PURPOSE: The aim of the study is to capture the difference between the groups in direct relation to the type of electrode array insertion during cochlear implantation (CI). The robotic insertion is expected to be a more gently option. As recent studies have shown, there is a difference in perception of visual vertical (SVV) and postural control related to the CI. We assume that there can be differences in postural control and space perception outcomes depending on the type of the surgical method. METHODS: In total, 37 (24 females, mean age ± SD was 42.9 ± 13.0) candidates for CI underwent an assessment. In 14 cases, the insertion of the electrode array was performed by a robotic system (RobOtol, Colin, France) and 23 were performed conventionally. In all of these patients, we performed the same examination before the surgery, the first day, and 3 weeks after the surgery. The protocol consists of static posturography and perception of visual vertical. RESULTS: The both groups, RobOtol and conventional, responded to the procedure similarly despite the dissimilar electrode insertion. There was no difference between two groups in the dynamic of perception SVV and postural parameters. Patients in both groups were statistically significantly affected by the surgical procedure, SVV deviation appeared in the opposite direction from the implanted ear: 0.90° ± 1.25; - 1.67° ± 3.05 and - 0.19° ± 1.78 PRE and POST surgery (p < 0.001). And this deviation was spontaneously adjusted in FOLLOW-UP after 3 weeks (p < 0.01) in the both groups. We did not find a significant difference in postural parameters between the RobOtol and conventional group, even over time. CONCLUSION: Although the robotic system RobOtol allows a substantial reduction in the speed of insertion of the electrode array into the inner ear, our data did not demonstrate a postoperative effect on vestibular functions (SVV and posturography), which have the same character and dynamics as in the group with standard manual insertion. REGISTRATION NUMBER: The project is registered on clinicaltrials.gov (registration number: NCT05547113).

• Keywords
• Adults, Cochlear implantation, Hearing loss, Posturography, Robot-assisted surgery, Subjective visual vertical,
• MeSH
• Adult MeSH
• Cochlear Implantation * methods   MeSH
• Cochlear Implants MeSH
• Middle Aged MeSH
• Humans MeSH
• Postural Balance * physiology   MeSH
• Robotic Surgical Procedures * methods   MeSH
• Space Perception * physiology   MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Comparative Study MeSH

Recently, transcranial electrical stimulation (tES) has gained increasing popularity among researchers, especially for recovery and improvement, but interpretation of these results is difficult due to variations in study methods and outcome measurements. The main goal of this study was to better understand the postural and balance indicators affected by cerebellar tES, as the cerebellum is the main brain region responsible for controlling balance. For this systematic literature review, three databases were searched for articles where the cerebellum was stimulated by any type of tES in either healthy participants or those with neurologic disorders. Postural, dynamic, and/or static stability measurements were recorded, and risk of bias was assessed on the PEDro scale. A total of 21 studies were included in the analysis. 17 studies reported improvements after application of tES. 14 studies stimulated the cerebellum unilaterally and 15 used this modality for 20 min. Moreover, all studies exclusively used transcranial direct current as the type of stimulation. Evaluation of PEDro results showed that studies included in the analysis utilized good methodology. Although there were some inconsistencies in study results, overall, it was demonstrated that tES can improve balance and postural index under both healthy and neurological conditions. Further research of bilateral cerebellar stimulation or the use of transcranial alternating current stimulation, transcranial random noise stimulation, and transcranial pulsed current stimulation is needed for a more comprehensive assessment of the potential positive effects of cerebellar tES on the balance system.

• Keywords
• Cerebellum, Postural stability, Review, Transcranial electrical stimulation,
• MeSH
• Humans MeSH
• Cerebellum * physiology   MeSH
• Posture physiology   MeSH
• Postural Balance * physiology   MeSH
• Transcranial Direct Current Stimulation * methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Systematic Review MeSH

BACKGROUND: Despite the increasing number of research studies examining the effects of age on the control of posture, the number of annual fall-related injuries and deaths continues to increase. A better understanding of how old age affects the neural mechanisms of postural control and how countermeasures such as balance training could improve the neural control of posture to reduce falls in older individuals is therefore necessary. The aim of this review is to determine the effects of age on the neural correlates of balance skill learning measured during static (standing) and dynamic (walking) balance tasks in healthy individuals. METHODS: We determined the effects of acute (1-3 sessions) and chronic (> 3 sessions) balance skill training on balance in the trained and in untrained, transfer balance tasks through a systematic review and quantified these effects by robust variance estimation meta-analysis in combination with meta-regression. We systematically searched PubMed, Web of Science, and Cochrane databases. Balance performance and neural plasticity outcomes were extracted and included in the systematic synthesis and meta-analysis. RESULTS: Forty-two studies (n = 622 young, n = 699 older individuals) were included in the systematic synthesis. Seventeen studies with 508 in-analysis participants were eligible for a meta-analysis. The overall analysis revealed that acute and chronic balance training had a large effect on the neural correlates of balance skill learning in the two age groups combined (g = 0.79, p < 0.01). Both age groups similarly improved balance skill performance in 1-3 training sessions and showed little further improvements with additional sessions. Improvements in balance performance mainly occurred in the trained and less so in the non-trained (i.e., transfer) balance tasks. The systematic synthesis and meta-analysis suggested little correspondence between improved balance skills and changes in spinal, cortical, and corticospinal excitability measures in the two age groups and between the time courses of changes in balance skills and neural correlates. CONCLUSIONS: Balance skill learning and the accompanying neural adaptations occur rapidly and independently of age with little to no training dose-dependence or correspondence between behavioral and neural adaptations. Of the five types of neural correlates examined, changes in only spinal excitability seemed to differ between age groups. However, age or training dose in terms of duration did not moderate the effects of balance training on the changes in any of the neural correlates. The behavioral and neural mechanisms of strong task-specificity and the time course of skill retention remain unclear and require further studies in young and older individuals. REGISTRATION: PROSPERO registration number: CRD42022349573.

• Keywords
• Balance training, Healthy aging, Neural adaptation, Postural balance,
• Publication type
• Journal Article MeSH
• Systematic Review MeSH

OBJECTIVE: The purpose of this study was to analyze short-term changes in dynamic and static balance after a manual therapy protocol in healthy participants and analyze any repercussions on mood and perception of change after applying articulatory techniques. METHODS: A single-blind, randomized, multicenter clinical trial was conducted. Participants were allocated to either a manual therapy group (MTG) (n = 101) or a control group (CG) without intervention (n = 99), and measures were taken before treatment, after the intervention, and 1 week after treatment. Assessments included the Star Excursion Balance Test, Unipedal Stance Test (UPST), Profile of Mood States (POMS), and Patient Global Impression of Change (PGIC) scale. RESULTS: Two hundred healthy participants completed the study (mean age, 22 [SD = 2.67]). There was a statistically significant interaction between groups and time measurements in the right leg for anterior (P = .003), posteromedial (P < .001), and posterolateral (P = .001) directions in favor of the MTG, as well as in the left leg for anterior (P < .001), posteromedial (P < .001), and posterolateral (P = .012) directions. The analysis failed to show statistically significant interactions between any of the factors for the UPST and POMS (P > .05). The MTG showed a significant improvement compared to the CG after treatment (P = .003) and at 1-week follow-up (P < .001) on the PGIC scale. CONCLUSION: The results suggest the MT intervention was effective on dynamic balance in post-intervention in healthy participants, and some of the directions maintained the results at 1-week follow-up. Perception of change in post-treatment and 1-week follow-up also significantly improved. The protocol did not seem to produce changes in static balance and mood states. Positive changes after manual therapy were maintained in the short term.

• Keywords
• Healthy People Programs, Mood Disorders, Musculoskeletal Manipulations, Postural Balance,
• MeSH
• Adult MeSH
• Double-Blind Method MeSH
• Single-Blind Method MeSH
• Humans MeSH
• Young Adult MeSH
• Musculoskeletal Manipulations * MeSH
• Postural Balance * MeSH
• Physical Therapy Modalities MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Randomized Controlled Trial MeSH

The representations of biochemical processes must balance visual portrayals with descriptive content to be an effective learning tool. To determine what type of representation is the most suitable for education, we designed five different representations of adenosine triphosphate (ATP) synthesis and examined how they are perceived. Our representations consisted of an overview of the process in a detailed and abstract illustrative format, continuous video formats with and without narration, and a combined illustrative overview with dynamic components. The five representations were evaluated by non-experts who were randomly assigned one of them and experts who viewed and compared all five representations. Subsequently, we conducted a focus group on the outcomes of these evaluations, which gave insight into possible explanations of our results, where the non-experts preferred the detailed static representation and found the narrated video least helpful, in contradiction to the experts who favored the narrated video the most.

• MeSH
• Biochemical Phenomena * MeSH
• Educational Status MeSH
• Learning * MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH

PURPOSE OF THE STUDY This article presents the evidence and the rationale for the recommendations for surgical treatment of degenerative lumbar stenosis (DLS) and spondylolisthesis that were recently developed as a part of the Czech Clinical Practice Guideline (CPG) "The Surgical Treatment of the Degenerative Diseases of the Spine". MATERIAL AND METHODS The Guideline was drawn up in line with the Czech National Methodology of the CPG Development, which is based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. We used an innovative GRADE-adolopment method that combines adoption and adaptation of the existing guidelines with de novo development of recommendations. In this paper, we present three adapted recommendations on DLS and a recommendation on spondylolisthesis developed de novo by the Czech team. RESULTS Open surgical decompression in DLS patients has been evaluated in three randomized controlled trials (RCTs). A recommendation in favour of decompression was made based on a statistically significant and clinically evident improvement in the Oswestry Disability Index (ODI) and leg pain. Decompression may be recommended for patients with symptoms of DLS in the event of correlation of significant physical limitation and the finding obtained via imaging. The authors of a systematic review of observational studies and one RCT conclude that fusion has a negligible role in the case of a simple DLS. Thus, spondylodesis should only be chosen as an adjunct to decompression in selected DLS patients. Two RCTs compared supervised rehabilitation with home or no exercise, showing no statistically significant difference between the procedures. The guideline group considers the post-surgery physical activity beneficial and suggests supervised rehabilitation in patients who have undergone surgery for DLS for the beneficial effects of exercise in the absence of known adverse effects. Four RCTs were found comparing simple decompression and decompression with fusion in patients with degenerative lumbar spondylolisthesis. None of the outcomes showed clinically significant improvement or deterioration in favour of either intervention. The guideline group concluded that for stable spondylolisthesis the results of both methods are comparable and, when other parameters are considered (balance of benefits and risks, or costs), point in favour of simple decompression. Due to the lack of scientific evidence, no recommendation has been formulated regarding unstable spondylolisthesis. The certainty of the evidence was rated as low for all recommendations. DISCUSSION Despite the unclear definition of stable/unstable slip, the inclusion of apparently unstable cases of DS in stable studies limits the conclusions of the studies. Based on the available literature, however, it can be summarized that in simple degenerative lumbar stenosis and static spondylolisthesis, fusion of the given segment is not justified. However, its use in the case of unstable (dynamic) vertebral slip is undisputable for the time being. CONCLUSIONS The guideline development group suggests decompression in patients with DLS in whom previous conservative treatment did not lead to improvement, spondylodesis only in selected patients, and post-surgical supervised rehabilitation. In patients with degenerative lumbar stenosis and spondylolisthesis with no signs of instability, the guideline development group suggests simple decompression (without fusion). Key words: degenerative lumbar stenosis, degenerative spondylolisthesis, spinal fusion, Clinical Practice Guideline, GRADE, adolopment.

• MeSH
• Lumbar Vertebrae surgery   MeSH
• Decompression, Surgical methods   MeSH
• Spinal Fusion * MeSH
• Humans MeSH
• Spinal Stenosis * surgery   MeSH
• Spondylolisthesis * complications   surgery   MeSH
• Constriction, Pathologic surgery   MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Publication type
• English Abstract MeSH
• Journal Article MeSH
• Systematic Review MeSH

INTRODUCTION: Body balance control represents a key factor preventing falls and subsequent injuries in seniors aged 65+. Intervention based on yoga exercises seem to be effective in improving balance. OBJECTIVE: The objective is to analyse and compare changes in static, dynamic, and total balance scores, changes in body composition and social indices as effects of yoga-based intervention. METHODS: A total of 500 participants (234 men aged 74.5 SD±7.74 and 266 women aged 76.9 SD±7.23) were assessed using the Tinetti Balance Assessment Tool, the InBody 230 bioimpedance body composition analyser, and the SF-36 Health Survey, applied to pre and post-testing. The experimental group (n=262; 122 males; 140 females) underwent a four-week yoga-based intervention, 30 minutes daily, while the control group (n=238; 112 males; 126 females) underwent its usual daily programme at senior homes or centres. The ANOVA model, consisting of the Group, Stage, Subject and Group × Stage interaction factors, was used for data evaluation. RESULTS: Intervention led to improvements in the static, dynamic and total balance scores in the experimental group compared to the control group. The results of SF-36 showed positive changes in the psychosocial aspects of health, such as promoting of calmness and happiness in male seniors and reducing fatigue, nervousness and depression in female seniors. The post-intervention decrease in body fat percentage and increase in muscle mass in seniors is discussed. CONCLUSIONS: The four-week yoga-based intervention had positive effects on the static, dynamic and total balance scores, body composition and social status.

UVOD: Nadzor telesnega ravnotežja je ključni dejavnik za preprečevanje padcev in posledičnih poškodb pri starejših od 65 let. Videti je, da ukrep na osnovi vaj joge učinkovito pripomore k izboljšanju ravnotežja. CILJ: Cilj je analizirati in primerjati spremembe ocene statičnega, dinamičnega in skupnega ravnotežja, spremembe sestave telesa ter spremembe socialnih kazalnikov po izvedbi ukrepa na osnovi vaj joge. METODE: 500 udeležencev (234 moških povprečne starosti 74,5 leta, SD ± 7,74 leta, in 266 žensk povprečne starosti 76,9 leta, SD ± 7,23 leta) je bilo v predhodnem in naknadnem testiranju ocenjenih z orodjem Tinetti za oceno ravnotežja (Tinetti Balance Assessment Tool), analizatorjem bioelektrične impedance InBody 230 in vprašalnikom o zdravju SF-36. Pri eksperimentalni skupini (n = 262; 122 moških; 140 žensk) je bil izveden 4-tedenski ukrep na osnovi vaj joge, ki so se izvajale 30 minut na dan, medtem ko je kontrolna skupina (n = 238; 112 moških; 126 žensk) izvajala svoj običajen dnevni program v domovih ali centrih za starejše. Za oceno podatkov je bil uporabljen model ANOVA s faktorji Skupina, Stopnja in Subjekt ter interakcijo Skupina × Stopnja. REZULTATI: Ukrep je v eksperimentalni skupini privedel do izboljšanja ocene statičnega, dinamičnega in skupnega ravnotežja v primerjavi s kontrolno skupino. Rezultati vprašalnika SF-36 so pokazali pozitivne spremembe na področju psihosocialnih vidikov zdravja, kot sta povečanje mirnosti in sreče pri starejših moških ter zmanjšanje utrujenosti, živčnosti in depresivnosti pri starejših ženskah. Opisano je zmanjšanje odstotka telesne maščobe in povečanje mišične mase pri starejših po izvedbi ukrepa. ZAKLJUČKI: 4-tedensko izvajanje ukrepa na osnovi vaj joge je pozitivno vplivalo na oceno statičnega, dinamičnega in skupnega ravnotežja, sestavo telesa in socialni status.

• Keywords
• ageing, balance control, chair yoga, health promotion, social health,
• Publication type
• Journal Article MeSH

Seniors are a constantly growing group of people in many societies. It is necessary to develop physiotherapeutic programs to improve their mobility. The aim of this study was to assess the impact of the physiotherapeutic program conducted unstable ground on selected indicators of motor functions of elderly women. Sixty women (60-80 years) participated in the research. Group A (N = 20) underwent a 12-week physiotherapeutic program on stable ground, group B (N = 20) followed an exercise program on unstable ground, and group C (N = 20) (control group) had no therapeutic intervention. The effects of the therapy were assessed by using a FreeMed platform (foot load analysis) and a Biosway balance system. The results were compared using ANOVA (the one-way analysis), the Kruskal-Wallis test and also the post hoc tests (Tukey's test and the multiple comparison test). In group A, a statistically significant change was observed in the static test and balance assessment, in group B this was observed in the static and dynamic foot tests and balance assessment, in group C, no statistical significance was achieved. The authors' physiotherapeutic program had a statistically significant effect on changes in the balance and selected indicators of the motor functions of the examined people. Comparing the results before and after the therapy more improvement changes were noted in women training on an unstable ground compared to women training on a stable ground.

• Keywords
• physical activity, seniors, stable ground, unstable ground,
• MeSH
• Exercise MeSH
• Humans MeSH
• Postural Balance * MeSH
• Aged MeSH
• Physical Therapy Modalities MeSH
• Exercise Therapy * MeSH
• Check Tag
• Humans MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Pharmacovigilance is the science of monitoring the effects of medicinal products to identify and evaluate potential adverse reactions and provide necessary and timely risk mitigation measures. Intelligent automation technologies have a strong potential to automate routine work and to balance resource use across safety risk management and other pharmacovigilance activities. While emerging technologies such as artificial intelligence (AI) show great promise for improving pharmacovigilance with their capability to learn based on data inputs, existing validation guidelines should be augmented to verify intelligent automation systems. While the underlying validation requirements largely remain the same, additional activities tailored to intelligent automation are needed to document evidence that the system is fit for purpose. We propose three categories of intelligent automation systems, ranging from rule-based systems to dynamic AI-based systems, and each category needs a unique validation approach. We expand on the existing good automated manufacturing practices, which outline a risk-based approach to artificially intelligent static systems. Our framework provides pharmacovigilance professionals with the knowledge to lead technology implementations within their organizations with considerations given to the building, implementation, validation, and maintenance of assistive technology systems. Successful pharmacovigilance professionals will play an increasingly active role in bridging the gap between business operations and technical advancements to ensure inspection readiness and compliance with global regulatory authorities.

• MeSH
• Automation MeSH
• Pharmacovigilance * MeSH
• Humans MeSH
• Risk Management MeSH
• Technology MeSH
• Artificial Intelligence * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

BACKGROUND: Postural control is required during various fast-paced and offensive ice hockey actions, and therefore seems to be an important component in ice hockey performance. METHODS: Data were collected from two ice hockey teams with differing performance levels. The higher-performance team consisted of 26 players (with ages of 16.3±0.9 y, heights of 178.26±6.71 cm, and weights of 74.3±9.6 kg). The lower-performance team consisted of 19 players (with ages of 16.2±1.8 y, heights of 176.11±9.81 cm, and weights of 68.7±13.9 kg). Each participant performed six unilateral stances under static conditions on a balance pad placed on a force platform and five bilateral stances under dynamic conditions using a wobble board placed on the force platform. RESULTS: The higher-level players performed better in the unilateral static stance task in both the anterior-posterior direction and the medial-lateral direction (with a P value of P<0.001), and total velocity (P=0.001). The higher-level players also performed better in both the anterior-posterior and medial-lateral directions, and total velocity (with P value of P<0.001), in the bilateral dynamic stance task and therefore performed significantly better than the lower-level players. CONCLUSIONS: Hockey players who possess a highly developed postural control strategy have a superior ability to compensate for unexpected postural disturbances and collisions, and thus possess a strong competitive advantage. Therefore, testing the balance abilities of hockey players under static and dynamic conditions may be useful for evaluating their competitive performance levels.

• MeSH
• Hockey * MeSH
• Humans MeSH
• Adolescent MeSH
• Postural Balance * MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Publication type
• Journal Article MeSH