Impact of McKenzie Method Therapy Enriched by Muscular Energy Techniques on Subjective and Objective Parameters Related to Spine Function in Patients with Chronic Low Back Pain.

BACKGROUND: The high incidence and inconsistencies in diagnostic and therapeutic process of low back pain (LBP) stimulate the continuing search for more efficient treatment modalities. Integration of the information obtained with various therapeutic methods and a holistic approach to the patient seem to be associated with positive outcomes. The aim of this study was to analyze the efficacy of combined treatment with McKenzie method and Muscle Energy Technique (MET), and to compare it with the outcomes of treatment with McKenzie method or standard physiotherapy in specific chronic lumbar pain. MATERIAL AND METHODS: The study included 60 men and women with LBP (mean age 44 years). The patients were randomly assigned to 1 of 3 therapeutic groups, which were further treated with: 1) McKenzie method and MET, 2) McKenzie method alone, or 3) standard physiotherapy for 10 days. The extent of spinal movements (electrogoniometry), level of experienced pain (Visual Analogue Scale and Revised Oswestry Pain Questionnaire), and structure of the spinal discs (MRI) were examined prior to the intervention, immediately thereafter, and 3 months after the intervention. RESULTS: McKenzie method enriched with MET had the best therapeutic outcomes. The mobility of cervical, thoracic, and lumbar spine normalized at levels corresponding to 87.1%, 66.7%, and 95% of respective average normative values. Implementation of McKenzie method, both alone and combined with MET, was associated with a significant decrease in Oswestry Disability Index, significant alleviation of pain (VAS), and significantly reduced size of spinal disc herniation. CONCLUSIONS: The combined method can be effectively used in the treatment of chronic LBP.

Development and Psychometric Properties of the Caregiver Burden Scale in Polish Caregivers of Stroke Patients.

Purpose: Most stroke patients require long-term care of their family members. Excessive care burden entails several negative consequences; therefore, the severity of the burden should be periodically assessed. For this purpose, valid multidimensional measures are needed. Our study, which is a part of a larger research project, aims to translate and evaluate the psychometric properties of the Polish Caregiver Burden Scale (CBS) in relation to construct validity and internal consistency in caregivers of the patients after stroke. Patients and Methods: The sample of this cross-sectional observational study consisted of 366 informal caregivers to consecutive first-ever stroke survivors. The five-factor Polish CBS and the Hospital Anxiety and Depression Scale (HADS) were administered during the home visits at three to six months after patients' hospitalisation. Exploratory (EFA), confirmatory (CFA) factor analyses and a net analysis were performed to investigate the internal structure and a factorial construct validity of the CBS. Correlation analyses between the CBS and the HADS were carried out to examine convergent validity. Cronbach's alpha and item-total correlation were applied to assess internal consistency. Results: Three out of five factors identified by EFA were similar to the original indices of the CBS, while the remaining two deviated from the original structure of the CBS. The CFA five-factor model represented an acceptable fit (confirmatory fit index, CFI = 0.96, root mean square error, RMSEA = 0.04) but only after a modification. All subscale scores of the CBS were positively correlated with the HADS, supporting the convergent validity. Cronbach's alpha coefficients for the overall scale (0.92) and all subscales (0.72-0.87) except one (0.69) and item-total correlation results indicated good internal consistency. Conclusion: The Polish version of the CBS showed acceptable internal consistency and good convergent validity. Factorial validity and structural integrity were partially supported. The interrelationships between the CBS subdomains, their partial mutual contamination, and the scale's non-orthogonal structure should be considered when interpreting the results of further studies using this version of the scale.

Distribution of plantar pressure during jogging barefoot or in minimalistic shoes in people who used to run in cushioned shoes.

BACKGROUND: In recent years, an increasing number of runners prefer jogging barefoot or in minimalistic shoes. The aim of this study was to compare the distribution of plantar pressure during jogging barefoot, in minimalistic shoes, or in shoes with cushioned soles, as these forces modulate the risk of injury. METHODS: The study included nine men aged between 24 and 25 years, who engaged in long-distance running. The plantar pressure of three foot zones (forefoot, midfoot, and hindfoot) was examined with WIN-POD electronic podometer during running barefoot, in minimalistic shoes, or in shoes with cushioned soles. RESULTS: Individuals who ran barefoot showed the greatest forefoot pressure, followed by those running in minimalistic shoes and cushioned shoes. In contrast, the heel pressure in individuals running in cushioned shoes was significantly greater than in those using minimalistic shoes or running barefoot. CONCLUSIONS: Switching from running in cushioned shoes to jogging barefoot is associated with the accumulation of greatest pressure in the forefoot and midfoot. The accumulation of the greatest pressure at the insertion of plantar aponeurosis can lead to the injuries of musculoskeletal system, in particular plantar aponeurositis. Even distribution of pressure among various parts of the foot in persons running in minimalistic shoes is associated with lower risk of injury than in the case of running barefoot.

Positive Impact on Physical Activity and Health Behaviour Changes of a 15-Week Family Focused Intervention Program: "Juniors for Seniors".

The promotion of physical activity (PA) in children and their parents requires effective planning and sometimes even interventions. This study shows the effect of PA during a 15-week intervention program "Junior for Seniors" by applying a socioecological model to the interpretation of the data. This comprehensive approach emphasizes the fact that health promotion should focus not only on intrapersonal factors but also on the multilevel factors that might be determinants and modulators of increased PA. In 2015, 24 children ("juniors," 14 girls and 10 boys, aged M = 7.96 ± 0.69) and 22 parents ("seniors," 14 mothers aged M = 38.86 ± 2.96 and 8 fathers aged M = 37.38 ± 2.97) were voluntarily enrolled in a study spread across three primary schools in the city of Poznan, Poland. The effectiveness of the intervention was determined according to postintervention behavioural changes in PA in comparison to preintervention levels, as reported by the parents and children. Overall, the study found increases in PA levels and reductions in sedentary time. Although the changes are modest, there are some unrecognized benefits of the intervention which may have occurred, such as improved sport and motor skills, more frequent family social behaviours (walks, meals, and visiting relatives), or simply improved quality of "do-together" leisure time PA.