Effect of trunk exercise upon lumbar IVD height and vertebral compliance when performed supine with 1 g at the CoM compared to upright in 1 g.

BACKGROUND: Spinal unloading in microgravity is associated with stature increments, back pain, intervertebral disc (IVD) swelling and impaired spinal kinematics. The aim of this study was to determine the effect of lateral stabilization, trunk rotation and isometric abdominal exercise upon lumbar IVD height, and both passive and active vertebral compliance when performed supine on a short-arm human centrifuge (SAHC)-a candidate microgravity countermeasure-with 1 g at the CoM, compared to that generated with equivalent upright exercise in 1 g. METHODS: 12 (8 male) healthy subjects (33.8 ± 7 years, 178.4 ± 8.2 cm, 72.1 ± 9.6 kg) gave written informed consent. Subjects performed three sets of upper body trunk exercises either when standing upright (UPRIGHT), or when being spun on the SAHC. Lumbar IVD height and vertebral compliance (active and passive) were evaluated prior to SAHC (PRE SAHC) and following the first SAHC (POST SPIN 1) and second Spin (POST SPIN 2), in addition to before (PRE UPRIGHT), and after upright trunk exercises (POST UPRIGHT). RESULTS: No significant effect upon IVD height (L2-S1) when performed UPRIGHT or on the SAHC was observed. Trunk muscle exercise induced significant (p < 0.05) reduction of active thoracic vertebral compliance when performed on the SAHC, but not UPRIGHT. However, no effect was observed in the cervical, lumbar or across the entire vertebral column. On passive or active vertebral compliance. CONCLUSION: This study, the first of its kind demonstrates that trunk exercise were feasible and tolerable. Whilst trunk muscle exercise appears to have minor effect upon IVD height, it may be a candidate approach to mitigate-particularly active-vertebral stability on Earth, and in µg via concurrent SAHC. However, significant variability suggests larger studies including optimization of trunk exercise and SAHC prescription with MRI are warranted. TRIAL REGISTRATION: North Rhine ethical committee (Number: 6000223393) and registered on 29/09/2020 in the German Clinical Trials Register (DRKS00021750).

[The German version of the Bath Body Perception Disturbance Scale (BBPDS-D) : Translation, cultural adaptation and linguistic validation on patients with complex regional pain syndrome]. / Die deutsche Version der Bath Body Perception Disturbance Scale (BBPDS-D) : Übersetzung, kulturelle Anpassung und linguistische Validierung an Patienten mit komplexem regionalem Schmerzsyndrom.

BACKGROUND: Besides the classical clinical manifestations, body perception disturbances are common among patients with complex regional pain syndrome (CRPS). The Bath Body Perception Disturbance Scale (BBPDS) represents a useful tool to assess these changes in CRPS patients; however, to date no validated German version is available. OBJECTIVE: The aim of this study was to translate the BBPDS into German, to perform a cross-cultural adaptation and linguistic validation in patients with acute (symptoms <3 months) and stable (symptoms ≥3 months) CRPS. MATERIAL AND METHODS: The original English version of the BBPDS was translated into German according to published guidelines (translation and back translation) and tested on 56 patients (mean age 50.9 ± 13.1 years) with acute (n = 28) or stable (n = 28) CRPS. RESULTS: The relative reliability, intraclass correlation and test-retest reliability were excellent overall and in the groups with acute and stable CRPS. The smallest detectable change was at 10 points. In the test-retest 48 points lay within the 95% confidence interval and visual inspection showed no tendency towards heteroscedasticity. Spearman's ρ­coefficient values showed no correlation between the total score of the BBPDS-D with the numerical rating scale (NRS, ρ = -0.19) and the EuroQol-5 D (ρ = 0.16). There were no significant differences between patients with acute and stable CRPS (p = 0.412). There were also no floor or ceiling effects. CONCLUSION: This German translation and cross-cultural adaptation of the original English version of the BBPDS is a valid instrument to assess body perception disturbances in German speaking CRPS patients. Future research should further assess the impact of body perception disturbance on treatment outcome and prognosis.

[Short-Term Cryotherapy--Putting Dynamic Foot and Ankle Stability at Risk?]. / Beeinflusst die Kühlsprayanwendung am Fuß die dynamische Stabilisationsfähigkeit?

BACKGROUND: The application of ice or other forms of cooling represent a common method to treat acute musculoskeletal injuries during sporting events in order to reduce pain. Often athletes return to competition immediately after cooling. It is not known if short-term cryotherapy in the form of ice spray has an influence on the joint's dynamic stability. The aim of this study was to investigate if application of ice spray to the ankle has an effect on the dynamic stability of the joint in healthy participants. METHODS: A randomized controlled single-blind pilot study with crossover-design was conducted. 22 healthy athletic participants (15 women, 7 men, mean age 31.8 years ± 5.7) were included. Time-to-stability (TTS) was used to investigate the effect of the interventions, ice spray and water spray, applied on the lateral ankle. TTS was assessed in medio-lateral (ML) and antero-posterior (AP) direction on a force plate with two different tests (side step down and 1-leg jump). Collected co-variables were age, gender, height, weight, previous ankle injuries, Tegner activity scale and leg dominance. RESULTS: There were no significant differences between the two tests (side step down and 1-leg jump) in TTS after the application of ice spray or a water spray compared to the baseline (p > 0.05). There was no significant difference between the two interventions. The testing of the co-variable "previous ankle injury" showed a significant influence on the TTS in medio-lateral direction in the 1-leg jump test of the non-dominant leg after application of ice spray (p = 0.027). On the dominant leg same tendency could be found (p = 0.062). CONCLUSION: The application of ice spray to the lateral ankle does not have an effect on dynamic stability in healthy participants. In participants with a previous ankle injury a significant decrease in dynamic stability after application of ice spray could be shown. Whether further factors affecting stability such as fatigue and the influence of an opponent player or the application of ice spray on adjacent muscles may augment this effect should be subject to future investigations.

[Development and evaluation of a German version of the Tegner activity scale for measuring outcome after anterior cruciate ligament injury]. / Entwicklung und Evaluation einer deutschen Version der Tegner Aktivitätsskala zur Erfassung der Funktion nach einer Verletzung des vorderen Kreuzbands.

BACKGROUND: The aim of this study is to provide a valid and reliable German version of the Tegner activity scale (Tegner-G). The Tegner activity scale assesses on 11 levels the activity in sports (competitive and recreational) and work of patients with anterior cruciate ligament injuries. The English original version was elaborated in Sweden and contains sports that are unknown in German-speaking countries. METHODS: The translation and adaptation was conducted in several steps according to the guidelines in the literature. The validity (discriminative validity and content validity) and (absolute and relative) reliability were determined in 46 patients after reconstruction of the anterior cruciate ligament and in 20 healthy subjects. The patients were divided into an acute group (< 3 months after operation; 11 men; 30.9 ± 8.3 years) and a chronic group (3 - 12 months after operation; 18 men; 31.3 ± 11.6 years). All subjects filled in the scale two times within 3 - 7 days. For the additional determination of the relation between activity and function, they also filled in the German version of the Lysholm score (Lysholm-G). RESULTS: The three groups differed significantly from each other (Kruskal-Wallis test: χ2 = 27.95, p < 0.001; post hoc Mann-Whitney U tests: acute-chronic p < 0.001; acute-control p < 0.001; chronic-control p = 0.003). There was a floor effect in the acute patient group. The intraclass correlation coefficients indicated a high relative reliability (ICC2,1 > 0.9). The minimal detectable change was 1.4 points. The relation between activity (Tegner-G) and function (Lysholm-G) was stronger in the acute than in the chronic patient group (ρ = 0.77 and ρ = 0.60, respectively). CONCLUSION: The psychometric properties of the Tegner-G are comparable to those of the English original version. The Tegner-G is thus valid and reliable for the German-speaking part of Switzerland. The application in other German-speaking countries probably requires adaptations for some of the sports included. The relation between activity and function changes depending on time since operation. This confirms that a comprehensive assessment of the outcome after an anterior cruciate ligament injury requires the separate assessment of both parameters.

[Physiotherapy interventions in osteoporosis]. / Physiotherapeutische Interventionen bei Osteoporose.

Osteoporosis is an increasing public health problem which ultimately causes fractures and a significant reduction in patient's health-related quality of life. In this context, physiotherapists are involved in a wide range of therapies related both to prevention and treatment of osteoporosis. The reduction of the risk of falling by elderly patients with osteoporosis is a very important goal for physiotherapists because it is known to significantly decrease fracture incidence. Indeed, exercise programs including elements of muscle strengthening and better body balance control have a positive effect on the risk of falling, hence reducing the incidence of fractures and increasing the health-related quality of life of osteoporotic patients. As a further consequence, the decreased fracture incidence has a key roll in reducing health care costs. Once a patient presents with an osteoporotic fracture, he may be assisted with various forms of passive, active-assisted and active therapies. This treatment will help reduce pain, increase patient's mobility and prevent the occurrence of additional fractures. In addition, a good and well-balanced education process regarding secondary osteoporosis prevention may also help to modify the behavior of patients and help to improve skeletal health in the longer term. The physiotherapist has definitively a major role to play in the interdisciplinary team aimed at preventing osteoporotic fractures in both primary and secondary prevention levels.