Analysis of Dynamic Plantar Pressure and Influence of Clinical-Functional Measures on Their Performance in Subjects with Bimalleolar Ankle Fracture at 6 and 12 Months Post-Surgery.

Recovery after ankle fracture surgery can be slow and even present functional deficits in the long term, so it is essential to monitor the rehabilitation process objectively and detect which parameters are recovered earlier or later. The aim of this study was (1) to evaluate dynamic plantar pressure and functional status in patients with bimalleolar ankle fracture 6 and 12 months after surgery, and (2) to study their degree of correlation with previously collected clinical variables. Twenty-two subjects with bimalleolar ankle fractures and eleven healthy subjects were included in the study. Data collection was performed at 6 and 12 months after surgery and included clinical measurements (ankle dorsiflexion range of motion and bimalleolar/calf circumference), functional scales (AOFAS and OMAS), and dynamic plantar pressure analysis. The main results found in plantar pressure were a lower mean/peak plantar pressure, as well as a lower contact time at 6 and 12 months with respect to the healthy leg and control group and only the control group, respectively (effect size 0.63 ≤ d ≤ 0.97). Furthermore, in the ankle fracture group there is a moderate negative correlation (-0.435 ≤ r ≤ 0.674) between plantar pressures (average and peak) with bimalleolar and calf circumference. The AOFAS and OMAS scale scores increased at 12 months to 84.4 and 80.0 points, respectively. Despite the evident improvement one year after surgery, data collected using the pressure platform and functional scales suggest that recovery is not yet complete.

Relationships between Physical Activity Level and Pain in the Spanish Population: A Cross-Sectional Study.

Introduction. One third of the world's population suffers from some form of pain. Physical inactivity is one of the causes that reduces physical fitness and may lead to an increase in the prevalence of pain in the population. Aims. To analyse the relationships between the level of physical activity (PAL) and the prevalence and degree of pain, the limitations and impact of pain on daily activities and the use of pain medication in the Spanish population. Hypothesis. PAL is related to pain among Spaniards. Methodology. A cross-sectional study design was used, based on data obtained from the Spanish National Health Survey 2017 with 17,777 participants. A descriptive analysis was performed. Nonparametric statistical tests were used: chi-square statistic to analyse intergroup differences in ordinal variables; Mann−Whitney U test to analyse intergroup differences in continuous variables. A correlation study was also performed between the variables of interest, using Spearman's rho. Results. Relationships were found between PAL and: prevalence of pain, degree of pain, limitations due to pain in usual activities, level of impact in daily activities and use of pain medication in the Spanish population (p < 0.001). Performing moderate and intense PA was related to lower prevalence and degree of pain in the population that performed it, compared to those who only walked or were inactive. Weak correlations were found between the level of PA and the study variables (p < 0.001). Conclusions. High PALs in the population are related to better indicators of pain among Spaniards, appearing to reduce the prevalence and degree of pain, as well as the limitations and impact caused by pain in the daily activities of citizens, and could reduce the use of pain medication in the adult Spanish population.

Measuring Recovery and Understanding Long-Term Deficits in Balance, Ankle Mobility and Hip Strength in People after an Open Reduction and Internal Fixation of Bimalleolar Fracture and Their Impact on Functionality: A 12-Month Longitudinal Study.

To analyze how balance and other physical capacities evolved after surgery in patients with a bimalleolar fracture and how these capacities and clinical variables (immobilization or unloading time) contribute to restoring patients' functionality, 22 patients and 10 healthy people (HC) were assessed for static and dynamic balance (Y-Balance test, YBT), dorsiflexion ankle mobility (ADFROM) and hip strength at 6 and 12 months after surgery. Patients' functional status was assessed through the Olerud Molander Ankle Score (OMAS) and the American Orthopaedic Foot and Ankle Society (AOFAS) score. Twenty-one patients with ankle fractures who completed the study showed a worse static and dynamic balance at 6 months. The YBT in the anterior direction (YBTA) revealed balance deficits in the operated limb at 12 months compared to the non-operated limb (-5.6%) and the HC (-6.7%). They also showed a decreased ADFROM compared to the non-operated limb (-7.4°) and the HC (-11°). In addition, medium-term (6 months) deficits in abductor strength hip but no hip strength deficits were found at 12 months after surgery. Relative weight analyses showed that ADFROM and hip strength explained 35-63% of the YBTA variance and AOFAS/OMAS scores. Balance, hip strength and ADFROM seem to be reliable indexes for assessing the functional status of these patients. These results could help to understand the relationship between these physical capacities and the patients' perceived functional status.

Clinical-Functional Evaluation and Test-Retest Reliability of the G-WALK Sensor in Subjects with Bimalleolar Ankle Fractures 6 Months after Surgery.

Ankle fractures can cause significant functional impairment in the short and long term. In recent years, gait analysis using inertial sensors has gained special relevance as a reliable measurement system. This study aimed to evaluate the differences in spatiotemporal gait parameters and clinical−functional measurements in patients with bimalleolar ankle fracture and healthy subjects, to study the correlation between the different variables, and to analyze the test−retest reliability of a single inertial sensor in our study population. Twenty-two subjects with bimalleolar ankle fracture six months after surgery and eleven healthy subjects were included in the study. Spatiotemporal parameters were analyzed with the G-WALK sensor. Functional scales and clinical measures were collected beforehand. In the ankle fracture group, the main differences were obtained in bilateral parameters (effect size: 0.61 ≤ d ≤ 0.80). Between-group differences were found in cadence, speed, stride length, and stride time (effect size: 1.61 ≤ d ≤ 1.82). Correlation was moderate (0.436 < r < 0.554) between spatiotemporal parameters and clinical−functional measures, explaining up to 46% of gait performance. Test−retest reliability scores were high to excellent (0.84 ≤ ICC ≤ 0.98), with the worst results in the gait phases. Our study population presents evident clinical−functional impairments 6 months after surgery. The G-WALK can be considered a reliable tool for clinical use in this population.

Sensor-based gait analysis in the premotor stage of LRRK2 G2019S-associated Parkinson's disease.

INTRODUCTION: There is a need for biomarkers to monitor the earliest phases of Parkinson's disease (PD), especially in premotor stages. Here, we studied whether there are early gait alterations in carriers of the G2019S mutation of LRRK2 that can be detected by means of an inertial sensor system. METHODS: Twenty-one idiopathic PD patients, 20 LRRK2-G2019S PD, 27 asymptomatic carriers of LRRK2-G2019S mutation (AsG2019S) and 36 controls walked equipped with 16 lightweight inertial sensors in three different experiments: i/normal gait, ii/fast gait and iii/dual-task gait. In the AsG2019S group, DaT-SPECT (123I-ioflupane) with semi-quantitative analysis was carried out. Motor and cognitive performance were evaluated using MDS-UPDRS-III and MoCA scales. We employed neural network techniques to classify individuals based on their walking patterns. RESULTS: PD patients and controls showed differences in speed, stride length and arm swing amplitude, variability and asymmetry in all three tasks (p < 0.01). In the AsG2019S group, the only differences were detected during fast walking, with greater step time on the non-dominant side (p < 0.05), lower step/stride time variability (p < 0.01) and lower step time asymmetry (p < 0.01). DaT uptake showed a significant correlation with step time during fast walking on the non-dominant side (r = -0.52; p < 0.01). The neural network was able to differentiate between AsG2019S and healthy controls with an accuracy rate of 82.5%. CONCLUSION: Our sensor-based analysis did not detect substantial and robust changes in the gait of LRRK2-G2019S asymptomatic mutation carriers. Nonetheless, step or stride time during fast walking, supported by the observed correlation with striatal DaT binding deserves consideration as a potential biomarker in future studies.

Quantifying balance deficit in people with ankle fracture six months after surgical intervention through the Y-Balance test.

BACKGROUND: Ankle fractures are among the most common traumatic fractures and have a great socio-economic impact. Consequences of an ankle fracture requiring surgical treatment (e.g. pain, reduced ankle range of motion (ROM), muscle weakness, etc.) lead to balance deterioration, which has a profound impact on activities of daily living. However, to the best of the authors' knowledge, no reliable clinical tests are available to monitor balance in patients after ankle surgery. OBJECTIVES: To quantify single-leg dynamic balance in patients with bimalleolar ankle fracture through the Y-Balance test (YBT). The second objective was to analyze the impact of ankle dorsiflexion ROM and hip strength on balance to optimize balance rehabilitation programs. DESIGN: Cross-sectional study. METHODS: 22 participants, who had undergone surgery after bimalleolar ankle fractures, were assessed for ankle ROM, hip strength, and dynamic balance six-months after the surgical intervention. The within-session reliability of YBT was calculated through the intraclass correlation coefficient (ICC) and the standard error of measurement (SEM). Student's t-tests were used to assess leg differences. A multiple regression analysis was performed to evaluate the role of ankle dorsiflexion ROM and hip abductor and adductor strength in predicting balance performance. RESULTS: YBT showed high-to-excellent within-session relative reliability (Healthy leg: 0.85 ≤ ICC≤0.96; Operated leg: 0.84 ≤ ICC≤0.96). SEM values were below 3.3 %. The operated leg showed significant lower YBT scores for anterior reach direction (-9.0 %; g=-0.70) and composite score (-4.5 %; g=-0.34). Multiple regression analysis showed that both, ankle dorsiflexion and hip abductor and adductor strength explained 66 % of the variance in the YBT anterior direction of the operated leg. CONCLUSIONS: The YBT is a reliable tool that allows the quantification of single-leg dynamic balance impairments from 6-months after surgery in patients with bimalleolar ankle fracture. Between-leg YBT differences in the anterior direction can be used as reference scores (3.3 %) for balance restoration. Balance rehabilitation programs should focus on improving ankle functionality and reducing hip muscle weakness with specific hip strength exercises and balance exercises with similar demands to the reaching tasks of the YBT to promote a faster recovery.

Physical Activity Is Associated With Better Executive Function in University Students.

Introduction: In recent years, the study of the benefits that physical exercise has on brain health has acquired special relevance. In order to implement exercise as an intervention to protect the brain, it is important to have a more clear idea of its effect in the young population. However, few studies have been carried out on these ages. Objective: The main objective of our study was to evaluate the association between physical activity (PA) with memory and executive function, in university students, analyzing the modulatory effect of sex. Methodology: We collected socio-demographic and life habit information, as well as data on the PA that was carried out during the previous week using the international PAquestionnaire short version (IPAQ-SF) questionnaire in 206 university students (mean age 19.55 ± 2.39; 67.5% women). Memory and executive function were assessed using a comprehensive battery of validate cognitive tests. Univariate and multivariate analyses were performed to correlate PA with cognitive tests scores and to evaluate the potential synergistic role of sex. Results: The main finding was that the total amount of PA correlated positively with several tests that evaluated aspects of executive function, specifically Stroop Colors (Pearson's r = 0.17; p = 0.01) and the Stroop Test Color-Word (Pearson's r = 0.15. p = 0.03). These results were adjusted by a large number of possible confounders and modifying variables in a multivariate analysis, like age, sex, academic record, day of the week, and time at which the test was performed. Additionally, we found out that sex had a synergistic effect with PA on the executive test Trail making test-A (TMTA), and in women, this association was stronger than in men. The more PA women reported, the better they performed, that is to say that they took less time to finalize the TMT-A (interaction term between PA and sex: b = -0.0009; p = 0.014). Conclusion: Our study adds evidence of the benefit of PA in cognition in the young population, specifically in the executive inhibitory control, and more significantly in women.

Binge Drinking in Young University Students Is Associated with Alterations in Executive Functions Related to Their Starting Age.

Our aim was to evaluate whether or not alcohol consumption in the form of binge drinking is associated with alterations of memory and executive functions in a population of university students. At the same time, we have studied the role of potential modulating factors, such as the APOE genotype or physical exercise.University students enrolled in academic year 2013-2014 at Escuelas Universitarias Gimbernat-Cantabria, affiliated with the University of Cantabria, were invited to participate in the study. We gathered sociodemographic data and details regarding the lifestyle of 206 students (mean age 19.55 ± 2.39; 67.5% women). We evaluated memory and executive functions via a series of validated cognitive tests. Participants were classified as binge drinkers (BD) and non-BD. Using Student's t-distribution we studied the association between cognitive tests and BD patterns. Multivariate analyses were carried out via multiple linear regression. 47.6% of the students were found to be BD. The BD differed significantly from the non-BD in their results in the executive functions test TMT B (43.41 ± 13.30 vs 37.40 ± 9.77; p = 0.0003). Adjusting by age, sex, academic records, age at which they started consuming alcohol, cannabis consumption, level of physical activity and other possible modifying variables, the association was statistically significant (p = 0.009). We noticed a statistically significant inverse correlation (Pearson's r2 = -0.192; p = 0.007) between TMT B and starting age of alcohol consumption. Differences were observed in another executive functions test, TMT A, but only in the group of women (19.73±6.1 BD vs 17.78±5.4 non-BD p = 0.05). In spite of the young age of our participants, BD was associated with a lower performance in the executive functions test (TMT B). These deficits were related to the age at which they started drinking alcohol, suggesting an accumulative effect.

Alteraciones cognitivas asociadas al patrón de bebedor de fin de semana en estudiantes universitarios: resultados preliminares / Cognitive impairment associated to binge drinking in university students: A preliminary analysis

Objetivo: evaluar el efecto del consumo de alcohol con patrón de bebedor de fin de semana (BD, del inglés binge drinkers) sobre la memoria y la función ejecutiva en estudiantes universitarios. Material y métodos: se realizó un estudio transversal en universitarios de las Escuelas Universitarias Gimbernat-Cantabria. Se recogieron datos sociodemográficos y hábitos de vida de 102 alumnos (media de edad 19,6 ± 0,25 años; 69,6 % mujeres). Se evaluó la memoria y la función ejecutiva utilizando una batería de test cognitivos validados y normalizados para la población española. Los participantes fueron clasificados en bebedores BD (consumidores de seis o más unidades de bebidas alcohólicas en 2 h) y no BD mediante el cuestionario de hábitos de vida. Se empleó la prueba de la t de Student para evaluar la asociación entre test cognitivos y patrón de consumo. Se realizaron análisis multivariantes mediante regresión lineal para ajustar por covariables sociodemográficas. Resultados: todos los estudiantes refirieron haber consumido alcohol en alguna ocasión. La media de edad de inicio del consumo fue de 15 ± 0,12 años. El 49 % de los estudiantes presentaba un patrón BD. Los bebedores BD difirieron significativamente en los resultados del Trail Making Test B (TMTB), que evalúa la función ejecutiva (42,7 ± 2,0 BD frente a 36,3 ± 1,2 no BD promedio segundos; p = 0,007). Ajustando por edad, sexo y expediente académico, la asociación entre TMTB y patrón BD fue también estadísticamente significativa (p = 0,020). La edad de inicio del consumo de alcohol se correlacionó de forma inversa con los resultados en el TMTB (r2 = -0,22; p = 0,027). Conclusión: el patrón de consumo de alcohol BD en estudiantes universitarios se asoció a un menor rendimiento en el test de función ejecutiva TMTB. Los inicios tempranos en el consumo de alcohol se correlacionaron con peores puntuaciones en TMTB, lo que sugiere un efecto acumulativo (AU)

Objective: To evaluate the effects of the alcohol consumption on memory and on executive function in university students who are consistent with the pattern of binge drinkers (BD). Materials and methods: A transversal study was conducted on university students at the University School of Gimbernat-Cantabria. Sociodemographic data and life habits were collected from 102 students (average age 19.6 ± 0.25 years; 69.6% women). Memory and executive functions were evaluated through a range of validated cognitive tests. Participants were classified as BD (consumers of six or more units of alcoholic drinks in 2 hours) and non BD. Besides, it was also studied the association between cognitive tests and the pattern of consumption through the student’s t-test. A multivaried analysis was carried out to adjust the sociodemographic cofactors. Results: All students admitted having consumed alcohol on occasion. The average age of the onset of consumption was 15 ± 0.12. 49% of the students had a pattern of BD. These binge drinkers differed significantly in their results of the Trail Making Test B (TMTB), an executive function test (42,7 ± 2,0 vs. 36,3 ± 1,2 second average; p = 0,007). Adjusting by age, sex and academic records, the association between TMTB and the pattern of BD was significant (p = 0,020). The age of onset of alcohol use was correlated inversely with the results in the TMTB (r2 = -0.22, p = 0.027). Discussion/Con - clusion: BD alcohol consumption pattern was associated in college students with a lower performance during the executive function test TMTB. Earlier alcohol consumption was associated to worse performances in TMTB, suggesting an accumulative effect (AU)