Immediate effect of neuromuscular electrical stimulation on the abductor hallucis muscle: A randomized controlled trial.

Hallux valgus (HV) is a foot deformity with deviation of the greater toe and the first metatarsal. There is little evidence on training the abductor hallucis muscle (AbdH) to treat HV because of the difficulty in implementing the necessary interventions. Although neuromuscular electrical stimulation (NMES) has been used to induce voluntary exercise, there is currently no study on NMES for AbdH. We aimed to verify the immediate effect of NMES on the AbdH muscle function. For the NMES group (n = 15), electrical stimulation was applied for 20 min. In the sham group (n = 15), the stimulating device was set but not turned on. Electromyogram, HV angle (HVA) at rest and during abduction of the big toe, and strength of the AbdH were evaluated. Analysis of covariance was used to investigate differences within groups using the baseline as the covariate. NMES significantly improved the maximal voluntary isometric contractions (%MVIC), HVA at exercise, and muscle strength (%MVIC: p = .00, HVA exercise: p = .00, AbdH strength: p = .00). HVA at rest showed no change (p = .12). Application of NMES on the AbdH muscle immediately improved its activity output, muscle strength, and HVA during exercise.

The shape of the transverse arch in high heels while standing.

INTRODUCTION: High heeled shoes have long been worn in society and they are known to cause biomechanical imbalances to not only the foot, but the whole musculoskeletal system. This study aims to show the detailed changes that happen to the shape of the transverse arch of the foot in high heels, using two different inclination degrees. METHODS: 68 women participated in this study. Two custom-made high heels were made with inclinations of 15 degrees and 30 degrees (cm). A weight-bearing ultrasound was used to assess the coronal view of the transverse arch in standing. ANOVA and Tuckey tests were used to compare the results between 0 degrees, 15 degrees and 30 degrees inclinations. RESULTS: The transverse arch height was slightly increased as the heel height increased (0DI-15DI: p = 0.5852 / 15DI-30DI: p = 0.395 / 0DI-30DI: p = 0.0593). The transverse arch length (0DI-15DI: p = 0.0486 / 15DI-30DI: p = 0.0004 / 0DI-30DI: p = 0.1105) and the area under the metatarsal heads (0DI-15DI: p = 0.0422 / 15DI-30DI: p = 0.0180 / 0DI-30DI: p = 0.9463) significantly decreased as the heel height increased. DISCUSSION: The main changes were viewed in the 30 degrees inclinations compared to 0 degrees inclination. When the toes are dorsiflexed in high heels, it stimulates the Windlass mechanism which in turn stiffens the plantar fascia and adducts the metatarsal heads, while the soft tissues shrink in response to loads. CONCLUSION: High heels affected the shape of the transverse arch even in short term standing, and these effects increased as the height of the heel increased.

Effects of deep thermotherapy on chest wall mobility of healthy elderly women.

Chest wall mobility decreases with age in community-dwelling women aged 65 years or older. Thermotherapy is used to improve soft-tissue extensibility. However, its effects on chest wall mobility are unclear. This study aimed to examine the effect of thermotherapy on chest wall mobility in healthy elderly women. Twenty-eight elderly women participated in this study. Chest wall mobility at three levels (axillary, xiphoid, and tenth rib), respiratory function (forced vital capacity and forced expiratory volume), and tissue temperature (skin temperature (ST)) and deep temperature (DT) with 10 mm and 20 mm depth from the skin (10 mm DT and 20 mm DT)) were measured before and after 15 minutes of thermotherapy. The subjects randomly received one of the three interventions (capacitive and resistive electric transfer (CRet), hot pack (HP), and sham CRet (sham)). Chest wall mobility at all levels significantly increased after CRet intervention. Hot pack significantly increased tenth rib excursion; it also significantly increased ST, 10 mm DT, and 20 mm DT, whereas CRet significantly increased 10 mm DT and 20 mm DT. There were significant differences between CRet, HP, and sham in ST, 10 mm DT, and 20 mm DT. Furthermore, 20 mm DT had increased more in CRet than in HP. CRet improved chest wall mobility at all levels and HP improved at the tenth rib level. This implies that CRet can be one of the approaches to improve chest wall mobility.

Association of low back pain with presenteeism in hospital nursing staff.

OBJECTIVES: Chronic low back pain (LBP) is known to cause various disorders compared with acute LBP. However, there was no study evaluating presenteeism due to LBP divided into subcategories by the duration of LBP. Therefore, this study aims to investigate the relationship between acute or chronic LBP and presenteeism in hospital nursing staff. METHODS: Overall, 1100 nurses filled in a questionnaire on basic attributes, LBP symptoms, depression symptoms, and work productivity. The subjects were divided into three groups based on the period of LBP and the compared work productivity. Work Limitation Questionnaire Japanese version (WLQ-J) was used for the assessment of work productivity. The effects of acute and chronic LBP on presenteeism were evaluated through multiple regression analysis models. RESULTS: In total, 765 subjects, without missing values, were included. The overall prevalence of LBP was 64.6% (acute LBP 47.5%, chronic LBP 17.1%). On multiple regression analysis, acute pain and presenteeism were not associated. Conversely, chronic LBP was associated with time management (adjusted ß = -2.3, 95% CI: -4.5 to -1.1), mental-interpersonal relationship (adjusted ß = -2.8, 95% CI: -5.1 to -0.6), and output (adjusted ß = -2.7, 95% CI: -5.4 to 0.0) after adjustment for sex and career years. When depression was included in the adjustment factors, chronic LBP and WLQ subscales were not associated. CONCLUSIONS: It became obvious that Chronic LBP in nurses was significantly related to time management, mental-interpersonal relationship, and output. The importance of preventing a decline in work productivity by taking precautions to prevent chronic LBP and depression was suggested.