Efficacy of aquatic therapy on electromyography indexes and pain intensity in men with non-specific chronic low back pain

Background: Movement therapy has known as a method to reduce pain and increase muscle strength in patients with low back pain. The aim of this study was to determine the effect of aquatic therapy on maximum muscle activity and pain intensity in men with non-specific chronic low back pain

Methods: Thirty male subjects with non-specific chronic low back pain were randomly divided into two aquatic therapy group [n=15] and control group [n=15]. Before and after intervention, subjects were assessed by maximum activity of lumbar erector spine muscles and pain severity. A 24 session protocol of aquatic therapy, sixty minutes per session lasting for 6 weeks and four sessions a week were applied. Subjects in control group didn't receive any therapeutic modality during the study period

The collected data were analyzed using independent-T test and paired samples-T test. The significance level was [p<0.05]

Results: No significant difference before and after intervention in maximum muscle activity of the Right and left upper and lower lumbar-erector spine muscles were observed [p>0/05]. However, the results about the pain intensity between the two groups showed significant difference in pre and post-test [p<0/05]

Conclusion: Aquatic therapy program had no significant effect on electromyography activity of erector spine muscles and disorders of lumbar muscles in men with NCLBP. However, this method of treatment reduced pain intensity in these patients significantly, that this reduction in pain may be due to neurological and physiological factors

Developing an appropriateness criteria for knee MRI using the rand appropriateness method [RAM]-2013

Knee pain Is one of the most common reasons patients visit their physician. In this regard Magnetic Resonance Imaging [MRI] is the tool of preference for diagnosis. The aim of this study was to determine appropriate guidelines for knee MRI administration using the RAND Appropriateness Method [RAM]-2013. This qualitative study was done in the Mashhad University of Medical Sciences in 2013. The most appropriate approved knee MRI administration clinical guidelines were evaluated using Guidelines Evaluation and Research Appraisal [AGREE]. Panel members consisting of six orthopedic and three rheumatologic doctors gave scores ranging from 1 to 9 for each scenario. The indications were grouped as appropriate, equivocal and inappropriate. Data were analyzed by descriptive statistics and SPSS ver. 18 software. Sixty-three scenarios were extracted from the guidelines and then the scenarios were evaluated in 26 indications. Thirty-two [50.79%] cases were considered appropriate, 12 [19.04%] cases uncertain and 19 [30.1%] cases inappropriate. The RAND appropriateness method is helpful in identifying the opinion of stakeholders in health care systems. Moreover, making practical use of clinical guidelines can improve patients' quality of care and prevent un-necessary costs

Outcome of patients with meningomyelocele

Meningomyelocele is the most common congenital anomaly of the central nerves system [CNS].It is not only a spinal cord anomaly; associate hindbrain abnormalities, hydrocephalus, bladder, and bowel disturbance, and orthopedic deformities make a team effort necessary. We reviewed our patients with meningomyelocele and evaluated their early and long-term outcomes. We included 45 patients with meningomyelocele operated on between 1990 and 2004 in this study. The medical records were reviewed from the aspects of neurological and physical findings, surgery performed, and complications. Parental age and education were analyzed when available. The chiary-square test was used for the statiscal analyses. There werel9 boys [42.2%] and 26 girls [57.8%]. The lumbar region was the site of the meningomyelocele in 27 patients [62%].Patients with cervical and sacral meningomyelocele had a higher rate of normal motor function than those with meningomyelocele at other levels [p=0.0001].We also noted that the higher the location of meningomyelocele, the greater the control of both sphincters [p=0.0013]. The management of children with meningomyelocele needs a team approach. The majority of patients can have a normal IQ and a socially acceptable degree of continence and be able to walk. The patients should be treated with aggressive therapies whenever possible