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PURPOSE: This study aimed to translate and cross-culturally adapt the Mini-BESTest into European Portuguese and to evaluate its psychometric properties in individuals with sensorimotor impairments. MATERIAL AND METHODS: A cross-sectional cross-cultural adaptation and validation study was conducted according to the COSMIN guidelines and the STROBE statement. The study included 100 participants with sensorimotor impairments who were able to walk 6 m. Cronbach's alpha and item-total correlations were used to assess internal consistency. Interpretability was assessed by examining floor and ceiling effects and skewness. To investigate construct validity, Spearman correlation coefficients and Bland-Altman analysis were performed to compare the Berg Balance Scale and the Mini-BESTest Inter- and intra-rater reliability were assessed by calculating the ICC, SEM and MDC based on video recordings of the participants during the Mini-BESTest assessments. RESULTS: The European Portuguese Mini-BESTest showed good internal consistency (Cronbach's α = 0.892) and no significant floor or ceiling effects. Excellent inter- and intra-rater reliability (ICC = 0.97) were also demonstrated, with MDC of 2.58 and 2.57, respectively. Furthermore, this instrument showed a significant correlation with the BBS (r = 0.902). Bland-Altman analysis showed small absolute differences. CONCLUSION: The European Portuguese Mini-BESTest is comparable to the original English version in terms of validity and reliability and is therefore highly recommended for use by Portuguese-speaking professionals to assess postural control.

The Mini-BESTest, increasingly recommended for addressing impaired postural control, has undergone its first comprehensive cross-cultural adaptation into European Portuguese.The Mini-BESTest may be a superior assessment tool compared to others because it can identify the specific postural control system that is impaired.In a clinical setting, the Mini-BESTest will aid in the development of appropriate intervention approaches, tailoring rehabilitation interventions to the specific needs of each patient.The Mini-BESTest is recommended for use by Portuguese-speaking professionals to assess postural control, as it has demonstrated good internal consistency, excellent inter- and intra-rater reliability, and significant correlation with the Berg Balance Scale.

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We aimed to conduct a biophysical comparison of angular (Biorower) and linear (Concept2) rowing ergometers across a wide spectrum of exercise intensities. Sixteen (eleven male) skilled rowers, aged 29.8 ± 8.6 and 23.6 ± 1.5 years, with international competitive experience, performed 7 × 3 min bouts with 30 W increments and 60 s intervals, plus 1 min of all-out rowing on both machines with 48 h in between. The ventilatory and kinematical variables were measured breath-by-breath using a telemetric portable gas analyzer and determined using a full-body markerless system, respectively. Similar values of oxygen uptake were observed between ergometers across all intensity domains (e.g., 60.36 ± 8.40 vs. 58.14 ± 7.55 mL/min/kg for the Biorower and Concept2 at severe intensity). The rowing rate was higher on the Biorower vs. Concept2 at heavy and severe intensities (27.88 ± 3.22 vs. 25.69 ± 1.99 and 30.63 ± 3.18 vs. 28.94 ± 2.29). Other differences in kinematics were observed across all intensity domains, particularly in the thorax angle at the finish (e.g., 19.44 ± 4.49 vs. 27.51 ± 7.59° for the Biorower compared to Concep2 at heavy intensity), likely due to closer alignment of the Biorower with an on-water rowing technique. The overall perceived effort was lower on the Biorower when compared to the Concept2 (14.38 ± 1.76 vs. 15.88 ± 1.88). Rowers presented similar cardiorespiratory function on both rowing ergometers, while important biomechanical differences were observed, possibly due to the Biorower's closer alignment with an on-water rowing technique.

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The speedometer is widely used to evaluate swimming velocity but has some constraints. With the constant development of inertial units (IMUs), it is expected that they will become a good alternative to the speedometer. This study aimed to compare the data retrieved by an IMU and a speedometer when breaststroke is performed at maximum speed. Sixteen swimmers, nine males and seven females (20.3 ± 3.3 vs. 18.7 ± 1.1 years old, 65.8 ± 11.2 vs. 57.7 ± 9.1 kg of body mass and 1.75 ± 0.07 vs. 1.61 ± 0.10 m of height, respectively), performed 4 × 25 m of breaststroke sprint. They were equipped with an IMU fixed to the sacrum and with the line of an electromechanical speedometer (acquisition frequency of 50 Hz) fixed at the central point in the lumbar region. Statistical parametric mapping was used to compare the velocity curves, IBM SPSS was used for descriptive statistics and Bland-Altman plots were used for agreement of measurements. The results show that the IMU and speedometer do not show similar patterns, and the velocity values measured by the IMU are lower (p < 0.001). Bland-Altman plots presented a larger bias in terms of coefficient of variation and intracycle velocity variation. It can be concluded that IMUs and speedometers are not substitutes for each other as methods for evaluating intracycle velocity variations.

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Chronic spinal pain (CSP) is a prevalent condition, and prolonged sitting at work can contribute to it. Ergonomic factors like this can cause changes in motor variability. Variability analysis is a useful method to measure changes in motor performance over time. When performing the same task multiple times, different performance patterns can be observed. This variability is intrinsic to all biological systems and is noticeable in human movement. This study aims to examine whether changes in movement variability and complexity during real-time office work are influenced by CSP. The hypothesis is that individuals with and without pain will have different responses to office work tasks. Six office workers without pain and ten with CSP participated in this study. Participant's trunk movements were recorded during work for an entire week. Linear and nonlinear measures of trunk kinematic displacement were used to assess movement variability and complexity. A mixed ANOVA was utilized to compare changes in movement variability and complexity between the two groups. The effects indicate that pain-free participants showed more complex and less predictable trunk movements with a lower degree of structure and variability when compared to the participants suffering from CSP. The differences were particularly noticeable in fine movements.

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The electrical stimulation of pedicle screws is a technique used to ensure its correct placement within the vertebrae pedicle. Several authors have studied these screws' electrical properties with the objective of understanding if they are a potential source of false negatives. As titanium screws are anodized with different thicknesses of a high electrical resistance oxide (TiO2), this study investigated, using analytical, numerical, and experimental methods, how its thickness may affect pedicle screw's resistance and conductivity. Analytical results have demonstrated that the thickness of the TiO2 layer does result in a significant radial resistance increase (44.21 mΩ/nm, for Ø 4.5 mm), and a decrease of conductivity with layers thicker than 150 nm. The numerical approach denotes that the geometry of the screw further results in a decrease in the pedicle screw conductivity, especially after 125 nm. Additionally, the experimental results demonstrate that there is indeed an effective decrease in conductivity with an increase in the TiO2 layer thickness, which is also reflected in the screw's total resistance. While the magnitude of the resistance associated with each TiO2 layer thickness may not be enough to compromise the ability to use anodized pedicle screws with a high-voltage electrical stimulator, pedicle screws should be the subject of more frequent electrical characterisation studies.

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PURPOSE: To compare the kinematic profile of 2 underwater pullout breaststroke techniques. METHODS: Sixteen swimmers (9 men, 20.67 [2.71] y old; 7 women, 18.86 [0.83] y old) performed 3 × 25-m breaststroke using 2 pullout breaststroke techniques: Fly-Kick first and Combined. A speedometer was used to assess the peak and the mean velocity during the glide, propulsion, and recovery phases of both techniques, as well as for the total underwater sequence. The underwater distance was retrieved from video footage and was considered for each pullout technique. The range of motion of the knee during the fly-kick was also retrieved, and the time to complete the 25 m was considered the performance outcome, accompanied by the mean velocity, stroke rate, stroke length, and stroke index. RESULTS: Velocity-time series showed different profiles between pullout techniques (P ≤ .05) mostly in the glide and propulsion phases for males and females, respectively. The mean velocity of 25 m was shown to be greater in females when using the Fly-Kick first technique (P = .05, d = 0.36). Greater values in total underwater distance and knee range of motion were also observed for this technique in both cohorts. Conclusions: Female swimmers presented a higher performance when using the Fly-Kick first technique. Different kinematic profiles arise when swimmers use different underwater pullout techniques where the Fly-Kick first may allow them to reach higher kinematical standard.

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This study aimed to systematically review and summarise the evidence about the effect of muscle fatigue on the knee proprioception of trained and non-trained individuals. A search in PubMed, Scopus, Web of Science and EBSCO databases and Google Scholar was conducted using the expression: "fatigue" AND ("proprioception" OR "position sense" OR "repositioning" OR "kinesthesia" OR "detection of passive motion" OR "force sense" OR "sense of resistance") AND "knee". Forty-two studies were included. Regarding joint-position sense, higher repositioning errors were reported after local and general protocols. Kinesthesia seems to be more affected when fatigue is induced locally, and force sense when assessed at higher target forces and after eccentric protocols. Muscle fatigue, both induced locally or generally, has a negative impact on the knee proprioception.

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In everyday life, we recurrently perform two tasks simultaneously, which is called dual-tasking. A common dual task is smartphone use while standing or walking. According to previous studies, this task can compromise postural stability. However, few studies have analyzed lower limb muscle activity during dual-tasking using smartphones. This study aimed to assess the postural sway and muscle activity during dual-tasking in young adults. Thirty-six healthy young adults (23.08 ± 3.92 years) participated in this study. They performed a single task (ST: keeping a quiet standing posture) and a dual task (DT: keeping the ST while simultaneously performing a cognitive task on their smartphone). Postural sway was assessed through the center of pressure (CoP) analysis using a force platform: total CoP displacement, CoP displacement in the anterior-posterior and medial-lateral directions, mean total velocity of the CoP, mean velocity of the CoP in the anterior-posterior and medial-lateral directions, and 95% confidence ellipse sway area. A surface electromyography system recorded the muscle activity of the lumbar spinal erector and five muscles of the lower limb (bilaterally). The results showed an increase in postural sway from the ST to the DT in all CoP variables (p < 0.05), and muscle activity in most muscles analyzed decreased from the ST to the DT (p < 0.05). In conclusion, our results reflect a decentralization of attention from motor performance once postural sway increased and muscle activity decreased in dual-task conditions.

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PURPOSE: Neural and peripheral effects of induced muscle pain on explosive force production were investigated. METHODS: Nine participants performed two maximal, six explosive, and six electrical stimulations induced (twitches and octets) isometric knee extensions before and after (15 min of rest) receiving an intramuscular injection of hypertonic saline (pain inducer) or isotonic (placebo) infusions in two laboratory visits separated by 7 days. RESULTS: It was observed a reduction of peak torque production in maximal voluntary contraction in both conditions (9.3 and 3.3% for pain and placebo, respectively) and in the rate of torque development in placebo (7%). There was an increase in the rate of torque development for twitch and octets (10.5 and 15.8%, respectively) in the pain condition and peak torque for twitch (12%) in both conditions (as did the total rate of torque development for octets). CONCLUSION: Force production decreases and increases during voluntary and involuntary contractions, respectively, suggesting that acute pain impairs force production via central mechanisms.

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Non-linear and dynamic systems analysis of human movement has recently become increasingly widespread with the intention of better reflecting how complexity affects the adaptability of motor systems, especially after a stroke. The main objective of this scoping review was to summarize the non-linear measures used in the analysis of kinetic, kinematic, and EMG data of human movement after stroke. PRISMA-ScR guidelines were followed, establishing the eligibility criteria, the population, the concept, and the contextual framework. The examined studies were published between 1 January 2013 and 12 April 2023, in English or Portuguese, and were indexed in the databases selected for this research: PubMed®, Web of Science®, Institute of Electrical and Electronics Engineers®, Science Direct® and Google Scholar®. In total, 14 of the 763 articles met the inclusion criteria. The non-linear measures identified included entropy (n = 11), fractal analysis (n = 1), the short-term local divergence exponent (n = 1), the maximum Floquet multiplier (n = 1), and the Lyapunov exponent (n = 1). These studies focused on different motor tasks: reaching to grasp (n = 2), reaching to point (n = 1), arm tracking (n = 2), elbow flexion (n = 5), elbow extension (n = 1), wrist and finger extension upward (lifting) (n = 1), knee extension (n = 1), and walking (n = 4). When studying the complexity of human movement in chronic post-stroke adults, entropy measures, particularly sample entropy, were preferred. Kinematic assessment was mainly performed using motion capture systems, with a focus on joint angles of the upper limbs.

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Musicians' body behaviour has a preponderant role in audience perception. We investigated how performers' motion is perceived depending on the musical style and musical expertise. To further explore the effect of visual input, stimuli were presented in audio-only, audio-visual and visual-only conditions. We used motion and audio recordings of expert saxophone players playing two contrasting excerpts (positively and negatively valenced). For each excerpt, stimuli represented five motion degrees with increasing quantity of motion (QoM) and distinct predominant gestures. In the experiment (online and in-person), 384 participants rated performance recordings for expressiveness, professionalism and overall quality. Results revealed that, for the positively valenced excerpt, ratings increased as a function of QoM, whilst for the negatively valenced, the recording with predominant flap motion was favoured. Musicianship did not have a significant effect in motion perception. Concerning multisensory integration, both musicians and non-musicians presented visual dominance in the positively valenced excerpt, whereas in the negatively valenced, musicians shifted to auditory dominance. Our findings demonstrate that musical style not only determines the way observers perceive musicians' movement as adequate, but also that it can promote changes in multisensory integration.

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Rowing performance depends on the design and building materials used for competition. Recently, attempting to improve rowing performance, the Randall foil has been attached to the top edge of a rowing Big blade, making it spoon shaped. The current study aimed to analyse the differences between Big blades with and without Randall foils in force-related variables. Nineteen rowers performed two bouts of 90 s at maximal effort tethered rowing and differences were found in cycle average peak force (4.33 ± 1.46 vs. 5.26 ± 1.57 N/kg), propulsive cycle average time (1.79 ± 0.38 vs. 1.52 ± 0.24 N/kg.s) and rate of force development (8.79 ± 4.75 vs. 12.07 ± 4.60 N/kg/s) for Big blades with and without foils (respectively). Differences were also observed between the middle (4.79 ± 1.21 vs. 4.08 ± 1.48 N/kg) and final phases (4.86 ± 1.45 vs. 4.04 ± 1.47 N/kg) of the rowing effort for the cycle average peak force of Big blades with and without Randall foils. Data suggest a positive effect of these foils on the force-time curve profile. Future studies should focus on testing its influence on free on-water rowing.

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Our aim was to investigate if using a warm-up routine that included parachute-resisted sprints with large hand-paddles improves 50 m freestyle performance in trained collegiate swimmers. Twelve swimmers (23.9 ± 2.2 years, 179 ± 7 cm, 77.1 ± 10.6 kg) participated in the study and completed two 50-m freestyle races, each preceded by a different warm-up routine, either control (CON) or experimental (EXP). The warm-up routines consisted of 500 m of swimming at self-selected speed, followed by four 10 s sprints with 1 min rest intervals. During EXP, sprints were performed using large hand-paddles and a swimming parachute, while during CON, sprints were performed freely. Performance and technique were assessed during the 50 m freestyle races. We found no significant differences in 25- and 50 m performance times (CON: 12.6 ± 0.8 vs. EXP: 12.5 ± 0.8 s, ES = 0.125; and CON: 26.8 ± 1.6 vs. EXP: 26.7 ± 1.7 s, ES = 0.06, respectively) between the two conditions. Mean stroke length (CON: 2.04 ± 0.21 vs. EXP: 2.02 ± 0.22 m·cycle-1, ES = 0.09), stroke frequency (CON: 55.4 ± 5.3 vs. EXP: 56.3 ± 5.2 cycles s-1, ES = 0.17), and propulsive time (CON: 0.62 ± 0.07 vs. EXP: 0.61 ± 0.06 s, ES = 0.15) were also not different between conditions. It is possible that the CON warm-up routine induced the priming effects that lead to PAPE, or that the EXP warm-up routine primed the athletes further but also induced greater fatigue, resulting in no significant effects on swimming performance. Our findings suggest that parachute-resisted sprints with hand-paddles during warm-up do not enhance 50 m freestyle swimming performance in trained collegiate swimmers. Coaches and practitioners should consider exploring different warm-up protocols to identify what works best for their athletes.

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The analysis of the external forces of swimming starts has revealed how swimmers propel themselves out of the block, but data should be properly interpreted to fully understand force-generation mechanisms. This study aimed to assess horizontal and vertical forces in the backstroke start based on swimmers' structural and propulsive actions. Firstly, a simulated structural force was estimated by two transient backstroke-start inter-segmental realistic body positions: a maximally tucked position and an extended one (just before the hands-off and the take-off, respectively). Secondly, 10 competitive backstroke swimmers performed four 15 m maximal backstroke starts with the external forces estimated. Thirdly, the simulated structural force was subtracted from raw horizontal and vertical force data, measured between hands-off and take-off instants, resulting in the propulsive forces. The application of the algorithm has evidenced that backstrokers' horizontal and vertical simulated-structural-force components contributed to ~40% of total force during start propulsion (~0.2-0.12 s before the take-off), followed by the propulsive horizontal force increment and a progressive vertical component reduction (~0.05 s) with ~20° take-off angle. Based on these findings, researchers and coaches can better guide swimmers as to the proper mechanical strategies to achieve effectiveness in the backstroke start, and to improve direct transfer of resistance training programs.

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Enhancing recovery is a fundamental component of high-performance sports training since it enables practitioners to potentiate physical performance and minimise the risk of injuries. Using a new sports legging embedded with an intelligent system for electrostimulation, localised heating and compression (completely embodied into the textile structures), we aimed to analyse acute recovery following a fatigue protocol. Surface electromyography- and torque-related variables were recorded on eight recreational athletes. A fatigue protocol conducted in an isokinetic dynamometer allowed us to examine isometric torque and consequent post-exercise acute recovery after using the sports legging. Regarding peak torque, no differences were found between post-fatigue and post-recovery assessments in any variable; however, pre-fatigue registered a 16% greater peak torque when compared with post-fatigue for localised heating and compression recovery methods. Our data are supported by recent meta-analyses indicating that individual recovery methods, such as localised heating, electrostimulation and compression, are not effective to recover from a fatiguing exercise. In fact, none of the recovery methods available through the sports legging tested was effective in acutely recovering the torque values produced isometrically.

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It has been suggested that sex distinctions in physiology may affect the swimming performance of each sex differently. Yet, sex-based performance dependency has not been taken into consideration by most of the researchers evaluating swimming start. Therefore, the purpose of this research was to determine the effect of sex heterogeneity on the spatiotemporal characteristics of swimming start by investigating the determinants of its performance. A total of fifty-two international-level swimmers (thirty females and twenty-two males) performed three repetitions of the kick-start up to the 15-m mark. During trials, data were collected using video cameras and instrumented starting block. To search for evidence of differences between the two groups, the one-way ANOVA was conducted. Pearson's correlation coefficients were calculated between measurements widely used to describe overall starting performance and selected kinematical variables of swimming start. A sex effect was exposed for temporal variables describing all swimming start phases (p ≤ 0.015). Male swimmers, by spending less time during the push-off from the starting block (p = 0.002; η p 2 = 0.18), reaching higher take-off velocity (p < 0.001; η p 2 = 0.29), traveling longer distances during flight (p < 0.001; η p 2 = 0.40), and swimming faster in the water phase (p < 0.001; η p 2 = 0.40), took starting advantage over their female counterparts. Consequently, performance measures such as 5-m, 10-m, and 15-m start times indicated that male participants were faster than females (p < 0.001; η p 2 ≥ 0.40). Only in the group of male swimmers a significant correlation between variables describing overall starting performance (5-m, 10-m, and 15-m times), and variables commonly highlighted as starting performance determining factors (block phase duration, take-off horizontal velocity, and flight distance) was found. The current study shows that the spatiotemporal variables of swimming start, the relation between them as well as overall starting performance, vary by sex. Consequently, the requirement of sex factor and its heterogeneity effect should be included not only in detailed characteristics of separate variables but also in all approaches undertaken. Those findings seem to play a crucial role mainly in swimming start evaluations in post-pubertal age groups of swimmers.

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PURPOSE: To evaluate the balance in patients with total knee arthroplasty (TKA) and knee osteoarthrosis (KOA), measured by postural stability computerized evaluation (PSCE), and to evaluate the effect of post-TKA patients' characteristics in their performance on PSCE. MATERIALS AND METHODS: An observational cross-sectional study was conducted in two sets of patients: (A) patients with KOA and primary TKA surgery scheduled and (B) patients who underwent primary TKA >9 months. Sociodemographic, radiographic, clinical and PSCE parameters (using the Biodex Balance System) were assessed. RESULTS: Post-TKA patients placed more load on the replaced knee than the contralateral osteoarthritic knee (p = 0.027). They had less imbalance on the balance tests performed with the eyes open, on stable (p = 0.032), and unstable platforms (p = 0.022). These patients also showed better postural stability in monopodalic stance, both standing on the TKA (p = 0.010) and contralateral knee (p = 0.017). Age, weight, pain on the operated knee, extension deficit on the operated knee, and Berg Balance Scale scores on post-TKA patients were significantly associated with their performance on PSCE tests. CONCLUSIONS: PSCE can be useful to quantify the balance of post-TKA and KOA patients.

Total knee arthroplasty is the definitive treatment for knee osteoarthrosis and it has several benefits, but its effect on balance is still unknown.Postural stability computerized evaluation is used to evaluate balance on vestibular diseases and it has been recently studied on musculoskeletal conditions.Postural stability computerized evaluation may be useful to evaluate patients' balance before and after total knee arthroplasty.

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INTRODUCTION: Despite years of experience with biological disease modifying anti-rheumatic drugs (bDMARD) in rheumatoid arthritis (RA), little is known about differences in infectious risk among bDMARDs. The aim of this study was to assess the incidence and type of infections in RA patients on bDMARDs and to determine possible predictors. METHODS: A retrospective multicenter cohort study that included patients registered in the Rheumatic Diseases Portuguese Registry (Reuma.pt) with RA, and exposed to at least one bDMARD until April 2021. RA patients under bDMARD and with at least one episode of severe infection (SI), defined as infection that requires hospitalization, use of parenteral antibiotics or that resulted in death, were compared to patients with no report of SI. Demographic and clinical data at baseline and at the time of each SI were collected to establish comparisons between different groups of bDMARDs. Comparisons between different bDMARDs were assessed and logistic regression was performed to identify predictors of SI. RESULTS: We included 3394 patients, 2833 (83.5%) female, with a mean age at RA diagnosis of 45.5±13.7 years. SI was diagnosed in 142 of the 3394 patients evaluated (4.2%), totaling 151 episodes of SI. At baseline, patients with SI had a significantly higher proportion of prior orthopedic surgery, asthma, interstitial lung disease, chronic kidney disease and corticosteroid use, higher mean age and longer median disease duration at first bDMARD. Nine patients died (6.0%). Ninety-two SI (60.9%) occurred with the first bDMARD, the majority leading to discontinuation of the bDMARD within 6 months (n=75, 49.7%), while 65 (43.0%) restarted the same bDMARD and 11 (7.3%) switched to another bDMARD (6 of them to a different mechanism of action). In the multivariate analysis, we found that chronic kidney disease, asthma, infliximab, corticosteroid use, interstitial lung disease, previous orthopedic surgery, higher Health Assessment Questionnaire and DAS284V-ESR are independent predictors of SI. CONCLUSION: This study described the incidence and types of SI among Portuguese RA patients on biologics, identifying several predictors of SI, both globally and with different bDMARDs. Physicians should be aware of the real-word infectious risk in RA patients on bDMARDs when making treatment decisions.

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Low back pain is one of the main causes of motor disabilities and psychological stress, with the painful process encompassing sensory and affective components. Noxious stimuli originate on the periphery; however, the stimuli are recombined in the brain and therefore processed differently due to the emotional environment. To better understand this process, our objective was to develop a mathematical representation of the International Association for the Study of Pain (IASP) model of pain, covering the multidimensional representation of this phenomenon. Data from the Oswestry disability index; the short form of the depression, anxiety, and stress scale; and pain catastrophizing daily questionnaires were collected through online completion, available from 8 June 2022, to 8 April 2023 (1021 cases). Using the information collected, an artificial neural network structure was trained (based on anomaly detection methods) to identify the patterns that emerge from the relationship between the variables. The developed model proved to be robust and able to show the patterns and the relationship between the variables, and it allowed for differentiating the groups with altered patterns in the context of low back pain. The distinct groups all behave according to the main finding that psychological and pain events are directly associated. We conclude that our proposal is effective as it is able to test and confirm the definition of the IASP for the study of pain. Here we show that the fiscal and mental dimensions of pain are directly associated, meaning that mental illness can be an enhancer of pain episodes and functionality.

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Music performance requires high levels of motor control. Professional musicians use body movements not only to accomplish and help technical efficiency, but to shape expressive interpretation. Here, we recorded motion and audio data of twenty participants performing four musical fragments varying in the degree of technical difficulty to analyze how knee flexion is employed by expert saxophone players. Using a computational model of the auditory periphery, we extracted emergent acoustical properties of sound to inference critical cognitive patterns of music processing and relate them to motion data. Results showed that knee flexion is causally linked to tone expectations and correlated to rhythmical density, suggesting that this gesture is associated with expressive and facilitative purposes. Furthermore, when instructed to play immobile, participants tended to microflex (>1 Hz) more frequently compared to when playing expressively, possibly indicating a natural urge to move to the music. These results underline the robustness of body movement in musical performance, providing valuable insights for the understanding of communicative processes, and development of motor learning cues.