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Zheng DKY, Liu JQJ, Chang JR, Ng JCY, Zhou Z, Wu J, Cheung CKC, Huang FF, Pinto SM, Samartzis D, Ferreira ML, Ekanayake K, Lord S, Wang X, Wong AYL. Are changes in pain intensity related to changes in balance control in individuals with chronic non-specific low back pain? A systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2024:100989. [PMID: 39293716 DOI: 10.1016/j.jshs.2024.100989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 05/19/2024] [Accepted: 06/13/2024] [Indexed: 09/20/2024]
Abstract
PURPOSE The aim of this study is to summarize the evidence regarding whether pain reduction in individuals with chronic non-specific low back pain (CNSLBP) following conservative interventions is related to corresponding improvements in balance control. METHODS Randomized controlled trials were identified from 5 databases (MEDLINE, Cochrane Library, Embase, Web of Science, and PsycINFO). Two reviewers independently screened and identified relevant studies that investigated the effects of nonsurgical or nonpharmacological CNSLBP treatments on both pain intensity and balance control. Meta-regression analyses were performed to establish the associations between post-treatment changes in these 2 variables. RESULTS 31 studies involving 1280 participants with CNSLBP were included. Moderate-quality evidence suggested that pain reduction was associated with and explained 34-45 % of decreases in body sway, as measured by center-of-pressure (CoP) area and CoP velocity with eyes open. However, no significant association was observed between pain reduction and CoP area or velocity in anteroposterior/mediolateral directions. Similarly, there was no significant association between pain reduction and CoP distance or radius. Low-quality evidence indicated that pain relief explained a 15 % improvement in one-leg stance with eyes open but not in the eyes-closed condition. Additionally, very low-quality evidence suggested that pain relief explained a 44 % decrease in the static anteroposterior stability index with eyes closed but not in the eyes-open, mediolateral, or overall conditions. Furthermore, low-quality evidence indicated that reduced pain was associated with and accounted for 25-43 % of the improved composite and posteromedial scores of the star-excursion balance test, rather than the anterior and posterolateral scores. CONCLUSION Depending on the type of balance assessment, pain relief following conservative interventions may slightly to moderately enhance balance control in individuals with CNSLBP. Clinicians should pay close attention to the balance control in patients with CNSLBP, particularly among older adults.
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Affiliation(s)
- Daniel K Y Zheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Jae Q J Liu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Jeremy R Chang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Jeffrey C Y Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Zhixing Zhou
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Jinlong Wu
- College of Physical Education, Southwest University, Chongqing 400715, China
| | - Chelsia K C Cheung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Frank F Huang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Sabina M Pinto
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Dino Samartzis
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA
| | - Manuela L Ferreira
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Kanchana Ekanayake
- University Library, The University of Sydney, Sydney, NSW 2006, Australia
| | - Stephen Lord
- Neuroscience Research Australia, University of New South Wales, Sydney, NSW 2052, Australia
| | - Xueqiang Wang
- Department of Rehabilitation Medicine, Wenzhou Medical University, Wenzhou 325035, China
| | - Arnold Y L Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, China; Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong 999077, China.
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Chaari F, Boyas S, Rebai H, Rahmani A, Sahli S. Effectiveness of 12-Week Core Stability Training on Postural Balance in Soccer Players With Groin Pain: A Single-Blind Randomized Controlled Pilot Study. Sports Health 2024:19417381241259988. [PMID: 39066655 DOI: 10.1177/19417381241259988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND Core stability training (CST) is effective in improving postural balance, core endurance, and self-reported outcomes in different populations. This study aimed to investigate the effect of CST in soccer players with groin pain (GP). HYPOTHESIS CST would improve postural balance performance, core endurance, and self-reported outcomes in soccer players with GP. STUDY DESIGN Randomized controlled trial. LEVEL OF EVIDENCE Level 2. METHODS Soccer players with GP who met the selection criteria were assigned randomly to a CST (CSTG, n = 10) or a control (CG, n = 10) group. The CG undertook no additional physical activity program besides their usual training. The CSTG performed a 12-week CST comprising 76 ~75 min sessions. Static (force platform) and dynamic (Y-Balance test) postural balance, core endurance (McGill trunk endurance tests), and self-reported outcomes (Copenhagen Hip and Groin Outcome Score [HAGOS]) were assessed before and immediately after the 12-week CST. RESULTS Significant improvements were seen in dynamic postural balance (P = 0.04 to <0.01), HAGOS scores (P = 0.02 to <0.01), and core endurance measures (P < 0.01) in the CSTG in posttest compared with pretest session and compared with CG. Static bipedal postural balance measures showed significant improvements (eyes open, P = 0.02; eyes closed, P < 0.01) in the CSTG in posttest compared with pretest session. However, no significant differences (P > 0.05) were observed between CSTG and CG after the training period. CONCLUSION A 12-week CST improved static (foam surface) and dynamic postural balance, core endurance measures, and HAGOS scores. CLINICAL RELEVANCE The beneficial effect of CST on improving postural balance, core endurance, and self-reported outcomes in soccer players with GP suggests that this training would be an important feature of rehabilitation programs for these players. Coaches and clinicians should prioritize CST training when designing rehabilitation programs.
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Affiliation(s)
- Fatma Chaari
- Research laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
- Le Mans University, Movement - Interactions, Performance, MIP, UR4334, France Faculty of Sciences and Technologies, Avenue Olivier Messiaen, 72000 Le Mans, France
| | - Sébastien Boyas
- Le Mans University, Movement - Interactions, Performance, MIP, UR4334, France Faculty of Sciences and Technologies, Avenue Olivier Messiaen, 72000 Le Mans, France
| | - Haithem Rebai
- Tunisian Research Laboratory 'Sports Performance Optimization' (LR09SEP01), National Center of Medicine and Science in Sports (CNMSS), Tunis, Tunisia
| | - Abderrahmane Rahmani
- Le Mans University, Movement - Interactions, Performance, MIP, UR4334, France Faculty of Sciences and Technologies, Avenue Olivier Messiaen, 72000 Le Mans, France
| | - Sonia Sahli
- Research laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
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Stöwhas K, Droppelmann G, Jorquera C, Feijoo F. Postural and Lumbopelvic Control: Crucial Factors in the Functionality of Patients with Low Back Pain-A Descriptive Cross-Sectional Study. J Clin Med 2024; 13:3836. [PMID: 38999405 PMCID: PMC11242385 DOI: 10.3390/jcm13133836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/24/2024] [Accepted: 06/25/2024] [Indexed: 07/14/2024] Open
Abstract
Background: Low back pain (LBP) is one of the most prevalent musculoskeletal disorders in adults worldwide. Alterations in postural and lumbopelvic control and functionality appear to be determining factors in its resolution. Methods: A cross-sectional study was performed. Patients with LBP were enrolled. Lumbar pain; postural control (PC), total area of the center of pressure (TACOP), and the velocity of the center of pressure (VCOP); lumbopelvic control (LPC); and functionality were evaluated. Statistical tests were implemented to determine differences between sex and age and correlation models among the variables. Results: Thirty adult patients with LBP were analyzed. A strong relationship was found between pain and functionality [r = 0.64; p < 0.001]. A moderate relationship was found between pain and TACOP [r = 0.395; p = 0.031]. A moderate relationship was observed between TACOP and functionality [0.413; p = 0.023] and between LPC and TACOP [r = 0.416; p = 0.001]. Conclusions: This study demonstrates the significant impact of LBP on postural control, lumbopelvic control, and functionality. These results highlight the importance of addressing postural and lumbopelvic control in LBP treatment. No significant differences based on gender and age were found, but all clinical variables differed significantly between the LBP and control groups, underscoring the unique impairments associated with LBP.
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Affiliation(s)
- Katherine Stöwhas
- Department of Rehabilitation, Clínica MEDS, Santiago 7691236, Chile;
- Facultad de Medicina, Escuela de Kinesiología, Universidad Finis Terrae, Santiago 7501014, Chile
| | - Guillermo Droppelmann
- Department of Rehabilitation, Clínica MEDS, Santiago 7691236, Chile;
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Carlos Jorquera
- Facultad de Ciencias, Escuela de Nutrición y Dietética, Universidad Mayor, Santiago 8580745, Chile;
| | - Felipe Feijoo
- School of Industrial Engineering, Pontificia Universidad Católica de Valparaíso, Valparaíso 2362807, Chile;
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Hao Z, Cheng X, Jiang H, Yang J, Li Y, Ambrose Lo WL, Yu Q, Wang C. The associations between lumbar proprioception and postural control during and after calf vibration in people with and without chronic low back pain. Front Bioeng Biotechnol 2024; 12:1329437. [PMID: 38572361 PMCID: PMC10987701 DOI: 10.3389/fbioe.2024.1329437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 01/19/2024] [Indexed: 04/05/2024] Open
Abstract
The relationships of lumbar proprioception with postural control have not been clarified in people with chronic low back pain. This study aimed to compare the associations between lumbar proprioception and postural control in response to calf vibration in individuals with and without chronic low back pain. In this study, we recruited twenty patients with chronic low back pain (CLBP group) and twenty healthy control subjects (HC group) aged between 18 and 50 years. This study was a cross-sectional study and completed from May 2022 to October 2022. The passive joint repositioning sense (PJRS) test for two positions (15° and 35°) were used to assess lumbar proprioception and expressed as the mean of reposition error (RE). Postural control was tested by adding and removing calf vibration while standing on a stable force plate with eyes closed. The sway velocity in the anterior-posterior (AP) direction of center of pressure (COP) data with a window of 15s epoch at baseline, during and after calf vibration was used to evaluate postural control. Mann-Whitney U-tests were used to compare the difference of lumbar proprioception between two groups, and the independent t-tests were used to compare the difference of postural control at baseline and during vibration, and a mixed design ANOVA was used to compare the difference of postural control during post-perturbation. In addition, to explore the association between postural control and lumbar proprioception and pain intensity, Spearman's correlations were used for each group. The major results are: (1) significantly higher PJRS on RE of 15° (CLBP: 95% CI [2.03, 3.70]; HC: 95% CI [1.03, 1.93]) and PJRS on RE of 35° (CLBP: 95% CI [2.59, 4.88]; HC: 95% CI [1.07, 3.00]) were found in the CLBP group; (2) AP velocity was not different between the CLBP group and the HC group at baseline and during calf vibration. However, AP velocity was significantly larger in the CLBP group compared with the HC group at epoch 2-14 after calf vibration, and AP velocity for the CLBP group took a longer time (23 epochs) to return to the baseline after calf vibration compared with the HC group (9 epochs); (3) lumbar proprioception represented by PJRS on RE of 15°correlated negatively with AP velocity during and after vibration for the HC group. Within the CLBP group, no significant relationships between PJRS on RE for two positions (15° and 35°) and AP velocity in any postural phases were found. In conclusion, the CLBP group has poorer lumbar proprioception, slower proprioceptive reweighting and impaired postural control after calf vibration compared to the HC group. Lumbar proprioception offers different information on the control strategy of standing control for individuals with and without CLBP in the situations with proprioceptive disturbance. These results highlight the significance of assessing lumbar proprioception and postural control in CLBP patients.
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Affiliation(s)
- Zengming Hao
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xue Cheng
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Haimei Jiang
- Department of Rehabilitation Medicine, The 10th Affiliated Hospital of Southern Medical University (Dongguan People’s Hospital), Dongguan, China
| | - Jiajia Yang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yan Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wai Leung Ambrose Lo
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qiuhua Yu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chuhuai Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Soysal Tomruk M, Tomruk M, Kalemci O. Comparisons of postural control, proprioception, muscle strength, pain and disability between individuals with acute, subacute and chronic low back pain. Somatosens Mot Res 2024; 41:26-33. [PMID: 36634047 DOI: 10.1080/08990220.2023.2165057] [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: 05/24/2022] [Accepted: 01/02/2023] [Indexed: 01/13/2023]
Abstract
PURPOSE/AIM Postural control, proprioception and lower extremity muscle strength are affected in individuals with low back pain (LBP). However, it is yet unknown whether these variables differentiate between acute, subacute and chronic stages of LBP. The aim was to investigate if there were any differences in postural control, proprioception, lower extremity muscle strength, pain intensity and disability between individuals in the different stages of LBP. MATERIALS AND METHODS In this cross-sectional study, 124 individuals with LBP were grouped as acute LBP (ALBP) (n = 38), subacute LBP (SLBP) (n = 30) and chronic LBP (CLBP) (n = 56) groups. Postural control was assessed via computerised technology. Lumbar proprioception, lower extremity muscle strength, pain intensity and disability were assessed using Joint Repositioning Error Test, hand-held dynamometer, Numeric Rating Scale and Oswestry Disability Index (ODI), respectively. Kruskal-Wallis Tests, ANCOVA and post hoc Mann-Whitney U-Test with Bonferroni correction were performed. RESULTS While there were no significant differences in terms of postural control, proprioception and pain intensity (p > 0.05), significant differences were found in terms of lower extremity muscle strength and ODI scores between groups when adjusted for age (p < 0.05). Individuals with CLBP demonstrated poorer lower extremity muscle strength than those with ALBP and SLBP, and higher disability than those with ALBP (p < 0.017). CONCLUSIONS Although postural control, proprioception and pain intensity were similar between individuals with acute, subacute and chronic LBP, muscle strength and disability seem to worsen stepwise as the pain becomes chronic. Muscle strength and disability should be taken into account while evaluating and/or managing individuals with acute and subacute stages of LBP.
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Affiliation(s)
- Melda Soysal Tomruk
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Burdur Mehmet Akif Ersoy University, Burdur, Turkey
| | - Murat Tomruk
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Burdur Mehmet Akif Ersoy University, Burdur, Turkey
| | - Orhan Kalemci
- Faculty of Medicine, Department of Neurosurgery, Dokuz Eylül University, İzmir, Turkey
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Ducas J, Memari S, Houle M, Schwendenmann Y, Abboud J, Yiou É, Descarreaux M. Impact of lumbar delayed-onset muscle soreness on postural stability in standing postures. Gait Posture 2024; 109:201-207. [PMID: 38350184 DOI: 10.1016/j.gaitpost.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/22/2024] [Accepted: 02/01/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Similar impact on proprioception has been observed in participants with lumbar delayed-onset muscle soreness (DOMS) and chronic low back pain (LBP), raising questions about the relevance of lumbar DOMS as a suitable pain model for LBP when assessing back pain-related postural stability changes. RESEARCH QUESTION Does lumbar DOMS impact postural stability? METHODS Twenty healthy adults participated in this experimental study and underwent a posturographic examination before and 24 to 36 h after a protocol designed to induce lumbar DOMS. Posturographic examination was assessed during quiet standing on both feet with eyes opened (EO), with eyes closed (EC), and on one-leg (OL) standing with eyes opened. Postural stability was assessed through center of pressure (COP) parameters (COP area, velocity, root mean square, mean power frequency) which were compared using repeated measure ANOVA. Moreover, pain, soreness and pressure pain threshold (PPT) on specific muscles were assessed. RESULTS There was a significant main effect of the postural condition on all COP variables investigated. More specifically, each COP variable reached a significantly higher value in the OL stance condition than in both EO and EC bipedal conditions (all with p < 0.001). In addition, the COP velocity and the mean power frequency along the anteroposterior direction both reached a significantly higher value in EC than in EO (p < 0.001). In contrast, there was no significant main effect of the DOMS nor significant DOMS X postural condition interaction on any of the COP variables. There was a significant decrease in the PPT value for both the left and right erector spinae muscles, as well as the left biceps femoris. SIGNIFICANCE Lumbar DOMS had no impact on postural stability, which contrasts findings in participants with clinical LBP. Although DOMS induces similar trunk sensorimotor adaptations to clinical LBP, it does not appear to trigger similar postural stability adaptations.
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Affiliation(s)
- Julien Ducas
- Department of Human Kinetics, Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada
| | - Sahel Memari
- Department of Human Kinetics, Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada; CIAMS Laboratory, Université Paris-Saclay, Orsay Cedex, France; CIAMS Laboratory, Université d'Orléans, Orléans, France; Research Department, Institut Franco-Européen de Chiropraxie, 94200 Ivry-Sur-Seine, France
| | - Mariève Houle
- Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada; Department of Anatomy, Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada
| | - Yves Schwendenmann
- Department of Human Kinetics, Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada
| | - Jacques Abboud
- Department of Human Kinetics, Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada
| | - Éric Yiou
- CIAMS Laboratory, Université Paris-Saclay, Orsay Cedex, France; CIAMS Laboratory, Université d'Orléans, Orléans, France
| | - Martin Descarreaux
- Department of Human Kinetics, Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada.
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Masoudi M, Ehsani F, Hedayati R, Ramezani M, Jaberzadeh S. Different montages of transcranial direct current stimulation on postural stability in chronic low back pain patients: A randomized sham-controlled study. J Back Musculoskelet Rehabil 2024; 37:1151-1161. [PMID: 38607747 DOI: 10.3233/bmr-230229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
BACKGROUND Impairment in both the motor and cognitive aspects of postural control is a critical issue in patients with chronic low back pain (CLBP) who experience high pain anxiety (HPA). OBJECTIVE This study aimed to compare the effects of cathodal and anodal transcranial direct current stimulation (c-tDCS and a-tDCS) over the dorsolateral prefrontal cortex (DLPFC) on postural control during cognitive postural tasks in CLBP patients with HPA. METHODS This study included 66 patients randomly assigned to three groups: DLPFC a-tDCS, DLPFC c-tDCS, and sham tDCS. All groups received 20 minutes of tDCS, but the stimulation was gradually turned off in the sham group. Postural stability indices were assessed using the Biodex Balance System. RESULTS Both the a-tDCS and c-tDCS groups showed a significant reduction in most postural stability indices at static and dynamic levels after the interventions (immediately, 24 hours, and one-week follow-up) during the cognitive postural task (P< 0.01). Additionally, there was a significant improvement in postural balance in the a-tDCS and c-tDCS groups compared to the sham tDCS group (P< 0.01). Furthermore, the a-tDCS group showed significantly greater improvement than the c-tDCS group (P< 0.01). CONCLUSION Based on the results, both a-tDCS and c-tDCS over the DLPFC had positive effects on postural control during cognitive postural tasks in CLBP patients with HPA.
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Affiliation(s)
- Mona Masoudi
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Fatemeh Ehsani
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Rozita Hedayati
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Mona Ramezani
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Shapour Jaberzadeh
- Non-invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, VIC, Australia
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Luque MZ, Aguiar AF, da Silva-Araújo AK, Zaninelli TH, Heintz OK, Saraiva-Santos T, Bertozzi MM, Souza NA, Júnior EO, Verri WA, Borghi SM. Evaluation of a preemptive intervention regimen with hesperidin methyl chalcone in delayed-onset muscle soreness in young adults: a randomized, double-blinded, and placebo-controlled trial study. Eur J Appl Physiol 2023; 123:1949-1964. [PMID: 37119360 DOI: 10.1007/s00421-023-05207-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 04/19/2023] [Indexed: 05/01/2023]
Abstract
PURPOSE Delayed-onset muscle soreness (DOMS) describes an entity characterized by ultrastructural muscle damage. Hesperidin methyl chalcone (HMC) is a synthetic flavonoid presenting analgesic, anti-inflammatory, and antioxidant properties. We evaluated the effects of HMC upon DOMS. METHOD In a preventive paradigm, 31 sedentary young men were submitted to a randomized, double-blinded parallel trial and received HMC 500 mg or one placebo capsule × 3 days before an intense dynamic exercise protocol (concentric/eccentric actions) applied for lower limbs for inducing muscle damage. Assessments were conducted at baseline, and 24 and 48 h after, comprising physical performance, and post-muscle soreness and damage, inflammation, recovery of muscle strength, and postural balance associated with DOMS. HMC safety was also evaluated. Thirty participants completed the study. RESULTS HMC improved the performance of participants during exercise (40.3 vs 51.3 repetitions to failure, p = 0.0187) and inhibited CPK levels (90.5 vs 57.9 U/L, p = 0.0391) and muscle soreness during passive quadriceps palpation (2.6 vs 1.4 VAS cm, p = 0.0439), but not during active actions, nor did it inhibit IL-1β or IL-10 levels. HMC improved muscle strength recovery, and satisfactorily refined postural balance, without inducing injury to kidneys or liver. CONCLUSIONS Preemptive HMC supplementation may be beneficial for boosting physical performance and for the amelioration of clinical parameters related to DOMS, including pain on muscle palpation, increased blood CPK levels, and muscle strength and proprioceptive deficits, without causing adverse effects. These data advance the understanding of the benefits provided by HMC for DOMS treatment, which supports its usefulness for such purpose.
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Affiliation(s)
- Mônica Z Luque
- Center for Research in Health Sciences, Biological and Health Sciences Center, University of Northern Paraná, Rua Marselha, 591, Jardim Piza, Londrina, Paraná State, 86041-140, Brazil
| | - Andreo F Aguiar
- Center for Research in Health Sciences, Biological and Health Sciences Center, University of Northern Paraná, Rua Marselha, 591, Jardim Piza, Londrina, Paraná State, 86041-140, Brazil
| | - Amanda K da Silva-Araújo
- Center for Research in Health Sciences, Biological and Health Sciences Center, University of Northern Paraná, Rua Marselha, 591, Jardim Piza, Londrina, Paraná State, 86041-140, Brazil
| | - Tiago H Zaninelli
- Department of Pathology, Biological Sciences Center, Londrina State University, Londrina, Paraná State, 86057-970, Brazil
| | - Olivia K Heintz
- Vascular Biology Program, Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Telma Saraiva-Santos
- Department of Pathology, Biological Sciences Center, Londrina State University, Londrina, Paraná State, 86057-970, Brazil
| | - Mariana M Bertozzi
- Department of Pathology, Biological Sciences Center, Londrina State University, Londrina, Paraná State, 86057-970, Brazil
| | - Natália A Souza
- Ribeirão Preto College of Nursing, São Paulo University, Ribeirão Preto, São Paulo State, 1404-902, Brazil
| | - Eros O Júnior
- Center for Research in Health Sciences, Biological and Health Sciences Center, University of Northern Paraná, Rua Marselha, 591, Jardim Piza, Londrina, Paraná State, 86041-140, Brazil
| | - Waldiceu A Verri
- Department of Pathology, Biological Sciences Center, Londrina State University, Londrina, Paraná State, 86057-970, Brazil
| | - Sergio M Borghi
- Center for Research in Health Sciences, Biological and Health Sciences Center, University of Northern Paraná, Rua Marselha, 591, Jardim Piza, Londrina, Paraná State, 86041-140, Brazil.
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Ehsani F, Masoudi M, Hedayati R, Jaberzadeh S. Transcranial direct current stimulation over dorsolateral prefrontal cortex improves postural stability in non-specific chronic low back pain patients with high fear of pain: A randomized sham-controlled trial. Eur J Neurosci 2023; 58:3315-3329. [PMID: 37519282 DOI: 10.1111/ejn.16090] [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: 04/29/2022] [Revised: 05/14/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023]
Abstract
Deficits in postural stability in response to environmental challenges are seen in chronic low back pain (CLBP) patients with high fear of pain (HFP). Hence, it is essential to follow effective approaches to treat postural stability deficits and improve the health status of these patients. The current study aimed to compare the effects of cathodal and anodal transcranial direct current stimulation (c-tDCS and a-tDCS) over the left dorsolateral prefrontal cortex (DLPFC) on postural stability in non-specific CLBP patients with HFP. In this randomized clinical trial study, 75 patients were randomly assigned to left DLPFC a-tDCS, left DLPFC c-tDCS and sham stimulation groups (n = 25 in each group). All groups received a single-session 2 mA tDCS for 20 min, but the stimulation was slowly turned off after 30 s in the sham group. Before, immediately, 24 h and 1 week after the interventions, postural stability indices were assessed using a Biodex Balance System. A significant reduction in most indices was shown in both a-tDCS and c-tDCS groups after interventions (immediately, 24 h and 1 week follow-up) during static and dynamic postural tasks compared with the sham tDCS group (p < .01). In addition, some tests showed a significant difference between a-tDCS and c-tDCS (p < .05). The findings indicated positive effects of both a-tDCS and c-tDCS on the left DLPFC, with more efficacy of a-tDCS on postural stability in LBP patients with HFP.
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Affiliation(s)
- Fatemeh Ehsani
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Mona Masoudi
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Rozita Hedayati
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Shapour Jaberzadeh
- Non-invasive Brain Stimulation and Neuroplasticity, Department of Physiotherapy, Nursing and Health Sceinces, Monash University, Melbourne, Australia
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Ożóg P, Weber-Rajek M, Radzimińska A, Goch A. Analysis of Postural Stability Following the Application of Myofascial Release Techniques for Low Back Pain-A Randomized-Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2198. [PMID: 36767565 PMCID: PMC9915703 DOI: 10.3390/ijerph20032198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/24/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Low back pain (LBP) is one of the most frequently observed disorders of the musculoskeletal system in the modern population. It is suggested that myofascial disorders in the highly innervated thoracolumbar fascia (TLF), reported in patients with LBP, may be an underlying cause of the ailment. Research also confirms that patients with LBP demonstrate poorer postural stability compared with individuals without the condition. Myofascial release techniques (MFR) are additional therapeutic options that complement existing therapies and help provide a more holistic treatment for chronic LBP (CLBP). OBJECTIVE Evaluation of changes in postural stability following one MFR intervention applied to CLBP subjects immediately after manual therapy and after a month. It was hypothesized that postural stability is going to aggravate immediately after the MFR intervention and improve one month after treatment compared with the baseline results before the treatment. METHODS 113 patients with CLBP participated in a randomized-controlled trial. The experimental group (n = 59) received one MFR intervention, whereas the control group (n = 54) did not receive any therapeutic intervention. Posturography was performed to determine experimental group's immediate response to the therapy and to evaluate the experimental and control groups' responses to the therapy one month after the intervention. RESULTS Only 2 out of 12 comparisons of stabilometric parameters demonstrated reliable effects that are in line with our research hypotheses. Even though both comparisons were observed for therapy outcomes within the experimental group, no reliable differences between the groups were found. CONCLUSIONS A single MFR treatment in the TLF did not affect postural stability in CLBP patients in the experimental group. Further studies are needed to extend the findings by performing a series of holistic MFR treatments applied to a larger area of the body surface that would induce more general tissue changes and thus having a greater impact on postural stability.
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Bonnette S, Riley MA, Riehm C, DiCesare C, Christy M, Wilson J, Schille A, Diekfuss JA, Kiefer AW, Jayanthi N, Myer GD. Differences in Lower Extremity Coordination Patterns as a Function of Sports Specialization. J Mot Behav 2023; 55:245-255. [PMID: 36642425 PMCID: PMC11187714 DOI: 10.1080/00222895.2023.2166453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 09/19/2022] [Accepted: 10/24/2022] [Indexed: 01/17/2023]
Abstract
The practice of early sport specialization, defined as intense year-round training in a single sport at the exclusion of others, is increasing in youth athletics. Despite potential benefits, sport specialization may be detrimental to the health of young athletes, as specialization may increase the risk of musculoskeletal injuries-particularly overuse injuries. However, there remains limited knowledge about how sports specialization uniquely alters underlying sports-related motor behavior. The purpose of this study was to compare the variability of movement patterns exhibited by highly sports specialized youth athletes to that of nonspecialized athletes during performance of a sport-specific, virtual reality based cutting task. It was hypothesized that highly specialized athletes would display different patterns of movement coordination compared to nonspecialized athletes during both the run-up phase and cut-and-decelerate phase. In support of the hypothesis, specialized athletes exhibited both intra- and inter-limb coordination that were significantly different than unspecialized athletes. Overall, the results indicate that the highly specialized athletes tended to exhibit greater degrees of coordination but also the ability to break the coordinated patterns of joint angle changes to execute a cutting maneuver, which requires asymmetric demands on the lower extremities while planting on one leg and changing direction.
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Affiliation(s)
- Scott Bonnette
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, USA
| | - Michael A. Riley
- Department of Rehabilitation, Exercise, & Nutrition Sciences, University of Cincinnati, Cincinnati, USA
| | - Christopher Riehm
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA, USA
| | | | - Michele Christy
- University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - John Wilson
- University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Andrew Schille
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA, USA
| | - Jed A. Diekfuss
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA, USA
- Emory Sports Medicine Center, Atlanta, GA, USA
| | - Adam W. Kiefer
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Neeru Jayanthi
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA, USA
- Emory Sports Medicine Center, Atlanta, GA, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA
| | - Gregory D. Myer
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA, USA
- Emory Sports Medicine Center, Atlanta, GA, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
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Martin J, Perraton L, Gupta A, Garofolini A, Malliaras P. The use of physical function capacity measures in the management of lower limb tendinopathy: A scoping review of expert recommendations. Phys Ther Sport 2023; 59:37-48. [PMID: 36502766 DOI: 10.1016/j.ptsp.2022.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Physical function capacity measures are recommended as outcome measures for people with lower limb tendinopathy. OBJECTIVE (i) Explore measures of physical function capacity recommended by experts in lower limb tendinopathy (ii) the context they were used, (ii) identify recommended criteria for exercise progression and return to sport or activity. DESIGN Scoping Review. METHOD Three databases were searched using keywords for lower limb tendinopathy and physical function capacity to identify studies that outlined a progressive exercise rehabilitation program. A 15-item tool was used for data extraction. RESULTS 26 studies were included, only eight recommended a physical function capacity measure. There were 10 physical function capacity measures identified for a range of lower limb tendinopathies including patellar (50%), Achilles (13%), proximal hamstring (13%), gluteal (13%), combined patellar and Achilles (13%). Pain was the most common criterion that was used to determine the progression of rehabilitation (96%), with physical function capacity measures rarely used (12%). CONCLUSION Physical function capacity measures are used infrequently across expert recommended exercise rehabilitation programs. There remains a high reliance on pain as the criterion for progression of exercises during rehabilitation. There is a need to develop measures of physical function capacity to better inform and progress rehabilitation.
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Affiliation(s)
- Joel Martin
- Department of Physiotherapy, Monash University, Melbourne, Victoria, Australia.
| | - Luke Perraton
- Department of Physiotherapy, Monash University, Melbourne, Victoria, Australia
| | - Amitabh Gupta
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | | | - Peter Malliaras
- Department of Physiotherapy, Monash University, Melbourne, Victoria, Australia
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Postural sway does not differentiate individuals with chronic low back pain, single and multisite chronic musculoskeletal pain, or pain-free controls: a cross-sectional study of 229 subjects. Spine J 2022; 22:1523-1534. [PMID: 35504568 DOI: 10.1016/j.spinee.2022.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/16/2022] [Accepted: 04/26/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Physical activity in its various forms are the most recommended prevention and treatment strategy for chronic low back pain (CLBP). Standing postural stability is a prerequisite for many types of physical activities. Systematic reviews have investigated the evidence for an association between CLBP and postural stability but results remain inconclusive. PURPOSE Our primary objective was to compare postural stability between pain-free controls and subjects with CLBP with or without leg pain and single and multisite chronic musculoskeletal pain subjects. The secondary objectives were to evaluate the association between postural stability with CLBP intensity and duration, demographics, physical characteristics and validated health and pain-related patient-reported outcome measures (PROMs). STUDY DESIGN/SETTING Cross-sectional study in a private chiropractic clinic setting PATIENT SAMPLE: Subjects included 42 pain-free controls and 187 patients with chronic musculoskeletal pain divided into CLBP with or without leg pain and single and multisite pain groups. OUTCOME MEASURES Pain intensity was measured using the numerical pain rating scale, PROMs Central Sensitization Inventory, Tampa Scale of Kinesiophobia, The Depression Scale, EuroQol-5D, Roland-Morris Disability Questionnaire, and Pain and Sleep Questionnaire Three-Item Index disability. Group differences were measured using area and velocity of sway on the force plate. METHODS Postural stability was assessed using a force plate on four 60-second bipedal quiet stance tests: eyes open on a stable surface, eyes closed on a stable surface, eyes open on an unstable foam surface, eyes closed on an unstable foam surface. Following the clinic visit, subjects completed an online web-based data entry detailing pain history, demographic data, physical characteristics, pain intensity via the numerical pain rating scale, and PROMS. RESULTS Postural sway parameters did not differ between pain-free controls and subjects with CLBP with or without leg pain and single and multisite chronic musculoskeletal pain subjects. Furthermore, severity and duration of CLBP pain in addition to central sensitization, kinesiophobia, depression, quality of life, disability, and effect of pain on sleep only had very weak associations with postural stability. CONCLUSIONS Chronic musculoskeletal pain appears not to influence bipedal postural stability.
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Viseux FJF, Simoneau M, Billot M. A Comprehensive Review of Pain Interference on Postural Control: From Experimental to Chronic Pain. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58060812. [PMID: 35744075 PMCID: PMC9230450 DOI: 10.3390/medicina58060812] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/09/2022] [Accepted: 06/14/2022] [Indexed: 11/24/2022]
Abstract
Motor control, movement impairment, and postural control recovery targeted in rehabilitation could be affected by pain. The main objective of this comprehensive review is to provide a synthesis of the effect of experimental and chronic pain on postural control throughout the available literature. After presenting the neurophysiological pathways of pain, we demonstrated that pain, preferentially localized in the lower back or in the leg induced postural control alteration. Although proprioceptive and cortical excitability seem modified with pain, spinal modulation assessment might provide a new understanding of the pain phenomenon related to postural control. The literature highlights that the motor control of trunk muscles in patient presenting with lower back pain could be dichotomized in two populations, where the first over-activates the trunk muscles, and the second under-activates the trunk muscles; both generate an increase in tissue loading. Taking all these findings into account will help clinician to provide adapted treatment for managing both pain and postural control.
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Affiliation(s)
- Frédéric J. F. Viseux
- Centre d’Evaluation et de Traitement de la Douleur (CETD), Hôpital Jean Bernard, Centre Hospitalier de Valenciennes, F-59322 Valenciennes, France
- Département Sciences de l’Homme et du Vivant (SHV), Université Polytechnique Hauts-de-France (UPHF), LAMIH, CNRS, UMR 8201, F-59313 Valenciennes, France
- Correspondence:
| | - Martin Simoneau
- Département de Kinésiologie, Faculté de Médecine, Université Laval, Québec, QC G1V 0A6, Canada;
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS) du CIUSSS de la Capitale Nationale, Québec, QC G1M 2S8, Canada
| | - Maxime Billot
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, F-86000 Poitiers, France;
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Wang H, Zheng J, Fan Z, Luo Z, Wu Y, Cheng X, Yang J, Zhang S, Yu Q, Lo WLA, Wang C. Impaired static postural control correlates to the contraction ability of trunk muscle in young adults with chronic non-specific low back pain: A cross-sectional study. Gait Posture 2022; 92:44-50. [PMID: 34823100 DOI: 10.1016/j.gaitpost.2021.11.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/28/2021] [Accepted: 11/15/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Patients with chronic non-specific low back pain (CNSLBP) were found with impaired postural control in previous studies. Since the trunk muscle take important efforts on core stability, the study aimed to examine the relationships of postural control during stance tasks and the contractility of trunk muscle in young adults with CNSLBP and without. METHODS Healthy individuals (n = 25) and individuals with CNSLBP (n = 30) were included. The thickness of the bilateral transversus abdominis (TrA) and lumbar multifidus (MF) was measured during rest and maximal voluntary contraction, and the change percentages (TrA%, MF%) were calculated. Regarding postural control, COP path length and sway area during the stance tasks were measured thrice in each group. RESULTS The bilateral TrA% of the CNSLBP group was less than that of the HC group (p < 0.05). The bilateral TrA% of the CNSLBP group was less than that of the HC group (p < 0.05). The bilateral MF% showed no significantly different(p > 0.05) between the two groups. Compared with healthy controls, CNSLBP patients resulted larger path length and sway area of COP during most of static stance tasks. During the EO task in the CNSLBP group, TrA% was found correlate to COP path length (p < 0.05); the right MF% was correlated with COP sway area (p < 0.05). No significant correlations appeared in the healthy controls (p > 0.05). CONCLUSIONS Compared with healthy individuals, impaired postural control during static stance with eyes open in patients with CNSLBP was likely to be related to the poor contraction ability of bilateral transversus abdominis and correlated to the normal contraction ability of right lumbar multifidus.
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Affiliation(s)
- Hongjiang Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Jiaxuan Zheng
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Ziyan Fan
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Zichong Luo
- Department of Electromechanical Engineering, Faculty of Science and Technology, University of Macau, Macau, China
| | - Yi Wu
- School of Arts and Design, Guangdong University of Technology, Guangzhou 510080, China
| | - Xue Cheng
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Jiajia Yang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Siyun Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Qiuhua Yu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Wai Leung Ambrose Lo
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Chuhuai Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
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IS THERE A RELATIONSHIP BETWEEN PAIN, LIMITS OF STABILITY AND SENSORY INTERACTION BALANCE IN PATIENTS WITH LUMBAR DISC HERNIATION? A CROSS-SECTIONAL STUDY. INTERNATIONAL JOURNAL OF HEALTH SERVICES RESEARCH AND POLICY 2021. [DOI: 10.33457/ijhsrp.942729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Nambi G, Abdelbasset WK, Elsayed SH, Verma A, George JS, Saleh AK. CLINICAL AND PHYSICAL EFFICIENCY OF VIRTUAL REALITY GAMES IN SOCCER PLAYERS WITH LOW BACK PAIN. REV BRAS MED ESPORTE 2021. [DOI: 10.1590/1517-8692202127062021_0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Virtual reality training (VRT) is an advanced technology that creates virtual games by a computer through specific software. It is a type of rehabilitation training commonly used in balance problems to treat musculoskeletal conditions. Objective: To determine and compare the effects of virtual reality games with those of core stabilization training on physical efficiency in soccer players with chronic low back pain. Methods: A randomized, double-blinded, controlled study was conducted on 60 LBP participants at a university hospital. The first group (n=20) received virtual reality (VR) training; the second group (n=20) received core stabilization (CS) training; and the third group (n=20) received conventional training exercises for four weeks. Scores of clinical and sports performance were measured at baseline, and after 4 weeks, 8 weeks and 6 months. Results: The baseline demographic and clinical characters did not show any significant differences (p>0.05) in the statistical analysis, which shows a homogenous population. Four weeks following the training, the VR training group showed more significant changes in clinical scores than the CS training and control groups (p≤0.001). The scores for sports performance also showed more significant improvement in the VR training group than in the other two groups (p≤0.001). The same improved clinical and sports performance changes were seen at 8 weeks and 6 months of follow-up in the VR training group, when compared to the other two groups (p≤0.001). Conclusion: This study suggests that training through virtual reality games results in long-term improvement in clinical and sports performance compared to other forms of training in soccer players with chronic low back pain.Level of evidence I b; Therapeutic studies – Investigation of treatment results.
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Affiliation(s)
- Gopal Nambi
- Prince Sattam bin Abdulaziz University, Saudi Arabia
| | | | - Shereen H. Elsayed
- Princess Nourah bint Abdulrahman University, Saudi Arabia; Cairo University, Egypt
| | - Anju Verma
- Prince Sattam bin Abdulaziz University, Saudi Arabia
| | | | - Ayman K. Saleh
- Prince Sattam Bin Abdulaziz University, Saudi Arabia; Al-Azhar University, Egypt
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A Study on the Relationship between Postural Control and Pain-Related Clinical Outcomes in Patients with Chronic Nonspecific Low Back Pain. Pain Res Manag 2021; 2021:9054152. [PMID: 34765050 PMCID: PMC8577937 DOI: 10.1155/2021/9054152] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/22/2021] [Accepted: 10/16/2021] [Indexed: 11/17/2022]
Abstract
Objectives To explore the relationship between postural control and pain-related clinical outcomes in patients with chronic nonspecific low back pain (cNLBP). Methods Participants with cNLBP and healthy individuals were recruited. Muscle activities were recorded during internal and external perturbation tasks. Postural control capacity was assessed by muscle onset time and integrals of electromyography (iEMGs) of postural muscles during the phases of anticipatory postural adjustments (APAs) and compensatory postural adjustments (CPAs). Correlation analysis was employed to investigate the relationship between postural control capacity, pain, and disability. Results Twenty-seven patients with cNLBP and 27 healthy participants were recruited. Gastrocnemius (GA) muscle onset time was earlier in the cNLBP group than in the control group in the internal perturbation task. The onset time of GA and erector spinae (ES) of the cNLBP group was later than that of the controls in the external perturbation task. Disability level moderately correlated with the iEMGs of rectus abdominis (RA), GA, and external oblique (EO) during APAs. Pain score moderately correlated with the iEMGs of RA, EO, and ES during CPAs of perturbation tasks. Conclusion cNLBP participants had altered muscle activation strategy to maintain postural stability in response to perturbation. This study further discovered that pain-related disabilities of cNLBP participants were likely related to the APAs capacity, whereas the pain intensity may relate to the CPAs capacity. Pain and disability may therefore be related to the control process of the posture-related muscles.
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Impairment of Proprioception in Young Adult Nonradicular Patients with Lumbar Derangement Syndrome. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5550257. [PMID: 34660792 PMCID: PMC8516538 DOI: 10.1155/2021/5550257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 08/17/2021] [Accepted: 09/07/2021] [Indexed: 11/17/2022]
Abstract
Maintaining body balance is a complex function based on the information deriving from the vestibular, visual, and proprioceptive systems. The aim of the study was to evaluate quiet single stance stability in young adults with lumbar derangement syndrome (LDS) and in the control group of the healthy subjects. The second aim of this study was to determine whether pain intensity, degree of disability, and the level of physical activity can influence postural control in patients with LDS. It is important to underline that selecting a homogeneous group of LBP patients using, for example, mechanical diagnosis and therapy method and Quebec Task Force Classification, can result in an increased sensitivity of the study. The study included 126 subjects: 70 patients with LDS (37 women, 33 men) and the control group 56 healthy volunteers (36 women, 20 men). In case of multiple group comparisons for variables with normal distribution, ANOVA post hoc test was used or, as the nonparametric equivalent, Kruskal-Wallis test. In all these calculations, the statistical significance level was set to p < 0.05. The stability index eyes open for the study group was 88.34 and for the control group 89.86. There was no significant difference in the level of postural control between the study and control groups (p > 0.05). The level of stability index eyes closed (SI EC) for the study group was 71.44 and for the control group 77.1. SI EC results showed significant differences in proprioceptive control during single leg stance between the study and control groups (p < 0.05). The level of pain intensity, the degree of disability, and physical activity level did not influence postural control in the study group with LDS. In summary, patients with LDS showed significantly worse proprioceptive control.
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Uçar İ, Karartı C, Cüce İ, Veziroğlu E, Özüdoğru A, Koçak FA, Dadalı Y. The relationship between muscle size, obesity, body fat ratio, pain and disability in individuals with and without nonspecific low back pain. Clin Anat 2021; 34:1201-1207. [PMID: 34378252 DOI: 10.1002/ca.23776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/08/2021] [Accepted: 08/08/2021] [Indexed: 01/24/2023]
Abstract
Patients with nonspecific low back pain (NSLBP) may face motor control problems and health disability barriers during various tasks. However, studies investigating the extent of these disadvantages, and possible associated factors are quite limited in patients with NSLBP. To compare motor control performances and physical assessment domains between patients with NSLBP and asymptomatic controls. Twenty-seven patients with NSBLP and 27 age- and sex-matched asymptomatic controls participated in this cross-sectional study. Ultrasonographic imaging was used to determine abdominal and multifidus muscles thicknesses and adipose tissue rate. Visual analog scale was used to assess LBP severity. Body mass index (BMI) and Oswestry Disability Index (ODI) scores of the participants were physical assessment domains of LBP. BMI values were greater in the NSLBP group compared to the asymptomatic participants. ANCOVA revealed a significant interaction effect regarding external abdominal oblique and multifidus lumborum muscles thickness, and abdominal adipose tissue (p = 0.015; p = 0.001; p = 0.006), respectively in terms of two groups. The thicknesses of these muscles were lesser in the NSLBP group compared with the control group. Similarly, abdominal adipose tissue was higher in the NSLBP group. The stepwise multiple regression analysis demonstrated that the Oswestry Disability Index and abdominal adipose tissue rate were significant and independent factors of the low back pain severity with 73.5% of the variance. The study results indicate that increased disability and fat infiltration are possible determinants influencing pain severity, although further research is required. Examining musculoskeletal properties of lumbar region could provide information about the limitation in patients with NSBLP.
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Affiliation(s)
- İlyas Uçar
- Department of Anatomy, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Caner Karartı
- Department of Physiotherapy and Rehabilitation, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - İsa Cüce
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Enes Veziroğlu
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Anıl Özüdoğru
- Department of Physiotherapy and Rehabilitation, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Fatmanur Aybala Koçak
- Physical Medicine and Rehabilitation, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Yeliz Dadalı
- Department of Radiology, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, Turkey
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Wu Z, Wang Y, Ye X, Chen Z, Zhou R, Ye Z, Huang J, Zhu Y, Chen G, Xu X. Myofascial Release for Chronic Low Back Pain: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2021; 8:697986. [PMID: 34395477 PMCID: PMC8355621 DOI: 10.3389/fmed.2021.697986] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 07/05/2021] [Indexed: 01/04/2023] Open
Abstract
Background: Chronic low back pain (CLBP) is one of the most common musculoskeletal diseases in the elderly, which has a severe impact on the health of the elderly. However, CLBP treatment is very challenging, and more effective treatment methods are needed. Myofascial release may be an effective therapy for the management of chronic musculoskeletal pain. It is widely used clinically to treat CLBP, but its clinical efficacy is still controversial. Objective: This study aims to systematically evaluate the effectiveness of myofascial release for patients with CLBP. Methods: We selected PubMed, Cochrane Library, EMBASE database, and Web of Science database articles published until April 5, 2021. Randomized controlled trials (RCTs) of myofascial release for CLBP were included. Outcome measures included pain, physical function, quality of life, balance function, pain pressure-threshold, trunk mobility, and mental health. For each outcome, Standardized mean differences (SMD) or mean differences (MD) and 95% confidence intervals (CIs) were calculated. Results: Eight RCTs (n = 375) were included based on inclusion and exclusion criteria. The meta-analysis showed that the overall efficacy of myofascial release for CLBP was significant, including two aspects: pain [SMD = -0.37, 95% CI (-0.67, -0.08), I 2 = 46%, P = 0.01] and physical function [SMD = -0.43, 95% CI (-0.75, -0.12), I 2 = 44%, P = 0.007]. However, myofascial release did not significantly improve quality of life [SMD = 0.13, 95% CI (-0.38, 0.64), I 2 = 53%, P = 0.62], balance function [SMD = 0.58, 95% CI (-0.49, 1.64), I 2 = 82%, P = 0.29], pain pressure-threshold [SMD = 0.03,95% CI (-0.75, 0.69), I 2 = 73%, P = 0.93], trunk mobility [SMD = 1.02, 95% CI (-0.09, 2.13), I 2 = 92%, P = 0.07] and mental health [SMD = -0.06, 95% CI (-0.83, 0.71), I 2 = 73%, P = 0.88]. Conclusions: In this study, we systematically reviewed and quantified the efficacy of myofascial release in treating CLBP. The meta-analysis results showed that myofascial release significantly improved pain and physical function in patients with CLBP but had no significant effects on balance function, pain pressure-threshold, trunk mobility, mental health, and quality of life. However, due to the low quality and a small number of included literature, more and more rigorously designed RCTs should be included in the future to verify these conclusions.
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Affiliation(s)
- Zugui Wu
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi Wang
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiangling Ye
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zehua Chen
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Rui Zhou
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zixuan Ye
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jinyou Huang
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
| | - Yue Zhu
- Baishui Health Center, Qujing, China
| | - Guocai Chen
- Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xuemeng Xu
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
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Chaari F, Rebai H, Boyas S, Rahmani A, Fendri T, Harrabi MA, Sahli S. Postural balance impairment in Tunisian second division soccer players with groin pain: A case-control study. Phys Ther Sport 2021; 51:85-91. [PMID: 34303123 DOI: 10.1016/j.ptsp.2021.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare postural balance outcomes between soccer players with and without groin pain (GP). DESIGN Case-control study. SETTING Laboratory. PARTICIPANTS Fifty-four soccer players, 27 with GP (GP group: GPG) and 27 healthy ones (control group: CG). MAIN OUTCOME MEASURES Static and dynamic postural balance were assessed with a force platform and Y-balance test (Y-BT), respectively. Hip abduction, internal rotation (IR), external rotation (ER) and total rotation (TR) of both limbs were evaluated. RESULTS The GPG exhibited significant higher centre of pressure values in the bipedal posture only on the foam surface in eyes opened and closed compared to controls. Besides, they had lower anterior, posteromedial and posterolateral reach distances and composite Y-BT score on the injured limb (IL) compared to non-injured limb (NIL) and dominant-limb (DL) of the CG. Moreover, they showed lower abduction, IR, ER, and TR on the IL compared to NIL and DL. CONCLUSIONS Dynamic unipedal postural balance disorder could be one of the limiting factors of performance in soccer players with non-time loss GP. Hence, postural balance data in these players could enable sport coaches and physical therapists to better understand the mechanisms contributing for performance decrease.
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Affiliation(s)
- Fatma Chaari
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Haithem Rebai
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Sébastien Boyas
- Le Mans University, MIP, EA, 4334, Laboratory "Movement, Interactions, Performance", Faculty of Sciences and Technologies, Department of Sport Sciences, Le Mans, France.
| | - Abderrahmane Rahmani
- Le Mans University, MIP, EA, 4334, Laboratory "Movement, Interactions, Performance", Faculty of Sciences and Technologies, Department of Sport Sciences, Le Mans, France.
| | - Thouraya Fendri
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Mohammed A Harrabi
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Sonia Sahli
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
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Nambi G, Abdelbasset WK, Alqahatani BA. Radiological (Magnetic Resonance Image and Ultrasound) and biochemical effects of virtual reality training on balance training in football players with chronic low back pain: A randomized controlled study. J Back Musculoskelet Rehabil 2021; 34:269-277. [PMID: 33285623 DOI: 10.3233/bmr-191657] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Virtual reality training is commonly used for balance problems in neurological conditions with the use of visual and auditory biofeedback. The knowledge about the effective implementation of this training in chronic low back pain is lacking. OBJECTIVE The objective of this study is to find the radiological and biochemical effects of virtual reality training in football players with chronic low back pain. METHODS A randomized, single-blinded controlled study was conducted on 36 participants. The first group received virtual reality training (VRT; n= 12), the second group received combined physical rehabilitation (CPR; n= 12), and the third group (control group; n= 12) received conventional training exercises for four weeks. Radiological (muscle cross-sectional area and muscle thickness) and biochemical (CRP, TNF-α, IL-2, IL-4, IL-6) values were measured at baseline and after four weeks. RESULTS Four weeks following training, the VRT group showed more significant changes in the muscle cross-sectional area than the CPR and control groups (p⩽ 0.001). Biochemical measures such as CRP, TNF-α, IL-2, IL-4, and IL-6 also showed significant improvement in the VRT group compared to the other two groups (p⩽ 0.001). CONCLUSION The results show that virtual reality training has positive effects on the radiological and biochemical aspects in university football players with chronic low back pain.
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Affiliation(s)
- Gopal Nambi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Walid Kamal Abdelbasset
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia.,Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt
| | - Bader A Alqahatani
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
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Sipko T, Glibowski E, Kuczyński M. Acute effects of proprioceptive neuromuscular facilitation exercises on the postural strategy in patients with chronic low back pain. Complement Ther Clin Pract 2021; 44:101439. [PMID: 34246129 DOI: 10.1016/j.ctcp.2021.101439] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/15/2021] [Accepted: 07/03/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Active treatments focused on improvement in motor function are postulated in chronic low back patients (CLBP). OBJECTIVE to establish the acute effects of PNF exercise on the postural control strategy. METHODS The sway of the body was tested before intervention in fifty-three CLBP patients and after that participants were randomly assigned into the intervention PNF group (n = 25). Mean velocity (VEL) and sample entropy (SEn), over the center of pressure in the mediolateral (ML) and anterior-posterior (AP) planes served to estimate the postural strategy and automaticity levels in the neuromuscular controller. Tandem and one-leg standing tests (OLST) with eyes open and eyes closed were used. RESULTS Pain intensity decreased after the intervention. The VEL was no longer vision-dependent in both planes. The SEn decreased immediately after the exercise and either returned to or even exceeded the baseline values in the OLST ML plane. CONCLUSION A single session of PNF exercise may have a beneficial effect on pain and postural control in CLBP patients. The statistically significant pain relief combined with newly acquired better control of posture may have encouraged the PNF group participants to a subconscious exploration of the stability area. Postural movements were more automatized in OLST in the delayed test.
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Affiliation(s)
- Tomasz Sipko
- Faculty of Physiotherapy, University School of Physical Education in Wrocław, Al Ignacego Jana Paderewskiego 35, 51-612, Wrocław, Poland.
| | - Edmund Glibowski
- Faculty of Physiotherapy, University School of Physical Education in Wrocław, Al Ignacego Jana Paderewskiego 35, 51-612, Wrocław, Poland
| | - Michał Kuczyński
- Faculty of Physiotherapy, University School of Physical Education in Wrocław, Al Ignacego Jana Paderewskiego 35, 51-612, Wrocław, Poland; Department of Biomechanics, Opole University of Technology, Ul. Prószkowska 76, 45-758, Opole, Poland
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Bousbaïne van de Kerckhove L, Lefaucheur JP, Sorel M. Differences in stabilometric correlates of pain relief after wearing postural insoles for six weeks between chronic nociceptive and neuropathic foot pain. An open-label pilot study. Neurophysiol Clin 2021; 51:267-278. [PMID: 34023188 DOI: 10.1016/j.neucli.2021.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/25/2021] [Accepted: 04/25/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE The aim of this study was to determine if the use of postural insoles could result in a noticeable reduction in the foot pain intensity in patients with a chronic pain condition, either nociceptive (ankylosing spondylitis, AS) or neuropathic (small fiber neuropathy, SFN). METHOD In this open-label pilot study, patients were asked to wear postural insoles for a continuous period of 6 weeks. The primary endpoint was the mean daily pain intensity at foot mobilization measured using a visual analogue scale (VAS). The secondary endpoints included global pain intensity scores (at rest or under mobilization), clinical questionnaires on pain and daily functioning (including the Brief Pain Inventory (BPI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Neuropathic Pain Symptom Inventory (NPSI) and the DN4 questionnaire), and posturo-podiatric variables assessed on clinical examination or using a baro-stabilometric platform. RESULTS The study was completed by 17 patients with AS and 12 patients with SFN. After wearing postural insoles for 6 weeks, a significant improvement was observed on the primary endpoint (decrease in VAS pain score at the foot during mobilization) in both groups of patients (from 6.4 ± 2.4 to 3.6 ± 2.6 (p = 0.0004) in the AS group and from 5.7 ± 2.2 to 2.4 ± 1.6 (p = 0.0003) in the SFN group). Improvement was also observed for all other pain and activity scores (global pain at rest or during mobilization (VAS), BDI, and BASDAI for the AS group or NPSI and DN4 for the SFN group), as well as for posturo-podiatric clinical variables. However, we did not find any difference in any clinical pain score whether the posturo-podiatric clinical outcomes were positive or not. Regarding the stabilometric measures, the only significant change after the intervention was a reduced mean velocity of center of pressure displacement in the AS group only (mVel in mm/s: from 7.4 ± 2.0 vs. 6.7 ± 1.9, p = 0.017). In addition, the reduction in mVel correlated to that of the BPI score (r = 0.48, p = 0.0496). CONCLUSION In both groups of patients, wearing postural insoles for 6 weeks led to a significant decrease in local pain intensity at foot level and to more global analgesic effects and positive posturo-podiatric changes. However, these latter changes did not appear to be strongly associated with pain relief. Nevertheless, an index of a better postural control, i.e. mVel decrease, was found to be related to a reduction of pain interference in daily life activities in AS patients, but not in SFN patients. Therefore, in the context of neuropathic pain, mechanisms other than postural changes likely contribute to the analgesic effects of wearing postural insoles, in contrast to nociceptive pain due to spinal osteoarthritis.
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Affiliation(s)
- Leïla Bousbaïne van de Kerckhove
- Univ Paris Est Creteil, EA4391, ENT, F-94010 Creteil, France; Osteopathic Office, 123 rue de l'Université, F-75007 Paris, France.
| | - Jean-Pascal Lefaucheur
- Univ Paris Est Creteil, EA4391, ENT, F-94010 Creteil, France; AP-HP, Henri Mondor University Hospital, Clinical Neurophysiology Unit, F-94010 Creteil, France
| | - Marc Sorel
- Univ Paris Est Creteil, EA4391, ENT, F-94010 Creteil, France; CH Sud-Seine-et-Marne, Pain Clinic (Centre d'Evaluation et Traitement de la Douleur), F-77140 Nemours, France
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26
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Šarabon N, Vreček N, Hofer C, Löfler S, Kozinc Ž, Kern H. Physical Abilities in Low Back Pain Patients: A Cross-Sectional Study with Exploratory Comparison of Patient Subgroups. Life (Basel) 2021; 11:life11030226. [PMID: 33802214 PMCID: PMC8000067 DOI: 10.3390/life11030226] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/06/2021] [Accepted: 03/07/2021] [Indexed: 11/29/2022] Open
Abstract
An abundance of literature has investigated the association between low back pain (LBP) and physical ability or function. It has been shown that LBP patients display reduced range of motion, decreased balance ability, impaired proprioception, and lower strength compared to asymptomatic persons. The aim of this study was to investigate the differences between LBP patients and healthy controls in terms of several physical abilities. Based on the premised that different biomechanical and physiological causes and consequences could be related to different types of LBP, a secondary exploratory attempt of the study was to examine the differences between LBP subgroups based on the pain location (local or referred) or type of pathology (discogenic or degenerative) on the level of impairment of function and ability. Participants performed range of motion tests, trunk maximal voluntary contraction force tests, a sitting balance assessment, the timed up-and-go test, the chair rise test, and the trunk reposition error test. Compared to the control group, symptomatic patients on average showed 45.7% lower trunk extension (p < 0.001, η2 = 0.33) and 27.7 % lower trunk flexion force (p < 0.001, η2 = 0.37) during maximal voluntary contraction. LBP patients exhibited decreased sitting balance ability and lower scores in mobility tests (all p < 0.001). There were no differences between groups in Schober’s test and trunk repositioning error (p > 0.05). No differences were observed among the LBP subgroups. The exploratory analyses are limited by the sample size and uncertain validity of the diagnostic procedures within this study. Further studies with appropriate diagnostic procedures and perhaps a different subgrouping of the LBP patients are needed to elucidate if different types of LBP are related to altered biomechanics, physiology, and function.
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Affiliation(s)
- Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, 6310 Izola, Slovenia; (N.V.); (Ž.K.)
- Laboratory for Motor Control and Motor Behaviour, S2P, Science to Practice Ltd., 1000 Ljubljana, Slovenia
- Human Health Department, InnoRenew CoE, 6310 Izola, Slovenia
- Correspondence:
| | - Nace Vreček
- Faculty of Health Sciences, University of Primorska, 6310 Izola, Slovenia; (N.V.); (Ž.K.)
| | - Christian Hofer
- Ludwig Boltzmann Institute for Rehabilitation Research, 3100 St. Pölten, Austria; (C.H.); (S.L.)
| | - Stefan Löfler
- Ludwig Boltzmann Institute for Rehabilitation Research, 3100 St. Pölten, Austria; (C.H.); (S.L.)
- Institute for Physical Medicine, Physiko und Rheumatherapie, 3100 St. Pölten, Austria;
| | - Žiga Kozinc
- Faculty of Health Sciences, University of Primorska, 6310 Izola, Slovenia; (N.V.); (Ž.K.)
- Andrej Marušič Institute, University of Primorska, 6000 Koper, Slovenia
| | - Helmut Kern
- Institute for Physical Medicine, Physiko und Rheumatherapie, 3100 St. Pölten, Austria;
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Manetti R, Manzoni D, Orsini P, Sebastiani L, Santarcangelo EL. Postural effects of interoceptive imagery as a function of hypnotizability. Physiol Behav 2021; 229:113222. [PMID: 33127462 DOI: 10.1016/j.physbeh.2020.113222] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 10/20/2020] [Accepted: 10/24/2020] [Indexed: 11/30/2022]
Abstract
The aim of the study was to investigate the effects of pleasant and unpleasant interoceptive imagery on postural control in participants with different hypnotizability, interoceptive sensibility and ability of imagery. Forty-one healthy individuals classified as high (highs), medium (mediums) and low hypnotizables (lows) according to the Stanford Hypnotic Susceptibility Scale, form A (SHSS, A) were characterized for Interoceptive Sensitivity (IS) through the Multisensory Assessment of Interoceptive Awareness (MAIA) and for organic mental imagery (ORG) through Betts' questionnaire. The experimental session included baseline closed eyes conditions preceding tasks of pleasant (P) and unpleasant imagery (U) and a neutral cognitive task (NT) while standing on a stabilometric platform. Subjective reports of vividness and pleasantness/unpleasantness of mental images were collected. Postural variables, ECG and pneumogram were acquired. Highs exhibited greater vividness of imagery than mediums/lows and larger Area of the Centre of Pressure (CoP), while mediums and lows decreased it during all tasks with respect to baseline conditions. Significant differences moderated by IS and ORG were found between highs and lows in the CoP Area. In all groups significant task related differences in the CoP Area were moderated only by IS. Cardiovascular variables were similar in the three groups, but differed among tasks and were influenced by IS and ORG. Our findings extend earlier observations on the role of hypnotisability in the postural correlates of sensorimotor imagery to interoceptive imagery, support the hypothesis that interoceptive sensibility moderates postural control and cardiorespiratory variables during interoceptive imagery, and confirm earlier reports of the absence of hypnotisability-related modulation of cardiorespiratory variables during emotional tasks.
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Affiliation(s)
- Rachele Manetti
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Diego Manzoni
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Paolo Orsini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Laura Sebastiani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Enrica L Santarcangelo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
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Eker Y, Belgen Kaygısız B. The effect of pain severity on balance, postural stability and fall risk in patients with shoulder pathologies. Arch Med Sci 2021; 17:390-396. [PMID: 33747275 PMCID: PMC7959054 DOI: 10.5114/aoms.2020.94491] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 03/05/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The study aimed to investigate how pain severity in the shoulder region affects balance ability, postural stability and fall risk. MATERIAL AND METHODS Sixty participants with shoulder pain, aged 42.45 ±6.51 years, were assessed using a Visual Analog Scale (VAS); they were divided into 2 subgroups as a mild pain group (group 1) and a moderate/severe pain group (group 2). According to VAS-at rest the mild-pain group included 39 and the moderate/severe-pain group included 21 subjects. According to VAS-during movement, the mild-pain group included 19 and the moderate/severe-pain group included 41 subjects. Balance ability-postural stability, fall risk and fear of falling were assessed by the Sportkat System, Berg Balance Scale (BBS), and Fall Efficacy scale (FES) respectively. Differences of variables between mild pain and moderate/severe pain groups were analyzed by the independent groups t-test in groups conforming to a normal distribution and the Mann-Whitney U test for the variables that did not fit a normal distribution. RESULTS A positive relationship was found between VAS-at rest and double-foot static balance test score right-left (RL) ratio, while a negative relationship was found between VAS-at rest and BBS score (p < 0.05). Significant differences were found between right foot static balance left score and RL ratio according to pain at rest (p < 0.05). CONCLUSIONS The results indicated that shoulder pain severity affects balance parameters. As pain level at rest increases, postural sway increases in a medio-lateral direction, and towards the left while standing on the right foot. Approaches regarding increasing balance and postural instability should be included in physiotherapy and rehabilitation programs of patients with shoulder pain at an early phase to protect patients from balance problems and fall risk.
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Affiliation(s)
- Yonca Eker
- Physiotherapy Unit, Dr. Burhan Nalbantoğlu State Hospital, Nicosia, Northern Cyprus, Mersin, Turkey
| | - Beliz Belgen Kaygısız
- European University of Lefke, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Lefke, Northern Cyprus, Mersin, Turkey
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Nambi G, Abdelbasset WK, Alsubaie SF, Moawd SA, Verma A, Saleh AK, Ataalla NN. Isokinetic training - its radiographic and inflammatory effects on chronic low back pain: A randomized controlled trial. Medicine (Baltimore) 2020; 99:e23555. [PMID: 33371083 PMCID: PMC7748199 DOI: 10.1097/md.0000000000023555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 11/02/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Isokinetic training (IKT) and core stabilization training (CST) are commonly used for balance training in musculoskeletal conditions. The knowledge about the effective implementation of these training protocols on radiological and biochemical effects in university football players with chronic low back pain (LBP) is lacking. OBJECTIVE To find and compare the effects of isokinetic training and CST on radiological and biochemical effects in university football players with chronic LBP. DESIGN Randomized, double-blinded controlled study. SETTING University hospital. PARTICIPANTS 60 LBP participants were randomized into isokinetic group (IKT; n = 20), core stabilization group (CST; n = 20) and the control group (n = 20) and received respective exercises for 4 weeks. OUTCOME MEASURES Radiological (muscle cross sectional area & muscle thickness) and biochemical (C-reactive protein, tumor necrosis factor -α, interleukin [IL]-2, IL-4, IL-6) values were measured at baseline and after 4 weeks (immediate effect). RESULTS The reports of the IKT, CST and control group were compared between the groups. Four weeks following training IKT group shows more significant changes in muscle cross sectional area (Psoas Major, Quadratus Lumborum, Multifidus and Erector Spinae muscles) and muscle thickness (Multifidus) than CST and control groups (p < 0.001). Biochemical measures such as C-reactive protein, tumor necrosis factor -α, IL-2, IL-4 and IL-6 also show significant improvement in IKT group than the other 2 groups (P < .001). CONCLUSION Training through Isokinetic is an effective treatment program than conventional exercise programs in the aspect of radiological and biochemical analysis in university football players with chronic LBP, which may also help to prevent further injury. The present study can be used to improve the physical therapist's knowledge and clinical decision skills on LBP in football players.
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Affiliation(s)
- Gopal Nambi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Walid Kamal Abdelbasset
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
- Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt
| | - Saud F. Alsubaie
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Samah A. Moawd
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
- Department of Physical Therapy for Cardiovascular/Respiratory disorder and Geriatrics, Faculty of physical therapy, Cairo University, Giza, Egypt
| | - Anju Verma
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Ayman K. Saleh
- Department of Surgery, College of Medicine, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Department of Orthopedic, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Nahla N. Ataalla
- Department of Radiological Sciences and Medical Imaging, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Saudi Arabia
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Pan F, Zhu R, Zander T, Lu S, Schmidt H. The sagittal sways of back lordosis and sacral orientation during still standing at different arm positions. J Biomech 2020; 114:110149. [PMID: 33271471 DOI: 10.1016/j.jbiomech.2020.110149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 10/29/2020] [Accepted: 11/21/2020] [Indexed: 11/25/2022]
Abstract
Lumbo-pelvic parameters in the sagittal plane are normally measured from lateral radiographs obtained at a single time point during upright standing with arms held forward to expose anatomical bony structures. However, the human trunk naturally sways during still standing, which potentially alters the targeted parameters. We therefore aimed to investigate the effect of postural sway on lumbo-pelvic parameters during still standing at different arm positions. A non-radiological back measurement device was used to determine the absolute changes of back lordosis and sacral orientation during one-minute still standing while participants (10 males and 10 females without low back pain) held their arms at eight different positions. When the arms were freely hanging down at both sides, males displayed median values of 25.2° (range: 15.6-45.0°) and 7.4° (range: 2.0-26.7°) for back lordosis and sacral orientation, which were smaller than those of 33.1° (range: 11.9-41.9°) and 16.1° (range: 0.8-22.8°) for females, respectively (P < 0.05). At the same arm position, the median values were 2.7° (range: 1.3-5.2°) and 2.9° (range: 1.6-4.5°) for change of back lordosis and change of sacral orientation, respectively. Sex displayed no significant influence for both measures. Different arm positions non-significantly affected the change of back lordosis. When hands rested on horizontal bars, the change of sacral orientation was significantly less than during other arm positions (P < 0.05). Hence, back lordosis and sacral orientation inherently change during still standing, independently of sex and arm position, which could compromise the reliability of measurements at a single time point. When categorizing subjects into groups with normal or abnormal lumbo-pelvic balance, this variability should be taken into consideration.
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Affiliation(s)
- Fumin Pan
- Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China; Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration (Tongji University), Ministry of Education, 389 Xincun Road, 200065 Shanghai, China; Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Rui Zhu
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration (Tongji University), Ministry of Education, 389 Xincun Road, 200065 Shanghai, China
| | - Thomas Zander
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Shibao Lu
- Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Hendrik Schmidt
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.
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Pain Catastrophizing Is Related to Static Postural Control Impairment in Patients with Nonspecific Chronic Low Back Pain: A Cross-Sectional Study. Pain Res Manag 2020; 2020:9629526. [PMID: 33193926 PMCID: PMC7641713 DOI: 10.1155/2020/9629526] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/01/2020] [Accepted: 10/10/2020] [Indexed: 12/29/2022]
Abstract
Purpose Pain catastrophizing may contribute to the altered trunk muscle activity in patients with nonspecific chronic low back pain (NSCLBP). It is unclear if pain catastrophizing influences static postural control in patients with NSCLBP. This study aimed to investigate the relationship between pain catastrophizing and static postural control in NSCLBP patients. Methods Sixty-eight participants with NSCLBP and 40 healthy participants were recruited. Postural control was assessed by the sway area and the sway length of the center of pressure (COP) during balance tests. Pain catastrophizing in participants with NSCLBP was assessed by the Pain Catastrophizing Scale (PCS). Bilateral transversus abdominis (TrA) activation was evaluated by ultrasound imaging-measured percent change in muscle thickness. Associations between COP parameter and PCS/subscales of PCS were examined by multiple linear regression (MLR). Results Our results observed a larger COP sway area in NSCLBP group under eyes-closed condition (p < 0.001) and a lower level of voluntary activation of the bilateral TrA (p < 0.001), compared with the healthy control group. The MLR analyses revealed that the COP area sway under eyes-closed condition was significantly associated with the PCS score/helplessness score of PCS, voluntary activation of the left TrA, and age in participants with NSCLBP (β = 0.222/0.236, 0.341/0.344, and 0.328/0.325; p=0.045/0.033, 0.002, and 0.004, resp.). Conclusions Static postural control was associated with pain catastrophizing, voluntary activation of TrA, and age in participants with NSCLBP. This indicated that pain catastrophizing may affect postural control and should be considered when interpreting balance test results and managing NSCLBP.
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Bataller-Cervero AV, Cimarras-Otal C, Roche-Seruendo LE, Alcázar-Crevillén A, Villalba-Ruete JA, Berzosa C. Static Balance Modification during the Workday in Assembly Chain Workers with and without Current Low Back Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207385. [PMID: 33050448 PMCID: PMC7600820 DOI: 10.3390/ijerph17207385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/06/2020] [Accepted: 10/08/2020] [Indexed: 11/16/2022]
Abstract
Background: Low back pain (LBP) is a common recurrent pathology among assembly chain workers. This population tends to spend most of the workday in a static standing posture and handling loads, with balance being essential for correct job performance. LBP is related to poorer postural control, so balance could be affected in this condition. Methods: The purpose of the present study is to analyze the deterioration of static balance generated by work activity in a prolonged standing position. We assess sway with a pressure platform at three moments of the workday (before, during, and after work), comparing the different balance parameters in 22 manufacturing plant workers with (17) and without (5) LBP. Results: In the pre-work capture, an independent t-test showed no significant differences between the pain and non-pain groups’ static balance parameters. Between the pre- and mid-workday captures, a two-way ANOVA with repeated measures showed a significant decrease in the medial-lateral center of pressure displacement with open eyes in workers with LBP. Conclusions: workers with low back pain do not show a greater deterioration in static balance than workers without pain during the workday.
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Affiliation(s)
- Ana Vanessa Bataller-Cervero
- Facultad de Ciencias de la Salud, Universidad San Jorge, 50830 Villanueva de Gállego, Spain; (A.V.B.-C.); (L.E.R.-S.); (C.B.)
| | - Cristina Cimarras-Otal
- Facultad de Ciencias de la Salud, Universidad San Jorge, 50830 Villanueva de Gállego, Spain; (A.V.B.-C.); (L.E.R.-S.); (C.B.)
- Correspondence:
| | - Luis Enrique Roche-Seruendo
- Facultad de Ciencias de la Salud, Universidad San Jorge, 50830 Villanueva de Gállego, Spain; (A.V.B.-C.); (L.E.R.-S.); (C.B.)
| | | | | | - César Berzosa
- Facultad de Ciencias de la Salud, Universidad San Jorge, 50830 Villanueva de Gállego, Spain; (A.V.B.-C.); (L.E.R.-S.); (C.B.)
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Nogueira JF, Carrasco AC, Pelegrinelli ARM, Guenka LC, Silva MF, Dela Bela LF, Dias JM, Moura FA, McVeigh JG, Cardoso JR. Posturography Comparison and Discriminant Analysis Between Individuals With and Without Chronic Low Back Pain. J Manipulative Physiol Ther 2020; 43:469-475. [PMID: 32718710 DOI: 10.1016/j.jmpt.2019.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 01/13/2019] [Accepted: 01/30/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aims of this study were to evaluate the center of pressure (CoP) in individuals with chronic low back pain (LBP) compared with matched controls and perform discriminant analysis to detect which CoP variables differentiate the groups. METHODS Thirty-two participants with LBP and 33 matched controls were evaluated on a force plate in a bipedal static position for 30 seconds in 2 conditions: eyes open (EO) and eyes closed (EC). Two discriminant analyzes were performed to detect which CoP variables could discriminate between groups. RESULTS Those with LBP had higher values (ie, poorer balance) for most variables compared with the control group. With EO, total displacement of sway (TDS) was as follows: LBP group (median [25%-75%]) 31.77 (26.39-41.79) cm, control group 27.21 (22.29-31.78) cm, P = .008 and area: LBP group 3.31 (2.33-4.68) cm2, control group 1.77 (1.3-2.71) cm2. With EC, TDS was as follows: LBP group 49.6 (39.65-68.15) cm, control group 38.77 (30.36; 45.65) cm, P = .003 and area: LBP group 4.68 (2.6-7.28) cm2, control group 2.4 (2.1-3.34) cm2. The discriminating variables in the EO condition were the TDS for the LBP group and the anteroposterior mean velocity for the control group, while in the EC condition they were mediolateral dispersion and area for the LBP group. CONCLUSION Individuals with chronic LBP had worse postural control performance than matched controls, and it is possible to characterize those with and without LBP with CoP variables.
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Affiliation(s)
- Jéssyca Fernandes Nogueira
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Aline Cristina Carrasco
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Alexandre Roberto M Pelegrinelli
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, Paraná, Brazil; Laboratory of Applied Biomechanics, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Leandro Caetano Guenka
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Mariana Felipe Silva
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Laís Faganello Dela Bela
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Josilainne Marcelino Dias
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Felipe Arruda Moura
- Laboratory of Applied Biomechanics, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Joseph Gerard McVeigh
- School of Clinical Therapies, College of Medicine and Health, University College Cork. Cork, Ireland
| | - Jefferson Rosa Cardoso
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, Paraná, Brazil.
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Comparative Effects of Isokinetic Training and Virtual Reality Training on Sports Performances in University Football Players with Chronic Low Back Pain-Randomized Controlled Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:2981273. [PMID: 32617104 PMCID: PMC7315304 DOI: 10.1155/2020/2981273] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/15/2020] [Accepted: 05/30/2020] [Indexed: 12/19/2022]
Abstract
Objective The objective of this study is to find and compare the effects of isokinetic training and virtual reality training on sports performances in university football players with chronic low back pain. Design This is a randomized, double-blinded controlled study. Methods The study was conducted on 45LBP participants at university hospital. First group (n = 15) received isokinetic training, second group (n = 15) received virtual reality training, and the control group (n = 15) received conventional training exercises for four weeks. Clinical (pain intensity and player wellness) and sports performance (40 m sprint, 4 × 5 m sprint, submaximal shuttle running, countermovement jump, and squat jump) scores were measured at baseline, after 4 weeks, 8 weeks, and 6 months. Results Four weeks following training VRT group shows more significant changes in pain intensity and player wellness scores than IKT and control groups (p ≤ 0.001). Sports performance variables (such as 40 m sprint, 4 × 5 m sprint, submaximal shuttle running, countermovement jump, and squat jump) scores also show significant improvement in VRT group than the other two groups (p ≤ 0.001). Conclusion Overall, our study suggests that strength training through virtual reality training protocol improves pain and sports performances than isokinetic training and other conventional trainings in university football players with chronic low back pain.
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Nambi G, Abdelbasset WK, Alqahtani BA, Alrawaili SM, Abodonya AM, Saleh AK. Isokinetic back training is more effective than core stabilization training on pain intensity and sports performances in football players with chronic low back pain: A randomized controlled trial. Medicine (Baltimore) 2020; 99:e20418. [PMID: 32481345 PMCID: PMC7249999 DOI: 10.1097/md.0000000000020418] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Isokinetic training (IKT) and core stabilization training (CST) are commonly used for balance training in musculoskeletal conditions. The knowledge about the effective implementation of these training protocols on sports performances in university football players with chronic low back pain (LBP) is lacking. OBJECTIVE To find and compare the effects of IKT and CST on sports performances in university football players with chronic LBP. DESIGN Randomized, double-blinded controlled study. SETTING University hospital. PARTICIPANTS Sixty LBP participants divided into isokinetic group (IKT; n = 20), core stabilization group (CST; n = 20), and the control group (n = 20) and received respected exercises for 4 weeks. OUTCOME MEASURES Clinical (pain intensity and player wellness) and sports performances (40 m sprint, 4 × 5 m sprint, submaximal shuttle running, counter movement jump, and squat jump) scores were measured at baseline, after 4 weeks, 8 weeks, and 3 months. RESULTS Four weeks following training IKT group shows more significant changes in pain intensity and player wellness scores than CST and control groups (P ≤ .001). Sports performance variables (40 m sprint, 4 × 5 m sprint, submaximal shuttle running, counter movement jump and squat jump) scores also show significant improvement in IKT group than the other 2 groups (P ≤ .001). CONCLUSION This study suggests that training through IKT improves pain intensity and sports performances than CST in university football players with chronic LBP.
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Affiliation(s)
- Gopal Nambi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Walid Kamal Abdelbasset
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
- Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza
| | - Bader A. Alqahtani
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Saud M. Alrawaili
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Ahmed M. Abodonya
- Anesthesia and Intensive Care Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
- College of Medicine, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Ayman K. Saleh
- College of Medicine, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
- Orthopedic Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
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Viseux FJF, Martins DF, Villeneuve P, Charpentier P, de Sant'Anna E Silva L, Salgado ASI, Lemaire A. Effect of sensory stimulation applied under the great toe on postural ability in patients with fibromyalgia. Somatosens Mot Res 2020; 37:172-179. [PMID: 32419591 DOI: 10.1080/08990220.2020.1765767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Fibromyalgia (FM) is a chronic pain syndrome, characterised by several symptoms. One of the most prevalent symptoms in FM is balance impairment that compromise the autonomy, function and performance status of patients.Purpose: The main objective of the present study was to evaluate the effect of sensory stimulation provided by the use of a low additional thickness of 0.8 mm placed under the great toes bilaterally on the centre of pressure (CoP) measures in patients with FM. It was hypothesised that postural ability would change with a low focal additional thickness used to compute these measures.Materials and Method: Twenty-four patients with FM voluntarily participated in this study. Postural performance during quiet standing was investigated through the CoP displacements recorded using a force-plate. Sensory stimulation was provided by a small additional thickness of 0.8 mm placed under the great toe bilaterally and two conditions were compared: additional thickness 0 (control) and 0.8 mm.Results: An improvement of body balance through spatial parameters with sensory cutaneous stimulation applied under the great toe bilaterally were observed in patients with FM. Our results showed a significant decrease of surface area and mean speed of CoP, associated to a significant decrease of variance of speed. An additional observation is that sagittal (Y) mean position of the CoP gets more anterior (+ 5 mm) relative to control condition.Conclusion: These findings brings new clinical perspectives in the development of intervention strategies in the management of patients with FM and balance disorders, completing validated therapeutic strategies.
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Affiliation(s)
- Frederic J F Viseux
- Laboratoire d'Automatique, de Mécanique et d'Informatique industrielle et Humaine (LAMIH) - UMR CNRS 8201, Université Polytechnique des Hauts-de-France, Valenciennes, France.,Centre d'Evaluation et de Traitement de la Douleur (CETD), Centre hospitalier de Valenciennes, Valenciennes, France.,Posture Lab, Paris, France
| | - Daniel F Martins
- Experimental Neuroscience Laboratory (LaNEx), Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Palhoça, Brazil
| | | | - Pascal Charpentier
- Centre d'Evaluation et de Traitement de la Douleur (CETD), Centre hospitalier de Valenciennes, Valenciennes, France
| | | | - Afonso S I Salgado
- Institute of Integral Health, Londrina, Brazil.,Experimental Neuroscience Laboratory (LaNEx), Postgraduate Program in Health Sciences, University of Southern Santa Catarina (UNISUL), Palhoça, Brazil
| | - Antoine Lemaire
- Centre d'Evaluation et de Traitement de la Douleur (CETD), Centre hospitalier de Valenciennes, Valenciennes, France
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Hlaing SS, Puntumetakul R, Wanpen S, Boucaut R. Balance Control in Patients with Subacute Non-Specific Low Back Pain, with and without Lumbar Instability: A Cross-Sectional Study. J Pain Res 2020; 13:795-803. [PMID: 32425585 PMCID: PMC7187545 DOI: 10.2147/jpr.s232080] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 04/08/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Patients with low back pain (LBP) have poorly coordinated neuromuscular control, which may alter the normal postural stability of the spine. Altered movement control may occur at any stage of LBP. PURPOSE (1) To identify differences in balance control and proprioceptive sense between subacute non-specific LBP (NSLBP) patients with and without lumbar instability (LI) and healthy subjects and (2) to investigate the correlation between factors of motor control deficits and balance. PATIENTS AND METHODS Thirty-six participants matched by gender, age, and body mass index (BMI) were allocated into three groups of 12: subacute NSLBP patients with LI, subacute NSLBP patients without LI, and healthy subjects. Balance, proprioceptive sense, pain, functional disability, and fear of movement were evaluated. RESULTS Subacute NSLBP patients with LI exhibited greater impairments in balance control, proprioceptive sense, and functional ability than patients without LI (p<0.05). Subacute NSLBP patients showed more impairments in balance control, proprioceptive sense, and fear of movement than healthy subjects (p<0.001), with the following effect sizes (partial η2) for static balance on stable and unstable surface: 0.597 and 0.560, anticipatory balance: 0.417, and dynamic balance: 0.536; proprioceptive sense: 0.676; and fear of movement: 0.379. Significant fair correlations were found between (1) static balance and proprioceptive sense, functional disability, and fear of movement; (2) functional reach test (FRT) and pain; and (3) the five times sit to stand test (FTSTS) and functional disability. CONCLUSION Subacute NSLBP patients with LI showed greater impairment in balance control than patients without LI. Reduced proprioceptive sense, increased pain, functional disability, and fear of movement were fairly related to impaired balance.
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Affiliation(s)
- Su Su Hlaing
- Human Movement Sciences, School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen40002, Thailand
- Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen40002, Thailand
| | - Rungthip Puntumetakul
- Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen40002, Thailand
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen40002, Thailand
| | - Sawitri Wanpen
- Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen40002, Thailand
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen40002, Thailand
| | - Rose Boucaut
- International Centre for Allied Health Evidence, University of South Australia, School of Health Sciences, Adelaide, SA5001, Australia
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The Amount and Temporal Structure of Center of Pressure Fluctuations During Quiet Standing in Patients With Chronic Low Back Pain. Motor Control 2020; 24:91-112. [DOI: 10.1123/mc.2018-0032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 04/30/2019] [Accepted: 05/26/2019] [Indexed: 11/18/2022]
Abstract
The characteristics of postural sway were assessed in quiet standing under three different postural task conditions in 14 patients with nonspecific chronic low back pain and 12 healthy subjects using linear and nonlinear center of pressure parameters. The linear parameters consisted of area, the mean total velocity, sway amplitude, the SD of velocity, and the phase plane portrait. The nonlinear parameters included the Lyapunov exponent, sample entropy, and the correlation dimension. The results showed that the amount of postural sway was higher in the patients with low back pain compared with the healthy subjects. Assessing the nonlinear parameters of the center of pressure showed a lower sample entropy and a higher correlation dimension in the patients with low back pain compared with the healthy subjects. The results of this study demonstrate the greater regularity and higher dimensionality of the center of pressure fluctuations in patients with nonspecific chronic low back pain, which suggests that these patients adopt different postural control strategies to maintain an upright stance.
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Boff TA, Pasinato F, Ben ÂJ, Bosmans JE, van Tulder M, Carregaro RL. Effectiveness of spinal manipulation and myofascial release compared with spinal manipulation alone on health-related outcomes in individuals with non-specific low back pain: randomized controlled trial. Physiotherapy 2019; 107:71-80. [PMID: 32026838 DOI: 10.1016/j.physio.2019.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To investigate the effectiveness of spinal manipulation combined with myofascial release compared with spinal manipulation alone, in individuals with chronic non-specific low back pain (CNLBP). DESIGN Randomized controlled trial with three months follow-up. SETTING Rehabilitation clinic. PARTICIPANTS Seventy-two individuals (between 18 and 50 years of age; CNLBP ≥12 consecutive weeks) were enrolled and randomly allocated to one of two groups: (1) Spinal manipulation and myofascial release - SMMRG; n=36) or (2) Spinal manipulation alone (SMG; n=36). INTERVENTIONS Combined spinal manipulation (characterized by high velocity/low amplitude thrusts) of the sacroiliac and lumbar spine and myofascial release of lumbar and sacroiliac muscles vs manipulation of the sacroiliac and lumbar spine alone, twice a week, for three weeks. MAIN OUTCOME MEASURES Assessments were performed at baseline, three weeks post intervention and three months follow-up. Primary outcomes were pain intensity and disability. Secondary outcomes were quality of life, pressure pain-threshold and dynamic balance. RESULTS No significant differences were found between SMMRG vs SMG in pain intensity and disability post intervention and at follow-up. We found an overall significant difference between-groups for CNLBP disability (SMG-SMMRG: mean difference of 5.0; 95% confidence interval of difference 9.9; -0.1), though this effect was not clinically important and was not sustained at follow-up. CONCLUSIONS We demonstrated that spinal manipulation combined with myofascial release was not more effective compared to spinal manipulation alone for patients with CNLBP. CLINICAL TRIAL REGISTRATION NUMBER NCT03113292.
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Affiliation(s)
- Taise Angeli Boff
- Master in Rehabilitation Sciences, Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil; Núcleo de Evidências e Tecnologias em Saúde (NETecS), Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil
| | - Fernanda Pasinato
- Núcleo de Evidências e Tecnologias em Saúde (NETecS), Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil; School of Physical Therapy, Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil
| | - Ângela Jornada Ben
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, The Netherlands
| | - Judith E Bosmans
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, The Netherlands
| | - Maurits van Tulder
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, The Netherlands; Department Physiotherapy & Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Rodrigo Luiz Carregaro
- Master in Rehabilitation Sciences, Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil; Núcleo de Evidências e Tecnologias em Saúde (NETecS), Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil; School of Physical Therapy, Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil.
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Neurophysiological Effects of High Velocity and Low Amplitude Spinal Manipulation in Symptomatic and Asymptomatic Humans: A Systematic Literature Review. Spine (Phila Pa 1976) 2019; 44:E914-E926. [PMID: 31335790 DOI: 10.1097/brs.0000000000003013] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Systematic review. OBJECTIVE To summarize the evidence of neurophysiological effects of spinal manipulative therapy (SMT) with a high velocity low amplitude thrust (HVLA-SMT) in asymptomatic and symptomatic humans. SUMMARY OF BACKGROUND DATA HVLA-SMT is effective in reducing back pain, but its mode of action is not fully understood. METHODS A systematic literature search (until July 2018) was conducted by a professional librarian in seven databases (Medline (OvidSP), Premedline (PubMed), EMBASE, Cochrane, CINAHL, PEDro, and Scopus). Two authors selected the studies according to the a priori described criteria and scored study quality. Only controlled studies of at least moderate quality were included. Effects of HVLA-SMT on a particular outcome measure were defined as more than one study showing a significantly greater effect of HVLA-SMT compared with the control intervention. RESULTS From the 18 studies included (932 participants in total), there was evidence only for an association between HVLA-SMT and changes in the autonomic nervous system, reflected in changes in heart rate variability and skin conductance. Most studies focused on healthy volunteers and none related neurophysiologic changes to pain reduction. CONCLUSION This systematic review points to HVLA-SMT affecting the autonomic nervous system. The effects seem to depend on the spinal level of HVLA-SMT application and might differ between healthy volunteers and pain patients. There is a need for high-quality studies that include patients, well characterized for pain duration and outcome measure baseline values, and address the relation between changes in neurophysiology and pain. LEVEL OF EVIDENCE 2.
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Lauenroth A, Reinhardt L, Schulze S, Laudner KG, Delank KS, Schwesig R. Does low back pain affect the reliability of postural regulation? Somatosens Mot Res 2019; 36:116-121. [PMID: 31116060 DOI: 10.1080/08990220.2019.1615427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The aim of this study was to examine the intraobserver reliability of a posturographic assessment in patients with low back pain. We investigated 24 symptomatic subjects with defined low back pain (mean: 57.9 years) and a pair-matched control group including 24 asymptomatic persons (mean: 58.1 years). Each participant underwent two measurements on a posturographic device (32 Hz sampling rate) based on the Interactive Balance System (time interval: 7 d). Test procedure consisted of tests on solid ground with eyes open (1) and eyes closed (2). Data analysis included parameters of motor output and a frequency band analysis. Reliability tests were realized using by intraclass correlations (ICC). Coefficients of ICC ranged from 0.36 (95% CI: 0.01-0.73) to 0.94 (95% CI: 0.86-0.97) in both test positions. For 69% (11/16) of the investigated parameters a high level (ICC > 0.75) of intraobserver reliability was reached. Based on the results, the posturographic measurement system used in this study seems to be appropriate for use in longitudinal study designs in an orthopaedic setting.
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Affiliation(s)
- Andreas Lauenroth
- a Department of Orthopedic and Trauma Surgery , Martin-Luther-University Halle-Wittenberg , Halle , Germany
| | - Lars Reinhardt
- a Department of Orthopedic and Trauma Surgery , Martin-Luther-University Halle-Wittenberg , Halle , Germany
| | - Stephan Schulze
- a Department of Orthopedic and Trauma Surgery , Martin-Luther-University Halle-Wittenberg , Halle , Germany
| | - Kevin G Laudner
- b School of Kinesiology and Recreation , Illinois State University , Normal , IL , USA
| | - Karl-Stefan Delank
- a Department of Orthopedic and Trauma Surgery , Martin-Luther-University Halle-Wittenberg , Halle , Germany
| | - René Schwesig
- a Department of Orthopedic and Trauma Surgery , Martin-Luther-University Halle-Wittenberg , Halle , Germany
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Amaral G, Martins H, Silva AG. Postural control in subclinical neck pain: a comparative study on the effect of pain and measurement procedures. Scand J Pain 2019; 18:295-302. [PMID: 29794294 DOI: 10.1515/sjpain-2017-0172] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 03/06/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS This study investigated whether young university students with neck pain (NP) have postural control deficits when compared to sex and age-matched asymptomatic subjects. METHODS Centre of pressure (COP) sway area, velocity, anterior-posterior and mediolateral distances were measured in participants with (n=27) and without (n=27) neck pain for different combinations of static standing (narrow stance, tandem stance and single leg stance) and measurement time (90, 60, 30 and 15 s) with eyes closed using a force plate. Additionally, static and dynamic clinical tests of postural control were used. RESULTS No significant between group differences were found for the COP measurements (p>0.05). However, individuals with subclinical NP were more likely to fail the 90 s tandem test (p<0.05) in the force plate and univariate comparisons revealed significant between group differences in the tandem and single leg stance clinical test measurements. CONCLUSIONS Taken together, the inconsistent results might suggest an emerging postural control deficit in university students with low disability and low intensity chronic idiopathic NP.
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Affiliation(s)
- Gabriela Amaral
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Helena Martins
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Anabela G Silva
- School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal.,Center for Health Technology and Services Research (CINTESIS.UA), Aveiro, Portugal, Phone: +234401558, extension: 23899, Fax: +234401597
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Koch C, Hänsel F. Non-specific Low Back Pain and Postural Control During Quiet Standing-A Systematic Review. Front Psychol 2019; 10:586. [PMID: 30967811 PMCID: PMC6440285 DOI: 10.3389/fpsyg.2019.00586] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 03/01/2019] [Indexed: 12/13/2022] Open
Abstract
Background: There is a great number of people who require treatment for non-specific low back pain (LBP) yet the causes are still unclear. One proposed cause for LBP is impaired motor control and more specific an impaired postural control. Objective: The purpose of this review is to provide an overview of postural control parameter differences in persons with and without non-specific LBP during quite standing. Methods: A literature search in five databases from January 2000 until January 2018 was performed and was followed by a hand search. Twenty-one articles comparing healthy adults and adults with non-specific LBP in neuromuscular and/or biomechanical parameters during bipedal stance without external perturbation in lab studies were examined. Data extraction and quality assessment were independently performed by two persons. Factors such as study population, outcome measures, and results were extracted from the articles and included in this analysis. Results: The results show that persons with and without non-specific LBP differed in several parameters of postural control such as the center of pressure displacement, postural control strategy, and muscle activation patterns. Conclusion: While the results show that none of the parameters alone lead to significant effects, the combination of neuromuscular and biomechanical parameters was associated with the impairment of postural control in individuals with LBP during standing. Since the studies included in this analysis used different methodological procedures a replication of these studies with standardized procedures is imperative for the acquisition of more conclusive evidence on the differences in postural control during standing.
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Affiliation(s)
- Cathrin Koch
- Department of Sport Psychology, Institute of Sport Sciences, Technische Universität Darmstadt, Darmstadt, Germany
| | - Frank Hänsel
- Department of Sport Psychology, Institute of Sport Sciences, Technische Universität Darmstadt, Darmstadt, Germany
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Areeudomwong P, Buttagat V. Proprioceptive neuromuscular facilitation training improves pain-related and balance outcomes in working-age patients with chronic low back pain: a randomized controlled trial. Braz J Phys Ther 2018; 23:428-436. [PMID: 30361077 DOI: 10.1016/j.bjpt.2018.10.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 10/09/2018] [Accepted: 10/09/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Proprioceptive neuromuscular facilitation training and general trunk exercises have been applied to treat chronic low back pain patients. However, there is currently little study to support the use of one treated intervention over the other to improve clinical outcomes and balance ability. OBJECTIVE To examine the effects of proprioceptive neuromuscular facilitation training on pain intensity, disability and static balance ability in working-age patients with chronic low back pain. METHODS Forty-four chronic low back pain participants aged 18-50 years were randomized either to a three-week proprioceptive neuromuscular facilitation training or to a control group receiving general trunk exercises. Pain intensity, disability and static balance ability were measured before and after the three-week intervention. RESULTS The proprioceptive neuromuscular facilitation training intervention showed a statistically significantly greater reduction in pain intensity and improved functional disability than the controls at three weeks (between-group difference: pain intensity 1.22 score, 95% CI: 0.58 to 1.88, p<0.001; disability 2.23 score, 95% CI: 1.22 to 3.24, p<0.001. The proprioceptive neuromuscular facilitation training intervention also had statistically better parameters of static balance ability than the control group (between-group difference: ellipse sway area during eye opened and closed conditions 129.09mm2, 95% CI: 64.93 to 175.25, p<0.01 and 336.27mm2, 95% CI: 109.67 to 562.87, p<0.05, respectively; the centre of pressure velocity during eye opened and eye closed conditions 6.68mm/s, 95% CI: 4.41 to 8.95, p<0.01 and 6.77mm/s, 95% CI: 4.01 to 9.54, p<0.01, respectively). CONCLUSION The three-week proprioceptive neuromuscular facilitation training provides better pain intensity, disability and static balance ability than general trunk exercises for working-age individuals with chronic low back pain but the effects do not reach the clinical meaningful level. The therapists should consider carefully when making recommendations regarding these interventions, taking into account effectiveness and costs.
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Affiliation(s)
- Pattanasin Areeudomwong
- Department of Physical Therapy, School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand.
| | - Vitsarut Buttagat
- Department of Physical Therapy, School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand
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Borysiuk Z, Konieczny M, Kręcisz K, Pakosz P, Królikowska B. Effect of six-week intervention program on postural stability measures and muscle coactivation in senior-aged women. Clin Interv Aging 2018; 13:1701-1708. [PMID: 30254430 PMCID: PMC6140720 DOI: 10.2147/cia.s167782] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective The objective involved the analysis of the efficiency of the Program of Movement Recreation of Elderly People (PMREP) exercise program expressed in terms of the stabilography measures and coactivation of muscles in women in the age group of 60–70 years. The assumption that was assumed stems from theoretical implications that the adequate postural stability is manifested in the decrease of the body sways measured by means of a force plate. Materials and methods The study involved a group of 60 females, all members of the active seniors’ association. The subjects were in the age range from 60 to 70 years. The subjects were divided into 2 groups of equal size: control and experimental. Subjects in both groups participated in the rehabilitation exercises: experimental (n=16, PMREP – twice a week/60 minutes), control (n=27, PMREP – only once a week/60 minutes). Results The study demonstrated that the completion of a 6-week PMREP program resulted in a decrease in the variability and velocity as well as indicators representing center of pressure displacement measured in the feet for the exercises performed with closed eyes with subjects standing on a high foam pad located on a force plate (P=0.001). No significant changes in coactivation of the calf muscles were recorded in the subjects. Conclusion The study concludes that a PMREP rehabilitation plan with an adequate program and frequency leads to an improvement of the vestibular system coupled with proprioception understood as an integrated process of sensor activation in the body. However, in regard to the coactivation of the muscles involved in maintaining postural stability, no significant differences have been observed.
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Affiliation(s)
- Zbigniew Borysiuk
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland,
| | - Mariusz Konieczny
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland,
| | - Krzysztof Kręcisz
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland,
| | - Paweł Pakosz
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland,
| | - Bożena Królikowska
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland,
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Yodchaisarn W, Puntumetakul R, Emasithi A, Boucaut R, Chatchawan U. Altered postural sway during quiet standing in women with clinical lumbar instability. J Phys Ther Sci 2018; 30:1099-1102. [PMID: 30154608 PMCID: PMC6110202 DOI: 10.1589/jpts.30.1099] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 05/30/2018] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The current study aimed to investigate the center of pressure, as an indicator
of postural sway, to determine any differences between women with clinical lumbar
instability and asymptomatic low back pain. [Participants and Methods] Thirty healthy and
fifteen clinical lumbar instability participants were measured for their postural sway in
the anterior-posterior and medial-lateral directions. The women were tested for postural
sway on a force plate in quiet standing and eyes closed. Center of pressure path length
and mean velocity in the anterior-posterior and medial-lateral directions and total area
of excursion were measured and analyzed for 30 seconds. [Results] Clinical lumbar
instability participants showed a significantly increase when compared with healthy
participants, in path length and mean velocity in both directions and total area of
excursion. [Conclusion] The findings suggest that chronic low back pain patients with
clinical lumbar instability have increased postural sway when vision is deprived. The
clinical significance of this has not yet been determined but may provide an opportunity
for therapy directed at improving balance control in this patient group.
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Affiliation(s)
| | - Rungthip Puntumetakul
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University: Khon Kaen, Thailand
| | - Alongkot Emasithi
- Department of Otolaryngology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
| | - Rose Boucaut
- School of Health Sciences (Physiotherapy), iCAHE (International Centre for Allied Health Evidence), Sansom Institute for Health Research, University of South Australia, Australia
| | - Uraiwan Chatchawan
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University: Khon Kaen, Thailand
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Viseux F, Lemaire A, Charpentier P. Contribution of neurosensory Posturotherapy in the management of specific chronic pain syndrome. Neurophysiol Clin 2018. [DOI: 10.1016/j.neucli.2018.05.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Shanbehzadeh S, Salavati M, Talebian S, Khademi-Kalantari K, Tavahomi M. Attention demands of postural control in non-specific chronic low back pain subjects with low and high pain-related anxiety. Exp Brain Res 2018; 236:1927-1938. [PMID: 29696316 DOI: 10.1007/s00221-018-5267-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 04/17/2018] [Indexed: 12/17/2022]
Abstract
Impaired postural control in chronic low back pain (CLBP) has been attributed to deficits in sensory and motor functions. However, it is not known if pain-related anxiety affects motor and cognitive function of postural control. The aim of this study was to compare the interactive effects of postural and cognitive function in CLBP patients with high and low pain-related anxiety and healthy subjects. Thirty-eight patients with nonspecific CLBP (19 with low and 19 with high pain-related anxiety levels) and 20 asymptomatic subjects participated. Postural control was assessed by center of pressure (COP) parameters including mean total sway velocity, area, anterior-posterior (A-P), and medial-lateral (Med-Lat) range. Postural task was assessed during four conditions (eyes open with and without ankle vibration-eyes closed with and without ankle vibrations). Participants performed the postural task with or without auditory Stroop task. Average reaction time and error ratio of auditory Stroop test were calculated as measures of the cognitive task performance. Significantly reduced sway area was observed in CLBP patients with high pain-related anxiety and control subjects during the dual-task condition as compared with the single task. In addition, A-P range was significantly reduced in CLBP patients with high pain-related anxiety during dual tasking when eyes were closed with ankle vibration. In addition, only the CLBP subjects with high pain-related anxiety showed significantly longer reaction times by increasing the difficulty of standing postural task. Pain-related anxiety may influence the postural cognitive interactions in CLBP patients. Furthermore, it may be considered as a contributing factor for postural strategies adopted by CLBP patients.
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Affiliation(s)
- Sanaz Shanbehzadeh
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mahyar Salavati
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Saeed Talebian
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Khosro Khademi-Kalantari
- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahnaz Tavahomi
- Department of Physical Therapy, Iran University of Medical Sciences, Tehran, Iran
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Rose-Dulcina K, Vuillerme N, Tabard-Fougère A, Dayer R, Dominguez DE, Armand S, Genevay S. Identifying Subgroups of Patients With Chronic Nonspecific Low Back Pain Based on a Multifactorial Approach: Protocol For a Prospective Study. JMIR Res Protoc 2018; 7:e104. [PMID: 29685875 PMCID: PMC5938595 DOI: 10.2196/resprot.9224] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 11/22/2017] [Indexed: 02/07/2023] Open
Abstract
Background Low back pain, especially nonspecific chronic low back pain (LBP), the leading cause of disability worldwide, represents both social and economic problems. Different therapeutic management techniques can be used, but their effects vary. Clinicians and researchers attribute the variation in the efficacy of therapeutic and management techniques to the heterogeneity of the nonspecific chronic low back pain population, and they agree that nonspecific chronic LBP must be subgrouped. Objective This study aims to identify nonspecific chronic LBP subgroups based on a multifactorial approach, including biomechanical, physical, and psychosocial data. Methods A total of 100 nonspecific chronic LBP patients and 30 healthy participants aged between 18 and 60 years will be recruited for this prospective study. A psychosocial profile will be established using questionnaires on anxiety, depression, functional disability, pain, fear of pain, avoidance belief, and physical activity. A physical capacity evaluation will be conducted. It will evaluate flexibility of the hips, lumbar spine, and lateral thoracolumbar segment, as well as trunk (extensor and flexor) muscle endurance. The subjects will perform functional daily life activities, such as walking, object lifting, forward bending, sit-to-stand, stand-to-sit, balance, and usual postures. Full body kinematics, kinetics, and surface electromyography of the trunk and hip muscles will be assessed during these tasks. The clustering classification methods for the statistical analysis will be determined according to the data and will be used to identify the subgroups of nonspecific chronic LBP patients. Results Data collection started in September 2017 and will be completed with the inclusion of all the participants (100 nonspecific chronic LBP and 30 control). The study results will be published in peer-reviewed journals and presented at relevant international conferences. Conclusions Numerous studies have showed that the therapeutic management of nonspecific chronic LBP is difficult and has inconstant effects caused by the complexity and heterogeneity of nonspecific chronic LBP. Identifying subgroups with a multifactorial approach is more comprehensive and closer to the pathophysiology of nonspecific chronic LBP. It also represents benefit interests and a challenge both clinically and socially. The perspective of this study is expected to support clinicians for a more adapted therapeutic management for each subgroup.
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Affiliation(s)
- Kevin Rose-Dulcina
- Willy Taillard Laboratory of Kinesiology, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Autonomie, gérontologie, e-santé, imagerie & société Laboratory, Department of Chemistry, Biology and Health, University Grenoble Alpes, Grenoble, France.,LAI Jean-Raoul Scherrer, University of Geneva and University Grenoble Alpes, Grenoble, France
| | - Nicolas Vuillerme
- Autonomie, gérontologie, e-santé, imagerie & société Laboratory, Department of Chemistry, Biology and Health, University Grenoble Alpes, Grenoble, France.,LAI Jean-Raoul Scherrer, University of Geneva and University Grenoble Alpes, Grenoble, France.,Institut Universitaire de France, Paris, France
| | - Anne Tabard-Fougère
- Willy Taillard Laboratory of Kinesiology, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Autonomie, gérontologie, e-santé, imagerie & société Laboratory, Department of Chemistry, Biology and Health, University Grenoble Alpes, Grenoble, France.,LAI Jean-Raoul Scherrer, University of Geneva and University Grenoble Alpes, Grenoble, France
| | - Romain Dayer
- Division of Paediatric Orthopaedics, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Dennis E Dominguez
- Division of Orthopaedic and Trauma Surgery, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Stephane Armand
- Willy Taillard Laboratory of Kinesiology, Department of Surgery, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,LAI Jean-Raoul Scherrer, University of Geneva and University Grenoble Alpes, Grenoble, France
| | - Stéphane Genevay
- Division of Rheumatology, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
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Sewell J, Dixon C, Morris R, Stuart S. Anatomical distribution of musculoskeletal disorders following a road traffic collision in litigants presenting to physiotherapists within a private-clinic in North-East England. Physiother Theory Pract 2018; 35:873-883. [PMID: 29659312 DOI: 10.1080/09593985.2018.1459986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Introduction: Musculoskeletal disorders (MSDs) are common following a road traffic collision (RTC) in England. Establishing the anatomical distribution of MSDs following RTC that present to physiotherapists may improve understanding and clinical practice. This study examined anatomical distribution of MSDs that present to physiotherapists within a litigant population following a RTC in England. Methods: A retrospective review of physiotherapy records was conducted at a private practice in North-East England. Data were collected from 2105 patients between January 2014 and December 2015. The primary outcome was anatomical regions with MSDs. Descriptive data is reported. Results: Overall, 90% of patients presented with a neck/upper back disorder, while 52% presented with a lower back disorder. Of the assessed patients, 46% presented with one MSD, 45% presented with two MSDs while 9% presented with ≥3 MSDs. Further analysis showed that those who presented to physiotherapy later and were not motor vehicle occupants (MVOs) were more likely to have upper-limb, lower-limb, or lumbar MSDs. Younger patients, who presented sooner and were non-MVO were more likely to have multiple regions affected by MSDs. Conclusions: This study presents epidemiological evidence that MSDs following a RTC occur primarily in the neck/upper back or lower back regions, and that multiple MSDs are common.
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Affiliation(s)
| | - Cheryl Dixon
- a On Medical Ltd ., Newcastle upon Tyne , England, UK
| | - Rosie Morris
- a On Medical Ltd ., Newcastle upon Tyne , England, UK.,b Institute of Neuroscience/Newcastle University Institute of Ageing , Newcastle University , Newcastle upon Tyne , England, UK
| | - Samuel Stuart
- a On Medical Ltd ., Newcastle upon Tyne , England, UK.,b Institute of Neuroscience/Newcastle University Institute of Ageing , Newcastle University , Newcastle upon Tyne , England, UK
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