Pedobarographic, Clinic, and Radiologic Evaluation after Surgically Treated Lisfranc Injury

INTRODUCTION

Lisfranc injuries are rare, often missed, and may cause permanent structural deterioration of tarsometatarsal joint, despite optimal management. Consequently, a Lisfranc injury may lead to disruption of the biomechanics of the normal foot during walking and may alter the plantar pressure distribution, which is essential for proper gait mechanics. Therefore, the main purpose of the study was to specify the dynamic plantar pressure, radiographic and clinical features, after surgically managed Lisfranc injuries.

METHODS

This study was carried out over a period of 10 years and included 62 patients who were surgically treated for Lisfranc injury, with mean 57-month follow-up. Radiological (intermetatarsal, Kite's, first metatarsophalangeal, Meary's, Hibbs' and calcaneal pitch angles, and medial cuneiform-fifth metatarsal distance), pedobarographical, and clinical results with the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score assessments for both feet were assessed.

RESULTS

In the radiological assessment, the mean first intermetatarsal (p = 0.006) and Meary's angle (p = 0.000) were decreased on the injured feet compared to the uninjured feet on the anteroposterior and lateral radiographs. In the pedobarographic assessment, the injured feet midfoot contact time increased (p = 0.03), and maximum force (p = 0.001), total peak pressure (p = 0.008), and contact area (p = 0.017) decreased, compared to the uninjured feet. The mean AOFAS score was 75/100 at the final follow-up visit. There was seen to be reduced both contact surface area and time of the midfoot.

CONCLUSION

Despite surgical management of Lisfranc injuries, the injured foot does not regain functional, radiological, or pedobarographical levels as compared to the uninjured foot for ≥ 57 months.

Early recovery of basic mobility under femoral nerve block after hip fracture surgery - A propensity score matched pilot study

BACKGROUND

Previous studies have shown better pain reduction utilizing femoral nerve block (FNB) in patients who underwent hip fracture surgery. However, few studies have focused on the recovery of physical function after FNB, and most studies excluded patients with dementia. We investigated the association between FNB performed in the operating room and the recovery of physical function after hip fracture surgery, including patients with dementia.

METHODS

A total of 103 patients with a mean age of 87.4 years who underwent hip fracture surgery under spinal anesthesia between July 2015 and December 2017 (46 patients receiving a single injection of FNB and 57 standard care) were enrolled. Patients with FNB versus standard care were matched by a propensity score to adjust for patient characteristics. An anesthesiologist performed FNB with 20ml of 0.2% ropivacaine, and the standard care group received intravenous 1000 mg acetaminophen or 50mg flurbiprofen once after surgery. After matching, 78 patients were analyzed. Our primary outcome was 3-day cumulated ambulation score (CAS, 0-18 points) and secondary outcomes were 1-day CAS on postoperative day 1-3 and length of hospital stay. We also stratified patient groups based on the presence of dementia and fracture type.

RESULTS

Patients undergoing FNB had significantly better 3-day CAS compared to standard care (mean [SD], 8.72 [3.42] vs 7.33 [2.62]; mean difference, 1.38 [95%CI; 0.03 - 2.74]; p = 0.048) and 1-day CAS on postoperative day two (mean [SD], 3.10 [1.39] vs 2.56 [0.94]; mean difference, 0.54 [0.01 - 1.07]; p = 0.049). Length of hospital stay did not significantly differ among the two groups (p = 0.65). Larger positive effect was likely to be seen for patients with a femoral neck fractures and for those without dementia.

CONCLUSIONS

Patients who underwent surgery with spinal anesthesia plus FNB had better ambulatory status early after hip fracture surgery compared to patients not offered FNB. The beneficial association between FNB and ambulatory status was likely to be observed especially in patients with femoral neck fracture and without dementia.

Effect of kinesio taping on low back pain during pregnancy: a systematic review and meta-analysis

BACKGROUND

Low back pain during pregnancy affects the normal daily activities of pregnant women to a certain extent. Current studies have shown that Kinesio Taping (KT) may be a treatment for low back pain during pregnancy, but there is still a lack of key evidence. The purpose of this study is to evaluate the efficacy and safety of KT in the treatment of low back pain during pregnancy.

METHODS

PubMed, Web of Science, The Cochrane Library, Scopus, Embase, Wanfang Data, CNKI, and VIP databases were searched to collect randomized controlled trials (RCTs) of the efficacy of KT intervention on low back pain in women during pregnancy. The retrieval time limit is from the establishment of the database to April 2021. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. Meta-analysis was performed using RevMan5.3 software.

RESULTS

A total of 7 RCTs were included, including 444 patients. Meta-analysis results showed that: Compared with the control group, KT intervention could significantly improve low back pain and dysfunction, VAS score (- 1.62, 95%CI - 2.08 to - 1.16, P < 0.00001, I2 = 77%), RMDQ score (- 1.00, 95%CI - 1.54 to - 0.46, P = 0.0003, I2 = 80%); The results of the meta-analysis of the subgroup showed that compared with the control group, the KT intervention was less than or equal to 1 week, and the waist pain and dysfunction were improved, with statistically significant differences. The difference in the improvement of low back pain was statistically significant after KT intervention for more than 1 week, but there was no statistically significant difference in RMDQ score (- 1.25, 95%CI - 2.66 to 0.15, P = 0.08, I2 =77%). Compared with the control group, KT intervention improved low back pain in the second and third trimesters, and the difference was statistically significant.

CONCLUSION

KT has a positive effect on the improvement of low back pain during pregnancy, KT intervention can significantly improve pregnant women's low back pain and dysfunction problems, improve the quality of life. It is suggested that future research should focus on the prevention and treatment of low back pain during pregnancy to provide more research data for improving women's health.

The effect of elastic therapeutic taping and rigid taping on pain, functionality, and tissue temperature in lumbar radiculopathy: a randomized controlled study

PURPOSE

To compare the therapeutic effects of different taping materials and techniques on pain, functionality, and tissue temperature in patients with lumbar radiculopathy. Methods: Patients with lumbar radiculopathy were included in the study (n = 51). Patients were randomly divided into three groups, which were the elastic taping (n = 17), rigid taping (n = 17), and placebo taping groups (n = 17). All patients were enrolled in a physiotherapy and rehabilitation program that included thermotherapy, electrotherapy, and exercise five times a week for 2 weeks. The pain was measured before and after treatment using the Visual Analogue Scale. Functionality and quality of life were measured using the Oswestry Low Back Pain Disability Questionnaire and Roland-Morris Disability Questionnaire. The tissue temperature of the treated area in the lumbar region was measured by digital electronic infra-red thermography. Results: After the treatment, pain, functionality, and quality of life were improved in all groups (p < 0.05). Elastic taping was more effective in decreasing pain and increasing functionality than placebo taping (p < 0.05), but no difference was observed between placebo taping and rigid tapping. Local tissue temperature did not change before and after treatment in the elastic taping group (p > 0.05). Tissue temperature increased in the rigid and placebo taping groups (p < 0.05). Conclusion: Taping therapy in patients with lumbar radiculopathy has a positive effect on pain and functional status. Elastic taping can be recommended for clinical use because its effect is superior in some recovery parameters and its ease of use.

The effects of combined sternocleidomastoid muscle stretching and massage on pain, disability, endurance, kinesiophobia, and range of motion in individuals with chronic neck pain: A randomized, single-blind study

BACKGROUND

The effect of interventions to the Sternocleidomastoid (SCM)-muscle, as an important element of neck movement which is overactive in individuals with chronic neck pain (CNP), are unknown.

OBJECTIVE

The aim of the current study is to investigate the effects of SCM stretching and massage on pain, range of motion (ROM), endurance, disability, and kinesiophobia in individuals with CNP.

METHODS

In this study, individuals with CNP were randomized 1:1 to parallel SCM-Group (n = 30) or control group (CG) (n = 30). Conventional physiotherapy was applied to CG. In addition to the same interventions applied to the CG, classical massage and stretching exercises were applied to the SCM-muscle in the SCM-Group. Treatment sessions were administered three times each week for a total of 5 weeks. Pain, endurance, ROM, disability, and kinesiophobia were evaluated. Both prior to and immediately following the treatments. Mixed-model repeated measured ANOVAs were then employed to determine if a group*time interaction existed on the effects of the treatment on each outcome variable for each group as the between-subjects variable and time as the within-subjects variables.

RESULTS

Improvements in pain, disability, ROM(extension, left-lateral flexion, and right/left-rotation), and endurance were found to be greater in the SCM-Group compared to the CG (p < 0.05). Changes in flexion and right-lateral flexion ROM and kinesiophobia did not significantly differ between the groups (p > 0.05).

CONCLUSION

Stretching exercises and massage applied to the SCM-muscle, together with conventional physiotherapy, can reduce pain and disability, and increase ROM and endurance in individuals with CNP. This treatment may therefore be considered for use as an alternative method in treating CNP. The study was registered in ClinicalTrials.gov (NCT04345042).

Pharmacist-led intervention in treatment non-adherence and associated direct costs of management among ambulatory patients with type 2 diabetes in southwestern Nigeria

BACKGROUND

Non-adherence to recommended therapy remains a challenge to achieving optimal clinical outcome with resultant economic implications.

OBJECTIVE

To evaluate the effect of a pharmacist-led intervention on treatment non-adherence and direct costs of management among patients with type 2 diabetes (T2D).

METHOD

A quasi-experimental study among 201-patients with T2D recruited from two-tertiary healthcare facilities in southwestern Nigeria using semi-structured interview. Patients were assigned into control (HbA1c < 7%, n = 95) and intervention (HbA1c ≥ 7%, n = 106) groups. Baseline questionnaire comprised modified 4-item Medication Adherence Questions (MAQ), Perceived Dietary Adherence Questionnaire (PDAQ) and International Physical Activity Questionnaire, to assess participants' adherence to medications, diet and physical activity, respectively. Post-baseline, participants were followed-up for 6-month with patient-specific educational intervention provided to resolve adherence discrepancies in the intervention group only, while control group continued to receive usual care. Subsequently, direct costs of management for 6-month pre-baseline and 6-month post-baseline were estimated for both groups. Data were summarized using descriptive statistics. Chi-square, McNemar and paired t-test were used to evaluate categorical and continuous variables at p < 0.05.

RESULTS

Mean age was 62.9 ± 11.6 years, and 160(79.6%) were females. Glycated haemoglobin (HbA1c) was 6.1 ± 0.6% (baseline) and 6.1 ± 0.8% at 6-month post-baseline (p = 0.094) for control group, and 8.7 ± 1.5% (baseline) versus 7.8 ± 2.0% (6-month), p < 0.001, for the intervention. Post-baseline, response to MAQ items 1 (p = 0.017) and 2 (p < 0.001) improved significantly for the intervention. PDAQ score increased significantly from 51.8 ± 8.8 at baseline to 56.5 ± 3.9 at 6-month (p < 0.001) for intervention, and from 56.3 ± 4.0 to 56.5 ± 3.9 (p = 0.094) for the control group. Physical activity increased from 775.2 ± 700.5 Metabolic Equivalent Task (MET) to 829.3 ± 695.5MET(p < 0.001) and from 901.4 ± 743.5MET to 911.7 ± 752.6MET (p = 0.327) for intervention and control groups, respectively. Direct costs of management per patient increased from USD 327.3 ± 114.4 to USD 333.0 ± 118.4 (p = 0.449) for the intervention, while it decreased from USD 290.1 ± 116.97 to USD289.1 ± 120.0 (p = 0.89) for control group, at baseline and 6-month post-baseline, respectively.

CONCLUSION

Pharmacist-led intervention enhanced adherence to recommended medications, diet and physical activity among the intervention patients, with a corresponding significant improvement in glycaemic outcome and an insignificant increase in direct costs of management. There is a need for active engagement of pharmacists in management of patients with diabetes in clinical practice.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT04712916 . Retrospectively-registered.

Efficacy of lumbar kinetic chain training for staged rehabilitation after percutaneous endoscopic lumbar discectomy

BACKGROUND

Percutaneous endoscopic lumbar discectomy (PELD) is a promising minimally invasive treatment for lumbar disc herniation (LDH). Postoperative rehabilitation can improve patient outcomes. Not only rehabilitation for surgical trauma but also rehabilitation for lumbar spine and lower kinetic chain dysfunction should be performed. The aims of this study were to investigate the efficacy of a lumbar kinetic chain training for staged rehabilitation after PELD for LDH.

METHODS

Fifty one LDH patients treated with PELD were studied. After surgery, patients underwent lumbar kinetic chain training for staged rehabilitation( staged group) or regular low back rehabilitation (regular group). The staged rehabilitation programme included three phases from 2 to 6, 7-12, and 13-24 weeks postoperatively, and different physical therapies were performed during these phases. The low back pain visual analogue scale (VAS), JOA score, ODI, SF-36, and cross-sectional area of the lumbar multifidus on MRI were assessed, and gait analysis was performed.

RESULTS

Twenty five patients in staged group and twenty six patients in regular group were included. There were no significant differences in age or sex between the two groups at baseline (p > 0.05). The VAS score decreased and the JOA and SF-36 scores increased in both groups from baseline to 6 weeks (P < 0.05). In the staged group, compared with the regular group, the VAS and ODI scores were lower and the JOA and SF-36 scores were higher at 6 weeks (P < 0.05); the VAS and ODI scores were lower and the SF-36 score was higher at 12 weeks (P < 0.05); the SF-36 score was higher at 24 weeks (P < 0.05); the cross-sectional area of the lumbar multifidus showed no differences at 12 weeks (P > 0.05); and the left-right support ratio of gait was higher at 24 weeks (P < 0.05).

CONCLUSIONS

The staged rehabilitation programme for LDH after PELD promoted postoperative recovery, and the efficacy of lumbar kinetic chain training was higher than that of regular low back muscle exercise.

Diabetes Self-Management Among Individuals With Diabetes and Physical Disabilities

PURPOSE

The purpose of this study was to examine diabetes self-management behavior among individuals who have diabetes living with and without physical limitations.

METHODS

Pooled cross-sectional data (2011-2016) from the Household Component of the Medical Expenditure Panel Survey was used. Dependent variables were utilization of dilated eye exams, foot checks, at least 1 dental checkup annually, treating diabetes with oral medication, treating diabetes with insulin injections, and engagement in moderate or vigorous physical exercise 5 times per week. The independent variable was diabetes with physical limitations compared with diabetes without physical limitations. The study controlled for predisposing, enabling, and need factors.

RESULTS

Findings indicate that individuals with diabetes and physical limitations were less likely to engage in moderate or vigorous physical exercise 5 times per week, have at least 1 annual dental checkup, and treat their diabetes orally with medication.

CONCLUSIONS

Self-management behavior was poor among individuals with diabetes and physical limitations. Environmental barriers may partially contribute to reasons why individuals with diabetes and physical limitations do not engage in diabetes self-management behaviors that would assist them in mitigating diabetes complications. Other reasons could be the lack of equipment accessibility or adaptability and cultural competence among providers treating/caring for individuals with physical limitations.

Morphology and epidemiological study of idiopathic scoliosis among primary school students in Chaozhou, China

BACKGROUND

Idiopathic scoliosis (IS) affects patients' quality of life, yet there have been few reports of its morphology and epidemiological study in the southeast region of China. The aim of this study is to access the curve characteristics, prevalence, and factors associated with IS in Chaozhou city.

METHODS

A cross-sectional study was performed in 2018, in which scoliosis screening was conducted among 5497 primary school students in Chaozhou city. Then, a case-control study based on the screening involving 2547 children was followed for the exploration of the associated factors. The questionnaires covering demographic characteristics, postural habits, cognition and self-sensation of scoliosis, and physical conditions were addressed for the investigation. ORs with 95%CIs were calculated based on logistic regression analysis to evaluate the factors associated with scoliosis.

RESULTS

The prevalence of IS among primary school students was 6.15% in Chaozhou city, with 4.04% for males and 8.71% for females. The average Cobb angle was 15° (range 8 to 37°). Multiple logistic regression analysis suggested that female (OR=2.45), BMI (OR=0.67), having myopia (OR=1.49), self-sensation of scoliosis with symptoms (OR=5.52), insufficient sleep time (OR=2.65, 3.33), and less exercise time (OR=7.09, 7.29) were significantly associated with IS.

CONCLUSIONS

The prevalence of IS among primary school students in Chaozhou was at an average level, and it was significantly higher in females than in males. Lower body mass, having myopia, insufficient sleep time, and lower physical activity were associated with IS.

Measuring Spatiotemporal Parameters on Treadmill Walking Using Wearable Inertial System

This study aims to measure and compare spatiotemporal gait parameters in nineteen subjects using a full wearable inertial mocap system Xsens (MVN Awinda, Netherlands) and a photoelectronic system one-meter OptoGaitTM (Microgait, Italy) on a treadmill imposing a walking speed of 5 km/h. A total of eleven steps were considered for each subject constituting a dataset of 209 samples from which spatiotemporal parameters (SPT) were calculated. The step length measurement was determined using two methods. The first one considers the calculation of step length based on the inverted pendulum model, while the second considers an anthropometric approach that correlates the stature with an anthropometric coefficient. Although the absolute agreement and consistency were found for the calculation of the stance phase, cadence and gait cycle, from our study, differences in SPT were found between the two systems. Mean square error (MSE) calculation of their speed (m/s) with respect to the imposed speed on a treadmill reveals a smaller error (MSE = 0.0008) using the OptoGaitTM. Overall, our results indicate that the accurate detection of heel strike and toe-off have an influence on phases and sub-phases for the entire acquisition. Future study in this domain should investigate how to design and integrate better products and algorithms aiming to solve the problematic issues already identified in this study without limiting the user's need and performance in a different environment.

Idiopathic scoliosis and associated factors among school children: a school-based screening in Ethiopia

Background

Early detection of scoliosis is a preface to prevent progression. In resource-constrained countries like Ethiopia, there is a need for a cost-effective reliable solution for screening. The surprising fact is that there is neither idiopathic scoliosis screening nor reporting of data from Ethiopia. This study aimed to identify the magnitude, associated factors of scoliosis among school children by using non-invasive and less expensive scoliometer Smartphone app and Adams forward bending test.

Methods

A school-based cross-sectional survey was carried out from March to June 2019 at seven primary schools. Children were screened by using physical examination (Adams forward bend test) and scoligauge iPhone app. Univariate and multivariable binary logistic regression model analysis was used to identify factors associated with idiopathic scoliosis.

Results

A total of 1905 children aged between 5 and 16 years were screened, 3.3 % (95 % CI 2.5–4.1) of them were found positive using the scoligauge HD and among them only 1.8 % were identified positive for Adam’s forward bend test. The associated factors of idiopathic scoliosis identified by multivariate analysis were; spinal pain (AOR 4.1, 95 % CI 2.42, 6.89), student sitting on stool: (AOR, 7.03; 95 % CI, 1.52, 32.5), sitting on the bench with a backrest (AOR 4.12; 95 %CI, 1.12, 15.14) and sitting on the bench without backrest: (AOR 4.56; 95 % CI 1.20, 17.34).

Conclusions

The magnitude of idiopathic scoliosis was relatively low in study setup. More attention is needed towards sitting furniture designs and for children reporting spinal pain.There is a reasonable level of recommendation to advocate that large school-based scoliosis screening was able to detect scoliosis among school children.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13690-021-00633-0.

Cervical movement kinematic analysis in patients with chronic neck pain: A comparative study with healthy subjects

BACKGROUND

Several studies have investigated cervical kinematic performance in patients with chronic neck pain, especially with fast movements. A recent systematic review recommended further study of cervical spine kinematics cervical motions in individuals with neck pain.

OBJECTIVES

This study aimed to examine cervical spine kinematics of naturally paced cervical motions in patients with chronic neck pain compared with a group of asymptomatic participants. Also, the relationships between cervical kinematic measures with neck pain intensity and disability were determined.

METHOD

Kinematic performance was measured in 20 individuals with chronic nonspecific neck pain and 20 healthy controls. Data were captured using a 7-camera motion analysis system. Parameters were range of cervical motion, peak velocity, duration of movement, and jerk index (smoothness of movement). Pain intensity and Neck Disability Index were also measured.

RESULTS

Duration of movements, peak velocities, and jerk indexes were significantly different between the two groups (p < 0.05). Pain intensity was significantly associated with duration of movement, range of motion, peak velocity, and smoothness predominantly in extension (r range = 0.4 to 0.6, p < 0.05).

CONCLUSION

This study's findings indicated altered cervical kinematic performance during naturally paced motions (particularly reduced smoothness of movement)in patients with chronic nonspecific neck pain compared to asymptomatic participants. Also, pain intensity was moderately associated with most kinematic measures, especially in extension. This study's results can help to understand better the impairments associated with chronic nonspecific neck pain.

Psychometric properties of the Cumulated Ambulation Score French translation

OBJECTIVE

To examine measurement properties (inter-rater reliability, agreement, validity, and responsiveness) of the Cumulated Ambulation Score French translation in patients with hip fracture.

DESIGN

Methodological study.

SETTING

A 20-bed orthopedic unit and 20-bed geriatric unit.

SUBJECTS

About 140 consecutive patients with a mean (SD) age of 83 (12) years.

INTERVENTIONS

The English version of the Cumulated Ambulation Score used to evaluate basic mobility was translated into French following international guidelines. Two raters independently assessed all patients on postoperative days one, two, three, and 30 after a hip fracture surgery. Relative and absolute inter-rater reliability and responsiveness (effect size for improvement from postoperative day two to 30) were evaluated. Convergent validity was analyzed by Spearman's correlation coefficient comparing the Cumulated Ambulation Score with two other measures on postoperative day two and 30.

MAIN MEASURE

Cumulated Ambulation Score.

RESULTS

The weighted Kappa value ranged from 0.89 to 1.0. The standard error of measurement and the smallest real difference of the Cumulated Ambulation Score ranged, respectively, from 0.12 to 0.23 and from 0.32 to 0.6 points, while the effect size reached 1.03 (95% CI 0.87-1.26). There was a strong positive correlation comparing the Cumulated Ambulation Score with the French Tinetti Assessment Tool (r ⩾ 0.83) and the French Mini Motor Test (r ⩾ 0.79).

CONCLUSIONS

Our findings indicate that the Cumulated Ambulation Score's French version is a reliable and valid tool to assess patients' basic mobility with hip fractures.

Effects of elastic tape in pregnant women with low back pain: A randomized controlled trial

BACKGROUND

Low back pain is a common problem in pregnant woman. Elastic tape is an alternative method that may reduce low back pain.

OBJECTIVES

To compare the effect of elastic tape to placebo tape in the treatment of low back pain in pregnant women.

METHODS

Forty pregnant women were allocated into two groups: elastic group (n= 20) and placebo group (n= 20). All participants were taped by either stretched (elastic group) or non-stretched (placebo group) Kinesio tape at the lower back area for one week.

RESULTS

After the application of stretched elastic tape, lower back pain was significantly reduced by 29.4% (p= 0.003) immediately post-taping and by a further 75.4% after wearing the tape for a week. Compared to the placebo group, lower back pain was significantly reduced in the elastic group after one week of wearing the tape (p< 0.001). Compared to placebo, the application of elastic tape significantly reduced the disability score (Roland-Morris Disability Questionnaire) after one week of wearing the tape (p= 0.018). Taping to the back improved walking speed (immediately and after one week) in both the elastic (p< 0.001, p< 0.001) and placebo groups (p< 0.001, p= 0.001); however, the application of either tape had little effect on posture change.

CONCLUSION

Elastic tape reduced back pain and improved physical function in pregnant women compared to the placebo tape.

A novel (targeted) kinesio taping application on chronic low back pain: Randomized clinical trial

The aim of the present clinical trial is to evaluate the efficacy of kinesio taping on patients with chronic low back pain, when the exploration identifies skin/fascia mobilization as a factor that could modify the treatment effect. This study is a randomized controlled trial with intention-to-treat analysis. Sixty-two participants with chronic low back pain were therefore recruited from a tertiary referral hospital. Targeted kinesio taping, according to skin/fascia mobility exploration, was applied in the experimental group (17 female/13 male; 49.47 ± 11.15 years) once a week for four sessions. The control group (17 female/14 male; 48.87 ± 9.09 years) underwent a placebo taping application. At post-treatment time there was a statistically significant reduction both in disability (Roland-Morris Disability Questionnaire) and pain (Numeric Pain Rating Scale) in the experimental group (disability: -2.88, 95% confidence interval [CI] -4.56 to -1.21, P < .001; pain: -1.58, 95% CI -2.67 to -0.54 P = .001) and the control group (disability: -1.82, 95% CI -3.46 to -0.17 P = .025; pain: -1.30, 95% CI -2.32 to -0.28 P = .008). However, at six months, these changes only remained significant in the experimental group (disability: -2.95, 95% CI -4.72 to -1.18, P < .001; pain: -1.06, 95% CI -2.07 to -0.04, P < .05). As a conclusion, the application of targeted kinesio taping produced a significant reduction in pain and disability, at 4 weeks and at 6 moths follow-up, although there were no differences between groups at any measurement time point.

The effectiveness of two different exercise approaches in adolescent idiopathic scoliosis: A single-blind, randomized-controlled trial

OBJECTIVES

The purpose of this study was to compare the efficacy of two different types of exercise methods in patients with adolescent idiopathic scoliosis.

METHODS

In total, 28 subjects with adolescent idiopathic scoliosis with a mild curve magnitude (10°-26°) were randomly divided into two groups: the Schroth group (n = 14) and the core group (n = 14). The patients in the Schroth group were treated with supervised Schroth exercises, and the patients in the core group were treated with supervised core stabilization exercises; both groups performed the exercises for three days per week for a total of 10 weeks, and both were given additional traditional exercises to perform. Assessment included Cobb angle (Radiography), trunk rotation (Adam's test), cosmetic trunk deformity (Walter Reed Visual Assessment Scale), spinal mobility (Spinal Mouse), peripheral muscle strength (Biodex System 4-Pro), and quality of life (Scoliosis Research Society-22 questionnaire).

RESULTS

It was found that patients in the Schroth group showed greater improvement in Cobb angles, thoracic trunk rotation angle, cosmetic trunk deformity, spinal mobility, and quality of life than those in the core group (p<0.05), except for in lumbar trunk rotation angle. Peripheral muscle strength improvement was greater in the core group than in the Schroth group (p<0.05).

CONCLUSION

Schroth exercises are more effective than core stabilization exercises in the correction of scoliosis and related problems in mild adolescent idiopathic scoliosis, and core stabilization exercises are more effective than Schroth exercises in the improvement of peripheral muscle strength.

TRIAL REGISTRATION

NCT04421157.

Effectiveness of placebo interventions for patients with nonspecific low back pain: a systematic review and meta-analysis

ABSTRACT

Little is known about the effectiveness of placebo interventions in patients with nonspecific low back pain (LBP). This systematic review assessed the magnitude of the effects of placebo interventions as compared to no intervention in randomized controlled trials (RCTs) including patients with LBP. Embase, MEDLINE (Ovid), and Cochrane CENTRAL databases were searched from inception to December 5, 2019. Randomized controlled trials comparing placebo intervention vs no intervention in adult patients with nonspecific LBP were included. Pain intensity, physical functioning, and health-related quality of life measured at short-term, medium-term, and long-term follow-up were the outcomes of this review. Twenty-one randomized controlled trials were included; one concerning acute LBP and one subacute LBP, whereas 19 studies reported on chronic LBP. In chronic LBP, placebo interventions were more effective than no intervention at short-term follow-up for pain intensity (standardized mean difference = -0.37, 95% confidence interval [CI] = -0.55 to -0.18, moderate-quality evidence), physical functioning (standardized mean difference -0.19, 95% CI = -0.39-0.01, moderate-quality evidence), and physical quality of life (mean difference = -2.71, 95% CI = -4.71-0.71, high-quality evidence), respectively. These effects were not significant at medium-term follow-up, and no data were available at long-term follow-up. These results show placebo interventions are more effective than no intervention at short-term follow-up in patients with chronic LBP. However, the magnitude of the effects is probably not clinically relevant (approximately 8 points on a 0-100 pain scale). Future research should identify effect modifiers and causal mechanisms explaining the short-term effects of placebo interventions in patients with chronic LBP.

Current Evidence Does Support the Use of KT to Treat Chronic Knee Pain in Short Term: A Systematic Review and Meta-Analysis

Objective

To demonstrate whether KT is better than placebo taping, nonelastic taping, or no taping in reducing pain.

Methods

PubMed, Embase, Web of Science, the Cochrane Central Library, and ClinicalTrials.gov were systematically searched up to 20 October 2020 for randomized controlled studies that used KT to treat chronic knee pain according to PRISMA guidelines. We extracted the mean differences and SD in pretreatment and posttreatment for selected outcomes measured in the experimental and control groups for subsequent meta-analyses.

Results

In total, 8 studies involving 416 participants fulfilled the inclusion criteria. Our results indicated that KT is better than other tapings (placebo taping or nonelastic taping) in the early four weeks. The mean difference was −1.44 (95% CI: −2.04–−0.84, I² = 49%, P ≤ 0.01). Treatment methods which were performed for more than six weeks (0.16 (95% CI: −0.35–0.68, I² = 0%, P=0.53)) show no significant difference in reducing pain. In studies in which visual analogue scale was measured, a positive effect was observed for KT combined with exercise program training (−3.27 (95% CI: −3.69–2.85, I² = 0%, P < 0.05)).

Conclusion

KT exhibited significant but temporary pain reduction.

Does kinesiotaping can improve static stability of the knee after anterior cruciate ligament rupture? A randomized single-blind, placebo-controlled trial

Background

The aim of the study was the assessment of the early impact of the selected kinesiotaping technique on the static stability of the knee joint in patients with ACL rupture on the basis of stabilographic parameters.

Methods

Sixty-two patients with a complete ACL rupture (32 patients in experimental group and 30 patients in placebo group) took part in the randomized single-blind, placebo-controlled trial. The ligament technique of KT was taken into consideration. Application of a KT tape only on the injured knee was to stabilize the knee joint. Experimental group had application of KT on the injured knee and the placebo group had a KT placebo application (with no tension on KT). Intervention and stabilographic test in both groups was the same.

Research tools included measurements of static stabilographic parameters on stabilometric platform CQStab2P®. Outcome measures were assessed before intervention and after KT application. The analysis included evaluation of outcome variables – total path length, (SP), statokinesiogram path length in the XY axes (SPML, SPAP), and mean velocities in the XY axes (MV, MVML, MVAP).

Results

The results show a statistically significant shortening of the SP, SPAP and SPML variables only in experimental group. In the placebo group the results were not significant. The analysis also showed a significant improvement in all analyzed variables in the experimental group compared to the healthy side. In the placebo group, the results did not improve significantly after KT application compared to the healthy side.

Conclusions

Application o

f KT in patients after ACL rupture shortened the total path length and improved the value of parameters in the frontal and sagittal planes in experimental group, which may suggest the potentially greater improvement in these parameters. By improving the values of the analyzed variables, the KT application is able to compensate for the loss of static stability of the knee.

Trial Registration

This study was registered retrospectively in the Australian New Zealand Clinical Trials Registry (ANZCTR). Registration number: ACTRN12616001407482.

Associations between the severity of disability level and fear of movement and pain beliefs in patients with chronic low back pain

BACKGROUND AND OBJECTIVES

Low back pain (LBP) is one of the leading forms of chronic pain and is among the leading causes of pain and disability. In this study, we investigated the associations between the severity of disability and fear of movement and pain beliefs as well as the impact of the fear of movement and pain beliefs on the quality of life in patients with chronic LBP.

METHODS

A total of 89 patients (42.29 ± 16.05 years) with chronic low back pain were included in the study. The instruments used in the assessments include the Visual Analogue Scale (VAS), the Oswestry Disability Index (ODI), the Tampa Kinesiophobia Scale (TKS), the Pain Belief Questionnaire (PBQ), and the SF 36-Short Form. Patients were assigned into three groups by disability severity based on ODI scores. Statistical analysis was performed using SPSS 15.

RESULTS

No statistically significant intergroup differences were found in TKS and PBQ scores (p> 0.05). A positive correlation was found between TKS scores, age (r: 0.227/p< 0.05), PBQ organic (r: -0.250/p< 0.05) scores.

CONCLUSIONS

Our study revealed high levels of kinesiophobia and similar pain beliefs, independent of the severity level of disability. We believe that cognitive-behavioral therapy that may reduce fear-avoidance behaviors and convert negative pain beliefs into positive ones should be added to rehabilitation procedures for LBP.

Functional effects of kinesiology taping for medial plica syndrome: a prospective randomized controlled trial

Background: Medial plica syndrome (MPS) is a common yet overlooked cause of anterior knee pain. The treatment options for MPS include a variety of conservative approaches, however, the effect of kinesiology taping (KT), which is a feasible and effective treatment choice for musculoskeletal pathologies, has not been studied.Objectives: We investigated the efficacy of KT in addition to exercise in terms of pain severity, pain threshold, functional muscle strength of lower extremity, dynamic balance, functional status, and quality of life in patients with MPS.Methods: Eighty participants with MPS were randomly and equally divided into two groups: 1) the KT group, which received KT in addition to a 6-week exercise program; and 2) the control group, which received the 6-week exercise program alone. The following evaluations were conducted before and after the treatment; pain threshold, pain severity, disability level, functional strength and dynamic balance of the lower extremity, and quality of life.Results: Pain intensity decreased during activity, at rest, and night (KT group p < .001; control group p ≤ 0.013), and pain thresholds increased (KT group p < .001; control group p = .008) in both groups, however, the after treatment measures were better in the KT group (p ≤ 0.012). The time taken to complete the stairs up and down test decreased in both groups (KT group p < .001, control group p = .007) with a better outcome in the KT group (p = .024). Disability scores improved significantly in the KT only (p < .001). The quality of life improved in both groups (KT group p < .001; control group p = .005).Conclusions: While exercise therapy is beneficial in MPS treatment for functionality and pain relief; KT, in addition to exercise, improved symptoms and decreased impairment more efficiently than exercise alone in patients with MPS in our study, and it is thus a favorable treatment option for MPS.

Changes in physical activity and sedentary behaviours from before to during the COVID-19 pandemic lockdown: a systematic review

OBJECTIVE

In March 2020, several countries banned unnecessary outdoor activities during COVID-19, commonly called 'lockdowns. These lockdowns have the potential to impact associated levels of physical activity and sedentary behaviour. Given the numerous health outcomes associated with physical activity and sedentary behaviour, the aim of this review was to summarise literature that investigated differences in physical activity and sedentary behaviour before vs during the COVID-19 lockdown.

DESIGN DATA SOURCES AND ELIGIBILITY CRITERIA

Electronic databases were searched from November 2019 to October 2020 using terms and synonyms relating to physical activity, sedentary behaviour and COVID-19. The coprimary outcomes were changes in physical activity and/or sedentary behaviour captured via device-based measures or self-report tools. Risk of bias was measured using the Newcastle-Ottawa Scale.

RESULTS

Sixty six articles met the inclusion criteria and were included in the review (total n=86 981). Changes in physical activity were reported in 64 studies, with the majority of studies reporting decreases in physical activity and increases in sedentary behaviours during their respective lockdowns across several populations, including children and patients with a variety of medical conditions.

CONCLUSION

Given the numerous physical and mental benefits of increased physical activity and decreased sedentary behaviour, public health strategies should include the creation and implementation of interventions that promote safe physical activity and reduce sedentary behaviour should other lockdowns occur.

Clinical and radiological outcomes of kinesiotaping in patients with chronic neck pain: A double-blinded, randomized, placebo-controlled study

Objectives

In this study, we aimed to evaluate the efficacy of kinesiotaping (KT) in patients with chronic non-specific neck pain (NSNP) in terms of pain, disability, cervical range of motion (ROM), and cervical lordosis.

Patients and methods

Between October 2013 and March 2014, a total of 50 patients (10 males, 40 females; mean age 35.1±9.9 years; range, 17 to 62 years) with chronic NSNP were randomized into the KT (n=25) or the sham KT intervention (n=25) groups. Both groups were additionally given a therapeutic exercise (TE) program. The Visual Analog Scale (VAS) and Neck Disability Index (NDI) scores and ROM measurements were recorded at baseline, at the end of treatment, and at one month. Lateral cervical digital radiographs were analyzed by the Cobb, posterior tangent and effective lordosis methods at baseline and at one month after the treatment.

Results

There was a statistically significant decrease in the VAS scores compared to baseline in the KT group. The NDI scores significantly decreased in both groups. The patients in the KT group experienced a significant increase in all planes of cervical ROM after the treatment. Cervical radiographs revealed a significant increase in the Cobb and posterior tangent angles only in the KT group.

Conclusion

Our study results suggest that KT significantly improves VAS, NDI scores, ROM and cervical lordosis angles. The combination of TE and KT is useful in reducing pain and disability and improving ROM and cervical lordosis loss in patients with chronic NSNP.

Association Between Kinesiophobia and Life Space Among Community-Dwelling Older People with Chronic Musculoskeletal Pain

OBJECTIVE

Kinesiophobia (i.e., fear of movement caused by pain) is increasingly acknowledged as a determinant of disuse among patients with chronic musculoskeletal pain. Kinesiophobia may affect life space-a crucial indicator of an active lifestyle among older people. This study aimed to investigate the previously unexamined association between kinesiophobia and life space among community-dwelling older people with chronic musculoskeletal pain.

DESIGN

Cross-sectional study.

SETTING

Community.

SUBJECTS

We analyzed data from 194 community-dwelling older people (age ≥65 years, mean age = 75.7 years, 71.6% women) with chronic musculoskeletal pain.

METHODS

Kinesiophobia, life space, and pain severity were assessed using the Tampa Scale for Kinesiophobia, Life Space Assessment, and Brief Pain Inventory. Linear regression models were applied to analyze the associations between kinesiophobia and life space, and pain severity and life space.

RESULTS

In our sample, the prevalence rates for chronic musculoskeletal pain were 10.82% (N = 21) for neck, 55.15% (N = 107) for lower back, 25.26% (N = 49) for shoulder, and 50.00% (N = 97) for knee. The results suggest that higher kinesiophobia is associated with smaller life space (adjusted beta = -0.91, 95% CI = -1.43 to -0.45, P < 0.001), even after adjustment for age, gender, years of education, pain severity, and presence of comorbidity. On the contrary, no significant association between pain severity and life space was observed (adjusted beta = -0.61, 95% CI = -2.92 to 1.72, P = 0.624).

CONCLUSIONS

Our findings suggest that kinesiophobia plays an important role in the determination of life space among older people with chronic musculoskeletal pain.

The effectiveness of superimposed neuromuscular electrical stimulation combined with strengthening exercises on patellofemoral pain: A randomized controlled pilot trial

BACKGROUND

Patellofemoral pain (PFP) is one of the most common disorders of the knee. Neuromuscular electrical stimulation (NMES) is often assumed by clinicians to be an effective adjunctive therapy to quadriceps strengthening.

OBJECTIVE

The aim of this study was to assess the efficacy of superimposed NMES combined with strengthening exercises to improve the recovery of quadriceps strength and function in patients with PFP.

METHODS

This study was planned as a single blind randomized controlled pilot study. A total of twenty-seven patients diagnosed with PFP were randomly assigned into 2 groups. Patients received superimposed NMES in addition to the standardized program (Group I) or only the standardized program (Group II). The patients in both groups were treated 3 times a week for 6 weeks and followed at 12 weeks. Primary outcome measure was quadriceps isokinetic muscle strength. The changes in dependent variables before treatment, 6th, and 12th weeks were analyzed using a 2 × 3 mixed-model analysis of variance.

RESULTS

There were significant improvements in the within groups statistics of all parameters for both groups (p< 0.05). No differences in quadriceps strength, Kujala and Lysholm scores between groups were found at the different time points [F (2, 21) = 0.86; p= 0.12, F (2, 21) = 0.001; p= 0.97, F (2, 21) = 0.12; p= 0.73, respectively].

CONCLUSIONS

The results indicate that superimposed NMES combined with the standardized rehabilitation program has no clinically significant superiority to standardized rehabilitation program alone.

Translation, Inter-rater Reliability, Agreement, and Internal Consistency of the Japanese Version of the Cumulated Ambulation Score in Patients after Hip Fracture Surgery

Objectives:

The aim of this study was to translate the Cumulated Ambulation Score (CAS) from English into Japanese in cooperation with different types of healthcare providers and to investigate its inter-rater reliability and internal consistency.

Methods:

Two physical therapists at each of three general hospitals in Japan measured the mobility of 50 consecutive post-operative hip fracture patients on two occasions between 2 and 6 days after surgery using the Japanese version of the CAS (CAS-JP). We analyzed the inter-rater reliability and agreement using both the linear weighted kappa and the interclass correlation coefficient; we also analyzed the internal consistency using Cronbach’s alpha coefficient.

Results:

The mean age of patients was 81 (SD: 11.6) years and 82% were women. Approximately half of the patients had severe cognitive impairment. Kappa was ≥ 0.93 for the three mobility activities and for the total CAS-JP score, the percentage agreement was ≥ 0.98, the ICC was ≥ 0.95, and Cronbach’s alpha coefficient was 0.85.

Conclusions:

We found that the CAS-JP possessed good inter-rater reliability, agreement, and internal consistency. The CAS-JP is a reliable and easy-to-use evaluation tool suitable for daily clinical practice across different healthcare providers to monitor mobility in older hip fracture patients in Japan. We suggest that CAS-JP be evaluated in future studies for use in younger patients and in other patient groups with mobility problems.

Level of pain, muscle strength and posture: effects of PBM on an exercise program in women with knee osteoarthritis - a randomized controlled trial

To evaluate the effectiveness of an exercise program associated to photobiomodulation (PBM) on pain, postural changes, functionally, and muscular strength in women, one of the risk factors, with knee osteoarthritis (OA). A randomized controlled trial, with a blinded assessor and intention-to-treat analysis and placebo control. Sixty-two participants with knee OA (with confirmed radiological diagnosis) were evaluated for this study. However, 34 were considered eligible and were randomized into two groups: EPPG - exercise and PBM placebo group (n = 17) and EPAG - exercise and PBM active group (n = 16), but one participant was excluded of EPAG. The exercise program and PBM (808 nm, 100 mW/point, 4 J/point, 56 J total, 91 J/cm2) were realized twice a week, during 8 weeks. West Ontario and the McMaster University Osteoarthritis Index (WOMAC) and Lequesne questionnaires, 1-repetition maximum test (1-RM) and posture evaluation software (SAPO) were used to analyze the effects of the therapies. In intragroup analysis, a significant improvement in pain WOMAC (p < 0.001), stiffness (p < 0.001), function (p < 0.001), Lequesne (p < 0.001), and 1-RM (all muscle groups) (p < 0.001) were observed. In this study, the exercise program improved pain, function, and muscle strength of all the participants. However, PBM, in the parameters used, did not optimize the effects of the exercise program in women with knee OA.

Evaluation of the short-term results of closed reduction and percutaneous K-wires fixation of displaced intra-articular calcaneal fractures (DIACF)

PURPOSE

Optimum management of displaced intra-articular calcaneal fractures (DIACF) still controversial. Open surgery carries the risk of wound complications, while non-operative management has a high incidence of arthrosis. To avoid these complications, minimally invasive and percutaneous fixation was introduced. The purpose of this study was to prospectively evaluate the short term clinical and radiological outcomes after closed reduction and percutaneous fixation of DIACF using K-wires.

PATIENTS AND METHODS

Outcomes of twenty patients were evaluated at the final follow up. A functional assessment using the AOFAS scoring system. Radiological parameters recorded included three angles (Böhler's, Gissane and posterior facet inclination angles) and three distances (calcaneal length, height and width). Any complications were reported at any follow-up.

RESULTS

The mean patient's age was 33 ± 15.2 years, 8 (40%) patients with type II fractures, 10 (50%) patients with type III fractures, and 2 (10%) with type IV fracture according to Sanders classification. After a mean follow-up of 9 months, the mean AOFAS score was 84, excellent in 9 patients (45%), good in 9 (45%), and fair in 2 (10%). At the final follow-up the Böhler's angle, Gissane angle and PFIA was 25.1° ± (5.2), 119.9° ± (9.4) and 51.7° ± (5.9) respectively and the calcaneal height, length and width was 41.8 mm ± (2.1), 75.1 mm ± (3.01) and 40.9 mm ± (2.6) respectively. We had no cases of deep infection, 20% had significant subtalar arthritis.

CONCLUSION

The closed reduction and percutaneous fixation technique for DIACF management offered acceptable clinical and radiographic outcomes, with fewer complications when compared to other management options.

Pedobarography shows no differences in gait after talar fractures

BACKGROUND

Fractures of the talus often lead to permanent restrictions of the affected limb. Possible alterations after these fractures in gait have not been evaluated yet.

OBJECTIVE

To evaluate possible alterations of gait by pedybarography after talar fractures.

METHODS

We conducted a retrospective single-centre study at a level I trauma center. Twenty patients with operatively treated talar fractures were followed up. Objective and subjective function of the ankle was measured using range of motion, clinical scores and dynamic pedobarography (emed-M; Novel, Germany).

RESULTS

There were 11 talar neck and 9 talar body fractures. All patients received screw fixation. There was a significant reduction in range of motion. The outcome was moderate to satisfying and the severity of the injury correlated with the clinical outcome and the range of motion. The presence of posttraumatic arthritis and joint incongruity lead to a decreased function of ankle and subtalar joint and resulted in a worse clinical outcome. AVN rate was associated to initial displacement. Dynamic pedobarography showed no significant changes in gait pattern.

CONCLUSIONS

Fractures of the talus lead to dissatisfaction, pain and malfunction. However, a change in gait pattern could not be proved.

Health-Related Quality of Life and Associated Factors Among Type Two Diabetic Patients on Follow-Up in Dessie Comprehensive Specialized Hospital, Dessie, North East Ethiopia, 2020

BACKGROUND

Diabetes mellitus is a disorder of carbohydrate metabolism and it is highly related with diminished HRQOL in Ethiopia; diabetic related complications especially bring major negative impacts on HRQOL.

OBJECTIVE

To assess HRQOL and associated factors among type two diabetic patients in Dessie Comprehensive Specialized Hospital, north east Ethiopia, 2020.

METHODS

Institutional-based cross-sectional study design was conducted on 417 patients through systematic random sampling technique from February 08 to April 08, 2020. WHO HRQOL 26 items were used to measure outcome variable. Face-to-face interview, document review and measurement were implemented to collect data. The data were analyzed by IBM SPSS Statistics version 25 and summarized by using tables. Simple linear regression analysis was done and forwarded to multivariable linear regression analysis at p-value <0.25. Next multivariable linear regression analysis was done and variables whose p-value less than 0.05 with unstandardized B-coefficient were declared significant predictor variables.

RESULTS

The mean scores of physical domain, psychological domain, environmental domain and social domain were 48±6.7 (47-49), 52±4.2 (50-52.3), 48.9±3.4 (48-50.4) and 49±4 (48-50), respectively. As age increased by one year, patients' physical HRQOL decreased by 0.031 factor, keeping effect of other variables constant [-0.031, 95% CI (-0.050 to-0.013)]. As duration of diabetes increased by one year, patients' physical HRQOL increased by 0.034 factor, keeping effect of other variables constant [0.034, 95% CI (0.004 to 0.065)]. In general, age, depression, perceived social stigma, self-employed, having two complications, widowed, insulin and oral anti-diabetic medication affected HRQOL negatively and duration of diabetes in physical domain and university level of education in environmental domain affected HRQOL positively.

CONCLUSION AND RECOMMENDATION

The mean score of health-related quality of life in physical health domain, psychological health domain, social health domain and environmental health domain was recorded nearly half score point out of a hundred. Health professionals should follow a holistic approach to management to address negatively associated predictor variables with HRQOL.

Comparison of kinesio taping and sham taping in patients with chronic low back pain: A protocol of randomized controlled trial

BACKGROUND

Chronic low back pain (CLBP) is a clinical condition characterized by moderate to severe pain in the lower spine that severely affects the patient's life experience and leads to disability and absenteeism. In the past few years, kinesio tape (KT) have been utilized by physiotherapists as a relatively novel band-aid method to reduce the pain of musculoskeletal disorders. Therefore, in this particular study, we intended to search the effects of KT and sham KT on pain, lumbar range of motion, and disability for CLBP.

METHODS

The present study was experimented in a physiotherapy clinic in the Yancheng First People's Hospital of Jiangsu Province. The study design was a randomized, double-blinded clinical trial. Inclusion criteria for the study were the followings: chief complaint pain in the area between 12 ribs and hip creases with or without leg pain; ages ranges from 18 to 65; low back pain lasts <6 weeks; and at any rate medium pain intensity (pain score ≥4). Participants were randomly allocated to 1 of 2 parallel combinations to receive either therapeutic KT or sham KT. Patients were assessed at baseline, at the end of the 12-day intervention, and at 4 weeks of follow-up. The main result measure was pain intensity using a numerical rating scale (NRS), and the secondary outcome measure was lumbar lateral flexion activity, Oswestry Disability Index (ODI), and adverse effects including allergic reactions or skin problems.

CONCLUSIONS

The results of this study will provide new information about the usefulness of KT as an additional component of a guideline-endorsed physiotherapy program in patients with chronic nonspecific low back pain.

TRIAL REGISTRATION

This study protocol was registered in Research Registry (researchregistry6070).

Lifestyle factors, self-management and patient empowerment in diabetes care

Although management of diabetes mellitus is improving, inadequately managed cases still exist. Prevention of diabetes mellitus requires an integrated and holistic approach based on the origin of the disease. In Europe only half of diagnosed patients with diabetes mellitus have good glycaemic control. Inadequate glycaemic control is significantly increasing the use of healthcare resources, the medical costs and mortality rates. A review was conducted in order to summarise and discuss central themes for prevention. A search of the databases PubMed, CINAHL, Cochrane and Google Scholar between January 2010-May 2019 was undertaken. The following keywords: 'diabetes mellitus', 'cardiovascular diseases', 'empowerment', 'self-management education' and 'lifestyle factors' were used in different combinations to identify eligible articles. Important variables for the prevention of diabetes mellitus and its complications are self-management of diabetes mellitus and the management of risk factors. Education and support for self-management are fundamental when caring for people with a chronic disease like diabetes mellitus. In order to achieve effective self-management including lifestyle modification it is also crucial to motivate people. In this review, the role of the three main pillars in diabetes care are identified and discussed; patient empowerment, self-management education and lifestyle modification in the management of people with diabetes mellitus.

The impact of diabetes mellitus on health-related quality of life in Saudi Arabia

Objective

To evaluate the effect of different demographic, clinical and social factors on diabetic patients' quality of life (QOL).

Research design and methods

A cross sectional study conducted on patients with type 2 diabetes who attended King Abdulaziz University Hospital outpatient clinics between February and March 2017. The patients were asked about sociodemographic data including age, sex, educational level, exercise history and marital status in addition to clinical data such as duration of diabetes, presence of comorbidities as well as medication history. The patients' QOL were assessed using EQ-5D-5L Arabic version.

Results

131 participants were included in the study with a median age 55 years old. Forty five percent of participants were male. Regarding EQ-5D scores, there were significant correlation with gender, exercise, hypertension, heart disease, marital status, educational level and duration of diabetes while there was a significant difference in EQ-VAS scores with respect to heart disease, level of education and duration of diabetes.

Conclusion

More attention needs to be given to the assessment of the QOL of diabetic patients and assessing the effect of different treatment modalities on improvement of patients’ QOL.

The immediate and short-term effects of dynamic taping on pain, endurance, disability, mobility and kinesiophobia in individuals with chronic non-specific low back pain: A randomized controlled trial

Evidence suggests that the application of Kinesio Tape (KT) on patients with chronic non-specific low back pain (CNLBP) is inconclusive. Dynamic tape (DT) is a relatively new treatment technique, which is increasingly being used as an adjunctive method to treat musculoskeletal problems. To our knowledge, no study has investigated the application of DT in individuals with CNLBP. To compare the immediate and short-term effects of DT versus KT and no tape among patients with CNLBP on pain, endurance, disability, mobility, and kinesiophobia. Forty-five patients with CNLBP were randomly assigned to 1 of 3 groups. Outcomes were measured at baseline, immediately, and on the third day post-application of tapes. The primary outcomes of pain, endurance, and disability were measured through the visual analog scale (VAS), Biering–Sorensen test, and Oswestry disability index (ODI), respectively. Secondary outcome measures of mobility and kinesiophobia were measured using the modified–modified Schober test and the Tampa Scale of Kinesiophobia, respectively. No significant immediate and short-term differences were found between DT and KT in pain, disability, mobility, and kinesiophobia. Improved back extensor endurance was observed for the DT group than KT (p = 0.023) and control group (p = 0.006). The application of DT may result in improvements only in back extensor endurance among individuals with CNLBP. This finding suggests that DT controls the processes that lead to back muscle fatigue.

Biomechanical image of the knee motion in patients with chronic anterior instability of the knee joint before and after Kinesio Taping

BACKGROUND AND OBJECTIVE

In the available literature there are no reports on the effectiveness of Kinesio Taping (KT) in the conservative treatment of patients with anterior instability of the knee. The purpose of the present research was to evaluate the influence of the selected KT technique in limiting the anterior translation of the tibia by performing a biomechanical analysis of the gait cycle of patients with anterior instability of the knee.

METHODS

A total of 31 patients qualified for the single group study. In all patients, a total tear of the anterior cruciate ligament was diagnosed. The research tool was a three-dimensional motion analysis BTS SMART system. The effectiveness of KT of the knee with an anterior cruciate ligament tear was assessed based on angular changes in the movement of the knee in three planes of motion during specific phases of the gait cycle.

RESULTS

The results show that KT does not significantly affect angular values of the knee joint in the sagittal and transverse planes of the affected and healthy limb during selected phases of the gait cycle.

CONCLUSIONS

Due to only observed changes in the frontal plane, the KT method should be modified to also improve knee function in other planes.

Taping for conditions of the musculoskeletal system: an evidence map review

Background

Taping is a common treatment modality used by many rehabilitation providers. Several types of tapes and taping methods are used in the treatment of musculoskeletal dysfunction and pain.

Purpose

To summarize and map the evidence related to taping methods used for various joints and conditions of the musculoskeletal system, and to provide clinicians and researchers with a user-friendly reference with organized evidence tables.

Data sources

The PEDro, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register for Controlled Trials, PubMed, and PROSPERO databases were searched from inception through October 31, 2019.

Study selection

Eligible studies were selected by two independent reviewers and included either systematic reviews (SRs) or randomized controlled trials (RCTs) and included a musculoskeletal complaint using a clinical outcome measure.

Data extraction

Data was extracted by two investigators independently. Risk of bias and quality were assessed using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) for SRs or the Physiotherapy Evidence Database (PEDro) scale for RCTs. The protocol was registered with PROSPERO (CRD42019122857).

Data synthesis

Twenty-five musculoskeletal conditions were summarized from forty-one SRs and 127 RCTs. There were 6 SRs and 49 RCTs for spinal conditions. Kinesio tape was the most common type of tape considered. Four evidence tables representing the synthesized SRs and RCTs were produced and organized by body region per condition.

Limitations

Inclusion of only English language studies. Also, the heterogeneous nature of the included studies prevented a meta-analysis.

Conclusions

There is mixed quality evidence of effectiveness for the different types of taping methods for different body regions and conditions. All of the SRs and RCTs found during our search of the taping literature have been organized into a series of appendices. A synthesis of the results have been placed in evidence tables that may serve as a useful guide to clinicians and researchers.

Immediate effect of kinesio taping on deep cervical flexor endurance: A non-controlled, quasi-experimental pre-post quantitative study

Objective Whether Kinesio taping® (KT) might change the endurance of the cervical deep flexor muscles.Methods: Healthy university students were assessed at baseline, immediately after the KT application over the posterior cervical muscles, and at a 24-h follow-up. The clinical assessment of the endurance of the deep cervical flexor muscles using the craniocervical flexion test (CCFT) was performed.Results: Sixty-two students (32 women) with a mean age of 20.4 ± 1.3 years completed the study protocol. Statistically significant pre- to post-taping differences in performance of the craniocervical flexion movement were found between baseline-immediate and baseline-24-h follow-up (p˂0.001). A statistically significant difference in the endurance of the cervical deepflexor muscles was found between baseline-immediate (for stage 2 result and cumulative endurance score), baseline-24-h follow-up (for stage 2result and cumulative endurance score), and immediate-24-h follow-up (for stage 2 result, for cumulative endurance score) p˂0.01.Conclusion: Cervical KT increased endurance for the short term.

Social participation is an important health behaviour for health and quality of life among chronically ill older Chinese people

BACKGROUND

Health behaviours (physical activity, maintenance of a healthy diet and not smoking) are known to be beneficial to the health and well-being of chronically ill people. With China's ageing population and increased prevalence of people with chronic diseases, the improvement of unhealthy behaviours in this population has become crucial. Although recent studies have highlighted the importance of social participation for health and quality of life (QoL) among older people, no study to date has included social participation along with more traditional health behaviours. Therefore, this study aimed to identify associations of multiple health behaviours (social participation, physical activity, maintenance of a healthy diet and not smoking) with health and QoL outcomes (including cognitive and physical function) among chronically ill older adults in China.

METHODS

For this nationally representative cross-sectional study, wave 1 data from the World Health Organization's Study on global AGEing and adult health (China) were examined. In total, 6629 community-dwelling older adults (mean age, 64.9 years) with at least one chronic disease were included. Multivariate linear regression analyses were used to evaluate associations of health behaviours with health and QoL outcomes while controlling for background characteristics.

RESULTS

Greater social participation was associated with better QoL [β = 0.127, standard error (SE) = 0.002, p < 0.001], cognitive function (β = 0.154, SE = 0.033, p < 0.001) and physical function (β = - 0.102, SE = 0.008, p < 0.001). Physical activity was associated with better QoL (β = 0.091, SE = 0.015, p < 0.001) and physical function (β = - 0.155, SE = 0.062, p < 0.001). Sufficient fruit and vegetable consumption was associated with better QoL (β = 0.087, SE = 0.015, p < 0.001).

CONCLUSIONS

Our findings suggest that social participation is an important health behaviour for quality of life and cognitive function among chronically ill older people in China. Health promotion programmes should expand their focus to include social participation as a health behaviour, in addition to physical activity, maintenance of a healthy diet and not smoking.

Epidemiology of adolescent idiopathic scoliosis in Isfahan, Iran: A school-based study during 2014-2015

Background:

Scoliosis is a three-dimensional deformity of the spine with lateral curvature in addition to the rotation of vertebral bodies. The aim of the present study was to determine the prevalence of adolescent idiopathic scoliosis (AIS) in our society and its demographic-related factors.

Materials and Methods:

This was a cross-sectional study that took place from November 2014 to March 2015 in Isfahan, Iran. During the period of study, 24 schools were randomly chosen from six zones by a simple random sampling method. In each school, about 120 students were randomly selected and evaluated. Anterior forward bending test and scoliometry were done in all students and suspicious ones referred to Alzahra spine clinic for further evaluation. The diagnosis of AIS was based on radiographic finding and Cobb angle more than 10°. Data about age, sex, height, body mass index, hand dominancy, and type of schoolbag were recorded.

Results:

A total number of 3018 children were evaluated and 19 were diagnosed with AIS that showed the prevalence of 0.62%. None of the study variables had a significant relation with the presence of AIS. The cutoff point for the detection of AIS with scoliometry was calculated as 3.5, with a sensitivity of 73.7% and specificity of 86.7%.

Conclusion:

The prevalence of AIS in our area was 0.62%, which was lower than previous reports and did not have a relation with demographic factors; however, screening surveys identify a significant number of children with AIS who could benefit from preventive treatment.

Efficacy of Piroxicam Mesotherapy in Treatment of Knee Osteoarthritis: A Randomized Clinical Trial

Introduction

Knee osteoarthritis (KOA) is one of the most common degenerative diseases that lead to pain and disability. Oral NSAIDs are effective drugs used to alleviate symptoms in patients with KOA, but they have several important complications, especially in the elderly. In this study, we evaluated the effectiveness of mesotherapy on pain reduction and improvement of functioning in patients with KOA.

Methods

Sixty-two patients with KOA, grade 2-3 of the Kellgren–Lawrence scale, were randomized into two groups: the mesotherapy group, in which two injections were applied with piroxicam at a 10-day interval, and the oral group, in which piroxicam was prescribed for 10 days. The patients were evaluated before the treatment and 2, 4, and 8 weeks after it using the Visual Analogue Scale (VAS), Oxford Knee Scare (OKS), and Western Ontario McMaster University Osteoarthritis Index (WOMAC, Persian version).

Results

There was no significant difference in demographic characteristics and baseline pain and function scores between the two groups. After 2, 4, and 8 weeks of follow-up, VAS, WOMAC, and OKS scores significantly improved in both groups (in the mesotherapy group: p value <0.001 in all three scores and in the oral group: p value <0.001 in the VAS scale and p value <0.05 in WOMAC and OKS scores). There was no significant difference between the two groups at any time in the VAS score, but improvement in WOMAC and OKS scales in the mesotherapy group was significantly better (p value <0.05 in both scales [p value <0.03 in OKS and p value <0.02 in WOMAC scales]). Side effects in both groups were not serious: limited heart burn in 32.2% of the total subjects in the oral group and pain at the injection site in 3.2% and bruises in 38.7% of the total subjects in the mesotherapy group.

Conclusion

Mesotherapy is an effective and safe treatment modality in patients with mild-to-moderate KOA in the short term. This trial is registered with IRCT2017052434113N1.

Long-term results of arthroscopic medial reefing for patellar instability

BACKGROUND

The purpose of the study was to investigate the long-term outcomes of the all-inside arthroscopic medial reefing (AAMR) procedure for patellar instability and the factors that affect successful outcome.

METHODS

In this retrospective study, AAMR with suture was performed in 16 knees of 15 patients who had at least one patellar dislocation and did not experience a decrease in pain and who did not have a major radiological bony abnormality. Preoperatively, Tegner and Lysholm scales were used; for the final evaluation Tegner, Lysholm, Kujala and Knee injury and Osteoarthritis Outcome Score (KOOS) were used.

RESULTS

The average age of the patients at the time of operation was 18 years (range: 11-36 years). The average follow-up time was 118.3 months (range: 85-143 months). Six of the 16 knees (37.5%) exhibited re-dislocation. Preoperatively, the mean Lysholm and Tegner were 66.5 and 4.0, respectively; and postoperatively increased to 89.3 (P = .001) and 4.66, respectively. At the final follow-up, mean Kujala was 89.3 (good), and mean KOOS was 91.4. In all patients with re-dislocation, fewer than four knots were used, and none of the patients with four knots exhibited re-dislocation. Re-dislocations occurred in two, two, one and one patients at two, three, five and eight years, respectively.

CONCLUSIONS

The AAMR technique is associated with minimal incisional scarring and an increase in functional scores. It is also associated with a high risk of re-dislocation compared with other methods. If the technique still needs to be used, despite the high re-dislocation rate, at least four knots should be applied.

Safety of exercise therapy after acute pulmonary embolism

OBJECTIVE

The role of exercise therapy after acute pulmonary embolism (PE) is unknown. Exercise therapy is safely used after myocardial infarction and chronic obstructive pulmonary disease. The aim of this study was to investigate the safety of exercise therapy after acute PE.

METHODS

We implemented a 3-month exercise program after acute PE. Outcomes were death, bleeding, readmissions, recurrent events, changes in peak VO2 and quality of life (QoL).

RESULTS

A total of 23 patients were enrolled and received anticoagulation; no adverse events were reported during the exercise period. One death, 1 DVT and 5 readmissions were reported due to non-exercise related reasons. Functional capacity improved as evidenced by an increased peak VO2 at 3 months (+3.9 ± 5.6 mL/kg/min; p = 0.05). Improvement in QoL was observed at 6-months on the functional (+17.0 ± 22.6, p = 0.03) and physical health factor scales (+0.9 ± 4.6, p = 0.03).

CONCLUSION

Exercise therapy is feasible and safe in appropriately anticoagulated patients after PE.

Rasch analysis of the anterior knee pain scale in adolescents with patellofemoral pain

OBJECTIVE

The aim of this study was to evaluate the Anterior Knee Pain Scale in a cohort of adolescents being treated conservatively for patellofemoral pain using Rasch analysis.

DESIGN

This is a psychometric study.

SETTING

Physical therapy clinics of a large pediatric hospital in Columbus, Ohio (United States).

SUBJECTS

A total of 646 adolescent patients with patellofemoral pain (76% female, 14.6 ± 1.6 years old).

INTERVENTION

Not applicable.

MAIN MEASURE

The Anterior Knee Pain Scale.

RESULTS

The median Anterior Knee Pain Scale score was 73 (interquartile range 64-81), with scores ranging from 7 to 100 on the 100-point scale. The Rasch person reliability for the Anterior Knee Pain Scale was 0.74 and the Cronbach's alpha was 0.75, representing an acceptable person reliability. Principal component analysis revealed a ratio of 5.2:1 demonstrating acceptable unidimensionality of the Anterior Knee Pain Scale. A significant misfit was observed in the item "Abnormal Painful Kneecap Movements" (Outfit Means Square 2.74, Infit Means Square 1.41). Ordering of item responses was unsatisfactory as only five of the 13 items demonstrated appropriate distinction between each of the responses. There was no differential item functioning for sex or age for all items of the Anterior Knee Pain Scale, based upon the criterion of ⩾ 0.5 logit difference.

CONCLUSION

The Anterior Knee Pain Scale does not meet interval-level measurement criteria and should be considered ordinal level data.

Effects of Kinesio Taping on peak torque and muscle activity in women with low back pain presenting fears and beliefs related to physical activity

BACKGROUND

KT is an elastic taping that has been widely used as an adjunct to conventional physiotherapy. The purpose of this study was to evaluate the effects of Kinesio Taping on peak torque, muscle fatigue index and muscle activity of erector spinae in women with low back pain presenting fears and beliefs related to physical activity.

METHODS

This is a pilot controlled clinical trial. The subjects were divided into two groups according to the Fear Beliefs Avoidance Questionnaire (FABQ): Group A (Patients with no fears and/or beliefs related to physical activity) and Group B (Patients with fears and/or beliefs related to physical activity). The Kinesio Taping was applied in "I" in order to facilitate erector spinae. An isokinetic dynamometer and a surface electromyography were used to evaluate the outcomes. The evaluations were performed without and with the KT.

RESULTS

Sample of 16 women equally divided into two groups with similar characteristics regarding age, weight, height, body mass index, functional capacity and pain levels in the evaluations without and with Kinesio Taping. There were within-groups and between-groups differences in the peak torque (p ≤ .05), with better results in the Group B. No differences were found on muscle fatigue index and muscle activity in both groups (p > .05).

CONCLUSION

It was concluded that Kinesio Taping had immediate effects in the peak torque of the erector spinae of women with nonspecific chronic low back pain presenting fears and beliefs related to physical activity. It is suggested that such results occurred by placebo effect. NCT: RBR-5xh3ch.

What Is the Effect on Kinesio Taping on Pain and Gait in Patients With Patellofemoral Pain Syndrome?

Introduction

Patellofemoral pain syndrome (PFPS) is one of the leading causes of anterior knee pain treated by orthopedists and physical therapists. This syndrome predominantly affects young, active individuals, and remains a challenging syndrome to manage due to the lack of quantitative diagnostic criteria to monitor during treatment. The etiology of this syndrome is believed to be multifactorial, with the gait and movement patterns of a patient potentially contributing to pain due to increased stress on the knee. In this study, we investigated the gait of participants with PFPS using the GaitRite system (CIR Systems Inc., Clifton, NJ) before and after the application of Kinesio Tape in order to assess the impact of Kinesio Tape on cadence, stance time, and pain.

Methods

A convenience sample of 10 participants were recruited for this study, with five participants without PFPS serving as controls, and five with PFPS in the Kinesio Tape group. Participants in the Kinesio Tape groups served as their own internal control, ambulating both before and after taping. All participants ambulated across the GaitRite carpet three times and completed a visual analogue scale pain score for each trip.

Results

The results of our study found there to be no significant difference in the cadence for gait between the participants without PFPS and participants with PFPS (105.2 seconds vs. 105.1 seconds, p = 0.272), or in the stance time between the control and PFPS group (1.43 seconds vs. 1.44, p = 0.907). Similarly, no significant difference was found in participants with PFPS before and after Kinesio Taping in the cadence and stance times (105.1 seconds vs. 107.4 seconds, p =0.288, and 1.44 vs. 1.40, p = 0.272). There was a significant difference in pain in PFPS participants before and after taping, with a 112.5% reduction in pain reported after taping (3.4 vs. 1.6, p < 0.05).

Discussion and conclusion

This study is one of the first studies to utilize the GaitRite system in order to analyze the impact of Kinesio Tape on gait in participants with PFPS. While our study failed to demonstrate a significant difference in the gait of participants with PFPS in comparison to those without PFPS, we did demonstrate a significant reduction in pain after the application of Kinesio Tape. These results suggest other variables addressed by the Kinesio Tape may be causing the pain associated with PFPS.

Dynamic and Stabilometric Analysis After Syndesmosis Injuries

BACKGROUND

Distal tibiofibular syndesmosis contributes to dynamic stability of the ankle joint and thereby affects gait cycle. The purpose of this study was to evaluate the grade of syndesmosis injury on plantar pressure distribution and dynamic parameters of the foot.

METHODS

Grade of syndesmosis injury was determined by preoperative plain radiographic evaluation, intraoperative hook test, or external rotation stress test under fluoroscopic examination, and two groups were created: group 1, patients with grade III syndesmosis injury (n = 17); and group 2, patients with grade II syndesmosis injury (n = 10). At the last visit, radiologic and clinical assessment using the Foot and Ankle Outcome Score was performed. Dynamic and stabilometric analysis was carried out at least 1 year after surgery.

RESULTS

The mean age of the patients was 48.9 years (range, 17-80 years), and the mean follow-up was 16 months (range, 12-24 months). No statistically significant difference was noted between two groups regarding Foot and Ankle Outcome Score. The comparison of stabilometric and dynamic analysis revealed no significant difference between grade II and grade III injuries (P > .05). However, comparison of the data of patients with grade III syndesmosis injury between injured and healthy feet showed a significant difference for dynamic maximum and mean pressures (P = .035 and P = .49, respectively).

CONCLUSIONS

Syndesmosis injury does not affect stance phase but affects the gait cycle by generating increased pressures on the uninjured foot and decreased pressures on the injured foot. With the help of pedobarography, processing suitable orthopedic insoles for the injured foot and interceptive measures for overloading of the normal foot may prevent later consequences of ankle trauma.

Short-Term Effects of PENS versus Dry Needling in Subjects with Unilateral Mechanical Neck Pain and Active Myofascial Trigger Points in Levator Scapulae Muscle: A Randomized Controlled Trial

Procedures such as dry needling (DN) or percutaneous electrical nerve stimulation (PENS) are commonly proposed for the treatment of myofascial trigger points (MTrP). The aim of the present study is to investigate if PENS is more effective than DN in the short term in subjects with mechanical neck pain. This was an evaluator-blinded randomized controlled trial. Subjects were recruited through announcements and randomly allocated into DN or PENS groups. Pain intensity, disability, pressure pain threshold (PPT), range of motion (ROM), and side-bending strength were measured. The analyses included mixed-model analyses of variance and pairwise comparisons with Bonferroni correction. The final sample was composed of 44 subjects (22 per group). Both groups showed improvements in pain intensity (ηp2 = 0.62; p < 0.01), disability (ηp2 = 0.74; p < 0.01), PPT (ηp2 = 0.79; p < 0.01), and strength (ηp2 = 0.37; p < 0.01). The PENS group showed greater improvements in disability (mean difference, 3.27; 95% CI, 0.27-6.27) and PPT (mean difference, 0.88-1.35; p < 0.01). Mixed results were obtained for ROM. PENS seems to produce greater improvements in PPT and disability in the short term.