A Preliminary Study of the Objective Measurement of Compliance Rates for Semirigid Lumbar-Support Use in Patients with Chronic Nonspecific Low Back Pain: How Important Is the Compliance Rate?

STUDY DESIGN: Clinical pilot study. PURPOSE: To objectively evaluate the compliance rate of lumbar-support use in patients with chronic nonspecific low back pain, as well as to assess low back pain intensity, disability, and fear-avoidance beliefs. OVERVIEW OF LITERATURE: Wearing time is an important factor in the assessment of the efficacy of lumbar-support use in patients with chronic nonspecific low back pain. Previous studies have measured lumbar-support wearing time based on subjective assessment, and these evaluations are not easily verifiable and are usually overestimated by subjects. METHODS: Twelve subjects with chronic nonspecific low back pain who had been wearing semirigid lumbar supports for 6 weeks were evaluated. Compliance was objectively monitored using temperature sensors integrated into the semirigid lumbar supports. Subjects wore their lumbar supports for 8 hour/day on workdays and 3 hour/day on holidays during the first 3 weeks. During the next 3 weeks, subjects were gradually weaned off the lumbar supports. Pain intensity was measured using a numerical rating scale. The Oswestry disability index was used to assess the subjects' disability. Fear-avoidance behavior was evaluated using a fear-avoidance beliefs questionnaire. RESULTS: The mean compliance rate of the subjects was 78.16%±13.9%. Pain intensity was significantly lower in patients with a higher compliance rate (p=0.001). Disability index and fear-avoidance beliefs (functional outcomes) significantly improved during the second 3-weeks period of the treatment (p<0.001, p=0.02, respectively). CONCLUSIONS: The compliance rate of patients wearing lumbar supports is a determining factor in chronic low back pain management. Wearing semirigid lumbar supports, as advised, was associated with decreased pain intensity, improved disability index scores, and improved fear-avoidance beliefs in patients with chronic nonspecific low back pain.

Effect of kinesiotaping and stretching exercise on forward shoulder angle in females with rounded shoulder posture

Background: Rounded shoulder posture is a common abnormal posture in upper quarter. Kinesiotape is a new intervention that recently used in rehabilitation. There are no studies have examined the effect of kinesiotape on rounded shoulder posture. Therefore the purpose of this study was to determine the effect of scapular kinesiotaping and pectoralis minor stretching exercise on forward shoulder angle in female subjects with rounded shoulder posture

Methods: Twenty female students aged between 18 to 25 years old with rounded shoulder posture participated in this study. Then, the subjects were randomly and equally assigned to two groups: the stretch group and the stretch plus kinesiotape group. Both groups were trained for doing home exercise to stretch Pectoralis minor bilaterally for two weeks. Kinesiotape group received kinesiotape on scapular area additionally. Forward shoulder angle was measured in four sessions including pre-intervention [first session], immediately after the first intervention [second session], fourth day [third session] and at the end of two weeks [fourth session]. Two-way repeated measures ANOVA [4×2] was used for data analysis

Results: kinesiotape group showed significant within-group decrease in forward shoulder angle between first session with three other sessions [P

Conclusion: scapular kinesiotaping along with pectoralis minor stretching exercise improved rounded shoulder posture in subjects of the present study. kinesiotape is suggested as a complementary treatment with immediate effects on postural correction of rounded shoulder

Comparative evaluation of core and knee extensor mechanism muscle activation patterns in a stair stepping task in healthy controls and patellofemoral pain patients

Background: Patellofemoral pain [PFP] is a common affliction and complex clinical entity. Deficit in neuromotor control of the core may be a remote contributing factor to the development of PFPS. Comparative evaluation of core and extensor mechanism muscle activation patterns between healthy group and patients involved by patellofemoral pain syndrome [PFPS] in a stair stepping task is the aim of this study

Methods: In this non-randomized interventional study fifteen males with PFPS and fifteen asymptomatic controls participated. Electromyographic [EMG] activity of Vastusmedialisobliquus [VMO], Vastuslateralis [VL], Gluteus medius [GMED], Gluteus Maximus [GMAX], Internal oblique [IO] and Erector spinae [ES] were recorded and EMG onsets were assessed in both stepping up [SU] and down [SD]. The time of foot contact determined by a foot switch

Results: During SU: Onset times of all muscles except, VL and ES in the controls were significantly less than PFPS group [P<0.05]. In PFPS group the temporal sequence of ES, VL and VMO were different from control groups. During SD: Onset times of all muscles except, GMAX and ES in the control group were significantly less than PFP group [P<0.05]. The sequence of muscle activity in both healthy and PFP groups were the same

Conclusion: Our findings are in line with previous researches about the effects of core on function and control of lower extremity. Activation patterns of core and vasti muscles are different between control and PFPS group during stair stepping task. Designing exercises to correct inappropriate timing of core muscles may have a role in management of PFPS and it needs more future researches

test-retest reliability of the onset of core and vasti electromyographic activity while ascending and descending stairs in healthy controls and patellofemoral pain patients

Patellofemoral pain [PFP] is a common affliction and complex clinical entity. It is hypothesized to result from abnormal patellar tracking caused by altered motor control. Deficit in neuromotor control of the core may be a remote contributing factor to the development of PFP. Application of reliable EMG measures would be helpful to handle this theory. Therefore, the purpose of this study was to determine the test-retest reliability of the core and vasti EMG onsets, while ascending/descending stairs. Ten males with PFP and ten healthy controls participated in this study. Vasti and Core EMG onsets during stair stepping were assessed two times a day. Intraclass correlation coefficients [ICCs] and standard errors of measurement [SEMs] were calculated. Ten males with PFP and ten healthy controls participated in this study. Vasti onsets of control cases [ICC 3,1 >/= 0.70] except Quadratus Lumborum [QL] which showed a moderate reliability [ICC for ascending=0.59 and for descending = 0.61]. In controls, Vasti in both tasks showed the highest absolute reliability. During ascending, high reliability [ICC >/= 0.70] in PFP group was demonstrated for all EMG onsets except Gluteus maximus [GMAX] and QL which showed a moderate reliability [ICC = 0.69 and 0.63 respectively]. In this group while descending stairs, all EMG onsets showed high relative reliability [ICC >/= 0.70]. Moderate to high absolute reliability was obtained for onset times while ascending/descending stairs in PFP group. During both ascending/descending, high reliability was found for all EMG reliability. Most EMG onsets during stair ascending/descending had moderate to high