Search Results (4,009)

Purpose: Despite significant attention being paid to compression garments (CG) in the sports field, there remains ongoing debate regarding their actual effectiveness in enhancing athletic performance and expediting post-exercise recovery. This article examines their various aspects, with a focus on CG design and the materials they are made of, aiming to analyze the importance of personalized compression strategies based on individual anthropometric measurements and non-linear compression designs. Methods: Using anthropometric analysis of 40 healthy participants, this study examines the morphological characteristics of the lower limb and their implications for CG design. Results: Measurements of limb length and circumferences revealed complex interactions among anatomical variables, emphasizing the need for customized and adaptable device design. Finite element simulations clarified the challenges in achieving uniform pressure gradients along the lower limb, highlighting the limitations of one-piece devices and suggesting tailored segmented designs for individual limb segments. Conclusion: The results demonstrate that one-piece devices often fail to provide optimal compression due to non-linear variations in limb dimensions. Conversely, segmented devices, particularly those with bilinear progression, exhibited superior performance in applying targeted compression across different limb segments. This more detailed approach to customization could significantly contribute to optimizing outcomes and user comfort. Full article

Objective: The aim of this study was to examine how transcranial electrical stimulation (tES) modulates intermuscular coherence (IMC) in sprinters and develop an interpretable neural network model for performance prediction. Methods: Thirty elite sprinters completed a randomized crossover trial involving three tES conditions: motor cortex stimulation (C1/C2), prefrontal stimulation (F3), and sham. Sprint performance metrics (0–100 m phase analysis) and lower-limb sEMG signals were collected. A Kolmogorov–Arnold Network (KAN) was trained to decode neuromuscular coordination–sprint performance relationships using IMC and time–frequency sEMG features. Results: Motor cortex tDCS increased 30–60 m sprint velocity by 2.2% versus sham (p < 0.05, η² = 0.25). γ-band IMC in key muscle pairs (rectus femoris–biceps femoris, tibialis anterior–gastrocnemius) significantly heightened under motor cortex stimulation (F > 4.2, p < 0.03). The KAN model achieved high predictive accuracy (R² = 0.83) through cross-validation, with derived symbolic equations mapping neuromuscular features to performance. Conclusions: Targeted tDCS enhances neuromuscular coordination and sprint velocity, while KAN provides a transparent framework for performance modeling in elite sports. Full article

Conventional upper limb rehabilitation methods often encounter significant obstacles, including high costs, limited accessibility, and reduced patient adherence. Emerging technological solutions, such as telerehabilitation, virtual reality (VR), and wearable sensor-based systems, address some of these challenges but still face issues concerning supervision quality, affordability, and usability. To overcome these limitations, this study presents an innovative and cost-effective rehabilitation system based on advanced computer vision techniques and artificial intelligence (AI). Developed using Python (3.11.5), the proposed system utilizes a standard webcam in conjunction with robust pose estimation algorithms to provide real-time analysis of patient movements during guided upper limb exercises. Instructional exercise videos featuring an NAO robot facilitate patient engagement and consistency in practice. The system generates instant quantitative feedback on movement precision, repetition accuracy, and exercise phase completion. The core advantages of the proposed approach include minimal equipment requirements, affordability, ease of setup, and enhanced interactive guidance compared to traditional telerehabilitation methods. By reducing the complexity and expense associated with many VR and wearable-sensor solutions, while acknowledging that some lower-cost and haptic-enabled VR options exist, this single-webcam approach aims to broaden access to guided home rehabilitation without specialized hardware. Full article

Recurrent erysipelas is a common and clinically significant condition that poses challenges for both patients and healthcare systems. Each episode may damage lymphatic vessels, leading to chronic lymphedema, which perpetuates the risk of further relapses. Recurrence rates remain high, ranging from 11% in outpatients during the first year to up to 46% of hospitalized patients within three years. The lower limbs are the most frequent site, although recurrences may also occur in other regions, such as the upper limb after mastectomy with lymph node dissection. This review summarizes current knowledge on risk factors, preventive measures, and chemoprophylaxis in recurrent erysipelas. Modifiable risk factors such as obesity, diabetes, venous insufficiency, tinea pedis, and poor hygiene play an important role, while non-modifiable factors include age, sex, and a history of prior episodes. Non-pharmacological strategies—weight reduction, glycemic control, smoking cessation, compression therapy, and meticulous skin care—form the cornerstone of prevention and may reduce the need for long-term antibiotics. Antibiotic prophylaxis, most commonly with oral penicillin V or intramuscular benzathine penicillin, has been shown to lower recurrence rates. However, efficacy may be reduced in patients with chronic edema or severe obesity. Macrolides serve as alternatives in penicillin-allergic patients, but concerns remain about resistance, adverse effects, and drug–drug interactions. In conclusion, recurrent erysipelas requires a multifaceted approach. While antibiotic prophylaxis is effective, its long-term success depends on simultaneous management of underlying conditions. Further studies are needed to define optimal regimens, treatment duration, and non-antibiotic alternatives. Full article

This paper presents the foot design for humanoid robot Mithra, with the goal of biomimetically improving impact behavior, natural power cycling throughout the gait cycle, and balance. For this purpose, an optimization framework was built which evaluates the human-inspired objectives using a dynamic finite element analysis validated by benchtop experiments. Using this framework and through several concept design iterations, a low-cost, compliant foot was optimized, designed, and fabricated. The analyses showed that the optimized foot significantly outperformed the baseline rigid foot in approaching the characteristics of human feet. The proposed framework is not limited to humanoids and can also be applied to the foot design for lower-limb prostheses and exoskeletons. Full article

Background: Postural control in healthy young adults involves complex neuromuscular processes; however, the kinematic and kinetic consequences of small, forward leg perturbations in a defined population are not fully described. This study aimed to characterize the kinematic and kinetic consequences of forward leg perturbations during quiet standing. Methods: This investigation used a quasi-experimental repeated-measures design. Sixteen healthy young women (20.1 ± 0.7 years), all right-leg dominant, were tested using the Gait Real-Time Analysis Interactive Laboratory (GRAIL) system. Forward treadmill perturbations were applied to each limb during quiet standing, and joint angles, ground reaction forces, and torques were measured across baseline, perturbation, and response phases. As the data were non-normally distributed, paired comparisons were conducted using the Wilcoxon test, with significance set at p < 0.05 (Bonferroni corrected) and effect sizes (r) reported. Results: Joint angles remained symmetrical between limbs (no significant differences after correction). In contrast, kinetic measures showed clear asymmetries: at baseline, the dominant limb produced greater knee torque (p = 0.0003, r = 0.73), ankle torque (p = 0.0003, r = 0.76), and medio-lateral GRF (p = 0.0003, r = 0.87). During perturbation, it again generated higher knee (p = 0.0036, r = 0.43) and ankle torques (p = 0.0003, r = 0.53), with larger medio-lateral GRF (p = 0.0003, r = 0.87). In the response phase, the dominant limb showed greater hip torque (p = 0.0033, r = 0.43) and a small dorsiflexion shift at the ankle (p = 0.0066, r = 0.41). Anterior–posterior GRF changes were minor and non-significant after correction. Conclusions: Induced forward leg movements caused limb-specific kinetic adjustments while maintaining overall kinematic symmetry. The dominant leg contributed more actively to balance recovery, highlighting its role in stabilizing posture under small perturbations. These findings are specific to the studied demographic and should not be generalized to males, older adults, left-dominant individuals, or clinical populations without further research. Full article

Introduction: Nowadays, there is evidence regarding a beneficial effect of heat on neuromuscular strength and muscle hypertrophy development. The aim of this study is to evaluate the effects of a 4-week passive sauna bathing program to extreme heat (100 ± 2 °C) as a support for a resistance strength training program on maximal strength and body composition. Methods: 30 young male subjects participated in the study. They were randomly assigned to a Hyperthermia group (HG, n = 14; age: 20.48 (19.12–22–30) years; weight: 76.30 (71.00–79.00) Kg; BMI: 23.92 (22.93–24.87) Kg/m²), or to a Normothermia group (NG, n = 15; age: 19.95 (19.10–21–94) years; weight: 61.70 (59.45–72.90) Kg; BMI: 21.56 (20.42–23.26) Kg/m²). All participants followed the same lower limb strength training program (2 exercises; 4 sets of 10 repetitions at 75% 1RM with progressive loading). Additionally, HG underwent two weekly sessions of exposure to extreme heat in a sauna (100 ± 2 °C and 24 ± 1% relative humidity, four sets of 10 min, 2 days per week). The intervention lasted for 4 weeks, followed by a 4-week deconditioning period. Maximum isometric knee flexion-extension strength, maximum counter-resistance strength, as well as body composition and anthropometric variables were assessed. Results: The HG group significantly increased body weight (p < 0.05) and muscle mass (p < 0.05), while their sum of six skinfolds (Σ6 skinfolds) significantly decreased (p < 0.05). Both groups improved their 1RM squat performance following the intervention program (p < 0.05; HG: r = 0.86; NG: r = 0.89). However, only the HG group continued to improve their squat 1RM after the deconditioning period (p < 0.001; r = 0.93), as well as their leg press 1RM (p < 0.01; r = 0.94). Maximal isometric strength increased only in the NG group at the end of the training program, with a significant increase in knee flexion torque (p < 0.05; r = 0.76). In contrast, the HG group showed significant increases in isometric strength after the deconditioning period in both knee extension (p < 0.05; r = 0.76) and knee flexion (p < 0.05; r = 0.75). Conclusions: A four-week period of passive sauna bathing at extreme heat appears to alter the chronology of strength responses. It also seems to induce favorable responses in terms of strength development and body composition. Full article

The physical demands of overhead tasks can lead to musculoskeletal strain, particularly in scenarios requiring prolonged arm elevation such as in Chemical, Biological, Radiological, and Nuclear (CBRN) operations. To address this, an active shoulder exoskeleton was developed that is compatible with CBRN protective gear. The aim of this laboratory study was to assess the biomechanical and physiological effects of the system during upper limb tasks representative of real-world applications, without the use of protective suits. Twenty-two male participants performed two tasks with and without the exoskeleton: (1) 5 kg lifting task and (2) repetitive spraying tasks with a spray lance. Muscle activity of the m. anterior deltoid was measured using surface electromyography, while energy expenditure was assessed via spiroergometry. The exoskeleton significantly reduced muscular demands in the anterior deltoid, with a decrease of up to 40% during the spraying task and 29% percent during lifting task. Additionally, oxygen consumption per kilogram of body mass decreased by 6.5 to 8.2% across tasks. Participants reported lower fatigue and greater task manageability when using the exoskeleton, particularly for sustained and semi-static overhead postures. The results demonstrate that the exoskeleton effectively reduces workload during upper limb tasks. These findings support its application not only for soldiers in contaminated environments but also in industrial settings involving overhead work. Future research will need to validate these effects under realistic CBRN conditions to confirm operational compatibility. Full article

Background: Mobility assessment is a crucial aspect of rehabilitation for individuals with lower limb amputation, as it directly influences their independence and quality of life. The objective of this study was to translate and cross-culturally adapt the Special Interest Group in Amputee Medicine (SIGAM) mobility grades questionnaire in the Persian language and to investigate its psychometric properties. Methods: The SIGAM mobility scale was translated into Persian according to international guidelines for cross-cultural adaptation of self-reported measures and was administered to forty Persian-speaking people with lower limb amputations. Measurement properties were evaluated following COSMIN (COnsensus-based Standards for the Selection of Health Measurement INstruments) recommendations and included internal consistency, test–retest reliability, and hypotheses testing for construct validity by comparing SIGAM mobility grades to the Locomotor Capabilities Index-5 (LCI-5), Houghton scale, Activities-specific Balance Confidence (ABC) scale, the 2-Minute Walk Test (2-MWT), and the Timed Up and Go (TUG). Results: SIGAM mobility scale demonstrated acceptable internal consistency (Kuder-Richardson 20 coefficient = 0.72) and excellent test–retest reliability (Cohen Kappa coefficient = 0.85). Hypothesis testing for construct validity confirmed the good to very good correlations of the Persian SIGAM mobility scale with the LCI-5 (r = 0.63, 0.55, and 0.63 for the general, basic, and advanced activities components, respectively), Houghton scale (r = 0.63), ABC scale (r = 0.73), 2-MWT (r = 0.50), and TUG test (r = −0.51). Conclusion: The Persian version of the SIGAM mobility scale demonstrated preliminary evidence of acceptable psychometric properties, supporting its clinical applicability. Full article

Background: Lower limb malalignment is a hallmark of knee osteoarthritis, with surgical correction techniques evolving from traditional mechanical alignment (MA) to kinematic alignment (KA) approaches. Restrictive kinematic alignment (rKA) represents a hybrid strategy combining principles from both techniques. This study evaluated short-term functional outcomes following robotic-assisted total knee arthroplasty (RoTKA), comparing MA versus rKA alignment strategies. Methods: This prospective, randomized, single-center study enrolled 96 patients with grade 3–4 idiopathic knee osteoarthritis (Kellgren–Lawrence classification). Patients were randomized to MA (n = 49, mean age 67 ± 9 years) or rKA (n = 47, mean age 66 ± 7 years) groups. Preoperative hip–knee–ankle (HKA) angles were 172.6° ± 1.1° and 172.9° ± 0.9° for MA and rKA groups, respectively. Outcomes were assessed using Visual Analog Scale (VAS) pain scores, range of motion (ROM), Knee Society Score (KSS), Oxford Knee Score (OKS) (primary outcome), SF-36, and Forgotten Joint Score (FJS-12). Results: Postoperative HKA angles were 179.5° ± 1.2° (MA) and 176.0° ± 1.5° (rKA). At 14 days postoperatively, knee ROM increased by 20.5% in the MA group and 25.7% in the rKA group, with a statistically significant 5.2% intergroup difference, indicating faster postoperative recovery (p = 0.008). VAS pain scores decreased by 7% in the rKA group while increasing by 13% in the MA group (p < 0.001). At one-year follow-up, FJS-12 scores were significantly higher in the rKA group (94.8 ± 3.2 vs. 91.9 ± 2.2, p < 0.001). No significant differences were observed in KSS, OKS, or SF-36 score between groups. Conclusions: Restrictive kinematic alignment demonstrated superior early postoperative outcomes compared to mechanical alignment in RoTKA, with significantly reduced pain and improved ROM. While one-year functional outcomes were comparable between techniques, rKA may offer advantages in the immediate postoperative period, supporting its consideration as a viable alignment strategy in robotic-assisted knee arthroplasty. Full article

Background: Vascular calcification has been highlighted as a prognostic factor for perioperative thrombosis but a protective factor for late restenosis in lower limb peripheral artery disease (LLPAD). The aim of this study was to investigate the association between calcification and twelve-month primary patency in patients with stenting of the common femoral artery (CFA) and its bifurcation for atheromatous stenosis. Materials/Methods: This single-center retrospective study analyzed consecutive limbs (n = 90) that underwent CFA stenting for symptomatic lesions between January 2018 and January 2023. Calcification was assessed using dedicated computed tomography angiography analysis software (EndoSize; Therenva), with blinded evaluation of volume (mm³) and density (Hounsfield Units) across three anatomically distinct zones: proximal CFA (Zone 1); distal CFA (Zone 2); and bifurcation segments (Zone 3). The primary endpoint was twelve-month primary patency, defined as a peak systolic velocity ratio (PSVR) < 2.4 on duplex ultrasound without target lesion revascularization. Secondary endpoints included predictors of restenosis using multivariable logistic regression. Results: Ninety cases of CFA stenting for LLPAD (lower limb peripheral artery disease) were analyzed. A total of 78.9% of CFA lesions were treated for claudication and 21.1% for critical limb-threatening ischemia (CLTI). Lesions were distributed as Azema types I (1%), II (43%), and III (56%). At twelve-month follow-up, primary patency (PSVR < 2.4) was achieved in 77.4% of limbs. Patent CFA stenting demonstrated significantly higher median calcification density in Zone 2 compared to those with restenosis (1122 [IQR: 903–1248] vs. 858 [788–987] HU; p = 0.006; q = 0.021 after false discovery rate correction). ROC curve analysis identified a density threshold of 800 HU with a 76% reduction in restenosis risk (OR 0.24; 95% CI: 0.08–0.72; p = 0.011). Bootstrap validation (1000 replications) confirmed threshold stability at 821 HU (95% CI: 656–990 HU). Conclusions: In this exploratory study, dense calcification (≥800 HU) in the distal CFA appears to be protective against twelve-month restenosis following stenting. These findings suggest that calcification density may serve as a valuable predictor for patient selection and procedural planning in CFA interventions. Full article

(1) Background: The global increase in life expectancy has generated growing interest in strategies that support functional independence and quality of life among older adults. Functional fitness—including strength, mobility, flexibility, and aerobic endurance—is essential for preserving autonomy during aging. In this context, physical exercise, particularly High-Intensity Interval Training (HIIT), has gained attention for its time efficiency and physiological benefits. This randomized controlled trial aimed to evaluate the effects of a group-based HIIT program on functional fitness in older adults; (2) Methods: Functional outcomes were assessed before, during, and after a 65-week intervention using standardized field tests, including measures of upper and lower body strength, flexibility, aerobic endurance, and agility. This study was prospectively registered at ClinicalTrials.gov (NCT07170579); (3) Results: Significant improvements were observed in the HIIT group across multiple domains of functional fitness compared to the control group, notably in upper body strength, lower limb flexibility, cardiorespiratory endurance, and mobility; (4) Conclusions: These results suggest that HIIT is an effective and adaptable strategy for improving functional fitness in older adults, with the potential to enhance performance in daily activities and support healthy aging in community settings. Full article

Aim: This study analyzed the concurrent validity of the Optojump infrared photocell system for estimating lower limb peak power by comparing it with the 15 s Wingate anaerobic test (WAnT) and examining relationships with sprint performance indicators. Methods: Twelve physically active university students (ten males, two females; age: 23.39 ± 1.47 years; body mass: 73.08 ± 9.19 kg; height: 173.67 ± 6.97 cm; BMI: 24.17 ± 1.48 kg·m⁻²) completed a cross-sectional validation protocol. Participants performed WAnT on a calibrated Monark ergometer (7.5% body weight for males, 5.5% for females), 30 s continuous jump tests using the Optojump system (Microgate, Italy), and 30 m sprint assessments with 10 m and 20 m split times. Peak power was expressed in absolute (W), relative (W·kg⁻¹), and allometric (W·kg^−0.67) terms. Results: Thirty-second continuous jump testing produced systematically higher peak power values across all metrics (p < 0.001). Mean differences indicated large effect sizes: relative power (Cohen’s d = 0.99; 18.263 ± 4.243 vs. 10.99 ± 1.58 W·kg⁻¹), absolute power (d = 0.86; 1381.71 ± 393.44 vs. 807.28 ± 175.45 W), and allometric power (d = 0.79). Strong correlations emerged between protocols, with absolute power showing the strongest association (r = 0.842, p < 0.001). Linear regression analysis revealed that 30 s continuous jump-derived measurements explained 71% of the variance in Wingate outcomes (R² = 0.710, p < 0.001). Sprint performance showed equivalent predictive capacity for both tests (Wingate: R² = 0.66; 30 s continuous jump: R² = 0.67). Conclusions: The Optojump infrared photocell system provides a valid and practical alternative to laboratory-based ergometry for assessing lower limb anaerobic power. While it systematically overestimates absolute values compared with the Wingate anaerobic test, its strong concurrent validity (r > 0.80), large effect sizes, and equivalent predictive ability for sprint performance (R² = 0.66–0.71) confirm its reliability as a field-based assessment tool. These findings underscore the importance of sport-specific, weight-bearing assessment technologies in modern sports biomechanics, providing coaches, practitioners, and clinicians with a feasible method for monitoring performance, talent identification, and training optimization. The results further suggest that Optojump-based protocols can bridge the gap between laboratory precision and ecological validity, supporting both athletic performance enhancement and injury prevention strategies. Full article

Background and Clinical Significance: Thoracic dorsal arachnoid web (DAW) is a rare intradural extramedullary condition characterized by a thin band of arachnoid tissue compressing the dorsal spinal cord. A hallmark imaging feature is the “scalpel sign”, which refers to anterior displacement of the thoracic spinal cord with dorsal cerebrospinal fluid (CSF) accumulation, producing a sagittal profile resembling a surgical scalpel. Although highly specific for DAW, this sign may also appear in other intradural conditions such as idiopathic ventral spinal cord herniation and arachnoid cysts. The clinical presentation is typically progressive and nonspecific, including lower limb weakness, sensory changes, gait disturbances, and, less frequently, sphincter dysfunction. Diagnosis is often delayed due to the subtle nature of the lesion and limited resolution of conventional Magnetic Resonance Imaging (MRI). High-resolution Three-Dimensional Constructive Interference in Steady State (3D-CISS) sequences improve diagnostic accuracy by highlighting indirect signs such as spinal cord deformation and dorsal CSF flow obstruction. Case Presentation: We report the case of a 57-year-old woman presenting with chronic cervico-dorsalgia, bilateral lower limb weakness, paresthesia, and progressive gait instability. Neurological examination revealed spastic paraparesis and hyperreflexia. Conventional MRI was inconclusive. However, sagittal T2-weighted and 3D-CISS sequences demonstrated the scalpel sign at the T4–T5 level, with anterior cord displacement and dorsal subarachnoid space enlargement. Surgical exploration confirmed the presence of a dorsal arachnoid web, which was resected. Postoperative follow-up showed clear improvement in motor function and gait. Conclusions: DAW should be considered in cases of unexplained thoracic myelopathy or cervico-dorsalgia with neurological signs. Early recognition of the scalpel sign using advanced MRI sequences is critical for timely diagnosis and surgical planning, which may lead to significant clinical improvement. Full article

In this paper, the evaluation of the mechanical performance of novel, designed topologically optimized shin pads with advanced materials will be conducted with the aid of Finite Element Analysis (FEA) to assess the endurance of the final structure on impact phenomena extracted from actual real-life data acquired from contact sports. The main focus of the developed prototype is to have high-enough energy absorption capabilities and vibration isolation properties, crucial for the development of trustworthy protective equipment. The insertion of advanced materials with controlled weight fractions and lattice geometries aims to strategically improve those properties and provide tailored characteristics similar to the actual human skeleton. The final design is expected to be used as standalone protective equipment for athletes or as a protective shield for the development of human lower limb prosthetics. In this context, computational investigation of the dynamic mechanical response was conducted by replicating a real-life phenomenon of the impact during a contact sport in a median condition of a stud kick impact and an extreme case scenario to assess the dynamic response under shock-absorption conditions and the final design’s structural integrity by taking into consideration the injury prevention capabilities. The results demonstrate that the proposed lattice geometries positively influence the injury prevention capabilities by converting a severe injury to light one, especially in the gyroid structure where the prototype presented a unified pattern of stress distribution and a higher reduction in the transmitted force. The incorporation of the PA-12 matrix reinforced with the reused ground tire rubber results in a structure with high enough overall strength and crucial modifications on the absorption and damping capabilities vital for the integrity under dynamic conditions. Full article