Pain Reduction and Posture Alignment Improvement in Older Adults with Chronic Low Back Pain: A Novel Approach Using Spinal Thermal Massage Bed and Calf Pneumatic Cell Compression.

BACKGROUND Chronic low back pain (CLBP) significantly affects the well-being of older adults, leading to diminished quality of life and heightened stress. Existing treatments have limited effectiveness and potential side effects. This study aimed to explore an integrative approach, employing a combination of spinal thermal massage bed (STMB) and intermittent pneumatic calf compression, as an alternative strategy for managing CLBP, improving body posture, reducing stress, and enhancing quality of life. MATERIAL AND METHODS Twenty-three participants aged 65-80 years completed a 4-week intervention involving eight sessions (2 per week) with the STMB device. Outcome measures included pain level assessed by the visual analog scale, trunk and pelvic tilting angles indicating spine curvature, stress level of the autonomic nervous system, Oswestry Disability Index, and EuroQol five-dimensions QoL questionnaire. RESULTS The study revealed significant reductions in pain intensity between baseline and mid-term scores (p=0.002) and between baseline and post-test scores (p=0.001). Moreover, notable improvements were observed in trunk and pelvic tilting angles (p<0.001) and stress scores between baseline and mid-term scores (p=0.037) and between baseline and post-test scores (p=0.019). However, no significant changes were observed in disability level or QoL. Participants expressed high satisfaction with the intervention, and no serious side effects were reported CONCLUSIONS This study provides compelling evidence supporting the safety and efficacy of combining STMB with intermittent pneumatic calf compression in reducing pain intensity and stress levels and improving trunk and pelvic tilting angles. Clinical trial number: KCT0008212.

Activation of Anterolateral Abdominal Muscles During Sling Bridge Exercises: Comparison of Different Pelvic Positions.

CONTEXT: Inappropriate activation of the anterolateral abdominal muscles affects the stability of the lumbopelvic zone and increases the appearance of pain and lesion in the area. Therefore, ways to improve its effective contraction are crucial in rehabilitation. The aim of this study was to compare the activation of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles in 3 different pelvic positions (down pelvis [DP], horizontal pelvis [HP], and up pelvis [UP]) during sling bridge exercise (SBE) to determinate which position is more effective to promote a correct contraction of the anterolateral abdominal muscles. DESIGN: Cross-sectional study. METHODS: Fifteen participants performed 3 variations (DP, HP, and UP) of a one-legged exercise called "supine pelvic lift" on a sling device. The thicknesses of the TrA, IO, and EO were recorded at rest and at the 3 positions using ultrasound imaging. Thickness, change ratio, lateral slide of TrA, and preferential and contraction activation ratio of TrA, IO, and EO were analyzed. RESULTS: TrA and IO showed greater activation (P = .01) in the UP position than the other pelvic positions. In addition, UP position decreased the activation of the EO (P = .01). CONCLUSION: Based on the results of this study, SBE in the UP position has the potential to improve normal contraction patterns of the musculature and can be used in future intervention of the lumbopelvic zone.

Influence of Anterior-Posterior External Surface Perturbation on Trunk Stability During Abdominal Stabilization Strategies While Sitting.

BACKGROUND Spinal and pelvic injuries during an unexpected perturbation are closely related to spinal stability, which is known to be controlled by abdominal stabilization maneuvers. This study aimed to evaluate the effects of unexpected perturbations on trunk stability and abdominal stabilization strategies in 42 sedentary adults while sitting. MATERIAL AND METHODS Abdominal stabilization strategies consisted of bracing and hollowing maneuvers. Abdominal bracing maneuvers (ABM) were focused on the abdominal wall muscles [inferior oblique (IO), exterior oblique (EO)], and abdominal hollowing maneuvers (AHM) were focused on deep muscle (TrA) activation. The subjects were instructed in abdominal stabilization maneuvers. Afterward, subjects were seated in a chair that could be moved forward or backward suddenly with the support surface. RESULTS Angular displacements of the upper thorax, lower thorax, and lumbopelvic during unexpected perturbation, with different abdominal stabilization maneuvers, were measured. During forward perturbation (d=0.71, F=10.324, P=0.001) and backward perturbation in high speed (d=0.62, F=9.265, P=0.011), there were significant differences in angular displacements of the upper thorax between hollowing and bracing maneuvers. Additionally, significant differences were found in the lumbopelvic angular displacement between the hollowing and bracing maneuvers (d=0.62, F=4.071, P=0.044). CONCLUSIONS Our findings indicate that the ABM is a better stabilizing technique for the upper thorax, and the AHM is a better stabilizing technique for the lumbopelvic region during unexpected perturbations at high speed in the seated position.

Effectiveness of Simulated Horseback Riding for Patients With Chronic Low Back Pain: A Randomized Controlled Trial.

CONTEXT: A simulated horseback riding (SHR) exercise is effective for improvement of pain and functional disability, but its comparative effectiveness with the other is unknown. OBJECTIVE: The authors aimed to demonstrate the effect of a SHR exercise in people with chronic low back pain. DESIGN: A randomized controlled trial. SETTINGS: Community and university campus. PARTICIPANTS: A total of 48 participants with chronic low back pain were divided into 2 groups, and SHR exercises (n = 24) or stabilization (STB) exercises (n = 24) were performed. INTERVENTIONS: The exercises were performed for 30 minutes, 2 days per week for 8 weeks. MAIN OUTCOME MEASURES: Numeric rating scale, functional disabilities (Oswestry disability index and Roland-Morris disability), and fear-avoidance beliefs questionnaire (FABQ) scores were measured at baseline and at 4 weeks, 8 weeks, and 6 months. RESULTS: A 2-way repeated analysis of variance identified that between-group comparisons showed significant differences in the FABQ related to work scale (F = 21.422; P = .01). There were no significant differences in the numeric rating scale (F = 1.696; P = .21), Oswestry disability index (F = 1.848; P = .20), Roland-Morris disability (F = 0.069; P = .80), and FABQ related to physical scale (F = 1.579; P = .24). In within-group comparisons, both groups presented significant differences in numeric rating scale (both SHR and STB after 4 wk), Oswestry disability index (both SHR and STB after 6 mo), and Roland-Morris disability (SHR after 6 mo and STB after 8 wk) compared with baseline values. In FABQ-related physical (SHR after 4 wk) and work scales (SHR after 6 mo), there were only significant differences in the SHR compared with baseline values. CONCLUSIONS: SHR exercise for 8 weeks had a greater effect than STB exercise for reducing work-related FABQ. The SHR exercise performed in a seated position could substantially decrease pain-related fear disability in young adults with chronic low back pain.

Effectiveness of therapeutic inflatable ball self-exercises for improving shoulder function and quality of life in breast cancer survivors after sentinel lymph node dissection.

BACKGROUND: The survival rate of breast cancer survivors (BCSs) is > 90%. Particular issues are upper arm dysfunction caused by surgery and treatments. Physical activity has been recommended to improve shoulder function and quality of life (QoL) in BCSs. However, rehabilitation programs tend not to be continuous. PURPOSE: To explore the effectiveness of therapeutic inflatable ball self-exercise for improving shoulder function and QoL in breast cancer survivors (BCSs) following breast cancer surgery. PATIENTS AND METHODS: Seventy-two BCSs were allocated to two groups, conventional self-exercise (CSE; n = 34; age, 48.9 ± 7.2 years) and therapeutic inflatable ball self-exercise (IBE; n = 38; age, 47.7 ± 8.9 years); 22 in the CSE and 23 in the IBE group completed the interventions. Both groups performed intervention for 12 weeks, three times per week and 15 min a day at least. Measurement was performed three times for shoulder range of motion (ROM), handgrip strength, Shoulder Pain and Disability Index (SPADI), and Functional Assessment of Cancer Therapy-Breast (FACT-B). RESULT: Flexion and extension of shoulder ROM showed significant differences between the two groups at 12 weeks. Flexion and extension of shoulder ROM showed significant differences for t1-t2 (p = 0.02) and t0-t1 (p = 0.04). Abduction showed a significant difference for t0-t1 (p = 0.03), t1-t2 (p = 0.02), and t0-t2 (p = 0.01). CSE (7 points) and IBE (20 points) satisfied the MDC in FACT-B total score. The MDC of the SPADI total score was 13 points in the CSE group and 9 points in the IBE group. CONCLUSION: IBE would be more appropriate to start the rehabilitation for BCSs and CSE would be effective after the pain has improved.

Specific muscle synergies in national elite female ice hockey players in response to unexpected external perturbation.

This study aimed to investigate specific muscle synergies in elite ice hockey players indicating highly developed postural control strategies used to restore balance against unexpected external perturbations. Seven elite athletes (EA) on the women's national ice hockey team and 7 non-athletes (NA) participated in this study. Based on trajectories of centre of mass (COM), analysis periods were divided into an initial phase (a balance disturbance after perturbation onset) and a reversal phase (a balance recovery response), respectively. Muscle synergies were extracted at each phase by using non-negative matrix factorization. k-means cluster analysis was performed to arrange similar muscle synergies in all participants. EA showed significantly shorter recovery period of COM and smaller body sway than NA. In the initial phase, we identified 2 EA-specific synergies related to ankle plantar flexors or neck extensors. In the case of an NA-specific synergy, co-activation of the ankle plantar flexors and dorsiflexors was found. In the reversal phase, no specific muscle synergies were identified. As the results, EA-specific muscle synergies showed low co-activation strategy of agonists and antagonists in ankle and neck extensors. Our results could provide critical information for rehabilitation strategies in athletes requiring high postural stability.

The Effectiveness of Hollowing and Bracing Strategies With Lumbar Stabilization Exercise in Older Adult Women With Nonspecific Low Back Pain: A Quasi-Experimental Study on a Community-based Rehabilitation.

OBJECTIVE: The purpose of this study was to explore the therapeutic effectiveness of hollowing lumbar stabilization exercise (HLSE) and bracing lumbar stabilization exercise (BLSE) for older adult women with nonspecific low back pain (NSLBP) in community welfare centers. METHOD: A total of 38 older adult women with NSLBP were allocated to either the HLSE group (n = 17, 70.4 ± 1.7 years) or the BLSE group (n = 21, 66.8 ± 4.4 years). Both groups performed intervention for 12 consecutive weeks, 3 times per week. Each group performed 5 lumbar stabilization exercises, including side plank exercise, bridge exercise, 4-kneeling exercise, prone plank exercise, and prone back extension exercise with hollowing and bracing strategy, respectively. The baseline and post-test values of trunk strength, low back disability (Korean Oswestry Disability Index [K-ODI] and Korean Roland Morris Disability Questionnaire [K-RMDQ]), and static balance (1-leg standing test) were compared by using per-protocol analysis. RESULTS: In trunk strength, the trunk flexor had significant difference (F = 11.10, P = .001) between groups and within groups of BLSE (t = -5.56, P = .001) and HLSE (t = -2.50, P = .024). Trunk back extensor of HLSE (t = -6.00, P = .001) and BLSE (t = -9.19, P = .001) only had significant within-group difference. However, in trunk side flexor, HLSE and BLSE had only significant difference between groups. In low back disability, K-ODI for HLSE (t = 4.50, P = .001) and BLSE (t = 4.60, P = .001) had significant within-group difference but no significant difference between groups (F = 0.28, P = .202). In K-RMDQ, HLSE only had significant within-group difference (t = 3.97, P = .001). In trunk muscle strength, the effect size of HLSE and BLSE groups for trunk flexor was HLSE -0.53 (medium) and BLSE -1.21 (large); trunk side flexor: HLSE 0.27 (small) and BLSE -0.24 (small); and trunk back extensor: HLSE 1.1 (large) and BLSE 2.00 (large), respectively. In low back disability, the effect size of both groups for K-ODI was HLSE 0.88 (large) and BLSE 1.05 (large), and K-RMDQ, HLSE 0.19 (small) and BLSE 0.40 (small), respectively. CONCLUSION: Our findings suggest that HLSE and BLSE could be recommended for community settings to improve trunk strength and low back disability in older adult women with NSLBP. Especially, HLSE and BLSE could be recommended for elderly women with NSLBP who have lower back disability and weak trunk muscle strength, respectively.

Examining impairment of adaptive compensation for stabilizing motor repetitions in stroke survivors.

The hand, one of the most versatile but mechanically redundant parts of the human body, suffers more and longer than other body parts after stroke. One of the rehabilitation paradigms, task-oriented rehabilitation, encourages motor repeatability, the ability to produce similar motor performance over repetitions through compensatory strategies while taking advantage of the motor system's redundancy. The previous studies showed that stroke survivors inconsistently performed a given motor task with limited motor solutions. We hypothesized that stroke survivors would exhibit deficits in motor repeatability and adaptive compensation compared to healthy controls in during repetitive force-pulse (RFP) production tasks using multiple fingers. Seventeen hemiparetic stroke survivors and seven healthy controls were asked to repeatedly press force sensors as fast as possible using the four fingers of each hand. The hierarchical variability decomposition model was employed to compute motor repeatability and adaptive compensation across finger-force impulses, respectively. Stroke survivors showed decreased repeatability and adaptive compensation of force impulses between individual fingers as compared to the control (p < 0.05). The stroke survivors also showed decreased pulse frequency and greater peak-to-peak time variance than the control (p < 0.05). Force-related variables, such as mean peak force and peak force interval variability, demonstrated no significant difference between groups. Our findings indicate that stroke-induced brain injury negatively affects their ability to exploit their redundant or abundant motor system in an RFP task.

Feasibility of a Smartphone-Based Exercise Program for Office Workers With Neck Pain: An Individualized Approach Using a Self-Classification Algorithm.

OBJECTIVE: To explore the feasibility of a newly developed smartphone-based exercise program with an embedded self-classification algorithm for office workers with neck pain, by examining its effect on the pain intensity, functional disability, quality of life, fear avoidance, and cervical range of motion (ROM). DESIGN: Single-group, repeated-measures design. SETTING: The laboratory and participants' home and work environments. PARTICIPANTS: Offices workers with neck pain (N=23; mean age ± SD, 28.13±2.97y; 13 men). INTERVENTION: Participants were classified as having 1 of 4 types of neck pain through a self-classification algorithm implemented as a smartphone application, and conducted corresponding exercise programs for 10 to 12min/d, 3d/wk, for 8 weeks. MAIN OUTCOME MEASURES: The visual analog scale (VAS), Neck Disability Index (NDI), Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), Fear-Avoidance Beliefs Questionnaire (FABQ), and cervical ROM were measured at baseline and postintervention. RESULTS: The VAS (P<.001) and NDI score (P<.001) indicated significant improvements in pain intensity and functional disability. Quality of life showed significant improvements in the physical functioning (P=.007), bodily pain (P=.018), general health (P=.022), vitality (P=.046), and physical component scores (P=.002) of the SF-36. The FABQ, cervical ROM, and mental component score of the SF-36 showed no significant improvements. CONCLUSIONS: The smartphone-based exercise program with an embedded self-classification algorithm improves the pain intensity and perceived physical health of office workers with neck pain, although not enough to affect their mental and emotional states.

Deficits in motor abilities for multi-finger force control in hemiparetic stroke survivors.

The ability to control redundant motor effectors is one of hallmarks in human motor control, and the topic has been studied extensively over several decades since the initial inquiries proposed by Nicholi Bernstein. However, our understanding of the influence of stroke on the control of redundant motor systems is very limited. This study aimed to investigate the effect of stroke-related constraints on multi-finger force control abilities in a visuomotor task. Impaired (IH) and less-impaired hands (LH) of 19 hemiparetic stroke survivors and 19 age-matched control subjects were examined. Each hand repeatedly produced isometric forces to match a target force of 5 N shown on a computer screen using all four fingers. The hierarchical variability decomposition (HVD) model was used to separate force-matching errors (motor performance) into task-relevant measures (accuracy, steadiness, and reproducibility). Task-irrelevant sources of variability in individual finger force profiles within and between trials (flexibility and multiformity) were also quantified. The IH in the stroke survivors showed deficits in motor performance attributed mainly to lower accuracy and reproducibility as compared to control hands (p < 0.05). The LH in stroke survivors showed lower reproducibility and both hands in stroke also had higher multiformity than the control hands (p < 0.05). The findings from our HVD model suggest that accuracy, reproducibility, and multiformity were mainly impaired during force-matching task in the stroke survivors. The specific motor deficits identified through the HVD model with the new conceptual framework may be considered as critical factors for scientific investigation on stroke and evidence-based rehabilitation of this population.

Feasibility of a Self-Determination Theory-Based Exercise Program in Community-Dwelling South Korean Older Adults: Experiences from a 13-Month Trial.

Little is known about the effectiveness of self-determination theory (SDT), a representative motivational theory, on exercise domain in older adults. This feasibility study used quantitative and qualitative approaches to evaluate the effectiveness of a 13-month group exercise program applying SDT-based motivational strategies on exercise adherence, physical fitness, and quality of life, and to explore factors affecting exercise adherence in South Korean older adults (N = 18). Exercise attendance rate was high (82.52%). There were significant differences in aerobic endurance (p < .001), lower body strength (p < .05), dynamic balance (p < .001), and perceived social functioning (p < .05) at 13 months compared with baseline. Factors affecting exercise adherence were related to the SDT-based motivational strategies. These results support the importance of health professionals applying SDT-based motivational strategies to exercise programs to help facilitate motivation for participation and to promote physical fitness and quality of life in older adults.

Effect of tDCS Combined With Physical Training on Physical Performance in a Healthy Population.

Purpose: The effectiveness of transcranial direct current stimulation (tDCS) combined with physical training has shown inconsistent results through research. Hence, a study utilizing a long-term tDCS application over the primary motor cortex and a large sample size is required to determine whether tDCS combined with physical training can increase physical performance (muscular strength, endurance, and explosive strength) in healthy adults. Material and methods: Fifty-six healthy adults were randomly distributed into two groups: active (active tDCS+ physical training) and sham (sham tDCS + physical training) and received the intervention three times per week for six weeks. Muscle strength was assessed using maximal isometric muscle strength (MIMS) by a digital dynamometer. Muscular endurance and lower limb explosive strength were assessed by using muscle fitness testing (MFT), and the Sargent jump test. Results: The active and sham groups exhibited significant improvement in all measured parameters in intragroup analyses. However, intergroup analyses revealed no significant difference between the groups. Conclusion: Our findings suggest that only physical training improved MIMS in the upper and lower extremities, MFT endurance scores, and lower limb explosive power. Thus, tDCS failed to demonstrate its effectiveness in a healthy population according to the protocol used in this study.

Effect of Transcranial Direct Current Stimulation with Balance Training in a Middle-Aged Population: Randomized Double-Blind Sham-Controlled Trial.

Introduction: The first signs of deteriorated balance impairment begin during middle age. Early intervention could delay the fall risk in older populations; hence, addressing balance deficits during this age is crucial. The authors aimed to determine the effects of transcranial direct current stimulation (tDCS) combined with balance training (BT) on the improvement of static and dynamic balance in a middle-aged population, along with the participants' safety and satisfaction. Methods: Participants (n = 28) were randomized into two groups: active tDCS (active tDCS + BT) and sham tDCS (sham tDCS + BT). Both groups received the intervention thrice a week for 6 weeks. Dynamic and static balance were assessed by sway rate changes with eyes open and closed, and the functional reach test and a postintervention survey were conducted to assess participants' safety and satisfaction. Results: The active tDCS group showed significantly greater static and dynamic balance improvements in sway scores. The surveys demonstrated the safety of the program and satisfaction of 80% of the participants with the combined intervention. Conclusion: tDCS could be used in a middle-aged population as part of regular BT to improve balance and minimize the risk of balance deficits in older populations while ensuring patient safety and satisfaction. This study is a subanalysis of a larger clinical trial that included young adults as well (Clinical trial number: KCT0007414).

Unsupervised virtual reality-based exercise program improves hip muscle strength and balance control in older adults: a pilot study.

OBJECTIVE: To assess the effects of an unsupervised virtual reality (VR)-based exercise program on hip muscle strength and balance control in older adults. DESIGN: Controlled cohort repeated-measures experimental design, a pilot study. SETTING: University research laboratory. PARTICIPANTS: Ambulatory older adults (N=32) from a local community. INTERVENTION: The VR group (n=18; mean ± SD, 68.28±3.74y; 4 men) completed the VR-based exercise program, whereas the remaining subjects in the control group (n=14; mean ± SD, 66.21±3.87y, 1 man) were asked to continue their daily routine for 8 weeks. MAIN OUTCOME MEASURES: Hip muscle strength was measured using a multimodal dynamometer, and ground reaction force using the backward stepping test and the results of the crossover stepping test were recorded using a force platform. RESULTS: The VR group showed significant improvement in hip muscle strength of the extensors, flexors, adductors, and abductors after 8 weeks (all P≤.001). However, no significant improvement was observed in the control group. The VR group had significantly greater ground reaction force on the backward stepping test (with eyes opened and closed) (all P<.005) and the crossover stepping test (with eyes opened and closed) (all P≤.001) compared with those at baseline. However, no significant improvement was observed in the control group. CONCLUSIONS: The VR-based exercise program includes the role of supervisor and feedback, which is important for older adults. Therefore, a VR-based exercise program may be a useful tool to improve decreased physical function in older adults as a home-based exercise.

Intensive unilateral neuromuscular training on non-dominant side of low back improves balanced muscle response and spinal stability.

Effective stabilization is important to increase sports performance. Imbalanced spinal muscle responses between the left and right sides increase the risk of spinal buckling and microtrauma at the intervertebral joints. The purpose of this study was to confirm whether intensive unilateral neuromuscular training (IUNT) focusing on the non-dominant side of the low back improves balanced muscle responses and spinal stability. The IUNT group (n = 8) performed side bridge and quadruped exercises using their non-dominant trunk muscles for 8 weeks, while the control group (n = 8) performed their regular training. Before and after the training, motion-capture cameras measured trunk angular displacement, and electromyography recorded the activities of both multifidus muscles (L4-5) during unexpected sudden forward perturbation. After the training in the IUNT group, the difference in onset time between both sides decreased to approximately 120 % compared with that before the training. The asymmetry of muscle activities also decreased from 56 to 23 %. Moreover, the angular displacement on the sagittal plane decreased to approximately 35 % after the training. We expect that IUNT focused on the non-dominant side of the low back will be useful to improve balanced back muscle responses and spinal stability during sudden trunk perturbation.

Changes in ankle range of motion and muscle strength in habitual wearers of high-heeled shoes.

BACKGROUND: Although cross-sectional biomechanical studies have reported that wearing high-heeled shoes can change the musculoskeletal system of the lower extremities, the long-term effects of wearing such shoes on the ankle remain unknown. The aim of this study was to reveal changes in ankle range of motion and muscle strength in habitual wearers of high-heeled shoes and to provide information for clinicians undertaking functional evaluations of the ankles of such patients. METHODS: Habitual wearers of high-heeled shoes (n = 10; age, 23.9 ± 2.7 years) and wearers of flat shoes (n = 10; age, 23.8 ± 2.1 years) were selectively recruited, and the range of motion, maximal voluntary isometric force, and concentric contraction power of their ankles were measured. RESULTS: Wearers of high-heeled shoes showed increased ankle range of motion on plantarflexion at 25 degrees and inversion at 10 degrees compared to flat shoe wearers (P < .05) but decreased dorsiflexion (about 17 degrees) and eversion (13 degrees; P < .05). Concentric contraction power in ankle eversion was also 2 times higher in wearers of high-heeled shoes (P < .05). CONCLUSIONS: These subjects had functional deformity of the ankle in a supinated direction and increased eversion power. CLINICAL RELEVANCE: We cautiously recommend that habitual wearers of high-heeled shoes (those who walk in such shoes for more than 5 hours more than 6 times a week) undertake intensive ankle stretching exercises in the direction of dorsiflexion as well as eversion.

Immediate effect of sling exercises combined with mechanic vibration and oscillation mobilization in chronic nonspecific low back pain patients: a randomized controlled trial.

PURPOSE: This study determined whether the combined application of sling exercises (SE) with targeted vibration and oscillations using a device called the Vibraoscillator (VO) is effective in reducing pain intensity, increasing range of motion (ROM), and enhancing back-related functions in patients with chronic nonspecific low back pain (CNLBP). MATERIALS AND METHODS: Thirty-six participants were randomized into experimental (SE + VO) and control (SE) groups. Both groups received the intervention twice a week for 4 weeks. The pain was assessed using the Numerical Rating Scale (NRS), ROM was measured using the Modified-Modified Schober's Test (MMST), and the level of disability was evaluated using the Oswestry Disability Scale (ODI). In addition, the global perceived effect (GPE) was determined. RESULTS: NRS and ODI scores significantly improved after the intervention in the experimental group. Only lumbar spine extension improved significantly in the case of ROM. The GPE satisfaction rate was 14.5% higher in the experimental group than in the control group. CONCLUSION: Based on the findings obtained in this study, the combined use of VO and SE in patients with CNLBP was effective in reducing pain, improving ROM, and reducing physical disability in comparison with the treatment of only SE.IMPLICATIONS FOR REHABILITATIONChronic nonspecific low back pain is a major public health problem because it affects almost every person at least once in their lifetime.A new device called a Vibraoscillator generates horizontal vibrations and vertical oscillation movements targeted to a specific area of treatment to promote the neurofacilitation of the targeted zone, aiming for a more focused treatment than general vibrations.This device, in combination with sling exercises, is hypothesized to reduce pain and increase the mobility of the targeted zone and back-related functions in these patients.Based on our findings, the combined use of these interventions twice a week for 4 weeks was effective in reducing pain and improving the range of movement, which consequently reduced physical disability in patients with chronic nonspecific low back pain.

Effects of transcranial direct current stimulation on physical and mental health in older adults with chronic musculoskeletal pain: a randomized controlled trial.

PURPOSE: We investigated the effects of transcranial direct current stimulation (tDCS) combined with physical therapy (PT) on pain levels, physical activity levels, quality of life, and depression in older adults with chronic musculoskeletal pain. METHODS: Twenty-five older adults (9 males and 16 females), aged between 66 and 86 years (active group 77.2 ± 3.9; sham group 76.6 ± 6.2), volunteers were randomly allocated in the active (active tDCS + PT) and sham groups (sham tDCS + PT), and received the intervention three times per week for 8 weeks. Pain level, physical activity level, depression state, and quality of life were assessed based on the Visual Analog Scale (VAS), Physical Activity Scale for the Elderly (PASE), Beck Depression Inventory (BDI) scale, and Short-Form 36 Health Survey Questionnaire (SF-36), respectively. Measurements were conducted four times: at baseline, mid-intervention, post-intervention, and 1-month follow-up. RESULTS: As a result, at 8 weeks, the active group yielded greater improvements in VAS, BDI, and SF-36 scores than the sham tDCS group. At follow-up, the tDCS group led to a greater improvement in VAS, PASE, and SF-36 scores compared to sham tDCS group (p < 0.05). CONCLUSION: Our results suggest a beneficial effect of tDCS combined with PT in older adults with chronic musculoskeletal pain in the reduction of pain sensation, increment of physical activity level, increment of the quality of life, and reduction of depression incidents. This opens the possibility the possibility of using tDCS as a regular treatment for this population's physical and mental health.

The Effects of tDCS with NDT on the Improvement of Motor Development in Cerebral Palsy.

We investigated the effects of transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) with neurodevelopmental treatment (NDT) on the improvement of motor development and reduction of spasticity in children with cerebral palsy (CP). Twenty-four children with CP were allocated to two groups: the tDCS + NDT group and the only NDT group, done 3 times per week for 5 weeks. The Gross Motor Function Measurement (GMFM-88) and Box and Block Test (BBT) were used to assess changes in motor development, and the Modified Ashworth Scale (MAS) was used to evaluate changes in spasticity. All measurements were carried out at 3 time points: baseline, post-intervention, and 1 month follow-up. We found improvements in the GMFM-88 total scores and in each individual GMFM-88 dimension scores, favoring the tDCS + NDT group over the only NDT group. The BBT scores improved only in the tDCS + NDT group. In addition, the MAS scores reduced in the hemibody with significant motor impairment only in the tDCS + NDT group. The present findings suggest that tDCS combined with NDT can be considered a promising intervention for children with CP, as it can enhance motor development and reduce spasticity in this population.

Patient-specific functional electrical stimulation strategy based on muscle synergy and walking posture analysis for gait rehabilitation of stroke patients.

OBJECTIVE: To evaluate a novel multi-channel functional electrical stimulation (FES) rehabilitation method based on the evaluation of patient-specific walking dysfunction. METHODS: This study investigated a novel multi-channel FES-based rehabilitation method that analysed the patient's muscle synergy and walking posture. A patient-specific FES profile was produced in the pre-evaluation stage by comparing the muscle synergy and walking posture of the patient with those of healthy control subjects. During the rehabilitation phase, this profile was used to determine an appropriate FES pulse width and amplitude for stimulating the patient's muscles as they walked across a flat surface. RESULTS: Two stroke patients with hemiplegic symptoms participated in a clinical evaluation of the proposed method involving a 4-week course of rehabilitation. An evaluation of the rehabilitation results based on a comparison of the pre- and post-rehabilitation muscle synergy and walking posture revealed that the rehabilitation enhanced the muscle synergy similarity between the patients and healthy control subjects and their quantitative walking performance, as measured by a 10-m walk test and walking speed, by up to 23.38% and 30.00%, respectively. CONCLUSION: These results indicated that the proposed rehabilitation method improved walking ability by improving muscle coordination and adequately supporting weakened muscles in stroke patients.