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Liu N, Liu G, Chang X, Xu Y, Hou Y, Zhang D, Wang L, Chen S. Combining various acupuncture therapies with multimodal analgesia to enhance postoperative pain management following total knee arthroplasty: a network meta-analysis of randomized controlled trials. Front Neurol 2024; 15:1361037. [PMID: 38562427 PMCID: PMC10984270 DOI: 10.3389/fneur.2024.1361037] [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: 12/24/2023] [Accepted: 02/20/2024] [Indexed: 04/04/2024] Open
Abstract
Objective This study aims to evaluate the efficacy and safety of various acupuncture treatments in conjunction with multimodal analgesia (MA) for managing postoperative pain and improving knee function in patients undergoing total knee arthroplasty (TKA), based on the findings from clinical research indicating the potential benefits of acupuncture-related therapies in this context. Methods We searched Web of Science, PubMed, SCI-hub, Embase, Cochrane Library, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Data, and Chinese Scientific Journal Database (VIP) to collect randomized controlled trials of acupuncture-related therapies for post-TKA pain. After independent screening and data extraction, the quality of the included literature was evaluated. The potential for bias in the studies incorporated in the analysis was assessed according to the guidelines outlined in the Cochrane Handbook 5.1. Network meta-analysis (NMA) was conducted using RevMan 5.4 and Stata 16.0 software, with primary outcome measures including visual analog scale (VAS), pain pressure threshold (PPT), hospital for special surgery knee score (HSS), and knee joint range of motion (ROM). Furthermore, the interventions were ranked based on the SUCRA value. Results We conducted an analysis of 41 qualifying studies encompassing 3,003 patients, examining the efficacy of four acupuncture therapies (acupuncture ACU, electroacupuncture EA, transcutaneous electrical acupoint stimulation TEAS, and auricular acupoint therapy AAT) in conjunction with multimodal analgesia (MA) and MA alone. The VAS results showed no significant difference in efficacy among the five interventions for VAS-3 score. However, TEAS+MA (SMD: 0.67; 95%CI: 0.01, 1.32) was more effective than MA alone for VAS-7 score. There was no significant difference in PPT score among the three interventions. ACU + MA (SMD: 6.45; 95%CI: 3.30, 9.60), EA + MA (SMD: 4.89; 95%CI: 1.46, 8.32), and TEAS+MA (SMD: 5.31; 95%CI: 0.85, 9.78) were found to be more effective than MA alone for HSS score. For ROM score, ACU + MA was more efficacious than EA + MA, TEAS+MA, and AAT + MA, MA. Regarding the incidence of postoperative adverse reactions, nausea and vomiting were more prevalent after using only MA. Additionally, the incidence of postoperative dizziness and drowsiness following ACU + MA (OR = 4.98; 95%CI: 1.01, 24.42) was observed to be higher compared to that after AAT + MA intervention. Similarly, the occurrence of dizziness and drowsiness after MA was found to be significantly higher compared to the following interventions: TEAS+MA (OR = 0.36; 95%CI: 0.18, 0.70) and AAT + MA (OR = 0.20; 95%CI: 0.08, 0.50). The SUCRA ranking indicated that ACU + MA, EA + MA, TEAS+MA, and AAT + MA displayed superior SUCRA scores for each outcome index, respectively. Conclusion For the clinical treatment of post-TKA pain, acupuncture-related therapies can be selected as a complementary and alternative therapy. EA + MA and TEAS+MA demonstrate superior efficacy in alleviating postoperative pain among TKA patients. ACU + MA is the optimal choice for promoting postoperative knee joint function recovery in TKA patients. AAT + MA is recommended for preventing postoperative adverse reactions. Systematic review registration https://www.crd.york.ac.uk/, identifier (CRD42023492859).
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Affiliation(s)
- Ningning Liu
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
- School of Acupuncture-Moxibustion and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Gaihong Liu
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Xiaoli Chang
- Research Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Yingxue Xu
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Yi Hou
- School of Acupuncture-Moxibustion and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Dongbin Zhang
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Lianzhu Wang
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Shaozong Chen
- Research Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
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Zhong Z, Zang W, Tang Z, Pan Q, Yang Z, Chen B. Effect of scapular stabilization exercises on subacromial pain (impingement) syndrome: a systematic review and meta-analysis of randomized controlled trials. Front Neurol 2024; 15:1357763. [PMID: 38497039 PMCID: PMC10940535 DOI: 10.3389/fneur.2024.1357763] [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: 12/19/2023] [Accepted: 02/14/2024] [Indexed: 03/19/2024] Open
Abstract
Objective To evaluate the effectiveness of scapular stabilization exercises (SSE) in the treatment of subacromial pain syndrome (SAPS). Methods Clinical randomized controlled trials (RCTs) on SSE in the treatment of SAPS were searched electronically in PubMed, Science Direct, Cochrane Central Register of Controlled Trials (CENTRAL), EBSCOhost, Physiotherapy Evidence Database (PEDro), Web of Science, and other databases from 2000 to 2022, supplemented by manual search. Final RCTs were selected based on inclusion and exclusion criteria, and the Physiotherapy Evidence Database scale was used to evaluate the methodological quality of the study. A meta-analysis was conducted on data using the RevMan5.4 software. Results Eight RCTs involving 387 participants were included. The meta-analysis showed that the experimental group (SSE) had greater improvements in the Visual Analog Scale score [Weighted Mean Difference (WMD) = -0.94, 95% CI (-1.23, -0.65), p < 0.001] and the Shoulder Pain and Disability Index score [WMD = -10.10, 95% CI (-18.87, -1.33), p = 0.02] than the control group (conventional physical therapy). However, range of motion (ROM) was not found to be greater in the experimental group than in the control group. Conclusion Existing evidence moderately supports the efficacy of SSE for reducing pain and improving function in SAPS, without significant improvement in ROM. Future research should focus on larger, high-quality, standardized protocols to better understand SSE's effects across diverse SAPS populations, treatment, and outcome measures. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=307437, CRD42022307437.
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Affiliation(s)
- Ziyi Zhong
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Wanli Zang
- Postgraduate School, Harbin Sport University, Harbin, China
| | - Ziyue Tang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qiaodan Pan
- School of Medicine, Tongji University, Shanghai, China
| | - Zhen Yang
- Department of Movement Sciences, KU Leuven-University of Leuven, Leuven, Belgium
| | - Bin Chen
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
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Pelzer D, Beaudart C, Bornheim S, Maertens de Noordhout B, Schwartz C, Kaux JF. Outcomes of Patients with Lower Limb Loss after Using a Training Prosthesis: A Retrospective Case Series Study. Healthcare (Basel) 2024; 12:567. [PMID: 38470678 PMCID: PMC10931137 DOI: 10.3390/healthcare12050567] [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: 12/27/2023] [Revised: 02/15/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
The aim of this retrospective case series study was to investigate outcomes in patients with lower limb loss based on whether or not they used a training prosthesis (TP) during rehabilitation. The medical records of 171 consecutive patients admitted to rehabilitation hospitalization between January 2014 and December 2018 following a major amputation of the lower limb were reviewed. Patients were categorized into two groups: patients who underwent rehabilitation with a TP and patients who did not use a TP. Outcomes (i.e., discharge destination, length of stay, number of sockets required, and number of the size adaptation of each socket, as well as functional level) were compared between groups. Of the 171 patients, 126 underwent rehabilitation with a TP, and 45 patients underwent rehabilitation without any TP. In conclusion, we found that patients who used a TP had a significantly shorter hospital length of stay when compared to those who did not. This length of stay for patients with TP was not influenced by age but was lowered by a higher body mass index (BMI), tibial instead of femoral amputation, and the male gender. No association was found between the use of TP and discharge destination, functional level, number of socket modifications, and number of sockets required.
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Affiliation(s)
- Doriane Pelzer
- Physical Medicine, Rehabilitation and Sports Traumatology Department, University and University Hospital of Liège, 4000 Liège, Belgium; (D.P.); (S.B.); (B.M.d.N.); (C.S.)
| | - Charlotte Beaudart
- Clinical Pharmacology and Toxicology Research Unit, Department of Biomedical Sciences, Namur Research Institute for Life Sciences (NARILIS), Faculty of Medicine, University of Namur, 5000 Namur, Belgium;
| | - Stephen Bornheim
- Physical Medicine, Rehabilitation and Sports Traumatology Department, University and University Hospital of Liège, 4000 Liège, Belgium; (D.P.); (S.B.); (B.M.d.N.); (C.S.)
| | - Benoît Maertens de Noordhout
- Physical Medicine, Rehabilitation and Sports Traumatology Department, University and University Hospital of Liège, 4000 Liège, Belgium; (D.P.); (S.B.); (B.M.d.N.); (C.S.)
| | - Cédric Schwartz
- Physical Medicine, Rehabilitation and Sports Traumatology Department, University and University Hospital of Liège, 4000 Liège, Belgium; (D.P.); (S.B.); (B.M.d.N.); (C.S.)
| | - Jean-François Kaux
- Physical Medicine, Rehabilitation and Sports Traumatology Department, University and University Hospital of Liège, 4000 Liège, Belgium; (D.P.); (S.B.); (B.M.d.N.); (C.S.)
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Maricot A, Lathouwers E, Verschueren J, De Pauw K, Meeusen R, Roelands B, Tassignon B. Test-retest, intra- and inter-rater reliability of the reactive balance test in patients with chronic ankle instability. Front Neurol 2024; 15:1320043. [PMID: 38434204 PMCID: PMC10906270 DOI: 10.3389/fneur.2024.1320043] [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: 10/12/2023] [Accepted: 01/23/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction The Reactive Balance Test (RBT) could be a valuable addition to research on chronic ankle instability (CAI) and clinical practice, but before it can be used in clinical practice it needs to be reliable. It has already been proven reliable in healthy recreational athletes, but not yet in patients with CAI who have shown persistent deficits in dynamic balance. The study aimed to determine the test-retest, intra-, and inter-rater reliability of the RBT in patients with CAI, and the test-retest and inter-rater reliability of the newly developed RBT score sheet. Methods We used a repeated-measures, single-group design to administer the RBT to CAI patients on three occasions, scored by multiple raters. We included 27 participants with CAI. The study used multiple reliability measures, including Pearson r, intra-class correlations (ICC), standard error of measurement (SEM), standard error of prediction (SEP), minimal detectable change (MDC), and Bland-Altman plots, to evaluate the reliability of the RBT's outcome measures (visuomotor response time and accuracy). It also assessed the test-retest and inter-rater reliability of the RBT score sheet using the same measures. Results The ICC measures for test-retest reliability were similar for accuracy (0.609) and VMRT (0.594). Intra-rater reliability had high correlations and ICCs for accuracy (r = 0.816, ICC = 0.815) and VMRT (r = 0.802, ICC = 0.800). Inter-rater reliability had a higher ICC for VMRT (0.868) than for accuracy (0.690). Conclusion Test-retest reliability was moderate, intra-rater reliability was good, and inter-rater reliability showed moderate reliability for accuracy and good reliability for VMRT. Additionally, the RBT shows robust SEM and mean difference measures. The score sheet method also demonstrated moderate test-retest reliability, while inter-rater reliability was good to excellent. This suggests that the RBT can be a valuable tool in assessing and monitoring balance in patients with CAI.
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Affiliation(s)
- Alexandre Maricot
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Elke Lathouwers
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jo Verschueren
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kevin De Pauw
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotics Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
| | - Romain Meeusen
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotics Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
- Department of Sports, Recreation, Exercise and Sciences (SRES), Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Bart Roelands
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotics Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
| | - Bruno Tassignon
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
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Sheikhi B, Rabiei P, Letafatkar A, Rossettini G. Is Adding Education to Trunk and Hip Exercises Beneficial for Patellofemoral Pain? A Randomized Controlled Trial. Arch Phys Med Rehabil 2024; 105:217-226. [PMID: 37717685 DOI: 10.1016/j.apmr.2023.08.030] [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: 02/26/2023] [Revised: 08/03/2023] [Accepted: 08/29/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE To investigate the effect of adding education to trunk and hip exercises in patients with patellofemoral pain (PFP). DESIGN A randomized controlled trial. SETTING Research laboratory. PARTICIPANTS Sixty patients with PFP (N=60) were randomly assigned to either an experimental group (education followed by trunk and hip exercises, n=30) or a control group (trunk and hip exercises, n=30). INTERVENTIONS Both groups received 8 weeks of trunk and hip exercises, while patients in the experimental group participated in 3 prior education sessions. MAIN OUTCOME MEASURES The primary outcome was pain; secondary outcomes were pain catastrophizing, kinesiophobia, function, and muscle strength. Outcomes were assessed at baseline, after 8 weeks (post-intervention), and 3 months post-intervention (follow-up). RESULTS No significant between-group differences were observed for pain outcome post-intervention. The experimental group showed superiority over the control group in the improvement of pain catastrophizing (mean difference: -2.32; 95% confidence interval [CI] -1.059 to 0.028) and kinesiophobia (mean difference: -3.56; 95% CI -1.067 to -0.035) at post-intervention. In the experimental group, improvements were maintained at follow-up assessment for all outcomes, except muscle strength. CONCLUSION Adding education to trunk and hip exercises was associated with greater improvements in psychological outcomes than trunk and hip exercises alone after the intervention. Education can be incorporated when designing trunk and hip exercises for patients with PFP.
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Affiliation(s)
- Bahram Sheikhi
- Department of Biomechanics and Sports Injuries, Kharazmi University, Tehran, Iran.
| | - Pouya Rabiei
- Faculty of Medicine, Laval University, Quebec City, Canada; Interdisciplinary Center for Research in Rehabilitation and Social Integration (Cirris), Quebec City, Canada
| | - Amir Letafatkar
- Department of Biomechanics and Sports Injuries, Kharazmi University, Tehran, Iran
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Starzak M, Niźnikowski T, Biegajło M, Nogal M, Arnista WŁ, Mastalerz A, Starzak A. Attentional focus strategies in racket sports: A systematic review. PLoS One 2024; 19:e0285239. [PMID: 38181000 PMCID: PMC10769023 DOI: 10.1371/journal.pone.0285239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 12/12/2023] [Indexed: 01/07/2024] Open
Abstract
The body of evidence has shown that the external focus of attention (EF) rather than the internal focus of attention (IF) enhances motor skill learning and performance. Within racket sports which require a high level of motor control, anticipation skills, and mental preparedness, effectively directing attention is essential to elicit improvements in athletic performance. The present review aimed to evaluate the scientific evidence concerning the effects of attentional focus instructions on motor learning and performance in racket sports. We systematically reviewed the literature according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The study was registered with the Open Science Framework (osf.io/m4zat). Four electronic databases (Web of Science, Scopus, MEDLINE, and SPORTDiscus) were searched for original research publications. Inclusion criteria were: peer-reviewed journals; healthy and free from injury participants; attentional focus literature specific to the external or internal focus; attentional focus related to motor learning or motor performance; studies included at least one comparator (e.g., different attentional focus group, or control groups with neutral or no specific instruction); publications in which task(s) or skill(s) related to one of the racket sports (tennis, table tennis, badminton, squash, or padel). The initial search yielded 2005 studies. Finally, 9 studies were included in the quantitative analysis. Overall, the results indicated that EF benefits the learning and performance of racket sport skills, compared to IF and over control conditions. The findings suggest that coaches and practitioners should consider the adoption of EF to optimize racket skills performance, particularly in novice or low-skilled athletes.
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Affiliation(s)
- Marcin Starzak
- Faculty of Physical Education and Health in Biała Podlaska, Józef Piłsudski University of Physical Education in Warsaw, Biała Podlaska, Poland
| | - Tomasz Niźnikowski
- Faculty of Physical Education and Health in Biała Podlaska, Józef Piłsudski University of Physical Education in Warsaw, Biała Podlaska, Poland
| | - Michał Biegajło
- Faculty of Physical Education and Health in Biała Podlaska, Józef Piłsudski University of Physical Education in Warsaw, Biała Podlaska, Poland
| | - Marta Nogal
- Faculty of Physical Education and Health in Biała Podlaska, Józef Piłsudski University of Physical Education in Warsaw, Biała Podlaska, Poland
| | - Weronika Łuba Arnista
- Faculty of Health Sciences, Lomza State University of Applied Sciences, Lomza, Poland
| | - Andrzej Mastalerz
- Faculty of Physical Education, Józef Piłsudski University of Physical Education in Warsaw, Warsaw, Poland
| | - Anna Starzak
- Faculty of Physical Education and Health in Biała Podlaska, Józef Piłsudski University of Physical Education in Warsaw, Biała Podlaska, Poland
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Ceccarelli C, Andreani A, Soave A, Salomon M, Maselli F. Use of blood flow restriction for increasing the strength of the ischiocrural muscles in anterior cruciate ligament rehabilitation: A case report. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2024; 29:e2059. [PMID: 37964694 DOI: 10.1002/pri.2059] [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: 04/18/2023] [Revised: 10/11/2023] [Accepted: 10/23/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND The hamstring muscles have a key function in the stability of the knee, limiting the anterior translation of the tibia. Therefore, to better perform rehabilitation after anterior cruciate ligament (ACL) surgery, it is important to develop a specific program based on hamstring strength recovery. It is possible to increase strength and muscle hypertrophy through high load exercises (HL); the recommended load is about 60%-80% of a maximum repetition (MR). Although low-load resistance training (LL) is ineffective at reproducing these values, the use of Blood Flow Restriction (BFR) with LL exercises appears to allow athletes to increase strength and muscle hypertrophy. This could limit functional decline and mitigate muscle atrophy allowing to optimize the recovery path and load management in post-operative patients. Recent scientific evidence, as far as the increasingly frequent use of BFR in rehabilitation and sports rehabilitation is concerned, suggests that these devices could represent one of the most significant innovations in the physiotherapy field. The aim of this study was to increase the strength of the hamstrings in the early phases of ACL rehabilitation with an LL-BFR training protocol for speeding up the development of adequate muscle strength. CASE DESCRIPTIONS The patient, a 25-year-old male professional footballer, suffered from ACL injury during a football match, and after three months, he underwent a reconstruction ACL surgery with medial Hamstring tendon autograft. The athlete engaged a pre-operative program to restore a full active and passive knee range of motion and increase muscular strength. The first rehabilitation phase was supported by the adoption of BFR for hamstring strengthening, starting from the sixth week post-surgery (T0). A complete assessment of posterior hamstring muscles was performed through a hand-held dynamometer and load detection platforms. Three different types of exercises, focusing on the hamstring muscles, were chosen. Two further assessments were performed over time (T1 ant T2), highlighting different changes that occurred. RESULTS Interesting results showed a significant increase between T0 and T1 for all the assessed outcomes; in this case an average increase in strength of 59.87% between the beginning and the end of 4 weeks rehabilitation protocol was obtained in the first interval (T0-T1), while only 25.26% resulted in the second interval (T1-T2). However, the collected data should be considered with caution due to some limitations: the single experience of a single patient can hardly be generalized. Moreover, the reliance on isometric measurement of maximal strength and the absence of a direct strength measurement of the hamstrings during squat remain questionable. CONCLUSION The final results suggest the capacity of the LL-BFR exercises to recreate a condition of a high intensity muscular effort with respect to load management, especially after surgery. This highlights the need to further investigate BFR adoption as it allows the patients to speed up their rehabilitation goals in developing adequate muscle strength.
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Affiliation(s)
| | - Alessandro Andreani
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise C/daTappino c/o Cardarelli Hospital, Campobasso, Italy
| | | | - Mattia Salomon
- Department of Clinical Sciences and Translational Medicine, University of Roma "Tor Vergata" c/o Medicine and Surgery School, Rome, Italy
- Department of Human Neurosciences, University of Roma "Sapienza Roma", Rome, Italy
| | - Filippo Maselli
- Department of Human Neurosciences, University of Roma "Sapienza Roma", Rome, Italy
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Zhang X, Chang T, Hu W, Shi M, Chai Y, Wang S, Zhou G, Han M, Zhuang M, Yu J, Yin H, Zhu L, Zhao C, Li Z, Liao X. Efficacy and safety of yoga for the management of chronic low back pain: an overview of systematic reviews. Front Neurol 2023; 14:1273473. [PMID: 37965167 PMCID: PMC10641484 DOI: 10.3389/fneur.2023.1273473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 10/03/2023] [Indexed: 11/16/2023] Open
Abstract
Background Yoga is a non-pharmacological conservative therapeutic modality that can be employed for the management of chronic low back pain (CLBP). In this overview, we have summarized and evaluated data from current systematic reviews (SRs) on the use of yoga for CLBP. Methods We comprehensively searched SRs on the use of yoga for CLBP in nine electronic databases from inception to September 2023. The methodological quality was evaluated using the Assessment of Multiple Systematic Review Scale-2 (AMSTAR-2). The reporting quality of the included SRs was evaluated using the Preferred Reporting Item for Systematic Review and Meta-Analysis-2020 (PRISMA-2020), and the quality of data was graded using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Two independent researchers performed the screening, data extraction, and quality assessment process of SRs. Results A total of 13 SRs were included. The results of the AMSTAR-2 indicated that the methodological quality of the included studies was relatively low. The PRISMA-2020 checklist evaluation results indicated that methodological limitations in reporting, especially regarding data processing and presentation, were the main weaknesses. The GRADE assessment indicated that 30 outcomes were rated moderate, 42 were rated low level, and 20 were rated very low level. Downgrading factors were mainly due to the limitations of the included studies. Conclusion Yoga appears to be an effective and safe non-pharmacological therapeutic modality for the Management of CLBP. Currently, it may exhibit better efficacy in improving pain and functional disability associated with CLBP. However, the methodological quality and quality of evidence for SRs/MAs in the included studies were generally low, and these results should be interpreted cautiously.
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Affiliation(s)
- Xianshuai Zhang
- Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Tianying Chang
- Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Wenlong Hu
- Shenzhen People's Hospital, Shenzhen, China
| | - Mingpeng Shi
- Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Yating Chai
- Department of Radiology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Siyi Wang
- Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Guohui Zhou
- Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Mingze Han
- Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Minghui Zhuang
- China Academy of Chinese Medical Sciences, Wangjing Hospital, Beijing, China
| | - Jie Yu
- China Academy of Chinese Medical Sciences, Wangjing Hospital, Beijing, China
| | - He Yin
- China Academy of Chinese Medical Sciences, Wangjing Hospital, Beijing, China
| | - Liguo Zhu
- China Academy of Chinese Medical Sciences, Wangjing Hospital, Beijing, China
| | - Changwei Zhao
- Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Zhenhua Li
- Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Xing Liao
- Center for Evidence-Based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
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Saravi B, Zink A, Ülkümen S, Couillard-Despres S, Wollborn J, Lang G, Hassel F. Clinical and radiomics feature-based outcome analysis in lumbar disc herniation surgery. BMC Musculoskelet Disord 2023; 24:791. [PMID: 37803313 PMCID: PMC10557221 DOI: 10.1186/s12891-023-06911-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 09/24/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Low back pain is a widely prevalent symptom and the foremost cause of disability on a global scale. Although various degenerative imaging findings observed on magnetic resonance imaging (MRI) have been linked to low back pain and disc herniation, none of them can be considered pathognomonic for this condition, given the high prevalence of abnormal findings in asymptomatic individuals. Nevertheless, there is a lack of knowledge regarding whether radiomics features in MRI images combined with clinical features can be useful for prediction modeling of treatment success. The objective of this study was to explore the potential of radiomics feature analysis combined with clinical features and artificial intelligence-based techniques (machine learning/deep learning) in identifying MRI predictors for the prediction of outcomes after lumbar disc herniation surgery. METHODS We included n = 172 patients who underwent discectomy due to disc herniation with preoperative T2-weighted MRI examinations. Extracted clinical features included sex, age, alcohol and nicotine consumption, insurance type, hospital length of stay (LOS), complications, operation time, ASA score, preoperative CRP, surgical technique (microsurgical versus full-endoscopic), and information regarding the experience of the performing surgeon (years of experience with the surgical technique and the number of surgeries performed at the time of surgery). The present study employed a semiautomatic region-growing volumetric segmentation algorithm to segment herniated discs. In addition, 3D-radiomics features, which characterize phenotypic differences based on intensity, shape, and texture, were extracted from the computed magnetic resonance imaging (MRI) images. Selected features identified by feature importance analyses were utilized for both machine learning and deep learning models (n = 17 models). RESULTS The mean accuracy over all models for training and testing in the combined feature set was 93.31 ± 4.96 and 88.17 ± 2.58. The mean accuracy for training and testing in the clinical feature set was 91.28 ± 4.56 and 87.69 ± 3.62. CONCLUSIONS Our results suggest a minimal but detectable improvement in predictive tasks when radiomics features are included. However, the extent of this advantage should be considered with caution, emphasizing the potential of exploring multimodal data inputs in future predictive modeling.
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Affiliation(s)
- Babak Saravi
- Department of Orthopedics and Trauma Surgery, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany.
- Department of Spine Surgery, Loretto Hospital, Freiburg, Germany.
- Institute of Experimental Neuroregeneration, Spinal Cord Injury and Tissue Regeneration Center Salzburg (SCI-TReCS), Paracelsus Medical University, Salzburg, 5020, Austria.
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
| | - Alisia Zink
- Department of Spine Surgery, Loretto Hospital, Freiburg, Germany
| | - Sara Ülkümen
- Department of Orthopedics and Trauma Surgery, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Sebastien Couillard-Despres
- Institute of Experimental Neuroregeneration, Spinal Cord Injury and Tissue Regeneration Center Salzburg (SCI-TReCS), Paracelsus Medical University, Salzburg, 5020, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Jakob Wollborn
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Gernot Lang
- Department of Orthopedics and Trauma Surgery, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Frank Hassel
- Department of Spine Surgery, Loretto Hospital, Freiburg, Germany
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Huang SX, Li HG, Liang HJ, Wang DM, Peng JH, Shen FC, Li WP, Lin L, Xiao ZY, Hou ZD. Comparison of clinical characteristics between adult-onset and juvenile-onset non-radiographic axial spondyloarthritis in Chinese patients: results from the COCAS cohort. Eur J Med Res 2023; 28:388. [PMID: 37770993 PMCID: PMC10537580 DOI: 10.1186/s40001-023-01387-x] [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: 04/04/2023] [Accepted: 09/20/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic disease predominantly affecting the axial skeleton. We aimed to describe the clinical characteristics of patients with non-radiographic axSpA (nr-axSpA) in China and compare the differences between adult- and juvenile-onset cases. METHODS A cross-sectional study was conducted using data from 776 patients with nr-axSpA in the Clinical Characteristic and Outcome in Chinese Axial Spondyloarthritis (COCAS) study cohort. Patients were divided into two groups including the adult-onset group (n = 662) and the juvenile-onset group (n = 114) according to age at disease onset. Baseline demographics and clinical characteristics were compared between patients with adult-onset and juvenile-onset nr-axSpA. RESULTS Overall, the male-to-female ratio was 1.26:1, the prevalence of HLA-B27 positivity was 72.2%, and the median age at disease onset of nr-axSpA was 22 years. Nearly 75% of nr-axSpA patients had peripheral arthritis in the disease course, and the prevalence of extra-articular manifestations was 10.4%. The juvenile-onset group contained a higher proportion of men (66.7% vs. 53.9%, P = 0.011) and a longer baseline disease duration (4.0 [4.0] vs. 1.6 [3.5], P < 0.001) than the adult-onset group. A family history of spondyloarthritis was more frequent in the juvenile-onset group than in the adult-onset group (23.7% vs. 15.4%, P = 0.028), but no significant difference in the prevalence of HLA-B27 positivity was observed between the two groups (P = 0.537). Regarding initial symptoms, peripheral arthritis occurred more often in patients with juvenile-onset nr-axSpA, whereas patients with adult-onset nr-axSpA presented more frequently with axial involvement. The prevalence of inflammatory back pain (IBP) was higher in the adult-onset group than in the juvenile-onset group (85.0% vs. 75.4%, P = 0.010), whereas the juvenile-onset group showed a higher prevalence of peripheral arthritis and enthesitis than the adult-onset group (67.5% vs. 48.5%, P < 0.001; 35.1% vs. 23.3%, P = 0.007, respectively). CONCLUSIONS Compared with adult-onset nr-axSpA, juvenile-onset nr-axSpA was more common in men and those with a family history of spondyloarthritis. Juvenile-onset nr-axSpA presents with a "peripheral predominant" mode at disease onset and a higher frequency of peripheral arthritis and enthesitis during the disease course.
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Affiliation(s)
- Shu-Xin Huang
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Hao-Guang Li
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Department of Rheumatology and Immunology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Hong-Jin Liang
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Dan-Min Wang
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Jian-Hua Peng
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Feng-Cai Shen
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Wei-Ping Li
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Ling Lin
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Department of Rheumatology, Shantou University Medical College, Shantou, 515041, China
| | - Zheng-Yu Xiao
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Zhi-Duo Hou
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China.
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China.
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Fenwick A, Reichel T, Eden L, Schmalzl J, Meffert R, Plumhoff P, Gilbert F. Deltoid Muscle Tension Alterations Post Reverse Shoulder Arthroplasty: An Investigation Using Shear Wave Elastography. J Clin Med 2023; 12:6184. [PMID: 37834827 PMCID: PMC10573934 DOI: 10.3390/jcm12196184] [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: 07/03/2023] [Revised: 08/06/2023] [Accepted: 09/05/2023] [Indexed: 10/15/2023] Open
Abstract
INTRODUCTION This study aimed to evaluate the utility of shear wave elastography (SWE) in assessing changes in deltoid muscle properties following reverse shoulder arthroplasty (RSA). METHODS Our cohort consisted of 18 patients who underwent RSA due to various conditions, including osteoarthritis, cuff arthropathy, and irreducible proximal humeral fractures. Pre- and postoperative muscle elasticity and stiffness were measured using SWE and were compared with functional outcomes and radiological parameters. RESULTS Our results showed significant changes in deltoid muscle elasticity after RSA, particularly in the anterior and middle portions. However, these alterations were not correlated with postoperative functional outcomes or specific radiological parameters. The study also underscored the potential of SWE for future applications, including the preoperative assessment of deltoid function, postoperative monitoring, and intraoperative use for optimal component positioning during RSA. CONCLUSION Further research, involving larger, more homogeneous patient cohorts is needed to confirm these findings and to explore the potential influence of these changes on the biomechanical design of implants and prosthesis positioning in RSA.
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Affiliation(s)
- Annabel Fenwick
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital of Wuerzburg, Oberduerrbacher Str. 6, 97080 Wuerzburg, Germany
- Department of Trauma, Orthopedic, Hand and Plastic Surgery, University Hospital of Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
| | - Thomas Reichel
- Muskuloskelettales Universitätszentrum München, Unfallchirurgie, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 München, Germany
| | - Lars Eden
- Department of Trauma, Shoulder and Reconstructive Surgery, Krankenhaus Rummelsberg GmbH, Rummelsberg 71, 90592 Schwarzenbruck, Germany
| | - Jonas Schmalzl
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital of Wuerzburg, Oberduerrbacher Str. 6, 97080 Wuerzburg, Germany
| | - Rainer Meffert
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital of Wuerzburg, Oberduerrbacher Str. 6, 97080 Wuerzburg, Germany
| | - Piet Plumhoff
- Ortho Höchberg, Zentrum für Orthopädie und Unfallchirurgie, Hauptstraße 78, 97204 Höchberg, Germany
| | - Fabian Gilbert
- Muskuloskelettales Universitätszentrum München, Unfallchirurgie, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 München, Germany
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12
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García-López FJ, Pastora-Bernal JM, Moreno-Morales N, Estebanez-Pérez MJ, Liñán-González A, Martín-Valero R. Virtual reality to improve low-back pain and pelvic pain during pregnancy: a pilot RCT for a multicenter randomized controlled trial. Front Med (Lausanne) 2023; 10:1206799. [PMID: 37731709 PMCID: PMC10507341 DOI: 10.3389/fmed.2023.1206799] [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: 04/16/2023] [Accepted: 08/14/2023] [Indexed: 09/22/2023] Open
Abstract
A significant proportion of women experience low back and pelvic pain during and after pregnancy, which can negatively impact their daily lives. Various factors are attributed to these complaints, and many affected women do not receive adequate healthcare. However, there is evidence to support the use of different physiotherapeutic interventions to alleviate these conditions. Virtual reality is a promising complementary treatment to physiotherapy, particularly in improving pain perception and avoidance. The primary objective of this study is to evaluate the efficacy of a four-week program combining VR and physiotherapy compared to standard physiotherapy in pregnant women with low back and pelvic pain, in terms of improving pain avoidance, intensity, disability, and functional level. The study also aims to investigate patient satisfaction with the VR intervention. This research will be conducted through a multi-center randomized controlled clinical trial involving pregnant patients residing in the provinces of Seville and Malaga with a diagnosis of low back and pelvic pain during pregnancy. The alternative hypothesis is that the implementation of a Virtual Reality program in combination with standard physiotherapy will result in better clinical outcomes compared to the current standard intervention, which could lead to the development of new policies and interventions for these pathologies and their consequences. Clinical trial registration: clinicaltrials.gov, identifier NCT05571358.
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Affiliation(s)
| | | | - Noelia Moreno-Morales
- Department of Physiotherapy, Faculty of Health Science, University of Malaga, Malaga, Spain
| | - María-José Estebanez-Pérez
- Department of Physiotherapy, Faculty of Health Science, University of Malaga, Malaga, Spain
- Department of Physiotherapy, Faculty of Health Science, Campus of Melilla, University of Granada, Melilla, Spain
| | - Antonio Liñán-González
- Department of Nursing, Faculty of Health Science, Campus of Melilla, University of Granada, Melilla, Spain
| | - Rocío Martín-Valero
- Department of Physiotherapy, Faculty of Health Science, University of Malaga, Malaga, Spain
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13
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Sanz-Junoy G, Gavín-Chocano Ó, Ubago-Jiménez JL, Molero D. Differential Magnitude of Resilience between Emotional Intelligence and Life Satisfaction in Mountain Sports Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6525. [PMID: 37569065 PMCID: PMC10419084 DOI: 10.3390/ijerph20156525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023]
Abstract
The field of mountain sports has its own characteristics, different from other sports modalities. Emotional intelligence and resilience not only refer to the adaptive capacity that can be developed after an adverse experience, but can also be factors that positively affect sporting performance in extreme conditions. In this study, 4818 athletes from the Spanish Federation of Mountain Sports and Climbing participated; 2696 were men (67.1%) and 1322 were women (32.9%), with a mean age of 49.42 years (±11.9). The Resilience Scale (RS-14), Wong Law Emotional Intelligence Scale (WLEIS-S) and Satisfaction with Life Scale (SWLS) were used. The aim was to provide evidence for the potential for resilience (personal competence and acceptance of self and life) among EI and life satisfaction in mountain and climbing athletes. The results showed that the coefficients of determination of personal competence [(Q2 = 0.286); (R2 = 0.578)], acceptance of self [(Q2 = 0.310); (R2 = 0.554)] and life satisfaction [(Q2 = 0.299); (R2 = 0.421)] for the estimation of the measurement model indicated a good model fit. In the future, it would be necessary to carry out specific studies discriminating by sport modality and methods for this area, with a large number of athletes and disciplines, as well as evaluating its possible applications for the improvement of emotional factors.
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Affiliation(s)
| | - Óscar Gavín-Chocano
- Department of Pedagogy, Lagunillas Campus, University of Jaén, 23071 Jaén, Spain;
| | - José L. Ubago-Jiménez
- Department of Didactics of Musical, Plastic and Corporal Expression, University of Granada, 18071 Granada, Spain;
| | - David Molero
- Department of Pedagogy, Lagunillas Campus, University of Jaén, 23071 Jaén, Spain;
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14
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Emamvirdi M, Hosseinzadeh M, Letafatkar A, Thomas AC, Dos'Santos T, Smania N, Rossettini G. Comparing kinematic asymmetry and lateral step-down test scores in healthy, chronic ankle instability, and patellofemoral pain syndrome female basketball players: a cross-sectional study. Sci Rep 2023; 13:12412. [PMID: 37524846 PMCID: PMC10390571 DOI: 10.1038/s41598-023-39625-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/27/2023] [Indexed: 08/02/2023] Open
Abstract
We aimed to understand whether ankle dorsiflexion range of motion (ROM) and dynamic knee valgus (DKV) kinematic inter-limb asymmetries would be associated with the Lateral Step-Down Test (LSD) in basketball players with chronic ankle instability (CAI), patellofemoral pain (PFP) and healthy controls (HC). An observational cross-sectional study with a between-subject design was employed. Female basketball athletes with CAI (n = 20), PFP (n = 20) and HC (n = 20) were recruited. Ankle dorsiflexion-ROM, DKV angle during a single-limb squat, and LSD quality were measured bilaterally. The Asymmetry index (ASI) was calculated to identify between-limb percentage imbalances. The correlation matrix between the tasks was calculated. Ankle dorsiflexion-ROM was less in the CAI and PFP than in the HC group regardless of limb (p < 0.001). DKV angle was greater in the CAI and PFP than in the HC group bilaterally (p < 0.001). LSDs were similar between the PFP and CAI groups (p = 0.698) but worse than the HC group (p = 0.001). The ASI showed asymmetry across all tasks (p < 0.001), with the greatest asymmetry for the DKV angle. The correlation matrix between tasks on both limbs was significant (p < 0.05). Our findings suggest significant asymmetries in ankle dorsiflexion-ROM and frontal plane knee control are present in female basketball athletes with CAI and PFP, and thus, highlights need to evaluate and reduce limb asymmetries in these populations.
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Affiliation(s)
- Mahsa Emamvirdi
- Department of Biomechanics and Sport Injuries, Kharazmi University, Tehran, Iran
| | - Mahdi Hosseinzadeh
- Department of Sport Injuries and Corrective Exercises, Sport Sciences Research Institute, No. 3, 5th Alley, Miremad Street, Motahhari Street, P O Box: 1587958711, Tehran, Iran.
| | - Amir Letafatkar
- Sports Injury and Corrective Exercises, Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran
| | - Abbey C Thomas
- Department of Applied Physiology, Health, and Clinical Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Thomas Dos'Santos
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, UK
- Manchester Institute of Sport, Manchester Metropolitan University, Manchester, UK
| | - Nicola Smania
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Neuromotor and Cognitive Rehabilitation Research Centre (CRRNC), University of Verona, Verona, Italy
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15
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Orr E, Arbel T, Levy M, Sela Y, Weissberger O, Liran O, Lewis J. Virtual reality in the management of patients with low back and neck pain: a retrospective analysis of 82 people treated solely in the metaverse. Arch Physiother 2023; 13:11. [PMID: 37194037 PMCID: PMC10189988 DOI: 10.1186/s40945-023-00163-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 03/31/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Clinically, neck pain disorders (NPD) and non-specific low back pain (NS-LBP) are respectively the fourth and first most common conditions associated with the greatest number of years lived with disability. Remote delivery of care may benefit healthcare sustainability, reduce environmental pollution, and free up space for those requiring care non-virtual care. METHODS A retrospective analysis was performed on 82 participants with NS-LBP and/or NPD who received exercise therapy delivered solely in the metaverse using virtually reality. The study was to determine if this was achievable, safe, had appropriate outcome measures that could be collected, and if there was any early evidence of beneficial effects. RESULTS The study demonstrated that virtual reality treatment delivered via the metaverse appears to be safe (no adverse events or side effects). Data for more than 40 outcome measures were collected. Disability from NS-LBP was significantly reduced (Modified Oswestry Low Back Pain Disability Index) by 17.8% (p < 0.001) and from NPD (Neck Disability Index) by 23.2% (p = 0.02). CONCLUSIONS The data suggest that this method of providing exercise therapy was feasible, and safe (no adverse events reported), that complete reports were obtained from a large selection of patients, and that software acquired outcomes were obtainable over a range of time points. Further prospective research is necessary to better understand our clinical findings.
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Affiliation(s)
| | | | | | - Yaron Sela
- School of Psychology, Reichman University, Herzliya, Israel
| | | | - Omer Liran
- Cedars-Sinai, Division of Health Services Research, Department of Medicine, Los Angeles, CA, USA
- Department of Psychiatry and Behavioral Sciences, Cedars-Sinai, Los Angeles, CA, USA
| | - Jeremy Lewis
- Therapy Department, Central London Community Healthcare National Health Service Trust, Finchley Memorial Hospital, London, N12 0JE, UK.
- Clinical Therapies, University of Limerick, Limerick, Ireland.
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Gholami Z, Faezi ST, Letafatkar A, Madreseh E. Pain neuroscience education, blended exercises and booster sessions as an effective therapy for pain, functional and psychological factors in patients with knee osteoarthritis: a study protocol for a single-blind randomised controlled trial with 2 2 factorial design during 6-month follow-up. BMJ Open 2023; 13:e070336. [PMID: 37173101 PMCID: PMC10186447 DOI: 10.1136/bmjopen-2022-070336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
INTRODUCTION This study aims to investigate whether a pain neuroscience education (PNE) combined with a blended exercises programme including aerobic, resistance, neuromuscular, breathing, stretching and balance exercises and diet education provides greater pain relief and improvement in functional and psychological factors than PNE and blended exercises alone and whether 'exercise booster sessions (EBS)' approach may improve outcomes and increase adherence in patients with knee osteoarthritis (KOA) (by telerehabilitation (TR)). METHODS AND ANALYSIS In this single-blind randomised controlled trial, 129 patients (both genders; age >40) diagnosed with KOA will be randomly assigned to one of the 22 treatment combinations as: (1) blended exercises alone (36 sessions over 12 weeks), (2) PNE alone (three sessions over 2 weeks), (3) combination of PNE with blended exercises (exercise three times a week for 12 weeks combined with three sessions of PNE) and (4) a control group. Outcome assessors will be blinded towards group allocation. The primary outcome variables are the visual analogue scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis index in knee osteoarthritis (WOMAC) score. Secondary outcomes include Pain Self-Efficacy Questionnaire (PSEQ), Depression, Anxiety and Stress Scale (DASS), Tampa Scale for Kinesiophobia (TSK), Short Falls Efficacy Scale International (FES-I), Pain Catastrophising Scale (PCS), Short Form Health Survey (SF-12) and Exercise Adherence Rating Scale (EARS), 30 s sit-to-stand test (30CST), Timed Up and Go (TUG), lower limbs' muscle strength and lower limb joints' active range of motion (AROM) will be performed at baseline, 3 and 6 months' postinterventions. The primary and secondary outcomes will assess at baseline, 3 months and 6 months postinterventions.The findings will be useful in establishing an effective treatment strategy covering multiple aspects behind KOA. The study protocol is conducted in clinical settings, thereby enhancing the possibility of future implementation of the treatments in the healthcare systems and self-care management. Results in comparison between groups will help to clarify the most effective of mixed-method TR (blended exercise, PNE, EBS with diet education) on more improvement in pain, functional and psychological factors in patients with KOA. This study will combine some of the most critical interventions, to be able to introduce a 'gold standard therapy' in the treatment of KOA. ETHICS AND DISSEMINATION The trial has been approved by the ethics committee for research involving human subjects of the Sport Sciences Research Institute of Iran (IR.SSRC.REC.1401.021). The study findings will be published in international peer-reviewed journals. TRIAL REGISTRATION NUMBER IRCTID: IRCT20220510054814N1.
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Affiliation(s)
- Zohreh Gholami
- Biomechanics and Sports Injuries, Kharazmi University - Karaj, Hesarak, Iran
| | | | - Amir Letafatkar
- Department of Biomechanics and Sport Injuries, Kharazmi University, Tehran, Iran
| | - Elham Madreseh
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
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van der Wilk S, Hoorntje A, Blankevoort L, van Geenen R, Kerkhoffs GMMJ, Kuijer PPFM. Physical activity after revision knee arthroplasty including return to sport and work: a systematic review and meta-analysis including GRADE. BMC Musculoskelet Disord 2023; 24:368. [PMID: 37161424 PMCID: PMC10170708 DOI: 10.1186/s12891-023-06458-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 04/25/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND The number of primary knee arthroplasties (KAs) performed annually is rising, especially among active, working age patients. Consequently, revision KA is also increasingly performed. Our aim was to systematically review the extent to which patients were physically active following revision KA, and the rate and timing of return to sport and work. METHODS A search was conducted in the databases Medline and Embase until February 24th, 2023. Studies describing patients with revision total knee arthroplasty (rTKA) or revision unicondylar knee arthroplasty (rUKA), with outcomes regarding physical activity or return to sport (RTS) or work (RTW) were included. Quality of studies was assessed using the Newcastle-Ottawa scale, meta-analyses were performed using RevMan 5.4 and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). RESULTS Of the 4,314 articles screened, 22 studies were included describing 2,462 rTKA patients (no rUKA), 42% were male with a mean age of 67 years (range 24 - 95). No studies reported objective physical activity measurements. Twenty-two studies reported patient reported outcome measures (PROMs). The PROMs that were pooled on a scale from zero to ten were the UCLA Activity Score, the Tegner Activity Level Scale, the Lower-Extremity Activity Scale, Devane Activity Score, and physical activity related subscales of the Knee injury and Osteoarthritis Outcome Score. The retrospective studies of moderate quality showed a statistically significant postoperative improvement of 1.7 points (MD = 1.71, 95% CI 1.48 - 1.94 (p < 0.0001); 14 studies, n = 1,211). For the prospective moderate-quality studies, a statistically significant postoperative increase of 0.9 points was found (MD = 0.89, 95% CI 0.48 - 1.30 (p < 0.0001); 6 studies, n = 1,027). Regarding RTS, 12% of patients participated in so-called 'non-recommended' activities (i.e., hockey, soccer, football, gymnastics, jogging, singles tennis, and basketball) after rTKA (1 study, n = 206). The pooled RTW was 86% (2 studies, range 18-95%, n = 234). CONCLUSIONS The majority of patients self-reported an improved postoperative activity level after rTKA. Patients could maintain an active lifestyle in daily life, including sports and work. For reliable physical activity, RTS and RTW estimations, more studies are required. In terms of GRADE, the quality of evidence for the five prospective studies was rated as low. LEVEL OF EVIDENCE Level 3.
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Affiliation(s)
- Sten van der Wilk
- Department of Orthopaedic Surgery & Sports Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.
| | - Alexander Hoorntje
- Department of Orthopaedic Surgery & Sports Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Program Musculoskeletal Health, Amsterdam, The Netherlands
- Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands
| | - Leendert Blankevoort
- Department of Orthopaedic Surgery & Sports Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Rutger van Geenen
- Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands
| | - Gino M M J Kerkhoffs
- Department of Orthopaedic Surgery & Sports Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Program Musculoskeletal Health, Amsterdam, The Netherlands
| | - P Paul F M Kuijer
- Department Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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18
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Bieniaszewska A, Sobieska M, Steinborn B, Gajewska E. Examination of Upper Limb Function and the Relationship with Gross Motor Functional and Structural Parameters in Patients with Spinal Muscular Atrophy. Biomedicines 2023; 11:biomedicines11041005. [PMID: 37189623 DOI: 10.3390/biomedicines11041005] [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: 02/15/2023] [Revised: 03/10/2023] [Accepted: 03/23/2023] [Indexed: 05/17/2023] Open
Abstract
Spinal muscular atrophy (SMA) is an autosomal recessive disorder caused by the deletion or/and mutation in the survival motor neuron 1 (SMN1) gene on chromosome 5. Until now, only a few articles investigating the relationship between upper limb function and the gross motor function in untreated SMA patients have been published. However, there is still a lack of publications including the relationship between structural changes such as cervical rotation, trunk rotation and side trunk shortening, and upper limb function. The aim of the study was to examine the upper limb function in patients with spinal muscular atrophy and the relationship between the upper limb function, gross motor function, and structural parameters. We present an analysis of 25 SMA patients, divided into sitter and walker groups, undergoing pharmacological treatment (nusinersen or risdiplam), examined twice between the initial examination and evaluation after a 12-month period. The participants were tested using validated scales such as the Revised Upper Limb Module (RULM), the Hammersmith Functional Motor Scale-Extended (HFMSE), and the structural parameters. Our results showed that patients demonstrated greater improvement on the RULM scale than on the HFMSE scale. Moreover, persistent structural changes negatively affected both the upper limb function and gross motor skills.
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Affiliation(s)
- Aleksandra Bieniaszewska
- Department of Developmental Neurology, Poznan University of Medical Sciences, 60-355 Poznan, Poland
- Doctoral School, Poznan University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland
| | - Magdalena Sobieska
- Department of Rehabilitation and Physiotherapy, Poznan University of Medical Sciences, 61-545 Poznan, Poland
| | - Barbara Steinborn
- Department of Developmental Neurology, Poznan University of Medical Sciences, 60-355 Poznan, Poland
| | - Ewa Gajewska
- Department of Developmental Neurology, Poznan University of Medical Sciences, 60-355 Poznan, Poland
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19
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Gong C, Dai S, Jin B, Xie Y. Comparison of Feng spinal mobilization with Maitland mobilization in management of chronic nonspecific low back pain: A cohort study. Medicine (Baltimore) 2023; 102:e32984. [PMID: 36800627 PMCID: PMC9935985 DOI: 10.1097/md.0000000000032984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
Feng spinal mobilization (FSM) is one of the most widely practiced techniques in traditional Chinese osteopathy, especially in China. However, whether this FSM technique is more effective than the Maitland posteroanterior mobilization (MM), which is widely used all over the world, is still unknown. The purpose of this study was to retrospectively analyze and compare the efficacy of these 2 treatments in patients with chronic nonspecific low back pain (CNLBP) as to provide a basis for the clinical treatment of chronic low back pain. A total of 83 patients, including 43 patients in the FSM group and 40 in the MM group, were enrolled in this cohort study. FSM or MM was performed on patients 3 times during a period of 2 weeks. Changes in the subjective and objective measurements were measured before and after the third treatment. The subjective symptoms recorded included the visual analogue scale (VAS), Oswestry disability index, and Patient Health Questionnaire-9. The objective symptoms, including the lumbar range of motion (ROM), and straight leg raise (SLR) height were also checked for any changes. The VAS scores were reassessed at the 1-year follow-up visit. The results showed that 2 weeks of FSM treatment significantly improved CNLBP patients modified Schober test (P < .05), extension ROM (P < .01), and SLR height (P < .05) while MM treatment did not. Both treatments significantly decreased the values of VAS, Oswestry disability index, and Patient Health Questionnaire-9 (P < .01). Compared to the MM treatment, the FSM treatment showed a much more significant improvement in VAS score (P < .01), range of motion of extension (P < .01), and SLR of both sides (P < .05). At the 1-year follow-up, VAS scores in both groups decreased significantly compared to pretreatments; however, there was no significant difference between the 2 groups. Our data suggested that the FSM treatment can provide better efficacy than MM in CNLBP patients, improving the VAS scores, lumbar extension ROM, and SLR height in a shorter time.
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Affiliation(s)
- Cheng Gong
- Department of Rehabilitation Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shiyin Dai
- Department of Rehabilitation Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Bing Jin
- Department of Rehabilitation Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ying Xie
- Department of Rehabilitation Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- * Correspondence: Ying Xie, Department of Rehabilitation Medicine, Beijing Friendship Hospital, Capital Medical University, No. 95, Yong An Street, Xi Cheng District, Beijing 100050, China (e-mail: )
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20
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Focus of Attention in Coach Instructions for Technique Training in Sports: A Scrutinized Review of Review Studies. J Funct Morphol Kinesiol 2023; 8:jfmk8010007. [PMID: 36648899 PMCID: PMC9844492 DOI: 10.3390/jfmk8010007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/02/2022] [Accepted: 12/22/2022] [Indexed: 01/11/2023] Open
Abstract
Literature reports superior performance when focusing one's attention during a movement on environmental effects of that movement (external focus, EF) compared to focusing on the moving body (internal focus, IF). Nevertheless, IF instructions still play an important role in the daily practice of coaches, trainers, and therapists. The current review compiles evidence for focus-of-attention concepts on movement form corrections and technique training. Reviews on the topic and selected additional papers addressing the effect of attentional focus on movement form or on kinetic, kinematic or muscle activity data were included. Both EF and IF instructions affect movement form. The reviews revealed that IF instructions seem to be better applicable to direct movement form changes than EF instructions. In contrast, EF instructions better facilitate optimization within the whole-body coordination, often resulting in better performance outcomes not directly linked to movement pattern changes. Several studies discuss focus-of-attention effects in the context of the optimal feedback control theory expanding on the constrained action hypothesis. In summary, EF and IF instructions both affect form and performance of movements, however, their relative efficacy is situation dependent. The often-purported superiority of EF over IF instructions cannot be generalized to all application contexts.
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21
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The Path to Translating Focus of Attention Research Into Canadian Physiotherapy, Part 1: Physiotherapists’ Self-Reported Focus of Attention Use Via a Study-Specific Questionnaire. JOURNAL OF MOTOR LEARNING AND DEVELOPMENT 2023. [DOI: 10.1123/jmld.2022-0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The focus of attention literature has shown robust findings for the benefits of providing statements that focus on the movement effect or outcome (external focus of attention [EFOA]) as opposed to focusing on the movement kinematics (internal focus of attention). Observational studies, however, have revealed that physiotherapists use fewer EFOA statements than internal focus of attention statements in their practice. Most evidence in this regard has been from non-Canadian physiotherapists working in stroke rehabilitation; consequently, we sought to examine whether Canadian physiotherapists working with various rehabilitation populations also use EFOA statements to a lesser extent than internal focus of attention statements. The “Therapists’ Perceptions of Motor Learning Principles Questionnaire (TPMLPQ)” was thus designed and data from 121 Canadian physiotherapists showed low relative frequencies of EFOA use (31.3% ± 14%) averaged across six hypothetical scenarios. A higher EFOA was reported, however, for two of the six scenarios: a functional reaching scenario (55.5% ± 37.0%) and pelvic floor task (65.6% ±32.9%). This data suggest that the findings of EFOA benefits have not been widely translated into Canadian physiotherapy settings; furthermore, the findings of the scenario-dependency warrant future investigation into factors, such as task characteristics, that may influence physiotherapists’ FOA use.
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22
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Khosrokiani Z, Letafatkar A, Hadadnezhad M, Sokhanguei Y. The comparison between the effects of pain education interventions with online and face-to-face exercise and the control group received biomedical education + standardized physical therapy in patients with chronic nonspecific neck pain during COVID-19: protocol for a parallel-group randomized controlled trial. Trials 2022; 23:1031. [PMID: 36539843 PMCID: PMC9763812 DOI: 10.1186/s13063-022-06932-3] [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: 12/08/2021] [Accepted: 11/15/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Various psychological issues and serious health concerns during the imposed lockdown by coronavirus disease 2019 (COVID-19) have induced many changes in the treatment of patients. More effective self-management strategies through tele-rehabilitation are suggested to be applied for patients with chronic neck pain to reduce referrals to health cares and disability support through COVID-19. Also, the pain neuroscience education (PNE) approach is an educational method used by health professionals to assist patients in understanding the biology, physiology, and psychosocial factors affecting their pain experience and aligning with the cognitions and beliefs associated with pain and recurrent disability. PNE combined with tele-rehabilitation could be a new solution to encourage patients to manage their condition by themselves and increase the continuity of practice instead of face-to-face sessions. OBJECTIVE This randomized control trial (RCT) aims to investigate the effects of PNE with online and face-to-face exercise interventions, and the control group received biomedical education + standardized physical therapy on neck pain and disability, psychological factors, and function in non-traumatic chronic neck pain. METHODS/DESIGN Patients with non-traumatic chronic neck pain (patient-centered care and active involvement of patients and the public) will be recruited via flyers displayed in hospitals and universities to participate in an RCT with two experimental and one control group designed to investigate the effects of PNE with online and face-to-face exercise interventions, and the control group received biomedical education + standardized physical therapy on neck pain and disability, psychological factors, and function in non-traumatic chronic neck pain. The outcomes will be measured at baseline, after PNE, and after 3 months of an exercise intervention. All outcomes are presented as mean ± SD, and statistical significance was set at α level of < 0.05. The normal distribution of the variables was verified by the Kolmogorov-Smirnov test, following a descriptive analysis. DISCUSSION It seems that PNE plus online and face-to-face exercise interventions are appropriate educational models for the treatment of patients with neck pain during COVID-19. Also, online training seems to encourage patients to continue their treatment. TRIAL REGISTRATION Iranian Registry of Clinical Trials IRCT20150503022068N5. Registered on 09 September 2021.
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Affiliation(s)
- Zohre Khosrokiani
- grid.412265.60000 0004 0406 5813Biomechanics and Corrective Exercise Laboratory, Faculty of Physical Education and Sport Sciences, Department of Biomechanics and Sport Injuries, Kharazmi University, Mirdamad Blvd., Hesari St, Tehran, 00982122258084 Iran
| | - Amir Letafatkar
- grid.412265.60000 0004 0406 5813Biomechanics and Corrective Exercise Laboratory, Faculty of Physical Education and Sport Sciences, Department of Biomechanics and Sport Injuries, Kharazmi University, Mirdamad Blvd., Hesari St, Tehran, 00982122258084 Iran
| | - Malihe Hadadnezhad
- grid.412265.60000 0004 0406 5813Biomechanics and Corrective Exercise Laboratory, Faculty of Physical Education and Sport Sciences, Department of Biomechanics and Sport Injuries, Kharazmi University, Mirdamad Blvd., Hesari St, Tehran, 00982122258084 Iran
| | - Yahya Sokhanguei
- grid.472458.80000 0004 0612 774XUniversity of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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23
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Castillo-Vejar L, Lizama-Fuentes M, Bascour-Sandoval C, Cuyul-Vásquez I. [Attentional focus instructions for therapeutic exercise in people with musculoskeletal disorders. A scoping review]. Rehabilitacion (Madr) 2022; 56:344-352. [PMID: 35469643 DOI: 10.1016/j.rh.2021.11.006] [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: 07/28/2021] [Revised: 10/28/2021] [Accepted: 11/28/2021] [Indexed: 06/14/2023]
Abstract
Attentional focus instructions are verbal strategies that could maximize the effects of exercise. The objective of this review was to explore and synthesize the available evidence on the incorporation of attentional focus instruction in the exercise of people with musculoskeletal disorders. A search of 11 databases was carried out until October 2020. Of 4,227 studies identified in the searches, 15 were included. The studies showed deficiencies in the conceptualization and definition of attentional focus instructions. The available evidence indicates that external focus is effective in improving motor learning and function. However, methodological limitations, clinical heterogeneity, the small number of articles included, and new experimental studies challenge the conclusions of the systematic reviews available to date. Attentional focus instructions in musculoskeletal disorders is an emerging field and requires further research. This review is a guide for future studies.
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Affiliation(s)
- L Castillo-Vejar
- Departamento de Procesos Terapéuticos, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco, Chile
| | - M Lizama-Fuentes
- Departamento de Procesos Terapéuticos, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco, Chile
| | - C Bascour-Sandoval
- Departamento de Medicina Interna, Universidad de La Frontera, Temuco, Chile; Carrera de Kinesiología, Universidad Autónoma de Chile, Temuco, Chile
| | - I Cuyul-Vásquez
- Departamento de Procesos Terapéuticos, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco, Chile.
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24
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Ghanati HA, Letafatkar A, Shojaedin S, Hadadnezhad M, Schöllhorn WI. Comparing the Effects of Differential Learning, Self-Controlled Feedback, and External Focus of Attention Training on Biomechanical Risk Factors of Anterior Cruciate Ligament (ACL) in Athletes: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610052. [PMID: 36011685 PMCID: PMC9408147 DOI: 10.3390/ijerph191610052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/08/2022] [Accepted: 08/12/2022] [Indexed: 05/13/2023]
Abstract
The current study aimed to compare the possible effects of differential learning strategy, self-controlled feedback, and external focus of attention on kinetic and kinematic risk factors of anterior cruciate ligament (ACL) injury in athletes. Forty-eight male athletes from three sports of handball, volleyball and basketball were selected for this study and were randomly divided into four groups: differential learning (n = 12), self-control feedback (n = 12), external focus (n = 12), and control (n = 12) group. All groups followed the intervention for eight weeks with three sessions per week. Data were analyzed by means of 4 × 2 repeated measures ANOVA followed by post hoc comparison (Bonferroni) at the significance level of p ≤ 0.05. A significant group × time interaction and the main effect of time was found for most kinetic and kinematic variables. The main effect of the group was significant only at the knee abduction angle. Differential learning and external focus of attention methods positively reduced the kinetic and kinematic variables that are considered risk factors for ACL injury. However, the effect sizes (Cohen's d) for the changes in most of the variables were larger for the differential learning group. Tailoring the boundary conditions that are based on the manipulations created in the exercise through variability and variety of movements associated with differential learning methods rather than repeating movements could reduce the risk of ACL injury.
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Affiliation(s)
- Hadi Abbaszadeh Ghanati
- Department of Biomechanics and Sport Injury, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran 1571914911, Iran
- Correspondence: (H.A.G.); (A.L.); (W.I.S.)
| | - Amir Letafatkar
- Department of Biomechanics and Sport Injury, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran 1571914911, Iran
- Correspondence: (H.A.G.); (A.L.); (W.I.S.)
| | - Sadredin Shojaedin
- Department of Biomechanics and Sport Injury, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran 1571914911, Iran
| | - Malihe Hadadnezhad
- Department of Biomechanics and Sport Injury, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran 1571914911, Iran
| | - Wolfgang I. Schöllhorn
- Department for Training and Movement Science, Johannes Gutenberg-University Mainz, 55122 Mainz, Germany
- Correspondence: (H.A.G.); (A.L.); (W.I.S.)
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25
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How D, Wagner H, Brach M. Using Motor Imagery to Access Alternative Attentional Strategies When Navigating Environmental Boundaries to Prevent Freezing of Gait – A Perspective. Front Hum Neurosci 2022; 16:750612. [PMID: 35422692 PMCID: PMC9003572 DOI: 10.3389/fnhum.2022.750612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 02/11/2022] [Indexed: 11/25/2022] Open
Abstract
Freezing of gait can cause reduced independence and quality of life for many with Parkinson’s disease. Episodes frequently occur at points of transition such as navigating a doorway. Therapeutic interventions, i.e., drugs and exercise, do not always successfully mitigate episodes. There are several different, but not exclusive causes for freezing of gait. People with freezing of gait are able to navigate dynamic situations like stairways by utilizing a different attentional strategy to over-ground walking, but may freeze when passing through a doorway. The question is, is it possible to employ a special attentional strategy to prevent freezing at this point? Motor imagery allows for learning motor skills in absolute safety and has been widely employed in a variety of populations, including other neuro-compromised groups. Motor imagery is not studied in a homologous manner in people with Parkinson’s Disease, leading to conflicting results, but may have the potential to establish a different attentional strategy which allows a subject to mitigate freezing of gait episodes. This paper will identify and discuss the questions that still need to be answered in order to consider this approach i.e., can this population access motor imagery, can motor imagery alter the attentional strategy employed when moving through doorways, what is the best motor imagery approach for people with Parkinson’s Disease and freezing of gait, and what dosage is most effective, while briefly outlining future research considerations.
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26
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Inter-limb asymmetry of kinetic and electromyographic during walking in patients with chronic ankle instability. Sci Rep 2022; 12:3928. [PMID: 35273300 PMCID: PMC8913811 DOI: 10.1038/s41598-022-07975-x] [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: 08/23/2021] [Accepted: 02/23/2022] [Indexed: 12/26/2022] Open
Abstract
After an initial ankle sprain, a relevant number of participants develop chronic ankle instability (CAI). Compensatory strategies in patients with CAI may change the inter-limb symmetry needed for absorbing movement-related forces. Accordingly, an increased risk of injury can occur. The present study aimed to compare the inter-limb asymmetry of kinetic and electromyography between individuals with CAI and without a history of an ankle sprain (Non-CAI) during walking. In this cross-sectional study, fifty-six athletes (28 CAI; 28 Non-CAI) participated. Participants walked at a comfortable pace over level ground while vertical ground reaction force (vGRF) and muscle activity of the tibialis anterior, peroneus longus, medial gastrocnemius, and gluteus medius were recorded. Inter-limb asymmetry during walking was calculated for each of the variables. Patients with CAI exhibited a greater inter-limb asymmetry of the first peak of vGRF, time to peak vGRF, and loading rate (P < 0.001), as well as presenting a greater inter-limb asymmetry of peroneus longus activity (contact phase) (P = 0.003) and gluteus medius activity (midstance/propulsion phase) (P = 0.010) compared to the Non-CAI group. No other differences in vGRF or muscles activity were observed between the groups. Our findings indicate that patients with CAI walk with greater inter-limb asymmetry in vGRF and muscle activity in different phases of the gait cycle compared to Non-CAI group. Our results could inform future studies on gait training aimed to reduce asymmetry during walking in patients with CAI.
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Delafontaine A, Hansen C, Marolleau I, Kratzenstein S, Gouelle A. Effect of a Concurrent Cognitive Task, with Stabilizing Visual Information and Withdrawal, on Body Sway Adaptation of Parkinsonian's Patients in an Off-Medication State: A Controlled Study. SENSORS (BASEL, SWITZERLAND) 2020; 20:E5059. [PMID: 32899926 PMCID: PMC7571225 DOI: 10.3390/s20185059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/02/2020] [Accepted: 09/04/2020] [Indexed: 12/23/2022]
Abstract
Background: In persons with Parkinson's disease (pwPD) any additional somatosensory or distractor interference can influence the posture. When deprivation of vision and dual-task are associated, the effect on biomechanical performance is less consistent. The aim of this study was to evaluate the role of the visual deprivation and a cognitive task on the static balance in earlier stage PD subjects. Methods: Fifteen off-medication state pwPD (9 women and 6 men), 67.7 ± 7.3 years old, diagnosed PD since 5.4 ± 3.4 years, only Hoehn and Yahr state 2 and fifteen young control adults (7 women and 8 men) aged 24.9 ± 4.9 years, performed semi-tandem task under four randomized experimental conditions: eyes opened single-task, eyes closed single-task, eyes opened dual-task and eyes closed dual-task. The center of pressure (COP) was measured using a force plate and electromyography signals (EMG) of the ankle/hip muscles were recorded. Traditional parameters, including COP pathway length, ellipse area, mediolateral/anteroposterior root-mean-square and non-linear measurements were computed. The effect of vision privation, cognitive task, and vision X cognitive was investigated by a 2 (eyes opened/eyes closed) × 2 (postural task alone/with cognitive task) repeated-measures ANOVA after application of a Bonferroni pairwise correction for multiple comparisons. Significant interactions were further analyzed using post-hoc tests. Results: In pwPD, both COP pathway length (p < 0.01), ellipse area (p < 0.01) and mediolateral/anteroposterior root-mean-square (p < 0.01) were increased with the eyes closed, while the dual-task had no significant effect when compared to the single-task condition. Comparable results were observed in the control group for who COP pathway was longer in all conditions compared to eyes opened single-task (p < 0.01) and longer in conditions with eyes closed compared to eyes opened dual-task (p < 0.01). Similarly, all differences in EMG activity of pwPD were exclusively observed between eyes opened vs. eyes closed conditions, and especially for the forward leg's soleus (p < 0.01) and backward tibialis anterior (p < 0.01). Conclusions: These results in pwPD without noticeable impairment of static balance encourage the assessment of both visual occlusion and dual-task conditions when the appearance of significant alteration during the dual-task could reveal the subtle worsening onset of the balance control.
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Affiliation(s)
- Arnaud Delafontaine
- CIAMS, University Paris-Sud, Université Paris-Saclay, 91405 Orsay, France;
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Clint Hansen
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-Universität zu Kiel, 24098 Kiel, Germany;
| | - Iris Marolleau
- CIAMS, University Paris-Sud, Université Paris-Saclay, 91405 Orsay, France;
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Stefan Kratzenstein
- CAU Motion Lab, Kiel University, Olshausenstraße 74, 24098 Kiel, Germany;
- Institute of Sport Science, Kiel University, Olshausenstraße 74, 24098 Kiel, Germany
| | - Arnaud Gouelle
- ProtoKinetics, Havertown, PA 19083, USA;
- Laboratory Performance, Santé, Métrologie, Société (PSMS), UFR STAPS, 51100 Reims, France
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Zaszczynska A, Sajkiewicz P, Gradys A. Piezoelectric Scaffolds as Smart Materials for Neural Tissue Engineering. Polymers (Basel) 2020; 12:E161. [PMID: 31936240 PMCID: PMC7022784 DOI: 10.3390/polym12010161] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 12/31/2019] [Accepted: 01/05/2020] [Indexed: 01/03/2023] Open
Abstract
Injury to the central or peripheral nervous systems leads to the loss of cognitive and/or sensorimotor capabilities, which still lacks an effective treatment. Tissue engineering in the post-injury brain represents a promising option for cellular replacement and rescue, providing a cell scaffold for either transplanted or resident cells. Tissue engineering relies on scaffolds for supporting cell differentiation and growth with recent emphasis on stimuli responsive scaffolds, sometimes called smart scaffolds. One of the representatives of this material group is piezoelectric scaffolds, being able to generate electrical charges under mechanical stimulation, which creates a real prospect for using such scaffolds in non-invasive therapy of neural tissue. This paper summarizes the recent knowledge on piezoelectric materials used for tissue engineering, especially neural tissue engineering. The most used materials for tissue engineering strategies are reported together with the main achievements, challenges, and future needs for research and actual therapies. This review provides thus a compilation of the most relevant results and strategies and serves as a starting point for novel research pathways in the most relevant and challenging open questions.
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Affiliation(s)
- Angelika Zaszczynska
- Institute of Fundamental Technological Research, Polish Academy of Sciences, Pawinskiego 5b St., 02-106 Warsaw, Poland
| | - Paweł Sajkiewicz
- Institute of Fundamental Technological Research, Polish Academy of Sciences, Pawinskiego 5b St., 02-106 Warsaw, Poland
| | - Arkadiusz Gradys
- Institute of Fundamental Technological Research, Polish Academy of Sciences, Pawinskiego 5b St., 02-106 Warsaw, Poland
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29
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Johnson L, Burridge J, Demain S, Ewings S. Comparing the Impact of an Implicit Learning Approach With Standard Care on Recovery of Mobility Following Stroke: Protocol for a Pilot Cluster Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e14222. [PMID: 31687935 PMCID: PMC6864481 DOI: 10.2196/14222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/17/2019] [Accepted: 07/16/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Although implicit and explicit learning approaches have been well investigated in healthy populations, there is less evidence regarding the relative benefits of each approach in clinical practice. Studies in stroke typically investigate single elements of an implicit learning approach (ILA; eg, reduced quantity feedback or an external focus of attention) within controlled environments. These studies predominantly evaluate performance, with few measuring this over time (ie, learning). The relevance and transferability of current research evidence into stroke rehabilitation is therefore limited. OBJECTIVE The objective of this study was to compare the ILA with standard care in the acute phase following stroke, to generate data and insights to inform the design of a definitive trial, and to understand patient and therapist perceptions of the ILA. METHODS This is a multicenter, assessor-blind, cluster randomized controlled pilot trial with nested qualitative evaluation. Stroke units (clusters) will be randomized to either ILA (intervention) or standard care (control) arms. Therapy teams at the intervention sites will be trained in the ILA and provided with an intervention manual. Those at the control sites will have minimal input from the research team, other than for data collection. Consent will be provided at the individual participant level. Once enrolled, participants will receive rehabilitation that focuses on lower limb recovery, using the designated approach. Measures will be taken at baseline, every 2 weeks until the point of discharge from hospital, and at 3 months post stroke onset. Measures include the Fugl Meyer Assessment (motor leg subsection), modified Rivermead Mobility Index, Swedish Postural Adjustment in Stroke Scale, and achievement of mobility milestones. Fidelity of the treatment approach will be monitored using observational video analysis. Focus groups and interviews will be used to gain insight into the perceptions of trial participants and clinical teams. RESULTS The first site opened to recruitment in February 2019. The opening of a further 5 sites will be staggered throughout 2019. Results are expected in early 2021. CONCLUSIONS The findings from this mixed methods pilot study will be used to inform the design of a definitive study, comparing the ILA with standard care in acute stroke rehabilitation. TRIAL REGISTRATION ClinicalTrials.gov NCT03792126; https://clinicaltrials.gov/ct2/show/NCT03792126. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/14222.
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Affiliation(s)
- Louise Johnson
- Stroke Unit, Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Bournemouth, United Kingdom
| | - Jane Burridge
- University of Southampton, Southampton, United Kingdom
| | - Sara Demain
- University of Plymouth, Plymouth, United Kingdom
| | - Sean Ewings
- University of Southampton, Southampton, United Kingdom
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