The clinical examination of patients with cervical spine pathology includes measures of posture, mobility, strength, and stability. The forward head position as measured by craniovertebral angle (CVA) has been suggested as a risk factor for cervical spine pathology. The purpose of this study was to describe CVA reference values in healthy adults and assess the relationship with age and sex. This prospective cross-sectional observational study measured the CVA in 122 healthy adults using digital analysis of a lateral view photograph. To facilitate this analysis, a marker was placed at the level of the C7 vertebra, with the tragus of the ear visible in the photograph. The CVA was measured using Kinovea 0.8.15 software, where the CVA was calculated using the intersection of a horizontal line with a line joining the spinous process of C7 and the tragus of the ear. Mean CVA values were 48.76° (6.77) across all participants, 50.07° (6.63) for females, and 47.46° (6.71) for males. Linear regression analysis indicated significant relationships with age and with sex. The study established CVA reference values in healthy adults and identified a significant difference in head position between males and females and a 1.6° decrease in CVA per decade of increased age.

Active motion examination of patients with cervical spine-related pathologies is necessary to establish baseline function, set physical therapy goals, and choose interventions. This study investigated the sagittal plane active range of motion (ROM) of the global (GCS) and upper cervical spine (UCS) in relation to age and sex in healthy volunteers. One hundred twenty-two volunteers aged 18 to 75 years participated. Volunteers were excluded if they displayed any characteristic that could affect cervical spine ROM. GCS and UCS flexion and extension were each measured three times using a CROM device. Linear regression models (LRMs) were developed to explore the relationships between age and sex and GCS and UCS ROM. The LRM for age showed a decrease in GCS flexion (−2.01°), GCS extension (−3.33°), and UCS extension (−1.87°) for every decade of increasing age. The LRM for sex showed that men displayed less ROM than women in GCS extension (−6.52°) and UCS extension (−2.43°). These results suggest an age-related loss of sagittal plane GCS ROM and UCS extension ROM, and sex-related differences in GCS and UCS extension with women having greater motion than men.

To identify the optimal distances to accelerate and decelerate in the 4-meter (4mWT) and 6-meter (6mWT) walking tests at comfortable and fast pace in people with stroke. A cross-sectional study was conducted with 49 individuals (median age 59.45 years). Participants completed three repetitions of each walk test (4mWT and 6mWT) at comfortable and fast pace. Data were collected using an OptiTrack motion capture system (8-camera). Acceleration and deceleration distances were defined as the distances required to reach and reduce from average walking speed, respectively. For the 4mWT, the optimal acceleration and deceleration distances were 1.12-m and 1.17-m at a comfortable pace, and 1.48-m and 1.50-m at a fast pace. For the 6mWT, they were 1.37-m and 1.88-m at a comfortable pace, and 1.89-m and 2.39-m at a fast pace. It is recommended to include 1.2-m at a comfortable or 1.5-m at a fast pace for acceleration and deceleration in the 4mWT and 2-m for acceleration at both comfortable and fast pace, 2-m for deceleration at a comfortable pace and 2.5-m for deceleration at fast pace in the 6mWT. Incorporating these distances may enhance the validity and comparability of walking speed assessments in stroke populations. Clinicaltrials.gov NCT0567901.

Background: Energy saving in race walking is an essential element of sports competition. The aim of this study was to determine the influence of increasing velocity in elite race walkers within the range of 8 to 15kmhr-1 on lateral, anterior-posterior, and vertical displacements of the center of mass (CoM), standardized for body height and stride length. Methods: The study involved 10 competitive race walkers of international champion level. They performed walking tests on a treadmill, with velocity increased by 1 kmhr-1 from 8 kmhr-1 to 15 kmhr-1. Movement was recorded using the Vicon system for motion spatial capture. Absolute, momentary lateral CoM_X(t), anterior-posterior CoM_Y(t), and vertical CoM_Z(t) changes in CoM placement in the gait cycle were calculated using a kinematic method and then standardized for body height (H) and stride length (STRL). Results: Increased gait velocity was associated with greater lateral CoM_X(t)std oscillations (by ca. 0.21% for H) and a decrease by 0.91% for STRL. These changes were statistically significantly different for technical and starting speeds, as well as between the lowest experimental speed and threshold/racing speeds. The anterior-posterior CoM_Y(t)std oscillations decreased by ca. 0.45% (H) and 1.79% (STRL), showing significant differences for technical, threshold, and racing speeds, as well as between the lowest experimental speed and technical, threshold, and racing speeds. The vertical component CoM_Z(t)std initially increased by 0.27% (STRL) up to 11 kmhr-1, and then decreased by 0.5% (STRL) to 15kmhr-1, whereas the variable standardized for body height increased by 0.56% (H), demonstrating significant contrasts between the lowest experimental speed and technical, threshold, and racing speeds. Conclusions: The highest decrease in oscillations (by 1.8% STRL) with increasing gait velocity was recorded for the anteriorposterior displacement of CoM standardized for stride length.

Background: Patients with temporomandibular disorders (TMD) often exhibit widespread hypersensitivity and comorbidities, suggesting nociplastic pain (NP) involvement. Aerobic exercise (AE) and strength training (ST) enhance tissue oxygenation, pain inhibition, and quality of life. This study compares AE and ST, combined with physical therapy (PT), on NP and TMD clinical features. Methods: This randomized‐controlled trial with blinded assessors assigned 43 TMD and NP patients to PT ( n = 15), PT + AE ( n = 15), or PT + ST ( n = 13). A 6‐week intervention included 12 PT sessions (education, manual therapy, jaw/neck exercises), with PT + AE performing high‐intensity intervallic AE (stationary bike) and PT + ST upper/lower extremities exercises. Primary outcome: pressure pain thresholds (PPT) with algometer. Secondary outcomes: central sensitization (CS)‐related symptoms, muscle strength, pain intensity, anxiety, sleep quality, kinesiophobia. Outcomes were assessed post‐intervention (T1) and at 12‐week follow‐up (T2). Results: At T1, PT + AE demonstrated significant reductions than PT in CS (−9.5; p = 0.04), pain (−23.2; p = 0.04), kinesiophobia (−4.1; p = 0.04), sleep impairment (−3.8; p = 0.01). Pain reductions persisted at T2 (VAS −26.2; p = 0.04). PT + ST reduced kinesiophobia only at T2 (−3.8; p = 0.01). At T1, PT + AE improved proximal‐PPT against PT + ST (−0.52 kg/cm ² ; p = 0.03), while PT + ST enhanced trapezius strength (10.9 kg; p < 0.01). Conclusions: Adding AE or ST to PT improves outcomes in TMD patients and NP, with PT + AE reducing pain and CS‐related symptoms more effectively.

Background/Objectives: Eccentric loading during landing is considered a key factor in the development of patellar tendinopathy and is associated with stiff landings and patellar tendinopathy. This study aims to investigate the relationship between tendon structure, presence of pain, and sex differences in landing kinematics and kinetics during countermovement jumps (CMJ) and tuck jump tests (TJT) in professional volleyball players. Methods: Professional volleyball players aged 18 to 30 years old (14 females and 25 males) participated in a cross-sectional study. Data included the Victorian Institute of Sport Assessment Patellar Tendon (VISA-P) questionnaire; patellar tendon ultrasound characterization tissue (UTC) scans, in order to identify groups with misaligned tendon fibers (MTF) or aligned tendon fibers (ATF); and biomechanical assessments for CMJ and TJT. The joint angle (JA) at the lower limb was measured at peak ground reaction force (peak_vGRF) and maximal knee flexion (max_KF). A general linear model was used to evaluate joint JA differences between tendon alignment, pain, and sex variables. Sample t-tests compared peak_vGRF, load time, load rate, and area based on tendon alignment, pain presence, sex, and jump. The statistical significance of p-value is >0.05, and the effect size (ES) was also calculated. Results: The MTF group revealed decreased knee JA during TJT at peak_vGRF (p = 0.01; ES = −0.66) and max_KF (p = 0.02; ES = −0.23). The presence of pain was associated with increased JA during the CMJ, particularly at peak_vGRF and max_KF for trunk, hip, and ankle joints. Females showed decreased peak_vGRF than males. Landing with misaligned tendon fibers showed longer load times compared to aligned tendon fibers (p = 0.021; ES = −0.80). The TJT exhibited a greater load rate than the CMJ (p = 0.00; ES = −0.62). Conclusions: Pain is a critical factor influencing greater JA during landing, particularly at the trunk, hip, and ankle joints in CMJ. Misaligned tendon fibers compromise landing dynamics by increasing trunk JA during TJT. Kinetics varied significantly by sex and jump type, while pain and tendon structure revealed limited differences.