Potential neurophysiological and biomechanical risk factors for sport-related back problems: A scoping review.

This scoping review aims (1) to map the literature dealing with neurophysiological and biomechanical aspects of back problems in athletes in order to identify valid risk-factors for their prevention, plus (2) to identify gaps in the existing research and propose suggestions for future studies. A literature search conducted with Scopus, Web of Science, MEDLINE and Cochrane Library was completed by Elsevier, SpringerLink and Google Scholar. The main neurophysiological risk factors identified leading to back problems in athletes are neuromuscular imbalance, increased muscle fatigability, muscle dysfunction and impaired motor control, whilst biomechanical risk factors include maladaptive spinal, spinopelvic and lower limb kinematics, side-to-side imbalances in axial strength and hip rotation range of motion, spinal overloading and deficits in movement pattern. However, most studies focused on back pain in the lumbar region, whereas less attention has been paid to thoracic and cervical spine problems. The range of sports where this topic has been studied is relatively small. There is a lack of research in sports in which the core muscles are highly involved in specific movements such as lifting weights or trunk rotations. A limited number of studies include female athletes and master athletes of both genders. In addition to chronic back pain patients, it is equally important to conduct research on healthy athletes with a predisposition to spine problems. Investigators should focus their empirical work on identifying modifiable risk factors, predict which athletes are at risk for back problems, and develop personalized sport-specific assessment tools and targeted prevention strategies for them. This review was registered using the Open Science Framework Registries (https://osf.io/ha5n7).

The effect of multi-function swing suspension training on upper and lower extremities function and quality of life in multiple sclerosis women with different disability status.

BACKGROUND: Multiple sclerosis (MS) can lead to impaired upper and lower extremity function (ULEF), which reduces the quality of life (QoL). Exercise is beneficial for symptom management, but newer approaches like multi-function swing suspension training (MFSST) need further investigation. Additionally, tailoring exercises to individual needs remains a challenging area of investigation. AIM: To investigate the effect of an MFSST program on ULEF, and QoL in MS women according to the expanded disability status scale (EDSS) score. METHODS: Forty-seven MS women meeting selection criteria were randomly assigned to intervention groups A (EDSS 2-4) and B (EDSS 4.5-6.5), and the control group (EDSS 2-6.5). Intervention groups did an 8-week MFSST program with 3 × 1hr sessions/week. Prior to the intervention, and after 4, 6, and 8 weeks, the 9-hole peg test (9HPT) and the timed 25-foot walk (T25FW) test were performed for both the intervention groups and the control group. The Short Form questionnaire (SF-36) was used to measure their QoL. RESULTS: Significant main effects for time were observed in both the 9HPT (F = 52.48, p = 0.001, Pη2 = 0.78) and the T25FW (F = 85.63, p = 0.000, Pη2 = 0.859). Speed increased between the pre-test, 4th week, 6th week, and 8th week in both tests. These tests revealed significant interaction effects between group and time. The 9HPT had an F-value of 9.01 (p = 0.001, Pη2 = 0.392), while the T25FW had an F-value of 13.812 (p = 0.000, Pη2 = 0.497). Across both tests, Group B, with higher EDSS scores, demonstrated greater speed improvement over the three-time measurements (4th week, 6th week, and 8th week) than Group A. The control group did not exhibit any improvement in speed. Intervention groups showed improvement in all QoL subscales except emotional role limitation. CONCLUSIONS: An 8-week MFSST improves ULEF and QoL in women with MS, particularly those with higher EDSS scores (more than 4.5). Notably, significant improvements were observed after four weeks of the intervention. The incorporation of a variety of exercises in a single device provides a significant advantage over traditional exercise programs. Therefore, MFSST can be a valuable and efficient tool for improving symptoms and QoL in MS patients. TRIAL REGISTRATION: IRCT20220526054997N1.

Ultrasonography and CT examination of ovarian follicular development in 'Testudo graeca' during 1 year in captivity.

BACKGROUND: The Greek or Mediterranean tortoise (Testudo graeca), commonly known as the spur-thighed tortoise, is a species of tortoise in the family Testudinidae that is found in North Africa, Western Asia and Europe. Several species of this genus are under threat in the wild, mainly from habitat destruction therefore, accurate information about the sexual cycle and the exact time of follicular development can be effective in successful reproduction planning and preventing species extinction. OBJECTIVE: The experimental part of this study is focused on the evaluation of the reproductive apparatus of tortoises and development of follicles in ovaries during 1 year by ultrasonography and computed tomography. METHODS: Ultrasonography and CT scanning was carried out on 10 female 'T. Graeca' tortoises which were maintained at Tehran Eram Zoo from November 2021 to November 2022 (1 year). Ultrasonography and CT exams were performed on all animals. RESULTS: In the first study, on 28 November 2021, the ovarian cycle was characterized by the presence of previtellogenic follicles and atretic follicles. The numbers of follicles were best demonstrated on CT examination. Ultrasonography and CT scan in the second study showed no change in type of follicles from previous study. In the third study, atretic follicles were more than previtellogenic follicles, whereas in the fourth one, the numbers of previtellogenic follicles were more than atretic follicles. In following, at 6 and 29 June 2022, the absence of atretic follicles and just presence of previtellogenic follicles were observed. On 20 July 2022, the presence of a few number of atretic follicles and more previtellogenic follicles were noticed. On 30 July 2022, the absence of atretic follicles and presence of previtellogenic follicles and, for the first time, preovulatory follicles were obvious. In four following studies the absence of atretic follicles and the presence of previtellogenic follicles were diagnosed. In the last study, the absence of atretic follicles and the presence of preovulatory and previtellogenic follicles were observed. CONCLUSION: In current study, the reproductive cycle of female T. Graeca is evaluated during 1 year in captivity with ultrasonography and CT scan. It can be concluded that in captivity, the reproductive cycle does not result in the formation of eggs or calcareous shells and atretic follicles in the study year continued as before; so this should be highly considered in captivity breeding programmes. This study also revealed that among imaging modalities, CT scan is the best modality for detecting the shape, size, type and numbers of the follicles for further evaluation of location and shape of the follicles.

Diaphragmatic breathing exercises in recovery from fatigue-induced changes in spinal mobility and postural stability: a study protocol.

Prolonged periods of sitting at work can increase trunk muscle fatigue from the continuous contraction of deep trunk muscles. Insufficient activity of these muscles can decrease muscular support to the spine and increases stress on its passive structures. This can lead to reduced spinal mobility and impaired postural stability. It may also stimulate nociceptor activity leading to pain. However, frequently used recovery modalities such as muscle strengthening and stretching exercises, can be time-consuming, impractical, and difficult to implement in the workplace. Diaphragmatic breathing exercises, which increase the activity of the deep trunk muscles by raising intra-abdominal pressure, seem to be a suitable alternative. However, little is known as to what extent diaphragmatic breathing exercises contribute to the reduction of fatigue induced by prolonged sitting. This paper presents a study protocol that aims to investigate the acute effect of diaphragmatic breathing exercises on recovery of fatigue-induced changes in spinal mobility and postural stability in sedentary middle-aged adults at risk of developing non-specific low back pain. Twenty sedentary adults aged between 25 and 44 years will perform Abt's fatigue protocol, followed by 1) active recovery using diaphragmatic breathing exercises and 2) passive recovery in the form of lying on the bed, respectively. There will be 1 week of rest in-between. Pre-fatigue, post-fatigue, and after the active and passive recovery, spinal mobility and postural stability will be evaluated using the spinal mouse device and a posturography system, respectively. The electromyography will be used to determine the muscle-fatigue conditions. We hypothesize that active recovery in a form of diaphragmatic breathing exercises would be more effective in restoring spinal mobility and postural stability followed by the fatigue of back and hamstring muscles compared to passive recovery in sedentary adults. Increasing core and respiratory muscle strength via these exercises could be beneficial for overall mobility and stability of the spine. Reducing compressive stress on the passive structures of the spine may be also beneficial for lowering low back pain. Therefore, we believe that diaphragmatic breathing exercises have the possibility to be incorporated into the workplace and contribute to better back health in sedentary middle-aged adults. Clinical Trial Registration: [https://www.irct.ir/trial/67015], identifier [IRCT20221126056606N1].

Improvement in the multiple sclerosis functional composite score by multi-function swing suspension training program.

BACKGROUND: Physical activity has been considered as a promising approach to slow down the disease process in Multiple Sclerosis (MS) patients. The functional impairments of MS have been studied in detail, while evidence of the efficacy of exercise training interventions on the Multiple Sclerosis functional composite (MSFC) score in these patients is limited. The aim of this study was to investigate the improvement in MSFC score by multi-function swing suspension training program (MFSST) in the women with MS. METHODS: The patients were divided into two groups as the intervention and control groups. A total of 47 MS patients completed the MSFC components at baseline and after the intervention: the timed 25-foot walk (T25FW); the 9-hole peg test (9HPT); and paced auditory serial addition test (PASAT). Z scores were created for each test based on control means. RESULTS: The MSFC score, 9HPT, T25FW, and PASAT showed a significant increment in comparison with the baseline levels in the four, six, and eight weeks following the first exercise session (all p<0.05). These differences in the control group were not significant. The improvement in the MSFC score and the component Z-scores in the intervention groups was found from the fourth week onwards. CONCLUSIONS: The study findings highlight that the progression of MS disability can be partially compensated by physical exercise. Overall, these results indicate that MFSST can be used as an effective treatment method in patients suffering from MS. Longer (years) exercise studies with larger samples of MS patients, with different MS subtypes, and of different sex, are needed to evaluate the effect of other types of exercise interventions on the MSFC score in MS patients with different disabilities.

Evaluation of thoracic vertebrae in healthy White New Zealand rabbit (Oryctolagus Cuniculus): Computed tomographic and morphometric study.

BACKGROUND: Computed tomography currently has a prominent role in diagnosis and evaluation of vertebral column. On the other hand, a thorough knowledge about vertebral column property in normal state is prerequisite an accurate diagnosis of different abnormalities in this region. OBJECTIVE: The purpose of this study was to present a complete and exact descriptive and morphometric evaluation of thoracic vertebrae in rabbits with computed tomography. In images which were constructed by CT, several structures and different parts of the thoracic vertebrae have been named. METHODS: Ten healthy, mature, White New Zealand rabbits were evaluated. The morphologic and morphometric parameters of the thoracic vertebrae were studied. In this study, several parameters of thoracic vertebrae, such as vertebral body height, spinous process height, transverse process length, transverse process width, etc., were measured by computed tomography. RESULTS: Some parameters, such as spinal canal height, spinal canal width, pedicle length, pedicle width, end plate width, and endplate height, had no significant difference through thoracic vertebrae but other parameters, such as vertebral body height, transverse process length, transverse process width, spinous process angle, transverse process angle, and vertebral body length, had a significant difference. CONCLUSIONS: In this study, a comprehensive anatomic atlas of CT anatomy of the thoracic vertebrae was produced for use by veterinary radiologists, clinicians, and surgeons. Finally, we must mention these two important points: (1) Many of the differences observed between rabbits and humans are based on the way the trunks of these two creatures are located on the ground and the differences in the way their bodies move. (2) In studies that are done by modelling humans on animals, it should be noted that the terms used in animal anatomy are different and the names are used using the principles of veterinary anatomy.

The effects of 10-week core stability training on balance in women with multiple sclerosis according to Expanded Disability Status Scale: a single-blinded randomized controlled trial.

BACKGROUND: The Expanded Disability Status Scale (EDSS) Score is one of the most extensively accepted clinical grading scales which used to the assessment of neurological impairment and disability in multiple sclerosis (MS). AIM: The aim of this study was to analyse the effect of 10-week core stability training (CST) program on balance in women with relapsing-remitting MS according to EDSS Score. DESIGN: A blind randomized controlled trial. SETTING: The Department of Sports Injuries and Corrective Exercise at the Shahid Bahonar University of Kerman. POPULATION: Sixty-nine MS women. METHODS: They were randomly assigned into two groups as the intervention group and the control group. These groups were categorized into three subgroups according to the EDSS as follows: subgroup A (EDSS 2.5 to 3.5), subgroup B (EDSS 3.5 to 4.5), and subgroup C (EDSS 4.5 to 5.5). The intervention group performed a CST program for 10 weeks and to evaluate static and dynamic balance performance in pre-and post-tests, the Biodex Stability System (BSS) have been used. In addition, the participants' core muscle function was evaluated using the endurance and isometric muscle strength tests. RESULTS: The results show a significant difference between post-test variables of the core muscles function, static and dynamic balances in interventional subgroups in comparison with the control subgroups. The improved balance order has been given as subgroup C > B > A. CONCLUSIONS: The CST program could be suggested as an efficient clinical intervention for improving dynamic and static balance in the MS women due to the improvement of core muscle function, especially for the EDSS Score more than 3.5. CLINICAL REHABILITATION IMPACT: The CST could be performed as an efficient clinical intervention for improving dynamic and static balance in MS women due to the improvement of core muscle function. The present protocol could be helpful for the patients with MS especially for the EDSS Score more than 3.5.