OpenPose-based motion analysis (OpenPose-MA), utilizing deep learning methods, has emerged as a compelling technique for estimating human motion. It addresses the drawbacks associated with conventional three-dimensional motion analysis (3D-MA) and human visual detection-based motion analysis (Human-MA), including costly equipment, time-consuming analysis, and restricted experimental settings. This study aims to assess the precision of OpenPose-MA in comparison to Human-MA, using 3D-MA as the reference standard. The study involved a cohort of 21 young and healthy adults. OpenPose-MA employed the OpenPose algorithm, a deep learning-based open-source two-dimensional (2D) pose estimation method. Human-MA was conducted by a skilled physiotherapist. The knee valgus angle during a drop vertical jump task was computed by OpenPose-MA and Human-MA using the same frontal-plane video image, with 3D-MA serving as the reference standard. Various metrics were utilized to assess the reproducibility, accuracy and similarity of the knee valgus angle between the different methods, including the intraclass correlation coefficient (ICC) (1, 3), mean absolute error (MAE), coefficient of multiple correlation (CMC) for waveform pattern similarity, and Pearson\'s correlation coefficients (OpenPose-MA vs. 3D-MA, Human-MA vs. 3D-MA). Unpaired t-tests were conducted to compare MAEs and CMCs between OpenPose-MA and Human-MA. The ICCs (1,3) for OpenPose-MA, Human-MA, and 3D-MA demonstrated excellent reproducibility in the DVJ trial. No significant difference between OpenPose-MA and Human-MA was observed in terms of the MAEs (OpenPose: 2.4° [95%CI: 1.9-3.0°], Human: 3.2° [95%CI: 2.1-4.4°]) or CMCs (OpenPose: 0.83 [range: 0.99-0.53], Human: 0.87 [range: 0.24-0.98]) of knee valgus angles. The Pearson\'s correlation coefficients of OpenPose-MA and Human-MA relative to that of 3D-MA were 0.97 and 0.98, respectively. This study demonstrated that OpenPose-MA achieved satisfactory reproducibility, accuracy and exhibited waveform similarity comparable to 3D-MA, similar to Human-MA. Both OpenPose-MA and Human-MA showed a strong correlation with 3D-MA in terms of knee valgus angle excursion.

The purpose was to determine the impact of both cognitive constraint and neuromuscular fatigue on landing biomechanics in healthy and chronic ankle instability (CAI) participants. Twenty-three male volunteers (13 Control and 10 CAI) performed a single-leg landing task before and immediately after a fatiguing exercise with and without cognitive constraints. Ground Reaction Force (GRF) and Time to Stabilization (TTS) were determined at landing in vertical, anteroposterior (ap) and mediolateral (ml) axes using a force plate. Three-dimensional movements of the hip, knee and ankle were recorded during landing using a motion capture system. Exercise-induced fatigue decreased ankle plantar flexion and inversion and increased knee flexion. Neuromuscular fatigue decreased vertical GRF and increased ml GRF and ap TTS. Cognitive constraint decreased ankle internal rotation and increased knee and hip flexion during the flight phase of landing. Cognitive constraint increased ml GRF and TTS in all three axes. No interaction between factors (group, fatigue, cognitive) were observed. Fatigue and cognitive constraint induced greater knee and hip flexion, revealing higher proximal control during landing. Ankle kinematic suggests a protective strategy in response to fatigue and cognitive constraints. Finally, these two constraints impair dynamic stability that could increase the risk of ankle sprain.

Wearables quantify the activity in team sports and indicate that players experience peak physical loads during competitions. Accordingly, players with limited court time in competitions will miss important training stimuli. The present study aimed to quantify these gaps in physical load in professional handball players. Activity of all players competing in the 2021/2022 Bundesliga (Germany) was tracked using Kinexon LPS sensors. Gaps in physical load were quantified comparing the 25% of appearances with the highest (HIGH; 51.8 ± 5.2 mins) and lowest court times (LOW; 10.1 ± 4.3 mins). Distances, accumulated acceleration, jumps, sprints, impacts, accelerations, and decelerations were analysed as absolute and relative (per minute) outcomes. Players were grouped into wings, backcourts, and pivots. Unpaired t-tests between HIGH and LOW were performed (p < .05), and effect sizes were calculated (Cohen´s d). Analyses revealed significant effects of court time on activity. While absolute activity increased for HIGH, relative activity increased for LOW (p < .05). In addition, effect sizes revealed position-specific gaps in physical load, particularly for acyclic activities (jumps, accelerations). Gaps in physical load resulting from limited court time are highly position-specific. Our observations may provide benchmarks for the position-specific calibration of compensatory training.

Loading both lateral and medial compartments is crucial to understanding the effect of muscle fatigue during sidestep cutting. The present study investigated the changes in tibiofemoral contact forces in the medial and lateral compartments and the muscle force contributions during the sidestep-cutting manoeuvre after a handball-specific fatigue protocol. Twenty female handball athletes performed three trials of the sidestep-cutting manoeuvre before (baseline) and after the fatigue protocol. Motion capture and ground reaction forces were measured, and the data were processed in OpenSim. The variables were compared using statistical parametric mapping (SPM), with a significance level of p < 0.05. The results showed a decreased knee flexion angle during fatigue in the early stance phase. In addition, the post-fatigue analysis demonstrated significantly reduced forces in vasti muscles. Similarly, during fatigue, the SPM analysis showed decreased tibiofemoral contact forces in the vertical and anterior directions. Vertical force applied to both medial and lateral condyles demonstrated a significant reduction after the fatigue protocol. These results indicated that forces applied to the tibiofemoral joint were reduced following the fatigue protocol compared to the baseline values. However, no consistent evidence exists that fatigue increases the risk of knee injuries.

Recently, a variety of technical approaches in world-class pole-vaulters\' behaviour have been observed. The aim of this study was to investigate the presence of subgroups using different technical approaches and to compare biomechanical performance differences. Biomechanical analysis of performances over 5.00 metres from 99 athletes were clustered with K-means methodology based on the relative position of the top hand at take-off and the direction of the top of the pole from take-off to the maximal pole bending. Analysis revealed four subgroups that were distinguished by higher and lower direction angle and relative position values. Despite differences in technique, the analysis did not reveal significant differences between these four groups in performance, take-off speed, or athlete anthropometrics. Nevertheless, these clusters showcased variations in pole-athlete interactions and pole bending, suggesting different strategies and physical requirements associated with each approach. Cluster 2 characterised the classical technique with a high direction angle and a take-off position close to the vertical plane. Cluster 4 displayed a technique with a low take-off angle, suggesting the influence of athletes like Lavillenie, in deviating from the conventional model. Understanding and categorising athletes based on their preferred technique can aid coaches in providing tailored instructions, leading to performance improvements.

This study examined the frequency of the most demanding scenarios (MDS) during official soccer matches using rolling averages over 1, 5, and 10 min. Forty-two Under-19 players from different positions (central defenders, full-backs, central midfielders, wide midfielders, offensive midfielders, and forwards) were monitored across 27 matches using GPS to track distance covered, high-speed running, sprint distance, accelerations, and decelerations. Intensity thresholds were established based on percentiles (0-25, 25-50, 50-75, 75-100, and ≥100). The main findings suggest that: (i) Peak Demands occur in less than 1% of all time windows and variables for all positions; (ii) Most efforts occur below peak demands, with around 95% for high-speed running and sprint distance, and 85% for accelerations, decelerations, and total distance; (iii) Significant differences in intensity distributions were found between positions, particularly at medium-low and high intensities. Regarding training prescription, relying solely on MDS may be limited, highlighting the need to supplement MDS with other metrics for a comprehensive understanding of match demands. This approach ensures better-informed training programs for soccer players.
The occurrence of peak demand events during soccer matches is infrequent. Therefore, understanding the frequency of efforts below the intensity threshold of the most demanding passages for each playing position and across various analysed variables and periods is of utmost importance.MDS might not be enough for effective soccer training planning. Complementing with additional metrics like GPS, tactical analysis, physiological data and psychological factors is essential for a comprehensive understanding of the game’s demands and tailored training programmes.

BACKGROUND: Early childhood caries (ECC) is a major global health issue affecting millions of children. Mitigating this problem requires up-to-date information from reliable surveillance systems. This enables evidence-based decision-making to devise oral health policies. The World Health Organization (WHO) advocates the adoption of mobile technologies in oral disease surveillance because of their efficiency and ease of application. The study describes developing an electronic, oral health surveillance system (EOHSS) for preschoolers in Egypt, using the District Health Information System (DHIS2) open-source platform along with its Android App, and assesses its feasibility in data acquisition.
METHODS: The DHIS2 Server was configured for the DHIS2 Tracker Android Capture App to allow individual-level data entry. The EOHSS indicators were selected in line with the WHO Action Plan 2030. Two modalities for the EOHSS were developed based on clinical data capture: face-to-face and tele/asynchronous. Eight dentists in the pilot team collected 214 events using modality-specific electronic devices. The pilot\'s team\'s feedback was obtained regarding the EOHSS\'s feasibility in collecting data, and a time-motion study was conducted to assess workflow over two weeks. Independent t-test and Statistical Process Control techniques were used for data analysis.
RESULTS: The pilot team reported positive feedback on the structure of the EOHSS. Workflow adaptations were made to prioritize surveillance tasks by collecting data from caregivers before acquiring clinical data from children to improve work efficiency. A shorter data capture time was required during face-to-face modality (4.2 ± 0.7 min) compared to telemodality (5.1 ± 0.9 min), p < 0.001). The acquisition of clinical data accounted for 16.9% and 21.1% of the time needed for both modalities, respectively. The time required by the face-to-face modality showed random variation, and the tele-modality tasks showed a reduced time trend to perform tasks.
CONCLUSIONS: The DHIS2 provides a feasible solution for developing electronic, oral health surveillance systems. The one-minute difference in data capture time in telemodality compared to face-to-face indicates that despite being slightly more time-consuming, telemodality still shows promise for remote oral health assessments that is particularly valuable in areas with limited access to dental professionals, potentially expanding the reach of oral health screening programs.

OBJECTIVE: To compare the kinematic profile of 2 underwater pullout breaststroke techniques.
METHODS: Sixteen swimmers (9 men, 20.67 [2.71] y old; 7 women, 18.86 [0.83] y old) performed 3 × 25-m breaststroke using 2 pullout breaststroke techniques: Fly-Kick first and Combined. A speedometer was used to assess the peak and the mean velocity during the glide, propulsion, and recovery phases of both techniques, as well as for the total underwater sequence. The underwater distance was retrieved from video footage and was considered for each pullout technique. The range of motion of the knee during the fly-kick was also retrieved, and the time to complete the 25 m was considered the performance outcome, accompanied by the mean velocity, stroke rate, stroke length, and stroke index.
RESULTS: Velocity-time series showed different profiles between pullout techniques (P ≤ .05) mostly in the glide and propulsion phases for males and females, respectively. The mean velocity of 25 m was shown to be greater in females when using the Fly-Kick first technique (P = .05, d = 0.36). Greater values in total underwater distance and knee range of motion were also observed for this technique in both cohorts. Conclusions: Female swimmers presented a higher performance when using the Fly-Kick first technique. Different kinematic profiles arise when swimmers use different underwater pullout techniques where the Fly-Kick first may allow them to reach higher kinematical standard.

OBJECTIVE: This study aimed to enhance the understanding of soccer match peak demands by describing worst-case scenario (WCS) and time spent above 80% and 90% of the WCS for total distance (TD) and high-speed running (HSR). The investigation considered playing level (first team vs under-19 [U19] team) and playing position (center backs, fullbacks, midfielders, and forwards) to assess how WCS and the time spent above specific thresholds vary across different populations.
METHODS: Data from 31 players in a professional Italian soccer club were collected during the 2022-23 season. Microtechnology devices tracked physical activity during matches. Players were categorized by position, and WCS was determined using rolling averages over a 1-minute period. Time spent above 80% and 90% of WCS for TD and HSR was calculated.
RESULTS: The U19 team exhibited higher HSR WCS compared with the first team (∼63 m·min-1 vs ∼56 m·min-1). Midfielders recorded the highest TD WCS (∼208 m·min-1), and forwards exhibited the highest HSR WCS (∼70 m·min-1). The first team spent significantly more time above 80% (∼6 min) and 90% (∼1 min) of TD WCS. Midfielders spent significantly more time above the 80% (∼7 min) of TD WCS, while forwards above the 80% (∼2 min) of HSR WCS.
CONCLUSIONS: The study emphasizes that WCS used alone may not sufficiently capture real match intensity. Considering the time spent above specific thresholds provides additional insights (ie, between-levels differences and position). Practitioners should consider both WCS and time spent above thresholds for individualized training prescriptions, reflecting differences in playing roles.

UNASSIGNED: The current study compared preparation time, errors, satisfaction, and preference for a prefilled syringe (PFS) versus two RSV vaccines requiring reconstitution (VRR1 and VRR2) in a randomized, single-blinded time and motion study.
UNASSIGNED: Pharmacists, nurses, and pharmacy technicians were randomized to a preparation sequence of the three vaccines. Participants read instructions, then consecutively prepared the three vaccines with a 3-5-min washout period in between. Preparations were video recorded and reviewed by a trained pharmacist for preparation time and errors using predefined, vaccine-specific checklists. Participant demographics, satisfaction with vaccine preparation, and vaccine preference were recorded. Within-subjects analysis of variance was used to compare preparation time. Mixed-effects Poisson and ordered logistic regression models were used to compare the number of preparation errors and satisfaction scores, respectively.
UNASSIGNED: Sixty-three pharmacists (60%), nurses (35%), and pharmacy technicians (5%) participated at four sites in the United States. The least squares mean preparation time per dose for PFS was 141.8 s (95% CI = 156.8-126.7; p <.0001) faster than for VRR1, 103.6 s (95% CI = 118.7-88.5; p <.0001) faster than for VRR2, and 122.7 s (95% CI = 134.2-111.2; p <.0001) faster than the pooled VRRs. Overall satisfaction (combined \"Very\" and \"Extremely\") was 87.3% for PFS, 28.6% for VRR1, and 47.6% for VRR2. Most participants (81.0%) preferred the PFS vaccine.
UNASSIGNED: The study is limited by the inability to completely blind observers. To minimize the effects of order, we utilized a 3-sequence block design; however, the order in which the vaccines were prepared may have affected outcomes. Participants were assessed once, whereas if repeated preparations were performed there may have been trained efficiencies gained for each vaccine.
UNASSIGNED: PFS vaccines can greatly simplify the vaccine preparation process, allowing administrators to prepare almost four times more doses per hour than with vial and syringe systems.