Journal of Functional Morphology and Kinesiology

Background: Hamate-lunate impingement or osteoarthritis can be a cause of ulnar-sided wrist pain. In the literature, the lunate has commonly been classified according to the configuration of its distal articular surface into type 1 and type 2, as described by Viegas. A type 1 lunate possesses only a distal articular surface for the capitate, while a type 2 lunate shows an additional medial facet articulating directly with the hamate. Type 2 lunates have been identified as a risk factor for ulnar-sided wrist pain and the development of osteoarthritis in the midcarpal wrist. However, this does not sufficiently explain all arthritic changes between the hamate and lunate. Methods: In this prospective anatomical-radiological cadaver study, 60 wrists were examined. The midcarpal articulation was documented using conventional X-ray, CT arthrography, and anatomical dissection. The study specifically analyzed the positioning of the lunate relative to the hamate apex and its association with the development of hamate-lunate osteoarthritis. For this purpose, the classification by Viegas was refined. Based on posterior-anterior (p.a.) X-ray examinations of the wrist lunates were divided into type 1a, type 1b, and type 2. The type 1a lunate articulates only with the capitate in the midcarpal joint. The type 1b lunate also articulates only with the capitate; however, medially, the apex of the hamate protrudes beyond a Differentiation Line (D-line), which extends from the radial border of the trapezium or the ulnar border of the lunotriquetral (LT) space, without forming a facet with the lunate. A type 2 lunate articulates distally with the capitate and has an additional medial facet with the hamate. Results: Osteoarthritis between the hamate and lunate was observed in both Viegas type 1 and type 2 lunates. According to our refined lunate classification, both in situ and radiologically, type 1b and type 2 lunates showed a substantially higher prevalence and severity of hamate-lunate osteoarthritis compared to type 1a lunates. However, there was no significant difference in the prevalence of hamate-lunate osteoarthritis between type 1b and type 2 lunates. Conclusions: Assessing lunate type and signs of osteoarthritis is essential when evaluating patients with ulnar-sided wrist pain. Our study demonstrates that osteoarthritis in Viegas type 1 lunate is influenced by the position of the hamate apex relative to the D-line. The refined lunate classification, based on correlated radiological and anatomical studies of the wrist, provides a straightforward method for identifying a potential cause of ulnar-sided wrist pain on p.a. X-rays. This classification can help guide further diagnostic and therapeutic decisions, such as wrist arthroscopy with possible resection of the hamate apex. Full article

Objectives: Gait kinematic and kinetic changes have been identified in older adults, highlighting the need to explore the principal age-related components and how these are associated with functional disability. This study aims to perform a factor analysis, including gait kinematic and kinetic parameters in older adults to establish determinant gait domains. Additionally, this study aims to identify which domains differentiate those without and with functional disability. Methods: Through a cross-sectional design, older adults aged 60 and over (n = 35 without and n = 25 with functional disability) were analyzed during overground gait. A principal component analysis (PCA) was used to determine principal components from gait parameters previously demonstrated to express age-related effects (spatiotemporal parameters, sagittal ankle moment and power, ground reaction forces peak, and tridimensional lower limb joints range of motion and positions at heel strike and toe-off). Results: Pace, variability, propulsion, hip and knee control, transverse ankle control, asymmetry, sagittal ankle control, frontal ankle control, frontal hip control, and pre-swing control domains explained 83.90% of the total gait variance in older adults. pace and frontal hip control distinguished individuals with disabilities. Conclusions: PCA identified ten gait domains in older adults. Pace and frontal hip control distinguished disabilities, revealing cautious walking patterns and weaker hip abductor strength. Full article

Objectives: This systematic review aims to critically analyze the available evidence on the effects of hemsball interventions in children and adolescents. Methods: This study followed PRISMA guidelines for identifying, selecting, and analyzing investigations. Systematic searches were conducted in five electronic databases (Web of Science, SportDiscus, Google Scholar, PubMed, and Scopus) until 23 February 2025. Only intervention studies with a control group assessing the effects of hemsball in children and adolescents were included. The methodological quality of randomized controlled trials was assessed using the PEDro scale, while comparative studies were analyzed using the MINORS index. Results: Out of 138 initially identified studies, five met the inclusion criteria. The included studies evaluated the effects of hemsball on balance, coordination, agility, manual dexterity, attention, and lower limb strength. The findings indicated significant improvements in balance, coordination, and manual dexterity in groups that participated in hemsball compared to controls. However, no significant differences were found in agility and lower limb strength. Conclusions: Hemsball programs appear to be effective in enhancing motor and coordination skills in children and adolescents, particularly in populations with special educational needs. However, the heterogeneity of the studies and the lack of information on intervention intensity limit the strength of the conclusions. Full article

Background: Knee osteoarthritis (OA) is a progressive joint disorder characterized by pain, stiffness, and functional impairment. Platelet-rich plasma (PRP) has been widely studied as a biological treatment for OA, with autologous PRP (A-PRP) being the most commonly used formulation. Recently, umbilical cord-derived PRP (C-PRP) has emerged as a potential alternative due to its hypothesized higher regenerative potential. However, evidence supporting its superiority over A-PRP remains limited. This study aims to compare the efficacy and safety of C-PRP and A-PRP in terms of pain relief and functional improvement over a 12-month follow-up period. Methods: This prospective cohort study included 84 patients with mild-to-moderate knee OA (Kellgren–Lawrence grades I–III), into two groups: 44 patients received a single intra-articular injection of C-PRP, and 40 received A-PRP. Pain and functional outcomes were assessed at baseline, 3, 6, 9, and 12 months using the Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee Injury and Osteoarthritis Outcome Score (KOOS). Statistical analysis was performed using the Mann–Whitney U, Exact Fisher test, repeated measures general linear model (GLM) and multivariate logistic regression. Results: Both C-PRP and A-PRP led to significant pain reduction and functional improvement over 12 months (p < 0.01 for both groups). Short-term analysis (3–6 months) showed slightly greater pain relief in the C-PRP group (VAS, p = 0.03 at 3 months), but this difference diminished at later time points. By 9 and 12 months, no significant differences were observed between the two groups in any clinical outcome measures (VAS, WOMAC, KOOS; p > 0.05). No serious adverse events were reported, and both treatments were well tolerated. Conclusions: This study found no long-term superiority of C-PRP over A-PRP in terms of pain relief or functional improvement in knee OA. While C-PRP showed a transient advantage in early pain relief, both treatments demonstrated similar clinical outcomes at 12 months. Given the limited scientific evidence supporting C-PRP and its higher logistical costs, A-PRP should remain the preferred PRP therapy for knee OA. Further randomized controlled trials with longer follow-up periods are needed to confirm these findings. Full article

Work-related musculoskeletal disorders (WMSDs) are a significant public health concern, particularly in professions requiring prolonged static postures. Objectives: This study examined the influence of demographic and occupational factors on the WMSD prevalence and provides evidence-based recommendations for workplace health improvements. Methods: A cross-sectional study (July–September 2024) surveyed 80 office employees in Varna, Bulgaria, using the Prevent 4 Work (P4Wq) questionnaire. ANOVA and t-tests assessed the WMSD prevalence across demographics, while Pearson’s correlations examined associations with age, BMI, and work experience. Data were analyzed in Jamovi v.2.6 (p < 0.05). Results: The sample (92.5% women, mean age 47.2 years) reported a high WMSD prevalence, with cervical pain (88.8%), lower back pain (83.8%), and shoulder pain (75.0%) being the most common. Work experience, age, and BMI were significantly correlated with WMSD severity, while gender showed no significant associations. Conclusions: WMSDs are highly prevalent among office employees, with lower back, neck, and shoulder pain being the most common complaints. Factors such as higher BMI, longer work experience, and increased workload are associated with greater symptom severity. These results emphasize the urgent need for targeted workplace interventions aimed at reducing ergonomic risks, improving posture, and enhancing employee well-being, ultimately fostering a healthier and more productive work environment. Full article

Objectives: This study aimed to evaluate the reliability of muscle oxygen saturation (SmO₂) and its correlation with variables from an inertial measurement unit (IMU) sensor placed on the knee at different exercise intensities. Methods: Fourteen university athletes participated in the study. Incremental ergospirometry was performed to exhaustion to calculate V’O₂max, determine training zones, heart rate, and workload using the IMU, and analyze muscle metabolism by SmO₂. Results: The analysis revealed significant differences between moderate-to-high-intensity zones (80–89% vs. 50–69%, Δ = 27% of SmO₂; p < 0.001) and high-intensity zones (90–100% vs. 50–79%, Δ = 35% of SmO₂; p < 0.001). SmO₂ values showed moderate reliability at moderate exercise intensities (e.g., ICC 0.744 at 50%) and high variability at higher intensities, with ICC values around 0.577–0.594, and CV% increasing up to 77.7% at 100% intensity, indicating decreasing consistency as exercise intensity increases. SmO₂ significantly decreases with increasing angular velocity (β = −13.9, p < 0.001), while knee joint load only shows significant correlations with SmO₂ in the moderate-to-high-intensity zones (r = 0.569, p = 0.004) and high-intensity zones (r = 0.455, p = 0.012). Conclusions: SmO₂ is a key predictor of performance during maximal incremental exercise, particularly in high-intensity zones. Moreover, SmO₂ has the potential to serve as a physiological marker of the internal load on the muscles surrounding the knee during exercise. The SmO₂ decrease could depend on the angular velocity and impact of the exposed knee during running. Full article

Objectives: Handgrip strength (HGS) has been used as an important health indicator due to its ability to predict morbidity and mortality risks in various populations. The aim was to investigate the relationship between HGS and health parameters among public sector workers. Methods: A cross-sectional study was carried out, including the participation of 129 workers. The body composition, presence of chronic non-communicable diseases (CNCDs), physical activity level, and physical capacity (flexibility, HGS, and lower limb endurance) of the workers were evaluated. Results: The results showed that most of the employees, regardless of sex, work in the administrative sector, are aged 40 years or older, have chronic non-communicable diseases (CNCDs), and are physically inactive. The majority of women have a body mass index (BMI) within the normal range and are more flexible. On the other hand, men demonstrated greater lower limb endurance. Lower HGS was associated with a higher BMI, the presence of a CNCD, and worse lower limb endurance. A negative correlation was observed between HGS and age, BMI, and body fat. Conversely, a positive correlation was found between HGS and muscle mass, as well as with lower limb muscle endurance. Conclusions: It can be concluded that individuals with lower HGS are more likely to have a high BMI, develop a CNCD, and present worse lower muscular endurance. Additionally, HGS was found to be reduced in older individuals and/or those with higher levels of body fat, and to be higher in those with normal physical capacity and body composition. Full article

Background: Spinal asymmetries and postural deviations are common concerns in young athletes, particularly those engaged in sports requiring repetitive and asymmetrical movements. Soccer, as a dynamic sport, involves high levels of trunk rotation, rapid directional changes, and frequent loading asymmetry, which may predispose players to spinal deviations. This study aimed to investigate the regional prevalence of primary and secondary angle trunk rotation (ATR) in adolescent male soccer players across different age groups. Methods: A total of 502 male participants (291 soccer players and 211 nonathletes) aged 11 to 14 years were included in the study. Participants underwent scoliosis screening using a scoliometer following Adam’s forward bending test. ATR measurements were recorded at the thoracic and lumbar spinal regions, with primary ATR (ATR-A) and secondary ATR (ATR-B) assessed separately. A chi-square test (χ²) evaluated the association between training level and the regional prevalence of ATR across different age groups. Results: No significant differences were observed in the regional prevalence of ATR-A and ATR-B in the 11-year-old group. However, by age 12, significant differences emerged in ATR-A prevalence (χ²(3) = 16.469, p = 0.001), while ATR-B remained nonsignificant (χ²(2) = 4.040, p = 0.133). In the 13- and 14-year-old groups, significant associations were found for both ATR-A (χ²(3) = 57.219, p < 0.001; χ²(4) = 34.157, p < 0.001) and ATR-B (χ²(3) = 31.481, p < 0.001; χ²(2) = 17.805, p < 0.001), with moderate to strong effect sizes. Conclusions: While no significant differences were observed in younger players, 13- and 14-year-old soccer players exhibited a significantly higher prevalence of ATR than nonathletes. The findings suggest that soccer players exhibited a higher prevalence of spinal asymmetries, particularly in older age groups, with lumbar ATR being more pronounced. The study highlights an increasing trend of spinal asymmetries with training level among young soccer players, likely due to the cumulative effects of asymmetric movement patterns. These findings emphasize the need for early detection and corrective interventions to mitigate potential long-term musculoskeletal imbalances in adolescent soccer players. Full article

Background: Chronic health conditions frequently result in gait disturbances, impacting quality of life and mobility. Smartphone-based gait analysis has emerged as a promising alternative to traditional methods, offering accessibility, cost effectiveness, and portability. This systematic review evaluates smartphone-based inertial measurement units’ validity, reliability, and sensitivity for assessing gait parameters in individuals with chronic conditions. Methods: A comprehensive literature search in Web of Science, PubMed, Google Scholar, and SportDiscus identified 54 eligible studies. Results: Validity was evaluated in 70% of the included studies, with results showing moderate-to-strong associations between smartphone apps and gold-standard systems (e.g., Vicon), particularly for parameters such as gait speed and stride length (e.g., r = 0.42–0.97). However, variability was evident across studies depending on the health condition, measurement protocols, and device placement. Reliability, examined in only 27% of the included studies, displayed a similar trend, with intraclass correlation coefficients (ICCs) ranging from moderate (ICC = 0.53) to excellent (ICC = 0.95) for spatiotemporal parameters. Sensitivity and specificity metrics were explored in 41% and 35% of the included studies, respectively, with several applications achieving over 90% accuracy in detecting gait abnormalities. Feasibility was rated positively in 94% of the included studies, emphasising the practical advantages of smartphones in diverse settings. Conclusions: The findings of this systematic review endorse the clinical potential of smartphones for remote and real-world gait analysis, while highlighting the need for standardised methodologies. Future research should adopt a more comprehensive approach to psychometric evaluation, ensuring that reliability aspects are adequately explored. Additionally, long-term studies are needed to assess the effectiveness of smartphone-based technologies in supporting the personalised treatment and proactive management of chronic conditions. Full article

Objective: Exploring how body composition and musculoskeletal characteristics relate to physical performance may provide insights for optimising training outcomes. We explored if body composition and musculoskeletal characteristics were associated with tactical and cardiorespiratory performance. Methods: A cross-sectional study of police recruits within the Western Australia Police Force was performed. Total and regional body composition was assessed using Dual-energy X-ray Absorptiometry, with the tibial morphology and mid-thigh muscle cross-sectional area assessed using peripheral Quantitative Computed Tomography. Tactical performance was measured with a Physical Performance Evaluation, and cardiorespiratory fitness assessed using the Beep Test. Variables that were significant in univariate regressions progressed to generalised linear models, assessing relationships between measures and performance outcomes. Results: Twenty-seven recruits aged 21–51 years (40.7% female) participated. Better tactical performance was associated with lower body fat percentage (p < 0.001), lower body mass index (p < 0.001), higher appendicular muscle mass (p = 0.005), and a lower proximal (66%) tibia polar cross-section moment of inertia (p = 0.007). Better cardiorespiratory fitness was associated with lower body fat percentage (p = 0.004), higher appendicular lean mass (p = 0.006), a lower proximal (66%) tibia polar cross-section moment of inertia (p = 0.005), and a higher mid-thigh muscle cross-sectional area (p < 0.001). Conclusions: Various body composition and musculoskeletal characteristics are associated with tactical performance and cardiorespiratory fitness in WA police recruits. Lower body fat percentage and higher appendicular muscle mass were associated with both better cardiorespiratory fitness and tactical performance, highlighting the potential relevance of these characteristics in preparing police recruits for operational duties. Full article

Background: In recent years, interest in probiotic supplementation has increased among athletes due to its potential benefits on sports performance. Thus, the aim of this trial was to investigate Lactobacillus plantarum’s effects on sports performance, intestinal damage, and oxidative stress biomarkers. Methods: Twenty-two physically active participants, nine females and thirteen males (age: 32.8 ± 5.2 years; height: 1.73 ± 0.1 m (meters); body mass: 72.2 ± 10.3 kg (kilograms) volunteered in this randomized, double-blind, placebo-controlled, parallel study. The participants performed a strenuous exercise session, and immediately after, their perceived exertion was assessed and blood samples were drawn to assess intestinal damage (IFABP: intestinal fatty acid binding protein) and oxidative stress (PC: protein carbonyls; TAC: total antioxidant capacity; total proteins; GSSG: glutathione disulfide; GSH: reduced glutathione and catalase). Twenty-four hours later, the participants ranked their recovery status and completed various sports performance tests: CMJ (countermovement jump), RAST (running-based anaerobic sprint), and YOYO IR1 (YOYO intermittent recovery test level 1). This was followed by a four-week supplementation period, in which the participants ingested one probiotic capsule per day containing 10 billion CFU (colony forming units) of Lactobacillus plantarum or a placebo capsule (dextrose). Results: The paired samples t-test revealed a significantly better result in the YOYO IR1 test in the probiotic group, while a significant reduction was observed in the TAC levels in the placebo group. Conclusions: The results suggest that Lactobacillus plantarum supplementation could increase YOYO IR1 sports performance test scores and may mitigate TAC value reduction. Full article

Objectives: The jumping ability and strength of the lower limbs in dancers are fundamental to their artistic performance. Similarly, the correct placement of the various leg positions, such as parallel and dehors, are essential aspects of dance technique. We aimed to analyze the effectiveness of a modified strength program on jumping capacity in parallel and dehors, and to assess whether this type of training improves the isometric strength of dancers. Methods: An experimental research study was conducted with pre- and post-intervention assessments on a group of nine semi-professional dancers (seven women and two men) (X = 20 years and DT = 6.67), with an average weight of 62.12 ± 7.38 kg and a height of 1.67 ± 0.05 m. Body composition, isometric strength in the lower limbs, and vertical jump capacity with feet in parallel and in the dehors position were analyzed. The “Simple and Sinister” kettlebell training protocol was implemented, reducing the number of sessions and the duration of the program while incorporating a progression in load. Results: Significant changes were observed in both the parallel jump and the dehors position; however, body composition and isometric strength, although showing higher values at the end of the intervention for all variables, did not demonstrate significant improvements. Thus, while in the pre-intervention phase, jump capacity was associated with multiple variables, in the post-intervention phase, an inverse association was found only with the percentage of body fat. Conclusions: A 12-week training program with two sessions per week is sufficient to achieve significant changes in the jumping ability of dancers, but not in the isometric strength of the lower limbs. Full article

Background: Fitness is relevant for firefighter occupational performance, but its influence on exertion and cognition during occupational tasks remains unclear. We aim to determine fitness’s influence on performance, exertion, and cognition during simulated firefighter occupational tasks. Methods: Two baseline fitness assessments occurred to measure aerobic fitness, strength, power, and body composition in 33 non-firefighter participants (females/males: 15/18; 25.18 ± 4.06 years; 174.01 ± 9.77 cm; 75.94 ± 13.18 kg). A third visit involved participants completing an occupational task assessment (OTA; four rounds of deadlifts, sandbag carries, and a cognitive assessment at 35 °C/50% humidity) to the best of their ability. Multiple linear regression models, including strength and power, aerobic capacity, and body composition, were used to predict OTA performance and exertion. Our outcomes included time to complete, exertion, and cognitive performance during the OTA. Results: The model predicted OTA time, RPE, skin temperature, and blood lactate (ps < 0.02), but not core temperature (p > 0.24). The model did not predict cognitive errors (ps > 0.06). Conclusions: These metrics of fitness provide meaningful predictive insight into firefighters’ occupational readiness during simulated occupational tasks. Full article

Background: Handedness dominance can be observed in the tactical aspects of a handball match geometry. Therefore, this study aimed to examine the asymmetry between shooting velocity and distance in left- and right-handed handball players, and also to see if there is a difference between scored and missed shots. Methods: The data were obtained from players participating in the EHF European Championship 2024, held in Germany. Results: In this study, 238 players were analyzed during the whole championship. They were divided into two groups: left- (N = 112) and right-handed players (N = 126). A total of 5710 shots taken by the players were collected and analyzed. The results show that the left-handed players had a higher score percentage (63.08%) than the right-handed players (57.86%). The right-handed players shot at a higher velocity (101.38 ± 18.00 km/h) than the left-handed players (99.36 ± 18.89 km/h) (p < 0.001). A similar difference was observed in the distance of the shots (7.61 ± 2.23 m; and 7.42 ± 2.59 m, respectively) (p < 0.001). The distance of the shots differed between the scored and missed shots (right-handed, p < 0.001; left-handed, p < 0.04). Conclusions: These findings suggest that an asymmetry in left- and right-handed players is present for both parameters. Also, the higher efficiency of the right side of a handball team could lead to asymmetry in the geometry of a handball match. Full article

Background: This cross-sectional study aims to clarify the relationship between coaches’ decisions and players’ relative age, biological maturation, and experience when identifying Under-14 (U14) players for the District and National Teams. Methods: A total of 360 male soccer players participating in the U14 national inter-association tournament, Lopes da Silva, were assessed. Birth dates were recorded, and players were categorized by birth quarter. Anthropometric measurements, fitness level (handgrip strength), and success indicators (performance evaluated by the coach, minutes played, and selection for the National Team) were documented, Maturation status was determined using bone age. Results: The majority of the sample was born in the 1st and 2nd quartiles regardless of maturation status. Morphological and functional differences between players born in different quartiles were no longer significant after controlling the effect of bone age. Late-maturing athletes played significantly fewer minutes. Among the players selected for the National Team, 89.9% were early or on-time maturers, and 92.9% were born in the first or second quartile of the year. While previous studies have shown reduced variability between bone and decimal age in the third and fourth quartiles, our findings indicate greater variability across all birth quartiles. Conclusions: Maturation status and relative age effect are crucial factors influencing coaches’ selection decisions. These findings highlight the need for a more equitable approach to talent identification, which should include track maturation bias avoiding the pursuit of short-term success and promoting long-term development programs for young soccer players. Undoubtedly, maturation status and relative age effect (RAE) play a significant role in a coach’s decision-making process. Full article

Background: Agility is crucial in game sports, requiring both motor and cognitive skills. Athletes must perceive and process information to adapt movements, yet traditional agility tests often lack cognitive and multidirectional demands. Additionally, modern test systems are mostly stationary. This study evaluated the novel and portable “Functional Agility Square Test” (FAST) for validity, reliability, and usefulness. Methods: To assess discriminant validity, 22 game sports (GS) and 22 non-game sports (NGS) athletes participated in one session. Test–retest reliability was examined with 36 GS athletes (20 female) across three sessions. Participants performed cognitive (FAST_COG), preplanned (FAST_MOT), and randomized (FAST_SAT) reactive change-of-direction tasks, each repeated three times per session. Results: Results showed significantly lower response times (RTs) in GS compared to NGS (p < 0.05). Mean RTs indicated moderate relative reliability (ICC 0.50–0.74), while medians showed moderate to good reliability (ICC 0.59–0.83). Usefulness was evident from the first session (FAST_MOT) or from the third session (FAST_SAT) based on median RTs. Conclusions: Thus, the FAST seems to be valid, reliable, and sensitive for GS-based agility assessment. Its portable setup enables ecologically valid field testing. Future research should further increase task complexity to better simulate game conditions. Full article

Background: In para-sports, like Cerebral Palsy (CP) Football, athletes must meet a minimum impairment level to ensure fair competition. The classification process traditionally relies on subjective tools like the modified Ashworth Scale, but there is a need for more objective methods. Surface electromyography (EMG) offers quantifiable data on muscle activation, which could enhance the accuracy and fairness of classification in this sport. Objective: The aim of this study is to analyze muscle activation patterns in international CP football players compared to healthy controls, using surface electromyography (EMG). Methods: A cross-sectional, observational case–control study (following STROBE guidelines) was carried out. The final sample consisted of 40 subjects (20 subjects with CP from the Spanish National Team and 20 semi-professional able-bodied football players). The muscle activation of the soleus, adductor magnus, and biceps femoris was evaluated at baseline and in maximum isometric contraction in both dominant/unaffected and non-dominant/affected lower limbs. Results: The main result of this study was that the affected lower limbs of the experimental group showed higher muscle activation at baseline compared to those of the control group (p < 0.001). On the other hand, when a maximum isometric contraction was requested, muscle activation was greater in the control group in both lower limbs. There was greater asymmetry between both muscle groups in the experimental group. Conclusions: Surface electromyography could be a useful tool to be used in the assessment of muscle activity in subjects with CP with an applicability in para-sport, making it possible to obtain differences between both hemispheres when there is upper motor neuron involvement. Full article

Older individuals with hip osteoarthritis (OA) who have difficulty walking, climbing stairs, or performing daily tasks often find non-weight-bearing (NWB) exercises essential for rebuilding strength and preserving function without further stressing the joints. In addition, those with a higher body mass index (BMI) particularly benefit from NWB therapy, as it alleviates joint pressure while facilitating safe and effective rehabilitation. Thus, NWB interventions, such as manual therapy (MT) and aquatic therapy (AT), are especially critical for older adults aged 60 and above, offering pain relief and functional improvement by minimizing gravitational impact on the hip joint. This review examines the effectiveness of these approaches in managing hip OA symptoms and decreasing pain. The inclusion criteria for the study consisted of randomized controlled trials or controlled trials focused on adult patients with primary osteoarthritis of the hip joint, utilizing interventions such as MT (including thrust joint mobilizations, non-thrust/oscillatory mobilizations, and soft tissue mobilization) or AT (including hydrotherapy and water therapy), and assessing outcomes related to pain. We selected nine studies that included a total of n = 1037 individuals. It evaluated outcomes such as self-reported pain levels using measures like the Western Ontario and McMaster Universities Osteoarthritis (WOMAC), Numeric Rating Scale (NRS), and Visual Analog Scale (VAS). Beyond statistical differences, both therapies were evaluated for Minimal Clinically Important Difference (MCID). While MT studies indicated a decrease in pain according to pain index scores, they showed short-term effectiveness till five weeks but lacked sustained clinical efficacy beyond this period. AT showed positive results within a ten-week period, although its effectiveness seemed to level off beyond this duration, falling below the threshold of clinical efficiency. After 10 weeks of treatment, there is no discernible clinical benefit in terms of pain reduction. Both interventions without gravitational impact seem suitable for providing short-term pain relief for primary hip osteoarthritis patients, but long-term pain relief—meaning after ten weeks—should be maintained through therapeutic exercise and patient education. Full article

Background/Objectives: Ataxia is quite common in pediatric neuromotor disorders and has a highly heterogeneous etiology. Mobility difficulties and functional limitations reflect the lack of coordination in this population. The aim of this study is to assess the effectiveness of an intensive program of Functional Partial Body Weight Support Treadmill Training (FPBWSTT) on the mobility and functionality of children with ataxia. Methods: Through a stratified randomized control trial, a sample of 18 children with progressive and non-progressive ataxia and GMFCS II-IV (mean age: 14 years; standard deviation: 2.5) was assessed prior to the intervention, post-intervention, and 2 months after its end. Motor and functional skills were assessed with the Gross Motor Function Measure (GMFM, items D-E), the Pediatric Balance Scale (PBS), a 10 m walk test (10 MWT), a 6 min walk test (6 MWT), the Scale for Assessment and Rating Ataxia (SARA), the TimedUp and Go (TUG) test, spatiotemporal gait parameters, and kinetic and kinematic variables of the pelvis and lower limb. Results: Statistically significant interactions and changes in favor of the FPBWSTT were found in all functional assessments and spatiotemporal gait parameters (p < 0.05), the majority of which were maintained for two months. There was no statistical interaction or change in kinematic parameters (p > 0.05), while kinetic variables were insufficiently collected and were not statistically analyzed. Conclusions: The FPBWSTT is more effective on the mobility and functionality of children with ataxia who are 8–18 years old, compared to typical physiotherapy. Kinematic variables may not be sensitive indicators of change over a short period of time and/or in this population. Full article