BACKGROUND This study aimed to investigate the impact of adding Pilates to PCEs, Pilates alone, or PCEs alone on nerve root function, pain, neck disability, craniovertebral angle (CVA), cervical endurance and muscles electromyography activity (EMG) in patients with forward head posture (FHP). DESIGN The pre–post, single-masked, randomized experimental trial. METHODS One hundred and twenty participants (20 to 45 years) with symptomatic FHP were randomly allocated to three groups; Group “A” received Pilates and PCEs, whereas Group “B” received only Pilates exercises and Group “C” received only PCEs; treatments were performed three times/week for 10 weeks. Eight participants dropped out during the study; therefore, an intention-to-treat analysis with multiple imputations was performed to handle missing data. Nerve root function (N20-P25), pain intensity, neck disability, CVA, cervical flexor and extensor muscle endurance and finally, upper trapezius (UT) and sternocleidomastoid (SCM) muscle activity were used to evaluate the patients’ pre- and post-treatment. RESULTS After 10 weeks of intervention, there was statistically significant differences in all outcome measures between groups A (Pilates and PCEs) and B (Pilates) and also between A (Pilates and PCEs) and C (PCEs), while there was no statistical significant difference between B (Pilates) and C (PCEs). Within group analysis reported statistical significant difference for all outcome measures in three groups with greater improvement in group A. CONCLUSION Pilates and PCEs are effective approaches in improving nerve root function (N20-P25), pain, neck disability, CVA, cervical endurance and muscles activity in patients with FHP with neither intervention demonstrating superiority over the other. Adding Pilates to PCEs is more effective than PCEs or Pilates alone for the management of FHP.
Introduction The graded ankle immobilization may affect muscle strength and agonist muscle activity during toe push-down. Therefore, in this study, we evaluated how the modification of ankle immobilization affected toe push-down strength and agonist muscle activity. Method We investigated the dominant foot of 21 healthy adult men using a custom-made measurement instrument, an ankle immobilization belt with adjustable immobilization, and surface electromyography. The subject muscles were the abductor hallucis (ABDH), flexor hallucis longus (FHL), tibialis anterior, and soleus (SOL). We measured the muscle activity and great toe push-down strength (GTPS) under five immobilization conditions: 0 (no immobilization), 20, 40, 60, and 80 mmHg. Finally, we calculated and compared the GTPS, muscle activity of each muscle, and the ABDH/FHL muscle activity ratio for each condition. Results The GTPS was significantly higher at 40, 60, and 80 mmHg than at 0 mmHg. It was also significantly higher at 80 mmHg than at 40 and 60 mmHg. FHL activity increased significantly at 40 mmHg and higher, whereas SOL activity increased at 60 mmHg and higher. The ABDH/FHL activity ratio was significantly greater at 0 mmHg than at 40 mmHg and above. It was also greater at 20 mmHg than at 80 mmHg. These results indicate that graded ankle immobilization affects the GTPS and FHL activities. Conclusion Our findings demonstrate that graded ankle immobilization influences the GTPS and FHL activities. This suggests that consideration of graded ankle immobilization levels may help minimize measurement errors in GTPS.
Background Most studies compare Parkinson's disease (PD) patients with healthy people, but no study has compared postural stability between all four stages of the disease. It remains unclear how patients at different stages use vision and proprioception to maintain balance. This study aimed to evaluate these differences. Methods We studied 39 PD patients in four severity groups and 40 healthy matched subjects. All stood on a force plate for 60 seconds. We tested four conditions: eyes open/closed on a solid surface and on a foam pad. Postural stability was evaluated by excursion, velocity and root mean square of Center of Pressure. A mixed ANOVA (5×2×2) was used for final analysis. Results The effect of closing the eyes on balance depended on the surface and disease stage (group×vision×surface interaction, p ≤ 0.033). In patients with stage 2 PD and healthy subjects, closing the eyes increased sway significantly only on foam (p ≤ 0.007). In contrast, stage 3 PD patients showed a significant increase in sway only on a solid surface when their eyes were closed (p ≤ 0.000). Stage 4 PD patients showed little change in sway across all conditions. Conclusion Patients in different stages use different strategies to control balance. The most notable finding was that stage 3 patients become overly dependent on vision even when proprioceptive input should be sufficient. This suggests that balance assessments should challenge both sensory systems, and rehabilitation programs should be tailored to the specific stage of the disease.
Background Pectoralis minor (PM) tightness may cause scapular anterior tilting, leading to rounded shoulder posture (RSP). Techniques such as stretching, manual or self-myofascial release (SMR), and instrument-assisted soft tissue mobilization (IASTM) are used to restore PM length. Purpose The aim of this study was to compare the acute effects of three different myofascial release techniques in asymptomatic individuals with PM tightness. Methods Thirty-nine subjects were randomized into three groups: the IASTM group, the manual myofascial release (MMR) group, and the SMR group. The PMI index was used to assess PM length and was the primary outcome measure. RSP, glenohumeral (GH) total arc motion, skin temperature and Pressure pain threshold (PPT) were secondary outcome measures. Results Significant within-group improvements in PMI were observed following IASTM (p=0.007) and MMR (p=0.042), whereas no significant change occurred following SMR (p>0.05). RSP improved significantly in the MMR (p=0.003) and SMR (p=0.006) groups. GH total arc motion increased significantly following IASTM and MMR (both p=0.010). PPT and skin temperature did not change significantly within any group (all p>0.05). Although post-intervention differences were observed for PMI, GH total arc motion, and skin temperature, change-score comparisons revealed no significant between-group differences for either the primary or secondary outcomes (all p>0.05). Conclusion IASTM, MMR, and SMR produced comparable immediate effects in individuals with PM tightness. These findings suggest that all three interventions may be considered viable options for the immediate management of PM tightness.
Introduction Intermittent claudication is reported as a barrier to adherence to cardiovascular rehabilitation in patients with peripheral arterial disease (PAD). The music stimulus could be an alternative to improve the performance of individuals with PAD during exercise. Objective To test the acute effect of music on walking capacity during a treadmill test in individuals with PAD in a pilot study. Method A single-blind pilot study was conducted with adults with PAD. Participants performed treadmill testing (TT) on two different days, in random order, with and without music. Both tests were performed using headphones, and the sessions were monitored by a researcher who was unaware of the presence or absence of music. The t-test was used for comparisons. An alpha of 5% was considered for statistical significance. Results The study included 13 individuals with PAD (69,85±10,75 years). The TT with music showed 31% greater walking distance, without statistical difference. The subjective perception of final effort was higher in the TT with music (p = 0.028). Groups that reported liking and not liking music increased walking distance, without statistical difference. In the group with predominantly medium-tempo music, the walking distance delta was 381% higher than that of the group with fast-tempo music, without statistical difference. Conclusion This pilot study suggests that music is a promising stimulus and that medium-tempo music may be a potential option for future clinical trials.
Introduction The integration of pain mechanisms into clinical reasoning is encouraged by advances in pain neuroscience, but its feasibility within routine osteopathic practice remains understudied. Objective To assess the feasibility of integrating a pain phenotype stratification procedure into osteopathic clinical reasoning and to describe exploratory changes in clinical measures following a single osteopathic manipulative treatment (OMT) session. Methods A single-arm, observational pilot study was conducted among participants with musculoskeletal pain. Pain phenotype stratification was based on the DN4 questionnaire and pain duration, with a three-month duration threshold used as a pragmatic criterion to distinguish between nociceptive and nociplastic phenotypes in participants without evidence of a neuropathic phenotype. The primary outcome was the feasibility of integrating the stratification procedure into routine osteopathic consultations. Secondary outcomes explored changes in pain intensity and pain-related measures using the Numerical Rating Scale (NRS), Brief Pain Inventory (BPI), Short-Form McGill Pain Questionnaire (SF-MPQ), and Neuropathic Pain Symptom Inventory (NPSI). Results Thirty-five participants were identified as potentially eligible, of whom 20 were enrolled. Fifteen participants (75.0%) completed the study protocol. The pain phenotype stratification procedure was completed for all participants who completed the protocol. No statistically significant differences were observed for exploratory outcomes. Conclusion This pilot feasibility study suggests that a standardised pain phenotype stratification procedure can be integrated into osteopathic clinical reasoning under routine clinical conditions. Exploratory changes following an OMT session do not permit conclusions regarding treatment efficacy. Controlled studies are warranted to determine the clinical value of incorporating pain phenotype stratification into osteopathic clinical reasoning.
