Neurophysiological relationship of neuromuscular fatigue and stress disorder in PTSD patients.

INTRODUCTION: Apart from mental disorders, other complications that have been reported in some patients with Post-Traumatic Stress Disorder (PTSD), include physical pain and being quick to fatigue, which can severely affect the patients' daily life. Therefore, this study aims to evaluate the relationship between PTSD and physical fatigue in people with PTSD. METHOD: 18 military men with (n = 9) and without PTSD (n = 9), with an age range of 45-60 years, volunteered to participate. They were randomly assigned into two groups: PTSD and non-PTSD groups. Recording of the surface electromyography (EMG) in a specific muscle was conducted twice in both groups, once at baseline and then again after a single session of fatiguing exercise. Data were analyzed by ANOVA with repeated measure (2✕2) at the significance level of 0.05. RESULTS: Results showed that there was a significant main effect of intervention on electrical activity and neural conduction variables in the PTSD group (p = 0.04, p = 0.02). There was also an effect of time for the both variables (P < 0.001). CONCLUSION: Stress disorders may affect the time to fatigue in PTSD patients and subsequently cause some difficulties in their daily life.

Magnitude, symmetry and attenuation of upper body accelerations during walking in women: The role of age, fall history and walking surface.

OBJECTIVES: The present experiment examined the role of age and fall history in upper body accelerations when walking on an even and on an uneven surface. STUDY DESIGN: An observational cross-sectional study. MAIN OUTCOME MEASURES: The magnitude (root mean square [RMS]), symmetry (harmonic ratio) and attenuation (attenuation coefficient) of upper body accelerations were quantified as primary outcomes; gait spatiotemporal parameters were measured as secondary outcomes. METHODS: Twenty young adults (mean ± SD age: 29.00 ± 4.51 yrs), 20 older non-fallers (66.60 ± 5.43 yrs) and 20 older fallers (68.55 ± 4.86 yrs) walked on an even and on an uneven surface, while wearing four accelerometers attached to the forehead, pelvis, right and left shanks. RESULTS: Older fallers exhibited increased RMS acceleration in the mediolateral direction at the pelvis level compared with young adults when walking on the even surface (0.18 ± 0.04 vs. 0.14 ± 0.02, respectively), whereas walking on an uneven surface was associated with reduced magnitude of acceleration in older fallers (0.19 ± 0.04) compared with non-fallers (0.23 ± 0.04) and young adults (0.22 ± 0.03). Among other changes, walking on the uneven surface diminished pelvis-to-head attenuation in the mediolateral direction in older fallers (38.07 ± 14.51) compared with non-fallers (50.96 ± 11.03) and young adults (62.62 ± 8.21; all ps<0.05). CONCLUSIONS: Reduced mediolateral accelerations in older fallers when walking on the uneven surface can be interpreted as a compensatory mechanism to preserve stability through increased body stiffness. Reduced postural flexibility in the frontal plane compromises the central role of the trunk in minimizing the impact of gait-related oscillations to the head, as evidenced by reduced mediolateral attenuation in older fallers.

The effect of theory-based educational intervention on correct principles of manual material handling among men.

BACKGROUND: Changing human behavior for the purposes of improving the way people work is an integral part of most educational interventions. This study aimed to evaluate the effect of a model based on the theory of planned behavior (TPB) on correct principles of manual material handling (MMH) among male soldiers. SUBJECTS AND METHODS: This study was a quasi-experimental, pretest-posttest research with a control group. Furthermore, 140 soldiers, from an area located in the city of Bandar Abbas, Iran, were selected through a simple random sampling and they were divided into two groups: intervention and control (70 subjects in each group). The data were collected using a three-part questionnaire including demographic information, the theory constructs, and MMH behavior. The intervention group was given the relevant education, and after 2 months, the both groups were evaluated. RESULTS: Based on regression analysis, attitude toward behavior and perceived behavioral control were predictors for correct principles of MMH. There were significant differences between the mean scores of the theory constructs before and after the education in intervention group (P < 0.001); however, no significant differences were observed in the theory constructs in the control group after the intervention. Before the education, the mean score of MMH of the intervention group was 38.30 ± 6.45; but after, the education, this changed into 44.20 ± 6.01, and significantly increased (P < 0.001). CONCLUSIONS: Educational intervention based on the TPB was effective in improving behavior for correct MMH in soldiers. Thus, the use of such educational programs according to the constructs of the planned behavior theory is recommended.

Relationship Between Hip Extensor Strength and Back Extensor Length in Patients With Low Back Pain: A Cross-Sectional Study.

OBJECTIVE: The purpose of this study was to examine the relationship between hip extensor strength and back extensor length in patients with low back pain (LBP) and healthy controls. METHODS: In 266 patients with LBP and 215 matched controls, back extensor length and hip extensor strength were measured and compared in the 2 groups using an independent t test. The Pearson correlation coefficient was used to determine correlation between these 2 variables. Multivariate logistic regression was used to test the risk of sustaining LBP with having these muscle insufficiencies. RESULTS: A significant difference in hip extensor strength was found between patients with LBP and controls (P < .001). Back extensor length was different in healthy men compared with the patients with LBP (P < .001) but was not significant between women with and without LBP (P = .34). The results showed a significant relationship between back extensor length and hip extensor strength in men with LBP (r = 0.6, P = .01). Multivariate logistic regression revealed that having a weak hip extensor (P = .001) or shortened back extensor (P = .01) could increase the risk of LBP occurrence. CONCLUSION: The findings support the assumptions of the presence of muscle imbalance of hip extensor weakness and back extensor tightness in male patients with LBP and that each muscle impairment may contribute to LBP.

The effects of KinesioTape on the treatment of lateral epicondylitis.

STUDY DESIGN: Randomized clinical trial. INTRODUCTION: KinesioTape (KT) is a noninvasive method to treat pain and muscular dysfunction. PURPOSE: To investigate the effect of KT with and without tension on pain intensity, pain pressure threshold, grip strength and disability in individuals with lateral epicondylitis, and myofacial trigger points in forearm muscles. METHODS: Thirty women with lateral epicondylitis and myofacial trigger point in forearm muscles were randomly assigned to KT with tension and placebo (KT without tension). The treatment was provided 3 times in one week, and outcome measures were assess pre-post treatment. RESULTS: The mean score of visual analogue scale (VAS) during activity decreased significantly from 6.4 and 6 pretest to 2.53 and 4.66 posttest, respectively, for the KT with and without tension groups. The mean score of Disabilities of the Arm, Shoulder and Hand decreased significantly from 16.82 and 22.79 pretest to 8.65 and 8.29 posttest, respectively, for the KT with and without tension groups. A paired t-test revealed a significant reduction in VAS during activity and Disabilities of the Arm, Shoulder and Hand before and after treatment in both groups (P < .05). Pain pressure threshold, grip strength, and VAS using an algometer revealed no significant differences. The study showed no significant difference in variables immediately after intervention. DISCUSSION: Improvements in functional disability were superior when KT was used with tension, than obtained with a placebo-no tension application. CONCLUSION: The application of KT produces an improvement in pain intensity and upper extremity disability in subjects with LE and MTP in forearm muscles, and KT with tension was more effective than placebo group. LEVEL OF EVIDENCE: NA. TRIAL REGISTRATION NUMBER: 100-216.

Association between composites of selected motion palpation and pain provocation tests for sacroiliac joint disorders.

BACKGROUND: The sacroiliac joint (SIJ) has been implicated as a potential source of low back and buttock pain. Several types of motion palpation and pain provocation tests are used to evaluate SIJ dysfunction. OBJECTIVE: The purpose of this study was to investigate the relationship between motion palpation and pain provocation tests in assessment of SIJ problems. DESIGN: This study is Descriptive Correlation. METHODS: 50 patients between the ages of 20 and 65 participated. Four motion palpation tests (Sitting flexion, Standing flexion, Prone knee flexion, Gillet test) and three pain provocation tests (FABER, Posterior shear, Resisted abduction test) were examined. Chi-square analysis was used to assess the relationship between results of the individuals and composites of these two groups of tests. RESULTS: No significant relationship was found between these two groups of tests. CONCLUSIONS: It seems that motion palpation tests assess SIJ dysfunction and provocative tests assessed SIJ pain which do not appear to be related.

The Persian version of the Berg Balance Scale: inter and intra-rater reliability and construct validity in elderly adults.

PURPOSE: As a well-known measure for quantifying functional mobility in elderly persons, Berg Balance Scale (BBS) was used in the present study to evaluate its psychometric properties among a sample of 106 elderly individuals speaking Persian language. METHOD: After forward-backward translation process, videotapes were recorded from all participants while performing 14 tasks of the BBS. The volunteers were also asked to perform the Timed Up and Go (TUG) test at the same session. To determine inter and intra-rater reliability, the videotapes were viewed by two experienced therapists while one of the raters assessed the videotaped performance of the subjects on a second occasion. RESULTS: Intraclass correlation coefficients (95% confidence interval) of 0.93 (0.87 0.96) and 0.95 (0.92 0.97) were obtained for inter and intra-rater reliability, respectively. Cronbach's alpha was 0.62 which is marginally lower than the cut-off point of 0.70. Furthermore, there were no ceiling and floor effects for the Persian version. In terms of construct validity, the BBS had a negative and strong correlation with the TUG (r = -0.74, p < 0.001). CONCLUSIONS: Acceptable levels of intra and inter-rater reliability with a moderate internal consistency and high validity were demonstrated for the Persian version of BBS.

The interaction between the location of lower extremity muscle fatigue and visual condition on unipedal postural stability.

The purpose of this study was to investigate the effects of unilateral muscle fatigue induced on the hip flexors/extensors or the ankle plantar/dorsiflexors on unipedal postural stability under different visual conditions. Twenty-four healthy young women completed 2 testing sessions 1 week apart with a randomized order assigned according to the muscles tested. During each session, one set of muscle groups was fatigued using isokinetic contractions: ankle plantar/dorsi flexors or hip flexor/extensors. Postural stability was assessed during trials of unilateral stance on a force plate before and after the fatigue protocol. 10 s into the trial, subjects were asked to close their eyes. Mean velocity, the area of the 95% confidence ellipse, and standard deviation of velocity in anteroposterior and mediolateral directions of center of pressure displacements were calculated for two periods of 5 s, immediately before and 1 s after the eyes closure. The results of the repeated measures ANOVAs showed a significant fatigue-by-fatigue segment by visual condition interaction for the CoP parameters. When the vision was removed, the interaction between fatigue and fatigue segment was significant for the CoP parameters. In conclusion, fatigue in both proximal and distal musculature of the lower extremity yielded decreased postural stability during unipedal quiet standing in healthy young women. This effect was more accentuated when visual information was eliminated. Withdrawing vision following fatigue to the proximal musculature, led to a significantly greater impairment of postural stability compared to the fatigue of more distal muscles.