Journal of Back and Musculoskeletal Rehabilitation

Robot-assisted gait training (RAGT) has been reported to treat motor dysfunction in patients with Parkinson’s disease (PD) in the last few years. However, the benefits of RAGT for treating motor dysfunction in PD are still unclear.

To investigate the efficacy of RAGT for motor dysfunction in PD patients.

We searched PubMed, Web of Science, Cochrane Library, Embase, CNKI, Wanfang, Chinese Biomedical Literature Database (CBM), and Chinese VIP Database for randomized controlled trials investigating RAGT to improve motor dysfunction in PD from the databases’ inception dates until September 1, 2022. The following outcome indexes were employed to evaluate motor dysfunction: the Berg Balance Scale (BBS), Activities-specific Balance Confidence Scale (ABC), 10-Meter Walk Test gait speed (10-MWT), gait speed, stride length, cadence Unified Parkinson Disease Rating Scale Part III (UPDRS III), 6-Minute Walk Test (6MWT), and the Timed Up and Go test (TUG). The meta-analysis was performed using the proper randomeffect model or fixed-effect model to evaluate the difference in efficacy between the RAGT and the control groups. The Cochrane Risk of Bias Tool was used for the included studies and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) was used to interpret the certainty of the results.

The results consisted of 17 studies comprising a total of 670 participants. Six hundred and seven PD patients with motor dysfunction were included: 335 in the RAGT group and 335 in the control group. This meta-analysis results established that when compared with the control group, robot-assisted gait training improved the BBS results of PD patients (MD: 2.80, 95%CI: 2.11–3.49, P < 0.00001), ABC score (MD: 7.30, 95%CI: 5.08–9.52, P < 0.00001), 10-MWT (MD: 0.06, 95%CI: 0.03–0.10, P = 0.0009), gait speed (MD: 3.67, 95%CI: 2.58–4.76, P < 0.00001), stride length (MD: 5.53, 95%CI: 3.64–7.42, P < 0.00001), cadence (MD: 4.52, 95%CI: 0.94–8.10, P = 0.01), UPDRS III (MD: - 2.16, 95%CI: - 2.48– - 1.83, P < 0.00001), 6MWT (MD: 13.87, 95%CI: 11.92–15.82, P < 0.00001). However, RAGT did not significantly improve the TUG test result of patients with PD (MD = - 0.56, 95% CI: - 1.12–0.00, P = 0.05). No safety concerns or adverse reactions among robot-assisted gait training patients were observed.

Even though RAGT can improve balance function, walking function, and gait performance and has demonstrated positive results in several studies, there is currently insufficient compelling evidence to suggest that it can improve all aspects of lower motor function.

In the working environment of modern society, a poor sitting posture for a prolonged time may lead to abnormal spinal alignment such as thoracic kyphosis (TK).

This study aimed to evaluate the efficacy of taping for posture correction of patients with TK, providing theoretical and empirical guidance for clinicians attempting to rectify TK posture.

The study included 15 subjects aged 30–60 years, all with a TK angle of ⩾ 40^∘. Subjects were required to ascend and descend a set of three steps (a low step, high step, and second low step) under three different conditions: without tape assistance, with taping assistance using 20% elongation, and with taping assistance using 40% elongation. A triaxial accelerometer was employed to measure and compare the anterior-posterior (AP), vertical (VT), and medial-lateral (MIL) movements of the thoracic vertebrae in the different conditions.

There were no significant differences in the MIL ( P = 0.903) or AP ( P = 0.114) movements between the no tape assistance and 20% elongation taping conditions. However, a significant difference was found in the VT movement ( P = 0.017). Comparing the no assistance condition to the 40% elongation taping condition, no significant changes were noted in the MIL movement ( P = 0.650), but significant differences were detected in both the VT ( P = 0.003) and AP movements ( P = 0.016). No significant differences were found in any of the three measurements between 20% and 40% elongation taping.

Taping serves as an effective method for immediately improving kyphotic posture. It corrects the position of the scapula and cervicothoracic line and exerts passive retraction on the relevant muscles, thus mitigating trunk imbalance.

Lumbar disc herniation (LDH) is a common clinical disease of the skeletal system, and its prevalence has been on a rise.

To evaluate the efficacy of Huoxue Tongluo decoction plus acupuncture in the treatment of lumbar disc herniation and its effectiveness in improving the functional recovery of the patients’ affected joints and mitigating their pain.

In this prospective study, 110 patients with lumbar disc herniation enrolled in our Hospital from June 2019 to June 2021 were collected and randomized to receive either conventional treatment (control group) or Huoxue Tongluo Decoction plus acupuncture (study group).

Huoxue Tongluo Decoction plus acupuncture resulted in more rapid mitigation of lower extremity symptoms and lumbar symptoms versus conventional treatment ( P < 0.05). Patients receiving traditional Chinese medicine (TCM) showed milder inflammatory responses than those with conventional medication, as evidenced by the lower serum concentrations of tumor necrosis factor- α (TNF- α ), interleukin (IL)-6, and high-sensitivity C-reactive protein (hs-CRP) ( P < 0.05). After treatment, the study group had higher Japanese Orthopedic Association (JOA) scores and lower visual analogue scale (VAS) scores than the control group ( P < 0.05), suggesting that the combination of the herbal decoction and acupuncture provided better functional recovery of the affected joints and pain mitigation for the patients. Furthermore, the lower Pittsburgh sleep quality index (PSQI) scores in patients in the study group indicated better sleep quality of patients after TCM intervention than after conventional treatment ( P < 0.05). Huoxue Tongluo Decoction plus acupuncture was associated with a significantly higher efficacy (94.55%) versus conventional treatment (80%) ( P < 0.05).

Huoxue Tongluo Decoction combined with acupuncture significantly offers a viable treatment alternative for lumbar disc herniation with promising treatment outcomes, mitigates patients’ limb pain, and improves their lumbar function and sleep quality. Further trials are, however, required prior to general application in clinical practice.

Low back pain is an important widespread health problem that can occur at any age, causing serious socioeconomic losses.

The objective of this study is to investigate the relationship between kinesiophobia severity and pain severity, depression, and quality of life in patients with mechanical low back pain.

The study sample consisted of 155 patients, of whom 72 were female and 83 were male, aged between 18 and 75 years with mechanical low back pain. Quality of life was assessed with the 36-Item Short Form Health Survey (SF-36), pain intensity with the Visual Analogue Scale (VAS), kinesiophobia with the Tampa Kinesiophobia Scale (TKS), and depression with the Beck Depression Inventory (BDI). Patients were divided into the low (TKS ⩽ 37) and high kinesiophobia (TKS > 37) groups according to the scores they obtained from TKS.

VAS-pain severity and BDI scores were significantly higher in the high kinesiophobia group than in the low kinesiophobia group ( p < 0.001). On the other hand, the SF-36 subscale scores were significantly higher in the low kinesiophobia group than in the high kinesiophobia group ( p < 0.001). The TKS scores were moderately correlated with VAS-pain severity ( r = 0.470; p < 0.001) and BDI scores ( r = 0.584; p < 0.001) in the positive direction, and strongly correlated with all sub-parameters of quality of life in the negative direction ( p < 0.001).

The results indicated that the severity of kinesiophobia in patients with non-inflammatory low back pain is associated with pain severity, depression, and poor quality of life.

Anatomical cup implantation is a promising approach in primary total hip arthroplasty (THA) and improves functional outcomes.

We aimed to evaluate the cup position and functional outcomes in primary THA with preoperative dynamic 3D planning.

We retrospectively reviewed 54 hips in 48 patients who underwent primary THA with anatomical cup implantation (mean follow-up time: 52 months). Cup positions were evaluated based on patient-specific morphology, the acetabular fossa and the combined anteversion test. Functional outcomes were assessed after THA. The paired-sample t -test was performed for surgical and contralateral native hips among 42 patients who underwent unilateral THA.

Two hips suffered intraoperative trochanteric fracture, but no hip dislocations occurred. No patients reported groin or thigh pain, and all patients were capable of deep squatting and one-leg standing. The mean Harris hip score, WOMAC score, and physical SF-36 score were 94.46 ± 6.16, 10.41 ± 3.62, and 95.19 ± 8.74, respectively. Except for acetabular offset, THA restored biomechanics to those of contralateral native hip, including cup anteversion, abduction, femoral offset and acetabular height ( P > 0.05).

This study provided evidence for the application of anatomical cup implantation assisted with dynamic 3D planning in primary THA, which restored morphology and improved functional outcomes.

Despite wobble board use being common in physiotherapy the effect of certain factors, essential to clinical reasoning, have not been investigated.

To determine the effect of biological sex, anthropometrics, footwear and dual tasking (DT) on wobble board balance performance.

Eighty-six healthy participants (44 females) had their wobble board performance measured during double-leg-stance (DLS) with eyes open (DLSEO), closed (DLSEC) and single-leg-stance (SLS) tasks, with and without footwear and a DT added. Anthropometrics were also measured.

Females outperformed males during most tasks, with some large effect sizes (ES). Performance was moderately related to weight and shoulder, waist and hip circumference. Overall, there were no differences between footwear and no footwear, except for males during SLS. DT made little difference, except during DLSEO and SLS, where single task was better than DT, though only females had a large ES.

During wobble board tasks, biological sex differences were observed and a modest correlation between anthropometrics and performance noted. DT and footwear had minimal effect.

Chronic low back pain (LBP) can lead to muscle spasms, limited range of motion, and abnormal posture, resulting in trunk muscle asymmetry.

This study aimed to assess the intra- and inter-rater reliability of a quantitative measurement of trunk coronal asymmetry in patients with chronic LBP, minimizing unnecessary gravity and friction force using a manual table in the prone position.

This prospective study was conducted at a single center, targeting patients with chronic LBP to measure trunk coronal asymmetry on a manual table in the prone position. The intra-class correlation coefficient (ICC) was calculated using one-way random-effects and two-way mixed-effects models.

Fifty-eight patients who had LBP for more than three months were enrolled from May 1, 2021, to December 31, 2021. The intra- and inter-rater reliabilities of the two examiners’ measurements were 0.872 and 0.899, and 0.852, respectively. Based on pain severity, the participants were classified into mild and severe groups, with ICCs of 0.823 and 0.889, and 0.936 and 0.918, respectively.

Measurement of trunk coronal asymmetry in the prone position using a manual table demonstrates high intra- and inter-rater reliability. In addition, the reliability increases with greater pain severity.

Epidural steroid injections are common procedures used to treat lumbosacral radicular pain due to lumbar disc herniation (LDH). It is crucial for the clinician to anticipate which patients can benefit from interventional treatment options.

This study aimed to examine the effect of radiological and clinical parameters on lumbar transforaminal epidural steroid injections (TFESI)/local anesthetic injection outcomes in patients with LDH.

This study included 286 patients with LDH (146 males and 140 females). All patients received a fluoroscopically guided TFESI (triamcinolone acetonide 40 mg, lidocaine 2%, and 2.5 ml of physiological saline). Patients were evaluated according to radicular pain, the Oswestry Disability Index (ODI) and the Hospital Anxiety and Depression Scale at baseline and 3 months after the injections. Demographic, clinical and magnetic resonance imaging (MRI) findings were recorded to assess the predictive factors for TFESI outcomes. Pfirrmann Grades 1 and 2 were classified as low-grade nerve root compression and Grade 3 was classified as highgrade nerve root compression.

Compared to baseline measurements there were significant improvements in radicular pain, ODI score, Laseque angle, and Schober test scores 3 months after injection. Improvements of at least 50% in radicular pain relief and the ODI functionality index were ( n = 214) 82%, ( n = 182) 70% respectively at 3 months. Correlation analyses revealed that a shorter duration of symptoms, lowgrade nerve root compression and foraminal/extraforaminal location on MRI findings were associated with a favorable response.

Lowgrade nerve root compression was a predictor of a favorable response to TFESI.

Previous studies have suggested an association between pelvic rotation (PR) and scoliotic deformity in severe adolescent idiopathic scoliosis (AIS), but none have investigated this relationship in mild to moderate AIS.

To investigate the relationship between PR and trunk rotation in mild to moderate AIS.

This was a case-control study. The cases were 32 AIS patients with PR in the opposite direction to the thoracic curve, and the controls were 32 AIS patients with PR in the same direction as the thoracic curve. All patients were assessed with the Adams forwards bend test. Type II trunk rotation was selected as exposure. Logistic regression was used to estimate the association between PR direction and types of trunk rotation while accounting for confounders. Multiple linear regression was used to analyse the relationships between PR magnitude and the angle of trunk rotation (ATR).

Logistic regression showed an unadjusted OR of 9.13 (95% CI 2.92–28.50, P < 0.001), and adjustment for sex and Cobb angle only slightly changed the OR (adjusted OR, 8.23; 95% CI, 2.51–27.01; P = 0.001). The concave/convex ratio was associated with ATR measurements in both cases ( β = - 0.379; P = 0.030) and controls ( β = - 0.468, P = 0.008).

An association was found between PR and trunk rotation, which may help achieve more effective physiotherapy in mild to moderate AIS.

Studies have shown that core muscle training can accelerate the recovery of motor function in stroke patients. However, there are no relevant reports to show the effect of core muscle training combined with functional electrical stimulation (FES) on the rehabilitation of stroke patients.

This study aimed to observe the efficacy of core muscle training combined with FES on motor and balance functions of lower limbs in stroke patients.

This study selected and divided 120 stroke patients with hemiplegia admitted to our hospital into the control and observation groups. Patients in the control group just received core muscle training; while patients in the observation group were treated by core muscle training combined with FES. Both groups were treated for 8 weeks. Subsequently, the clinical data and information of all patients were collected and counted. Muscle strength changes were observed by detecting paralytic dorsiflexor (pDF), plantar flexor (pPF), knee extensor (pKE), and knee flexor (pKF) before and after treatment. Motor and balance abilities of both groups were scored through the 10-meter walking test (10 MWT), Berg balance scale (BBS), functional ambulation category (FAC) scale, timed up and go (TUG) test, and lower extremity motricity index (MI-Lower).

No significant difference was found in clinical data between the two groups. The intensity of pDF, pPF, pKE, and pKF significantly increased in both groups after treatment, and the intensity of these parameters was higher in the observation group relative to the control group. Additionally, 10 MWT and TUG test scores of patients in the observation group were notably decreased while the BBS and MI-Lower scores were significantly increased after treatment compared with those in the control group.

Core muscle training combined with FES can significantly improve the rehabilitation effect of lower limb motor and balance functions in stroke patients.

There has been a dearth of research into the benefits of water-based workouts for ankylosing spondylitis (AS) patients.

This study aimed to compare the effect of Aqua Stretch and Aqua Pilates in improving quality of life (QOL), function, and pain in AS patients.

This study was conducted on 40 patients, who were randomly assigned to the Aqua Pilates, Aqua Stretch, and control groups. The experimental groups attended interventions for six-week. QOL, pain intensity, function, and fatigue were measured before and after treatments.

Except for the chest expanding, all variables in the Aqua Stretch group changed significantly after six weeks ( p < 0.05). QOL ( p = 0.002), 6MWT ( p = 0.016), and Schober flexion ( p = 0.011) showed changes, while BASDAI ( p = 0.0001), VAS ( p = 0.0001), fatigue ( p = 0.0001), and Schober extension ( p = 0.028) showed significant decreases. Except for chest expansion and Schober extension, which did not alter significantly after six-week of Aqua Pilates ( p > 0.05), all other variables did. There was an increasing trend in 6MWT and Schober flexion ( p = 0.021) and a decreasing trend in BASDAI ( p = 0.002), VAS ( p = 0.0001) and fatigue ( p = 0.002). Except for QOL ( p = 0.016), no statistically significant differences were found between the groups.

All variables had a significant change after six-week Aqua Stretch, except for the chest expanding. Chest expanding and Schober extension were the variables which had no significant change after six-week Aqua Pilates. With the exception of QOL, no statistically significant differences were found between the groups. Aqua Stretch had the greatest effect on the VAS, as measured by the minimum clinically relevant differences (MCID). Moreover, in Aqua Stretch alone, there was a notable impact on fatigue, QOL, and the BASDAI.

No study to date has concurrently evaluated the impact of radiological factors, psychosocial factors, and central sensitization (CS) related symptoms in a single lumbar spinal canal stenosis (LSS) patient cohort.

To investigate the associations between these factors and clinical symptoms in LSS patients.

We recruited 154 patients with LSS scheduled for surgery. Patient-reported outcome measures and imaging evaluation including clinical symptoms, psychosocial factors, CS-related symptoms, and radiological classifications. Spearman’s rank correlation coefficient and multiple regression analyses were employed.

Spearman’s correlation revealed CS-related symptoms positively correlated with low back pain ( r = 0.25, p < 0.01), leg pain ( r = 0.26, p < 0.01), and disability ( r = 0.32, p < 0.01). Pain catastrophizing positively correlated with leg pain ( r = 0.23, p < 0.01) and disability ( r = 0.36, p < 0.01). Regression analysis showed that pain catastrophizing was associated with disability ( β = 0.24, 95%CI = 0.03–0.18), and CS-related symptoms with low back pain ( β = 0.28, 95%CI = 0.01–0.09). Radiological classifications were not associated with clinical symptoms.

Our findings suggest that psychosocial factors and CS-related symptoms, rather than radiological factors, seem to contribute to clinical symptoms in patients with LSS.

Adolescent idiopathic scoliosis (AIS) is the most common structural deformity of the spine during adolescence, which could cause varying degrees of physical and mental damage to patients. Schroth therapy and sling exercise are widely used in the treatment of patients with AIS currently, and have shown the significant therapeutic effect relatively.

To observe the efficacy of sling exercise combined with Schroth therapy on adolescents with mild idiopathic scoliosis (MIS).

Sixty patients with AIS were randomly divided into the Schroth + sling group ( n = 31) and the Schroth group ( n = 29). Patients in both groups received Schroth therapy, and sling exercise was added in the Schroth + sling group. Before and after 12 weeks of treatment, the Cobb angle, angle of trunk rotation (ATR), Scoliosis Research Society-22 (SRS-22) scale score and averaged electromyography (AEMG) of bilateral paraspinal muscles were evaluated.

After the treatment, Cobb angle, ATR in both groups were decreased compared with those before ( P < 0.001), and the decrease in the Schroth + sling group was more obvious ( P < 0.05). The AEMG of bilateral paraspinal muscles and the total score, posture, mental health of SRS-22 of the two groups improved compared with those before treatment ( P < 0.05), and the Schroth + sling group had a significant improvement than the Schroth group ( P < 0.05).

Schroth therapy improved the degree of scoliosis, torticollis, quality of life, and bilateral paraspinal strength on adolescents with mild idiopathic scoliosis. The effect was more pronounced when the sling exercise was included in the treatment regimens.

To measure hamstring flexibility, the active knee extension (AKE) test is preferred over the straight leg raise (SLR) test as it can be used to measure hamstring flexibility more selectively. However, hamstring stretching is primarily conducted in the SLR position (maximal hip flexion in the supine position) as it allows for maximal hip flexion in the supine position.

This study evaluates the effects of proprioceptive neuromuscular facilitation (PNF) stretching in the AKE position (maximal knee extension with 90^∘ flexion of the hip in the supine position) on hip, knee, and ankle flexibility.

SLR, AKE, and active dorsiflexion (ADF) tests were used to determine the range of motion (ROM) before (pre-ROM) and after (post-ROM) stretching. PNF stretching consisted of maximal isometric knee flexion at the end range with external resistance to prevent knee flexion. One set of PNF stretches (five trials of six seconds each) was conducted.

The post-ROMs of hip, knee, and ankle measured via the SLR, AKE, and ADF tests, respectively, were significantly higher than the pre-ROMs.

The improvement in knee flexibility was greater than the improvement in hip and ankle flexibility. The AKE position is recommended in clinical settings during PNF stretching for individuals with hamstring tightness. Furthermore, PNF stretching in the AKE position increases the ADF ROM.

McKenzie standing trunk extension exercises have been used for the management of low back pain (LBP). However, no study to date has investigated the effect of standing trunk extension postures on spinal height and clinical outcomes.

To evaluate in subjects with LBP following a period of trunk loading how spinal height, pain, symptoms’ centralization and function outcome measures respond to two standing postures interventions: (1) repetitive trunk extension (RTE) and (2) sustained trunk extension (STE).

A consecutive sample of convenience of people with LBP were recruited to participate in 2-session physical therapy using either RTE or STE in standing.

Thirty participants (18 women) with a mean age of 53 ± 17.5 years completed the study. The first session resulted in spinal height increase (spinal growth) of 2.07 ± 1.32 mm for the RTE intervention and 4.54 ± 1.61 mm for the STE group ( p < 0.001; ES = 1.67), while the second session (2-week following the first session) resulted in spinal growth of 2.39 ± 1.46 mm for the RTE group and 3.91 ± 2.06 mm for the STE group ( p = 0.027; ES = 0.85). The STE group presented with the larger reduction in most pain from 6 to 2 as compared to the RTE group from 6 to 4 between Session 1 and Session 2 ( p < 0.001). There was no difference between the groups in Modified Oswestry score and symptoms centralization ( p = 0.88 and p = 0.77, respectively).

People with LBP experienced greater spine growth and improvements of pain during standing STE as compared to RTE. People with LBP could use such postures and movements to alleviate their LBP and improve spine height while in a weight bearing position.

The restoration and management of the uninvolved side have been emphasized to prevent a second anterior cruciate ligament (ACL) injury and to ensure that athletes return to sports after ACL reconstruction.

To determine the factors influencing the single leg hop test (SLHT) and single leg vertical jump test (SLVJT) at 1 year postoperatively after ACL reconstruction in both the involved and uninvolved sides.

Ninety-four patients who underwent ACL reconstruction were assessed at 1 year postoperatively. Multiple regression models included eight independent variables with two dependent variables (SLHT and SLVJT.), each on the involved and uninvolved side.

On the involved side, the Y balance test (YBT), extensor peak torque per body weight (PT/BW), Biodex balance system anteroposterior index (BBS-API), and sex accounted for 53.9% of the variance in SLHT ( P = 0.002), and extensor PT/BW and YBT accounted for 26.3% of the variance in SLVJT ( P = 0.027). On the uninvolved side, YBT, sex, age, BBS-API, and flexor PT/BW accounted for 47.0% of the variance in SLHT ( P = 0.046), and flexor PT/BW, YBT, and age accounted for 44.9% of the variance in SLVJT ( P = 0.002).

Knee extensor strength on the involved side and flexor strength on the uninvolved side influence the two functional performance tests. The YBT was an important factor in the two functional performance tests in both sides. Anteroposterior stability was the only factor that influenced the SLHT bilaterally.

Foot arch dynamics play an important role in dynamic postural control. Association between foot arch dynamics and postural control among adolescent athletes remains poorly explored.

To examine the relationship between foot arch dynamics, intrinsic foot muscle (IFM) morphology, and toe flexor strength and dynamic postural stability after jump landing and repetitive rebound jump performance in competitive adolescent athletes.

Based on foot arch dynamics, evaluated from relative change in the foot arch height in sitting and standing positions, 50 adolescent athletes were classified as stiff, normal, or flexible. IFM morphology was evaluated by ultrasonography. Dynamic postural stability index (DPSI) was measured as participants jumped and landed with the right leg onto a force plate, whereas repetitive rebound jumping performance was assessed using the jump height and reactive jump index.

The stiff group had a significantly worse DPSI and vertical stability index than the normal group ( p = 0.26, p = 0.44, respectively), and worse anteroposterior stability index (APSI) values than the flexible group ( p = 0.005). Multivariate regression models of the relationship between the APSI and foot arch dynamics showed adequate power (probability of error = 0.912).

Increased foot arch stiffness negatively affects dynamic balance during jump-landing, which may deteriorate their performance.

Elastic taping that applies shear force affects joint movement. However, it remains uncertain whether elastic taping or stretching is more effective in improving flexibility.

We investigated whether elastic taping for flexibility improvement is comparable to traditional stretching.

In this randomized controlled trial, 64 university students were randomly allocated to two groups: elastic taping on the sole or 30 s of static stretching. The primary outcome measures were the straight leg raising angle, tested with an equivalence margin ( ± 9.61^∘ on changes), and the fingertip-to-floor distance. Secondary outcomes were the hip flexor and knee extensor strength, two-step distance, adverse events, and pain intensity during the intervention, which were compared using conventional statistical methods.

The mean differences in straight leg raising between the two groups after the interventions were not greater than the equivalence margin (mean [95% CI]: 1.4 [ - 6.9, 9.5]; equivalence margin, - 9.61^∘ to 9.61^∘). There were no consistent differences between groups in terms of secondary outcomes except for pain intensity during the intervention ( p > 0.05). Elastic taping did not induce pain.

Elastic taping augments the flexibility-improving effect comparable to static stretching, based on an equivalence margin. Elastic taping of the sole appears to be an alternative method of improving flexibility.

Musculoskeletal injuries, such as strains, are prevalent across all age groups and have a substantial impact on daily functioning and quality of life.

To examine the effectiveness of high-intensity interval training (HIIT) with traditional rehabilitation programs on pain, range of motion (ROM), muscular strength, and functional changes in promoting accelerated recovery from musculoskeletal injuries.

A total of 80 participants (54 males, 26 females; mean age 35.6 years) with various musculoskeletal injuries were randomly assigned to either the HIIT group ( n = 40) or the traditional rehabilitation group ( n = 40). The HIIT group underwent a six-week supervised program, with three sessions per week. The traditional rehabilitation group followed a similar six-week program emphasizing low to moderate intensity exercises and traditional rehabilitation techniques. Outcome measures, including pain levels, ROM, muscular strength, and functional outcomes, were assessed pre- and post-intervention.

Significant improvements were observed in both the HIIT and traditional rehabilitation groups. However, the HIIT group demonstrated superior outcomes. Participants in the HIIT group experienced a greater reduction in pain levels compared to the traditional rehabilitation group (mean visual analog scale (VAS) score decrease of 5.2 vs. 3.8, respectively, p < 0.05). Functional outcomes significantly favored the HIIT group, with participants achieving faster completion times in the Timed Up and Go test (mean reduction of 2.1 seconds vs. 1.5 seconds, respectively, p < 0.01) and longer distances in the Single Leg Hop test (mean increase of 32 cm vs. 25 cm, respectively, p < 0.05).

HIIT showed superior effectiveness over traditional rehabilitation in accelerating recovery from musculoskeletal injuries, with greater pain reduction and improved functional outcomes. Incorporating HIIT into rehabilitation protocols may offer an efficient approach for expedited recovery and enhanced functional capacity.

Hip osteoarthritis (OA) is a chronic progressive disease that impresses a noticeable burden to society and healthcare systems. Physical exercise constitutes the first-line hip OA treatment approach, nevertheless, there is currently no gold standard method to treat this disease.

To evaluate the efficacy of proprioceptive neuromuscular facilitation (PNF) on functioning in patients with hip OA.

A pilot randomized controlled trial (RCT) was carried out on patients with painful bilateral hip OA with a body mass index (BMI) < 30 kg/m². After the randomization, the experimental group was treated with PNF protocol and the control group with conventional physical therapy (10 sessions of manual therapy, 5 sessions/week for 2 weeks). The Harris Hip Score (HHS) was the primary outcome, whereas we assessed as secondary outcomes: pain, range of motion, and muscle strength of hip, physical performance, and quality of life.

Twenty patients (40 hips) were enrolled and randomized into two groups: PNF group (mean age: 70.7 ± 8.07; BMI: 25.1 ± 3.07; 7 females and 3 males) and control group (mean age: 74.9 ± 10.72; BMI: 26.8 ± 3.78; 6 females and 4 males). The results showed a statistically significant improvement of HHS in the study group (T1: 90.6 ± 5.63) than in the control group (T1: 77.3 ± 10.9) (between-group p value < 0.001). Three months after the treatment we have statistically significant maintenance in the PNF group (T2:89.6 ± 6.32, within-group Δ T0-T2 p < 0.01) while the control group did not maintain the improvements recorded at T1 (T2: 71.4 ± 15.8).

The results of this pilot RCT showed that incorporating PNF exercises into the rehabilitation program yielded notable enhancements in improving lower limb function, strength and ROM in hip OA patients. Nonetheless, further prospective studies including wider sample size are needed to implement scientific knowledge on this physical therapy approach, in patients with hip osteoarthritis.

The local hemodynamic response after cupping therapy has been considered as a contributing factor for improving muscle tissue health; however, the effects of cupping pressure and duration on the spatial hemodynamic response have not been investigated.

The objective of this study was to investigate the hemodynamic response inside and outside the cupping cup under various pressures and durations of cupping therapy.

A 3-way factorial design with repeated measures was used to investigate the main and interaction effects of the location (areas inside and outside the cup), pressure ( - 225 and - 300 mmHg) and duration (5 and 10 min) on the hemodynamic response of the biceps muscle. A functional near-infrared spectroscopy was used to assess hemodynamic changes in 18 participants.

A significant three-way interaction of the location, pressure, and duration factors was observed in oxyhemoglobin ( p = 0.023), deoxy-hemoglobin ( p = 0.013), and blood volume ( p = 0.013). A significant increase was observed in oxyhemoglobin, blood volume, and oxygenation compared to pre-cupping ( p < 0.05) in the area outside the cup.

Our findings indicate that an appropriate combination of cupping pressure and duration can effectively affect the spatial hemodynamic response of the biceps.

Home exercise programs (HEPs) are cost-effective and efficacious treatments for musculoskeletal pain conditions. Although HEPs are an important part of the continuum of care, non-adherence limits their effectiveness.

The objective of this study was to examine adherence and specific barriers to clinician-prescribed HEPs in adults with musculoskeletal pain.

A cross-sectional study was conducted with a total of 300 patients presenting to an outpatient pain clinic in an academic medical center. Participants’ self-reported information, including HEP completion frequency and barriers, was collected through a survey.

The participants’ mean age was 54.1 ± 15.8 years (females = 133 (65.5%)). Of 203 participants, 99 (48.8%) adhered to HEP, 56 (27.6%) partially adhered, and 48 (23.6%) did not adhere. One hundred eighty-seven (92.1%) participants reported receiving adequate instructions, and 175 (86.2%) reported receiving instructional materials. Age and “sufficient instructions” were found to be significant determinants of adherence ( p < 0.05), while gender and handouts were not ( p > 0.05). Pain in more than one body part was significantly ( p < 0.05) associated with motivational barriers for non-adherence.

Age and participants’ perception of sufficient instructions were significant factors for non-adherence. These results emphasize the importance of therapist-provided instructions to overcome barriers to adherence.

Low back pain (LBP) has emerged as a major public health concern leading to significant work productivity loss and deterioration in the quality of life.

A randomized, double-blind, placebo-controlled parallel-group clinical trial was conducted to investigate the effect of E-PR-01, a proprietary blend of Vitex negundo leaves and zingiber officinale rhizome, in individuals with LBP.

Seventy-two individuals aged 18 to 60 years with LBP were randomized in a 1:1 ratio in either the E-PR-01 or placebo group. The participants were instructed to take 2 capsules/day of the study products in two divided doses for 30 days. The study outcomes were changes in functional activity, bending flexibility, pain intensity, work productivity, and sleep quality. The sustained effect of the study products was also evaluated on the pain and physical functioning for 7 days after stopping the product intake. The product’s safety was evaluated by adverse events reporting throughout the study.

Compared to the placebo, the E-PR-01 demonstrated a statistically significant reduction in functional disability (mean RMQ score: - 5.47 vs. - 2.48), pain intensity (mean VAS score: - 31.29 vs. - 14.55) and improved bending flexibility (mean distance: - 5.60 vs. - 2.38 cm). In addition, a significant improvement in work productivity as well as sleep quality was also observed. In the E-PR-01 group, a statistically significant sustained effect was observed compared to the placebo for the pain intensity ( p < 0.0005) and the functional activity ( p < 0.0001) scores. No significant adverse event was reported in the study.

E-PR-01 significantly improved low back pain and bending flexibility in adults without adverse effects. Moreover, the effect of E-PR-01 lasted 7 days after stopping the intervention.

Degenerative spinal deformity (DSD) is believed to originate from degeneration of the discs and facet joints and vertebral wedging. Currently, the nosogeny of DSD is not yet fully clarified and there has been no systematic study on the impact of their lower back muscle strength on quality of life.

To determine the characteristics of back extensor strength (BES) in different body positions and examine their correlations with health-related quality of life (HQOL) in degenerative spinal deformity (DSD) patients.

Participants comprised 60 DSD patients and 40 healthy volunteers. Maximal isometric BES was evaluated by dynamometers with the subject in three different positions (standing, prone, sitting). The visual analogue scale (VAS) score, Oswestry Disability Index (ODI), Roland–Morris Disability Questionnaire (RMQ), and 36-item Short Form Health Survey (SF-36) score were used to evaluate patient HQOL. Correlations between the BES in different body positions and HQOL were analysed.

The BES values in three body positions were significantly smaller in DSD patients than healthy subjects ( P < 0.05). The standing BES was found to be negatively associated with ODI and RMQ ( R = 0.313, p < 0.05 and R = 0.422, p < 0.01, respectively). A negative relationship between sitting BES and RMQ was also seen ( R = 0.271, p < 0.05). In addition, the standing and prone BES were positively correlated with the physical functioning score of the SF-36 ( R = 0.471, p < 0.01 and R = 0.289, p < 0.05, respectively), and the sitting BES was positively correlated with the role-physical score of the SF-36 ( R = 0.436, p < 0.01).

The results indicate that the back extensor muscle is compromised in DSD patients and there are differences in predicting the severity of disability and physical HQOL scores with BES in different positions. Standing BES was the most reliable contributor to HQOL among three body positions.

Joint position reproduction measures the angle acuity of reference angle reproduction using an indicator angle. However, reference angles are often not available.

This study aimed to examine joint position sense at three different targeted joint angles, which were estimated from the maximum range of motion (maxROM) without a reference angle at each targeted joint angle.

The maxROM was measured in straight leg raise (SLR) and active knee extension (AKE) positions. In both positions, a targeted joint angle at 75% of the maxROM was assessed first, followed by that at 50% and 25% of the maxROM. A one-sample t-test was used to analyze differences between the targeted and reproduced angles in both positions.

All reproduced angles significantly differed from the targeted angle in both SLR and AKE positions except for the reproduced angle measured at 75% maxROM. Overall, position errors in the AKE position were higher than those in the SLR position.

Estimating the angle based on the maxROM without a matched reference angle may lead to significant discrepancies in comparison with the targeted joint angle. In clinical settings, if accurate reproduction of motions is required to improve proprioception, providing a reference angle might be helpful.