Mobility

机动性
  • 文章类型: Systematic Review
    大脑映射工具的最新进展使功能性任务期间的大脑活动研究成为可能,揭示早期脑损伤后和康复后的神经可塑性。了解活动受限的神经相关性对于治疗脑瘫(CP)患者至关重要。目的是总结CP儿童移动性的神经相关性,并描述现有文献中使用的大脑映射方法。该系统评价是根据PRISMA指南进行的,并在PROSPERO(n°CRD42021240296)上注册。文献检索在PubMed和Embase数据库中进行。涉及CP参与者的观察性研究,平均年龄高达18岁,包括利用大脑映射技术并将其与移动性结果相关联的技术。根据样品特征对结果进行了分析,大脑绘图方法,流动措施,和主要结果。使用我们研究小组先前创建的清单评估了偏见的风险,根据STROBE指南,Cochrane手册,和关键评估技能计划(CASP)。共有15项研究,包括313名CP儿童和229名使用静态和移动技术的典型发育儿童,均符合纳入标准。研究表明,患有CP的儿童在行动活动期间大脑活动增加,大脑重组的变异性更高,比如步态,安静的站立,骑自行车,与具有典型发育的儿童相比,以及粗大的运动任务。改变的大脑活动和重组强调了进行更多研究以调查CP儿童活动期间神经相关性的重要性。这些信息可以指导针对脑神经可塑性的神经康复策略以获得功能增益。
    Recent advances in brain mapping tools have enabled the study of brain activity during functional tasks, revealing neuroplasticity after early brain injuries and resulting from rehabilitation. Understanding the neural correlates of mobility limitations is crucial for treating individuals with cerebral palsy (CP). The aim is to summarize the neural correlates of mobility in children with CP and to describe the brain mapping methods that have been utilized in the existing literature. This systematic review was conducted based on PRISMA guidelines and was registered on PROSPERO (n° CRD42021240296). The literature search was conducted in the PubMed and Embase databases. Observational studies involving participants with CP, with a mean age of up to 18 years, that utilized brain mapping techniques and correlated these with mobility outcomes were included. The results were analyzed in terms of sample characteristics, brain mapping methods, mobility measures, and main results. The risk of bias was evaluated using a checklist previously created by our research group, based on STROBE guidelines, the Cochrane Handbook, and the Critical Appraisal Skills Programme (CASP). A total of 15 studies comprising 313 children with CP and 229 with typical development using both static and mobile techniques met the inclusion criteria. The studies indicate that children\"with\'CP have increased cerebral activity and higher variability in brain reorganization during mobility activities, such as gait, quiet standing, cycling, and gross motor tasks when compared with children with typical development. Altered brain activity and reorganization underline the importance of conducting more studies to investigate the neural correlates during mobility activities in children with CP. Such information could guide neurorehabilitation strategies targeting brain neuroplasticity for functional gains.
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  • 文章类型: Journal Article
    除了减少温室气体排放的社会和政府行动,也迫切需要改变个体的行为来限制全球气温上升。然而,事实证明,这些个体变化在普通人群中很难实现。
    我们在五个电子数据库中进行了系统评价,目的是系统地描述促进高收入和中上收入国家个人和家庭气候友好行为的干预措施的内容。
    我们纳入了25项研究。分析包括对所使用的行为改变技术(BCT)的识别以及对其承诺比率的比较。在我们的三个结果类别中,能源消耗,用水量,和移动性最常用的BCT类别并不是在行为改变方面最有前途的类别。
    基于这些结果,我们对气候变化缓解干预措施的建议是包括提供有关如何执行所需行为的具体说明的组件(塑造知识),设定目标和承诺(目标和计划),替代不希望的行为,和实践所需的行为(重复和替换)。其他具有类似目的的评论使用不同的措辞,定义,或其干预组件标签中的详细程度,这使得很难比较结果。我们建议使用标准化的分类系统,就像BCT分类法和承诺比率相结合,这项研究已证明是对应用的干预技术进行分类并给出成功技术指示的合适工具。
    UNASSIGNED: Besides societal and governmental actions to mitigate greenhouse gases, individual behavioral changes are also urgently needed to limit global temperature rise. However, these individual changes have proven to be difficult to achieve in the general population.
    UNASSIGNED: We conducted a systematic review in five electronic databases with the aim of systematically depicting the content of interventions that promote climate-friendly behavior in individuals and households in high- and upper-middle-income countries.
    UNASSIGNED: We included 25 studies. The analyses included identification of the used Behavior Change Techniques (BCTs) and comparison of their promise ratio. Across our three outcome categories energy consumption, water consumption, and mobility the most frequently used BCT categories are not the ones that are most promising in terms of behavior change.
    UNASSIGNED: Based on these results, our recommendation for climate change mitigation interventions is to include components that provide concrete instructions on how to perform the desired behavior (shaping knowledge), setting goals and commitments (goals and planning), substituting undesired behavior, and practicing desired behavior (repetition and substitution). Other reviews with similar aims use different wordings, definitions, or degrees of detail in their intervention component labelling which makes it difficult to compare the results. We recommend to use a standardized classification system, like the BCT taxonomy in combination with the promise ratio, which this study has shown to be a suitable tool to classify applied intervention techniques and give an indication of successful techniques.
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  • 文章类型: Journal Article
    该评论着重于源自核工业释放的人为钌(Ru)的形态和迁移,并提供了有关环境中钌的最新信息。它提供了钌物种在水性和陆地环境中分布的主要途径的分析,从它的自然发生开始,从人为来源产生和释放,主要的物种形成,以生物积累结束,这可能与人类健康直接或间接相关。优先考虑属于切尔诺贝利后时间框架的文献来源,其中Ru-103和Ru-106是研究的主要裂变同位素,因为它们在环境中的可追溯性和相对较长的半衰期。
    The review focuses on speciation and migration of anthropogenic ruthenium (Ru) originated from nuclear industry releases and presents updated information regarding Ru in the environment. It provides analysis of the main pathways of Ru species distribution in the aqueous and terrestrial environment, starting from its natural occurrence, generation and release from anthropogenic sources, predominant speciation, and ending with bioaccumulation, which can be directly or indirectly related to human health. Literature sources belonging to the post-Chernobyl time frame were preferentially considered, in which Ru-103 and Ru-106 are the major fission isotopes studied due to their traceability in the environment and their relatively long half-lives.
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  • 文章类型: Systematic Review
    背景:无标记运动捕捉(MMC)使用摄像机或深度传感器进行全身跟踪,并提出了一种有希望的方法,可以客观地监控社区环境中的功能表现,帮助临床决策神经退行性疾病,如痴呆。
    目的:本系统综述的主要目的是通过全身追踪研究MMC的应用,量化痴呆症患者的功能表现,轻度认知障碍,帕金森病。
    方法:对Embase的系统搜索,MEDLINE,CINAHL,和Scopus数据库在2022年11月至2023年2月之间进行,共产生1595个结果。纳入标准为MMC和全身追踪。共纳入157项研究进行全文筛选,其中符合筛选标准的26项符合条件的研究纳入审查..
    结果:主要是,选定的研究集中在步态分析(n=24),而其他功能任务,例如坐下来站立(n=5)和踩踏(n=1),也被探索过。然而,纳入的任何研究均未评估日常生活活动.MMC模型在研究中各不相同,包括深度相机(n=18)与标准摄像机(n=5)或移动电话相机(n=2),并使用深度学习模型进行后处理。然而,只有6项研究与已建立的黄金标准动作捕捉模型进行了严格的比较.
    结论:尽管它有潜力成为分析痴呆症患者运动和姿势的有效工具,轻度认知障碍,和帕金森病,需要进一步的研究来确定MMC在量化真实世界中的移动性和功能表现方面的临床应用价值.
    BACKGROUND: Markerless motion capture (MMC) uses video cameras or depth sensors for full body tracking and presents a promising approach for objectively and unobtrusively monitoring functional performance within community settings, to aid clinical decision-making in neurodegenerative diseases such as dementia.
    OBJECTIVE: The primary objective of this systematic review was to investigate the application of MMC using full-body tracking, to quantify functional performance in people with dementia, mild cognitive impairment, and Parkinson disease.
    METHODS: A systematic search of the Embase, MEDLINE, CINAHL, and Scopus databases was conducted between November 2022 and February 2023, which yielded a total of 1595 results. The inclusion criteria were MMC and full-body tracking. A total of 157 studies were included for full-text screening, out of which 26 eligible studies that met the selection criteria were included in the review. .
    RESULTS: Primarily, the selected studies focused on gait analysis (n=24), while other functional tasks, such as sit to stand (n=5) and stepping in place (n=1), were also explored. However, activities of daily living were not evaluated in any of the included studies. MMC models varied across the studies, encompassing depth cameras (n=18) versus standard video cameras (n=5) or mobile phone cameras (n=2) with postprocessing using deep learning models. However, only 6 studies conducted rigorous comparisons with established gold-standard motion capture models.
    CONCLUSIONS: Despite its potential as an effective tool for analyzing movement and posture in individuals with dementia, mild cognitive impairment, and Parkinson disease, further research is required to establish the clinical usefulness of MMC in quantifying mobility and functional performance in the real world.
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  • 文章类型: Systematic Review
    目的:综合评估针对晚期癌症患者行动的非药物干预措施的证据,考虑到类型,可能影响结果的疗效和环境因素。
    方法:对成人(≥18岁)晚期(III-IV期)癌症非药物干预研究的系统评价,并使用临床或患者报告的结果指标评估移动性。在三个电子数据库(MEDLINE,EMBASE和CINAHL)截至2024年6月。使用JoannaBriggs研究所工具评估方法质量,并通过复杂干预框架的背景和实施评估环境因素。由于纳入研究的临床异质性,进行了叙述性综合。
    结果:纳入了包括2,464名参与者的38项研究。最常见的移动性结果测量是6分钟步行测试(26/38研究)。运动是最常见的干预措施,(33项研究:27项有氧和抗性,5有氧,在21/33个结果中发现了1个阻力与有氧训练)和活动能力的改善。在3/5的研究中,电疗干预导致了移动性的显着改善。地理因素(如距离、运输,停车要求)可能限制参与18/38研究。人群中缺乏种族多样性是显而易见的,语言能力是12项研究的纳入标准。
    结论:运动和神经肌肉电刺激似乎可以改善晚期癌症的运动结果。针对流动性的其他非药物干预措施的评估应考虑获取和包容性,并适应这些人口的需求。
    OBJECTIVE: To synthesise evidence evaluating non-pharmacological interventions targeting mobility among people with advanced cancer, considering the type, efficacy and contextual factors that may influence outcome.
    METHODS: Systematic review of studies of non-pharmacological interventions in adults (≥ 18 years) with advanced (stage III-IV) cancer, and assessing mobility using clinical or patient-reported outcome measures. Searches were conducted across three electronic databases (MEDLINE, EMBASE and CINAHL) up to June 2024. Methodological quality was assessed using Joanna Briggs Institute tools and contextual factors were evaluated through the Context and Implementation of Complex Interventions framework. A narrative synthesis was conducted due to clinical heterogeneity of included studies.
    RESULTS: 38 studies encompassing 2,464 participants were included. The most frequent mobility outcome measure was the 6-min walk test (26/38 studies). Exercise was the most common intervention, (33 studies: 27 aerobic and resistance, 5 aerobic, 1 resistance versus aerobic training) and improvements in mobility were found in 21/33 outcomes. Electrotherapy interventions led to significant improvements in mobility in 3/5 studies. Geographical factors (e.g. distance, transport, parking requirements) potentially limited participation in 18/38 studies. A lack of ethnic diversity among populations was evident and language proficiency was an inclusion criterion in 12 studies.
    CONCLUSIONS: Exercise and neuromuscular electrical stimulation appear to improve mobility outcomes in advanced cancer. The evaluation of other non-pharmacological interventions targeting mobility should consider access and inclusivity, and be adaptable to the needs of this population.
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  • 文章类型: Journal Article
    与交通相关的排放仍然是美国和全球空气污染的重要来源。有证据表明,以前实施的限制交通流量的政策影响了空气污染水平。因此,与COVID-19大流行相关的缓解策略改变了人群水平的流动模式,为研究美国各地的空气污染变化提供了独特的机会。例如,为了减缓大流行的蔓延,州和地方政府开始实施各种缓解措施,包括呆在家里的指令,社会距离措施,学校关闭,和旅行限制。这项范围审查旨在总结有关美国大流行期间空气质量如何通过缓解措施而发生变化的现有证据。我们发现66篇文章符合我们的纳入标准。一般来说,综合结果显示,二氧化氮(NO2)和一氧化碳(CO)在全国范围内下降。研究观察到细颗粒物和粗颗粒物(PM2.5,PM10)的混合方向和变化幅度,臭氧(O3)二氧化硫(SO2)。很少有文章试图通过关联背景因素来解释空气质量变化中这种显著的异质性,比如流动性,交通流量,和人口因素。然而,所有的研究都认为,空气污染的变化在美国各地是不均匀的,甚至在一个城市内是不同的。
    Traffic-related emissions continue to be a significant source of air pollution in the United States (US) and around the globe. Evidence has shown that previous policies implemented to restrict-traffic flows have affected air pollution levels. Thus, mitigation strategies associated with the COVID-19 pandemic that modified population-level mobility patterns provide a unique opportunity to study air pollution change across the US. For instance, to slow the spread of the pandemic, state and local governments started implementing various mitigation actions, including stay-at-home directives, social distancing measures, school closures, and travel restrictions. This scoping review aimed to summarize the existing evidence about how air quality changed through mitigation practices throughout the pandemic in the US. We found 66 articles that fit our inclusion criteria. Generally, the consolidated results revealed that nitrogen dioxide (NO2) and carbon monoxide (CO) decreased across the country. Studies observed mixed directions and magnitudes of change for fine and coarse particulate matter (PM2.5, PM10), ozone (O3), and sulfur dioxide (SO2). Few articles tried to explain this notable heterogeneity in air quality changes by associating contextual factors, such as mobility, traffic flow, and demographic factors. However, all studies agreed that the change in air pollution was nonuniform across the US and even varied within a city.
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  • 文章类型: Journal Article
    背景:超声检查已用于识别结构,定量,和质的肌肉变化。这些变化已经在ICU住院期间在不同的肌肉中进行了评估;然而,尚不清楚它是否可以预测ICU出院后的功能。
    目的:分析超声评估的肌肉变化与ICU幸存者的力量和功能之间的关系。
    方法:根据MOOSE指南进行了系统评价,并在PROSPERO中注册。以下数据库的搜索由两位作者进行:PubMed,Cinahl,Embase,Scopus,LILACS,WebofScience,科学直接。使用NOS和AHRQ量表进行定性分析。使用“R”进行荟萃分析,\"metafor\"包。异质性通过I2和Cochran'sQ检验进行评估。进行了荟萃回归分析,以验证主持人,采用漏斗图和Egger回归截距检验对发表偏倚进行分析。
    结果:16篇论文被纳入定性评估,9个用于定量评估。有证据表明MT和肌肉力量之间存在相关性(r=0.20[0.11;0.27];p<0.0001),和MT(r=0.35[0.19;0.49];p<0.0001),CSA(r=0.30[0.10;0.47];p=0.0038),EI(r=-0.29[-0.53;-0.01];p=0.043)和迁移率。在亚组分析中,发现了一些特定肌肉与力量和活动能力之间存在相关性的证据。
    结论:有证据表明US评估的肌肉特征与功能结局之间存在相关性。
    BACKGROUND: Ultrasonography has been used to identify structural, quantitative, and qualitative muscle changes. These changes have been assessed in different muscles during ICU stays; however, it is unclear if it can predict functioning after ICU discharge.
    OBJECTIVE: To analyze the relationship between muscle changes assessed by ultrasonography and the strength and functioning of ICU survivors.
    METHODS: A systematic review with a meta-analysis was performed according to the MOOSE guidelines and registered in PROSPERO. Searches of the following databases were performed by two of the authors: PubMed, Cinahl, Embase, Scopus, LILACS, Web of Science, and Science Direct. Qualitative analysis was performed using NOS and AHRQ scales. Meta-analysis was performed using the \"R\", \"metafor\" package. Heterogeneity was assessed by I2 and Cochran\'s Q test. Meta-regression analyses were performed to verify the moderators, and funnel plots and Egger\'s regression intercept test were used to analyze the publication bias.
    RESULTS: Sixteen articles were included in the qualitative assessment, and nine were used in the quantitative assessment. There is evidence of correlations between MT and muscle strength (r = 0.20 [0.11; 0.27]; p < 0.0001), and MT (r = 0.35 [0.19; 0.49]; p < 0.0001), CSA (r = 0.30 [0.10; 0.47]; p = 0.0038), EI (r = -0.29 [-0.53; -0.01]; p = 0.043) and mobility. In the subgroup analyses, some evidence of a correlation between specific muscles and strength and mobility were found.
    CONCLUSIONS: There is evidence for the correlation between muscle characteristics assessed by US and functioning outcomes.
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  • 文章类型: Journal Article
    脑瘫(CP)是最常见的儿童期发病残疾。根据严重程度的步态演变在儿童中是众所周知的,并且被认为在没有辅助设备的情况下行走的年龄在8至12岁之间。然而,在成年人中,临床经验以及科学研究报告,通过临床评估,问卷调查和访谈,行走困难的增加导致辅助设备在日常步行中的依赖性增加。对于许多患有CP的人来说,这种变化将发生在30-40年左右,失去流动性的风险随着年龄的增长而增加。这篇叙述性综述旨在首先提供成年CP患者衰老时运动功能和步态下降的客观证据。然后提供机械假设来解释这些变化。许多研究将患有CP的个体与典型的发展中人群进行了比较,然而,随着老龄化的演变在很大程度上被研究不足。合并症诊断包括CP患者随着年龄的增长,运动功能和步态下降的潜在决定因素之一,最初的表现发生在早期,随着年龄的增长而恶化。同样,衰老似乎会导致神经肌肉和心血管系统的改变,比他们典型的发展(TD)同龄人更早。未来的研究应该,然而,尝试更好地了解CP的生理特性如何随着年龄的增长而变化,这可能为维持CP患者功能和生活质量的更好策略铺平道路。
    Cerebral palsy (CP) is the most common childhood-onset disability. The evolution of gait according to severity is well known amongst children and thought to peak between 8 and 12 years of age among those walking without assistive devices. However, among adults, clinical experience as well as scientific studies report, through clinical assessments, questionnaires and interviews, increasing walking difficulties leading to an increased dependency of assistive devices in everyday ambulation. For many individuals with CP, this change will occur around 30-40 years, with the risk of losing mobility increasing with age. This narrative review aims to first provide objective evidence of motor function and gait decline in adults with CP when ageing, and then to offer mechanistic hypotheses to explain those alterations. Many studies have compared individuals with CP to the typically developing population, yet the evolution with ageing has largely been understudied. Comorbid diagnoses comprise one of the potential determinants of motor function and gait decline with ageing in people with CP, with the first manifestations happening at an early age and worsening with ageing. Similarly, ageing appears to cause alterations to the neuromuscular and cardiovascular systems at an earlier age than their typically developing (TD) peers. Future studies should, however, try to better understand how the physiological particularities of CP change with ageing that could pave the way for better strategies for maintaining function and quality of life in people with CP.
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  • 文章类型: Journal Article
    尽管通过视频会议进行的有监督和实时远程康复现在在帕金森病(PD)患者中变得很普遍,其对平衡和步态的疗效尚不清楚。本文使用范围研究方法来回顾当前有关视频会议远程康复对PD患者平衡和步态影响的证据。我们还探讨了研究是否在远程康复期间使用可穿戴技术通过视频会议评估和治疗平衡和步态。使用PubMed进行文献检索,ISI的知识网,科克伦图书馆,和Embase。提取数据用于研究设计,治疗,和结果。本综述包括14项研究。其中,七项研究调查了远程康复的影响(例如,远程瑜伽和适应性理疗练习)平衡和步态测量(例如,自我报告的平衡,平衡秤,步行速度,移动性,和运动症状)在评估和治疗中使用视频会议。通过视频会议进行的远程康复计划对于患有PD的人来说是可行且安全的;但是,疗效还需要确定,因为只有四项研究有一个平行组。此外,没有研究使用可穿戴技术。没有发现视频会议远程康复对PD患者平衡和步态影响的有力证据,暗示未来有动力,prospective,需要强有力的临床试验。
    Although supervised and real-time telerehabilitation by videoconferencing is now becoming common for people with Parkinson\'s disease (PD), its efficacy for balance and gait is still unclear. This paper uses a scoping approach to review the current evidence on the effects of telerehabilitation by videoconferencing on balance and gait for patients with PD. We also explored whether studies have used wearable technology during telerehabilitation to assess and treat balance and gait via videoconferencing. Literature searches were conducted using PubMed, ISI\'s Web of Knowledge, Cochrane\'s Library, and Embase. The data were extracted for study design, treatment, and outcomes. Fourteen studies were included in this review. Of these, seven studies investigated the effects of telerehabilitation (e.g., tele-yoga and adapted physiotherapy exercises) on balance and gait measures (e.g., self-reported balance, balance scale, walking speed, mobility, and motor symptoms) using videoconferencing in both assessment and treatment. The telerehabilitation programs by videoconferencing were feasible and safe for people with PD; however, the efficacy still needs to be determined, as only four studies had a parallel group. In addition, no study used wearable technology. Robust evidence of the effects of telerehabilitation by videoconferencing on balance and gait for patients with PD was not found, suggesting that future powered, prospective, and robust clinical trials are needed.
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  • 文章类型: Systematic Review
    背景:上四分之一y平衡测试(YBT-UQ)是一种用于检测肌肉骨骼损伤风险的功能筛查工具,援助康复,和监控动态功能,力量和控制,然而,目前对影响达到分数的内在和外在因素知之甚少。
    目的:本系统评价旨在确定年龄,性别,或干预措施影响了到达分数,以及在非受伤的运动人群中肢体之间的差异是否很常见,次要目的是确定运动是否影响YBT-UQ范围。
    方法:WebofScience,PubMed,和SportDiscus从2012年1月至2023年11月16日进行了系统搜索,揭示了23项研究符合2012年至2023年英语出版的纳入标准,任何年龄的健康参与者,包括男性和女性,运动人群,YBT-UQ用于评估上肢活动/稳定性,报告标准化的到达分数,和同行评审全文。通过美国国立卫生研究院(NIH)质量评估工具对方法学质量进行评估,观察性队列和横断面设计,和pre-post无对照组。
    结果:年龄,性别,运动,疲劳是影响因素;年龄较大的运动员(即>18岁)获得了更高的得分,男性,处于良好的休息状态。肢体之间的差异在运动人群中并不常见;因此,不对称可能有助于医生帮助识别损伤风险。
    结论:这是对YBT-UQ影响因素进行的首次系统综述,从而为临床医生提供了有关影响运动人群得分的特征的背景。可以从中确定标准值,并进一步帮助临床决策或领域改善损伤风险。
    BACKGROUND: The upper quarter y-balance test (YBT-UQ) is a functional screening tool used to detect musculoskeletal injury risk, aid rehabilitation, and monitor dynamic function, strength and control, yet little is currently known about intrinsic and extrinsic factors that influence reach scores.
    OBJECTIVE: This systematic review aimed to determine if age, sex, or interventions influenced reach scores and whether between-limb differences were common in non-injured sporting populations, with a secondary aim to identify if sport impacted YBT-UQ reach.
    METHODS: Web of Science, PubMed, and SportDiscus were systematically searched from January 2012 to November 16, 2023, revealing twenty-three studies satisfying inclusion criteria of published in English between 2012 and 2023, healthy participants of any age including both males and females, athletic populations, YBT-UQ use to assess upper limb mobility/stability, report normalised reach scores, and peer-reviewed full-texts. Methodological quality was evaluated via National Institutes of Health (NIH) quality assessment tools for controlled interventions, observational cohort and cross-sectional designs, and pre-post with no control group.
    RESULTS: Age, sex, sport, and fatigue were influencing factors; greater reach scores were achieved in older athletes (i.e. >18 years), males, and in a well-rested state. Between-limb differences were not common in sporting populations; therefore, asymmetries may be useful for practitioners to aid injury risk identification.
    CONCLUSIONS: This is the first systematic review investigating YBT-UQ influencing factors and thereby provides context for clinicians regarding characteristics that impact reach scores in sporting populations, from which normative values could be determined and further aid clinical decisions or areas to improve regarding injury risk.
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