A New Test for Achilles Tendinopathy Based on Kager's Fat Pad Clinical Assessment Predictive Values.

Background This study aimed to check the diagnostic accuracy of a new test to identify Achilles tendinopathy. STUDY DESIGN: Observational study. METHODS: Seventy patients recruited from a private medical centre met the diagnostic criteria for unilateral Achilles tendinopathy (age, 45.1 ± 12.7 years; weight, 75.00 ± 10 kg; height, 1.75 ± 0.1 m) and were tested based on both Achilles tendons. Seventy patients with a unilateral Achilles tendinopathy ultrasound diagnosis were tested using David's test. RESULTS: Most (86%) subjects demonstrated Kager's fat pad asymmetry in relation to the Achilles tendon in the complete passive dorsiflexion in the prone position (David's sign). No healthy tendons had David's sign. CONCLUSIONS: The presence of asymmetry in Kager's fat pad in relation to the Achilles tendon during complete passive dorsiflexion is strongly indicative of ultrasound-diagnosed tendinopathy. David's test demonstrated a sensitivity of 85.71% (95% CI, 77.51% to 93.91%) and a specificity of 100% (95% CI, 100% to 100%), while noting the lack of blinding of the assessors and the uncertainty of the diagnostic measures (95% CI). Asymmetry of the fat pad could potentially serve as a characteristic marker for patients with Achilles tendinopathy.

Efficacy of Vitamin D Supplementation in Addition to Aerobic Exercise Training in Obese Women with Perceived Myalgia: A Single-Blinded Randomized Controlled Clinical Trial.

Obese women were more susceptible to myalgia because of their significantly lower vitamin D concentrations; the present study investigated the efficacy of vitamin D in addition to an aerobic interval training in the management of obese women with myalgia. Forty-five obese women with vitamin D deficiency and myalgia (30 to 40 years old) were assigned randomly into three equal groups. Group A received an aerobic interval training with vitamin D supplementation, Group B received vitamin D supplementation only, and Group C received aerobic interval training only; participants in all groups were on calorie deficient diets. The study outcomes were the Visual Analog Scale (VAS) for Pain Evaluation, serum vitamin D level, and Cooper 12-Minute Walk Test for Functional Capacity Evaluation, while the Short-Form Health Survey (SF) was used for assessment of quality of life. We detected a significant improvement in pain intensity level, serum vitamin D level, and quality of life in all groups with significant difference between Group A and groups B and C. We also detected a significant improvement in functional capacity in groups A and C, with no significant change in Group B. Aerobic interval training with vitamin D supplementation was more effective for the management of obese women with perceived myalgia.

Effect of dextrose phonophoresis versus pulsed electromagnetic field on temporomandibular dysfunction: A randomized, controlled study.

OBJECTIVE: This study investigated and compared the efficacy of dextrose phonophoresis and Pulsed Electromagnetic Field (PEMF) on pain, range of motion (ROM) and function in patients with Temporomandibular Dysfunction (TMD). METHODS: 45 patients with TMD aging from 25 to 45 years, with mean age 29 ± 2.5 years were included in this study, they were assigned randomly into 3 equal groups each contain fifteen TMJ dysfunction patients. Group (A) in which each patient received 50% dextrose phonophoresis for 5 min and therapeutic ultrasound for 5 min, Group (B) in which each patient received Pulsed Electromagnetic Field (PEMF) with frequency of 50 HZ for 50 min, and traditional physiotherapy ultrasound for 5 min, while in the control group (C) the patients received traditional physiotherapy ultrasound for 5 min only, the frequency of treatment session in the three groups was 3 days per week for 4 weeks. The assessment tools were visual analog scale (VAS) for pain evaluation, plastic ruler for TMJ ROM measurements while Fonseca's questionnaire was used for evaluation of TM function at baseline and 4 weeks later. RESULTS: Paired t-test for comparison between pre and post treatment measurements in each group showed significant decrease pain as well as improvement of ROM and Fonseca's questionnaire in group A and B than placebo group. CONCLUSIONS: The results found that both dextrose phonophoresis and PEMF have beneficial effects considering pain, ROM and function in patients with (TMD).

Bournemouth questionnaire Arabic version: Cross-cultural adaptation, validity, and reliability for patients with low back pain.

OBJECTIVE: To translate, culturally adapt, validate, and investigate the reliability of Arabic version of Bournemouth questionnaire (BQ) for patients with low back pain. METHOD: Thirty experts (three panels) and 70 low back pain patients (37.5 ± 13.9 years) were involved in this study. Test-retest as well as internal consistency analyses were used to assess reliability. Intraclass correlation coefficient (95% confidence interval) was used to assess test-retest analysis, whereas Cronbach alpha value was calculated to assess the internal consistency. BQ Arabic version validity was evaluated in forms of face, content, internal, and external construct validity. Internal construct validity was evaluated with factor analysis, and external construct validity was tested by the correlation between the Arabic version of BQ and short-form (36) health survey (SF-36) questionnaire. RESULTS: Factor analysis revealed that BQ had a single factor. BQ has a very good correlation with SF-36 questionnaire (r = .74). Arabic version of BQ has a high internal consistency reliability where Cronbach alpha value was 0.889 at baseline and 0.911 after 1 week. The test-retest analysis was between 0.87 and 0.96 and for the BQ total score was 0.95 (p < .0001) indicating that test-retest results are highly correlated. CONCLUSION: The Arabic version of BQ is a valid, reliable, and feasible scale for assessment of low back patients. It is short, easy-to-apply, need short time to complete and comprehensive scale. So it may be considered as a preferable scale for clinical assessment of Arabic speaking patients with low back pain.

Effect of Pre-training and Post-training Nordic Exercise on Hamstring Injury Prevention, Recurrence, and Severity in Soccer Players.

OBJECTIVE: To investigate the effect of adding Nordic exercise as post-training in decreasing hamstring initial, recurrent injuries rates, and their severity. METHODS: In this randomly controlled trial study, 34 professional football players aged 21 to 35 years were randomly assigned into two groups (17 players each) from Sporting clubs at Alexandria, Egypt. For group one, Nordic hamstring exercise (NHE) was performed pre-training and post-training. For group two, NHE was only performed pre-training. The control group was the same team during the previous season. Length of the trial was 12 weeks. The Australian football association injury form was used to collect incidence of injuries for each subject in both groups. RESULTS: Pooled results based on total injuries showed that group one had significantly less hamstring initial injuries (92% less) than the previous season, while group two had 80% less initial injuries and 85% less recurrent injuries than previous season. Regarding the severity of injuries in term of mean number of absent days, it was 1 day for group one and 2.7 days for group two while it was 7.95 days for the previous season during total risk time of 116.3±13.2 and 117.6±5.7 exposure hours for group one and group two, respectively. CONCLUSION: The use of NHE as a prevention protocol was effective in reducing all hamstring injuries with the use of NHE during pre-training and post-training having the greatest effect.