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Kapitán M, Jouklová N, Machač S, Hodačová L, Čermáková E, Schmidt J. Changes in spinal curve during dentistry studies measured with a Spinal Mouse device: A five-year prospective study. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2024. [PMID: 39030855 DOI: 10.1111/eje.13026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 05/29/2024] [Accepted: 07/07/2024] [Indexed: 07/22/2024]
Abstract
INTRODUCTION Musculoskeletal disorders (MSDs) often arise and develop during dentistry studies. The most affected regions are related to the spine. Possible associations between spinal curve parameters and MSDs have not yet been investigated amongst dentistry students. This longitudinal observational study aimed to determine whether spinal curve changes during dentistry studies, analyse the relationship between objective findings and subjectively declared MSDs and compare spinal curve parameters with those published in the literature. MATERIALS AND METHODS Seventy-three dentistry students answered a questionnaire on MSDs, and were examined using the Spinal Mouse® device at the beginning, in the middle, and at the end of their 5-year study. RESULTS The spinal curve exhibited a gender diversity in the lumbar lordosis angle, sacrum inclination, and thoracolumbar ratio. From the first to fifth study year, we observed an increase in the range of motions in the sagittal and frontal planes, an increase in the maximal extent of right lateral inclination, and a decrease in maximal left lateral inclination. Whole-spine backward inclination increased only in women, and forward sacral inclination decreased. No statistically significant relationships were found between the objective findings and subjectively declared MSDs. CONCLUSIONS The spinal curve shape differed between men and women and changed during dentistry studies. No objective markers or predictors of MSDs were found amongst the dentistry students. These findings can serve as a benchmark for further studies on the association between MSDs and objective findings.
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Affiliation(s)
- Martin Kapitán
- Department of Dentistry, Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czech Republic
- Department of Dentistry, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Nela Jouklová
- Department of Dentistry, Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czech Republic
- Department of Dentistry, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Stanislav Machač
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Rehabilitation and Sports Medicine, University Hospital Motol, Prague, Czech Republic
- Institute of Sports Medicine, Prague, Czech Republic
| | - Lenka Hodačová
- Department of Preventive Medicine, Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czech Republic
| | - Eva Čermáková
- Department of Medical Biophysics, Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czech Republic
| | - Jan Schmidt
- Department of Dentistry, Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czech Republic
- Department of Dentistry, University Hospital Hradec Králové, Hradec Králové, Czech Republic
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Allaire C, Yong PJ, Bajzak K, Jarrell J, Lemos N, Miller C, Morin M, Nasr-Esfahani M, Singh SS, Chen I. Directive clinique n o445 : Gestion de la douleur pelvienne chronique. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2024; 46:102284. [PMID: 38341222 DOI: 10.1016/j.jogc.2023.102284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
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Allaire C, Yong PJ, Bajzak K, Jarrell J, Lemos N, Miller C, Morin M, Nasr-Esfahani M, Singh SS, Chen I. Guideline No. 445: Management of Chronic Pelvic Pain. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2024; 46:102283. [PMID: 38341225 DOI: 10.1016/j.jogc.2023.102283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
OBJECTIVE To provide evidence-based recommendations for the management of chronic pelvic pain in females. TARGET POPULATION This guideline is specific to pelvic pain in adolescent and adult females and excluded literature that looked at pelvic pain in males. It also did not address genital pain. BENEFITS, HARMS, AND COSTS The intent is to benefit patients with chronic pelvic pain by providing an evidence-based approach to management. Access to certain interventions such as physiotherapy and psychological treatments, and to interdisciplinary care overall, may be limited by costs and service availability. EVIDENCE Medline and the Cochrane Database from 1990 to 2020 were searched for articles in English on subjects related to chronic pelvic pain, including diagnosis, overlapping pain conditions, central sensitization, management, medications, surgery, physiotherapy, psychological therapies, alternative and complementary therapies, and multidisciplinary and interdisciplinary care. The committee reviewed the literature and available data and used a consensus approach to develop recommendations. Only articles in English and pertaining to female subjects were included. VALIDATION METHODS The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and conditional [weak] recommendations). INTENDED AUDIENCE Family physicians, gynaecologists, urologists, pain specialists, physiotherapists, and mental health professionals. TWEETABLE ABSTRACT Management of chronic pelvic pain should consider multifactorial contributors, including underlying central sensitization/nociplastic pain, and employ an interdisciplinary biopsychosocial approach that includes pain education, physiotherapy, and psychological & medical treatments. SUMMARY STATEMENTS RECOMMENDATIONS.
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Marques ACF, Rossi FE, Neves LM, Diniz TA, Messias IDA, Barela JA, Horak FB, Júnior IFF. Combined Aerobic and Strength Training Improves Dynamic Stability and can Prevent against Static Stability Decline in Postmenopausal Women: A Randomized Clinical Trial. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2023; 45:e465-e473. [PMID: 37683658 PMCID: PMC10491475 DOI: 10.1055/s-0043-1772178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 03/07/2023] [Indexed: 09/10/2023] Open
Abstract
OBJECTIVE To analyze the effect of combined training (CT) in postural control and gait parameters in postmenopausal women. METHODS A parallel-group, randomized, control study was conducted with 16 weeks of combined training (n = 16) versus a non-training control group (n = 12) in postmenopausal women (aged 59.3 ± 8.0). Pre and postintervention assessments included postural control (using an AMTI force platform - Advanced Mechanical Technology, Inc., Watertown, MA, USA) and gait impairments (using baropodometry). In addition, the upper limb strength and abdominal tests, as well as aerobic capacity, assessed functional indicators. RESULTS The CT intervention in postmenopausal women resulted in improved gait (stride length (p = 0.006); speed (p = 0.013); double support time (p = 0.045); and improved postural control (displacement area of postural sway in a normal base of support with eyes open (p = 0.006). Combined training increased functional indicators (abdominal - p = 0.031; aerobic capacity - p = 0.002). CONCLUSION In conclusion, combined aerobic plus strength training effectively improved gait and balance control in older women. The postmenopausal women from the CT group walked faster and with bigger steps after the intervention than the control group. In addition, they presented decreased postural sway in standing and decreased the percentage of double support time while walking, which means improved static and dynamic balance control and functional indicators.
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Affiliation(s)
| | - Fabrício Eduardo Rossi
- Immunometabolism of Skeletal Muscle and Exercise Research Group, Department of Physical Education, Universidade Federal do Piauí, Teresina, PI, Brazil
| | - Lucas Melo Neves
- Universidade Santo Amaro, São Paulo, SP, Brazil
- Department of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Iracimara de Anchieta Messias
- Faculty of Science and Technology, Universidade Estadual Paulista “Júlio de Mesquita Filho,” Presidente Prudente, SP, Brazil
| | - José A. Barela
- Department of Physical Education, Instituto de Biociências, Rio Claro, SP, Brazil
| | - Fay B. Horak
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States
| | - Ismael Forte Freitas Júnior
- Faculty of Science and Technology, Universidade Estadual Paulista “Júlio de Mesquita Filho,” Presidente Prudente, SP, Brazil
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Wagner S, Bring A, Åsenlöf P. Construct validity of the Mini-BESTest in individuals with chronic pain in specialized pain care. BMC Musculoskelet Disord 2023; 24:391. [PMID: 37198616 DOI: 10.1186/s12891-023-06504-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/09/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Balance assessment scales are important clinical tests to identify balance impairments. Chronic pain (> 3 months) is associated with impaired dynamic balance; however, very few balance assessment scales are psychometrically evaluated for the population. The purpose of this study was to evaluate the construct validity and internal consistency of the Mini-BESTest for individuals with chronic pain in specialized pain care. METHODS In this cross-sectional study, 180 individuals with chronic pain (> 3 months) were assessed with the Mini-BESTest and included in the analyses. For construct validity, five alternative factor structures were evaluated using a confirmatory factor analysis. In addition, we tested the a priori hypotheses about convergent validity with the 10-meter walk test, and divergent validity with the Brief Pain Inventory (BPI): pain intensity, the Tampa Scale of Kinesiophobia-11 (TSK-11), and the Pain Catastrophizing Scale (PCS-SW). Internal consistency was evaluated for the model with the best fit. RESULTS A one-factor model with added covariance via the modification indices showed adequate fit indices. In line with our hypotheses, Mini-BESTest showed convergent validity (rs = > 0.70) with the 10-meter walk test, and divergent validity (rs = < 0.50) with BPI pain intensity, TSK-11, and PCS-SW. Internal consistency for the one-factor model was good (α = 0.92). CONCLUSIONS Our study supported the construct validity and internal consistency of the Mini-BESTest for measuring balance in individuals with chronic pain, who were referred to specialized pain care. The one-factor model showed an adequate fit. In comparison, models with subscales did not reach convergence, or showed high correlations between subscales, implying that Mini-BESTest is measuring one construct in this sample. We, therefore, propose using the total score, instead of subscale scores, for individuals with chronic pain. However, further studies are necessary to establish the reliability of the Mini-BESTest in the population.
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Affiliation(s)
- Sofia Wagner
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Annika Bring
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Pernilla Åsenlöf
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
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Reis AM, Brito LGO, Teixeira CPF, de Araújo CC, Facio FA, Herrmann V, Juliato CRT. Is There a Difference in Whole Body Standing Posture in Women With Urinary Incontinence Based on the Presence of Myofascial Dysfunction in the Pelvic Floor Muscles? Phys Ther 2021; 101:6315144. [PMID: 34228785 DOI: 10.1093/ptj/pzab171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 03/01/2021] [Accepted: 05/04/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the prevalence of postural changes in women who had urinary incontinence (UI) with myofascial dysfunction (MD) and women who had UI without MD in the pelvic floor muscles (PFM). METHODS A cross-sectional study was performed with 234 women who had UI and were at least 18 years old at the urogynecology outpatient clinic of a tertiary academic hospital. The International Consultation on Incontinence Questionnaire-Short Form and the International Consultation on Incontinence Questionnaire-Overactive Bladder were used to collect urinary data. Standing postural assessment was performed using photogrammetry in anterior, posterior, and right and left lateral views and was analyzed with Postural Assessment Software. MD was defined as pain of any intensity during palpation of the PFM, and the strength of these muscles was evaluated using the Modified Oxford Scale. RESULTS The prevalence of MD in women with UI was 51.7% (121/234). Women with MD had significantly smaller angles in the horizontal alignment of the pelvis in the right-side view (mean [SD] = -11.9 [6.9] degrees and -9.6 [7.1] degrees), left-side view (-13.6 [6] degrees and -11.5 [6.6] degrees), and vertical alignment of the body in the left-side view (3 [1.5] degrees and 3.4 [1.5] degrees), showing anterior pelvic tilt and posterior displacement of the body. CONCLUSION Women with UI and MD had greater anterior pelvic tilt and posterior displacement of the body than women without dysfunction. IMPACT This study informs physical therapists and other health care professionals about the prevalence of MD in the pelvic floor muscles of women with UI and highlights the need to rule out MD, because it appears to be a concomitant impairment in women who self-report UI. During a postural screen, health care professionals should look for anterior pelvic tilt relative to horizon when evaluating posture in women with UI and MD. The findings of postural changes in women with MD and UI may influence the PFM assessment. LAY SUMMARY Women with involuntary urinary loss, pain, and stiffness in the pelvic area may show changes in posture associated with this condition.
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Affiliation(s)
- Amanda Martins Reis
- Department of Obstetrics and Gynecology, School of Medicine, University of Campinas (UNICAMP), Campinas, Brazil
| | - Luiz Gustavo Oliveira Brito
- Department of Obstetrics and Gynecology, School of Medicine, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Camila Carvalho de Araújo
- Department of Obstetrics and Gynecology, School of Medicine, University of Campinas (UNICAMP), Campinas, Brazil
| | - Fábio Augusto Facio
- Department of Physiotherapy and Osteopathy, UniMetrocamp University Center, Campinas, Brazil
| | - Viviane Herrmann
- Department of Obstetrics and Gynecology, School of Medicine, University of Campinas (UNICAMP), Campinas, Brazil
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Rodríguez-Torres J, López-López L, Cabrera-Martos I, Prados-Román E, Granados-Santiago M, Valenza MC. Effects of an Individualized Comprehensive Rehabilitation Program on Impaired Postural Control in Women With Chronic Pelvic Pain: A Randomized Controlled Trial. Arch Phys Med Rehabil 2020; 101:1304-1312. [PMID: 32325162 DOI: 10.1016/j.apmr.2020.02.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 02/23/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the effectiveness of an individualized comprehensive rehabilitation program (ICPR) on impaired postural control, pain, self-perceived health status, and functionality in women with chronic pelvic pain. DESIGN Randomized controlled trial. SETTING Women with chronic pelvic pain were recruited from the Gynecology Department of the University Hospital San Cecilio in Granada, Spain. PARTICIPANTS Participants (N=38) who were randomly divided into 2 groups. INTERVENTIONS The intervention group received an 8-week ICRP, and the control group received a leaflet with ergonomic information. MAIN OUTCOME MEASURES The main outcomes included were postural control (Mini Balance Evaluation Systems [Mini BESTest] and timed Up and Go [TUG]), pain (Brief Pain Inventory), self-perceived health status (EuroQol 5 dimensions [EQ-5D]), and functionality (Oswestry Disability Index [ODI]). RESULTS Significant differences were found between groups in the Mini BESTest and TUG scores with large effect sizes. The Brief Pain Inventory, EQ-5D, and ODI also presented significant differences in the between-groups analysis, with better scores in the intervention group after treatment. In the follow-up analysis, significant differences were found between groups in the Mini BESTest (P<.001), the cognitive TUG subscale (P=.032), interference of pain (P<.001), anxiety and depression (P=.001), and visual analog scale EQ-5D (P=.026) subscales, as well as the ODI (P<.001). CONCLUSIONS Our results show significant improvements on postural control, pain, self-perceived health status, and functionality in women with chronic pelvic pain who received an 8-week ICRP.
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Affiliation(s)
- Janet Rodríguez-Torres
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Laura López-López
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Irene Cabrera-Martos
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Esther Prados-Román
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - María Granados-Santiago
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Marie C Valenza
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.
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Harris-Hayes M, Spitznagle T, Probst D, Foster SN, Prather H. A Narrative Review of Musculoskeletal Impairments Associated With Nonspecific Chronic Pelvic Pain. PM R 2019; 11 Suppl 1:S73-S82. [PMID: 31233286 DOI: 10.1002/pmrj.12209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The purpose of this narrative review is to present the evidence relating to musculoskeletal impairments found in people with nonspecific chronic pelvic pain (CPP). The musculoskeletal impairments assessed in this review include pelvic floor muscle: performance, resting state, strength, activation, posture and movement patterns. A search was performed systematically using PubMed, Cochrane, CINAHL, Embase, and Web of Science databases from 1998 to 2018 to identify studies reporting the relationship between nonspecific CPP and musculoskeletal impairments of the hip, pelvis, and trunk. The search resulted in 2106 articles that were screened by two authors. Remaining articles were screened by an additional two authors for inclusion in this review. Thirty-one articles remained after initial screening. Full-text publications were reviewed and an additional 25 articles were excluded. Six additional articles were located through review of the reference lists of included articles. The final review included 12 publications. Seven of these studies were cross-sectional cohorts or case-control comparing patients with CPP to asymptomatic controls. The level of evidence for the studies included in this review was low at Levels 4 and 5. We were unable to draw clear conclusions regarding the relationships of musculoskeletal impairments and CPP because validity and use of terms and assessments were inconsistent. Further research is needed with standardized definitions and measurements to better understand the musculoskeletal system as it relates to nonspecific CPP.
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Affiliation(s)
- Marcie Harris-Hayes
- Program in Physical Therapy and Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Theresa Spitznagle
- Program in Physical Therapy and Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Daniel Probst
- Division of Physical Medicine and Rehabilitation, Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Stefanie N Foster
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri
| | - Heidi Prather
- Division Physical Medicine and Rehabilitation, Departments of Orthopaedic Surgery and Neurology, Washington University School of Medicine, St. Louis, Missouri
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