Predictive Model of All-Cause Death in Patients with Heart Failure using Heart Rate Variability. / Modelo Preditivo de Mortalidade por Todas as Causas em Pacientes com Insuficiência Cardíaca Usando a Variabilidade da Frequência Cardíaca.

BACKGROUND: Central Illustration : Predictive Model of All-Cause Death in Patients with Heart Failure using Heart Rate Variability. BACKGROUND: Short and long-duration heart rate variability (HRV) data from Holter monitoring could identify predictors of all-cause death in heart failure (HF) patients. OBJECTIVES: To build a predictive model of all-cause death in patients with HF using HRV. METHODS: Retrospective study including patients with suspected or confirmed HF who were admitted for decompensated HF or syncope that underwent Holter monitoring. In analysis of augmented sympathetic tonus, we evaluated the lowest HRV in nonoverlapping 10-minutes periods throughout 24h continuous electrocardiographic signal recording (short HRV variables). Variables with p<0.01 were included in a multivariate Cox regression model to determine the occurrence of the all-cause death. Variables with statistical significance in Cox regression were chosen to build the predictive model. P<0.05 was considered significant. RESULTS: A total of 116 patients were included, mean age of 71.9±16.3 years, 45.7% men, mean follow-up of 2.83±1.27 years. Thirty-nine deaths occurred (33.6%). By comparing survivors vs. non-survivors, the variables that showed statistical significance were lowest SDNN, lowest rMSSD, age and left ventricular ejection fraction (LVEF). In Cox regression, independent predictors of all-cause death were: age>69 years (HR 3.95, 95%CI 1.64-9.52); LVEF≤57% (HR 4.70, 95%CI 2.38-9.28) and lowest rMSSD≤12ms (HR 5.54, 95%CI 2.04-15.08). An integer value was assigned to each variable. Score<3 showed AUC=0.802 (95%CI 0.72-0.87). CONCLUSION: In HF patients hospitalized for decompensated HF or syncope, independent long-term predictors of all-cause death were age, LVEF, and 10-minutes rMSSD. These findings indicate that even brief moments of high sympathetic tone can impact survival, specifically in the elderly and patients with HF with reduced ejection fraction.

Do exist differences in kinematics and EMG of the hip and knee between male runners with and without patellofemoral pain in different running speeds?

OBJECTIVE: Patellofemoral pain (PFP) presents a higher prevalence in female runners, while PFP in male is somehow neglected. Moreover, the effects of progressive greater running speed have not been reported. This study investigates the influence of progressive greater running speed on lower limb tridimensional kinematics and muscle activation (EMG) in male runners with PFP while compared with controls. DESIGN: Cross-Sectional Design. METHODS: Thirteen runners with PFP and 18 controls ran in a treadmill under three different speeds: 9, 11, and 13 km/h. Principal component scores from kinematic data and EMG onset and amplitude were used to compare groups through the Mann-Whitney test at each running speed. RESULTS: Male PFP subjects presented increased hip internal rotation at 11 km/h and increased hip and knee internal at 13 km/h, as well as reduced knee adduction at all speeds. PFP subjects also ran with delayed and shorter vastus medialis oblique pre-activation compared with normal subjects. CONCLUSIONS: This study demonstrated that PFP increased knee and hip internal rotation at higher demand running, therefore, it is important to evaluate the transverse plane of the hip and knee biomechanics in male runners with PFP to optimize the rehabilitation and reconditioning method of these subjects.

Modelo Preditivo de Mortalidade por Todas as Causas em Pacientes com Insuficiência Cardíaca Usando a Variabilidade da Frequência Cardíaca / Predictive Model of All-Cause Death in Patients with Heart Failure using Heart Rate Variability

Resumo Fundamento Dados de curto e de longo prazo da variabilidade da frequência cardíaca (VFC) poderiam identificar preditores de mortalidade por todas as causas em pacientes com insuficiência cardíaca (IC). Objetivos Construir um modelo preditivo de mortalidade por todas as causas em pacientes com IC usando a VFC. Métodos Estudo retrospectivo incluindo pacientes com suspeita ou diagnóstico confirmado de IC internados por IC descompensada ou síncope e que realizaram exame de Holter 24 horas. Na análise do tônus simpático aumentado, nós avaliamos a VFC mais baixa em períodos de 10 minutos não sobrepostos em um registro contínuo de sinal eletrocardiográfico por 24 horas (VFC de curta duração). As variáveis com p<0,01 foram incluídas no modelo de regressão multivariada de Cox para determinar a ocorrência da mortalidade por todas as causas. As variáveis com significância estatística na regressão de Cox foram escolhidas para construir o modelo preditivo. Um p<0,05 foi considerado estatisticamente significativo. Resultados Um total de 116 pacientes foram incluídos, com idade média de 71,9±16,3 anos, 45,7% eram do sexo masculino. O tempo médio de acompanhamento foi de 2,83 ± 1,27 anos. Trinta e nove (33,6%) óbitos ocorreram. Na comparação de sobreviventes e não sobreviventes, as variáveis que mostraram significância estatística foram menor SDNN, menor rMSSD, idade e fração de ejeção ventricular esquerda (FEVE). Na regressão Cox, os preditores independentes de mortalidade por todas as causas foram: idade > 69 anos (HR 3,95, IC95% 1,64-9,52); FEVE≤57% (HR 4,70, IC95% 2,38-9,28) e menor rMSSD ≤12ms (HR 5,54; IC 95% 2,04-15,08). Um valor inteiro foi atribuído para cada variável. Este escore < 3 apresentou uma área sob a curva de 0,802 (IC95% 0,72-0,87). Conclusão Em pacientes com IC internados por IC descompensada ou síncope, preditores de longo prazo de mortalidade por todas as causas foram idade, FEVE, e rMSSD em 10 minutos. Esses achados indicam que mesmo breves momentos de tônus simpático elevado podem ter impacto na sobrevida, principalmente em idosos e pacientes com IC e fração de ejeção reduzida.

Abstract Background Short and long-duration heart rate variability (HRV) data from Holter monitoring could identify predictors of all-cause death in heart failure (HF) patients. Objectives To build a predictive model of all-cause death in patients with HF using HRV. Methods Retrospective study including patients with suspected or confirmed HF who were admitted for decompensated HF or syncope that underwent Holter monitoring. In analysis of augmented sympathetic tonus, we evaluated the lowest HRV in nonoverlapping 10-minutes periods throughout 24h continuous electrocardiographic signal recording (short HRV variables). Variables with p<0.01 were included in a multivariate Cox regression model to determine the occurrence of the all-cause death. Variables with statistical significance in Cox regression were chosen to build the predictive model. P<0.05 was considered significant. Results A total of 116 patients were included, mean age of 71.9±16.3 years, 45.7% men, mean follow-up of 2.83±1.27 years. Thirty-nine deaths occurred (33.6%). By comparing survivors vs. non-survivors, the variables that showed statistical significance were lowest SDNN, lowest rMSSD, age and left ventricular ejection fraction (LVEF). In Cox regression, independent predictors of all-cause death were: age>69 years (HR 3.95, 95%CI 1.64-9.52); LVEF≤57% (HR 4.70, 95%CI 2.38-9.28) and lowest rMSSD≤12ms (HR 5.54, 95%CI 2.04-15.08). An integer value was assigned to each variable. Score<3 showed AUC=0.802 (95%CI 0.72-0.87). Conclusion In HF patients hospitalized for decompensated HF or syncope, independent long-term predictors of all-cause death were age, LVEF, and 10-minutes rMSSD. These findings indicate that even brief moments of high sympathetic tone can impact survival, specifically in the elderly and patients with HF with reduced ejection fraction.

Biomechanical and Anthropometric Factors That Differentiate National- and Regional-Level Judo Players.

PURPOSE: The study aimed to identify the variables that differentiate judo athletes at national and regional levels. Multivariable analysis was applied to biomechanical, anthropometric, and Special Judo Fitness Test (SJFT) data. METHOD: Forty-two male judo athletes from 2 competitive groups (14 national and 28 state levels) performed the following measurements and tests: (1) skinfold thickness, (2) circumference, (3) bone width, (4) longitudinal length, (5) stabilometric tests, (6) dynamometric tests, and (7) SJFT. The variables with significant differences in the Wilcoxon rank-sum test were used in stepwise logistic regression to select those that better separate the groups. The authors considered models with a maximum of 3 variables to avoid overfitting. They used 7-fold cross validation to calculate optimism-corrected measures of model performance. RESULTS: The 3 variables that best differentiated the groups were the epicondylar humerus width, the total number of throws on the SJFT, and the stabilometric mean velocity of the center of pressure in the mediolateral direction. The area under the receiver-operating-characteristic curve for the model (based on 7-fold cross validation) was 0.95. CONCLUSION: This study suggests that a reduced set of anthropometric, biomechanical, and SJFT variables can differentiate judo athlete's levels.

Fractal Brownian Motion Assessment of the Center of Pressure Excursion During Impulse Phase on Standard Vertical Jump.

This study presents and applies fractal Brownian motion assessment of the center of pressure (COP) excursion during feet ground contact on standard vertical jump impulse phase with long and short countermovement (CM) in relation with lower limb muscle stretch-shortening cycle (SSC) comparing it with no CM and SSC. Fifty-four tests were performed by a group of six healthy male students of sports and physical education degree without previous injury, specific training, or fitness ability. Three repetitions were performed by each subject of a squat jump (SJ) without CM and SSC, countermovement jump (CMJ) with long CM and SSC, as well as drop jump (DJ) with short CM and SSC after depth jump from a 40 cm step. During trial tests ground reaction force and force moments were acquired with force platform and impulse phases were segmented for COP coordinates computation. Fractal Brownian motion analysis of COP excursion during impulse phases conduced to detection of differences between critical time and displacement as well as short and long-term diffusion coefficient (Ds, Dl) and Hurst index scale exponent (Hs, Hl), with Ds, Dl presenting statistical significative correlations -0.491, -0.559 and Hs, Hl non statistical significative correlations 0.266 and -0.424 with MVJ height (ht) at 5% significance for explaining underlying mechanisms on CM and SSC at MVJ.Clinical Relevance- This work contributes with new method for the study expansion of the center of pressure excursion and stability during feet ground contact from orthostatic standing position to the impulse phase during standard maximum vertical jump as the most adequate method for assessment of lower limb muscle stretch-shortening cycle.

A telediagnosis assistance system for multiple-lead electrocardiography.

The diffusion of telemedicine opens-up a new perspective for the development of technologies furthered by Biomedical Engineering. In particular, herein we deal with those related to telediagnosis through multiple-lead electrocardiographic signals. This study focuses on the proof-of-concept of an internet-based telemedicine system as a use case that attests to the feasibility for the development, within the university environment, of techniques for remote processing of biomedical signals for adjustable detection of myocardial ischemia episodes. At each signal lead, QRS complexes are detected and delimited with the J-point marking. The same procedure to detect the complex is used to identify the respective T wave, then the area over the ST segment is applied to detect ischemia-related elevations. The entire system is designed on web-based telemedicine services using multiuser, remote access technologies, and database. The measurements for sensitivity and precision had their respective averages calculated at 11.79 and 24.21% for the leads of lower noise. The evaluations regarding the aspects of user friendliness and the usefulness of the application, resulted in 88.57 and 89.28% of broad or total acceptance, respectively. They are robust enough to enable scalability and can be offered by cloud computing, besides enabling the development of new biomedical signal processing techniques within the concept of distance services, using a modular architecture with collaborative bias.

Avaliação da Dinâmica do Acoplamento da Condução Atrioventricular à Variação dos Intervalos RR em Atletas e Indivíduos Sedentários / Assessing Dynamic Atrioventricular Conduction Time to RR-interval Coupling in Athletes and Sedentary Subjects

Resumo Fundamento O tempo de condução atrioventricular (TCAV) é influenciado pelo estímulo autonômico e sujeito a remodelação fisiológica. Objetivo Avaliar a variabilidade da TCAV batimento-a-batimento e o intervalo RR em atletas e indivíduos sedentários saudáveis. Métodos Vinte adultos, incluindo 10 indivíduos sedentários saudáveis (controles) e 10 corredores de elite de longa distância (atletas), com idade, peso e altura ajustados foram submetidos à avaliação do equivalente metabólico máximo (MET) e registro de ECG em repouso supino de 15 minutos sete dias depois. O intervalo entre os picos da onda P e da onda R definiu o TCAV. Foram calculadas a média (M) e o desvio padrão (DP) de intervalos RR consecutivos (RR) e TCAV acoplados, bem como as linhas de regressão de RR vs. TCAV (RR-TCAV). A condução AV concordante foi definida como o slope RR-AVCT positivo e, caso contrário, discordante. Um modelo de regressão linear multivariada foi desenvolvido para explicar o MET com base nos parâmetros de variabilidade do TCAV e intervalo RR. Nível de significância: 5%. Resultados Nos atletas, os valores de M-RR e DP-RR foram maiores que nos controles, enquanto M-TCAV e DP-TCAV não foram. Os slopes RR-TCAV foram, respectivamente, 0,038 ± 0,022 e 0,0034 ± 0,017 (p < 0,05). Utilizando um valor de corte de 0,0044 (AUC 0,92 ± 0,07; p < 0,001), o slope RR-TCAV mostrou 100% de especificidade e 80% de sensibilidade. Em um modelo multivariado, o slope DP-RR e RR-TCAV foram variáveis explicativas independentes do MET (razão F: 17,2; p < 0,001), apresentando especificidade de 100% e sensibilidade de 90% (AUC: 0,99 ± 0,02; p < 0,001). Conclusão Em corredores de elite, o acoplamento dinâmico de TCAV para intervalo RR apresenta condução AV discordante espontânea, caracterizada por slope na linha de regressão TCAV negativa vs. intervalo RR. O desvio padrão dos intervalos RR e o slope da linha de regressão do TCAV vs. intervalo RR são variáveis explicativas independentes do MET. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

Abstract Background Atrioventricular conduction time ( AVCT ) is influenced by autonomic input and subject to physiological remodeling. Objective To evaluate beat-by-beat AVCT and RR-interval variability in athletes and healthy sedentary subjects. Methods Twenty adults, including 10 healthy sedentary (Controls) and 10 elite long-distance runners (Athletes), age, weight and height-adjusted, underwent maximal metabolic equivalent (MET) assessment, and 15-min supine resting ECG recording seven days later. The interval between P-wave and R-wave peaks defined the AVCT . Mean (M) and standard deviation (SD) of consecutive RR-intervals (RR) and coupled AVCT were calculated, as well as regression lines of RR vs. AVCT (RR-AVCT) . Concordant AV conduction was defined as positive RR-AVCT slope and discordant otherwise. A multivariate linear regression model was developed to explain MET based on AVCT and RR-interval variability parameters. Significance-level: 5 %. Results In Athletes, M-RR and SD-RR values were higher than in Controls, whereas M-AVCT and SD-AVCT were not. RR-AVCT slopes were, respectively, 0.038 ± 0.022 and 0.0034 ± 0.017 (p < 0.05). Using a cut-off value of 0.0044 (AUC 0.92 ± 0.07; p < 0.001), RR-AVCT slope showed 100% specificity and 80% sensitivity. In a multivariate model, SD-RR and RR-AVCT slope were independent explanatory variables of MET (F-ratio: 17.2; p < 0.001), showing 100% specificity and 90% sensitivity (AUC 0.99 ± 0.02; p < 0.001). Conclusion In elite runners, AVCT to RR -interval dynamic coupling shows spontaneous discordant AV conduction, characterized by negative AVCT vs. RR -interval regression line slope. RR -intervals standard deviation and AVCT vs. RR -interval regression line slope are independent explanatory variables of MET (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

Assessing Dynamic Atrioventricular Conduction Time to RR-interval Coupling in Athletes and Sedentary Subjects. / Avaliação da Dinâmica do Acoplamento da Condução Atrioventricular à Variação dos Intervalos RR em Atletas e Indivíduos Sedentários.

Background Atrioventricular conduction time ( AVCT ) is influenced by autonomic input and subject to physiological remodeling. Objective To evaluate beat-by-beat AVCT and RR-interval variability in athletes and healthy sedentary subjects. Methods Twenty adults, including 10 healthy sedentary (Controls) and 10 elite long-distance runners (Athletes), age, weight and height-adjusted, underwent maximal metabolic equivalent (MET) assessment, and 15-min supine resting ECG recording seven days later. The interval between P-wave and R-wave peaks defined the AVCT . Mean (M) and standard deviation (SD) of consecutive RR-intervals (RR) and coupled AVCT were calculated, as well as regression lines of RR vs. AVCT (RR-AVCT) . Concordant AV conduction was defined as positive RR-AVCT slope and discordant otherwise. A multivariate linear regression model was developed to explain MET based on AVCT and RR-interval variability parameters. Significance-level: 5 %. Results In Athletes, M-RR and SD-RR values were higher than in Controls, whereas M-AVCT and SD-AVCT were not. RR-AVCT slopes were, respectively, 0.038 ± 0.022 and 0.0034 ± 0.017 (p < 0.05). Using a cut-off value of 0.0044 (AUC 0.92 ± 0.07; p < 0.001), RR-AVCT slope showed 100% specificity and 80% sensitivity. In a multivariate model, SD-RR and RR-AVCT slope were independent explanatory variables of MET (F-ratio: 17.2; p < 0.001), showing 100% specificity and 90% sensitivity (AUC 0.99 ± 0.02; p < 0.001). Conclusion In elite runners, AVCT to RR -interval dynamic coupling shows spontaneous discordant AV conduction, characterized by negative AVCT vs. RR -interval regression line slope. RR -intervals standard deviation and AVCT vs. RR -interval regression line slope are independent explanatory variables of MET (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0).

Do hip strength, flexibility and running biomechanics predict dynamic valgus in female recreational runners?

BACKGOUND: Dynamic valgus has been the focus of many studies to identify its association to an increased risk of running-related injuries. However, it is not known which physical and biomechanical variables are associated with this movement dysfunction. RESEARCH QUESTION: This study aimed to test the correlation between strength, flexibility and biomechanical variables and dynamic valgus in female runners. METHODS: Twenty-nine healthy females ran on a treadmill at 2.92 m/s and performed strength, range of motion and endurance tests. Pelvic, hip and ankle kinematics were measured with a 3D motion analysis system. Six multiple linear regression models were used to identify the ability of physical and biomechanical variables to predict excursion and peak of contralateral pelvic drop, hip adduction and internal rotation. RESULTS: Contralateral pelvic drop and hip adduction were positively correlated to ankle eversion and step cadence. Hip internal rotation had a negative correlation with ankle eversion. Despite significance, predictor variables explained less than 30% of dynamic valgus variance during running. No interest variable had significant correlation with the hip strength and hip and ankle passive range of motion. SIGNIFICANCE: The results showed that distal joint kinematics and spatiotemporal variables should be considered during biomechanical running analysis to identify their possible relationship with joint overload caused by dynamic valgus. Caution should be taken when linking hip disorders during running to posterolateral hip strength and stiffness, core endurance, and ankle dorsiflexion range of motion since no correlation occurred amongstthese variables in this sample of female runners.

Association between circadian Holter ECG changes and sudden cardiac death in patients with Chagas heart disease.

OBJECTIVE: Chagas disease (ChD) is a parasitic illness, largely spread over South America. ChD usually causes progressive myocardium damage, either by direct parasite action or through autoimmune response. Sudden cardiac death (SCD) is prevalent in the early disease stages, being associated with a high variety of ectopic cardiac beats. This study aims at applying heart rate variability (HRV) and heart rate turbulence (HRT) techniques over Holter electrocardiogram (ECG) records to investigate the association with SCD in Chagas heart disease (ChHD). APPROACH: From a retrospective evaluation of a local database, the Holter records from 78 outpatients (34 female) were divided into groups: SCD deaths (20) and alive patients (56). To consider circadian autonomic changes, the analysis was performed in three periods: (a) entire 24 h record, (b) 12 h daylight period, and (c) the remaining 12 h including night rest. Eight variables were extracted using HRV and HRT approaches from each record and analysed together with the left ventricular ejection fraction (LVEF) estimated by echocardiography. MAIN RESULTS: The set of parameters was reduced by both the forward- and backward-stepwise approach and classification was performed using the k-nearest neighbours method and a leave-one-out cross-validation in a set of ten bootstrap trials, where SCD data were randomly taken and repositioned to balance the groups. The best 24 h model predicted SCD with 89.9% ± 0.9% accuracy using three HRV variables. The use of 12 h segments increased the accuracy up to 91.0% ± 1.2% in a model with the standard deviation parameter measured during the day (SDNNday) and night (SDNNnight). Although considered as playing a major role in SCD, LVEF did not show an association with SCD in this sample. SIGNIFICANCE: The degree of HRV and its circadian changes are associated with SCD in ChHD patients.

Prediction of mild anatomical leg length discrepancy based on gait kinematics and linear regression model.

BACKGOUND: Leg length discrepancy (LLD) can be related to different pathologies, due to an inadequate distribution of mechanical loads, as well as gait kinematics asymmetries resulted from LLD. RESEARCH QUESTION: To validate a model to predict anatomical LLD (ALLD) based on gait kinematics. METHODS: Gait of 39 participants with different lower limb pathologies and mild discrepancy were collected. Pelvic, hip, knee and ankle kinematics were measured with a 3D motion analysis system and ALLD, femur discrepancy (FD) and tibia discrepancy (TD) were measured by a computerized digital radiograph. Three multiple linear regression models were used to identify the ability of kinematic variables to predict ALLD (model 1), FD (model 2) and TD (model 3). RESULTS: Difference between peak knee and hip flexion of the long and short lower limb was selected by models 1 (p < 0.001) and 2 (p < 0.001). Hip adduction was selected as a predictor only by model 1 (p = 0.05). Peak pelvic obliquity and ankle dorsiflexion were not selected by any model and model 3 did not retain any dependent variable (p > 0.05). Regression models predicted mild ALLD with moderate accuracy based on hip and knee kinematics during gait, but not ankle strategies. Excessive hip flexion of the longer limb possibly occurs to reduce the limb to equalize the LLD, and discrepancies of the femur and tibia affects gait cycle in a different way. SIGNIFICANCE: This study showed that kinematic variables during gait could be used as a screening tool to identify patients with ALLD, reducing unnecessary x-ray exposure and assisting rehabilitation programs.

Generalized Lower Limb Joint Angular Phase Space Analysis of Subject Specific Normal and Modified Gait.

This study presents and applies generalized angular phase space analysis to lower limb joint angles of specific subject during normal and modified gait for discrimination of gait and joint angular movements. Case study of an adult healthy male in-vivo and noninvasive kinematic assessment of skin surface adhesive markers at lower limb was performed at human movement lab during normal gait, stiff knee gait and slow running. Musculoskeletal modeling was performed using AnyGait v.0.92 morphing Twente Lower Extremity Model (TLEM) to match the size and joint morphology of the stick-figure model. Inverse kinematics was performed obtaining hip, knee and ankle joint flexion-extension angular displacements, velocities and accelerations. Generalized phase space analysis was applied to lower limb joint angular displacements, velocities and accelerations. Directional statistics was applied to generalized phase planes with mean direction, resultant length and circular standard deviation assessment. Rayleigh test was employed for directional concentration and coordination assessment, and Watson's $\mathrm{U^{2$ goodness of fit test applied to the von Mises distribution. Results point for the importance of subject specific study, generalized joint angular phase space analysis, comparing results with other normalization methods and validation of applied methods with qualitative clinical analysis.

Biomechanical alterations of gait on overweight subjects

Abstract Introduction Obesity is a major global public health issue and approximately half of the population is classified as overweight. Many studies have investigated gait modification in obese people; however, no research has been carried out in overweight subject´s gait influence. Methods The goal of this study was to identify biomechanical changes on gait in overweight subjects by the application of principal component analysis (PCA). Two groups of adults participated of this study: overweight (n = 9; 25.0 < Body Mass Index < 29.9 kg/m2), and normal-weight (n = 15; 20.0 < Body Mass Index < 24.9 kg/m2. Three-dimensional kinematics of the lower limb and ground reaction forces (GRF) were recorded during gait. PCA was performed on data. Results PCA evidenced statistical differences at the first principal component (PC) of the sagittal ankle movement, anteroposterior and mediolateral GRF, as well as at the third PC of the sagittal hip movement and mediolateral GRF. Overweight subjects walked with reduced ankle plantarflexion at toe-off and reduced hip flexion at the heel strike and at mid swing, as well as a reduced hip extension during push off. Additionally, increased anteroposterior and mediolateral GRF on overweight subjects were observed. Conclusion overweight individuals might adjust their gait characteristics in response to their increased weight to reduce overload lower limbs joints. These gait modifications pointed to a possible increase in the risk of musculoskeletal pathology in this population.

Prediction of 3D ground reaction forces during gait based on accelerometer data

Abstract Introduction The aim of this study was to predict 3D ground reaction force signals based on accelerometer data during gait, using a feed-forward neural network (MLP). Methods Seventeen healthy subjects were instructed to walk at a self-selected speed with a 3D accelerometer attached to the distal and anterior part of the shank. A force plate was embedded into the middle of the walkway. MLP neural networks with one hidden layer and three output layers were selected to simulate the anteroposterior (AP), vertical (Vert) and mediolateral (ML) ground reaction forces (GRF). The input layer was composed of fourteen inputs obtained from accelerometer signals, selected based on previous studies. Principal component analysis (PCA) was used to compare the simulated and collected curves. The Pearson correlation coefficient and the mean absolute deviation (MAD) between signals were calculated. Results PCA identified small, but significant differences between collected and simulated signals in the loading response phases of AP and ML GRF, while Vert did not show differences. The correlation between the simulated and collected signals was high (AP: 0.97; Vert: 0.98; ML: 0.80). MAD was 1.8%BW for AP, 4.5%BW for Vert and 1.4%BW for ML. Conclusion This study confirmed that multilayer perceptron neural network can predict the highly non-linear relationship of shank acceleration parameters and ground reaction forces, as well as other studies have done using plantar pressure devices. The greater advantages of this device are the low cost and the possibility of use outside the laboratory environment.

Effect of Resistance Training on Blood Pressure and Autonomic Responses in Treated Hypertensives.

Trevizani, GA, Seixas, MB, Benchimol-Barbosa, PR, Vianna, JM, da Silva, LP, and Nadal, J. Effect of resistance training on blood pressure and autonomic responses in treated hypertensives. J Strength Cond Res 32(5): 1462-1470, 2018-This study evaluated the effect of resistance training (RT) on heart rate variability (HRV) and on blood pressure (BP) responses to acute and short-term exposure in treated hypertensive (HT) subjects. Twenty-one men participated in the study, 8 HT under drug treatment regimen and achieving adequate BP control before inclusion and 13 normotensive (NT). The RT protocol consisted of 12 sessions with eight exercises (leg extension, leg press, leg curl, bench press, seated row, triceps push-down, seated calf flexion, and seated arm curl) performed for two sets of 15-20 repetitions with 50% of one repetition maximum with 2-minute rest intervals in between sets, 3×/week. Heartbeat measurements were taken before and after RT, and BP was measured at the beginning and at the end of each session after 10-minute rest. The repeated measures analysis of variance (effect: group vs. training) evaluated BP and HRV responses. Effect size (ES) calculation measured the magnitude of the RT effect on these variables. There was a statistically significant reduction in postexercise systolic BP in both groups (p = 0.040), without significant change in resting BP along RT (p = 0.159). Regarding HRV, it was observed a reduced sympathetic-vagal balance (training interaction vs. group: p = 0.058, ES = -0.83) in HT subjects. Resistance training promotes a significant acute reduction of BP in the HT and NT groups and provides a slight benefit of cardiac autonomic balance in the HT.

Consistency of surface electromyography assessment at lower limb selected muscles during vertical countermovement.

Given the difficulty of invasive methods to assess muscle action during natural human movement, surface electromyography (sEMG) has been increasingly used to capture muscle activity in relation to kinesiological analysis of specific tasks. Isolated isometric, concentric and eccentric forms of muscle action have been receiving the most attention for research purposes. Nevertheless natural muscle action frequently involves the use of a preceding eccentric muscle action as a form of potentiation of immediate muscle concentric action, in what is designated as muscle stretch-shortening cycle (SSC). The most frequently applied protocols for the evaluation of SSC on vertical jumps are by virtue of their reproducibility and control of experimental conditions, squat jump (SJ) without countermovement (CM), countermovement jump (CMJ) with long CM and drop jump (DJ) with short CM. The methods used to extract information and relationship of the captured signals also present a high diversity, with the question about the consistency of the methods and obtained results. The objective of this study is to evaluate the consistency of the analysis and results by applying different EMGs signal analysis techniques related to strategic muscle groups of the lower limbs at different countermovement evaluated in vertical jumps. Raw sEMG signals of 5 lower limb muscles of 6 subjects during SJ, CMJ and DJ were rectified, filtered and obtained their envelope, and then correlated (CR) for detection of synergistic, agonist and antagonist activity, applied principal component analysis (PCA) for the detection of uncorrelated components explaining maximum variability and normalized cross-correlation (CCRN) for detection of maximum correlations and time lag. CR of EMG envelopes presented higher coactivities (CoA) in DJ relative to SJ and these CoA superior to CMJ with greater synergy in DJ relative to SJ and CMJ that present several loop cycles corresponding to time lag of activity. CCRN of the EMG envelopes presented also higher CoA in DJ when compared to SJ and both higher CoA to CMJ. PCA allowed to detect a principal component (PC) explaining 92.2% of the variability of EMG in DJ, 90.6% in SJ and 78.7% in CMJ, the second PC responsible for the explanation of 4.9% variability in DJ, 6.7% in SJ and 15.3% in CMJ.

Crossover assessment of cardiolocomotor synchronization during running.

PURPOSE: This study aimed at testing the hypothesis that positive cardiolocomotor coordination (CLC) measure occurs by chance during a running task where the heart rate (HR) is approximated to the step frequency (StepF). METHODS: The electrocardiogram and electromyogram from the right gastrocnemius lateralis muscle were continuously recorded from ten healthy young men running at a paced rhythm of 152 step/min, to monitor HR and StepF. CLC was evaluated by phase synchrograms and the index of conditional probability (iCP). Results were validated with surrogate data and a crossover approach, where the HR of one subject was related to the StepF of another one, and comparisons were made combining subjects two by two. RESULTS: Six subjects showed synchrogram structures and high iCP values (≥0.8), suggesting the occurrence of physiological entrainment, when the HR reached the SF range. In crossover analysis, phase synchrograms and iCP presented similar behavior of original data when the HR from one subject was close enough to the SF from another one. Significant iCP values in 46 of 90 comparisons (51%) were observed, including all cases crossing signals among the six positive cases. CONCLUSION: Synchrogram and iCP tools currently employed for measuring CLC are not appropriate because they indicate the occurrence of this phenomenon even among subjects who ran on different days and times of each other.

Muscle Fatigue Assessment During Cycle Ergometer Exercise Using Principal Component Analysis of Electromyogram Power Spectra.

During muscle fatigue analysis some standard indexes are calculated from the surface electromyogram (EMG) as root mean square value (RMS), mean (Fmean), and median power frequency (Fmedian). However, these parameters present limitations and principal component analysis (PCA) appears to be an adequate alternative. In this context, we propose two indexes based on PCA to enhance the quantitative muscle fatigue analysis during cyclical contractions. Signals of vastus lateralis muscle were collected during a maximal exercise test. Twenty-four subjects performed the test starting at 12.5 W power output with increments of 12.5 W⋅min-1, maintaining cadence of 50 rpm until voluntary exhaustion. The epochs of myoelectric activation were identified and used to estimate the power spectra. PCA was then applied to the power spectra of each subject. The standard (ST) and Euclidean (ED) distances were employed to estimate the alteration occurred due to fatigue. For comparison, the standard indexes were calculated. ST, ED, and RMS value were adequate for muscle fatigue analysis. Among these parameters, ST was more sensitive with higher effect size. Moreover, the Fmean and Fmedian were not sensitive to fatigue. The proposed method based on PCA of EMG in frequency domain allowed producing fatigue indexes suitable for cyclical contractions.