Comparisons of lumbosacral kinematics among non-specific chronic low back pain subgroups and healthy during prolonged sitting: A cross-sectional observational study.

BACKGROUND: The literature has suggested a variety of postural changes of the spine that possibly contribute to the increase in back pain during sitting in persons with non-specific chronic low back pain (NS-CLBP). However, the heterogeneity of NS-CLBP persons has made the ability to attribute pain increase to a particular sitting posture very difficult. Therefore, the purpose of this study was to compare lumbosacral kinematics and their roles in pain increase among homogenous NS-CLBP subgroups and healthy controls over a 1-h sitting period. METHODS: Twenty NS-CLBP subjects with motor control impairment [10 classified as having flexion pattern (FP) disorder, and 10 with active extension pattern (AEP) disorder], and 10 healthy controls participated in the study. Subjects underwent a 1-h sitting protocol on a standard office chair. Lumbosacral postures including sacral tilt, third lumbar vertebrae (L3) position, and relative lower lumbar angle were recorded using two-dimensional inclinometers over the 1-h period. Perceived back-pain intensity was measured using a visual analog scale every 10 min throughout the sitting period. RESULTS: All study groups (FP, AEP and healthy controls) significantly differed from each other in the measured lumbosacral kinematics at the beginning as well as at the end of the sitting period (p ≤ 0.05). Only the NS-CLBP subgroups showed significant changes in the lumbosacral kinematics across the 1-h sitting period (p < 0.01), and that the directions of change occurred toward end spinal postures (lumbar kyphosis for FP subgroup and lumbar lordosis for the AEP subgroup). In addition, both NS-CLBP subgroups reported a similarly significant increase in pain through mid-sitting (p < 0.001). However, after mid-sitting, the AEP subgroup reported much less increase in pain level that was accompanied by a significant decrease in the lumbar lordotic postures (p = 0.001) compared to FP subgroup. CONCLUSION: The present study's findings suggest that each NS-CLBP subgroup presented with differently inherent sitting postures. These inherently dysfunctional postures coupled with the directional changes in the lumbosacral kinematics toward the extreme ranges across the 1-h sitting period, might explain the significant increase in pain among subgroups.

Correlation between anxiety and chronic motion sensitivity.

BACKGROUND: Chronic motion sensitivity (CMS) is a combination of autonomic symptoms provoked by exposure to motion. The correlation between anxiety and CMS is not yet well understood. OBJECTIVES: 1) To compare median anxiety levels between young adults with and without CMS. 2) To examine the effect of anxiety on postural stability with immersion virtual reality. 3) To compare anxiety levels between sexes. METHODS: Participants included 60 adults (20-40 years), with and without CMS. After determining their current and general anxiety levels, postural stability was measured. RESULTS: There were significant differences in median (minimum, maximum) state- and trait-anxiety scores between participants with and without CMS, but no significant differences in median state- and trait-anxiety scores between males and females with CMS. There was a significant inverse relationship between state- and trait-anxiety scores and postural stability (ρ= -0.28, p = 0.03, and ρ= -0.32, p = 0.01, respectively). The stepwise regression analysis showed the Motion Sickness Susceptibility Questionnaire-Short Form score to be the only variable contributing significantly to postural stability (R2 = 26.2%; t = -4.5, p < 0.001). CONCLUSIONS: Young adults with CMS are more anxious, although anxiety does not contribute to postural stability in this group. Anxiety levels do not appear to differ between young adult males and females with CMS.

Chronic Effects of Pediatric Ear Infections on Postural Stability.

BACKGROUND: Ear infections in children often cause abnormal postural stability. However, the long-term effects of recurrent ear infections on postural stability have not been investigated. PURPOSE: The purpose of this study was to examine the long-term effects of multiple ear infections on pediatric postural stability. METHODS: Forty children aged 10-12 years were divided into two groups (18 participants with a history of tympanostomy tubes and/or 3 or more ear infections prior to age five and 22 participants without a history of tympanostomy tubes and/or 0-2 ear infections prior to age five). Computerized Stability Evaluation Test (SET) and noncomputerized postural stability were measured for all participants. RESULTS: A significant difference was found in median postural stability scores in the SET during a tandem stance on an unstable surface between the two groups (median (minimum, maximum) of 9.1 (1.4, 11.4) versus 5.8 (1.7, 12.8), p = 0.04). In addition, there was a significant difference in median Pediatric Balance Scale scores between participants with versus without ear infection (54 (47, 56) versus 56 (55, 56), p = 0.001). CONCLUSIONS: Results suggest that children ages 10-12 with a history of tympanostomy tubes and/or 3 or more ear infections prior to age five have decreased postural stability.

Effects of adjustments to wheelchair seat to back support angle on head, neck, and shoulder postures in subjects with cerebral palsy.

A wheelchair is usually a source of mobility for people with moderate to severe cerebral palsy, who are unable to walk. They spend long periods of time sitting in their wheelchair, which can affect their head and neck alignment. Opening the seat to back support angle of the wheelchair can modify realignment of body segments and improve posture. Aims: To examine the effect of seat to back support angle adjustments on head, neck, and shoulder postural alignment in people with cerebral palsy. Methods: Nine participants with cerebral palsy who use a wheelchair for mobility sat in a research wheelchair. Sagittal head angle (SHA), cervical angle (CVA), and shoulder angle (SA) from photographs were examined using the Coach's Eye device during three different seat to back support angles of the wheelchair (90°, 100°, 110°). Results: There were significant differences in mean SHA and CVA among the different seat to back support angles (p < .001). However, there was no significant difference in mean SA. Conclusion: Head (SHA) and (CVA) alignment was closest to neutral posture with seat to back support angles set at 110°. Thus, adjusting the wheelchair back support to a 110º would provide the most appropriate sagittal head and cervical angle for this population.

Effects of head motion on postural stability in healthy young adults with chronic motion sensitivity.

BACKGROUND: Motion sensitivity, or motion sickness, is common in modern vehicular and visually stimulating environments. Several studies have shown a relationship between motion sensitivity and decreased postural stability. We aimed to evaluate the effects of head motion (horizontal and vertical) on postural stability in healthy adults with and without chronic motion sensitivity (CMS). METHODS: Sixty healthy adult men and women (age, 20-40 years) with CMS (CMS group, n = 30) and without CMS (non-CMS group, n = 30) participated in the study. Postural stability was assessed during three conditions (static, horizontal head motion, and vertical head motion) using computerized dynamic posturography. Group and condition-related differences in equilibrium scores were evaluated. RESULTS: There was no significant group x condition interaction (F2,114 = 0.9, partial ƞ2 = 0.04, p = 0.35). However, significant condition-related differences in equilibrium scores were observed (F2,114 = 26.4, partial ƞ2 = 0.31, p < 0.001). Equilibrium scores were significantly worse in the horizontal and vertical head motion conditions compared to those in the static condition (p < 0.001), but were comparable in vertical and horizontal head motion conditions (p = 0.27). CONCLUSIONS: Postural stability was lower in the horizontal and vertical conditions compared to the static condition. However, horizontal and vertical head motions had comparable effects on postural stability in both CMS and non-CMS groups, contrary to our expectations.

The Effect of Monophasic Pulsed Current with Stretching Exercise on the Heel Pain and Plantar Fascia Thickness in Plantar Fasciitis: A Randomized Controlled Trial.

Plantar fasciitis (PF) is one of the most common causes of heel and foot pain. Monophasic pulsed current (MPC) is an electrical stimulation used to accelerate the healing processes. The purpose of this study was to determine the effect of MPC and MPC combined with plantar fascia stretching exercises (SE) on heel pain and plantar fascia thickness in treatment of PF and see if there is any relationship between heel pain and plantar fascia thickness after intervention. Forty-four participants diagnosed with PF were randomly assigned to two group; MPC group or MPC combined with plantar fascia SE. Plantar fascia thickness was measured with musculoskeletal ultrasound. Although no statistical differences between the two groups were found, heel pain and the plantar fascia thickness significantly decreased in both groups after the intervention (p < 0.001). No significant correlation was found between changes in heel pain and plantar fascia thickness after 4 weeks of treatment. Our results indicated that MPC can reduce heel pain and plantar fascia thickness caused by PF. However, MPC combined with plantar fascia SE is not superior to MCP only in terms of reduction in heel pain and plantar fascia thickening.

Non-specific chronic low back pain and physical activity: A comparison of postural control and hip muscle isometric strength: A cross-sectional study.

Most research on sedentary lifestyle has focused on pain and disability, while neuromuscular outcomes (postural control and strength) have received less attention. The objective of the study was to determine whether low level of physical activity is negatively associated with measures of lower body muscular strength and postural control in individuals with and without non-specific chronic low back pain (NSCLBP).Twenty-four subjects with NSCLBP (28.8 ±â€Š5.9 years) and 24 age, gender, and body mass index matched healthy controls participated in the study. Subjects were sub-classified into 4 subgroups based on their physical activity level: Non-active NSCLBP; Active NSCLBP; Non-active healthy control; and Active healthy control. Each subgroup consisted of 12 subjects. Peak force of hip muscles strength was assessed using a handheld dynamometer. Postural control was assessed using computerized posturography and the Y Balance Test.There was no significant group by physical activity interaction for strength and static and dynamic postural control, except for static control during left single leg stance with eyes closed (P = .029). However, there was a significant difference in strength and postural control by physical activity (P < .05). Postural control and peak force of hip muscles strength were significantly associated with physical activity (r ranged from 0.50 to 0.66, P < .001 and r ranged from 0.40 to 0.59, P < .05, respectively).Postural control and hip strength were independently related to physical activity behavior. A sedentary behavior may be an important risk factor for impaired postural control and hip muscles strength, and that physical fitness is vital to neuromuscular outcomes.

Comparison of Protonics™ Knee Brace With Sport Cord on Knee Pain and Function in Patients With Patellofemoral Pain Syndrome: A Randomized Controlled Trial.

CONTEXT: Protonics™ knee brace has been suggested as an intervention for patients with patellofemoral pain syndrome. However, the effectiveness of this knee brace compared with traditional conservative methods knee rehabilitation is lacking. OBJECTIVE: To compare the effect of Protonics™ knee brace versus sport cord on knee pain and function in patients with patellofemoral pain syndrome. DESIGN: Randomized controlled trial. SETTING: Loma Linda University. PARTICIPANTS: There were 41 subjects with patellofemoral pain with a mean age of 28.8 (5.0) years and body mass index of 25.6 (4.7) kg/m2 participated in the study. INTERVENTION: Subjects were randomized to 1 of 2 treatment groups, the Protonics™ knee brace (n = 21) or the sport cord (n = 20) to complete a series of resistance exercises over the course of 4 weeks. MAIN OUTCOME MEASURES: Both groups were evaluated according to the following clinical outcomes: anterior pelvic tilt, hip internal/external rotation, and iliotibial band flexibility. The following functional outcomes were also assessed: Global Rating of Change Scale, the Kujala score, the Numeric Pain Rating Scale, and the lateral step-down test. RESULTS: Both groups showed significant improvement in the outcome measures. However, the Protonics™ knee brace was more effective than the sport cord for the Global Rating of Change Scale over time (immediate 1.0 [2.1] vs post 2 wk 3.0 [2.2] vs 4 wk 4.6 [2.3] in the Protonics™ brace compared with 0.0 [2.1] vs 1.3 [2.2] vs 3.0 [2.3] in the sport cord, P < .01), suggesting greater satisfaction. CONCLUSIONS: Both study groups had significant improvements in the clinical and functional symptoms of patellofemoral pain. The Protonics™ knee brace group was significantly more satisfied with their outcome. However, the sport cord may be a more feasible and cost-effective method that yields similar results in patients with patellofemoral pain syndrome.

Augmented reality glasses improve adherence to evidence-based intubation practice.

Background: The risk of failing or delaying endotracheal intubation in critically ill patients has commonly been associated with inadequate procedure preparation. Clinicians and trainees in simulation courses for tracheal intubation are encouraged to recall the steps of how to intubate in order to mitigate the risk of a failed intubation. The purpose of this study was to assess the effectiveness of using optical head mounted display augmented reality (AR) glasses as an assistance tool to perform intubation simulation procedure. Methods: A total of 32 subjects with a mean age of 30±7.8, AR (n1=15) vs non-augmented reality(non-AR) (n2=17). The majority were males (n=22, 68.7%). Subjects were randomly assigned into two groups: the AR group and the non-AR group. Both groups reviewed a video on how to intubate following the New England Journal of Medicine (NEJM) intubation guidelines. The AR group had to intubate using the AR glasses head mount display compared to the non-AR where they performed regular intubation. Results: The AR group took longer median (min, max) time (seconds) to ventilate than the non-AR group (280 (130,740) vs 205 (100,390); η 2 =1.0, p=0.005, respectively). Similarly, there was a higher percent adherence of NEJM intubation checklist (100% in the AR group vs 82.4% in the non-AR group; η2=1.8, p<0.001). Conclusion: The AR glasses showed promise in assisting different health care professionals on endotracheal intubation simulation. Participants in the AR group took a longer time to ventilate but scored 100% in the developed checklist that followed the NEJM protocol. This finding shows that the AR technology can be used in a simulation setting and requires further study before clinical use.

Effect of Gender, Toe Extension Position, and Plantar Fasciitis on Plantar Fascia Thickness.

BACKGROUND:: Ultrasound is a widely used diagnostic tool for patients with plantar fasciitis. However, the lack of standardization during the measurement for plantar fascia thickness has made it challenging to understand the etiology of plantar fasciitis, as well as identify risk factors, such as gender. The purpose of this study was to investigate gender differences regarding plantar fascia thickness while controlling for metatarsophalangeal (MTP) joint position in the healthy and those with unilateral plantar fasciitis. METHODS:: Forty participants (20 with unilateral plantar fasciitis and 20 controls) with plantar fascia thickness (mean age, 44.8 ± 12.2 years) participated in this study. The majority were females (n = 26, 65%). Plantar fascia thickness was measured via ultrasound 3 times at 3 different MTP joint positions: (1) at rest, (2) at 30 degrees of extension, and (3) at maximal extension. RESULTS:: When comparing gender differences, the males in the plantar fasciitis group had a significantly thicker plantar fascia than the females ( P = .048, η2 = 2.35). However, no significant differences were observed between healthy males and females. The males with unilateral plantar fasciitis also had significantly thicker asymptomatic plantar fasciae collectively compared with controls ( P < .05), whereas females with unilateral plantar fasciitis had a similar but not significant change. CONCLUSION:: It appears that healthy males and females have similar plantar fascia thickness. However, as plantar fasciitis develops, males tend to develop thicker plantar fasciae than their female counterparts, which could have future treatment implications. LEVEL OF EVIDENCE:: Level III, case-control comparative study.

Metatarsophalangeal joint extension changes ultrasound measurements for plantar fascia thickness.

BACKGROUND: Ultrasound is an inexpensive method for quantifying plantar fascia thickness, especially in those with plantar fasciitis. Ultrasound has also been used to assess the effectiveness of various treatments for plantar fasciitis by comparing plantar fascia thickness before and after an intervention period. While a plantar fascia thickness over 4 mm via ultrasound has been proposed to be consistent with plantar fasciitis, some researchers believe the 4 mm plantar fascia thickness level to be a dubious guideline for diagnosing plantar fasciitis due to the lack of standardization of the measurement process for plantar fascia thickness. In particular, no universal guidelines exist on the positioning of the metatarsophalangeal (MTP) joints during the procedure and the literature also has inconsistent protocols. The purpose of this study is to investigate and compare the influence of MTP joint extension on plantar fascia thickness in healthy participants and those with unilateral plantar fasciitis. METHODS: The plantar fascia thickness of forty participants (20 with unilateral plantar fasciitis and 20 control) was measured via ultrasound three times at three different MTP joint positions: 1) at rest, 2) 30° of extension from the plantar surface, and 3) maximal extension possible. RESULTS: The plantar fascia became significantly thinner as MTP joint extension increased in both the plantar fasciitis group (p < 0.001) and the control group (p < 0.001). In the plantar fasciitis group, the involved plantar fascia was 1.2 to 1.3 mm thicker (p < 0.001) than the uninvolved side depending on the MTP joint position. In the control group, the difference in plantar fascia thickness between the two sides was less than 0.1 mm (p < 0.92) at any MTP joint position. CONCLUSIONS: MTP joint position can influence the ultrasound measurement of plantar fascia thickness. It is recommended that plantar fascia thickness measurements be performed with the toes at rest. If MTP joints must be extended, then the toes should be extended maximally and then noted to ensure subsequent ultrasound procedures are repeated. Standardizing the position of the MTP joints is not only important for attaining the most accurate thickness measurement of the plantar fascia, but is also important to researchers who use plantar fascia thickness to determine the effectiveness of various plantar fasciitis interventions.

Antioxidants and Autism: Teachers' Perceptions of Behavioral Changes.

BACKGROUND: Children with Autism Spectrum Disorder (ASD) demonstrate a physiological imbalance between free radicals, resultant from oxidative stress, and antioxidants. Oxidative stress is linked to the pathogenesis of this neurocognitive disorder. The aim of this pilot feasibility study was to examine the effect of consumption of high concentration antioxidant cacao on behavior of children with ASD. METHODS: This was a 4-week pre-test post-test experimental pilot study of high antioxidant cacao and children with ASD. Participants consumed 8 squares (or 16 grams) per day of the dark chocolate which had a concentration of 70% cacao and 30% organic cane sugar (total antioxidant concentration was 8,320). The two main behavioral measures were the Aberrant Behavior Checklist- 2nd Edition and the Autism Spectrum Rating Scale which were completed by the child's teacher at baseline and end of week four. RESULTS: Sixteen participants were recruited for this study. Follow up data was available on 12 participants (9 males, 3 females, mean age of 10.9 ±3.9 years). Significant improvements on the Autism Spectrum Rating Scale were noted in Social/Communication (P = .03, η2=0.79), Unusual Behaviors (P = .02, η2=0.70), and Self-Regulation (P = .04, η2=0.59). No significant changes were noted on any of the Aberrant Behavior Checklist-2 subscales (P >.05). CONCLUSION: Results from this study support the potential therapeutic benefit of antioxidants in improving social communication, unusual behaviors, and self-regulation behaviors of children with ASD. Further robust randomized controlled trials are now necessary to elaborate the validity of these findings.

The use of augmented reality glasses in central line simulation: "see one, simulate many, do one competently, and teach everyone".

OBJECTIVE: The aim of this study was to investigate the feasibility of using augmented reality (AR) glasses in central line simulation by novice operators and compare its efficacy to standard central line simulation/teaching. DESIGN: This was a prospective randomized controlled study enrolling 32 novice operators. Subjects were randomized on a 1:1 basis to either simulation using the augmented virtual reality glasses or simulation using conventional instruction. SETTING: The study was conducted in tertiary-care urban teaching hospital. SUBJECTS: A total of 32 adult novice central line operators with no visual or auditory impairments were enrolled. Medical doctors, respiratory therapists, and sleep technicians were recruited from the medical field. MEASUREMENTS AND MAIN RESULTS: The mean time for AR placement in the AR group was 71±43 s, and the time to internal jugular (IJ) cannulation was 316±112 s. There was no significant difference in median (minimum, maximum) time (seconds) to IJ cannulation for those who were in the AR group and those who were not (339 [130, 550] vs 287 [35, 475], p=0.09), respectively. There was also no significant difference between the two groups in median total procedure time (524 [329, 792] vs 469 [198, 781], p=0.29), respectively. There was a significant difference in the adherence level between the two groups favoring the AR group (p=0.003). CONCLUSION: AR simulation of central venous catheters in manikins is feasible and efficacious in novice operators as an educational tool. Future studies are recommended in this area as it is a promising area of medical education.

Effect of Gaze Stability Exercises on Chronic Motion Sensitivity: A Randomized Controlled Trial.

BACKGROUND AND PURPOSE: Motion sensitivity is a common condition among the general population and may be accompanied by postural instability and anxiety. Preliminary studies suggest that minimal dosage of gaze stability exercises improves postural stability in young adults with chronic motion sensitivity. The aim of this study was to investigate the effect of progressive gaze stability exercises on postural stability, motion sensitivity, and anxiety in healthy young adults with chronic motion sensitivity. METHODS: We conducted a single-blind randomized controlled trial to assess the effect of gaze stability exercises on chronic motion sensitivity. Forty-one participants of both genders ages 20 to 40 years with chronic motion sensitivity were randomly assigned to 2 groups. The intervention group performed gaze stability exercises while the sham group performed saccadic eye movement exercises for 6 weeks. Computerized Dynamic Posturography with Immersion Virtual Reality (CDP-IVR)-condition 1 (C1) and condition 2 (C2)-Motion Sensitivity Quotient (MSQ), Motion Sickness Sensitivity Susceptibility Questionnaire Short Form (MSSQ-Short: MSA, MSB), and State-Trait Anxiety Inventory for Adults (STAI Form Y-2) were the outcome measures used. RESULTS: There was no significant group × time interaction for MSA, MSB, MSSQ percentile, STAI, MSQ, C1 mean, or C2 mean. However, posttreatment a significant difference in the mean CDP-IVR score of C2 was identified between the 2 groups. For C2, the intervention group demonstrated a 117% increase in the mean CDP-IVR score compared with a 35.2% increase in the sham group. MSQ reduced significantly from baseline to 6 weeks postintervention in the intervention group (4.0 ± 1.2 vs 1.9 ± 0.9). Anxiety was significantly reduced in the sham group only (38.2 ± 1.9 vs 35.8 ± 2.2). DISCUSSION AND CONCLUSIONS: Based on the results of this study, progressive gaze stability exercises appear to have value for managing chronic motion sensitivity in healthy young adults. Further research with larger sample size and broader age range is needed to generalize these findings.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A203).

CPR in medical TV shows: non-health care student perspective.

INTRODUCTION: There are over a dozen medical shows airing on television, many of which are during prime time. Researchers have recently become more interested in the role of these shows, and the awareness on cardiopulmonary resuscitation. Several cases have been reported where a lay person resuscitated a family member using medical TV shows as a reference. The purpose of this study is to examine and evaluate college students' perception on cardiopulmonary resuscitation and when to shock using an automated external defibrillator based on their experience of watching medical TV shows. METHODS: A total of 170 students (nonmedical major) were surveyed in four different colleges in the United States. The survey consisted of questions that reflect their perception and knowledge acquired from watching medical TV shows. A stepwise regression was used to determine the significant predictors of "How often do you watch medical drama TV shows" in addition to chi-square analysis for nominal variables. RESULTS: Regression model showed significant effect that TV shows did change students' perception positively (p<0.001), and they would select shock on asystole as the frequency of watching increases (p=0.023). CONCLUSION: The findings of this study show that high percentage of nonmedical college students are influenced significantly by medical shows. One particular influence is the false belief about when a shock using the automated external defibrillator (AED) is appropriate as it is portrayed falsely in most medical shows. This finding raises a concern about how these shows portray basic life support, especially when not following American Heart Association (AHA) guidelines. We recommend the medical advisors in these shows to use AHA guidelines and AHA to expand its expenditures to include medical shows to educate the public on the appropriate action to rescue an out-of-hospital cardiac arrest patient.

A Pilot Study: Parent Perceptions of Behavior Change in Their Child With Autism Spectrum Disorder Following High Antioxidant Cacao Consumption.

BACKGROUND: Autism spectrum disorder (ASD) is a heterogeneous neurocognitive disorder with primary symptomology related to maladaptive behaviors and communication deficits. Children with ASD tend to have higher free radicals than antioxidants compared with their matched controls. This disequilibrium of oxidative stress has been associated with the pathogenesis of this neurocognitive disorder. The aim of this pilot feasibility study was to examine the effect of high antioxidant cacao consumption on behavior in children with ASD. METHODS: This was a 4-wk repeated measures experimental pilot study of high antioxidant cacao and children with ASD. Participants consumed 8 squares (or 16 g) per day of the dark chocolate that had a concentration of 70% cacao and 30% organic cane sugar (total antioxidant activity was 8320 µmoles TE/100 g). The 2 main behavioral measures, Aberrant Behavior Checklist, 2nd ed (ABC-2) and the Autism Spectrum Rating Scale (ASRS), were completed by the child's parent at baseline, end of week 2, and end of week 4. RESULTS: Seventeen participants were recruited for this study. Follow-up data were available for 16 participants (12 males, 4 females, aged 4 to 17 y). Significant improvements were noted on the ABC-2 subscales of irritability (P = .03, η2= 0.25), social withdrawal (P = .01, η2= 0.29), stereotypic behavior (P = .05, η2 = 0.13), hyperactivity/noncompliance (P = .04, η2 = 0.20), and inappropriate speech (P = .05, η2 = 0.16). Significant improvements were noted on the ASRS subscales of social/communication (P = .04, η2 = 0.25), unusual behaviors (P = .003, η2= 0.20), self-regulation (P = .02, η2= 0.32), and total scores (P < .001, η2= 0.54). CONCLUSION: Results from this study support previous literature on antioxidant intake as an adjunct therapy to improve behaviors of children with ASD. More robust randomized controlled trials are now necessary to validate and elaborate on these findings.

Effect of visual input on postural stability in young adults with chronic motion sensitivity: A controlled cross-sectional study.

BACKGROUND: Chronic motion sensitivity (CMS) has been defined as a feeling of un-wellness elicited by either actual or perceived motion. CMS is a common condition and is more prevalent in females than in males. In addition to a variety of symptoms, young adults with CMS have less postural stability than those without CMS. OBJECTIVE: To determine whether dependence on visual cues for postural stability is different between young adults with and without CMS, and whether it differs by gender within each group. METHODS: Sixty young adults (30 females and 30 males) were assigned to one of two groups (CMS or non-CMS) using the Motion Sickness Susceptibility Questionnaire-Short Form. Postural stability was measured for all participants using the Bertec Balance Advantage-Computerized Dynamic Posturography with Immersion Virtual Reality. RESULTS: A significant difference was found in mean postural stability scores during immersion virtual reality between the CMS and non-CMS groups (p < 0.001); however, no significant difference was shown in mean postural stability between males and females within the CMS and non-CMS groups (p = 0.10 and p = 0.97, respectively). CONCLUSION: The results suggest that young adults with CMS are over-reliant on visual cues for postural stability, and that visual dependence is not influenced by gender.

Effect of Sitting Pause Times on Balance After Supine to Standing Transfer in Dim Light.

BACKGROUND AND PURPOSE: The risk of falling for older adults increases in dimly lit environments. Longer sitting pause times, before getting out of bed and standing during the night, may improve postural stability. The purpose of this study was to measure the effect of sitting pause times on postural sway velocity immediately after a supine to standing transfer in a dimly lit room in older adult women. METHODS: Eighteen healthy women aged 65 to 75 years who were able to independently perform supine to standing transfers participated in the study. On each of 2 consecutive days, participants assumed the supine position on a mat table and closed their eyes for 45 minutes. Then, participants were instructed to open their eyes and transfer from supine to sitting, with either 2- or 30-second pause in the sitting position followed by standing. The sitting pause time order was randomized. RESULTS: A significant difference was observed in postural sway velocity between the 2- and 30-second sitting pause times. The results revealed that there was less postural sway velocity after 30-second than 2-second sitting pause time (0.61 ± 0.19 vs 1.22 ± 0.68, P < .001). DISCUSSION: Falls related to bathroom usage at night are the most common reported falls among older adults. In the present study, the investigators studied the effect of sitting pause times on postural sway velocity after changing position from supine to standing in a dimly lit environment. The findings showed that the mean postural sway velocity was significantly less after 30-second sitting pause time compared with 2-second sitting pause time. CONCLUSIONS: Postural sway velocity decreased when participants performed a sitting pause of 30 seconds before standing in a dimly lit environment. These results suggest that longer sitting pause times may improve adaptability to dimly lit environments, contributing to improved postural stability and reduced risk of fall in older adult women when getting out of bed at night.

Cross-Cultural Adaptation and Psychometric Properties Testing of the Arabic Anterior Knee Pain Scale.

BACKGROUND PFPS is one of the most frequently occurring overuse injuries affecting the lower limbs. A variety of functional and self-reported outcome measures have been used to assess clinical outcomes of patients with PFPS, however, only the Anterior Knee Pain Scale (AKPS) has been designed for PFPS patients. MATERIAL AND METHODS We followed international recommendations to perform a cross-cultural adaptation of the AKPS. The Arabic AKPS and the Arabic RAND 36-item Health Survey were administered to 40 patients who were diagnosed with PFPS. Participants were assessed at baseline and after 2 to 3 days assessed with the Arabic AKPS only. The measurements tested were reliability, validity, and feasibility. RESULTS The Arabic AKPS showed high reliability for both temporal stability, internal consistency (Cronbach's alpha was 0.81 for the first assessment and 0.75 for the second), excellent test-retest reliability (Intraclass Correlation Coefficients ICC=0.96; 95% confidence interval (CI): 0.93, 0.98) and good agreement (standard error of measurement SEM=1.8%). The Arabic AKPS was significantly correlated with physical components of the RAND 36-Item Health Survey (Spearman's rho=0.69: p<0.001). No ceiling or floor effects were observed. CONCLUSIONS The Arabic AKPS is a valid and reliable tool and is comparable to the original English version and other translated versions.

Validity and reliability of wheelchair sitting posture measures using Coach's Eye in abled subjects.

People in wheelchairs spend a long time in the sitting position and often incur alignment problems resulting in neck and back pain. This study: (1) assessed the validity/reliability of Coach's Eye (CE) smart device application, (2) examined the effect of seat to back support angle adjustments on head, neck, and shoulder posture in the sitting position, and (3) compared changes in cervical rotation at each back support angle. Abled subjects sat in a wheelchair with back support angles positioned at 90°, 100°, and 110°. CE, as well as ImageJ software, was used to analyze three angles: sagittal head angle (SHA), cervical angle (CVA), and shoulder angle (SA). There were highly significant differences for CVA and SA (p < 0.001) among the three seat to back support angles. Validity of CE was examined by correlating CE with ImageJ scores. CE had high validity for all angles (r = 0.99, 0.98, 0.99 respectively, p < 0.001). Inter-rater reliability for SHA, CVA, and SA was high (intraclass correlation coefficient [ICC] ranged from 0.95 to 0.99). Head (CVA) and shoulder (SA) alignment was closest to neutral posture with back support angles set at 110° and 90°, respectively.