Context: The scientific literature shows conflicting evidence about the relationship between adiposity and bone mass in overweight and obese populations. Objective: The aim of this review was to quantify the correlation between adipose mass (absolute and relative) and bone mineral density (BMD) in overweight and obese populations. Data Sources: Three databases were searched electronically. In addition, reference lists of relevant articles were screened. Study Selection: A total of 16 studies, comprising 2587 participants and 75 correlation coefficients were selected for inclusion in the review. Data Extraction: Data were extracted from each study using a standardized form. Results: Multilevel modeling indicated opposing relationships between BMD and adiposity: absolute adiposity correlated positively, and relative adiposity negatively, with BMD. Sex and age were the primary moderators of these relationships. Strong evidence supported a negative relationship between relative adipose mass and BMD in men (R = −0.37; 95%CI, −0.57 to −0.12) and in those aged less than 25 years (R = −0.28; 95%CI, −0.45 to −0.08). Conclusion: To prevent bone loss in overweight and obese populations, nutrition- and exercise-based interventions that focus on a controlled reduction of adipose mass with concomitant preservation of lean mass are recommended. Systematic Review Registration: PROSPERO no. CRD42015024313.

Assistive products are items which allow older people and people with disabilities to be able to live a healthy, productive and dignified life. It has been estimated that approximately 1.5% of the world’s population need a prosthesis or orthosis. The objective of this study was to systematically identify and review the evidence from randomized controlled trials assessing effectiveness and cost-effectiveness of prosthetic and orthotic interventions. Literature searches, completed in September 2015, were carried out in fourteen databases between years 1995 and 2015. The search results were independently screened by two reviewers. For the purpose of this manuscript, only randomized controlled trials which examined interventions using orthotic or prosthetic devices were selected for data extraction and synthesis. A total of 342 randomised controlled trials were identified (319 English language and 23 non-English language). Only 4 of these randomised controlled trials examined prosthetic interventions and the rest examined orthotic interventions. These orthotic interventions were categorised based on the medical conditions/injuries of the participants. From these studies, this review focused on the medical condition/injuries with the highest number of randomised controlled trials (osteoarthritis, fracture, stroke, carpal tunnel syndrome, plantar fasciitis, anterior cruciate ligament, diabetic foot, rheumatoid and juvenile idiopathic arthritis, ankle sprain, cerebral palsy, lateral epicondylitis and low back pain). The included articles were assessed for risk of bias using the Cochrane Risk of Bias tool. Details of the clinical population examined, the type of orthotic/prosthetic intervention, the comparator/s and the outcome measures were extracted. Effect sizes and odds ratios were calculated for all outcome measures, where possible. At present, for prosthetic and orthotic interventions, the scientific literature does not provide sufficient high quality research to allow strong conclusions on their effectiveness and cost-effectiveness.

Current selection of cushioning materials for therapeutic footwear and orthoses is based on empirical and anecdotal evidence. The aim of this investigation is to assess the biomechanical properties of carefully selected cushioning materials and to establish the basis for patient-specific material optimisation. For this purpose, bespoke cushioning materials with qualitatively similar mechanical behaviour but different stiffness were produced. Healthy volunteers were asked to stand and walk on materials with varying stiffness and their capacity for pressure reduction was assessed. Mechanical testing using a surrogate heel model was employed to investigate the effect of loading on optimum stiffness. Results indicated that optimising the stiffness of cushioning materials improved pressure reduction during standing and walking by at least 16 and 19% respectively. Moreover, the optimum stiffness was strongly correlated to body mass (BM) and body mass index (BMI), with stiffer materials needed in the case of people with higher BM or BMI. Mechanical testing confirmed that optimum stiffness increases with the magnitude of compressive loading. For the first time, this study provides quantitative data to support the importance of stiffness optimisation in cushioning materials and sets the basis for methods to inform optimum material selection in the clinic.

As a proficient golf swing is a key element of success in golf, many golfers make significant effort improving their stroke mechanics. In order to help enhance golfing performance, it is important to identify the performance determining factors within the full golf swing. In addition, explicit instructions on specific features in stroke technique requiring alterations must be imparted to the player in an unambiguous and intuitive manner. However, these two objectives are difficult to achieve due to the subjective nature of traditional coaching techniques and the predominantly implicit knowledge players have of their movements. In this work, we have developed a set of visualisation and analysis tools for use in a virtual golf coaching environment. In this virtual coaching studio, the analysis tools allow for specific areas require improvement in a player's 3D stroke dynamics to be isolated. An interactive 3D virtual coaching environment then allows detailed and unambiguous coaching information to be visually imparted back to the player via the use of two virtual human avatars; the first mimics the movements performed by the player; the second takes the role of a virtual coach, performing ideal stroke movement dynamics. The potential of the coaching tool is highlighted in its use by sports science researchers in the evaluation of competing approaches for calculating the X-Factor, a significant performance determining factor for hitting distance in a golf swing

Background: Currently there is a paucity of research providing recommendations on the type of orthotic or material used in its construction for different patient requirements. Objectives: To gain a greater understanding of the characteristics of orthotic materials and how they affect gait so to enhance the clinical decision-making process. Study Design: Repeated measures. Methods: Plantar pressures and kinematics were evaluated for 10 participants while walking on a treadmill under various conditions which included, shoes only and shoes with four different flat insoles and custom devices created in each of two densities of two materials. Results: For the flat insoles, medium density ethyl vinyl acetate was found to produce greater peak pressures than at least one of the other material conditions and low and medium density polyurethane were most effective at increasing average contact area and at reducing pressure time integral. For the custom devices, while no significant differences were evident, when compared to the shoe only condition, medium density polyurethane increased average contact area by a greater percentage than the other materials. Conclusions: Results for medium density polyurethane suggest a possible difference in loading characteristics, indicating a potential material suitability for patients with a compromised ability to deal with pressure. Clinical relevance Findings from the present study provide information for a clinician to draw an evidence-based orthotic prescription based on material properties.