The seventh cervical vertebra is an appropriate landmark for thoracic kyphosis measures using distance from the wall.

Background: Hyperkyphosis is frequently found nowadays due to the change in current lifestyles and age-related system decline. A simple hyperkyphosis measurement can be made easily using the perpendicular distance from the landmark to the wall. However, the existing evidence applied two different landmarks [occiput and the seventh cervical vertebra (C7)] and the measurement using rulers was susceptible to error due to their misalignment. Objective: To assess an appropriate landmark for thoracic kyphosis measurement using distance from the wall (KMD), by comparing between occiput and C7, as measured using rulers and verified using data from a specially developed machine, the so-called infrared-gun kyphosis wall distance tool (IG-KypDisT), and the Cobb angles. Methods: Community-dwelling individuals with a risk of thoracic hyperkyphosis (age ≥10 years, n=43) were cross-sectionally assessed for their thoracic hyperkyphosis using the perpendicular distance from the landmarks, occiput and C7, to the wall using rulers and IG-KypDisT. Then the Cobb angles of these participants were measured within seven days. Results: The outcomes from both landmarks differed by approximately 0.8 cm (p= 0.084). The outcomes derived from C7 were more reliable (ICCs>0.93, p<0.001), with greater concurrent validity with the radiologic data (r= 0.738, p<0.001), with the overall variance predicted by the regression models for the Cobb angles being higher than that from the occiput (47-48% from C7 and 38-39% from occiput). The outcomes derived from rulers and IG-KypDisT showed no significant differences. Conclusion: The present findings support the reliability and validity of KMD assessments at C7 using rulers as a simple standard measure of thoracic hyperkyphosis that can be used in various clinical, community, and research settings.

Prevalence, frontal plane knee alignment, and lower limb joint pain and injury in generalized joint hypermobility in Thai physical therapy students.

Objectives: The primary aim was to study the prevalence of generalized joint hypermobility (GJH) among Thai physical therapy (PT) students. The secondary aims were to compare the lower limb alignments and lower limb joint pain and injury between GJH and non-GJH individuals. Furthermore, the association between GJH, lower limb alignment, and joint pain and injury were also evaluated. Material and methods: Generalized joint hypermobility was assessed using the Beighton score with a cut-off of 4/9 in 255 PT students. The lower limb alignments measured in the study included pelvic tilt angle, tibiofemoral angle, quadriceps angle (QA), and navicular drop. Tibiofemoral angle and QA were measured with and without quadriceps contraction. The history of lower limb joint pain and injury was recorded with a simple questionnaire. Lastly, logistic regression analysis was used to study the association between GJH, lower limb alignment, and joint pain and injury. Results: The prevalence of GJH was 21.18% among the studied population. Quadriceps angle during quadriceps relaxation of the non-dominant leg of the GJH group was the only lower limb alignment found greater than those of the non-GJH group. The rate of lower limb joint pain and injury was not different between the two groups. Furthermore, no significant association between GJH, lower limb alignment, and lower limb joint pain and injury was found. Conclusions: GJH is not uncommon among Thai PT students. Only the non-dominant QA was found different between groups. Generalized joint hypermobility neither increase risk nor is it associated with lower limb joint pain and injury among Thai PT students.

Validity and reliability of the block method for measuring thoracic hyperkyphosis.

OBJECTIVE: This study aimed to investigate the concurrent validity of the block method as compared with the gold standard (Cobb's method). An additional aim was to examine the intra- and inter-rater reliability of expert and novice assessors using the block method. METHODS: In a cross-sectional study, we enrolled 62 participants with hyperkyphosis aged ≥10 years, with hyperkyphosis defined as one or more blocks. The participants were stratified by age (<60 years and ≥60 years). To determine concurrent validity, and kyphosis was assessed in all the participants using the block method and Cobb's method. Finally, 15 participants were included in a reliability study. To determine intra- and inter-rater reliability, each participant was assessed twice, 7 days apart, by one expert and one novice using the block method. RESULTS: The concurrent validity of the block method and gold standard method showed moderate correlation (rs = 0.53, P < .001). However, after stratifying the participants by age (<60 years and ≥60 years), there was small to moderate correlation (rs = 0.42, P = .006, and rs = 0.64, P = .002, respectively). The intra- and inter-rater reliability of the expert and novice assessors was excellent (ICC3,1 = 0.82-0.97, P < .001). CONCLUSIONS: The findings showed small correlation in those <60 and moderate correlation in those ≥60 years, and reported excellent reliability. The block method can be used by novices with strong reliability. This method is a practical technique for early screening hyperkyphosis in the elderly.

The effects of light touch cue on gait initiation in patients with Parkinson's disease.

INTRODUCTION: One of the common impairments in patients with Parkinson's disease (PD) is disturbance of gait initiation. A light touch cue improves postural stability in patients with PD. Little is known about the effects of a light touch cue on gait initiation. This study investigated the effects of a light touch on gait initiation in patients with PD. METHODS: This study was a cross-sectional study design. Sixteen patients with PD (Hoehn & Yahr stage 2-3) participated in the study and were evaluated two gait conditions (no touch (NT) and light touch (LT) conditions). Gait initiation was divided into 5 events including event A, B, C, D, and E. Outcome measures included maximum center of pressure (COP) displacement and velocity in anteroposterior (AP) and mediolateral (ML) directions, and the first step time. RESULTS: Participants with LT had greater COP displacement compared with the NT condition in all events of gait initiation except COP-AP displacement in event D. Additionally, the COP velocity in LT condition was faster than the NT condition in COP-ML velocity in event A, COP-AP velocity in event B, COP-AP velocity and COP-ML velocity in event C. Moreover, participants with LT presented significantly shorter the first step time than the NT condition. CONCLUSIONS: These findings demonstrated that a light touch cue improved gait initiation in patients with PD by increased weight shifting to initial stance limb, increased postural stability of stance limb, increased velocity of weight transfer toward stance limb, and a shortened first step time.

Thai dance exercises benefited functional mobility and fall rates among community-dwelling older individuals.

BACKGROUND: With dramatic increase in the number of older individuals, special efforts have been made to promote the levels of independence and reduce fall rates among these individuals. OBJECTIVE: To investigate the effects of Thai dance exercises over 6 weeks on functional mobility and fall rates in community-dwelling older individuals. METHODS: Sixty-one community-dwelling older adults were interviewed and assessed for their demographics and fall data during 6 months prior to participation in the study. Then they completed the quasi-experimental Thai dance exercise program for 50 minutes/day, 3 days/week over 6 weeks. Their functional mobility relating to levels of independence and safety were assessed prior to training, at 3-week and 6-week training. After completing the program at 6 weeks, participants were prospectively monitored for fall data over 6 months. RESULTS: Participants improved their functional mobility significantly after 3- and 6-week training ( p < 0.01 ) . The number of faller individuals obviously decreased from 35% ( n = 21 ) prior to training to only 8% ( n = 5 ) after training ( p < 0.01 ) . CONCLUSION: The current findings further extend benefits of Thai dance as an alternative musical exercise program to promote levels of independence and safety among community-dwelling older adults.

Is the occiput-wall distance valid and reliable to determine the presence of thoracic hyperkyphosis?

BACKGROUND: Hyperkyphosis may be frequently found nowadays due to the change in current lifestyles of sustained flexion postures and age-related system decline. The occiput-wall distance (OWD) is a practical measure that is commonly used to screen and monitor thoracic hyperkyphosis in epidemiologic studies. However, there was no clear evidence to support the clinical utility of the tool as compared to the data from direct standard measures. OBJECTIVES: To investigate psychometric properties-including validity, reliability, and appropriate cut-off point-of the OWD to determine the presence of thoracic hyperkyphosis, as compared to a standard Cobb's method. DESIGN: Observational study. METHODS: This study was conducted in ninety-nine participants, aged 10 years and above who had different degrees of thoracic hyperkyphosis from several communities. All participants were assessed for their severity of thoracic hyperkyphosis using the OWD, and 14 participants were involved in a reliability study. Within 7 days later, all participants were at a hospital to complete a radiographic examination. RESULTS: Outcomes from OWD had good concurrent validity with the Cobb angles (r = 0.683, P < 0.001) and excellent rater reliability when assessed by well-trained health professionals (ICCs > 0.9, P < 0.001). The OWD of at least 6.5 cm had the best diagnostic properties to determine the presence of thoracic hyperkyphosis (sensitivity = 71.4%, specificity = 76.6%, and area under the curve = 0.846). CONCLUSION: The findings support validity and reliability of OWD, and offer a clear cut-off point to determine the presence of thoracic hyperkyphosis for clinical utility in various settings.

Effect of interferential current stimulation in management of hemiplegic shoulder pain.

OBJECTIVE: To study the immediate effects of interferential current stimulation (IFC) on shoulder pain and pain-free passive range of motion (PROM) of the shoulder in people with hemiplegic shoulder pain (HSP). DESIGN: Double-blind, placebo-controlled clinical trial. SETTING: Institutional physical therapy clinic, neurologic rehabilitation center. PARTICIPANTS: A population-based sample of people with HSP (N=30) was recruited. INTERVENTION: Participants were divided into 2 groups--an IFC group and a placebo group--by using a match-paired method (age, sex, and Brunnstrom motor recovery stage). In the IFC group, participants received IFC for 20 minutes with an amplitude-modulated frequency at 100 Hz in vector mode. The current intensity was increased until the participants felt a strong tingling sensation. MAIN OUTCOME MEASURES: Pain intensity and pain-free PROM of the shoulder until the onset of pain were measured at baseline and immediately after treatment. RESULTS: Participants reported a greater reduction in pain during the most painful movement after treatment with IFC than with placebo (P<.05). The IFC group showed a greater improvement in posttreatment pain-free PROM than the placebo group in shoulder flexion (P<.01), abduction (P<.01), internal rotation (P<.01), and external rotation (P<.01). CONCLUSIONS: This study provides evidence that IFC is effective for the relief of pain during movement and also increases the pain-free PROM of the shoulder in people with HSP.

Abdominal muscle activity during abdominal hollowing in four starting positions.

The aim of this study was to investigate the activity of the rectus abdominis (RA), external abdominal oblique (EO), and transversus abdominis/internal abdominal oblique (TrA/IO) muscles during abdominal hollowing (AH) in four positions: crook lying, prone lying, four-point kneeling, and wall support standing. Thirty-two healthy participants, aged 21.3+/-0.8 years were recruited. They were instructed to perform maximal voluntary contraction (MVC) and AH. The electromyography (EMG) data of each muscle during AH were normalized as a percentage of MVC. During AH in all four starting positions, significant differences were found in the EMG activity of RA, EO, and TrA/IO (p<0.001). The TrA/IO exhibited the highest while the RA exhibited the lowest EMG activity. Among the four different starting positions, only the TrA/IO showed significant difference in mean EMG activity (p<0.001). The results suggest that all four starting positions can facilitate TrA/IO activity with minimal activity from RA and EO.

Vastus lateralis and vastus medialis obliquus muscle activity during the application of inhibition and facilitation taping techniques.

OBJECTIVE: To evaluate the effect of inhibition and facilitation taping techniques on the activity of vastus lateralis and vastus medialis obliquus. DESIGN: Repeated-measures design. SETTING: Laboratory in an educational institution. SUBJECTS: Thirty healthy females aged between 18 and 23 years. INTERVENTION: Subjects were tested during the application of inhibition tape, facilitation tape and no tape to vastus lateralis in random order. MAIN OUTCOME MEASURES: Electromyographic activity of vastus lateralis and vastus medialis obliquus during stair descent was recorded using bipolar surface electrodes. RESULTS: Electromyographic activity of vastus lateralis and vastus medialis obliquus during the application of inhibition tape or facilitation tape did not alter significantly compared with no tape condition. CONCLUSIONS: Taping designed to inhibit or facilitate muscle activity via sensory stimulation does not affect vastus lateralis or vastus medialis obliquus activity in healthy subjects. Further investigation is required to find a means of muscle taping that could be recommended as an intervention for patients with patellofemoral pain syndrome.