The relationship between the psoas major muscle morphology characteristics with disability index and pain in patients with chronic nonspecific low back pain.

BACKGROUND: Chronic nonspecific low back pain (CNLBP) is a common disorder in people of active ages and significantly affects their quality of life. Different structures in the lumbar area can cause LBP. The lumbar muscle disorders, including the psoas major (PM) muscles, have an essential role in LBP. Magnetic Resonance Imaging (MRI) has been introduced as a safe and useful instrument for investigating the morphological properties of skeletal muscle. In general, PM morphology changes may be one reason for the pain and disability experienced in CNLBP patients. Thus, this study aimed to assess the relationship among the PM's Cross-sectional area (CSA), medial-lateral (ML), and anterior-posterior (AP) diameters, with disability index and pain score in patients with CNLBP. METHOD: One hundred twenty patients with CNLBP (60 men and 60 women) participated in this cross-sectional study. Axial MRIs were obtained from L3/L4 and L4/L5 disc levels. Then, patients filled out Rolland Morris Disability Questionnaires, demographic data forms, and the Numeric Pain Rating Scale (NPRS). Image J software was used to analyze the images. Using Linear Regression and the Pearson test, the correlation between muscle CSA and diameters, as well as data obtained from questionnaires and NPRS, was analyzed. RESULTS: Results from the statistical analysis showed no statistically significant relationship among morphological characteristics of the psoas major muscle in L3/L4 and L4/L5 disc levels with disability index and pain score (p < 0.05). CONCLUSIONS: There is no significant relationship between the PM morphological characteristics and disability index and pain score. Therefore, muscle CSA and diameters are insufficient to determine the cause of CNLBP.

Assessment of Hip Range of Motion Limitations in Cases with Low Back Pain Based on the Classified Movement System Impairment.

Background: The hip joint's limitation causes lumbopelvic compensatory motions, accumulating tissue stress on the lumbar spines. It is essential and valuable to evaluate hip rotation range of motion (ROM) in different low back pain (LBP) classifications to understand them and plan the best exercise program. This study aimed to compare hip rotation ROM between subjects with and without LBP classified in movement system impairment (MSI). Materials and Methods: In this cross-sectional study, 100 subjects with LBP were classified into different MSI subgroups (mean age of 41.66 ± 7.82 years), and 100 healthy subjects (mean age of 38.96 ± 8.84 years) participated. Passive and active hip medial and lateral rotations ROM in prone and supine positions for dominant and non-dominant lower limbs were measured. Results: Generally, in the LBP group, minimal lateral rotation as compared to controls in movement tests measuring hip rotation ROM actively and passively, in prone and sitting positions, and for dominant and non-dominant limbs (P < 0.05). There were no significant differences among the LBP subgroups (P > 0.05). Conclusions: Due to LBP, regardless of the MSI categories, remarkably restricted hip lateral rotation ROM.

Effect of Transfer Energy Capacitive and Resistive Therapy on Shoulder Pain, Disability, and Range of Motion in Patients With Adhesive Capsulitis: A Study Protocol for a Randomized Controlled Trial.

Objective: We describe a protocol to evaluate the effectiveness of transfer energy capacitive and resistive (TECAR) therapy on shoulder passive range of motion, shoulder pain, and disability index in patients with adhesive capsulitis. Methods: This study will be a double-blinded randomized clinical trial with a 1-month follow-up. For the purpose of this research, 30 patients with a 3-month history of shoulder pain and disability diagnosed as adhesive capsulitis will be selected and then randomized into 2 groups, including conventional physiotherapy consisting of electrophysical modalities and therapeutic exercises, which will be given to the control group. In the intervention group, after conventional physiotherapy, 10 minutes of TECAR therapy in resistive mode will be applied on both the anterior and inferior aspects of the shoulder joint. Outcome measures will be related to shoulder passive range of abduction, flexion, and external rotation that will be measured using a digital inclinometer, as well as shoulder pain and disability index that will be assessed by the validated questionnaire. Assessment will be done at baseline, 1 day after the intervention, and by passing 1 month. Results: The statistical analysis will describe within-group and between-group comparisons; the findings will be illustrated in tables and charts. Conclusion: Given the reason that the effectiveness of TECAR therapy has not been widely evaluated in adhesive capsulitis, the findings of this pilot study would provide baseline information on the effectiveness and complications of this treatment method and possibly propose a more appropriate protocol for patients with adhesive capsulitis.

Neuromuscular Electrical Stimulation in Conjunction with Conventional Swallowing Therapy in the Treatment of Dysphagia Caused by Multiple Sclerosis: A Single-Case Experimental Design.

INTRODUCTION: Dysphagia as a consequence of multiple sclerosis (MS) puts individuals at higher risk of dehydration, malnutrition, and aspiration pneumonia. This study intended to investigate the effects of a combined program of neuromuscular electrical stimulation (NMES) and conventional swallowing therapy to improve swallow safety and efficiency, oral intake, and physical, emotional, and functional impacts of dysphagia in people with dysphagia and MS. METHODS: In this single-case experimental study with ABA design, two participants with dysphagia caused by MS underwent 12 sessions therapy during 6 weeks following a baseline of 4 evaluation sessions. They were evaluated 4 more times in the follow-up phase after therapy sessions. Scores of Mann Assessment of Swallowing Ability (MASA), DYsphagia in MUltiple Sclerosis (DYMUS), and timed test of swallowing capacity were obtained at baseline, during treatment, and in the follow-up phases. The Dysphagia Outcome and Severity Scale (DOSS) based on videofluoroscopic swallow studies, Persian-Dysphagia Handicap Index (Persian-DHI), and Functional Oral Intake Scale (FOIS) were also completed before and after treatment. Visual analysis and percentage of nonoverlapping data were calculated. RESULTS: MASA, DYMUS, FOIS, and DHI scores indicated significant improvement in both participants. Although the scores of the timed test of swallowing capacity in participant 1 (B.N.) and DOSS in participant 2 (M.A.) showed no changes, considerable improvements including reducing the amount of residue and the number of swallows required to clear bolus were seen in the posttreatment videofluoroscopic records of both participants. CONCLUSION: NMES in conjunction with conventional dysphagia therapy based on motor learning principles could improve the swallowing function and decrease disabling effects of dysphagia on different aspects of life in participants with dysphagia caused by MS.

Comparison of immediate and delayed effects of superficial and deep dry needling in patients with upper trapezius myofascial trigger points.

BACKGROUND: Dry needling is one of the most common treatments for this condition. In this study the immediate and delayed effects of superficial dry needling (SDN) and deep dry needling (DDN) on upper trapezius muscle function and patients' pain and disability was evaluated. METHODS: In this quasi-experimental study, 47 women with active MTrPs were randomly divided into SDN and DDN groups and received one session treatment. Pain and disability were assessed before and one week after intervention with visual analogue scale (VAS) and neck disability index (NDI) questionnaire. Muscle activity was assessed by surface electromyography (sEMG) before, immediately and one week after intervention. RESULTS: Both groups showed significant decrease in VAS (p < 0.001) and NDI (p < 0.001) after one week, however no significant difference were found between the groups (p > 0.05). A significant increase in sEMG activity was observed only in DDN group after one week (p < 0.007), but there were no significant differences in sEMG activity in SDN group after intervention and between the two groups (p > 0.05). CONCLUSION: Both SDN and DDN could be effective in reducing pain and disability in patients with active MTrPs of upper trapezius muscle. Regarding muscle function DDN seems to be more effective. So that based on evaluation of the therapist in some cases with not significant muscle dysfunction SDN as a gentle and less invasive method could be used but for long term effectiveness and in those with significant muscle dysfunction DDN could be used.

The effects of intrinsic foot muscles strengthening exercises on foot kinetic parameters in pronated foot subjects during forward jump landing.

Background: Pronated foot is one of the most important factors that may lead to musculoskeletal injuries of the lower extremities. Among all treatments for this disorder, intrinsic foot muscles strengthening exercises (IFMSE) have an important role in management of the individuals with pronated foot. Although the effect of the IFMSE is well accepted in this population; however, their impacts on foot kinetic are yet to be clarified. The present study aims to identify the effects of the IFMSE on foot kinetic parameters in pronated foot individuals during forward jump landing. Materials and Methods: In this quasi-experimental study, 20 asymptomatic male and female subjects (mean age of 22.65 ± 2.51 years) with pronated foot structures were selected by using a simple non-random sampling method. The ground reaction force (GRF), rate of loading (ROL), and the resultant vector of time to stabilization (RVTTS) were examined during a forward jump landing task by using a force plate before and after six weeks of the IFMSE. Result: The findings showed that the following parameters were not significantly change before and after of the IFMSE: GRF (1.97 ± 0.49 vs. 2.03 ± 0.54, P =0.667), ROL (.09 ±0.12 vs. 08 ±.12, P =.632), and RVTTS (2836.60 ± 1144.62 vs. 2644.35 ± 704.71, P =.479). Conclusion: In the pronated feet subjects, the IFMSE alone was not capable of changing the kinetic parameters of the foot, or the duration of using these exercises. In this study, six weeks may not be enough to make changes the foot kinetic parameters and therefore these exercises should be used for a longer period of time.

The effects of intrinsic foot muscles strengthening exercises on knee kinematic in pronated foot subjects during forward jump landing.

Introduction: The foot and ankle are a complex set of multiple joints with multiple degrees of freedom that play an important role in static and dynamic activities. The intrinsic and extrinsic muscles of this complex play a role in controlling the deformity of the arch; thus, the aim of this study was to investigate the effect of the intrinsic foot muscle-strengthening exercises on knee kinematic parameters in pronated foot subjects during forward jump landing. Methods: This interventional study was performed on students aged 20-30-years old with foot pronation in the School of Rehabilitation. In this study, the kinematic changes of the knee in the frontal, sagittal and transverse plane before and after 6 weeks of strengthening exercises of the intrinsic foot muscles during the forward jump-landing task were examined using a motion analyser. All data analysis was performed offline using a special software program in the MATLAB software environment. Results: Knee angle variables have a normal distribution before and after exercise. The ICC coefficient of all variables was calculated as between 0.44 and 0.71; therefore, the reproducibility of the variables under study in this study was considered moderate to good. The knee angle on the frontal plate was 2.54 ± 2.4 before the exercises and 2.49 ± 2.14 after the exercises, and there was no significant difference between them (P = 0.21). Conclusion: Plantar intrinsic foot muscle-strengthening exercises alone have no effect on the kinematic changes of the knee in people with foot pronation, or the duration of strengthening exercises should be increased during the day to see the effect of strengthening the intrinsic muscles among pronated foot subjects.

Effects of Dry Needling on Pain in Patients with Knee Osteoarthritis: A Preliminary Study.

Background: Osteoarthritis is one of the most common rheumatological diseases and is also considered as one of the causes of myofascial trigger points (MtrPs). Dry needling (DN) is one of the methods used for the treatment of the MtrPs. The aim of the current study was to investigate the effects of DN on pain in participants with knee osteoarthritis (KOA). Materials and Methods: In this before and after preliminary clinical trial study, patients with mild to moderate KOA were enrolled. In one session, after determining the location of trigger points in quadriceps and gastrocnemius muscles, the patients underwent DN. The pain was evaluated at baseline, by passing 4 days and 1 month from the intervention using the Visual Analog Scale (VAS). Results: Sixteen patients with a mean age of 56.5 (4.53) years old have completed the study and follow-up period. According to the ANOVA analysis, VAS values indicated a significant decrease in pain score at the 4th and 1 month after the intervention compared to baseline (P < 0.001). There was no significant difference between VAS at the 4th day of intervention and also 1 month later of intervention (P = 0.087). Conclusion: The application of one session DN can lead to improvement in pain intensity in participants with mild to moderate KOA.

Dual-template rectangular nanotube molecularly imprinted polypyrrole for label-free impedimetric sensing of AFP and CEA as lung cancer biomarkers.

A high-performance sensing layer based on dual-template molecularly imprinted polymer (DMIP) was fabricated and successfully applied for one-by-one detection of carcinoembryonic antigen (CEA) and alpha-fetoprotein (AFP) as lung cancer biomarkers. The plastic antibodies of AFP and CEA were created into the electropolymerized polypyrrole (PPy) on a fluorine-doped tin oxide (FTO) electrode. Raman spectroscopy, field emission scanning electron microscopy (FE-SEM), cyclic voltammetry (CV), and electrochemical impedance spectroscopy (EIS) tests were performed to pursue the formation and characterization of the sensing layer. Methyl orange (MO) increased the conductivity of PPy and induced the formation of MO doped PPy (PPy-MO) rectangular-shaped nanotubes. Using impedimetric detection, the rebinding of the template antigens was evaluated, the charge transfer resistance increased as the concentration of AFP and CEA increased. The linear dynamic ranges of 5-104 and 10-104 pg mL-1 and detection limits of 1.6 and 3.3 pg mL-1 were obtained for CEA and AFP, respectively. Given satisfactory results in the determination of AFP and CEA in the human serum samples, high sensitivity, and good stability of DMIP sensor made it a promising method for sensing of AFP and CEA in serum samples.

The role of cell surface proteins gene expression in diagnosis, prognosis, and drug resistance of colorectal cancer: In silico analysis and validation.

Cell surface proteins (CSPs) are an important type of protein in different essential cell functions. This study aimed to distinguish overexpressed CSPs in colorectal cancer to investigate their biomarker, prognosis, and drug resistance potential. Raw data of three datasets including 1187 samples was downloaded then normalization and differential expression were performed. By the combination of the cancer genome atlas (TCGA) clinical data, survival analysis was carried out. Information of all CSPs was collected from cell surface protein atlas. The role of each candidate gene expression was investigated in drug resistance by CCEL and GDSC data from PharmacoGX. CRC samples including 30 tumor samples and adjacent normal were used to confirm data by RT-qPCR. Outcomes showed that 66 CSPs overexpressed in three datasets, and 146 CSPs expression associated with poor prognosis features in TCGA data that TIMP1 and QSOX2 can associate with poor patient survival independently. High-risk patients illustrated more fatality than low-risk patients based on the risk score calculated by the expression level of these genes. Receiver operating characteristic curve analysis showed that 39 CSPs as perfect biomarkers for diagnosis in CRC. Furthermore, QSOX2 and TIMP1 expression levels increased in tumor samples compared to adjacent normal samples. The Drug resistance analysis demonstrated ADAM12 and COL1A2 up-regulation among 66 overexpressed CSPs caused resistance to Venetoclax and Cyclophosphamide with a high estimate, respectively. Many CSPs are deregulated in CRC, and can be valuable candidates as biomarkers for diagnosis, prognosis, and drug resistance.

The Effectiveness of Sternocleidomastoid Muscle Dry Needling in Patients with Cervicogenic Headache.

BACKGROUND: Cervicogenic headache (CGH) is a secondary headache with a cervical source that radiates pain to the head or face. Accordingly, one reason of CGH is myofascial trigger points. The purpose of this study was to investigate the effect of one session dry needling (DN) of myofascial trigger points of the sternocleidomastoid (SCM) muscle in patients with CGH. MATERIALS AND METHODS: In this before-and-after clinical trial, 16 females aged 18-60 years with a clinical diagnosis of CGH were enrolled. All of the patients received one session DN into the myofascial trigger points of the SCM muscle. Headache index (HI), headache duration, headache frequency, and headache disability index (HDI) were assessed at 2 weeks before and 2 weeks after the intervention. This study was registered in Clinical Trials as IRCT20181109041599N1. RESULTS: One session DN into myofascial trigger points of the SCM muscle showed a significant improvement in HI (P < 0.001). Duration and frequency of headache as well as HDI significantly reduced after intervention (P < 0.001). CONCLUSION: One session DN into myofascial trigger points of the SCM muscle was effective on improvement of HI, headache duration, headache frequency, and HDI in patients with CGH.

Vertically grown nanosheets conductive polypyrrole as a sorbent for nanomolar detection of salicylic acid.

A selective detection strategy for salicylic acid (SA) based on the electrosorption/electrodesorption process using an electrochemically controlled solid phase extraction (EC-SPME) configuration is presented. We used conducting polymer polypyrrole (PPy) bearing the anionic dopant nitrate (PPy/nitrate) as a sorbent element for the extraction of SA in plasma and urine samples. The vertically grown nanosheets conducting film was directly synthesized by cyclic voltammetry method on a rod-shaped stainless steel electrode. The prepared electrode was employed for selective electrosorption of SA from sample solutions by applying positive potential and following its successive electrodesorption by the use of negative potential. Several parameters like synthesis conditions, anion dopant effect, potential and time of electrosorption/electrodesorption, and exchange anion type were explored to achieve the optimal conditions. The morphology of nanostructure PPy/nitrate sorbent was characterized by scanning electron microscopy (SEM). The electrosorption of SA was demonstrated by using FT-IR and fluorescence microscopic imaging. The obtained linear dynamic range (LDR), the limit of detection (LOD), and RSD% of SA determination by fluorescence spectrometry were 5-100 nanomol L-1, 1.4 nanomol L-1 and 4.9 (n = 5), respectively. The suggested technique was successfully applied for the quantification and determination of trace amounts of SA in biomedical samples without any additional treatment.

Utilizing 808 nm laser for sensitizing of melanoma tumors to megavoltage radiation therapy.

Melanotic melanoma has high content of melanin and laser can destroy melanin-containing cells through thermal effect. In this study, the therapeutic effect of 808 nm laser therapy was investigated on B16-F10 melanoma tumor growth and tumor-bearing mice survival time. In addition, as laser can destroy melanin as the main cause of melanoma radioresistance, the effect of laser administration to enhance radiation therapy efficacy at B16-F10 cancer cells was evaluated in vitro and in vivo. Laser therapy (1 W/cm2 × 4 min) could cause significant (P < 0.05) inhibition of melanoma tumors' growth (~ 61%) and about three times increase of the tumor-bearing mice survival time in comparison with no-treatment group. In addition, the mice which were treated with 1 W/cm2 × 4 min laser administration plus 6 Gy megavoltage radiation therapy exhibited ~ 68% lesser tumors' volume and 27 days increase of survival time in comparison with 6 Gy irradiated tumor-bearing mice. Also, significantly higher (P < 0.05) tumor necrosis percentage was observed at the histopathological slides of 1 W/cm2 × 4 min laser + RT treated mice tumors (57 ± 12%) in comparison with radiation therapy group (31 ± 10%). Therefore, not only laser therapy can inhibit melanoma tumors' growth per se but also its combination with radiation therapy can cause a significant enhancement of radiation therapy efficacy. The laser administration can be used as a radiosensitizing method for melanotic melanoma radiation therapy.

The effects of passive stretching on the blood glucose levels of patients with type 2 diabetes.

BACKGROUND: Type 2 diabetes is characterized by poor glycemic control due to decreased insulin sensitivity. Physical activity plays an important role in the management of diabetes and reduces blood glucose level. The aim of this study was to evaluate the effectiveness of passive stretching (PS) on the blood glucose level (BGL) of diabetic patients. MATERIALS AND METHODS: In this randomized clinical trial, fifty patients with type 2 diabetes and mean age of 50.7 ±â€¯4.8 years were randomly and equally allocated into control and intervention groups. Patients in the intervention and control groups underwent 20 min of passive stretching (PS) and passive movement (PM), respectively. BGL was measured before and immediately after, 20 min after and 1 h after PS/PM in the two study groups. BGL at the mentioned times was compared between and within the groups. RESULTS: The findings showed that when compared with before the PS (195.7 ±â€¯30.1), BGL significantly reduced (p < 0.001) immediately after (178.9 ±â€¯29.7), 20 min after (183.2 ±â€¯29.1), and 1 h after (187.8 ±â€¯29.6) the PS. However, BGL after PM (immediately, 20 min and 1 h after PM) did not significantly change (p > 0.05). CONCLUSION: The findings of this study indicated that PS has a significant effect on the reduction of the immediate BGL in type 2 diabetic patients. The trend reduced even though the effect remained for 1 h after PS. It is therefore suggested that the effectiveness of these types of activities should be evaluated over a longer duration of study.

The relationship between cross-sectional area of multifidus muscle and disability index in patients with chronic non-specific low back pain.

BACKGROUND: Nonspecific low back pain (NSLBP) is a common problem that may have an effect on the level of functional ability. Imaging techniques indicated the degeneration of multifidus muscles in patients with low back pain. But its relationship with disability in NSLBP is unclear. OBJECTIVE: To assess the relationship between changes in multifidus muscle morphology in MRI as paraclinical data with changes in the level of disability as clinical data in patients with CNLBP, whose MRI studies are normal. Moreover, the relationship between multifidus CSA and its thickness was determined. DESIGN: Cross-sectional study. METHODS: A total of 45 subjects with CNLBP participated in this study. Multifidus muscle thickness and cross-sectional area (CSA) for both sides in L4-L5 and L5-S1 levels were measured with MRI and Image J software. Level of disability was assessed with Roland-Morris disability index. RESULTS: There was no significant relationship between multifidus muscle's CSA or thickness variations among the L4-L5 and L5-S1 levels and disability index score. Furthermore, Pearson's test showed significant positive relationship between thickness and CSA of muscles (p˂0.05). CONCLUSION: The relationship between lumbar multifidus Thickness and disability in CNLBP with normal MRI study, is not proven in this study. Multifidus muscle thickness in L4-L5 or L5-S1 level can be representative of its CSA in patients with CNLBP and normal MRI.

The concentration data of heavy metals in vegetables of Guilan province, Iran.

Food safety is a major problem currently facing the world and food consumption has been identified as the major pathway for human exposure to hazardous pollutants such as heavy metals. These datasets include the concentration of heavy metals like Cd, Pb, Cu, Ba, Co and Sn in selected vegetables in Guilan province and estimate daily intake of metals. The results of this dataset showed that the average concentration of heavy metals including Cd, Pb, Cu, Ba, Co and Sn in total vegetables were 0.55, 1.098, 4.095, 5.98, 0.69, and 0.2 mg/kg, respectively. The mint showed higher levels of Pb, Cu and Co contamination compared to other vegetables. The estimated daily intakes of Cd, Pb, Cu, Ba, Co and Sn for children were 0.311, 0.622, 2.320, 3.388, 0.391, 0.119 µg/day, whereas for adults were 0.182, 0.363, 1.357, 1.98, 0.228, 0.069 mg/kg, respectively. The present data highlights that both adults and children consuming vegetables ingest significant amount of these metals.

A comparison of foot kinetic parameters between pronated and normal foot structures during forward jump landing.

BACKGROUND: Pronated foot is one of the most important factors that may lead to musculoskeletal injuries of the lower extremities. It is known that in a pronated foot, excessive mechanical loads are applied to the lower limb structures, which result in the altered foot biomechanics, including vertical ground reaction forces (VGRFs) and rate of loading (ROL). Therefore, the aim of this study was to determine the changes in foot kinetic parameters in the pronated compared to the normal foot structures. METHODS: In this cross-sectional study, 15 individuals (mean age of 23.27 ± 3.28 years) with asymptomatic pronated feet and 15 normal subjects (mean age of 23.40 ± 3.11 years) were recruited from both genders by using a simple non-random sampling method. VGRF, ROL, and the resultant vector of time to stabilization (RVTTS) were evaluated during the forward jump landing task by using a force plate. RESULTS: The findings showed that the following parameters were significantly higher in the group of pronated feet than in the normal subjects: VGRF (3.30 ± 0.17 vs. 2.81 ± 0.15, p = .042), ROL (0.10 ± 0.01 vs. 0.07 ± 0.006, p = .020), and RVTTS (2592.80 ± 141.24 vs. 2114.00 ± 154.77, p = .030). CONCLUSION: All the measured foot kinetic parameters were higher in the pronated foot subjects than in the normal participants. An impaired movement control and greater forces imposed on the foot region of the pronated foot, compared to the normal foot individuals, were discovered indicating the former group's possible increase of susceptibility to various musculoskeletal injuries.

A comparison of lower limb muscle activation pattern using voluntary response index between pronated and normal foot structures during forward jump landing.

BACKGROUND: Pronated of the foot is one of the important factors contributing to musculoskeletal problems affecting the lower extremities. It is known that in a pronated foot, excessive mechanical load is applied to the lower limb structures which may result in altered biomechanics and muscle activation patterns. The aim of this study was to determine changes in the muscle activation pattern of the lower extremities in individuals with pronated, compared to normal, feet, using the voluntary response index (VRI). METHODS: In this cross sectional study, 15 asymptomatic pronated foot individuals (mean age 23.27 ± 3.28 years) and 15 normal subjects (mean age 23.40 ± 3.11 years) were recruited by simple non-random sampling. Electrical activities of gluteus medius (GM), vastus lateralis (VL), vastus medialis (VM), biceps femoris, semitendinosus (ST), and medial gastrocnemius (MG) muscles were recorded during a forward jump landing task. Voluntary response index (VRI) variables, included similarity index (SI) and magnitude (Mag) were also evaluated. RESULTS: Muscle activity of VM (p < 0.001) and ST (p = 0.010) were significantly higher but VL (p = 0.039) and MG (p = 0.001) were significantly lower in pronated foot, compared to normal subjects. Similarity index was found to be different (p < 0.001) between pronated foot and healthy individuals. No significant difference was found in terms of Mag between the two groups (p = 0.576). CONCLUSION: The altered pattern of lower limb muscle activation identified in the pronated foot during landing may be attributed to the different activation involving VL, VM, MG and ST muscles. Adaptations to the biomechanical effects, due to the pronated foot causing altered activation of VL, VM, MG, and ST muscles, results in an altered pattern of muscle activation. This change in activation pattern may harm the effectiveness of movement control processes; and might also predispose individuals with pronated feet, to injuries. It seems that an altered motor strategy with the aim of minimizing biomechanical changes, predisposes individuals to injuries. However, further large scale studies are needed to support the findings of the present study.

Quantification of dry needling on myofascial trigger points using a novel ultrasound method: A study protocol.

INTRODUCTION: Myofascial pain syndrome (MPS) is a neuromuscular dysfunction consisting of both motor and sensory abnormalities. Considering the high prevalence of MPS and its related disabilities and costs, this study was designed to determine the reliability of new ultrasonographic indexes of the upper trapezius muscle as well as the sensitivity and specificity of 2D ultrasound imaging for diagnostic purposes. Furthermore, we sought to evaluate the effectiveness of dry needling (DN) on studied ultrasonographic indexes. MATERIALS AND METHODS: This study will be performed in two steps with two different designs. The first is a pilot study and was designed as a semi-experimental study to determine the sensitivity and specificity of ultrasonography for the diagnosis of MPS and the reliability of ultrasonographic measurements like muscle thickness, area of myofascial trigger points (MTrPs) in longitudinal view, echogenicity of MTrPs in longitudinal view, echogenicity of muscle with MTrPs in longitudinal and transverse views, and pennation angle of upper trapezius muscle. The second study is an interventional study which was designed to investigate the effectiveness of DN on ultrasonographic measurements, for which the reliability was determined in the first study. CONCLUSION: we will quantify the effectiveness of DN on MTrPs and muscle tissue by using novel ultrasonographic indexes. The results of the current study will provide baseline information to design more interventional studies to improve the evaluation of other treatments of MPS.

Ultrasonography in Diagnosis of Myofascial Pain Syndrome and Reliability of Novel Ultrasonic Indexes of Upper Trapezius Muscle.

BACKGROUND: Myofascial pain syndrome (MPS) is a common non-articular musculoskeletal disorder. It is characterized by local and referred pain due to the presence of myofascial trigger points (MTrPs). MTrPs most commonly involve the upper trapezius muscle and can be visualized using ultrasound imaging. This study was designed to determine the inter-rater reliability of some new ultrasonographic indices of the upper trapezius muscle and the sensitivity and specificity of 2D ultrasound imaging in the diagnosis of MPS. MATERIALS AND METHODS: This semi-experimental study enrolled 15 participants of both genders (mean age: 40.60 ± 5.74 years) with suspected symptoms of MPS. In the first step of the study, the sensitivity and specificity of ultrasonography for diagnosis of MPS was determined in a double blind manner. In the second step, some ultrasonographic measurements, such as muscle thickness, area of MTrPs in longitudinal view, echogenicity of MTrPs in longitudinal view, echogenicity of muscle with MTrPs in longitudinal and transverse views, and the pennation angle of the upper trapezius muscle were measured twice and their reliability was determined using the value of the mean of the two measurements. RESULTS: The sensitivity and specificity of ultrasonographic diagnosis were 91% and 75%, respectively. The inter-rater reliability of upper trapezius muscle thickness, pennation angle, area of MTrPs, echogenicity of active MTrPs in longitudinal view, echogenicity of muscle with MTrPs in transverse view and echogenicity of muscle with MTrPs in longitudinal view were 0.91, 0.96, 0.93, 0.83, 0.93, and 0.91, respectively. CONCLUSIONS: 1. Our findings indicated that ultrasonography is a useful method for the diagnosis of MPS owing to its high sensitivity. 2. Appropriate reliability of the quantitative ultrasonographic indices of interest, especially the area of MTrPs and their echogenicity, could be useful for long-term monitoring and designing interventional studies for better management of the syndrome.