Background: Wheelchair Tai Chi (WCTC) has been proved to have benefits for the brain and motor system of spinal cord injury (SCI) patients. However, the characteristics of corticomuscular coupling during WCTC are scarcely known. We aimed to investigate changes following SCI on corticomuscular coupling, and further compare the coupling characteristics of WCTC with aerobic exercise in SCI patients. Methods: A total of 15 SCI patients and 25 healthy controls were recruited. The patients had to perform aerobic exercise and WCTC, while healthy controls needed to complete a set of WCTC. The participants accomplished the test following the tutorial video in a sitting position. The upper limb muscle activation was measured from upper trapezius, medial deltoid, biceps brachii and triceps brachii with surface electromyography. Cortical activity in the prefrontal cortex, premotor cortex, supplementary motor area and primary motor cortex was simultaneously collected by functional near-infrared spectroscopy. The functional connectivity, phase synchronization index and coherence values were then calculated and statistically analyzed. Results: Compared to healthy controls, changes in functional connectivity and higher muscle activation were observed in the SCI group. There was no significant difference in phase synchronization between groups. Among patients, significantly higher coherence values between the left biceps brachii as well as the right triceps brachii and contralateral regions of interest were found during WCTC than during aerobic exercise. Conclusion: The patients may compensate for the lack of corticomuscular coupling by enhancing muscle activation. This study demonstrated the potential and advantages of WCTC in eliciting corticomuscular coupling, which may optimize rehabilitation following SCI.

Many studies exist on the incidence and related risk factors of running injuries, such as those obtained during marathons. However, in gorge-terrain marathons, an insufficient number of reports exist in the relevant literature. Therefore, this study aimed to explore the incidence of musculoskeletal injuries occurring in participants in the 2013 to 2018 Taroko Gorge Marathons in Taiwan and the distribution of running injuries and related influencing factors. A total of 718 runners who entered the physiotherapy station presented with records of treatment and injuries and filled out a running-related injury and self-training questionnaire for further statistical analysis. The association between risk factors and injury were evaluated by logistic regression. The injured areas on the lower extremities after the gorge marathon were as follows: 28% in the knees, 20% in the posterior calves, 13% in the thighs, 10% in the ankles, and 8% in the feet. The analysis of injury-related risk factors showed that male athletes demonstrated a higher risk of thigh injury than female athletes (OR = 2.42, p = 0.002). Underweight runners exhibited a higher risk of thigh injury (OR = 3.35, p = 0.006). We conclude that in the gorge marathon the rates of knee, calf, thigh, and foot injuries are significantly increased. Medical professionals, coaches, and runners may use the findings of this study to reduce the potential risk of running injuries in marathons.

A rehabilitation program after anterior cruciate ligament reconstruction is of great importance to obtain a satisfactory prognosis after surgery. However, there is still an onging debate over whether closed kinetic chain or open kinetic chain exercises should be chosen. Our study was designed to compare the in vivo tibiofemoral kinematics during closed kinetic chain and open kinetic chain exercises. Eighteen healthy volunteers were asked to perform box squat and unloaded/10 kg-loaded seated knee extension. In vivo 3-dimensional analysis of tibiofemoral kinematics of different motions were determined using a dual fluoroscopic imaging system. The study found significantly more tibial anterior displacement during loaded seated knee extension than during unloaded seated knee extension from 25°-50° of knee flexion (p ≤ 0.031). The knees exhibited significantly more internal tibial rotation and lateral tibial translation during the box squat than both seated knee extensions during mid-flexion. In addition, the knees showed less internal-external (IE) range of motion (ROM) from 20°- 75° of flexion (p < 0.001) and medial-lateral (ML) ROM from 75° to full extension (p ≤ 0.006) during box squat than both extensions. This knowledge may help optimize rehabilitation plans for patients post ACL reconstruction.

Background: Evidence on the effects of plantar intrinsic foot muscle exercise in older adults remains limited. This study aimed to evaluate the effect of an integrated intrinsic foot muscle exercise program with a novel three-dimensional printing foot core training device on balance and body composition in community-dwelling adults aged 60 and above. Methods: A total of 40 participants aged ≥ 60 years were enrolled in this quasi-experimental, single-group, pretest-posttest design; participants were categorized into two groups, those with balance impairment and those without balance impairment. The participants performed a 4-week integrated intrinsic foot muscle exercise program with a three-dimensional printing foot core training device. The short physical performance battery (SPPB) and timed up and go test were employed to evaluate mobility and balance. A foot pressure distribution analysis was conducted to assess static postural control. The appendicular skeletal muscle mass index and fat mass were measured by a segmental body composition monitor with bioelectrical impedance analysis. The Wilcoxon signed rank test was used to determine the difference before and after the exercise program. Results: Among the 40 enrolled participants (median age, 78.0 years; female, 80.0%; balance-impaired group, 27.5%), the 95% confidence ellipse area of the center of pressure under the eyes-closed condition was significantly decreased (median pretest: 217.3, interquartile range: 238.4; median posttest: 131.7, interquartile range: 199.5; P = 0.001) after the exercise. Female participants without balance impairment demonstrated a significant increase in appendicular skeletal muscle mass index and a decrease in fat mass. Participants in the balance-impaired group exhibited a significant increase in SPPB. Conclusions: Integrated intrinsic foot muscle exercise with a three-dimensional printing foot core training device may improve balance and body composition in adults aged 60 and above. Trial registration: ClinicalTrials.gov ID: NCT05750888 (retrospectively registered 02/03/2023).