Bubble Inclinometer Research Articles

Shape of the Sagittal Curvatures of the Spine in Young Female Volleyball Players

Background: The issue of the relation betweeen training loads on the shape of the spine of young players is of significant importance, as with the advancement of training seniority, unfavorable changes may be perpetuated resulting in possible consequences in the next stages of ontogenesis. The aim of this study was to assess the formation of the sagittal curvatures of the spine in girls practicing volleyball versus their nonpractising peers. Methods: We examined 60 girls aged 10–13 years, including 30 volleyball players and 30 untrained peers. The Baseline Bubble inclinometer was applied as a research. The data were analyzed based on Mann–Whitney U test and Pearson Chi-square test. Results. There were statistically significant intergroup differences in lumbar lordosis curvature values (Z = −2.67; p = 0.007). The prevalence of correctness values of the thoracic kyphosis curvature, was group-dependent (χ2(1) = 4.34; p = 0.037). Group also determined the prevalence of lumbar lordosis normalities (χ2(1) = 5.41; p = 0.020). Conclusions. Volleyball has a beneficial effect on the formation of the thoracic kyphosis, while the lumbar lordosis is shallowed under the influence of training. This indicates the need for a holistic approach to player training and the need to supplement the technique and tactics training with exercises to strengthen the muscles that stabilize the lumbar spine, improve spinal mobility, learn how to control the anterior tilt of the pelvis and train the fascia.

Lower urinary tract symptoms in children with Duchenne muscular dystrophy: An evaluation in terms of functional level, posture, and muscle strength.

To examine factors associated with lower urinary tract symptoms (LUTS) and lower urinary tract dysfunction (LUTD) in children with Duchenne muscular dystrophy (DMD). This cross-sectional study included 45 individuals diagnosed with DMD between the ages of 5 and 18 years. LUTS were evaluated with the Dysfunctional Voiding and Incontinence Scoring System, functional levels with the Brooke Upper Extremity Functional Classification and the Vignos Scale, lumbar lordosis angle with a bubble inclinometer, pelvic inclination angles with a digital inclinometer, and muscle strength with a hand-held dynamometer. The mean age of the children was calculated as 9.00 ± 3.32 years, body weight as 31.10 ± 12.59 kg, and height as 125.87 ± 18.46 cm. LUTD was detected in 20 children (44.44%). There was an association between high LUTD severity and low strength of the following muscles: bilateral hip flexor (Dominant: r = -0.338, p = 0.023; nondominant: r = -0.411, p = 0.005), quadriceps femoris (Dominant: r = -0.445, p = 0.002; nondominant: r = -0.504, p < 0.001), elbow flexor (Dominant: r = -0.461, p = 0.001; nondominant: r = -0.455, p = 0.002), and elbow extensor (Dominant: r = -0.442, p = 0.002; nondominant: r = -0.450, p = 0.002). Upper extremity functionality level was significantly higher in the LUTD-negative group (p = 0.004). There was no relationship between lumbar lordosis and pelvic inclination angles and LUTS symptoms (p > 0.05). To provide the adequate care for bladder health in children with DMD, it is essential to focus on parameters that will increase functionality and independence in this population.

Reliability and concurrent validity of the bubble inclinometer for visual estimation of straight leg raise in asymptomatic individuals

IntroductionThe straight leg raise (SLR) test is commonly used to investigate neurodynamic problems or hamstring muscle length. Visual estimation can be used to identify the degrees of hip flexion during the SLR test. However, intra-tester and inter-tester reliability, as well as concurrent validity, await formal investigation.MethodsThis study was an experimental study. Two testers, a novice and an experienced physical therapist, measured hip flexion angles during the SLR test using visual estimation for two sessions and the bubble inclinometer method during the first session in 31 asymptomatic participants, in random order. Intra-tester reliability (intraclass correlation coefficient, ICC&lt;sub&gt;3,3&lt;/sub&gt;), inter-tester reliability (ICC&lt;sub&gt;2,3&lt;/sub&gt;), concurrent validity (Pearson correlation with bubble inclinometer), and measurement error was represented as standard error of measurement (SEM) and minimal detectable change (MDC), were calculated.ResultsThe concurrent validity and intra-tester reliability of visual estimation for both testers were good (ICC&lt;sub&gt;3,3&lt;/sub&gt; = 0.885 with 95% confidence interval = 0.775–0.943, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and excellent (ICC&lt;sub&gt;3,3&lt;/sub&gt; = 0.904 with 95% confidence interval = 0.810–0.952, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), respectively. Inter-tester reliability of visual estimation was poor (ICC&lt;sub&gt;2,3&lt;/sub&gt; = 0.373 with 95% confidence interval = 0.027–0.639, &lt;i&gt;p&lt;/i&gt; = 0.018).ConclusionsAlthough the concurrent validity of visual estimation with the bubble inclinometer was good, and intra-tester reliability was excellent, the inter-tester reliability was poor. Therefore, caution should be exercised if more than one tester is involved in visual estimation.

The Concurrent Validity and Reliability of the Smartphone Measurement Application to Evaluate Iliotibial Band Tightness: A Cross-Sectional Study

Purpose: In recent years, the medical use of smartphones has increased with the development of hardware. The study aims to evaluate the reliability and concurrent validity of iPhone® measurement application to measure ITB tightness. Methods: This was a cross-sectional study. Thirty athletes with ITB tightness (17 males, 13 females) between 20 and 45 years old were included and assessed in this study. The intraclass correlation coefficient (ICC) was used to evaluate the reliability of each smartphone measurement, and Bland–Altman analysis was used to examine measurement errors. The ITB tightness was measured with Ober test using a bubble inclinometer and iPhone® measurement application and evaluated by two experienced physiotherapists. The researchers carried out three measurements for both extremities, using both the bubble inclinometer and the iPhone® measurement application. Measurement values were recorded by a third physiotherapist. Results: The iPhone® measurement application has strong inter-rater (ICC=0.941) and intra-rater (ICC=0.986) reliability and concurrent validity (r=0.945) in measuring ITB tightness. Conclusion: From the cross-sectional study’s results, it can be concluded that the iPhone® measurement application possesses strong intra-rater and inter-rater reliability and concurrent validity and can be used for measuring ITB tightness.

Effects of Sub-Occipital Muscle Inhibition with and Without Hold Relax Agonist Contraction of Hamstrings on Pain, Disability and Craniovertebral Angle in Neck Pain Patients with Hamstring Tightness

Background: Neck pain is a prevalent musculoskeletal disorder with significant impacts on individuals' daily functioning and quality of life. The Superficial Backline (SBL) concept suggests that muscles and fascial structures are interconnected, implying that addressing muscle tightness in one area can influence distant regions. This study explored the effects of sub-occipital muscle inhibition (SMI) with and without hold-relax agonist contraction (HR-AC) of the hamstrings on pain, disability, and craniovertebral angle in patients with neck pain and hamstring tightness. Objective: To determine the efficacy of SMI with and without HR-AC on pain relief, neck disability, and craniovertebral angle in patients suffering from neck pain and hamstring tightness. Methods: This randomized controlled trial included 34 participants aged 20-40 years with neck pain (NPRS ≥ 5) and hamstring tightness (≥ 30° extension lag). Participants were randomly assigned to two groups: Group A (SMI without HR-AC) and Group B (SMI with HR-AC). Interventions were administered three times per week for two weeks. Pain, craniovertebral angle, and neck disability were assessed using the Numeric Pain Rating Scale (NPRS), Bubble Inclinometer, Image J software, and Neck Disability Index (NDI). Data were collected at baseline and post-treatment. Statistical analysis was performed using SPSS version 25, with paired and independent t-tests used to compare outcomes within and between groups. Results: Significant reductions in NPRS scores were observed in both groups: Group A (mean pre-treatment: 6.25 ± 0.85, post-treatment: 3.18 ± 0.98) and Group B (mean pre-treatment: 6.40 ± 0.986, post-treatment: 2.133 ± 0.743). Craniovertebral angle improved significantly in both groups: Group A (mean pre-treatment: 41.25° ± 3.51, post-treatment: 45.48° ± 2.94) and Group B (mean pre-treatment: 40.99° ± 2.70, post-treatment: 49.02° ± 2.868). NDI scores also showed marked improvement: Group A (mean pre-treatment: 32.96 ± 3.04, post-treatment: 15.38 ± 3.39) and Group B (mean pre-treatment: 33.03 ± 2.89, post-treatment: 11.25 ± 3.27). Group B demonstrated more significant improvements in all measured outcomes compared to Group A (p &lt; 0.05). Conclusion: Both interventions, SMI without HR-AC and SMI with HR-AC, significantly reduced pain, improved craniovertebral angle, and decreased neck disability. However, the combination of SMI with HR-AC was more effective, highlighting the importance of addressing both ends of the myofascial chain in managing neck pain and hamstring tightness.

Comparison of Lower Extremity Alignment among Taekwondo Athletes of Various Subdisciplines.

Background and Objectives: Studies analyzing lower extremity alignment (LEA) LEA among taekwondo subdisciplines athletes are lacking. This study compared LEA in the dominant and nondominant legs intaekwondo athletes. Materials and Methods: Twelve measurements of LEA were analyzed for 157 athletes (63 sparring, 50 demonstration, and 44 poomsae athletes) registered with the Korea Taekwondo Association. LEA was measured in the standing, supine, and prone positions using alignment application, a goniometer, a bubble inclinometer, a height gage, and a palpation meter. Results: The analysis revealed that the dominant leg of poomsae athletes showed greater genu valgum alignment than that of sparring athletes (p < 0.01), whereas the dominant leg of sparring athletes showed greater rearfoot varum alignment than that of demonstration athletes (p < 0.01). Furthermore, the nondominant leg of poomsae athletes showed greater genu valgum alignment than that of sparring and demonstration athletes (p < 0.01), whereas the nondominant leg of sparring athletes showed greater rearfoot varum alignment than that of demonstration athletes (p < 0.01). In addition, demonstration athletes had better forefoot varus alignment than poomsae athletes (p < 0.01). Conclusions: This study revealed that LEA characteristics vary among taekwondo athletes according to their subdiscipline. The results of this study would help in designing training programs tailored to each subdiscipline that would best address their LEA characteristics and help to prevent injuries.

Effect of Weight Bearing Versus Non-Weight Bearing Strengthening Exercises on Dynamic Balance in Knee Osteoarthritis Patients: Randomized Controlled Trial

Background: knee osteoarthritis (OA) is one of the most aging problems that causes many problems such as pain, reduced balance, difficulty of walking, up &amp; down stairs and may result in inability to move and dependency. Dynamic balance has been found to be affected in patients with knee OA. Purpose: The aim of this study was to evaluate and compare the effect of weight bearing (WB) and non-weight bearing (NWB) strengthening exercises on dynamic balance, pain and proprioception in knee OA patients. Subjects &amp; Methods: Sixty patients from both genders, diagnosed with bilateral knee OA mild to moderate (according to Kellgran and Lawrence classification) divided equally into three groups G I (control), G II (WB) and G III (NWB), their mean value of age were 59.7 ± 4.5, 60.6 ± 4 and 60.1 ± 4.9 years respectively and body mass index were 28.8 ± 1, 28.6 ± 0.8and 28.2 ± 1.6 kg/m2 respectively. G I received conventional treatment (TENS and stretching exercises for quadriceps, hamstring and calf muscles), G II received the conventional treatment and WB strengthening exercises while G III received the conventional treatment and NWB strengthening exercises. Interventions were performed for 12 sessions (3 sessions/ week) over a period of four weeks. Outcomes were assessed at the beginning and at the end of the fourth week using biodex balance system for dynamic balance, visual analogue scale (VAS) for pain intensity and bubble inclinometer for joint repositioning error (JRE) for measuring proprioception. Result: G II was improved in all measurements with significant difference between the pre and post measurements of all measured variables, while G II were significant difference of BBS and VAS and G I there was significance difference of VAS only. There were significance differences between G II and G I in VAS, BBS and JRE measurements and between G II and G III in VAS and JRE only with superiority to G II, while there were significance differences between G I and G III in VAS and BBS with superiority to G III. Conclusion: Both WB and NWB exercises are effective in improving dynamic balance and pain in patients with knee OA. With superiority to WB exercises in improving proprioception.

Reliability and Validity of a Smartphone Device and Clinical Tools for Thoracic Spine Mobility Assessments.

Quantifying thoracic spine mobility with reliable and valid tools is a challenge for clinicians in practice. The aim of this study is to determine the reliability and validity of a smartphone device, bubble inclinometer and universal goniometer to quantify the static kyphotic curve and active range of motion of the thoracic spine. A total of 17 participants (mean age = 23.7 ± 2.3 years) underwent repeated measurements with three raters, on three separate days performing the lumbar-locked trunk rotation, standing full extension, standing full flexion, standing relaxed curve and seated trunk rotation assessments. Mostly "Good" to "Excellent" intra-rater (ICC ranging from 0.624 to 0.981) and inter-reliability (ICC ranging from 0.671 to 0.968) was achieved with the smartphone and clinical tools. "Excellent" validity (ICC ranging from 0.903 to 0.947) with the smartphone was achieved during lumbar-locked trunk rotation and standing relaxed curve assessment. "Good" validity (ICC ranging from 0.836 to 0.867) of the smartphone was achieved during the seated trunk rotation. The Samsung s9+ smartphone with the iSetSquare mobile application is a reliable and valid tool to use for clinical assessments assessing thoracic spine mobility.

Association between Thoracic Kyphosis and Forward Head Posture in Teenagers: An Analytical Cross-Sectional Study

Background: Hyperkyphosis of the thoracic spine and forward head posture are common alterations in teenagers and cause diverse symptomatology, but their association still remains obscure. Objectives: This study aimed to evaluate the association between thoracic kyphosis and forward head posture in teenagers between 11 and 17 years of age. Methods: In this analytical cross-sectional study, 84 students between 11 and 17 participated. Those who suffered from previous traumatic injuries in the thoracic or cervical spine were excluded. A Stadler® flexible ruler and a SenseAid® bubble inclinometer were used to measure thoracic kyphosis. The measurement of forward head posture was conducted through the craniovertebral angle. An application denominated “Forward Head Posture©” was employed, and an ad hoc questionnaire was utilized. Information such as sex, age, and pain in the cervical and thoracic spine among the study population was collected from this questionnaire. Results: A positive correlation and a statistically significant association (P &lt; 0.05) were found between forward head posture and thoracic kyphosis. Age showed a significant association with forward head posture (a prevalence ratio (PR) = 1.15, P = 0.005), and students reporting backache had a lower prevalence of this forward head posture (aPR = 0.64, P = 0.025). Conclusions: There was a positive correlation and a statistically significant association between forward head posture and thoracic kyphosis in teenagers between 11 and 17 years of age.

Technical note-the use ofan inclinometer to accurately guide intra-operative femoral de-rotational osteotomies.

Femoral de-rotational osteotomies are a safe and effective treatment for symptomatic excessive femoral anteversion or retroversion. The author's preferred technique for performing a de-rotational osteotomy is via a subtrochanteric transverse osteotomy with intramedullary nail fixation. We describe a method for guiding femoral de-rotation correction intra-operatively using a bubble inclinometer.

Manual Therapy versus Localisation (Tactile, Sensory Training) in Patients with Non-Specific Neck Pain: A Randomised Clinical Pilot Trial.

Manual therapy (MT) techniques typically incorporate localised touch on the skin with the application of specific kinetic forces. The contribution of localised touch to the effectiveness of MT techniques has not been evaluated. This study investigated the immediate effects of MT versus localisation training (LT) on pain intensity and range of movement (ROM) for neck pain. In this single-blind randomised controlled trial thirty eligible neck pain volunteers (23 females and 7 males), aged 28.63 ± 12.49 years, were randomly allocated to MT or to a motionless (LT) group. A single three-minute treatment session was delivered to each group's cervico-thoracic area. The LT involved tactile sensory stimulation applied randomly to one out of a nine-block grid. Subjects were asked to identify the number of the square being touched, reflecting a different location on the region of skin. MT involved three-minute anteroposterior (AP) glides and sustained natural apophyseal glides (SNAG) techniques. Pre- and post-intervention pain intensity were assessed using a pressure pain threshold (PPT) algometer and the numeric pain rating scale (NPRS). Neck ROM was recorded with a bubble inclinometer. Improvements in ROM and self-reported pain were recorded in both groups (p < 0.001) without differences in NPRS, ROM or PPT scores between groups (p > 0.05). Tactile sensory training (localisation) was as effective as MT in reducing neck pain, suggesting a component of MT's analgesic effect to be related with the element of localised touch rather than the forces induced during passive movements.

Effect of radial shock wave and ultrasound therapy combined with traditional physical therapy exercises on foot function and dorsiflexion range in plantar fasciitis: a prospective randomized clinical trial.

This study aimed to assess the effect of radial shock wave and ultrasound therapy combined with traditional physical therapy on foot function and range of motion in chronic plantar fasciitis. Sixty-nine participants with chronic plantar fasciitis (25-56 years) were allocated randomly into three groups. Group (A) received ultrasound (US) therapy plus conventional physical therapy exercises (in the form of stretching, strengthening exercise, and deep friction massage), Group (B) received a radial shock wave (RSW) therapy plus conventional physical therapy exercises, and Group (C) received a combination of both RSW and US therapy in addition to conventional physical therapy exercises, with 3 sessions per week for US therapy and one session for RSW therapy, in addition to 45 minutes of exercises for all groups for 4 consecutive weeks. Foot function was assessed using the foot function index (FFI), and ankle dorsiflexion range of motion was measured using the Baseline® bubble inclinometer at baseline and 4 weeks following treatment. ANOVA revealed significant differences (p<0.05) in the measured outcomes among the groups after treatment. Tukey's honest significant difference post-hoc test demonstrated a highly statistically significant (p<0.001) improvement in the assessed outcomes of group C in the post-intervention settings when compared to the other groups. After 4 weeks of intervention, the mean (SD) of FFI in groups A, B, and C were (64.54±4.91, 61.93±4.17, and 45.16±4.57) respectively, and the active range of motion (ROM) of the ankle dorsiflexion were (35.27±3.22, 36.59±2.91, and 41.85±3.04) respectively. The addition of RSW to US with the conventional physical therapy program improved foot function and ankle dorsiflexion range of motion significantly for patients with chronic plantar fasciitis.

Reliability and Validity of the Clinometer™ Smartphone Application for Measuring Knee Flexion

The purpose of this study was to investigate the reliability and validity of the Clinometer™ smartphone application. Intrarater and interrater reliability were calculated for devices (i.e., goniometer, Clinometer™, bubble inclinometer) using intraclass correlation coefficient, standard error of measurement, and minimal detectable change. Interinstrument reliability and Clinometer™ validity were also assessed. Intrarater reliability was good (intraclass correlation coefficients = .70 − .83) and interrater reliability was moderate (intraclass correlation coefficient = .63 − .72) across devices. Interinstrument reliability and Clinometer™ validity were supported across analyses. The Clinometer™ is comparable to a goniometer or bubble inclinometer for measuring prone knee flexion.

Association between age, sex and cervical and upper cervical rotation tests. Descriptive and correlational study in healthy volunteers.

Active cervical spine rotation (ACROM Rot) shows cervical rotation and flexion rotation test (FRT); side-bending rotation test (SBRT) and upper cervical axial rotation test (C0-C2ART) are described to measure upper cervical rotation. The objectives of this study are (1) to describe the normal range of motion (ROM) of ACROM Rot, and the ROM in FRT, SBRT and C0-C2ART tests; (2) to explore the correlation among the four tests and (3) to investigate the influence of age and sex in their ROM. A cross-sectional study was carried out with healthy volunteers from 18 to 75 years of age. Tests were measured using a CROM device and a bubble inclinometer. Descriptive analysis was performed to establish normative data for the ROM tests. Correlation analysis was conducted to understand the relation between upper and global cervical rotation ROM and among the three upper cervical rotation tests. Linear regression models were developed to understand the influence of age and sex in the ROM of all tests. Normative values were obtained from 122 healthy volunteers (50% male), by sex and age strata. The degree of correlation ranged between 0.582 (p < 0.01) for FRT and ACROM Rot left and 0.217 (p < 0.05) for SBRT and C0-C2ART left. Linear regression models showed the influence of sex for ACROM Rot right (men -4.64° less than women), SBRT (men -4.1° less than women) left and C0-C2ART right and left (men -2.24° and -1.78° less than women). The age influenced rotation ROM with a decrease for every 10 years of -2.11° and -1.96° for ACROM Rot right and left, of -1.72° and -1.26° for FRT right and left and -0.58° and -0.41° for C0-C2ART right and left in the linear regression models. No association was found between age and SBRT (p = 0.63 for right SBRT and p = 0.49 for left SBRT). Weak-to-moderate correlation was found between the upper cervical spine rotation tests and with the ACROM. Women had a larger ROM in ACROM Rot right, SBRT left and C0-C2ART. Decreases in ROM related with age were observed for ACROM Rot, FRT and C0-C2ART but not for SBRT.

The shape of the sagittal curvatures of the spine in a high-level acrobatic gymnasts – comparison by sex

Specific loads on the spine and the very young age at which acrobatic gymnastics training is undertaken require monitoring the shape of the spine curvatures in gymnasts to detect possible postural abnormalities. The aim of this descriptive study was to assess and compare the shape of the spine in the sagittal plane in acrobatic gymnasts of both sexes and their associations with demographic and somatic variables. The study group included 159 acrobatic gymnasts aged 12-19 (106 females and 53 males) from 16 European countries. The study was designed as a survey and measurements of somatic variables and the angles of inclination (using the Baseline Bubble inclinometer) at four topographic points of the spine: S1, L5/S1, Th12/L1, C7/Th1. Based on the angles of spinal inclination, the sizes of the sacral slope (SS), lumbar lordosis (LL), and thoracic kyphosis (TK) were calculated. Body posture was assessed based on Wolański’s modified typology. The angles of SS and LL were significantly higher in females, and TK did not differ between sexes. Training experience positively correlated only with the size of the SS in both sexes. Age and somatic variables were significantly correlated with the size of the sagittal curvatures, mainly in females. The majority of gymnasts had a normal angle of SS and TK and a flattened LL. The equivalent and lordotic types of body posture were more frequent in females, and the kyphotic type in males. The incorrect body posture was noted in 19.8% of females and 43.4% of males. We concluded that acrobatic gymnasts are not at risk of increasing the size of spinal curvatures in the sagittal plane, but males show a tendency toward flattened LL and kyphotic type of body posture.

The reliability and validity of the Turkish version of the self-administered neck mobility assessment tool (s-rom-neck) in patients with chronic neck pain.

The self-administered neck mobility assessment tool (S-ROM-Neck) is the subjective cervical region range of motion (S-ROM) assessment scale. The study aimed to demonstrate the reliability and validity of the Turkish version of the S-ROM-Neck in patients with chronic neck pain. : A cross-sectional study was conducted with a total of 60 chronic neck pain patients in the Physical Therapy and Rehabilitation Clinic of Pamukkale University Hospital between January and August 2021. The mean age of the individuals was 34.1 ± 9.9 years. Patients were assessed with S-ROM-Neck twice to prove the test-retest reliability. In addition, Visual Analogue Scale (VAS), Neck Disability Index (NDI) and bubble inclinometer measurement were used to analyze the construct validity of S-ROM-Neck. The intraclass correlation coefficients of the S-ROM-Neck were higher than 0.80 (ICC > 80, CI: 0.90-98). The internal consistency of the S-ROM-Neck total score was within the acceptable limits (α = 0.754). Construct validity was high regarding the correlation analysis (r > 0.05, p < 0.01). Turkish S-ROM-Neck is a valid and reliable tool to assess the S-ROM of individuals with chronic neck pain.

Early versus delayed rehabilitation protocol after arthroscopic rotator cuff repair

Objective: To assess the effect of immobilization versus early range of motion exercises in treating primary arthroscopic rotator cuff repair secondary to full-thickness tear. Design: Parallel group randomized clinical trial. Participants: 30 patients with primary arthroscopic rotator cuff repair secondary to full-thickness tear participated in the study. Interventions: Patients were divided into two groups, 15 in each group. The first group (A) received early range of motion (ROM) exercises started 2 weeks post-operative; and the second group (B) immobilized immediately post operative and received delayed range of motion exercises started 6 weeks post-operative. Main outcomes: Shoulder pain and function were assessed by shoulder pain and disability index (SPADI). ROM of shoulder flexion, abduction, and internal rotation were assessed by standard goniometer. Scapular protraction was assessed by digital caliper and scapular upward rotation was assessed by bubble inclinometer. All outcomes were assessed in both groups 6 weeks, 3 months and 6 months postoperative. Results: A significant increase in flexion, abduction and internal rotation ROM at 6 weeks, 3 months and 6 months was observed between groups in favor of Group A.

Hyperkyphosis among the Elderly in a Community: A Descriptive Cross-sectional Study.

Aging brings progressive changes in the physiology of the musculoskeletal system that leads to postural changes and degenerative diseases in elderly. The most common postural change is hyperkyphosis which decreases physical performance, ability to perform daily activities, overall quality of life, and increases the risk of falls in elderly. The aim of the study was to find out the prevalence of hyperkyphosis among the elderly in a community. A descriptive cross-sectional study was done in a local community from 26 May 2019 to 8 June 2019 after obtaining ethical approval from the Institutional Review Committee (Protocol approval number: 138/19). Participants above 60 years of age were included in the study. Convenience sampling was done. A bubble inclinometer was used to measure the degree of kyphosis. Point estimate and 95% Confidence Interval were calculated. Among 144 elderly participants, hyperkyphosis was present in 90 (62.50%) (54.59-70.41, 95% Confidence Interval) with the mean hyperkyphosis being 47.07±4.83˚. The elderly in the age group of 70-75 years had a higher degree of hyperkyphosis with a mean value of 47.77±4.92˚. The mean hyperkyphosis was 48.18±5.30˚ and 45.31±3.36˚ in female and male participants respectively. The prevalence of hyperkyphosis was found to be higher in our study compared to other studies conducted in similar settings. Early identification and interventions of hyperkyphosis are thus warranted to prevent the detrimental consequences in the later stages of life. aging; hyperkyphosis; posture.

Effects of A Progressive Rehabilitation Program on Shoulder Internal Rotation Range of Motion, Acromiohumeral Distance, And Pain in An Adolescent Female Swimmer with Subacromial Pain (Impingement) Syndrome

Shoulder injuries are common in competitive youth swimmers because of sport-specific changes in upper extremity physical characteristics and acromio-humeral distance (AHD). These physical alterations could cause abnormal scapular kinematics and positioning. Subacromial pain syndrome (SPS), scapular dyskinesis, and SLAP lesions require a multiphase approach. A 14-years-old female athlete who has been swimming for 7 years had SPS symptoms for 14 months. She also had scapular dyskinesis and suspected SLAP lesion. She received 15 treatment sessions. We conducted a progressive and comprehensive rehabilitation program consisting of electrotherapy, thermal agent, mobilization techniques, posterior shoulder stretching exercises, upper and lower extremity strengthening, proprioception, scapular stabilization, and core stabilization exercises, rhythmic stabilization exercises, plyometric exercises, and the advanced thrower’s 10 program. Internal rotation range of motion (IRROM) with bubble inclinometer, pain with Visual Analog Scale, and AHD with ultrasonographic imaging were assessed before treatment and at the end of the 9th and 15th treatment sessions. Before treatment, IRROM was 52°, AHD was 10.67 mm, and pain intensity at rest and during swimming was 0 and 3.1 cm, respectively. After 9 treatment sessions, IRROM was 55.6°, AHD was 11.62 mm, pain intensity at rest and during swimming was 3.7 cm and 5.1 cm, respectively. At the end of the treatment, IRROM was 58.33°, AHD was 12.02 mm, pain intensity at rest and during swimming was 0 cm. A progressive and challenging rehabilitation program may positively change the scapular and glenohumeral kinematic patterns leading to an increase in AHD and IRROM, therefore a decrease in pain.

Effects of neural mobilization on sciatic nerve excursion, symptoms, and regional function in individuals with nerve-related low back pain

IntroductionLow back pain is one of the most common musculoskeletal disorders andneural mobilization was usually rendered as a treatment for Nerve related low back pain (N-LBP). But warrants more support for its effectiveness and related outcomes. To find the effect of neural mobilization in improving nerve mobility and symptoms among individuals with N-LBP.MethodsAn experimental study was conducted in physiotherapy outpatient department with 23 subjects after obtaining written consent and were divided into two groups using simple random allocation as experimental (EG, &lt;i&gt;n&lt;/i&gt; = 13) and control group (CG, &lt;i&gt;n&lt;/i&gt; = 10). A standardized musculoskeletal evaluation was done prior to the treatment to quantify pain (numeric pain rating scale – NPRS), lumbar range (bubble inclinometer), sciatic nerve mobility (ultrasonogram – USG) and regional function (Oswestry Disability Index – ODI). Participants received therapy for pain modulation and spinal conditioning exercises with or without neural mobilization for 10 sessions spread over 3 weeks. The pre and post treatment data were analyzed using non parametric testing with significance (&lt;i&gt;p&lt;/i&gt; &lt; 0.05).ResultsBetween group analyses showed the following observation; pain intensity (&lt;i&gt;p&lt;/i&gt; &lt; 0.047), lumbar range (flexion – &lt;i&gt;p&lt;/i&gt; &lt; 0.555, extension – &lt;i&gt;p&lt;/i&gt; &lt; 0.294), nerve mobility (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) and functional disability (ODI – &lt;i&gt;p&lt;/i&gt; &lt; 0.617), with significance only in pain intensity and nerve mobility among EG compared to CG. Within group analysis showed a statistical and clinical significance for all above variables post treatment in both the groups.ConclusionsNeural mobilization improves nerve mobility (sciatic nerve excursion) and symptom, can be rendered as a treatment in individuals with nerve related LBP.