Correction to: The experiences of people with incomplete spinal cord injury or disease during intensive balance training and the impact of the program: A qualitative study (Spinal Cord, (2022), 10.1038/s41393-022-00823-9)

The original version of this article contained a spelling error in an author name. The last name of the corresponding author, Dr. Kristin Musselman, should be corrected from Mussleman to Musselman. The original article has been corrected

The measurement properties of the Lean-and-Release test in people with incomplete spinal cord injury or disease

Objective: To evaluate test-retest reliability, agreement, and convergent validity of the Lean-and-Release test for the assessment of reactive stepping among individuals with incomplete spinal cord injury or disease (iSCI/D). Design: Multi-center cross-sectional multiple test design. Setting: SCI/D rehabilitation hospital and biomechanics laboratory. Participants: Individuals with motor incomplete SCI/D (iSCI/D). Interventions: None. Outcome Measures: Twenty-six participants attended two sessions to complete the Lean-and-Release test and a battery of clinical tests. Behavioral (i.e. one-step, multi-step, loss of balance) and temporal (i.e. timing of foot off, foot contact, swing of reactive step) parameters were measured. Test-retest reliability was determined with intraclass correlation coefficients, and agreement was evaluated with Bland–Altman plots. Convergent validity was assessed through correlations with clinical tests. Results: The behavioral responses were reliable for the Lean-and-Release test (ICC = 0.76), but foot contact was the only reliable temporal parameter using data from a single site (ICC = 0.79). All variables showed agreement according to the Bland–Altman plots. The behavioral responses correlated with scores of lower extremity strength (0.54, P\u3c0.01) and balance confidence (0.55, P \u3c 0.01). Swing time of reactive stepping correlated with step time (0.73, P \u3c 0.01) and cadence (−0.73 P \u3c 0.01) of over ground walking. Conclusions: The behavioral response of the Lean-and-Release test is a reliable and valid measure for people with iSCI/D. Our findings support the use of the behavioral responses to evaluate reactive stepping for research and clinical purposes. Trial registration: ClinicalTrials.gov identifier: NCT02960178

Which trunk inclination directions best predict multidirectional-seated limits of stability among individuals with spinal cord injury?

Objective: To determine which trunk inclination directions most accurately predict multidirectional-seated limits of stability among individuals with spinal cord injury (SCI). Design: Predictive study using cross-sectional data. Setting: Pathokinesiology Laboratory. Participants: Twenty-one individuals with complete or incomplete sensorimotor SCI affecting various vertebral levels participated in this study. Interventions: Participants were instructed to lean their trunk as far as possible in eight directions, separated by 45°intervals, while seated on an instrumented chair with their feet positioned on force plates. Outcomes measures: Eight direction-specific stability indices (DSIs) were used to define an overall stability index (OSI) (limits of stability). Results: All DSIs significantly correlated with the OSI (r = 0.816-0.925). A protocol that only tests the anterior, left postero-lateral, and right lateral trunk inclinations accurately predicts multidirectional-seated postural stability (R 2 = 0.98; P < 0.001). Conclusion: Multidirectional-seated postural stability can be predicted almost perfectly by evaluating trunk inclinations performed toward the anterior, left postero-lateral, and right lateral directions

Required muscle mass for preventing lifestyle-related diseases in Japanese women

Research articl

Effect of Spatially Distributed Sequential Stimulation on Fatigue in Functional Electrical Stimulation Rowing

Objective: A critical limitation in clinical applications using functional electrical stimulation (FES) for rehabilitation exercises is the rapid onset of muscle fatigue. Spatially distributed sequential stimulation (SDSS) has been demonstrated to reduce muscle fatigue during FES compared to conventional single electrode stimulation (SES) in single joint movements. Here we investigated the fatigue reducing ability of SDSS in a clinical application, i.e., FES-rowing, in able-bodied (AB) participants. Methods: FES was delivered to the quadriceps and hamstring of 15 AB participants (five female, ten male) for fatiguing FES-rowing trials using SES and SDSS, participants rowed with voluntary arm effort while endeavoring to keep their legs relaxed. Fatigue was characterized by the time elapsed until a percent decrease occurred in power output (TTF), as well as the trial length indicating the time elapsed until the complete stop of rowing. Result: Trial length was significantly longer in SDSS rowing than in SES (t-test, {p} < 0.01 , ${d}=0.71$ ), with an average SDSS:SES trial length ratio of 1.31 &#x00B1; 0.47. TTF $_{SDSS}$ was significantly longer than TTF $_{SES}$ with a median TTF $_{SDSS}$ :TTF $_{SES}$ ratio of 1.34 ranging from 1.03 to 5.41 (Wilcoxon Ranked Sum, {p} < 0.01 , ${r}=0.62$ ). No rower experienced a decrease in TTF with SDSS. Conclusion: SDSS reduced fatigue during FES-rowing when compared to SES in AB individuals, resulting in a lengthened FES-rowing period by approximately 30&#x0025;. Application of SDSS would increase the effectiveness of FES-rowing as rehabilitative exercise for individuals with paralyses

Quantitative response of healthy muscle following the induction of capsaicin: an exploratory randomized controlled trial

Abstract Background Myofascial pain syndrome (MPS) is a prevalent chronic pain disorder primarily characterized by myofascial trigger points (MTrPs). There is limited knowledge on the pathophysiology and mechanisms underlying MTrP and its development. Research has previously demonstrated the identification of MTrPs using ultrasound and vibration sonoelastography, although there is some contradictory evidence regarding if MTrPs present as hyper or hypoechoic regions. Electromyography (EMG) investigations of MTrP have demonstrated that MTrPs are usually located proximal to innervation zones where the peak surface EMG signals are obtained from. Central sensitization has been proposed as the primary mechanism underlying MTrP development. Central sensitization is associated with hyperexcitability of neuronal responses to normal or noxious stimuli. There is a need for a study that measures ultrasound image textural changes and motor unit activity responses in the muscle following sensitization. The purpose of this study is to determine whether sensitizing healthy muscle using capsaicin induces a regional change in image texture variables within the specific and surrounding muscles, as well as the motor unit frequency and amplitude changes that accompany them. This is an exploratory trial that aims to provide preliminary evidence on whether central sensitization is a direct cause of taut band and MTrP development. Methods Ethical approval was obtained from the University Health Network (UHN) Research Ethics Board. This proposed study is a single centered, factorial, randomized placebo-controlled trial with two independent variables, depth of capsaicin application and dose of capsaicin, for a total of six treatment arms and three control treatment groups. Discussion This will be the first study that assesses the B-mode ultrasound image texture of induced sensitized muscles and will provide more evidence on muscle motor unit activity and regional changes of central sensitization. Findings from this study may support one of few hypotheses proposed delineating the involvement of central sensitization in the development of trigger points. Trial registration National Institutes of Health ClinicalTrials.gov NCT03944889 . Registered on May 07, 201