The Role of Movement Pattern in Relation to Running Related Injuries Risk Factors

About 52.3 million American run on a regular basis. Up to 79% of runners get injured every year and the rate of injury has not declined over the past decades. Females have twice the risk of developing a running related injury (RRI). Rate of loading (ROL), tibial impact shock (TIS), and low movement variability may contribute to the development of RRI. Not much is known, however, about the relationships between impact kinetics (i.e. ROL, TIS) and movement variability. In addition, there is a lack of understanding about the effects of sex and speed on the aforementioned RRI risk factors. Therefore, the purpose of this dissertation was to study the association between impact kinetics and movement variability, and to investigate the effects of sex and speed on biomechanical variables including ROL, TIS, movement variability and coordination patterns during running.Thirty-six healthy runners participated in study one and two. In study three, data from thirty-two of those runners were analyzed. Vertical ground reaction force, 3D motion-analysis of lower extremities joint angles, tibial vertical acceleration, and electromyography (EMG) of lower extremity muscles were collected at running speeds that represented subject’s long slow distance speed (LSD), LSD+15%, and LSD+30%. Movement variability and patterns of hip and knee joints were quantified by using the vector coding method. ROL and TIS, peak EMG of five lower extremity muscles were calculated. In study one, Pearson’s correlation coefficients were used to investigate the association between movement variability and patterns with ROL and TIS at LSD speeds. In study two, repeated measure ANOVAs were used to investigate the effect of sex and speed on EMG and impact forces. In study three, a self-organizing map (SOM) was used to investigate biomechanical coordination patterns during running at LSD and LSD+30%.The most notable results from this dissertation suggest that 1) movement variability and patterns of hip and knee joints are associated with impact kinetics, 2) females exhibit a greater increase in ROL as running speed increases, and 3) greater running speeds are associated with a general shift to a coordination strategy characterized by greater magnitudes of RRI risk factors

NEURAL NETWORK METHOD TO PREDICTING STANCE-PHASE GROUND REACTION FORCE IN DISTANCE RUNNERS

The purpose of this study was to use machine learning (i.e., artificial neural network – ANN), to predict vertical ground reaction force (vGRF) from tibial accelerations in runners with different foot strike patterns and at different running speeds. Thirty-eight healthy runners ran at three different speeds: the pace at which the runner spends most of their training time (LSD), 15% faster than LSD (LSD15), and 30% faster than LSD (LSD30). vGRF and IMU-based accelerations from the tibia were collected during the last 30 seconds at each speed. Tibial accelerations were used to calculate the resultant tibial acceleration (RTA). Time-series stance-phase vGRF and RTA from 34 subjects at all three speeds were used to train the ANN. Trials from two males and two females, who exhibited different foot-strike patterns, were used to test the ANN. The prediction error of the ANN was 102.4 N (1.6 N/kg or 0.16 BW) across the entire stance phase of running. The ability to predict GRF with an ANN and only RTA as input appears to be practical and feasible

Oral semaglutide adequate glycaemia control with safe cardiovascular ‎profile

BackgroundType 2 diabetes is a chronic and progressive disease that ‎associated with series complication such as major adverse ‎cardiovascular events. Adequate glycaemic control proven ‎to reduce this risk. Orally administered semaglutide ‎promising medication in managing patient with type 2 ‎diabetes.‎AimsTo assess the cardiovascular safety and efficacy of semaglutide, a recently approved glucagon-like peptide 1 receptor agonist (GLP-1 RA) for type 2 diabetes.Methods Pub Med, ‎Google Scholar, and EBSCO ‎ databases were ‎systematically search for relevant articles. The terms‎ diabetes‎, Glucagon-like peptide, semaglutide‎ were used. Out of hundred twenty-two records, only ‎four fulfilled ‎the inclusion criteria.Results Four placebo-controlled studies with oral semaglutide ‎were included. Single study concern about the cardiovascular safety of oral semaglutide ‎and showed that, ‎compared with placebo, semaglutide ‎ was not associated ‎with increased in the cardiovascular events. On the other ‎hand, the remaining trials shown that, semaglutide ‎ can ‎effectively control the blood glucose as evident by ‎reduction in HA1c.ConclusionOral semaglutide can effectively and safely lower blood glucose without increase in the major adverse ‎cardiovascular events‎‎ (MACE).

USE OF SELF-ORGANIZING MAPS TO STUDY SEX- AND SPEED-DEPENDENT CHANGES IN RUNNING BIOMECHANICS

Self-organizing maps (SOM) are a type of artificial neural network for 1) clustering variables and visualizing large datasets and 2) quantifying coordination patterns. The purpose of this study was to use a SOM to investigate the effect of sex and speed on coordination patterns during running. Seventeen females and 15 males ran at their long-slow distance (LSD) training speed and at a speed 30% faster than LSD. Thirty-seven biomechanical variables (gait parameters, joint kinematics, coupling angle variability, EMG, and impact kinetics) were recorded and/or calculated, and analyzed with a SOM. The SOM analysis showed a significant shift in coordination pattern for males and females as running speed increased. This shift was characterized primarily by increases in the rate of ground reaction force loading, tibial impact shock, step lengths, and medial gastrocnemius muscle activation

Conservative management and follow‐up of bilateral condylar fractures in pediatric patients: A case report

Key Clinical Message Conservative treatment of bilateral condylar fractures, including intermaxillary fixation using arch bars and elastic bands, yields satisfactory results in pediatric patients. Therefore, the conservative approach should be considered the first line of treatment for bilateral condylar mandibular fractures in pediatric patients. Abstract Road traffic accidents (RTAs) are considered the leading cause of mortality and morbidity of children and adults in Saudi Arabia. Head injuries and fractures are the most common form of injuries resulting from RTAs, with mandibular fractures being the most common head injury; condylar fractures are the most frequent type of mandibular fracture. A review of the literature reveals diverse opinions about the best approach for treating bilateral condylar fractures in pediatric patients. The findings of the literature review are reported in this study. The case presented here shows the result of adopting a conservative approach to treating a bilateral extracapsular displaced condylar fracture. An elastic band was fixed onto intermaxillary fixation (IMF) screws at the midline upper and lower jaws; the patient was followed up for almost 3 years. The conservative approach yielded excellent results, as both condyles were fully repositioned and healed, without causing any deviation or limitation of the mouth opening. The results of this case support considering the conservative approach as the first line of treatment for bilateral condylar mandibular fractures in pediatric patients

Use of Self-Organizing Maps to Study Sex- and Speed-Dependent Changes in Running Biomechanics

Background Up to 79% of runners get injured every year, with higher rates of injuries occurring in females than males. A self-organizing map (SOM) is a type of artificial neural network that can be used to inspect large datasets and study coordination patterns. The purpose of this study was to use an SOM to study the effects of sex and speed on biomechanical coordination patterns. Method Thirty-two healthy runners ran on an instrumented treadmill at their long slow distance speed (LSD) and at speed 30% faster (LSD + 30%). Vertical ground reaction force (vGRF), vertical tibial acceleration, step parameters, electromyograms (EMG) of six lower limb muscles, and joint angles were collected across speeds. Rate of loading (ROL), tibial impact shock (TIS), coupling angle variability (CAV) and movement pattern proportions for hip/knee sagittal and hip frontal / knee sagittal plane couplings, peak EMG, step length, step rate, and knee and ankle joint angle at initial contact were used as an input for the SOM (37 variables). Results The analysis identified four clusters (i.e., running patterns). While males and females showed similar distribution across clusters at LSD (p = .36) and at LSD + 30% (p = .51), females did exhibit a significant (p = .03) shift between clusters as the speed increased from LSD to LSD + 30% whereas males did not (p = .17). The shift was associated with an increase in TIS, ROL, step length, step rate, vastus lateralis EMG, hip flexion/knee extension movement pattern proportion, and a decrease in ST EMG and CAVIC for hip sagittal/knee sagittal coupling. Conclusion As running speed increased there was a significant change in the coordination pattern in females, which was characterized by increases in several variables that are purported risk factors for running related injuries

Effect of texting and handwriting on hand-grip and key-pinch strength among female-collegiate students: randomized controlled trial

Objectives: To evaluate immediate and long-term effect of texting or handwriting on hand-grip and key-pinch strength among healthy female students. Method: The single-blind, randomised controlled trial was conducted between February and April 2021 after approval from the ethics review committee of the College of Medical Rehabilitation Sciences, Taibah University, Saudi Arabia, and comprised female Physio Therapy students aged 19-23 years who were right-hand dominant and had normal body mass index. The subjects used smartphones and electronic gadgets for >2hrs daily, writing more than 10min/day. They were randomised using sealed envelopes into five groups. Group A practised 10min texting, group B 15min texting, group C 10min writing, group D 15min writing, and group E used the phones only for talking or watching, with no texting or writing, and was taken as the control group. Hand-grip strength and key- pinch strength were assessed one minute before starting, and within one minute after having finished the assigned hand activity. All measurements were recorded in the sitting position using a single hand-grip dynamometer. Data was analysed using SPSS 23. Results: Of the 65 individuals assessed, 60(92.3%) were initially enrolled, but the study was finished by 50(83.3%) subjects with a mean age of 20.88±0.98 years and mean body mass index 20.8±2.30kg/m2. There were 12(24%) subjects in group A, 7(14%) in group B, 12(24%) in group C, 10(20%) in group D and 9(18%) in group E. The association of the time-based groups with hand-grip and key-pinch strength was not significant (p>0.05). Conclusions: Texting and handwriting did not have any significant immediate effect on hand-grip or key-pinch strength. Clinical Trial Number: (NCT04810416). Key Words: Hand-strength, Pinch-strength, Students, Text messaging, Writing

Quality of Clinical Guidelines on Oral Care for Children with Special Healthcare Needs: A Systematic Review

Robust evidence-based guidelines are important in everyday clinical practice, especially when delivering and managing oral care needs to a vulnerable group such as children with special healthcare needs (SHCNs). Methods: To assess the quality of guidelines on the management of oral care for children with special healthcare needs (SHCNs) and to find appropriate guidelines, an electronic search of MEDLINE Ovid was carried out alongside an additional search of common guideline websites. The AGREE II tool was used to assess the quality of the guidelines. Assessment was undertaken independently by three assessors. Furthermore, the underlying evidence used to formulate recommendations in the identified guidelines was qualitatively assessed. Results: There were nine guidelines, with 41 recommendations, that met the eligibility criteria. The quality of the guidelines was generally found to be poor. Only one guideline was assessed as “recommended” by the assessors, based on the quality of the methods, the reporting, or both. Only 2 of the 41 sets of recommendations, made across the nine guidelines, were judged to be valid and based on a rigorous systematic review of the evidence. Conclusions: The current state of guidelines on oral care management for children with special healthcare needs (SHCNs) is, on the whole, of very low quality. The scientific community should work together to enhance the quality and strength of the current clinical guidelines and to ensure that they are trustworthy prior to implementation