Gait asymmetries have been documented in individuals after anterior cruciate ligament (ACL) reconstruction (ACLR). The relationship between gait asymmetry and associated psychological factors, however, is not yet known. This study aimed to examine the relationship between kinesiophobia (fear of reinjury) and asymmetry of vertical ground reaction force (vGRF) and lower-extremity muscular activity in individuals after ACLR during gait. Twenty-eight males with a history of ACLR participated in the study. Force plate and surface electromyography was used to record peak vGRF and muscular activity. The Tampa Scale of Kinesiophobia (TSK-11) was used to measure kinesiophobia. Spearman’s rank correlations analysis was used to examine the relationship between TSK-11 scores and both gait asymmetry variables. There was a significant positive relationship between TSK-11 and asymmetry of the second peak of vGRF (rs = 0.531, p = 0.002). In addition, there was a significant positive association between asymmetry of rectus femoris activity (rs = 0.460, p = 0.007) and biceps femoris activity (rs = 0.429, p = 0.011) in the contact phase. Results revealed a significant relationship between kinesiophobia and asymmetry in muscle activity and vGRF in different phases of the gait cycle. Interventions addressing kinesiophobia early in the rehabilitation after ACLR may support the restoration of gait symmetry, facilitate a more rapid return to sport, and reduce the risk of ACL reinjury.

After an initial ankle sprain, a relevant number of participants develop chronic ankle instability (CAI). Compensatory strategies in patients with CAI may change the inter-limb symmetry needed for absorbing movement-related forces. Accordingly, an increased risk of injury can occur. The present study aimed to compare the inter-limb asymmetry of kinetic and electromyography between individuals with CAI and without a history of an ankle sprain (Non-CAI) during walking. In this cross-sectional study, fifty-six athletes (28 CAI; 28 Non-CAI) participated. Participants walked at a comfortable pace over level ground while vertical ground reaction force (vGRF) and muscle activity of the tibialis anterior, peroneus longus, medial gastrocnemius, and gluteus medius were recorded. Inter-limb asymmetry during walking was calculated for each of the variables. Patients with CAI exhibited a greater inter-limb asymmetry of the first peak of vGRF, time to peak vGRF, and loading rate (P < 0.001), as well as presenting a greater inter-limb asymmetry of peroneus longus activity (contact phase) (P = 0.003) and gluteus medius activity (midstance/propulsion phase) (P = 0.010) compared to the Non-CAI group. No other differences in vGRF or muscles activity were observed between the groups. Our findings indicate that patients with CAI walk with greater inter-limb asymmetry in vGRF and muscle activity in different phases of the gait cycle compared to Non-CAI group. Our results could inform future studies on gait training aimed to reduce asymmetry during walking in patients with CAI.

Electrocardiography (ECG) is one of the imperative diagnostic tools in cardiology. In spite of considerable advances in imaging and diagnostic methods in cardiology, ECG has still maintained its crucial role in the diagnosis of variant problems and pathologies; moreover, it would be so helpful in guiding rapid and appropriate therapies in the field of cardiology and internal medicine [1][2][3][4]. Accordingly, performance of correct and standard ECG is an inevitable need for each health system; missing the probable errors in ECG and inability to correct them may lead to unfavorable outcomes including misdiagnosis and inappropriate treatment [4][5][6][7]. This pilot study was conducted to evaluate the familiarity of ECG operators with essential points of ECG-performance. In the current pilot study, ECG operators were interviewed by an educated student. All of the questions were similar to each operator and they were asked subjective questions, together with objective ones. The questions were asked according to a standard questionnaire. A student of biomedical sciences was well-educated to ask questions, without any possible guiding clues. This descriptive pilot study was conducted from June 2016 to November 2016. In this study, 150 ECG operators including 103 females (68.7%) and 47 males (31.3%) were interviewed. The mean age of them was 30.8±10.5 years. Also, 55(36.7%), 21(14%), 67(44.7%), 6(4%) and 1(0.7%) of them had high school diploma, Associate, Bachelor, Master and PHD degrees, respectively. Only 47.3% of them plugged off the ECG device when they performed a standard ECG. Plugging off the device during ECG-performance perhaps seems to be a simple and trivial issue; however, more than half of the ECG-operators performed ECG while the device was plugged in, that may lead to some disturbance, including noises and misinterpretation.On the other hand, 72.7% of them plugged in the ECG device at the end of the usage of the ECG-device; once, they were asked to show speed and voltage buttons, 74.7% and 72% of them made true answers. As objective questions, ECG with changed speed and voltage was presented to them to recognize the speed or voltage errors; only 47.3% and 46% of them recognize the speed and voltage errors, respectively. In this study, 65.3% of the subjects controlled and checked the set-up of the ECG device including speed and voltage before performing ECG and 4% at the beginning of working shift; however, about 30.7% did not check the ECG device in view of speed and voltage set-up. Also, 96.7% and 89.3% of the ECG operators defined correct places of the limb and chest leads, respectively. When they were asked to perform a classic left sided-ECG, 96.7% and 96% of them showed correct performance of installation of limb and chest leads, respectively. When they were asked to perform right sided-ECG, 71.3% showed true performance. The true performance was lower when they were asked to perform posterior sided-ECG, in which, only 49.3% revealed true performance. Once, they were asked to perform Lewis-ECG lea...