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Comparing Knee Kinetics and Kinematics in Healthy Individuals and Those With Knee Osteoarthritis, With and Without Flat Feet

Maryam Sohrabi, Giti Torkaman, and Fariba Bahrami

Individuals with knee osteoarthritis (KOA) and flat feet are more likely to experience increased pain and cartilage damage. This study aimed to investigate the knee kinetics, kinematics, pain, and physical function in individuals with moderate symptomatic KOA, in comparison to asymptomatic control participants. Thirty volunteers with moderate KOA (with flat feet n = 15, with normal feet n = 15) and 30 asymptomatic people (with flat feet n = 15, with normal feet n = 15) were evaluated. The knee adduction angular impulse, knee flexion moment, knee flexion angular impulse, and knee flexion angle were measured during level walking. The pain was assessed in patients with KOA. The study found that individuals with KOA had a significant increase in the knee adduction angular impulse compared with the asymptomatic people (P < .05). The KOA with flat feet group had significantly lower knee flexion moment, knee flexion angular impulse, and knee flexion angle values than the KOA with normal feet group (P < .05). Furthermore, the KOA with flat feet group had a higher pain score than the KOA with normal feet group. Individuals with osteoarthritis and flat feet had lower knee flexion moments which may indicate reduced knee force exerted through compensatory mechanisms. Despite this reduction, they reported significantly higher levels of pain compared with those without flat feet, a finding that warrants further investigation in future studies.

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Ten Years Gone

Patrick O. McKeon and Jennifer M. Medina McKeon

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The Midfoot Joint Complex (Foot Arch) Contributes to the Upper Body Position in Bipedal Walking and Coordinates With the Lower Limb Joints

Leonardo D. Barsante, Paula M.M. Arantes, Daniela V. Vaz, Fabricio A. Magalhães, Diego S. Carvalho, Aline C. Cruz, Renan A. Resende, Juliana M. Ocarino, Sérgio T. Fonseca, and Thales R. Souza

This study estimated the contribution of the midfoot joint complex (MJC) kinematics to the pelvis anterior–posterior positions during the stance phase of walking and investigated whether the MJC is functionally coordinated with the lower limb joints to maintain similar pelvic positions across steps. Hip, knee, ankle, and MJC sagittal angles were measured in 11 nondisabled participants during walking. The joints’ contributions to pelvic positions were computed through equations derived from a link-segment model. Functional coordination across steps was identified when the MJC contribution to pelvic position varied and the summed contributions of other joints varied in the opposite direction (strong negative covariations [r ≤ −.7] in stance phase instants). We observed that the MJC plantarflexion (arch raising) during the midstance and late stance leads the pelvis backward, avoiding excessive forward displacement. The MJC was the second joint that contributed most to the pelvis positions (around 18% of all joints’ contributions), after the ankle joint. The MJC and ankle were the joints that were most frequently coordinated with the other joints (≅70% of the stance phase duration). The findings suggest that the MJC is part of the kinematic chain that determines pelvis positions during walking and is functionally coordinated with the lower limb joints.

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Dr Charles J. (Chuck) Dillman: A Remembrance

Robert Shapiro, Robert Gregor, and John Challis

In August 2023, the biomechanics community suffered a significant loss with the death of Dr Charles J. Dillman. His work in the area of sport biomechanics was groundbreaking. In this tribute, 10 former students and 9 former colleagues remember “Chuck” and his impact on their lives, careers, and the field of biomechanics.

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Early Maladaptive Schemas, Cognitive Fusion, and Anabolic-Androgenic Steroid Use Attitudes: The Mediating Role of Muscle Dysmorphia in Iran

Mehdi Ebrahimi, Zahra Zamani, and Ebrahim Bagheri

In recent decades, the interest in having an ideal body in men has caused a pathological tendency to be muscular, followed by a tendency to use anabolic-androgenic steroids (AASs). This study was designed to evaluate the mediating role of muscle dysmorphia in the relationship between early maladaptive schemas and body image-related cognitive fusion with the tendency to use AAS in male athletes. Out of the total number of men referring to fitness clubs in Isfahan, Iran, 474 men were evaluated using a multistage random cluster sampling method. The questionnaires used in this research included the Muscle Dysmorphic Disorder Inventory, Cognitive Fusion Questionnaire—Body Image, Young Schema Questionnaire—Short Form, and Prototype Willingness Model Questionnaire. The results demonstrated that the relationship of AAS use with body image-related cognitive fusion and the three maladaptive schemas with the mediation of muscle dysmorphia is significant. The present study provides significant implications in the discussion of prevention and treatment of AAS addiction.

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The Efficiency of Respiratory Exercises in Rehabilitation of Low Back Pain: A Systematic Review and Meta-Analysis

Haiting Zhai, Liqing Zhang, JiXiang Xia, and Cheng Li

Background: Low back pain (LBP) is a common musculoskeletal disorder, and respiratory exercise is considered a nonsurgical management method. Therefore, this systematic review and meta-analysis aims to estimate the results of randomized controlled trials on the effect of respiratory training in reducing LBP and its dose relationship. Methods: The present study was conducted from January 2020 to January 2022, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (2020). Relevant studies were searched in multiple databases including PubMed, Web of Science, the Cochrane Library, EBSCO, Scopus, ScienceDirect, Wan Fang and China Knowledge Network, ClinicalTrials.gov, and Google Scholar, using a combination of MeSH/Emtree terms and free-text words. The heterogeneity of the studies was assessed using the I 2 statistic. Results: A total of 14 publications were included in the meta-analysis, with a total sample size of 698 individuals, aged 60–80 years. Respiratory exercise was effective in relieving LBP (standardized mean difference = −0.87, P < .00001) and improving physical disability (standardized mean difference = −0.79, P < .00001). The type of breathing and the total duration of breathing exercises were found to be the source of heterogeneity in this study by subgroup analysis. Subgroup analysis revealed that the most significant effect sizes of breathing resistance exercise to reduce LBP and the most significant effect sizes of breathing relaxation techniques to alleviate physical disability were performed 3 to 5 times per week and period >4 weeks. Respiratory exercise reducing LBP and improving functional disability was most effective when the total duration of the intervention was >500 minutes. Funnel plots showed that the results of the 2 overall studies were reliable without publication bias. Conclusions: Respiratory exercise can effectively reduce LBP and improve physical disability. Therefore, these exercises can be regarded as a part of a LBP management plan. We recommend an exercise program with 30 to 50 minutes, 3 to 5 times per week, and >4 weeks of breathing resistance exercise program as the most effective for treating LBP.

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In Remembrance: The Life and Legacy of Michael T. Turvey (1942–2023)

Michael A. Riley and Dagmar Sternad

Michael T. Turvey passed away on August 12, 2023 at the age of 81. This obituary aims to honor his life and career by highlighting some key events in his personal and professional life, noting some of his many remarkable accomplishments, and emphasizing his exceptional mentorship, friendship, and generosity.

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The Role of Imitation, Primitives, and Spatial Referent Coordinates in Motor Control: Implications for Writing and Reading

Shelia Guberman and Mark L. Latash

We review a body of literature related to the drawing and recognition of geometrical two-dimensional linear drawings including letters. Handwritten letters are viewed not as two-dimensional geometrical objects but as one-dimensional trajectories of the tip of the implement. Handwritten letters are viewed as composed of a small set of kinematic primitives. Recognition of objects is mediated by processes of their creation (actual or imagined)—the imitation principle, a particular example of action–perception coupling. The concept of spatial directional field guiding the trajectories is introduced and linked to neuronal population vectors. Further, we link the kinematic description to the theory of control with spatial referent coordinates. This framework allows interpreting a number of experimental observations and clinical cases of agnosia. It also allows formulating predictions for new experimental studies of writing.

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Preventing Suicide and Promoting Mental Health Among Student-Athletes From Diverse Backgrounds

Karrie L. Hamstra-Wright, John E. Coumbe-Lilley, and Eduardo E. Bustamante

Suicide and contributing mental health conditions in athletes are shared concerns within health care and society at large. This commentary focuses on suicide risk among athletes and the role of sports medicine professionals in preventing suicide and promoting mental health. In this commentary, we draw on the scientific literature and our clinical experiences to pose and answer these questions: Does suicide risk among athletes vary by sociodemographic factors (eg, sex, gender, race/ethnicity, family income, sexual orientation) or if injured? Do sociodemographic differences influence access to and benefits from services among athletes? How do I know my athletes are at risk for suicide? What do I do if one of my athletes shares with me that they have considered suicide? Within our commentary, we review the current literature and clinical practices regarding these questions and close with actionable suggestions and recommendations for future directions.

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Preparing the Athletic Trainer for Interprofessional Collaborative Practice: A Report From the Association for Athletic Training Education-Research Network

Sarah A. Manspeaker, Justin P. Young, Nicole A. Wilkins, Chad Clements, Dorice A. Hankemeier, Richelle M. Williams, Stacy E. Walker, and Lindsey E. Eberman

Contemporary health care emphasizes interprofessional collaborative practice (IPCP), described as when providers from two or more professions work together to achieve the highest-quality patient care. Historically, athletic trainers have naturally collaborated with physicians, in part due to our defined scope of practice, but more importantly as a benefit to achieving positive patient outcomes. Athletic trainers also collaborate with nurses, physical therapists, physician assistants, and other health care professionals when providing care to physically active patients and populations. Due to the oftentimes continuous contact with patients while engaging these other health care professionals, athletic trainers are well suited to expand their interprofessional collaborations to other disciplines and serve as key stakeholders in the IPCP team. To assist in this expansion of IPCP, there are several professional organizations and a substantial body of literature focusing on effective engagement in IPCP that can serve as resources for athletic training. This commentary will address the background of IPCP and the relevance of the athletic trainer within the interprofessional team, as well as identify resources for additional information.