Core Stability Research Articles

Postoperative early initiation of sequential exercise program in preventing persistent spinal pain syndrome type-2 after modified transforaminal lumbar interbody fusion: a prospective randomized controlled trial.

This prospective randomized controlled trial aimed to investigate the impact of early postoperative sequential motor control (starting first day post-operatively) and core stabilization training (starting fifth week post-operatively) compared to conventional exercise (starting fifth weeks post-operatively) on the risk of developing persistent spinal pain syndrome type-2 (PSPS-T2). 395 patients with lumbar degenerative diseases (LDDs) undergoing modified transforaminal lumbar interbody fusion and a 12-week postoperative exercise program (sequential vs. conventional exercise: 214 vs. 181) were evaluated for low back pain (LBP) intensity, Oswestry Disability Index (ODI), pressure pain threshold (PPT), temporal summation (TS), fatty infiltration of paraspinal muscles, transversus abdominis (TrA) activation capacity and Fear-Avoidance Beliefs Questionnaire (FABQ) pre-operatively, 3 months post-operatively, and 1 year post-operatively. At 3-month postoperative assessment, LBP in sequential exercise group were lower than those in conventional exercise group (P < 0.05), and sequential-exercise patients had greater local-area PPTs, lower TS, lower TrA activation capacities and less fatty infiltration of erector spinae than did the conventional-exercise patients (P < 0.05). At 1-year postoperative assessment, fewer sequential-exercise patients had PSPS-T2 compared with conventional-exercise patients (11/214 vs. 20/181; P < 0.05). LBP at rest and FABQ were lower in sequential-exercise patients than conventional-exercise patients (P < 0.05). Furthermore, both PPT and TS at 1-year postoperative assessment were associated with these measurements at 3-month postoperative assessment in patients with PSPS-T2 (P < 0.05). Postoperative sequential exercise has more positive effects to avoid PSPS-T2 than conventional exercise in patients with LDDs possibly because of its advantages in improving central and peripheral sensitization.

Temporal trends in weight-based disparities in physical fitness of children: 30-years of continuous surveillance through Slovenian national system

BackgroundObesity in childhood has deleterious consequences for health while improving physical fitness can significantly reduce health risks related to high body mass index. We aimed to examine the evolution of disparities in physical fitness based on weight status among 7–15-year-olds in Slovenia between 1989 and 2019 and compare these trends across sex, age and socioeconomic status.MethodsWe used annual data collected within the SLOfit monitoring system in the period between 1989 and 2019, totalling 4,256,930 participants (about 137 000 per year). We examined cardiorespiratory fitness (600-m run test), muscular fitness (60-s sit-ups, bent arm hang, and standing broad jump test) and skill-related fitness (backwards obstacle course, 60-m dash, arm plate tapping). We grouped children according to the IOTF cut-offs for BMI to those living with normal weight or excess weight and estimated changes in physical fitness over time by fitting quantile regression models separately by sex and age group, and then using segmented regression to identify the patterns of trends over time.ResultsWeight-based disparities in physical fitness were large in 1989 and have further increased by 2019. The increase in disparities was generally around 5 percentiles larger in boys, and 10–15-year-olds compared to younger children. It was particularly pronounced for body core strength and speed in boys (up to 15 and 19 percentiles, respectively) and upper body strength and speed among girls (up to 13 percentiles). Most of the increase in disparities in health-related fitness accumulated during the 2010s, when the fitness of children generally improved, but much less so in children living with excess weight.ConclusionsDespite recent improvements in population fitness levels, children with excess weight seem to be left behind, which adds to existing health inequalities. Our results should encourage policymakers to redesign policies aimed at promoting physical activity and enhancing physical fitness to make them more equitable and ultimately lead to reducing inequalities in fitness.

The Acetylene Bridge in Intramolecular Singlet Fission: A Boon or A Nuisance?

Various analogues of the alkylsilylacetylene group are frequently used as auxiliary groups to enhance the solubility and stability of the acene dimer core, widely used as platforms to investigate intramolecular singlet fission (iSF) mechanisms. However, while in the 2,2'-linked dimers they are primarily auxiliary groups, these are essential fragments of the bridging units in 6,6'/5,5'-linked dimers, the two preferred choices for dimerization. The starkly different iSF dynamics observed in the two variants raise the question of what role the acetylene bridges play. Here, we systematically designed a set of (oligo-)para-phenylene bridged 2,2'-linked pentacene dimers with an additional acetylene fragment in the bridging unit to mimic the structure of 6,6'-linked dimers. Contrasting the results with previously reported analogous 2,2'-linked and 6,6'-linked pentacene dimers reveals that the acetylene bridges contribute to significant conformational freedom. This effect provides a mechanism to promote spin evolution within the triplet pair to achieve free triplets but also offers new parasitic pathways for triplet-pair recombination, revealing that this structural motif can be both a boon and a nuisance. Additionally, our analysis reveals that these bridges directly modify the electronic states, highlighting significant pitfalls of the standard chromophore-bridge-chromophore framework used to design and interpret photophysics of iSF materials.

The Acetylene Bridge in Intramolecular Singlet Fission: A Boon or A Nuisance?

Various analogues of the alkylsilylacetylene group are frequently used as auxiliary groups to enhance the solubility and stability of the acene dimer core, widely used as platforms to investigate intramolecular singlet fission (iSF) mechanisms. However, while in the 2,2’‐linked dimers they are primarily auxiliary groups, these are essential fragments of the bridging units in 6,6’/5,5’‐linked dimers, the two preferred choices for dimerization. The starkly different iSF dynamics observed in the two variants raise the question of what role the acetylene bridges play. Here, we systematically designed a set of (oligo‐)para‐phenylene bridged 2,2’‐linked pentacene dimers with an additional acetylene fragment in the bridging unit to mimic the structure of 6,6’‐linked dimers. Contrasting the results with previously reported analogous 2,2’‐linked and 6,6’‐linked pentacene dimers reveals that the acetylene bridges contribute to significant conformational freedom. This effect provides a mechanism to promote spin evolution within the triplet pair to achieve free triplets but also offers new parasitic pathways for triplet‐pair recombination, revealing that this structural motif can be both a boon and a nuisance. Additionally, our analysis reveals that these bridges directly modify the electronic states, highlighting significant pitfalls of the standard chromophore‐bridge‐chromophore framework used to design and interpret photophysics of iSF materials.

A New Framework for Integrating DNN-Based Geographic Simulation Models within GISystems

As a crucial spatial decision support tool, Geographic Information Systems (GISystems) are widely used in fields such as digital watersheds, resource management, environmental assessment, and regional governance, with their core strength lying in the integration of geographic simulation models from various disciplines, enabling the analysis of complex geographical phenomena and the resolution of comprehensive spatial problems. With the rapid advancement of artificial intelligence, deep neural network-based geographic simulation models (DNN-GSMs) have increasingly replaced traditional models, offering significant advantages in simulation accuracy and inference speed, and have become indispensable components in GISystems. However, existing integration methods do not adequately account for the specific characteristics of DNN-GSMs, such as their formats and input/output data types. To address this gap, we propose a novel tight integration framework for DNN-GSMs, comprising four key interfaces: the data representation interface, the model representation interface, the data conversion interface, and the model application interface. These interfaces are designed to describe spatial data, the simulation model, the adaptation between spatial data and the model, and the model’s application process within the GISystem, respectively. To validate the proposed method, we construct a spatial morphology simulation model based on CNN-LSTM, integrate it into a GISystem using the proposed interfaces, and conduct a series of predictive experiments on island morphology evolution. The results demonstrate the effectiveness of the proposed integration framework for DNN-GSMs.

Flexibar And Non-Flexibar Exercises And Its Effects On Trunk Activation- A Review Of Literature

Objective: To systematically review the randomised controlled trials to evaluate the effects of flexi-bar and non-flexi-bar exercises, specifically stabilization training, on trunk muscle activity in various postures. Methodology: The study included randomized control trials and clinical trials published between 2007-2018 , focusing on patients with upper trunk muscle weakness aged above 18. Exclusion criteria included a study with overlapping data, a study with associated disorders, or abstract-only papers. The search strategy involved a search of existing literature from databases like PubMed, Google Scholar, Cochrane Library, PEDro, and Research Gate, removing duplicates and identifying relevant articles. The full-text screening was performed, and the remaining relevant articles underwent data extraction. Surface electromyography (EMG) was used to measure the activity of selected trunk muscles, which was then normalized to maximum voluntary isometric contraction. Results: The findings of this study indicate that flexi-bar exercises resulted in higher activation of trunk muscles compared to non-flexi-bar exercises (stabilization training). The unique physical response induced by the vibration created through the swinging motion of the flexi bar triggered reflexive contractions of core muscles, leading to increased muscle activity. This suggests that flexi bar exercises may be beneficial in promoting muscular activation and potentially alleviating low back pain by evening out muscular imbalances.Conclusion: The results of this study support the use of flexi-bar exercises for activating trunk muscles, particularly when compared to non-flexi-bar exercises (stabilization training).

Physical therapy in a patient with viral -encephalitis hemi-paresis: A Case report

The purpose of the rehabilitation program is to improve motor skills, coordination, sensory system, mobilization and other existing disorders to achieve activity of daily living (ADL). Physical therapy as part of the multidisciplinary approach can provide core stability exercises, muscular facilitation and stimulation of motion of the upper and lower extremities, balance exercises and mobility exercises, as well as strengthening exercises with PNF facilitation and active stimulation techniques and using the patient's body weight as a training burden. Bobath approach and facilitation exercise can reduce spasticity by strengthening the antagonist muscles. MMT right upper extremity 3/5, left upper extremity 4/5, right lower extremity 2/5, and left lower extremity 3/5. Ashworth scale right upper extremity 1/4, right lower extremity 2/4, and left lower extremity 1/4. Clonus is reduced, the patient can stand with maximum support without clonus for 10 minutes. Trunk impairment scale 12/23 and Barthel index 65/100. Anthropometric examination showed differences in the circumference of the lower extremities, namely the right patella circumference 34-32 cm left, right upper leg 39 cm-left 37 cm, and left lower leg 29-24 cm. Mobilize the patient to a laying position with minimal assistance. Mobilization of the patient is being able to sit with minimal assistance, namely stabilization in the pelvis, sitting to standing with moderate support, which is supported at the knee bilaterally, and standing with support at the knee and pelvic for 10 minutes. This case report concludes that although physiotherapy is done late with strengthening exercise and core stability strengthening techniques, lying down strengthening exercise, it can improve motor skills, coordination, which in turn will increase the patient's independence in carrying out functional activities and ADLs.

Effect of Core Stability Exercise and Treadmill Training on Balance in a patient with Cerebellar Ataxic Cerebral palsy- A Case Report

Cerebral palsy (CP) is defined as a set of developmental illnesses that affect posture and mobility, causing activity restriction owing to abnormalities that are not progressive in the developing brain of the fetus or neonate. Children with cerebellar ataxic CP often exhibit undeveloped or malformed cerebellar structures, resulting in challenges for the cerebellum to integrate the neural input required to control movement and balance smoothly. Patients with cerebellar ataxic cerebral palsy have difficulty in maintaining balance and trunk control which leads to difficulty in performing their activities of daily living and result in dependency. Thus, reporting cases like these is crucial to evaluate the impact of core stabilization intervention and treadmill walking on balance in a child having cerebellar ataxic cerebral palsy. A 7-year-old female child born at full term delivered via normal vaginal delivery with a birth weight of 2700 gm had no difficulties during antenatal, natal or postnatal phases. At the age of 6 years, mother noticed that the child had difficulty in standing and walking independently, she had difficulty in performing her activities of daily living independently. The patient underwent an 8-week intervention consisting of core stabilization exercise protocol and treadmill walking along with traditional physiotherapy intervention. The outcome measures included Pediatric Balance Scale for static balance and MFT for dynamic balance. The patient showed significant improvement in both static as well as dynamic balance following the intervention. Thus, combined impact of core stabilization exercise protocol and treadmill walking can bring early effective changes on balance in a patient with cerebellar ataxic cerebral palsy.

One-time low concentration betadine eye wash: A novel treatment for epidemic viral conjunctivitis for accelerated recovery.

This study aims to renew the management of viral epidemic conjunctivitis by introducing a one-time, low-concentration ocular surface povidone-iodine (LOS-pI) wash. Among the 3,002 patients screened, 1,328 with acute conjunctivitis were categorized into two groups. Group A (664 patients) underwent a 1% betadine wash in addition to the standard treatment protocol (Eye Lubricant + Moxifloxacin 0.5% eyedrops), while Group B (664 patients) followed the standard protocol alone. In cases of membranous conjunctivitis, manual membrane removal was performed. Treatment responses were observed daily for three days, followed by weekly assessments for two additional weeks. Co-infection of adenovirus with enterovirus was found to be the main cause, often accompanied by staphylococcal superinfection. Group A showed complete resolution of conjunctival inflammation, with a remarkable 76.05% of patients experiencing improvement within an average of 2.6±0.51 days, in contrast to Group B's average of 7.5±1.1 days (p <0.05). Additionally, 13% of Group B patients with recalcitrant conjunctivitis significantly recovered following the 1% betadine wash. Complications (subconjunctival hemorrhage: 34.04%, superficial punctate keratitis: 6.02%) were more prevalent in Group B. The authors hypothesized that a single wash with betadine is sufficient to reduce disease duration and prevent secondary infections and complications. The core strength of our study lies in its substantial sample size. To our knowledge, no similar previous research has been conducted, on such a larger scale. Viral conjunctivitis brings discomfort, work absenteeism, and financial burden. A single low-concentration betadine wash expedites recovery and reduces complications in acute infective conjunctivitis. This approach significantly enhances patient outcomes and alleviates the socioeconomic impact of the condition.

The Effect of Circuit Training and Plyometric Exercise on Agility and Core Strength in Karate Players

Since karate is one of the most well-known martial arts and the word "karate" means "empty hand" (kara = empty, te = hand), it refers to the practice of punches, kicks, and blocking moves without the use of weapons. So the purpose of the study to find dose agility and core strength can can change by after undergoing the certain exercise which are plyometric exercise and circuit training in the male and female plyers

The Effect of 8 Weeks of Dynamic Neuromuscular Stabilization Training on Pain, Electromyography Activity of Lumbar Muscles, and Quality of Life in People with Chronic Low Back Pain

Objectives: To evaluate the effects of an 8-week DNS training program on pain, EMG activity, and quality of life in individuals with CLBP. Design: Semi-experimental study. Participants: Thirty male participants with non-specific CLBP, divided into DNS (n=15) and control (n=15) groups. Main Outcome Measures: Pain levels (Quebec Back Pain Disability Scale), lumbar muscle EMG activity (MegaWin EMG device), and quality of life (SF-36 questionnaire). Results: The DNS group showed significant pain reduction (P=0.00), increased EMG activity in rectus abdominis (P=0.000), erector spinae (P=0.002), and gluteus maximus (P=0.002), and improved quality of life (P=0.02). Conclusions: DNS exercises significantly reduce pain, enhance muscle activity, and improve quality of life in CLBP patients

Abdominal Drawing-In Maneuver is Less Effective for Core Stability During High Load Tasks: A Systematic Review

Context: The abdominal drawing-in maneuver (ADIM) is a technique commonly used to activate deep core muscles for the prevention and rehabilitation of low back pain. However, its benefits during high-load tasks (HLT) are unclear. Objectives: The primary objective of this article is to review the literature to determine whether the use of ADIM enhances core stabilization during HLT. Additionally, we will examine if other factors, beyond load, could influence the effectiveness of this activation maneuver. Methods: A search was conducted using PubMed databases for studies that compared interventions using ADIM to those without ADIM. The literature search spanned from January 1981 to March 2024. Only studies that included kinematic assessments were selected. Results: The search yielded 359 studies, of which 24 were included in the final analysis. Task load was analyzed based on Mottram and Comerford's criteria, alongside other approaches such as the source of the perturbation applied to the subject and body position. In conditions using ADIM, better performance was observed in only 16.66% of interventions with HLT, whereas other conditions (OC) without ADIM performed better in 83.33% of interventions using HLT. When core stability was tested against external perturbations, ADIM was less effective in all scenarios. In lying positions, ADIM performed better in 4 tasks, while OC performed better in 2. In upright positions, ADIM was more effective in 7 tasks, while OC performed better in 6. Conclusions: The findings suggest that ADIM should not be used if the goal is to train core stability and strength during HLT. Abdominal drawing-in maneuver was less effective for stabilizing the core during tasks involving external perturbations, and its use was also less effective in upright positions.

Incidence and biomechanical risk factors for running-related injuries: A prospective cohort study

BackgroundInjuries among runners is significant, yet the contributing risk factors remain elusive. The objective of this study was to examined the incidence and biomechanical elements associated with running-related injuries. MethodsA 24-week prospective study was carried out. Injury incidence was calculated per 1000 h of running, with participants completing bi-monthly online questionnaires. Biomechanical risk factors, encompassing plantar pressure, muscle strength of hip and knee muscles, core stability, dorsiflexion, passive hip internal rotation, lower extremity length, Q-angle, and shank-forefoot alignment, were assessed at baseline. Logistic regression was used to investigate the relationship between injury incidence and these biomechanical risk factors. ResultsNinety-eight runners participated in the study. Injury incidence was 8.1 per 1000 h of running, with 41 runners experiencing musculoskeletal injuries during the follow-up period. The knee emerged as the most commonly affected joint, constituting 28.4 % of injuries. The Odds Ratio for hip external rotator muscle strength was .84 (95 % Confidence Interval = .71 - .99). ConclusionGreater force during hip external rotation was identified as a protective factor against running injuries. These findings bear significance for the formulation and implementation of preventive strategies.

Fabrication of stable hydrogel microspheres with hydrophobic shell using water-in-water (W/W) Pickering emulsion template

Hydrogel microspheres are promising for food applications. The water-in-oil (W/O) emulsion template is commonly used to prepare the hydrogel microspheres. However, this method often involves synthetic surfactants and toxic organic solvents to remove the oil phase. The swelling problem of the resultant microspheres is another obstacle. In this study the water-in-water (W/W) emulsion template of gelatin-in-dextran was used to prepare the hydrogel microspheres, without the addition of surfactants, toxic reagents and high energy input. To prevent swelling, zein particles modified with alginate were served as a hydrophobic shell of the gelatin core. The formation evolution of these core–shell microspheres and its relevant factors including phase behavior of the immiscible gelatin/dextran, the binding of zein/alginate and the addition of the modified zein particles were investigated. It was found that small amount of alginate could induce zein particles to absorb on the gelatin surface, whereas the excess led to absorption competition. When using 0.6 wt% particles with zein/alginate ratio of 1:0.5, the ideal core–shell microspheres which were fully covered by the particles and with a self-supporting architecture in uniform size (18.8 ± 0.1 μm) and spherical shape were obtained. These microspheres showed remarkable stability under the conditions of heat treatment, varied pHs and salt concentrations and long-term storage either in refrigerator or room environment. Their sizes were easily manipulated by adjusting the concentration and molar mass of the biopolymers. It is believed that the desired stability and tunable sizes of these edible core–shell microspheres could contribute the development of their applications in foods.

Validation of a laser visual feedback and core stability exercise programme to improve lateropulsion reduction and pushing intensity in stroke patients with pusher syndrome: A Delphi study.

The patient with pusher syndrome (PS) is characterized by showing postural control alterations due to a lack of perception of his own body in the space. It appears when the patient actively pushes with his unaffected limbs towards the injured side, reacting with resistance to passive straightening towards the midline. Between 10% and 50% of strokes present PS. Nowadays, there is no clearly defined treatment for PS. To design and validate an exercise program using visual feedback and specific core stability exercises (FeViCoS) for the treatment of patients with PS. Validation was conducted by expert consensus using the Delphi method. Thirteen neurorehabilitation experts participated in the process. An online questionnaire with 18 Likert-type questions was used to evaluate the designed program. Consensus was considered reached if there was convergence between the quartile 1 and 3 values (RIQ=Q1-Q3) or if the relative interquartile range (RIR) was less than 20%. The degree of agreement between experts was measured by calculating the Fleiss' kappa coefficient. A total of 2 rounds were required to achieve 97.44% consensus with 100% participation. The RIR was less than or equal to 20% for all questions. The Fleiss' kappa index (0.831) showed that the degree of agreement between experts was excellent. Neurorehabilitation experts considered FeViCoS valid for the therapeutic approach to patients with PS. Expert consensus suggests a novel strategy in physical therapy clinical practice to improve balance and postural orientation in patients with subacute stroke and PS.

Learning Curve Analysis for Robotic-assisted Harvest of Deep Inferior Epigastric Perforator Flap

Summary: The deep inferior epigastric perforator (DIEP) flap is the preferred method for autologous breast reconstruction after mastectomy, but risks the development of hernia, bulge, and decreased core strength. Robotic harvest of DIEP vessels may limit abdominal wall morbidity through smaller fascial incisions and preservation of motor nerves. This study shows the expected learning curve (LC) for robotic harvest and compares the LC between a general surgeon (GS) and a plastic surgeon (PS). A retrospective cohort study was performed for patients who underwent bilateral robotic DIEP flap harvest from October 2021 to September 2022. We evaluated robotic pedicle dissection time (DT) and compared the times between GS and PS. We calculated LC for each surgeon using the cumulative sum (CUSUM) method, . The LC was identified as the peak of the CUSUM graph. Forty-four flap dissections were recorded during the collection period: 27 by the PS and 17 by the GS. There was no significant difference in DT between the GS and the PS (P = 0.366), and both surgeons saw a decrease in DT over time. Using the CUSUM method, we see the peak of the plot at patient 9 for the PS and the peak of the plot at patient 5 for the GS, after which cumulative DT decreased. As robotic harvest of DIEP flaps becomes accepted, plastic surgeons who wish to incorporate it into their practice may achieve proficiency in their DT within 10 flap harvests and a similar DT compared with robotic-trained GSs.

USING THE BACKFIX METHOD TO REHABILITATE ATHLETES’ INJURY IN TRIPLE JUMP – A CASE STUDY

The triple jump is a complex athletic event where performance relies on a combination of speed, strength, and advanced technique in executing the three phases that form the biomechanics of the event. Due to the specific forces exerted on the athlete's musculoskeletal system, along with potential weaknesses in physical training, athletes are at risk of injury. This case study presents the original approach used to rehabilitate and prevent new injuries usually experienced by the Romanian athlete G.R.C., a 25-year-old European junior vice-champion in the triple jump. He sought treatment at the MediSport SRL clinic for multiple chronic and acute injuries that were limiting his performance. Comprehensive clinical and functional evaluations revealed all these limitations, prompting an integrated approach to his rehabilitation and training program. After the kinesitherapy program consisting of 18 sessions focused on functional musculoskeletal balancing using an electronic dynamometer, a key component of the BackFix system and method, important improvements were observed in core stability, static balance, and posture. Additionally, muscle strength in the previously deficient areas increased, pain disappeared in all affected regions, and recovery time after competitive effort improved, laying the foundation for optimal performance in the 2024 summer season. The successful use of the BackFix method leads us to recommend it as an alternative to other traditional training and recovery methods, while also encouraging further research into its application in the triple jump and other sports branches.

Free-Weight Resistance Training Enhances Core Muscle Strength but Does Not Translate to Improved Athletic Performance in Adolescent Canoe/Kayak Athletes.

While previous evidence has shown that using free weights for resistance training is a more practical approach to enhancing strength, there is a relatively low prevalence of free-weight resistance training among adolescent kayak/canoe athletes. Therefore, this study aims to assess the impact of free-weight resistance training on body composition and various performance factors among adolescent canoe/kayak athletes. Twenty-seven young sprint kayakers and canoeists (14 ± 1 years; 164 ± 7 cm; 56 ± 8 kg) completed this study. Following baseline assessments, athletes were randomly divided into two training groups: the free-weight resistance training group (FW) or the control group (C). The FW group underwent free-weight resistance training sessions twice weekly for 24 weeks. The C group maintained their regular bodyweight training sessions during the same timeframe. All participants performed both the pre- and post-training assessments for the following dependent variables: body composition, upper-body power, upper-body isometric muscle strength, isometric mid-thigh pull, core strength, countermovement jump, balance, anaerobic ability, and aerobic performance. After 24 weeks of training, the free-weight resistance training group exhibited a significant increase in body weight (from 56 ± 5 kg to 58 ± 4 kg, p < 0.05) and improvements in the number of straight leg raise repetitions (from 23 ± 6 to 26 ± 4, p < 0.05) compared to the control group. However, the two groups observed no significant differences between upper-body isometric muscle strength, power, balance, and anaerobic/aerobic performance. A 24-week training duration might be insufficient for novice participants in resistance training. Future research should consider incorporating an adaptation period or a learning phase for movements before training, thereby enhancing the efficacy of free-weight resistance training in increasing strength.

Effectiveness of Mulligan Mobilization Technique and Core Stabilization Exercises in Female Patients With Knee Osteoarthritis: A Randomized Controlled Single-Blind Study

ObjectivesThe aim of this study was to compare the effectiveness of the Mulligan mobilization (MM) technique and Core stabilization (CS) exercises added to the conventional physiotherapy (CP) program in female patients with knee osteoarthritis (KOA). MethodsThe study included 42 female patients diagnosed with bilateral KOA. Participants were randomly divided into 3 groups as CP group (mean age: 57.79 ± 7.43 years), MM group (mean age: 56.14 ± 6.95 years), and CS group (mean age: 54.36 ± 6.56 years). They were divided into 3 groups and treated 3 sessions per week for 4 weeks. Pain intensity, range of motion (ROM), and muscle strength were evaluated with visual analog scale, universal goniometer, and handheld dynamometer, respectively. Balance, aerobic capacity, and functional level were assessed with 30-second sit-to-stand test, 6-minute walk test, and Western Ontario and McMaster Universities Osteoarthritis Index. The quality of life of the participants was evaluated with the Nottingham Health Profile. ResultsAfter treatment, significant improvement was achieved in the all parameters evaluated in the groups (P < .05). CS was found to be more effective in reducing resting pain intensity than the other two treatment approaches (P = .001). It was observed that MM technique increased knee flexion ROM more (P = .001). There was no superiority of MM group and CS group over each other in balance, functional level, aerobic capacity, and quality of life assessments (P > .05). ConclusionOur study showed that CP, MM technique, and CS exercises were effective treatment approaches in the management of KOA in female patients. Results revealed that the MM technique was more effective in increasing knee flexion ROM, and the CS exercise was more effective in reducing resting pain intensity in female patients with KOA.

The Comparison of Scar Mobilization Techniques with and without Core Stability Exercises on Scar Tissue Mobility and Lumbopelvic Pain

Abdominal adhesions and lumbopelvic pain can occur after a caesarean section. Many treatment approaches, such as injections, massage, surgical release, soft tissue release, strengthening, stretching and core stability exercises are available for abdominal scars. Physiotherapy treatments are considered safer and more convenient. The study aims to compare the effects of scar mobilization techniques with and without core stability exercises on scar tissue mobility and lumbopelvic pain. The study was a randomized clinical trial conducted at the Rafiqa Hospital and Fatima Hospital, Sargodha, Pakistan. A sample of 30 participants was allocated in Group A and B. Group A received scar mobilization and core stability exercises, while Group B received only scar mobilization, with both groups undergoing 3 sessions per week for total three weeks. The groups were assessed at baseline after the 5th and 9th sessions, using Oswestry Low Back Pain Disability Questionnaire (ODI), Numeric Pain Rating Scale (NPRS), Manual Scar Mobility Testing (MSMT), and Vancouver Scar Scale (VSS). Moreover, the data were analyzed using SPSS 25. The mean age of participants was 27.22 ± 4.21, and their body mass index was 27.10 ± 3.53. Both groups showed significant differences within the subject’s scores of disability, pain and scar mobility (p&lt;0.05). Between-group comparison of both groups at post-treatment II showed considerable improvement in pain scores (NPRS score, p&lt;0.05). Whereas non-significant results were in other outcome measures (disability and scar mobility p&gt;0.05) in post-treatment II. Scar mobilization techniques with core stability exercises were more effective than scar mobilization techniques alone in the conservative treatment of females with lumbopelvic and scar pain after caesarean section.