Static Plantar Pressure under Different Conditions in Children with Surgically Treated Unilateral Slipped Capital Femoral Epiphysis.

BACKGROUND: Slipped capital femoral epiphysis (SCFE) is the most common hip disease during infancy and adolescence. Our study aimed to analyze static plantar pressure in children with surgically treated unilateral SCFE. METHODS: Twenty-two children with right SCFE with in situ fixation with one percutaneous screw were assessed by PoData plantar pressure analysis under three different conditions (open eyes, eyes closed, and head retroflexed). RESULTS: The total foot loading was significantly higher on the unaffected limb compared with the affected one for all the three testing conditions (p < 0.05). When assessing the differences between testing conditions, there were no significant differences for the right and left foot loadings, or for the three sites of weight distribution, except for the right fifth metatarsal head (lower loading in eyes-closed condition in comparison to eyes open, p = 0.0068), left fifth metatarsal head (increased loading in head-retroflexed condition in comparison to eyes open, p = 0.0209), and left heel (lower loading in head-retroflexed condition in comparison to eyes open, p = 0.0293). CONCLUSION: Even after a successful surgical procedure, differences in foot loading can impact the postural static activities in different conditions (natural eyes-open, eyes-closed, or head-retroflexed posture).

Comparison between Exercise Program-Foot Orthoses Treatment and Exercise Program Alone after Pilon Fracture Surgery: Study Protocol for a Randomized Controlled Trial.

The management of tibial pilon fractures is challenging and often leads to complications and limitations in ankle function. The study aims to investigate myotonometric parameters and muscle strength of ankle muscles, as well as gait pattern and balance among patients following surgical treatment of pilon fractures. The randomized controlled study will analyze the differences between the patients who will follow a 3-month physical exercise program and will wear customized foot orthoses (i.e., customized orthotic arch support insoles) versus patients who will attend only the physical exercise program. For each group, at least 21 patients will be required. The assessment involves four different testing procedures: myotonometry (anterior tibialis, medial and lateral gastrocnemius, and longus peroneus assessed using MyotonPRO), muscle strength testing (ankle dorsiflexors, plantar flexors, and peroneal muscles assessed using MicroFET2 dynamometer), analysis of gait parameters (using Scheinworks treadmill), and double-leg and single-leg balance tests (using K-Force plate). After 3 months, the assessments will record which of the two treatments (physical exercise program with or without wearing customized foot orthoses) has better outcomes in regaining ankle muscle properties and tone, as well as the restoration of gait and balance.

Using A-Mode Ultrasound to Assess the Body Composition of Soccer Players: A Comparative Study of Prediction Formulas.

For elite athletes, monitoring body composition is important for maximizing performance without health risks. Amplitude (A)-mode ultrasound (AUS) has attracted increasing attention as an alternative to skinfold thickness measurements commonly used for assessing the amount of body fat in athletes. AUS accuracy and precision, however, depend on the formula used to predict body fat percentage (%BF) from subcutaneous fat layer thicknesses. Therefore, this study evaluates the accuracy of the 1-point biceps (B1), 9-sites Parrillo, 3-sites Jackson and Pollock (JP3), and 7-sites Jackson and Pollock (JP7) formulas. Relying on the previous validation of the JP3 formula in college-aged male athletes, we took AUS measurements in 54 professional soccer players (aged 22.9 ± 3.83 y, mean ± SD) and compared the results given by different formulas. The Kruskal-Wallis test indicated significant differences (p < 10-6), and Conover's post hoc test revealed that the JP3 and JP7 data come from the same distribution, whereas the data given by B1 and P9 differ from all the others. Lin's concordance correlation coefficients for B1 vs. JP7, P9 vs. JP7, and JP3 vs. JP7 were 0.464, 0.341, and 0.909, respectively. The Bland-Altman analysis indicated mean differences of -0.5 %BF between JP3 and JP7, 4.7 %BF between P9 and JP7, and 3.1 %BF between B1 and JP7. This study suggests that JP7 and JP3 are equally valid, whereas P9 and B1 overestimate %BF in athletes.

Influence of the Text Neck Posture on the Static Dental Occlusion.

Background and Objectives: The excessive use of smartphones for various tasks led to a new adverse postural phenomenon called text neck. The aim of this study was to investigate the effect of the text neck posture (TNP) on static occlusion by using the T-Scan III occlusal diagnostic system. Materials and Methods: Nineteen subjects (aged 20 to 24 years) were considered for this research. They had normal values for anterior overbite and overjet, Angle Class I occlusion, no posterior crossbite, and no signs or symptoms of cervical or temporo-mandibular disorders. Occlusal registrations were performed with the T-Scan III system in a normal, neutral head posture (NHP), as well as in the TNP. The investigated parameters were: occlusion time (OT), asymmetry index of the occlusal force (AOF), percent of the maximum movie force (%MMF), and the time elapsed from the last occlusal contact until the maximum intercuspation (MAT-OTB). The last three parameters were analyzed in the maximum area frame (MA) of the registrations. For the statistical analysis of the recorded data, the Wilcoxon Signed Ranks test and the Spearman's correlation coefficient were used. Results: The following values were obtained in NHP and in TNP: for AOF, 14.88 ± 10.39% and 18.04 ± 12.83%, respectively; for OT, 1.34 ± 1.84 s and 1.32 ± 1.8 s, respectively; for the %MMF, 97.5 ± 2.83% and 96.31 ± 3.17%, respectively; for MAT-OTB, 2.08 ± 1.82 s and 1.45 ± 2.3 s, respectively. There were no statistically significant differences between the static occlusal parameters measured in NHP and those in TNP. However, the high values of the AOF and OT in NHP revealed an imbalance of the occlusal force distribution between the right and left side in maximum intercuspation (MI), as well as a lack of simultaneity of static occlusal contacts. Furthermore, there was a significant, direct, and strong correlation between OT and AOF in NHP. Conclusions: The NHP should not be used as the starting position in TNP simulations in T-Scan studies, so as to avoid statistically insignificant differences between static occlusion in NHP and TNP. The healthy standing subjects, with normal occlusal relationships from the clinical point of view, revealed an occlusal instability in NHP when examined with the T-Scan.

Postural Balance in Relation with Vision and Physical Activity in Healthy Young Adults.

Postural balance is an essential part of a wide range of activities, from daily living tasks to sports. Regularly repeated physical and/or sport activities improve both the postural performance and the postural strategy. The aim of our study was to evaluate if the physical activity level is a factor that influences postural balance performance, including the impact of vision and gender, in healthy young adults. Postural balance was assessed in 78 subjects (38 males and 40 females, aged 20.64 ± 1.18 years) by using the PoData system, in open (EO) and closed (EC) eye conditions. Based on the physical activity level, subjects were classified in two groups-low physical activity level (n = 36, 46.15%) and moderate physical activity level (n = 42, 53.85%). A group significant difference was found only for the average centre of pressure (CoP) deviations on the latero-lateral axis (CoPX), with a higher lateral deviation of the CoP (toward right) in the low physical activity group (F = 4.005, p = 0.04). CoP path length, the 90% confidence ellipse and maximum CoP speed were significantly increased in EC conditions. A statistically significant interaction effect (vision × physical activity) was observed for the CoP path length (F = 7.9, p = 0.006).

Could Ultrasound Be Used as a Triage Tool in Diagnosing Fractures in Children? A Literature Review.

Fracture is one of the most frequent causes of emergency department visits in children, conventional radiography being the standard imaging tool used for following procedures and treatment. This imagistic method is irradiating and harmful, especially for children due to their high cell division rate. For this reason, we searched the literature to see if musculoskeletal ultrasound is a good alternative for diagnostic and follow-up regarding fractures in the pediatric population. After searching the databases using MeSH terms and manual filters, 24 articles that compare X-ray and ultrasound regarding their specificity and sensitivity in diagnosing fractures were included in this study. In the majority of the studied articles, the specificity and sensitivity of ultrasound are around 90-100%, and with high PPVs (positive predictive values) and NPVs (negative predictive values). Although it cannot replace conventional radiography, it is a great complementary tool in fracture diagnosis, having a sensitivity of nearly 100% when combined with clinical suspicion of fracture, compared with X-ray.

Work-related musculoskeletal complaints in massage practitioners.

BACKGROUND: Work-related musculoskeletal complaints (WMSCs) are induced or aggravated by work activities and/or work conditions. OBJECTIVE: The aim was to evaluate the impact of work as a massage practitioner, with a special emphasis on WMSCs. METHODS: Massage practitioners were invited to participate in the study through an advert in the rehabilitation medical clinics. The participants completed a self-administered questionnaire, collecting general data and questions about WMSCs. RESULTS: Thirty-seven subjects (88.09%) reported pain in at least one body part in the last 4 weeks. The most common WMSCs was pain in the neck region (69.04%), followed by pain in the shoulder region (54.76%), upper back (52.38%), lower back (40.48%), wrist-hand (33.33%) and elbow (21.43%). The massage practitioners aged between 21 and 30 years old reported significantly more frequently WMSCs localized in neck, shoulders, wrist-hand, upper back and lower back. CONCLUSIONS: This study shows that WMSCs are widely reported among massage practitioners. The most common complaints were reported in the neck and shoulder regions, especially in younger massage practitioners.

Current Paradigm of Hepatitis E Virus Among Pediatric and Adult Patients.

Hepatitis E virus (HEV) infection is a polymorphic condition, present throughout the world and involving children and adults. Multiple studies over the last decade have contributed to a better understanding of the natural evolution of this infection in various population groups, several reservoirs and transmission routes being identified. To date, acute or chronic HEV-induced hepatitis has in some cases remained underdiagnosed due to the lower accuracy of serological tests and due to the evolutionary possibility with extrahepatic manifestations. Implementation of diagnostic tests based on nucleic acid analysis has increased the detection rate of this disease. The epidemiological and clinical features of HEV hepatitis differ depending on the geographical areas studied. HEV infection is usually a self-limiting condition in immunocompetent patients, but in certain categories of vulnerable patients it can induce a sudden evolution toward acute liver failure (pregnant women) or chronicity (immunosuppressed patients, post-transplant, hematological, or malignant diseases). In acute HEV infections in most cases supportive treatment is sufficient. In patients who develop chronic hepatitis with HEV, dose reduction of immunosuppressive medication should be the first therapeutic step, especially in patients with transplant. In case of unfavorable response, the initiation of antiviral therapy is recommended. In this review, the authors summarized the essential published data related to the epidemiological, clinical, paraclinical, and therapeutic aspects of HEV infection in adult and pediatric patients.

Predicting functional disability in patients with spondyloarthritis using a CRP-based algorithm: A 3-year prospective study.

This prospective study explored the link between values of C-reactive protein (CRP) in patients with SpA (ankylosing spondylitis, psoriatic arthritis, reactive arthritis, or arthritis-related inflammatory bowel disease) and functional disability in order to derive an algorithm that may predict functional disability based on disease activity. Patients diagnosed with Spa were classified into five groups based on the type of therapy and they were followed up for 3 years. Group 1: Symptomatic medication alone; Group 2: Disease-modifying antirheumatic drugs (DMARDs); Group 3: DMARDs and 30 rehabilitation sessions twice a year; Group 4: Group 3 therapy and biologic anti-tumor necrosis factor-alpha (anti-TNF-α) drugs; and Group 5: Group 4 therapy and, in addition, a daily home-adapted kinesiotherapy program. CRP, modified Health Assessment Questionnaire (mHAQ-S), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and T-score of the patients were recorded. Correlation and multivariate regression analyses were conducted using demographic data, CRP, and mHAQ-S scores to derive the CRP-mHAQ-S correlation algorithm. Statistical analysis included the chi-square, Mann-Whitney, and multiple regression tests and repeated measures analysis of variance. A total of 144 patients were enrolled, all of whom completed the study. The best predictive model (P<0.001) provided the algorithm mHAQ-S36=17.14+0.12xCRP0-0.24xCRP12-0.15xCRP36 (CRP0, CRP12, and CRP36 correspond to CRP levels at baseline, 12, and 36 months, respectively, and mHAQ-S36 to mHAQ-S score at 36 months). This derived algorithm based on objective CRP assessment may have implications in the prediction of functional disability evolution in patients with SpA.

The Impact of Overweight and Obesity on Plantar Pressure in Children and Adolescents: A Systematic Review.

We aimed to synthesise the results of previous studies addressing the impact of overweight and obesity on plantar pressure in children and adolescents. An electronic search of scientific literature was conducted using PubMed, Cochrane and Scopus database, with keywords: "plantar pressure" AND "children" AND "obesity"; "plantar pressure" AND "adolescents" AND "obesity", "plantar pressure" AND "children" AND "overweight", "plantar pressure" AND "adolescents" AND "overweight". Twenty-two articles were included in the review and the following data were recorded: authors, publication year, type of technology (systems, software) for the determination of plantar pressure, study characteristics. Most of the articles used dynamic plantar pressure determination with only four using static plantar pressure measurement. Using ultrasonography with static plantar pressure determination, the correlation between structural and functional changes in the feet of obese children. In overweight and obese children and adolescents, important findings were recorded: higher contact area, increased maximum force beneath the lateral and medial forefoot, increased pressure-time integral beneath the midfoot and 2nd-5th metatarsal regions. Significantly increased foot axis angle and significantly flatter feet were observed in obese subjects in comparison to their normal-weight counterparts. The obese children presented increased midfoot fat pad thickness, with decreased sensitivity of the whole foot and midfoot.

Upper Extremity Fractures in Children-Comparison between Worldwide, Romanian and Western Romanian Region Incidence.

(1) Background: Fractures represent a significant part of all pediatric injuries, with distal forearm fracture being the most common fracture type in children. (2) Methods: In this comparative, epidemiological study we collected fracture incidence data from the scientific literature and compared it to real-world data extracted from the Romanian national and regional hospital database. In order to collect information on the epidemiology of upper extremity fractures in children, we conducted a systematic literature review on Medline, via PubMed. Extracted incidence data were stratified by fracture location, age or age interval and gender. Nationwide and Western Region incidence values were calculated for different fracture locations of the upper extremity using data extracted from a centralized hospital database. Incidence values were calculated using the mid-2018 census data. The search was restricted to the pediatric population. (3) Results: Incidence values for upper arm fractures nationwide and for Western Region were 54.83/100,000 person-years and 64.79/100,000 person-years, respectively. Forearm fractures had an incidence of 139.77/100,000 person-years and 139.56/100,000 person-years, respectively. The overall incidence of upper extremity fractures nationwide and for the Romanian Western Region were 206.02/100,000 person-years and 220.14/100,000 person-years, respectively. (4) Conclusions: Incidence of upper extremity fractures in the pediatric population varies according to the analyzed data. The calculated incidence depends on the site of fractures, assessed population (worldwide, Romanian population or regional-Western part of Romania) or patients' age.

Rat Animal Model of Pectus Excavatum.

BACKGROUND: pectus excavatum (PE) is the most common congenital deformity of the thoracic wall. Lately, significant achievements have been made in finding new, less invasive treatment methods for PE. However, most of the experimental work was carried out without the help of an animal model. In this report we describe a method to create an animal model for PE in Sprague-Dawley rats. METHODS: We selected 15 Sprague-Dawley rat pups and divided them into two groups: 10 for the experimental group (EG) and 5 for the control group (CG). We surgically resected the last four pairs of costal cartilages in rats from the EG. The animals were assessed by CT-scan prior to surgery and weekly for four consecutive weeks. After four weeks, the animals were euthanized and the thoracic cage was dissected from the surrounding tissue. RESULTS: On the first postoperative CT, seven days after surgery, we observed a marked depression of the lower sternum in all animals from the EG. This deformity was present at every CT-scan after surgery and at the post-euthanasia assessment. CONCLUSIONS: By decreasing the structural strength of the lower costal cartilages, we produced a PE animal model in Sprague-Dawley rats.

Smartphone Use and Postural Balance in Healthy Young Adults.

Maintaining an upright posture while talking or texting on the phone is a frequent dual-task demand. Using a within-subjects design, the aim of the present study was to assess the impact of a smartphone conversation or message texting on standing plantar pressure and postural balance performance in healthy young adults. Thirty-five subjects (mean age 21.37 ± 1.11 years) were included in this study. Simultaneous foot plantar pressure and stabilometric analysis were performed using the PoData system, under three conditions: no phone (control), talking on a smartphone (talk) and texting and sending a text message via a smartphone (text). Stabilometric parameters (center of pressure (CoP) path length, 90% confidence area and maximum CoP speed) were significantly affected by the use of different smartphone functions (p < 0.0001). The CoP path length and maximum CoP speed were significantly higher under the talk and text conditions when compared to the control. CoP path length, 90% confidence area and maximum CoP speed were significantly increased in talk compared to text and control. Talking on the phone also influenced the weight distribution on the left foot first metatarsal head and heel as compared with message texting. Postural stability in healthy young adults was significantly affected by talking and texting on a smartphone. Talking on the phone proved to be more challenging.

Assessment of Static Plantar Pressure, Stabilometry, Vitamin D and Bone Mineral Density in Female Adolescents with Moderate Idiopathic Scoliosis.

(1) Background: Adolescent idiopathic scoliosis (AIS) can be associated with vitamin D deficiency and osteopenia. Plantar pressure and stabilometry offer important information about posture. The objectives of our study were to compare static plantar pressure and stabilometric parameters, serum 25-OH-vitamin D3 and calcium levels, and bone mineral densitometry expressed as z-score in patients with moderate AIS and healthy subjects. (2) Methods: 32 female adolescents (idiopathic S shaped moderate scoliosis, main lumbar curve) and 32 gender and age-matched controls performed: static plantar pressure, stabilometry, serum 25-OH-vitamin D3 and calcium levels, and dual X-ray absorptiometry scans of the spine. (3) Results: In scoliosis patients, significant differences were recorded between right and left foot for total foot, first and fifth metatarsal, and heel loadings. Stabilometry showed a poorer postural control when compared to healthy subjects (p < 0.001). Patients had significantly lower vitamin D, calcium levels, and z-scores. Lumbar Cobb angle was significantly correlated with the z-score (r = -0.39, p = 0.02), with right foot fifth metatarsal load (r = -0.35, p = 0.04), center of pressure CoPx (r = -0.42, p = 0.01), CoP displacement (r = 0.35, p = 0.04) and 90% confidence ellipse area (r = -0.38, p = 0.03). (4) Conclusions: In our study including female adolescents with idiopathic S shaped moderate scoliosis, plantar pressure and stabilometric parameters were influenced by the main scoliotic curve.

Do different dental conditions influence the static plantar pressure and stabilometry in young adults?

BACKGROUND: Posture is influenced by many factors and dental occlusion seems to have its role on postural stabilization. Our rationale to perform the study was to find out if there are differences of static plantar pressure and stabilometric parameters depending on different dental conditions. METHODS: The observational study consisted in plantar pressure assessment and stabilometric analysis of 95 right-handed healthy volunteer subjects (mean age 22.94 ± 2.52 years) by using the PoData system. Each subject followed four measurements with open eyes: mandibular postural position, maximum intercuspation, biting on cotton rolls and maximum mouth opening. Plantar pressure was recorded on 1st and 5th metatarsal heads and heel, and was expressed as percentage of weight distribution on each foot. The recorded centre of pressure (CoP) parameters were: CoP path length, 90%confidence ellipse area and maximum CoP speed. Statistical analysis used repeated-measures ANOVA with Bonferroni posthoc analysis and Friedman test. RESULTS: Loading on the left 5th metatarsal head was significantly higher in maximum mouth opening condition when compared to maximum intercuspation and to biting on cotton rolls. The left heel loading was significantly lower in the maximum mouth opening in comparison to maximum intercuspation. The CoP path length and maximum CoP speed were significantly higher in maximum mouth opening compared to the other three conditions. Confidence ellipse area had significantly lower values in maximum intercuspation and in the biting on cotton rolls conditions compared to the mandibular postural position, and in maximum intercuspation compared to maximum mouth opening. CONCLUSION: In young adults with an optimum functional occlusion the static plantar pressure is influenced by the maximum mouth opening. An improved postural stability was recorded in maximum intercuspation (a condition used during swallowing) in comparison to mandibular postural position (a condition that allows relaxation of the masticatory muscles after functional moments).

Respiratory function, functional capacity, and physical activity behaviours in children and adolescents with scoliosis.

OBJECTIVES: To assess pulmonary function and functional capacity in children and adolescents with mild or moderate idiopathic scoliosis who were included in a rehabilitation programme, and to observe some of their physical activity behaviours. METHODS: Forty children (aged 9-17 years) with mild or moderate idiopathic scoliosis (patients) and 40 sex- and age-matched healthy controls were included in the study. Physical activity behaviours (hours of time spent at a desk and at a computer, hours of competitive and non-competitive practice of exercise per week) were recorded. Patients were assessed before beginning rehabilitation and 12 weeks after an exercised-based programme by spirometry and functional capacity testing (6-minute walk test). RESULTS: All respiratory and functional capacity parameters were significantly increased after physical therapy compared with before beginning physical therapy in patients. However, there were still differences between patients and controls in all assessed parameters after therapy. Children and adolescents who were diagnosed with scoliosis spent a longer time at a computer, and had reduced regular and competitive physical exercise compared with controls. CONCLUSIONS: In children and adolescents with mild/moderate idiopathic scoliosis, pulmonary parameters and functional capacity are improved after 12 weeks of supervised physical therapy.

Static plantar pressure and functional capacity in children with femoral shaft fractures treated by titanium elastic nailing.

BACKGROUND: Femoral shaft fractures represent common fractures of the lower limb in the paediatric population. The objectives of our study were to analyse the static plantar pressure and functional capacity in children with surgically treated unilateral femoral shaft fractures, 1 month after the metallic implant removal. METHODS: Our study included 24 children with unilateral femoral shaft fracture (fracture site contralateral to the dominant leg) treated by titanium elastic nailing (TEN) implants, with the removal of the implant 6 months after initial surgery. The patients were divided into two groups: Group 1 (12 patients without inpatient rehabilitation) and Group 2 (12 patients who attended inpatient rehabilitation). The patients and 12 gender and age-matched healthy controls performed plantar pressure analysis and functional capacity testing (6-min walk test: 6MWT). For patients in Group 1 and 2 the assessments were performed 1 month after the TEN implant removal. Paired t-tests were used to compare the intragroup data. A one-way ANOVA test for independent measures was performed to assess the differences for plantar pressure, and 6MWT among study groups and controls. RESULTS: All study patients had left femoral shaft fractures (affected limb). The patients and controls were all right leg dominant. In both Group 1 and Group 2 total foot loading was significantly higher on the non-affected limb compared with the affected limb. When compared to the non-affected limb, the loadings on the affected limb were significantly increased on the first and fifth metatarsal in Group 1, and on the fifth metatarsal in Group 2, with a significantly smaller heel loading. When compared with the controls we found significant differences for all pressure parameters, except for the right foot load for the rehabilitation group. Although the functional capacity values were higher in the rehabilitation group the two patients groups had significantly lower 6MWT values. CONCLUSIONS: When compared to healthy controls children with surgically treated unilateral femoral shaft fractures, although assessed after 7 months, had a different weight distribution on the feet and a decreased functional capacity. A rehabilitation programme included in the management of these patients is important for regaining their functional level.

Relative and absolute within-session reliability of the modified Star Excursion Balance Test in healthy elite athletes.

BACKGROUND: The Star Excursion Balance Test (SEBT) is commonly used to assess dynamic postural balance both in clinical practice and research. The aim of our study was to assess the within-session relative and absolute reliability of participants' performance of the modified SEBT (mSEBT) using a single practice trial in healthy elite athletes who were familiar with the test. METHODS: An intra-session repeated-measures design was used to investigate the relative and absolute reliability of participants' (healthy athletes partaking in sports at a high-risk of ankle sprain injury) performance of the mSEBT. A total of 122 healthy elite athletes from soccer (n = 73), basketball (n = 15), and volleyball (n = 34) performed one practice trial and three test trials within one session, in three directions (anterior, postero-medial, and postero-lateral), for both legs. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), and smallest detectable change at a 95% confidence were calculated. RESULTS: We found a good to excellent relative within-session intra-rater reliability between the three trials on specified directions, with an ICC (3,1) from 0.90 to 0.95. SEM and SDC95 for normalized and composite scores, for both legs ranged from 0.91 to 2.86, and 2.54 to 7.94, respectively. CONCLUSIONS: In conclusion, we report good to excellent within-session reliability for the mSEBT. Our results confirm that the test can be reliably used with only one practice trial in healthy elite athletes familiar with the test.

Preseason Dynamic Balance Performance in Healthy Elite Male Soccer Players.

Lower limb musculoskeletal injuries in sports are linked with balance abnormalities and altered postural control. Dynamic balance screening should be performed in order to identify athletes at risk. The purpose of the study was to evaluate the preseason dynamic balance performance and side-to-side asymmetry of healthy elite male soccer players, using modified Star Excursion Balance Test (mSEBT). Seventy-three elite soccer players (23.8 ± 5.4 years) were evaluated using the mSEBT. Normalized reach distances, side-to-side asymmetries, and composite scores were determined. The composite scores were 93.33% ± 8.99% for dominant leg and 93.36% ± 9.23% for nondominant leg. No significant differences were found between dominant and nondominant limb in any direction. The mSEBT is an easy-to-use tool to measure the dynamic balance performance in elite athletes. It can be applied successfully during preseason physical examinations. Future studies are needed to establish predictive cutoff points in order to increase mSEBT use in screening soccer players for dynamic balance abnormalities and identify those at risk for noncontact lower limb injuries.

Assessment of children with pectus excavatum without surgical correction.

OBJECTIVE: To assess respiratory function and functional capacity in children with pectus excavatum who followed a physical therapy program, to compare these parameters to healthy controls and to evaluate adherence of this category of patients (pectus excavatum without surgical indications) to a supervised exercise program. METHODS: This study included 14 children with pectus excavatum and 14 gender and age-matched healthy controls. The study patients performed a 12-week exercise program. They were assessed at the beginning and at the end of rehabilitation by spirometry and functional capacity testing (6-min walk test). Parents of children with pectus excavatum completed a 10-item adherence questionnaire. RESULTS: In the study patients all respiratory parameters increased after rehabilitation. After 12 weeks there were no differences between study patients and controls, except for functional capacity that still had lower values in children with pectus excavatum. The parents of all patients agreed about fitting of the training program with their child's daily routine, low difficulty of the exercises, the child following the physiotherapist's instructions and confidence in the results of rehabilitation. CONCLUSIONS: In children with pectus excavatum without surgical indications, forced vital capacity, forced expiratory volume in 1 s and functional capacity assessed by the 6­min walk test improved significantly after a 12-week supervised exercise program. The study showed that adherence to the exercise-based program was good for all patients.