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Jäckle K, Meier MP, Klockner F, Roch PJ, Hawellek T, Weiser L, Lehmann W. The influence of pelvic tilt on sacral insufficiency fracture occurrence: Insights into the prevalence of high pelvic tilt among patients affected. Injury 2024; 55:111520. [PMID: 38594084 DOI: 10.1016/j.injury.2024.111520] [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: 03/06/2024] [Accepted: 03/29/2024] [Indexed: 04/11/2024]
Abstract
INTRODUCTION Fragility fractures without significant trauma of the pelvic ring in older patients have an increasing incidence due to demographic change. Influencing factors other than osteoporotic bone quality that lead to an insufficiency fracture are not yet known. However, it is suspected that the pelvic tilt (PT) has an effect on the development of such an insufficiency fracture. This study explores the influence of the PTs in patients with insufficiency fractures of the posterior pelvic ring. MATERIALS AND METHODS A total of 49 geriatric patients with fragility fractures of the pelvic ring were treated at a university hospital level-1 trauma center during a period between February and December 2023, and their fractures were classified according to the FFP classification of Rommens and Hofmann. Complete sets of computer tomography (CT) and radiological images were available to determine the PT angle of the patients. RESULTS 34 FFP type 2 and 15 FFP type 3 classified patients were included in the study. Significant difference was seen in the pelvic tilt (PT) angle between the patient group with insufficiency fractures (n= 49; mean age: 78.02 ± 11.80) and the control group with lumbago patients (n= 53; mean age: 69.23 ± 11.23). The PT was significantly higher in the patients with insufficiency fractures (25.74° ± 4.76; p⁎⁎⁎⁎ ≤ 0.0001). CONCLUSIONS The study demonstrates a significant extension of the PT angle of individuals with insufficiency fractures when compared to those with lumbago. The result suggests a potential association between pelvic tilt and fracture susceptibility. TRIAL REGISTRATION A retrospective study about the influence of sagittal balance of the spine on insufficiency fractures of the posterior pelvic ring measured by the "pelvic tilt angle", DRKS00032120. Registered 20th June 2023 - Prospectively registered. Trial registration number DRKS00032120.
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Affiliation(s)
- Katharina Jäckle
- Department for Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Robert-Koch Str. 40, 37075 Göttingen, Germany.
| | - Marc-Pascal Meier
- Department for Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Robert-Koch Str. 40, 37075 Göttingen, Germany
| | - Friederike Klockner
- Department for Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Robert-Koch Str. 40, 37075 Göttingen, Germany
| | - Paul Jonathan Roch
- Department for Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Robert-Koch Str. 40, 37075 Göttingen, Germany
| | - Thelonius Hawellek
- Department for Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Robert-Koch Str. 40, 37075 Göttingen, Germany
| | - Lukas Weiser
- Department for Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Robert-Koch Str. 40, 37075 Göttingen, Germany
| | - Wolfgang Lehmann
- Department for Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Robert-Koch Str. 40, 37075 Göttingen, Germany
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Salsali M, Sheikhhoseini R, Sayyadi P, Hides JA, Dadfar M, Piri H. Association between physical activity and body posture: a systematic review and meta-analysis. BMC Public Health 2023; 23:1670. [PMID: 37649076 PMCID: PMC10470156 DOI: 10.1186/s12889-023-16617-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/25/2023] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVE To estimate the possible associations between posture and physical activity (PA). DESIGN A systematic review and meta-analysis. DATA SOURCES The search was conducted in seven databases (PubMed, Web of Science, SportDiscus, EMBASE, Scopus, Cochrane Library, and CINAHL) for studies published from inception to January 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies were required to meet following criteria: (1) study design: cross-sectional, case control and cohort studies. (2) Participants: people of all ages without any diagnosed diseases. (3) Exposure and outcome: studies that examined the possible effect or correlations between PA, physical inactivity, physical exertion and human body posture. RESULTS Sixteen cross-sectional studies, two cohort studies and one case control study involving a total of 16772 participants aged from 6 to 79 years were included. Correlational studies showed that there was a significant relationship between PA and posture (C = 0.100, CI 95% = 0.012-0.186). However, regression studies demonstrated that there was not a significant association between PA and posture (C = 1.00, CI 95% = 0.998-1.002). Three studies investigated the association between PA and the lumbar lordosis and showed that there was not a significant association between the lordosis and PA (CI 95%: -0.253-0.048, P = 0.180). In addition, four studies showed that there were not any associations between scoliosis and PA (CI 95%: 0.819, 1.123, P = 0.607). The evidence of heterogeneity and publication bias was found among all analyzed data (P < 0.05). Also, meta regression was used for age and BMI and the results were not significant. CONCLUSION Although a weak correlation was shown to exist between PA and human posture, the odds ratio indicated that there was not a significant association between PA and human posture. The lack of a significant relationship may indicate that multiple biopsychosocial factors may be involved in human posture. In summary, our study highlights the need for caution when interpreting the results of meta-analyses, particularly when there is significant heterogeneity and publication bias in the included studies.
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Affiliation(s)
- Mohammad Salsali
- Faculty of Physical Education and Sport Sciences, Allameh Tabataba’i University, Tehran, Iran
| | - Rahman Sheikhhoseini
- Department of Corrective Exercise & Sport Injury, Faculty of Physical Education and Sport Sciences, Allameh Tabataba’i University, Western Azadi Sport Complex Boulevard, Hakim Highway, Tehran, Iran
| | - Parisa Sayyadi
- Department of Health and Sport Medicine, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Julie A. Hides
- School of Health Sciences and Social Work, Griffith University, Queensland, Australia
- Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Mahdis Dadfar
- Department of Human Health and Performance, Faculty of Kinesiology, University of Houston, Houston, TX USA
| | - Hashem Piri
- Department of Corrective Exercise & Sport Injury, Faculty of Physical Education and Sport Sciences, Allameh Tabataba’i University, Western Azadi Sport Complex Boulevard, Hakim Highway, Tehran, Iran
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Luger T, Bonsch R, Seibt R, Krämer B, Rieger MA, Steinhilber B. Intraoperative active and passive breaks during minimally invasive surgery influence upper extremity physical strain and physical stress response-A controlled, randomized cross-over, laboratory trial. Surg Endosc 2023:10.1007/s00464-023-10042-9. [PMID: 37084097 PMCID: PMC10120511 DOI: 10.1007/s00464-023-10042-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/25/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVE Investigate the effect of passive, active or no intra-operative work breaks on static, median and peak muscular activity, muscular fatigue, upper body postures, heart rate, and heart rate variability. BACKGROUND Although laparoscopic surgery is preferred over open surgery for the benefit of the patient, it puts the surgeons at higher risk for developing musculoskeletal disorders especially due to the less dynamic and awkward working posture. The organizational intervention intraoperative work break is a workplace strategy that has previously demonstrated positive effects in small-scale intervention studies. METHODS Twenty-one surgeons were exposed to three 90-min conditions: no breaks, 2.5-min passive (standing rest) or active (targeted stretching and mobilization exercises) breaks after 30-min work blocks. Muscular activity and fatigue of back, shoulder and forearm muscles were assessed by surface electromyography; upper body posture, i.e., spinal curvature, by inclination sensors; and heart rate and variability (HRV) by electrocardiography. Generalized estimating equations were used for statistical analyses. This study (NCT03715816) was conducted from March 2019 to October 2020. RESULTS The HRV-metric SDNN tended to be higher, but not statistically significantly, in the intervention conditions compared to the control condition. No statistically significant effects of both interventions were detected for muscular activity, joint angles or heart rate. CONCLUSION Intraoperative work breaks, whether passive or active, may counteract shoulder muscular fatigue and increase heart rate variability. This tendency may play a role in a reduced risk for developing work-related musculoskeletal disorders and acute physical stress responses.
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Affiliation(s)
- Tessy Luger
- Institute of Occupational and Social Medicine and Health Services Research, Eberhard Karls University and University Hospital Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany.
| | - Rosina Bonsch
- Institute of Occupational and Social Medicine and Health Services Research, Eberhard Karls University and University Hospital Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany
- Plastic, Reconstructive and Burn Surgery, Clinic for Hand, BG Clinic Tübingen, Schnarrenbergstraße 95, 72076, Tübingen, Germany
| | - Robert Seibt
- Institute of Occupational and Social Medicine and Health Services Research, Eberhard Karls University and University Hospital Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany
| | - Bernhard Krämer
- Department of Gynecology and Obstetrics, University Hospital Tübingen, Calwerstraße 7, 72076, Tübingen, Germany
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, Eberhard Karls University and University Hospital Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany
| | - Benjamin Steinhilber
- Institute of Occupational and Social Medicine and Health Services Research, Eberhard Karls University and University Hospital Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany
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Jang CW, Park J, Cho HE, Park JH. Appraisal of the New Posture Analyzing and Virtual Reconstruction Device (PAViR) for Assessing Sagittal Posture Parameters: A Prospective Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11109. [PMID: 36078824 PMCID: PMC9517778 DOI: 10.3390/ijerph191711109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 08/29/2022] [Accepted: 09/03/2022] [Indexed: 06/15/2023]
Abstract
The purpose of this study was to report the clinical validation of the posture analyzing and virtual reconstruction device (PAViR) system, focusing on the accuracy of sagittal spinal parameters, compared with the EOS imaging system. Seventy patients diagnosed with segmental and somatic dysfunction were recruited between February 2020 and November 2020. Each patient was examined using the EOS imaging system and PAViR; the sagittal parameters of human body posture [forward head posture (FHP), T1 tilt angle (T1t), knee flexion angle (KF), lumbar lordosis angle (LL), and pelvic tilt angle (PT)] were analyzed to verify the correlation between the results of the two devices. The median differences in the results of the two devices showed significant differences in FHP (T4-frontal head and T4-auditory canal), T1t, and PT. In the correlation analysis, the values of FHP (C7-auditory canal, T4-frontal head, and T4-auditory canal), T1t, and PT showed a moderate correlation between the two devices (r = 0.741, 0.795, 0.761, 0.621, and 0.692, respectively) (p < 0.001). The KF and LL was fairly correlated (r = 0.514 and 0.536, respectively) (p = 0.004, both). This study presents the potential of a novel skeletal imaging system without radiation exposure, based on a 3D red-green-blue-depth camera (PAViR), as a next-generation diagnostic tool by estimating more accurate parameters through continuous multi-data-based upgrades with artificial intelligence technology.
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Affiliation(s)
- Chan Woong Jang
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul 06229, Korea
| | - Jihyun Park
- Department of Rehabilitation Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong 18450, Korea
| | - Han Eol Cho
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul 06229, Korea
| | - Jung Hyun Park
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul 06229, Korea
- Department of Medical Device Engineering and Management, Yonsei University College of Medicine, Seoul 06229, Korea
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Abdominal Adiposity Increases Lordosis and Doubles the Risk of Low Back Pain. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12157616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Vertebral disorders have significant health and economic impacts, and due to aging and current lifestyle habits, there is a trend toward their increase. Obesity and the alignment of vertebral curvatures can be associated with back pain. Objective: This study aims to analyze whether general and abdominal obesity are associated with cervical, dorsal, and lumbar vertebral pain as well as increased or decreased values of cervical, dorsal, and lumbar vertebral curvatures. Methodology: Body composition, degree of vertebral curvature, and the perception of cervical, dorsal, and lumbar pain were evaluated in a study population of 301 people (>18 years old). Linear and logistic regression analyses were performed to evaluate the influence of several variables of body composition on vertebral angles and cervical, dorsal, and lumbar pain. Results: Lumbar pain was the most prevalent (66.1%), mainly affecting women (70.9%). They were also shown to have greater lumbar angles (p < 0.001). The degrees of lumbar curvature increased, as did the BMI, waist circumference, and waist-to-height ratio. Cervical and dorsal curvatures were increased by all the variables of adiposity and abdominal adiposity. It was found that people with abdominal obesity carried twice the risk of lower back pain than those without abdominal obesity (OR = 2.172, p < 0.05). In addition, an increased lumbar angle was related to an increased risk of low back pain (OR = 1.031, p < 0.05). Cervical pain, on the other hand, was associated with the waist-height index (OR = 0.948, p <0.01). Conclusions: This study shows that increased lumbar curvature and abdominal obesity may be risk factors for lower back pain. In addition, it shows an association between the amount of body and abdominal fat in relation to the degree of curvature of the spine in the sagittal plane. Investigating the effect of obesity on vertebral morphology and musculoskeletal disorders makes it possible to prescribe interventions and therapeutic strategies.
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Plandowska M, Kędra A, Kędra P, Czaprowski D. Trunk Alignment in Physically Active Young Males with Low Back Pain. J Clin Med 2022; 11:jcm11144206. [PMID: 35887971 PMCID: PMC9317919 DOI: 10.3390/jcm11144206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/12/2022] [Accepted: 07/18/2022] [Indexed: 12/10/2022] Open
Abstract
Background: Systematic physical activity has become an essential part of the guidelines for the prevention and treatment of low back pain (LBP). The aim of this study was to assess differences in trunk alignment parameters with regard to the level of physical activity in groups of individuals with and without LBP. Methods: 43 participants with LBP and 37 healthy persons were recruited. Participants were divided into two subgroups: (1) students with a moderate level of physical activity (MPA); (2) students with a high level of physical activity (HPA). An original questionnaire was used to assess the prevalence of LBP. The spinal posture was measured using the Formetric 4D rasterstereographic system. Results: There were no significant differences between groups for any of the parameters assessed: trunk imbalance, trunk inclination, trunk torsion, pelvic tilt, pelvic inclination, pelvic torsion, kyphotic angle and lordotic angle. Conclusions: There are no differences in trunk alignment parameters in the sagittal, frontal and transversal planes between physically active males with and without LBP. Therefore, it can be assumed that physical activity may reduce the risk of the deterioration of trunk alignment in males with LBP younger than 25 years.
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Affiliation(s)
- Magdalena Plandowska
- Faculty of Physical Education and Health, Jozef Pilsudski University of Physical Education in Warsaw, 21-500 Biala Podlaska, Poland; (A.K.); (P.K.)
- Correspondence:
| | - Agnieszka Kędra
- Faculty of Physical Education and Health, Jozef Pilsudski University of Physical Education in Warsaw, 21-500 Biala Podlaska, Poland; (A.K.); (P.K.)
| | - Przemysław Kędra
- Faculty of Physical Education and Health, Jozef Pilsudski University of Physical Education in Warsaw, 21-500 Biala Podlaska, Poland; (A.K.); (P.K.)
| | - Dariusz Czaprowski
- Department of Health Sciences, University College in Olsztyn, 10-283 Olsztyn, Poland;
- Center of Body Posture, Bydgoska 33, 10-243 Olsztyn, Poland
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Elabd AM, Elabd OM. Relationships between forward head posture and lumbopelvic sagittal alignment in older adults with chronic low back pain. J Bodyw Mov Ther 2021; 28:150-156. [PMID: 34776134 DOI: 10.1016/j.jbmt.2021.07.036] [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: 02/15/2021] [Revised: 06/19/2021] [Accepted: 07/16/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Abnormal posture creates abnormal stress and strain in many spinal structures which are considered predisposing factors for chronic mechanical low back pain. PURPOSE To examine the relationships among pain intensity, forward head posture (decreased craniovertebral angle) and lumbopelvic sagittal alignment (pelvic incidence, pelvic tilt, sacral slope, and lumbar lordosis) in chronic mechanical low back pain patients. METHODS A cross-section correlational study was conducted on one hundred patients. A numerical-pain-rating scale was used to determine pain intensity. Standardized standing lateral radiographs were analyzed to measure the spinopelvic angles. Reported data were analyzed using correlation coefficients, and regression analyses. RESULTS Lumbar lordosis had very strong positive correlations with each pain intensity and sacral slope. Pain intensity had a strong positive correlation with sacral slope. Moderate positive correlations highlighted between pelvic tilt and craniovertebral angle. Moreover, the pelvic incidence had weak positive correlations with each sacral slope and pelvic tilt. Negative correlations were strong between pelvic tilt and each of pain intensity, lumbar lordosis and sacral slope. Craniovertebral angle had moderate negative correlations with each of pain, lumbar lordosis, and sacral slope. However, the pelvic incidence had no relations with pain, craniovertebral angle lumbar lordosis. Overall, an association of demographic data and measured variables had a significant effect on the pain multi-regression equation prediction model. They accounted for 76.60% of the variation in pain. CONCLUSION Abnormal spinopelvic posture relates to chronic mechanical low back pain. There are significant associations among pain intensity, FHP and lumbopelvic sagittal alignment in chronic mechanical low back pain patients.
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Affiliation(s)
- Aliaa M Elabd
- Basic Science Department, Faculty of Physical Therapy, Pharos University in Alexandria, Egypt.
| | - Omar M Elabd
- Department of Physical Therapy for Musculoskeletal Disorders, Faculty of Physical Therapy, Delta University for Science and Technology, Gamasa, Egypt
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Mahmoud WS. Examining the efficacy of short foot exercises as an effective stand-alone treatment for mechanical low back pain associated with foot overpronation. ISOKINET EXERC SCI 2021. [DOI: 10.3233/ies-210178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Abnormal foot mechanics in foot over-pronation has an identified relationship with mechanical low back pain (MLBP). OBJECTIVE: To explore the use of short foot exercises (SFEs) as a standalone treatment for MLBP with foot over-pronation. METHODS: Forty-six patients with MLBP (PwMLBP) presenting with and foot over-pronation were analyzed. They were randomized into the SFE (short foot exercise), SFE plus traditional physical therapy treatment (SFE+TPT), and control (CG) groups. Functional disability and pain level were measured using the Oswestry Disability Index (ODI) and visual analog scale (VAS), respectively. Ultrasonography measured the cross-sectional area (CSA) of the abductor hallucis (AbdH) muscle. The foot posture and navicular drop (ND) were investigated using the foot posture index-6 (FPI) score and ND test, respectively. RESULTS: The CSA of the AbdH and VAS scores improved significantly (p< 0.001) between the groups, more in the SFE+TPT group than in the SFE group (p< 0.001). The ND, FPI, and ODI measures improved significantly among the groups (p< 0.001), with no significant difference (p> 0.002) between the SFE and SFE+TPT groups. The CG did not show significant differences in the outcome measures (p> 0.002). Based on the effect size, SFEs significantly improved all the variables of interest (d>1). CONCLUSION: SFEs, with or without TPT may offer an effective treatment for PwMLBP with foot over-pronation.
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Affiliation(s)
- Waleed S. Mahmoud
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Kingdom of Saudi Arabia
- Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Manual Pressure Release and Low-Grade Electrical Peripheral Receptor Stimulation in Nonspecific Low Back Pain: A Randomized Controlled Trial. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021. [PMID: 33474700 DOI: 10.1007/5584_2020_605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
Chronic nonspecific low back pain is a frequent clinical condition affecting the general population and influencing disability level and quality of life. We performed a single-blinded, randomized, and controlled study to compare the effectiveness of manual pressure release (MPR) and electrical neuromodulation (ENM) treatments in the management of chronic low back pain. There were 20 patients with chronic low back pain randomly assigned to 6 treatment sessions with either technique. Both groups were treated for 2 days a week for 3 weeks. Myofascial trigger points (MTrPs) were identified and skin conductance, pressure-pain threshold, postural changes, and the Oswestry Disability Index were assessed before and after each treatment session, along with the protocol-end data compared against the baseline data in each group. We found an outstanding and about equal deactivation of MTrPs from pre- to post-treatment in both groups, reducing disability in patients with chronic low back pain. The study highlights the ENM as a reliable tool for the evaluation of MTrPs, given a high agreement with the MPR. The effect on the neuromuscular condition of treating the "key trigger points" found in this study advances the knowledge of medical rehabilitation.
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Li J, Zhang D, Shen Y, Qi X. Lumbar degenerative disease after oblique lateral interbody fusion: sagittal spinopelvic alignment and its impact on low back pain. J Orthop Surg Res 2020; 15:326. [PMID: 32795374 PMCID: PMC7427743 DOI: 10.1186/s13018-020-01837-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 07/29/2020] [Indexed: 12/18/2022] Open
Abstract
Background We determined the incidence and risk factors of low back pain (LBP) in patients with lumbar degenerative disease after single-level oblique lateral interbody fusion (OLIF). Methods We retrospectively reviewed 120 lumbar degenerative disease patients who underwent single-level OLIF. We compared preoperative and postoperative radiographic parameters, including segmental lordosis (SL), lumbar lordosis (LL), disk height (DH), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), thoracic kyphosis (TK), and C7-sagittal vertical axis (SVA). Clinical outcomes were evaluated using the Oswestry Disability Index (ODI) scores and visual analog scale (VAS) scores for back and leg pain. All patients were followed up for at least 2 years. Results Thirty-eight patients had postoperative LBP (VAS score for back pain ≥3; LBP group); the remaining 82 patients were in the non-LBP group. Age (P = 0.082), gender (P = 0.425), body mass index (P = 0.138), diagnosis (degenerative spondylolisthesis vs. lumbar spinal stenosis; P = 0.529), surgical level (P = 0.651), blood loss (P = 0.889), and operative time (P = 0.731) did not differ between the groups. In both groups, the ODI and VAS scores for back pain and leg pain significantly improved at the final follow-up compared with the preoperative scores (P = 0.003). Except for the VAS score for back pain (P = 0.000), none of the scores significantly differed between the two groups at the final follow-up (P > 0.05). In the non-LBP group, LL, SL, DH, TK, and SS significantly improved, while PT and C7-SVA significantly decreased at the final follow-up as compared with the preoperative values. In both groups, DH significantly improved postoperatively, with no significant between-group difference (P = 0.325). At the final follow-up, LL, PI-LL mismatch, PT, and C7-SVA showed significantly greater improvement in the non-LBP group than in the LBP group (P < 0.05). Multivariate analysis identified PT, PI-LL mismatch, and C7-SVA as significant risk factors for LBP after OLIF. Conclusion OLIF for single-level lumbar degenerative disease had satisfactory clinical outcomes. PT, PI-LL mismatch, and C7-SVA were significant risk factors for postoperative LBP. Patients with appropriately decreased PT, improved C7-SVA, and PI-LL match experienced less LBP.
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Affiliation(s)
- Jia Li
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, People's Republic of China.,The Key Laboratory of Orthopedic Biomechanics of Hebei Province, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, People's Republic of China
| | - Di Zhang
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, People's Republic of China.,The Key Laboratory of Orthopedic Biomechanics of Hebei Province, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, People's Republic of China
| | - Yong Shen
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, People's Republic of China.,The Key Laboratory of Orthopedic Biomechanics of Hebei Province, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, People's Republic of China
| | - Xiangbei Qi
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, People's Republic of China. .,The Key Laboratory of Orthopedic Biomechanics of Hebei Province, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, People's Republic of China.
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Miyachi R, Miyazaki J. Relationship Between Lumbar Motor Control Ability and Spinal Curvature in Elderly Individuals. Healthcare (Basel) 2020; 8:healthcare8020130. [PMID: 32397367 PMCID: PMC7349748 DOI: 10.3390/healthcare8020130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 11/23/2022] Open
Abstract
This study aimed to clarify the relationship between spine curvature and the movement pattern/motor control ability of the lumbar and hip joints during prone hip extension in elderly individuals. The participants were 14 elderly people who attended a community health class. We measured the motion angle, motion ratio (movement pattern), and motor control ability of the lumbar and hip joints during prone hip extension. In addition, the lumbar lordosis angle and thoracic kyphosis angle were measured in the standing position. There was no correlation between the spinal curvature in the standing position and the lumbar/hip joint movement pattern and motor control ability during prone hip extension. When evaluating the lumbar spine, it is necessary to perform a comprehensive evaluation by interpreting static evaluations such as spinal alignment or dynamic evaluations such as movement patterns and motor control abilities.
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