Oswestry Disability Index, Roland-Morris Disability Questionnaire, and Quebec Back Pain Disability Scale: Responsiveness and Minimal Clinically Important Changes in Iranian People with Lumbar Disc Herniation Following Physiotherapy.

Objectives: The present study aimed to investigate the responsiveness of the Persian version of the Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), and Quebec Back Pain Disability Scale (QBPDS) and detect minimal clinically important changes (MCICs) of these questionnaires in people with lumbar disc herniation. Methods: Ninety-two patients with lumbar herniated disc completed the Persianversion of the ODI, RMDQ, and QBPDS before and after the physiotherapy intervention. Additionally, they completed a global rating of change scale after the final physiotherapy session to give an account of non-improved and improved outcomes. The responsiveness of these three disability questionnaires was represented by Receiver Operating Characteristic (ROC) and correlation analyses. The MCIC was defined as the best cut-off when sensitivity and specificity were optimally balanced. Results: Area under the ROC curves are in the acceptable range for ODI and QBPDS (0.78 and 0.70, respectively). Moreover, ODI, RMDQ, and QBPDS have significant positive fair to moderate correlation with the external anchor (P<0.001). The MCIC values for ODI, RMDQ, and QBPDS were 13, 5.5, and 14.5 points, respectively. Conclusion: Our results revealed that the ODI and QBPDS questionnaires have adequate responsiveness to detect improvements in the functional status of lumbar herniated disc patients following a physiotherapy treatment. Therefore, the ODI and QBPDS seem to be superior to the RMDQ for use in randomized clinical trials and clinical settings in patients with herniated lumbar discs. The MCIC scores of 13 and 14.5 obtained for the ODI and QBPDS can help to identify important changes in the clinical status of an individual patient and treatment efficacy.

Measuring the force perception in knee flexor/ extensor muscles in patients with anterior cruciate ligament injury and healthy subjects.

BACKGROUND: Force perception as a contributor to the neuromuscular control of the knee joint may be altered after anterior cruciate ligament (ACL) injury. OBJECTIVE: This study aimed to compare the force perception accuracy in the knee joints of patients with ACL injury and healthy subjects. METHODS: Twenty-six patients with ACL injury and 26 healthy subjects participated in this case-control study. Participants were asked to produce 50% of the maximum voluntary isometric contraction of the knee muscles as a target force and reproduce it in their limbs in flexion and extension directions. RESULTS: There were significant interactions between group and condition as well as group, condition, and limb in the force perception error respectively (P< 0.05). The highest amount of error was seen in the contralateral limb of the ACL injury group when the reference force was produced in the injured limb (P< 0.05). CONCLUSION: The findings revealed that the force perception accuracy in the knee flexor/extensor muscles of individuals with ACL injury is impaired. Moreover, error is most evident when the patient produces force in the injured limb and replicates it in the uninjured limb in both flexion and extension directions. Therefore, the rehabilitation programs should encompass neuromuscular training in both quadriceps and hamstrings after ACL injury.

Reliability of assessment of upper trapezius morphology, its mechanical properties and blood flow in female patients with myofascial pain syndrome using ultrasonography.

OBJECTIVE: In the present study, the intra-rater reliability of upper trapezius morphology, its mechanical properties and intramuscular blood circulation in females with myofascial pain syndrome were assessed using ultrasonography. DESIGN: A total of 37 patients (31.05 ± 10 years old) participated in this study. Ultrasonography producer was set up in three stages: a) Gray-scale: to measure muscle thickness, size and area of trigger points; b) Ultrasound elastography: to measure muscle stiffness; and c) Doppler imaging: to assess blood flow indices. RESULTS: According to data analysis, all variables, except End Diastolic Velocity (EDV), had excellent reliability (>0.806). Intra-class Correlation Coefficient (ICC) for EDV was 0.738, which was considered a poor to good reliability. CONCLUSION: The results of this study introduced a reliable method for developing details of upper trapezius features using muscular ultrasonography in female patients. These variables could be used for objective examination and provide guidelines for treatment plans in clinical settings.

Ultrasonography for the assessment of the upper trapezius properties in healthy females: a reliability study.

BACKGROUND: to date, an assessment of morphometric features, muscle stiffness and blood flow in the upper trapezius among healthy females at rest and contraction states has not been conducted. So, in the current research, the intra-rater reliability of ultrasonographic features of upper trapezius in healthy females was examined. METHOD: in this study stiffness and thickness of the upper trapezius in rest and contraction states were measured by ultrasonography on 12 healthy female subjects (28.33±5.05 years old). Color Doppler imaging was used to assess muscle circulation in the rest state only. Every step and calculation of measurements was repeated 3 times with the same rater. Therefore, in total 36 measurements were done for each variable. RESULTS: according to the analysis, the value of intra class correlation coefficient (ICC) for total variables showed an excellent level of reliability. Thickness at contraction had maximum reliability (ICC= 0.993) and Minimum Diastolic Velocity had the lowest reliability (ICC=0.771). CONCLUSIONS: the results of current research demonstrated that real time ultrasonography is a reliable method for measurement of various parameters of upper trapezius, including morphometric features, its stiffness and blood supply in non-symptomatic females. These mentioned variables can likely be used for objective assessment and provide numerical reference value for clinical plans.