Fingertip-floor Distance Research Articles

IMMEDIATE EFFECTS OF POST FACILITATION STRETCH TECHNIQUE ON STRAIGHT LEG RAISE WITH/WITHOUT THORACO-LUMBER DIRECT MYOFACIAL RELEASE IN NON-SYMPTOMATIC ADULTS

Background: Hamstring tightness is a condition which if it is remaining untreated it could be related later on to the posture imbalance and movement restriction. There are many techniques to increase the elasticity of hamstrings. Post facilitation stretching (PFS) along with thoraco-lumbar direct myofascial release (MFR) technique is emerging as a novel therapy for improving hamstring muscle length. Objective: To determine the immediate effects of post facilitation stretching technique on SLR with/without thoraco-lumber direct myofascial release on straight leg raise among non-symptomatic adults. Methods: A randomized control trial (RCT) was conducted at FIMS College of rehabilitation Abbottabad Pakistan after approval from HOD. A total of n=24 non symptomatic adults were recruited through non-probability convenient sampling technique. The inclusion criteria were non symptomatic adults with tight hamstrings, age group 18 to 40 years, normal healthy adults, both gender groups, SLR (passive) of 80° degree or less, finger floor distance of 5 cm or more. The participants were than randomly divided into two control group (n=12) and experimental group (n=12). The post facilitation stretch technique was applied in both groups, but experimental group additionally received thoraco-lumber direct myofascial release technique as well. To assess the total mobility of the lumbo-pelvic region and hamstring elasticity fingertip to floor distance was measured and straight leg raise test with the help of goniometer. The data was collected at the baseline and immediately after session. Results: The mean age of the study participant was 23.41±2.31 years. The pre-post analysis showed that right and left straight leg raise (SLR) as well as fingertip floor distance were significantly (p<0.001) improved immediately after the intervention with large effect size. When compared both groups immediately after the intervention, experimental group which received myofascial release in addition post facilitation stretch showed more significant improvement with large effect size in right & left SLR and fingertip floor distance (p<0.001) as compared to control group where only post facilitation stretch technique was applied. Conclusions: The present study concluded that post facilitation stretch along with the thoracolumbar direct myofascial release technique significantly improve hamstrings flexibility. The efficacy of thoracolumbar direct myofascial release has contributed in increasing SLR and Finger Floor Distance tests parameters. Keywords: hamstring, muscle length, myofascial release, muscle energy technique, post facilitation stretch, stretching exercises.

Physical and rehabilitation medicine and health sport network in Champagne Region: A descriptive study over 1 year

A major aim of hospitalization programs in physical and rehabilitation medicine (PRM) department is to obtain long term adherence to exercise into daily life for maintaining the effects. The prevention of most chronical diseases is made by physical activities, education, food balance and drugs. We describe the follow-up of chronically ill patients after hospital discharge during 1 year. It is a descriptive study of patients rehabilitated in tertiary PRM hospital department for chronical diseases from 2013 to 2015 who kept a physical activity through a regional health sport system after hospital discharge. The 6 minutes walk test, 45 s chair-stand test, fingertip-floor distance, Ricci and Gagnon's questionnaires were collected at the beginning and after 1 year. We followed-up 15 patients mostly in Reims. The average age was 49.8 ± 11.5 years (min 23, max 65), 27% of men. The chronical diseases were: multiple sclerosis ( n = 4), neuropathy ( n = 2), polyradiculonevritis ( n = 2), spinal cord injury ( n = 2), polyarthritis ( n = 1), Ehlers-Danlos syndrome ( n = 1), chronic obstructive bronchopneumopathy ( n = 1), chronic back pain ( n = 1), head injury with hemiparesis ( n = 1). The initial and final 6 mintutes walk tests are respectively 441 ± 109 and 466 ± 117 meters ( P = 0.09), the 45 s chair-stand tests 18 ± 3.5 and 20 ± 5.3 repetitions ( P = 0.05), the fingertip-floor tests 3 ± 11 and 1 ± 10 cm ( P = 0.005), the Ricci and Gagnon questionnaires 23 ± 4.45 and 31 ± 5.13 ( P = 0.009). The physical capacities improved by rehabilitation programs can be maintained with adapted physical activities in regional sport network systems. The coordination of these networks, the formation of sport teachers, the risk management measures made by physiatrists must be considered. Moreover, there is a social interest in addition to physical improvement.

Chronic low back pain among French healthcare workers and prognostic factors of return to work (RTW): a non-randomized controlled trial.

BackgroundMany factors influence the return to work of workers with chronic low back pain (CLBP). They have been said to vary according to socio-professional group. This study first aimed to compare prognostic factors influencing the return to work of CLBP healthcare workers (HCWs) and other workers (non-HCWs) after rehabilitation coupled with an occupational intervention. The second objective was to improve the evolution of indicators such as clinical examination, psychosocial impact and pain impact.MethodsBetween 2007 and 2012, a cohort of 217 CLBP workers (54.8 %-women; mean age = 41.3 ± 9.5 years, 118 non-HCWs; 99 HCWs mainly from the public sector) was included in an ambulatory rehabilitation program (standard physiotherapy or intensive network physiotherapy) coupled with an occupational intervention. Workers completed a questionnaire and had a clinical examination at baseline and after 24 months’ follow up. Physical, social and occupational data was collected at the same time. Statistical analyses were performed to evaluate prognostic factors for return to work and compare the two worker populations.ResultsThere was no difference between groups for the rate of OP (occupational physician) intervention or type of physiotherapy. 77.3 % of workers returned to work after 2 years following inclusion. To be an HCW (OR 0.1; 95 % CI [0.03–0.34]), to have less than 112 sick- leave days (OR 1.00; 95 % CI [0.93–1.00]), a small fingertip-floor distance (OR 0.96; 95 % CI [0.93–0.99]), a low anxiety/depression score (OR 0.97; 95 % CI [0.95–1.00]), a low impact of CLBP on daily life (OR 0.96; 95 % CI [0.93–1.00]), and on quality of life (OR 0.98; 95 % CI [0.95–1.00]) at baseline were statistically associated with return to work after 2 years of follow up. Only the profession (workplace) was statistically associated with return to work after 2 years of follow up using multivariate analysis.ConclusionTo our knowledge, this is the first cohort study concerning predictive factors of RTW among CLBP workers after 2 years of follow up. Interventions in the work environment did not seem to predict job retention significantly. But only 50 % of the employees in both groups (HCW and non-HCW) had one intervention at their workplace after 2 years. This study underlined the fact that the type of physiotherapy with a well-trained physiotherapist used to take care of CLBP could not impact on the RTW forecast. To develop these initial results, it might be interesting to study the comparison between private and public sectors and to randomize the physiotherapeutic intervention.

The benefits of elective spinal implant removal: a retrospective study of 137 patients.

While spinal instrumentations are becoming more common, the advantages of elective spinal implant removal remain ambiguous. We hypothesized that elective implant removal of the posterior spine is beneficial. A retrospective study evaluated 137 consecutive trauma patients with elective implant removal of the posterior spine. If additional cages were present, they were not removed. Primary outcomes were the change in pre- and post-operative pain, fingertip-floor distance (FFD), and Cobb angles. Some secondary outcomes consisted of complications, work disability, and pelvic incidence (PI). Different stabilization approaches and cage sizes were compared. The presence and amount of pain as well as the FFD showed significant improvement. There was no loss of reduction. Delayed wound healing was observed in 9%, but only 3% needed revision. Thoracic fascial dehiscences were seen only in patients (9%) that had stand-alone posterior surgery. Larger cages were associated with increased work disability. An increased PI was associated with less post-operative pain and decreased FFD. In this study, trauma patients benefited from elective implant removal of the posterior spine due to lower presence and level of pain, improved function and low revision rates; irrespective of an initial combined or stand-alone posterior approach or varying cage sizes. However, stand-alone posterior instrumentation may be accompanied by increased rates of fascial dehiscence surgeries and larger cages may lead to increased work disability. Increased PI may be associated with less pain after spinal implant removal.

Has a Mono- or Bisegmental Lumbar Spinal Fusion Surgery an Influence on Self-Assessed Quality of Life, Trunk Range of Motion, and Gait Performance?

This investigation prospectively compared self-assessed quality of life and biomechanical measures of physical function before and after spinal fusion surgery in 26 adult patients with symptomatic lumbar degenerative disease. The objective was to demonstrate that (1) due to a reduction of low back pain, quality of life as well as gait parameters would improve after a spinal fusion surgery and (2) gait performance is more similar to that observed in healthy controls at the same age, whereas trunk range of motion remains unchanged after surgery. Current outcome evaluations of spinal fusion surgery are based on radiological changes and self-report questionnaires. However, these traditional measures do not sufficiently assess the functionality. Twenty-six patients with a mean age of 59.3 (SD: 10.1) years and 20 healthy subjects at the same age were evaluated. Before and approximately 6 months after a mono- or bisegmental spinal fusion surgery, patients completed self-report questionnaires and biomechanical assessments of gait analysis and trunk range of motion in the 3 principal planes of the body. Results indicated an improvement in quality of life as well as an increased pain-free walking distance, walking speed, step length, and maximum hip extension during the stance phase of gait. Anterior pelvis and thorax tilt were significantly reduced after the surgery without significant differences compared with the control group. Regarding the trunk range of motion, we observed a decrease in maximum forward flexion and an increase in the fingertip-floor distance after surgery. The study results show that lumbar spinal fusion is a useful procedure to improve patient's quality of life and gait performance. Although we performed only mono- and 2-level fusions, the sagittal alignment of the pelvis and thorax during walking was normalized. Clinical gait analysis contributes to the advancement of our knowledge regarding the functional changes after a spinal fusion surgery. 2.

THE BALNEOTHERAPY LINKS WITH SEAFARERS HEALTH IN RANDOMIZED CLINICAL TRIAL

Study objective: to evaluate the impact of new origin high salinity geothermal water for reinforcing the comprehensive health of seamen and explore the safety profile of water. Methods. 180 seamen were randomized into three groups: geothermal (65) which has got 108 g/l salinity geothermal water bath for 2 weeks daily five times a week, music group (50) which has received music therapy at home, 65 participants have got no treatment. Outcomes measures: systolic and diastolic blood pressure, heart and breathing rate, skin temperature, fingertip-floor distance, joint mobility failures, mood scale, VAS pain scale, 5-point Likert‘s well-being scale and cognitive failures questionnaire (CFQ). Safety was assessed for effects on the cardiopulmonary system and the side effects. The statistical analysis of the data was performed by using the SPSS21 software package. Results: after the 2 weeks in geothermal group reduced blood pressure, heart and breathing rate (p0.001); pain (p0.001), skin temperature (p0.05), improved spine (p 0.05) and joint mobility (p 0.001), general well-being (p0.001), mood (p0.001) and cognitive functions (p=0.001) were observed. In the music therapy group reduced breathing rate (p0.01), pain (p0.05) and improved general well-being (p0.01) were observed. Adverse events were rare in both groups. No significant changes were observed in the control group. Conclusions: the balneotherapy using very high salinity geothermal waters has multiple health-enhancing effects and is safe for seamen.

Efeitos do alongamento na qualidade de vida e flexibilidade de mulheres jovens

Objetivo: Analisar o impacto do alongamento muscular sobre a qualidade de vida e flexibilidade de mulheres jovens. Métodos: Foram selecionadas 11 participantes, com baixos escores de qualidade de vida avaliada pelo SF-36, que realizaram um protocolo de alongamento muscular geral durante quatro semanas. A avaliação foi realizada antes, imediatamente após e um ano após o alongamento, utilizando o SF-36 e a medida da distância terceiro dedo-solo. Resultados: Houve diferença estatisticamente significante em quase todos os aspectos da qualidade de vida após um ano (p0,05), exceto no aspecto de capacidade funcional (p=0,20) e estado geral de saúde (p=0,08). Na medida da distância terceiro dedo-solo também se observou diferença estatística importante entre as três avaliações (p=0,02). Conclusão: Estes resultados sugerem que, após um período de tempo, os escores do SF-36 para avaliação da qualidade de vida diminuem, mas não retornam aos iniciais. Ainda, pode-se observar diminuição da amplitude de movimento após um ano.

Operative Behandlung traumatischer Frakturen der Brust- und Lendenwirbelsäule

Operative Behandlung traumatischer Frakturen der Brust- und Lendenwirbelsäule

Fear-avoidance beliefs and distress in relation to disability in acute and chronic low back pain

Patients with chronic low back pain (LBP) frequently demonstrate high scores for fear-avoidance beliefs and distress. We need better knowledge about fear-avoidance beliefs and distress in early stages of LBP. The objectives of this study were to compare the level of fear-avoidance beliefs and distress in patients with acute LBP to patients with chronic LBP, and to assess the relationship of fear-avoidance beliefs and distress to disability in acute and chronic LBP. Two different back pain groups including 123 patients with acute and 233 patients with chronic LBP were studied. Main outcome measures were Oswestry Disability Index and work loss. The scores for fear-avoidance beliefs and distress in patients with acute LBP were significantly lower than among patients with chronic LBP. The results of the multivariate regression analyses, adjusting for sociodemographic, pain and clinical variables, demonstrated that whereas fear-avoidance beliefs for physical activity and distress were significantly associated with the Oswestry Disability Index, fear-avoidance beliefs for work and distress were significantly associated with work loss. The associations showed the same pattern in acute and chronic LBP. In addition, several of the pain and clinical variables were significantly associated with the Oswestry Disability Index and fingertip–floor distance was associated with work loss. In conclusion, fear-avoidance beliefs and distress influence pain-related disability both in early acute and long-term chronic LBP. The results replicate previous reports on the association between pain experience, fear-avoidance beliefs, distress, and disability in chronic LBP, and extend the findings to patients at an early stage of acute LBP.

Continuous low-level heatwrap therapy for treating acute nonspecific low back pain

Nadler SF, Steiner DJ, Erasala GN, Hengehold DA, Abeln SB, Weingand KW. Continuous low-level heatwrap therapy for treating acute nonspecific low back pain. Arch Phys Med Rehabil 2003;84:329-34. Objective: To evaluate the efficacy of 8 hours of continuous low-level heatwrap therapy for the treatment of acute nonspecific low back pain (LBP). Design: Prospective, randomized, parallel, single-blind (investigator), placebo-controlled, multicenter clinical trial. Setting: Five community-based research facilities. Participants: Two-hundred nineteen subjects, aged 18 to 55 years, with acute nonspecific LBP. Intervention: Subjects were stratified by baseline pain intensity and gender and randomized to one of the following groups: evaluation of efficacy (heatwrap, n=95; oral placebo, n=96) and blinding (oral ibuprofen, n=12; unheated back, wrap n=16). All treatments were administered for 3 consecutive days with 2 days of follow-up. Main Outcome Measures: Primary: day 1 mean pain relief (0- to 5-point verbal response scale). Secondary: muscle stiffness (101-point numeric rating scale), lateral trunk flexibility (fingertip-floor distance), and Roland-Morris Disability Questionnaire over 3 days of treatment and 2 days of follow-up. Results: Heatwrap therapy was shown to provide significant therapeutic benefits when compared with placebo during both the treatment and follow-up period. On day 1, the heatwrap group had greater pain relief (1.76[plusmn].10 vs 1.05[plusmn].11, P [lt ].001), less muscle stiffness (43.1[plusmn]1.21 vs 47.6[plusmn]1.21, P=.008), and increased flexibility (18.6[plusmn].44cm vs 16.5[plusmn].45cm, P=.001) compared with placebo. Disability was also reduced in the heatwrap group (5.3 vs 7.4, P=.0002). Adverse events were mild and infrequent. Conclusion: Continuous low-level heatwrap therapy was shown to be effective for the treatment of acute, nonspecific LBP. [copy ] 2003 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Étude de faisabilité dˈun programme dˈévaluation de lˈécole du dos

OBJECTIVES: Testing the feasability of a back school assessment programme in two populations of people suffering with chronic low back pain. MATERIAL: Twenty-nine patients were randomly included in a chronic low back pain assessment programme (15 patients waiting for back school and 14 patients after back school). METHODS: The programme was made of the measure of the age, the sex, the body mass index, the pain (VAS, St Antoine Hospitalˈs Pain Questionnaire - SAPQ), the anxiety, the depression, the RIII nociceptive reflex, the fingertip-floor distance, the strength of the flexors and of the extensors of the lumbar spine (CybexR 6000 isocinetic dynamometer), the lumbar function (EIFEL, Dougados), the Dallas self-questionnaire. The Back School Education programme was made of five sessions (information, ergonomies, extension exercises). RESULTS: Comparing the two populations we didnˈt observe significant differences concerning the age, the body mass index, the anxiety and depression levels, the pain (VAS, SAPA, RIII nociceptive reflex), the lumbar stiffness, the lumbar disability, the quality of life; the patients who had achieved back school had a peak torque of the flexors and a ratio flexors/extensors significantly lower. Comparing men and women we observed significant differences in the SAPQ and the musclesˈstrength. The SAPQ was correlated with the depression and anxiety levels, the lumbar disability, the peak torque of the flexors. The VAS was correlated with the age, the lumbar stiffness, the depression level, the peak torque of the flexors. The RIII nociceptive reflex was correlated with the ratio flexors/extensors. CONCLUSION: This study present some biases but this objective assessment of chronic low back pain appeared as feasible. The pain must be investigated in term of intensity, expression, alleviation. The impairment of the flexors muscles in women and after back school has to be confirmed. The different tests are relevant to determinate the efficiency of the back school programmes.

Toe-touch test. A measure of its validity.

The primary purpose of this study was to investigate the relationships between the vertical fingertip-floor distance (FFD) and the hip and vertebral components of trunk flexion during the toe-touch test. Measurements were taken from lateral photographs of each subject standing in the erect and maximally flexed positions. The subjects were healthy young men (n = 16) and women (n = 17). The mean FFD was 3 cm below floor level (-3 cm) with a standard deviation of 8 cm. Reliability of this measure was indicated by a test-retest correlation coefficient of .97. The FFD was a measure of both trunk (r = -.85) and hip flexion (r = -.79), but not of vertebral flexion (r = .10). At maximum trunk flexion, therefore, FFD is mainly a measure of the extensibility of the hamstring muscles that limit hip flexion when the knees remain extended. The toe-touch test was determined to be unsuitable for monitoring the effect of a treatment regimen to improve vertebral mobility because the partial correlation coefficient between vertebral flexion and FFD was -.64 (p less than .01), with the effect of hip flexion held constant. Although this correlation is significant, it means that less than half of the variation in FFD can be explained by changes in vertebral mobility. For this group of young adults, no significant correlations existed between the FFD and limb length and abdominal girth at maximum trunk flexion.

Trunk strength, back muscle endurance and low-back trouble : Nicolaisen T, Jørgensen K. Scand J Rehab Med 1985: 17: 121–127

The strength and endurance of the trunk muscles was studied in relation to the extent of earlier low-back trouble (LBT) in a homogeneous, and occupationally active group. Twenty-four female and 53 male postmen with an occupational seniority of more than 2 years took part in the investigation. The cumulative lifetime prevalence, the one-year and the point prevalence of LBT were 67%, 62%, and 4% in females and 55%, 52%, and 0% in males. The rates are higher than in a representative Danish population 40 years old. Anthropometrical measurements and isometric strength (MVC) in trunk flexors and extensors were recorded. The flexibility of the spine, hip and knee joints, the fingertip-floor distance, and the restricted extension of the knee were evaluated. The isometric endurance in the trunk extensors was measured by two methods: 1) prone with the unsupported trunk in a horizontal position and the legs and hips fixated to a couch; and 2) standing, at 60% MVC. The participants were divided into three groups according to the extent of previous LBT, Group I: LBT to a degree that made work impossible, Group II: LBT experienced but not to such a degree that work was hindered, and Group III: LBT never experienced. The main findings were that the isometric endurance time of the trunk extensors was shorter in group I than in II and III, while the trunk muscle strength, anthropometrical measures and joint flexibility were independent of the persons' earlier low-back episodes. Differences in the distribution of ST and FT muscle fibres are suggested as an explanation of the endurance difference.(ABSTRACT TRUNCATED AT 250 WORDS)

The relation of spinal x-ray to low-back pain and physical activity among 60-year-old men and women.

X-ray findings in the thoracic and lumbar spine from 666 60-year-old men and women from a general population were related to anamnestic data and physical measurements. Disc degenerations were significantly more common among those with low-back pain (LBP) compared with those without. The corresponding calculated predictive values stressed the importance of taking precaution in interpreting the radiologic findings in the clinical situation. In several instances, there were significantly more positive (abnormal) radiologic findings among those with the heaviest work. Disc degeneration and scoliosis were particularly frequent in this regard. Absolute weight and body mass index was significantly higher in persons with spondylosis. The fingertip-floor distance was greater with higher frequency of spondylosis and L4 disc degeneration.

Trunk Strength, Back Muscle Endurance and Low-Back Trouble

The strength and endurance of the trunk muscles was studied in relation to the extent of earlier low-back trouble (LBT) in a homogeneous, and occupationally active group. Twenty-four female and 53 male postmen with an occupational seniority of more than 2 years took part in the investigation. The cumulative lifetime prevalence, the one-year and the point prevalence of LBT were 67%, 62%, and 4% in females and 55%, 52%, and 0% in males. The rates are higher than in a representative Danish population 40 years old. Anthropometrical measurements and isometric strength (MVC) in trunk flexors and extensors were recorded. The flexibility of the spine, hip and knee joints, the fingertip-floor distance, and the restricted extension of the knee were evaluated. The isometric endurance in the trunk extensors was measured by two methods: 1) prone with the unsupported trunk in a horizontal position and the legs and hips fixated to a couch; and 2) standing, at 60% MVC. The participants were divided into three groups according to the extent of previous LBT, Group I: LBT to a degree that made work impossible, Group II: LBT experienced but not to such a degree that work was hindered, and Group III: LBT never experienced. The main findings were that the isometric endurance time of the trunk extensors was shorter in group I than in II and III, while the trunk muscle strength, anthropometrical measures and joint flexibility were independent of the persons' earlier low-back episodes. Differences in the distribution of ST and FT muscle fibres are suggested as an explanation of the endurance difference.

Hand positions at possible critical points in the stoop-lift movement.

Abstract Erectores spinae exhibit a period of electrical silence during trunk flexion from the erect position and return extension. This study defined the positions of the fingertips relative to the floor at the end-points of the period of myoelectric silence. These points are termed ‘critical’ and were investigated in 15 male and 15 female young adults (x¯ = 21 years). The two critical points were similar in terms of the fingertip-floor distance (x¯ = 0·30m) and significantly different from the maximally flexed position (x¯ = − 0·04 m). There were no significant differences between the experimental groups in the flexed positions. Anthropometric differences had little effect on the measures. The fingertip-floor distance provided a good estimate of trunk and hip flexion but was a poor indicator of the degree of flexion of the thoracolumbar vertebral column.