Cycling kinematics in healthy adults for musculoskeletal rehabilitation guidance

Background Stationary cycling is commonly used for postoperative rehabilitation of physical disabilities; however, few studies have focused on the three-dimensional (3D) kinematics of rehabilitation. This study aimed to elucidate the three-dimensional lower limb kinematics of people with healthy musculoskeletal function and the effect of sex and age on kinematics using a controlled bicycle configuration. Methods Thirty-one healthy adults participated in the study. The position of the stationary cycle was standardized using the LeMond method by setting the saddle height to 85.5% of the participant’s inseam. The participants maintained a pedaling rate of 10–12 km/h, and the average value of three successive cycles of the right leg was used for analysis. The pelvis, hip, knee, and ankle joint motions during cycling were evaluated in the sagittal, coronal, and transverse planes. Kinematic data were normalized to 0–100% of the cycling cycle. The Kolmogorov-Smirnov test, Mann-Whitney U test, Kruskal-Wallis test, and k-fold cross-validation were used to analyze the data. Results In the sagittal plane, the cycling ranges of motion (ROMs) were 1.6° (pelvis), 43.9° (hip), 75.2° (knee), and 26.9° (ankle). The coronal plane movement was observed in all joints, and the specific ROMs were 6.6° (knee) and 5.8° (ankle). There was significant internal and external rotation of the hip (ROM: 11.6°), knee (ROM: 6.6°), and ankle (ROM: 10.3°) during cycling. There was no difference in kinematic data of the pelvis, hip, knee, and ankle between the sexes (p = 0.12 to 0.95) and between different age groups (p = 0.11 to 0.96) in all anatomical planes. Conclusions The kinematic results support the view that cycling is highly beneficial for comprehensive musculoskeletal rehabilitation. These results might help clinicians set a target of recovery ROM based on healthy and non-elite individuals and issue suitable guidelines to patients.

Musculoskeletal Rehabilitation, Strength, and Conditioning

This chapter is comprised of 15 clinically based and also knowledge based questions and answers. The corresponding answers to the questions can be found at the end of the chapter, each of which has a short explanation and at least one reference.

Musculoskeletal Rehabilitation Status Monitoring Based on sEMG

The reduction and improper movements in people’s modern life will lead to physical discomfort, pain, and inflammation, which have generally affected the quality of people’s daily life and work efficiency. The pain caused by improper movements are called musculoskeletal pain, which can be relieved or eliminated with treatment. Musculoskeletal disorders are actually one of the most common medical conditions, which affects approximately one quarter of all adults in the world. Although surface electromyography (sEMG) is an acknowledged technology in musculoskeletal rehabilitation study, it is considerably significant to monitor the musculoskeletal rehabilitation status based on sEMG. In order to monitor the musculoskeletal rehabilitation status, we combine fuzzy theory with neural network. This article proposes variable size, sliding window-based, generalized, dynamic, fuzzy neural network (GD-FNN), musculoskeletal rehabilitation status monitoring, that is, the window length of sliding window of sample data changes with the size of sample period. Finally, this study made a simulation on subjects, and the experimental results show that the proposed variable size, sliding window-based GD-FNN, musculoskeletal rehabilitation status monitoring method not only has good monitoring effect but also put on a good performance in root-mean-squared error (RMSE) and mean absolute percentage error (MAPE).

mHealth Apps for Musculoskeletal Rehabilitation: State of the Practice Review (Preprint)

BACKGROUND The number of mobile health (mHealth) apps released for musculoskeletal (MSK) injury treatment and self-management of home-exercise programmes (HEPs) has risen rapidly in recent years as digital health interventions are explored and researched in more detail. As this number grows, it is becoming increasingly difficult for users to navigate the market and select the most appropriate app for their use-case. It is also unclear as to what features developers of these apps are harnessing to support patient self-management, and how they fit into clinical care pathways. OBJECTIVE The objective of this study was to scope the current market of mHealth apps for MSK rehabilitation and to report on the app features, claims, evidence-base and functionalities. METHODS A cross-sectional study of apps for MSK rehabilitation was performed across both major app stores: iOS App Store and Google Play Store. Four search terms were used; physiotherapy rehabilitation, physical therapy rehabilitation, rehabilitation exercise and therapeutic exercise, to identify apps which were then cross-referenced against set selection criteria by four reviewers. Each reviewer, where possible, downloaded the app and accessed supplementary literature available on the product to assist in data extraction. RESULTS A total of 1322 apps were identified. After application of the inclusion/exclusion criteria and removal of duplicates, 144 apps were included in the study. Over half of the included apps (56.3%) had been released within the past three years. Three quarters (74.3%) of the apps made no reference to evidence supporting the design or efficacy of the app, with only 11.1% providing direct citations to research. The majority of apps did utilise exercise pictures (95.8%) or videos (67.4%), however comparatively few harnessed additional features to encourage engagement and support self-management such as an adherence log (45.8%), communication portal (22.2%), patient reported outcome capture (25%), or direct feedback (39.6%). Of note, and somewhat concern, many of these apps prescribed generic exercises (64.6%) in the absence of individualised input to the user, with few providing specific patient education (34%), and safety advice or disclaimers (26.4%). CONCLUSIONS The cohort of apps included in this study contained a large heterogeneity of features meaning it is difficult for users to identify the most appropriate or effective app. Many apps are missing the opportunity to offer key features which could promote exercise adherence and encourage self-management in musculoskeletal rehabilitation. Furthermore, very few developers currently offering products on the market are providing evidence to support the design and efficacy of their technologies.

Implementing the 27 PRISMA 2020 Statement items for systematic reviews in the sport and exercise medicine, musculoskeletal rehabilitation and sports science fields: the PERSiST (implementing Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science) guidance

Poor reporting of medical and healthcare systematic reviews is a problem from which the sports and exercise medicine, musculoskeletal rehabilitation, and sports science fields are not immune. Transparent, accurate and comprehensive systematic review reporting helps researchers replicate methods, readers understand what was done and why, and clinicians and policy-makers implement results in practice. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement and its accompanying Explanation and Elaboration document provide general reporting examples for systematic reviews of healthcare interventions. However, implementation guidance for sport and exercise medicine, musculoskeletal rehabilitation, and sports science does not exist. The Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science (PERSiST) guidance attempts to address this problem. Nineteen content experts collaborated with three methods experts to identify examples of exemplary reporting in systematic reviews in sport and exercise medicine (including physical activity), musculoskeletal rehabilitation (including physiotherapy), and sports science, for each of the PRISMA 2020 Statement items. PERSiST aims to help: (1) systematic reviewers improve the transparency and reporting of systematic reviews and (2) journal editors and peer reviewers make informed decisions about systematic review reporting quality.

Musculoskeletal Rehabilitation: State-of-the-Art

Musculoskeletal rehabilitation has been receiving growing attention in the scientific research field taking into account the functional consequences of chronic pain that have been frequently underestimated and undertreated. The usual rehabilitative care of a wide range of diseases affecting physical function and independence in activities of daily living needs to be improved with novel approaches. In this scenario, the recent literature has highlighted the great advantages of multidisciplinary and comprehensive pain management. The Special Issue highlights the importance of advancements in musculoskeletal rehabilitation in terms of instrumental physical therapies, therapeutic exercise, osteopathic manual therapy, innovative approaches and the correlation with dentistry. Physicians should be aware of the presence of novel therapeutic approaches that are changing the clinical scenario of musculoskeletal rehabilitation.

Cycling Kinematics in Healthy Adults for Musculoskeletal Rehabilitation Guidance

Background: Stationary cycling is commonly used for postoperative rehabilitation of physical disabilities, but few studies have focused on the three-dimensional (3D) kinematics of rehabilitation. This study aimed to elucidate the three-dimensional lower limb kinematics of musculoskeletally healthy people and the effect of sex and age on kinematics using a controlled bicycle configuration.Methods: Thirty-one healthy adults participated in the study. The stationary cycle positioning was standardized using the LeMond method by setting the saddle height to 85.5% of the participant’s inseam. The participants maintained a pedaling rate of 10–12 km/h, and the average value of three successive cycles of the right leg was used for analysis. The pelvis, hip, knee, and ankle joint motions during cycling were evaluated in the sagittal, coronal, and transverse planes. Kinematic data were normalized to 0–100% of the cycling cycle. The Kolmogorov-Smirnov test, Mann-Whitney U test, Kruskal-Wallis test, and k-fold cross-validation were used to analyze the data.Results: In the sagittal plane, the cycling ranges of motion (ROMs) were 1.6° (pelvis), 43.9° (hip), 75.2° (knee), and 26.9° (ankle). The coronal plane movement was observed in all joints, and the specific ROMs were 6.6° (knee) and 5.8° (ankle). There was significant internal and external rotation of the hip (ROM: 11.6°), knee (ROM: 6.6°), and ankle (ROM: 10.3°) during cycling. There was no difference in kinematic data of the pelvis, hip, knee, and ankle between sexes (p = 0.12 to 0.95) and among ages (p = 0.11 to 0.96) in all anatomical planes.Conclusions: The kinematic results support the assertion that cycling is highly recommended for comprehensive musculoskeletal rehabilitation. These results may help clinicians choose a target recovery ROM based on healthy and non-elite individuals and issue suitable guidelines to patients.