Biomechanical Posture Analysis in Healthy Adults with Machine Learning: Applicability and Reliability.

Posture analysis is important in musculoskeletal disorder prevention but relies on subjective assessment. This study investigates the applicability and reliability of a machine learning (ML) pose estimation model for the human posture assessment, while also exploring the underlying structure of the data through principal component and cluster analyses. A cohort of 200 healthy individuals with a mean age of 24.4 ± 4.2 years was photographed from the frontal, dorsal, and lateral views. We used Student's t-test and Cohen's effect size (d) to identify gender-specific postural differences and used the Intraclass Correlation Coefficient (ICC) to assess the reliability of this method. Our findings demonstrate distinct sex differences in shoulder adduction angle (men: 16.1° ± 1.9°, women: 14.1° ± 1.5°, d = 1.14) and hip adduction angle (men: 9.9° ± 2.2°, women: 6.7° ± 1.5°, d = 1.67), with no significant differences in horizontal inclinations. ICC analysis, with the highest value of 0.95, confirms the reliability of the approach. Principal component and clustering analyses revealed potential new patterns in postural analysis such as significant differences in shoulder-hip distance, highlighting the potential of unsupervised ML for objective posture analysis, offering a promising non-invasive method for rapid, reliable screening in physical therapy, ergonomics, and sports.

The Role of Muscle Biomarkers in Adolescent Idiopathic Scoliosis.

Adolescent idiopathic scoliosis (AIS) is the predominant orthopedic disorder in children, affecting 1-3% of the global population. Research in this field has tried to delineate the genetic factors behind scoliosis and its association with heredity since AIS is considered a polygenic disease and has different genetic and epigenetic factors. The current study conducted a narrative review of the literature, focusing on biomarkers in the pathophysiology of muscle in AIS patients. Articles were collected from Scopus, Pubmed, and Web of Science. The key screening parameters were scoliosis classification, sampling, and the biomarkers evaluated. This review emphasizes potential key mechanisms and molecular regulators in muscle tissue. While there has been limited focus on the proteins contributing to muscle changes in AIS, significant attention has been given to genomic studies of single-nucleotide polymorphisms, particularly in LBX1. Despite these efforts, the exact causes of AIS remain elusive, with several theories suggesting genetic and hormonal factors. This review identified critical protein biomarkers such as Gi-protein alpha subunits, fibrillin-1 and -2, and various differentially expressed proteins, which may be linked to muscle alterations in AIS. This field of research is still limited due to a lack of homogeneity in the distinction of patients by groups and curve severity. Although the pathophysiology of AIS is still unclear, molecular research is important to guide the treatment of AIS before achieving skeletal maturity, thus avoiding serious problems associated with posture changes and low quality of life. In the future, a more comprehensive synergy between orthopedic and molecular research might ameliorate the diagnosis and treatment of AIS patients.

Thermal profile classification of the back of sportive and sedentary healthy individuals.

BACKGROUND: Infrared thermography (IRT) is a non-harmful, risk-free imaging technique and it has application for healthy and pathological population. OBJECTIVE: The aim of this study is to evaluate the thermographic profiles of the back of sport practitioners from different disciplines and compare it with those of sedentary healthy individuals. METHOD: The back of 160 healthy subjects were evaluated, and participants were grouped considering their sport practice: team sport (TS), individual sport (IS), weight training (WT), inactive (I). Three regions of interest were identified to analyze the cervical, thoracic and lumbar temperatures of the back. RESULTS: The Multivariate analysis of variance (MANOVA) resulted significant showing statistical differences for the cervical (p < 0.001), dorsal (p = 0.0011), and lumbar areas (p = 0.0366). The Tukey post-hoc test for pairwise comparison showed statistically significant differences between groups. For the cervical area significance was found between the IN and WT group (p = 0.002), the IN and IS group (p < 0.001), IN and TS group (p = 0.020). The dorsal area resulted significant between the IN and WT group (p = 0.007), the IN and IS group (p < 0.001), IN and TS group. The lumbar area showed significant differences only between the IN and WT group and the IN and IS group (p = 0.043). CONCLUSION: This study demonstrated that inactive individuals manifest a statistically significant higher temperature in the cervical, dorsal and lumbar area of the back compared to sportive individuals.

Physical Activity, Sun Exposure, Vitamin D Intake and Perceived Stress in Italian Adults.

The last decades of global development have, due to rapid urbanization, pressuring entire populations to changes in lifestyle and dietary habits, led to an increase in the prevalence of mental disorders, including stress. This study explored how lifestyle and dietary factors, such as physical activity, sun exposure, and vitamin D intake are related to perceived stress in a Mediterranean-based population. Physical activity level was evaluated using the international physical activity questionnaires (IPAQ), sun exposure was evaluated using the sunlight exposure measurement questionnaire (SEM-Q), and validated food frequency questionnaires (FFQs) were used to assess dietary intakes. The perceived stress of the study participants was evaluated using the perceived stress scale (PSS). Multivariate logistic regression models were used to test for potential associations. In the most adjusted model, an inverse association between physical activity level, sunlight exposure, vitamin D intake, and high perceived stress was found (OR = 0.72, 95% CI: 0.51, 1.00, OR = 0.72, 95% CI: 0.52, 0.99, OR = 0.69, 95% CI: 0.53, 0.89, respectively). However, when stratifying the population by level of physical activity, the retrieved associations with sunlight exposure and dietary vitamin D intake were significant only among those individuals reporting being moderately to highly physically active (OR = 0.16, 95% CI: 0.08, 0.33 and OR = 0.46, 95% CI: 0.28, 0.76, respectively), while results on low physically active participants were null. In conclusion, this study demonstrated that higher dietary intake of vitamin D and sunlight exposure are associated with a lower likelihood of having high perceived stress among physically active individuals.

Modified Isoinertial-Based Ruffier Test in Healthy Individuals: A Feasibility Study.

Cardiorespiratory fitness is an essential indicator in sports science and sports medicine that can be assessed with several tests. The Ruffier test is a submaximal test valid to estimate maximum oxygen uptake; it consists of 30 squats in 45 s, which may be challenging for inexperienced individuals. This study aims to verify the feasibility of a modified inertial-based version of the Ruffier test to assess cardiorespiratory fitness with 10 squats in 15 s. Both classic and isoinertial Ruffier tests were administered to thirty-five healthy young adults (20 men and 15 women), age 22.06 ± 2.13 years, BMI 23.87 ± 2.74. The two one-sided test confirmed the comparability of the isoinertial Ruffier test with its classic version within equivalence bounds of ±3.726. Furthermore, gender, age, body weight, the difference between peak heart rate after isoinertial squatting and resting heart rate, and the isoinertial Ruffier index are the coefficients of our best VO2max prediction model with an adjusted R2 of 0.937, sensitivity of 0.89, and specificity of 0.81. The study evidenced the feasibility of the isoinertial Ruffier test to measure cardiorespiratory fitness through a quick, safe, and short squat test easy to perform in fitness centers and primary care clinics.

Infrared thermography for the evaluation of adolescent and juvenile idiopathic scoliosis: A systematic review.

INTRODUCTION: Adolescent and Juvenile Idiopathic Scoliosis are a three-dimensional spine deformity characterized by a muscle alteration of the convex and concave sides of the scoliosis, which can be evaluated with different non-invasive and radiation-free methods such as infrared thermography. The objective of the present review is to assess infrared thermography as a potential method to evaluate alterations of the scoliosis. MATERIALS AND METHODS: A systematic review was performed by collecting articles from PubMed, Web of Science, Scopus, and Google Scholar, published from 1990 to April 2022, on the use of infrared thermography to evaluate adolescent and juvenile idiopathic scoliosis. Relevant data were collected in tables, and the primary outcomes were discussed narratively. RESULTS: Of the 587 articles selected, only 5 were in line with the objective of this systematic review and were eligible for the inclusion criteria. The findings of the selected articles corroborate the applicability of infrared thermography as an objective method to assess the thermal differences of the muscles between the convex and concave sides of scoliosis. The overall quality of the research was uneven in the reference standard method and assessment of measures. CONCLUSION: Infrared thermography is providing promising results to discriminate thermal differences in scoliosis evaluation, albeit there are still some concerns about considering it as a diagnostic tool for scoliosis evaluation because specific recommendations for collecting data are not met. We propose additional recommendations to existing guidelines to perform thermal acquisition to reduce errors and provide the best results to the scientific community.

The Role of Lubricin, Irisin and Exercise in the Prevention and Treatment of Osteoarthritis.

Osteoarthritis is a chronic degenerative musculoskeletal disease that worsens with age and is defined by pathological alterations in joint components. All clinical treatment recommendations for osteoarthritis promote exercise, although precise molecular pathways are unclear. The purpose of this study was to critically analyze the research on lubricin and irisin and how they relate to healthy and diseased joint tissue. Our research focused specifically on exercise strategies and offered new perspectives for future potential osteoarthritis treatment plans. Although lubricin and irisin have only recently been discovered, there is evidence that they have an impact on cartilage homeostasis. A crucial component of cartilage lubrication and integrity, lubricin is a surface-active mucinous glycoprotein released by the synovial joint. Its expression increases with joint movement. In healthy joints, lubricin molecules cover the cartilage surface to lubricate the boundary of the joint and inhibit protein and cell attachment. Patients with joint trauma, inflammatory arthritis, or genetically mediated lubricin deficiency, who do not produce enough lubricin to protect the articular cartilage, develop arthropathy. Irisin, sometimes known as the "sports hormone", is a myokine secreted primarily by skeletal muscle. It is a physiologically active protein that can enter the circulation as an endocrine factor, and its synthesis and secretion are primarily triggered by exercise-induced muscle contraction. We searched PubMed, Web of Science, Google Scholar, and Scopus using the appropriate keywords to identify the most recent research. The studies considered advance our knowledge of the role that exercise plays in the fight against osteoarthritis, serve as a valuable resource, and support the advancement of osteoarthritis prevention and therapy.

The influence of different sports on cartilage adaptations: A systematic review.

Molecular composition and structural adaptation are changes in the cartilage tissue after different stimuli. Sports activities with different loads at different angles, speeds, and intensities can modify the molecular composition of the articular cartilage, hence it is crucial to understand the molecular adaptations and structural modifications generated by sports practice and this review aims to synthesize the current evidence on this topic. A systematic search until July 2022 was performed on the database Medline, Pubmed, Scopus, and Web of Science with a collection of 62,198. After the screening process, the included articles were analyzed narratively. Thirty-one studies have been included in the analysis. From the results emerged that running, swimming, ballet and handball were not correlated with detrimental structural or molecular cartilage adaptation; instead, soccer, volleyball, basketball, weightlifting, climbing, and rowing showed signs of cartilage alteration and molecular adaptation that could be early predictive degeneration's signs. From the included studies it came to light that the regions more interested in morphological cartilage changes were the knee in athletes from different disciplines. In conclusion, different sports induce different cartilage modifications both at a molecular and structural level and it is important to know the risks correlated to sports to implement preventive strategies.

Thermography and rasterstereography as a combined infrared method to assess the posture of healthy individuals.

The demand for noninvasive methods to assess postural defections is increasing because back alterations are more common among the healthy population. We propose a combined infrared method of rasterstereography and thermography to assess the back without harmful effects. This study aims to provide reference data on rasterstereography and thermography to evaluate the back of a healthy population and to further study the correlation between these two methods. This cross-sectional research involved 175 healthy individuals (85 males and 90 females) aged 22 to 35 years. There is a large Cohen's d effect size in the cervical depth (males = 43.77 ± 10.96 mm vs. females = 34.29 ± 7.04 mm, d = 1.03), and in the lumbar lordosis angle (males = 37.69 ± 8.89° vs. females = 46.49 ± 8.25°, d = - 1.03). The back temperature was different for gender in the cervical area (males = 33.83 ± 0.63 °C vs. females = 34.26 ± 0.84 °C, d = - 0.58) and dorsal area (males = 33.13 ± 0.71 °C vs. females = 33.59 ± 0.97 °C, d = - 0.55). Furthermore, in the female group there was a moderate correlation of lumbar temperature with lumbar lordosis angle (r = - 0.50) and dorsal temperature with shoulders torsion (r = 0.43). Males showed a moderate correlation for vertebral surface rotation RMS with cervical (r = - 0.46), dorsal (r = - 0.60), and lumbar (r = - 0.50) areas and cervical temperature with shoulders obliquity (r = 0.58). These results highlight a possible correlation between rasterstereography and thermography, which may elucidate the underlying mechanics of spinal alterations and thermal muscle response. Our findings may represent reference data for other studies using noninvasive methods to assess postural alterations.

Molecular Assessment of Healthy Pathological Articular Cartilages in Physically Active People: A Scoping Review.

Physiological aging triggers a cascade of negative effects on the human body and the human joint is only one of the several compartments affected by this irreversible and natural process. Osteoarthritis and cartilage degeneration can cause pain and disability; therefore, identifying the molecular processes underlying these phenomena and the biomarkers produced during physical activity is of critical importance. In the present review, the main goal was to identify and discuss the articular cartilage biomarkers analyzed in studies in which physical or sports activities were adopted and eventually to propose a standard operating procedure for the assessment. Articles collected from Pubmed, Web of Science, and Scopus were scrutinized to detect reliable cartilage biomarkers. The principal articular cartilage biomarkers detected in these studies were cartilage oligomeric matrix protein, matrix metalloproteinases, interleukins, and carboxy-terminal telopeptide. The articular cartilage biomarkers identified in this scoping review may aid in a better comprehension of where research on the topic is heading and offer a viable instrument for streamlining investigations on cartilage biomarker discovery.

Ergonomic Evaluation of Young Agricultural Operators Using Handle Equipment Through Electromyography and Vibrations Analysis Between the Fingers.

Background: Agricultural handle equipment is present on all production areas' farms. They are handy and portable; however, excessive use can lead to acute traumas or accidental injuries. Repetitive movements, awkward postures, and hand-arm vibrations predispose them to pain and work-related musculoskeletal disorders. The purpose of this study was to observe the interaction of handle equipment in terms of electromyographic activity and analyze the postural work-related alterations. Materials and methods: Twenty male agricultural operators, mean age 24 ± 1.54 years, underwent the electromyographic analysis testing their muscular activities with a brushcutter, electric saw, and hedge trimmer in four different test conditions. Results: The brushcutter proved to be the agricultural handle equipment with the higher mean frequency (3.37 ± 0.38 Hz) and root mean square (5.25 ± 1.24 ms-2). Furthermore, the digital postural analysis showed a general asymmetry of the main arm and the respective side of the trunk. The head resulted right inclined in the anterior frontal plane by 5.7° ± 1.2°; the right scapula lower than the left in the posterior frontal plane (8.5° ± 1.8°), and a working trunk inclination of 34.15° ± 5.7°. Conclusions: Vibrations of handle equipment and awkward working postures represent a risk for agricultural operators. Preventive measures are required to avoid young operators from experiencing musculoskeletal disorders all lifelong.

Postural Evaluation in Young Healthy Adults through a Digital and Reproducible Method.

Different tools for the assessment of posture exist, from the simplest and cheap plumb line to complex, expensive, 3D-marker-based systems. The aim of this study is to present digital postural normative data of young adults collected through a mobile app to expand the possibilities of digital postural evaluation. A sample of 100 healthy volunteers, 50 males and 50 females, was analyzed with the mobile app Apecs-AI Posture Evaluation and Correction System® (Apecs). The Student's t-test evaluated differences between gender to highlight if the digital posture evaluation may differ between groups. A significant difference was present in the anterior coronal plane for axillary alignment (p = 0.04), trunk inclination (p = 0.03), and knee alignment (p = 0.01). Head inclination (p = 0.04), tibia shift (p = 0.01), and foot angle (p < 0.001) presented significant differences in the sagittal plane, while there were no significant differences in the posterior coronal plane. The intraclass correlation coefficient (ICC) was considered to evaluate reproducibility. Thirteen parameters out of twenty-two provided an ICC > 0.90, three provided an ICC > 0.60, and six variables did not meet the cut-off criteria. The results highlight that digital posture analysis of healthy individuals may present slight differences related to gender. Additionally, the mobile app showed good reproducibility according to ICC. Digital postural assessment with Apecs could represent a quick method for preventing screening in the general population. Therefore, clinicians should consider this app's worth as an auxiliary posture evaluation tool.

The Incidence of Bracing Treatment on Static and Dynamic Baropodometric Parameters in Adolescent Idiopathic Scoliosis.

Postural balance is an important but not well-studied concept in the treatment of adolescent scoliosis. The aim of this study was to assess whether conservative treatment with Sforzesco bracing induced negative perturbations on postural stability, as related to static, postural, and dynamic baropodometric indicators. Twelve subjects (12 females, aged 11−16) with moderate AIS, were selected among a group of 97 patients. Inclusion criteria were: (1) confirmed diagnosis of moderate AIS (Cobb angle of 21° to 35° for the primary curve); (2) thoracic or thoracolumbar primary curve; (3) skeletal immaturity with growth cartilage visible on pretreatment radiographs (Risser < 5); (4) chronological age between 11 and 16 years; and (5) Sforzesco bracing treatment. All patients underwent a physical examination and radiological measurements with anteroposterior and lateral scans. Static, postural, and dynamic assessments were performed twice by barefoot patients, with and without Sforzesco bracing. Comparison between demographic, anthropometric, and clinical data highlighted a homogeneity of the sample. We evaluated the point of maximum pressure with and without bracing and found no statistically significant differences (p value = 0.22). In postural measurements, the laterolateral oscillations, anteroposterior oscillations, and average speed of oscillations were evaluated, comparing measurements with and without bracing. There were no statistically significant differences, except for the mean rate of oscillation, which was slightly increased in the recordings with a brace compared to those without a brace, p value = 0.045. Our findings show no statistically significant differences (p > 0.05) in static, postural, and dynamic baropodometric indicators.

How Physical Activity Affects Knee Cartilage and a Standard Intervention Procedure for an Exercise Program: A Systematic Review.

(1) Background: Cartilage degeneration with the natural aging process and the role of physical activity on cartilage wellness is still not clear. The objective of the present review was to understand how different physical activity interventions affect the cartilage and to propose a Standard Operating Procedure for an exercise program to maintain knee joint health; (2) Methods: Articles were collected on three different electronic databases and screened against the eligibility criteria. Results were collected in tables and the main outcomes were discussed narratively; (3) Results: A total of 24 studies have been included after the screening process and aerobic, strength, flexibility, postural balance, and mobility interventions were detected. Different protocols and types of interventions were adopted by the authors; (4) Conclusions: Physical activity interventions have mainly positive outcomes on cartilage structure, but the protocols adopted are different and various. A Standard Operating Procedure has been proposed for a physical intervention focalized on cartilage wellness that could be adopted as an intervention in the clinical setting. Furthermore, the creation of a standardized protocol wants to help scientific research to move in the same direction.

Does Back Pain Go on Holiday in the Summer?

Back pain is one of the leading causes of disability among adults worldwide [...].

Immunohistochemical evaluation of autotaxin and lubricin in mild osteoarthritic rat model performing moderate physical activity.

Levels of the enzyme autotaxin (ATX) are elevated in synovial fluid and plasma of osteoarthritic patients, correlating positively with radiographic and symptomatic severity of the disease. Therefore, ATX is studied as potential marker for the progression of osteoarthritis (OA), whereas the chondrocyte-secreted glycoprotein Lubricin has chondroprotective properties. The aim of this study was to evaluate the expression of ATX and Lubricin in healthy and mild OA rat articular cartilage of femur, tibia and patella, and to analyse the effect of a protocol of moderate physical activity on their expressions. Mild OA resulted from anterior cruciate ligament transection and rats exercised on a treadmill for 12 weeks. Computerized staining intensity of immunostaining was used to evaluate ATX and Lubricin expressions. Higher expressions of ATX were found in femur and tibia of OA rats, suggesting that this molecule could participate in the progression of the disease, although not involved in the patella. In the femur, physical activity performed by OA rats was able to lower ATX expression, encouraging the evidence that joint movement is beneficial for the cartilage, although no significant differences in Lubricin expression were detected in femur, tibia and patella. This evidence might shade some light about the role of ATX, Lubricin and physical exercise in OA progression.

Running Footwear and Impact Peak Differences in Recreational Runners.

Running is a physical activity and the investigation of its biomechanical aspects is crucial both to avoid injuries and enhance performance. Recreational runners may be liable to increased stress over the body, particularly to lower limb joints. This study investigates the different running patterns of recreational runners by analyzing characteristics of the footwear impact peak, spatiotemporal, and kinematic parameters among those that present with a peak impact and those that do not, with a 3D markerless system. Thirty recreational runners were divided into two groups: impact peak group (IP) (n = 16) and no impact peak group (n = 14) (n-IP). Kinematic and spatiotemporal parameters showed a large Cohen's d effect size between the groups. The mean hip flexion was IP 40.40° versus n-IP 32.30° (d = -0.82). Hip extension was IP 30.20° versus n-IP 27.70° (d = -0.58), and ankle dorsiflexion was IP 20.80°, versus n-IP 13.37° (d = -1.17). Stride length was IP 117.90 cm versus n-IP 105.50 cm (d = -0.84). Steps per minute was IP group 170 spm, versus n-IP 163 spm (d = -0.51). The heel-to-toe drop was mainly 10-12 mm for the IP group and 4-6 mm for the n-IP group. Recreational runners whose hip extension is around 40°, ankle dorsiflexion around 20°, and initial foot contact around 14°, may be predisposed to the presence of an impact peak.

Adapted physical activity in subjects and athletes recovering from covid-19: a position statement of the Società Italiana Scienze Motorie e Sportive.

Coronavirus disease 2019 (COVID-19) is a worldwide pandemic illness that is impacting the cardiovascular, pulmonary, musculoskeletal, and cognitive function of a large spectrum of the worldwide population. The available pharmacological countermeasures of these long-term effects of COVID-19 are minimal, while myriads of non-specific non-pharmacological treatments are emerging in the literature. In this complicated scenario, particular emphasis should be dedicated to specific exercise interventions tailored for subjects and athletes recovering from COVID-19. Specific guidelines on adapted physical activity in this critical population are unavailable so far, therefore, in this position statement of the Società Italiana di Scienze Motorie e Sportive (SISMeS) the members of the steering committee of the research group Attività Motoria Adattata, Alimentazione, Salute e Fitness have indicated the adapted physical activity approaches to counteract the long-term effects of the COVID-19, both in good health people and athletes.

Exploiting real-world data to monitor physical activity in patients with osteoarthritis: the opportunity of digital epidemiology.

Osteoarthritis is a degenerative joint disease that affects millions of people worldwide. Current guidelines emphasize the importance of regular physical activity as a preventive measure against disease progression and as a valuable strategy for pain and functionality management. Despite this, most patients with osteoarthritis are inactive. Modern technological advances have led to the implementation of digital devices, such as wearables and smartphones, showing new opportunities for healthcare professionals and researchers to monitor physical activity and therefore engage patients in daily exercising. Additionally, digital devices have emerged as a promising tool for improving frequent health data collection, disease monitoring, and supporting public health surveillance. The leveraging of digital data has laid the foundation for developing a new concept of epidemiological study, known as "Digital Epidemiology". Analyzing real-world data can change the way we observe human behavior and suggest health interventions, as in the case of physical exercise and osteoarthritic patients. Furthermore, large-scale data could contribute to personalized and precision medicine in the future. Herein, an overview of recent clinical applications of wearables for monitoring physical activity in patients with osteoarthritis and the benefits of exploiting real-world data in the context of digital epidemiology are discussed.

Kinesiological Treatment of Early Spine Osteoarthritis in a Motorcyclist.

This case report speculates that the prolonged vibrations from enduro off-road sports are deleterious to the spine. The results of this case report may also aid sports physicians in better understanding this complex and relatively unknown phenomenon. No published data are present in the current literature that demonstrate the correlation between early spine osteoarthritis from enduro motorcycle overuse and the long-term management effects of a non-invasive kinesiological approach to reduce pain and inflammation and improve spine mobility and muscle strength.