Cross cultural adaptation, reliability and validity of the Persian version of the university of Wisconsin running injury and recovery index.

BACKGROUND: The University of Wisconsin Running Injury and Recovery Index (UWRI) was developed to evaluate running ability after a running-related injury. The aim of this study was to translate and cross-culturally adapt the UWRI into Persian (UWRI-Persian) and to investigate its psychometric properties in patients with a running-related injury. METHODS: The UWRI-Persian was translated using the Beaton guidelines. One hundred and seventy-three native Persian patients with running-related injuries were participated in the study. The exploratory factor analysis was carried out using the principal component analysis method with Varimax rotation. The construct validity of the UWRI-Persian was evaluated using the Pearson correlation with the pain self-efficacy questionnaire (PSEQ), Tampa scale for Kinesiophobia (TKS), and visual analogue scale (VAS). Test-retest reliability was tested among 64 patients who completed the form again after seven days. RESULTS: The UWRI-Persian showed excellent internal consistency for total score (α = 0.966). An excellent internal consistency (α = 0.922) was shown for psychological response and good internal consistency (α = 0.887) for running progression. The interclass correlation coefficient for the UWRI-Persian total scores was 0.965 (95% CI, 0.942 to 0.979), indicating high intra-rater reliability. The UWRI-Persian showed a moderate correlation with the PSEQ (r = 0.425) and the TSK (r = 0.457) and a weak correlation with the VAS (r = 0.187). These findings suggest no floor or ceiling effects. CONCLUSIONS: The UWRI is a reliable and valid tool for Persian-speaking patients with running-related injuries. The UWRI was successfully translated from English to Persian and demonstrated good to excellent internal consistency, validity and reliability with no floor or ceiling effects.

Is Adding Education to Trunk and Hip Exercises Beneficial for Patellofemoral Pain? A Randomized Controlled Trial.

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.

Examining the influence of pain neuroscience education followed by a Pilates exercises program in individuals with knee osteoarthritis: a pilot randomized controlled trial.

BACKGROUND: Knee osteoarthritis (OA) is a multifactorial form of rheumatic condition contributing to physical and psychological factors. Treatments have been provided solely and often compared with each other. An alternative view is that combined treatments addressing physical and psychological factors may result in more benefits. This study aimed to investigate the effect of pain neuroscience education (PNE) followed by Pilates exercises (PEs) in participants with knee OA, compared to PE alone. METHODS: In this two-arm assessor-blind pilot randomized controlled trial, fifty-four community-dwelling adults with knee OA were randomly assigned to the PNE followed by PEs and PEs groups (27 in each group). The study was conducted between early July 2021 and early March 2022 at the university's health center. Primary outcomes were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) subscales of pain and physical limitation and secondary outcomes were Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, Pain Self-Efficacy Questionnaire, and Timed "Up & Go" test covering function. The primary and secondary outcomes were measured at baseline and eight weeks post-treatment. A general linear mixed model was used for between-group comparison with a statistical significance level of 0.05. RESULTS: Significant within-group differences were observed in all outcomes in both groups at post-treatment. There were no statistically between-group differences in pain (adjusted mean difference: -0.8; 95% CI -2.2 to 0.7; p = 0.288), physical limitation (adjusted mean difference: -0.4; 95% CI -4 to 3.1; p = 0.812) and function (adjusted mean difference: -0.8; 95% CI -1.8 to 0.1; p = 0.069) at eight weeks. For pain catastrophizing (adjusted mean difference: -3.9; 95% CI -7.2 to -0.6; p = 0.021), kinesiophobia (adjusted mean difference: -4.2; 95% CI -8.1 to -0.4; p = 0.032), and self-efficacy (adjusted mean difference: 6.1; 95% CI 0.7 to 11.5; p = 0.028) statistically between-group improvements were observed favoring PNE followed by PEs group after the treatment. CONCLUSIONS: Combining PNE with PEs could have superior effects on psychological characteristics but not on pain, physical limitation, and function, compared to PEs alone. This pilot study emphasizes the need to investigate the combined effects of different interventions. TRIAL REGISTRATION: IRCT20210701051754N1.

Ankle dorsiflexion range of motion and landing postures during a soccer-specific task.

INTRODUCTION: Ankle dorsiflexion range of motion (DF-ROM) has been shown to be associated with poor landing posture. However, previously used tasks have been controlled, and it is unclear whether clinical measurements of the ankle DF-ROM, are associated with landing positions during sport-specific task. This study sought to determine the relationship between ankle DF-ROM and landing positions. METHODS: Thirty male soccer players participated in this study. The ankle DF-ROM was measured by the weight bearing lunge test in degrees using a cell phone app (TiltMeter). Landing patterns were assessed during a soccer-specific task using landing error scoring system items using Kinovea software. Simple correlations were used to evaluate the relationships between ankle DF-ROM and landing error scores. RESULTS: Significant correlations were found between ankle DF-ROM and landing errors (r = -0.450, P = 0.006). A decreased ankle DF-ROM was associated with greater landing errors in a soccer specific situation. CONCLUSION: These results suggest that ankle DF-ROM may serve a useful clinical measure for identifying poor landing posture in the real-world environment. Therefore, assessment of ankle DF-ROM could be included in the screening process, which could help identify the cause of the faulty motion.

Effects of Kinesio Taping on Tuck Jump Performance in Competitive Male Athletes.

This study aimed to measure the acute effects of kinesio taping at different stretches on tuck jump performance in active individuals. Seventy-five males (23.01±2.24 years, 178.35±8.12 cm, 72.47±6.58 kg) were randomly distributed into three groups: (1) kinesio taping without stretch, (2) kinesio taping with approximately 50% stretch, and (3) kinesio taping with approximately 75% stretch. The tuck jump performance of all participants was determined at baseline, immediately after applying kinesio taping, and 24 and 72 hours later. The participants' tuck jump performance did not improve immediately after the kinesio taping application, 24 hours, and 72 hours after the application. No significant differences were found between the kinesio taping groups at any time point (p>0.05). This study demonstrated no effects of kinesio taping on neuromuscular performance.

Hip and Core Muscle Activation During High-Load Core Stabilization Exercises.

BACKGROUND: There is some evidence that high-load lumbar stabilization exercises, such as back bridge, can recruit both local and global muscles. HYPOTHESIS: Therapeutic exercises would optimize gluteus maximus (GMax), gluteus medius (GMed), multifidus (MF), and transversus abdominis (TrA) activation, while minimizing the activation of the tensor fascia latae (TFL) and erector spinae (ES) muscles in healthy individuals. DESIGN: Cross-sectional study. SETTING: Research laboratory. LEVEL OF EVIDENCE: Level 4. METHODS: In this cross-sectional study, surface electromyography (EMG) of GMax, GMed, TFL, TrA, MF, and ES was used to quantify the gluteal-to-TFL muscle activation (GTA) index and a ratio of local to global (L/G) lumbar muscles during (1) the elbow-toe exercise in the prone position, (2) the elbow-toe with right left lifted, (3) the hand-knee with left arm and right leg lifted, (4) the back bridge, (5) the back bridge with right leg lifted, (6) the back bridge with left leg lifted, (7) the side bridge with left leg lifted, (8) the side bridge with right leg lifted, and (9) the elbow-toe with right leg horizontally lifted exercises in healthy individuals (20 men, 20 women; age, 25 ± 4 years). RESULTS: The back bridge exercise with left leg lift generated the highest L/G muscles activity ratio (L/G = 3.35) while the hand-knee exercise yielded the lowest L/G muscles activity ratio (L/G = 1.21). The side bridge exercise with left elbow and foot and lifting the right leg (GTA = 63.78), hand-knee exercise (GTA = 49.62), back bridge (GTA = 28.05), and elbow-toe exercise with left leg horizontally lifted (GTA = 23.02) generated the highest GTA indices, respectively. Meanwhile, the normalized EMG amplitude for GMax was significantly less than the TFL, for elbow-toe exercise (P < 0.001), back bridge with left leg lift (P = 0.001), side bridge exercise with the right elbow and foot and lifting the left leg (P = 0.002), and elbow-toe exercise with right leg horizontally lifted (P < 0.001). CONCLUSION: The highest GTA indexes were observed during (1) the side bridge lifting the dominant leg and (2) the hand-knee horizontally lifting dominant leg, respectively. The L/G ratio was highest during (1) the back bridge lifting nondominant leg, (2) back bridge, and (3) back bridge lifting dominant leg, respectively. This study supports the use of back bridge exercises to strengthen the MF and side bridges to improve gluteal muscle activation. CLINICAL RELEVANCE: The highest GTA index was observed in the side bridge lifting the right leg. Highest L/G ratio was in the back bridge with nondominant leg lifted. This study supports the use of back bridge exercises to strengthen the MF. This study supports the use of side bridges to improve gluteal muscle activation.

Altered trunk and lower extremity movement coordination after neuromuscular training with and without external focus instruction: a randomized controlled trial.

BACKGROUND: This study sought to determine the effects of a 6-week neuromuscular training (NMT) and NMT plus external focus (NMT plus EF) programs on trunk and lower extremity inter-segmental movement coordination in active individuals at risk of injury. METHODS: Forty-six active male athletes (controls = 15, NMT = 16, NMT plus EF = 15) participated (age = 23.26 ± 2.31 years) in this controlled, laboratory study. Three-dimensional kinematics were collected during a drop vertical jump (DVJ). A continuous relative phase (CRP) analysis quantified inter-segmental coordination of the: (1) thigh (flexion/extension)-shank (flexion/extension), (2) thigh (abduction/adduction)-shank (flexion/extension), (3) thigh (abduction/adduction)-trunk (flexion/extension), and (4) trunk (flexion/extension)-pelvis (posterior tilt/anterior tilt). Analysis of covariance compared biomechanical data between groups. RESULTS: After 6 weeks, inter-segmental coordination patterns were significantly different between the NMT and NMT plus EF groups (p < 0.05). No significant differences were observed in CRP for trunk-pelvis coupling comparing between NMT and NMT plus EF groups (p = 0.134), while significant differences were observed CRP angle of the thigh-shank, thigh-trunk couplings (p < 0.05). CONCLUSIONS: Trunk and lower extremity movement coordination were more in-phase during DVJ in the NMT plus EF compared to NMT in active individuals at risk of anterior cruciate ligament injury. TRIAL REGISTRATION: The protocol was prospectively registered at UMIN_RCT website with ID number: UMIN000035050, Date of provisional registration 2018/11/27.

Comparing myofascial meridian activation during single leg vertical drop jump in patients with anterior cruciate ligament reconstruction and healthy participants.

BACKGROUND: Muscles work synergistically to support the body during landing. Myofascial meridians have been described to classify muscles into functional synergies. The role that these functional lines plays in positioning the trunk and lower extremity of patients with anterior cruciate ligament reconstruction (ACLR) and healthy athletes during drop landing tasks remains unclear. RESEARCH QUESTION: The purpose of this study was to compare the front and back functional lines (FFL and BFL) muscle activation in patients with ACLR and healthy participants during single leg vertical drop jump (SLVDJ). METHODS: Thirty-two male athletes (post-ACLR = 16, healthy = 16) participated (age = 23.3 ± 2.3 years). Superficial electromyography of FFL (adductor longus [AL], rectus abdominis [RA], pectoralis major) and BFL (vastus lateralis [VL], gluteus maximus [GMax], latissimus dorsi [LD]) was collected during the SLVDJ and compared at initial contact and maximum knee flexion between groups using t-tests and limbs using paired-samples t-tests. RESULTS: In the FFL, the AL (p < 0.05) and RA (p < 0.05) muscles were more active in the healthy group compared to the ACLR group at initial contact and maximum knee flexion. PM demonstrated greater activation in the healthy group only at maximum knee flexion (p < 0.05). In the BFL, the VL (p < 0.05) and GMax (p < 0.05) muscles were more active in the ACLR group, whereas the LD (p < 0.05) muscles demonstrated greater activation in the healthy group at initial contact and maximum knee flexion. There were no healthy group inter-limb differences in FFL and BFL activation. ACLR participants demonstrated greater non-injured limb VL, AL, GMax and LD activation (p < 0.05) and greater injured limb PM and RA activation (p < 0.05). SIGNIFICANCE: Based on the present data, patients after ACLR may present with an alteration in BFL and FFL muscles activation during a drop jump task. Functional line muscles during dynamic activities may change lower extremity positioning and lead to increase ACL injury risk.

The influence of kinesio taping on trunk and lower extremity motions during different landing tasks: implications for anterior cruciate ligament injury.

PURPOSE: The purpose of the study was to investigate the influence of a 72-h KT application on trunk and lower extremity kinematics during different landing tasks. METHODS: Twenty-nine competitive male athletes participated in this study. The sum of knee valgus and lateral trunk lean, symmetry index (SI), and peak angles of lateral trunk lean, hip flexion, knee abduction and flexion were assessed for all participants during single-leg drop landing (SLDL), single-leg vertical drop jump (SLVDJ), vertical drop jump (DLVDJ), and double leg forward jump (DLFJ), at baseline and seventy-two hours following KT application. RESULTS: The KT application resulted in more knee flexion and abduction, sum of knee valgus and lateral trunk lean as compared with the non-KT condition during SLDL (P < 0.05). Nonetheless, there were no differences in SI, maximum angle of the lateral trunk lean during SLDL, SLVDJ, nor hip flexion, knee abduction, and flexion during DLVDJ, and DLFJ tasks (P > 0.05). CONCLUSIONS: The research findings suggest that KT after 72-h application may improve knee abduction and sum of knee valgus and lateral trunk lean during SLDL, knee flexion during SLDL and SLVDJ in individuals displaying risky single-leg kinematics. Therefore, KT application may marginally improve high-risk landing kinematics in competitive male athletes. LEVEL OF EVIDENCE: Level III.

Comparing Pain Neuroscience Education Followed by Motor Control Exercises With Group-Based Exercises for Chronic Low Back Pain: A Randomized Controlled Trial.

BACKGROUND: Different individualized interventions have been used to improve chronic low back pain (CLBP). However, their superiority over group-based interventions has yet to be elucidated. We compared an individualized treatment involving pain neuroscience education (PNE) plus motor control exercise (MCE) with group-based exercise (GE) in patients with CLBP. METHODS: Seventy-three patients with CLBP were randomly assigned into the PNE plus MCE group (n = 37) and GE group (n = 36). Both PNE plus MCE and GE were administered twice weekly for 8 weeks. Pain intensity (as measured using the VAS), disability (as measured using the Roland-Morris Disability Questionnaire), fear-avoidance beliefs (as measured using the Fear-Avoidance Beliefs Questionnaire), and self-efficacy (as measured using the Pain Self-Efficacy Questionnaire) were assessed at baseline and 8 weeks post-intervention. A 2 × 2 variance analysis (treatment group × time) with a mixed-model design was applied to statistically analyze the data. RESULTS: Both groups showed significant improvements in all the outcome measures, with a large effect size (P < 0.001, partial eta squared [ηp2 ] = 0.66 to 0.81) after the intervention. The PNE plus MCE group showed greater improvements, with a moderate effect size in pain intensity (P = 0.041, ηp2  = 0.06) and disability (P = 0.021, ηp2  = 0.07) compared to the GE group. No significant difference was found in fear-avoidance beliefs during physical activity and work, and self-efficacy (P > 0.05) between the 2 groups. CONCLUSION: PNE and MCE seem to be better at reducing pain intensity and disability compared to GE, while no significant differences were observed for fear-avoidance beliefs and self-efficacy between the 2 groups in patients with CLBP. With regard to the superiority of individualized interventions over group-based ones, more studies are warranted.