Prevalence and sensitivity of trigger points in lumbo-pelvic-hip muscles in patients with patellofemoral pain syndrome.

OBJECTIVES: Changes in the activity of the lumbo-pelvic-hip muscles have been established as a major cause of patellofemoral pain syndrome (PFPS), a common orthopedic problem. The present study aimed to compare the prevalence and sensitivity of myofascial trigger points (MTrPs) in lumbo-pelvic-hip muscles in persons with and without PFPS. METHODS: Thirty women with PFPS and 30 healthy women 18-40 years old were recruited for this study. The prevalence of MTrPs was assessed by palpation, and pressure algometry was used to measure the pressure pain threshold. This study evaluated the areas where MTrPs are most commonly found in the lumbar muscles (internal oblique, erector spinae and quadratus lumborum), pelvic muscles (gluteus maximus, gluteus medius, gluteus minimus and piriformis), and hip muscles (hip adductor, quadriceps, hamstring, tensor fascia lata and sartorius). Independent t-tests were used to compare mean pressure pain thresholds between the two groups. Chi-squared tests were used to compare the prevalence of MTrPs. RESULTS: The prevalence of MTrPs was significantly higher in most of the lumbo-pelvic-hip muscles in patients with PFPS compared to healthy persons. However, there were no significant differences between groups in the prevalence of MTrPs in the gluteus minimus or adductor muscles. The pressure pain threshold in lumbo-pelvic-hip muscles was lower in patients with PFPS compared to healthy participants. CONCLUSION: In patients with PFPS the prevalence of MTrPs in the lumbo-pelvic-hip region was higher, and the pressure pain threshold was lower, than in healthy people. Thus therapy to treat PFPS should target the lumbo-pelvic-hip muscles.

Comparison of grip and pinch strength in young women with and without hyperkyphosis: A cross-sectional study.

BACKGROUND: Hyperkyphosis is a common postural defect with high prevalence in the 20 to 50 year old population. It appears to compromise proximal scapular stability. Grip and pinch strength are used to evaluate general upper extremity function. OBJECTIVE: The aim of this study was to compare pinch and grip strength between young women with and without hyperkyphosis. METHODS: Thirty young women (18-40 years old) with hyperkyphosis and 30 healthy women matched for age and body mass index participated in the study. Hyperkyphosis was confirmed by measuring the kyphosis angle with a flexible ruler. Grip strength was measured with the Waisa method and a dynamometer. Pinch strength was assessed with a pinch meter. RESULTS: Grip (P= 0.03) and pinch strength (P= 0.04) were significantly lower in women with hyperkyphosis compared to the control group. Kyphosis angle correlated weakly with grip (r= 0.26) and pinch strength (r= 0.23). CONCLUSIONS: Hyperkyphotic posture has led to decreased grip and pinch strength compared to people without hyperkyphosis.

Effect of sacroiliac manipulation on postural sway in quiet standing: a randomized controlled trial.

BACKGROUND: Sacroiliac joint manipulation can alter joint and muscle control mechanisms through local and remote effects. Postural balance is controlled by supraspinal (rambling) and spinal-peripheral (trembling) mechanisms. A manipulation may interfere with postural control in quiet standing. OBJECTIVES: To evaluate the immediate effects of sacroiliac joint manipulation on postural control in patients with (1) sacroiliac dysfunction and (2) to determine whether rambling and trembling are affected by sacroiliac joint manipulation. METHODS: 32 patients aged between 20 and 50 years old were selected by convenience after confirmation of sacroiliac joint dysfunction by clinical examination. These patients were randomly allocated either to manipulation or sham manipulation group. Displacement, velocity and frequency of the center of pressure, rambling and trembling in the anterior-posterior and medial-lateral directions were our primary outcomes and analyzed immediately before and after the intervention in quiet standing. The physical therapists who performed the physical, biomechanical and statistical examinations, were all blinded to the patients' grouping. RESULTS: No differences were found between the two groups but trembling velocity (0.14 and -0.11 for intervention and sham group, respectively) and frequency (0.17 and 0.11 for intervention and sham group respectively) increased after intervention in the treatment group in the anterior-posterior direction. CONCLUSION: Generally, sacroiliac joint manipulation had no superiority than sham treatment regarding postural control as measured by rambling-trembling analysis of center of pressure. Manipulation may increase muscle activation in the treatment group due to increased trembling parameters. Trial number: IRCT2014072715932N8 - http://www.irct.ir/searchresult.php?keyword=%D8%B3%D9%88%DB%8C%D9%87&id=15932&field=&number=8&prt=13&total=10&m=1.

The Prevalence of Musculoskeletal Pain and Forward Head Posture among Heroin Users during their Withdrawal with Methadone.

BACKGROUND: Heroin is an extremely addictive narcotic drug derived from morphine. Its continued use requires increased amounts of the drug to achieve the same effect, resulting in tolerance and addiction. This study was done in order to determine the prevalence of musculoskeletal pain and forward head posture among heroin users during their withdrawal. METHODS: This research was a cross-sectional study that was done on 90 heroin users (83 males, 7 females) aged between 20 to 40 years (32.5 ± 3.81) during their withdrawal in Shiraz, Iran. They were selected by simple randomized sampling. Data were collected by a form regarding age, sex, the duration of heroin use, and musculoskeletal pain. Pain was measured by VAS (visual analog scale) and forward head posture was evaluated by plumb line. Pearson correlation technique and chi-square were used for analyzing the data. FINDINGS: The results revealed that the majority of heroin users suffered from musculoskeletal pain during their withdrawal. At the end of withdrawal 53.4% had severe pain, 38.8% had moderate pain, and 7.8% of them had mild pain. Pain in the lower extremities and low back was more common than the upper extremities. The intensity of pain before withdrawal was mild, during withdrawal was moderate, and at the end was sever, but there was no significant correlation between them. The results also showed 43.3% of subjects had normal posture and 56.7% had forward posture. CONCLUSION: According to the results, the intensity of pain increased during the withdrawal period; therefore, more attention must be paid to this complication in heroin users for better evaluation and a successful withdrawal.

Comparison of Physical Fitness among Smoker and Non-Smoker Men.

BACKGROUND: It is well documented that cigarette smoking has negative impacts on body health, as well as social health, economy, culture, etc. Nowadays, there is a large body of evidence that smoking is the cause of numerous life-threatening diseases like cardiovascular and pulmonary diseases along with different kinds of cancer. The aim of this study was to compare the physical fitness of smokers and non smokers. METHODS: This cross-sectional study was conducted on 64 non-sportsmen (34 non-smokers and 30 smokers) aging 19-27 years. Both groups were matched for age, weight, height and body mass index (BMI). The smokers used cigarettes at least 5 cigarettes a day for 2 years. None of them had a musculoskeletal disease. We used a questionnaire and physical fitness tests for data gathering. The tests were used to measure muscle strength, endurance, speed, agility and flexibility in both groups. FINDINGS: The muscle strength was significantly different in smokers and non-smokers (P = 0.012). Moreover, smokers had less agility (P = 0.004) and speed (P = 0.008) than non-smokers. However, although smokers were weaker than non- smokers, the differences in muscle endurance (P = 0.066) and flexibility (P = 0.095) were not the statistically significant. CONCLUSION: According to these results, the smokers were less powerful than nonsmokers. In addition, physical activity skills in young smokers were decreased. Therefore, smoking will cause a gradual loss of physical strength and active personal and social power.

Effect of static stretching of muscles surrounding the knee on knee joint position sense.

BACKGROUND: Muscle stretching is widely used in sport training and in rehabilitation. Considering the important contribution of joint position sense (JPS) to knee joint stability and function, it is legitimate to question if stretching might alter the knee JPS. OBJECTIVE: To evaluate if a stretch regimen consisting of three 30 s stretches alters the knee JPS. DESIGN AND SETTING: A blinded, randomised design with a washout time of 24 h was used. SUBJECTS: 39 healthy students (21 women, 18 men) volunteered to participate in this study. METHODS AND MAIN OUTCOME MEASURES: JPS was estimated by the ability to reproduce the two target positions (20 degrees and 45 degrees of flexion) in the dominant knee. The absolute angular error (AAE) was defined as the absolute difference between the target angle and the subject perceived angle of knee flexion. AAE values were measured before and immediately after the static stretch. Measurements were repeated three times. The static stretch comprised a 30 s stretch followed by a 30 s pause, three times for each muscle. RESULTS: The AAE decreased significantly after the stretching protocols for quadriceps (3.5 (1.3) vs 0.7 (2.4); p<0.001), hamstring (3.6 (2.2) vs 1.6 (3.1); p = 0.016) and adductors (3.7 (2.8) vs 1.7 (2.4); p = 0.016) in 45 degrees of flexion, but no differences were found for values of the gastrocnemius and popliteus muscles in this angle and for the values of all muscles in 20 degrees of flexion (p>0.05). CONCLUSION: The accuracy of the knee JPS in 45 degrees of flexion is improved subsequent to a static stretch regimen of quadriceps, hamstring and adductors in healthy subjects.