Validity and test-retest reliability of photogrammetry in adolescents with hyperkyphosis.

BACKGROUND: A variety of noninvasive instruments have been introduced in the literature to assess thoracic curvature, although the psychometric properties of many of these instruments have not been satisfactory. Photogrammetry is a safe, accessible, and reliable technique. However, its validity in adolescents with hyperkyphosis has not yet been investigated. OBJECTIVES: To investigate the validity and test-retest reliability of photogrammetry in the measurement of thoracic kyphosis among adolescents with hyperkyphosis. METHODS: Fifty adolescents with hyperkyphosis participated in this study. The kyphosis angle was measured using radiography and photogrammetry. A two-way random model of the intraclass correlation coefficient (ICC2,3) was used to estimate relative reliability. Absolute reliability was assessed by calculating the standard error of the measurements (SEM) and the minimal detectable change (MDC). Pearson's correlation coefficient was calculated to evaluate the validity of the photogrammetry technique. Bland-Altman plots were plotted to determine the agreement between the angles measured by radiography and photogrammetry. RESULTS: There was a strong correlation between the values obtained from the photogrammetry technique and those from the radiography method (r = 0.94). The 95% limits of agreement indicated that the photogrammetric measurements of thoracic kyphosis angle might range from 2.4 degrees greater to 10.2 degrees lower than the Cobb radiographic angle. Photogrammetric measurements of thoracic kyphosis showed excellent test-retest reliability (ICC = 0.97; SEM = 1.67; MDC = 4.62). CONCLUSION: High reliability of photogrammetry technique and its strong correlation with radiographic Cobb angle support the application of this technique for the measurement of thoracic kyphosis in clinical practice.

Effect of a Spinomed orthosis on balance performance, spinal alignment, joint position sense and back muscle endurance in elderly people with hyperkyphotic posture: A randomized controlled trial.

BACKGROUND: Hyperkyphosis may cause balance impairment in elderly people. Although the effectiveness of orthoses for improving balance in hyperkyphotic elderly people has received much attention, the mechanisms by which devices affect balance remain unknown. OBJECTIVES: The objective of this study was to evaluate changes in balance performance, thoracic kyphosis angle, craniovertebral angle, back muscle endurance and joint position sense after 3 months of wearing a Spinomed orthosis. The study also included a secondary exploratory analysis to determine whether changes in any of the above-mentioned outcome measures can predict balance performance improvement in elderly people with hyperkyphosis. STUDY DESIGN: Parallel group randomized controlled trial. METHODS: In total, 44 hyperkyphotic elderly people were randomly allocated to an experimental group, who wore a Spinomed orthosis and a control group, who did not. No other treatment or change in physical activity was permitted during the study. A blinded assessor evaluated thoracic kyphosis angle, joint position sense, craniovertebral angle, back muscle endurance, Timed Up and Go Test time and Berg Balance Scale score at baseline and after 5, 9 and 13 weeks. All dependent variables were measured without the orthosis and analyzed separately using a 2 × 4 (time × group) mixed model analysis of variance. Based on the results of correlation analysis, thoracic kyphosis angle, back muscle endurance and joint position sense were selected as independent variables in a stepwise multiple regression model. RESULTS: The two-way (group × time) interactions were significant in terms of Berg Balance Scale (F = 11.6, P ⩽ 0.001, ηp2=0.59), Timed Up and Go Test (F = 3.74, P = 0.013, ηp2=0.46), thoracic kyphosis angle (F = 43.39, P ⩽ 0.001, ηp2=0.96), craniovertebral angle (F = 5.245, P = 0.002, ηp2=0.59) and joint position sense (F = 4.44, P = 0.005, [Formula: see text]). The two-way interaction was not significant in terms of back muscle endurance; however, the main effect of group was significant for this variable (F = 3.85, P = 0.025). Stepwise multiple regression showed that thoracic kyphosis angle and joint position sense were significant determinants of Timed Up and Go Test time (R2 = 0.155, P = 0.037 and R2 = 0.292, P = 0.012, respectively). CONCLUSION: Wearing a Spinomed orthosis for 3 months improved the posture, position sense and muscle performance of hyperkyphotic elderly people. Orthoses may improve balance performance by correcting spinal alignment and increasing proprioceptive information.

The effect of Propolis on inhibition of Aspergillus parasiticus growth, aflatoxin production and expression of aflatoxin biosynthesis pathway genes.

BACKGROUND AND PURPOSE: Aflatoxins are one of the most important mycotoxins, which have been classified as Group I carcinogenic compounds by the International Agency for Research on Cancer. This investigation aimed to examine the effect of Propolis on inhibition of the Aspergillus parasiticus growth, aflatoxin production and expression of aflatoxin biosynthesis pathway genes. MATERIALS AND METHODS: A standard strain of Aspergillus parasiticus (ATCC 15517) was used to perform antifungal susceptibility test, using a microdilution method in accordance with the CLSI M38-A2 guidelines. The aflatoxin concentrations in the control and treated media were determined by HPLC. Also, the quantitative changes in the level of nor-1, ver-1 and omtA genes expression in aflatoxin biosynthetic pathway were analyzed using Real-Time PCR method. RESULTS: The results showed that the minimum inhibitory concentrations (MIC) of propolis was 100 µg/ml. The results showed that total levels of aflatoxin decreased from 386.1 ppm to 3.01 ppm at 50 µg/ml of propolis. In addition, quantitative real-time PCR analysis showed that the level of nor-1, ver-1 and omtA genes expression was significantly decreased after treatment with propolis extract. CONCLUSIONS: The findings reveal that propolis extract, have a significant inhibitory effect on important genes for aflatoxin biosynthesis pathway in aflatoxin production.

The effects of counterforce brace on pain in subjects with lateral elbow tendinopathy: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Lateral elbow tendinopathy, also known as "tennis elbow" or "lateral epicondylitis," is a common disease leading to pain in the lateral side of the elbow and disability during hand gripping. A counterforce brace is one of the most conventional treatments. However, its effects on outcomes remain inconclusive. OBJECTIVES: To investigate the effects of counterforce braces on pain in subjects with lateral elbow tendinopathy. Grip strength was reviewed as a secondary outcome. STUDY DESIGN: Systematic review and meta-analysis of randomized controlled trials. METHODS: PubMed, Embase, Scopus, Web of Science, CENTRAL, PEDro, ProQuest, RECAL, and RehabData were searched from January 1, 1995, through June 15, 2019. RESULTS: Seventeen studies were included with a total of 1145 participants. A small improvement in pain over the short term (standardized mean difference -0.02; 95% confidence interval: -0.85 to 0.80) and a moderate-to-large improvement in pain in subjects 45 years or younger (standardized mean difference -0.86; 95% confidence interval: -2.45 to 0.72) in favor of the brace versus physiotherapy interventions were found. In contrast, over the long-term physiotherapy interventions (standardized mean difference 1.17; 95% confidence interval: -0.00 to 2.34), wrist splint (standardized mean difference 0.35; 95% confidence interval: -0.07 to 0.76), and laser therapy (standardized mean difference 0.58; 95% confidence interval: -0.44 to 1.59) had better effects on pain improvement versus the brace. CONCLUSION: The results indicated that physiotherapy interventions compared to counterforce braces have better effects, especially over the long-term. However, counterforce braces may have better effects on pain in younger people (<45 years old) over the short term (<6 weeks). CLINICAL RELEVANCE: The results suggest that counterforce bracing is a reasonable strategy to alleviate pain over the short term. However, the subgroup analysis suggests that factors such as age may have a role in their effectiveness.