OAR@UM Collection:

Associations between anthropometric characteristics, self-reported musculoskeletal and visceral symptoms, and squat movement quality : a cross-section study

2026-03-04T06:39:22Z

Title: Associations between anthropometric characteristics, self-reported musculoskeletal and visceral symptoms, and squat movement quality : a cross-section study Authors: Xerri de Caro, John; Pirotta, Andrew; Schembri, Emanuel; Borg, Malcolm Abstract: Background: This study investigated associations between anthropometric characteristics, postural deviations, musculoskeletal and visceral symptoms, and squat movement quality to clarify how individual physical attributes and symptom profiles influence fundamental movement performance. Method(s): A cross-sectional observational study recruited adults aged 18–65 who could ambulate without pain. Anthropometric and body composition measures were collected. Standardized posture images and multi-angle squat videos were obtained, and visual classifications of posture and squat technique were conducted using predefined criteria. Descriptive statistics characterized the sample, and multivariable logistic regression with LASSO regularization examined associations between demographic, postural, and symptom variables and binary squat outcomes. Results: Two hundred participants (57.5% female; median age 26 years) were included. Males showed higher stature, lean mass, and waist circumference, whereas females exhibited higher body fat and reported more neck pain and headaches. Forward head posture was common (62%), while women demonstrated more favorable upper-body alignment. Most participants maintained neutral lumbar posture and grounded heels during squats, with sex differences in foot rotation and knee path. Higher fat mass predicted reduced squat depth (OR = 1.06, 95% CI: 1.00 to 1.11, p = 0.033); heel lift and absent forward knee movement were associated with better spinal neutrality (OR = 0.07 and 0.18, both p ≤ 0.002); and low skeletal muscle mass (OR = 0.87, 95% CI: 0.79 to 0.95, p = 0.004) and heel lift (OR = 7.09, 95% CI: 1.86 to 26.2, p = 0.003) predicted suboptimal knee tracking. Only 8% achieved a fully “perfect” squat. Conclusion(s): Suboptimal squat mechanics were linked to higher fat mass, lower skeletal muscle mass, and compensatory lower-limb strategies, suggesting that squat quality reflects an interaction among body composition, posture, and motor control rather than any single demographic or anthropometric factor.

Effect of neuromuscular electrical nerve stimulation on quadriceps muscle strength and endurance in COPD patients. A randomised controlled trial

2026-01-29T14:32:05Z

Title: Effect of neuromuscular electrical nerve stimulation on quadriceps muscle strength and endurance in COPD patients. A randomised controlled trial Authors: Debattista, Randall; Agius, Tonio P.; Sciriha, Anabel Abstract: Introduction: Neuromuscular Electric Nerve Stimulation (NMES) is a modality that is gaining interest as part of the management of participants with Chronic Obstructive Pulmonary Disease (COPD). Given the increased knowledge of how the muscle changes structurally as the respiratory condition deteriorates, treatment options are being investigated to help maintain and improve strength and endurance in patients who are limited due to poor exercise tolerance and increased dyspnoea and cannot part-take in rehabilitation.; Method: Using a randomised control trial design, 33 participants who required admission to hospital due to an acute exacerbation of COPD, with a moderate to severe classification based on the MRC score, were recruited and randomly allocated to an experimental (males: 83.33%, females: 16.67%) or control group (males: 60%, females: 40%). Isometric quadriceps strength was assessed using the hand-held dynamometer, and quadriceps endurance was evaluated with the quadriceps endurance test. Additionally, the rectus femoris cross-sectional area, width, and thickness were measured using an ultrasound. All outcome measures were measured at baseline and upon discharge from the hospital, following the intervention, in all participants. The experimental group received 30 minutes of NMES stimulation on the quadriceps muscles daily throughout their hospitalisation stay (mean days: Experimental – 7.78 days, Control–9.45 days), over and above the usual physiotherapy treatment provided to all participants by physiotherapists in the ward. The control group received only Physiotherapy treatment provided in the ward. All outcome measures were repeated before discharge.; Results: Statistically significant improvements in rectus femoris thickness (left and right: P<0.001) and rectus femoris width on the right side (P=0.017) were reported in the experimental group. In contrast, statistically significant declines in mean values for the left and right Rectus Femoris width were registered for the control group (left: P=0.006, right: P< 0.001).

Utilizing muscle energy techniques for biomechanical changes in chronic obstructive pulmonary disease : variations in outcomes based on Global Initiative for Chronic Obstructive Lung Disease Classification

2025-04-16T13:18:02Z

Title: Utilizing muscle energy techniques for biomechanical changes in chronic obstructive pulmonary disease : variations in outcomes based on Global Initiative for Chronic Obstructive Lung Disease Classification Authors: Agius, Tonio P.; Sevasta, Kimberley; Sciriha, Anabel Abstract: Background: Muscle energy techniques (METs) are manipulative interventions under current investigation for their impact not only within the musculoskeletal domain, but also in chronic obstructive pulmonary disease (COPD) patients. Previous research reported beneficial effects from a 4-week MET program on pulmonary function, functional capacity, and daily activities. Patients diagnosed with COPD are categorized using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy, to guide tailored treatment regimens for different COPD phenotypes. Given positive outcomes from the MET program across all COPD classifications, investigating outcomes with the different traditional GOLD stages seemed warranted.; Materials and methods: A parallel-group, randomized controlled trial was adopted. A total of 108 participants with COPD were recruited and randomly assigned to the intervention or control group. All patients were classified by the GOLD classification. The intervention group received MET interventions, three-times weekly for 4 consecutive weeks, while the control group continued with their standard medical treatment. The study is clinically registered (clinicaltrials.gov identifier: NCT04773860).; Results: All 108 patients completed the program, showing significant improvements across all three GOLD classifications. A significant difference in forced expiratory volume in 1 second (FEV1 ) was reported across the three GOLD classifications at both time points (p < 0.001). The changes observed in forced vital capacity (FVC) measures displayed significant differences at week 0 when comparing all three groups (p = 0.039). No statistically significant differences were observed in the other outcome measures.; Conclusion: A 4-week MET program resulted in more significant improvements in lung function measures among more severe COPD patients, whereas no substantial improvements were observed in chest measurements, activities of daily living (ADLs), or exercise tolerance tests when examining the different GOLD stage groups.; Clinical significance: This study shows benefits of a 4-week MET intervention period on patients suffering from COPD, which led to statistically significant improvements resulted within the pulmonary function measures, chest expansion and ADL performance, and improvement in walking distance. All these outcome measurements provide evidence that this technique can be an effective treatment which can be used as an adjunct with other nonpharmacological physiotherapeutic treatments offered to these patients. Analysis per GOLD classification did not result in any differences between the groups based on COPD severity.

Short term effects of MET programme in patients diagnosed with Chronic Obstructive Pulmonary Disease : a randomised controlled trial

2024-02-06T10:03:36Z

Title: Short term effects of MET programme in patients diagnosed with Chronic Obstructive Pulmonary Disease : a randomised controlled trial Authors: Sevasta, Kimberley; Agius, Tonio P.; Sciriha, Anabel Abstract: Background: Muscle Energy Techniques have been reported to provide beneficial effects on range of movement in multiple musculoskeletal dysfunctions. Noting these physiological effects and clinical recommendations, the effects of MET s are given importance through investigations on their input in managing COPD symptoms. The maintenance of such outcomes has though not been investigated. Therefore, the aim is to look into the short-term effects, 4-week post completion of the intervention, on pulmonary function, chest measurements, exercise tolerance and ADLs. Method: This paper reports outcomes from a randomised controlled trial. 108 patients with COPD were recruited and assigned to 2 groups. The intervention group underwent a 4-week MET programme applied to the accessory muscles of respiration. The control group on the other hand continued with standard medical treatment. Outcome measures were assessed at baseline, at the 4th week time point on completion of the intervention, and again 4 weeks after. The outcome measures were performed in both groups which consisted of the pulmonary function tests, 6-min walk test (6MWT), chest measurements and the Manchester Respiratory Activities of Daily Living (MR-ADL) questionnaire. Results: Significant improvements were observed after 4 weeks from cessation of MET intervention when compared to baseline for pulmonary function measures (p < 0.001), chest measurements (p < 0.001) and ADLs (p < 0.001), in subjects enrolled in the intervention group. Conclusions: Significant short-term effects in outcome measures following 4 weeks from completion of the MET programme were observed in the intervention group.