Neuromuscular Electrical Stimulation of Peroneal Longus on Balance Control Ability in Young Adults with Chronic Ankle Instability: A Randomized Controlled Trial.

OBJECTIVE: This study aimed to investigate the effects of six weeks of peroneal longus neuromuscular electrical stimulation (NMES) on the balance control ability in young adults with chronic ankle instability (CAI). DESIGN: This study is a double blind randomized controlled trial. Six weeks of NMES and placebo intervention were conducted in the NMES and control groups for 20 minutes, three times a week, respectively. Thirty-eight participants successfully completed the whole intervention and single-leg standing tests. The kinetics data of the center of pressure (COP) trajectory during static single-leg stance were measured using a Kistler force platform. Two-way repeated measures ANOVA was used to analyze the electrical stimulation effects. RESULTS: Significant interactions were detected in CAIT scores and all balance parameters including Displacement X (Dx), Displacement Y(Dy), 95% confidence ellipse area (95%AREA), root-mean-square (RMS) and COP mean displacement velocity (MV) (p < 0.05, 0.103 ≤ η2 ≤ 0.201). Significant between-group differences were found in CAIT scores (p = 0.003, Cohen's d = 0.215), Dx (p = 0.045, Cohen's d = 0.107), RMS-ml (p = 0.019, Cohen's d = 0.143) and 95%AREA (p = 0.031, Cohen's d = 0.123) after the six weeks interventions. CONCLUSION: Six weeks of NMES on the peroneus longus can improve static balance control ability in young adults with CAI, especially the stability of ankle frontal plane.

The use of artificial intelligence in the treatment of rare diseases: A scoping review.

With the increasing application of artificial intelligence (AI) in medicine and healthcare, AI technologies have the potential to improve the diagnosis, treatment, and prognosis of rare diseases. Presently, existing research predominantly focuses on the areas of diagnosis and prognosis, with relatively fewer studies dedicated to the domain of treatment. The purpose of this review is to systematically analyze the existing literature on the application of AI in the treatment of rare diseases. We searched three databases for related studies, and established criteria for the selection of retrieved articles. From the 407 unique articles identified across the three databases, 13 articles from 8 countries were selected, which investigated 10 different rare diseases. The most frequently studied rare disease group was rare neurologic diseases (n = 5/13, 38.46%). Among the four identified therapeutic domains, 7 articles (53.85%) focused on drug research, with 5 specifically focused on drug discovery (drug repurposing, the discovery of drug targets and small-molecule inhibitors), 1 on pre-clinical studies (drug interactions), and 1 on clinical studies (information strength assessment of clinical parameters). Across the selected 13 articles, we identified total 32 different algorithms, with random forest (RF) being the most commonly used (n = 4/32, 12.50%). The predominant purpose of AI in the treatment of rare diseases in these articles was to enhance the performance of analytical tasks (53.33%). The most common data source was database data (35.29%), with 5 of these studies being in the field of drug research, utilizing classic databases such as RCSB, PDB and NCBI. Additionally, 47.37% of the articles highlighted the existing challenge of data scarcity or small sample sizes.

Brain activation during standing balance control in dual-task paradigm and its correlation among older adults with mild cognitive impairment: a fNIRS study.

BACKGROUND: This study aimed to compare the balance ability and functional brain oxygenation in the prefrontal cortex (PFC) among older adults with mild cognitive impairment (MCI) under single and dual tasks, and also investigate their relationship. Neural regulatory mechanisms of the brain in the MCI were shed light on in balance control conditions. METHODS: 21 older adults with MCI (female = 12, age: 71.19 ± 3.36 years) were recruited as the experimental group and 19 healthy older adults (female = 9, age: 70.16 ± 4.54 years) as the control group. Participants completed balance control of single task and dual task respectively. Functional near-infrared spectroscopy (fNIRS) and force measuring platform are used to collect hemodynamic signals of the PFC and center of pressure (COP) data during the balance task, respectively. RESULTS: The significant Group*Task interaction effect was found in maximal displacement of the COP in the medial-lateral (ML) direction (D-ml), 95% confidence ellipse area (95%AREA), root mean square (RMS), the RMS in the ML direction (RMS-ml), the RMS in the anterior-posterior (AP) direction (RMS-ap), sway path (SP), the sway path in the ML direction (SP-ml), and the sway path in the AP direction (SP-ap). The significant group effect was detected for five regions of interest (ROI), namely the left Brodmann area (BA) 45 (L45), the right BA45 (R45), the right BA10 (R10), the left BA46 (L46), and the right BA11 (R11). Under single task, maximal displacement of the COP in the AP direction (D-ap), RMS, and RMS-ap were significantly negatively correlated with R45, L45, and R11 respectively. Under dual task, both RMS and 95%AREA were correlated positively with L45, and both L10 and R10 were positively correlated with RMS-ap. CONCLUSION: The MCI demonstrated worse balance control ability as compared to healthy older adults. The greater activation of PFC under dual tasks in MCI may be considered a compensatory strategy for maintaining the standing balance. The brain activation was negatively correlated with balance ability under single task, and positively under dual task. TRIAL REGISTRATION: ChiCTR2100044221 , 12/03/2021.

The association between serum adipokines levels with senile osteoporosis: a systematic review and meta-analysis.

Objective: The clinical correlation between adipokines levels in the blood and the incidence of senile osteoporosis (SOP) has not been clearly studied. We conducted this meta-analysis to elucidate the relationship between three common adipokines levels (leptin, adiponectin, and chemerin) and the incidence of SOP. Methods: We searched databases such as CNKI, CBM, VIP, Wanfang, PubMed, Web of Science, Embase, and the Cochrane Library to collect articles published since the establishment of the database until July 30, 2022. Results: In total, 11 studies met the selection criteria. Our meta-analysis showed that serum leptin levels were significantly lower (mean difference [MD], -2.53, 95% CI: -3.96 to -1.10, I2 = 96%), chemerin levels were significantly higher (MD, 30.06, 95% CI: 16.71 to 43.40, I2 = 94%), and adiponectin levels were not significantly different (MD, -0.55, 95% CI: -2.26 to 1.17, P = 0.53, I2 = 98%) in SOP patients compared with healthy older individuals with normal bone mineral density (BMD). In addition, correlation analysis showed that leptin levels were positively correlated with lumbar bone mineral density (LBMD) (r = 0.36) and femoral bone mineral density (FBMD) (r = 0.38), chemerin levels were negatively correlated with LBMD (r = -0.55) and FBMD (r = -0.48), and there were significant positive correlations between leptin and adiponectin levels and body mass index (BMI) (r = 0.91 and 0.97). Conclusions: The likelihood of having SOP was higher in older individuals with low levels of leptin and higher levels of chemerin. In addition, BMI was somewhat lower with low levels of leptin and adiponectin. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42022356469.

Test-retest reliability of kinematic and kinetic parameters during dual-task stair walking in the elderly.

Objective: This study aims to evaluate the test-retest reliability of kinematics and kinetics during single and dual-task stair walking in the elderly. Methods: Fifteen healthy elderly adults were recruited. Kinematic and kinetic parameters were measured using an infrared motion analysis system (Vicon, Oxford Metrics Ltd., Oxford, United Kingdom) and force platforms (Switzerland, Kistler 9287BA and 9281CA). Participants were tested under single-task and dual-task (serial 3 subtractions or carrying a cup of water) conditions. Each participant completed two sessions on two separate days with a 1-week interval. Intraclass correlation coefficients (ICC), Pearson correlation coefficient (r), and Bland-Altman plot were used to assess the reliability of stair walking. Results: When ascending stairs, the ICC of kinematics and kinetics ranged from fair to excellent (ICC = 0.500-0.979) in the single and dual tasks, except for step length (ICC = 0.394) in the single task. The r value of kinematics and kinetics ranged from 0.704 to 0.999. When descending stairs, the ICC of kinematics and kinetics ranged from good to excellent (ICC = 0.661-0.963), except for min hip moment (ICC = 0.133) and min ankle moment (ICC = 0.057) in the manual task. The r value of kinematics and kinetics ranged from 0.773 to 0.960 in the single and dual tasks. In the Bland-Altman plots, all the zero values and most of the dots fell in the 95% confidence interval, and the mean difference was found to be close to zero for all the parameters during stair walking. Conclusion: These results obtained from this study show the good test-retest reliability of step cadence, step speed, and step width during single- and dual-task stair walking in the elderly, and the poor reliability of step length during ascending stairs. All the kinetic parameters, including min hip moment, max knee moment, and min ankle moment, had good test-retest reliability during single- and dual-task stair walking, but min hip moment and min ankle moment had poor reliability during manual-task descending stair. These results may help researchers in the assessment of biomechanics of dual-task stair walking in the elderly and to interpret the effect of interventions in this population.

Effects of fatigue on balance and ankle proprioception during drop landing among individuals with and without chronic ankle instability.

This study aimed to explore the effects of fatigue on the balance and ankle proprioception during drop landing of individuals with chronic ankle instability (CAI). A total of 35 participants with unilateral CAI and 35 healthy participants participated in this study. A static balance test, dynamic balance test, and ankle proprioception test were conducted before and after fatigue. Fatigue was induced with turn back runs and vertical jumps protocol. Sway distance of the center of pressure (COP), root mean square of the COP (RMS), total excursions (TOTEX), mean velocity (MVELO), 95% confidence ellipse area of the COP movements (95% AREA), Normalise Reach Distance in the anterior (ANT), posteromedial (PM), and posterolateral (PL) directions, and the area under the curve (AUC) were calculated and analyzed. There were significant group by fatigue interactions for static balance variables, normalise reach distance in the PM and PL directions, and AUC. Fatigue reduced balance and ankle proprioception in individuals with CAI. After fatigue, static and dynamic balance and ankle proprioception during drop landing were significantly worse in the CAI group than in the control group. Fatigue had a significant negative effect on balance and ankle proprioception in CAI patients. Therefore, fatigue may be an important factor causing repeated ankle sprain in CAI patients.

The Lower Limb Stiffness, Moments, and Work Mode During Stair Descent Among the Older Adults.

OBJECTIVE: Lower limb stiffness strategies and work mode changes between young and older adults during stair descent are unclear. This study investigated the effect of aging on the lower limb stiffness, moments, and joint work mode during stair descent. DESIGN: Twenty young adults and 20 older adults were recruited from the local community for stair descent test. Kinematics and kinetics data were collected by Vicon system and Kistler force plate. The lower limb stiffness, moments, and work mode were calculated and assess between groups. RESULTS: No significant differences in gait parameters were detected between groups. Compared with young adults, older adults have decreased leg stiffness, knee and ankle stiffness, increased peak hip extension moment, hip stiffness, and ankle work contribution. CONCLUSIONS: The older adults actively reduce the lower limb stiffness to reduce the risk of injury during stair descent. The hip joint strategy reduces the risk of forwarding falls and ankle joint compensation work mode to make up for the lack of knee extension strength. This provides a reference for the focus of exercise intervention and rehabilitation strategies for older adults.

Muscle co-contraction and pre-activation in knee and ankle joint during a typical Tai Chi brush-knee twist-step.

This study aimed to investigate the co-contraction and pre-activation of agonistic and antagonistic muscles in experienced Tai Chi (TC) practitioners during normal walking (NW) and brush-knee twist-step (BKTS). The electromyographic activities of rectus femoris, biceps femoris, and tibialis anterior and lateral gastrocnemius muscles were collected during BKTS and NW in 28 TC practitioners. The pre-activation of knee and ankle joints before initial landing of left foot, and the co-contraction of knee and ankle joint in double-stance phase I (DSI), single-stance phase (SS), double-stance phase II (DSII), and swing phase (SW) were calculated during BKTS and NW. Ankle co-contraction significantly increased during DSI and SS in BKTS movements than compared with that in NW. For DSI and SW, SS and DSII, and DSII and SW, a significant difference was found in BKTS. The pre-activation of knee joint significantly decreased in BKTS and NW. This study indicated greater ankle joint muscle co-contraction in DSI and SS of stance phase and lower knee joint muscle co-contraction and pre-activation than in NW in BKTS movement. In addition, greater ankle joint muscle co-contraction was observed in the DSI, SS, and DSII of stance phase than those of swing phase in BKTS movement.

Eight-week virtual reality training improves lower extremity muscle strength but not balance in adolescents with intellectual disability: A randomized controlled trial.

Purpose: This study aims to assess the effects of 8-week virtual reality (VR) training on balance and lower extremity muscle strength in adolescents with intellectual disability (ID). Methods: Thirty adolescents with intellectual disability were randomly divided into the virtual reality group and control group. The participants in the virtual reality group and the control group received the virtual reality training and the physical education (PE) course, respectively, for 8 weeks. The Berg Balance Scale (BBS), Timed Up and Go (TUG) test and lower extremity muscle strength were measured before and after the training. Results: The between-group results showed that the participants in the virtual reality group increased the muscle strength of hip flexors (p < 0.001), hip extensors (p = 0.002), hip abductors (p < 0.001), knee flexors (p < 0.001), knee extensors (p = 0.002) and ankle plantar flexors (p = 0.042) significantly after training, compared to the control group. However, no significant improvement was found in the berg balance scale and timed up and go scores between the virtual reality group and control group after training (p > 0.05). The within-group results showed that the strength of all the muscle groups significantly increased after training in the virtual reality group (p < 0.05) compared to the baseline. However, no significant difference was found in the muscle strength in the control group before and after training. The within-group berg balance scale and timed up and go scores showed no significant improvements in both groups. Conclusion: Virtual reality training intervention might be effective in improving the lower extremity muscle strength, but no significant improvement was found on balance ability in adolescents with intellectual disability.

Effects of Tai Chi on the neuromuscular function of the patients with functional ankle instability: a study protocol for a randomized controlled trial.

BACKGROUND: Ankle instability limits physical activities and undermines a person's quality of life. Tai Chi's health benefits have been reported in different population groups. However, the effects of Tai Chi on neuromuscular function among young adults with functional ankle instability (FAI) remain unclear. Therefore, we aim to investigate the effect of Tai Chi on young adults with FAI. METHODS: This study will be conducted as a randomized controlled trial with blinded assessors. A total of 104 young adults with FAI will be recruited and randomly assigned to intervention and control groups. The participants in the simplified Tai Chi exercise program (STCEP) group will receive a 12-week Tai Chi training. The participants in the control group will receive a low-intensity exercise program and health education for 12 weeks. The primary and secondary outcomes will be assessed at baseline, 4th, 8th, and 12th weeks. Primary outcome measures will include the Cumberland Ankle Instability Tool (CAIT) score, kinematics/kinetics data, electromyography during single-leg landing tasks, and the modified Star Excursion Balance Test (mSEBT). Secondary outcome measures will include the total time of Dynamic Leap and Balance Test (DLBT), ankle muscle strength, and ankle proprioception. DISCUSSION: This study will investigate the effects of Tai Chi exercise on the neuromuscular function of patients with FAI, as indicated by ankle joint biomechanics, ankle proprioception, balance, ankle muscle strength, and ankle muscle activation. Results will demonstrate that Tai Chi can be an effective exercise for young adults with FAI. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2100044089 . Registered on 10 March 2021.

Effects of dual tasks on kinematic and kinetic performances during stair descent: respective effects of manual and cognitive tasks.

BACKGROUND: Stair descent is one of the most common and challenging daily activities for several populations, particularly under dual-task conditions. This study investigated the effects of cognitive or manual task on kinematics and kinetics during stair descent. METHODS: A total of 37 participants performed stair descent under three conditions: stair descending only, stair descending while performing a cognitive task and stair descending while performing a manual task. Kinematic and kinetic data were collected. Multivariate analysis of variance with repeated measures was conducted to test the significant differences among the three conditions. RESULTS: The gait performance, loading rate, lower limb joint moments and powers were significantly lower under the two dual-task conditions compared with stair descending only. The participants had lower knee flexion/extension range of motion, loading rate, peak hip flexion moment, first peak knee extensor moment, second peak ankle plantar flexion moment, first knee power absorption and less stride width under the manual task compared with the cognitive task. CONCLUSIONS: Dual tasks during stair descent had a significant impact on the kinematics and kinetics of motion, and the effect was more significant while performing a concurrent manual task in healthy young adults. Further studies could focus on the complexity level of dual tasks on the biomechanical parameters during stair walking.