OBJECTIVE:Stair ascent, as a routine yet complex daily activity, imposes greater motor demands on older adults and is associated with an increased fall risk. Aging leads to gait adaptive changes; however, the gait adaptive changes during stair ascent across young adults, middle-aged adults, and older adults remain unclear. METHODS:This study employed a cross-sectional design and ultimately enrolled 36 healthy young adults, 36 middle-aged adults, and 36 older adults, with the oldest participants under 75 years of age. A three-dimensional motion analysis system combined with a surface electromyography system was used to collect gait data during stair ascent in all three groups, and differences in dynamic stability, joint coordination, and lower extremity muscle activation among the groups were further analyzed. RESULTS:Dynamic stability in the mediolateral direction during stair ascent was significantly lower in older adults than in young adults and middle-aged adults, and that trunk-pelvis transverse plane variability was significantly lower in older adults than in young adults. Regarding coordination modes, compared with young adults, middle-aged and older adults overall exhibited increased in-phase mode, decreased anti-phase mode, with lower-limb inter-joint coordination shifting toward greater proximal dominance and reduced distal dominance. Regarding muscle activation levels, older adults exhibited significantly higher activation of the medial gastrocnemius, biceps femoris, gluteus maximus, gluteus medius, and tibialis anterior than young and/or middle-aged adults. CONCLUSION:These findings indicate that aging induces changes in coordination modes during stair ascent in middle-aged and older adults, and that the effects of aging on dynamic stability, coordination variability, and muscle function are more pronounced in older adults. This study was limited by its age range and cross-sectional design; therefore, the generalizability of the results to older adults of advanced age and their relationship with fall risk require further verification.

Stair negotiation is a critical activity for evaluating and maintaining an individual's functional independence. Because of its complex movement patterns, which place high demands on lower extremity joint kinematics, muscle strength, and balance control, it serves as a highly sensitive indicator in rehabilitation assessment. However, there is currently a lack of efficient methods for collecting biomechanical data during stair negotiation, as well as scientific and standardized evaluation procedures. Establishing a biomechanical evaluation specification can effectively support the quantitative collection, processing, and analysis of this movement data. A unified standard facilitates the integration and sharing of multi-center data, more accurately revealing the correlations between biomechanical parameters and motor dysfunction. This, in turn, enhances the precision and effectiveness of rehabilitation assessments and training programs. To this end, this specification defines the terminology, facilities and equipment, physical testing environment, experimental procedures, test reports, primary outcome measures, personnel requirements, and precautions for the biomechanical testing of stair negotiation. It is applicable to various populations capable of independently completing stair negotiation tasks and can be utilized for biomechanical data collection and functional evaluation in rehabilitation, offering high feasibility and safety.

This study aimed to explore the cardiopulmonary function, physical activity, and activation of major lower-limb muscles in individuals with knee osteoarthritis (OA) with increased cardiovascular disease (CVD) risk. A total of 21 individuals with knee OA and increased CVD risk and 29 individuals with isolated knee OA completed the long-form International Physical Activity Questionnaire (IPAQ) in an interview format. Pulmonary function was assessed by measuring Forced Vital Capacity (FVC) and Maximum Voluntary Ventilation (MVV). Cardiorespiratory fitness was evaluated using a treadmill-based cardiopulmonary exercise test (CPET) with a modified Bruce protocol. Furthermore, surface electromyography (sEMG) data were collected from the major lower-limb muscles of the symptomatic limb during stair-climbing tasks performed at a self-selected, habitual speed. Compared with the knee OA group, the knee OA with CVD risk group demonstrated significant reductions in vigorous physical activity, maximal voluntary ventilation (MVV), and a lesser decrease in peak oxygen uptake. Additionally, the knee OA with increased CVD group showed greater muscle activation of the biceps femoris (BF) during stair ascent and descent. Furthermore, there was a negative relationship observed between lower MVV and greater BF activation in the knee OA with the CVD risk group. These findings suggest two main conclusions. First, sEMG serves as a valuable non-invasive tool for identifying clinical hallmarks in knee OA patients at risk of CVD by detecting aberrant muscle activation during stair climbing. Second, among these at-risk individuals, superior cardiovascular function is linked to a more balanced knee muscle coordination pattern, as reflected by the inverse relationship between MVV and biceps femoris activation.

Background This study aimed to examine the differences in core muscle morphometry and contraction changes between postpartum individuals with and without pelvic girdle pain (PGP). Understanding the observed changes in muscle thickness and contraction characteristics is crucial for tailoring effective core muscle rehabilitation strategies that promote optimal postpartum recovery. Methods A cross-sectional study was conducted involving 150 postpartum women with PGP and 50 asymptomatic individuals as matched controls. Real-time musculoskeletal ultrasound was used to measure core muscle morphometry and assess changes in muscle thickness and percentage change during various tasks. Results Compared with asymptomatic women, individuals with PGP exhibited substantially reduced diaphragm excursion and thinner muscle thickness of the transverse abdominal muscle (TrA) during active straight leg raise (ASLR) tests with abdominal muscle contractions (P < 0.05). The TrA respiratory contraction rate and preferential activation ratio during abdominal breathing were also lower in the PGP group (PGP = 0.46 (0.13 to 1.41); asymptomatic women = 0.98 (0.05 to 2.05), P = 0.01). In addition, postpartum women with PGP showed increased activation of the internal oblique muscle during ASLR tests with abdominal muscle contractions compared to controls (PGP: 47%; asymptomatic women: 45%, P < 0.05). Furthermore, the bilateral lumbar multifidus muscle was smaller and thinner on the right side in the PGP group than the asymptomatic group (P < 0.001). Conclusion Postpartum women with PGP exhibited thinner muscle thickness on core muscle morphometry and less muscle change during abdominal breathing and the ASLR test.

Knee osteoarthritis (OA) alters lower-extremity kinematics during stair ascent, but interjoint coordination changes remain unclear. Improving coordination and balance is also a critical target for knee OA rehabilitation. This study compared lower-extremity interjoint coordination during stair ascent between 69 knee OA individuals and 30 age-matched healthy older adults. Knee OA participants were randomized into Tai Chi or control (balance and postural training) groups, receiving 12-week interventions. 3D motion analysis assessed interjoint coordination via perimeter, area, and coordination coefficient of cyclogram at baseline and postintervention. Compared with healthy elderly, individuals with knee OA exhibited greater sagittal plane joint excursions, increased hip-knee angular range, and less smooth cyclograms. Postintervention, both groups exhibited reduced excursions in the sagittal and frontal planes, with greater reductions observed in the control group. The Tai Chi group showed decreased hip-ankle and knee-ankle angular ranges, whereas the control group displayed reduced hip-knee ranges, both shifting coordination parameters toward healthy levels. Only the sagittal plane hip-knee cyclogram area differed significantly between interventions, being smaller in the balance group. Knee OA impairs stair ascent coordination in elderly. Both interventions enhance coordination, but Tai Chi's benefits are predominantly sagittal specific, whereas balance training improves both planes and demonstrates superior efficacy in improving hip-knee flexion-extension coordination.

ObjectiveThe aim of this study was to compare the therapeutic efficacy of integrating virtual reality technology with conventional pelvic floor rehabilitation therapy versus conventional therapy alone in postpartum women with myofascial pelvic pain syndrome.MethodsFifty-seven postpartum women diagnosed with myofascial pelvic pain syndrome were recruited for this study between March 1, 2023, and December 29, 2023. All participants were randomly assigned to two groups. The experimental group (n = 27) underwent virtual reality training combined with conventional pelvic floor rehabilitation therapy, while the control group (n = 30) received only conventional pelvic floor rehabilitation therapy. Both groups completed ten treatment sessions. Changes in pelvic floor muscle contraction function were assessed using pelvic floor surface electromyography. Musculoskeletal ultrasound was employed to measure muscle thickness and Young's modulus of the pelvic floor muscles. The Visual Analog Scale was used to evaluate the degree of pain experienced during palpation of the pelvic floor muscles.ResultsThe experimental group demonstrated a significant reduction in relaxation time during the fast muscle contraction stage of the pelvic floor muscle's Glazer S-EMG (P < 0.05). No statistically significant differences were observed in the Visual Analog Scale, pelvic floor muscle thickness, or Young's modulus of the pelvic floor muscle during resting and maximum contraction states (P > 0.05).ConclusionThe integration of virtual reality technology with conventional pelvic floor rehabilitation therapy has the potential to improve the relaxation capacity of fast-twitch muscle fibers within the pelvic floor muscles. However, it does not seem to offer any benefits in increasing pelvic floor muscle thickness or in alleviating myofascial pelvic pain.Trial registryThe registry and the registration number: Chinese Clinical Trial Registry (number ChiCTR2300069517).

PurposePostural control and respiration are closely integrated processes vital for stability in older adults. Although Tai Chi emphasizes coordinated breath and movement, quantitative evidence comparing neuromuscular and biomechanical adaptations between long-term and beginner practitioners remains limited. This study systematically examined differences in breathing regulation and postural control during Tai Chi movements across the two groups.MethodsA three-dimensional motion analysis system synchronized with force plates and surface electromyography was employed. Lower-limb kinematics, kinetics, muscle activity, and thoracoabdominal motion were assessed during four classical Tai Chi movements in 21 long-term and 21 beginner practitioners. Primary outcomes included respiratory parameters, joint range of motion (ROM), center of pressure (COP) displacement, and cross-correlation between respiratory volume and center of mass (COM) trajectory.ResultsCompared with beginners, long-term practitioners exhibited slower, deeper breathing, greater lower-limb joint ROM, particularly in the sagittal and frontal planes, and larger anteroposterior COP displacement during single-leg stance (Kick with Heel). During Wild Horse's Mane, they showed significantly lower cross-correlation between breathing and COM displacement, indicating task-specific decoupling between respiration and posture.ConclusionLong-term Tai Chi practice enhances motor control through optimized diaphragmatic breathing, improved joint flexibility, and adaptive coordination between respiration and posture. These findings provide systematic biomechanical and physiological evidence for the mechanisms by which Tai Chi may improve postural control and respiratory function.

OBJECTIVES:This study evaluates the efficacy of Tai Chi versus balance training on functional performance and postural control during sit and stand transitions in individuals with knee osteoarthritis. DESIGN:Single-blind randomized trial. METHODS:Sixty-nine patients with knee osteoarthritis were assigned to Tai Chi (n = 35) or balance training (n = 34) for 12 weeks. Assessments were conducted pre- and post-intervention. A motion analysis system and force plates were used to measure center of mass displacement and velocity, trunk flexion angle, knee extension moment, and movement duration during sit and stand transitions. Symptoms and function were assessed by the Knee Injury and Osteoarthritis Outcome Score. RESULTS:Twenty-four participants in the Tai Chi group and 28 participants in the Balance group completed the trial. The main effects of time showed significant reductions in movement duration, trunk flexion angle, and anterior-posterior center of mass displacement during sit and stand transitions in both groups (p ≤ 0.014). Both groups showed significant reduced peak backward center of mass velocity and increased peak downward center of mass velocity during stand-to-sit after training (p ≤ 0.021). Furthermore, Knee Injury and Osteoarthritis Outcome Score indicated significant improvements in symptoms and function in both groups (p ≤ 0.002). CONCLUSIONS:Tai Chi and balance training are both effective exercise therapies for improving symptoms, functional performance and postural control during sit-to-stand and stand-to-sit transitions in individuals with knee osteoarthritis. These interventions may serve as viable alternative therapies for managing symptoms and enhancing function in individuals with knee osteoarthritis. REGISTRATION:ChiCTR1800018028.

BACKGROUND AND PURPOSE:To compare the effects of Tai Chi and balance and postural control training on spatiotemporal parameters and dual-task costs during stair negotiation in knee osteoarthritis participants. METHODS:Sixty-nine knee osteoarthritis participants were randomly assigned to either the Tai Chi group or the balance and postural control training group. All participants underwent interventions twice a week for 12 weeks. Pain scores, spatiotemporal parameters and dual-task costs during stair ascent and descent were measured before and after the intervention. RESULTS:Both groups reported significant reductions in pain and improvements in spatiotemporal parameters following the intervention. The Tai Chi group exhibited a significantly greater reduction in initial double stance time during stair descent compared with the balance and posture control training group under both single-task (F = 8.177, p = 0.006, η2 = 0.143) and dual-task (F = 5.007, p = 0.03, η2 = 0.093) conditions. Meanwhile, the balance and posture control training group showed significant reductions in the dual-task cost values of cadence (p = 0.003) and speed (p = 0.038), although no significant between-group differences were observed. DISCUSSION:Both Tai Chi and balance and postural control training alleviated pain and improved spatiotemporal parameters during stair negotiation in participants with knee osteoarthritis. However, improvements in dual-task cost of cadence and speed were limited, potentially due to insufficient intervention or gait strategy adaptations. Only the balance and postural control group showed a significant reduction in dual-task cost during stair descent, indicating its advantage in maintaining stability under cognitive load. TRIAL REGISTRATION:ChiCTR1800018028.

ObjectiveLumbo-pelvic-hip complex muscle training is considered a crucial component of exercise rehabilitation for postpartum women with pelvic girdle pain (PGP). However, there is a paucity of research evidence regarding the morphological changes and contraction function of these muscles in postpartum women with PGP. Understanding the alterations in lumbo-pelvic-hip complex muscles function associated with PGP, is crucial for tailoring effective rehabilitation strategies and promoting optimal postpartum recovery. Therefore, this study aims to compare the differences in muscle thickness and contraction function of lumbo-pelvic-hip complex muscle between postpartum women with PGP and asymptomatic controls using ultrasound imaging.MethodsOne hundred and fifty postpartum women with PGP and fifty age-matched asymptomatic postpartum women were recruited in this study. Real-time musculoskeletal ultrasound was utilized to measure the resting muscle thickness of nine lumbo-pelvic-hip complex muscles, including the erector spinalis (ES), latissimus dorsi (LD), quadratus lumbalis (QL), gluteus maximus (GMax), gluteus medius (GMed), piriformis (PF), iliacus muscle (IM), rectus femoris (RF), and biceps femoris (BF). The thickness of the GMax, GMed, RF, and BF muscles were measured at maximum contraction to calculate a contraction: rest ratio.ResultsCompared to the asymptomatic women, those with PGP exhibited reduced resting thickness of the ES and GMax muscles bilaterally, as well as increased resting thickness of the right LD and IM muscles. Furthermore, the PGP group demonstrated decreased thickness of the left GMed and right RF muscles at maximum contraction. The contraction ratio was also diminished for the GMax muscles bilaterally, left GMed, and right RF in women with postpartum PGP. Conclusion: Postpartum women with PGP demonstrated reduced thickness, asymmetry, and diminished contractility of the lumbo-pelvic-hip complex muscles. Exercise prescriptions for postpartum women with PGP should incorporate targeted strengthening of the ES, GMax, GMed, and RF muscles.ConclusionPostpartum women with PGP demonstrated reduced thickness, asymmetry, and diminished contractility of the lumbo-pelvic-hip complex muscle. Exercise prescriptions for postpartum women with PGP should incorporate targeted strengthening of the ES, GMax, GMed, and RF muscles.

Background context: Physical activities such as walking and climbing stairs are pervasive in human daily life. Individuals with scoliosis frequently encounter dysfunction in their muscle recruitment. Multiple studies have corroborated the presence of muscle dysfunction in individuals diagnosed with scoliosis. However, there is currently a noteworthy research gap regarding the exploration of changes in muscle characteristics and disparities from those observed in individuals without scoliosis during everyday activities, specifically stair climbing. Purpose This study aims to examine the unique patterns of muscle activity during daily life in individuals with scoliosis and distinguish the specific differences between scoliosis patients and the healthy controls. The findings of this study are significantly important for the future accurate assessment of scoliosis and the development of rehabilitation treatment plans. Study design: Case-control study Sample size: 28 IS and 28 controls Outcome measures: Root Mean Square(RMS), Maximum Voluntary Isometric Contraction(MVIC)%, RMS ratio(RMS convex / RMS concave) Methods The surface electromyography (sEMG) device utilized in this study was the Delsys Trigno, which is manufactured in the USA. It has a sampling frequency of 1500Hz. It recorded the activation level, peak contraction, and average activation level of the erector spinae (at T6, T10, and L3 levels), gluteus maximus, gluteus medius, external oblique, and rectus abdominis muscles during three different types of locomotion for both the 28 individuals with IS and the 28 control participants. Results The movement patterns of the IS patient significantly differ from those of the normal population during level walking and ascending or descending stairs. In level walking, there is an asymmetry in the activation levels of the T6 and L3 erector spinae muscles, with lower activation on the convex side compared to the concave side. Similarly, during stair ascent, the activation of the T6 and T10 erector spinae muscles is asymmetric, with higher activation on the convex side than the concave side. Moreover, during stair descent, the activation of the T6 erector spinae muscle is asymmetric, with higher activation on the convex side than the concave side. Conclusions During level walking and stair activities, IS patients exhibit pronounced abnormal movement patterns that significantly differ from those of the control group. Under different activity conditions such as level walking, ascending and descending stairs, IS patients demonstrate abnormal muscle activation in different segments of the spine. It is crucial for clinicians to prioritize the symmetry of muscle activation in the spinal region of IS patients and consider incorporating symmetry training for these muscles.

Objective:To observe the difference in postural stability and lower limb joint angle between patients with different severity of Knee Osteo-arthritis(KOA,low KOA kinesiophobia and high KOA kinesiophobia)and age-matched non-KOA symptomatic patients during stairs negotiation by using three-dimensional motion analysis system.Methods:Three-dimensional motion analysis system was used to detect the differences of biome-chanical factors such as postural stability(MoS)and joint angle among 78 patients with low KOA kinesiophobia,high KOA kinesiophobia and non-KOA symptoms during stairs negotiation.Results:The sagittal and coronal MoS of patients with low and high KOA kinesiophobia were worse than those of asymptomatic people.Compared with asymptomatic people,the maximum angle of hip flexion,maximum angle of hip adduction and range of knee flexion and extension in patients with low and high KOA kinesiophobia increased.Maximum angle of ankle dorsiflexion and maximum angle of knee flexion in patients with low KOA kinesiophobia decreased;the maximum angle of knee flexion decreased in patients with low KOA ki-nesiophobia.Compared with asymptomatic people,the maximum angle of hip flexion increased in low and high KOA kinesiophobia patients,the range of motion of ankle varus increased in low KOA kinesiophobia patients,and the maximum angle of hip adduction increased in high KOA kine-siophobia patients.Conclusion:The sagittal and coronal stability of KOA patients with low and high KOA is poor,but no significant effect of KOA patients is found.

BACKGROUND:The emergence of severe sepsis is contingent upon the occurrence of a cytokine storm (CS), a multifaceted process intricately entwined with the temporal dimension, thereby rendering the infection response remarkably intricate. Consequently, it becomes imperative to discern and accurately identify the optimal timing for interventions, predicated upon the dynamic timeline of inflammatory changes. Moreover, the administration of exogenous low-dose pro-inflammatory agents has exhibited the potential to impede the relentless progression of the inflammatory cascade. Hence, the present study aims to scrutinize the impact of exogenous Local Inflammatory Response (eLIR) on the body surface in the context of the inflammatory cascade during sepsis, within a temporal framework, with a particular emphasis on the point of exacerbation of inflammation.METHODS:Rats were induced sterile sepsis by intraperitoneal injection of zymosan (ZY) at an appropriate dosage. The temporal progression of inflammatory changes and eLIR effects were described based on the trend of serum crucial inflammatory cytokines, tring to quest time-point of inflammatory aggravation in sepsis. Then, the varying degrees of surface inflammation caused by eLIR on this time point leading to the final effects on the inflammatory cascade response were explored. In addition, given the authentic pathological progression of sepsis, further observation was conducted on the impact of another intervention timing of eLIR on the inflammatory cascade. The survival rate was measured. Serum and organ related inflammatory cytokines were detected, and organ histopathology was investigated.RESULTS:In present study, a dosage of 600 mg/kg ZY was found to be optimal for the sterile sepsis model. Initiating eLIR 6 h prior to ZY injection, the maximum effect point of eLIR could be precisely align with the inflammatory aggravation point of sterile sepsis. Initiating eLIR at this time, 3 sessions of eLIR were found to be more effective than 1 or 2 sessions in mitigating inflammatory responses during the initial stage of inflammation and the peak of inflammation. Notably, the findings also suggested that this intervention improve survival rate. In addition, the anti-inflammatory efficacy has been substantially diminished by the prompt initiation of 3 sessions of eLIR immediately after ZY injection at the onset of sepsis. Similarly, the current findings did not demonstrate a statistically significant enhancement in survival rates with eLIR at this time point.CONCLUSIONS:Compared with the initial stage of inflammation, low-scale inflammation caused by a certain intensity of eLIR (3 sessions) on the body surface can more effectively pry the inflammation aggravation time-point, thereby shifting the pro-inflammatory to anti-inflammatory milieu, impeding the disproportionate cytokines release in inflammatory diseases, slowing down the inflammatory cascade, and improving the survival rate of sepsis.

Background contextTraditional 3D motion analysis typically considers the spine as a rigid entity. Nevertheless, previous single-joint models have proven inadequate in evaluating the movement across different spinal segments in patients with idiopathic scoliosis (IS). Scoliosis significantly impairs movement functions, especially during activities such as ascending and descending stairs. There is a lack of research on the patterns of stair movement specifically for patients with IS.PurposeThis study aims to investigate the trunk kinematics in college students with IS during stair ascent and descent tasks. A total of 56 participants, 28 with IS and 28 healthy controls, were recruited for this case-control study. The trunk movements were analyzed using a motion analysis system that incorporated a multi-segment spine model. Understanding the multi-segment spine kinematics during stair tasks can contribute to the development of effective rehabilitation programs for individuals with IS.Study designCase-control studySample size28 IS and 28 controlsOutcome measuresCobb angle, spinal curvature, spinal active range of motion (ROM), KinematicsMethodsThe Qualisys system (Gothenburg, Sweden) was utilized in this study with a sampling frequency of 150Hz. It recorded the kinematics in the thoracic, lumbar, thoracic cage, and pelvis during ascending and descending stairs for both the 28 IS individuals and the 28 control participants. Additionally, clinical parameters such as the Cobb angle, curvature of the spine, spinal range of motion (ROM), and other relevant factors were concurrently assessed among the subjects. Project supported by the National Natural Science Foundation of China (Grant No. 82205306). The authors declare no conflict of interest in preparing this article.ResultsThe findings of this study revealed that IS individuals exhibited reduced kyphotic curvature in the sagittal plane (P<0.05) when compared to the control group. In contrast, these IS patients displayed greater coronal curvature (Cobb angle) in the frontal plane and a more substantial difference in thoracic side bending range of motion in comparison to the control group (P<0.05). Moreover, during the ascending stair activity, IS patients showed reduced thoracic cage flexion-extension range of motion (P<0.05), while displaying increased lumbar rotation range of motion and anterior-posterior pelvic tilt range of motion (P<0.05) in contrast to the control group. Notably, the kinematic analysis during the descent of stairs indicated that IS patients exhibited larger range of motion in thoracic flexion-extension, thoracic side bending, thoracic cage side bending, thoracic rotation, and thoracic cage rotation when compared to the control group (P<0.05).ConclusionsThe results showed significant differences in trunk kinematics between the two groups during both stair ascent and descent tasks. The utilization of the "multi-segment spine model" facilitates the acquisition of motion information across multiple segments of the spine in patients diagnosed with IS, effectively enhancing the assessment outcomes derived from imaging information. The three-dimensional structural deformity in the trunk affects both static and dynamic activity patterns. In different activity states, IS patients demonstrate stiff movements in certain segments while experiencing compensatory instability in others. In the future, clinical rehabilitation programs for IS should prioritize stair-related activity training.

Staircases are a frequently encountered obstacle in daily life, requiring individuals to navigate ascending and descending movements that place additional demands on the trunk and lower limbs compared to walking on level surfaces. Therefore, it is crucial to examine the biomechanical characteristics of the trunk and lower limbs in individuals with scoliosis during stair activity. The aim of this study was to investigate the biomechanical differences in trunk and lower limbs during daily stair activities between patients with scoliosis and a healthy population. Additionally, the study aimed to explore the relationship between trunk abnormalities and lower limb biomechanics, providing a clinical and objective assessment basis for scoliosis. The Qualisys system, based in Gothenburg, Sweden, was employed for data collection in this study, with a sampling frequency of 150 Hz. It captured the kinematics of the trunk and lower limbs, as well as the kinetics of the lower limbs during stair ascent and descent for both the 28 individuals with scoliosis and the 28 control participants. The results indicate that scoliosis patients demonstrated significantly higher asymmetry compared to the control group in various measures during ascent and decent. These include different parts of kinematics and kinetics. Scoliosis patients demonstrate noticeable variations in their movement patterns compared to the healthy population when engaging in stair activities. Specifically, during stair ascent, scoliosis patients exhibit a seemingly more rigid movement pattern, whereas descent is characterized by an unstable pattern.

Objectives: This meta-analysis aims to synthesize the available data on the effectiveness of hamstring stretching exercises in relieving pain intensity and improving function for patients with low back pain. Methods: Google Scholars, PubMed, Embase, Cochrane, MEDLINE, CNKI, Wanfang, and VIP were searched from inception to August 2023. We included randomized controlled trials that investigated the effectiveness of hamstring stretching exercises in patients with low back pain. The primary outcomes assessed were pain intensity, hamstring muscle flexibility, and function. Study selection, data extraction, and assessment of risk of bias were performed independently by two reviewers. Results: Our searches retrieved 344 trials, of which 14 met the inclusion criteria for this review ( n = 735 participants). The combined meta-analysis showed hamstring stretching resulted in lower pain scores (standardized mean difference = −0.72, 95% confidence interval: −1.35 to −0.09; I 2 = 89%, p = 0.03) in different categories of low back pain. Subgroup analysis showed that hamstring stretching led to a larger range of motion for cases of back pain with radiating pain (standardized mean difference = 2.39, 95% confidence interval: 1.76 to 3.02; I 2 = 0%, p < 0.001). The combined meta-analysis revealed that hamstring stretching resulted in lower Oswestry Disability Index scores in comparison to regular treatment, particularly in individuals suffering from low back pain across all subtypes (mean difference = −6.97, 95% confidence interval: −13.34 to −0.60; I 2 = 95%, p = 0.03). Conclusions: This meta-analysis demonstrates the effectiveness of hamstring stretching exercises in reducing pain intensity in various categories of low back pain and improving the straight leg raise in patients experiencing back pain with radiating pain. Additionally, it highlights the improvement in function for patients with back pain across all subtypes.

Background: Knee osteoarthritis (KOA) is a prevalent chronic degenerative disease, especially among athletes due to their high physical demands. While community -based Tai Chi is recommended for KOA rehabilitation, its feasibility is often limited by external factors like weather and logistics. Internet -based Tai Chi could offer a more accessible alternative. This study aims to compare the therapeutic effects of Internet -based Tai Chi with community -based Tai Chi in athletes with KOA and to explore the underlying mechanisms of Tai Chi's therapeutic action. Methods and Analysis: In this parallel randomized controlled trial, 96 athletes with KOA in China will be randomly assigned to either an Internet -based or a community -based Tai Chi group in a 1:1 ratio. The intervention consists of 60 -minute Tai Chi sessions, conducted twice weekly for 12 weeks. Primary outcome measures include the Western Ontario and McMaster University Osteoarthritis Index. Secondary outcomes encompass the 20 -meter walk test, Timed Up and Go test, Osteoarthritis Self -Efficacy Scale, SF -36 health survey, and assessments of muscle strength and ultrasound echo intensity in quadriceps, hip abductors, and core muscles, along with lateral trunk lean angle. Attendance rates and adverse events will also be documented. Assessments will occur at baseline, 3 months, and 6 months. Data will be analysed on both intention -to -treat and per protocol bases. Conclusion: This trial will provide insights into the viability and efficacy of Internet -based Tai Chi as a therapeutic option for athletes with KOA, comparing it against the traditional community -based approach. It will also contribute to the understanding of Tai Chi's therapeutic mechanisms in managing KOA, potentially offering an innovative, accessible rehabilitation strategy for athletes.

Accumulative evidence has shown that Tai Chi Chuan has significant rehabilitative effects in the elderly and in those with chronic diseases. Based on different movement patterns, the individual stances of Tai Chi Chuan require different integrated abilities and also meet the needs of different rehabilitation goals. However, there is still lack of efficient means of collecting rehabilitation related data and accurate methods of assessing the quality of Tai Chi Chuan movements. Establishing specifications for data collection and assessment techniques for the Tai Chi Chuan movements can help to quantify the relevant research work. Uniform standards enable better integration and sharing of Tai Chi Chuan movements data. It can help to find the link between rehabilitation status and Tai Chi Chuan movements data more accurately, allowing better application of Tai Chi Chuan in rehabilitation training.Therefore, this standard regulates the terms and definitions of data collection for Tai Chi Chuan, techniques of data collection and assessment, facilities and equipment, personnel requirements, sites and environmental requirements,as well as assessment precautions for Tai Chi Chuan movements. This standard is applicable to rehabilitation related data collection and assessment of rehabilitation function for Tai Chi Chuan movements, with good feasibility, and safety.

Objective: Individuals with knee osteoarthritis are at higher risk for falls during transitions between floor and stair walking due to their reduced lower extremity function. However, the adjust gait characteristics of knee osteoarthritis subjects for dealing with stair transitions have not been explored. We aimed to investigate gait strategies in individuals with knee osteoarthritis compared to age-matched individuals without knee OA during the transition between walking on floor and stairs. Method: Gait of 30 individuals with knee osteoarthritis and 30 individuals without knee osteoarthritis during floor-to-stair and stair-to-floor walking transitions were accessed using a 3D motion capture system. Foot-tread clearance, and angles of lower extremity joints and trunk at Foot-tread clearance timepoint were analyzed by using biomechanical software (Visual 3D). Results: Compared with asymptomatic control group, the knee osteoarthritis group demonstrated no difference in vertical Foot-tread clearance and horizontal Foot-tread clearance during stair transitions. However, ankle dorsiflexion ( p = 0.01) decreased, hip flexion ( p = 0.02) and trunk lateral tilt ( p = 0.02) increased in knee osteoarthritis group during the stair ascent transition. Moreover, trunk lateral tilt to the support side ( p = 0.003) and pelvic rotation ( p = 0.03) increased, while hip abduction of the swing leg ( p = 0.03) decreased during the stair descent transition in individuals with knee osteoarthritis. Conclusion: Increased trunk lateral tilt and altered angle of hip may be a strategy utilized by individuals with knee OA to increase the foot clearance ability and compensate for the disease-related loss of lower extremity strength, range of motion, and balance. However, compensatory manifestations, such as the increased lateral tilt of the trunk and movement of the gravity center may enhance the risk of falls and result in more abnormal knee joint loading.

目的 用Kinect探讨针刺结合康复训练对脑卒中患者上肢功能的影响.方法 将脑卒中后上肢功能障碍患者随机分为对照组(康复训练)和治疗组(针刺+康复训练)各15例.比较两组患者治疗前后改良Barthel指数(modified Barthel index,MBI)、Fugl-Meyer 运动功能评估(Fugl-Meyer assessment,FMA)及 Wolf 运动功能测试(Wolf motor function test,WMFT),用Kinect评估两组患者干预前后前臂放桌面、伸肘、喝水3个动作的运动时间(motor time,MT)、运动单位数量(motor unit number,MUN)、曲率指数(index of curvature,IC)、肘关节屈曲角度(elbow flexion angle,EFA)、肩关节屈曲角度(shoulder flexion angle,SFA)与肩关节内收角度(shoulder adduction angle,SAA)的变化.结果 经过6周治疗,治疗组患者MBI和FMA分数、WMFT总分数及伸肘分数均高于对照组(P＜0.05);两组患者MBI和FMA分数、WMFT总分数、前臂放桌面、伸肘及喝水分数组内比较均高于治疗前(P＜0.05).治疗组患者3个动作的MT、MUN、IC、EFA、SFA、SAA改善情况均优于对照组(P＜0.05);两组患者前臂放桌面、伸肘动作的EFA均较治疗前增加(P＜0.05),MT、MUN、IC、SFA、SAA均较治疗前减小(P＜0.05);两组患者喝水动作的EFA、SFA均较治疗前增加(P＜0.05),MT、MUN、IC、SAA均较治疗前减小(P＜0.05).结论 针刺结合康复训练可以提高脑卒中患者上肢功能.Kinect能精准反映脑卒中患者上肢功能的变化,适合运用于临床工作.