Comparison of tactile acuity between patients with chronic patellofemoral pain with central sensitization and healthy persons: A cross-sectional study.

BACKGROUND: Patellofemoral pain (PFP) is a common multifactorial condition in young and physically active people. OBJECTIVE: The occurrence of central sensitization may play an important role in sensory disturbance. This study was designed to investigate, in patients with chronic PFP, the presence of disturbances in tactile acuity with central sensitization. METHODS: Thirty patients with chronic PFP and 30 matched healthy controls entered this cross-sectional study. Graphesthesia (numerical score), two-point discrimination (mm), and point-to-point sensation (mm) were assessed in all participants. RESULTS: The results of between-group comparisons showed that there were significant differences between the involved knee in patients with chronic PFP and healthy participants in graphesthesia (median = 13 [case], 19 [control]; p < .001), two-point discrimination (median = 25.8 [case], 20.3 [control]; p < .001), and point-to-point sensation (median = 14.5 [case], 6.2 [control]; p < .001). There was also a significant difference in graphesthesia between the non-involved knee in patients with chronic PFP and healthy participants (median = 17 [case], 19 [control]; p = .003). The results of within-group comparisons revealed a significant difference in graphesthesia, two-point discrimination, and point-to-point sensation between the involved and non-involved knee in patients with chronic PFP (p < .001). Moreover, there was a positive correlation between two-point discrimination and pain in patients with chronic PFP (r = 0.446, p = .014). CONCLUSION: The findings of this study reveal that there is a sensory deficit in patients with chronic PFP. Because sensory information is necessary for motor control and pain perception, we can assume that clinical symptoms in these patients are related to sensory deficits.

Biomechanical Analysis of the Pelvis Angular Excursion in Sagittal Plane in Response to Asymmetric Leg Loading Tasks in Females with and without Non-specific Chronic Low Back Pain.

BACKGROUND: Controlling pelvic excursions is the focus of stabilization exercises such as legs loading tasks in rehabilitation of non-specific chronic low back pain (NSCLBP) patients. Progression of these exercises is based on the ability to perform tasks with minimal sagittal pelvic excursions. In spite of emphasis on minimizing pelvic motions, no previous studies have investigated kinematic analysis of the pelvic excursions during leg loading exercises in NSCLBP patients. OBJECTIVE: This study aims to investigate the sagittal pelvis excursion during performing asymmetric leg loading tasks in individuals with and without NSCLBP. MATERIAL AND METHODS: In this cross-sectional study, kinematic data were collected from 15 NSCLBP patients and 15 asymptomatic participants by a motion analysis system during right and left leg loading tasks with 2 levels of difficulty. Pelvis segments were modeled using Visual3D motion analysis software. Maximum pelvic excursion in the sagittal plane was calculated during each task. Mixed model analysis of variances (group, task difficulty level, side) was performed for statistical analysis. RESULTS: The maximum sagittal pelvic excursion values of all tasks in NSCLBP were smaller than those in the control group; however, no significant main effects and interactions were found between two groups. CONCLUSION: These results suggest that NSCLBP patients completed loading tasks without differences in sagittal pelvic excursions as compared to controls. Assessment of NSCLBP patients only based on pelvic angular excursion may not be sufficient for clinical decision making. Furthermore, asymptomatic individuals may need to practice for controlling pelvic excursion during leg loading exercises similar to the CLBP patients.

A Practical Sensor-Based Methodology for the Quantitative Assessment and Classification of Chronic Non Specific Low Back Patients (NSLBP) in Clinical Settings.

The successful clinical application of patient-specific personalized medicine for the management of low back patients remains elusive. This study aimed to classify chronic nonspecific low back pain (NSLBP) patients using our previously developed and validated wearable inertial sensor (SHARIF-HMIS) for the assessment of trunk kinematic parameters. One hundred NSLBP patients consented to perform repetitive flexural movements in five different planes of motion (PLM): 0° in the sagittal plane, as well as 15° and 30° lateral rotation to the right and left, respectively. They were divided into three subgroups based on the STarT Back Screening Tool. The sensor was placed on the trunk of each patient. An ANOVA mixed model was conducted on the maximum and average angular velocity, linear acceleration and maximum jerk, respectively. The effect of the three-way interaction of Subgroup by direction by PLM on the mean trunk acceleration was significant. Subgrouping by STarT had no main effect on the kinematic indices in the sagittal plane, although significant effects were observed in the asymmetric directions. A significant difference was also identified during pre-rotation in the transverse plane, where the velocity and acceleration decreased while the jerk increased with increasing asymmetry. The acceleration during trunk flexion was significantly higher than that during extension, in contrast to the velocity, which was higher in extension. A Linear Discriminant Analysis, utilized for classification purposes, demonstrated that 51% of the total performance classifying the three STarT subgroups (65% for high risk) occurred at a position of 15° of rotation to the right during extension. Greater discrimination (67%) was obtained in the classification of the high risk vs. low-medium risk. This study provided a smart "sensor-based" practical methodology for quantitatively assessing and classifying NSLBP patients in clinical settings. The outcomes may also be utilized by leveraging cost-effective inertial sensors, already available in today's smartphones, as objective tools for various health applications towards personalized precision medicine.

Effects of Ankle Kinesio Taping on Postural Control in Stroke Patients.

BACKGROUND: To investigate the effects of kinesio taping on postural control in stroke patients. MATERIALS AND METHODS: Forty stroke patients aged 30 to 60 years were randomly divided into an experimental and a control group. In the experimental group, kinesio tape (KT) was applied directly on the skin over the affected ankle in the direction of dorsiflexion and eversion to correct the equinovarus deformity. The tape was kept on the ankle for 1 day. The results were measured with the forward reach test, lateral reach test, Berg Balance Scale (BBS), and timed up and go test. Center of pressure (COP) displacement and velocity were also measured while the patients stood on a force plate. All variables were measured on the first day immediately after taping and 24 hours later in the KT group, and on the first day and also 24 hours later in the control group. RESULTS: There was a statistically significant difference in BBS between the first day and 24 hours later in the KT group (P = .01). The forward reach test and mediolateral displacement of the COP differed significantly after taping in the experimental group compared to the control group (P = .04). Immediately after taping, BBS improved significantly in the KT group (P = .02). CONCLUSIONS: The application of KT improved forward reach test results and displacement of the COP in stroke patients.