Effects of a Randomized Home-Based Quality of Movement Protocol on Function, Posture and Strength in Outpatients with Obesity

The aim of this study was to determine the effects of two different home-based training interventions on functional parameters and body composition in obese patients. Sixty-four obese patients were recruited at the IRCCS Istituto Auxologico Italiano and randomly assigned into a movement quality group (MQ) and a conventional training group (CT). In the MQ, the training protocol combined various stimuli based on whole-body movement patterns, mobility, motor control and diaphragmatic breathing. The CT included traditional bodyweight resistance-training exercises. All patients were tested for movement efficiency (Functional Movement Screen, FMS), postural control (Modified Balance Error Scoring System, M-BESS), breathing pattern (Total Faulty Breathing Scale, TFBS), muscular strength (Handgrip Strength Test, HST and Five Repetition Sit to Stand, FRSTS) and body composition (Waist Circumference, WC, Body Mass Index, BMI, Body fat mass percentage, Fat Mass) before and after a 6-week period of training. Significant interactions and main effects of time (p < 0.0001) were found in MQ compared to CT in the FMS, M-BESS and TFBS parameters, while muscular strength (HST, FRSTS) and body composition parameters improved similarly in both groups with a main effect of time (p < 0.05). These findings suggest that a 6-week movement quality training is effective in ameliorating postural control and movement efficiency with similar improvements in muscular strength and body composition compared with a mere traditional home-based training. Fitness coaches and practitioners might consider the MQ intervention as a valuable alternative to conventional training when treating obesity.

Movement Quality Parameters During Gait Assessed by a Single Accelerometer in Subjects with Osteoarthritis and Following Total Joint Arthroplasty

Background: This study aimed to evaluate which of movement quality parameters measured with a single trunk worn Inertial Measurement Unit (IMU) can distinguish the gait pattern of people with hip or knee osteoarthritis (OA) compared to asymptomatic controls. Secondly, we evaluated the sensitivity of these parameters to capture gait changes at 6 weeks, 3, 6, and 12 months following total knee arthroplasty (TKA). Thirdly, we investigated whether observed changes in movement quality from 6 weeks and 12 months following total knee arthroplasty were related to changes in patient-reported outcome measures.Methods: Twenty people with hip OA, 18 people with knee OA, and 20 asymptomatic controls participated in this study. Seventeen people with knee OA were treated with a TKA and additionally followed for one year postoperatively. The participants were equipped with a single trunk-worn IMU and were instructed to walk back and forth along a 10m walkway at a self-selected speed. The movement quality parameters (quantified by symmetry—step/stride regularity; complexity—Sample entropy; smoothness—Log Dimensionless Jerk; and dynamic stability—maximum Lyapunov Exponent) were calculated from the raw 3D acceleration signal. Comparisons were made between groups and between timepoints in the TKA patients. Finally, changes in movement quality were correlated with patient-reported outcomes in the TKA group.Results: We found significant group differences in movement symmetry and stability pre-operatively. Post-TKA, all parameters, except movement smoothness, reflected an initial decrease in movement quality at 6 weeks post-TKA, but all except movement complexity, normalised after 6 months. Moreover, improved movement quality (6 weeks-12 months post-TKA) related to improvements in patient-reported outcome measures.Conclusions: A single lower back IMU can characterise movement quality before and after a total joint arthroplasty. Most symmetry measures recovered but a more unstable, less complex gait pattern was observed at follow-up. The correlation between these parameters and patient-reported outcome measures shows the potential to monitor movement quality in a clinical setting to inform objective data driven personalised rehabilitation of quantified gait symmetry, stability, complexity, and smoothness.

Attitudes toward signing human avatars vary depending on hearing status, age of signed language exposure, and avatar type

The use of virtual humans (i.e., avatars) holds the potential for interactive, automated interaction in domains such as remote communication, customer service, or public announcements. For signed language users, signing avatars could potentially provide accessible content by sharing information in the signer’s preferred or native language. As development of signing avatars has gained traction in recent years, many different methods of creating signing avatars have been developed, and the resulting avatars vary widely in their appearance, the naturalness of their movements, and their facial expressions--all of which may potentially impact users’ acceptance of the avatars. We designed a study to test the effects of these intrinsic properties of different signing avatars, while also examining the extent to which people’s own language experiences change their responses to signing avatars. We created video stimuli showing individual signs produced by 1) a live human signer (Human), 2) an avatar made using computer-synthesized animation (CS Avatar), and 3) an avatar made using high-fidelity motion capture (Mocap avatar). We surveyed 191 American Sign Language users, including Deaf (N = 83), Hard-of-Hearing (N = 34), and Hearing (N= 67) groups. Participants rated the three signers on multiple dimensions which were then combined to form ratings of Attitudes, Impressions, Comprehension, and Naturalness. Analyses demonstrated that the Mocap avatar was rated significantly more positively than the CS avatar on all primary variables. Correlations revealed that signers who acquire sign language later in life are more accepting of, and likely to have positive impressions of signing avatars. Finally, those who learned ASL earlier were more likely to give lower, more negative ratings to the CS avatar, but this association was not seen for the Mocap avatar or the Human signer. Together, these findings suggest that movement quality and appearance significantly impact users’ ratings of signing avatars, and show that signed language users with earlier age of ASL exposure are the most sensitive to movement quality issues seen in computer-generated avatars. We suggest that future efforts to develop signing avatars be considerate of retaining the fluid movement qualities which are integral to signed languages.

Visual assessment of movement quality: a study on intra- and interrater reliability of a multi-segmental single leg squat test

Background The Single Leg Squat test (SLS) is a common tool used in clinical examination to set and evaluate rehabilitation goals, but there is not one established SLS test used in the clinic. Based on previous scientific findings on the reliability of the SLS test and with a methodological rigorous setup, the aim of the present study was to investigate the intra- and interrater reliability of a standardised multi-segmental SLS test. Methods We performed a study of measurement properties to investigate the intra- and interrater reliability of a standardised multi-segmental SLS test including the assessment of the foot, knee, pelvis, and trunk. Novice and experienced physiotherapists rated 65 video recorded SLS tests from 34 test persons. We followed the Quality Appraisal for Reliability Studies checklist. Results Regardless of the raters experience, the interrater reliability varied between “moderate” for the knee variable (ĸ = 0.41, 95% CI 0.10–0.72) and “almost perfect” for the foot (ĸ = 1.00, 95% CI 1.00–1.00). The intrarater reliability varied between “slight” (pelvic variable; ĸ = 0.17, 95% CI -0.22-0.55) to “almost perfect” (foot variable; ĸ = 1.00, 95% CI 1.00–1.00; trunk variable; ĸ = 0.82, 95% CI 0.66–0.97). A generalised kappa coefficient including the values from all raters and segments reached “moderate” interrater reliability (ĸ = 0.52, 95% CI 0.43–0.61), the corresponding value for the intrarater reliability reached “almost perfect” (ĸ = 0.82, 95% CI 0.77–0.86). Conclusions The present study shows a “moderate” interrater reliability and an “almost perfect” intrarater reliability for the variable all segments regardless of the raters experience. Thus, we conclude that the proposed standardised multi-segmental SLS test is reliable enough to be used in an active population.

Age Is More Predictive of Safe Movement Patterns Than Are Physical Activity or Sports Specialization: A Prospective Motion Analysis Study of Young Athletes

Background: Movement quality and neuromuscular balance are noted predictors of acute injury. Early sports specialization and extremely high activity levels have been linked to elevated risk of injury. Purpose: To investigate for any relationships among quality of physical movement, quantity of physical activity, and degree of sports specialization in a healthy cohort of active children and adolescents. Study Design: Cross-sectional study with prospectively collected data. Methods: Healthy children between the ages of 10 and 18 years were recruited and completed the Hospital for Special Surgery Pediatric Functional Activity Brief Scale to assess quantity of physical activity and the Jayanthi scale to assess degree of sports specialization (high, score of 2 or 3; low, score of 0 or 1). Movement quality was assessed using motion analysis sensors during 5 repetitions of 4 different jumping and squatting motions, with a maximum score of 100 per participant. Independent-samples t tests were used to compare participants with high versus low specialization on physical activity and movement quality. A Spearman correlation was used to determine the relationship between quantity of physical activity and movement quality, and linear regression was used to assess for the effect of participant age on relevant covariables. Results: Final analyses included 147 participants (72% male) with a mean ± SD age of 13.4 ± 2.2 years. Participants who were highly specialized displayed better movement quality than did participants with low sports specialization (27.6 ± 14.0 vs 19.8 ± 10.1; P < .01). Participants who were highly specialized had significantly higher activity levels (24.6 ± 5.9 vs 18.1 ± 6.9; P < .001). Movement quality was moderately correlated with physical activity level ( r = 0.335; P < .001). Physical activity; hours of organized sports activity; hours of free, unorganized physical activity; and specialization level were not significant predictors of movement quality when controlling for age. Age alone predicted 24.2% of the variance in the overall movement quality score ( R2 = 0.242; B = 3.0; P < .001). Conclusion: This study found that sports specialization and physical activity levels were not associated with movement quality when controlling for age, which was the most important variable predicting athletic movement quality. Although all participants displayed movement patterns that were associated with high risk for injury, overall movement quality improved with advancing chronological age. Clinical Relevance: All young athletes should ensure that neuromuscular training accompanies sport-specific training to reduce risk of injury.