Umeå University's logo

Adolescent idiopathic scoliosis (AIS) is a significant challenge to global paediatric health. Early detection and longitudinal monitoring are critical for initiating non operative interventions and preventing irreversible skeletal complications. The aim of this study was to evaluate the efficacy of infrared thermography (IRT) entropy as a non invasive screening technique for adolescent idiopathic scoliosis. To this end, we recruited 203 patients with idiopathic scoliosis and 105 healthy controls, all aged 8 to 18 years. The analysis examined differences in back entropy and temperature values between the idiopathic scoliosis and control groups, whilst calculating the area under the receiver operating characteristic (ROC) curve to assess classification performance. Data analysis was conducted between February and July 2025. A significant disparity was identified between the idiopathic scoliosis group and the control group in both back entropy and temperature values (P < 0.05), with idiopathic scoliosis patients exhibiting markedly reduced entropy and significantly elevated temperatures (for example, in the upper right (UR) region, entropy decreased from 2.63 ± 0.46 bits in the control group to 1.79 ± 0.41 bits in the left convex, while temperature increased from 36.1 ± 0.7 °C to 36.5 ± 0.1 °C). Intragroup analysis revealed good symmetry in both entropy and temperature between the left and right sides of the back in the control group (P > 0.05). Conversely, both entropy and temperature values exhibited significant left right asymmetry in the idiopathic scoliosis group (P < 0.05). ROC curve analysis demonstrated that entropy had good discriminatory ability in distinguishing AIS patients from controls, suggesting its potential utility as an adjunctive screening tool. This approach, being radiation free, effectively addresses the limitation of cumulative radiation exposure inherent in current X ray dependent detection protocols.

Background: Exercise-induced metabolic changes, especially lipidomic changes are generally associated with improvements in cardiovascular health. Despite numerous previous studies, the differences in lipidomic profile response to different types of exercise training remain unclear. This study aimed to investigate how two different exercise intensities affect aerobic capacity and serum lipidomic profiles in healthy adolescents.

Methods: Twenty-four healthy untrained male adolescents (13.08 ± 0.88 years old) were recruited and randomly assigned to moderate-intensity continuous training (MICT) group or sprint interval training (SIT) group to complete a specific training on a cycle ergometer for 6 weeks. Peak oxygen uptake (VO2peak) and body composition were measured, and blood samples were collected for serum lipoproteins and lipidomic analysis. Anthropometric, VO2peak, and serum biochemical data were analyzed using two-way repeated analysis of variance, while targeted lipidomic analysis was performed by principal component analysis and paired-sample t-test.

Results: VO2peak significantly improved from 39.05 ± 8.17 to 47.52 ± 8.51 [F (1, 44) = 14.75, p < 0.05] for MICT and from 40.13 ± 6.37 to 48.42 ± 7.01 [F (1, 44) = 14.75, p < 0.05] for SIT. A total of 28 lipids in MICT and 5 lipids in SIT showed significant changes out of 276 identified lipids (FC > 1.5 or <1/1.5, FDR <0.05). In MICT, 21 lipids, including sphingolipid (SP) and phospholipid (PL), decreased, while 7 lipids increased. In SIT, all 5 lipids, which were free fatty acid (FFA), decreased.

Conclusion: Although both MICT and SIT induced similar and significant improvements in VO2peak, serum lipid adaptations to the training differed. The primary changes in serum lipidomic intermediates for both types of training were reductions; however, SIT affected FFA, while MICT predominantly influenced SPs and PLs.

Objectives: To explore whether active physical exercise (APE) is more effective than conventional continuous passive motion (CPM) in improving functional knee recovery and quality of life without increasing the risk of complication in patients with endoprosthetic knee replacement for bone tumor.

Methods: Six hundred and fourteen patients were enrolled and allocated to either APE or CPM for 6 months. APE was specific for patients with bone tumors on the distal femur (APE-F) and proximal tibia (APE-T), whereas CPM was similar to both types of patients (CPM-F and CPM-T). APE for both APE-F and APE-T patients was started on the second post-operation day, and CPM was initiated on the second post-procedure day in CPM-F patients, and in the seventh post-procedure week in CPM-T patients. The 6-month APE training consisted of three stages with training intensity progressively increasing though limited within a range of metabolic equivalent (MET) on each stage. Training intensity was individualized based on personal basic MET. The patients were followed up for 5 years for regular assessments of functional knee recovery, quality of life, and rate of complications.

Results: APE-F and APE-T patients presented with significantly better results in functional knee recovery and quality of life in comparison with CPM-F and CPM-T patients, respectively. In addition, APE-T patients reached a similar level of quality of life as APE-F patients 6-month post-operation, whereas CPM-T patients reached a similar level of quality of life as CPM-F patients 3 years after the procedure. Nevertheless, APE training did not induce a higher incidence of complications than CPM training.

Conclusions: APE training was more effective in improving functional knee recovery and quality of life without increasing the risk of complications than CPM training, thus, being strongly recommended to the patients for post-operation rehabilitation.

Rehabilitation plays a critical role in the functional recovery of pediatric patients following rotationplasty for lower extremity malignant bone tumors. However, due to the limited number of cases and the unique characteristics of the surgery, there is a paucity of studies that have longi‑ tudinally evaluated the effect of rehabilitation strategies on long‑term functional recovery after rotationplasty. Therefore, the present study aimed to identify an effective rehabilitation approach for pediatric patients undergoing rotationplasty for malignant bone tumors of the lower limb. Additionally, the study aimed to assess the effect of rehabilitation on long‑term functional recovery and quality of life. A total of 12 patients were included in the current study, with a mean age at surgery of 6.58±1.73 years (range, 4‑10 years). These patients underwent rotationplasty for malignant bone tumors of the lower extremity at the Fourth Medical Center of the Chinese People's Liberation Army General Hospital (Beijing, China) between March 2014 and March 2019. After surgery, patients underwent a 6‑month postoperative rehabilitation programme, either on an outpatient or inpatient basis, with exercise therapy as the key training modality. The follow‑up outcomes at 3, 6 and 12 months and at 3 and 5 years were recorded and analyzed, ensuring a comprehensive evaluation of long‑term progress. The results demonstrated a gradual enhancement in functional performance and quality of life. Within a year of surgery, the patients displayed significant improvements in both functional recovery and quality of life, and all indicators remained stable 1 year later compared with those at 1 year post‑surgery. More specifically, patients showed restored muscle strength and walking ability to normal levels, with a significant increase in muscle strength to 5/5. In addi‑ tion, the study revealed that the mean distance covered in the 6‑min walk test was 403.08±12.52 meters, while a duration of 8.83±0.72 sec was recorded in the timed up and go test. All patients have been continuously monitored up to date. The follow‑up period for all patients ranged from 60 to 120 months, with a mean of 89.83±17.55 months. Overall, the findings indi‑ cated that the early postoperative period was a critical period for functional recovery, and that early postoperative rehabilita‑ tion interventions resulted in significant improvements to the rate and quality of functional recovery over time, thus further improving quality of life.

Yoga is effective in binge eating disorder (BED) treatment, but it does not seem effective enough to improve low physical fitness. In contrast, high-intensity interval training (HIIT) is effective in improving physical fitness but has never been studied in the context of BED. In the study, 47 young inactive females with mild to moderate BED were recruited and randomly assigned to a HIIT group (HIIT), a Yoga group (YG), or a control group (CG; age, 19.47 ± 0.74, 19.69 ± 0.874, and 19.44 ± 0.63 years; BMI, 21.07 ± 1.66, 21.95 ± 2.67, and 20.68 ± 2.61 kg/m², respectively). The intervention groups participated in 8-week specific exercises, while the CG maintained their usual daily activity. Before and after the training, participants were evaluated for BED using the binge eating scale (BES) and for physical fitness. The obtained data were compared within groups and between groups, and a correlation analysis between BES and physical fitness parameters was performed. After the training, the YG presented significant improvements in BES (- 20.25%, p = 0.006, η_p² = 0.408), fat mass (FM, - 3.13%, p = 0.033, η_p² = 0.269), and maximal oxygen consumption (VO₂max, 11.51%, p = 0.000, η_p² = 0.601), whereas the HIIT showed significant improvements in body weight (BW, - 1.78%, p = 0.006, η_p² = 0.433), FM (- 3.94%, p = 0.033, η_p² = 0.285), and BMI (- 1.80%, p = 0.006, η_p² = 0.428), but not in BES. Comparisons between groups revealed that both HIIT and YG had significantly higher VO₂max levels than CG (HIIT 12.82%, p = 0.006, η_p² = 0.088; YG: 11.90%, p = 0.009, η_p² = 0.088) with no difference between HIIT and YG. Additionally, YG presented significantly lower BES than both HIIT (15.45%, p = 0.02, η_p² = 0.03) and CG (11.91%, p = 0.022, η_p² = 0.03). In conclusion, Yoga is an effective treatment for BED, but HIIT is not, despite its high efficacy in improving physical fitness.

BACKGROUND: Physical exercise has been shown to be beneficial for individuals with Alzheimer's disease (AD), although the underlying mechanisms are not fully understood.

METHODS: Six-month-old Amyloid precursor protein/Presenilin 1 (APP/PS1) transgenic (Tg) mice and wild-type (Wt) mice were randomly assigned to either a sedentary group (Tg-Sed, Wt-Sed) or an exercise group (Tg-Ex, Wt-Ex) undertaking a 12-week, moderate-intensity treadmill running program. Consequently, all mice were tested for memory function and amyloid β (Aβ) levels and phosphorylation of tau and protein kinase B (Akt)/glycogen synthase kinase-3 (GSK3) were examined in tissues of both the cortex and hippocampus.

RESULTS: Tg-Sed mice had severely impaired memory, higher levels of Aβ, and increased phosphorylation of tau, GSK3α tyrosine279, and GSK3β tyrosine216, but less phosphorylation of GSK3α serine21, GSK3β serine9, and Akt serine473 in both tissues than Wt-Sed mice in respective tissues. Tg-Ex mice showed significant improvement in memory function along with lower levels of Aβ and less phosphorylation of tau (both tissues), GSK3α tyrosine279 (both tissues), and GSK3β tyrosine216 (hippocampus only), but increased phosphorylation of GSK3α serine21 (both tissues), GSK3β serine9 (hippocampus only), and Akt serine473 (both tissues) compared with Tg-Sed mice in respective tissues.

CONCLUSIONS: Moderate-intensity aerobic exercise is highly effective in improving memory function in 9-month-old APP/PS1 mice, most likely through differential modulation of GSK3α/β phosphorylation in the cortex and hippocampus.

The molecular mechanisms underlying muscular adaptations to concentric (CON) and eccentric (ECC) exercise training have been extensively explored. However, most previous studies have focused on specifically selected proteins, thus, unable to provide a comprehensive protein profile and potentially missing the crucial mechanisms underlying muscular adaptation to exercise training. We herein aimed to investigate proteomic profiles of human skeletal muscle in response to short-term resistance training. Twenty young males were randomly and evenly assigned to two groups to complete a 4-week either ECC or CON training program. Measurements of body composition and physiological function of the quadriceps femoris were conducted both before and after the training. Muscle biopsies from the vastus lateralis of randomly selected participants (five in ECC and four in CON) of both before and after the training were analyzed using the liquid-chromatography tandem mass spectrometry in combination with bioinformatics analysis. Neither group presented a significant difference in body composition or leg muscle mass; however, muscle peak torque, total work, and maximal voluntary contraction were significantly increased after the training in both groups. Proteomics analysis revealed 122 differentially abundant proteins (DAPs; p value < 0.05 & fold change >1.5 or <0.67) in ECC, of which the increased DAPs were mainly related to skeletal muscle contraction and cytoskeleton and enriched specifically in the pentose phosphate pathway, extracellular matrix-receptor interaction, and PI3K-Akt signaling pathway, whereas the decreased DAPs were associated with the mitochondrial respiratory chain. One hundred one DAPs were identified in CON, of which the increased DAPs were primarily involved in translation/ protein synthesis and the mitochondria respiratory, whereas the decreased DAPs were related to metabolic processes, cytoskeleton, and de-ubiquitination. In conclusion, the 4-week CON and ECC training resulted in distinctly different proteomic profiles, especially in proteins related to muscular structure and metabolism.

Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity and characterized by progressive development during growth, and eventually to a curvature of the spine greater than 10 degrees on the posteroanterior radiograph. AIS usually does not present symptoms in early age, which makes the diagnosis and treatment of these patients difficult. Thus, a follow-up observation of all suspicious AIS patients becomes very important to monitor the progression of spinal cord deformity. Telerehabilitation is a new type of rehabilitation, which links the professional physiotherapists and the patients through telecommunication and information technology. Telerehabilitation can be synchronous (through any device real-time connection between patients and therapists), asynchronous (computer-based intervention for remote monitoring by the physiotherapists and offline adjustments), or a combination of both. The COVID-19 pandemic has caused medical health care system chaos and affected seriously the ongoing disease management in many countries. Telerehabilitation can reduce the spreading risk of COVID-19, the cost of face-to-face rehabilitation service, the pressure on the staff, and the financial burden on the patients. In this review, we briefly describe the development of telerehabilitation, its current status and related technologies, and its application in clinical practice of AIS. In addition, we discussed the limitations of the current telerehabilitation and its future prospection. We believe that telerehabilitation could provide high quality rehabilitation service to the patients, thus becoming the mainstream of rehabilitation to the population of AIS.

Background: In the clinic, patients with endoprosthetic knee replacement for bone tumour generally experience loss of neuromuscular control and body balance, which consequently affects knee function and quality of life. Active physical exercise (APE) has been proven to be effective in rehabilitation. However, in the literature, no systematic study has been performed to make a general guideline of APE training on the patients.

Methods: A total number of 528 patients who have had endoprosthetic knee replacement for tumour resection was collected from July 2009 to December 2016. After operation, the patients were randomly attributed to rehabilitation of either APE training or conventional continuous passive motion (CPM) for six months. The APE training was specific for patients with a bone tumour on the distal femur (APE-F) and the proximal tibia (APE-T), and the whole training was divided into three stages with different training items and training intensity which was progressively increased with limited intensity in terms of metabolic equivalent (MET) level for each stage. For each individual patient, the APE training intensity was personal based on personal basic MET. The patients were followed up for five years for regular assessments of functional knee recovery and quality of life.

Findings: Both APE training and CPM training induced significant improvements in functional knee recovery and quality of life throughout the whole period of follow-up. Nevertheless, the improvements were more significant in patients following APE training than in that following CPM training (APE-F vs. CPM-F and APE-T vs. CPM-T). Additionally, the specific APE training induced significantly better functional knee recovery throughout the whole five-year of follow-up, and quality of life in the first six-month post-operation in patients of APE-F than in that of APE-T. In contrast, the CPM training induced significantly better improvements in both functional knee recovery and quality of life the whole five-year of follow-up. Nevertheless, the early APE training, especially for the patients of APE-T, did not induce more incidence of complication of any type compared to CPM training (APE-F vs. CPM-F and APE-T vs. CPM-T).

Interpretation: APE training is more effective in improving functional knee recovery and quality of life than CPM training. The results observed in patients of APE-T and APE-F in comparison to that of CPM-F and CPM-T demonstrates further the advantage of APE training over CPM training in rehabilitation. The low complication incidence following APE training is attributed to the well-controlled training intensity through personal MET. Taken together, the study provided strong evidence for clinical application of APE training on the patients.

Lipids play an important role in coordinating and regulating metabolic and inflammatoryprocesses. Sprint interval training (SIT) is widely used to improve sports performance and healthoutcomes, but the current understanding of SIT-induced lipid metabolism and the correspondingsystemic inflammatory status modification remains controversial and limited, especially in maleadolescents. To answer these questions, twelve untrained male adolescents were recruited andunderwent 6 weeks of SIT. The pre- and post-training testing included analyses of peak oxygenconsumption (VO2peak), biometric data (weight and body composition), serum biochemical pa-rameters (fasting blood glucose, total cholesterol, high-density lipoprotein cholesterol, low-densitylipoprotein cholesterol, triacylglycerol, testosterone, and cortisol), inflammatory markers, and tar-geted lipidomics. After the 6-week SIT, the serum C-reactive protein (CRP), interleukin (IL)-1β, IL-2,IL-4, IL-10, tumor necrosis factor (TNF)-α, and transforming growth factor (TGF)-β significantlydecreased (p < 0.05), whereas IL-6 and IL-10/TNF-α significantly increased (p < 0.05). In addition,the targeted lipidomics revealed changes in 296 lipids, of which 33 changed significantly (p < 0.05,fold change > 1.2 or <1/1.2). The correlation analysis revealed that the changes in the inflammatorymarkers were closely correlated with the changes in some of the lipids, such as LPC, HexCer, andFFA. In conclusion, the 6-week SIT induced significant changes in the inflammatory markers andcirculating lipid composition, offering health benefits to the population.