The reliability and concurrent validity of a new iPhone® application for measuring active lumbar spine flexion and extension range of motion in patients with low back pain.

Objective: To investigate the reliability and validity of an iPhone® application (iHandy® Level) for measuring active lumbar flexion-extension range of motion (ROM) in chronic nonspecific low back pain (CNLBP) patients. Methods: Fifteen CNLBP patients were recruited. The participants stood in a relaxed position and the T12-L1 and S1-S2 spinal levels were identified through palpation and were marked on the skin. Two blinded examiners used a gravity-based inclinometer and the application in order to measure ROM. The instruments were lined up appropriately and the participants were asked to perform maximum lumbar flexion following by maximum extension. First, each examiner placed the instruments over the T12-L1 level and then over the S1-S2 level during the movements. In order to calculate flexion-extension ROM, the measurement which was obtained from T12-L1 was subtracted from S1-S2. Intraclass correlation coefficient (ICC) models (3, k) and (2, k) were used in order to determine the intrarater and inter-rater reliability, respectively. The Spearman's correlation coefficients (rs ) and Bland-Altman plots were used in order to examine the validity. Results: Fair-to-excellent intrarater (ICC = 0.39-0.89) and moderate-to-good inter-rater reliability (ICC = 0.55-0.77) were observed using the inclinometer. Moreover, poor-to-good intrarater (ICC = 0.30-70) and inter-rater (ICC = 0.13-0.70) reliability were found with the application. The Spearman's correlation coefficients demonstrated low-to-moderate associations between the measures of the two instruments (rs ≥ 0.22). The Bland-Altman plots indicated that there was a significant difference between the instruments for measuring flexion ROM. The difference was not significant for measuring extension ROM. Conclusion: The iHandy® Level application does not have sufficient validity for measuring active lumbar flexion ROM in CNLBP patients.

Antileishmanial activity of prenylated coumarins isolated from Ferulago angulata and Prangos asperula.

Leishmaniasis has a wide spectrum of signs and symptoms due to infection to numbers of Leishmania species and makes enormous mortality and morbidity. There are clues of antileishmanial effects of prenylated coumarins. Apiaceae family is one of the most important sources of coumarins. Air-dried aerial parts of Ferulago angulata and fruits of Prangos asperula were extracted with n-hexane, using a soxhlet apparatus. The solvents were evaporated under reduced pressure. Column chromatography and crystallization process resulted to isolation of three prenylated coumarins. (1)H-nuclear magnetic resonance, electron ionization Mass and Infrared spectra were used for elucidation of isolated compounds. Leishmanicidal activity of isolated coumarins was assessed on Leishmania major strain (MRHO/IR/75/ER) for the first time. Suberosin epoxide and suberosin were isolated from aerial parts of F. angulata and osthol was extracted from grounded fruits of P. asperula. Osthol showed a significant antileishmanial effect on promastigotes in early hours of exposure with IC50 of 14.40 µg/mL but suberosin epoxide showed only a weak antileishmanial activity. IC50 of osthol and suberosin epoxide after 48 h were 10.79 and 54.0 µg/mL, respectively. Suberosin showed no remarkable effect in these concentrations. This is the first report on the pharmacological activity of suberosin epoxide. Substantial difference between efficacies of two isomers, osthol and suberosin remarks the importance of prenyl substituent location on C-8.