The more the better? Integration of vertebral pelvic angles (VPA) PJK thresholds to existing alignment schemas for prevention of mechanical complications after adult spinal deformity surgery.

PURPOSE: While existing adult spinal deformity (ASD) alignment schemas acknowledge the dynamic relationship between the pelvis and spine, consideration of vertebral pelvic angles (VPA) thresholds for PJK may provide further insight into the relationship of each individual vertebra to the pelvis, which may allow for greater individualization of operative targets. Herein, we examine VPA's utility in preventing mechanical complications and its possible unification with prevalent scoring systems. METHODS: In a retrospective cohort study of a prospectively collected database, operative ASD patients ≥ 18 years with complete baseline (BL) and two-year (Y) operative, radiographic, and health-related quality of life data were included. Descriptive analyses, means comparison, and logistic regression tests were applied to explore demographic and surgical differences, as well as the impact of alignment goals on outcomes. Cohorts were grouped as patients who met VPA non-PJK thresholds, as defined by Duvvuri et al. 2023 alone versus traditional GAP/SAAS alignment matching versus combined VPA + SAAS + GAP. The Non-PJK VPA validated mean for L1PA was 10.4 ± 7.0 and T9PA 8.9 ± 7.5. RESULTS: 398 patients met inclusion criteria (mean age 61 ± 14 years, 78% female, BL BMI 27 ± 6, BL CCI 2 ± 2). At baseline, mean vertebral pelvic angles were as follows: T1PA: 24 ± 14; T4PA 20 ± 13, T9PA 15 ± 12, L1PA 11 ± 10, L4PA 11 ± 6. Mean vertebral pelvic angles at 6 W postoperatively: T1PA 16 ± 10, T4PA 12 ± 10, T9PA 8 ± 9, L1PA 9 ± 8, L4PA 11 ± 5. 240 (60%) patients attained optimal L1PA, while 104 patients (26.1%) reached non-PJK mean for T9PA. 89 patients (22%) were optimal by both VPA standards. VPA-Optimal group demonstrated significantly lower rates of 1Y PJK (17% v 83%, p = 0.042) and PJF by 2Y (7% v. 93%, p = 0.038). When patients attained VPA goals in addition to GAP/SAAS goals at 6 W, they demonstrated significantly lower rates of Y1 PJK (p = 0.026) and Y1 and Y2 PJF. Those with optimal VPA registered greater SRS-22 scores across multiple domains (p < 0.02) as well as a greater rate of normal neurological examination at 6 W (p = 0.048). CONCLUSIONS: Vertebral pelvic angles are a reliable measure of global alignment, and respecting certain targets may help prevent development of PJK/PJF. The value of VPA can be augmented through integration with GAP/SAAS frameworks to prevent complications and improve quality of life.

Joint-line obliquity angle is significantly affected by hip abduction and adduction: A simulated analysis.

PURPOSE: Different methods for quantifying joint-line obliquity (JLO) have been described, including joint-line obliquity angle (JLOA), Mikulicz joint-line angle (MJLA) and medial proximal tibial angle (MPTA). The goal of the present study was to quantify the variation of JLOA based on the position of the hip. The hypothesis of our study is that JLO is significantly influenced by the abduction/adduction of the limb, unlike MJLA. METHODS: One hundred long-leg-weightbearing X-rays were used. At time 0 and after 30 days, two observers performed different measurements, including (1) distance between pubic symphysis and center of the femoral head, (2) distance between center of the femoral head and center of the ankle joint, (3) distance between center of the ankle and medial malleolus, (4) hip-knee-ankle angle, (5) MPTA, (6) lateral distal femoral angle, (7) joint-line congruency angle, (8) JLOA, (9) MJL and (10) angle between Mikulicz line and line perpendicular to the ground. The changes of the JLOA based on the position of the hip (abducted, neutral, bipedal stance adduction and monopodal stance adduction) were calculated with trigonometric formulas and with simulation on an orthopaedic planning digital software. RESULTS: The JLOA change between adducted and abducted positions was on average 12.8° (SD 0.9 mm). The MJL did not vary significantly based on hip position. CONCLUSIONS: The adduction/abduction of the lower limb has a considerable impact on JLOA. Methods like MJLA which are not affected by hip position should be preferred for JLO evaluation. LEVEL OF EVIDENCE: Diagnostic study, level III.

Deep unfolding network with spatial alignment for multi-modal MRI reconstruction.

Multi-modal Magnetic Resonance Imaging (MRI) offers complementary diagnostic information, but some modalities are limited by the long scanning time. To accelerate the whole acquisition process, MRI reconstruction of one modality from highly under-sampled k-space data with another fully-sampled reference modality is an efficient solution. However, the misalignment between modalities, which is common in clinic practice, can negatively affect reconstruction quality. Existing deep learning-based methods that account for inter-modality misalignment perform better, but still share two main common limitations: (1) The spatial alignment task is not adaptively integrated with the reconstruction process, resulting in insufficient complementarity between the two tasks; (2) the entire framework has weak interpretability. In this paper, we construct a novel Deep Unfolding Network with Spatial Alignment, termed DUN-SA, to appropriately embed the spatial alignment task into the reconstruction process. Concretely, we derive a novel joint alignment-reconstruction model with a specially designed aligned cross-modal prior term. By relaxing the model into cross-modal spatial alignment and multi-modal reconstruction tasks, we propose an effective algorithm to solve this model alternatively. Then, we unfold the iterative stages of the proposed algorithm and design corresponding network modules to build DUN-SA with interpretability. Through end-to-end training, we effectively compensate for spatial misalignment using only reconstruction loss, and utilize the progressively aligned reference modality to provide inter-modality prior to improve the reconstruction of the target modality. Comprehensive experiments on four real datasets demonstrate that our method exhibits superior reconstruction performance compared to state-of-the-art methods.

Offloading effect in the unoperated contralateral knee after unilateral medial open wedge high tibial osteotomy: A SPECT/CT analysis.

BACKGROUND: An open wedge high tibial osteotomy (OWHTO) may lead to gait alteration, which change the contact loading in the contralateral knee, while clear evidence about the impact on contralateral knee still lacks. The purpose of the current study was to evaluate the change in scintigraphic uptake using SPECT-CT in the medial compartment of the contralateral knee following OWHTO. METHODS: Contralateral radiographic measurements were performed for patients with medial osteoarthritis and varus malalignment of >5° treated with OWHTO in this retrospective analysis. The medial compartmental changes according to SPECT/CT analysis before and 1-year after OWHTO were evaluated on the contralateral side. RESULTS: The study comprised 72 patients. The mean preoperative mechanical femorotibial angle was a mean varus of 7.6° (range, 5.1° - 13.0°), corrected to a mean valgus of 2.5° (range, 1.9° - -8.5°) postoperatively. The average grading of the scintigraphic uptakes in the medial compartment of the contralateral knee was significantly decreased 1 year postoperatively than after the surgery (from 2.8 ± 0.4 to 2.1 ± 0.6, p < 0.001). Measurable differences in varus alignment on radiographs of the contralateral limb were identified. The preoperative mechanical axis value decreased from 8.0° ± 2.4° to 6.7° ± 2.6° at the 3-month postoperative visit (p = 0.011). The overall decrease in varus alignment remained at the 2-year final postoperative follow-up. CONCLUSION: Alignment correction by OWHTO results in reducing scintigraphy uptakes in medial compartment and improvement in mechanical alignment of the contralateral knee. LEVEL OF EVIDENCE: Therapeutic Level IV.

Cone-Beam Weight-Bearing Computed Tomography of Ankle Arthritis and Total Ankle Arthroplasty.

Weight-bearing computed tomography has multiple advantages in evaluating the hindfoot and ankle. It can assess hindfoot and ankle alignment, pathology in ankle arthritis, and complications related to total ankle replacements. It is an essential tool in ankle osteoarthritis diagnostic, preoperative planning, and total ankle replacement outcomes. It allows for better accuracy and reproducibility of alignment and implant size. In addition, it has the potential to more assertively detect complications related to weight bearing.

Unraveling the Hemolytic Toxicity Tapestry of Peptides using Chemical Space Complex Networks.

Peptides have emerged as promising therapeutic agents. However, their potential is hindered by hemotoxicity. Understanding the hemotoxicity of peptides is crucial for developing safe and effective peptide-based therapeutics. Here, we employed chemical space complex networks (CSNs) to unravel the hemotoxicity tapestry of peptides. CSNs are powerful tools for visualizing and analyzing the relationships between peptides based on their physicochemical properties and structural features. We constructed CSNs from the StarPepDB database, encompassing 2004 hemolytic peptides, and explored the impact of seven different (dis)similarity measures on network topology and cluster (communities) distribution. Our findings revealed that each CSN extracts orthogonal information, enhancing the motif discovery and enrichment process. We identified 12 consensus hemolytic motifs, whose amino acid composition unveiled a high abundance of lysine, leucine, and valine residues, while aspartic acid, methionine, histidine, asparagine and glutamine were depleted. Additionally, physicochemical properties were used to characterize clusters/communities of hemolytic peptides. To predict hemolytic activity directly from peptide sequences, we constructed multi-query similarity searching models (MQSSMs), which outperformed cutting-edge machine learning (ML)-based models, demonstrating robust hemotoxicity prediction capabilities. Overall, this novel in silico approach uses complex network science as its central strategy to develop robust model classifiers, to characterize the chemical space and to discover new motifs from hemolytic peptides. This will help to enhance the design/selection of peptides with potential therapeutic activity and low toxicity.

Enhancing total knee arthroplasty outcomes: the role of individualized femoral sagittal alignment in robotic-assisted surgery - A randomized controlled trial.

BACKGROUND: Optimal sagittal alignment of the femoral prosthesis is critical to the success of total knee arthroplasty (TKA). While robotic-assisted TKA can improve alignment accuracy, the efficacy of default femoral alignment versus individualized alignment remains under scrutiny. This study aimed to compare the differences in prosthetic alignment, anatomical restoration, and clinical outcomes between individualized femoral sagittal alignment and default sagittal alignment in robotic-assisted TKA. METHODS: In a prospective randomised controlled trial, 113 patients (120 knees) underwent robotic-assisted TKA were divided into two groups: 61 with individualized femoral flexion (individualized alignment group) and 59 with default 3-5° flexion (default alignment group). The individualized alignment was based on the distal femoral sagittal anteverted angle (DFSAA), defined as the angle between the mechanical and distal anatomical axes of the femur. The radiographic and clinical outcomes were compared. RESULTS: Despite similar postoperative femoral flexion angles between groups (P = 0.748), the individualized alignment group exhibited significantly lower incidences of femoral prosthesis extension and higher rates of optimal 0-3° prosthesis flexion (9.8% vs. 27.1%, P = 0.014,78.7% vs. 55.9%, p = 0.008, respectively). The individualized alignment group also demonstrated more favourable changes in sagittal anatomy, with higher maintenance of postoperative anterior femoral offset within 1 mm (54.1% vs. 33.9%, P = 0.026) and posterior condylar offset within 1 mm and 2 mm (44.3% vs. 25.4%, p = 0.031,73.8% vs. 50.8%, p = 0.010, respectively). Although slight improvement in the Hospital for Special Surgery Knee Score (HSS) at three months was observed (P = 0.045), it did not reach a minimal clinically important difference. CONCLUSION: Individualized tailoring of femoral sagittal alignment in robotic-assisted total knee arthroplasty (TKA) enhances prosthetic alignment and anatomical restoration, suggesting potential improvements in postoperative outcomes.

Strategic Surgical Intervention in a Rare Presentation of Hip-Spine Syndrome With Lumbosacral Malunion: A Case Report.

The hip and lumbar spine are closely related and can create similar patterns of pain and dysfunction. Furthermore, diagnosing and treating hip and spine conditions can be challenging due to the overlap of symptoms. This report describes the successful treatment of a 54-year-old male with hip-spine syndrome following multiple surgeries for spondylolytic spondylolisthesis. The patient presented with low back pain (LBP) and bilateral hip pain, with radiological findings indicating spinal deformity and hip joint synovitis. Two years after two-stage corrective surgery, including pedicle subtraction osteotomy (PSO), the hip synovitis resolved and the symptoms improved. This case emphasizes the need to consider hip-spine syndrome as a possible complication of lumbosacral spine fusion surgery and demonstrates the efficacy of two-stage corrective surgery with pedicle subtraction osteotomy in treating this condition.

Electric-field assisted spatioselective deposition of MIL-101(Cr)PEDOT to enhance electrical conductivity and humidity sensing performance.

Precise deposition of metal-organic framework (MOF) materials is important for fabricating high-performing MOF-based devices. Electric-field assisted drop-casting of poly(3,4-ethylenedioxythiophene)-functionalized (PEDOT) MIL-101(Cr) nanoparticles onto interdigitated electrodes allowed their precise spatioselective deposition as percolating nanoparticle chains in the interelectrode gaps. The resulting aligned materials were investigated for resistive and capacitive humidity sensing and compared with unaligned samples prepared via regular drop-casting. The spatioselective deposition of MOFs resulted in up to over 500 times improved conductivity and approximately 6 times increased responsivity during resistive humidity sensing. The aligned samples also showed good capacitive humidity sensing performance, with up to 310 times capacitance gain at 10 versus 90 % relative humidity. In contrast, the resistive behavior of the unaligned samples rendered them unsuitable for capacitive sensing. This work demonstrates that applying an alternating potential during drop-casting is a simple yet effective method to control MOF deposition for greater efficiency, conductivity, and enhanced humidity sensing performance.

Cross-domain additive learning of new knowledge rather than replacement.

In medical clinical scenarios for reasons such as patient privacy, information protection and data migration, when domain adaptation is needed for real scenarios, the source-domain data is often inaccessible and only the pre-trained source model on the source-domain is available. Existing solutions for this type of problem tend to forget the rich task experience previously learned on the source domain after adapting, which means that the model simply overfits the target-domain data when adapting and does not learn robust features that facilitate real task decisions. We address this problem by exploring the particular application of source-free domain adaptation in medical image segmentation and propose a two-stage additive source-free adaptation framework. We generalize the domain-invariant features by constraining the core pathological structure and semantic consistency between different perspectives. And we reduce the segmentation generated by locating and filtering elements that may have errors through Monte-Carlo uncertainty estimation. We conduct comparison experiments with some other methods on a cross-device polyp segmentation and a cross-modal brain tumor segmentation dataset, the results in both the target and source domains verify that the proposed method can effectively solve the domain offset problem and the model retains its dominance on the source domain after learning new knowledge of the target domain.This work provides valuable exploration for achieving additive learning on the target and source domains in the absence of source data and offers new ideas and methods for adaptation research in the field of medical image segmentation.

A layout framework for genome-wide multiple sequence alignment graphs.

Sequence alignments are often used to analyze genomic data. However, such alignments are often only calculated and compared on small sequence intervals for analysis purposes. When comparing longer sequences, these are usually divided into shorter sequence intervals for better alignment results. This usually means that the order context of the original sequence is lost. To prevent this, it is possible to use a graph structure to represent the order of the original sequence on the alignment blocks. The visualization of these graph structures can provide insights into the structural variations of genomes in a semi-global context. In this paper, we propose a new graph drawing framework for representing gMSA data. We produce a hierarchical graph layout that supports the comparative analysis of genomes. Based on a reference, the differences and similarities of the different genome orders are visualized. In this work, we present a complete graph drawing framework for gMSA graphs together with the respective algorithms for each of the steps. Additionally, we provide a prototype and an example data set for analyzing gMSA graphs. Based on this data set, we demonstrate the functionalities of the framework using two examples.

Relationship between spinal alignment and functional disability after thoracolumbar spinal fractures: A systematic review.

Background: Thoracolumbar spinal fractures (TLSF) can cause pain, neurological deficits, and functional disability. Operative treatments aim to preserve neurological function, improve functional status, and restore spinal alignment and stability. In this review, we evaluate the relationship between spinal alignment and functional impairment in patients with TLSF. Methods: We performed a systematic review in accordance with the PRISMA guidelines to identify full-text articles that evaluate the correlation between spinal alignment and functional outcomes of TLSF. The artificial intelligence software Rayyan assisted the screening process. Functional outcomes referred to activity/disability, quality of life, and pain scores, as well as return to work metrics. Radiological assessments included were vertebral compression angle, Cobb and Gardner angles, sagittal vertical axis, pelvic incidence, and pelvic tilt. Statistical analyses were performed for the data provided by articles using the SPSS v24. Results: Of 1,616 articles reviewed, 6 were included for final analysis. Only 1 study primarily addressed the effects of spinopelvic parameters and functional outcomes. Four studies correlated Cobb angles with functional outcome, while 3 others compared vertebral compression angles with functional outcomes. Outcomes were assessed using work status or a combination of VAS pain and spine score, ODI, SF-36, and RMDQ-24. Neither the analysis done within the articles, nor the one made with the raw data provided by them, showed a significant correlation between the radiological measurements assessed at time of injury and final functional outcomes. Conclusions: A correlation between the assessed spinal radiological measurements assessed with the functional outcomes of TLSF was not found in this review. Further well-designed prospective studies are necessary to evaluate spinal alignment measurements in TLSF with functional outcomes.

Comparing the effects of lower limb orthoses on knee pain, function, quality of life, and knee joint alignment in people with medial knee osteoarthritis.

Introduction: The purpose of this study was to compare the impact of three types of orthoses (knee orthosis, ankle foot orthosis (AFO), and foot orthosis) on knee alignment, pain, function, and quality of life in individuals with medial knee osteoarthritis (MKOA). Method: Thirty patients took part in this study and were randomly assigned to three groups (n = 10 in each group) based on the type of intervention. Knee function was assessed using the knee injury and osteoarthritis outcome score (KOOS) questionnaire, and knee alignment was evaluated by measuring angles using the images of bony prominence (AMI) method. Results: After using knee orthosis and AFO, all subscales of KOOS showed significant improvement (p < .05). However, there was no significant difference in the results after using foot orthosis (p > .05). Conclusion: The findings indicate that knee orthosis or AFO for 6 weeks can improve clinical outcomes for individuals with MKOA. This suggests that clinicians can consider using knee orthosis and AFO among the available treatment options to improve clinical outcomes.

Individual Differences in Accent Imitation.

All talkers show some flexibility in their speech, and the ability to imitate an unfamiliar accent is a skill that shows vast individual differences. Yet the source of these individual differences, in particular whether they originate from perceptual, motor, or social/personality factors, is not yet clear. In the current study, we ask how individual differences in these factors predict individual differences in deliberate accent imitation. Participants imitated three accents, and attempts were rated for accuracy. A set of measures tracking individual differences in perceptual, motor, cognitive, personality, and demographic factors were also acquired. Imitation ability was related to differences in musical perception, vocal articulation, and the personality characteristic of "openness to experience," and was affected by attitudes towards the imitated talkers. Taken together, results suggest that deliberate accent imitation skill is modulated not only by core perceptual and motor skills, but also by personality and affinity to the talker, suggesting that some aspects of deliberate imitation are a function of domain-general constraints on perceptual-motor systems, while others may be modulated by social context.

ScSeI Monolayer for Photocatalytic Water Splitting.

We theoretically identify the ScSeI monolayer as a promising new 2D material for photocatalysis through first-principles calculations. The most notable feature is the significant difference in carrier mobility, with electron mobility in the horizontal direction being 20.66 times higher than hole mobility, minimizing electron-hole recombination. The ScSeI monolayer exhibits a bandgap of 2.51 eV, with the valence band maximum at -6.37 eV and the conduction band minimum at -3.86 eV, meeting the requirements for water splitting. Phosphorus doping lowers the Gibbs free energy by 1.63 eV, enhancing the catalytic activity. The ScSeI monolayer achieves a hydrogen production efficiency of 17%, surpassing the commercial threshold of 10% and shows excellent mechanical, thermal, and dynamic stability, indicating feasibility for experimental synthesis and practical application. Additionally, the monolayer maintains its photocatalytic properties under tensile strain (-6% to 6%) and in aqueous environments, reinforcing its potential as an effective photocatalyst. Based on these findings, we believe the ScSeI monolayer is a highly promising photocatalyst.

Precise positional alignment of atom-resolved HAADF images of heteroepitaxial interface with low signal-to-noise ratio.

Heteroepitaxial interfaces are important because they determine the performance of devices such that career mobility is sensitive to the distribution of roughness, strain and composition at the interface. High-angle annular dark field imaging in scanning transmission electron microscopy has been utilized to capture them at an atomic scale. For precise identification of atomic column positions, a technique has been proposed to average multiple image frames taken at a high scanning rate by their positional alignment for increasing signal-to-noise ratio. However, the positional alignment between frames is sometimes incorrectly estimated because of the almost perfect periodic structure at the interfaces. Here, we developed an approach for precise positional alignment, where the images are first aligned by two consecutive images and then are aligned more precisely against the integrated image of the first alignment. We demonstrated our method by applying it to the heterointerface of Si0.8Ge0.2 (Si: silicon, Ge: germanium) epitaxial thin films on a Si substrate.

Dual-Site Molecular Dipole Enables Tunable Interfacial Field Toward Efficient and Stable Perovskite Solar Cells.

The interfacial management in perovskite solar cells (PSCs), including mitigating the carrier transport barrier and suppressing non-radiative recombination, still remains a significant challenge for efficiency and stability enhancement. Herein, by screening a family of fluorine (F) terminated dual-site organic dipole molecules, the study aims to gain insight into the molecular dipole array toward tunable interfacial field. Both experimental and theoretical results reveal that these functional interfacial dipole molecules can effectively anchor on perovskite surface through Lewis acid-base interaction. In addition, the tailored side-chain with terminated F atoms allows for altering and constructing a well matched perovskite/Spiro-OMeTAD interfacial contact. As a result, the inserting dual-site organic dipole array effectively modulates the interface to deliver a gradient energy level alignment, facilitating carrier extraction and transport. The optimal dual-site dipole trifluoro-methanesulfonamide mediated N-i-P PSCs achieve the highest efficiency of 25.47%, together with enhanced operational stability under 1000 h of the simulated 1-sun illumination exposure. These findings are believed to provide insight into the design of dual-site molecular dipole with sufficient interfacial tunability for perovskite-based optoelectronic devices.

Impact of commissural alignment on the hemodynamic performance of supra-annular self-expandable transcatheter aortic valves.

BACKGROUND: Hemodynamic impact of commissural alignment (CA) with self-expandable transcatheter aortic valves (TAVR) has not been investigated yet. AIMS: To determine hemodynamic impact of CA with self-expandable TAVR. METHODS: Multicentric ambispective study comparing patients who underwent self-expandable TAVR in seven centers with the Evolut Pro/Pro+ (EP) (Medtronic) and Acurate neo2 (AN2) (Boston Scientific) with and without CA strategies. The degree of commissural misalignment (CMA) was assessed by computed tomography/angiography and 1-year transvalvular gradients/regurgitation evaluated by echocardiography. A matched comparison according to annular dimensions/eccentricity, prosthesis size/type, and baseline left ventricular function and gradients was performed. RESULTS: A total of 557 patients, mean age 80.7 ± 6.6 years, 61.4% men, and STS score of 4.3 ± 3.1% were analyzed. A CA technique was attempted in 215 patients (38.6%), including 113 patients with AN2 and 102 patients with EP. None/mild CMA was found in 158 (73.5% vs. 43.6% if no CA attempted, p < 0.001) with no differences between devices (AN2:75.2%; EP:71.6%, p = 0.545). Patients with moderate/severe CMA had a greater aortic peak gradient (22.3 ± 8.7 vs. 19.7 ± 8.5, p = 0.001), significantly greater progression of both peak (p = 0.002) and mean gradients (p = 0.001) after matching, and higher rate of central aortic regurgitation (1.2% vs. 0.4%, p = 0.005) at 1-year, but not a greater proportion of patients with mean gradient ≥ 10 mmHg. CONCLUSIONS: The use of CA strategies significantly reduced the rate of CMA for the self-expandable TAVR devices ACN2 and EP which was associated to lower transvalvular gradients and intra-prosthetic regurgitation progression at 1-year although no criteria of structural deterioration were met at this follow up. CLINICALTRIALS: org: NCT05097183.

The Influence of Body Position on the Resting Motor Threshold of Posterior Root-Muscle Reflexes Evoked via Transcutaneous Spinal Cord Stimulation.

Background: Thoracolumbar transcutaneous spinal cord stimulation (tSCS) non-invasively evokes posterior root-muscle reflexes (PRMR) with the aim of neuromodulating sensorimotor function following spinal cord injury. Research is still in its infancy regarding the effect of body position on the nature of these spinally evoked responses. Therefore, the aim of this study was to investigate the influence of body position on the nature of PRMR responses during tSCS. Methods: A total of 11 (6M, 5F) participants completed a full PRMR recruitment curve from 10 ma up to 120 ma (10 ma increments) at the T11/12 intervertebral space using a singular 3.2 cm diameter cathode. At each intensity, three paired pulses (50 ms inter-pulse interval), followed by three singular pulses with a six-second delay were applied in each body position (supine, supine 90-90, sitting and standing) in a randomised order. The PRMR responses in lower limb muscles were recorded using wireless electromyographic sensors placed on the Soleus, Tibialis Anterior, Rectus Femoris and Bicep Femoris long head. A two-way (body position × muscle) repeated measures analysis of variance was used to investigate the effect of body position on PRMR-evoked responses. Results: There was a significant main effect of body position on PRMR resting motor threshold (RMT) (p < 0.001), first response peak-to-peak amplitude (p = 0.003) and percentage post-activation depression (%PAD) (p = 0.012). Sitting had significantly higher RMT and significantly lower first response peak-to-peak amplitudes compared to all other positions, but significant differences in %PAD were only detectible between supine and standing. Conclusions: Body position influences the nature of PRMR-evoked responses during tSCS.