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A special issue of Symmetry (ISSN 2073-8994). This special issue belongs to the section "Life Sciences".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 23610

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Prof. Dr. Piotr Morasiewicz

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Department of Orthopaedic and Trauma Surgery, University Hospital in Opole, Institute of Medical Sciences, University of Opole, Witosa 26, 41-405 Opole, Poland
Interests: Ilizarow method; orthopaedics; peripheral nerve surgery; sports medicine; traumatology
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Prof. Dr. Nejc Šarabon

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Faculty of Health Sciences, University of Primorska, 6310 Izola, Slovenija
Interests: human movement; aging; injuies prevention; rehabilitation; ergonomics
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Prof. Jarosław Filipiak

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Faculty of Mechanical Engineering, Wroclaw University of Science and Technology, Wroclaw, Poland
Interests: mechanobiology; tissue biomechanics; regenerative medicine; biomaterials

Prof. Dr. Paweł Reichert

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Department of Orthopaedics, Traumatology and Hand Surgery, Faculty of Medicine, Wroclaw Medical University and Clinical Department of Orthopaedics, Traumatology and Hand Surgery, University Hospital, Borowska 213, 50-556 Wroclaw, Poland
Interests: hand surgery; orthopaedics; peripheral nerve surgery; sports medicine; traumatology
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Prof. Daniel Kotrych

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Department of Orthopedics, Traumatology and Orthopedic Oncology, Pomeranian Medical University, Szczecin, Poland
Interests: biomechanics and medicine

Special Issue Information

Dear Colleagues,

Symmetry is present in many aspects in the human body, medicine and biomechanics of the locomotor system, which allows for proper and safe functioning. Achieving symmetry in the functioning of a part of the human body, the biomechanics of gait or other biomechanical parameters of the limbs are important for physicians, physiotherapists and patients themselves. Asymmetry may disturb the functioning of the human body, especially in relation to the musculoskeletal system. Asymmetry disturbs normal gait, sufficient muscular strength, balance, proprioception and joint mobility, which can cause pain and disturb biomechanics.

In this Special Issue, we invite papers exploring and discussing the topic of (a) symmetry in medicine and biomechanics and their importance for physicians, physiotherapists and human health in general. We welcome papers exploring the prevalence of asymmetries in different organs, systems, disease units, associations between different asymmetries (e.g., local or global; asymmetries in structure, strength, power, stability, flexibility, movement kinematics or other aspects), relationships between asymmetries and general human health, quality of life, treatment outcomes, quality of gait, other aspects of human biomechanics, and methodological as well as interventional studies concerning human body (a) symmetries.

Submit your paper and select the Journal “Symmetry” and the Special Issue “Symmetry in Medicine and Biomechanics” via: MDPI submission system. Our papers will be published on a rolling basis and we will be pleased to receive your submission once you have finished it.

Prof. Dr. Piotr Morasiewicz
Prof. Dr. Nejc Šarabon
Prof. Jarosław Filipiak
Prof. Paweł Reichert
Prof. Daniel Kotrych
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Symmetry is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

symmetry
asymmetry
biomechanics
gait
organs
systems
strength
stability
disease units

Published Papers (10 papers)

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Research

12 pages, 1361 KiB

Open AccessFeature PaperArticle

Donor-Site Morbidity after Osteocutaneous Free Fibula Transfer: Longitudinal Analysis of Stair Climbing Asymmetry and Functional Outcome

by Matteo Zago, Riccardo Di Giuli, Giada Beltramini, Alessandro Bolzoni, Alessandro Baj, Manuela Galli, Aldo Bruno Giannì and Chiarella Sforza

Symmetry 2022, 14(9), 1888; https://0-doi-org.brum.beds.ac.uk/10.3390/sym14091888 - 09 Sep 2022

Cited by 1 | Viewed by 1166

Abstract

The autologous vascularised free fibula flap is currently considered the best option for facial reconstruction after oncological surgery, but its donor-site morbidity has not been fully examined. The purpose was to evaluate donor-site changes in temporal and spatial kinematic gait parameters during stair climbing, as well as the gait symmetry. Fourteen patients (48 ± 16 years) were evaluated before and six months after harvest of a vascularised free fibula flap. Temporal gait variables for both the ascent and descent phases did not change after surgery (2-way ANOVA, p > 0.05). During stair ascent, ankle flexion (healthy side, increased; donor side, reduced; low effect size) had a significant time × side interaction. During stair descent, hip flexion was significantly larger on the donor side (medium effect size). Significant time × side interactions were observed for ankle inversion (healthy side, reduced; donor side, increased; and low effect size) and knee flexion (healthy side, increased; donor side, unchanged; and low effect size). Medium effect sizes were found for hip flexion side differences (significant). No relevant spatio-temporal nor kinematic asymmetry emerged apart from ankle joint kinematics. Overall, only the side effect of hip flexion during descent was both statistically significant and practically meaningful. Considering the slight modifications of the gait variables, no major functional limitations were found following vascularised free fibula flap reconstruction during stair climbing and descent. Full article

(This article belongs to the Special Issue Symmetry in Medicine and Biomechanics)

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8 pages, 1392 KiB

Open AccessArticle

The Symmetry of Lower Back Pain as a Potential Screening Factor for Serious Pathology: A Survey Study

by Grzegorz Miękisiak, Rafał Załuski, Dariusz Szarek, Samuel D. Pettersson, Justyna Fercho, Adam Druszcz and Celina Pezowicz

Symmetry 2021, 13(11), 1994; https://0-doi-org.brum.beds.ac.uk/10.3390/sym13111994 - 21 Oct 2021

Viewed by 2269

Abstract

Background: Pain maps provide reliable information on pain location in various conditions. This study explored the feasibility of pain maps as a screening tools for serious underlying conditions. The pain symmetry was evaluated as the possible distinguishing feature. Methods: A Web-based survey on the correlation of pain-related disability and pain pattern was developed. Respondents with lower back pain were asked to mark the exact location of their pain over the pain chart. The symmetry index was calculated and used to divide subjects into two groups that were then compared in terms of the prevalence of red flags for serious pathologies, as well as the pain-related disability measured with COMI and ODI instruments. Results: Of the 4213 respondents who completed the survey, 1018 were included in the study. The pain related disability was greater in respondents with asymmetrical pain patterns, as shown with all instruments. The distribution of red flags was also dependent on pain symmetry. The history of weight loss (6.70 vs. 1.76 p < 0.001) and fever (4.91 vs. 2.14 p < 0.001) were more prevalent with symmetrical pain patterns, and the history of trauma was more frequent with asymmetrical pain (21.41 vs. 10.71 p < 0.001). Conclusions: It was shown that the symmetry of pain is correlated to the prevalence of red flags and pain-related disability. Full article

(This article belongs to the Special Issue Symmetry in Medicine and Biomechanics)

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7 pages, 1856 KiB

Open AccessCommunication

Levels of Agreement for the Direction of Inter-Limb Asymmetry during Four Simple Change-of-Direction Tests in Young Male Handball Players: A Pilot Study

by Žiga Kozinc, Chris Bishop, Jernej Pleša and Nejc Šarabon

Symmetry 2021, 13(10), 1940; https://0-doi-org.brum.beds.ac.uk/10.3390/sym13101940 - 15 Oct 2021

Cited by 1 | Viewed by 1220

Abstract

The purpose of this pilot study was to investigate the effects of change-of-direction (CoD) angle (90° vs. 180°) and the inclusion of acceleration approach on total task time, CoD deficit, and agreement regarding inter-limb asymmetry direction across CoD tasks. The sample included 13 young male handball players (age: 22.4 ± 3.2 years). The CoD tasks were performed over a 10 m distance with 90° and 180° turns. Both CoD tasks were performed under two conditions: (1) from the standing start and, (2) with a 10 m prior acceleration approach. Linear sprint times over a 10 m distance were also recorded for the purpose of determining the CoD deficit. The differences between the outcomes of different test variants were assessed with pairwise t-tests and associated Cohen’s d effect size. The agreement in terms of inter-limb asymmetry direction was assessed descriptively, using percentage of agreement. Results showed that the inclusion of the 10 m approach reduced the total task time (mean differences ranging between 0.26 and 0.35 s; d = 2.27–4.02; p < 0.002). The differences between 90° and 180° turn times were statistically significant under both conditions: (a) without approach (0.44–0.48 s; d = 4.72–4.84; all p < 0.001), and (b) with approach (0.50–0.54 s; d = 4.41–5.03; p < 0.001). The agreement regarding inter-limb asymmetry direction among the tasks was 30.7–61.5%. The differences between the tasks could be explained by the angle–velocity trade-off. The results of this study imply that the CoD tasks should not be used interchangeably when assessing inter-limb asymmetries. Full article

(This article belongs to the Special Issue Symmetry in Medicine and Biomechanics)

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13 pages, 3142 KiB

Open AccessFeature PaperArticle

The Relationship between Preseason Common Screening Tests to Identify Inter-Limb Asymmetries in High-Level Senior and Professional Soccer Players

by Fernando J. Santos, Aníbal J. Valido, Inês S. Malcata, Cátia C. Ferreira, Dalton M. Pessôa Filho, Carlos E. L. Verardi and Mário C. Espada

Symmetry 2021, 13(10), 1805; https://0-doi-org.brum.beds.ac.uk/10.3390/sym13101805 - 28 Sep 2021

Cited by 3 | Viewed by 2237

Abstract

This study sought to examine inter-limb asymmetries in common screening tests performed during preseason and to analyze the relationship between the performance in the different tests. Nineteen high-level senior and professional soccer players (age: 23.2 ± 3.1 years; height: 181 ± 0.06 cm; body mass: 75.2 ± 4.8 kg) performed several common screening tests during preseason: Dorsiflexion lunge test (DLT); bent knee fall out test (BKFO); y-balance anterior test (YBT A); y-balance posterolateral test (YBT PL); Y-balance posteromedial test (YBT PM); Heel-rise test (HRT) and single leg hamstring bridge test (SLHBT). High levels of reliability (ICC > 0.88 and <0.94) were observed in all the studied variables. Inter-limb significant differences were observed in DLT and YBT PM test (p < 0.01) but YBT A, HRT and SLHBT presented trivial effect size (ES) (0.03; 0.07 and 0.13, respectively), contrary to DLT, BKFO and YBT PL, all with small ES (0.20; −0.23 and −0.22) and YBT PM, which revealed very large ES (2.91). Considering all data, high-level senior and professional soccer players present fairly good mean values of lower limb symmetry. Performance considering all tests was different, a fact associated with different biomechanical dynamics (e.g., YBT), nonetheless, the correlations between tests underline the relationship between these, which could represent important evidence to consider for injury prevention and performance enhancement programs. Full article

(This article belongs to the Special Issue Symmetry in Medicine and Biomechanics)

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12 pages, 1149 KiB

Open AccessArticle

Acute Effects of Vibration Foam Rolling Warm-Up on Jump and Flexibility Asymmetry, Agility and Frequency Speed of Kick Test Performance in Taekwondo Athletes

by An-Hsu Chen, Chih-Hui Chiu, Chin-Hsien Hsu, I-Lin Wang, Kuei-Ming Chou, Yung-Shen Tsai, Yu-Fang Lin and Che-Hsiu Chen

Symmetry 2021, 13(9), 1664; https://0-doi-org.brum.beds.ac.uk/10.3390/sym13091664 - 09 Sep 2021

Cited by 4 | Viewed by 4136

Abstract

The effect of asymmetry on flexibility and jump in taekwondo athletes and the influence of vibration foam rolling on asymmetry and frequency speed of kick test has not been examined. This study examined the effects of three warm-up protocols on subsequent sports performance in elite male taekwondo athletes. Fifteen elite male taekwondo athletes (20.63 ± 1.18 years) completed three warm-up protocols in a randomized order: general warm-up [GW], GW with vibration foam rolling [GW + VR], and GW with double VR for the weaker leg [GW + double VR]), was delivered before the subsequent tests: flexibility, single-leg countermovement jump (CMJ), 505 agility, hexagon test, and multiple frequency speed of kick tests (FSKTs). Relative to GW, the GW + VR significantly improved the hexagon test (GW + VR = 11.60 ± 1.01 s; GW = 12.80 ± 1.58 s). In addition, the GW + VR and GW + double VR yielded greater kick numbers in FSKT 5 (GW + VR = 21.13 ± 1.96 reps; GW + double VR = 20.93 ± 1.67 reps; GW = 19.27 ± 1.62 reps) and a higher kick decrement index (GW + VR = 5.45 ± 2.57%; GW + double VR = 5.88 ± 3.22%; GW = 9.54 ± 5.00%). However, the GW + VR and GW + double VR did not significantly improve the flexibility and CMJ asymmetry performance. The GW + VR is more beneficial for warming up than the GW is among male collegiate taekwondo athletes. Full article

(This article belongs to the Special Issue Symmetry in Medicine and Biomechanics)

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12 pages, 12558 KiB

Open AccessArticle

Body Balance after Fascial Therapy in Athletes with Soft Lower Limb Muscle Injuries

by Łukasz Pawik, Malwina Pawik, Magdalena Karwacka, Emilia Wysoczańska, Aleksandra Schabowska, Natalia Kuciel, Karolina Biernat, Agnieszka Dębiec-Bąk, Joanna Lewandowska and Felicja Fink-Lwow

Symmetry 2021, 13(9), 1586; https://0-doi-org.brum.beds.ac.uk/10.3390/sym13091586 - 28 Aug 2021

Cited by 2 | Viewed by 1873

Abstract

Background: Most injuries in competitive sports are due to overstrain and excessive muscular and fascial tension. This study aimed to assess the effects of a single session of fascial therapy on balance and lower limb weight-bearing in professional athletes following a lower limb soft-tissue injury. Methods: A pedobarographic platform was used to assess the weight-bearing on both lower limbs and corporal balance. A total of 41 athletes with an acute soft-tissue injury involving the quadriceps femoris muscle were included in the study. Each patient underwent myofascial therapy in the injured limb only. The therapy was intended to release tension and improve proprioception. Results: The injured and healthy limbs showed significant asymmetry in body weight distribution. Before treatment, the patients bore less weight on the injured limb than on the healthy limb. After fascial therapy, eyes-closed tests showed an improved weight distribution symmetry between the two lower limbs. There were no significant differences in the values of the evaluated balance parameters between those measured at baseline and those measured after the therapy, measured after the rehabilitation session. Conclusions: A single fascial therapy session has a beneficial effect on corporal balance in runners with an injured lower limb. Full article

(This article belongs to the Special Issue Symmetry in Medicine and Biomechanics)

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9 pages, 2444 KiB

Open AccessArticle

The Symmetry and Predictive Factors in Two-Stage Bilateral Hip Replacement Procedures

by Krystian Kazubski, Łukasz Tomczyk, Mariusz Ciszewski, Jarosław Witkowski, Paweł Reichert and Piotr Morasiewicz

Symmetry 2021, 13(8), 1472; https://0-doi-org.brum.beds.ac.uk/10.3390/sym13081472 - 11 Aug 2021

Cited by 1 | Viewed by 1257

Abstract

Background: Approximately 10–25% of total hip replacement patients undergo a bilateral procedure. The purpose of this study was to compare selected parameters associated with the first and second hip arthroplasty in patients undergoing two-stage treatment due to bilateral hip osteoarthritis and establish the predictive factors for the second procedure. Methods: This study compared the data on bilateral total hip replacement surgeries conducted in the period between 2017 and 2021 (42 patients). The following parameters from the first and second procedure were compared: the prosthetic stem, head, and insert cup size; type of cup insert; duration of anesthesia; duration of hospitalization; and the number of complications. Results: The mean duration of hospital stay at the time of the first total hip arthroplasty was 5.83 days and 5.4 days during the second stay. The mean stem sizes used during the first and second total hip replacement procedures were 7.11 and 7.09, respectively. The mean sizes of endoprosthetic cups used at the first and second total hip replacement procedures were 52.64 and 53.04, respectively. There were no significant differences between the mean prosthetic head size at the first and second surgery. The cup type used during the first and second surgery showed no difference. The mean duration of anesthesia used during the first and second total hip replacement surgery was 108.09 min and 104.52 min, respectively. We recorded a mean of 0.07 complications per patient at the first surgery and 0.02 at the second surgery. Conclusions: Our study results showed symmetry duration of anesthesia, length of hospital stay, number of complications per patient, stem size, prosthetic head size, cup insert size, and cup insert type at the first and second surgery in patients with two-stage bilateral total hip arthroplasty. We observed a strong correlation between the stem sizes of the first and second hip endoprostheses. There was also a strong correlation between the cup sizes used during the first and second surgery. Full article

(This article belongs to the Special Issue Symmetry in Medicine and Biomechanics)

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14 pages, 1168 KiB

Open AccessArticle

Bilateral Symmetry of Jumping and Agility in Professional Basketball Players: Differentiating Performance Levels and Playing Positions

by Sime Versic, Miran Pehar, Toni Modric, Vladimir Pavlinovic, Miodrag Spasic, Ognjen Uljevic, Marin Corluka, Tine Sattler and Damir Sekulic

Symmetry 2021, 13(8), 1316; https://0-doi-org.brum.beds.ac.uk/10.3390/sym13081316 - 22 Jul 2021

Cited by 8 | Viewed by 2761

Abstract

Although functional asymmetry is very common and normal in professional athletes, the better interlimb symmetry between dominant and nondominant sides (bilateral symmetry) could contribute to successful performance in basketball. The aim of this study was to evaluate the importance of bilateral symmetry of the one-leg jumping and agility performances in differentiating basketball players according to their (i) playing position (guards, forwards, and centers) and (ii) performance levels (first division vs. second division). The participants were 102 professional male basketball players, with all members of the teams competing in the two highest national divisions at the moment of testing (height: 194.92 ± 8.09 cm; body mass: 89.33 ± 10.91 kg; 21.58 ± 3.92 years of age). Performance levels (first division, N = 58 vs. second division, N = 44) and playing positions (guards, N = 48; forwards, N = 22; centers, N = 32) were observed as dependent variables. We measured one-leg jumping capacities (running vertical jump and lay-up vertical jump), basketball-specific preplanned agility (CODS), and basketball-specific reactive agility (RAG), all executed on dominant and nondominant sides. Accordingly, the bilateral symmetry of jumping and agility was calculated by calculating the ratio of the corresponding performances on the dominant and nondominant sides. Factorial analysis of variance (performance levels × positions) indicated that the bilateral symmetry of one-leg jumping differentiated players according to their playing position, with better bilateral symmetry among guards (F-test = 6.11 (medium effect size) and 5.81 (small effect size), p < 0.05 for lay-up and running-jump symmetry, respectively). Performance levels significantly differed in the bilateral symmetry of lay-up jump, with better symmetry for first-division players (F-test = 10.11 (medium effect size), p < 0.001), which was mostly influenced by significant differences among guards. Playing positions and performance levels did not differ in bilateral symmetry of the CODS and RAG. The study reveals the importance of bilateral symmetry of the sport-specific performance in differentiating playing positions and performance levels in basketball. Further studies in other multidirectional sports and other sport-specific performances are warranted. Full article

(This article belongs to the Special Issue Symmetry in Medicine and Biomechanics)

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11 pages, 1814 KiB

Open AccessArticle

Morphometric Evaluation of Detailed Asymmetry for the Proximal Humerus in Korean Population

by Eunah Hong, Dai-Soon Kwak and In-Beom Kim

Symmetry 2021, 13(5), 862; https://0-doi-org.brum.beds.ac.uk/10.3390/sym13050862 - 12 May 2021

Cited by 3 | Viewed by 1794

Abstract

Computer-assisted orthopedic surgery and patient-specific instruments are widely used in orthopedic fields that utilize contralateral side bone data as a template to restore the affected side bone. The essential precondition for these techniques is that the left and right bone features are similar. Although proximal humerus fracture accounts for 4% to 8% of all fractures, the bilateral asymmetry of the proximal humerus is not fully understood. The aim of this study is to investigate anthropometric differences of the bilateral proximal humerus. One hundred one pairs of Korean humerus CT data from 51 females and 50 males were selected for this research. To investigate bilateral shape differences, we divided the proximal humerus into three regions and the proximal humerus further into five sections in each region. The distance from the centroid to the cortical outline at every 10 degrees was measured in each section. Differences were detected in all regions of the left and right proximal humerus; however, males had a larger number of significant differences than females. Large bilateral differences were measured in the greater tubercle. Nevertheless, using contralateral data as a template for repairing an affected proximal humerus might be possible. Full article

(This article belongs to the Special Issue Symmetry in Medicine and Biomechanics)

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14 pages, 3055 KiB

Open AccessArticle

Axisymmetric Finite Element Modelling of the Human Lens Complex under Cataract Surgery

by M. T. Cardoso, B. Feijóo, A. P. G. Castro, F. J. Ribeiro and P. R. Fernandes

Symmetry 2021, 13(4), 696; https://0-doi-org.brum.beds.ac.uk/10.3390/sym13040696 - 16 Apr 2021

Cited by 4 | Viewed by 2030

Abstract

Cataract is a disease opacifying the crystalline, leading to a blurred vision and ultimately to blindness. With an aging population, the incidence of cataract is increasing, as well as the number of treatments. The solution available is its complete removal, followed by an implant of an intraocular lens (IOL). Although the post-operative complications on cataract surgeries have been decreasing in general, the bag-IOL complex dislocation is still an issue, probably being the most serious complication under this procedure. In this work, an axisymmetric Finite Element (FE) modelling strategy of the crystalline complex during the process of accommodation under cataract surgery is proposed. The goal was to understand the influence of biomechanical alterations promoted by the IOL on bag-IOL dislocation after surgery. An increase of force and stress in the zonules was verified in the pseudophakic eye compared to the complete eye, which could explain why zonules break years after surgery, leading to the bag-IOL dislocation. The axisymmetric FE model proposed in this work is innovative in this field, which still lacks detailed research, and can be an important complement for the clinical and biomechanical work on the crystalline complex. Full article

(This article belongs to the Special Issue Symmetry in Medicine and Biomechanics)

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