Background Latent and active myofascial trigger points (MTrPs) in knee-associated muscles may play a key role in pain management among patients with knee osteoarthritis (KOA). The aim of this study was to investigate the effect of dry needling treatment on pain intensity, disability, and range of motion (ROM) in patients with KOA. Methods This randomized, single-blinded, clinical trial was carried out for 6 weeks of treatment and 6-month follow-up. A total of 98 patients met the entry criteria and were randomly assigned to the dry needling latent and active myofascial trigger point (MTrPs) with the stretching group or the oral diclofenacwith the stretching group. Numeric Pain Rating Scale (NPRS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and ROM were statistically analyzed before and after treatment and at the 6-month follow-up. Results A total of 42 patients in the dry needling group (DNG) and 35 patients in the diclofenac group (DG), respectively, completed the study, and there was no significant difference in the general data between the two groups. After treatments, both the groups showed a good effect in knee pain, function, and ROM, However, the DNG showed a significantly better result than the DG. Especially in the results of the 6-month follow-up, the DNG showed much better results than the DG. Conclusions Dry needling on latent and active MTrPs combined with stretching and oral diclofenac combined with stretching can effectively relieve pain, improve function, and restore knee ROM affected by KOA. However, the effects of dry needling and stretching are better and longer lasting than those of oral diclofenac and stretching for at least 6 months. Trial registration Registered in the Chinese Clinical Trial Registry ( www.chictr.org.cn ) in 17/11/2017 with the following code: ChiCTR-INR-17013432.

Objective To make a bibliometric analysis of global trends in research into exercise interventions for stroke between 2001 and 2021. Method This study did the systematic literature from 2001 to 2021 in Web of Science Core Collection. CiteSpace software was used to analyze the relationship of publications with countries, journals, authors, references, and keywords. Results A total of 3,484 publications were obtained in the bibliometric analysis. The number of publications increased gradually over the period. The United States have the most number of publications. The journal stroke had the most citations per paper (106.95) and the highest impact factor (IF 2020, 7.194). The most high frequency keywords are “stroke,” “rehabilitation,” and “recovery,” the top of burst key words are “health,” “speed,” and “aerobic exercise”. Conclusion These findings provide the trends of exercise for stroke s and provided the potential research frontiers in the past 20 years. It will be a useful basis for further research into focus issues, cooperators, development trends.

目的:了解全国康复科医务工作者的体力活动水平是否符合世界卫生组织(World Health Organization,WHO)的标准.方法:采用横断面研究,在2017年7月份将调查问卷发放至全国30多个省份和地区,对康复科医务工作者的体力活动水平进行调查和分析,调查内容包含个人基本信息、体力活动情况、大肌群训练量、准备活动和整理活动情况、体力活动需求及建议等.结果:回收问卷2021份,剔除无效问卷52份,最终纳入1969份.结果显示:约75％的康复科医务工作者的中、高等强度体力活动时间达到了WHO的基本要求,但仅有50％左右的受访者达到了较高水平要求,不同职业的受访者在中、高等强度体力活动时间上均存在显著性差异(P＜0.05).其次,每周进行大肌群训练的康复科医务工作者占57.19％,男女性在大肌群训练频度、训练组数和重复次数上均存在显著性差异(P＜0.05).此外,康复科医务工作者体力活动前、后进行准备活动、整理活动的时间不足,高达78.22％的受访者准备活动时间低于推荐标准或不进行准备活动,整理活动不达标者多达86.18％;不同性别的人群进行准备活动的时间存在显著性差异(P＜0.05),进行整理活动的时间无显著性差异(P＞0.05).在近两千名受访者中,高达88.17％的康复科医务工作者有增强体力活动的需求,然而工作繁忙和身体疲倦成为了阻碍他们进行体力活动的主要原因,60％以上的受试者建议通过完善医院体育设施、减小工作压力等方式来改善现状.不同性别受访者在体力活动需求、影响因素、建议举措上都存在显著性差异.结论:调查中,大部分康复科医务工作人员的中、高等强度体力活动时间达到了WHO的基本要求,但仅半数人员达到了较高水平的要求.同时,大部分受访者进行大肌群训练、准备活动和整理活动的时间也低于推荐标准,且在前两者上存在显著的性别差异.尽管大部分康复科医务工作者对增强体力活动有着强烈的需求,但参与工作后事业繁忙和身体疲倦成了主要的阻碍因素,他们希望能通过完善医院体育设施、减小工作压力等方式来改善现状.

Background: Whole body vibration (WBV) training as an intervention method can cure chronic low back pain (CLBP). Different WBV parameters exert different effects on lumbar-abdominal muscle performance. Currently, there is a lack of study researched the influence of WBV training on patients with CLBP by lumbar–abdominal muscle activity. Therefore, this study aimed to investigate how WBV and exercise and their interactions influence lumbar-abdominal muscle activity in patients with CLBP. Methods : a group of ambulatory patients with chronic low back pain. Muscle activities of the multifidus (MF), erector spinae (ES), abdominal oblique externus muscle (AOE) and the rectus abdominis muscle (RA) were measured by surface electromyography, whereas participants performed 4 different exercises (single bridge, plank, side stay and V crunch) during three whole body vibration conditions and a no-vibration condition in a single experimental session. Results : Compared with the same exercises without whole body vibration, muscle activity increased when whole body vibration was added to the exercises. MF；the WBV frequency (P=0.002,) and exercise (P<0.001) presented significant effects on the root mean square of MF, whereas exercise * frequency (P=0.044) also resulted in significant interaction effects. ES: the significant differences were detected at WBV frequency (P<0.001), exercise (P<0.001), the interaction effect of exercise and frequency (P=0.225) was no significant. RA: the significant difference was detected at WBV frequency (P=0.018), the effect of exercise (P=0.590) and the exercise * frequency interaction (P=0.572) were no significant. AOE: the significant difference was detected at WBV frequency (P<0.001), the effect of exercise (P=0.152) and the exercise * frequency interaction (P=0.380) were no significant. Conclusion : Adding whole body vibration to exercise could increase muscle activation of lumbar–abdominal muscle in patients with CLBP. The optimum frequency for lumbar–abdominal muscles is 15 Hz. The best exercises include plank for multifidus and erector spinae, V crunch for rectus abdominis and single bridge for abdominal oblique externus.

Patellofemoral pain syndrome (PFPS) is common and affects approximately 15% of individuals at different ages and activity levels. As a non-surgical intervention, physiotherapy is widely used to treat PFPS. Neuromuscular training exercise is one of the most effective methods for decreasing musculoskeletal pain and improving knee function. However, the effectiveness of neuromuscular training exercise for treating PFPS is not without argument. The purpose of this study is to evaluate the effect of neuromuscular training exercise on patellofemoral pain and whether the neuromuscular training exercise have more advantage effects than taping and health education. We will operate a prospective, single-blind, randomized controlled trial of 60 patients with patellofemoral pain. Individuals will be indiscriminately assigned to two intervention groups and a health education group. The neuromuscular training exercise which includes the muscle strength training, balance training and knee joint proprioception training, and taping group will use “Y” and “I” type taping on the participants three times a week for three months. The health education group will be given education lectures once each week and which last for three months. The primary outcome measures include the adverse events, visual analog scale for pain, and Anterior Knee Pain Scale Index, which is a knee function self-report questionnaire to evaluate the function of the knee especially for PFPS patients. The secondary outcome measures are the muscle strength and endurance of knee joint flexion and extensor muscles, knee joint proprioception, muscle thickness of the quadriceps femoris, knee function ability, and quality of life. We will manage the intention-to-treat analysis for individuals who will withdraw from this study. According to previous studies, neuromuscular training exercise and the taping method are effective treatment for PFPS patients. In this study, we will perform a neuromuscular training exercise for patients with PFPS. We believe that this study may prove the effectiveness of neuromuscular training exercise in treating PFPS. Chinese Clinical Trial Registry, ChiCTR1800014995 . Registered on 27 February 2018.

BACKGROUND This study investigated how whole-body vibration (WBV), exercise, and their interactions influence core muscle activity in healthy young adults. MATERIAL AND METHODS Twenty-three healthy young adults (8 males and 15 females; age: 21.87±2.33 years) participated in the study. The activities of muscle multifidi (MM), rectus abdominis muscle (RM), erector spinae (ES), abdominis obliquus externus (AOE), and abdominis obliquus internus (AOI) were measured through surface electromyography (sEMG) while participants were performing 4 different exercise forms under 3 WBV conditions (condition 1: 5 Hz, 2 mm; condition 2: 10 Hz, 2 mm; and condition 3: 15 Hz, 2 mm) and a no-WBV condition in single experimental sessions. RESULTS The WBV frequency of 15 Hz is the best vibration stimulation for core muscles in all of the exercises (P<0.05). Single bridge is a better exercise for RM and AOE (P<0.05) compared with other exercises, and crunches is the best exercise for MM, AOI, and ES (P<0.05). Significant interaction effect was observed in different frequencies and exercises (P>0.05) except for AOI (F=0.990, P=0.378). CONCLUSIONS High vibration frequencies can lead to enhanced exercise benefits within an appropriate frequency range, and different exercises have diverse effects on various muscles. Single bridge and crunches are appropriate exercise forms for lumbar-abdominal muscles.

目的 通过表面肌电信号(sEMG)分析,对比非特异性腰痛(NLBP)患者与正常人在静态平衡模式改变时,上肢肌群与腰背部核心肌群激活时间的差异.方法 2017年9月至12月,纳入NLBP患者(NLBP组)与正常受试者(正常组)各21例.两组于站立位分别完成右侧上肢前屈与外展各2次,记录右侧三角肌前束、中束,双侧竖脊肌和双侧多裂肌的肌电信号,计算各肌肉与主动肌之间的相对激活时间并比较.结果 上肢前屈时,两组右侧多裂肌、双侧竖脊肌均在主动肌(三角肌前束)之前激活,而左侧多裂肌在主动肌之后激活;NLBP组右侧竖脊肌的相对激活时间大于正常组(t=-2.393,P=0.019).上肢外展时,正常组双侧多裂肌和双侧竖脊肌在主动肌(三角肌中束)之前激活;NLBP组左侧竖脊肌在主动肌之前激活,双侧多裂肌、右侧竖脊肌在主动肌之后激活;两组对应肌肉的相对激活时间均无显著性差异(t<1.393,P>0.05).结论 正常人通过上肢的前屈和外展来改变静态平衡时,腰背部核心肌群会提前激活,而NSLBP患者的核心肌群则有延迟激活的趋势.

Objective: This study systematically reviews previous work on the effects of whole body vibration exercise (WBVE) on pain associated with chronic musculoskeletal disorders. Data Sources: Seven electronic databases (PubMed, Embase, CINAHL, Web of Science, Cochrane, Physiotherapy Evidence Database [PEDro], and the China National Knowledge Infrastructure) were searched for articles published between January 1980 and September 2018. Study Selection: Randomized controlled trials involving adults with chronic low back pain (CLBP), osteoarthritis (OA), or fibromyalgia were included. Participants in the WBVE intervention group were compared with those in the nontreatment and non-WBVE control groups. Data Extraction: Data were independently extracted using a standardized form. Methodological quality was assessed using PEDro. Data Synthesis: Suitable data from 16 studies were pooled for meta-analysis. A random effects model was used to calculate between-groups mean differences at 95% confidence interval (CI). The data were analyzed depending on the duration of the follow-up, common disorders, and different control interventions. Results: Alleviation of pain was observed at medium term (standardized mean difference [SMD], -0.67; 95% CI, -1.14 to -0.21; I-2, 80%) and long term (SMD, -0.31; 95% CI, -0.59 to -0.02; I-2, 0%). Pain was alleviated in osteoarthritis (OA) (SMD, -0.37; 95% CI, -0.64 to -0.10; P<.05; I-2, 22%) and CLBP (SMD, -0.44; 95% CI, -0.75 to -0.13; P<.05; I-2, 12%). Long-term WBVE could relieve chronic musculoskeletal pain conditions of OA (SMD, -0.46; 95% CI, -0.80 to -0.13; P<.05; I-2, 0%). WBVE improved chronic musculoskeletal pain compared with the treatment "X" control (SMD, -0.37; 95% CI, -0.61 to -0.12; P<.05; I-2, 26%), traditional treatment control (SMD, -1.02; 95% CI, -2.44 to 0.4; P>.05; I-2, 94%) and no treatment control (SMD, -1; 95% CI, -1.76 to -0.24; P<.05; I-2, 75%). Conclusions: Evidence suggests positive effects of WBVE on chronic musculoskeletal pain, and long durations of WBVE could be especially beneficial. However, WBVE does not significantly relieve chronic musculoskeletal pain compared with the traditional treatment. Further work is required to identify which parameters of WBVE are ideal for patients with chronic musculoskeletal pain. (C) 2019 by the American Congress of Rehabilitation Medicine

目的:通过问卷调查的方式探讨马拉松跑者膝关节损伤的情况及其影响因素.为后期的马拉松跑者膝关节的损伤康复和预防提供理论依据.方法:在2016年上海国际马拉松赛中随机选取850例全马跑者进行问卷调查,问卷为自行设计,主要包括两方面内容:跑步者的基本信息;膝关节损伤的影响因素.统计方法为交叉表的单因素卡方分析以及向前逐步法二元Logistic回归分析.结果:在有效的800份问卷中,膝关节损伤总的发病率为23％.相比于其他的年龄段,膝关节的损伤在40-50岁这个年龄段最不易发生(P＜0.05);不同性别的跑者在膝关节处的损伤并没有显著性差异.力量不足(P＜0.01)、准备活动不足(P＜0.01)、鞋子不适(P=0.015)、疲劳(P＜0.01)、姿势不正确(P＜0.01)、旧伤病(P＜0.01)这些损伤因素与膝关节损伤之间具有相关性.其中旧伤病(OR=4.873)与力量不足(OR=4.074)是膝关节损伤较高的风险因素.结论:膝关节损伤是马拉松跑者中最为常见的损伤部位,其损伤与力量训练和旧伤病有着较深的联系.建议马拉松跑者平时应注重膝关节周围肌群的训练,保护好以前受过伤的部位,防止二次损伤.

Objective:To explore the influence of vibration stimulation on chronic low back pain patients lumbo-abdominal major muscles under different vibration stimulation conditions,and to determine the best vibration frequency and location by surface electromyography (sEMG) analysis.Method:sEMG signals from the lumbo-abdominal major muscles of 21 chronic low back pain patients were measured with the MyoResearch XP Master Software Version 1.07.17.Each subjects performed 3 exercises on 0Hz,5Hz,10Hz,15Hz a vibration platform:plank,side stay and the "V" crunch.Result:①The surface electromyography of erector muscles showed significant difference between different exercises (P＜ 0.05).Under plank and "V" crunch,there were significant differences between different frequency (P＜0.05).②The external oblique surface EMG values:in the four case of frequency,there were significant differences between different exercises (P＜0.05).Under plank and side stay conditions,there were significant differences between different frequency (P＜ 0.05).③The surface electromyography of rectus abdominis muscle:there were significant differences between different movements (P＜0.05) under 5Hz and 0Hz.There was no significant difference in frequency between three groups (P＞ 0.05).Conclusion:Different vibration stimulation conditions has different effects on the lumbo-abdominal major muscles in patients with chronic lower back pain.Erector muscles:the best frequency of vibration is 15Hz.the best exercise is side stay.External oblique:the best frequency of vibration is 15Hz,the best exercise is side stay.Rectus abdominis:the best exercise on the vibration platform is "V" crunch.Although the rectus abdominis discharge capacity had increased with increasing frequency,but the muscles were not activated significantly.

目的 探究青年人和老年人腰椎本体感觉的差异,同时探究腰椎本体感觉的性别差异.方法 2017年9月至11月,随机抽取社区内65～80岁老年人58例作为老年组,20～30岁青年人56例作为青年组.使用Con-Trex多关节等速肌力测试与训练系统进行腰椎本体感觉测试.采用关节位置被动复位法测试腰椎后伸和前屈方向的本体感觉,以实际复位角度与目标角度差值的绝对值即绝对误差角度进行比较.结果 老年组腰椎前屈、后伸的关节复位的绝对误差角度值均显著大于青年组(t>4.218,P<0.001).老年男性和女性的绝对误差角度值均明显大于青年男性和女性(t>2.844,P<0.001).相同的年龄层中,男性与女性间的绝对误差角度无显著性差异(t<1.473,P>0.05).结论 老年人腰椎本体感觉功能劣于青年人,老年男性和女性的本体感觉功能也都分别劣于青年男性和女性.在老年人和青年人中,男性和女性的腰椎本体感觉无差异.

This study aims to examine the correlations between lumbar neuromuscular function and pain, lumbar disability in patients with nonspecific low back pain (NSLBP).Ninety patients, with ages 18 to 37 years old, with NSLBP were recruited in this study. The lumbar neuromuscular function was tested by the CON-TREX multijoint isokinetic test and training machine. This study uses the visual analog scale (VAS) and Roland-Morris Disability Questionnaire (RMDQ) to evaluate the pain and the dysfunction index of patients who have low back pain, respectively.Pearson correlation coefficient is used to evaluate the correlation between lumbar neuromuscular function and the VAS and RMDQ scores. VAS and RMDQ scores have correlations with the proprioception in the flexion of the lumbar vertebra flexion; the peak torque of both flexion and extension muscle groups; and average power and endurance at different angular velocities. The decrease of lumbar muscle strength, endurance, and lumbar proprioception of the lumbar vertebra leads to an increase in pain intensity and lumbar disability.This study suggests that patients with chronic low back pain require targeted training in muscle strength, endurance, and lumbar proprioception, providing a theoretical basis for prevention and treatment of chronic NSLBP patients.

Objective To assess the test-retest reliability of pressure biofeedback in measuring intra abdominal pressure in the lumbar region for normal subjects .Methods We choosed 33 subjects (20 to 27 years old) and asked them to do four movements (movement A :prone position ;movement B :supine position with flexion hip and knee joint ;movement C :supine position with single flexion hip and knee joint ;movement D :prone position with flexion shoulder joint ;) by using pressure biofeedback twice totally ,and the last measurement should be done after 24 h .The indicator of test-retest reliability of joint position was intraclass correlation co-efficient (ICC) .Results The test-retest reliability of intra abdominal pressure was modest in the four movements in the lumbar re-gion ,and the values of ICC were from 0 .786 - 0 .848 .The test-retest reliability of intra abdominal pressure was good in Movement A [ICC(95% CI)= 0 .817(0 .630 - 0 .910)] ,Movement B [ICC(95% CI)= 0 .848 (0 .692 - 0 .925)] ,Movement D [ICC(95% CI)= 0 .841(0 .678 - 0 .921)] .And the test-retest reliability of intra abdominal pressure was good in Movement C [ICC (95% CI) =0 .786(0 .566 - 0 .894)] .Conclusion The test-retest reliability of intra abdominal pressure was modest and good in the lumbar re-gion ,and pressure biofeedback could be useful to assess intra abdominal pressure .

BACKGROUND:Treatment programs for low back pain are of great varieties, but there is stil no a definite treatment. Pressure biofeedback instrument is a tool to measure abdominal muscle activity, and its reliability in the treatment of low back pain is less reported. OBJECTIVE:To explore the reliability and feasibility of the pressure biofeedback instrument for assessment of low back pain. METHODS:Thirty patients with chronic low back pain were enrol ed and subject to four kinds of postures:posture A was prone position;posture B was supine position with flexion of the knee joints, posture C was supine position with unilateral flexion of the hip and knee joint, posture D was prone position with unilateral shoulder flexion. Intra-abdominal pressure values under the different postures were measured twice within a week in the same subject. Intraclass correlation coefficient (ICC) was used to assess the reliability. RESULTS AND CONCLUSION:Posture A had good test-retest reliability, and the value of ICC was 0.853 (95%confidence interval:0.691-0.930);posture B showed moderate test-retest reliability, and the ICC value was 0.751 (95%confidence interval:0.477-0.882);posture C also had moderate test-retest reliability, and the ICC value was 0.789 (95%confidence interval:0.557-0.900), posture D had good test-retest reliability, and the value of ICC was 0.892 (95%confidence interval:0.641-0.919). Therefore, the pressure biofeedback for evaluation of low back pain has good reliability, which can be used for the evaluation of low back pain.