OBJECTIVES:This study aimed to investigate tibial nerve dynamics during the straight leg raise (SLR) test in patients with lumbar disc herniation (LDH) and the relationship between neurological symptoms and dynamics at the radiating pain-occurring (RPO) angle. METHODS:Participants with LDH were 20 adults (10 males, 10 females, average age of 58.4 years, average body mass index [BMI] of 21.9 kg/m2) who visited the orthopedic clinic between November 2019 and December 2020. The SLR test was performed at 20°, 40°, and the RPO angle for patients with LDH. In healthy participants, the test was performed at 20°, 40°, and the maximum elevation angle. The excursion and strain of the proximal and distal ends of the tibial nerve were compared using ultrasound imaging at each angle. Furthermore, the nerve dynamics at the RPO angle were compared between the LDH groups with and without neurological symptoms. RESULTS:Movement at the proximal and distal ends of the tibial nerves at 20° and 40° leg elevation was smaller in the LDH group than in the healthy group. No significant difference was observed in the amounts of strain at these two angles. In LDH, nerve strain at the RPO angle was lower in the group with neurological symptoms than in the group without. During the SLR test, excursion of the tibial nerve was less in LDH than in healthy participants, suggesting that the sciatic nerve was more strained in LDH. CONCLUSION:Our findings show an association between insufficient tibial nerve strain during SLR and neurological symptoms.
OBJECTIVE:The purpose of this study was to examine brain function activity changes in patients with left basal ganglia ischemic stroke (LBGIS) in order to identify the specific brain regions associated with motor function. METHODS:The study compared 35 patients with LBGIS and 34 healthy control participants (HCs). Functional connectivity density (FCD) was calculated to explore brain functional activity difference between the 2 groups of participants, and receiver operating characteristics (ROC) curve was used to test the specificity of these different regions. Pearson's correlation was employed to evaluate relationships between FCD values and clinical scores. RESULTS:In the LBGIS group, FCD values were increased in the left cerebellum 9 lobe (L_C9), right inferior temporal gyrus (R_ITG), left middle temporal gyrus (L_MTG), and right supplementary motor area (R_SMA) but decreased in the left calcarine sulcus (L_CS), right lingual gyrus (R_LG), right cuneus (R_C), right supramarginal gyrus (R_SG), right inferior frontal gyrus (R_IFG), and left inferior parietal gyrus (L_IPG). ROC curves demonstrated that these designated brain areas alone distinguished between the LBGIS and HC groups with high sensitivity and specificity. In patients with LBGIS, L_C9 and R_SMA displayed significant correlations with the Fugl-Meyer assessment and Barthel index scores. CONCLUSIONS:Patients with LBGIS exhibit changes in the functional activity of multiple brain regions, and L_C9 and R_SMA may be key areas to promote motor function in people with LBGIS.
OBJECTIVE:This study aimed to examine the responsiveness of bridge maneuvers in subjects with low back pain (LBP) with respect to these outcomes. METHODS:One hundred and thirty-nine patients with subacute and chronic LBP participated in a physical therapy program averaging 7.46 sessions of supervised exercises and home exercises to improve lumbar stability. At the beginning of the program and after the last session, participants completed the Oswestry Disability Index (ODI-I) and the Pain Numerical Rating Scale (NRS), and performed Supine Bridge test (SBT), Right Side Bridge Test (RBT), Left Side Bridge Test (LBT), and Prone Bridge Test (PBT). Global perception of effectiveness was measured with a 7-point Global Perceived Effect Questionnaire. RESULTS:The optimal cutoff points were approximately 38.5 seconds for the Prone Bridge Test (PBT), (44% sensitivity; 78% specificity), 29.5 seconds for the RBT (55% sensitivity; 67% specificity), and 142 seconds for the SBT (45% sensitivity; 67% specificity). The areas under curves ranged from 0.56 (SBT) to 0.61 (PBT and RBT). Low to moderate significant relationships (p < .01) among bridge maneuvers, pain and disability (-0.23 to -0.39) and high correlations among each bridge maneuver and each other (0.69-0.81) emerged. CONCLUSION:Although bridge maneuvers were responsive to changes in lumbar stability and correlated significantly with pain and disability, these measures were not sufficiently sensitive or specific at baseline to predict these outcomes.
OBJECTIVE:The purpose of this meta-analysis was to systematically review the effects of acupuncture with letrozole's effect on polycystic ovary syndrome (PCOS) ovulation and pregnancy outcomes. METHODS:We searched 7 electronic databases for clinical studies of acupuncture combined with letrozole for PCOS published until August 31, 2024. Meta-analysis was done using RevMan 5.4, while funnel plot symmetry was evaluated using Stata 16.0. RESULTS:Fifteen randomized controlled trials, encompassing 1311 cases, were included. The meta-analysis revealed that acupuncture combined with letrozole significantly improved the clinical efficacy rate (RR = 1.27, 95% CI [1.17, 1.37], P < .001), pregnancy rate (RR = 1.84, 95% CI [1.59, 2.13], P < .001), ovulation rate [RR = 1.30, 95% CI [1.18, 1.43], P < .001), endometrial thickness (MD = 1.05, 95% CI [0.76, 1.34], P < .00001), serum estradiol levels (MD = 8.34, 95% CI [6.71, 9.96], P < .001) and the rate of A-type endometrium (RR = 2.19, 95% CI [1.35, 3.55], P < .001). Additionally, it significantly reduced the miscarriage rate (RR = 0.20, 95% CI [0.08, 0.51], P < .001), serum luteinizing hormone levels (MD = -2.10, 95% CI [-3.58, -0.62], P < .001), serum testosterone levels (MD for treatment ≤3 menstrual cycles = -0.43, 95% CI [-0.49, -0.37], P < .001; MD for treatment >3 menstrual cycles = -3.06, 95% CI [-5.12, -0.99], P < .001), ovarian volume (MD = -2.21, 95% CI [-2.99, -1.43], P < .001), and TCM syndrome scores (MD = -4.33, 95% CI [-5.43, -3.24], P < .001). Begg's test for publication bias indicated some degree of bias (P ≤ .05). CONCLUSION:Current evidence suggests that acupuncture combined with letrozole may be more effective for PCOS than letrozole alone; however, the quality of this evidence is low, necessitating further high-quality research to confirm these findings. PROTOCOL REGISTRATION:Registered in PROSPERO on August 23 2024 (ID: CRD42024582344) .
Objectives The purpose of this study was to investigate differences in immediate effects of a warm-up and Instrument-Assisted Soft Tissue Mobilization (IASTM) treatment in patients with symptomatic plantar fasciopathy (PF) and asymptomatic groups. Methods Twenty five subjects with PF and 25 asymptomatic subjects were recruited. Symptomatic subjects experienced plantar heel pain greater than 3 months, heel palpation discomfort, and pain with the first-morning step. Both groups received a warm-up and IASTM. Pre- and post-treatment measurements included visual analog scale (VAS) pain scores in the PF group, stiffness at the origin and navicular levels, origin thickness, ankle and 1st metatarsal phalangeal joint (first MTPJ) weight-bearing ROM, and Foot Health Status Questionnaire (FHSQ). Two-way mixed ANOVAs determined group and intervention effects. The Wilcoxon Signed-Rank test was performed to examine PF group VAS changes, and correlations identified the association between tissue properties and clinical presentations. Results The intervention group showed significance in 1) reduced PF pain level (P < .001; d = 0.801), 2) increased weight-bearing 1st MTPJ (P = .039; ηp2 = 0.08) and ankle ROM (P < .001; ηp2 = 0.41) in both groups, and 3) decreased PF origin thickness between-group differences (P = .001; ηp2 = 0.20). For all subjects, 1) the higher FHSQ pain level was associated with lesser origin stiffness and greater thickness, 2) higher origin stiffness was correlated with lesser ankle ROM, and 3) greater thickness was associated with less 1st MTPJ ROM. Conclusion An IASTM treatment with warm-up immediately reduced PF symptoms, increased weight-bearing 1st MTPJ and ankle ROM in both groups, and decreased group differences in origin thickness.
OBJECTIVE:This study aimed to investigate the effects of aquatic exercises (AEs) and total resistance exercises (TRX) on the pain and function of women with knee osteoarthritis. METHODS:This randomized controlled trial was conducted on 53 patients diagnosed with knee osteoarthritis. The patients were randomly allocated into 3 groups of TRX (n = 19), AEs (n = 18), and control (n = 16). The experimental groups received 8 weeks of TRX and AEs, and the control group only received medication. Outcomes were measured before, after 8-weeks of intervention, and after a 6-month follow-up. Outcomes were the visual analog scale (VAS), the quadriceps strength was examined by a dynamometer, the function was assessed using the Western Ontario and McMaster universities osteoarthritis index (WOMAC), functional capacity was measured using the timed up and go test (TUG), 40-meter walking speed (WS) test, and going up and down 8-stair (GUDS), and the quality of life (QOL) was evaluated using the SF-36. RESULTS:Pain and QOL improved significantly after the 8-week intervention and 6-month follow-up in both experimental groups (P < .05). However, quadriceps strength, TUG, WS, and GUDS improved significantly after the 8-week intervention and 6-month follow-up only in the TRX group (P < .05). In addition, the WOMAC improved only in the AEs group (P < .05). CONCLUSIONS:The TRX intervention enhanced the strength and functional capacity of the patients with knee osteoarthritis more effectively compared to the AEs, while improving pain and QOL were similar to the AEs.
OBJECTIVE:The aim of this study was to compare the biomechanical effects between localized and nonlocalized rotation manipulations on cervical spondylotic radiculopathy and to investigate the influence of cervical disc degeneration on the manipulations using finite element models. METHODS:In this study, 4 progressively degenerative finite element models of C3 to C7 segments were created to simulate cervical localized and nonlocalized rotation manipulations. In each model, disc degeneration was simulated at the C5 to C6 segment, a disc protrusion was assumed to be in the left posterolateral region of the C5 to C6 disc, and 2 rotation manipulations were performed on the right. Thirty nodes on the left posterolateral region of the C5 to C6 disc were selected, and the displacement and stress of the nodes, as well as the facet joint stress at the C5 to C6 level, were calculated and compared. RESULTS:The displacement and stress in the left posterolateral region of the disc, as well as the facet joint stress at the C5 to C6 level, were higher in localized rotation manipulation than those in nonlocalized rotation manipulation (P < .05). The displacement and stress in the left posterolateral region of the disc decreased with the severity of disc degeneration (P < .05). CONCLUSION:Using finite element models, this study demonstrated that cervical spine degeneration can adversely affect the biomechanical effects of rotation manipulations, in that more severe disc degeneration may be associated with poorer biomechanical effect. However, for the same level of degeneration severity, localized rotation manipulation may be more specific than nonlocalized rotation manipulation.
OBJECTIVE:The purpose of this scoping review was to assess the literature on patient education and delivery methods utilized by chiropractors. METHODS:For this scoping review, we searched peer-reviewed and gray literature including all study designs except for commentaries and protocols, which pertained to patient education within the chiropractic setting. Studies that included pediatrics were excluded. A literature search was performed through PubMed, Index to Chiropractic Literature, CINAHL, and Cochrane Database of Systematic Reviews from journal inception to March 4, 2025. After extraction, findings were qualitatively analyzed using thematic analysis. RESULTS:Of 2338 articles identified, 68 studies were eligible for thematic analysis. There was heterogeneity in the content and delivery methods of patient education. More lifestyle education reported than pain education. Predominately, education was delivered by direct instruction in a multimodal treatment approach. CONCLUSION:Our literature findings suggest that chiropractors are utilizing pain education in addition to other patient education topics, such as lifestyle education, ergonomics/biomechanics, diagnosis/prognosis, and self-management strategies. Patient education is performed as part of a multimodal treatment approach within the chiropractic setting, primarily through direct instruction.
OBJECTIVE:The purpose of this study was to examine the effect of adding cervical stability training (CST) to a battery of treatment modalities on somatosensory evoked potential (SSEP) in patients with forward head (FHP) and chronic mechanical neck pain (CMNP). METHODS:Sixty patients with FHP and CMNP were randomized into 2 groups: Group A (study group) was subjected to CST and a battery of treatment modalities, whereas Group B (traditional group) underwent a battery of treatment modalities alone. Treatment was applied 3 sessions per week for 8 successive weeks. The primary outcomes were SSEP and craniovertebral angle (CVA). The secondary outcomes were visual analog scale for pain intensity, Neck Disability Index Arabic version for functional disability, an endurance test for neck flexor and extensor muscles, craniocervical flexion test for deep cervical flexor muscles activation, lateral radiographs using the posterior tangent method for cervical lordotic curvatures, and a phone application clinometer for cervical range of motion. RESULTS:The findings demonstrated short-term statistically significant differences (P < .05) at posttreatment between the study and traditional treatment groups in favor of the study group. The mean difference and 95% CI between both groups in SSEP and CVA = 1.83 (1.63, 2.03) and 7.37 (6.49, 8.25), respectively. CONCLUSION:For patients with chronic neck pain, CST exercises plus a battery of treatment modalities exhibited a greater effect on primary and secondary outcomes than the battery of treatment modalities alone.
OBJECTIVE:The purpose of this study was to investigate the inter-rater reliability of the 6-item movement control test battery (MCTB) in individuals with and without chronic non-specific low back pain (CNLBP) using different rating methods, including individual tests, summation, and direction-specific tests, for movement control impairment detection through real-time observation. METHODS:Forty-seven participants with and without CNLBP were recruited. Participants were asked to perform MCTB (flexion-specific tests: waiter's bow, sitting knee extension, and quadruped rocking backward; extension-specific tests: pelvic tilt, prone knee flexion, and quadruped rocking forward), while 2 raters simultaneously and independently observed the movement control. Inter-rater reliability was analyzed using the chi-square test, percentage agreement (PA), kappa coefficient, and prevalence-adjusted and bias-adjusted kappa (PABAK). RESULTS:The chi-square showed significant associations (P < .05) between the 2 raters in all tests and grading methods. For PA, all grading methods showed an acceptable level (PA > 70%), except prone knee flexion and extension-specific tests. The acceptable kappa levels (kappa > 0.4) were obtained in the flexion-specific tests and all individual tests except the prone knee flexion. The kappa of the summation did not reach the acceptable agreement level; however, this method yielded acceptable inter-rater reliability after using PABAK (PABAK = 0.62). CONCLUSIONS:The findings support inter-rater reliability of the flexion-specific tests, summation, and most individual tests for clinical use. However, the prone knee flexion and the extension-specific tests should be used with caution.
OBJECTIVES:The purpose of this study was to assess the reliability of a visual-cognitive system for measuring simple, serial, and choice reaction times, and examined their associations with age, physical activity, and grip strength. METHODS:Ninety participants were divided into 3 age groups (18-34, 35-64, and 65+ years). Reaction times were assessed using a commercially available visual-cognitive training platform. Grip strength was measured with a hand dynamometer, and activity level was evaluated using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). RESULTS:Choice reaction times differed significantly by age, with younger adults responding faster than older adults (P < .05). Simple and serial reaction times were also shortest in the youngest group. Significant associations were found between reaction times, age, and activity level (P < .05), with no significant differences by sex (P > .05). Intra-rater reliability was highest for simple reaction time (ICC = 0.70-0.80), followed by choice (ICC = 0.66-0.76) and serial (ICC = 0.62-0.73). Between-day reliability was good for simple (ICC = 0.81) and serial (ICC = 0.76) reaction times, and moderate for choice (ICC = 0.63). Inter-rater reliability was good across all measures (ICCs ≥ 0.70). CONCLUSIONS:Choice reaction time appears to be particularly sensitive to age-related differences. Higher activity levels and greater grip strength are associated with faster responses. The tested visual-cognitive technology demonstrated acceptable reliability for assessing performance-related reaction times.
OBJECTIVE:The purpose of this study was to evaluate the intra- and inter-rater reproducibility of the Flexicurve for assessing the flexion and extension range of motion of the thoracic and lumbar spine. METHODS:Intrarater reproducibility (n = 35) was assessed by a single rater on 2 different days, and inter-rater reproducibility (n = 37) was assessed on 1 day by 3 different raters. The assessment protocol involved palpation and identification of spinous processes (SP), molding of the Flexicurve along the maximum range of flexion and extension, marking of SP on the Flexicurve, careful removal of the Flexicurve, drawing of the curvature contours obtained by the Flexicurve on paper, identification of SP on the drawing, photographic recording of the drawn contour, and analysis of the photograph using MATLAB 8.5. Data were analyzed using intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimum detectable change (α < 0.05). RESULTS:Excellent ICCs were obtained for intrarater reproducibility of thoracic and lumbar spine flexion and extension, with SEM ranging from 0.7° to 1.7°. Except for lumbar spine extension, which achieved satisfactory ICC, inter-rater reproducibility showed excellent ICCs for other measures, with SEM ranging from 2° to 5°. Intrarater reproducibility of the software resulted in excellent ICCs, with SEM ranging from 0.7° to 4.4°. CONCLUSION:Due to established reproducibility and precision, the Flexicurve can be used for assessments of thoracic and lumbar spinal range of motion. Rigorous methodological care is recommended for its protocol, especially regarding thoracic extension.
OBJECTIVE:The purpose of this study was to assess both intra- and inter-examiner reliability of manual muscle testing (MMT) within Applied Kinesiology (AK) practice. METHODS:Comprehensive searches were conducted in Medline, Scopus, Ebsco, and Embase, alongside manual searches of reference lists, with no date restrictions through October 14, 2023. Only studies applying MMT according to AK principles were included. Methodological quality was assessed using QAREL and Part B of the COSMIN checklist. A qualitative data synthesis was done to analyze reliability data. RESULTS:From 8,720 initial records, 7 studies met the inclusion criteria. Four were rated as good or very good quality, while 3 were rated as poor or inadequate. Intraexaminer reliability was assessed in 3 studies: 1 demonstrated high reliability (ICC > 0.86), while 2 showed poor reliability (k = -0.14 to 0.29, with 27%-40% agreement). Inter-examiner reliability, evaluated in 6 studies, ranged widely from k = -0.51 to 0.91. A subgroup analysis including only studies that used MMT without additional challenge procedures showed inter-examiner reliability ranging from k = -0.05 to 0.91. The piriformis muscle demonstrated the highest reliability (k = 0.7 to 0.91), while the hamstrings had the lowest (k = -0.07 to 0.24). CONCLUSION:The reliability of MMT in AK ranged from nonexistent to very strong, depending on the type of analysis. MMT involving nonmusculoskeletal challenges showed nonexistent reliability and therefore not recommended for clinical use. However, MMT without challenges may be clinically useful, particularly for the deltoid, gluteus maximus, piriformis, and iliopsoas, which demonstrated moderate to very strong reliability.
OBJECTIVES:This randomized controlled trial aimed to evaluate the effects of transcutaneous electrical acupoint stimulation (TEAS) on sleep quality and menopausal symptoms in postmenopausal women. METHODS:A total of 69 eligible postmenopausal women were recruited and randomly assigned to 1 of 3 groups: experimental TEAS, sham, or control (n = 23 each), using a block randomization method. The TEAS group received cutaneous electrical stimulation at 5 specific acupuncture points, while the sham group received stimulation at nonrelated points, and the control group received no intervention, all groups received routine primary care. Outcome measures included the Pittsburgh Sleep Quality Index (PSQI) and the Menopause Rating Scale (MRS), administered at baseline, immediately after the intervention, and one month postintervention. Data were analyzed using SPSS24, Kruskal-Wallis, Mann-Whitney, Toki and Chi-square tests. A significance level of P < .05 was considered significant. RESULTS:Data from 65 participants were analyzed after accounting for exclusions. At baseline, there were no significant differences in PSQI scores across the 3 groups. However, the TEAS group showed significantly greater improvement in PSQI scores immediately after the intervention (7.36 ± 3.21 vs 9.36 ± 2.38 and 9.76 ± 2.46, P = .012) and 1 month later (6.90 ± 2.97 vs 9.04 ± 2.62 and 9.61 ± 2.33, P = .003) compared to the sham and control groups. Although no significant differences in MRS scores were observed immediately postintervention, a significant reduction in menopausal symptoms was noted in the TEAS group 1 month later (26.18 ± 4.83 vs 29.95 ± 5.65 and 27.42 ± 4.15, P = .042). CONCLUSION:TEAS appeared to be effective in improving sleep quality and reducing menopausal symptoms in postmenopausal women. TRIAL REGISTRATION:Iranian Clinical Trials Registry IRCT20130812014333N167 (registered, 18/04/2021).
OBJECTIVE:This study investigated the potential mechanism by which massage protects against intervertebral disc (IVD) trauma progression. METHODS:A total of 24 male Sprague-Dawley rats were randomly divided into sham, model, and model plus massage groups (8 rats per group). A rat model of lumbar IVD trauma was established by needle puncture combined with intradiscal tumor necrosis factor-alpha (TNF-α) injection. Two days after modeling, rats received massage therapy on the BL23 acupoint once daily. Pain-related behavioral tests were conducted. Hematoxylin-eosin staining was employed for histopathological observation of lumbar IVDs. The levels of oxidative stress-related markers were determined using assay kits. Western blotting was utilized for estimating the Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) signaling-associated protein expression in rat lumbar IVDs. RESULTS:Rats in the massage group had less mechanical allodynia and thermal hyperalgesia. Following massage, the pathological damages in rat lumbar IVDs were improved, reactive oxygen species and malondialdehyde levels were reduced, and superoxide dismutase and glutathione contents were increased. The phosphorylation of JAK2 and STAT3 in lumbar IVDs was inhibited in rats with massage therapy. CONCLUSIONS:Massage improves pain-related behaviors, inhibits oxidative stress, and suppresses the JAK2/STAT3 signaling pathway in puncture-induced rats.
OBJECTIVE:The purpose of this population-based study was to examine whether sedentary behavior (SB) and light physical activity intensity (LPA) are associated with pain in older adults. A further aim is to investigate the psychosomatic complaints as mediators between SB and pain. METHODS:Individuals aged ≥50 from the 2018 Study on Aging, Health, and Health-seeking Behavior reported on SB and LPA using the International Physical Activity Questionnaire and pain severity using a cross-culturally validated item from the bodily pain subscale of the MOS SF-36. Multivariable logistic regression models evaluated the associations of SB and LPA with pain. Bootstrapping analyses assessed whether psychosomatic complaints mediate the association between SB and pain. RESULTS:Among 1201 participants (mean ± SD age = 66.1 ± 11.9 years; women = 63.3%), the prevalence of SB and pain was 21.4% and 43.0%, respectively. Compared with <8 h/d, ≥8 h/d of SB was positively associated with pain (OR = 2.42, 95% CI = 1.71-3.42). However, LPA was associated with 11% lower odds of reporting pain (OR = 0.89, 95% CI = 0.81-0.98). Self-rated health (41.2%), anxiety (23.5%), comorbidity (20.6%), functional limitations (17.6%), depression (13.2%), and sleep problems (11.8%) were associated with pain and mediated the SB-pain link. CONCLUSIONS:The present study observed that SB and LPA were associated with pain in older adults residing in Ghana, and psychosomatic complaints were identified as potential mechanisms in the pathway between SB and pain. Managing the pain burden in old age may require shifting the 24-hour behavior from SB to LPA and addressing the inherent psychosomatic complaints.
OBJECTIVE:This study aimed to establish the effect of core stabilization exercises applied face-to-face (FTF) and with telerehabilitation (TR) on core muscle thickness, functional capacity, back-related performance, and quality of life in asymptomatic individuals. METHOD:In this randomized trial, 54 asymptomatic individuals were included in the study. FTF and TR groups performed core stabilization exercises 3 days a week for 8 weeks. Core muscle thickness was assessed by ultrasound imaging; functional capacity was assessed with repetitive side reaching, overhead lifting, and overhead working tests; back performance was assessed with the back performance scale (BPS); and quality of life was assessed with the SF-36 questionnaire. RESULTS:Following the core stabilization exercise program, the thickness of the right and left Transversus Abdominis muscles-measured at rest and during contraction and the thickness of the Internal Oblique muscle increased in both groups; however, the increases in Transversus Abdominis thickness at both resting and during contraction, were significantly greater in the FTF group compared with the TR group (P < .005). The improvement in the overhead working test (P = .02, effect size [ES] = 0.33) and back performance scale (BPS) score (P = .00, ES = 0.39) was greater in the FTF group compared with the TR group. CONCLUSION:Core stabilization exercises provided improvements in core muscle thickness, functional capacity, back-related performance, and quality of life in asymptomatic individuals. Improvements in these parameters might inform future research investigating the prevention of low back pain with therapeutic exercise. In addition, this study demonstrated that core stabilization exercises can be implemented via TR as an alternative to FTF interventions.
OBJECTIVE:This study aimed to evaluate the effects of nonthrust joint mobilization on pain, functional disability, and range of motion in patients with adhesive capsulitis (AC) of the shoulder. METHODS:This meta-analysis included all English-language randomized controlled trials and prospective quasi-experimental studies evaluating the effects of joint mobilization on pain, disability, and range of motion in adult patients with any type of AC. PubMed and SCOPUS were searched for studies published before November 2021. Further studies were identified through manual screening of the reference lists. Cochrane Collaboration tool for risk of bias (RoB 2.0) was used for risk of bias assessment. Results were pooled using random effects meta-analysis. RESULTS:Nineteen articles involving 812 patients were included in the synthesis. Regarding the effect on pain, the overall weighted mean difference was -1.19 with significant heterogeneity. For functional disability, overall weighted mean differences were -8.69 with significant heterogeneity, 10.11 with significant heterogeneity, and -7.18 with heterogeneity for studies using SPADI, Constant Murley, and DASH scores, respectively. Regarding the effect of shoulder mobilization on flexion, abduction, external, and internal rotations, overall weighted mean differences of 17.71, 13.89, 9.68, and 11.75 degrees, all with significant heterogeneity, were reported. CONCLUSIONS:This meta-analysis found statistically significant improvements in the reduction of pain, improvement in function, and restoring of range of motion among patients with adhesive capsulitis, regardless of the mobilization technique used. However, the results should be interpreted with some caution, because of high levels of heterogeneity and lack of high-quality studies in this field.
OBJECTIVE:The purpose of this study was to compare the static and dynamic balance ability of para taekwondo athletes, taekwondo athletes, and sedentary healthy individuals. METHODS:This comparative cross-sectional study was conducted with 9 para taekwondo athletes, 9 taekwondo athletes, and 11 healthy individuals with sedentary lifestyles. Static balance ability and dynamic balance ability were evaluated. RESULTS:The 2-leg static balance test area of the sedentary healthy group was lower than that of para taekwondo athletes. The duration of the single-leg static balance test was greater in para taekwondo athletes than in other groups, and the area was greater in taekwondo athletes than in other groups. The dynamic balance area was higher in the para taekwondo group than in the sedentary group. CONCLUSION:Para taekwondo athletes with upper limb deficiency at or below the elbow level had worse static 2-leg and single-leg static balance. However, the functional balance of these athletes was better compared to that of healthy individuals.
OBJECTIVE:This study aimed to assess the reliability and construct validity of the Turkish version of the Atroshi-Lyrén 6-Item carpal tunnel syndrome (CTS) Symptoms Scale (A-L Scale-Tr) and to examine its associations with patient-reported outcome measures, including the Boston Carpal Tunnel Questionnaire (BCTQ) and Quick Disability of the Arm, Shoulder and Hand (QuickDASH). METHODS:A forward-backward translation procedure was performed following international guidelines. Sixty-two patients with unilateral CTS were invited to complete the A-L Scale-Tr. The test-retest reliability, convergent, and discriminant validity were evaluated. RESULTS:The A-L Scale-Tr revealed high values of internal consistency (Cronbach's alpha = 0.854), and test-retest reliability (ICC = 0.96, 95% CI = 0.93-0.98). In the A-L Scale-Tr the factor structure was found optimal and explained 58.39% of the variance. The validity analysis showed strong correlation with night pain (r = 0.821), moderate correlation with BCTQ Symptoms Severity Scale (r = 0.564) and BCTQ Functional Status Scale (r = 0.453), QuickDASH (r = 0.474), pain at rest (r = 0.557), and pain at activity (r = 0.497) (P < .001). CONCLUSIONS:It was found that the A-L Scale-Tr has good reliability and construct validity for symptom severity assessment in CTS. The A-L scale will be useful to clinicians and researchers in Turkish patients.
