The Effect of Remote Myofascial Release on Chronic Nonspecific Low Back Pain With Hamstrings Tightness.

CONTEXT: Anatomy trains theory states that performing techniques in any part of the superficial myofascial backline can remotely treat other parts of this pathway. Due to the connections of different parts of the superficial backline, it is possible to influence the hamstring by performing the technique in the lumbar area. As chronic nonspecific low back pain (LBP) may lead to or be caused by hamstring tightness, remote myofascial release (MFR) techniques using the superficial backline can help improve hamstring tightness. OBJECTIVE: This study aimed to evaluate the effect of remote MFR on hamstring tightness for those with chronic nonspecific LBP. DESIGN: Single-blind, parallel design. SETTING: The present study was performed at the clinical setting of Tarbiat Modares University in Iran. METHODS: This study included 40 participants (20 males and 20 females) who were 40.5 (5.3) years old with chronic nonspecific LBP and hamstring tightness. INTERVENTIONS: Participants were randomly divided into the lumbar MFR (remote area) and hamstring MFR groups. Participants underwent 4 sessions of MFR for 2 weeks. MAIN OUTCOME MEASURES: A passive knee-extension (PKE) test was used for muscle tightness evaluation 3 times. RESULTS: Repeated-measure analysis of variance test showed that after the lumbar and hamstring MFR, the PKE was significantly reduced in both legs: lumbar MFR (right knee: from 61.04° [2.17°] to 51.01° [4.11°], P ≤ .003 and left knee: from 63.02° [3.12°] to 52.09° [2.48°], P ≤ .004) and hamstring MFR (right knee: from 62.01° [4.32°] to 50.50° [7.18°], P ≤ .001 and left knee: from 63.11° [2.56°] to 51.32° [5.31°], P ≤ .002). Least Significant Difference (LSD) post hoc test results showed that the 2 groups were not significantly different after the MFR (P ≥ .05). Also, the intraclass correlation coefficient index showed that the PKE test has excellent reliability (intraclass correlation coefficient, .910 for the right limb and .915 for the left limb). The minimal detectable change at the 95% confidence interval indicated that a change greater than or equal to 6° is required to exceed the threshold of the error PKE test, respectively. CONCLUSION: The present study showed that the remote MFR technique to the lumbar region demonstrated the same significant results in decreasing hamstring tightness as was noted in hamstring MFR to both limbs in patients with chronic nonspecific LBP.

Comparison of two ellipsoidal models for the estimation of left ventricular end-systolic stress in patients with significant coronary artery disease.

Background: The shape of the left ventricle (LV) is an important index to explore cardiac pathophysiology. A comparison was provided to estimate circumferential, longitudinal, and radial wall stress in LV based on the thick-walled ellipsoidal models of Mirsky and Ghista-Sandler for discriminating significant coronary artery disease (CAD) patients from no CAD patients. Materials and Methods: According to the angiography findings, 82 patients with CAD were divided into two groups: 25 patients without significant CAD and 57 patients with significant CAD of single vessel and multivessel. An ellipsoidal LV geometry was used to calculate end-systolic passive stress as the mechanical behavior of LV. Echocardiographic views-based measurements of LV diameters used to estimate the end-systolic wall stress. Results: Circumferential wall stress between the control group and significant CAD groups was significantly elevated for the Ghista model (P = 0.008); also, radial and longitudinal stress of the multi-vessel CAD group was significantly higher than the control group (P = 0.01 and P = 0.005, respectively). All stress parameters of the multi-vessel CAD group were statistically significant compared to the control group for the Mirsky model. Receiver operating characteristics curve analysis was shown the circumferential stress of multi-vessel CAD with an area under the curve (AUC) of 0.736 for the Ghista model and an AUC of 0.742 for the Mirsky model. Conclusion: These results indicated that Ghista and Mirsky model estimates of circumferential passive stress were the potential biomechanical markers to predict patients with multi-vessel CAD. It could be a noninvasive and helpful tool to quantify the contractility of LV.

Effect of Remote Myofascial Release on Lumbar Elasticity and Pain in Patients With Chronic Nonspecific Low Back Pain: A Randomized Clinical Trial.

Objective: The purpose of this study was to evaluate the effects of myofascial release technique of a remote area on lumbar elasticity and low back pain (LBP) in patients with chronic nonspecific LBP. Methods: For this clinical trial, 32 participants with nonspecific LBP were assigned to a myofascial release group (n = 16) or a remote release group (n = 16). Participants in the myofascial release group received 4 sessions of myofascial release to the lumbar region. The remote release group received 4 myofascial release sessions to the crural and hamstring fascia of the lower limbs. Low back pain severity and elastic modulus of the lumbar myofascial tissue were assessed before and after treatment by the Numeric Pain Scale and ultrasonography examinations. Results: The mean pain and elastic coefficient in each group before and after myofascial release interventions were significantly different (P ≤ .0005). The results showed that the changes in mean pain and elastic coefficient of the 2 groups after myofascial release interventions were not significantly different from each other (F1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22 = 1.48, P = .230, 95% confidence interval) (effect size = 0.22). Conclusion: The improvements in the outcome measures for both groups suggest that remote myofascial release was effective in patients with chronic nonspecific LBP. The remote myofascial release of the lower limbs reduced the elastic modulus of the lumbar fascia and LBP.

The effect of transcutaneous electrical nerve stimulation on pain and electrical stimulation muscle thickness in patients with non-specific chronic low back pain-based ultrasonographic evaluation.

Aim: The existing mechanisms of transcutaneous electrical nerve stimulation (TENS) focuses more on the effect of neural tissue. This study investigated the effect of TENS on the thickness of the erector spinae muscles and reducing pain. Patients & methods: 56 individuals with low back pain participated in this single-blind, pre/post-test study. For 2 weeks, participants underwent ten sessions of TENS. The ultrasound evaluations examined the thickness of the erector spinae muscle, and the visual analog scale measured the severity of low back pain. Results: There was a decrease in pain score and muscle thickness after the interventions (p ≤ 0.004). There was also a strong correlation between reducing pain and decreasing muscle thickness (R = 0.709; p = 0.000). Conclusion: Following TENS in the lumbar, in addition to reducing pain, the thickness of the erector spinae muscles also decreased. Clinical Trial Registration: IRCT20200423047173N1 (ClinicalTrials.gov).

Low back pain is one of the common problems in different societies, which can greatly impact people's social performance. Therefore, safe treatment methods must be used to relieve low back pain quickly. The TENS device is a safe electrical device available that can be used in the early stages of low back pain. The results of the present study on 20 people with low back pain showed that the use of this device, in addition to reducing low back pain, also affects the structure of the muscles in the back area and can help people improve their performance.

Carotid Artery Wall Motion Estimation from Consecutive Ultrasonic Images: Comparison between Block-Matching and Maximum-Gradient Algorithms.

BACKGROUND: Radial movement of the arterial wall is a well-known indicator of the mechanical properties of arteries in arterial disease examinations. In the present study, two different motion estimation methods, based on the block-matching and maximum-gradient algorithms, were examined to extract the radial displacement of the carotid artery wall. METHODS: Each program was separately implemented to the same axial consecutive ultrasound images of the carotid artery of 10 healthy men, and the radial displacement waveform of this artery was extracted during two cardiac cycles. The results of the two methods were compared using the linear regression and Bland-Altman statistical analyses. The maximum and mean displacements traced by the block-matching algorithm were compared with the same parameters traced by the maximum-gradient algorithm. The frame numbers in which the maximum displacement of the wall occurred were compared too. RESULTS: There were no significant differences between the maximum and the mean displacements traced by the block-matching algorithm and the same parameters traced by the maximum-gradient algorithm according to the pair t-test analysis (p value > 0.05). There was a significant correlation between the radial movement of the common carotid artery measured with the block-matching and maximum-gradient methods (with a correlation coefficient of 0.89 and p value < 0.05). The Bland-Altman analysis results confirmed a good agreement between the two methods in measuring the radial movement, with a mean difference and limits of agreement of 0.044 ± 0.038. The results showed that both methods found the maximum displacement occurring in the same frame. CONCLUSION: Both block-matching and maximum-gradient algorithms can be used to extract the radial displacement of the carotid artery wall and in addition, with respect to the pixel size as error, the same results can be obtained.

Effect of Ga-As (904nm) and He-Ne (632.8 nm) laser on injury potential of skin full-thickness wound.

Injury potential may have a triggering biological role in wound healing. In this study, the effect of photostimulation to promote wound healing and its effect on injury potential was investigated using the Ga-As and He-Ne lasers. In this study, 30 healthy male Sprague-Dawley rats were randomly divided into a control and two laser groups, He-Ne and Ga-As laser. A 2.5 cm craniocaudal full-thickness skin incision was made on each animal's dorsal region. Differential skin surface potential was measured before and immediately after the injury and also up to the 21st day, every other day. Wound surface area was also measured. Immediately after injury, wound potential significantly increased in all three groups. Maximum positive peak of injury potential was greater in Ga-As group compared to He-Ne laser and control groups (P<0.05) and lasting period of maximum positive potential in two laser groups was longer than that in the control group. There were no significant differences between the mean potential of before wounding and after the 15th, 17th, and 19th day in Ga-As, He-Ne, and control group, respectively (P>0.05). On the other hand, Ga-As and He-Ne laser facilitated the normal distribution of skin potential after wounding. These findings demonstrate that Ga-As laser may be more effective on wound closure and on returning the injury potential to normal level than the He-Ne laser.