Objective: To evaluate the trends in physical fitness in children and adolescents. Method: The present study focusses on a longitudinal analysis of the single two-legged jump (S2LJ) from children and adolescents, who participated in the DONALD study from 2004 till 2022. P_max/body mass (power, surrogate for muscular performance), V_max (bounce speed, surrogate for coordination), F_max/body mass (force, surrogate for muscular strength) and V max F max / BM (Nerve-Muscle Index, surrogate for jump efficiency) were examined by linear mixed models and propensity-score(PS)-matching analysis. Results: Data from 1,485 measurements from males and 1,445 from females were included. Mean age was 10.9 years for males and 11.4 years for females. The range of the number of repeated S2LJ was 1 to 8, the median was 3. In PS-matching analysis, there was a dose-effect relationship between the test date and the S2LJ parameters in such a way that P_max/body mass and F_max/body mass decreased with more recent test dates (effect size at a difference in the test date of 1.7 decades: 0.25 - 0.3) whereby V_max and V max F max / BM showed no consistent trend. Conclusion: Motor performance in children, assessed by the S2LJ, has decreased over the last two decades, mainly due to lower muscular strength, while motor efficiency and coordination seemed to be unchanged.

Objectives: This study investigated the impact of hamstring strain injuries (HSI) and vision on muscle recruitment and postural control in athletes with HSI. Methods: Fourteen athletes with HSI and fourteen healthy controls performed a single-leg balance task under eyes-closed and eyes-open conditions while leaning to the maximum forward and backward. The root-mean-square electromyography (EMG), median frequency, and center of pressure (COP) trajectories were calculated for 15 seconds. A two-way repeated measures ANOVA was conducted to assess differences between the groups and eye conditions. Results: Individuals with HSI exhibited lower hamstring activation during postural leans in the lateral hamstring (p=0.009) during forward lean and both lateral (p=0.001) and medial hamstring (p<0.001) during backward lean. There were no significant changes in median frequency between the groups. Consequently, this resulted in a greater sway range and a larger 95% confidence ellipse area. The eye conditions primarily affected EMG frequency and COP parameters during leaning in both directions. Conclusion: Athletes with HSI exhibit a persistent deficit in hamstring activation, adversely affecting their postural control. These muscle impairments may compromise balance control and may impact sports performance. Therefore, implementing balance training programs should be considered in clinical rehabilitation for HSI.

Objective: To investigate the effect of ischemic preconditioning (IC) on bilateral hip abductor strength, fatigue, and power in patients with knee osteoarthritis (KOA). Methods: Participants (n=10) with KOA completed isokinetic and isometric hip abductor assessments on a Biodex dynamometer both before and after IC. IC was administered during a single session and consisted of 5 minutes of inflation (225mmHg) followed by 5 minutes of reperfusion for 50 minutes. Changes in strength and endurance measures before and after IC were compared using paired t-tests and magnitude of significant differences were reported using Cohen’s d effect sizes. Results: Isokinetic hip abductor peak torque (d=.42, p=.027) and average power (d=.57, p=.029) in the involved limb, and isokinetic peak torque (d=.37, p=.044) in the uninvolved limb increased significantly after IC compared to baseline. There were no changes in isokinetic average power in the uninvolved limb, or isometric peak torque and fatigue index in both limbs after IC (p=.13-.77). Conclusions: A single session of IC improved hip abductor strength in both limbs and power in the involved limb in KOA patients. IC should continue to be investigated as a safe and clinically convenient intervention that can supplement traditional modalities to improve muscle function in KOA.

Objectives: To record Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure (MEP) in neuro-rehabilitation patients and establish correlation with functional status, quality of life, demographics and co-morbidities. Methods: Respiratory muscle strength was measured in 50 stroke patients and 50 spinal cord injury (SCI) patients. Both groups were evaluated with the Modified Barthel Index (MBI-Shah version) and the 36-Item Short Form Survey. Demographics, medical history, history of moderate physical activity prior to injury and American Spinal Injury Association (ASIA) classification were recorded. Results: Respiratory muscle strength declined with age and males exhibited higher MIP and MEP in the SCI group and higher MEP, but not MIP, in stroke. In the ASIA D SCI subgroup, the MBI total score was moderately positively correlated with MIP and MEP values. In stroke, MBI total score and MEP were positively correlated in both sexes and MBI total score and MIP in females. Diabetes mellitus absence correlated with higher MIP and MEP in SCI. Prior physical activity was linked to higher MIP, MEP in stroke and to higher MIP in SCI. Conclusions: Age, sex, functional capacity, SCI classification, quality of life components, history of physical activity and diabetes influence respiratory muscle strength in the studied population.

Objectives: The synergy between arm and shoulder muscles, along with isometric finger flexor strength, are crucial for climbing proficiency. However, tests often assess these factors separately rather than in a unified action. This study aimed to determine the intra- and inter-session reliability of the mean propulsive velocity (MPV) during pull-ups on a large hold and on small climbing edges. Methods: Ten male climbers (self-reported maximal grade 6b-8b on French scale) participated in two identical sessions. During each session, participants performed two blocks of two pull-ups on a large hold and on four small climbing edges (25, 20, 15, and 10mm) in randomized order. The MPV was recorded using a linear position transducer. Results: The MPV during climbing pull-ups at 20mm (0.75±0.16 m/s), 15mm (0.73±0.16 m/s), and 10mm (0.52±0.15 m/s) was reduced compared to a pull-up on a large hold (0.84±0.16m/s). Intraclass correlation coefficients (ICCs) were good-to-excellent across hold sizes for intra-session (ICC 0.84-0.99) and inter-session (ICC 0.73-0.96) measurements. Conclusions: The results suggest that the MPV assessed during climbing-specific pull-ups on small holds provides valuable insights into finger, elbow and shoulder muscle force capacities in a unified action. This test could be considered a sport-specific test for monitoring performance in climbers.

Objectives: To assess the performance of five osteoporosis clinical risk assessment tools (SCORE, ORAI, ABONE, OST and OSIRIS), in a subgroup of young postmenopausal women aged 50-64, who underwent DXA screening. Methods: The abovementioned osteoporosis risk assessment tools were calculated for 258 young postmenopausal women (aged 50-64) who had a DXA scan, in Crete/Greece. Results: Patients with a T-score≤-2.5 or a T-score≤-2.0 had a statistically significant higher value of SCORE, ORAI and ABONE and a lower value of OST, OSIRIS, and OSIRIS Adjusted Score, compared to the patients with T-score>-2.5 and T-score>-2.0, respectively. ORAI (T-score≤-2.0) and OST (T-score≤-2.5) demonstrated the highest sum of sensitivity and specificity. CHAID analysis further confirmed the relative significance of the OST tool in the osteoporosis group (T-score≤-2.5 vs. T-score>-2.5), for a cut-off of 2.8. In the other group (T-score≤-2.0 vs T-score>-2.0) the ORAI score showed a significantly important relationship for a cut-off of 8. Conclusion: OST, despite its performance limitations, correlates best with the DXA measurements of young (50-64), postmenopausal osteoporotic women, a fact which may suggest its’ potential role as a screening tool in this specific age group.

Objective: Obesity and diabetes mellitus (DM) are major risk factors for osteoarthritis (OA), but it remains unclear how comorbidity affects apoptosis signaling in OA. This study investigated the effect of metabolic diseases on apoptosis and apoptosis-related intracellular and extracellular signaling in OA. Methods: Excision materials of human articular cartilage from total knee arthroplasties were collected. The samples were divided into four groups as, control OA, OA+DM, OA+Obese, and OA+DM+obesity. Protein activities were determined using Western blot and ELISA. Results: Caspase-3 levels were significantly increased in chondrocytes in which OA was associated with DM or obesity. However, an increase in Bcl-2 activity was also observed in these comorbidities. The increased levels of CaMKII in the same groups also indicate an increase in cellular activity in comorbidities. While IL-6 and TNF-α did not show significant changes, matrix regulatory protein CYR61 levels reflected the intracellular apoptotic activity. Conclusion: Metabolic diseases have a stimulatory effect on the etiopathology of osteoarthritis by enhancing cellular signaling towards apoptosis and that matrix signaling proteins may play a key role in regulating these effects. Examining OA with its accompanying diseases will lead to a better understanding of the cellular mechanisms that differ in OA.

Objective: To analyze the incidence and influencing factors of perioperative occult blood loss in elderly hip fracture patients. Methods: 145 cases of elderly hip fracture patients treated at our hospital from July 2022 to December 2023 were retrospectively analyzed. Patients were grouped based on the presence or absence of perioperative occult blood loss. Results: A total of 145 elderly hip fracture patients were included, with an average occult blood loss of 574.58±63.21 ml. Occult blood loss occurred in 42 cases, with an incidence rate of 28.97%, while 103 cases did not experience occult blood loss, with an incidence rate of 71.03%. Conclusion: Perioperative occult blood loss in elderly hip fracture patients is common and is associated with factors such as the type of surgery, anesthesia, postoperative drainage, and autologous blood transfusion. These factors constitute risk factors for perioperative occult blood loss in this patient population and warrant clinical attention and early preventive measures.

Objective: To explore the therapeutic effects of Maohuoside A (MHA) on rats with osteoarthritis (OA) induced by anterior cruciate ligament transection, and to analyze its impact on the activation of adenosine monophosphate-activated protein kinase (AMPK). Methods: Sprague-Dawley male rats were divided into six groups: Sham, OA, L-MHA, M-MHA, H-MHA, and H-MHA + Compound C (n = 12 per group). The Sham group had sham surgery, while the OA, L-MHA, M-MHA, and H-MHA groups underwent OA via ACL severing. L-MHA, M-MHA, and H-MHA groups received low, moderate, and high doses of Maohuoside A, respectively, and the H-MHA + Compound C group received high-dose Maohuoside A plus Compound C. Hematoxylin-eosin (HE) staining and Safranin O/Fast Green staining were used to assess articular cartilage damage and degeneration, and the OARSI score was used to evaluate the extent of cartilage degeneration. Results: Compared with the OA group, the L-MHA, M-MHA, and H-MHA groups showed decreased OARSI scores, increased relative levels of Bcl-2 mRNA, decreased relative levels of Bax mRNA, reduced serum levels of IL-1β, IL-6, and TNF-α, increased relative levels of Collagen II mRNA, decreased relative levels of MMP-13 mRNA, and increased relative levels of BMP2, Runx2, and Osterix mRNA. Additionally, the relative level of cartilage AMPKα (Thr172) phosphorylation increased (P<0.05). Conclusion: This study suggests that Maohuoside A exerts anti-osteoarthritis (OA) effects by activating AMPK.

Objective: To elucidate how indomethacin may slow the progression of osteoarthritis (OA). Methods: Chondrocytes were treated with IL-1β (10 ng/mL) for 12 hours to create an in vitro model of OA. Following this, 10 µM of indomethacin was added to the IL-1β-treated chondrocytes for an additional 4 hours to evaluate its effects on inflammation, anabolism, catabolism, apoptosis, and autophagy using ELISA, western blot, immunofluorescence and flow cytometry, respectively. Results: IL-1β significantly stimulated inflammatory responses, hampered anabolic processes, induced catabolic activity, accelerated apoptosis, and inhibited autophagy in chondrocytes, as well as activated the PI3K/AKT/mTOR signaling pathway. However, treatment with indomethacin reversed the effects of IL-1β stimulation on chondrocytes and simultaneously suppressed the activation of the PI3K/AKT/mTOR signaling pathway. Conclusions: Our findings indicate the mechanism of action of indomethacin in mitigating OA progression, indicating that it can inactivate the PI3K/AKT/mTOR signaling pathway, thereby regulating inflammation, metabolism, apoptosis, and autophagy in chondrocytes, which attenuates the development of OA.

Non-specific chronic low back pain (NSCLBP) with movement control impairment (MCI) subgroup often experiences postural pain and functional lumbar spine instability. This scoping review had two aims: 1) to map the evidence related to dynamic neuromuscular stabilization (DNS) efficacy as a spinal stabilization strategy and to identify gaps in the literature that may exist regarding the effectiveness of DNS in low back pain management and 2) to align the DNS approach as a potential intervention for MCI patients. The clinical trial studies related to DNS exercises were searched from inception until February 2024 through electronic databases, such as PubMed, Google Scholar, PEDro, and Science Direct. The Arksey and O’Malley methodology and PRISMA-ScR checklist were followed to report the findings. A total of 18 studies offering a total sample of 483, were included based on the inclusion criteria. The results of 14 studies summarized the DNS-related influence on neural substrates and core stability. The availability of only 4 studies on DNS efficacy in chronic low back pain indicates a dearth of evidence. This review highlighted the DNS efficacy in improving core muscle activation and painrelated symptoms in NSCLBP patients while emphasising the need for prospective research in the MCI subgroup.

Anterior tarsal tunnel syndrome, an infrequent entrapment neuropathy involving the deep peroneal nerve beneath the inferior extensor retinaculum in the anterior ankle, is often overlooked on medical images, leading to delayed diagnosis and treatment. We present the case of a 52-year-old male, an avid runner, who exhibited a sensation of burning and tingling in the dorsal region of both feet. Electrophysiologic studies suggested bilateral deep peroneal neuropathy. Subsequent magnetic resonance imaging revealed bilateral focal regions of signal alteration, consistent with scarring, encasing the deep peroneal nerves at the anterior tarsal tunnel. These regions were indented by the deep laminae of the inferior extensor retinacula, suggesting compression. The constellation of findings was consistent with anterior tarsal tunnel syndrome. This is a unique case of bilateral deep peroneal nerve entrapment exacerbated by repetitive microtrauma, culminating in anterior tarsal tunnel syndrome. Notably, this case represents the first instance in literature where MRI played a pivotal role in diagnosis.