Nowadays, increasing attention is being paid to techniques aimed at assessing a subject’s ability to maintain or regain control of balance, thus reducing the risk of falls. To this end, posturographic analyses are performed in different clinical settings, both in unperturbed and perturbed conditions. This article presents a new Hardware-In-the-Loop (HIL) equipment designed for the development of an automatic perturbator for postural control analysis, capable of providing controlled mechanical stimulation by means of an impulsive force exerted on a given point of the body. The experimental equipment presented here includes the perturbator and emulates its interaction with both the subject’s body and the operator performing the test. The development of the perturbator and of the entire HIL equipment is described, including component selection, modeling of the entire system, and experimentally verified simulations used to study and define the most appropriate control laws.

Objective: In the isokinetic literature, relatively limited attention has been paid to muscles of the wrist. Therefore, the objective of this study was to present an isokinetic profile of these muscles comprising the flexors (F); extensors (E); and ulnar (U) and radial (R) deviators. Method: The dominant-side F, E, U and R in 40 healthy participants (20 women and 20 men) were tested concentrically (Con) and eccentrically (Ecc) using a single speed of 90°/s. Results: Men were significantly stronger than women in both the Con and Ecc tests, as indicated by both the absolute (Nm) and the bodyweight-normalized (Nm/kgbw) representations. However, the bodyweight-normalized women/men strength ratio (78.6 ± 8.0%) was significantly higher than the absolute strength ratio (64.1 ± 6.6%). For both the Con and Ecc tests, and irrespective of the representation (absolute or normalized), the U was the strongest muscle group, followed successively by the F, R and E. This rank order was highly significant statistically. The eccentric/concentric strength ratios, E/C_F and E/C_U, were significantly higher in men than in women, with no remarkable inter-sex differences for E/C_E and for E/C_R. A correlational analysis, which included all pairs of basic isokinetic outcome parameters (e.g., the PM of F_con), was performed with respect to ‘sex’ using a nonparametric bootstrap procedure, revealing that men had significantly higher overall correlation coefficients compared to women. Conclusions: The consistency of the main findings with respect to both the sex of the participants and the various strength ratios supports the use of the current protocol. The observed strength order (U > F > R > E) may assist clinicians in setting preliminary return-to-function targets after wrist rehabilitation.

Background: The therapeutic effect of neurodynamic mobilization (NM) of the median nerve in mild to moderate carpal tunnel syndrome (CTS) remains inconclusive based on subjective reports and nerve conduction studies. Sonographic measurement of cross-sectional area (CSA) of the median nerve provides an objective method to evaluate treatment outcomes. Objective: To compare the effect of carpal bones and flexor retinaculum mobilization (CBFRM) vs. NM using various subjective outcome measures and a single objective measure: sonographic measurement of the median nerve CSA. Methods: Fifty-one individuals with mild to moderate CTS were randomly assigned to three groups:(1) CBFRM (n=17) (2) NM (n= 17) and (3) a control group awaiting surgery (n=17). Outcomes were assessed pre and post intervention and consisted of included median nerve CSA, pain severity rating using a visual analogue scale (VAS) and functional status using the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire. Pain improvement was also evaluated using the Pain Relief Scale (PRS). The intervention consisted of eight sessions over four weeks. Results: Both NM and CBFRB interventions significantly reduced pain and improved function compared with the control group. While both groups showed reduced median nerve CSA, post-hoc analysis revealed that this reduction was primarily driven by the NM group, with the CBFRB group not differing significantly from either condition. Conclusions: NM appears to be an effective conservative intervention for patients with mild to moderate CTS, demonstrating meaningful clinical and functional improvements. In addition, sonographic assessment of median nerve CSA may serve as a valuable complementary objective measure for evaluating treatment response and monitoring clinical status.

Background / Objective: In the isokinetic literature, relatively limited attention has been given to muscles of the wrist. Therefore, the objective of this study was to present an isokinetic profile of these muscles comprising the flexors (F), extensors (E), ulnar (U) and radial (R) deviators. Method: The dominant side F, E, U and R in 40 healthy participants (20 women and 20 men) were tested concentrically and eccentrically, using a single speed of 90°/s. Results: Men were significantly stronger than women in both the concentric and eccentric tests as indicated by both the absolute (Nm) or the bodyweight normalized (Nm/kgbw) representations. However, the bodyweight normalized women/men strength ratio (78.6±8.0%) was significantly higher than the absolute’s (64.1±6.6%). For both the concentric and eccentric effort and irrespective of the representation (absolute or normalized) the U was the strongest muscle group followed successively by F, R and E. This rank order was highly significant statistically. The eccentric/concentric strength ratios: E/CF and E/CU were significantly higher in men than in women with no remarkable inter-sex differences for E/CE and for E/CR. A correlational analysis which included all pairs of the basic isokinetic outcome parameters (e.g., the PM of Fcon) and performed with respect to ‘sex’ using Fisher’s r-to-z transformation, revealed that men had significantly higher overall correlation coefficients compared to women. Conclusions: The uniformity of main findings with respect to both the sex of the participants and the various strength ratios strongly support the validity of the findings. Specifically, the original rank ordering of the wrist muscle can potentially serve as an additional and preliminary guideline for return to normal strength pattern in rehabilitation of the wrist.