Back pain in children and adolescents: a cross-sectional study.

PURPOSE: Back pain is a growing problem worldwide, not only in adults but also in children. Therefore, it is becoming increasingly important to investigate and understand the factors that influence the early onset of back pain. The aim of this study was to determine the prevalence of back pain in children and adolescents and to identify predisposing risk factors and protective factors. METHODS: A cross-sectional study was conducted between October and December 2019 in schools from northern Portugal, evaluating 1463 students aged 9 to 19 years, of both genders. The instruments used were the Spinal Mouse® to assess posture, the Inbody 230® to assess body composition, an online questionnaire to characterize the sample and back pain, and the FITescola® battery test to access physical fitness. RESULTS: Half of the subjects experienced back pain at least once in their lifetime. The most frequently mentioned were lumbar spine and thoracic spine, mostly with mild or moderate pain intensities. Age, female gender, percent body fat, prolonged smartphone and computer use, hyperkyphosis, and the lateral global spine tilt to the left side are all factors with higher relative risk of back pain. Practicing physical activity or sports regularly and video games have a protective effect. CONCLUSION: The prevalence of back pain in children and adolescents is very high: The study enhances the case for protective factors such as physical activity habits or video games while reinforcing risk factors such as percent body fat, prolonged smartphone or computer use, and posture.

Using Raw Accelerometer Data to Predict High-Impact Mechanical Loading.

The purpose of this study was to develop peak ground reaction force (pGRF) and peak loading rate (pLR) prediction equations for high-impact activities in adult subjects with a broad range of body masses, from normal weight to severe obesity. A total of 78 participants (27 males; 82.4 ± 20.6 kg) completed a series of trials involving jumps of different types and heights on force plates while wearing accelerometers at the ankle, lower back, and hip. Regression equations were developed to predict pGRF and pLR from accelerometry data. Leave-one-out cross-validation was used to calculate prediction accuracy and Bland-Altman plots. Body mass was a predictor in all models, along with peak acceleration in the pGRF models and peak acceleration rate in the pLR models. The equations to predict pGRF had a coefficient of determination (R2) of at least 0.83, and a mean absolute percentage error (MAPE) below 14.5%, while the R2 for the pLR prediction equations was at least 0.87 and the highest MAPE was 24.7%. Jumping pGRF can be accurately predicted through accelerometry data, enabling the continuous assessment of mechanical loading in clinical settings. The pLR prediction equations yielded a lower accuracy when compared to the pGRF equations.

Swimmers' Effective Actions during the Backstroke Start Technique.

The analysis of the external forces of swimming starts has revealed how swimmers propel themselves out of the block, but data should be properly interpreted to fully understand force-generation mechanisms. This study aimed to assess horizontal and vertical forces in the backstroke start based on swimmers' structural and propulsive actions. Firstly, a simulated structural force was estimated by two transient backstroke-start inter-segmental realistic body positions: a maximally tucked position and an extended one (just before the hands-off and the take-off, respectively). Secondly, 10 competitive backstroke swimmers performed four 15 m maximal backstroke starts with the external forces estimated. Thirdly, the simulated structural force was subtracted from raw horizontal and vertical force data, measured between hands-off and take-off instants, resulting in the propulsive forces. The application of the algorithm has evidenced that backstrokers' horizontal and vertical simulated-structural-force components contributed to ~40% of total force during start propulsion (~0.2-0.12 s before the take-off), followed by the propulsive horizontal force increment and a progressive vertical component reduction (~0.05 s) with ~20° take-off angle. Based on these findings, researchers and coaches can better guide swimmers as to the proper mechanical strategies to achieve effectiveness in the backstroke start, and to improve direct transfer of resistance training programs.

Acute Recovery after a Fatigue Protocol Using a Recovery Sports Legging: An Experimental Study.

Enhancing recovery is a fundamental component of high-performance sports training since it enables practitioners to potentiate physical performance and minimise the risk of injuries. Using a new sports legging embedded with an intelligent system for electrostimulation, localised heating and compression (completely embodied into the textile structures), we aimed to analyse acute recovery following a fatigue protocol. Surface electromyography- and torque-related variables were recorded on eight recreational athletes. A fatigue protocol conducted in an isokinetic dynamometer allowed us to examine isometric torque and consequent post-exercise acute recovery after using the sports legging. Regarding peak torque, no differences were found between post-fatigue and post-recovery assessments in any variable; however, pre-fatigue registered a 16% greater peak torque when compared with post-fatigue for localised heating and compression recovery methods. Our data are supported by recent meta-analyses indicating that individual recovery methods, such as localised heating, electrostimulation and compression, are not effective to recover from a fatiguing exercise. In fact, none of the recovery methods available through the sports legging tested was effective in acutely recovering the torque values produced isometrically.

Effects of a Multicomponent Exercise Training Program on Balance Following Bariatric Surgery.

Patients who undergo bariatric surgery (BS) have an increased risk of falls. Our aim was to determine if a multicomponent exercise intervention after BS improves balance. Eighty-four patients with obesity enrolled for BS were recruited and 1 month after BS randomly allocated to a control (CG; standard medical care) or exercise group (EG; exercise plus standard medical care) consisting of a supervised multicomponent training program (3d/week; 75 min/session; 5 months). Anthropometry, lower limb muscle strength (isokinetic dynamometer), vitamin D (ELISA) and balance in bipedal stance (force platform) were assessed pre-BS, 1 month and 6 months post-BS. One month post-BS, significant balance improvements were observed, namely in antero-posterior center of gravity (CoG) displacement and velocity, and medio-lateral and total CoG velocity. Between 1- and 6-months post-BS, improvements in balance were observed only in the EG, with a significant treatment effect on CoG displacement area and antero-posterior CoG displacement. No significant differences were observed between EG and CG over time in any of the anthropometric, muscle strength, and vitamin D variables assayed. In conclusion, a multicomponent exercise intervention program improves some balance parameters in patients with severe obesity following BS and therefore should be part of post-BS follow-up care as a potential strategy to reduce falls and associated injuries.

Balance and Posture in Children and Adolescents: A Cross-Sectional Study.

Balance and posture are two topics that have been extensively studied, although with some conflicting findings. Therefore, the aim of this work is to analyze the relationship between the postural angles of the spine in the sagittal plane and the stable static balance. A cross-sectional study was conducted with children and adolescents from schools in northern Portugal in 2019. An online questionnaire was used to characterize the sample and analyze back pain. Spinal postural angle assessment (pelvic, lumbar, and thoracic) was performed using the Spinal Mouse®, while stabilometry assessment was performed using Namrol® Podoprint®. Statistical significance was set as α = 0.05. The results showed that girls have better balance variables. There is a weak correlation between the anthropometric variables with stabilometry variables and the postural angles. This correlation is mostly negative, except for the thoracic spine with anthropometric variables and the lumbar spine with BMI. The results showed that postural angles of the spine are poor predictors of the stabilometric variables. Concerning back pain, increasing the postural angle of the thoracic spine increases the odds ratio of manifestation of back pain by 3%.

Can increased load carriage affect lower limbs kinematics during military gait?

The aim of this study was to investigate if increased load carriage, in male military personnel, can affect the lower limbs kinematics. Twelve male military volunteers from the Portuguese Army were recruited and evaluated in an unloaded and loaded gait condition. Linear kinematics and lower limbs joint angle at heel strike, midstance and toe off were calculated. The stance, swing and double support times were found to be different between load conditions (p < 0.05). There was an interaction between load and limb (p < 0.05) for joint angles, during midstance, with limbs performing different movements in the frontal plane during loaded gait. Load increase had a different effect on the right knee, with a reduction in the abduction (valgus). This study may be beneficial in offering suggestion to improve the performance of gait with load and in an attempt to help prevent possible injuries. Practitioner summary: Increased load can affect lower limbs of male soldiers at the pelvic, hip and knee angles on the frontal plane, which can alter the joint force distribution. While these alterations may indicate protective mechanics, load management procedures should be implemented along with gait monitoring to avoid negative effects in performance.

Effects of tailored lateral wedge insoles on medial knee osteoarthritis based on biomechanical analysis: 12-week randomized controlled trial.

BACKGROUND: Lateral wedge insoles adjusted by biomechanical analysis may improve the condition of patients with medial knee osteoarthritis. DESIGN: This is a prospective, randomized, controlled, single-blind clinical trial. SETTING: The study was conducted in a biomechanics laboratory. SUBJECTS: A total of 38 patients with medial knee osteoarthritis were allocated to either an experimental group (lateral wedge insoles) or a control group (neutral insoles). INTERVENTIONS: Experimental group (n = 20) received an adjusted lateral wedge insole of 2, 4, 6, 8, or 10 degrees, after previous biomechanical analysis. Control group (n = 18) received a neutral insole (0 degrees). All patients used the insoles for 12 weeks. MAIN MEASURES: Visual analogue scale, Knee Injury and Osteoarthritis Outcome Score questionnaire, biomechanical parameters: first and second peak of the external knee adduction moment and knee adduction angular impulse, and physical performance tests: 30-second sit-to-stand test, the 40-m fast-paced walk test, and the 12-step stair-climb test. RESULTS: After 12 weeks, between-group differences did not differ significantly for pain intensity (-12.5 mm, (95% CI -29.4-4.4)), biomechanical parameters (p = 0.05), Knee Injury and Osteoarthritis Outcome Score, and physical performance tests, except on the Knee Injury and Osteoarthritis Outcome Score subscale other symptoms (p = 0.002; 13.8 points, (95% CI 5.6-22.0)). CONCLUSION: Tailored wedge insoles were no more effective at improving biomechanical or clinically meaningful outcomes than neutral insoles, except on symptoms. More participants from the experimental group reported they felt some improvement. However, these effects were minimal and without clinical significance.

Equimetrix Device: Criteria Based Validation and Reliability Analysis of the Center of Mass and Base of Support of a Human Postural Assessment System.

Human postural control is a fundamental ability for static and dynamic tasks, especially in hiper- and hipo-functional populations, such as the elderly. The Equimetrix is a clinical device developed to assess both the base of support (BoS) and the center of mass (CoM) dynamics, thus allowing their use as new evaluation and training tools. This study aims to perform a criteria based validation of Equimetrix by comparing the BoS and CoM data with gold-standard equipment. A motion capture system, force platform, and pressure mat were used to calculate the CoM, center of pressure (CoP) and BoS during bipedal, unipedal, feet together and full tandem stances. Results demonstrate an excellent reliability of Equimetrix in terms of spatial accuracy of the CoM, although over-estimating the CoM height. Differences were found when comparing Mean velocity Path with the CoM, but not with the CoP, indicating a lower reliability in time-based parameters. The Equimetrix presents a tendency to overestimate the BoS, with mixed reliability values, which may be related to the different size of sensing elements between the Equimetrix and the pressure sensing mat. These are encouraging results that should be further explored during dynamic tasks.

Does Gait with an Ankle Foot Orthosis Improve or Compromise Minimum Foot Clearance?

The purpose of this study was to investigate if the use of an ankle foot orthosis in passive mode (without actuation) could modify minimum foot clearance, and if there are any compensatory mechanisms to enable these changes during treadmill gait at a constant speed. Eight participants walked on an instrumented treadmill without and with an ankle foot orthosis on the dominant limb at speeds of 0.8, 1.2, and 1.6 km/h. For each gait cycle, the minimum foot clearance and some gait linear kinematic parameters were calculated by an inertial motion capture system. Additionally, maximum hip and knee flexion and maximum ankle plantar flexion were calculated. There were no significant differences in the minimum foot clearance between gait conditions and lower limbs. However, differences were found in the swing, stance and step times between gait conditions, as well as between limbs during gait with orthosis (p < 0.05). An increase in hip flexion during gait with orthosis was observed for all speeds, and different ankle ranges of motion were observed according to speed (p < 0.05). Thus, the use of an ankle foot orthosis in passive mode does not significantly hinder minimum foot clearance, but can change gait linear and angular parameters in non-pathological individuals.

Exercise modality effect on oxygen uptake off-transient kinetics at maximal oxygen uptake intensity.

NEW FINDINGS: What is the central question of this study? Do the mechanical differences between swimming, rowing, running and cycling have a potential effect on the oxygen uptake (V̇O2) off-kinetics after an exercise sustained until exhaustion at 100% of maximal oxygen uptake (V̇O2max) intensity? What is the main finding and its importance? The mechanical differences between exercise modes had a potential effect and contributed to distinct amplitude of the fast component (higher in running compared with cycling) and time constant (higher in swimming compared with rowing and cycling) in the V̇O2 off-kinetic patterns at 100% of V̇O2max intensity. This suggests that swimmers, unlike rowers and cyclists, would benefit more from a longer duration of training intervals after each set of exercise performed at V̇O2max intensity. The kinetics of oxygen uptake (V̇O2) during recovery (off-transient kinetics) for different exercise modes is largely unexplored, hampering the prescription of training and recovery to enhance performance. The purpose of this study was to compare the V̇O2 off-transient kinetics response between swimmers, rowers, runners and cyclists during their specific mode of exercise at 100% of maximal oxygen uptake (V̇O2max) intensity and to examine the on-off symmetry. Groups of swimmers, rowers, runners and cyclists (n = 8 per group) performed (i) an incremental exercise protocol to assess the velocity or power associated with V̇O2max (vV̇O2max or wV̇O2max, respectively) and (ii) a square-wave exercise transition from rest to vV̇O2max/vV̇O2maxwV̇O2maxwV̇O2max until volitional exhaustion. Pulmonary exchange parameters were measured using a telemetric portable gas analyser (K4b(2) ; Cosmed, Rome, Italy), and the on- and off-transient kinetics were analysed through a double-exponential approach. For all exercise modes, both transient periods were symmetrical in shape once they had both been adequately fitted by a double-exponential model. However, differences were found in the off-kinetic parameters between exercise modes; the amplitude of the fast component of the V̇O2 off-response was higher in running compared with cycling (48 ± 5 and 36 ± 7 ml kg(-1) min(-1) , respectively; P < 0.001), and the time constant of the same phase was higher in swimming compared with rowing and cycling (63 ± 5, 56 ± 5 and 55 ± 3 s, respectively; P < 0.001). Although both phases were well described by a double-exponential model, the differences between exercise modes had a potential effect and contributed to distinct V̇O2 off-transient kinetic patterns at 100% of V̇O2max intensity.

Kinematic, kinetic and EMG analysis of four front crawl flip turn techniques.

This study aimed to analyse the kinematic, kinetic and electromyographic characteristics of four front crawl flip turn technique variants. The variants distinguished from each other by differences in body position (i.e., dorsal, lateral, ventral) during rolling, wall support, pushing and gliding phases. Seventeen highly trained swimmers (17.9 ± 3.2 years old) participated in interventional sessions and performed three trials of each variant, being monitored with a 3-D video system, a force platform and an electromyography (EMG) system. Studied variables: rolling time and distance, wall support time, push-off time, peak force and horizontal impulse at wall support and push-off, centre of mass horizontal velocity at the end of the push-off, gliding time, centre of mass depth, distance, average and final velocity during gliding, total turn time and electrical activity of Gastrocnemius Medialis, Tibialis Anterior, Biceps Femoris and Vastus Lateralis muscles. Depending on the variant, total turn time ranged from 2.37 ± 0.32 to 2.43 ± 0.33 s, push-off force from 1.86 ± 0.33 to 1.92 ± 0.26 BW and centre of mass velocity during gliding from 1.78 ± 0.21 to 1.94 ± 0.22 m · s(-1). The variants were not distinguishable in terms of kinematical, kinetic and EMG parameters during the rolling, wall support, pushing and gliding phases.

Insights into animal and plant lectins with antimicrobial activities.

Lectins are multivalent proteins with the ability to recognize and bind diverse carbohydrate structures. The glyco -binding and diverse molecular structures observed in these protein classes make them a large and heterogeneous group with a wide range of biological activities in microorganisms, animals and plants. Lectins from plants and animals are commonly used in direct defense against pathogens and in immune regulation. This review focuses on sources of animal and plant lectins, describing their functional classification and tridimensional structures, relating these properties with biotechnological purposes, including antimicrobial activities. In summary, this work focuses on structural-functional elucidation of diverse lectin groups, shedding some light on host-pathogen interactions; it also examines their emergence as biotechnological tools through gene manipulation and development of new drugs.

Hydrodynamic analysis of different finger positions in swimming: a computational fluid dynamics approach.

The aim of this research was to numerically clarify the effect of finger spreading and thumb abduction on the hydrodynamic force generated by the hand and forearm during swimming. A computational fluid dynamics (CFD) analysis of a realistic hand and forearm model obtained using a computer tomography scanner was conducted. A mean flow speed of 2 m · s(-1) was used to analyze the possible combinations of three finger positions (grouped, partially spread, totally spread), three thumb positions (adducted, partially abducted, totally abducted), three angles of attack (a = 0°, 45°, 90°), and four sweepback angles (y = 0°, 90°, 180°, 270°) to yield a total of 108 simulated situations. The values of the drag coefficient were observed to increase with the angle of attack for all sweepback angles and finger and thumb positions. For y = 0° and 180°, the model with the thumb adducted and with the little finger spread presented higher drag coefficient values for a = 45° and 90°. Lift coefficient values were observed to be very low at a = 0° and 90° for all of the sweepback angles and finger and thumb positions studied, although very similar values are obtained at a = 45°. For y = 0° and 180°, the effect of finger and thumb positions appears to be much most distinct, indicating that having the thumb slightly abducted and the fingers grouped is a preferable position at y = 180°, whereas at y = 0°, having the thumb adducted and fingers slightly spread yielded higher lift values. Results show that finger and thumb positioning in swimming is a determinant of the propulsive force produced during swimming; indeed, this force is dependent on the direction of the flow over the hand and forearm, which changes across the arm's stroke.

Detection of Mycoplasma spp. in free-living seabirds.

This study aimed to investigate the presence of Mycoplasma spp. and identify the species of mycoplasma isolates obtained from seabirds found on Brazilian coastal beaches. Tracheal and cloacal swab samples were collected from 50 seabirds rescued by three conservation and marine animal rehabilitation centers located in Brazil. The tracheal and cloacal samples were subjected to mycoplasma culture and the isolates were identified through PCR. A "Mollicutes-specific" 16S rRNA PCR reaction was employed for triage. Four species-specific PCR reactions were used to detect Mycoplasma gallisepticum, Mycoplasma synoviae, Mycoplasma meleagridis, or M. gallinarum. The Mollicutes positive and species negative samples were submitted do 16S rRNA sequencing. Eighteen (36%) of 50 seabirds tested positive for mycoplasma by culture. In the PCR for the genus, 28 (56%) of 50 seabirds were positive for Mycoplasma spp., with 13 (26%) detected in the trachea, one (2%) in the cloaca, and 14 (28%) in both sites. In the species-specific PCR, M. gallisepticum was detected in 17.8%, and M. meleagridis in 17.8%. Both species were detected in 14.3%. Of the isolates not characterized at species level, we obtained ten sequences and they were divided into three clusters. The first cluster was closely related to M. meleagridis, the second to M. synoviae, and the third grouped M. tully, M. gallisepticum, and M. imitans. Four and five of nine species of seabirds studied had mycoplasma detected by culture or PCR, respectively. Mycoplasmas were found in the majority of the animals studied, with the highest prevalence proportionally found in Sula leucogaster, and the lowest in Fregata magnificens. The phylogenetic analysis identified Mycoplasma spp. adapted to aquatic birds.

Mechanical loading prediction through accelerometry data during walking and running.

Currently, there is no way to assess mechanical loading variables such as peak ground reaction forces (pGRF) and peak loading rate (pLR) in clinical settings. The purpose of this study was to develop accelerometry-based equations to predict both pGRF and pLR during walking and running. One hundred and thirty one subjects (79 females; 76.9 ± 19.6 kg) walked and ran at different speeds (2-14 km·h-1) on a force plate-instrumented treadmill while wearing accelerometers at their ankle, lower back and hip. Regression equations were developed to predict pGRF and pLR from accelerometry data. Leave-one-out cross-validation was used to calculate prediction accuracy and Bland-Altman plots. Our pGRF prediction equation was compared with a reference equation previously published. Body mass and peak acceleration were included for pGRF prediction and body mass and peak acceleration rate for pLR prediction. All pGRF equation coefficients of determination were above 0.96, and a good agreement between actual and predicted pGRF was observed, with a mean absolute percent error (MAPE) below 7.3%. Accuracy indices from our equations were better than previously developed equations. All pLR prediction equations presented a lower accuracy compared to those developed to predict pGRF. Walking and running pGRF can be predicted with high accuracy by accelerometry-based equations, representing an easy way to determine mechanical loading in free-living conditions. The pLR prediction equations yielded a somewhat lower prediction accuracy compared with the pGRF equations.

Peak ground reaction forces can be accurately predicted through raw accelerometry data.These predictions are valid for a broad range of body masses and for ankle, lower back and hip accelerometer placements.Peak loading rate prediction presented lower accuracy compared with peak ground reaction force prediction.These findings result in a simple method to predict mechanical loading in clinical practice, which is relevant in some areas of sports medicine such as bone health and injury prevention.

Detection of Mycoplasma species at various anatomical sites of dogs from different types of kennels.

This work aimed to detect Mycoplasma cynos, M. canis, M. edwardii, and M. molare in different types of kennels, in addition to evaluating their distribution in different colonization sites. The dogs belonged to different kennels from armed forces (n = 3), shelters (n = 3), and commercial purposes (n = 2). Samples of the oropharynx, genital mucosa, and ear canal were collected from each dog (n = 98), totaling 294 samples. Aliquots were submitted to isolation and the samples confirmed as Mycoplasma spp. were subjected to conventional PCR for M. canis and multiplex PCR for M. edwardii, M. molare, and M. cynos detection. Of the 98 dogs studied, 63.3% (62) were positive in at least one anatomical site evaluated for Mycoplasma spp. Among the 111 anatomical sites positive for Mycoplasma spp., M. canis, M. edwardii, and M. molare were detected in 29.7% (33/111), 40.5% (45/111), and 2.70% (3/111), respectively. No animal was positive for M. cynos.

D-Scan measurement of ablation threshold incubation effects for ultrashort laser pulses.

We report the validation of the Diagonal Scan (D-Scan) technique to determine the incubation parameter for ultrashort laser pulses ablation. A theory to calculate the laser pulses superposition and a procedure for quantifying incubation effects are described, and the results obtained for BK7 samples in the 100 fs regime are compared to the ones given by the traditional method, showing a good agreement.

Kinematic analysis of three water polo front crawl styles.

During water polo matches, players use different front crawl styles. The purpose of this study was to conduct a kinematic analysis of three water polo front crawl styles: front crawl with head under water, front crawl with head above water, and front crawl when leading the ball. Ten proficient water polo players performed 3 × 15 m sprints in each front crawl style, which were recorded three-dimensionally by two surface and four underwater cameras. The results showed no differences in performance and several kinematic characteristics among the water polo front crawl styles. However, front crawl when leading the ball showed shorter stroke length and greater stroke frequency. Front crawl with head underwater presented greater maximal finger depth and elbow angle at mid-stroke position. Front crawl with head above water and when leading the ball showed greater trunk obliquity and maximal depth of right and left foot, and shorter kick stroke frequency. The findings suggest that proficient players learn to master front crawl with head above water to achieve top velocity. Despite the common use of the front crawl with head underwater as the basis for water polo fast displacement, coaches should emphasize the use of the specific water polo styles to attain high performance.

Does the Back Plate Position Influence Swimming Start Temporal Characteristics?

The current study examined the back plate position impact on the block phase movement pattern and total starting performance with a distinction for sex. Thirty-eight swimmers performed starts changing the back plate position (preferred position, one position forward and one position backward), with the data being assessed using a 3D dynamometric central and a video camera. In males, the 15 m start time was 0.1 s shorter for the preferred position compared with the backward position (p < 0.05). Regardless of the back plate positioning, the swimmers spent a similar time on the block. A more forward position of the back plate postponed the rear foot take-off and consequently reduced the front foot stand duration. A back plate position effect was revealed for those variables with a larger effect size in males whereas in females, a change of about two positions was needed to reach a significance level. Probably due to the specification of physical domains, a greater impact on the changes introduced was noted for males. Therefore, whilst searching for the optimal starting position, adjustments to the back plate placement might affect a greater number of males than females. To reinforce the starting optimization during the training process and its monitoring, the effect of personal preference toward the starting block setting was also considered.