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Dunn JA, Wong B, Sinclair SK, Henninger HB, Bachus KN, Foreman KB. Extended physiological proprioception is affected by transhumeral Socket-Suspended prosthesis use. J Biomech 2024; 166:112054. [PMID: 38513398 DOI: 10.1016/j.jbiomech.2024.112054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 01/30/2024] [Accepted: 03/17/2024] [Indexed: 03/23/2024]
Abstract
The objective of this study was to define targeted reaching performance without visual information for transhumeral (TH) prosthesis users, establishing baseline information about extended physiological proprioception (EPP) in this population. Subjects completed a seated proprioceptive targeting task under simultaneous motion capture, using their prosthesis and intact limb. Eight male subjects, median age of 58 years (range 29-77 years), were selected from an ongoing screening study to participate. Five subjects had a left-side TH amputation, and three a right-side TH amputation. Median time since amputation was 9 years (range 3-54 years). Four subjects used a body-powered prosthetic hook, three a myoelectric hand, and one a myoelectric hook. The outcome measures were precision and accuracy, motion of the targeting hand, and joint angular displacement. Subjects demonstrated better precision when targeting with their intact limb compared to targeting with their prosthesis, 1.9 cm2 (0.8-3.0) v. 7.1 cm2 (1.3-12.8), respectively, p = 0.008. Subjects achieved a more direct reach path ratio when targeting with the intact limb compared to with the prosthesis, 1.2 (1.1-1.3) v. 1.3 (1.3-1.4), respectively, p = 0.039 The acceleration, deceleration, and corrective phase durations were consistent between conditions. Trunk angular displacement increased in flexion, lateral flexion, and axial rotation while shoulder flexion decreased when subjects targeted with their prosthesis compared to the intact limb. The differences in targeting precision, reach patio ratio, and joint angular displacements while completing the targeting task indicate diminished EPP. These findings establish baseline information about EPP in TH prosthesis users for comparison as novel prosthesis suspension systems become more available to be tested.
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Affiliation(s)
- Julia A Dunn
- Department of Biomedical Engineering University of Utah, United States; Department of Orthopaedics University of Utah, United States
| | - Bob Wong
- College of Nursing University of Utah, United States
| | - Sarina K Sinclair
- Department of Orthopaedics University of Utah, United States; Department of Veterans Affairs, Salt Lake City, UT, United States
| | - Heath B Henninger
- Department of Biomedical Engineering University of Utah, United States; Department of Orthopaedics University of Utah, United States
| | - Kent N Bachus
- Department of Biomedical Engineering University of Utah, United States; Department of Orthopaedics University of Utah, United States; Department of Veterans Affairs, Salt Lake City, UT, United States
| | - K Bo Foreman
- Department of Orthopaedics University of Utah, United States; Department of Veterans Affairs, Salt Lake City, UT, United States; Department of Physical Therapy and Athletic Training University of Utah, United States.
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Sevik Kacmaz K, Unver B. Immediate effects of elbow orthoses on elbow proprioception in asymptomatic individuals: A randomized sham-controlled single-blinded study. J Hand Ther 2024:S0894-1130(23)00198-9. [PMID: 38360486 DOI: 10.1016/j.jht.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 11/01/2023] [Accepted: 12/28/2023] [Indexed: 02/17/2024]
Abstract
BACKGROUND Improving proprioception can reduce the risk of injuries, while its disruption may lead to injuries and recurrent or persistent symptoms. PURPOSE This study aimed to evaluate the immediate effects of elbow orthoses on elbow proprioception in asymptomatic individuals. STUDY DESIGN This was a randomized, controlled, single-blinded study with a sham application. METHODS Sixty participants were equally distributed into three orthosis groups (counterforce, sleeve, and sham). Proprioception was assessed using active joint position sense error (JPSE) at 70° and 110° of elbow flexion at three time points: baseline (BS), immediately after (IA) wearing the orthosis, and 30 minutes after (30MA) wearing the orthosis. RESULTS Between groups: No significant difference in JPSE was observed at 70° (p = 0.095); however, there was a significant difference at 110° (p = 0.005). Between time points: At 70°, JPSE did not exhibit a significant difference (p = 0.055), whereas a significant difference was observed at 110° (p = 0.020). Interaction of time points×groups: No significant interaction was observed either at 70° (p = 0.476) or at 110° (p = 0.346). At 70°, within the sleeve group, significant differences were identified between BS-30MA (p = 0.001) and IA-30MA (p = 0.009). At 110°, in the sleeve group, significant differences were observed between BS-30MA (p = 0.007) and IA-30MA (p = 0.007). In the counterforce group, significant differences were identified between BS-30MA time points (p = 0.001). At 70°, no difference was observed within the overall evaluation in the counterforce group (p > 0.05), whereas at 110°, a significant difference was noted (p = 0.026). At both 70° and 110°, no differences were identified within the overall evaluation in the sleeve and sham groups (p > 0.05). CONCLUSIONS In asymptomatic individuals, sleeve orthosis improved elbow proprioception at 70°, whereas both counterforce and sleeve orthoses were effective at 110°.
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Affiliation(s)
- Kevser Sevik Kacmaz
- Department of Physical Therapy and Rehabilitation, Izmir Katip Celebi University, Cigli, Izmir, Turkey.
| | - Bayram Unver
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Balçova, Izmir, Turkey.
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Nakai Y, Kijimuta T, Takeshita Y, Kiyama R, Araki S, Miyazaki T, Kawada M. Effects of External Abdominal Pressure Support on Dynamic Balance: A Randomized Crossover Study. Sports (Basel) 2023; 11:217. [PMID: 37999434 PMCID: PMC10675581 DOI: 10.3390/sports11110217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/26/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023] Open
Abstract
Abdominal pressure is vital in protecting the lumbar spine and controlling postural balance. Dynamic balance is associated with movement stability, adaptation to load, and reduced injury risk. Although trunk stability has been examined using belts and braces, the effects of external abdominal pressure support (APS) on balance control remain unknown. In this study, we aimed to determine the effects of external APS on dynamic balance. Overall, 31 young adults participated in this randomized crossover study. External APS was provided using a device that could be pressurized and decompressed by inflating a cuff belt wrapped around the trunk. The modified Star Excursion Balance Test was performed under external APS and non-APS conditions. The maximum anterior, posterolateral, and posteromedial values normalized to the spinal malleolar distance and their respective composite values were compared between the two conditions with and without APS. Posterolateral, posteromedial, and composite values were significantly higher in the APS condition than in the non-APS condition (p < 0.001). The external APS was effective in immediately improving dynamic balance. Furthermore, APS was effective in dynamic balance control as it improved stability during anterior trunk tilt, which displaces the center of gravity forward.
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Affiliation(s)
- Yuki Nakai
- Department of Mechanical Systems Engineering, Faculty of Engineering, Daiichi Institute of Technology, 1-10-2 Kokubuchuo, Kirishima 899-4395, Japan (Y.T.)
| | - Takara Kijimuta
- Department of Mechanical Systems Engineering, Faculty of Engineering, Daiichi Institute of Technology, 1-10-2 Kokubuchuo, Kirishima 899-4395, Japan (Y.T.)
| | - Yasufumi Takeshita
- Department of Mechanical Systems Engineering, Faculty of Engineering, Daiichi Institute of Technology, 1-10-2 Kokubuchuo, Kirishima 899-4395, Japan (Y.T.)
| | - Ryoji Kiyama
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan; (R.K.); (M.K.)
| | - Sota Araki
- Course of Physical Therapist, Department of Rehabilitation, Faculty of Health Sciences, Tohoku Fukushi University, 1-8-1 Kunimi Aoba-ku, Sendai 981-8522, Japan;
| | - Takasuke Miyazaki
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan;
| | - Masayuki Kawada
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan; (R.K.); (M.K.)
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Marchant A, Wallwork SB, Ball N, Witchalls J, Waddington G. The effect of compression and combined compression-tactile stimulation on lower limb somatosensory acuity. Front Sports Act Living 2023; 5:1235611. [PMID: 37927453 PMCID: PMC10622748 DOI: 10.3389/fspor.2023.1235611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
Background Lower limb somatosensation and proprioception are important for maintaining balance. Research has shown that compression garments or exposure to textured surfaces, can enhance somatosensation however, little is known about the effect of combined compression and texture on somatosensory acuity in the lower limb. This study aimed to assess the effects of combined compression socks with a plantar textured sole, on lower limb somatosensory acuity. Methods Thirty participants completed a somatosensory acuity task (active movement extent discrimination apparatus; AMEDA) under three conditions: barefoot (control condition), standard knee-high compression sock (compression sock), and knee-high compression sock with internal rubber nodules situated on the sole (textured-compression sock). Somatosensory acuity was assessed between the different sock conditions for the (i) entire group, (ii) high performers, and (iii) low performers. It was hypothesized that low performers would see gains wearing either sock, but the greatest improvement would be in the textured-compression sock condition. Results AMEDA scores were not significantly different between conditions when the entire group was analyzed (p = 0.078). The low performers showed an improvement in somatosensory acuity when wearing the compression sock (p = 0.037) and the textured compression sock (p = 0.024), when compared to barefoot, but there was no difference between the two sock conditions (p > 0.05). The high performers did not show any improvement (p > 0.05 for all). Conclusion These findings demonstrate that additional sensory feedback may be beneficial to individuals with lower baseline somatosensory acuity but is unlikely to provide benefit for those with higher somatosensory acuity.
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Affiliation(s)
- Ashleigh Marchant
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Sarah B. Wallwork
- IIMPACT in Health, University of South Australia, Adelaide, SA, Australia
| | - Nick Ball
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Jeremy Witchalls
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Gordon Waddington
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
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Bai J, Hua A, Weng D, Wang N, Wang J. Effects of non-extensible lumbar belts on static and dynamic postural stability. BMC Musculoskelet Disord 2023; 24:362. [PMID: 37158940 PMCID: PMC10165835 DOI: 10.1186/s12891-023-06476-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/28/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Previous studies have found that increased intra-abdominal pressure helps to reduce spinal loading and improve spine stability. Non-extensible lumbar belts (NEBs) could elevate intra-abdominal pressure and augment spinal stability. NEBs have been used in the healthcare field to help reduce pain and improve spine function for people with low back pain. However, the effect of NEBs on static and dynamic postural stability is not clear. METHODS This study aimed to investigate whether NEBs affect static and dynamic postural stability. Twenty-eight healthy male subjects were recruited to finish four static postural stability tasks and two dynamic postural stability tests. Center of pressure (COP) values during 30 s of quiet standing, dynamic postural stability index (DPSI) and Y balance test (YBT) score with and without NEBs were analyzed. RESULTS NEBs had no significant effect in all COP variables in the static postural tasks. The results of a repeated measure two-way ANOVA indicated the NEBs significantly improved the dynamic postural stability in YBT score and DPSI (F (1,27) = 5.506, p = .027, [Formula: see text] and F (1,27) = 83.94, p = .000, [Formula: see text] respectively). CONCLUSIONS The study results indicate that non-extensible belts improve dynamic stability in healthy male participants, with potential implications for rehabilitation and performance enhancement programs.
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Affiliation(s)
- Jingyuan Bai
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, 310058, China
| | - Anke Hua
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, 310058, China
| | - Dongkai Weng
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, 310058, China
| | - Nan Wang
- Hangzhou Weizhen Health Technology Co., Ltd., 310058, Hangzhou, China
| | - Jian Wang
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, 310058, China.
- Center for Psychological Sciences, Zhejiang University, Hangzhou, 310058, China.
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Azadinia F, Kingma I, Mazaheri M. Effect of external lumbar supports on joint position sense, postural control, and postural adjustment: a systematic review. Disabil Rehabil 2023; 45:753-771. [PMID: 35259058 DOI: 10.1080/09638288.2022.2043464] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To review the effects of external lumbar supports on various aspects of sensorimotor function including joint position sense (JPS), postural control, anticipatory postural adjustments (APAs), and compensatory postural adjustments (CPAs). METHODS A systematic literature search was performed in PubMed, EMBASE, Scopus, Ovid, Cochrane library, and Web of Science. Two reviewers selected studies which assessed the effect of lumbosacral orthosis or kinesio-tape on JPS, postural control or APAs/CPAs in subjects with and without low back pain (LBP). The methodological quality of included studies was assessed using a modified version of Downs and Black's checklist. RESULTS Findings demonstrated moderate effects of lumbosacral orthosis on specific aspects of sensorimotor control including JPS and to a lesser extent standing stability. These domains were not or minimally affected by application of kinesio-tape. Both orthosis and kinesio-tape had negligible effects on APAs and CPAs. CONCLUSIONS The positive effects of lumbar orthosis on JPS or postural control were mostly observed in conditions where sources of proprioceptive feedback are impaired (such as LBP) or absent (standing with eyes closed on an unstable surface). However, evidence does not prove significant positive effects for the application of kinesio-tape to improve sensorimotor control.IMPLICATIONS FOR REHABILITATIONWearing lumbar orthosis leads to an improvement in joint position sense.Postural stability seems to be affected to some extent by utilizing lumbar orthosis.Clinicians can administer orthosis to improve sensorimotor adaptation, especially in conditions with poor proprioception.Kinesio-tape had negligible effects on all domains of sensorimotor control.Improvement of sensorimotor function as a result of application of kinesio-tape is questionable.
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Affiliation(s)
- Fatemeh Azadinia
- School of Rehabilitation Sciences, Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Idsart Kingma
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Masood Mazaheri
- Department of Plastic and Reconstructive Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Pereira L, Pinto V, Reinas R, Kitumba D, Alves OL. Long-Term Clinical and Radiological Evaluation of Low-Grade Lumbar Spondylolisthesis Stabilization with Rigid Percutaneous Pedicle Screws. ACTA NEUROCHIRURGICA. SUPPLEMENT 2023; 135:417-423. [PMID: 38153503 DOI: 10.1007/978-3-031-36084-8_64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
The armamentarium of surgical treatment options for lumbar spondylolisthesis (LS) includes decompression alone, stabilization with interlaminar devices, or instrumented fusion, through open or minimally invasive approaches. Despite its safe profuse use in distinctive lumbar spine disorders, using percutaneous pedicle screws (PPSs) alone to stabilize LS has never been described before. We performed a retrospective study of prospectively collected data, enrolling 24 patients with LS and scrutinizing clinical and radiological outcomes. A statistically significant decrease in visual analog scale (VAS) scores (p < 0.001) and Oswestry Disability Index (ODI) scores (p < 0.001) was observed, as was a reduction in the intake of acetaminophen after surgery (p = 0.022). In the long-term, PPS effectively reduced the index-level range of motion (p < 0.001), reduced preoperative slippage (p = 0.03), and maintained foraminal height, thus accounting for the positive clinical outcomes. It induced a significant segmental kyphotic effect (p < 0.001) that was compensated for by a favorable increase in the pelvic incidence minus lumbar lordosis (PI-LL) index (0.028).
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Affiliation(s)
- L Pereira
- Department of Neurosurgery, Hospital Center of Vila Nova de Gaia/Espinho, Porto, Portugal
| | - V Pinto
- Department of Neurosurgery, Hospital Center of Vila Nova de Gaia/Espinho, Porto, Portugal
| | - R Reinas
- Department of Neurosurgery, Hospital Center of Vila Nova de Gaia/Espinho, Porto, Portugal
| | - D Kitumba
- Department of Neurosurgery, Hospital Center of Vila Nova de Gaia/Espinho, Porto, Portugal
- Department of Neurosurgery, Hospital Américo Boavida, Angola, Portugal
| | - O L Alves
- Department of Neurosurgery, Hospital Center of Vila Nova de Gaia/Espinho, Porto, Portugal
- Department of Neurosurgery, Hospital Lusíadas Porto, Porto, Portugal
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Oleiwi MA, Shah SZA, Bilal H, Zeb A, Ahmad A, Hegazye FA, Chen H. Efficacy of orthotic support in mitigating low back pain and disability in low back pain sufferers. J Back Musculoskelet Rehabil 2023; 36:1111-1125. [PMID: 37355884 DOI: 10.3233/bmr-220200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/26/2023]
Abstract
BACKGROUND Low back pain (LBP) is a prevalent disabling ailment that affects people all over the world. A wide variety of orthotic designs, ranging from lumbosacral corsets to rigid thermoplastic thoraco-lumbosacral orthosis are used for managing LBP. OBJECTIVE Explore and summarize quality literature on the efficacy of orthotic devices in the management of LBP. METHODS A systematic review and meta-analysis of the literature on the efficacy of orthosis in low back pain management conducted using electronic databases. Studies utilizing orthotic management alone or combined with other therapies for 2 weeks or above were included. A meta-analysis was performed on primary and secondary variables using Mean difference (MD), Inverse variance (IV), and fixed effect model with 95% CI, Physiotherapy Evidence Database (PEDro) scale, Cochrane Risk of Bias 2 (RoB2) tool were used to assess the quality of evidence and the risk bias. RESULTS Out of 14671 studies, only 13 Randomized Controlled Trials (RCT) were deemed eligible for inclusion in this study, all level 1 evidence. We found that orthotics could significantly mitigate LBP (P-value < 0.00001). Similarly, a significant reeducation in LBP-associated disability was observed after orthotic intervention (P-value 0.004). CONCLUSION Lumber orthosis plays a significant role in LBP and associated disability mitigations in sufferers of LBP.
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Affiliation(s)
- Malik Abdulkadhim Oleiwi
- Department of Rehabilitation Medicine and Physical Therapy, Institute of Medical Technology, Middle Technical University, Baghdad, Iraq
| | - Sayed Zulfiqar Ali Shah
- TopSupport International Sports Performance and Rehabilitation Center, Shenzhen, Guangdong, China
- Department of Rehabilitation Medicine and Physical Therapy, Institute of Medical Technology, Middle Technical University, Baghdad, Iraq
| | - Hazrat Bilal
- Institute of Physical Medicine and Rehabilitation, Khyber Medical University, Peshawar, Pakistan
| | - Alam Zeb
- Institute of Physical Medicine and Rehabilitation, Khyber Medical University, Peshawar, Pakistan
| | - Ashfaq Ahmad
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | | - Hong Chen
- Department of Rehabilitation Medicine and Physical Therapy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Jafarian FS, Jafari-Harandi M, Yeowell G, Sadeghi-Demneh E. The Efficacy of Lumbar Support on Pain, Disability, and Motor Control in Women With Postpartum Pelvic Girdle Pain: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e40553. [PMID: 35857366 PMCID: PMC9350821 DOI: 10.2196/40553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 11/30/2022] Open
Abstract
Background Pregnancy-related posterior pelvic girdle pain (PPGP) is one of the most important clinical manifestations of postpartum back pain. Those affected often complain of discomfort during daily activities. It is hypothesized that altered motor control is associated with perceived pain. Pelvic support can regulate possible underlying altered motor control mechanisms and decrease pain. However, the influence of a lumbosacral orthosis, which is broader support that allows for a wider contact area and more skin sensory stimulation to restore proper motor function, has not yet been investigated in women with postpartum PPGP. Objective This study investigates the efficacy of broader lumbar support and narrower pelvic support on pain, proprioception, disability, and muscle strength in women with pregnancy-related PPGP. Methods This study will be a single-center, 3-armed, participant-blinded, randomized controlled trial. In total, 84 women diagnosed with pregnancy-related PPGP will be recruited and randomly assigned into 3 groups. Intervention groups A and B will receive pelvic and lumbar supports, respectively. Group C (control) will receive only a patient education leaflet containing advice on strengthening exercises, comfortable positions, and other practical information. The study outcomes are pain, effort score during the active straight leg raising test, maximum isometric hip flexion force, maximum isometric hip external rotation force, maximum isometric trunk rotation force, and joint position reproduction of hip abduction. The study outcomes will be measured at 4 time points: baseline (T1), immediately after the intervention (T2), 4 weeks following interventions began (at this time, the intervention period is completed) (T3), and 1 week after discontinuing the interventions (T4) to evaluate the possible lasting effects of wearing supports. Multivariate analysis of variance will be used to test between- and within-group differences. Results Recruitment for this study will be started in summer 2022 and is expected to be completed by the end of fall 2022. Conclusions This study will examine the efficacy of broader lumbar support as an early rehabilitative treatment for women receiving postpartum posterior pelvic pain support compared to those receiving a narrower pelvic support. We expect the broader lumbar support to impact pain management and disability better than the current narrower pelvic belt. Long-term follow-up studies will help determine whether such lumbosacral orthosis reduces pain and improves daily activities in women with pregnancy-related PPGP. Trial Registration Iranian Registry of Clinical Trials IRCT20150210021034N11; https://www.irct.ir/trial/54808 International Registered Report Identifier (IRRID) PRR1-10.2196/40553
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Affiliation(s)
- Fahimeh-Sadat Jafarian
- Musculoskeletal Research Center, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahmonir Jafari-Harandi
- Department of Obstetrics & Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Ebrahim Sadeghi-Demneh
- Musculoskeletal Research Center, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Neurosurgeons Relate Heterogeneous Practices Regarding Activity and Return to Work After Spine Surgery. World Neurosurg 2022; 162:e309-e318. [PMID: 35259506 DOI: 10.1016/j.wneu.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Given the paucity of relevant data, the Council of State Neurosurgical Societies Workforce Committee launched a survey of neurosurgeons to assess patterns in activity restriction recommendations following spine surgery; the ultimate goal was to optimize and potentially standardize these recommendations. The aim of this initial study was to determine current practices in activity restrictions and return to work guidelines following common spinal procedures. METHODS The survey included questions regarding general demographics and practice data, postoperative bracing/orthosis utilization, and guidelines for postoperative return to different levels of activity/types of work following specific spine surgery interventions. A spectrum of typical spine surgeries was assessed, including microdiscectomy, anterior cervical discectomy and fusion (ACDF), and lumbar fusion, both open and minimal invasive surgery (MIS) approaches. RESULTS There was significant interprocedure and intraprocedure variation in the neurosurgeons' recommendations for postoperative activity and return to work recommendations after various spinal surgery procedures. Comparisons of the different surgical procedures evaluated revealed significant differences in cervical collar use (more often used following ≥2-level ACDF than single-level ACDF; P < 0.001), return to both sedentary and light physical work (greater restriction with ≥2-level ACDF than with single-level ACDF; P < 0.001), and return to a light exercise regimen (sooner following MIS versus open lumbar fusion; P < 0.001). CONCLUSIONS This survey demonstrated little consistency regarding return to work recommendations, general activity restrictions, and orthosis utilization following common spinal surgical procedures. Addressing this issue also has significant implications for the societal and personal costs of spine surgery.
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11
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Kadri MA, Violette M, Dallaire M, de Oliveira FCL, Lavallière M, Ngomo S, Beaulieu LD, Larivière C, da Silva RA. The immediate effect of two lumbar stabilization methods on postural control parameters and their reliability during two balance tasks. J Man Manip Ther 2021; 29:235-243. [PMID: 33385191 DOI: 10.1080/10669817.2020.1864961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Background: Lumbosacral orthosis (LSO) and/or the isolated contraction of the transversus abdominis muscle by the abdominal drawing-in maneuver (ADIM) can increase lumbar stiffness, consequently influencing postural control. The purpose of this study was to compare the effects of LSO and ADIM on postural control during two balance tasks and determine their reliability.Methods: Twenty participants (50% men) randomly performed three experimental conditions: 1) without lumbar stabilization, 2) with LSO), and 3) with ADIM. Each experimental condition was tested in two postural tasks: semi-tandem and one-legged stance on a force platform for 30 seconds, while the Center of pressure postural (COP) parameters were computed.Results: The two methods of lumbar stabilization were comparable and did not significantly reduce the COP values across time, even though a few individuals presented a change in their COP data above the levels of measurement errors. The reliability of these measurements was generally acceptable and sometimes excellent (≥ 0.90 and ≤10% error measurement).Conclusions: Both LSO and isolated contraction of the transversus abdominis muscle by ADIM do not change postural control in one-legged stance and in semi-tandem tasks. These results have implications for use or not these methods for postural control on a rehabilitation perspective.
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Affiliation(s)
- Mohamed Abdelhafid Kadri
- Département des Sciences de la Santé, Centre intersectoriel en santé durable, Laboratoire de recherche BioNR - Université du Québec à santé (UQAC), Saguenay, Québec, Canada
| | - Marianne Violette
- Programme de physiothérapie de l'Université McGill offert en extension à l'Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada
| | - Mathieu Dallaire
- Programme de physiothérapie de l'Université McGill offert en extension à l'Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada
| | - Fábio Carlos Lucas de Oliveira
- Département des Sciences de la Santé, Centre intersectoriel en santé durable, Laboratoire de recherche BioNR - Université du Québec à santé (UQAC), Saguenay, Québec, Canada
| | - Martin Lavallière
- Département des Sciences de la Santé, Centre intersectoriel en santé durable, Laboratoire de recherche BioNR - Université du Québec à santé (UQAC), Saguenay, Québec, Canada
| | - Suzy Ngomo
- Département des Sciences de la Santé, Centre intersectoriel en santé durable, Laboratoire de recherche BioNR - Université du Québec à santé (UQAC), Saguenay, Québec, Canada.,Programme de physiothérapie de l'Université McGill offert en extension à l'Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada
| | - Louis-David Beaulieu
- Département des Sciences de la Santé, Centre intersectoriel en santé durable, Laboratoire de recherche BioNR - Université du Québec à santé (UQAC), Saguenay, Québec, Canada.,Programme de physiothérapie de l'Université McGill offert en extension à l'Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada
| | - Christian Larivière
- Occupational Health and Safety Research Institute Robert-Sauvé, 505 boul. De Maisonneuve Ouest, Montreal, Quebec, Canada
| | - Rubens A da Silva
- Département des Sciences de la Santé, Centre intersectoriel en santé durable, Laboratoire de recherche BioNR - Université du Québec à santé (UQAC), Saguenay, Québec, Canada.,Programme de physiothérapie de l'Université McGill offert en extension à l'Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada
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12
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Broatch JR, Halson SL, Panchuk D, Bishop DJ, Waddington G. Compression enhances lower‐limb somatosensation in individuals with poor somatosensation, but impairs performance in individuals wth good somatosensation. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.214] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- James R. Broatch
- Institute for Health and Sport (iHeS) Victoria University Melbourne Vic. Australia
- Australia Institute of Sport Canberra ACT Australia
| | - Shona L. Halson
- Australia Institute of Sport Canberra ACT Australia
- School of Behavioural and Health Sciences Australian Catholic University Melbourne Vic. Australia
| | | | - David J. Bishop
- Institute for Health and Sport (iHeS) Victoria University Melbourne Vic. Australia
| | - Gordon Waddington
- Australia Institute of Sport Canberra ACT Australia
- University of Canberra Research Institute for Sport and Exercise Canberra ACT Australia
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Samani M, Shirazi ZR, Hadadi M, Sobhani S. A randomized controlled trial comparing the long-term use of soft lumbosacral orthoses at two different pressures in patients with chronic nonspecific low back pain. Clin Biomech (Bristol, Avon) 2019; 69:87-95. [PMID: 31302494 DOI: 10.1016/j.clinbiomech.2019.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 04/22/2019] [Accepted: 07/02/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND There is concern that wearing soft lumbosacral orthoses for prolonged periods may impair motor function. Moreover, the pressure applied by lumbosacral orthoses on the abdominal wall is usually ignored when these orthoses are prescribed. METHOD In this randomized controlled trial study, 48 patients with chronic nonspecific low back pain were randomly divided into high pressure, normal pressure and control groups. All groups received medication for 4 weeks. The normal pressure and high pressure groups, in addition to medication, used soft lumbosacral orthoses at normal pressure and 50% increased pressure, respectively. Motor function outcome measures were strength, endurance, proprioception and electromyographic activity of the trunk muscles. Clinical outcome measures were pain and disability, which were evaluated in two sessions before and after a 4-week interval. FINDINGS Isometric strength, endurance and most of the electromyographic parameters were generally unaffected by wearing the lumbosacral orthosis. Pain improved in all groups, and disability and proprioception improved in the high pressure and normal pressure groups. Between-group differences in these three measures indicated better results in the lumbosacral orthoses groups than in the control group. The improvements in pain and proprioception were significantly greater in the high pressure group than the normal pressure group. INTERPRETATION Long-term use of lumbosacral orthoses had no significant adverse effects on motor function or clinical factors in patients with chronic low back pain. Increasing lumbosacral orthosis tightness may improve motor functioning and the clinical efficacy of the orthosis. CLINICAL TRIAL REGISTRATION NUMBER Code: IRCT201708192391N38.
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Affiliation(s)
- Mahbobeh Samani
- Student Research Committee, Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Rojhani Shirazi
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohammad Hadadi
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sobhan Sobhani
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Zhang LY, Négyesi J, Okuyama T, Tanaka M, Hortobágyi T, Nagatomi R. Position of compression garment around the knee affects healthy adults' knee joint position sense acuity. Hum Mov Sci 2019; 67:102519. [PMID: 31522078 DOI: 10.1016/j.humov.2019.102519] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 09/07/2019] [Accepted: 09/07/2019] [Indexed: 11/26/2022]
Abstract
Athletes use compression garments (CGs) to improve sport performance, accelerate rehabilitation from knee injuries or to enhance joint position sense (JPS). The position of CGs around the knee may affect knee JPS but the data is inconsistent. The purpose of the present study was to determine the effects of CG position on healthy adults' knee joint position sense acuity. In a counterbalanced, single-blinded study, 16 healthy young adults (8 female, age: 25.5 y) performed an active knee joint position-matching task with and without (CON) a below-knee (BK), above-knee (AK), or whole-knee (WK) CG in a randomized order on the dominant (CompDom) or the non-dominant leg (CompNon-Dom). We also determined the magnitude of tissue compression by measuring anatomical thigh and calf cross sectional area (CSA) in standing using magnetic resonance imaging (MRI). Subjects had less absolute repositioning error (magnitude of error) in BK compared with CON condition. On the other hand, the analysis of the direction of error (constant error) revealed that in each condition subjects tended to underestimate the target position (AK, BK and CON: 75%; WK: 94%). In WK condition there was a significantly larger negative error (-2.7 ± 3.4) as compared with CON (-1.6 ± 3.7) condition. There also was less variable error, in WK compared to BK and CON conditions, indicating less variability in their position sense using a WK CG, regardless of the underestimation. CG reduced thigh CSA by 4.5 cm2 or 3% and calf CSA by Δ1.3 cm2 or 1%. The position of CG relative to the knee modifies knee JPS. The findings helps us better understand how the application of a WK CG may support athletic activities.
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Affiliation(s)
- Li Yin Zhang
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - János Négyesi
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Takeshi Okuyama
- Department of Robotics, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
| | - Mami Tanaka
- Department of Robotics, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
| | - Tibor Hortobágyi
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Ryoichi Nagatomi
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Sendai, Japan; Division of Biomedical Engineering for Health & Welfare, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
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15
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Shahvarpour A, Preuss R, Larivière C. The effect of extensible and non-extensible lumbar belts on trunk postural balance in subjects with low back pain and healthy controls. Gait Posture 2019; 72:211-216. [PMID: 31255888 DOI: 10.1016/j.gaitpost.2019.06.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 05/23/2019] [Accepted: 06/19/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Previous findings suggest that wearing a lumbar belt may benefit some patients with low back pain; however, the mechanisms of action are not yet fully understood. RESEARCH QUESTION The effect of wearing two flexible (extensible and non-extensible) lumbar belts on trunk postural control was investigated during an unstable sitting task. METHODS Healthy subjects and subjects with LBP sat on a wobbling chair, with and without the lumbar belts. Chair rotation was measured in the sagittal and frontal planes, and 10 linear and nonlinear measures of balance were computed to assess the quantity (3 measures) and quality (7 measures) of the movements. RESULTS Both lumbar belts induced similar changes in specific measures of trunk postural control, for both subject groups, generally indicative of more instability and less controllability, but with low effect sizes (0.14 and 0.40). Subjects with LBP also showed lower entropy (complexity; effect size 0.93) and higher determinism (predictability; effect size 0.56) than healthy controls, under all test conditions. These findings indicate that the subjects with LBP used a less complex, more predictable trunk postural control strategy, suggestive of impaired adaptability and responsiveness to dynamic trunk postural control demands. The findings also suggest other factors related to dynamic adaptability may be impaired by lumbar belt use. SIGNIFICANCE The effects of the lumbar belts on trunk postural control were small, however, their practical implications for the management of LBP remain to be determined in relation to other effects of lumbar belts (e.g. increased mechanical stiffness).
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Affiliation(s)
- Ali Shahvarpour
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boul. de Maisonneuve O, Montreal, QC, H3A 3C2, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada.
| | - Richard Preuss
- School of Physical and Occupational Therapy, McGill University, 3654 prom Sir-William-Osler, Montreal, QC, H3G 1Y5, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada.
| | - Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boul. de Maisonneuve O, Montreal, QC, H3A 3C2, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada.
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16
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Beaudette SM, Pinto BL, Brown SHM. Tactile Feedback can be Used to Redistribute Flexion Motion Across Spine Motion Segments. Ann Biomed Eng 2018; 46:789-800. [PMID: 29464461 DOI: 10.1007/s10439-018-1998-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 02/12/2018] [Indexed: 12/01/2022]
Abstract
This experiment investigates the efficacy of tactile feedback in affecting changes to dynamic spine movements. A sample of (n = 24) young, healthy males were assessed while completing targeted spine flexion movements with instruction to minimize stretching of the skin beneath an applied tactile stimulus (liquid bandage). Localized tactile stimuli were placed bilaterally at either lumbar (L4), lower thoracic (T10) or upper thoracic (T4) levels. Results demonstrate that localized tactile feedback elicited a re-distribution of spine flexion movement across spine sub-sections (e.g. lumbar vs. thoracic) and intervertebral segments (e.g. C7/T1 through L5/S1). Further, tactile feedback successfully limited the magnitude of end-range flexion, but did not limit functional mid-range spine flexion. Finally, tactile feedback located in the lower thoracic region (T10) increased thoracic flexion variability; however, tactile feedback located at the T4 and L4 regions had no significant effect on movement variability. These findings provide evidence that spine neuromuscular control patterns can be altered using simple tactile stimuli. In terms of low back injury prevention and/or rehabilitation, the tactile feedback investigated here has apparent utility in limiting recognized mechanical risk factors for low back injury; specifically, the local incidence of flexion at specific spine levels, and the incidence of end-range flexion.
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Affiliation(s)
- Shawn M Beaudette
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Brendan L Pinto
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Stephen H M Brown
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada.
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17
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Mi J, Ye J, Zhao X, Zhao J. Effects of lumbosacral orthoses on postural control in individuals with or without non-specific low back pain. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2017; 27:180-186. [PMID: 29071410 DOI: 10.1007/s00586-017-5355-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 10/04/2017] [Accepted: 10/17/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To investigate the effect of lumbosacral orthoses (LSOs) on postural control in individuals with or without non-specific low back pain (NSLBP). METHODS Individuals with NSLBP (n = 28) and healthy controls (n = 28) were enrolled to assess the postural control with or without LSOs. Postural control was tested using the Balance Master® NeuroCom system by the modified clinical test of sensory interaction and balance. RESULTS Relative to controls, patients with NSLBP had deficits in postural control with greater center of pressure (COP) sway velocity when standing on firm surface (with eyes open: p = 0.002; with eyes closed: p = 0.002) and standing on foam surface (with eyes open: p = 0.024; with eyes closed: p < 0.001). In the braced condition, the COP sway decreased in all subjects with or without NSLBP when standing on foam surface. There was no significant difference in the effect of LSOs on postural control between NSLBP group and healthy controls. CONCLUSION Individuals with NSLBP have poorer postural control than controls. LSOs seem to improve postural control when standing on unstable surfaces in subjects with or without NSLBP. The effect of LSOs on postural control may not depend on the level of baseline.
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Affiliation(s)
- Jie Mi
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Jiling Ye
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Xin Zhao
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Jie Zhao
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China.
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18
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Boucher JA, Roy N, Preuss R, Larivière C. The effect of two lumbar belt designs on trunk repositioning sense in people with and without low back pain. Ann Phys Rehabil Med 2017; 60:306-311. [DOI: 10.1016/j.rehab.2017.03.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 02/20/2017] [Accepted: 03/05/2017] [Indexed: 01/03/2023]
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Effects of joint stabilizers on proprioception and stability: A systematic review and meta-analysis. Phys Ther Sport 2017; 25:65-75. [DOI: 10.1016/j.ptsp.2016.05.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 03/31/2016] [Accepted: 05/10/2016] [Indexed: 11/19/2022]
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20
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Azadinia F, Ebrahimi E, Kamyab M, Parnianpour M, Cholewicki J, Maroufi N. Can lumbosacral orthoses cause trunk muscle weakness? A systematic review of literature. Spine J 2017; 17:589-602. [PMID: 27988341 DOI: 10.1016/j.spinee.2016.12.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 11/14/2016] [Accepted: 12/09/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND Wearing lumbosacral orthosis (LSO) is one of the most common treatments prescribed for conservative management of low back pain. Although the results of randomized controlled trials suggest effectiveness of LSO in reducing pain and disability in these patients, there is a concern that prolonged use of LSO may lead to trunk muscle weakness and atrophy. PURPOSE The present review aimed to evaluate available evidence in literature to determine whether LSO results in trunk muscle weakness or atrophy. STUDY DESIGN This is a systematic review. METHODS A systematic search of electronic databases including PubMed, Scopus, ScienceDirect, and Medline (via Ovid) followed by hand search of journals was performed. Prospective studies published in peer-reviewed journals, with full text available in English, investigating the effect of lumbar orthosis on trunk muscle activity, muscle thickness, strength or endurance, spinal force, and intra-abdominal pressure in healthy subjects or in patients with low back pain, were included. Methodological quality of selected studies was assessed by using the modified version of Downs and Black checklist. This research had no funding source, and the authors declare no conflicts of interest-associated biases. RESULTS Thirty-five studies fulfilled the eligibility criteria. The mean and standard deviation of the quality score was 64±9.7%. Most studies investigating the effect of lumbar orthosis on electromyographic activity (EMG) of trunk muscles demonstrated a decrease or no change in the EMG parameters. A few studies reported increased muscle activity. Lumbosacral orthosis was found to have no effect on muscle strength in some studies, whereas other studies demonstrated increased muscle strength. Only one study, which included ultrasound assessment of trunk muscle stabilizers, suggested reduced thickness of the abdominal muscles and reduced cross-sectional area of the multifidus muscles. Out of eight studies that investigated spinal compression load, the load was reduced in four studies and unchanged in three studies. One study showed that only elastic belts reduced compression force compared to leather and fabric belts and ascribed this reduction to the elastic property of the lumbar support. CONCLUSION The present review showed that the changes in outcome measures associated with muscle work demands were inconsistent in their relation to the use of lumbar supports. This review did not find conclusive scientific evidence to suggest that orthosis results in trunk muscle weakness.
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Affiliation(s)
- Fatemeh Azadinia
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Ebrahimi
- Department of Physical therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Mojtaba Kamyab
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohamad Parnianpour
- Biomechanics Laboratory, Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - Jacek Cholewicki
- MSU Center for Orthopedic Research, Department of Surgical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - Nader Maroufi
- Department of Physical therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Lin YH, Sun MH. The effect of lifting and lowering an external load on repositioning error of trunk flexion-extension in subjects with and without low back pain. Clin Rehabil 2016; 20:603-8. [PMID: 16894803 DOI: 10.1191/0269215506cr971oa] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To determine whether the repositioning error of trunk flexion-extension in individuals with low back pain is different from that in those not experiencing low back pain when lifting and lowering external loads. Design: A case-control study. Setting: Physical therapy department of a medical centre. Subjects: Twenty subjects with subacute low back pain and 20 control subjects without low back pain. Interventions: Tasks with and without lifting and lowering an external load. Main outcome measures: The trunk repositioning errors were measured with Measurand Shape Tape. Results: In subjects with low back pain, trunk repositioning errors were significantly reduced when lifting and lowering an external load in the direction of flexion (3.779 ±1.26 degrees in a loaded condition versus 4.82±2.97 degrees in an unloaded condition; P B< 0.05) and extension (3.17±2.15 degrees in a loaded condition versus 5.039±3.74 degrees in an unloaded condition; p < 0.05). In control subjects, trunk repositioning errors were not significantly changed when lifting and lowering an external load in the direction of flexion (2.80±1.39 degrees in a loaded condition versus 2.63±1.24 degrees in an unloaded condition; p < 0.05) and extension (2.87±1.40 degrees in a loaded condition versus 3.15±1.50 degrees in an unloaded condition; P>0.05). The direction of motion (trunk flexion or extension) was not shown to be significant in this study. Conclusion: Performing the task whilst lifting or lowering a submaximal load showed a reduced trunk repositioning error in subjects with subacute low back pain. Lifting and lowering a submaximal load might be considered as one of the rehabilitative strategies to hasten a return to work.
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Affiliation(s)
- Yang Hua Lin
- Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, 259, Wen-Hwa 1st Rd., Kweishan, Taoyuan, Taiwan 333.
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Kong YS, Jang GU, Park S. The effects of prone bridge exercise on the Oswestry disability index and proprioception of patients with chronic low back pain. J Phys Ther Sci 2015; 27:2749-52. [PMID: 26504285 PMCID: PMC4616086 DOI: 10.1589/jpts.27.2749] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 05/25/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to investigate the effect of bridge exercises on
the Oswestry disability index (ODI) scores and proprioception among patients with chronic
low back pain (CLBP). [Subjects and Methods] A total of 38 patients participated in this
study. After eight weeks of bridge exercise, the joint position angle of the body trunk
was measured and the ODI was used in survey form to investigate the intensity of the
patients’ low back pain. [Results] After eight weeks of exercise, the ODI showed
significant differences in all three groups. Subjects’ joint position sense of the trunk
in both lumbar flexion and extension was also significantly different after completing the
exercise program; this was true for all three groups. [Conclusion] Performing the prone
bridge exercise for eight weeks improved proprioceptive function and reduced pain and
impediment of activity, showing it a more effective exercise than other bridge
exercises.
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Affiliation(s)
- Yong-Soo Kong
- Department of Physical Therapy, College of Medical Science, Catholic University of Daegu, Republic of Korea
| | - Gwon-Uk Jang
- Department of Physical Therapy, College of Medical Science, Catholic University of Daegu, Republic of Korea
| | - Seol Park
- Department of Physical Therapy, College of Medical Science, Catholic University of Daegu, Republic of Korea
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23
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Proprioception in musculoskeletal rehabilitation. Part 2: Clinical assessment and intervention. ACTA ACUST UNITED AC 2015; 20:378-87. [DOI: 10.1016/j.math.2015.01.009] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 01/04/2015] [Accepted: 01/15/2015] [Indexed: 01/14/2023]
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Steinberg N, Waddington G, Adams R, Karin J, Tirosh O. The effect of textured ballet shoe insoles on ankle proprioception in dancers. Phys Ther Sport 2015; 17:38-44. [PMID: 26563491 DOI: 10.1016/j.ptsp.2015.04.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 02/18/2015] [Accepted: 04/13/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Impaired ankle inversion movement discrimination (AIMD) can lead to ankle sprain injuries. The aim of this study was to explore whether wearing textured insoles improved AIMD compared with barefoot, ballet shoes and smooth insoles, among dancers. METHODS Forty-four adolescent male and female dancers, aged 13-19, from The Australian Ballet School were tested for AIMD while barefoot, wearing ballet shoes, smooth insoles, and textured insoles. RESULTS No interaction was found between the four different footwear conditions, the two genders, or the two levels of dancers in AIMD (p > .05). An interaction was found between the four different footwear conditions and the three tertiles when tested in ballet shoes (p = .006). Although significant differences were found between the upper tertiles and the lower tertiles when tested with ballet shoes, barefoot and with smooth insoles (p < .001; p < .001; p = .047, respectively), when testing with textured insoles dancers in the lower tertile obtained similar scores to those obtained by dancers in the upper tertile (p = .911). CONCLUSION Textured insoles improved the discrimination scores of dancers with low AIMD, suggesting that textured insoles may trigger the cutaneous receptors in the plantar surface, increasing the awareness of ankle positioning, which in turn might decrease the chance of ankle injury.
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Affiliation(s)
- Nili Steinberg
- Institute of Sport Exercise and Active Living (ISEAL), Victoria University, Victoria, Australia; Wingate College of Physical Education and Sports Sciences, Wingate Institute, Netanya, Israel.
| | | | - Roger Adams
- School of Physiotherapy, University of Sydney, Australia
| | - Janet Karin
- The Australian Ballet School, Melbourne, Australia
| | - Oren Tirosh
- Institute of Sport Exercise and Active Living (ISEAL), Victoria University, Victoria, Australia
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Yang J, Lee B, Kim C. Changes in proprioception and pain in patients with neck pain after upper thoracic manipulation. J Phys Ther Sci 2015; 27:795-8. [PMID: 25931733 PMCID: PMC4395717 DOI: 10.1589/jpts.27.795] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 10/24/2014] [Indexed: 11/25/2022] Open
Abstract
[Purpose] The purpose of this study was to conduct cervical stability training and upper
thoracic manipulation for patients with chronic neck pain and then investigate the changes
of cervical proprioception and pain. [Subjects and Methods] Subjects were 30 workers with
mechanical neck pain, who were randomly divided into an upper thoracic manipulation group
and a cervical stability training group. Upper thoracic manipulation after cervical
stability training was conducted for the upper thoracic manipulation group, and only
stability training was conducted for the cervical stability training group. The
intervention period was six weeks, and consisted of three sessions a week, each of which
lasted for 30 minutes. For proprioception measurement, an electro-goniometer was used to
measure reposition sense before and after the intervention. The visual analogue scale was
used to assess pain. [Results] After the intervention, the error angle was significantly
smaller in flexion and right left side-bending, and pain was significantly reduced in the
upper thoracic manipulation group. According to the post intervention comparison of the
two groups, there were significant differences in the proprioception and pain values.
[Conclusion] Conducting both cervical stability training and upper thoracic manipulation
for patients with chronic neck pain was more helpful for the improvement of proprioception
and pain than cervical stability training alone.
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Affiliation(s)
- Jinmo Yang
- Department of Physical Therapy, The Graduate School, Daejon University, Republic of Korea
| | - Byoungkwon Lee
- Deptartment of Physical Therapy, Konyang University, Republic of Korea
| | - Changbeom Kim
- Department of Physical Therapy, The Graduate School, Daejon University, Republic of Korea
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Morrisette DC, Cholewicki J, Logan S, Seif G, McGowan S. A randomized clinical trial comparing extensible and inextensible lumbosacral orthoses and standard care alone in the management of lower back pain. Spine (Phila Pa 1976) 2014; 39:1733-42. [PMID: 25054648 PMCID: PMC4521401 DOI: 10.1097/brs.0000000000000521] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Single blinded, randomized clinical trial for the evaluation of lumbosacral orthoses (LSOs) in the management of lower back pain (LBP). OBJECTIVE To evaluate the effects of two types of LSOs on self-rated disability in patients with LBP. SUMMARY OF BACKGROUND DATA LSOs are commonly used for the management of LBP, but their effectiveness may vary because of design. An inextensible LSO (iLSO) reduces trunk motion and increases trunk stiffness, whereas an extensible LSO (eLSO) does not. METHODS A total of 98 participants with LBP were randomized to 3 groups: (1) standard care (SC) group, which included medication and physical therapy (n = 29), (2) SC with eLSO (eLSO group) (n = 32), and (3) SC with iLSO (iLSO group) (n = 37). Outcome measures were evaluated before and after 2 weeks of treatment: modified Oswestry Disability Index (ODI), Patient Specific Activity Scale, pain ratings, and Fear Avoidance Beliefs Questionnaire. RESULTS There were no statistically significant differences between groups at baseline. Compared with the SC alone, iLSO group showed greater improvement on the ODI scores (P = 0.01) but not the eLSO group. The ODI scores improved by a mean of 2.4 (95% confidence interval [CI], 2.2-7.1), 8.1 (95% CI, 2.8-13.4), and 14.0 (95% CI, 8.2-19.8) points for SC, eLSO, and iLSO groups, respectively. Individuals wearing the iLSO had 4.7 times higher odds of achieving 50% or greater improvement in the ODI scores than those assigned to SC (95% CI, 1.2-18.5, P = 0.03). Both the eLSO and iLSO groups had a greater improvement in the Patient Specific Activity Scale scores than the SC group (P = .05 and P = 0.01, respectively), but the change did not meet the minimal clinically important difference. Pain ratings improved for all 3 groups, with no statistical difference between them. Finally, no significant differences across groups were found for the Fear Avoidance Beliefs Questionnaire. CONCLUSION An iLSO led to greater improvement in ODI scores than SC and an eLSO. We surmise that the likely mechanism responsible for this difference in outcome was the added trunk stiffness and motion restriction by the iLSO. LEVEL OF EVIDENCE 2.
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Affiliation(s)
- David C Morrisette
- *Division of Physical Therapy, College of Health Professions, Medical University of South Carolina, Charleston †Center for Orthopedic Research, Osteopathic Surgical Specialties, College of Osteopathic Medicine, Michigan State University, East Lancing ‡Family Services Research Center, Medical University of South Carolina, Charleston §Division of Physical Therapy, College of Health Professions, Medical University of South Carolina, Charleston; and ¶Department of Physical Therapy, Medical University of South Carolina Hospital Authority, Charleston
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Azadinia F, Kamyab M, Behtash H, Maroufi N, Larijani B. The effects of two spinal orthoses on balance in elderly people with thoracic kyphosis. Prosthet Orthot Int 2013; 37:404-10. [PMID: 23401294 DOI: 10.1177/0309364612474487] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Hyperkyphosis increases the risk of falls for elderly people by reducing postural balance. Spinomed orthosis and the posture-training support are two available options for improving postural balance but have never been compared. OBJECTIVES To compare the effect of the Spinomed orthosis and the posture-training support on balance in elderly people with thoracic hyperkyphosis. STUDY DESIGN This study is a clinical trial on an accessible sample of elderly people with thoracic kyphosis. METHOD Eighteen participants (16 women and 2 men), aged 60-80 years, with thoracic kyphosis greater than 50°, completed the study procedure. Subjects were randomly allocated to two groups, namely, Spinomed orthosis and the posture-training support groups. Sensory organization test and limits of stability were assessed using the EquiTest system and the Balance Master system, respectively. Balance score, directional control, and reaction time were measured to evaluate balance with and without orthosis in a random order. RESULTS In the posture-training support group, significant changes were observed in the studied balance parameters: balance score (p < 0.001), directional control (p = 0.027), and reaction time (p = 0.047). There was a significant change in balance score (p < 0.001) and directional control (p = 0.032) in the Spinomed group. However, there were no significant differences in the effect of the two orthoses, the Spinomed orthosis and posture-training support, on balance factors. CONCLUSION Both Spinomed orthosis and posture-training support may improve balance in the elderly with thoracic hyperkyphosis in a similar manner.
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Affiliation(s)
- Fatemeh Azadinia
- Department of Orthotics and Prosthetics, Faculty of Rehabilitation Sciences, Tehran University of Medical Sciences, Tehran, Iran
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Salekzamani Y, Mirzaee S, Shakouri SK, Nezami N. Pain relieving effect of thermoplastic lumbosacral orthosis with adjustable posterior pad in chronic non-specific low back pain. IRANIAN RED CRESCENT MEDICAL JOURNAL 2011; 13:903-5. [PMID: 22737439 PMCID: PMC3371899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Accepted: 08/10/2011] [Indexed: 11/29/2022]
Affiliation(s)
- Y Salekzamani
- Physical Medicine and Rehabilitation Research Center, Tabriz, Eastern Azerbaijan, Iran
| | - S Mirzaee
- Physical Medicine and Rehabilitation Research Center, Tabriz, Eastern Azerbaijan, Iran
| | - S K Shakouri
- Physical Medicine and Rehabilitation Research Center, Tabriz, Eastern Azerbaijan, Iran
| | - N Nezami
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Eastern Azerbaijan, Iran,Correspondence: Nariman Nezami, MD, Physical Medicine and Rehabilitation Research Center, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Post code: 5165665811, Eastern Azerbaijan, Iran. Tel.: +98-411-3363231, Fax: +98-411-3363231, E-mail:
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Lumbar repositioning accuracy as a measure of proprioception in patients with back dysfunction and healthy controls. Asian Spine J 2011; 5:201-7. [PMID: 22164313 PMCID: PMC3230646 DOI: 10.4184/asj.2011.5.4.201] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Revised: 04/07/2011] [Accepted: 04/08/2011] [Indexed: 11/17/2022] Open
Abstract
Study Design A control group cross-sectional design. Purpose To compare the difference in repositioning accuracy, as a measure of lumbar proprioception, between patients with back dysfunction and healthy subjects. Overview of Literature Evidence suggests that spinal stability might be compromised in patients with back dysfunction. Lumbar proprioception in back dysfunction has not, however, been adequately investigated. Methods Forty-five participants, representing three groups, took part in the study. Subjects in group one (n = 15) were healthy subjects. Subjects in group two (n = 15) had a history of non-specific mechanical back dysfunction, while subjects in group three (n = 15) had discogenic back dysfunction. Subjects were required to reproduce a target position of 30° lumbar flexion and the absolute error (AE) was calculated. Results The AEs between target and reproduced positions were calculated. The average repositioning AEs were 2.8, 7.5, and 7.1° for the control, mechanical, and discogenic back dysfunction groups respectively. Analysis of variance revealed significant difference between the three groups (p < 0.0002). The AEs were greater in the two back dysfunction groups compared to the control group. Post-hoc tests revealed significant difference in AEs between the control and mechanical group (p < 0.0003), and discogenic group (p < 0.0001), while there was no significant difference between the mechanical and discogenic back dysfunction groups (p = 0.73). Conclusions Differences in proprioception do exist between subjects with back dysfunction and normal subjects. The proprioceptive deficits do exist regardless of the cause of the back dysfunction, and may represent an important aspect of the patho-physiology of such a condition.
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Scibek JS, Mell AG, Downie BK, Palmieri-Smith R, Hughes RE. IMPACT OF PAIN ON SHOULDER ELEVATION VELOCITY IN PATIENTS WITH ROTATOR CUFF TEARS. ACTA ACUST UNITED AC 2011. [DOI: 10.1142/s0218957710002429] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Pain is routinely implicated as a factor when considering impaired movement in injured populations. Movement velocity is often considered during the rehabilitation process; unfortunately our understanding of pain's impact on shoulder movement velocity in rotator cuff tear patients is less understood. Therefore, the purpose of this study was to test the hypothesis that there would be an increase in peak and mean shoulder elevation velocities following the decrease of shoulder pain in rotator cuff tear patients, regardless of tear size. Fifteen subjects with full-thickness rotator cuff tears (RCT) performed humeral elevation and lowering in three planes before and after receiving a lidocaine injection to relieve pain. Pain was assessed using a visual analog scale. Humeral elevation velocity data were collected using an electromagnetic tracking system. A significant reduction in pain (pre-injection 3.53 ± 1.99; post-injection 1.23 ± 1.43) resulted in significant increases in maximum and mean humeral elevation velocities. Mean shoulder elevation and lowering velocities increased 15.10 ± 2.45% while maximum shoulder movement velocities increased 12.77 ± 3.93%. Furthermore, no significant relationships were noted between tear size and movement velocity. These significant increases in movement velocity provide evidence to further support the notion that human motion can be inhibited by injury-associated pain, and that by reducing that pain through clinical interventions, human movement can be impacted in a positive fashion.
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Affiliation(s)
- Jason S. Scibek
- Department of Athletic Training, Duquesne University, Pittsburgh, PA, USA
| | - Amy G. Mell
- Thomson Healthcare, Ann Arbor, MI, USA
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Brian K. Downie
- MedSport, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | | | - Richard E. Hughes
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
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Effects of vision and tactile stimulation of the neck on postural control during unperturbed stance and cervical joint position sense in young asymptomatic adults. Spine (Phila Pa 1976) 2010; 35:1589-94. [PMID: 20628325 DOI: 10.1097/brs.0b013e3181e6cd22] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Before and after intervention trials. OBJECTIVE To evaluate the effects of visual input and tactile stimulation of the neck on postural control during unperturbed stance and cervical joint position sense. SUMMARY OF BACKGROUND DATA Although beneficial effects on lower-limb joints proprioception have been reported when vision was available and when tactile stimulation was applied around lower-limb joints, there has hitherto been no study investigating whether and how vision and tactile stimulation applied to the neck could modify postural control during unperturbed stance and joint position sense. METHODS The effects of visual input and tactile stimulation of the neck on postural control during unperturbed stance (Experiments 1 and 2) and cervical joint position sense (Experiments 3 and 4) were assessed in four separate experiments. During these experiments, two experimental tasks (a postural task during unperturbed stance and the CRT to NHP) were executed without (No vision) and with the availability of the vision (Vision) and without (No tactile stimulation condition) and with the application of strips of adhesive bandage to the skin over and around the neck (Tactile stimulation condition). Twelve different subjects participated in the four experiments. RESULTS For experiments 1 and 2, decreased centre of foot pressure displacements were observed in the Vision relative to the No vision and in the Tactile stimulation relative to the No tactile stimulation condition. For experiments 3 and 4, more accurate and more consistent repositioning performances were observed in the Vision relative to the No vision and in the Tactile stimulation relative to the No tactile stimulation condition, as indicated by decreased absolute and variable errors, respectively. CONCLUSION Altogether, our results suggest that subjects were able to take advantage of vision and increased neck cutaneous information provided by the by strips of adhesive bandage applied to the neck to improve postural control during unperturbed stance and cervical joint position sense.
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Munoz F, Salmochi JF, Faouën P, Rougier P. Low back pain sufferers: is standing postural balance facilitated by a lordotic lumbar brace? Orthop Traumatol Surg Res 2010; 96:362-6. [PMID: 20452305 DOI: 10.1016/j.otsr.2010.01.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2009] [Revised: 11/24/2009] [Accepted: 01/18/2010] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The use of a lumbar lordosis orthotic device in the treatment of discogenic low back pain could be a valuable option and rehabilitation tool. The lumbar lordosis brace has been designed to meet these requirements and acts as a reminder to the patient to maintain a physiological lumbar lordosis curvature since it comprises a vertical panel on the chest and a curved rigid shell at the back. This lumbar lordosis brace exerts the necessary degree of compression in the lumbar region and achieves correction of the sagittal plane spine balance to improve postural control of the lumbar spine. Quantitative analysis of the centre of pressure (CoP) deviations, which are necessary to maintain the standing posture helps evaluate the impact of such device on postural balance. PATIENTS AND METHODS Eleven patients suffering from lumbar pain with discopathy (seven females and four males) had to stand on a force platform with their eyes closed under two basic conditions (fitted or not with a lumbar lordosis brace). RESULTS On the antero-posterior axis, the lordosis brace achieved a 6mm CP deviation from its mean position and a 51% reduction in the mean displacement prior to the initiation of the postural control mechanisms. DISCUSSION The forces applied by the lumbar lordosis brace (through compression and/or change in the spinal sagittal balance) seem to improve the quality of the patient's balance strategy. Posturography appears as a valuable tool for in situ investigation of the postural benefits achieved when using a thoracolumbosacral orthosis in patients suffering from lumbar pain. LEVEL OF EVIDENCE LEVEL IV: .
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Affiliation(s)
- F Munoz
- Exercise Physiology Laboratory, EA4338, scientific area of Savoie-Technolac, Savoie University, Le-Bourget-du-Lac, France
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Gay A, Harbst K, Kaufman KR, Hansen DK, Laskowski ER, Berger RA. New method of measuring wrist joint position sense avoiding cutaneous and visual inputs. J Neuroeng Rehabil 2010; 7:5. [PMID: 20146811 PMCID: PMC2828456 DOI: 10.1186/1743-0003-7-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2009] [Accepted: 02/10/2010] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Aspects of afferent inputs, generally termed proprioception, are being increasingly studied. Extraneous factors such as cutaneous inputs can dramatically interfere while trying to design studies in order to determine the participation of the different structures involved in proprioception in the wrist position sense. We tried to determine validity and repeatability of a new wrist joint position measurement device using methodology designed to minimize extraneous factors and isolate muscle and joint inputs. METHODS In order to test the reliability of the system, eighty young-adult subjects without musculoskeletal or neurologic impairments affecting the right upper extremity were tested using a custom made motion tracking system. Testing consisted of two conditions: active reproduction of active placement and passive reproduction of passive placement. Subjects performed two repetitions of each target position (10, 20, and 30 degrees of flexion and extension) presented in a random order. Test- retest reliability was then tested. RESULTS The average constant error in the passive condition was -0.7 degrees +/- 4.7 degrees as compared to the active condition at 3.7 degrees +/- 5.1 degrees. Average absolute error in the passive condition was 4.9 degrees +/- 2.9 degrees compared to the active condition in which absolute error was 5.9 degrees +/- 3.5 degrees. DISCUSSION Test-retest repeatability in both conditions was less than the 5 degrees magnitude typical of clinical goniometry. Errors in the active condition (less than 2 degrees ) were slightly smaller than the passive condition, and the passive condition was also associated with poorer consistency between apparatus sensors and skin sensors. CONCLUSIONS The current system for measurement of wrist joint proprioception allows the researcher to decrease extraneous influences that may affect joint position sense awareness, and will help in future study aiming to determine precisely the role of the different structure involved in proprioception.
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Affiliation(s)
- Andre Gay
- Biomechanics Laboratory, Division of Orthopedic Research, Mayo Clinic, 200 First Street SW. Rochester, MN 55095, USA
| | - Kimberly Harbst
- Biomechanics Laboratory, Division of Orthopedic Research, Mayo Clinic, 200 First Street SW. Rochester, MN 55095, USA
| | - Kenton R Kaufman
- Biomechanics Laboratory, Division of Orthopedic Research, Mayo Clinic, 200 First Street SW. Rochester, MN 55095, USA
| | - Diana K Hansen
- Biomechanics Laboratory, Division of Orthopedic Research, Mayo Clinic, 200 First Street SW. Rochester, MN 55095, USA
| | - Edward R Laskowski
- Biomechanics Laboratory, Division of Orthopedic Research, Mayo Clinic, 200 First Street SW. Rochester, MN 55095, USA
| | - Richard A Berger
- Biomechanics Laboratory, Division of Orthopedic Research, Mayo Clinic, 200 First Street SW. Rochester, MN 55095, USA
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Preuss RA, Popovic MR. Three-dimensional spine kinematics during multidirectional, target-directed trunk movement in sitting. J Electromyogr Kinesiol 2009; 20:823-32. [PMID: 19674918 DOI: 10.1016/j.jelekin.2009.07.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Revised: 07/14/2009] [Accepted: 07/17/2009] [Indexed: 11/16/2022] Open
Abstract
The current study provides a quantitative assessment of three-dimensional spine motion during target-directed trunk movements in sitting. Subjects sat on an elevated surface, without foot support, and targets were placed in five directions, at three subject-specific distances (based on trunk height). Subjects were asked to lean toward the target, touch it with their head, and return to upright sitting. A retro-reflective motion analysis system was used to measure spine motion, using three kinematic trunk models (1, 3 and 7 segments). Significant differences were noted in the total trunk motion measured between the models, as well as between target distances and directions. In the most segmented model, inter-segmental trunk motion was also found to differ between trunk levels, with complex interaction effects involving target distance and direction. These findings suggest that inter-segmental spine motion is complex, task dependent, and often unevenly distributed between spine levels, with motion patterns differing between subjects, even in the absence of pathology. Use of a multi-segmental model provides the most interpretable findings, allowing for differentiation of individual motion patterns of the spine. Such an approach may be beneficial to the understanding of movement-related spine pathologies.
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Affiliation(s)
- Richard A Preuss
- Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute, 520 Sutherland Drive, Toronto, Ontario, Canada.
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Effects of spinal manipulation on trunk proprioception in subjects with chronic low back pain during symptom remission. J Manipulative Physiol Ther 2009; 32:118-26. [PMID: 19243723 DOI: 10.1016/j.jmpt.2008.12.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2008] [Revised: 10/15/2008] [Accepted: 10/19/2008] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the immediate effects of spinal manipulative therapy (SMT) on trunk proprioception in subjects with asymptomatic chronic low back pain (CLBP) and determine if those effects lasted 1 week. METHODS This unbalanced randomized controlled crossover design examined 33 subjects with CLBP. Proprioception was tested via joint position sense, threshold to detect passive motion (TTDPM), direction of motion (DM), and force reproduction. Each subject received lumbar manipulation or a sham procedure followed by proprioception retest. This procedure was repeated 1 week later using the opposing treatment. Subjects receiving SMT in the second session returned a third time receiving the sham procedure again. RESULTS Spinal manipulative therapy produced an effect for TTDPM in the manipulation first group (P = .008), the sham procedure produced an effect for joint position sense in the sham first group (P = .005). Spinal manipulative therapy had a 1-week effect for the manipulation first group (P = .006). No effect was noted for either DM or force reproduction. CONCLUSIONS Results suggest SMT had minimal immediate effect on trunk proprioception. The effects noted occurred in session 1, implicating learning as a potential source. Learning, from repetitive proprioception training, may enhance neuromuscular control in subjects with CLBP before the use of therapeutic exercise. Subjects showed smaller deficits than previously reported for TTDPM or DM, suggesting proprioception deficits may correlate with pain level.
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Tsang WW, Fu SN, Lui F, Hui-Chan CW. Trunk Position Sense in Older Tai Chi Sword Practitioners. Hong Kong Physiother J 2009. [DOI: 10.1016/s1013-7025(10)70009-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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The effects of a neoprene knee sleeve on subjects with a poor versus good joint position sense subjected to an isokinetic fatigue protocol. Clin J Sport Med 2008; 18:259-65. [PMID: 18469568 DOI: 10.1097/jsm.0b013e31816d78c1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES It has been shown that muscle fatigue has a negative influence on proprioception. Several studies already have demonstrated improvement of proprioception by using knee sleeves. HYPOTHESIS Neoprene knee sleeves have different effects on the joint position sense in locally fatigued subjects with good or poor proprioceptive acuity. DESIGN A true experimental design with random assignment to intervention and control limbs. SETTING Military hospital, department of physical medicine and rehabilitation. PARTICIPANTS Sixty-four healthy subjects. INTERVENTIONS All subjects underwent four consecutive assessments of the same active joint-repositioning test under different conditions (braced, nonbraced, fatigued, and nonfatigued). MAIN OUTCOME MEASUREMENTS A three-way analysis of variance with repeated-measures design was conducted to investigate the effects of side (braced versus control side), assessment sequence (one to four), and proprioceptive acuity ("good" versus "poor"), and their interactive effect on the joint position sense. RESULTS Post hoc analysis revealed that only subjects with "poor" proprioceptive acuity benefit from the braced condition before the isokinetic fatigue protocol (P < 0.001). In contrast, all subjects benefit from the braced condition after the fatigue test. CONCLUSIONS Bracing is helpful in individuals with a poor baseline proprioceptive acuity in both fatigued and nonfatigued states. Subjects with a good joint position sense benefit from bracing only when in a fatigued state. The present findings suggest a rationale for using neoprene knee sleeves as a preventative measure or treatment in subjects and patients to enhance proprioceptive acuity in a fatigued state. Classification into "poor" and "good" proprioceptive acuity is only relevant in the nonfatigued condition.
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Shoulder kinematics in patients with full-thickness rotator cuff tears after a subacromial injection. J Shoulder Elbow Surg 2007; 17:172-81. [PMID: 18036839 DOI: 10.1016/j.jse.2007.05.010] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2006] [Revised: 04/23/2007] [Accepted: 05/09/2007] [Indexed: 02/01/2023]
Abstract
The purpose of this study was to test the hypothesis that scapulohumeral rhythm (SHR) is altered in patients with full-thickness rotator cuff tears due to pain. Fifteen subjects (mean age, 60.2 +/- 8.9 years; mean height, 1.72 +/- 0.10 m; mean weight, 85.43 +/- 18.32 kg) performed humeral elevation in the 3 planes before and after a lidocaine injection. Pain was assessed by use of a visual analog scale, and data were collected with an electromagnetic tracking system. Three-dimensional scapular kinematics (scapulothoracic motion) and glenohumeral elevation were assessed. A linear regression model was used to calculate SHR (ratio of scapulothoracic motion to glenohumeral elevation) for equal phases of elevation (I, II, and III) and lowering (IV, V, and VI). Pain was significantly reduced (P </= .05), causing shifts in SHR to occur for frontal plane elevation (phase III, 1:1.72 to 1:2.78; phase V, 1:1.56 to 1:2.56), resulting in an increase in glenohumeral motion and a reduced reliance on scapular rotation for humeral motion. As SHR decreased, the contribution of glenohumeral elevation increased significantly whereas scapular upward and downward rotation tended to decrease. Differences in anterior-posterior and medial-lateral tilting of the scapula did not correspond with changes in SHR. The findings provide evidence of compensatory increases in SHR due to pain associated with full-thickness rotator cuff tear.
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Cameron ML, Adams RD, Maher CG. The effect of neoprene shorts on leg proprioception in Australian football players. J Sci Med Sport 2007; 11:345-52. [PMID: 17889610 DOI: 10.1016/j.jsams.2007.03.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2006] [Revised: 03/05/2007] [Accepted: 03/12/2007] [Indexed: 11/26/2022]
Abstract
Our purpose was to assess the effect of wearing close-fitting neoprene shorts on swinging leg movement discrimination (MD) scores in elite level Australian Football players. Twenty players had their swinging leg MD assessed using the active movement extent discrimination apparatus (AMEDA), once wearing close-fitting neoprene and once wearing loose-fitting running shorts. Subjects were randomly allocated to one of the shorts conditions prior to repeating the test in the other condition. The AMEDA was used to assess the accuracy at which subjects judge the extent of a standing backward swinging leg movement corresponding to the late swing early stance phase of running. Each subject performed 40 movements made to one of five randomly set physical limits, and without the aid of vision made a judgment as to the perceived limit position. From the accuracy of these judgments, a movement discrimination (MD) score was calculated for each subject under each condition. Subjects were grouped as having low or high neuromuscular control, or ability to use proprioception when controlling active movements without vision, based on their loose-shorts MD score. Analysis was performed on the MD scores obtained for each limb from subjects in the two groups, under the two shorts-wearing conditions. There was no main effect of wearing close-fitting shorts when the cohort was treated as a whole. A significant interaction effect was obtained (F=17.027, p=0.0006) whereby the mean MD score of the low neuromuscular control ability group was improved when wearing neoprene shorts but was reduced for the high ability group. Wearing close-fitting neoprene shorts has a beneficial effect on leg swing judgment accuracy in subjects with low neuromuscular control ability. Conversely, leg swing judgment accuracy for subjects with high ability was reduced by wearing neoprene shorts.
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Van Tiggelen D, Coorevits P, Witvrouw E. The use of a neoprene knee sleeve to compensate the deficit in knee joint position sense caused by muscle fatigue. Scand J Med Sci Sports 2007; 18:62-6. [PMID: 17490457 DOI: 10.1111/j.1600-0838.2007.00649.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The importance of good proprioceptive abilities is stressed in many rehabilitation protocols. In contrast, it has been shown that muscle fatigue has a negative influence on proprioception. The objective of this study was to evaluate the effects of a neoprene knee sleeve (NKS) on the joint position sense in a fatigued knee joint. Sixty-four healthy subjects underwent four successive assessments of the same active joint repositioning test (AJRT) in an open kinetic chain setting under different conditions. First, each subject performed the AJRT without brace. One knee was braced during the second assessment. Subjects wore the brace for 6 h and were submitted to a fatigue protocol, followed by the third assessment under the same conditions as the previous one. The fourth and last AJRT was performed immediately after the third one but both knees were non-braced. When the subjects wore an NKS, significant differences in repositioning error were demonstrated between both sides. On the braced side, no significant differences were observed between the baseline assessment and the third assessment. NKS compensate the deficit in joint position sense due to fatigue. The use of NKS could be justified as a preventive measure or treatment in subjects to enhance proprioception.
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Affiliation(s)
- D Van Tiggelen
- Department of Traumatology & Rehabilitation, Military Hospital of Base Queen Astrid, Belgian Ministry of Defense, Bruynstraat 2, Brussels, Belgium.
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Cholewicki J, Shah KR, McGill KC. The effects of a 3-week use of lumbosacral orthoses on proprioception in the lumbar spine. J Orthop Sports Phys Ther 2006; 36:225-31. [PMID: 16676872 DOI: 10.2519/jospt.2006.36.4.225] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Longitudinal, repeated-measures, factorial design. The trunk axial rotation repositioning error was the dependent variable, while the orthoses, test mode (passive versus active), and the testing session were the independent variables. OBJECTIVES To verify whether lumbosacral orthoses (LSOs) affect proprioception in the lumbar spine and whether these effects change over a 3-week period during which the LSO is consistently worn. BACKGROUND To date, there is no compelling evidence that lumbar orthoses support the spine. One hypothesis advanced by several authors is that they may enhance position sense (proprioception) in the lumbar spine. METHODS AND MEASURES Fourteen subjects without low back pain wore lumbosacral orthoses 3 hours a day for 3 weeks. Spine proprioception was tested in a seated posture in 3 sessions (days 0, 7, and 21). RESULTS A significant 3-way interaction was found between the effects of the orthoses, session, and test mode (P = .03). The ratio of passive to active average error indicated that after 3 weeks of wearing LSO, proprioception in the passive test worsened in relation to the active test with the LSO. In contrast, proprioception in the passive test improved in relation to the active test when performed without the LSO. CONCLUSIONS The LSO did affect proprioception in the lumbar spine. These effects most likely changed over time due to sensorimotor adaptation. However, no overall proprioceptive benefits could be ascertained from healthy subjects wearing the LSO.
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Affiliation(s)
- Jacek Cholewicki
- Biomechanics Research Laboratory, Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT 06520-8071, USA.
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Goldberg A, Hernandez ME, Alexander NB. Trunk Repositioning Errors Are Increased in Balance-Impaired Older Adults. J Gerontol A Biol Sci Med Sci 2005; 60:1310-4. [PMID: 16282565 DOI: 10.1093/gerona/60.10.1310] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Controlling the flexing trunk is critical in recovering from a loss of balance and avoiding a fall. To investigate the relationship between trunk control and balance in older adults, we measured trunk repositioning accuracy in young and balance-impaired and unimpaired older adults. METHODS Young adults (N = 8, mean age 24.3 years) and two groups of community-dwelling older adults defined by unipedal stance time (UST)-a balance-unimpaired group (UST > 30 seconds, N = 7, mean age 73.9 years) and a balance-impaired group (UST < 5 seconds, N = 8, mean age 79.6 years)-were tested in standing trunk control ability by reproducing a approximately 30 degrees trunk flexion angle under three visual-surface conditions: eyes opened and closed on the floor, and eyes opened on foam. Errors in reproducing the angle were defined as trunk repositioning errors (TREs). Clinical measures related to balance, trunk extensor strength, and self-reported disability were obtained. RESULTS TREs were significantly greater in the balance-impaired group than in the other groups, even when controlling for trunk extensor strength and body mass. In older adults, there were significant correlations between TREs and three clinical measures of balance and fall risk, UST and maximum step length (-0.65 to -0.75), and Timed Up & Go score (0.55), and between TREs and age (0.63-0.76). In each group TREs were similar under the three visual-surface conditions. Test-retest reliability for TREs was good to excellent (intraclass correlation coefficients > or =0.74). CONCLUSIONS Older balance-impaired adults have larger TREs, and thus poorer trunk control, than do balance-unimpaired older individuals. TREs are reliable and valid measures of underlying balance impairment in older adults, and may eventually prove to be useful in predicting the ability to recover from losses of balance and to avoid falls.
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Affiliation(s)
- Allon Goldberg
- Institute of Gerontology, Division of Geriatric Medicine, Department of Internal Medicine, The University of Michigan, Ann Arbor, 48201, USA.
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