Background: As a result of stroke, patients have problems with locomotion and transfers, which lead to frequent falls. Recovery after stroke is a major goal of rehabilitation, but it is difficult to choose which treatment method is most beneficial for stroke survivors. Recently, powered robotic exoskeletons are used in treatment to maximize the neural recovery of patients after stroke, but there are no studies evaluating the changes in balance among patients rehabilitated with an exoskeleton. Purpose: The aim of this study was to evaluate the effects of Ekso GT exoskeleton-assisted gait training on balance, load distribution, and functional status of patients after ischemic stroke. Methods: The outcomes are based on 44 patients aged 55–85 years after ischemic stroke who were previously randomly assigned into two groups: experimental (with Ekso GT rehabilitation) and control (with classical rehabilitation). At baseline and after 4 weeks of treatment, the patients were evaluated on balance, load distribution, and functional status using, respectively a stabilometric platform, the Barthel Index, and the Rivermead Mobility Index. Results: In the experimental group, balance improved regarding the variables describing sway area as ellipse major and minor axes. In the control group, improvement was noted in sway velocity. After the therapy, total load distribution on feet in both groups showed a small and insignificant tendency toward reduction in the amount of uninvolved limb loading. In the control group, significant load transfer from the backfoot to the forefoot was noted. Both forms of rehabilitation caused significant changes in functional status. Conclusions: Both training with the use of the Ekso GT exoskeleton and classical physiotherapy lead to functional improvement of patients after ischemic stroke. However, in the experimental group, improvement was observed in a larger number of categories, which may suggest potentially greater impact of treatment with the exoskeleton on functional status. Also, both forms of rehabilitation caused significant changes in balance, but we have noted some trends indicating that treatment with exoskeleton may be more beneficial for some patients. The load transfer from the backfoot to the forefoot observed in the control group was an unfavorable phenomenon. We suggest that the Ekso GT exoskeleton may be a promising tool in the rehabilitation of patients after stroke. Trial registration: Trial ID ACTRN12616000148471

The aim of this study was to examine the effect of excessive feet arching (symmetrical and asymmetrical) on plantar pressure distribution and on the alignment of pelvis, spine and shoulder girdle. Eighty-one women (20–40 years old, 61 +/− 12 kg, 165 +/− 5 cm) were divided into 3 groups based on the foot arch index (Group 1 - with normally arched feet, Group 2 with one foot properly arched and the other high-arched, Group 3 with both feet high-arched). Plantar pressure distribution between the right and left foot for the forefoot, midfoot and rearfoot, respectively and body posture were assessed. A slight increase in longitudinal arch of the foot caused changes in the distribution of feet loads both between limbs and between the forefoot and rearfoot and also influenced the whole body. Asymmetrical high-arching of the feet resulted in asymmetry of lower limb load and in the height of the shoulder girdle. We have suggested that any alteration of the foot arch may be harmful to body tissues and should not be considered as correct. Due to the fact that slight increases in longitudinal arch of the foot are very common, they should be considered as a foot defect, and appropriate corrective exercises should be used to prevent forefoot overload and alterations in body posture.

The aim of the study was to evaluate pelvic floor muscle bioelectrical activity in healthy, young, and nulliparous women, and to present normative values for all phases and parameters measured with the Glazer Protocol. In this study, 96 healthy, young, nulliparous women (age 22–27 years; 168.6 ± 5.1 cm; 57.1 ± 11.8 kg) were tested. The bioelectrical activity of the pelvic floor muscles was collected using an endovaginal electrode with the Glazer Protocol, which included the following series of muscles contractions and relaxations: pre-baseline rest, phasic contractions, tonic contractions, isometric contractions for muscle endurance evaluation, and post-baseline rest. The following normative values of the bioelectrical signal for all phases of the Glazer Protocol were calculated: mean, minimal, and maximal values, 95% confidence interval, standard deviation, 95% standard deviation confidence interval, variance, coefficient of variation, and standard error of measurement. Average Mean Amplitude (μV) was as follows: pre-baseline rest (6.26 ± 3.33 μV), phasic contractions (49.76 ± 26.44 μV), tonic contractions (37.05 ± 25.99 μV), endurance contraction (16.10 ± 6.68 μV), and post-baseline rest (6.93 ± 3.99 μV). This study was the first in which normative values for all phases of the Glazer Protocol were reported. This protocol is very often used in electromyography devices as a tool for pelvic floor muscle assessment. Due to the fact that the interpretation of the pelvic floor muscle evaluation is complex and difficult, the authors believe that the normative values proposed in this study allow for comprehensive interpretation of this test (both qualitatively and quantitatively) and provide a reference point for parameters measured in women with different pelvic floor dysfunctions.

The aim of the study was to determine the between-trial and between-day reliability of the Glazer protocol and our multi-activity surface electromyography (sEMG) measurement protocol for pelvic floor muscle (PFM) evaluation. The bioelectrical activity of PFM was collected using an endovaginal electrode in 30 young, Caucasian, nulliparous women (age 22–27, 168.6 ± 5.1 cm, 57.1 ± 11.8 kg). The between-trial and between-day reliability of the original Glazer protocol and the new multi-activity sEMG protocol were assessed during the following phases: pre-baseline rest, phasic (flick) contractions, tonic contractions, endurance contraction, and post-baseline rest. The Glazer protocol was characterized by poor and moderate measurement reliability. The time-domain parameters for the rise and fall of the signal amplitude and median frequency showed poor between-trial and between-day reliability. The mean and peak amplitudes indicated mainly good between-trial and moderate between-days reliability. Our protocol showed moderate to excellent reliability of both time-domain and quantitative parameters of muscle recruitment. In our protocol, the frequency-domain parameters describing muscle fatigue demonstrated much higher reliability than in the case of the Glazer protocol. The most important information obtained in this study was the significant improvement of diagnostic validity in PFM bioelectrical activity evaluation. The higher reliability of our sEMG protocol compared to original Glazer protocol allowed us to suggest that protocol modifications and changes in sEMG signal processing methods were effective in the improvement of PFM assessment quality. The new parameters calculated from the sEMG signal proposed in our sEMG protocol allowed us to obtain additional clinically important information about PFM dysfunctions regarding specific deficits of muscle contraction such as decrease in muscle strength; endurance or coordination related to, e.g., stress urinary incontinence; or pelvic floor muscle imbalance after childbirth.

The aim of this study is to assess if the application of different methods of active recovery (working the same or different muscle groups from those which were active during fatiguing exercise) results in significant differences in muscle performance and if the efficiency of the active recovery method is dependent upon the specific sport activity (training loads). A parallel group non-blinded trial with repeated measurements. Thirteen mountain canoeists and twelve football players participated in this study. Measurements of the bioelectrical activity, torque, work and power of the vastus lateralis oblique, vastus medialis oblique, and rectus femoris muscles were performed during isokinetic tests at a velocity of 90°/s. Active legs recovery in both groups was effective in reducing fatigue from evaluated muscles, where a significant decrease in fatigue index was observed. The muscles peak torque, work and power parameters did not change significantly after both modes of active recovery, but in both groups significant decrease was seen after passive recovery. We suggest that 20 minutes of post-exercise active recovery involving the same muscles that were active during the fatiguing exercise is more effective in fatigue recovery than active exercise using the muscles that were not involved in the exercise. Active arm exercises were less effective in both groups which indicates a lack of a relationship between the different training regimens and the part of the body which is principally used during training.

Objective. The aim of this study was to assess the effectiveness of a 3‐week rehabilitation programme focusing only on the cervical region, pain intensity, range of motion in the cervical spine, head posture, and temporomandibular joint (TMJ) functioning in subjects with idiopathic neck pain who did not report TMJ pain. Design. A parallel group trial with follow‐up. Methods. The study included 60 participants divided into 2 groups: experimental: n = 25, 27‐57 years old, experiencing idiopathic neck pain and who underwent a 3‐week rehabilitation programme, and the control, n = 35, 27‐47 years, who were cervical pain‐free. At baseline and after 3 weeks of treatment in the experimental group and with a 3‐week time interval in the control group, pain intensity, head posture in the sagittal plane, range of motion in the cervical spine, and TMJ functioning were evaluated. Results. After 3 weeks of rehabilitation, there was a significant decrease in pain intensity, improved range of motion of the cervical spine and head posture, and improved clinical condition of TMJ in participants with idiopathic neck pain who did not report TMJ pain. Conclusion. The study suggested that idiopathic neck pain is associated with limited range of motion in the cervical spine, incorrect head posture, and TMJ dysfunction. Our data suggests that therapy focusing only on the cervical region may improve the clinical condition of the TMJ in subjects with idiopathic neck pain who do not report TMJ pain. These observations could be helpful in physiotherapeutic treatment of neck and craniofacial area dysfunctions. This trial is registered with ISRCTN Registry ISRCTN14511735.