Compensatory spinopelvic motions with and without a handheld task following a perturbation in standing between subjects with and without chronic low back pain

Vibration training reducing falls in community-living older adults: a pilot randomized controlled trial

BACKGROUND

Although vibration training has been applied in older adults, it remains unclear if it can reduce falls.

AIMS

This pilot randomized-controlled trial aimed to test the effects of an 8-week vibration training program on reducing falls among community-dwelling adults.

METHODS

Forty-eight older adults were randomized to two groups: training and control. The training group received three weekly training sessions over eight weeks while the control group maintained their normal lifestyle over the 8-week period. Immediately before (or baseline), following (post-training), and three months after (retest) the 8-week training course, a group of fall risk factors were assessed for all participants. Each participant was also exposed to an unexpected gait-slip on a treadmill during post-training and retest sessions. Their daily-living fall incidence was collected for 12 months after the baseline test. The slip fall was the primary outcome, prospective all-cause falls were the secondary outcome, and fall risk factors acted as the tertiary ones.

RESULTS

The vibration training program significantly reduced the risk of slip-falls and improved all fall risk factors immediately after the training course. The training effect may be carried over for three months. The 8-week training program could also lower the number of falls between the baseline test and retest and reduce the recurrent faller rate across the 12 months after the baseline test.

DISCUSSION

This study indicates that vibration training might have some effects on fall-related measures in older adults.

CONCLUSIONS

An 8-week vibration training program could be effective to reduce falls in older adults.

CLINICALTRIALS

GOV REGISTRATION NUMBER

NCT02694666.

Ankle reaction times with tray usage following a slip perturbation between subjects with and without chronic low back pain

BACKGROUND

Abnormal stepping strategies have been associated with handheld tasks in subjects with chronic low back pain (LBP). However, the dominant ankle reactions of subjects with LBP remain unclear following a perturbation during handheld tasks.

RESEARCH QUESTION

Are there differences in the reaction times of the ankle muscles during handheld tasks between subjects with and without LBP following a treadmill-induced slip perturbation?

METHODS

Thirty-seven right limb dominant subjects with LBP and 37 subjects without LBP participated in the study. Each subject was introduced to a slip perturbation (1.37 m/sec velocity for 8.22 cm) with and without a handheld tray in random order. Subjects were allowed to recover by stepping forward for a 0.12 s duration while bilateral tibialis anterior (TA) and gastrocnemius (GA) muscle reaction times were measured by electromyography (EMG).

RESULTS

The EMG results indicated that the groups demonstrated significant interactions on the limb sides and muscles (F = 4.86, p = 0.03). The dominant TA reaction time was significantly faster in the LBP group (t = 2.14, p = 0.03) while holding a tray.

SIGNIFICANCE

The LBP group demonstrated faster reaction times on the dominant TA muscles during perturbations. Clinicians need to consider dominance-dependent compensatory ankle dorsiflexion strategies in LBP patients to help enhance dynamic balance and control.

Compensatory Ground Reaction Forces during Scoliotic Gait in Subjects with and without Right Adolescent Idiopathic Scoliosis

Although the asymmetries of scoliotic gait in adolescent idiopathic scoliosis (AIS) groups have been extensively studied, recent studies indicated conflicting results regarding the ground reaction forces (GRFs) during gait in subjects with spinal deformity. The asymmetry during the stance phase might be clarified with three-dimensional (3D) compensations of GRFs between similar characteristics of subjects with and without AIS. The purpose of this study was to compare the normalized 3D GRF differences during the stance phase of gait while considering age, BMI, and Cobb angle between subjects with and without right AIS. There were 23 subjects with right convexity of thoracic idiopathic scoliosis and 22 age- and gender-matched control subjects. All subjects were right upper/lower limb dominant, and the outcome measures included the Cobb angles, normalized GRF, and KAI. The mediolateral (M/L) third peak force on the dominant limb decreased in the AIS group (t = 2.58, p = 0.01). Both groups demonstrated a significant interaction with the 3D indices (F = 5.41, p = 0.02). The post-hoc analysis identified that the M/L plane of asymmetry was significantly different between groups. The Cobb angles were negatively correlated with the vertical asymmetry index (r = −0.45, p = 0.03); however, there was no significant correlation with age (r = −0.10, p = 0.65) or body mass index (r = −0.28, p = 0.20). The AIS group demonstrated decreased GRF in the dominant limb M/L plane of the terminal stance phase. This compensatory motion was confirmed by a significant group difference on the M/L plane of the KAI. This KAI of vertical asymmetry correlated negatively with the Cobb angle. The asymmetric load transmission with compensatory vertical reactions was evident due to abnormal loading in the stance phase. These kinetic compensatory patterns need to be considered with asymmetry on the dominant limb when developing rehabilitation strategies for patients with AIS.

Manual Pressure Release and Low-Grade Electrical Peripheral Receptor Stimulation in Nonspecific Low Back Pain: A Randomized Controlled Trial

Chronic nonspecific low back pain is a frequent clinical condition affecting the general population and influencing disability level and quality of life. We performed a single-blinded, randomized, and controlled study to compare the effectiveness of manual pressure release (MPR) and electrical neuromodulation (ENM) treatments in the management of chronic low back pain. There were 20 patients with chronic low back pain randomly assigned to 6 treatment sessions with either technique. Both groups were treated for 2 days a week for 3 weeks. Myofascial trigger points (MTrPs) were identified and skin conductance, pressure-pain threshold, postural changes, and the Oswestry Disability Index were assessed before and after each treatment session, along with the protocol-end data compared against the baseline data in each group. We found an outstanding and about equal deactivation of MTrPs from pre- to post-treatment in both groups, reducing disability in patients with chronic low back pain. The study highlights the ENM as a reliable tool for the evaluation of MTrPs, given a high agreement with the MPR. The effect on the neuromuscular condition of treating the "key trigger points" found in this study advances the knowledge of medical rehabilitation.