Purpose: Screening for dysphagia at the intensive care unit (ICU) soon after extubation can prevent aspiration, pneumonia, lower mortality, and shorten re-feeding interval. This study aimed to modify the Gugging Swallowing Screen (GUSS), which was developed for acute stroke patients, and to validate it for extubated patients in the ICU. Methods: In this prospective study, forty-five patients who had been intubated for at least 24 h were recruited consecutively at the earliest 24 h after extubation. The modified GUSS-ICU was performed twice by two speech and language therapists independently. Concurrently, gold standard the flexible endoscopic evaluation of swallowing (FEES) was performed by an otorhinolaryngologist. Measurements were conducted within a three-hour period; all testers were blinded to each other’s results. Results: According to FEES, 36 of 45 (80%) participants were diagnosed with dysphagia; 13 of those were severe, 12 moderate, and 11 mild. Compared to FEES, the GUSS-ICU predicted dysphagia well (area under the curve for the initial rater pair: 0.923, 95% CI 0.832–1.000 and 0.923, 95% CI 0.836 -1.000 for the second rater pair). The sensitivity was 91.7% (95% CI 77.5–98.3%) and 94.4% (95% CI 81.3–99.3%); the specificity was 88.9% (51.8–99.7%) and 66.7% (29.9–92.5%); the positive predictive values were 97.1% (83.8–99.5%) and 91.9% (81.7–96.6%), and the negative predictive values were 72.7% (46.8–89%) and 75% (41.9–92.6%) for the first and second rater pairs, respectively. Dysphagia severity classification according to FEES and GUSS-ICU correlated strongly (Spearman’s rho: 0.61 for rater 1 and 0.60 for rater 2, p < 0.001). Agreement by all testers was good (Krippendorffs Alpha: 0.73). The interrater reliability showed good agreement (Cohen`s Kappa: 0.84, p < 0.001). Conclusion: The GUSS-ICU is a simple, reliable, and valid multi-consistency bedside swallowing screen to identify post-extubation dysphagia at the ICU. Trial registration: ClinicalTrials.gov Identifier: NCT04532398,31/08/2020.

Arthrogenic muscle inhibition (AMI) is a neuromuscular impairment commonly observed following anterior cruciate ligament reconstruction (ACLR). This condition, characterized by persistent quadricep inhibition due to altered afferent feedback, significantly impacts neuromuscular recovery, delaying return to running and sport. Despite advancements in rehabilitation strategies, AMI may persist for months or even years after ACLR, leading to muscle strength asymmetries, altered biomechanics, and an increased risk of reinjury. The mechanisms underlying AMI involve both peripheral (joint effusion, mechanoreceptor dysfunction) and central (corticospinal inhibition, neuroplasticity alterations) components, which collectively hinder voluntary muscle activation and movement control. AMI alters gait mechanics, reduces knee stability, and promotes compensatory patterns that increase injury risk. Current return-to-sport protocols emphasize strength symmetry and functional performance but often neglect neuromuscular deficits. A comprehensive assessment integrating neuromuscular, biomechanical, and proprioceptive evaluations is needed at specific stages to optimize rehabilitation and minimize reinjury risk. Future research should explore targeted interventions such as neuromuscular stimulation, cognitive–motor training, and advanced gait analysis to mitigate AMI’s impact and facilitate a safer, more effective return to sport.

Background: Arthrogenic muscle inhibition (AMI), anterior knee laxity, and kinesiophobia are key barriers to recovery after anterior cruciate ligament reconstruction (ACLR). While each has been independently studied, their interrelationships during the early postoperative phase remain unclear. Methods: This cross-sectional study included 56 patients (mean age: 26.5 ± 5.7 years) who underwent ACLR using hamstring autografts. Clinical AMI grading, GNRB^® arthrometer measurements of anterior tibial translation, and the Tampa Scale for Kinesiophobia-11 (TSK-11) were used to assess neuromuscular inhibition, mechanical laxity, and psychological fear, respectively. All evaluations were performed at 34.9 ± 4.2 postoperative days. Statistical analyses included one-way ANOVA, Kruskal–Wallis, and Spearman correlation. Results: No significant differences in TSK-11 scores were observed across AMI grades (p = 0.327). Similarly, anterior laxity did not differ significantly between AMI groups (p = 0.182). Correlation between GNRB measurements and TSK-11 scores was non-significant (rho = −0.220, p = 0.103). Conclusions: In the early phase following ACLR, AMI, anterior laxity, and kinesiophobia appear to be independent domains. These findings suggest that early postoperative rehabilitation should address each dimension individually. Further longitudinal studies are needed to explore their potential interactions over time.

The aim of this study was to compare cervical spine kinematics in rugby union front row players during machine-based and “live” scrummaging. Cervical spine kinematics was measured via electromagnetic tracking of sensors attached to the head and thorax. Joint angles were extracted from each trial at two time points (“bind” prior to engagement and instant of impact) for comparison between scrummaging conditions. The effect of scrummaging condition on kinematics was evaluated using a mixed effects model and estimations were based on a Bayesian framework. With differences ranging from 38° to 50°, the results show that the cervical spine is consistently more flexed when scrummaging against opponents than against a scrum machine. In contrast, there are little differences in the excursion of lateral-flexion (range 5–8°) and axial rotation (7°) between the two conditions. The findings from this study provide clear information on motion patterns in different scrum formations, and suggest that the current design of scrum machines may not promote the same pattern of movement that occurs in live scrums. The results highlight that findings from previous studies that have investigated kinematics during machine-based scrummaging may not be generalisable to a competitive scrummaging context.

Measuring cervical spine kinematics in rugby scrummaging is important from an injury prevention perspective. However, choosing an appropriate measurement system is challenging. Since reliability of a measurement system is critical for meaningful interpretation of results, this study evaluated test–retest reliability of an electromagnetic tracking and optoelectronic motion capture system for measurement of cervical spine kinematics during scrummaging. Reliability of joint kinematics at discrete time points was evaluated using intraclass correlation coefficients (ICC), standard error of measurement (SEM), and minimal detectable change (MDC). Reliability of kinematic curves was assessed using coefficient of multiple correlations (CMC) and standard deviations (curve SD). In both systems, seven ICC values were considered to be excellent (>0.75), while two were fair to good (0.44–0.66). Minimal detectable change values for flexion/extension were found to be higher than for other movement directions, and CMC values were only moderate. Overall, reliability was comparable in both systems.