Plantar load distribution with centers of gravity balance and rearfoot posture in daily lives of Taiwanese college elite table tennis players: a cross-sectional study.

Background: Table tennis is an asymmetric sport involving the powerful forward swing of the upper limbs depends on the solid support of the lower limbs. The foot drive really affects the weight balance and stroke accuracy even though the distance and momentum of the lower limb displacement are limited within a limited range. Given that previous research on table tennis has typically focused on the footwork and stroke performance of professional players, the study aimed to investigate the daily static and dynamic plantar load distribution as well as the centers of gravity balance and rearfoot posture among Taiwanese college elite table tennis players. Methods: This is a cross-sectional study of 70 elite male table tennis players (age: 20.0 ± 0.9 years; height: 173.4 ± 5.1 cm, weight: 67.6 ± 5.3 kg, experience: 10.0 ± 1.6 years) and 77 amateur table tennis players of the same gender (age: 20.1 ± 0.8 years, height: 167.4 ± 4.4 cm, weight: 64.3 ± 4.0 kg, experience: 4.4 ± 1.2 years) from Taiwanese universities. The JC Mat optical plantar pressure analyzer was applied to determine the plantar load distribution along with arch index (AI) and centers of gravity balance. Assessment of rearfoot postural alignment was mainly used to contrast the performance of the centers of gravity balance. Results: The static arch indices of both feet in the elite group were symmetrical and considered normal arches (AI: 0.22 ± 0.07) during their non-training and non-competition daily lives. Their static plantar loads were symmetrically concentrated on the bipedal lateral metatarsals (P < 0.05) as well as shifted to the medial and lateral heels (P < 0.05) and the lateral metatarsals (P < 0.05) during the walking midstance phase. Additionally, the plantar loads were mainly applied to the bipedal medial (P < 0.01) and lateral heels (P < 0.05) during the transitional changes between both states. Elite athletes had symmetrical and evenly distributed centers of gravity on both feet (left: 50.03 ± 4.47%; right: 49.97 ± 4.47%) when standing statically, along with symmetrical rearfoot angles and neutral position of the subtalar joint (left: 2.73 ± 2.30°; right: 2.70 ± 2.32°) even though they were statistically lower than those of the amateur athletes (P < 0.05). Conclusions: The daily static and dynamic foot patterns of Taiwanese college elite table tennis players were characterized by plantar load distribution on the lateral metatarsals and the entire calcaneus along with balanced centers of gravity and normal rearfoot posture. This foot and posture layout outlines the excellent athletic performance of the foot and ankle in professional athletes. Portions of this text were previously published as part of a preprint (https://doi.org/10.21203/rs.3.rs-2993403/v1).

Bipedal Static Supination and Dynamic Forefoot Loading Characteristics in Taiwanese College Badminton Players: A Cross-Sectional Study.

CONTEXT: Badminton is a unilateral sport that involves repetitive jumping, lunging and quick changes of direction with the lower limb, thus, plantar pressure profiles and foot postural profiles are critical to maintaining balance and coordination. OBJECTIVE: The purpose of this study was to explore the characteristics of static and dynamic plantar pressure profiles with rearfoot posture in elite and recreational badminton players as well as assess the transitional changes of plantar loads between static and dynamic states. METHODS: A cross-sectional survey was conducted among 65 college-level elite male badminton players (mean age: 20.2 ± 1.2 years; mean height: 177.4 ± 4.6 cm; mean weight: 72.6 ± 4.6 kg) and 68 recreational badminton players of the same gender (mean age: 19.9 ± 0.8 years; mean height: 170.3 ± 3.9 cm; mean weight: 67.7 ± 3.2 kg). The JC Mat was used to evaluate the arch index (AI), plantar pressure distribution (PPD), centers of gravity, and the characteristics of the footprint. Static foot posture was determined by examining the rearfoot alignment. RESULTS: Both groups' AI fell within the normal range. The static plantar loads of the elite group were distributed at the bipedal lateral part of longitudinal arches and heels (p < 0.01), while the right foot experienced higher centers of gravity (p < 0.05). The elite group's static rearfoot postural alignment exhibited a higher degree of rearfoot varus than the recreational group (p < 0.05). In addition, the elite group's dynamic plantar loads were mainly exerted at the medial and lateral metatarsals of both feet (p < 0.05). During the transition state, the recreational group's plantar loads were mainly shifted to the bipedal lateral part of metatarsals and heels (p < 0.05), whereas the elite group's bipedal lateral longitudinal arches as well as the medial and lateral heels experienced a reduction in plantar loads (p < 0.01). CONCLUSION: For elite badminton players, the findings revealed a possible connection among the static supinated foot, centers of gravity tending towards the right foot, and increased forefoot plantar loads in the dynamic state. The finding merits further exploration of the possible links between transitional changes in plantar pressure distribution in both states and related foot injuries resulting from intense competition and regular training in badminton.

Elite Tennis Players Experiencing High-Arched Supination and Cuboids Dropped Foot Syndromes in Daily Normal Gait.

Many studies have focused on the plantar pressure characteristics of specific movements and footwork in tennis. However, little research has been conducted for exploring the foot characteristics among tennis professionals' daily habitual paces. This study aims to examine the pressure profiles associated with foot posture and balance abilities of elite tennis players during normal gait to understand how foot loading patterns result from habitual paces that may be derived from intensive tennis training and competition. A cross-sectional comparative study is conducted on 95 male college elite tennis players (mean age: 20.2 ± 1.2 years) and 100 male recreational tennis players (mean age: 19.8 ± 0.9 years). Bipedal plantar pressure distributions (PPDs) associated with arch index (AI) and centers of gravity balance are explored through the plantar pressure device. The foot posture is estimated to determine the rearfoot postural alignment. During the midstance phase of walking with a normal gait, the bipedal AI values of the elite group are significantly lower, indicating that they have high-arched feet. Additionally, the elite group experienced higher PPDs at the lateral regions of their longitudinal arches and heels and relatively lower PPDs at the medial portions of both feet. Rearfoot postural alignment resonance analysis of the PPDs suggests that the elite group experienced foot supination associated with cuboid dropped. Moreover, the right foot bears heavier centers of gravity balance in the present study. The elite tennis players in the study are categorized as having high-arched supination with cuboids dropped when performing daily habitual paces. This finding warrants further investigation into the correlation between possible injuries and daily habitual paces that may result from tennis' intensive training and competition.

The Relationship between Medical Staff's Emotional Labor, Leisure Coping Strategies, Workplace Spirituality, and Organizational Commitment during the COVID-19 Pandemic.

Many medical issues have gradually emerged under the severe impact of the COVID-19 pandemic, which has not only changed the medical culture but also tested medical staffs' response abilities, emotional pressure, sense of identity, and belonging to the organization. The relationships among medical staffs' emotional labor, leisure coping strategies, workplace spirituality, and organizational commitment during the COVID-19 pandemic are explored in this study. With medical staffs as the research subjects, a questionnaire survey was conducted using convenience sampling; a total of 360 questionnaires were distributed and 330 were returned, for a recovery rate of 91%. There were 300 valid questionnaires after 30 invalid questionnaires were excluded, for an effective recovery rate of 90%. SPSS and AMOS software were used for statistical analysis. According to the research results: (1) emotional labor had a significant effect on workplace spirituality, (2) workplace spirituality had a significant impact on organizational commitment, (3) emotional labor had a negative and significant impact on organizational commitment, (4) emotional labor had a significant impact on leisure coping strategies, and (5) the mediating effect of workplace spirituality between emotional labor and organizational commitment was not significant. Finally, relevant practical suggestions are provided based on the results of this study.

The Behavioral Intention and Influencing Factors of Medical Staff toward COVID-19 Vaccinations.

This study mainly explored the behavioral intention and influencing factors of medical staff toward COVID-19 vaccinations. Medical staff were taken as the research subjects. This study selected 300 research subjects by the intentional sampling method and conducted a questionnaire survey. A total of 260 questionnaires were recovered (a recovery rate of 86%), and the number of valid questionnaires was 212, for an effective questionnaire rate of 81%. SPSS and AMOS were used for statistical analysis. As known from the research results: (1) medical staffs' perception of COVID-19 vaccinations had a positive and significant impact on their behavioral intention for receiving COVID-19 vaccinations; (2) medical staffs' perception of COVID-19 vaccinations had a negative and significant impact on the barriers to receiving COVID-19 vaccinations; (3) medical staffs' motivation of receiving COVID-19 vaccinations had a positive and significant positive effect on their behavioral intention of receiving COVID-19 vaccinations; and (4) medical staffs' motivation of receiving COVID-19 vaccinations had a positive and significant impact on the barrier to receiving COVID-19 vaccinations.

Traceable Features of Static Plantar Pressure Characteristics and Foot Postures in College Students with Hemiplegic Cerebral Palsy.

Patients with cerebral palsy (CP) are characterized by disturbances of mobility with postural and foot deformities. Subsequent development of CP may lead to changes in plantar loading. This study examined the characteristics of foot types and relative loads associated with centers of gravity and foot posture in college students with left and right hemiplegic CP, as well as these differences between unaffected and hemiplegic limbs. A cross-sectional study of 45 hemiplegic college students with mild CP and 62 healthy students was conducted. Static plantar pressure was measured with a JC Mat. CP students exhibited low arches, and their plantar pressure distributions (PPDs) were mainly exerted on the left forefoot, as well as on the right forefoot and rearfoot. The weight shifted to the unaffected foot with dual plantar loading regions (forefoot and rearfoot), rather than the hemiplegic foot with a single region (forefoot). PPDs commonly increased at the medial metatarsals of both feet, and hemiplegic CP students presented the increased PPDs on the medial aspect of the hemiplegic foot accompanied by a rearfoot valgus posture pattern. The findings revealed a traceable feature to a possible connection among the pronated low arches, mild centers of gravity, metatarsal syndrome and rearfoot valgus of the hemiplegic limbs in CP patients.

Characteristics of Plantar Pressure with Foot Postures and Lower Limb Pain Profiles in Taiwanese College Elite Rugby League Athletes.

BACKGROUND: This study aimed to explore the differences in the distributions of plantar pressure in static and dynamic states and assess the possible pain profiles in the lower limb between elite rugby league athletes and recreational rugby players. METHODS: A cross-sectional study of 51 college elite rugby athletes and 57 recreational rugby players was undertaken. The arch index (AI) and plantar pressure distributions (PPDs) with footprint characteristics were evaluated via the JC Mat. Rearfoot alignment was examined to evaluate the static foot posture. The elite group's lower-limb pain profiles were examined for evaluating the common musculoskeletal pain areas. RESULTS: The recreational group's AI values fell into the normal range, whereas the elite group's arch type fell into the category of the low arch. Results from the elite group were: (1) the PPDs mainly exerted on the entire forefoot and lateral midfoot regions in static standing, and transferred to the forefoot region during the midstance phase of walking; (2) the static rearfoot alignment matched the varus posture pattern; (3) the footprint characteristics illustrated the features of low-arched, supinated, dropped metatarsal heads and dropped cuboid feet; and (4) the phalanx and metatarsophalangeal joints, and the abductor hallucis and abductor digiti minimi of the plantar plate were common musculoskeletal pain areas. CONCLUSIONS: Characteristics of higher plantar loads beneath forefoot and midfoot associated with low-arched supinated feet in bipedal static stance could be the traceable features for the foot diagram of elite rugby league athletes. The limb pain profiles of the elite rugby league athletes within this study echoed the literature on rugby injuries, and reflected the features of metatarsophalangeal joint pains and dropped cuboids. The relationships among the low-arched supinated feet, metatarsophalangeal joint pains and cuboid syndrome are worth further studies.

Relationships between Plantar Pressure Distribution and Rearfoot Alignment in the Taiwanese College Athletes with Plantar Fasciopathy during Static Standing and Walking.

BACKGROUND: Plantar fasciopathy (PF) is usually related to changes in foot arch, foot shape and rearfoot posture. However, little research has been implemented by using large-scale datasets, and even less has been conducted centering on plantar pressure distributions (PPDs) of different genders of PF athletes. This study aimed to investigate the relationships among the arch index (AI), the PPDs and the rearfoot postural alignment in hundreds of college athletes with PF during static standing and walking. METHODS: Cross-sectional study of 100 male and 102 female athletes with PF was undertaken. The PF athletes' pain assessment and self-reported health status were examined for evaluating their musculoskeletal painful areas. RESULTS: The PF athletes' PPDs mainly concentrated on inner feet in static standing, and transferred to lateral forefeet during the midstance phase of walking. The males' PPDs from the static standing to the midstance phase of walking mainly transferred to anterolateral feet. The females' PPDs mainly transferred to posterolateral feet. The PF athletes' static rearfoot alignment matched the valgus posture pattern. The medial band of plantar fascia and calcaneus were the common musculoskeletal pain areas. CONCLUSIONS: Characteristics of higher plantar loads beneath medial feet associated with rearfoot valgus in bipedal static stance could be the traceable features for PF-related foot diagrams. Higher plantar loads mainly exerted on the lateral forefoot during the midstance phase of walking, and specifically concentrated on outer feet during the transition from static to dynamic state. Pain profiles seem to echo PPDs, which could function as the traceable beginning for the possible link among pronated low-arched feet, PF, metatarsalgia, calcanitis and Achilles tendinitis.

Differences in Pivot Leg Kinematics and Electromyography Activation in Various Round House Kicking Heights.

The round house kick (RHK) is a common technique in taekwondo (TKD). The kicking action originates from the dynamic stability of the pivot leg. However, some knee injuries are caused by more difficult kicking strategies, such as kicks to the opponent's head. This study analyses the effects on TKD players in the lower extremity kinematic and neuromuscular reactions from different kicking heights. This study recruited 12 TKD players (age=20.3 ± 1.3 years, height = 1.72 ± 0.09 m, mass = 62.17 ± 9.45 kg) with no previous lower extremity ligament injuries. All athletes randomly performed 3 RHK at different heights (head, chest, and abdomen), repeating each kick 5 times. During the RHK action, the kinematics and muscle activations of the pivot leg were collected using six high-speed cameras and electromyography devices. The results found that during the RHK return period a high kicking position demonstrated larger knee valgus with the straight knee, and more hamstring activation on the pivot leg. The RHK pivot foot for TKD players encountered more risk of injury from high target kicking. The hamstring muscle played an important stabilizing role. It is recommended that sports medicine clinicians or sports coaches use this information to provide further protective injury prevention strategies.

Plantar Pressure Profiles and Possible Foot Syndromes of Taiwanese College Elite Basketball Players.

BACKGROUND: Plantar pressure assessments are useful for understanding the functions of the foot and lower limb and for predicting injury incidence rates. Musculoskeletal fatigue is likely to affect plantar pressure profiles. This study aimed to characterize college elite basketball players' plantar pressure profiles and pain profiles during static standing and walking. METHODS: Fifty-one male elite basketball players and 85 male recreational basketball players participated in this study. An optical plantar pressure measurement system was used to collect the arch index (AI), regional plantar pressure distributions (PPDs), and footprint characteristics during static and dynamic activities. Elite basketball players' pain profiles were examined for evaluating their common musculoskeletal pain areas. RESULTS: The AI values were in the reference range in recreational basketball players and considerably lower in elite basketball players. Elite basketball players' static PPDs of both feet were mainly exerted on the lateral longitudinal arch and the lateral heel and were relatively lower on the medial longitudinal arch and medial and lateral metatarsal bones. The PPDs mainly transferred to the lateral metatarsal bone and lateral longitudinal arch and decreased at the medial heel during the midstance phase of walking. The footprint characteristics of elite basketball players illustrated the features of calcaneal varus (supinated foot) of high arches and dropped cuboid foot. The lateral ankle joints and anterior cruciate ligaments were the common musculoskeletal pain areas. CONCLUSIONS: Elite basketball players' AI values indicated high arches, and their PPDs tended to parallel the features of the high-arched supinated and dropped cuboid foot. Their pain profiles resonated with the common basketball injuries and reflected the features of Jones fracture and cuboid syndrome. The potential links among high-arched supinated foot, Jones fracture, and cuboid syndrome are worth further study.

Characteristics of Plantar Pressures and Related Pain Profiles in Elite Sprinters and Recreational Runners.

BACKGROUND: Plantar pressure measurement is effective for assessing plantar loading and can be applied to evaluating foot performance. We sought to explore the characteristics of plantar pressures in elite sprinters and recreational runners during static standing and walking. METHODS: Arch index (AI) values, regional plantar pressure distributions (PPDs), and footprint characteristics were examined in 80 elite sprinters and 90 recreational runners using an optical plantar pressure measurement system. Elite sprinters' pain profiles were examined to evaluate their most common pain areas. RESULTS: In recreational runners, AI values in males were in the normal range and in females were high arch type. The AI values were significantly lower in elite sprinters than in recreational runners. In elite sprinters, particularly males, the static PPD of both feet was higher at the medial metatarsal bone and the lateral heel and lower at the medial and lateral longitudinal arches. Elite male sprinters' PPD of both feet was mainly transferred to the medial metatarsal bone and decreased at the lateral longitudinal arch and the medial heel during the midstance phase of walking. The lateral knee joint and biceps femoris were the most common sites of musculoskeletal pain in elite sprinters. CONCLUSIONS: Elite sprinters' AI values could be classified as high arches, and their PPD tended to parallel the features of runners and high-arched runners. These findings correspond to the profile of patellofemoral pain syndrome (PFPS)-related plantar pressure. The pain profiles seemed to resonate with the symptoms of high-arched runners and PFPS. A possible link between high-arched runners and PFPS warrants further study.

Therapeutic efficacy evaluation of 111In-labeled PEGylated liposomal vinorelbine in murine colon carcinoma with multimodalities of molecular imaging.

UNLABELLED: In our previous studies using combined radioisotopes with chemotherapeutic liposomal drugs (i.e., (111)In-labeled polyethylene glycol (PEG)ylated liposomal vinorelbine) we have reported possible therapeutic efficiency in tumor growth suppression. Nevertheless, the challenge remains as to whether this chemotherapy has a therapeutic effect as good as that of combination therapy. The goal of this study was to investigate the real therapeutic effectiveness of 6 mol% PEG (111)In-vinorelbine liposomes via the elevation of the radiation dosage and reduction in the concentration of chemotherapeutic agents. METHODS: Murine colon carcinoma cells transfected with dual-reporter genes (CT-26/tk-luc) were xenografted into BALB/c mice. The biodistribution was estimated to determine the drug profile and targeting efficiency of (111)In-vinorelbine liposomes. Bioluminescence imaging and (18)F-FDG small-animal PET were applied to monitor the therapeutic response after drug administration. The survival in vivo was estimated and linked with the toxicologic and histopathologic analyses to determine the preclinical safety and feasibility of the nanomedicine. RESULTS: Effective long-term circulation of radioactivity in the plasma was achieved by 6 mol% PEG (111)In-vinorelbine liposomes, and this dose showed significantly lower uptake in the reticuloendothelial system than that of 0.9 mol% PEG (111)In-vinorelbine liposomes. Selective tumor uptake was represented by cumulative deposition, and the maximum accumulation was at 48 h after injection. The combination therapy exhibited an additive effect for tumor growth suppression as tracked by caliper measurement, bioluminescence imaging, and small-animal PET. Furthermore, an improved survival rate and reduced tissue toxicity were closely correlated with the toxicologic and histopathologic results. CONCLUSION: The results demonstrated that the use of 6 mol% PEG (111)In-vinorelbine liposomes for passively targeted tumor therapy displayed an additive effect with combined therapy, not only by prolonging the circulation rate because of a reduction in the phagocytic effect of the reticuloendothelial system but also by enhancing tumor uptake. Thus, this preclinical study suggests that 6 mol% PEG (111)In-vinorelbine liposomes have the potential to increase the therapeutic index and reduce the toxicity of the passively nanotargeted chemoradiotherapies.

Improvement of biodistribution and therapeutic index via increase of polyethylene glycol on drug-carrying liposomes in an HT-29/luc xenografted mouse model.

Liposomes modified with a high concentration of polyethylene glycol (PEG) could significantly prolong the retention time of the carried drug in the circulation, thus improving the drug accumulation in the tumor. In this study, 6 mol% rather than 0.9 mol% PEGylated liposomes (100 nm in diameter) encapsulated with indium-111 were used in a human colorectal carcinoma HT-29/luc tumor-bearing mouse model for comparing the PEGylation effect. Pharmacokinetics, biodistribution, passive-targeted assay, bioluminescence imaging (BLI) and tumor growth measurements were used for the spatial and temporal distribution, tumor localization and therapeutic evaluation of the drug. Pharmacokinetic studies indicated that the terminal half-life (T((1/2))lambdaz) and C(max) of 6 mol% PEG (111)In liposomes were similar to those of 0.9 mol% PEG (111)In liposomes. In the blood, the total body clearance (Cl) of 6 mol% PEG (111)In liposomes was about 1.7-fold lower and the area under the curve (AUC) was 1.7-fold higher than those of 0.9 mol% PEG (111)In liposomes. These results showed that the long-term circulation and localization of 6 mol% PEGylated liposomes was more appropriate for use in the tumor-bearing animal model. In addition, the biodistribution of 6 mol% PEG (111)In liposomes showed significantly lower uptake in the liver, spleen, kidneys, small intestine and bone marrow than those of 0.9 mol% PEG (111)In liposomes. The clearance rate of both drugs from the blood decreased with time, with the maximum at 24 h post intravenous (i.v.) injection. Prominent tumor uptake and the highest tumor/muscle ratios were found at 48 h post injection. Both AUC and relative ratio of the AUCs (RR-AUC) also showed that 6 mol% PEGylated liposomes significantly reduced the uptake of drugs in the reticuloendothelial system (RES), yet enhanced the uptake in the tumor. Gamma scintigraphy at 48 h post injection also demonstrated more distinct tumor uptake with 6 mol% PEG (111)In liposomes as compared to that of 0.9 mol% PEGylated liposomes (p<0.01). BLI and in vivo tumor growth tracing showed that growth in tumor volume could largely be inhibited by 6 mol% PEG (111)In liposomes. The results suggest that 6 mol% PEGylated liposomes might be a more suitable liposomal carrier for drug delivery than 0.9 mol% PEGylated liposomes, not only by reducing the drug accumulation in the RES or its related organs, but by prolonging drug circulation and eventually enhancing the targeting efficiency in the tumor to reach a better therapeutic index.

Diagnostic and therapeutic evaluation of 111In-vinorelbine-liposomes in a human colorectal carcinoma HT-29/luc-bearing animal model.

Colorectal carcinoma is a highly prevalent and common cause of cancer in Taiwan. There is still no available cure for this malignant disease. To address this issue, we applied the multimodality of molecular imaging to explore the efficacy of diagnostic and therapeutic nanoradiopharmaceuticals in an animal model of human colorectal adenocarcinoma [colorectal cancer (CRC)] that stably expresses luciferase (luc) as a reporter. In this study, an in vivo therapeutic efficacy evaluation of dual-nanoliposome (100 nm in diameter) encaged vinorelbine (VNB) and (111)In-oxine on HT-29/luc mouse xenografts was carried out. HT-29/luc tumor cells were transplanted subcutaneously into male SCID mice. Multimodality of molecular imaging approaches including bioluminescence imaging (BLI), gamma scintigraphy, whole-body autoradiography (WBAR) and in vivo tumor growth tracing, histopathology and biochemistry/hematology analyses were applied on xenografted SCID mice to study the treatments with 6% polyethylene glycol (PEG) of (111)In-NanoX/VNB-liposomes. In vivo tumor growth tracing and BLI showed that tumor volume could be completely inhibited by the combination therapy with (111)In-VNB-liposomes and by chemotherapy with NanoX/VNB-liposomes (i.e., without Indium-111) (P<.01). The nuclear medicine images of gamma scintigraphy and WBAR also revealed the conspicuous inhibition of tumor growth by the combination therapy with (111)In-VNB-liposomes. Animal body weights, histopathology and biochemistry/hematology analyses were used to confirm the safety and feasibility of radiopharmaceuticals. A synergistic therapeutic effect on CRC xenografted SCID mice was proven by combining an Auger electron-emitting radioisotope (Indium-111) with an anticancer drug (VNB). This study further demonstrates the beneficial potential applications of multimodality molecular imaging as part of the diagnostic and therapeutic approaches available for the evaluation of new drugs and other strategic approaches to disease treatment.