Reliability of Ultrasound Measurements of the Lumbar Multifidus and Transversus Abdominis Muscles during Lying and Unstable Sitting Positions in Individuals With and Without Chronic Low Back Pain.

Background: The reliability studies are limited to support ultrasound usage during dynamic conditions; for example, unstable sitting position. Objective: This study aims to examine the reliability of ultrasound measurements of the lumbar multifidus and transversus abdominis during lying and unstable sitting positions in individuals with chronic low back pain (CLBP) and asymptomatic individuals considering abnormal lumbar lordosis. Material and Methods: In this observational study, intrarater within-day and between-day reliability of muscle thickness and contraction ratio of the lumbar multifidus and transversus abdominis muscles were assessed using ultrasound imaging. In total, 40 participants (27 with CLBP, 13 asymptomatic individuals) with abnormal lumbar lordosis were recruited. The degree of lumbar lordosis has been measured by a flexible ruler. The muscle thickness was assessed at lying and sitting on a gym ball for both muscles in three sessions. Results: Both groups had well to high ICCs of thickness measurement and contraction ratio in the transversus abdominis and lumbar multifidus muscles during both static (ICC=0.71-0.99) and semi-dynamic conditions (ICC=0.73-0.98). The standard error of measurements and minimal detectable changes were rather small in both groups. Conclusion: Ultrasound imaging is a highly reliable method to assess muscle thicknesses and contraction ratio of the transversus abdominis and lumbar multifidus during different conditions, even in patients with CLBP and abnormal lumbar lordosis.

Understanding the possibilities and limitations of assistive technology in health and welfare services for people with intellectual disabilities, staff perspectives.

PURPOSE: Little is known regarding what assistive technology (AT) exists and how it is used in welfare services for people with intellectual disabilities (ID). This study aimed to explore healthcare staff's perspectives and insights regarding AT in daily support and welfare services for people with ID. We also sought to explore the associations between the use of AT and workplace-related factors and background characteristics (e.g., gender, age, and experience). MATERIALS AND METHODS: Three focus group discussions were conducted with 11 informants (8 women, 3 men) working in home-based and day services. Also, 176 healthcare staff (43 men, 133 women) who worked in municipal home-based services and day services completed a questionnaire comprised of background questions and 14 items with a five-point answer scale. RESULTS: Number of years using AT was positively associated with a positive attitude and use of AT among the staff. Staff were mainly positive towards AT and believed that it could represent various possibilities in the everyday lives of people with ID and their own service delivery. However, the staff expressed uncertainties and ethical concerns regarding AT, and they experienced a lack of knowledge, focus, and awareness about technology in services for this group. The quantitative results mainly showed positive associations between believing in AT's usefulness and using it in services for people with ID. CONCLUSIONS: The findings indicate that providing equipment and resources, personal interests, and staff attitudes are essential factors in successfully implementing AT for people with ID.Implications for rehabilitationHealthcare staff have a positive attitude towards using AT for people with intellectual disabilities, but they also perceive uncertainty and ethical concerns.The staff believe that there is a broad range of AT devices and systems available that can support the independence and participation of people with intellectual disabilities.The staff need to receive more training and technical supports from their workplace and AT-related experience is associated positively with the use of assistive technology by the staff.

Effect of a semi-rigid backpack type thoracolumbar orthosis on thoracic kyphosis angle and muscle performance in older adults with hyperkyphosis: a randomized controlled trial.

PURPOSE: To investigate the effect of a semi-rigid backpack type thoracolumbar orthosis (TLO) on thoracic kyphosis angle (TKA) and potentially contributing factors of hyperkyphosis, including position sense and back muscle strength and endurance. METHOD: This randomized, controlled trial was conducted on 48 older adults with hyperkyphosis, randomly allocated to an experimental or control group. The experimental group wore a semi-rigid TLO for 3 consecutive months. The control group received no external support or exercise. Thoracic kyphosis angle (TKA), joint position sense, back muscle strength and endurance were evaluated at the baseline and at the end of week 6 and week 12. RESULTS: The two-way (group × time) interactions were significant in terms of TKA (F = 37.88, p ≤ 0.001, ηp2 = 0.45), muscle strength (F = 26.005, p ≤ 0.001, ηp2 = 0.36), muscle endurance measured via load cell (F = 3.417, p = 0.039, ηp2 = 0.06), and endurance holding time of Ito test (F = 3.629, p = 0.045, ηp2 = 0.07). A further analysis using one-way repeated measures of ANOVA showed that TKA, muscle strength and endurance were significantly improved in the experimental group. Also, two-way interactions were significant for absolute error and variable error of trunk neutral repositioning test from a trunk flexed and/or extended position for global components and horizontal components trunk repositioning test. CONCLUSION: Wearing a semi-rigid backpack type TLO even from an unknown brand for short periods during the day (e.g., 2-4 h) over 3 months not only modifies kyphotic posture but also can enhance back muscle performance in older adults with hyperkyphosis. IMPLICATIONS FOR REHABILITATIONPrescription of a semi-rigid backpack type thoracolumbar orthosis for older adults has no adverse effects such as muscle weakness if it is applied for short periods during the day.A semi-rigid backpack thoracolumbar orthosis can prevent position sense degradation in older adults with hyperkyphosis.A semi-rigid backpack type thoracolumbar orthosis may counteract trunk flexion and kyphotic posture by applying the biomechanical principles of the three-point pressure system.Improvement in spinal alignment resulting from wearing thoracolumbar orthosis should not occur in exchange for muscle deconditioning.

Protective and risk factors in the grieving process among cancer-bereaved parents: A qualitative study.

This Norwegian nationwide study explored cancer-bereaved parents' perceptions of protective and risk factors in their grieving process. A total of 162 parents answered two open-ended questions 2-8 years after their child's death due to cancer. Qualitative analysis revealed three main themes: memories of the child's illness and death, going forward in life, and relationships-a resource and a barrier. The results support the perspective of going forward in life and accepting grief as part of life, contrary to the notion of "getting over" or "detaching" from the deceased child. Social support is also crucial for cancer-bereaved parents.

Effect of Motor Control Training on Trunk Muscle Morphometry, Pain, and Disability in People With Chronic Low Back Pain: A Systematic Review and Meta-Analysis.

OBJECTIVE: The aim of this systematic review and meta-analysis was to study the effects of motor control training (MCT) on trunk muscle morphometry measured by ultrasound imaging and pain and disability in individuals with chronic low back pain. METHODS: PubMed, Web of Science, Scopus, and Cochrane Library databases were searched from study inception until January 2021. Randomized control trials evaluating both muscle morphometry and pain or disability in individuals with chronic low back pain were included. Study selection, data extraction, and quality assessment were performed by 2 reviewers independently. Modified Downs and Black tool and the Grading of Recommendations Assessment, Development and Evaluation approach were used to assess the risk of bias and quality of evidence, respectively. A meta-analysis was performed using a random effects model with mean difference or standardized mean difference (SMD). RESULTS: Of 3459 studies initially identified, 15 studies were included, and 13 studies were selected for meta-analysis. The results revealed no differences in the resting thickness of the transversus abdominis, internal and external oblique, and lumbar multifidus muscles in studies that compared MCT with other interventions. The transversus abdominis muscles contraction ratio was greater (SMD = 0.93; 95% confidence interval [CI], -0.0 to 1.85) and lower pain (weighted mean difference: -1.07 cm; 95% CI, -1.91 to -0.22 cm; P = .01) and disability (SMD = -0.86; 95% CI, -1.42 to -0. 29; P < .01) scores were found in the groups who underwent MCT compared with other interventions. CONCLUSION: This systematic review and meta-analysis found that motor control exercise training increased the transverse abdominis contraction ratio (muscle activation) and improved the level of pain and disability compared to other interventions in people with chronic low back pain. However, motor control exercise training was not superior to other interventions in increasing the resting thickness of deep abdominal and lumbar multifidus muscles in intervention times less than 12 weeks.

Impact of resilience and social support on long-term grief in cancer-bereaved siblings: an exploratory study.

BACKGROUND: Bereavement research has mainly explored potential risk factors associated with adverse outcomes, and the role of protective factors has received less attention. More knowledge is needed about factors related to unresolved grief in bereaved siblings. This study aimed to assess grief adjustment and possible gender differences among bereaved young adults 2-10 years after losing a brother or sister to cancer. We also sought to explore how resilience and social support influenced their grief. METHODS: A total of 99 young adults (18-26 years) who had lost a brother or sister to cancer between the years 2009 and 2014 were invited to participate in this Norwegian nationwide study. The study-specific questionnaire was completed by 36 participants (36.4%). Social support during the sibling's illness, after the death, and during the past year, in addition to grief and resilience, were measured. RESULTS: Overall, the prevalence of unresolved grief was 47.2% among bereaved siblings, whereas 52.8% had worked through their grief. The level of having worked through grief and resilience was similar between male and female siblings. Bereaved siblings with higher Personal Competence reported lower unresolved grief. CONCLUSION: Approximately half of the young adults experience unresolved grief 2-10 years after losing a sibling to cancer. The findings also highlight the need for long-term support for bereaved siblings to help improve their resilience and better have worked through their grief.

Using welfare technology for individuals with intellectual disabilities. Expectations, experiences, and challenges of intellectual disability nursing students during clinical placement.

PURPOSE: Little is known about how welfare technology (WT) is used in welfare services for people with intellectual disabilities. This study aimed to explore expectations, experiences, and challenges concerning the use of WT for people with intellectual disabilities among bachelor-level intellectual disability nursing students during clinical placement. MATERIALS AND METHODS: A written reflection assignment (four open questions about using WT) was collected from 100 intellectual disability nursing students (30 males, 70 females). Four focus group discussions were also performed with 13 intellectual disability nursing students before and after their clinical placements. RESULTS: Analysis of the assignments showed that "security and safety" technology was the most frequently used WT category for people with intellectual disabilities in the clinical placement settings in municipal welfare and day services. The students reported "Compensation and wellness" technology as the top category to promote the quality of services for people with intellectual disabilities. However, people with intellectual disabilities mostly used WT for "Social contact". Students were mainly positive towards WT and believed it could improve the service quality and the everyday lives of this group. However, the students requested to learn more about WT and ethical issues regarding WT before clinical placement. Additionally, they experienced a lack of knowledge, focus, and awareness about technology in services for this group. CONCLUSION: The findings suggest that although intellectual disability nursing students have a positive attitude towards using WT for people with intellectual disabilities, they require more skill training and ethical knowledge before entering clinical practice. IMPLICATIONS FOR REHABILITATIONStudents were mainly positive towards welfare technology and believed that it could improve the service quality and the everyday lives of people with intellectual disabilities.Before their clinical placement, intellectual disability nursing students requested to learn more about welfare technology and ethical issues regarding welfare technology."Security and safety" technology was the most used category for people with intellectual disabilities in the municipal welfare and day services."Social contact" technology was the most used category by people with intellectual disabilities.

The Effects of Challenging Walking Conditions on Kinematic Synergy and Stability of Gait in People with Knee Osteoarthritis: A Study Protocol.

Background: Knee osteoarthritis (KOA) may considerably change the gait parameters, including the gait variability patterns. Uncontrolled manifold (UCM) analysis has been used to evaluate the relationship between motor control and gait variability as a useful index for assessing the multi-segmental movements' coordination during walking. To our knowledge, no research has evaluated the alterations in the gait kinematic parameters during normal and narrow path walking in individuals with KOA as compared to asymptomatic people. Materials and Methods: In this cross-sectional study, individuals diagnosed with mild to moderate medial KOA and asymptomatic people will walk at their comfortable preferred speed on a treadmill. A motion capture system will be used to record at least 50 successful gait cycles. The kinematic variability of joints during gait will be analyzed using UCM, with the center of mass (COM) displacement considered as the performance variable. The primary outcome measure will be the lower limb synergy index. Variability of the COM displacement and changes in angles and angular velocities of lower extremity joints will be assessed as the secondary outcomes. Results: The results of this protocol study provide information on the lower limb kinematic synergy during gait on normal and narrow paths for individuals with KOA and asymptomatic controls. Conclusion: This information will help the researchers and clinicians understand KOA patients' gait variability characteristics more deeply. Moreover, it may lead to an enhanced evidence-based approach for clinical decision-making concerning improving gait stability and decreasing the falling risk in these people.

Uncontrolled manifold analysis of gait kinematic synergy during normal and narrow path walking in individuals with knee osteoarthritis compared to asymptomatic individuals.

Knee osteoarthritis (KOA) is a common musculoskeletal disorder resulting in altered gait patterns. Uncontrolled manifold (UCM) analysis has been demonstrated as a useful approach for quantitative analysis of motor variability and synergies. The present study aimed to investigate the changes in the kinematic synergy, controlling the center of mass (COM) position while walking on normal and narrow paths in people with KOA compared to asymptomatic participants. In this cross-sectional study, twenty people with mild to moderate KOA and twenty asymptomatic individuals walked at their comfortable preferred speed across normal and narrow paths on a treadmill. The UCM analysis was performed separately using the lower limb segmental angles as elemental variables and the COM displacement as a performance variable during the stance phase of gait for the frontal and sagittal planes. The results revealed that KOA and asymptomatic individuals could exploit kinematic synergy to control the COM displacement regardless of walking conditions (p < 0.05). Furthermore, the variance within the UCM and synergy index were significantly higher on the narrow path than the normal walking in the mediolateral direction in the KOA group (p < 0.05). The findings of this study suggest that individuals with KOA modify their gait kinematic variability to ensure a stronger kinematic synergy when walking on a challenging narrow path.

Impairments in trunk muscles performance and proprioception in older adults with hyperkyphosis.

BACKGROUND AND OBJECTIVES: Thoracic hyperkyphosis is one of the most common postural deformities in the geriatric population. This study investigated whether trunk proprioception, muscle strength, and endurance differ between older adults with hyperkyphosis and the age-matched control group. This study also aimed to explore the association of kyphotic posture with muscle performance, position sense, and force sense. METHODS: Ninety-seven elderly volunteers (61 with hyperkyphosis and 36 normal controls) participated in this cross-sectional study. The kyphosis degree, trunk position sense, force sense, back muscle strength, and endurance were assessed in all participants. RESULTS: The results showed lower back extensor strength and endurance, also higher force and position sense error in the hyperkyphotic group than the control group. In addition, the findings revealed that back extensor strength and endurance, as well as trunk position sense, were associated with kyphotic posture in older adults. DISCUSSION AND IMPLICATIONS: This study suggests that back extensor strength and endurance and trunk position sense and force sense are potentially modifiable impairments associated with thoracic kyphosis in older adults with hyperkyphosis. It seems monitoring these potentially contributing factors would be helpful in the assessment and treatment of hyperkyphotic older individuals.

Test-retest reliability of a load cell setup, Ito, and timed loaded standing tests for measuring muscle strength and endurance in older adults with and without hyperkyphosis.

BACKGROUND: The association of back muscle weakness with greater thoracic kyphosis has been widely documented. Reliable and easy-to-use techniques are needed to monitor changes in muscle function over time and assess the effectiveness of therapeutic interventions. Therefore, the present study aimed to evaluate the test-retest reliability of a designed load-cell setup and two clinical tests, namely Ito and Timed loaded standing (TLS) tests for measuring back muscle function (i.e., strength and endurance) in older adults with and without hyperkyphosis. METHOD: Fifty-three older people (28 with thoracic hyperkyphosis and 25 normal age-matched controls) completed the present test-retest reliability study. A two-way random model of the Intraclass Correlation Coefficient (ICC2,3) was used to estimate relative reliability. Absolute reliability was assessed by calculating Standard Error of the Measurements (SEM) and Minimal Detectable Change (MDC). RESULTS: The findings showed excellent test-retest reliability in all performed tests for this population (ICC = 0.95-0.99). In addition, the MDC values for measuring endurance time via load cell, Ito, and TLS tests in the hyperkyphosis group, were 16.5, 28.2, and 35.1 s, respectively. These values ranged from 36 to 39 s for the control group. CONCLUSION: The present study suggests high test-retest reliability of the designed load-cell setup, Ito, and TLS for assessing back extensor muscle strength and endurance in older adults with and or without hyperkyphosis.

Bereaved parents' quality of life: resilience and professional support.

OBJECTIVES: The study aimed to compare the quality of life (QoL) among cancer-bereaved parents with a control group and explore how resilience and support from healthcare professionals associated with QoL of parents 2-8 years after the loss of a child to cancer. METHODS: This nationwide, cross-sectional survey was administered among parents (n=161) who lost their child to cancer between 2009 and 2014, compared with a matched control parent group (n=77). A study-specific questionnaire, Resilience Scale for Adults (six factors: 'Perception of self', 'Planned future', 'Social competence', 'Structured style', 'Family cohesion' and 'Social resources'), and a single-item measure of parents' QoL were included for the study. RESULTS: There was a lower QoL in both bereaved parents (mean=5.1) compared with the control parents (mean=5.8) (p<0.001). Two resilience factors, 'Perception of self' (OR=1.8, p=0.004) and 'Planned future' (OR=2.05, p<0.001), and given sufficient information during the child's last month (OR=2.63, p=0.003) were positively associated with long-term QoL in cancer-bereaved parents. CONCLUSION: The findings indicate lower QoL among both fathers and mothers 2-8 years after losing a child to cancer. The study also highlights the positive role of resilience and the importance of informational support on long-term QoL in cancer-bereaved parents. Bereavement support should be tailored for supporting individual needs.

Reliability of ultrasound measurement of the lateral abdominal and lumbar multifidus muscles in individuals with chronic low back pain: A cross-sectional test-retest study.

OBJECTIVES: Ultrasound (US) imaging has been suggested to evaluate the morphology and function of trunk muscles; however, little is known about the reliability of the US measures in patients with chronic low back pain (CLBP). This study aimed to evaluate intrarater reliability of US imaging of the lateral abdominal and lumbar multifidus muscles in individuals with nonspecific CLBP. METHODS: In this cross-sectional study, intrarater within-day and between-day reliability of US measurements of the transversus abdominis, internal oblique, external oblique and lumbar multifidus (at the L3-L4, L4-L5, and L5-S1 levels) muscles were obtained on both sides. The resting and contracted thickness and contraction ratio of each muscle were measured in 21 individuals with nonspecific CLBP. RESULTS: All US measurements of the lateral abdominal and lumbar multifidus muscles demonstrated good to excellent within-day (Intraclass correlation coefficients (ICCs: 0.80-0.98) and between-day (ICCs: 0.80-0.97) reliability. The standard error of the measurement (SEMs) and minimal detectable change (MDCs) of the lateral abdominal muscles on both sides ranged 0.5-1.6 mm and 0.4-4.4 mm, respectively. The SEMs and MDCs of the LM muscles on both sides ranged 1.1-2.7 mm and 2.86-7.49 mm, respectively. CONCLUSION: The findings indicate that US imaging has good to high intrarater within- and between-day reliability for assessing absolute thickness and contraction ratio of the trunk muscles on both right and left sides in patients with nonspecific CLBP. The vertical alignment of the US transducer is a reliable method for assessing the lateral abdominal muscles.

Cervical movement kinematic analysis in patients with chronic neck pain: A comparative study with healthy subjects.

BACKGROUND: Several studies have investigated cervical kinematic performance in patients with chronic neck pain, especially with fast movements. A recent systematic review recommended further study of cervical spine kinematics cervical motions in individuals with neck pain. OBJECTIVES: This study aimed to examine cervical spine kinematics of naturally paced cervical motions in patients with chronic neck pain compared with a group of asymptomatic participants. Also, the relationships between cervical kinematic measures with neck pain intensity and disability were determined. METHOD: Kinematic performance was measured in 20 individuals with chronic nonspecific neck pain and 20 healthy controls. Data were captured using a 7-camera motion analysis system. Parameters were range of cervical motion, peak velocity, duration of movement, and jerk index (smoothness of movement). Pain intensity and Neck Disability Index were also measured. RESULTS: Duration of movements, peak velocities, and jerk indexes were significantly different between the two groups (p < 0.05). Pain intensity was significantly associated with duration of movement, range of motion, peak velocity, and smoothness predominantly in extension (r range = 0.4 to 0.6, p < 0.05). CONCLUSION: This study's findings indicated altered cervical kinematic performance during naturally paced motions (particularly reduced smoothness of movement)in patients with chronic nonspecific neck pain compared to asymptomatic participants. Also, pain intensity was moderately associated with most kinematic measures, especially in extension. This study's results can help to understand better the impairments associated with chronic nonspecific neck pain.

Protective and risk factors associated with psychological distress in cancer-bereaved parents: A cross-sectional study.

PURPOSE: Research shows that knowledge about mental health status, both protective and risk factors, is limited in cancer-bereaved parents. The study aimed to investigate (1) the extent of psychological distress in bereaved parents 2-8 years after the loss of a child to cancer compared to non-bereaved parents, and (2) psychological distress in association with resilience, the extent of having coped with the grief, time since the loss, and past psychological distress in cancer-bereaved parents. DESIGN: Retrospective, cross-sectional study. METHODS: A Norwegian nationwide study-specific questionnaire was completed by 162 parents who had lost a child to cancer, and 77 matched non-bereaved parents. We used the Cohort Norway-Mental Health Index and Resilience Scale for Adults to measure psychological distress and resilience, respectively. The extent of having coped with grief was also measured. RESULTS: Bereaved parents experienced significantly more symptoms of psychological distress, albeit not clinical psychological distress, compared to non-bereaved parents. The bereaved parents who have coped with their grief or had higher resilience reported lower psychological distress. Positive "Perception of self" and well "Planned future" were the strongest predictors of psychological distress in both bereaved fathers and mothers. CONCLUSION: Both fathers and mothers experience more psychological distress symptoms 2-8 years after losing a child to cancer than non-bereaved parents. The findings also highlight the need for long-term support to bereaved parents in order to help to improve their resilience and to better cope with their grief.

Effects of combining diaphragm training with electrical stimulation on pain, function, and balance in athletes with chronic low back pain: a randomized clinical trial.

BACKGROUND: It is unknown how diaphragm training combined with electrical stimulation affects pain, function, static stability, and balance in athletes with chronic low back pain (CLBP). This study aimed to explore the effects of combining diaphragm training with electrical stimulation on pain, function, static stability, and dynamic balance in athletes with nonspecific CLBP. METHODS: The design was a randomized clinical trial. A total of 24 amateur athletes (12 women, 12 men, mean age: 35.2 ± 9.8) with nonspecific CLBP were randomly allocated into two groups. The experimental group (n = 12) received diaphragm training plus Transcutaneous Electrical Nerve Stimulation (TENS), while the control group (n = 12) received TENS alone. Both groups underwent 12 sessions over a four-week period. Static stability, dynamic balance, pain, and function were measured pre- and post-intervention. RESULTS: Analysis of variance 2 × 2 revealed greater improvements in pain (p < 0.001), static stability (p < 0.001), and dynamic balance (p < 0.01) in the experimental group compared to the control group. Function was improved in both groups following the interventions (p < 0.001), and there was a trend of a larger improvement in the experimental group than the control group (p = 0.09). Fisher's exact test showed that the experimental group reported ≥50% improvement only in the pain score, not function, compared to the group that received TENS alone (p = 0.005). CONCLUSIONS: Pain, function, static stability, and dynamic balance were improved in both groups following 12 intervention sessions. However, pain, static stability, and dynamic balance were improved to a greater extent in diaphragm training plus TENS than TENS alone in amateur athletes with CLBP. Therefore, it seems beneficial to add diaphragm training to the rehabilitation program for athletes with nonspecific CLBP. TRIAL REGISTRATION: The trial was retrospectively registered in the Iranian Registry of Clinical Trials ( www.irct.ir ) on September 10, 2020 as IRCT20090228001719N8 .

Altered ultrasonographic activity of abdominal muscles during breathing in males with and without nonspecific chronic low back pain.

PURPOSE: This study aimed to investigate the altered ultrasonographic activity of abdominal muscles during breathing in males with and without nonspecific chronic low back pain (NSCLBP). DESIGN: Cross-sectional study. METHODS: Twenty males with NSCLBP and 20 males without NSCLBP were recruited. Muscle thickness change was measured by ultrasonography during breathing in the end-inspiration and end-expiration phases for the transverse abdominis (TrA), internal oblique (IO), external oblique (EO), and rectus abdominis (RA) muscles. The data were normalized to the end-inspiration thickness. An independent t test was run to analyze the data at a confidence level of 95% (p < 0.05). RESULTS: The participants with NSCLBP had thicker IO muscles in the end-inspiration (p = 0.030) and end-expiration (p = 0.017) phases as well as greater RA (p = 0.006) and smaller EO (p = 0.003) normalized thickness changes during breathing. CONCLUSION: The normalized thickness changes during breathing differed between the participants with and without NSCLBP. Reduced EO and increased RA activity may predispose the spine to further injuries. Therefore, normalizing the breathing pattern should be considered in the management of people with NSCLBP.

Short-term effect of kinesiology taping on pain, functional disability and lumbar proprioception in individuals with nonspecific chronic low back pain: a double-blinded, randomized trial.

BACKGROUND: This study aimed to evaluate the effect of kinesiology taping (KT) on lumbar proprioception, pain, and functional disability in individuals with nonspecific chronic low back pain (CLBP). METHODS: Thirty individuals with nonspecific CLBP participated in this double-blinded, randomized clinical trial from July 2017 to September 2018. The participants were randomized into two groups: KT (n = 15) and placebo group (n = 15). KT was applied with 15-25% tension for 72 h, and placebo taping was used without tension. Lumbar repositioning error was measured by a bubble inclinometer at three different angles (45° and 60° flexion, and 15° extension) in upright standing. Pain and disability were assessed by the Short-Form McGill Pain Questionnaire and Oswestry Disability Index, respectively. All measurements were recorded at baseline and 3 days after taping. RESULTS: Pain and disability scores reduced 3 days after taping in the KT group with large effect sizes (p < 0.05). Only the total score of pain was significantly different between the groups 3 days after taping and improved more in the KT group with a large effect size (p < 0.05). However, lumbar repositioning errors were similar between the groups after 3 days (p > 0.05). Also, only constant error of 15° extension showed a moderate correlation with disability (r = 0.39, p = 0.02). CONCLUSION: KT can decrease pain and disability scores after 3 days of application. Although placebo taping can reduce pain, the effect of KT is higher than placebo taping. The findings do not support the therapeutic effect of KT and placebo taping as a tool to enhance lumbar proprioception in patients with nonspecific CLBP. TRIAL REGISTRATION: The study prospectively registered on 21.05.2018 at the Iranian Registry of Clinical Trials: IRCT20090301001722N20 .

The Effect of Respiratory Phase on Abdominal Muscle Activity During Stable and Unstable Sitting Positions in Individuals With and Without Chronic Low Back Pain.

OBJECTIVE: The aim was to assess the abdominal muscle activities during inspiration and expiration at different sitting positions in individuals with and without chronic low back pain (CLBP). METHODS: This study was conducted on 36 participants (18 with CLBP and 18 healthy controls). Ultrasound imaging was used to assess thickness changes of the transverse abdominis, internal oblique, rectus abdominis, and external oblique muscles. Muscle thickness was measured during inspiration and expiration under 3 different stability levels: sitting on a chair, sitting on a gym ball, and sitting on a gym ball with lifting the left foot. The muscle thickness measured in these positions was normalized to the actual muscle thickness at rest in supine lying and presented as a percentage of thickness change. RESULTS: Both groups displayed greater abdominal muscle activities as the stability of the surface decreased during both respiratory phases. However, compared with the healthy controls, the CLBP group showed smaller muscle thickness changes in all abdominal muscles, except the external oblique, in both respiration phases while sitting on a gym ball with lifting the left foot. The CLBP group displayed overactivity of the rectus abdominis muscle relative to the healthy controls while sitting on a chair in both respiratory phases. CONCLUSION: The findings of the study indicate that as the stability of the support surface decreases, individuals with CLBP had more difficulty activating all abdominal muscles in a similar manner compared to healthy controls in both respiratory phases, which might affect both respiration and postural stability.

Effect of Posterior Pelvic Tilt Taping on Abdominal Muscle Thickness and Lumbar Lordosis in Individuals With Chronic Low Back Pain and Hyperlordosis: A Single-Group, Repeated-Measures Trial.

OBJECTIVE: The purpose of this study was to investigate the effect of posterior pelvic tilt taping (PPTT) on lumbar lordosis, pain, disability, and abdominal muscle thickness in individuals with nonspecific chronic low back pain with hyperlordosis. METHODS: A prospective, single-group, repeated-measures design was conducted with 31 individuals with nonspecific chronic low back pain (16 men, 15 women) with hyperlordosis (mean ± SD = 59.3° ± 2.9°). Participants' mean age, pain, disability, and lumbar lordosis were, respectively, 35.7 ± 9.9 years, 5.1 ± 1.3, 26.8 ± 11.5, and 59.3° ± 2.9°. The thickness of the abdominal muscles on both sides was measured in the crook lying position by ultrasound imaging. PPTT was performed on both sides. Pain intensity, functional disability, lumbar lordosis angle, and abdominal muscle thickness were measured before PPTT (W0), 1 week after PPTT (W1), and 1 week after PPTT removal (W2). RESULTS: Analysis revealed significant reductions in lumbar lordosis, pain, and disability, and increased abdominal muscle thickness, at W1 and W2 compared with W0 (P < .001). There were no significant differences in lumbar lordosis or abdominal muscle thickness between W1 and W2. CONCLUSION: The current study showed in a small group of participants that 1 week of PPTT may improve lumbar lordosis, pain, disability, and abdominal muscle thickness in individuals with nonspecific chronic low back pain with hyperlordosis.