, deformities within the musculoskeletal system, gait parameters across the various types of osteogenesis imperfecta (p < 0.001). The most affected gait parameters were: cadence, gait speed and step length. The greatest deformities of lower limbs and spine were presented in patients with osteogenesis imperfecta type III. CONCLUSIONS: These findings are significant for understanding gait abnormalities in osteogenesis imperfecta patients and designing customized physiotherapy programs to help them participate fully in daily life. Improvement of muscle strength is one of the key for easier engagement in activities like walking or stair-climbing.

The Impact of Normobaric Hypoxia and Intermittent Hypoxic Training on Cardiac Biomarkers in Endurance Athletes: A Pilot Study.

This study explores the effects of normobaric hypoxia and intermittent hypoxic training (IHT) on the physiological condition of the cardiac muscle in swimmers. Hypoxia has been reported to elicit both beneficial and adverse changes in the cardiovascular system, but its impact on the myocardium during acute exercise and altitude/hypoxic training remains less understood. We aimed to determine how a single bout of intense interval exercise and a four-week period of high-intensity endurance training under normobaric hypoxia affect cardiac marker activity in swimmers. Sixteen young male swimmers were divided into two groups: one undergoing training in hypoxia and the other in normoxia. Cardiac markers, including troponin I and T (cTnI and cTnT), heart-type fatty acid-binding protein (H-FABP), creatine kinase-MB isoenzyme (CK-MB), and myoglobin (Mb), were analyzed to assess the myocardium's response. We found no significant differences in the physiological response of the cardiac muscle to intense physical exertion between hypoxia and normoxia. Four weeks of IHT did not alter the resting levels of cTnT, cTnI, and H-FABP, but it resulted in a noteworthy decrease in the resting concentration of CK-MB, suggesting enhanced cardiac muscle adaptation to exercise. In contrast, a reduction in resting Mb levels was observed in the control group training in normoxia. These findings suggest that IHT at moderate altitudes does not adversely affect cardiac muscle condition and may support cardiac muscle adaptation, affirming the safety and efficacy of IHT as a training method for athletes.

Methods for Spatiotemporal Analysis of Human Gait Based on Data from Depth Sensors.

Gait analysis may serve various purposes related to health care, such as the estimation of elderly people's risk of falling. This paper is devoted to gait analysis based on data from depth sensors which are suitable for use both at healthcare facilities and in monitoring systems dedicated to household environments. This paper is focused on the comparison of three methods for spatiotemporal gait analysis based on data from depth sensors, involving the analysis of the movement trajectories of the knees, feet, and centre of mass. The accuracy of the results obtained using those methods was assessed for different depth sensors' viewing angles and different types of subject clothing. Data were collected using a Kinect v2 device. Five people took part in the experiments. Data from a Zebris FDM platform were used as a reference. The obtained results indicate that the viewing angle and the subject's clothing affect the uncertainty of the estimates of spatiotemporal gait parameters, and that the method based on the trajectories of the feet yields the most information, while the method based on the trajectory of the centre of mass is the most robust.

Does the Aquatic Breathing Program Improve Lung Function in Adolescents with Scoliosis?

Aim: To determine pulmonary parameters in adolescents with scoliosis after three weeks of intensive physiotherapeutic scoliosis-specific exercises based on the Aquatic Breathing Program (ABP) compared to corrective swimming (CS).Methods: A pretest-posttest control group design was used. The ABP group comprised 13 adolescents (age 14.2 ± 1.4) and the CS group 10 adolescents (age 14.1 ± 1.5) with mild to moderate scoliosis. Both groups participated in a threeweek intervention consisted of three types of exercises: corrective, general and aquatic. ABP group participated in the Aquatic Breathing Program and CS group took part in corrective swimming. Spirometric measurements were taken before and after the intervention.Results: ABP group demonstrated a greater increase (p = .05) in the predicted percentage values of forced expiratory volume in 1 s (FEV1) and maximal expiratory flow at 25% of forced vital capacity (MEF25), both in absolute terms and in percentage values (MEF25%pred) compared to the CS group. CS group exhibited lower values of all measured parameters in the second examination, and some of those differences were found to be statistically significant.Conclusions: The Aquatic Breathing Program can be used in adolescents with mild to moderate scoliosis to improve lung function.

Types of falls and strategies for maintaining stability on an unstable surface.

BACKGROUND: Falls constitute an important health issue. They cause significant morbidity, mortality and have marked psychological effects on the individual, too. The aim of this study has been to determine parameters describing human movement strategies for balance and the reaction if balance is lost as a result of an unstable ground, and to attempt to describe the types of falls. MATERIAL AND METHODS: The study group comprised 20 volunteers. Kinematic parameters of falling and dynamic stability were measured using the Vicon Motion System and the Biodex Balance System SD. During the test, subjects stood for 20 s on the tilting platform. The analysis was conducted based on the first recordings, when the participants were not prepared for the event and their reactions were natural. A cluster analysis tool was applied to divide the behavior of people during the test. RESULTS: Based on motion range for kinematic parameters, the cluster analysis revealed 2 types of human behavior: falling (stepping) and restoring balance. Two types of falls were also observed: side and back falls. Moreover, on the basis of angular values for tilting plate, 4 zones were determined. The frequency of access to these zones by each joint revealed 3 strategies to maintain balance: ankle, knee and hip strategy. CONCLUSIONS: A set of initial conditions that may be used for future numerical simulations was also determined. Furthermore, the results presented in this study are likely to support the analysis of the effects and the falling patterns. Med Pr 2018;69(3):245-252.

Clinicopathologic characteristics and resection rates of papillary early gastric cancer removed by endoscopic submucosal dissection.

The aim of this study was to assess the: 1) clinicopathologic features of papillary early gastric cancer (PEGC) (13 cases) compared to tubular early gastric cancer (TEGC) (41 cases); 2) efficiency of endoscopic submucosal dissection (ESD) in treatment of PEGC. From January 2007 to February 2016, a total of 54 consecutive patients with early gastric cancer (EGC) underwent ESD at the Department of Gastroenterology of the Pomeranian Medical University in Poland. The histologic type of carcinoma was assessed according to the WHO histological classification of GC. The extension of GC into the submucosa was measured using the Aperio Scan Scope image analysis system tools. PEGCs were diagnosed in 24.1% of the cases of EGC. PEGCs were significantly more elevated in macroscopic examination and better demarcated tumors than TEGC. There were no significant differences between gender, tumor location, ulceration, tumor size, depth of invasion (T), presence of intestinal metaplasia and lymphocytic infiltrate. Curative resection was achieved in 87.1% of patients with EGCs treated with ESD. The lower rate of curative resection (R0) observed in PEGC (76.9%) vs TEGC (90.2%) was not statistically significant. Further studies will be necessary to confirm the clinical and morphological presentation of PEGCs.

First signs of elderly gait for women.

BACKGROUND: The aims of this study have been twofold: to attempt to reduce the number of spatiotemporal parameters used for describing gait through the factor analysis and component analysis; and to explore the critical age of decline for other gait parameters for healthy women. MATERIAL AND METHODS: A total of 106 women (aged ≥ 40 years old (N = 76) and ≤ 31 years old (N = 30)) were evaluated using a pressure-sensitive mat (Zebris Medical System, Tübingen, Germany) for collecting spatiotemporal gait parameters. RESULTS: The factor analysis identified 2 factors - labelled Time and Rhythm - that accounted for 72% of the variation in significant free-gait parameters; the principal component analysis identified 4 of these parameters that permit full clinical evaluation of gait quality. No difference was found between the groups in terms of the values of parameters reflecting the temporal nature of gait (Rhythm), namely step time, stride time and cadence, whereas significant differences were found for total double support phase (p < 0.001). Next, seeking evidence of a critical decline in gait, we selected 3 parameters: total double support, stride time and velocity. We concluded that the women taking part in the experiment manifested significant signs of senile gait after the age of 60 years old, with the first symptoms thereof already manifesting themselves after 50 years of age. CONCLUSIONS: We show that among 26 spatiotemporal parameters that may be used for characterizing gait, at least a half of them may be omitted in the assessment of gait correctness; a finding that may be useful in clinical practice. The finding that the onset of senile gait occurs in the case of women after the age of 60 years old, in turn, may be useful in evaluating the ability for performing types of physical work that mainly require ambulation. Med Pr 2017;68(4):441-448.

Histomorphologic features of early gastric carcinoma treated by endoscopic submucosal dissection: relation to efficiency of endoscopic resection.

OBJECTIVE: Early gastric cancer (EGC) is defined as cancer invasion confined to the mucosa or submucosa, irrespective of lymph node metastasis. Recently endoscopic submucosal dissection (ESD) has been widely accepted for the treatment for dysplasia and EGC without lymph node metastases. While the method has been advanced in Far East countries, ESD is still being developed in Europe and has not gained enough popularity although it has been recommended as the treatment of choice for superficial gastric neoplastic lesions by European Society of Gastrointestinal Endoscopy (ESGE) in 2015. METHODS: The aim of the study was to perform a retrospective analysis of clinical and histomorphologic features of 58 cases of EGCs removed by ESD in a university hospital in Western Pomerania in Poland and to evaluate factors related to the efficiency of ESD resection. RESULTS: With univariate analysis, indications for ESD with the highest R0 rate were found in EGCs limited to mucosa (T1a, small mucosal, M), without muscularis mucosa invasion, localised in the middle/lower part of stomach and intestinal type in histological examination. The R0 complete resection rate was significantly (p < 0.0001) lower for T1b than that for T1a tumours (21.4% vs. 100%). Tumours with submucosal involvement were associated with lower efficiency of ESD procedure. CONCLUSIONS: Our data showed that in EGCs with favourable histomorphologic characteristics, ESD seemed to be a totally efficient and safe method of treatment in a European small-volume centre. R0 resection rate reached 81.1% of cases and median time of the ESD procedure was 61.5 min.

Expression of Mismatch Repair Proteins in Early and Advanced Gastric Cancer in Poland.

BACKGROUND Mutations in DNA of mismatch repair (MMR) genes result in failure to repair errors that occur during DNA replication in microsatellites, resulting in accumulation of frameshift mutations in these genes and leading to DNA mismatch replication errors and microsatellite instability. Gastric cancers (GCs) with high MSI (MSI-H) are a well-defined subset of carcinomas showing distinctive clinicopathological features. In this study we investigated the rate of MSI and the correlation between MSI status and clinicopathological features of GC. MATERIAL AND METHODS The study included 107 patients with GCs: 61 with advanced gastric cancers (AGC) and 46 with early gastric cancer (EGC). MSI deficiency in GCs was assessed by the immunohistochemical analysis of expression of MMR proteins - MLH1, MSH2, MSH6, and PMS2 - using formalin-fixed and paraffin-embedded tissue. RESULTS A total of 6 (5.6%) MSI-H were observed. The loss of MMR proteins expression was associated with the intestinal type of GC in Lauren classification, and tubular and papillary architecture in WHO classification. There was no statistically significant association between negative MMR expression and other selected clinical parameters: age, sex, tumor location, depth of invasion (EGC and AGC), lymph nodes status, presence of the ulceration, and lymphocytic infiltrate. CONCLUSIONS In the present era of personalized medicine, the histological type of GC and MMR proteins status in cancer cells are very important for the proper surveillance of patients with familial GC and sporadic GCs, as well as for selecting the proper follow-up and treatment. Larger collaborative studies are needed to verify the features of MSI-H GCs in Poland.

Hospital Ethics Committees in Poland.

According to UNESCO guidelines, one of the four forms of bioethics committees in medicine are the Hospital Ethics Committees (HECs). The purpose of this study was to evaluate how the above guidelines are implemented in real practice. There were 111 hospitals selected out of 176 Polish clinical hospitals and hospitals accredited by Center of Monitoring Quality in Health System. The study was conducted by the survey method. There were 56 (50%) hospitals that responded to the survey. The number of HECs members fluctuated between 3 and 16 members, where usually 5 (22% of HECs) members were part of the board committee. The composition of the HECs for professions other than physicians was diverse and non-standardized (nurses-in 86% of HECs, clergy-42%, lawyers-38%, psychologists-28%, hospital management-23%, rehab staff-7 %, patient representatives-3%, ethicists-2%). Only 55% of HECs had a professional set of standards. 98% of HECs had specific tasks. 62% of HECs were asked for their expertise, and 55% prepared <6.88% of the opinions were related to interpersonal relations between hospital personnel, patients and their families with emphasis on the interactions between superiors and their inferiors or hospital staff and patients and their families. Only 12% of the opinions were reported by the respondents as related to ethical dilemmas. In conclusion, few Polish hospitals have HECs, and the structure, services and workload are not always adequate. To ensure a reliable operation of HECs requires the development of relevant legislation, standard operating procedures and well trained members.

The impact of a vestibular-stimulating exercise regimen on postural stability in women over 60.

BACKGROUND/OBJECTIVE: The aim of this study was to assess whether a program of exercise specifically designed to target the vestibular organ improved the postural stability of female participants over 60 years old. METHODS: Twenty-eight healthy female volunteers aged from 60 years to 76 years were assigned to a group (n = 15) engaging in vestibular-stimulating exercises, or to a control group (n = 13) engaging in traditional training exercises. Training sessions (∼45 minutes each) occurred twice a week over the course of 3 months. The following parameters were analyzed before and after training for both groups: stabilogram ellipse area and radii, total length of stabilogram, and visual-inspection indicator (eyes open). RESULTS: Results in terms of stabilogram ellipse area and radius without visual control (eyes closed) revealed statistically significant differences in the experimental group between the values before and after the training regimen (74.8 ± 51.6 - 54.5 ± 42.5 for area of ellipse, 6.6 ± 2.8 - 5.8 ± 2.8 for axis minor, 13.2 ± 4.3 - 11.1 ± 3.3 for axis major, respectively). No significant changes were observed in the control group. CONCLUSION: Exercises stimulating the vestibular organ, such as those described herein, should be a part of efforts to improve balance in older people.

Biomechanical comparison of two surgical methods for Hallux Valgus deformity: Exploring the use of artificial neural networks as a decision-making tool for orthopedists.

Hallux Valgus foot deformity affects gait performance. Common treatment options include distal oblique metatarsal osteotomy and chevron osteotomy. Nonetheless, the current process of selecting the appropriate osteotomy method poses potential biases and risks, due to its reliance on subjective human judgment and interpretation. The inherent variability among clinicians, the potential influence of individual clinical experiences, or inherent measurement limitations may contribute to inconsistent evaluations. To address this, incorporating objective tools like neural networks, renowned for effective classification and decision-making support, holds promise in identifying optimal surgical approaches. The objective of this cross-sectional study was twofold. Firstly, it aimed to investigate the feasibility of classifying patients based on the type of surgery. Secondly, it sought to explore the development of a decision-making tool to assist orthopedists in selecting the optimal surgical approach. To achieve this, gait parameters of twenty-three women with moderate to severe Hallux Valgus were analyzed. These patients underwent either distal oblique metatarsal osteotomy or chevron osteotomy. The parameters exhibiting differences in preoperative and postoperative values were identified through various statistical tests such as normalization, Shapiro-Wilk, non-parametric Wilcoxon, Student t, and paired difference tests. Two artificial neural networks were constructed for patient classification based on the type of surgery and to simulate an optimal surgery type considering postoperative walking speed. The results of the analysis demonstrated a strong correlation between surgery type and postoperative gait parameters, with the first neural network achieving a remarkable 100% accuracy in classification. Additionally, cases were identified where there was a mismatch with the surgeon's decision. Our findings highlight the potential of artificial neural networks as a complementary tool for surgeons in making informed decisions. Addressing the study's limitations, future research may investigate a wider range of orthopedic procedures, examine additional gait parameters and use more diverse and extensive datasets to enhance statistical robustness.

The Impact of Resistance Training on Equilibrium Abilities and Quality of Life in Older Adults after SARS-CoV-2 Survival.

Background: The scientific literature on COVID-19 and its long-term impacts on all-body systems and their treatments is still limited. The aim of the study was to create a safe protocol-based intervention to improve functional and equilibrium abilities in older adults impacted by COVID-19. Methods: This study used a sample of 46 people (intervention group: n = 26; control group: n = 20). Resistance training (RT) was held twice a week, with 60 min per session for 8 weeks. The postural stability and quality of life questionnaire (WHQOOL) was completed during pre- and post-testing. Results: The results indicated significant differences in overall stability index (OSI) with eyes open (EO), anterior-posterior stability index (APSI) EO, fall-risk index 6-2 (FRI6-2) values in males (p < 0.05), and APSI EO (p < 0.05) values in females compared to control groups, respectively. In the training, a significant improvement was reported in OSI EO and APSI EO (p < 0.05) female groups compared to baseline results and in FRI6-2 values in both gender groups (p < 0.01-men, p < 0.05-women). The effect of the intervention was recorded in the intervention group in the OSI EO (Z = -3.12, p < 0.01, R = 0.533) and FRI6-2 (Z = -2.06, p < 0.05, R = 0.354). Additionally, significantly different reactions between the groups were observed in the psychological domain (DOM2) (Z = 2.194, p < 0.028, R = 0.389), social relationship domain (DOM3) (Z = 2.051, p < 0.0403, R = 0.361), and in question 2 concerning general health (Z = 3.309, p < 0.0009, R = 0.535). Conclusions: The findings indicate that RT had a positive effect on older adults affected by COVID-19, led to a significant improvement in their postural stability, and had a significant impact on elements of psychological well-being and quality of life.

Resistance Exercise Program Is Feasible and Effective in Improving Functional Strength in Post-COVID Survivors.

Background: Evidence suggests that COVID-19 infection can cause lasting health consequences. Multidisciplinary rehabilitation services have been recommended to reduce the sequalae. However, the effectiveness of physical exercise interventions remains insufficiently documented. The aim of this study was to develop and implement a specific and well-tolerated protocol-based intervention to reduce muscle weakness in older adults impacted by COVID-19. Methods: Forty-six older adults were randomized into intervention and control groups. Isometric and isokinetic strength assessments were conducted for selected muscle groups using a JBA Staniak® torquemeter and Biodex System 3 dynamometer. Functional abilities were evaluated with the Time Up and Go test and Chair Stand Tests. Results: Men in the intervention group demonstrated a significant improvement in static conditions for knee flexors (KFs), trunk extensors (TEs) and trunk flexors (TFs) and in dynamic conditions for knee extensors (KEs). Women in the intervention group showed a significant improvement in static conditions for EFs, KFs, TEs and TFs and in dynamic conditions for a KE and a KF. The interaction GROUP × TESTING SESSION was significant for the Chair Test (s) and Chair Test (n). Conclusions: Our results demonstrate the effectiveness of a well-tolerated, protocol-based approach that can be used to diminish long-lasting functional deficits in post-COVID survivors.

Effect of Water-Based vs. Land-Based Exercise Intervention (postCOVIDkids) on Exercise Capacity, Fatigue, and Quality of Life in Children with Post COVID-19 Condition: A Randomized Controlled Trial.

Evidence suggests that COVID-19 can cause lasting health consequences called post-COVID-19 condition. We conducted a three-group, randomized controlled trial for children aged 10-12 years with post COVID-19 condition. Participants were randomized to AQUA, LAND, or CONTROL groups. The AQUA and LAND training sessions were conducted twice a week for eight weeks. The primary outcomes were exercise capacity, measured using the modified Balke treadmill protocol, and fatigue, measured using the Cumulative Fatigue Symptoms Questionnaire (CFSQ). The secondary outcome was health-related quality of life (HRQoL), measured with the Pediatric Quality of Life Inventory (PedsQL) for children and parents. A total of 74 of the 86 children completed the intervention and attended the post-intervention assessment. The absolute maximal oxygen uptake (VO2max) values increased after both AQUA (p = 0.001) and LAND (p = 0.004) interventions. No significant differences were found in the degree of total fatigue and individual fatigue symptoms. A significant improvement was found in the PedsQL reported by the parents in the LAND group. In conclusion, the applied eight-week water-based and land-based exercise training programs improved exercise capacity in children aged 10-12 years old with post COVID-19 condition. The parents of the children in the training groups also noted an improvement in HRQoL.

The Neurospora crassa chr-1 gene is up-regulated by chromate and its encoded CHR-1 protein causes chromate sensitivity and chromium accumulation.

The ChrA membrane protein belongs to the CHR superfamily of chromate ion transporters, which includes homologues from bacteria, archaea and eukaryotes. Bacterial ChrA homologues confer chromate resistance by exporting chromate ions from the cell's cytoplasm. The Neurospora crassa strain 74-A chr-1 gene encodes a putative CHR-1 protein of 507 amino acid residues, which belongs to the CHR superfamily. RT-PCR assays showed that expression of the chr-1 gene was up-regulated by chromate exposure of N. crassa cultures. Introduction in N. crassa of sense and antisense fragments of the chr-1 gene, as part of a silencing module within the pSilent-1 vector, produced transformants with a phenotype of resistance to chromate and diminished accumulation of chromium, as compared with the control strain containing only the vector. A chromate-resistance phenotype was also observed in N crassa strains deleted in the genomic chr-1 gene, thus confirming that the absence of CHR-1 protein confers chromate resistance to the fungus. The cDNA from N. crassa chr-1 gene (Ncchr-1) was cloned into the pYES2 vector under the control of a GAL promoter and the resulting recombinant plasmid was transferred to the yeast Saccharomyces cerevisiae. Galactose-induced S. cerevisiae transformants expressing Ncchr-1 were more sensitive to chromate and accumulated 2.5 times more chromium than the induced strain containing only the vector. Excess sulfate, a chromate analog, was unable to protect S. cerevisiae chr-1 transformants from chromate toxicity. These data indicate that the N. crassa CHR-1 protein functions as a transporter that takes up chromate; it also appears that this transport occurs in a sulfate-independent fashion. This is the first report assigning a role as a chromate transporter to a nonbacterial CHR protein.

Kinetic analysis of gait in adults with asymptomatic flatfoot.

PURPOSE: The aim of our study was to assess the influence of asymptomatic flatfoot on the kinetic parameters of the lower limb during gait. METHODS: Individuals of both sexes were studied: 15 women [age 25 ± 5 years] and 19 men [age 25 ± 4 years] with bilateral asymptomatic flatfoot, as well as 16 women [age 26±4 years] and 14 men [age 24 ± 3 years] with normal feet on both sides. A threedimensional VICON motion analysis system coupled with KISTLER dynamometric platforms was used to perform kinetic gait analysis. RESULTS: Women with flatfoot showed significantly lower maximal relative moments in the ankle in the sagittal plane ( p < 0.05) and significantly lower maximal relative moments in the knee in the sagittal plane in the Terminal Stance ( p < 0.001). In men, a significant difference was found in terms of hip rotation moment in the transverse plane in the Mid Stance ( p < 0.01): men with normal feet showed moments of external rotation, while men with flatfoot generated internal rotational moments. Moreover, men with flatfoot showed significantly lower ( p < 0.01) maximal relative moments in the knee in the transverse plane in the Mid Stance. CONCLUSIONS: Women with flatfoot have a weakened lower limb propulsion mechanism, whereas, in men with flatfoot, there is a change in the mechanics of the lower limb in the transverse plane. Our findings cast some doubt on flatfoot as a putative risk factor for stress injuries and degenerative changes in lower-limb structures, and suggest that gender differentiation should be taken into account in the analysis and therapy of flatfoot.

Hip joint mobility in relation to measurement position, gender and limb dominance.

PURPOSE: The purpose of this study was to determine whether three different measurement position yield divergent results in ROM using a goniometer, and how is it affected by anthropometrical factors. METHODS: We measured the range of rotation in the hip joint in healthy participants aged 21.6 ± 1.88, seeking to determine how the distribution of internal vs. external rotation (RI) within the total range of mobility (TR) was influenced by the measurement position used, the gender of the participant, and the dominant lower limb. RESULTS: We found that not only gender and limb dominance, but also the body position in which hip joint's range of motion is measured significantly affects the values of TR and RI. We found that TR achieves the highest values in the prone position - PrP (males: 95.35 ± 12.44 and 93.15 ± 12.49; females: 103.75 ± 14.87 and 106.25 ± 15.56) and the lowest values in supine position - SuP (male: 62.65 ± 8.51 and 57.85 ± 9.60; female: 59.5 ±12.27 and 55.85 ±8.54). The analysis shows that CERD occurs <0.42 RI in females (PrP) and <0.88 RI in men (PrP and sitting position - StP), and CIRD > 1.72 RI in women (StP), and > 2.08 RI in men (PrP). CONCLUSIONS: Due to the similarities between asymmetry of internal/external rotation in the hip joint and asymmetry in the rotation of the shoulder found in Glenohumeral Internal Rotation Deficit (GIRD), we propose the concepts of Coxal Internal Rotation Deficit (CIRD) and Coxal External Rotation Deficit (CERD) as tools to indicate the possibility for injury to the hip joint, and propose threshold rotation index values serving as indicators of these deficits.

Using nonlinear measures to evaluate postural control in healthy adults during bipedal standing on an unstable surface.

PURPOSE: This study examined the use of nonlinear measures - sample entropy (SampEn), fractal dimension (FD), and the Lyapunov exponent (LyE) - to evaluate postural control in adults during standing on an unstable surface, with and without visual feedback. METHODS: 14 healthy young adults (24.07 ± 7.32 years) completed bipedal standing trials on an unstable-plate Biodex Balance System (BBS) connected to a Vicon system, with eyes open and closed. Each trial lasted 20 sec. Analysis was performed based on the center of mass (CoM), for which the three nonlinear measures were calculated. RESULTS: Excluding visual feedback was found to cause a significant increase in linear and nonlinear parameters. Moreover, SampEn and FD values were found to be significantly higher in the PD direction, compared to AP or ML, whereas LyE values in this direction were minimal. CONCLUSIONS: Results show that the three nonlinear measures provide a useful way of evaluating postural control in healthy adults. Moreover, it seems that introducing an unstable surface meant that the projection of the CoM was not perpendicular to the surface, but rather set at a certain continually changing angle, forcing the whole system to adapt to chaotic and unpredictable conditions. Such refined changes in conditions can be evaluated in a precise way only by using nonlinear measures.

Chronic Exposure to Normobaric Hypoxia Increases Testosterone Levels and Testosterone/Cortisol Ratio in Cyclists.

The aim of this study was to analyze the effects of the "live high, train low" method (LH−TL) and intermittent hypoxic training (IHT) on testosterone (T) and cortisol (C) levels in cyclists. Thirty cyclists participated in the experiment. The LH−TL group (n = 10) was exposed to normobaric hypoxia (FiO2 = 16.3%) for 11−12 h a day and trained in normoxia for 3 weeks. In the IHT group (n = 10), participants followed the IHT routine three times a week for 3 weeks in normobaric hypoxia (FiO2 = 16.3%). The control group (N; n = 10) followed the same training protocol in normoxia. The LH−TL training was found to significantly increase (p < 0.05) T levels and the testosterone/cortisol (T/C) ratio during the experiment. The area under the curve (AUC) calculated for T levels over 4 weeks was significantly (p < 0.05) higher in the LH−TL group, by 25.6%, compared to the N group. The results also indicated a significant correlation (r = 0.53; p < 0.05) between AUC for T levels over 4 weeks and ∆ values of hemoglobin (HGB) in the LH−TL group. Overall, the findings show that LH−TL training at a moderate simulated altitude contributes to an increase in T levels and T/C ratio in athletes, which is a beneficial change stimulating anabolic processes and erythropoiesis.