Journal of Back and Musculoskeletal Rehabilitation

Problems with motor functions, balance and gait ability commonly occur in stroke patients and cause asymmetric posture imbalance and gait patterns.

We examined the effects of gait training (GT) combined with portable functional electrical stimulation (FES) on motor functions, balance and gait ability of stroke patients.

A single blind, randomized control trial was conducted with 34 post stroke patients who were randomly allocated to two groups: 1) FES + GT group ( n = 17) and the placebo FES + GT (PLBO + GT) group ( n = 17). All interventions were given for 30 minutes, 5 days a week for 4 weeks. Fugl-Meyer assessment (FMA) was used to measure motor function of lower extremity. Performance oriented mobility assessment (POMA) was used to balance and gait ability. OptoGait was used to analyze gait ability.

Both groups showed significant improvements in motor function, balance and gait ability. The FES + GT group showed significantly greater improvement in motor function, balance and gait abilities after four weeks compared to the PLBO + GT group.

It was found that the gait training applied with FES is effective in improving the motor function, balance and gait abilities of stroke patients.

Central sensitization (CS) is present in a subgroup of patients with chronic low back pain (CLBP). Studies on the relationship between CS and functioning have limited operationalizations of CS and functioning.

To determine whether CS was related to functioning in patients with CLBP (cross-sectional); and to determine whether changes in CS were related to changes in functioning (longitudinal).

An observational prospective cohort study with data collected at baseline and discharge of an interdisciplinary pain rehabilitation program was executed. CS indicators: CS Inventory part A (CSI-A), quantitative sensory testing (QST), root mean square of successive differences of heart-rate variability (RMSSD). Functioning measures: lifting capacity, physical functioning subscale of Rand36 (Rand36-PF), Work Ability Score (WAS), Pain Disability Index (PDI). Main analyses included correlation and multiple regression controlling for confounders; cross-sectional with baseline data and longitudinal with deltas ( Δ ).

76 patients with primary CLBP participated at baseline and 56 at discharge. Most associations were weak (cross-sectional r 𝑝𝑎𝑟𝑡𝑖𝑎𝑙 = - 0.30–0.24; longitudinal r 𝑝𝑎𝑟𝑡𝑖𝑎𝑙 = - 0.37–0.44). Cross-sectional multiple regression significant associations: mechanical pain threshold-QST and lifting capacity ( r 𝑝𝑎𝑟𝑡𝑖𝑎𝑙 = - 0.39), parasympathetic/vagal tone-RMSSD and physical functioning–Rand36-PF ( r 𝑝𝑎𝑟𝑡𝑖𝑎𝑙 = 0.26). Longitudinal multiple regression significant associations: Δ parasympathetic/vagal tone-RMSSD and Δ lifting capacity ( r 𝑝𝑎𝑟𝑡𝑖𝑎𝑙 = 0.48), Δ CSI-A and Δ disability-PDI ( r 𝑝𝑎𝑟𝑡𝑖𝑎𝑙 = 0.36). Cross-sectional and longitudinal final regression models explained 24.0%–58.3% and 13.3%–38.0% of total variance.

CS was weakly related to functioning, and decreases in CS were weakly-moderately related to increases in functioning.

Because shoulder pain can have an unfavorable prognosis, it is important to have a better understanding of factors that may influence recovery.

To determine the association between recovery from shoulder pain and the presence of depression, anxiety, and pain catastrophizing.

In a prospective cohort study with a six months follow-up, we included patients visiting an orthopaedic department with shoulder pain. Primary outcome was recovery from shoulder pain measured with the Shoulder Pain and Disability Index at three and six months. Information about depression and anxiety (Hospital Anxiety and Depression Scale), pain catastrophizing (Pain Catastrophizing Scale), and demographic and clinical factors were collected at baseline. A linear mixed model was used to estimate the effects of depression, anxiety, pain catastrophizing, and underlying shoulder disorders on recovery.

We included 190 patients. There were no statistically significant associations between the presence of depression, anxiety, and pain catastrophizing, and three- and six-month recovery. Also between the underlying shoulder disorders and recovery at three and six months, there were no statistically significant associations.

: We could not prove that depression, anxiety, and pain catastrophizing, as well as underlying shoulder disorders, were associated with recovery of shoulder pain at six months.

Disturbances in pelvic girdle tilt can cause compensatory changes affecting postural dysfunctions, and can lead to hip and groin strain changes and back pain. However, we still have no clear information on the normative values of pelvic girdle tilt and mobility.

The study aimed to (1) evaluate the position and mobility of the pelvic girdle in the sagittal and frontal planes in asymptomatic adults aged 19–30, (2) evaluate the possible variation of results according to gender and to develop a proposal for normative values, and (3) evaluate whether body mass, height and BMI are related to the magnitude of hip girdle position and mobility.

The research was conducted in a sample group consisting of 346 men and women using the scaled form of the anthropometric level of the Duometr ® The values of position and mobility of the pelvic girdle in the sagittal and frontal planes were analyzed.

Differences were noted in the values of the pelvic tilt ( p = 0.033) between the men and women. The women showed slightly higher values of posterior range of motion ( p = 0.0002) and total range of motion ( p = 0.002). The other parameters did not show any significant variation. There was no clear association between body weight, height and BMI and the study variables, except for a small, significant correlation between BMI and posterior pelvic tilt in women ( r = 0.175, p = 0.005). In the frontal plane there were no differences in the analyzed variables in terms of gender or side of the body measured.

There was no association between the anthropometric variables and the pelvic girdle tilt and mobility. No size variation by gender was observed in the frontal plane. Slight differences were observed in the sagittal plane. Normative values are proposed.

Tibial rotation accompanying sagittal movement contains the phenomenon of screw-home movement (SHM) of the knee, which plays an important role in knee stability during extension.

This study aimed to investigate the change of SHM in patients with knee osteoarthritis (OA).

Thirty-one sex-matched patients with knee OA and 31 normal subjects were recruited. The total tibial rotation was obtained during knee sagittal movement (extension and flexion) using an inertial measurement unit. The acquired angle of tibial rotation was divided into eight periods. The total tibial rotation and the variation of each period were compared between the OA and control groups. The difference in tibial rotation according to Kellgren-Lawrence (KL) grade was compared.

The total tibial rotation of the OA group decreased compared with the control group during knee extension and flexion ( P < 0.001). Variations of tibial rotation were significantly different between groups in all periods ( P < 0.001) except for knee extension at 70 ∘ to 45 ∘ ( P = 0.081). There was no significant difference in tibial rotations among the KA grades of OA patients.

We found a reduction in the total tibial rotation and loss of the SHM in the unloaded OA knee. It could be predicted that reduced SHM appeared early in knee OA.

One of the main problems faced by physiotherapists in primary care is low back pain with or without radiation to lower limbs. There are many different treatment approaches for the management of low back pain. Despite the large amount of published studies, the evidence remains contradictory.

To evaluate the influence of the osteopathic manipulation of the sacroiliac joint on low back pain with or without radiation to lower limbs.

Single-blind randomized clinical controlled trial. Participants with low back pain with or without lower limb radiation were randomized to osteopathic manipulation of the sacroiliac joint group (intervention, 6 sessions) or to an electrotherapy group (control, 15 sessions) for 3 weeks. Measures were taken at baseline (week 0) and post-intervention (week 4). The primary outcome measures were pain (Visual Analogue Scale), functional disability (Oswestry disability index and Roland Morris questionnaire). The secondary outcome measure was pain threshold at muscular tender points in the quadratus lumborum, pyramidal, mayor gluteus, and hamstrings.

In all, 37 participants completed the study. The results of the intragroup comparisons showed statistically significant improvements in both groups in the visual analogue scale (Osteopathic manipulation group, P = 0.000; Electrotherapy group, P = 0.005) and Oswestry disability index (Osteopathic manipulation group, P = 0.000; Electrotherapy group- P = 0.026) but not in the Roland Morris questionnaire ( P = 0.121), which only improved in the intervention group ( P = 0.01). The osteopathic manipulation was much more effective than electrotherapy improving to pain and functional disability.

Osteopathic manipulation of the sacroiliac joint improves pain and disability in patients with sacroiliac dysfunction after three weeks of treatment.

Kyphoplasty for osteoporotic vertebral compression fractures (OVCF) is a short but painful intervention. Different anesthetic techniques have been proposed to control pain during kyphoplasty; however, all have limitations.

To compare the effectiveness and safety of ultrasound-guided thoracic paravertebral block with local anesthesia for percutaneous kyphoplasty (PKP).

In this prospective study, non-randomized patients with OVCF undergoing PKP received either ultrasound-guided thoracic paravertebral block (group P) or local anesthesia (group L). Perioperative pain, satisfaction with anesthesia, and complications were compared between the groups.

Mean intraoperative (T1–T4) perioperative visual analog scale (VAS) scores were significantly lower in group P than in group L (2 [1–3] vs. 3 [2–4], 2 [2–3] vs. 4 [2–4], 2 [2–3] vs. 5 [3–5], and 3 [2–3] vs. 5 [3–5], respectively; P < 0.05). Investigators’ satisfaction scores, patients’ anesthesia satisfaction scores, and anesthesia re-administration intention rate were significantly higher in group P than in group L (4 [3–5] vs. 3 [2–4], 2 [2–3] vs. 2 [1–3], 90.63% vs. 69.70%; P < 0.05). There was no significant intergroup difference in complications.

Ultrasound-guided thoracic paravertebral block has similar safety to and better effectiveness than local anesthesia in PKP.

Numerous studies have investigated factors for trunk, balance stability and gait parameters of post-stroke patients. Evidence-based recommendations are required for the treatment of ankle proprioceptive exercise with thermal stimulation in post-stroke patients.

We investigated the effects of ankle proprioceptive exercise with thermal stimulation on the trunk stability, balance, and gait ability of post-stroke patients.

A total of 30 patients were randomly divided into the ankle proprioceptive training and thermal stimulation group (APT) and control group. The APT group performed ankle proprioceptive exercises with thermal stimulation for 60 min five times a week for eight weeks. The control group followed conservative treatment for 60 min five times a week for eight weeks. Trunk stability was measured with the trunk impairment scale (TIS) and balance tests were performed with the center of pressure (COP), limits of stability (LOS), Berg Balance Scale (BBS), and functional reach test (FRT) and gait ability was performed by OptoGait and 10 m WT.

There was a significant difference ( p < 0.05) between before and after training in both groups. The APT group showed significant improvement in both groups.

This study can be used as intervention data for recovering trunk, balance stability and gait parameters in post-stroke patients.

Dry needling (DN) is commonly used to treat myofascial trigger points (MTrPs).

To compare the effect between DN with and without needle retention in the treatment of MTrPs in the upper trapezius muscle.

Fifty-four patients who had active MTrPs in the upper trapezius muscle were randomly allocated into the DN group or the DN with retention group. The DN group received DN only, while the DN with retention group received DN with needle retention for 30 minutes. The visual analogue scale (VAS) and pressure pain threshold (PPT) were recorded both before and after 7 and 14 days of the treatment sessions.

Both groups showed a significant decrease of the VAS at 7 and 14 days (mean difference DN group - 53.0, DN with retention group - 57.0, p < 0.001). The PPT was also significantly improved in both groups (mean difference DN group 109.8 kPa, DN with retention group 132.3 kPa, p < 0.001). However, there were no significant differences in the VAS or PPT between the groups.

Both DN and DN with retention had significant improvement of pain intensity in the treatment of MTrPs in the upper trapezius muscle at 14 days. However, pain reduction was not significantly different between the interventions.

Psychological factors influence the development and persistence of chronic low back pain (CLBP) and may impair the psychosocial rehabilitation success.

To examine the effects of a combined pain competence and depression prevention training compared to the pain competence training alone and as well as the patients’ stages of pain on the long-term psychosocial rehabilitation success.

In this controlled multicentre study with cluster-block randomization, patients with CLBP in different stages of pain (I–III) received either pain competence training (control group, CG; n = 255) or combined pain competence and depression prevention training (intervention group, IG; n = 271; per protocol). Depressive symptoms (primary outcome), anxiety, somatization, health status, and average pain intensity (secondary outcomes) were assessed up to 12 months of follow-up. Standardised questionnaires were used to record the outcomes, which were filled out by the patients themselves. Analyses after multiple imputation ( N = 1225) were conducted to validate multi- and univariate analyses of variance.

Patients in stage of pain I and II showed significant improvements in depressive symptoms, anxiety, mental health, and average pain intensity at the 12-month follow-up, irrespective from treatment condition.

Multidisciplinary rehabilitation seems to be appropriate for patients with CLBP in stage of pain I and II. However, patients in stage of pain III need more psychological treatments to manage their mental comorbidities.

Low back pain (LBP) is a prevalent disorder and leading cause of disability worldwide. In Saudi Arabia, patients with LBP are dispensed with educational materials to supposedly facilitate their recuperation.

Appraise the suitability of educational materials provided for people with LBP in Saudi Arabia to determine whether they meet the needs of patients, inform self-management, and are consistent with clinical practice guidelines.

A qualitative data collection method was used, and content analyses were conducted to analyse data based on manifest content. Educational items in English and Arabic were collected from relevant health providers in Saudi Arabia.

Seventeen educational materials were sourced from: Ministry of Health hospitals ( n = 10), military hospitals ( n = 4), private hospitals ( n = 2), and a multidisciplinary healthcare association ( n = 1). Six identified sub-themes comprise: epidemiological/anatomical data about LBP ( n = 6); causes/risk factors ( n = 10); exercise ( n = 14) and physical activity-related ( n = 3) recommendations; treatment-related recommendations ( n = 2); general health and lifestyle-related recommendations ( n = 8); and postural and ergonomics-related recommendations ( n = 13). A common theme emerged, that ‘the content of educational materials hindered reassurance and self-management for people with LBP.’

The reviewed educational materials fail to adequately report information that assure patients or inform their self-management among the Saudi population with LBP. Further, reviewed items are heavily influenced by the biomedical model of pain.

The relationship between the endurance of the lumbar paraspinal muscles and morphological changes needs to be clarified. In this context, the importance can be revealed of increasing the endurance level of the paraspinal muscles in the prevention and treatment of low back diseases.

The aim of this study was to examine the relationship between the clinical evaluation results of the cross-sectional area (CSA) and fat infiltration of the lumbar deep paraspinal muscles.

The study included 37 patients with mechanical low back pain (mechanical), 41 patients with lumbar hernia without root compression (discopathy) and 36 healthy individuals as a control group. The functional status of the lumbar deep paraspinal muscles was evaluated clinically with muscle endurance tests. The fat infiltration and CSA of the muscles were evaluated on axial MRI sections at the L3-S1 level.

The mean values of the prone bridge, Biering-Sorenson, and trunk flexion tests were seen to be highest in the control group and lowest in the discopathy group ( p < 0.001). In all tests, the longest test period was obtained at < 10% fat infiltration and the shortest at > 50% fat infiltration. It was observed that as the amount of fat infiltration of the muscles increased, the test times were shortened. There was no significant relationship between the endurance level and the CSA of the groups.

The study results demonstrated that the endurance of the paraspinal muscles is associated with the fat infiltration of the muscles. In patients with chronic low back pain, information about muscle morphology and degeneration can be obtained with simple endurance tests without the need for further measurements. On clinical examination, a weak endurance level of the paraspinal muscles indicates the presence of a low back problem and an increase in the amount of fat infiltration.

Scapular dyskinesis has been associated with shoulder dysfunctions, and changes in electromyographic (EMG) activity have been reported during the execution of some exercises.

To compare upper limb muscles EMG of asymptomatic subjects with and without scapular dyskinesis during bench-press and dumbbell fly exercise performed on different surface stability conditions.

Twenty-eight physically active men were allocated into two groups: Control group ( n = 14) and Dyskinesis group ( n = 14). The participants performed six repetitions lasting three seconds of the bench press and dumbbell fly exercises with 50% of one-repetition maximum (1RM) on a bench and a Swiss ball. The EMG activity of the pectoralis major, serratus anterior, upper and lower trapezius, anterior deltoid, biceps and triceps muscles were recorded.

No differences were found between groups, regardless of exercise or surface type. Inserting the unstable surface in the supine exercise promoted a slight increase in upper trapezius EMG activity for the control [4.32 (95% CI: 1.04 to 7.60)] and dyskinesis [3.30 (95% CI: 0.34 to 6.27)] groups.

There is no difference in upper limb muscle EMG activity between subjects with and without scapular dyskinesis. In addition, inserting unstable surfaces did not modify EMG activity.

Osteoporotic hip fractures have posed a significant burden to society, and more epidemiological data is required.

To compare the epidemiological differences of hip fracture patients in Spain and China.

This was a retrospective comparative study. Comparisons were made in terms of morbidity, demographic and anthropometric characteristics, length of stay, cost of hospitalization, and mortality by consulting the medical histories of osteoporotic hip fractures in two hospitals. The t test was used for measurement data, and the X 2 test was used for count data. The difference is statistically significant when p < 0.05.

A total of 757 patients were enrolled in this study, with 426 from Virgen Macarena University Hospital (HUVM) and 331 from Xi’an Daxing Hospital (XDH). The average age was 81.4 ± 9.26 and 76.0 ± 8.08 years; the proportion of women was 74.9% and 68.0%, respectively. The incidence of osteoporotic hip fractures in Seville residents over 50 years old was approximately 239 per 100,000 residents, compared to 158 per 100,000 residents in Xi’an. The timing of surgery in Spanish patients was significantly longer than in Chinese patients, 78.7 ± 48.2 vs. 60.7 ± 43.1 hours, p = 0.000. There were 81 deaths in Spain and 43 deaths in China during the one-year follow-up period ( p = 0.026).

In terms of incidence, demographics, surgical methods, and mortality, there are significant differences between hip fracture patients in Seville, Spain and Xi’an, China.

Non-specific low back pain (NS-LBP) is a serious public health problem. Tai Chi is promising in reducing the risk of falls and alleviating symptoms in this population.

To investigate the effect of Tai Chi on gait and dynamic balance in elderly women with NS-LBP.

20 women (age > 65 yr.) with NS-LBP were randomly assigned to a Tai Chi group ( n = 10) or a control group ( n = 10). The Tai Chi group practiced Tai Chi exercise 3 times a week for 6 weeks. Each session lasted 60 minutes. Pain, spatiotemporal gait features and dynamic balancing capacity were assessed at 0 and 6 weeks.

Compared to the control group at 6 weeks, the Tai Chi group had a significant decrease in VAS ( p = 0.027) and stride width ( p = 0.019), significant improvement in gait velocity, stride length ( p < 0.001). Regarding dynamic balance capacity, the Tai Chi group had significant improvements in anterior (Left: p = 0.001; Right: p = 0.038), postero-lateral (Left: p < 0.001; Right: p = 0.038), and postero-medial (Left: p = 0.015; Right: p = 0.018).

6-week Tai Chi can relieve pain and improve gait and dynamic balance in elderly women with NS-LBP, which suggests Tai Chi could be a promising rehabilitation intervention to reduce the risk of falls in this population.

Postural disorders are frequently observed in Parkinson’s disease (PD). The underlying mechanisms that cause postural disorders are not fully understood and the majority of these disorders have no response to antiparkinsonian treatments. These disabling conditions require further investigation to better understand the underlying mechanisms in order to develop effective treatments.

The aim of this study was to investigate the frequency of axial postural disorders in PD and to determine the associated clinical risk factors.

In this single-center clinical trial, the data of PD patients were reviewed retrospectively. The frequencies of postural disorders were determined, and the demographic clinical characteristics of the patients were compared.

The records of 127 patients with idiopathic PD were analyzed. Axial posture disorders were found in 42.6% of patients. Patients with axial posture disorders were older when the disease onset was detected, amongst these patients the condition was also longer lasting. The mean levodopa dose was higher in the patients with posture disorders. The initial symptom was bradykinesia and the Hoehn and Yahr’s score was ⩾ 3 in the majority of the patients with posture disorder. Additionally, constipation, hallucinations, postural instability, and falls were significantly more common in patients with posture disorders.

Posture disorders were observed in nearly half of PD patients and were more frequently observed in patients with an advanced condition. In addition, our investigation has found that it is crucial to follow up with patients who present with bradykinesia for the development of postural disorder.

The Sciatica Frequency Index (SFI) and Sciatica Bothersomeness Index (SBI) are two separate indices scored for both the bothersomeness and frequency of radiating symptoms. There is no Turkish scale used specifically for sciatica.

We aimed to translate SBI and SBI in Turkish and investigate the reliability and validity of these indices.

A total of 80 patients with lumbar disc herniation (LDH) were prospectively included. Construct validity was assessed by comparing the SBI and SFI with subscales of Short Form 36 (SF-36), back and leg Numeric Rating Scale (NRS) and Roland Morris Disability Questionnaire (RMDQ). Reliability was assessed by internal consistency (Cronbach’s alpha) and test-retest reliability.

A weak correlation was found between SBI/SFI, back NRS and SF-36 subgroups while a moderate correlation was found between SBI/SFI, RMDQ and leg NRS. The SBI and SFI had high internal consistency measured by Cronbach’s alpha (0.76 and 0.73). Test-retest reliability of the SBI and SFI were 0.95 (95% CI: 0.92–0.97) and 0.95 (95% CI: 0.92–0.97) respectively, indicating excellent reliability.

The Turkish versions of the SFI/SBI are a valid and reliable tool supporting their usability in patients with LDH-induced sciatica.

To date, only one study assessed the spinal mobility and muscle strength of patients who were treated either with fusion or brace treatment.

The aim of this retrospective study was to evaluate the range of motion (ROM) and strength of the cervical and thoracic/lumbar spine in patients who underwent spinal fusion for the treatment of adolescent idiopathic scoliosis (AIS) in comparison to healthy individuals.

Patients ( n = 28) who were treated surgically for AIS were included in the study. An age and gender matched control group ( n = 22) was included that consisted of healthy individuals. DAVID ® Lumbar/Thoracic Extension, Lumbar/Thoracic Rotation, and Cervical Extension/Lateral Flexion devices were used to measure cervical and lumbar/thoracic ROM as well as muscle strength.

Significant differences were observed between groups in all ROM measurements except thoracic/lumbar sagittal flexion ROM measurement ( p = 0.198). There were significant differences between groups in terms of muscle strength, except thoracic lumbar left rotation strength ( p = 0.081).

The findings of the current study demonstrated that cervical and thoracic/lumbar range of motion, as well as muscle strength, were significantly decreased in surgically treated adolescent idiopathic scoliosis patients compared to healthy counterparts. However, trunk (thoracic/lumbar) flexion range of motion and trunk left rotation muscle strength were not significantly different.

The Low Back Pain Treatment Beliefs Questionnaire (LBP-TBQ) was developed to systematically measure patients’ preferences about common treatments for low back pain (LBP). However, the questionnaire is not available in the Arabic language.

To translate and cross-culturally adapt the LBP-TBQ to the Arabic language and assess its clinimetric properties.

The LBP-TBQ was translated into Arabic version according to published guidelines. In pilot testing, the face and content validity of the translated questionnaire was assessed. Two hundred and fifty patients with LBP completed the translated LBP-TBQ for five common LBP treatments. In addition, a subgroup of 51 participants completed the questionnaire on two consecutive occasions to examine the test-retest reliability.

Confirmatory factor analysis results showed that the Arabic version of LBP-TBQ has three factors: (1) “credibility”, (2) “effectiveness and fitness”, and (3) “concerns”, and this 3-factors model had the best fit for the data for all the five treatments. Cronbach’s α of the total items ranged from 0.812 to 0.899, while the sub-scores ranged from 0.557 to 0.837, indicating moderate to high internal consistency. The ICC ( 2 , 1 ) ranged from 0.626 to 0.909, which shows acceptable to good test-retest reliability. Correlation with other LBP questionnaires was < 0.3, demonstrating acceptable discriminant validity. Finally, the questionnaire showed acceptable criterion validity for all the subscales and the general questionnaire.

The Arabic version of LBP-TBQ is reliable, valid, and appropriate to use in clinical and research settings.

Low back pain is one of the most common musculoskeletal diseases in the modern society, causing a huge economic burden, and has become an important public health problem. Years lived with disability caused by low back pain increased rapidly as a result of population growth and ageing worldwide, with the biggest increase seen in low-income and middle-income countries. In this context, the prevention and treatment of low back pain in the elderly warrant attention and research.

The aim is to determine the correlation between vital capacity (VC) and vertebral body translation during lumbar flexion and extension in adults aged 60 to 69 years.

A total of 192 adults aged 60 to 69 years were selected by cluster sampling in Lishui City, Zhejiang Province, China. The VC of the study population was tested and the ratio of VC to body mass (BM) was calculated. The lumbar hyperextension and hyperflexion of the study population were radiographed using a Hitachi 500 mAs X-ray machine made in Japan to verify vertebral body translations in each segment.

The differences of test values of VC ( P = 0.004), VC/BM ratio ( P = 0.012) and vertebral body translation in the L5-S1 segment during flexion and extension ( P < 0.001) of the populations aged 60 to 64 and 65 to 69 years were all statistically significant. The vertebral body translation in the L5-S1 segment during lumbar flexion and extension in the population aged 60 to 69 years was negatively correlated with the VC (rs = - 0.207 and P = 0.004) and VC/BM ratio (rs = - 0.248 and P = 0.001), showing statistical significance.

The vertebral body translation of during lumbar flexion and extension correlates with the VC in the population aged 60 to 69 years. Recognition of this correlation may help to guide further lumbar stabilization exercises.

Many studies have compared muscle length and muscle activity for low back pain. However, compensatory movement for non-specific low back pain has not yet been studied sufficiently.

The purpose of this study was to compare the length of the hip flexor, lumbar extensor endurance and the muscle activity of the erector spinae and gluteus maximus during hip extension, and the compensatory movement of the lumbar in people with or without nonspecific chronic low back pain.

In this case-control study, 16 participants with non-specific chronic LBP and 17 without LBP were included. Hip flexor length was assessed by the modified Thomas test. Lumbar extensor endurance was assessed by the modified Biering-Sorensen test. Muscle activity of the erector spinae and gluteus maximus during hip extension was measured using a Delsys-Trigno wireless EMG system. Compensatory lumbar movements during hip extension were measured using a digital inclinometer.

Muscle activity of the erector spinae and compensatory lumbar movements were significantly higher in the LBP group. ( p < 0.05). Hip flexor length, muscle activity of the gluteus maximus and endurance of the lumbar extensor were significantly differences in the LBP group ( p < 0.05).

Shortened hip flexors, low gluteus maximus activity, and high erector spinae activity during hip extension, lumbar extensor weak endurance, lumbar compensatory movement are potential factors for non-specific LBP.

25-hydroxy vitamin D (25OHD) deficiency is associated with cardiovascular disease and poor physical performance.

To assign the effect of 25OHD level on cardiac rehabilitation (CR) in patients with coronary artery disease (CAD).

One-hundred-thirty-five patients with CAD who underwent a CR programme were enrolled in this retrospective study. Patients were divided into two-group according to 25OHD level (Group 1: < 20 ng/dl; Group 2: ⩾ 20 ng/dl). All patients received CR for 30 sessions. Each participant performed 40 minutes of aerobic exercise with a cycloergometer followed by muscle strengthening exercises. The patients were evaluated before and after CR by a pulmonary function test (PFT) and a cardiopulmonary exercise test (CPET).

There were 77 (57%) patients in Group 1 and 58 patients (43%) in Group 2. Demographic characteristics between the groups were similar. Pre- and post-rehabilitation CPET parameters were lower in Group 1 ( p < 0.05). Both groups had significant improvement in CPET ( p < 0.05). Post-rehabilitation PFT parameters (FEV 1 , FVC) were higher in Group 2 ( p < 0.05). There was a positive correlation between the 25OHD-level and the CPET-PFT parameters ( p < 0.05).

25OHD deficiency in patients with CAD reduces the response to CR. It also affects respiratory function according to the FEV 1 , FVC parameters. In patients scheduled for CR, 25OHD-levels should be evaluated, and any deficiency corrected.

While a number of preclinical studies have examined the effectiveness of low-intensity pulsed ultrasound (LIPUS) as a potential treatment for knee osteoarthritis (OA), there have been few clinical studies which have indirectly confirmed cartilage regeneration by magnetic resonance imaging (MRI).

The aim of this clinical trial was to investigate whether LIPUS effectively increased knee cartilage thickness and improved pain and function in knee OA patients.

This study was a prospective, single-group, home-based self-therapy trial. We included patients ( n = 20) with OA pain. Each patient used an ultrasonic stimulation device (BODITREK JOINT™) for more than 20 sessions. Outcomes were assessed by MRI, Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the 36-Item Short Form Survey (SF-36) for assessing quality of life.

Nineteen subjects completed this study. There was no significant increase in the cartilage thickness measured by MRI after LIPUS treatment. LIPUS therapy significantly decreased VAS score and WOMAC score, and significantly increased SF-36 score. The subgroup analysis in patients with knee OA showed that LIPUS treatment showed better for older patients with lower Kellgren-Lawrence grades.

Pain, function, and quality of life improved after LIPUS, but there was no significant increase in cartilage thickness through MRI.

Optimal postoperative management is controversial after arthroscopic rotator cuff repair (ARCR).

The aim of the study was to evaluate outcomes of patients with and without postoperative sling immobilization after undergoing arthroscopic RCR rotator cuff repair.

369 arthroscopic full thickness superior rotator cuff tears (RCT) with a minimum follow-up of 6 months were included in this study. Propensity score matching was performed for age, sex, BMI, and tear size. Pain (VAS score), shoulder range of motion (ROM), functional outcome (ASES, Constant-Murley [CM] and Oxford shoulder score [OSS]), and health related quality of life (SF-36) scores were compared between patients with and without sling immobilization.

According to the propensity match score, 92 patients (50 sling immobilization and 42 no sling immobilization) were matched to be almost identical in age (62.5 ± 8.0 vs. 61.8 ± 5.9), sex (female 78% vs. 76.2%), BMI (28.1 ± 2.8 vs. 27.8 ± 2.6), and tear size (2.7 ± 1.1 vs. 2.9 ± 0.8). The postoperative physical functioning domain of SF-36 scores was found to be significantly higher in the no sling group ( p = 0.034).

Early mobilization after arthroscopic small and medium sized full thickness superior rotator cuff repair is associated with improved ROM and quality of life scores.

Shoulder external rotation in the throwing motion involves movement of the scapulothoracic and glenohumeral joints, thoracic spine, and the thorax. Restriction of thoracic expansion may decrease scapulothoracic joint motion and compensate by excessive glenohumeral joint motion. However, it is unclear how restricting the expansion of the thorax alters shoulder motion.

To elucidate changes in scapulothoracic and glenohumeral joint movements caused by restricted thoracic expansion.

Kinematic data were obtained using an electromagnetic tracking device (Liberty; Polhemus), from 18 male participants, during shoulder external rotation in the sitting position with and without restriction of thoracic expansion. The displacements from the start position to the maximum external rotation position were compared, and Pearson’s correlation coefficient was calculated.

A significant difference was observed in the scapulothoracic posterior tilt angle ( P < 0.01) and glenohumeral external rotation angle ( P < 0.01). A significant positive correlation existed between scapulothoracic posterior tilt and glenohumeral external rotation ( P < 0.05) with and without restriction.

Restriction of thoracic expansion decreased scapulothoracic motion and increased glenohumeral motion. Thus, a decrease in thoracic expansion may change scapulothoracic and glenohumeral movements, which may be a risk factor for throwing injuries.