Parsonage-Turner syndrome, affecting suprascapular nerve and especially to infraspinatus muscles after COVID-19 vaccination in a professional wrestler, a case report and literature review of causes and treatments.

BACKGROUND: Acute peripheral neuropathy, also known as Parsonage-Turner syndrome or neuralgic amyotrophy, mostly affects the upper brachial plexus trunks, which include the shoulder girdle. It is typically accompanied by abrupt, intense pain, weakness, and sensory disruption. The etiology and causes of this disease are still unknown because of its low prevalence, however viral reactions-induced inflammation is one of its frequent causes. CASE PRESENTATION: Here, we introduce a professional wrestler patient who was diagnosed with PTS after vaccination and was treated, and we review some articles in this field. CONCLUSION: When it comes to shoulder-girdle complaints and pain, Parsonage-Turner syndrome can be a differential diagnosis. Corticosteroids during the acute period, followed by physical therapy, appear to be an efficient way to manage pain, inflammation, muscular atrophy, and the process of recovering to full nerve regeneration.

Comparison between patients with COPD and healthy subjects on spatiotemporal, moment and kinematic parameters: A quasi-experimental study.

Background and Aims: Chronic obstructive respiratory diseases (COPD) not only cause damage to the respiratory system as well as the heart and blood vessels of the patient but also have a direct effect on the condition of the musculoskeletal system. The risk of falling is increasing due to dysfunction of the joints as well as aging, which occurs frequently in this population. Gait deficits are known as an important risk factor for falls. This research aimed to investigate the gait of COPD patients compared to healthy people to gain a better understanding of the reasons for falls. Methods: Twenty patients with COPD and 20 age and BMI-matched healthy individuals were included in this study. Sixteen markers were applied to the lower body of the subjects. Spatio-temporal, kinematic, and maximum moment parameters were measured in different phases in three lower body joints, including the hip, knee, and ankle. Results: The results showed that all spatio-temporal parameters in patients were significantly lower than in healthy people. The ankle angle in the sagittal plane at initial contact was significantly difference (p = 0.03). As well as, in the frontal plane the hip angle in the mid-stance showed a significant difference (p = 0.02). There was also a significant difference in maximum hip moment in the sagittal plane between the two groups (p = 0.01). Conclusion: The larger hip angle of the patients can be related to the balance problems in the mediolateral direction. The moment showed a significant difference in the hip joint. Since the hip muscles are directly in a synergistic relationship with the trunk muscles, it seems the performance of these muscles is likely to be seriously damaged due to respiratory diseases.

Comparison of 4 weeks of cupping and Kinesio-taping on clinical and ultrasound outcomes of carpal tunnel syndrome during pregnancy.

OBJECTIVE: To explore effect of cupping and Kinesio-taping techniques on clinical and ultrasound outcomes of carpal tunnel syndrome (CTS) during pregnancy. METHODS: Thirty pregnant women suffering from CTS were randomly assigned into Kinesio-taping (n = 15) and cupping (n = 15) groups. In Kinesio-taping group, individuals underwent Kinesio-taping for three days, one day with no treatment, and three days with Kinesio-taping, continuing this procedure for four weeks. In cupping group, cupping was moved for 5 min with pressure of 50 mm-Hg on the carpal tunnel area. This procedure continued longitudinally in forearm area for 2 min. The therapeutic intervention of cupping group continued with eight sessions, two days a week for 4 weeks. Ultrasound outcomes including median nerve cross-sectional area through ultrasonography, and clinical outcomes including pain through visual analog scale and severity of symptoms and functional status through Boston questionnaire were measured in both groups before and after therapeutic program. RESULTS: In both groups, a significant reduction was observed in all variables after treatment compared to pre-treatment (P < 0.001). In inter-group comparison, a significant improvement was found in outcomes of Boston questionnaire and ultrasound results about median nerve cross-sectional area at pisiform and hook of hamate in cupping group compared to Kinesio-taping at end of four weeks (P < 0.001). CONCLUSION: Both cupping and Kinesio-taping improved clinical and ultrasound outcomes of CTS. However, efficacy of cupping compared to Kinesio-taping was better in improvement of median nerve cross-sectional area at hamate hook and pisiform levels, symptoms severity scale, and functional status scale, which makes the results clinically more applicable.

Comparing the effectiveness of flexi-bar and stability exercises on postural control in chronic nonspecific low back pain: A randomized controlled study.

Objectives: This study aimed to compare the effect of flexi-bar and stabilization exercises on static and dynamic postural control in patients with chronic nonspecific low back pain. Patients and methods: In this randomized controlled study conducted between November 2019 and March 2020, 38 patients (19 males, 19 females; mean age: 33.8±6.2 years; range, 20 to 45 years) were randomly assigned into flexi-bar (n=19) and stabilization (n=19) groups. Both groups received general physiotherapy for three sessions per week, a total of 10 sessions. Besides, the flexi-bar group received flexi-bar exercises, and the stabilization group received stabilization exercises. Postural sway was assessed with a force platform in three difficult conditions, including open eye, close eye, and one-leg standing and dynamic posture with the modified Star Excursion Balance Test. Results: After the intervention, both groups showed a significant improvement in static and dynamic postural control (p<0.05). However, no significant differences were found between groups after treatment, while only the phase-plane portrait of opened eyes condition was significantly improved (p=0.03), in the flexi-bar group compared to the stabilization group. Conclusion: Both flexi-bar and stabilization exercises effectively improved static and dynamic postural control, but none of the exercises was superior to the other. Flexi-bar is recommended as an effective tool in low back pain rehabilitation.

The effect of fatigue on electromechanical response times in basketball players with and without persistent low back pain.

Typically, athletes alter movement mechanics in the presence of back pain, but the effect of these changes on lower extremity injury risk is not well understood. This study aimed to compare the effect of fatigue on electromechanical response times during a choice reaction task in basketball players with and without persistent low back pain. Twenty-four male basketball players participated. Total reaction time (TRT), premotor time (PMT), and electromechanical delay (EMD data were recorded before and after fatigue. The chronic low back pain (CLBP) group had significantly longer EMD in Med gastrocnemius (p = 0.001) and Tibialis anterior (p = 0.001), and shorter EMD in Vastus Lateralis (p = 0.001), Vastus Medialis Oblique (p = 0.003), and Semitendinosus (p = 0.025) muscles after fatigue. PMT in the CLBP group had longer than the Non-CLBP in Vastus Lateralis (p = 0.010), Vastus Medialis Oblique (p = 0.017), Semitendinosus (p = 0.002). Also, TRT was longer in knee flexion (p = 0.001) and ankle plantarflexion (p = 0.001) muscle groups. The different effects of fatigue on electromechanical response times of the knee and ankle in people with CLBP may represent the effect of an axial injury on lower extremity injury risk factors in situations of higher cognitive load, similar to competitive play.

Thoracic and Lumbar Sagittal Spinal Curvature Adaptations between Elite Iranian Road and Speed Cyclists.

BACKGROUND: Despite existing some research on the effects of professional cycling on cyclist's spinal curvature angles, no research is available concentrating on possible differences in various types of professional cycling. Road (outdoor) and speed (indoor) cyclists have different anthropometric and predominant postures during cycling. The current study aims to investigate if cyclists with different types of cycling may have dissimilar spinal curvature adaptations. OBJECTIVE: Forty-eight male subjects, including 16 elite road cyclists, 16 elite sprint cyclists and 16 non-athletes as the control group were recruited in this non-experimental study. MATERIAL AND METHODS: In this cross-sectional study, a spinal mouse was used to measure the thoracic and lumbar curvature angles in standing position. RESULTS: The mean values of thoracic kyphosis and lumbar lordosis angles were found as follows 48.3±7.2º & -20.3±7.2º for elite road cyclists; 46.6±8.1º & -22.5±7.7º for elite sprint cyclists; and 37.5±4.1º & -19±6.3º for the control group. The results confirmed that both the road and sprint cyclists showed significantly more hyper-kyphosis posture in their thoracic region when compared to the control group (p<0.05). CONCLUSION: All road cyclists showed no significantly higher degrees of thoracic angle relative to the sprint cyclists (p>0.05). However, all the cyclists and the control groups showed a normal range of lumbar lordosis angle. As a conclusion, the results of this study confirmed that an elite cyclist may predispose these subjects to the risk of hyper-kyphotic posture. The road cycling may result in more hyper-kyphosis due to the longer time, spent in flexed position.

Postural Balance Evaluation in Patients with Chronic Obstructive Pulmonary Disease.

BACKGROUND: The risk of falling in patients with chronic obstructive pulmonary disease (COPD) is higher than healthy people, imposing a great financial burden on patients due to clinical diagnosis and treatment. This study aimed to compare static balance between two groups of healthy people and COPD patients, based on cognitive tasks and vision tests, using linear and non-linear analyses. MATERIALS AND METHODS: A total of 15 patients with COPD and 14 age- and gender-matched healthy individuals were recruited in this study. Variations in the center of pressure were recorded in both medial-lateral (ML) and anterior-posterior (AP) directions by implementing visual feedback and cognitive tasks, with the subject standing on a force plate. Data related to the center of pressure were analyzed in the AP and ML directions by linear methods (i.e., standard deviation of displacement, standard deviation of maximum velocity, average velocity, and phase plane). Also, the nonlinear method (Lyapunov exponents) was used in both directions. RESULTS: The cognitive tasks improved the center of pressure variables in both groups. In association with the vision tests, only lack of vision had a significant effect on the patients. The results of the linear analysis in the ML direction were significantly higher in the COPD group as compared to the healthy group; however, the results were not significant in the AP direction. Also, the non-linear analysis showed significant differences between the groups. CONCLUSION: Use of both linear and non-linear analyses is necessary for evaluating the balance of patients with breathing difficulties. Balance disorders in COPD patients were mostly in the ML direction; therefore, postural deformities might be one of the reasons for balance problems in the AP direction.

Effect of Pulsed Electromagnetic Fields on Clinical Signs and Quality of Life in Patients with Hemophilic Arthropathy of the Knee Joint: A Randomized Controlled Trial.

BACKGROUND: Hemophilic arthropathy (HA) causes severe joint damage and impairs the quality of life (QoL) of hemophiliacs. This study was undertaken to evaluate the effect of pulsed electromagnetic fields (PEMFs) on the clinical signs and QoL of patients with severe hemophilia A experiencing moderate HA in the knee joint. MATERIALS AND METHODS: Thirty-six severe hemophiliacs with HA of the knee joint were randomly assigned into the PEMF (n = 20) or placebo (n = 16) groups. The PEMF group received 60 min of PEMF (2 Hz, 25 Gauss for 30 min and 70 Hz, 30 Gauss for 30 min) on the knee joint, three times per week for 6 weeks. The clinical signs, QoL, and pain intensity were measured by the Hemophilia Joint Health Score, A36 Hemofilia-QoL Questionnaire, and visual analog scale, respectively, before and after treatment. RESULTS: In the PEMF group, a significant difference before and after intervention in terms of clinical signs, QoL, and pain intensity (P < 0.05) was founded. Between-group analysis showed a significant improvement in clinical signs (except for atrophy, strength, and swelling duration), QoL, and pain intensity in the PEMF versus control group (P < 0.05). CONCLUSIONS: PEMF can improve the clinical signs, QoL, and pain intensity of severe hemophilia A patient with moderate knee hemophilic arthropathy.

Effect of using the Flexi-Bar tool on erector spinae muscle activation under different standing weight-bearing conditions.

OBJECTIVES: The Flexi-Bar and Bodyblade are oscillatory tools used in rehabilitation centers worldwide to enhance muscle activity. Because of a lack of reports on the Flexi-Bar, this study focused on erector spinae (ES) muscle activation under different conditions. METHODS: Twelve university students (age 21 ± 2.5 years old) were recruited in this study and were tested while using a loaded Flexi-Bar for 10 seconds. Comparison between muscle activation on the right and left sides in the cervical, thoracic, and lumbar regions was measured by electromyography during two-leg and one-leg (left and right) standing. RESULTS: The results showed that during oscillation using the right hand, the right cervical muscles showed significantly higher activation levels than the left cervical muscles, while the thoracic and lumbar regions showed significantly higher muscle activities on the left side. CONCLUSION: The current study showed that the Flexi-Bar might be used for muscle activation and reeducation, as well as for specific exercise therapy in spinal muscle imbalance.

The effects of cupping therapy as a new approach in the physiotherapeutic management of carpal tunnel syndrome.

BACKGROUND AND PURPOSE: Cupping therapy has been used widely as a safe and common method to tackle soft tissue lesions in most Asian countries, Central Europe, and parts of the United States. In this study, cupping therapy has been used for the treatment of carpal tunnel syndrome (CTS), which is the most common entrapment neuropathy. The aim of this study was to investigate the effect of cupping therapy on the clinical findings of patients with CTS. METHODS: This is a randomized clinical trial. For this research, a total of 56 hands with CTS were studied, aged 18-60 years, and of both genders. The participants were divided into two groups: test and control, regardless of the severity of their CTS. In the control group, 28 were treated with routine physiotherapy (transcutaneous electrical nerve stimulation and ultrasound), and in the test group, the other 28 were treated with routine physiotherapy with cupping therapy. The variables used to determine the effect of cupping were symptom severity scale, functional status scale, distal sensory latency, and distal motor latency. The severity of symptoms and functional status of patients was evaluated with the help of the Boston questionnaire, and the distal latency was evaluated through electromyography. RESULTS: The results of study demonstrated a significant improvement in symptom severity (p = 0.006) and also a significant decrease in distal sensory latency (p = 0.007) of the test group (routine physiotherapy with cupping) as compared with the control group (routine physiotherapy). CONCLUSIONS: The results showed that incorporation of cupping therapy in a routine physical therapy programme can reduce the severity of symptoms and improve the distal sensory disturbance of the median nerve. Therefore, it is suggested that cupping, as a convenient and low-cost method, can be used as a complementary therapy in the treatment of CTS.

The effect of different hip rotation angles on electromyography activity of the quadriceps muscle during closed kinetic chain tasks in healthy females.

[Purpose] The purpose of this study was to investigate electromyographic activity of the quadriceps muscle in different positions of hip rotation (while standing on the toes) in healthy females. [Participants and Methods] The study was conducted on 35 healthy females. Electromyographic activity of the rectus femoris, vastus medialis oblique, and vastus lateralis muscles were recorded with the hip in a neutral position as well as different angles of internal and external rotation (15, 30, and 45 degrees (°)) while the participants were standing on their toes. [Results] There was a significant difference of 15° in external rotation, a neutral position, 15° of internal rotation, and at the end of an internal rotation position. Paired comparison between muscle activity using Bonferroni showed that vastus lateralis activity in 15° of external rotation, a neutral position, 15° of internal rotation, and at the end of a position of internal rotation was more than that of rectus femoris muscle. [Conclusion] The present study showed that average vastus lateralis activity was the highest in all positions. However, the positions studied in the current study did not lead to an increase in muscle activity of the vastus medialis oblique as a medial dynamic stabilizer compared to vastus lateralis.

The effects of vacuumic bracing system on the patellofemoral articulation in patients with patellofemoral pain syndrome.

Patellar bracing is a component of treatment of patellofemoral joint (PFJ) problems. A new vacuumic brace was designed by the researchers that act based on an external vacuuming suction. Ten patients were undertaken for the CT scan study at both 0 degrees and 30 degrees knee flexion immediately pre- and post-bracing. Also they examined clinically pre, post and 1 week after using the brace. Measurements of patellofemoral joint space width (PFJSW) and patellofemoral joint area (PFJA) showed that the application of the vacuumic brace is able to create a significant patellofemoral joint distraction at both knee angles. A significant reduction in visual analog scale (VAS) and increase in kujala patellofemoral score (KPS) was found in subjects after using the brace for 1 week. In conclusion, the results conveyed that application of the vacuumic brace is able to create a joint distraction and useful changes in VAS and KPS parameters.