Effects of telerehabilitation-based respiratory and corrective exercises among the elderly with thoracic hyper-kyphosis: a clinical trial.

BACKGROUND: Aging is associated with changes in the musculoskeletal system, including increased susceptibility to spine malalignments. Utilizing corrective exercises with a therapeutic emphasis can be beneficial in the elderly with thoracic spine hyperkyphosis. OBJECTIVE: This study aimed to investigate the effects of six weeks of telerehabilitation-based respiratory and corrective exercises on quality of life, disability, thoracic kyphosis, craniovertebral angle, shoulder angle, cranial angle, and chest expansion in the elderly with thoracic spine hyperkyphosis. METHODS: In this clinical trial, a total of 40 participants aged 60 and above with thoracic hyperkyphosis were randomly divided into the control (N = 20) and experimental (N = 20) groups. The experimental group performed the corrective exercises for six weeks (3 sessions per week). The control group performed general stretching exercises during the same time period. We measured the outcomes of quality of life, disability, thoracic kyphosis, craniovertebral angle, shoulder angle, cranial angle, and lung expansion before and after the intervention. Analysis of covariance (ANCOVA) was employed to analyze the data. A P-value ≤ 0.05 was considered statistically significant. RESULTS: Quality of life (P < 0.001, Effect Size (ES): 0.44), chest expansion (P < 0.001, ES: 0.56), thoracic kyphosis angle (P < 0.001, ES: 0.31), craniovertebral (P < 0.001, ES: 0.33), cranial (P < 0.001, ES: 0.38), and shoulder (P = 0.005, ES: 0.20) angles were significantly improved in the experimental group as compared with controls. However, no statistically significant difference was observed between the two groups in terms of physical ability (P = 0.251, ES: 0.04). CONCLUSION: It is therefore recommended that online corrective exercises be used in the rehabilitation protocol to improve the quality of life, posture, chest expansion, and disability in the elderly with thoracic kyphosis.

The effect of various therapeutic exercises on forward head posture, rounded shoulder, and hyperkyphosis among people with upper crossed syndrome: a systematic review and meta-analysis.

OBJECTIVES: This review study aimed to evaluate the impact of therapeutic exercises on Upper-Crossed Syndrome (UCS). The study utilized a systematic review and meta-analysis approach to investigate the effects of various therapeutic exercises on forward head posture, rounded shoulders, and hyperkyphosis associated with upper crossed syndrome. METHODS: The study identified relevant keywords for each independent and dependent variable and conducted a search in scientific databases, including PubMed, Web of Science, Scopus, and Google Scholar, without any time limitations until 12 August 2023. Overall, 4625 articles were found in the selected databases, which were reduced to 1085 after being entered into the EndNote software and removing duplicate data. The full texts of 30 remaining studies were reviewed; ten articles meeting the criteria were included. Additionally, 12 studies from the Google Scholar database were included, resulting in 22 studies. Using Comprehensive meta-analysis software (CMA ver 3), data heterogeneity was measured with I2 and the Q tests. The Funnel Plot and Egger test methods were utilized to determine the possibility of publication bias. The JBI checklist was used to assess the quality of the studies. RESULTS: The results of the meta-analysis showed that therapeutic exercises were effective in improving forward head, rounded shoulders, and thoracic kyphosis angles (CI 95% = -1.85-1.161, P = 0.001, P = 0.001, CI95%=-1.822-1.15, and P = 0.001, CI 95%= -1.83-1.09, respectively). CONCLUSION: Based on the results, it appears that performing therapeutic exercises in the form of strength exercises, stretching, shoulder-based exercises, and incredibly comprehensive exercises that target all muscles may be effective in reducing forward head, rounded shoulders, thoracic kyphosis, and overall UCS.

Mechanical energy flow analysis in athletes with and without anterior cruciate ligament reconstruction during single-leg drop landing.

Techniques that reduce mechanical energy have been linked to lower chances of experiencing an Anterior Cruciate Ligament (ACL) injury. Although there is evidence that movement patterns are altered in athletes who have undergone Anterior Cruciate Ligament Reconstruction (ACLR), energy transfer mechanisms have not been examined. This study aimed to compare energy flow mechanisms during single-leg drop landing between athletes with and without history of ACLR. A total of 20 female athletes were included in this study. Ten participants underwent ACLR 12 months ago (mean age, 21.57 ± 0.41 years) and 10 were healthy controls (mean age, 20.89 ± 0.21 years). Participants executed the single-leg drop landing (SLL) maneuver by descending from a 30 cm wooden box and landing on the tested leg on an embedded force plate. Information collected during the SLL trials was refined using rigid-body analysis and inverse dynamics within Nexus software, ultimately allowing construction of skeletal models of the athletes. Ankle and knee mechanical energy expenditure (MEE) was higher in the control participants during landing. However, the result for the hip MEE demonstrated that MEE of the control group was significantly lower compared with the ACLR group, but MEE of the control subjects was higher as compared to ACLR group (p ˂ 0.05). Results suggest the avoidant use of the quadriceps muscle post ACLR leads to knee-avoidant mechanics and loss of knee joint power generation during a SLL task.

Electromyography of scapular stabilizers in people without scapular dyskinesis during push-ups: a systematic review and meta-analysis.

Background: Push-up (PU) is widely considered an effective exercise to stabilize the scapular, especially if performed on unstable surfaces. However, available studies cover a wide range of exercise variations and differ according to exercise prescription, muscle selection and study design. Therefore, findings are contradictory, and conclusions for a proper application of the PU are difficult to draw. Objective: To synthesize the available literature on the changes in the activity of the periscapular muscles in individuals without scapular dyskinesis while performing different types of PU on unstable surfaces. Search procedure: Four online databases were searched from the earliest publications to 9 August 2023, using predefined keywords. Out of the 2,850 potential references identified in the primary search, 92 studies were reviewed in detail, of which 38 met the inclusion criteria and were included. Methodological quality was evaluated using a standardized form based on the Newcastle‒Ottawa scale for observational studies. Data combination was performed using CMA (v3), and the random-effects model was used to calculate the standardized mean difference (SMD) with a 95% confidence interval (CI). Results: The use of unstable surfaces in people without scapular dyskinesis led to increased activity of the upper trapezius during the PU (p = 0.017; I2 = 84.95%; SMD = 0.425 [95% CI 0.077, 0.773]) and knee PU (p = 0.023; I2 = 70.23%; SMD = 0.474 [95% CI 0.066, 0.882]) exercises and increased activity of the middle trapezius (MT) (p = 0.003; I2 = 64.50%; SMD = 0.672 [95% CI 0.225, 1.119]) and serratus anterior (SA) (p = 0.039; I2 = 4.25%; SMD = 0.216 [95% CI 0.011, 0.420]) muscles during the push-up plus (PUP) exercise. Conclusion: Using an unstable support base during PU does not necessarily increase the activity of all scapular stabilizers. The amount of muscle activity depends on the type of PU other than the type of support base. If an unstable surface is used, PUP exercise appears to be the most effective modality to increase the quality of training, improve performance, and prevent the occurrence of scapular dyskinesis due to the increase in the activity of the MT and SA muscles. Systematic Review Registration: http://www.crd.york.ac.uk/PROSPERO, CRD42021268465.

Comparison of mechanical energy transfer during right-forward lunge between female amateur and professional badminton players.

BACKGROUND: Regarding their skill levels, badminton players present different movement patterns during front and right lunging. The main objective of this study was to compare the mechanical energy transfers attributable to right-forward lunges between amateur and professional badminton players to study variations in mechanical efficiency at various skill levels. METHOD: In this cross-sectional study, twenty female badminton players were recruited (Professional group n = 10 and Amateur group n = 10). The kinematics and kinetics of the lower extremities were recorded while performing right-forward lunges using Vicon motion capture and Kistler force plates. Mechanical energy expenditures (MEE) were extracted in eccentric transfer, concentric transfer, and no-transfer phases for the hip, knee, and ankle joints. At each joint, mechanical energy compensations (MEC) were also determined. Independent samples t-tests were used to analyze data at a significance level of α = 0.05. RESULT: Regards to mechanical energy expenditures at the initial heel contact phase, the professional players demonstrated statistically significant more ankle no-transfer (p < 0.003), less knee concentric transfer (p < 0.026), more knee eccentric transfer (p < 0.001), and less hip no-transfer (p < 0.001). At the same time, the amateur athletes showed significantly more ankle eccentric transfer (p < 0.042) at maximal knee flexion angle time point. Analyzing mechanical energy compensation coefficients showed that the professional athletes had significantly less ankle concentric transfer (p < 0.001), more knee concentric transfer (p < 0.001), more knee eccentric transfer (p < 0.001), and more hip eccentric transfer (p < 0.001) at initial contact phase. While they found to have significantly more ankle eccentric transfer (p < 0.007), less knee concentric transfer (p < 0.001), less knee eccentric transfer (p < 0.001), more hip concentric transfer (p < 0.001), and more hip eccentric transfer (p < 0.001) at maximal knee flexion angle. CONCLUSION: it is shown that the mechanical energy efficiency of the right-forward lunge is skill-related. It seems that altered lunge landing biomechanics may increase the risk of ankle and knee injuries and muscular damages in amateur athletes. It is recommended for amateur players to follow a injury prevention training program that promotes proper lunging technique.

The effect of dual-task on jump landing kinematics and kinetics in female athletes with or without dynamic knee valgus.

It has been indicated that dual tasks may multiply the possibility of injuries due to divided attention. This study aimed to investigate the effect of dual-task on kinematics and kinetics of jump landing in female athletes with and without dynamic knee valgus. In this study, 32 recreational athletes between 18 and 30 years old were recruited and divided into with (n = 17) and without (n = 15) dynamic knee valgus groups. The 3-D positions of retroreflective markers were recorded at 200 Hz using a 8-camera Kestrel system (Motion Analysis Corporation, Santa Rosa, CA), while ground reaction forces were synchronously recorded at 1000 Hz using 2 adjacent force plates (FP4060-NC; Bertec Corporation, Columbus, OH). Kinematics and kinetics of jump landing were recorded while counting backward digits as a dual task, and also without counting backward digits as a single task. One-way repeated measures of variance were used to analyse data at the significant level of 95% (α < 0.05). The study found that the dual-task affected the angles and moments of hip, knee, and ankle joints (P < 0.05) in both groups. Additionally, the effect of the dual-task differed significantly between the two groups in the angles hip flexion (P < 0.001), knee abduction (P < 0.001), and ankle internal rotation (P = 0.001), as well as the moments hip flexion (P < 0.001), hip abduction (P = 0.011), knee flexion (P = 0.017), knee internal rotation (P < 0.001), ankle dorsiflexion (P = 0.046), ankle eversion (P < 0.001), and ankle internal rotation (P = 0.046). Athletes with dynamic knee valgus may have been less able to protect themselves during the landing and are more prone to lower extremities injuries. As a result, using kinematics and kinetics in athletes with dynamic knee valgus during landing may help identify potential mechanisms associated with risk factors of lower extremity injuries and ACL injuries as well.

Association between physical activity and body posture: a systematic review and meta-analysis.

OBJECTIVE: To estimate the possible associations between posture and physical activity (PA). DESIGN: A systematic review and meta-analysis. DATA SOURCES: The search was conducted in seven databases (PubMed, Web of Science, SportDiscus, EMBASE, Scopus, Cochrane Library, and CINAHL) for studies published from inception to January 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies were required to meet following criteria: (1) study design: cross-sectional, case control and cohort studies. (2) Participants: people of all ages without any diagnosed diseases. (3) Exposure and outcome: studies that examined the possible effect or correlations between PA, physical inactivity, physical exertion and human body posture. RESULTS: Sixteen cross-sectional studies, two cohort studies and one case control study involving a total of 16772 participants aged from 6 to 79 years were included. Correlational studies showed that there was a significant relationship between PA and posture (C = 0.100, CI 95% = 0.012-0.186). However, regression studies demonstrated that there was not a significant association between PA and posture (C = 1.00, CI 95% = 0.998-1.002). Three studies investigated the association between PA and the lumbar lordosis and showed that there was not a significant association between the lordosis and PA (CI 95%: -0.253-0.048, P = 0.180). In addition, four studies showed that there were not any associations between scoliosis and PA (CI 95%: 0.819, 1.123, P = 0.607). The evidence of heterogeneity and publication bias was found among all analyzed data (P < 0.05). Also, meta regression was used for age and BMI and the results were not significant. CONCLUSION: Although a weak correlation was shown to exist between PA and human posture, the odds ratio indicated that there was not a significant association between PA and human posture. The lack of a significant relationship may indicate that multiple biopsychosocial factors may be involved in human posture. In summary, our study highlights the need for caution when interpreting the results of meta-analyses, particularly when there is significant heterogeneity and publication bias in the included studies.

The effects of exercise training on knee repositioning sense in people with knee osteoarthritis: a systematic review and meta-analysis of clinical trials.

OBJECTIVE: Osteoarthritis (OA) of the knee is one of the most common global joint disorders, especially in aging population, and is among leading health-related concerns of societies. Therefore, this systematic review and meta-analysis was done to investigate the results related to the effects of exercise interventions on knee repositioning sense in patients with knee OA. METHODS: An extensive search was independently performed in electronic databases including PubMed, MEDLINE, Web of Science, SCOPUS, and Google Scholar, to identify randomized clinical trials (RCTs) conducted on knee OA and to evaluate knee repositioning sense before and after different exercise interventions. After extracting relevant data from eligible studies, results of the studies were pooled using a random-effects model of meta-analysis. The Physiotherapy Evidence Database (PEDro) of clinical trials was used for quality assessment of eligible studies. RESULTS: Among 2702 studies identified in the initial search, 17 studies were eligible for final systematic review and meta-analysis. The results showed that the patients who participated in different exercise interventions had significantly less knee repositioning error (mean differences: -1.141 degrees (95%CI: -1.510, -0.772, P < .001) compared to those who did not undergo exercise interventions. The eligible studies exhibited publication bias (Intercept: -6.69, P = .002), and the data showed significant heterogeneity (I2 = 85.633%, Q = 153.125, P < .001). Moreover, meta regression showed more prolonged exercise duration might have more effects on knee repositioning error (Coefficient=-0.860, 95% CI=-1.705, -0.016, Z=-2.00, P = .045). CONCLUSION: There is strong evidence that exercise interventions may effectively reduce knee repositioning error. Moreover, it seems that more prolonged exercise duration may be associated with the greater effect size.

The sacroiliac dysfunction and pain is associated with history of lower extremity sport related injuries.

BACKGROUND: The purpose of this study was to examine the association of sacroiliac joint (SIJ) dysfunction and pain with overuse and acute lower limb and pelvic girdle injuries of Iranian basketball players. METHODS: In this cross-sectional study, basketball-related injury data were collected during 2019-2020 from 204 basketball players of the Iranian league using the online Information Retrospective Injury Questionnaire. A researcher then performed ten clinical tests to assess SIJ dysfunction and pain (five tests for dysfunction and five tests for pain). Data analysis was performed by logistic regression at the confidence interval of 95%. RESULTS: Within our sample (n = 204), injury rates were calculated across sub-groups of athletes that had only SIJ pain (n = 19), only SIJ dysfunction (n = 67), both SIJ pain and dysfunction (n = 15) or no SIJ complaints (n = 103). Across these groups, a total of 464 injuries were reported. SIJ pain group reported 80 injuries (17.2%), SIJ dysfunction group reported 210 injuries (45.2%), both SIJ pain and dysfunction group reported 58 injuries (12.5%, and the no SIJ pain or SIJ dysfunction group reported 116 injuries (25.0%). Participants with SIJ pain were more likely to report previous pelvic girdle injuries (overuse: odds ratio (OR): 0.017; 95% CI: 0.005-0.56; p < 0.001 and acute: OR: 0.197; 95%CI: 0.101-0.384; p < 0.001) and also lower limb injuries (overuse: OR: 0.179, 95%CI: 0.082-0.392, p < 0.001). Participants with SIJ dysfunction only were likely to report acute pelvic girdle injuries (OR: 0.165; 95%CI: 0.070-0.387; p < 0.001) and acute lower limb injuries (OR: 0.165; 95%CI: 0.030-0.184; p < 0.001). CONCLUSION: The presence of SIJ dysfunction and pain is associated with a history of acute and overuse injuries in the pelvic girdle and lower limb. Thus, SIJ dysfunction and pain should be specifically evaluated and addressed when designing rehabilitation programs for sports-related injuries.

Altered muscle strength and flexibility among a subgroup of women with chronic nonspecific low back pain: Cross-sectional case-control study.

OBJECTIVE: To compare muscle strength and flexibility among a subgroup of women with extension-related chronic nonspecific low back pain (CNLBP) with healthy controls. METHODS: In this case-control study, 32 subjects with and without extension-related CNLBP were tested (n = 16 in each group). Gluteal, abdominal, paravertebral, and hamstring strength, along with hip flexor flexibility and hamstring flexibility were compared between groups. Data were analyzed using the Mann-Whitney test (p < .007). RESULTS: The CNLBP subgroup displayed significantly lower strength of all muscles analyzed (p < .007), with the exception of gluteus medius. The flexibility of the hip flexors and hamstrings were not significantly reduced among the women with CNLBP (p > .007). DISCUSSION: The present study showed that alterations in muscle strength, but not flexibility, partly consistent with those previously hypothesized but not objectively reported, were present among a subgroup of women with extension-related CNLBP. These results may have implications for the selection of therapeutic exercises among this subgroup of people with CNLBP.

The effect of fatigue on electromechanical response times in basketball players with and without persistent low back pain.

Typically, athletes alter movement mechanics in the presence of back pain, but the effect of these changes on lower extremity injury risk is not well understood. This study aimed to compare the effect of fatigue on electromechanical response times during a choice reaction task in basketball players with and without persistent low back pain. Twenty-four male basketball players participated. Total reaction time (TRT), premotor time (PMT), and electromechanical delay (EMD data were recorded before and after fatigue. The chronic low back pain (CLBP) group had significantly longer EMD in Med gastrocnemius (p = 0.001) and Tibialis anterior (p = 0.001), and shorter EMD in Vastus Lateralis (p = 0.001), Vastus Medialis Oblique (p = 0.003), and Semitendinosus (p = 0.025) muscles after fatigue. PMT in the CLBP group had longer than the Non-CLBP in Vastus Lateralis (p = 0.010), Vastus Medialis Oblique (p = 0.017), Semitendinosus (p = 0.002). Also, TRT was longer in knee flexion (p = 0.001) and ankle plantarflexion (p = 0.001) muscle groups. The different effects of fatigue on electromechanical response times of the knee and ankle in people with CLBP may represent the effect of an axial injury on lower extremity injury risk factors in situations of higher cognitive load, similar to competitive play.

Establishing minimal clinically important difference for effectiveness of corrective exercises on craniovertebral and shoulder angles among students with forward head posture: a clinical trial study.

BACKGROUND: Previous studies have addressed the effects of different exercises and modalities on forward head posture (FHP), but the minimal clinically important difference (MCID) of the effect of exercises on FHP remains unclear. Therefore, this study aimed to investigate the effects of selective corrective exercises (SCEs) on the craniovertebral angle (CVA) and shoulder angle (SA) in students with FHP and to establish MCID for these angles. METHODS: In this randomized clinical trial study, a total of 103 second-grade male students with FHP were enrolled. Participants were randomly assigned to experimental and control groups. CVA and SA of participants were measured before and after the 8-week selective corrective exercise program (including strengthening and stretching exercises). The photogrammetric method was used to measure CVA and SA. MCID value was calculated for CVA and SA using the distribution method. RESULTS: The results showed that there was a significant difference between the experimental and control groups in terms of CVA (F = 89.04, P = 0.005, Effect size = 0.47) and SA (F = 18.83, P = 0.005, Effect size = 0.16). After eight weeks of selective corrective exercises, the MCID values of CVA and SA were 1.40° and 1.34°, respectively. CONCLUSION: This study revealed that the selective corrective exercises might lead to postural correction of students having FHP problem. Results further indicated that a corrective exercise program would be considered beneficial if it increased CVA and SA values at least 1.40 and 1.34 degrees, respectively.

Sport-related injuries in Iranian basketball players: evidence from a retrospective epidemiologic study (2019-20).

OBJECTIVES: Basketball is a contact sport with complex movements that include jumps, turns, and changes in direction, which cause frequent musculoskeletal injuries in all regions of the body. Also, injury patterns among athletes, particularly basketball players, continue to evolve and change. The current retrospective epidemiologic study aimed to investigate the incidence, severity, and sports-related risk factors of injuries in Iranian basketball players from 2019 to 2020. METHODS: Using the Information Retrospective Injury Questionnaire (online version), data on basketball-related injuries were collected retrospectively for 204 basketball players of the Iranian league (professional super league and first-division league) during the 2019/2020 season. RESULTS: A total of 628 injuries were reported, which was equivalent to 6.07 injuries/1000 h. The ankle was the location of most injuries (n = 116 or 26.9%; overuse injuries (n = 40 or 20.3%)), followed by lower back/pelvis injuries (acute injury n = 67 (15.5%) and overuse injuries (n = 23; 11.6%)), knee injuries (acute injury n = 62 (15.7%) and overuse injuries (n = 31 (14.3%)), wrist/fingers injuries (acute injury (n = 85 (13.4%)) and overuse injuries (n = 8; 4.0%)), and shin/calf injuries (acute injury (n = 35; 8.1%) and overuse injuries (n = 28; 14.2%)). Mean time loss in first-division league players was much higher than professional super league players (7.84/1000 h exposure vs. 4.30/1000 h exposure), respectively. CONCLUSION: The ankle sprain was the most common injury in our study. Lower back/pelvis injuries had the longest time loss. Injury was more frequent among first-division league players than those in the professional super league. Injuries during practice were notably more frequent than during competition with different patterns of injuries.

Lower extremity kinematic coupling during single and double leg landing and gait in female junior athletes with dynamic knee valgus.

BACKGROUND: Dynamic knee valgus (DKV) is a common lower extremity movement disorder among females. This study aimed to investigate kinematic couplings between lower extremity joints in female junior athletes with DKV during single and double-leg landing and gait. METHODS: Twenty-six physically active female junior athletes (10-14 years old) with DKV were recruited. Kinematic couplings between rearfoot, tibia, knee, and hip were extracted using eight Vicon motion capture cameras and two force plates. Zero-lag cross-correlation coefficient and vector coding were used to calculate kinematic couplings between joints during physical tasks. Paired t-test and Wilcoxon tests were run to find significant couplings between joint motions and coupling strengths. Bonferroni posthoc was used to determine significance with α ≤ 0.05. RESULTS: The results showed that the strongest kinematic relationship existed between rearfoot eversion/inversion and tibial internal/external rotation during all three tasks. Correlations of the rearfoot supination/pronation with tibial rotations, knee, and hip motions in sagittal, frontal, and transverse planes were very strong to strong during double-leg landing and moderate to weak during gait. A weak correlation was observed between rearfoot supination/pronation and hip adduction/abduction during single-leg landing. CONCLUSIONS: Coupling relationships between rearfoot, knee, and hip vary by the task intensity and alignment profiles in female juniors with DKV.

Altered ultrasonographic activity of abdominal muscles during breathing in males with and without nonspecific chronic low back pain.

PURPOSE: This study aimed to investigate the altered ultrasonographic activity of abdominal muscles during breathing in males with and without nonspecific chronic low back pain (NSCLBP). DESIGN: Cross-sectional study. METHODS: Twenty males with NSCLBP and 20 males without NSCLBP were recruited. Muscle thickness change was measured by ultrasonography during breathing in the end-inspiration and end-expiration phases for the transverse abdominis (TrA), internal oblique (IO), external oblique (EO), and rectus abdominis (RA) muscles. The data were normalized to the end-inspiration thickness. An independent t test was run to analyze the data at a confidence level of 95% (p < 0.05). RESULTS: The participants with NSCLBP had thicker IO muscles in the end-inspiration (p = 0.030) and end-expiration (p = 0.017) phases as well as greater RA (p = 0.006) and smaller EO (p = 0.003) normalized thickness changes during breathing. CONCLUSION: The normalized thickness changes during breathing differed between the participants with and without NSCLBP. Reduced EO and increased RA activity may predispose the spine to further injuries. Therefore, normalizing the breathing pattern should be considered in the management of people with NSCLBP.

Single leg landing kinematics in volleyball athletes: A comparison between athletes with and without active extension low back pain.

PURPOSE: The purpose of this study was to compare kinematics of the lower extremity and lumbar spine during a single leg landing task between female volleyball athletes with and without persistent low back pain (LBP). METHODS: In this cross sectional study, 36 volunteer female volleyball athletes with (n = 18) and without (n = 18) LBP were recruited. Two specifically trained physical therapists selected only athletes with a specific movement-based subgroup of LBP for inclusion. Three dimensional kinematic and ground reaction force data were recorded for each athlete across three single leg landing trials by utilizing a Vicon 6-camera motion capture system and one in-floor embedded Kistler force plate, respectively. Independent t-tests compared data between the two groups. RESULTS: Lumbar lordosis when standing (p = 0.046) as well as on initial contact (p = 0.025) and at the time which the maximal vertical ground reaction force occurred (p = 0.020) were significantly greater in the LBP group. There were no other significant differences. CONCLUSIONS: The tendency for this specific subgroup of athletes to consistently adopt more extended lumbar postures in both static and dynamic tasks may be worth considering by those involved in coaching, performance optimizing and injury prevention.

Effectiveness of Therapeutic Exercise on Forward Head Posture: A Systematic Review and Meta-analysis.

OBJECTIVE: The purpose of this systematic review and meta-analysis was to summarize the results related to the effects of corrective exercises on postural variables in individuals with forward head posture (FHP). METHODS: A systematic review of the electronic literature through February 2017 was independently performed by 2 investigators. The electronic databases searched included PubMed, MEDLINE, Web of Science, ScienceDirect, Cochrane Central Register of Controlled Clinical Trials, Google Scholar, and Scopus. Methodological quality was evaluated using the Physiotherapy Evidence Database scale. Meta-analyses were carried out for craniovertebral angle (CVA), cranial angle (CA), and pain intensity. RESULTS: Seven randomized clinical trials comprising 627 participants met the study criteria. The between-groups pooled random odds ratios for CVA, CA, and pain were 6.7 (confidence interval [CI] = 2.53-17.9, P = .0005), 0.7 (CI = 0.43-1.2, P = .2), and 0.3 (95% CI = 0.13-0.42, P < .001), respectively. No publication bias was observed. Level 1a evidence (strong) indicates exercise training can effectively modify CVA, and level 1b evidence (moderate) indicates exercise may improve pain but not CA. CONCLUSION: The findings suggest that therapeutic exercises may result in large changes in CVA and moderate improvement in neck pain in participants with FHP. The precise nature of the relationship between FHP and musculoskeletal pain, and improvements in both after therapeutic exercise, remains to be established.

Dry Needling in myofascial tracks in Non-Relaxing Pelvic Floor Dysfunction: A case study.

OBJECTIVE: The aim of this case report is to describe the use of Dry Needling (DN) in myofascial tracks related to the pelvic floor (PF) in the management of a male with Non-Relaxing Pelvic Floor Dysfunction (NRPFD). CLINICAL FEATURES: A 42-year-old man, with a 20-year history of frequent urination, was referred to the physical therapy clinic by a urologist with diagnosis of NRPFD. The patient was suffering from a sense of incomplete evacuation and difficulty to start urination. He had to urinate every 30 min. The initiation of urination was so difficult that patient had to facilitate it by splashing warm water on his penis. INTERVENTION AND OUTCOME: DN was performed for 10 sessions. The first three sessions were performed every other day in the same week. In the second week, DN was performed twice at three-day intervals, and the other sessions were performed such that one session was held per week. Selected stretching exercises were prescribed in the first session. The results showed that the patient had reported no urination during sleep, and urination six to eight times when was awake. A three-month follow-up with a telephone-based interview showed that the symptoms did not recur. CONCLUSION: This study showed the possible efficacy of prescribing DN in myofascial tracks in the management of a male with NRPFD. More studies are required to clarify the issue.

The Effect of Harmonic Technique vs End Range Loading Exercises on Pain and Disability in Patients With Non-Specific Chronic Low Back Pain: A Preliminary Study.

OBJECTIVE: The purpose of this study was to compare the effects of end range loading (ERL) vs harmonic technique (HT) on patients with chronic low back pain (LBP). METHOD: Fourteen volunteer patients with LBP were randomly assigned to 2 groups based on a blocked randomization method with 7 patients in the HT group and 7 patients in the ERL group. The patients received 10 sessions of treatment for 5 sessions per week. Pain intensity and disability score were recorded using the numeric pain scale and Roland-Morris Disability questionnaire (RMQ), respectively, before and after the treatment period. RESULTS: Although pain intensity (P = .02) and the RMQ score (P = .03) decreased in the HT technique group, no statistically significant change was found in the ERL group for the RMQ score (P > .05). The effect size for HT was .6 and .3 for numeric pain scale and RMQ, respectively. CONCLUSION: This preliminary study showed that pain intensity and disability improved in subjects with chronic LBP in the HT group. More investigations with larger sample size are needed to clarify these findings.