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Femoroacetabular impingement syndrome (FAIS) is a common source of hip pain in young, active individuals and treatments have yielded variable success rates. Weakness of the hip flexors in individuals with FAIS often fails to be resolved during treatment and has been correlated to worse patient reported outcomes and joint damage. This study used musculoskeletal modeling to investigate the differences in iliacus and psoas force production and JCFs during walking between individuals with FAIS and healthy controls (HCs) and to simulate hip flexor strength and weakness in participants and evaluate the resulting changes in JCFs during walking. Five conditions of iliacus and psoas strength were evaluated: 50%, 75%, 100%, 125%, and 150% of the model’s default strength. Statistical parametric mapping was used to compare outcomes between groups and between flexor strength conditions. There were no significant differences between the FAIS and HC groups. Increased flexor strength caused higher resultant JCFs and directional components of the JCF throughout the gait cycle. Decreased flexor strength caused lower JCFs across most of the gait cycle; there was no difference in the resultant or superior JCF during preswing and the medial JCF was higher during a small percentage of preswing. These findings indicate that increasing hip flexor strength may have a more uniform effect on JCFs while decreasing flexor strength results in more varied effects between individuals and across the gait cycle.

Objective: To determine the association of functional outcome for flexor tendon repair for the surgery timings. Study Design: Case Series. Place and Duration of Study: Plastic and Reconstructive Surgery Department, Dr Ruth KM Pfau Civil Hospital, Karachi Pakistan, from Apr to Sep 2021. Methodology: A total of 98 patients were equally divided into the early duration of tendon repair and the delayed duration of tendon repair. Patients were assessed to evaluate the functional outcome of flexor tendon repair in terms of tendon power assessed by the MRC scale, active movement at joints and the incidence of rupture. Functional outcome was assessed as Excellent (75-100), Good (50-74), Fair (24-49) and Poor (0-24). Results: In early repair, tendon power on the second post-operative day was observed as 11(22%) patients had movement against gravity but were powerless than normal, and 39(78%) patients had maximum strength. In comparison, in delayed repair, 5(10%) patients had movement against gravity but not against resistance, and 45(90%) patients had movement against gravity but were more powerless than normal. The active motion on the second post-operative day in early repair cases, 47(94%) patients had excellent active motion, while 30(60%) patients had good active motion in delayed repair. The tendon rupture was found 4(8%) in early repair and 10(20%) in delayed repair. Conclusion: Early tendon repair had excellent active motion and a lower ratio of tendon rupture than delayed repair.

In this study, we investigated the effects of an eight-week strength development program on male karate students from Vietnam National University-Но Chi Minh City (VNU-HCM). Objectives'. The main objective was to assess the impact of this strength development program on key muscle groups crucial for karate performance, including the head, hip, elbow, and shoulder regions. Method: Eleven male karate practitioners from VNU-HCM participated in an experimental eight-week strength development program. Force torque measurements of the head, hip, elbow, and shoulder muscle groups were taken before and after the intervention. Statistical analysis was conducted to evaluate the significance of observed changes. Results: The eight-week strength development program resulted in significant enhancements in the force torque of the head, hip, elbow, and shoulder muscle groups among male karate practitioners from VNU-HCM. These improvements were statistically significant, with values ranging from P < 0.05 to P < 0.001. Conclusion: The study concludes that the eight-week strength development program is appropriate and effective for increasing muscle contraction force in male karate practitioners at VNU-HCM. The significant increases in peak torque observed in the head, hip, elbow, and shoulder muscles underscore the program's efficacy. These findings offer valuable insights for strength training and can be a reference for future studies or training programs. Moreover, the results suggest that such a program can be seamlessly integrated into the training routine of karate practitioners to enhance their overall performance and muscle strength. This study establishes a foundational understanding of how targeted strength training can benefit specific muscle groups crucial for martial arts performance, thereby providing valuable insights for further research and practical applications in sports training.

ObjectiveThis study analyzes muscle synergy patterns during maximal-effort upper limb testing. The aim was to examine neuromuscular coordination and identify hidden compensatory activations that could inform ergonomic and rehabilitative strategies for preventing work-related upper limb disorders (WRULDs).Material and MethodsSurface electromyography (sEMG) was recorded from six pairs of upper limb muscles: the deltoids, biceps brachii, brachioradialis, triceps brachii, wrist flexors, and wrist extensors. Twenty-three healthy adults (median age 24.69±4.13) underwent a standardized series of classic isolated manual strength tests for each muscle group, performed at maximal effort. For each trial, the muscle showing the highest sEMG amplitude was identified as the dominant contributor and compared to the intended target. Statistical analyses were performed using Jamovi, including chi-square tests and Cohen’s Kappa to assess agreement.ResultsAcross 276 trials, the intended muscle was dominant in 72% of cases. In the remaining 28%, a different muscle produced the highest activation, indicating frequent synergistic compensation. The biceps brachii failed to dominate in 65% of its own tests, with the deltoid or brachioradialis often taking over. The deltoid was the dominant muscle in 26% of all trials. In contrast, triceps and deltoid tests showed high isolation success (98–100%). Concordance between tested and dominant muscles was moderate (Cohen’s κ ≈ 0.66; χ² p < 0.001, statistically significant). No consistent side-dominance patterns were observed.ConclusionsEven in standardized strength testing, healthy individuals frequently recruit alternate muscles. Persistent synergy patterns may contribute to WRULD development over time. Identifying such patterns could enable earlier ergonomic interventions, more targeted rehabilitation, and refinement of muscle testing protocols.

The primary purpose of this study was to determine whether muscle strength or power is a better predictor of fallers (including both single and recurrent) in everyday living conditions among community-dwelling older adults. Secondly, we identified the optimal threshold of the identified fall predictors to best differentiate fallers from non-fallers. Ninety-four healthy older adults (72.0 ± 5.5 years) participated in the study. After reporting retrospective falls from the past year, participants were assessed for isometric strength capacities of the knee extensors and flexors. Lower limb power performance was calculated based on the time used to complete the five times sit-to-stand (STS) test. Fifty-six participants (59.6%) reported not falling, and 38 participants (40.4%) reported one or more falls in the past year. No significant differences were found between non-fallers and fallers for knee extensor (p = 0.729) and flexor (p = 0.157) strength capabilities. Non-fallers took significantly less time to complete the STS test (p = 0.010) and demonstrated more leg muscle power (p = 0.016) than fallers. The overall accuracy of classifying fallers and non-fallers was 63.8% and 64.9% for leg muscle power and the STS duration, respectively. The leg power and STS duration optimal cutoff values to discriminate fallers and non-fallers were determined as 1.3 W/(kg × m) and 12 s. Results suggest that STS leg muscle power is more predictive of everyday living falls than strength in community-dwelling older adults. Findings provide valuable information to assist with screening high fall risk older adults and develop muscle power training-based interventions to prevent falls in this population.

ObjectiveThis study aims to evaluate arm muscle testing techniques in healthy individuals as a preliminary step towards incorporating these methods into compulsory medical exams (CMEs) for early detection of work-related upper limb disorders (WURLDs).MethodsSix muscle groups (deltoids, biceps brachii, brachioradialis, triceps brachii, wrist flexors, and extensors) were examined using clinical muscle strength testing, dynamometry and surface electromyography (sEMG) in 26 healthy individuals. BMI was recorded. Thermography was used to detect trigger points. Data analysis was performed using IBM SPSS 27.ResultsSignificant correlations were observed between clinical assessments and dynamometry in the deltoids (p=0.007, 95% CI [0.02, 0.62]), brachioradialis (p=0.045, 95% CI [0.01, 0.57]), and triceps (p=0.019, 95% CI [0.03, 0.64]), as well as between dynamometry and sEMG in the deltoids (p=0.039, 95% CI [0.01, 0.56]), brachioradialis (p=0.093, 95% CI [0.00, 0.52]), and triceps (p=0.170, 95% CI [0.02, 0.54]). Correlations were found between BMI and muscle strength in the deltoids (right: r=0.51, p=0.007, 95% CI [0.15, 0.75]; left: r=0.45, p=0.019, 95% CI [0.08, 0.71]), biceps (right: r=0.42, p=0.026, 95% CI [0.05, 0.68]; left: r=0.40, p=0.035, 95% CI [0.03, 0.66]), and right brachioradialis (r=0.37, p=0.045, 95% CI [0.01, 0.65]). Overweight individuals were more likely to have detectable brachioradialis trigger points on thermography.ConclusionsThese findings show significant correlations between clinical and instrumental examination methods, supporting the potential integration of these techniques into CMEs for early detection of WURLDs. Future research should focus on larger sample sizes and longitudinal studies to validate these findings.

For quantifying muscle strength in clinical and research practice, establishing the reliability of measurements, specifically to the procedures used, is essential for credible findings. The objective was to establish the reliability of isokinetic measurement of ankle plantar and dorsal flexors (PF/DF) and invertors and evertors (INV/EV) on an IsoMed 2000 dynamometer. Twenty healthy subjects (10 males, 10 females, mean age: 23.1 ± 3.1 years) completed an isokinetic measurement session. The intraclass correlation coefficient (ICC) and standard error of measurement were assessed for peak torque and work of ankle PF/DF (concentric and eccentric) and INV/EV (concentric) for the preferred and nonpreferred limb. Standardized isokinetic measurements of reciprocal PF/DF and INV/EV muscle actions were associated with ICC ranging from 0.77 to 0.98 for the majority of observed parameters. The exception was work in the eccentric mode in the ankle DF and peak torque in the concentric mode in the ankle INV on the preferred limb, where ICC ranged from 0.64 to 0.71. The IsoMed 2000 isokinetic dynamometer can be reliably employed in future studies for reciprocal ankle PF/DF and INV/EV assessment in healthy adult subjects after implementation of a familiarization session.

Background and purpose Soong classification is used to estimate volar locking plate prominence and evaluate the risk for flexor tendon ruptures after surgical treatment of distal radius fractures (DRFs). However, the scientific community has questioned the Soong classification due to lacking evidence. Therefore, this study aimed to evaluate the accuracy of Soong grading as a predictor for flexor tendon issues and plate removal. Patients and methods We performed a retrospective single-center review of adult distal radius fracture patients treated with a volar locking plate between 2009 and 2019. In total, 2779 patients were included in the study. The primary outcome was a flexor tendon issue (flexor tendon rupture, tendinitis, or flexor irritation), whereas plate removal was a secondary outcome. Using Soong grade 0 as a reference, we used univariable and multivariable logistic regression to calculate odds ratios (OR) with 95% confidence intervals (CI) for flexor tendon issues and plate removal. Results In total, 756 (27%) patients were graded as Soong 0, 1679 (60%) Soong 1, and 344 (12%) Soong 2, respectively. There were 32 (1.2%) patients with flexor tendon issues, of which 4 were flexor tendon ruptures, 8 tendinitises, and 20 flexor irritations. The adjusted OR for flexor tendon issues was 4.4 (CI 1.1–39.7) for Soong grade 1 and 9.7 (CI 2.2–91.1) for Soong grade 2. The plate was removed from 167 (6.0%) patients. Soong grade 1 had a univariable OR of 1.8 (CI 1.2–2.8) for plate removal, and Soong grade 2 had an OR of 3.5. (CI 2.1–5.8), respectively. Conclusion Flexor tendon ruptures are rare complications after the volar plating of DRFs. A higher Soong grade is a risk factor for flexor tendon issues and plate removal. Trial registration The trial was retrospectively registered.

This study investigates the impact of increasing backpack load on the gait of adolescents during stair descent. Sixteen healthy male students (age = 12.9 ± 0.6 years) were required to descend the stairs in 4 loaded conditions. The kinematic, kinetic, and EMG data were collected synchronously and gait parameters, especially indicators of balance control, were analyzed. The posterior tilt angles (COM-COP IA in the sagittal plane) (0%–42%, 48%–53%, 58%–91%, p < 0.01), trunk anterior tilt angles (9–33%, 51–65%, p < 0.01), and CV of stride length (p < 0.01) increased with the backpack load. The COM-Step edge separation decreased with the increased backload (p < 0.01). In addition, the hip flexion torque (25–40%, 45–51%, p < 0.01), the rectus femoris activation, and the hip stiffness increased significantly as the load up to 15% Body Weight (BW)and 20% BW. The increasing backpack load may affect adolescent’s stair descent gait. Especially as the load was up to 15% BW, the adolescents’ bodies tended to tilt backwards relative to the support foot during the single stance phase. They may activate the hip flexors and tilt forward the trunk to recover from the balance perturbation, which was associated with increased hip flexion torques. This adjustment was more pronounced with the increasing backpack load. However, excessive forward flexion may increase the risk of forward falls. The boundaries of adjustment need further research in the future. Findings from this study provide baseline information on the intrinsic mechanisms of balance control during stair descent.

Shot putters throw a heavy shot by “pushing”. Pushing involves the coordinated extension of multiple joints and is a common motor task for both upper and lower limbs. In lower limb musculature, proximal-specific development and association with motor performance have been shown in athletes. However, as the upper limb is not mechanically loaded to support the body during daily locomotion, it may develop differently from the lower limb. We investigated the cross-sectional area of the prime movers of the upper limb and upper trunk (pectoralis major, deltoid, triceps brachii, and palmar flexors) in eleven male shot put athletes and fourteen untrained males by obtaining magnetic resonance images and manually tracing the muscles on the images. All target muscles were significantly larger in athletes than non-athletes (p < 0.01), with “huge” effect sizes for the pectoralis major and palmar flexors (d = 2.74, 2.04). All target muscle cross-sectional areas were positively correlated with season best record (r ≥ 0.62, p ≤ 0.04), with a particularly strong correlation for the palmar flexors (r = 0.96). These results suggest that the distal muscles of the upper limb are also expected to develop and are strongly associated with motor performance. This is especially true for the distal upper limb muscles (palmar flexors) in shot putters. These findings provide insight into potential training interventions for athletic performance in forceful upper limb movements.