Night Screen Time is Associated with Cognitive Function in Healthy Young Adults: A Cross-Sectional Study.

Background: In recent years, a significant shift toward remote work, virtual education, and social distancing measures was witnessed, thereby leading people to increasingly depend on digital devices for communication, work, and entertainment. This increased exposure to screens has raised concerns regarding its potential impact on cognitive function. Purpose: This study investigated the relationship between screen time and cognitive function among healthy young adults. Methods: One hundred forty-five healthy individuals (mean age 21.55 ± 2.84 years) participated in this cross-sectional study. Sociodemographic information including age, sex, height, weight, and level of education were obtained. Participants reported screen time using a screen time questionnaire. Cognitive function tests including, Paced Auditory Serial Addition Task (PASAT), Montreal Cognitive Assessment (MoCA) and Symbol Digit Modalities Test (SDMT) were conducted. Multilinear regression analyses were used to examine the associations between age, sex, level of education, screen time, and cognitive function. Results: One hundred thirty-nine participants (76 women) completed the study. Increased night screen time, bachelor's educational level, and women were associated with lower PASAT scores (R2=0.258; p≤0.047). Moreover, increased night screen time was associated with lower MoCA scores (R2=0.029; p=0.035). However, no associations were found between night screen time and SDMT scores. Conclusion: Participants who had higher night screen exposure had lower cognitive scores in the information speed processing, working memory, calculation, and attention domains. Considering these findings, this study emphasizes on the importance of setting a future recommended screen time guidelines for young adults as well as to promote healthy cognitive habits in order to preserve cognitive function and reduce the risk of developing neurodegenerative disease in the future. Future prospective cohort studies involving a more diverse age range is needed.

Are accelerometer-measured sitting and physical activity times associated with muscle mass and strength in healthy young adults in the UAE?

Background: A high prevalence of obesity, sedentary behavior, and physical inactivity could affect muscle mass and strength in young adults in the United Arab Emirates (UAE). Therefore, we investigated the association of sex, body mass index (BMI), and accelerometer-measured sitting and physical activity (PA) times with skeletal muscle mass index (SMI), hand grip, and thigh muscle strength in healthy young adults in the UAE. Methods: In this cross-sectional study, 156 healthy young adults (age 21.68 ± 3.01 years, BMI 25.40 ± 4.79 kg/m2, 52.6 % women) were included. BMI and muscle mass were recorded using a bioelectrical impedance analyzer. Maximum hand grip strength and thigh muscle torque were assessed using the Jamar-smart hand-dynamometer and Biodex System-4-Pro, respectively. Participants wore a triaxial Fibion accelerometer on their anterior thigh for >10 h per day for 4-7 days to measure their sitting and PA times. Multiple linear regression analyses were used. Results: Participants spent most of their time sitting (11.37 ± 1.10 h), followed by standing (2.92 ± 0.86 h), walking (1.58 ± 0.55 h), and vigorous intensity PA (4.79 ± 5.85 min) per 16-h day. Sex (p < 0.001) and BMI (p < 0.001) were negatively associated with all muscle mass and strength variables. Men had more muscle mass and strength than women. As BMI increased, muscle mass and muscle strength decreased. Accelerometer-measured sitting and walking times were negatively associated with concentric hamstrings (p = 0.044) and quadriceps torques (p = 0.031), respectively. Conclusion: Sex, BMI, and accelerometer-measured sitting and walking times were associated with muscle mass and/or muscle strength in healthy young adults. Women and those with a high BMI need interventions to improve their muscle mass and strength. The paradox regarding the association of PA with muscle mass and strength in younger adults may be due to possible influences from other factors (e.g., resistance training, dietary intakes, etc.) superseding that of accelerometer-measured PA.

Effectiveness of an Intensive, Functional, and Gamified Rehabilitation Program on Upper Limb Function in People With Stroke (EnteRtain): A Multicenter Randomized Clinical Trial.

BACKGROUND1: Despite a growing interest in gaming rehabilitation for upper limb (UL) recovery post-stroke, studies investigating the effects of game-based rehabilitation incorporating functional games are lacking. OBJECTIVE: To investigate the efficacy of an intensive, functional, gamified rehabilitation program compared to task-based training on UL motor function in acute/sub-acute stroke survivors. METHODS: This randomized, multicenter, single-blind, clinical trial comprises 120 participants with unilateral stroke who were randomized to receive either gamified training (n = 64) using the ArmAble™ [experimental group (EG)] or task-based training (n = 56) in conjunction with conventional therapy for 2 hours per day, 6 days per week for 2 weeks, followed by UL rehabilitation for another 4 weeks at home. Primary outcomes evaluated by a blinded assessor included the Fugl-Meyer Assessment-Upper Extremity (FM-UE), and Action Research Arm Test (ARAT). Data were analyzed using a linear mixed-effect regression model. RESULTS: The mean (standard deviation) age of the participants was 54.4 ± 11.7 years (78.1% men) in the EG and 57.7 ± 10.9 years (73.2% men) in the comparator group (CG). The median (interquartile range) time since stroke was 30.0 (54.0) days in the EG and 22.5 (45.0) days in the CG. Following the 2-week intervention, a statistically significant improvement was observed in the EG for the FM-UE [between-group mean differences (95% confidence interval): -3.9 (-6.5, -1.3); P = .003]; but not for the ARAT [-2.9 (-5.8, 0.0); P = .051]. Gains at 6 weeks were significantly greater in the EG for both FM-UE [-3.9 (-6.5, -1.3); P = .003]; and ARAT [-3.0 (-5.9, -0.0); P = .046]. CONCLUSION: Gamified rehabilitation using the ArmAble™ device has shown immediate and short-term improvement in UL function after acute/sub-acute stroke. CLINICAL TRIALS REGISTRY NUMBER: CTRI/2020/09/027651.

Transmission of fore-and-aft floor vibration to the spine and head of standing people.

Sixteen standing male participants were subjected to fore-and-aft sinusoidal vibration with peak magnitude and frequency in the range 0.44-4.431 ms-2 and 2-6 Hz, respectively. The fore-and-aft, lateral and vertical transmissibilities to the first dorsal vertebra (T1), eighth dorsal vertebra (T8), twelfth dorsal vertebra (T12), fourth lumbar vertebra (L4) and head were measured. Large inter-participant variability was observed in the transmissibilities at all locations. Nevertheless, peaks in the range 3-4.5 Hz were identified at all locations, implying a whole-body resonance in this frequency range. The response was found dominant in the mid-sagittal plane as the lateral transmissibility showed low values. Below 4.5 Hz, the fore-and-aft transmissibility increased with moving from caudal to cranial locations of the upper body. However, at higher frequencies, the opposite trend was observed. The results can be used for developing models that may help understand how vibration affects health and comfort.

Association of sociodemographic, anthropometric, and sleep quality factors with accelerometer-measured sitting and physical activity times among Emirati working women during the COVID-19 pandemic: A cross-sectional study.

BACKGROUND: Although a significant lack of physical activity has been linked to an increase in obesity among Emirati women, the factors associated with accelerometer-measured sitting and physical activity times in Emirati women remain unclear. OBJECTIVES: To explore the association of accelerometer-measured sitting and physical activity times with sociodemographic, anthropometric, and sleep quality factors among Emirati working women. DESIGN: A cross-sectional study. METHODS: A convenience sample of 163 healthy working Emirati women aged 18-45 years was used. Sedentary and physical activity times were measured using the Fibion accelerometers worn on the thighs for 4-7 days. General demographic information, anthropometric measurements, and self-reported sleep quality (Pittsburgh sleep quality index score) were collected. Only participants who had valid data (i.e. wear time of ⩾600 min (10 h) per day for a minimum of 4-7 days) were evaluated. All values were normalized to a 16-h day to mitigate differences in wear time among the participants. RESULTS: Overall, 110 Emirati women were included. The mean sitting time per 16-h day was 11.6 ± 1.1 h; mean moderate activity time per day, 40.88 ± 17.99 min; and mean vigorous activity time per day, 2.41 ± 1.21 min. Longer sitting time was associated with high body fat, secondary education, and divorce. Sitting time was reduced in those with good sleep quality. Moderate-to-vigorous physical activity time was increased in women with postgraduate education and was decreased in women with a longer work experience and with comorbidities. The total activity time increased with increasing age and good sleep quality, whereas it decreased with increasing body fat, presence of at least one comorbidity, secondary education, and divorce. CONCLUSION: Certain demographic, anthropometric, and sleep quality factors were associated with accelerometer-measured sitting and physical activity times among Emirati working women. Future longitudinal studies should consider these factors when investigating predictors of physical activity levels in this population.

Association of Sociodemographic Factors with Physical Activity and Sleep Quality in Arab and Non-Arab Individuals of Both Sexes during the COVID-19 Pandemic.

We explored the association of sociodemographic and anthropometric factors with self-reported physical activity (PA) and sleep quality in Arab and non-Arab individuals of both sexes during the COVID-19 pandemic. In this cross-sectional study, 638 participants (those recovered from COVID-19 = 149, and non-infected = 489) of both sexes aged 18-55 years were recruited. Their sociodemographic and anthropometric information, PA (self-reported using the International Physical Activity Questionnaire Short-form [IPAQ-SF)]) and sleep quality (self-reported using the Pittsburgh Sleep Quality Index [PSQI]) were documented. The association between participants' characteristics, PA levels, and sleep quality were determined using the chi-squared test. Variables significantly associated with IPAQ and PSQI in bivariate analyses were included in a multivariate binary logistic regression model. Men were more active than women (odds ratio [OR] = 1.66, p = 0.010), and non-Arab participants were more active than Arab ones (OR = 1.49, p = 0.037). Participants ≥40 years, men, non-Arab participants, and those who were working were more likely to have a good sleep quality than those ≤40 years (OR 1.70, p = 0.048), women (OR 1.10, p = 0.725), Arab individuals (OR 1.95, p = 0.002), and unemployed people (OR 2.76, p = 0.007). Male and non-Arab participants seemed to have a better self-reported PA and sleep quality compared to female and Arab participants, during the pandemic.

Known-group validity of passive knee joint position sense: a comparison between individuals with unilateral anterior cruciate ligament reconstruction and healthy controls.

BACKGROUND: Knee joint position sense (JPS) might be negatively affected after injuries to the anterior cruciate ligament (ACL). Recent systematic reviews suggest further investigation of psychometric properties, including validity, of knee JPS tests following ACL reconstruction (ACLR). This study investigated the known-group validity by comparing knee JPS errors between individuals who underwent unilateral ACLR and healthy controls. METHODS: This cross-sectional study involved 36 men, including 19 after ACLR (ACLR group) and 17 healthy controls (control group). In both groups, the absolute error (AE), constant error (CE) and variable error (VE) of passive knee JPS were calculated in the flexion and extension directions, for two target angles (30° and 60° flexion) per direction. Discriminative validity was evaluated by comparing JPS errors between the operated and non-operated knees in the ACLR group. Known-group validity was evaluated by comparing JPS errors between the operated knees in the ACLR group and the asymptomatic non-dominant knees of healthy controls. RESULTS: Mean AE, CE and VE for all tests were 4.1°, - 2.3° and 3.6° for the operated knees in the ACLR group, 5.5°, - 2.6° and 3.3° for the non-operated knees in the ACLR group and 4.6°, - 2.6° and 3.3° for the non-dominant knees in the control group, respectively, regardless of the test direction and target angle. The operated knees in the ACLR group did not show significantly greater JPS errors compared to the contralateral knees in the ACLR group and to the non-dominant knees in the control group (p ≥ 0.05). On the other hand, the non-operated knees showed significantly greater AE for the 0°-60° flexion test (p = 0.025) and CE for the 0°-30° flexion test (p = 0.024) than the operated knees in the ACLR group. JPS errors did not significantly differ in the operated knees in the ACLR group based on the direction of movement and the target angle. However, the errors were significantly higher when the knee was moved through a greater range compared to that of a lesser range between the starting and target angles. CONCLUSION: The ACLR knees did not show greater passive JPS errors than the contralateral or control knees. The direction of movement and target angle did not influence the JPS acuity after ACLR. However, higher JPS errors were evident when the knee was moved through a greater range compared to a lesser range of motion. Further studies investigating the psychometric properties of standardized JPS tests following ACLR are warranted.

Do kinematic measures, added to clinical measures, better predict upper extremity motor impairments at three months post-stroke?

OBJECTIVE: Predicting post-stroke recovery through prediction models is crucial for choosing appropriate treatment options. However, the existing models predominantly incorporate clinical measures although measurement of movement quality using kinematic measures is essential for distinguishing various types of recovery. Thus, this study aimed at determining if, by considering varied aspects of recovery, adding kinematic measurements over clinical measures would better predict upper extremity (UE) motor impairments at three months post-stroke. MATERIALS AND METHODS: Eighty-nine stroke survivors (58.9 ± 11.8 years) were assessed for clinical predictors between 4 and 7 days, kinematic predictors within 1 month, and the impairment outcome of the Fugl Meyer Assessment of the UE (FM-UE) at three months post-stroke. Significant predictors (p<0.05) with a variation inflation factor (VIF) <10 were selected for model development. After performing further step-wise selection, three models incorporating clinical outcomes, kinematic measurements, and a combination of these two, respectively, were formulated. RESULTS: The clinical model (R2 = 0.70) included shoulder abduction finger extension (SAFE) scores, the National Institutes of Health Stroke Scale (NIHSS), and the Montreal Cognitive Assessment (MoCA). The kinematic model (R2 = 0.34) included total displacement, total time, and reaction time. The combined model (R2 = 0.72) comprised of SAFE score and shoulder flexion. All the models had a minimal mean squared error on cross validation, which indicated a good validity. CONCLUSION: The performance of clinical and combined prediction models for predicting three-month post-stroke UE motor recovery was nearly similar. However, in order to detect minimal changes over time and to understand all aspects of motor recovery, there is a need to add instrument-based kinematic measures.

Perception and knowledge of learners about the use of 3D technologies in manual therapy education - a qualitative study.

OBJECTIVES: Manual therapy is a specific hands-on approach used and taught by various professions such as physiotherapy and osteopathy. The current paradigm of teaching manual therapy incorporates the traditional 'See one, do one, teach one' approach. However, this 'teacher centred' approach may not enable learners to develop the complex clinical skills of manual therapy. In this context, 3D technologies such as virtual reality may facilitate the teaching and learning of manual therapy. Hence the aim of the current study was to investigate the perception, knowledge and attitude of manual therapy learners about the use of 3D technologies in manual therapy education. METHODS: An exploratory qualitative research design using semi-structured interviews was used in this study. A total of ten manual therapy (5 physiotherapy and 5 osteopathic) students (mean age = 32; 80% female) enrolled in an appropriate physiotherapy or osteopathic degree provided by a New Zealand recognized institution (e.g., university or polytechnic) participated in this study. Data saturation was achieved after 10 interviews (average duration: 35 min) that provided thick data. A thematic analysis was used for data analysis. RESULTS: Six factors were identified which appeared to influence participants' perception of role of technology in manual therapy education. These were (1) the sufficiency of current teaching method; (2) evolution as a learner (a novice to an expert); (3) need for objectivity; (4) tutor feedback; (5) knowledge and (6) barriers and enablers. These six factors influenced the participants' perception about the role of 3D technologies in manual therapy education with participants evidently taking two distinct/polarized positions ('no role' (techstatic) versus a 'complete role' (techsavvy)). CONCLUSION: Although 3D technology may not replace face-to-face teaching, it may be used to complement the traditional approach of learning/teaching to facilitate the learning of complex skills according to the perceptions of manual therapy learners in our study. The advantage of such an approach is an area of future research.

Is Thoracic Kyphosis Relevant to Pain, Autonomic Nervous System Function, Disability, and Cervical Sensorimotor Control in Patients with Chronic Nonspecific Neck Pain?

There is great interest in thoracic kyphosis, as it is thought to be a contributor to neck pain, neck disability, and sensorimotor control measures; however, this has not been completely investigated in treatment or case control studies. This case control design investigated participants with non-specific chronic neck pain. Eighty participants with a defined hyper-kyphosis (>55°) were compared to eighty matched participants with normal thoracic kyphosis (<55°). Participants were matched for age and neck pain duration. Hyper-kyphosis was further categorized into two distinct types: postural kyphosis (PK) and Scheuermann's kyphosis (SK). Posture measures included formetric thoracic kyphosis and the craniovertebral angle (CVA) to assess forward head posture. Sensorimotor control was assessed by the following measures: smooth pursuit neck torsion test (SPNT), overall stability index (OSI), and left and right rotation repositioning accuracy. A measure of autonomic nervous system function included the amplitude and latency of skin sympathetic response (SSR). Differences in variable measures were examined using the Student's t-test to compare the means of continuous variables between the two groups. One-way ANOVA was used to compare mean values in the three groups: postural kyphosis, Scheuermann's kyphosis, and normal kyphosis group. Pearson correlation was used to evaluate the relationship between participant's thoracic kyphosis magnitude (in each group separately and as an entire population) and their CVA, SPNT, OSI, head repositioning accuracy, and SSR latency and amplitude. Hyper-kyphosis participants had a significantly greater neck disability index compared to the normal kyphosis group (p < 0.001) with the SK group having greatest disability (p < 0.001). Statistically significant differences between the two kyphosis groups and the normal kyphosis group for all the sensorimotor measured variables were identified with the SK group having the most decreased efficiency of the measures in the hyper-kyphosis group, including: SPNT, OSI, and left and right rotation repositioning accuracy. In addition, there was a significant difference in neurophysiological findings for SSR amplitude (entire sample of kyphosis vs. normal kyphosis, p < 0.001), but there was no significant difference for SSR latency (p = 0.07). The CVA was significantly greater in the hyper-kyphosis group (p < 0.001). The magnitude of the thoracic kyphosis correlated with worsening CVA (with the SK group having the smallest CVA; p < 0.001) and the magnitude of the decreased efficiency of the sensorimotor control measures and the amplitude and latency of the SSR. The PK group, overall, showed the greatest correlations between thoracic kyphosis and measured variables. Participants with hyper-thoracic kyphosis exhibited abnormal sensorimotor control and autonomic nervous system dysfunction compared to those with normal thoracic kyphosis.

Sedentary and physical activity time differs between self-reported ATLS-2 physical activity questionnaire and accelerometer measurements in adolescents and young adults in the United Arab Emirates.

BACKGROUND: Most young adults and adolescents in the United Arab Emirates (UAE) do not meet the established internationally recommended physical activity levels per day. The Arab Teen Lifestyle Study (ATLS) physical activity questionnaire has been recommended for measuring self-reported physical activity of Arab adolescents and young adults (aged 14 years to mid-twenties). The first version of the ATLS has been validated with accelerometers and pedometers (r ≤ 0.30). The revised version of the questionnaire (ATLS-2, 2021) needs further validation. The aim of this study was to validate the self-reported subjective sedentary and physical activity time of the ATLS-2 (revised version) physical activity questionnaire with that of Fibion accelerometer-measured data. METHODS: In this cross-sectional study, 131 healthy adolescents and young adults (aged 20.47 ± 2.16 [mean ± SD] years (range 14-25 years), body mass index 23.09 ± 4.45 (kg/m2) completed the ATLS-2 and wore the Fibion accelerometer for a maximum of 7 days. Participants (n = 131; 81% non-UAE Arabs (n = 106), 13% Asians (n = 17) and 6% Emiratis (n = 8)) with valid ATLS-2 data without missing scores and Fibion data of minimum 10 h/day for at least 3 weekdays and 1 weekend day were analyzed. Concurrent validity between the two methods was assessed by the Spearman rho correlation and Bland-Altman plots. RESULTS: The questionnaire underestimated sedentary and physical activity time compared to the accelerometer data. Only negligible to weak correlations (r ≤ 0.12; p > 0.05) were found for sitting, walking, cycling, moderate intensity activity, high intensity activity and total activity time. In addition, a proportional/systematic bias was evident in the plots for all but two (walking and moderate intensity activity time) of the outcome measures of interest. CONCLUSIONS: Overall, self-reported ATLS-2 sedentary and physical activity time had low correlation and agreement with objective Fibion accelerometer measurements in adolescents and young adults in the UAE. Therefore, sedentary and physical activity assessment for these groups should not be limited to self-reported measures.

Erratum to "A new accelerometer (Fibion) device provides valid sedentary and upright time measurements compared to the ActivPAL4 in healthy individuals" [Heliyon 8(10) (October 2022) e1103].

[This corrects the article DOI: 10.1016/j.heliyon.2022.e11103.].

Patient and public involvement in research: a review of practical resources for young investigators.

Patient and public involvement (PPI) in every aspect of research will add valuable insights from patients' experiences, help to explore barriers and facilitators to their compliance/adherence to assessment and treatment methods, bring meaningful outcomes that could meet their expectations, needs and preferences, reduce health care costs, and improve dissemination of research findings. It is essential to ensure competence of the research team by capacity building with available resources on PPI. This review summarizes practical resources for PPI in various stages of research projects-conception, co-creation, design (including qualitative or mixed methods), execution, implementation, feedback, authorship, acknowledgement and remuneration of patient research partners, and dissemination and communication of research findings with PPI. We have briefly summarized the recommendations and checklists, amongst others, for PPI in rheumatic and musculoskeletal research (e.g. the European Alliance of Associations for Rheumatology (EULAR) recommendations, the Core Outcome Measures in Effectiveness Trials (COMET) checklist and the Guidance for Reporting Involvement of Patients and the Public (GRIPP) checklist). Various tools that could be used to facilitate participation, communication and co-creation of research projects with PPI are highlighted in the review. We shed light on the opportunities and challenges for young investigators involving PPI in their research projects, and have summarized various resources that could be used to enhance PPI in various phases/aspects of research. A summary of web links to various tools and resources for PPI in various stages of research is provided in Additional file 1.

Test-Retest Reliability of a Passive Joint Position Sense Test After ACL Reconstruction: Influence of Direction, Target Angle, Limb, and Outcome Measures.

Background: The joint position sense (JPS) is an element of proprioception and defined as an individual's ability to recognize joint position in space. The JPS is assessed by measuring the acuity of reproducing a predetermined target angle. The quality of psychometric properties of knee JPS tests after anterior cruciate ligament reconstruction (ACLR) is uncertain. Purpose/Hypothesis: The purpose of this study was to evaluate the test-retest reliability of a passive knee JPS test in patients who underwent ACLR. We hypothesized that the passive JPS test would produce reliable absolute error, constant error, and variable error estimates after ACLR. Study Design: Descriptive laboratory study. Methods: Nineteen male participants (mean age, 26.3 ± 4.4 years) who had undergone unilateral ACLR within the previous 12 months completed 2 sessions of bilateral passive knee JPS evaluation. JPS testing was conducted in both the flexion (starting angle, 0°) and the extension (starting angle, 90°) directions in the sitting position. The absolute error, constant error, and variable error of the JPS test in both directions were calculated at 2 target angles (30° and 60° of flexion) by using the angle reproduction method for the ipsilateral knee. The standard error of measurement (SEM), smallest real difference (SRD), and intraclass correlation coefficients (ICCs) with 95% Cis were calculated. Results: ICCs were higher for the JPS constant error (operated and nonoperated knee, 0.43-0.86 and 0.32-0.91, respectively) compared with the absolute error (0.18-0.59 and 0.09-0.86, respectively) and the variable error (0.07-0.63 and 0.09-0.73, respectively). The constant error of the 90°-60° extension test showed moderate to excellent reliability for the operated knee (ICC, 0.86 [95% CI, 0.64-0.94]; SEM, 1.63°; SRD, 4.53°), and good to excellent reliability for the nonoperated knee (ICC, 0.91 [95% CI, 0.76-0.96]; SEM, 1.53°; SRD, 4.24°). Conclusion: The test-retest reliability of the passive knee JPS tests after ACLR varied depending on the test angle, direction, and outcome measure (absolute error, constant error, or variable error). The constant error appeared to be a more reliable outcome measure than the absolute error and the variable error, mainly during the 90°-60° extension test. Clinical Relevance: As constant errors have been found reliable during the 90°-60° extension test, investigating these errors-in addition to absolute and variable errors-to reflect bias in passive JPS scores after ACLR is warranted.

Right hemisphere brain lateralization for knee proprioception among right-limb dominant individuals.

Introduction: Studies indicate that brain response during proprioceptive tasks predominates in the right hemisphere. A right hemisphere lateralization for proprioception may help to explain findings that right-limb dominant individuals perform position matching tasks better with the non-dominant left side. Evidence for proprioception-related brain response and side preference is, however, limited and based mainly on studies of the upper limbs. Establishing brain response associated with proprioceptive acuity for the lower limbs in asymptomatic individuals could be useful for understanding the influence of neurological pathologies on proprioception and locomotion. Methods: We assessed brain response during an active unilateral knee joint position sense (JPS) test for both legs of 19 right-limb dominant asymptomatic individuals (females/males = 12/7; mean ± SD age = 27.1 ± 4.6 years). Functional magnetic resonance imaging (fMRI) mapped brain response and simultaneous motion capture provided real-time instructions based on kinematics, accurate JPS errors and facilitated extraction of only relevant brain images. Results: Significantly greater absolute (but not constant nor variable) errors were seen for the dominant right knee (5.22° ± 2.02°) compared with the non-dominant left knee (4.39° ± 1.79°) (P = 0.02). When limbs were pooled for analysis, significantly greater responses were observed mainly in the right hemisphere for, e.g., the precentral gyrus and insula compared with a similar movement without position matching. Significant response was also observed in the left hemisphere for the inferior frontal gyrus pars triangularis. When limbs were assessed independently, common response was observed in the right precentral gyrus and superior frontal gyrus. For the right leg, additional response was found in the right middle frontal gyrus. For the left leg, additional response was observed in the right rolandic operculum. Significant positive correlations were found between mean JPS absolute errors for the right knee and simultaneous brain response in the right supramarginal gyrus (r = 0.464, P = 0.040). Discussion: Our findings support a general right brain hemisphere lateralization for proprioception (knee JPS) of the lower limbs regardless of which limb is active. Better proprioceptive acuity for the non-dominant left compared with the dominant right knee indicates that right hemisphere lateralization may have meaningful implications for motor control.

A new accelerometer (Fibion) device provides valid sedentary and upright time measurements compared to the ActivPAL4 in healthy individuals.

Background: Thigh-worn accelerometers can accurately measure time spent sitting, standing and walking in free-living settings. Aim: To investigate the concurrent validity of a new Fibion accelerometer and a validated ActivPAL4 accelerometer for estimating sedentary and upright time in healthy individuals. Methods: A total of 29 healthy individuals, aged between 18 and 50 years, wore the Fibion and ActivPAL4 devices on the same thigh with a medical adhesive tape during one typical weekday. Concurrent validity of the Fibion and ActivPAL4 was assessed by comparing time spent in sitting, walking and standing using intraclass correlation coefficient and Bland-Altman plots. Results: Intraclass correlation coefficients were ≥0.843 which indicated good to excellent validity between the two devices for measuring sedentary (sitting) and upright (standing and walking) time. Analysis of the Bland Altman plots revealed a reasonable agreement for sitting, standing and walking time between both devices. No proportional bias was evident in the Bland-Altman plots. Conclusion: The Fibion demonstrated good to excellent validity in measuring sedentary and upright time compared to the ActivPAL4 in healthy individuals.

Traditional, religious, and cultural perspectives on mental illness: a qualitative study on causal beliefs and treatment use.

PURPOSE: Limited information is known from studies regarding traditional, religious, and cultural perspectives on mental illness and the use of traditional and alternative therapies by mentally ill people in Indonesia. This study explored traditional, religious, and cultural beliefs about causes of mental illness and the use of traditional/alternative treatments for mentally ill patients. METHOD: We adopted a qualitative content analysis method as proposed by Schreier. This study was conducted at a mental Hospital in Indonesia. We interviewed 15 nurses and 15 patients. Data were analysed using qualitative content analysis method. RESULTS: Five discrete but interrelated themes emerged: 1) Possessed illness and belief in supernatural forces; 2) Sinful or cursed illness; 3) Witchcraft or human-made illness; 4) traditional/alternative treatments; and 5) Barriers to treatment of mental illness. CONCLUSION: Traditional/alternative treatments play an important role in meeting the need for mental health treatment. The findings are relevant for mental health nurses who provide direct to their patients, and for other areas of mental health practice. We also found a lack of knowledge about the causes of mental illness among patients and families. Education should be at the heart of mental health promotion to raise the level of mental health literacy in Indonesia.

Comparative effects of tensioning and sliding neural mobilization on peripheral and autonomic nervous system function: A randomized controlled trial.

Background: Although different types of neural mobilization (NM) exercises induce different amounts of longitudinal nerve excursion and strain, the question whether the increased longitudinal stress and nerve excursion from sliding or tensioning intervention may subtly affect the neural functions has not been answered yet. Objective: To compare the effects of tensioning NM versus sliding NM of the median nerve on peripheral and autonomic nervous system function. Methods: In this randomized controlled trial, 90 participants were randomly assigned to tensioning NM, sliding NM, or sham NM. The neurophysiological outcome measures included peak-to-peak amplitude of the dermatomal somatosensory evoked potential (DSSEP) for dermatomes C6, C7, C8, and T1. Secondary outcome measures included amplitude and latency of skin sympathetic response. All outcome measures were assessed pretreatment, immediately after the two weeks of treatment and one week after the last session of the treatment. Results: A 2-way repeated measures ANOVA revealed significant differences between the three groups. The post hoc analysis indicated that tensioning NM significantly decreased the dermatomal amplitude for C6, C7, C8, and T1 ( p < 0 . 005 ). Sympathetic skin responses in the gliding NM group showed lower amplitudes and prolonged latencies post-treatment when compared to tensioning NM group ( p < 0 . 05 ). In contrast, no significant changes were observed in the DSSEPs and skin sympathetic responses for participants in the sham treatment group ( p > 0 . 05 ). Conclusions: A tensioning NM on the median nerve had a possible adverse effect on the neurophysiology variables of the nerves involved in the neural mobilization. Thus, tensioning NM with the current parameters that place increased stress and strain on the peripheral nervous system should be avoided.

Thigh muscle co-contraction patterns in individuals with anterior cruciate ligament reconstruction, athletes and controls during a novel double-hop test.

Efficient neuromuscular coordination of the thigh muscles is crucial in maintaining dynamic knee stability and thus reducing anterior cruciate ligament (ACL) injury/re-injury risk. This cross-sectional study measured electromyographic (EMG) thigh muscle co-contraction patterns during a novel one-leg double-hop test among individuals with ACL reconstruction (ACLR; n = 34), elite athletes (n = 22) and controls (n = 24). Participants performed a forward hop followed by a 45° unanticipated diagonal hop either in a medial (UMDH) or lateral direction (ULDH). Medial and lateral quadriceps and hamstrings EMG were recorded for one leg (injured/non-dominant). Quadriceps-to-Hamstring (Q:H) ratio, lateral and medial Q:H co-contraction indices (CCIs), and medial-to-lateral Q:H co-contraction ratio (CCR; a ratio of CCIs) were calculated for three phases (100 ms prior to landing, initial contact [IC] and deceleration phases) of landing. We found greater activity of the quadriceps than the hamstrings during the IC and deceleration phases of UMDH/ULDH across groups. However, higher co-contraction of medial rather than lateral thigh muscles during the deceleration phase of landing was found; if such co-contraction patterns cause knee adduction, a putative mechanism to decrease ACL injury risk, during the deceleration phase of landing across groups warrants further investigation.

The burden of injury in Central, Eastern, and Western European sub-region: a systematic analysis from the Global Burden of Disease 2019 Study.

BACKGROUND: Injury remains a major concern to public health in the European region. Previous iterations of the Global Burden of Disease (GBD) study showed wide variation in injury death and disability adjusted life year (DALY) rates across Europe, indicating injury inequality gaps between sub-regions and countries. The objectives of this study were to: 1) compare GBD 2019 estimates on injury mortality and DALYs across European sub-regions and countries by cause-of-injury category and sex; 2) examine changes in injury DALY rates over a 20 year-period by cause-of-injury category, sub-region and country; and 3) assess inequalities in injury mortality and DALY rates across the countries. METHODS: We performed a secondary database descriptive study using the GBD 2019 results on injuries in 44 European countries from 2000 to 2019. Inequality in DALY rates between these countries was assessed by calculating the DALY rate ratio between the highest-ranking country and lowest-ranking country in each year. RESULTS: In 2019, in Eastern Europe 80 [95% uncertainty interval (UI): 71 to 89] people per 100,000 died from injuries; twice as high compared to Central Europe (38 injury deaths per 100,000; 95% UI 34 to 42) and three times as high compared to Western Europe (27 injury deaths per 100,000; 95%UI 25 to 28). The injury DALY rates showed less pronounced differences between Eastern (5129 DALYs per 100,000; 95% UI: 4547 to 5864), Central (2940 DALYs per 100,000; 95% UI: 2452 to 3546) and Western Europe (1782 DALYs per 100,000; 95% UI: 1523 to 2115). Injury DALY rate was lowest in Italy (1489 DALYs per 100,000) and highest in Ukraine (5553 DALYs per 100,000). The difference in injury DALY rates by country was larger for males compared to females. The DALY rate ratio was highest in 2005, with DALY rate in the lowest-ranking country (Russian Federation) 6.0 times higher compared to the highest-ranking country (Malta). After 2005, the DALY rate ratio between the lowest- and the highest-ranking country gradually decreased to 3.7 in 2019. CONCLUSIONS: Injury mortality and DALY rates were highest in Eastern Europe and lowest in Western Europe, although differences in injury DALY rates declined rapidly, particularly in the past decade. The injury DALY rate ratio of highest- and lowest-ranking country declined from 2005 onwards, indicating declining inequalities in injuries between European countries.