Search Results (1,016)

Background: The COVID-19 pandemic significantly reduced physical activity levels, particularly among older people, negatively impacting their postural balance and increasing the risk of falls and hip fractures. This study aims to assess the effect of a virtual reality-based exergame physical activity protocol at home on improving postural balance in older people. Materials and Methods: A quasi-experimental design was employed with 10 older people (71 ± 9 years) who participated in a virtual reality-based exergame physical activity protocol consisting of eighteen 25 min sessions conducted at home. The protocol incorporated 3D movement tracking using a sensor attached to the participants’ bodies to monitor postural sway in real time. Clinical measurements included the Timed Up and Go test and posturographic measures of center-of-pressure, including sway area, velocity, and standard deviation in the mediolateral and anteroposterior directions under four conditions: static with the eyes open and eyes closed and dynamic voluntary sway in the mediolateral direction following a 30 Hz metronome with the eyes open and eyes closed. Paired t-tests were used to compare pre- and post-intervention data. Results: The intervention led to significant improvements in postural balance as measured using both posturographic measures (p < 0.05) and the Timed Up and Go test (p = 0.04). Conclusion: The virtual reality-based exergame physical activity protocol conducted at home, comprising eighteen 25 min sessions, effectively improves postural balance in older people. Full article

Background/Objectives: Body posture is developmentally variable and individually diversified. As a chain of numerous unconditioned and conditioned reflexes, it is, in its essence, a psychomotor habit. The aim of the study was to create an original typology of body posture based on measurements using the Diers Formetric III 4D system. Methods: The research included 303 children aged 10–12. Results: Taking the ranges of standards for the angle of thoracic kyphosis (42–55°) and lumbar lordosis (33–47°) into account, it was shown that there are nine types of body posture. These are as follows: reduced kyphosis, reduced lordosis (K < 42°; L < 33°); reduced kyphosis, normal lordosis (K < 42°; 33° ≤ L ≤ 47°); reduced kyphosis, increased lordosis (K < 42°; L > 47°); normal kyphosis, reduced lordosis (42° ≤ K ≤ 55°; L < 33°); normal kyphosis, normal lordosis (42° ≤ K ≤ 55; 33° ≤ L ≤ 47°); normal kyphosis, increased lordosis (42° ≤ K ≤ 55°; L > 47°); increased kyphosis, reduced lordosis (K > 55°, L < 33°); increased kyphosis, normal lordosis (K > 55°; 33° ≤ L ≤ 47°); and increased kyphosis, increased lordosis (K > 55°; L > 47°). Conclusions: In the final evaluation of the Diers Formetric III 4D examination, the traditional division into round, concave, round-concave, and flat backs should be supplemented and expanded to include the nine posture types mentioned above. This will enable a more precise selection of corrective exercises, which will significantly improve their quality and effectiveness. Full article

Background: Falls and fall consequences in older adults are global health issues. Previous studies have compared postural sways or stepping strategies between older adults with and without fall histories to identify factors associated with falls. However, more in-depth neuromuscular/kinematic mechanisms have remained unclear. This study aimed to comprehensively investigate muscle activities and joint kinematics during reactive balance control in older adults with different fall histories. Methods: This pilot observational study recruited six community-dwelling older fallers (≥1 fall in past one year) and six older non-fallers, who received unpredictable translational balance perturbations in randomized directions and intensities during standing. The whole-body center-of-mass (COM) displacements, eight dominant-leg joint motions and muscle electrical activities were collected, and analyzed using the temporal and amplitude parameters. Results: Compared to non-fallers, fallers had significantly: (a) smaller activation rate of the ankle dorsiflexor, delayed activation of the hip flexor/extensor, larger activation rate of the knee flexor, and smaller agonist-antagonist co-contraction in lower-limb muscles; (b) larger knee/hip flexion angles, longer ankle dorsiflexion duration, and delayed timing of recovery in joint motions; and (c) earlier downward COM displacements and larger anteroposterior overshooting COM displacements following unpredictable perturbations (p < 0.05). Conclusions: Compared to non-fallers, fallers used more suspensory strategies for reactive standing balance, which compensated for inadequate ankle/hip strategies but resulted in prolonged recovery. A further longitudinal study with a larger sample is still needed to examine the diagnostic accuracies and training values of these identified neuromuscular/kinematic factors in differentiating fall risks and preventing future falls of older people, respectively. Full article

Dentist–patient communication is at the core of providing quality dental care. This study aims to review the importance, challenges, strategies, and training of dentist–patient communication. The World Dental Federation (FDI) emphasizes the importance of effective communication between oral healthcare providers and patients as a critical component of high-quality care. Effective dentist–patient communication allows dentists to accurately and effectively pass on essential medical information to patients. It improves the dentist’s efficiency, boosts self-confidence, reduces occupational stress, and minimizes the risks of complaint or litigation. Moreover, it alleviates dental anxiety and fear, helps build trust between dentists and patients, addresses patients’ needs and preferences, increases patients’ adherence to improved treatment outcomes, and ultimately leads to enhanced patient satisfaction. Nonetheless, it has been widely acknowledged that dentists universally encounter the repercussions arising from suboptimal communication strategies. Time constraints, difficulties in establishing rapport, the oral-health illiteracy of the patients, the poor communication skills of the dentists, dentists’ perceptions, and language barriers often hinder dentist–patient communication. Dentists should take the patient-centered approach as a premise and acquire verbal and non-verbal communication skills to overcome these communication barriers. The patient-centered approach comprises the understanding of patients’ illness, shared decision-making, and intervention with mindfulness of the patient’s own pace. Simple, succinct, and jargon-free language should be used in verbal communication. Proper body postures and gestures are fundamental for showing positive attitudes towards patients. Communication training for dental students should involve a structured pedagogical approach that includes didactic instruction, role-playing exercises, patient interviewing, and ongoing assessments. Key components of effective communication skills training in dental education include motivational interviewing, open-ended questioning, affirmations, reflective listening, and summaries to enhance patient engagement and adherence to treatment plans. Full article

Background: Nowadays, not only is a high, long life expectancy desired, but also longevity with quality. Quality of life in adulthood is a multidimensional construct related to the perception of one’s own health, psychological and socio-emotional factors, functionality for daily activities, and body composition. Objective: This study evaluates the effects of physical activity level (PAL), strength, balance, and body composition on perceived health in healthy adults. Methods: An observational, cross-sectional study with consecutive, non-probabilistic inclusion of cases was conducted. Body fat percentage (BFP) was measured by DXA. Physical activity level was assessed using accelerometry. The strength index (S_Index) was estimated using dynamometry. Postural control was assessed through posturography. The composite equilibrium score from the Sensory Organization Test (SOT_CES) was conducted to measure postural stability under various sensory conditions using dynamic posturography. Perceived health was calculated using the SF36 questionnaire, which detects health states, both positive and negative. A linear regression model was generated between each domain of SF36 with SOT_CES, BFP, PAL, and S_Index. Results: A total of 64 males with a mean age of 55 ± 5 years and a mean body mass index of 27 ± 4 kg/m² were recruited. Results showed a negative correlation between physical function (ß = −0.7; t = −3.163; p = 0.003; R² = 23.7%) and general health (ß = −0.227; t = −3.425; p = 0.001; R² = 17.4%) with BFP. Also, it showed a negative correlation between physical function (ß = 0.047; t = −2.643; p = 0.011; R² = 17.5%) and general health (ß = 0.016; t = −3.044; p = 0.004; R² = 14.6%) with S_Index. On the other hand, no relation was observed between SF36 and SOT_CES. Finally, only the emotional role showed a positive correlation (ß = −0.02; t = −2.629; p = 0.011; R² = 23.1%) with PAL. Conclusion: A lower BFP and higher S_Index are associated with increased physical function and general health. Also, the higher the PAL, the greater the emotional health. On the other hand, no relation was observed between SF36 and the balance detected from SOT_CES. Full article

Background: The current study examined whether there is an association between the dominant leg (DL) and the side of angle trunk rotation (ATR) and evaluated postural asymmetries and anthropometric characteristics between adolescent male soccer players and non-athletes across different age groups (11–14 years). Methods: This study included 502 male participants: 291 soccer players (age: 13 ± 2 years; height: 158 ± 17 cm; weight: 50.6 ± 12 kg) and 211 non-athletes (age: 13 ± 2 years; height: 158.3 ± 11 cm; weight: 50.5 ± 21 kg). The participants were categorized into four age groups: 11, 12, 13, and 14 years. Using a scoliometer, the primary (A) and secondary (B) ATR measurements were recorded and categorized into subgroups of 0–2, 3–5, and ≥6 degrees. A Chi-square test and a Mann–Whitney U-test were employed to analyze the raw data. Results: In soccer players, a significant association was found between the DL and primary ATR (p < 0.001). Conversely, non-athletes exhibited a significant association between the DL and secondary ATR only (p < 0.05). No significant differences were observed in the anthropometric characteristics and ATR for the 11-year-old boys (p > 0.05). For the 12-year-old boys, there was a significant difference in the ATR-A region (p < 0.01). For the 13-year-olds, significant differences were found in height, ATR-A region, ATR-B side, ATR-B region, and ATR-B degrees (p < 0.05). The 14-year-old soccer players demonstrated significant differences in ATR metrics compared with non-athletes in the same age group (p < 0.01). Conclusions: The results indicate that older adolescent soccer players exhibited a higher ATR tendency compared to non-athletes. This suggests that daily soccer training and DL usage contribute to increase postural asymmetries and physical development variations in adolescence. These findings underscore the necessity for monitoring body posture health in athletes during the early period of adolescence in an attempt to mitigate the potential negative long-term impacts on their life. Full article

Introduction: The evidence showed that the risk of falls was higher in women, and yoga was considered an effective rehabilitation method for preventing falls. However, there had been no previous attempts to synthesize the evidence specifically for the use of yoga in preventing falls among older women. Objectives: This systematic review aimed to strengthen the existing body of evidence by focusing exclusively on the impact of yoga in improving fall-related physical functions among older women. Methods: A systematic review was conducted following the PRISMA guidelines. The protocol was developed in advance of the study and registered on PROSPERO (Registration number: CRD42024506550). Results: The effects of yoga on balance, gait, and lower-limb strength were inconsistent. It showed that yoga programs designed to prevent falls in older women might not demonstrate the same effectiveness as those identified in previous systematic reviews for the general older adult population. Conclusions: This systematic review is the first to exclusively explore the impact of yoga on fall-related physical functions in older women. However, this review did not directly observe a definitive effect of yoga on fall prevention in older women. Future studies should delve deeper into identifying appropriate yoga postures and determining the optimal dose required to enhance physical function and prevent falls. Full article

Background/Objectives: Implementing and optimizing pelvic floor muscle (PFM) training programs is crucial for reducing the risk of dysfunctions, improving athletic performance, and enhancing quality of life for athletes. The aim of this study was to assess PFM activation in female athletes during postural challenges. Methods: An observational and descriptive study was conducted with twenty-five female rugby players. Surface electromyography was used to evaluate the PFMs in five different body positions under stable and unstable conditions. Results: The peak amplitude of the PFMs at baseline differed according to the physical demand of each position (p < 0.001). The lowest percentage activation was in the supine position (16.23%), while the highest recruitment was observed during the parallel squat (40.69%). The percentage of maximum voluntary contraction also differed according to each position (p = 0.001). The values were similar in supine position, side plank (104%), and standing position, being significantly lower (p < 0.05) than those reached during the off-knees quadruped hold (121.58%), full plank (121.97%), and parallel squat (151.40%); however, the values were comparable between stable and unstable positions (p = 1.000). Conclusions: Positions that challenge gravity and pelvic biomechanics, such as the squat, plank, and quadruped, facilitate greater activation of the PFMs. Contrary to previous recommendations, these exercises do not appear to have significant negative effects; therefore, consideration should be given to the implementation of these exercises for the management of pelvic floor dysfunction and as part of comprehensive exercise programs designed to improve overall core and pelvic floor function. Full article

Background/Objectives: Long-term work-related musculoskeletal disorders are predominantly influenced by factors such as the duration, intensity, and repetitive nature of load lifting. Although traditional ergonomic assessment tools can be effective, they are often challenging and complex to apply due to the absence of a streamlined, standardized framework. Recently, integrating wearable sensors with artificial intelligence has emerged as a promising approach to effectively monitor and mitigate biomechanical risks. This study aimed to evaluate the potential of machine learning models, trained on postural sway metrics derived from an inertial measurement unit (IMU) placed at the lumbar region, to classify risk levels associated with load lifting based on the Revised NIOSH Lifting Equation. Methods: To compute postural sway parameters, the IMU captured acceleration data in both anteroposterior and mediolateral directions, aligning closely with the body’s center of mass. Eight participants undertook two scenarios, each involving twenty consecutive lifting tasks. Eight machine learning classifiers were tested utilizing two validation strategies, with the Gradient Boost Tree algorithm achieving the highest accuracy and an Area under the ROC Curve of 91.2% and 94.5%, respectively. Additionally, feature importance analysis was conducted to identify the most influential sway parameters and directions. Results: The results indicate that the combination of sway metrics and the Gradient Boost model offers a feasible approach for predicting biomechanical risks in load lifting. Conclusions: Further studies with a broader participant pool and varied lifting conditions could enhance the applicability of this method in occupational ergonomics. Full article

Background: This study aimed to explore the potential associations between voice metrics of patients with PD and their motor symptoms. Methods: Motor and vocal data including the Unified Parkinson’s Disease Rating Scale part III (UPDRS-III), Harmonic–Noise Ratio (HNR), jitter, shimmer, and smoothed cepstral peak prominence (CPPS) were analyzed through exploratory correlations followed by univariate linear regression analyses. We employed these four voice metrics as independent variables and the total and sub-scores of the UPDRS-III as dependent variables. Results: Thirteen subjects were included, 76% males and 24% females, with a mean age of 62.9 ± 10.1 years, and a median Hoehn and Yahr stage of 2.3 ± 0.7. The regression analysis showed that CPPS is associated with posture (UPDRS-III posture scores: β = −0.196; F = 10.0; p = 0.01; R² = 0.50) and UPDRS-III postural stability scores (β = −0.130; F = 5.57; p = 0.04; R² = 0.35). Additionally, the associations between CPPS and rapid alternating movement (β = −0.297; p = 0.07), rigidity (β= −0.36; p = 0.11), and body bradykinesia (β = −0.16; p = 0.13) showed a trend towards significance. Conclusion: These findings highlight the potential role of CPPS as a predictor of postural impairments secondary to PD, emphasizing the need for further investigation. Full article

A rapidly growing body of experimental evidence in the literature shows that the effects of humans interacting with vibrating structures, other humans, and their surrounding environment can be critical for reliable estimation of structural vibrations. The Interaction-based Vibration Serviceability Assessment framework (I-VSA) was proposed by the authors in 2017 to address this, taking into account human-structure dynamic interactions (HSI) to simulate the structural vibrations experienced by each occupant/pedestrian. The I-VSA method, however, had limited provisions to simulate simultaneously multiple modes of structure in HSI, to simulate human-human and human-environment interactions, and the movement pattern of the occupants/pedestrians. This study proposes a new Agent-based Vibration Serviceability Assessment framework, termed AVSA, to address the following limitations: (a) allowing for multiple modes of structure to be simulated simultaneously, (b) to simulate effects of vibrations on gait parameters and walking pattern/routes, and (c) to simulate human-environment interactions, and movement patterns for any desired interior layout and use case. The AVSA framework was used to simulate the response and to assess the vibration serviceability of a lightweight floor under a combination of sitting and walking traffic, where three vertical modes of vibrations were engaged simultaneously. The results of the simulations show that for all tests, the experimental Cumulative Distribution Functions of the vibrations experienced by the participants are within the 95% confidence interval predicted by the AVSA method. The proposed method provides a generic and flexible framework to simulate simultaneously different interaction modalities, different human tasks and postures, and multiple modes of structure and the human body. Full article

Background/Objectives: Exercise for children with cystic fibrosis leads to well-known health benefits. However, maintaining regular activity is challenging due to the daily demands of academics, clinical care, and family tasks. Home-based exercise programs offer a more adaptable alternative, fitting into family schedules. This study evaluated the effectiveness of the “KidMove” program, a parent-supervised, tailored, home exercise regimen. Methods: A quasi-experimental study was conducted with an intervention group (IG) and a wait-list control group (CG). The “KidMove” program lasted 12 weeks and included 35 exercises targeting endurance, resistance, flexibility, and neuromotor training. The primary outcome, endurance, was measured with the Modified Shuttle Walking Test, while secondary outcomes included body composition, resistance, flexibility, postural control, respiratory function, and health-related quality of life. Data were collected at baseline and post-intervention. A per-protocol analysis was conducted with generalized estimating equations (GEEs). Results: Forty-six children aged 10 ± 4 years (6 to 18 years), mostly male (n = 24; 52.2%), participated. Significant improvements were observed in the Modified Shuttle Walking Test [Wald χ² = 14.24, p < 0.001], postural control [Wald χ² = 3.89, p = 0.048], knee flexibility [Wald χ² = 5.58, p = 0.018], and emotional functioning [Wald χ² = 9.34, p = 0.002] categories. Conclusions: The “KidMove” program offers a practical, family friendly alternative to center-based exercise by empowering parents to support their children’s physical activity at home, endurance, flexibility, and emotional well-being, while reducing the logistical challenges. Full article

Deep learning, a subfield of artificial intelligence that uses neural networks with multiple layers, is rapidly changing healthcare. Its ability to analyze large datasets and extract relevant information makes it a powerful tool for improving diagnosis, treatment, and disease management. The integration of DL with pressure mats—which are devices that use pressure sensors to continuously and non-invasively monitor the interaction between patients and the contact surface—is a promising application. These pressure platforms generate data that can be very useful for detecting postural anomalies. In this paper we will discuss the application of deep learning algorithms in the analysis of pressure data for the detection of postural asymmetries in 139 patients aged 3 to 20 years. We investigated several main tasks: patient classification, hemibody segmentation, recognition of specific body parts, and generation of automated clinical reports. For this purpose, convolutional neural networks in their classification and regression modalities, the object detection algorithm YOLOv8, and the open language model LLaMa3 were used. Our results demonstrated high accuracy in all tasks: classification achieved 100% accuracy; hemibody division obtained an MAE of approximately 7; and object detection had an average accuracy of 70%. These results demonstrate the potential of this approach for monitoring postural and motor disabilities. By enabling personalized patient care, our methodology contributes to improved clinical outcomes and healthcare delivery. To our best knowledge, this is the first study that combines pressure images with multiple deep learning algorithms for the detection and assessment of postural disorders and motor disabilities in this group of patients. Full article

Background/Objectives: Ocular proprioception is implicated in balance control and heterophoria is associated with abnormal posture, though previous research focused mainly on the role of vertical phoria and the use of vertical prisms. This study aims to evaluate whether ocular misalignment and prismatic correction of horizontal phoria affect posture. Methods: Sixty-nine (N = 69) young healthy subjects were included and equally divided by horizontal distance phoria: orthophoria (n = 23), esophoria (n = 23) and exophoria (n = 23). A prism of low power (two-diopter) was placed base out on the non-dominant eye, reducing misalignment in esophorics and increasing it in exophorics more than in orthophorics. Dynamic computerized posturography was performed with the sensory organization test protocol (SOT) of the EquiTest^® NeuroCom^® version 8 platform both without and with prism, always maintaining subjects unaware of prism use. A mixed model for repeated measures analysis of variance was run to evaluate the main effect of prism and the interaction effect of prism with baseline phoria. Results: Composite movement strategy score without prism was 88.1 ± 2.8% (ankle-dominant strategy) and slightly increased to 89.0 ± 3.1% with prism insertion (p = 0.004), further shifting toward ankle strategy. Composite equilibrium score without prism was 80.3 ± 6.5% and remained stable with prism insertion (81.3 ± 8.2%, p = 0.117), medio-lateral and antero-posterior projection of center of gravity did not displace significantly under prism insertion (p = 0.652 and p = 0.270, respectively). At baseline, posturographic parameters were statistically independent of individual phoria, and no significant interaction between prism insertion and individual phoria was documented for any parameters (p > 0.05 for all). Secondary analysis and pairwise comparisons confirmed that the effect of prism was strongly selective on condition SOT 5 (eyes-closed, platform sway-referenced) with improvement of equilibrium (70.4 ± 9.7% with prism vs. 65.7 ± 11.6% without) and more use of ankle strategy (81.6 ± 5.3% with prism vs. 78.2 ± 6.0% without), without any interaction of phoria and ocular dominance, while the other conditions were comparable with and without prism. Conclusions: A two-diopter prism base out on the non-dominant eye induces the body to use the ankle joint more independently of individual phoria, suggesting a small improvement in postural control, while maintaining oscillations of the center of gravity unaltered. Prism seems to enhance the function of vestibular system selectively. Phoria adjustments with prismatic correction enable intervention in postural behavior. Extraocular muscles could act as proprioceptors influencing postural stability. Full article

Industrial physical therapy (IPT) interventions by physical therapists can enhance labor productivity. However, in Japan, there is a scarcity of case studies involving corporate visits, questionnaire-based data, and insights into corporate demands. Addressing this gap is vital for improving presenteeism related to chronic pain and increasing employees’ health literacy, thereby advancing corporate health management. This case study evaluates the effectiveness of a workshop aimed at preventing and reducing chronic pain among employees in the Development Department of Company A, an information technology (IT) firm. The research employed pre- and post-survey questionnaires, workshop interventions, and meetings with corporate management to assess the current state of musculoskeletal chronic pain and productivity losses and to verify the intervention’s effectiveness. Approximately 50 participants attended the workshop in person, while around 30 participated online, totaling 80 attendees. A total of 56 (51 men and 5 women) individuals responded to the pre-workshop questionnaire, and 28 responded to the post-workshop questionnaire. The age distribution of the 56 pre-survey respondents was as follows: 9 in their twenties, 13 in their thirties, 22 in their forties, and 12 aged 50 and older. Preliminary survey results showed that 55.4% of participants experienced chronic pain in at least one body part. The average presenteeism value was 82.8% (standard deviation = 16.8). It was also found that literacy regarding appropriate pain management strategies was low. An independent t-test comparing literacy scores based on the presence or absence of pain showed no significant differences (p = 0.34). Additionally, a one-way ANOVA conducted to examine differences across four age groups revealed no significant differences (F = 0.934, p = 0.431). Results from the post-workshop questionnaires indicated that more than 70% of the employees experienced an increase in understanding and satisfaction, with positive feedback on the improvement of knowledge about chronic pain mechanisms and posture. However, there were also requests for more interactive communication and a desire to learn more about specific care methods, suggesting the need to provide interventions tailored to appropriate stages of preventive medicine. Full article