The effects of the Posterior X Taping versus augmented feedback on lower-extremity kinematic and muscle activity pattern during unilateral weight-bearing activities in men with tibiofemoral varus malalignment.

PURPOSE: Tibiofemoral Varus Malalignment (TFRV) contributes to overuse injuries by altering lower limb biomechanics. Both Posterior X Taping (PXT) and Real Time Feedback (RTF), have each been recommended for subjects with TFRV as they are thought to enhance control of excessive tibiofemoral rotations. This paper evaluates this claim. METHODS: A total of recreational male 24 athletes with TFRV participated in the current study. Kinematic and electromyography variables of lower extremity were synchronously ​recorded on five consecutive repetitions of the single-legged-squat (SLS) and forward-step-down) FSD) tasks before and after applications of PXT and RTF. RESULTS: The subjects at post-intervention in RTF group exhibited decreased hip adduction during FSD, and decreased hip adduction and internal rotation during eccentric and concentric phases of the SLS; Additionally, we observed increased gluteus medius activity during eccentric phase of the SLS and FSD tasks. In contrast, subjects at the post-intervention in PXT group exhibited decreased tibiofemoral external rotation and increased ankle external rotation during all the phases of both SLS and FSD tasks. CONCLUSION: These results suggest that the PXT and RTF interventions are recommended to immediately improve the functional defects of the subjects with TFRV during SLS and FSD tasks.

The comparison between the effects of pain education interventions with online and face-to-face exercise and the control group received biomedical education + standardized physical therapy in patients with chronic nonspecific neck pain during COVID-19: protocol for a parallel-group randomized controlled trial.

BACKGROUND: Various psychological issues and serious health concerns during the imposed lockdown by coronavirus disease 2019 (COVID-19) have induced many changes in the treatment of patients. More effective self-management strategies through tele-rehabilitation are suggested to be applied for patients with chronic neck pain to reduce referrals to health cares and disability support through COVID-19. Also, the pain neuroscience education (PNE) approach is an educational method used by health professionals to assist patients in understanding the biology, physiology, and psychosocial factors affecting their pain experience and aligning with the cognitions and beliefs associated with pain and recurrent disability. PNE combined with tele-rehabilitation could be a new solution to encourage patients to manage their condition by themselves and increase the continuity of practice instead of face-to-face sessions. OBJECTIVE: This randomized control trial (RCT) aims to investigate the effects of PNE with online and face-to-face exercise interventions, and the control group received biomedical education + standardized physical therapy on neck pain and disability, psychological factors, and function in non-traumatic chronic neck pain. METHODS/DESIGN: Patients with non-traumatic chronic neck pain (patient-centered care and active involvement of patients and the public) will be recruited via flyers displayed in hospitals and universities to participate in an RCT with two experimental and one control group designed to investigate the effects of PNE with online and face-to-face exercise interventions, and the control group received biomedical education + standardized physical therapy on neck pain and disability, psychological factors, and function in non-traumatic chronic neck pain. The outcomes will be measured at baseline, after PNE, and after 3 months of an exercise intervention. All outcomes are presented as mean ± SD, and statistical significance was set at α level of < 0.05. The normal distribution of the variables was verified by the Kolmogorov-Smirnov test, following a descriptive analysis. DISCUSSION: It seems that PNE plus online and face-to-face exercise interventions are appropriate educational models for the treatment of patients with neck pain during COVID-19. Also, online training seems to encourage patients to continue their treatment. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT20150503022068N5. Registered on 09 September 2021.

Effect of combining eight weeks of neuromuscular training with dual cognitive tasks on landing mechanics in futsal players with knee ligament dominance defect: a randomized controlled trial.

BACKGROUND: The performing of jump and landing in futsal simultaneous with divided attention is one of the most common mechanisms of non-contact anterior cruciate ligament (ACL) injury. Neuromuscular training has effectively reduced the risk of ACL injury, but the effect of neurocognitive training has received less attention. This study investigated the effect of combining 8 weeks of neuromuscular training with dual cognitive tasks on the landing mechanics of futsal players with knee ligament dominance defects. METHODS: Thirty male futsal players (mean ± SD: age: 21.86 ± 3.27 years) with knee ligament dominance defects were purposefully identified by the tuck jump test and were randomly divided into the intervention and the control group. The intervention group performed dual task (DT) training for three weekly sessions for 8 weeks and 60 min each, while the control group only did activities of daily living. During the drop vertical jump test, 2D landing kinematics in two moments of initial contact (IC) and full flexion (FF) were assessed. Data were analyzed by means of 2 × 2 repeated measures ANOVA followed by post hoc comparison (Bonferroni) at the significance level of (α ≤ 0.05). RESULTS: A significant improvement was observed in the intervention group compared to the control group for the dynamic knee valgus at IC (F1,28 = 6.33; P = 0.02, ES = 0.31) and FF (F1,28 = 13.47; P = 0.003, ES = 0.49), knee flexion at IC (F1,28 = 20.08; P = 0.001, ES = 0.41) and FF (F1,28 = 13.67; P = 0.001, ES = 0.32), ankle dorsiflexion at IC (F1,28 = 37.17; P = 0.001, ES = 0.72) and FF (F1,28 = 14.52; P = 0.002, ES = 0.50), and trunk flexion at FF (F1,28 = 20.48; P = 0.001, ES = 0.59) angles. Changes in the trunk flexion at IC (F1,28 = 0.54; P = 0.47, ES = 0.03) and trunk lateral flexion at IC (F1,28 = 0.006; P = 0.93, ES = 0.00) and FF (F1,28 = 2.44; P = 0.141, ES = 0.148) angles were not statistically significant. CONCLUSIONS: DT training compared to the control group improved landing mechanics in futsal players with knee ligament dominance defects. TRIAL REGISTRATION: Current Controlled Trials using the IRCT website with ID number IRCT20210602051477N1 prospectively registered on 20/06/2021.

What Does Provide Better Effects on Balance, Strength, and Lower Extremity Muscle Function in Professional Male Soccer Players with Chronic Ankle Instability? Hopping or a Balance Plus Strength Intervention? A Randomized Control Study.

Chronic ankle instability (CAI) has a higher frequency in soccer due to the rapid changes in body movement. Thus, this study compared the effects of eight weeks of a hopping protocol and a combined protocol of balance plus strength in a within-between group analysis. Thirty-six male professional soccer players participated in this study and were randomly allocated in three groups: control group (CG, n = 12), hopping group (HG, n = 12), and balance plus strength group (BSG, n = 12). Strength, static and dynamic balance, and function were assessed at baseline and eight weeks post intervention. First, Foot and Ankle Ability Measure (FAAM) and FAAM sport scales were applied. Then, a dynamometer was used to measure strength of the muscles around the hip, knee, and ankle joints. The Bass stick measured static balance and the Y balance test measured dynamic balance. Additionally, functional tests were carried out by Triple Hop, the Figure 8 hop, and vertical jump. A repeated measures ANOVA [(3 groups) × 2 moments] was used to compare the within and between group differences. In general, all tests improved after eight weeks of training with both protocols. Specifically, the BSG improved with large ES for all tests, while the HG improved all test with small to large effect sizes (ES). Furthermore, HG showed higher values for vertical jump (p < 0.01, ES = 1.88) and FAAMSPORT (p < 0.05, ES = 0.15) than BSG. BSG showed higher values for hip abduction (p < 0.05, ES = 2.77), hip adduction (p < 0.05, ES = 0.87), and ankle inversion (p < 0.001, ES = 1.50) strength tests, while HG showed higher values for knee flexion [ES = 0.86, (0.02, 1.69)] and ankle plantarflexion [ES = 0.52, (−0.29, 1.33)]. Balance plus strength protocol showed more positive effects than the hopping protocol alone for soccer players with CAI.

Comparison of effect of wobble board training with and without cognitive intervention on balance, ankle proprioception and jump landing kinetic parameters of men with chronic ankle instability: a randomized control trial.

BACKGROUND: The aim of the present study was to compare the effect of a wobble board training (WBT) course with and without cognitive intervention (CI) on balance, ankle proprioception and jump-landing kinetic parameters in active men with chronic ankle instability (CAI). METHODS: Twenty-one active men in the age range of 18-25 years with CAI were randomly divided into three groups of WBT for five weeks as follows: with CI (n = 7); without CI (n = 7); control (n = 7). In this study, balance was evaluated by Y-Balance Test and Balance Error Scoring System, proprioception was evaluated as active and passive replication of 15-degree inversion angle and Maximum inversion angle minus 5-degrees, and single-leg jump-landing test was used for measurement of kinetic variables as pre-test and post-test in similar conditions. RESULTS: Post-test of both groups of WBT with and without CI showed a significant improvement in all variables compared to pre-test (p ≤ 0.05); however, in post-test, there was no significant difference in any of the variables between WBT groups with and without CI (p ≥ 0.05). CONCLUSIONS: A course of WBT with and without CI leads to a significant improvement in balance, proprioception and jump-landing kinetic parameters, including time to stabilization and center of pressure displacement in active men with CAI. Although the WBT group with CI showed a greater improvement in mean than WBT group without CI, but the difference was not significant in any of the variables. TRIAL REGISTRATION: Retrospectively Registered. irict.ir Identifier: IRCT20200617047818N1 on 05-02-2021.

Comparing the Effects of Differential Learning, Self-Controlled Feedback, and External Focus of Attention Training on Biomechanical Risk Factors of Anterior Cruciate Ligament (ACL) in Athletes: A Randomized Controlled Trial.

The current study aimed to compare the possible effects of differential learning strategy, self-controlled feedback, and external focus of attention on kinetic and kinematic risk factors of anterior cruciate ligament (ACL) injury in athletes. Forty-eight male athletes from three sports of handball, volleyball and basketball were selected for this study and were randomly divided into four groups: differential learning (n = 12), self-control feedback (n = 12), external focus (n = 12), and control (n = 12) group. All groups followed the intervention for eight weeks with three sessions per week. Data were analyzed by means of 4 × 2 repeated measures ANOVA followed by post hoc comparison (Bonferroni) at the significance level of p ≤ 0.05. A significant group × time interaction and the main effect of time was found for most kinetic and kinematic variables. The main effect of the group was significant only at the knee abduction angle. Differential learning and external focus of attention methods positively reduced the kinetic and kinematic variables that are considered risk factors for ACL injury. However, the effect sizes (Cohen's d) for the changes in most of the variables were larger for the differential learning group. Tailoring the boundary conditions that are based on the manipulations created in the exercise through variability and variety of movements associated with differential learning methods rather than repeating movements could reduce the risk of ACL injury.

Effects of the real-time feedback and knee taping on lower-extremity function during ergometer pedaling in subjects with tibiofemoral varus alignment.

BACKGROUND: The effect of the Posterior X Taping (PXT) used for subjects with Tibiofemoral Varus Malalignment (TFRV) aimed to control excessive tibiofemoral rotations is still unclear. Further, it is critical to use evidence-based therapeutic exercises to prevent non-contact injuries, especially in repetitive movements. OBJECTIVE: To investigate whether the PXT and real-time feedback (RTF) interventions would improve lower extremity functions during the pedaling task in subjects with TFRV. METHODS: Twenty-four male recreational athletes with TFRV participated in this study; Kinematic and muscle activity were synchronously recorded on ten consecutive pedal cycles during the last 30 s of 2-min pedaling. RESULTS: The present study indicated that the subjects at the post-intervention of the RTF group exhibited significant decreased hip adduction and internal rotation, significant decreased tibiofemoral external rotation between 144° and 216° of crank angle, significant increased vastus medialis activity between 144° and 288° of crank angle, and significant increased gluteus medius activity between 180° and 144° of crank angle; In contrast, the subjects at the post-intervention of the PXT group exhibited significant decreased tibiofemoral external rotation and increased ankle external rotation at all the crank angles. No between-group differences were observed in pre-and post-intervention. SIGNIFICANCE: These results suggest that the PXT and RTF interventions are recommended to immediately improve the functional defects of the subjects with TFRV during the pedaling task.

Comparison the Effect of Pain Neuroscience and Pain Biomechanics Education on Neck Pain and Fear of Movement in Patients with Chronic Nonspecific Neck Pain During the COVID-19 Pandemic.

INTRODUCTION: Self-management education is the basis of any intervention for persons with chronic musculoskeletal pain. Given the biopsychosocial nature of chronic musculoskeletal pain, an educational approach based on the biopsychosocial model would seem to be an appropriate educational model for the treatment of these people during coronavirus disease 2019 (COVID-19). The aim of this study was to compare the effect of pain neuroscience education (PNE) and pain biomechanics education, using online and face-to-face sessions on pain and fear of movement, in people with chronic nonspecific neck pain during COVID-19. METHODS: In this multicenter assessor-blinded randomized controlled trial, 80 patients (both male and female) with chronic nonspecific neck pain (based on the inclusion criteria of the study) participated in educational sessions (face-to-face and online) from the beginning September until the end of October 2021. The participants were randomly divided into two groups (through the selection of numbers from 1 to 80, hidden in a box), with one group receiving PNE (treatment group) and the other group receiving pain biomechanics education (control group). Pain and fear of movement before and after the intervention were measured on the Numerical Pain Rating Scale and the Tampa Scale of Kinesiophobia, respectively. A 2 × 2 variance analysis (treatment group × time) with a mixed-model design was applied to statistically analyze the data. RESULTS: No significant change in pain (P = 0.23) was observed between the two groups (P = 0.24, Cohen's d = 0.17, 95% confidence interval [CI] - 0.21 to 0.35), while changes in the fear of movement variable were reported to be significant (P = 0.04, Cohen's d = 0.34, 95% CI 0.11-0.51), in favor of PNE. Intra-group change was seen only in the PNE group for the fear of movement variable (P = 0.04; 14.28%↓). CONCLUSION: In our study population PNE did not affect the pain index, leading to the conclusion that PNE should not be used as the only treatment, but possibly in combination with other active/passive therapy to enhance the results for patients with nonspecific chronic neck pain. Moreover, online treatment may help clinicians to increase their interaction with patients during COVID-19 lockdown.

Therapeutic routine with respiratory exercises improves posture, muscle activity, and respiratory pattern of patients with neck pain: a randomized controlled trial.

Neck pain and forward head posture (FHP) are typical in prolonged smartphone users and need to be targeted for treatment. We aimed to compare the effect of a routine therapeutic program with and without respiratory exercises on smartphone users with FHP and non-specific chronic neck pain (NSCNP). Sixty patients (aged 24.7 ± 2.1 years) with FHP and NSCNP were randomly assigned to the routine therapeutic program (n = 20), combined respiratory exercises with a routine therapeutic program (n = 20), or control (n = 20) groups. At baseline, there was no difference among groups at all variables. Each programme was implemented three times a week for eight weeks. Primary Outcome was pain measured by visual analogue scale (VAS), and secondary ones were forward head angle, the activity of specific muscles, and respiratory patterns, measured by photogrammetry, electromyography and manual, respectively. All outcomes were measured at baseline and eight weeks post-treatment. We used the repeated measures analysis of variance to examine the interaction between time and group, paired t-test for intragroup comparison, one-way analysis of variance for intergroup comparison, and Tukey post hoc test at a significant level 95% was used. There were significant differences in the combined group compared with the routine therapeutic group (P = 0.03) for diaphragm muscle activation, respiratory balance (P = 0.01), and the number of breaths (P = 0.02). There were significant within-group changes from baseline to post-treatment in the combined group for all outcomes above, but no changes in the therapeutic exercise routine group. Despite respiratory pattern, none of the secondary outcomes proved to be superior in the combination group compared to the routine therapeutic program in smartphone users with FHP and NSCNP. Future studies with longer follow-up assessments could strengthen these results.Trial registration: Current Controlled Trials using the IRCT website with ID number of, IRCT20200212046469N1 "Prospectively registered" at 04/03/2020.

Valgus Control Feedback and Taping Improves the Effects of Plyometric Exercises in Women With Dynamic Knee Valgus.

BACKGROUND: Female athletes are more predisposed to anterior cruciate ligament (ACL) injuries in comparison with their male counterparts. Research on ACL injury prevention strategies has demonstrated beneficial effects of plyometric exercises and feedback (FB) during the exercises. FB has resulted in reductions in vertical ground-reaction force and kinematic risk factors associated with ACL injury. Furthermore, taping (TP) may draw attention to the restriction created by the tape and serve as real-time biofeedback. The additional influence of FB and TP on plyometric exercises has not been determined. HYPOTHESIS: FB and TP interventions delivered during plyometric exercises would result in positive changes in biomechanics and muscle onset in female athletes displaying dynamic knee valgus. DESIGN: Controlled trial. SETTING: University research laboratory. LEVEL OF EVIDENCE: Level 2. METHODS: Forty-eight active female athletes were divided into 3 groups: control (n = 16), plyometric training with FB (n = 16), and plyometric training with TP (n = 16). The 2 experimental groups performed a 6-week exercise program with either FB or TP. The control group continued its regular team schedule. Knee joint position sense, landing error scoring system (LESS), and the onset of muscle activation (the point at which muscle activation exceeds 3 standard deviations over baseline and continued above this threshold for at least 25 ms) before landing for the rectus femoris, vastus medialis, vastus lateralis, gluteus medius, semitendinosus, and biceps femoris during pre- and posttests were measured. RESULTS: The vastus lateralis onset later in the TP group compared with the FB group (d [95% CI] = 0.64 [0.35-0.82], P = 0.01). Joint position sense accuracy improved only in the TP group (d = -0.63, P = 0.001). Both the FB (d = -0.85, P = 0.001), and TP (d = -0.82, P = 0.001) groups improved in LESS scores. CONCLUSION: The results of the present study showed that plyometric exercises with FB or TP affect LESS and the onset of the vastus lateralis in active uninjured women with dynamic knee valgus, while TP improves joint position sense. Therefore, when more accurate joint position sense is desired, practitioners may use plyometric with TP. If an improved LESS score is desired, plyometrics with either TP or FB are acceptable. CLINICAL RELEVANCE: Our findings indicate that female athletes may benefit more when completing a plyometric training program with a TP versus an FB. Trainers, coaches, and clinicians should consider utilizing instructions that promote an external focus when implementing plyometric training programs with male athletes.

Adding a smartphone app to global postural re-education to improve neck pain, posture, quality of life, and endurance in people with nonspecific neck pain: a randomized controlled trial.

BACKGROUND: In this study, the effect of adding a smartphone app to an 8-week global postural reeducation (GPR) on neck pain, endurance, quality of life, and forward head posture (FHP) in patients with chronic neck pain and FHP was evaluated. METHODS: Sixty male and female office workers (38.5 ± 9.1 years) with chronic neck pain were randomly assigned into three groups: group 1 (GPR+ a smartphone app, n = 20), group 2 (GPR alone, n = 20), and group 3 (the control group, n = 20). The primary outcome was pain and the secondary outcomes were disability, quality of life, endurance, and posture. Pain, disability, endurance, quality of life, and posture were evaluated using the visual analog scale (VAS), neck disability index (NDI), progressive iso-inertial lifting evaluation (PILE) test, quality of life questionnaire (SF-36), and photogrammetry, respectively, at pre-and post-8-week interventions. A one-way analysis of covariance (ANCOVA) has been conducted to statistically analyze the data. RESULTS: The GPR+ a smartphone app had statistically significant improvements versus GPR alone in pain (mean difference, - 2.05 ± 0.65, ES (95% CI) - 0.50 (- 1.04 to - 0.01), P = 0.04), disability (difference = 11.5 ± 1.2, ES (95% CI) = 0.31 (0.22 to 0.97), p = 0.033), FHP (difference = 1.6 ± 0.2, ES (95% CI) = 0.31 (0.09 to 0.92), p = 0.047), and endurance (difference = 2 ± 3.3, ES (95% CI) = 0.51 (0.02 to 1.03), p = 0.039). Both of the GPR+ a smartphone app and GPR alone groups had statistically significant differences versus the control group in all outcomes. CONCLUSION: When a workplace assessment and management could not be as part of any intervention, adding a smartphone app to GPR for NP may be an appropriate tool to administer a home and work exercise program resulting in elevating pain and disability, as well as improving FHP and endurance. TRIAL REGISTRATION: Current Controlled Trials using the UMIN-RCT website UMIN000039720 . Retrospectively registered on January 9, 2020.

Scapular exercise combined with cognitive functional therapy is more effective at reducing chronic neck pain and kinesiophobia than scapular exercise alone: a randomized controlled trial.

OBJECTIVE: The aim of this study was to compare the effectiveness of scapular exercises alone and combined with cognitive functional therapy in treating patients with chronic neck pain and scapular downward rotation impairment. DESIGN: Single-blind randomized controlled trial. SETTING: Outpatient. SUBJECTS: A total of 72 patients (20-45 years old) with chronic neck pain were studied. INTERVENTION: Allocation was undertaken into three groups: scapular exercise (n = 24), scapular exercise with cognitive functional therapy (n = 24) and control (n = 24) groups. Each programme lasted three times a week for six weeks. MAIN OUTCOMES: The primary outcome measure was pain intensity measured by the visual analogue scale scores. The secondary outcome measures included kinesiophobia and muscles activity. RESULTS: Statistically significant differences in pain intensity were found when multidisciplinary physiotherapy group including a cognitive functional approach was compared with the scapular exercise alone group at six weeks (effect size (95% CI) = -2.56 (-3.32 to -1.80); P = 0.019). Regarding kinesiophobia, a significant between-group difference was observed at six-week (effect size (95% CI) = -2.20 (-2.92 to -1.49); P = 0.005), with the superiority of effect in multidisciplinary physiotherapy group. A significant between-group differences was observed in muscle activity. Also, there were significant between-group differences favouring experimental groups versus control. CONCLUSION: A group-based multidisciplinary rehabilitation programme including scapular exercise plus cognitive functional therapy was superior to group-based scapular exercise alone for improving pain intensity, kinesiophobia and muscle activation in participants with chronic neck pain.

Efficacy of throwing exercise with TheraBand in male volleyball players with shoulder internal rotation deficit: a randomized controlled trial.

BACKGROUND: The Glenohumeral internal-rotation deficit (GIRD) is related to the altered eccentric external-rotator (ER), the concentric internal-rotator (IR), muscle strength, and the ER: IR ratio. GIRD has been documented as a risk factor for shoulder injuries. However, few studies have investigated the effect of an exercise training on these parameters in athletes with GIRD. Therefore, the purpose of this study was to evaluate the effects of an 8-week throwing exercise with a TheraBand for retraining the rotator cuff on Electromyography (EMG) activity of selected muscles, rotator cuff muscle strength, the glenohumeral (GH) joint IR range of motion (ROM) and GH joint position sense in asymptomatic male volleyball players with GIRD. METHODS: Sixty male volleyball players with GIRD were randomized into either a training group or a control group. The experimental group underwent an 8-week throwing exercise with a TheraBand including 5 sessions of stretching and 3 sessions of strengthening exercises per week. The control group received an active self-exercise program. EMG (onset time and muscle activation), shoulder range of motion (ROMs), strength and GH joint position sense were all assessed pre and post trainings. RESULTS: There were statistically significant within-group differences in the EMG activity of the anterior deltoid (p = 0.005), middle deltoid (p = 0.007), posterior deltoid (p = 0.004), infraspinatus (p = 0.001) and supraspinatus (p = 0.001) muscles, IR ROM (p = 0.001), rotator cuff muscle strength ratio (p = 0.001), and GH joint position sense (p = 0.033) in the experimental group. A 2 × 2 analysis of variance with a mixed model design and independent and paired t-tests were used for statistical analysis. CONCLUSIONS: Throwing exercise with a TheraBand improved shoulder muscle activation, IR ROM, rotator cuff muscle strength ratio and GH joint position sense in participants with GIRD. These findings may improve the treatment of GIRD in a clinical setting. Although the results are significant, further studies should follow up the long-term effects of the Throwing exercise with a TheraBand on GIRD. TRIAL REGISTRATION: Current Controlled Trials using the UMIN-RCT website with ID number of, UMIN000038416 "Retrospectively registered" at 2019/10/29.

Comparing the Effectiveness of Cognitive Functional Treatment and Lumbar Stabilization Treatment on Pain and Movement Control in Patients With Low Back Pain.

BACKGROUND: The treatment of chronic low back pain (LBP) should target both behavioral variables and physical performance factors. HYPOTHESIS: Cognitive functional treatment (CFT) and lumbar stabilization treatment (LST) will result in positive changes in pain and lumbar movement control (LMC) in patients with LBP. STUDY DESIGN: Pretest-posttest intervention. LEVEL OF EVIDENCE: Level 3. METHODS: After screening, 52 participants (mean age, 44.3 ± 2.46 years) with chronic LBP were allocated into CFT (n = 17), LST (n = 17), or control (n = 18) groups. Pain and LMC were evaluated before and after 8 weeks of intervention with visual analog scale (VAS) and Luomajoki LMC battery tests, respectively. RESULTS: Compared with baseline, pain and LMC were reduced and improved significantly in both groups after 8 weeks. However, the changes in both variables were not significantly different between groups. Percent change for pain between pretest and posttest values in the LST group was a decrease of 45% (P = 0.003), compared with a decrease of 40% (P = 0.003) in the CFT group. Change in LMC in the LST group was a decrease of 100% (P = 0.026), compared with a decrease of 200% (P = 0.018) in the CFT group. There as no change for both variables in the control group. CONCLUSION: Both CFT and LST groups improved LMC scores and reduced pain intensity. However, there was no difference between the 2 experimental groups on pain and LMC test results. CLINICAL RELEVANCE: In this study, intended to construct an intervention for people with chronic LBP, the primary aims were to help individuals "make sense of their pain," develop effective pain control strategies via body relaxation and extinction of safety behaviors, and adopt healthy lifestyle behaviors to affect cognitive factors known to affect pain sensitivity and disability. These primary aims were achieved through an emphasis on factors such as development of positive beliefs, reduced fear, increased awareness, enhanced understanding and control of pain, adaptive coping, enhanced self-efficacy, confidence, and improved mood through the class-based intervention.

The effect of manual therapy and stabilizing exercises on forward head and rounded shoulder postures: a six-week intervention with a one-month follow-up study.

BACKGROUND: The purpose of this study is to evaluate the effect of a six-week combined manual therapy (MT) and stabilizing exercises (SEs), with a one-month follow-up on neck pain and improving function and posture in patients with forward head and rounded shoulder postures (FHRSP). METHODS: Sixty women with neck pain and FHRSP were randomized into three groups: Group 1 performed SE and received MT (n = 20), Group 2 performed SE (n = 20) and Group 3 performed home exercises (n = 20) for six weeks. The follow-up time was one month after the post test. The pain, function, and head and shoulder angles were measured before and after the six-week interventions, and during a one-month follow-up. RESULTS: There were significant within-group improvements in pain, function, and head and shoulder posture in groups 1 and 2. There were significant between-group differences in groups 1 and 2 in head posture, pain, and function favoring group 1 with effect size 0.432(p = 0.041), 0.533 (P = 0.038), and 0.565(P = 0.018) respectively. There were significant between-group differences in both intervention groups versus the control group favoring the intervention groups. CONCLUSION: These findings suggest that both interventions were significantly effective in reducing neck pain and improving function and posture in patients. However, the improvement in function and pain were more effective in Group 1 as compared to Group 2, suggesting that MT can be used as a supplementary method to the stabilizing intervention in the treatment of neck pain. More researches are needed to confirm the result of this study. TRIAL REGISTRATION: UMIN000030141 modified on 2018.03.08. This study is a randomized control trial registered at UMIN-CTR website, the trial was retrospectively registered and the unique trial number is UMIN000030141 .

The efficacy of a HUBER exercise system mediated sensorimotor training protocol on proprioceptive system, lumbar movement control and quality of life in patients with chronic non-specific low back pain.

BACKGROUND: There is a relation between deficits of the proprioceptive system and movement control dysfunction in patients with chronic low back pain (LBP) but, the exact mechanism of this relation is unknown. Exercise therapy has been recognized as an effective method for low back pain treatment. In spite of this, it is not clear which of the various exercise therapy programs lead to better results. OBJECTIVE: Therefore, the present analyze the efficacy of a HUBER study aims to exercise system mediated sensorimotor training protocol on proprioceptive system, lumbar movement control (LMC) and quality of life (QOL) in patients with chronic non-specific LBP. DESIGN: Quasi-experimental study. METHODS: 53 patients with chronic non-specific LBP (mean age 37.55 ± 6.67 years,and Body Mass Index (BMI) 22.4 ± 3.33) were selected by using Roland-Morris Disability Questionnaire (RMQ) and were assigned into two experimental (N= 27) and control groups (N= 26) The experimental group underwent a five-week (10 sessions) Sensorimotor training by using the Human Body Equalizer (HUBER) spine force under the supervision of an investigator. The movement control battery tests, the HUBER machine testing option, goniometer and visual analogue scale used for movement control, neuromuscular coordination, proprioception and LBP assessment respectively. The assessments were completed in pre-test and after five weeks. The paired and sample T tests were used for data analysis in SPSS program version 18 (Significance level were set at a P value < 0.05). RESULTS: The HUBER system mediated sensorimotor training demonstrated significant improvement in the proprioceptive system, LMC and QOL (P= 0.001). Also There was a significant reduction in the pain scores of subjects with chronic non-specific LBP in the sensorimotor group (P= 0.001). LIMITATIONS: In this study, only the short term effects of the sensorimotor training were examined. CONCLUSIONS: The results suggest that a sensorimotor training program causes significant improvement in patients with chronic non-specific LBP. Future research should be carried out with a larger sample size to examine the long term effects of the sensorimotor training program on treatment of patients with chronic non-specific LBP. Considering the efficacy of the sensorimotor training, it is recommended that this intervention should be applied to treatment of patients with chronic non-specific LBP in the future.

Relationship between functional movement screening score and history of injury and identifying the predictive value of the FMS for injury.

This study aimed to reveal the functional ability of functional movement screening (FMS) scores in determining an athlete's predisposition to injury. One hundred (50 females and 50 males) university level athletes, weight of 69.44 ± 5.84 kg, height of 172.69 ± 7.26 cm, age of 22.56 ± 2.99 years and Baecke score 21.66 ± 1.73, practised in football, handball and basketball sports (at least for 5 years), with no recent (<6 weeks) history of musculoskeletal injury were recruited. Of the 100 subjects, 35 of them suffered an acute, lower extremity (ankle = 20 and knee = 15 subjects) injury. An odds ratio was calculated at 4.70, meaning that an athlete has an approximately 4.7 times greater chance of suffering a lower extremity injury during a regular competitive season if they score less than 17 on the FMS. This study provides FMS reference values for university level athletes that will assist in the interpretation of individual scores when screening athletes for musculoskeletal injury and performance factors. More research is still necessary before implementing the FMS into a pre-participation physical examination for athletics, but due to the low cost and its simplicity to implement, it should be considered by clinicians and researchers in the future.

Relationship between functional movement screening score and history of injury.

BACKGROUND AND AIM: The Functional Movement Screen (FMS™) is a screening instrument that evaluates selective fundamental movement patterns. The main aim of this study was to investigate the relationship between the FMS™ score and history of injury, and attempt to determine which active students are prone to injury. METHODS: One hundred physically active (50 females and 50 males) students, between 18 and 25 years of age, with no recent (<6 weeks) history of musculoskeletal injury were recruited. All participants performed the FMS™ and were scored using the previously established standardized FMS™ criteria. The chi square, independent t-test, one-way analysis of variance, and POSTHOC Bonferroni tests were used for data analysis with a preset alpha value of p < 0.05. RESULTS: Of the 100 subjects, 35 suffered an acute lower extremity (ankle = 20, knee = 15) injury in practice or competition. An odds ratio was calculated at 4.70, meaning that an athlete had an approximately 4.7 times greater chance of suffering a lower extremity injury during a regular competitive season if they scored less than 17 on the FMS™. There were statistical differences between the pre-season FMS™ scores of the injured and non-injured groups, the ankle injury, knee injury, and non-injured groups, and also between contact injury, non-contact injury, and non-injured groups. DISCUSSION AND CONCLUSION: This cross-sectional study provides FMS™ reference values for physically active students, which will assist in the interpretation of individual scores when screening athletes for musculoskeletal injury and performance factors. More research is still necessary before implementing the FMS™ into a pre-participation physical examination (PPE) for athletics, but due to the low cost and its simplicity to implement, it should be considered by clinicians and researchers in the future. LEVEL OF EVIDENCE: 2B.

Reliability and validity of the AutoCAD software method in lumbar lordosis measurement.

OBJECTIVE: The aim of this study was to determine the reliability and validity of the AutoCAD software method in lumbar lordosis measurement. METHODS: Fifty healthy volunteers with a mean age of 23 ± 1.80 years were enrolled. A lumbar lateral radiograph was taken on all participants, and the lordosis was measured according to the Cobb method. Afterward, the lumbar lordosis degree was measured via AutoCAD software and flexible ruler methods. The current study is accomplished in 2 parts: intratester and intertester evaluations of reliability as well as the validity of the flexible ruler and software methods. RESULTS: Based on the intraclass correlation coefficient, AutoCAD's reliability and validity in measuring lumbar lordosis were 0.984 and 0.962, respectively. CONCLUSIONS: AutoCAD showed to be a reliable and valid method to measure lordosis. It is suggested that this method may replace those that are costly and involve health risks, such as radiography, in evaluating lumbar lordosis.