Hollman, John H.

Background: Running often elicits stress urinary incontinence (SUI) in parous athletes. While cadence retraining improves running biomechanics, its impact on incontinence is unclear. This feasibility study assessed the implementation and preliminary effects of a 6-week cadence retraining program in parous female runners with SUI. Methods: A total of 8 participants with self-reported SUI and a preferred running cadence ≤ 170 steps/minute underwent treadmill testing before and after the intervention. The program involved a 6-week cadence retraining program using a Garmin Forerunner 55 watch. Feasibility was assessed across 6 domains. Running outcome measures included cadence and vertical oscillation. SUI outcome measures included the Questionnaire for Urinary Incontinence Diagnosis and Urinary Distress Inventory-6 scores. Paired t-tests were conducted (α = .05). Results: Following the 6-week program, feasibility outcomes supported the viability of study procedures and high adherence. Statistically significant increases in cadence ( P = .016) and decreases in vertical oscillation ( P = .019) and concomitant decreases in Questionnaire for Urinary Incontinence Diagnosis ( P = .013) and Urinary Distress Inventory-6 ( P = .042) scores were observed. Discussion: This study demonstrated the feasibility and acceptability of a 6-week cadence retraining program for parous runners with SUI. Given the growing movement to foster athleticism after pregnancy, these findings will appeal to physical therapists searching for acceptable treatment options for SUI in parous runners. Preliminary running mechanics and SUI symptoms warrant a larger randomized controlled trial. A power analysis estimated a sample size of 66 participants for a future full-scale efficacy study.

Purpose: This study examined if vertical bladder excursion during pelvic floor muscle (PFM) contraction, measured with transabdominal ultrasound (TAUS), improved following a single training session 0-5 days postpartum. It also assessed patient satisfaction with the training. Methods: 75 healthy, female volunteers within 0-5 days post-vaginal delivery were recruited during their inpatient postpartum stay. Participants completed one in-person session involving a standardized bladder filling protocol, TAUS imaging during PFM contractions, a PFM training session using TAUS as visual biofeedback, and a two-question post intervention survey. Vertical bladder base excursions were compared pre- and post- training between two groups: those whose bladder bases descended and those whose ascended during baseline contractions. A mixed model ANOVA with one between-group factor (baseline descenders vs. ascenders) and one within-group factor (pre- vs. post-training) analyzed the change in bladder lift. Patient satisfaction was assessed with Likert scales. Results: Mean vertical excursion increased from 0.12 cm (SD = 0.48) to 0.32 cm (SD = 0.33) post-training, which was statistically significant (p <.001, Cohens d = 0.767). Greater improvements were noted in those with a bladder base descent at baseline. All participants reported the experience to be helpful or very helpful and were satisfied or very satisfied. Discussion: Participants increased vertical bladder excursion during PFM contraction with TAUS biofeedback within a single session, especially those with baseline paradoxical bladder excursion and perineal trauma during delivery. Participants found the experience helpful and satisfying, suggesting TAUS biofeedback may be a useful tool in early postpartum PFM rehabilitation.

ImportanceThis is the first population-based study quantifying the incidence of nonsynostotic positional plagiocephaly and/or brachycephaly (PPB) in infancy and its association with developmental disorders.ObjectiveTo report the incidence of PPB before age 1 year, the incidence of craniosynostosis, and the percentage of children with PPB diagnosed with a developmental disorder by age 7 years.Design, Setting, and ParticipantsThis was a retrospective, population-based cohort study of children in the Rochester Epidemiology Project (REP) born in Olmsted County, Minnesota, from January 1, 2008, through December 31, 2012, with follow-up through age 7 years. Data were analyzed from March 2021 to April 2024.ExposurePhysical examination detecting cranial deformity.Main Outcomes and MeasuresThe primary outcome was the incidence of PPB. Secondary outcomes were the incidence of craniosynostosis and the percentage of children with PPB diagnosed with a developmental disorder by age 7 years.ResultsOf 9909 infants (5084 [51.3%] male; 9205 [92.9%] born at term and 704 [7.1%] born preterm) included in the study, 575 had PPB, for a PPB incidence of 5.8% (95% CI, 5.3%-6.3%). The incidence of PPB was 5.3% (95% CI, 4.8%-5.8%) in term infants vs 11.8% (95% CI, 9.4%-14.6%) in preterm infants. The incidence of craniosynostosis was 0.16% (95% CI, 0.09%-0.26%). A developmental disorder was known or suspected in 4.2% (95% CI, 2.7%-6.2%) of infants at the time of PPB diagnosis; among 402 infants with PPB and follow-up through age 7 years, 30 (7.5%; 95% CI, 5.0%-10.7%) had a confirmed developmental disorder by 7 years of age. The prevalence of autism spectrum disorder (ASD) in children with a history of PPB who were followed up to age 7 years was 2.2% (9 of 402 children).Conclusions and RelevanceThis study found that only a small percentage of the infants had positional head deformity significant enough to be documented and/or referred for subspecialty evaluation, and only a small subset of these children went on to have a developmental disorder in childhood. This information is helpful for counseling families about their child’s developmental risk at time of PPB diagnosis.

Background: Women with stress urinary incontinence (SUI) may have altered running mechanics and reduced hip muscle strength compared with women without SUI. Little research has examined running metrics and functional lower extremity strength of parous runners. Objective: To determine whether SUI severity correlates with running metrics and lower extremity muscle strength among parous women. Study Design: This was a cross-sectional observational study of 22 parous participants (mean age 39.8 years, with a mean of 3.4 pregnancies and 8.1-year interval since last delivery). Methods: Participants completed the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI), Urinary Distress Inventory-6 (UDI-6), Colorectal-Anal Distress (CRAD) Inventory-8, and Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6), and Questionnaire for Urinary Incontinence Diagnosis (QUID) and provided demographic, relevant running, and obstetric/gynecologic history information. After a brief warm-up, participants completed 30-second single-leg sit-to-stand tests bilaterally and a standardized 10-minute treadmill run with pod cadence assessment. Pearson-product moment correlation coefficients were calculated (α = .05). Results: Prolonged ground contact times were associated with higher ICIQ-UI SF (r= 0.523, P= .015), POPDI-6 (r= 0.694, P< .001), and UDI-6 scores (r= 0.577, P= .006), while lower cadences were associated with higher POPDI-6 (r=−0.550, P= .010) and UDI-6 scores (r=−0.444, P= .044). Conclusions: Parous female runners with more severe SUI and prolapse symptoms demonstrate altered running mechanics characterized by prolonged ground contact times and slower cadences.

Abstract Objective The objective of this study was to compare the lexical sophistication of personal statements submitted by professional physical therapist education program applicants with those generated by OpenAI’s Chat Generative Pretrained Transformer (ChatGPT). Methods Personal statements from 152 applicants and 20 generated by ChatGPT were collected, all in response to a standardized prompt. These statements were coded numerically, then analyzed with recurrence quantification analyses (RQAs). RQA indices including recurrence, determinism, max line, mean line, and entropy were compared with t-tests. A receiver operating characteristic curve analysis was used to examine discriminative validity of RQA indices to distinguish between ChatGPT and human-generated personal statements. Results ChatGPT-generated personal statements exhibited higher recurrence, determinism, mean line, and entropy values than did human-generated personal statements. The strongest discriminator was a 13.04% determinism rate, which differentiated ChatGPT from human-generated writing samples with 70% sensitivity and 91.4% specificity (positive likelihood ratio = 8.14). Personal statements with determinism rates exceeding 13% were 8 times more likely to have been ChatGPT than human generated. Conclusion Although RQA can distinguish artificial intelligence (AI)-generated text from human-generated text, it is not absolute. Thus, AI introduces additional challenges to the authenticity and utility of personal statements. Admissions committees along with organizations providing guidelines in professional physical therapist education program admissions should reevaluate the role of personal statements in applications. Impact As AI-driven chatbots like ChatGPT complicate the evaluation of personal statements, RQA emerges as a potential tool for admissions committees to detect AI-generated statements.

AbstractIntroductionCarpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment syndrome. Although prior studies have explored the anatomic changes of the median nerve and carpal arch with different wrist deviations and positionings, the change in safe zone distance between the median nerve and ulnar artery with ulnar or radial wrist deviations has not been adequately investigated.ObjectiveTo identify the optimal wrist positioning that increases the safe zone distance between the median nerve and ulnar artery using ultrasound in patients with CTS.DesignRetrospective cohort study.SettingQuaternary medical center multidisciplinary outpatient hand clinic.ParticipantsTwenty five patients (41 wrists) with clinical CTS who received an electrodiagnostic study (EDX) to evaluate CTS within 1 year prior to enrollment.InterventionsUltrasound‐identified safe zone distance measurements were obtained in each patient between the ulnar aspect of the median nerve and the radial aspect of the ulnar artery with the wrist in neutral radial‐ulnar deviation as well as in passive ulnar and radial deviation.Main Outcome MeasureThe ultrasound‐identified safe zone distance with the wrist in each of the three positions.ResultsThe interstructural safe zone distance was significantly greater when measured in the ulnarly deviated position (1.08 cm) compared with either the neutral (0.61cm, p < .001) or radially deviated positions (0.52 cm, p < .001). Interstructural safe zone distance did not differ between those with normal, mild, moderate, or severe classifications of pathology, or between dominant and nondominant limbs.ConclusionThis study demonstrates that the ultrasound‐measured interstructural safe zone distance was significantly greater in the ulnarly deviated position than in either the neutral position or radially deviated position. These findings may lead to improvement in the safety of ultrasound‐guided injections.

Background: Suspension training systems, which use body weight resistance under unstable conditions, may be effective for muscle strengthening in persons with scapular dyskinesis or subacromial impingement syndrome. Hypothesis: Greater arm, scapular, and trunk muscle recruitment will occur during horizontal abduction row exercises. Study Design: Descriptive laboratory study. Level of Evidence: Level 5. Methods: Surface electromyography data were collected from 28 participants (14 men, 14 women). A total of 13 right-sided muscles were studied at a sampling frequency of 1000 Hz. Maximal voluntary isometric contractions (MVICs) were established. Participants completed 3 repetitions per exercise in random order. We compared muscle recruitment during 3 rowing exercises: low row, high row, and horizontal abduction row. Data were compared with repeated-measures analyses of variance and post hoc Bonferroni corrections. Results: For high row and horizontal abduction row conditions, the upper, middle, and lower trapezius and posterior deltoid demonstrated >60% MVIC magnitudes of recruitment, and the upper erector spinae demonstrated 40% to 60% MVIC magnitudes of recruitment, respectively. In contrast, in the low row exercise, 40% to 60% MVIC magnitudes of recruitment were observed only in the middle trapezius, latissimus dorsi, and posterior deltoid. Conclusion: With the suspension system, high row and horizontal abduction row exercises promote muscle strengthening (>50% MVIC) in the upper, middle, and lower fibers of the trapezius, posterior deltoid, and upper erector spinae. Clinical Relevance: Rowing exercises performed with suspension straps may be recommended for muscle strengthening in patients with scapular dyskinesis and subacromial impingement syndrome as well as for healthy persons in need of enhanced scapular muscle performance.