Low Back Muscle Research Articles

Use of QR Codes for Promoting a Home-Based Therapeutic Exercise in Patients with Lumbar Disc Herniation and Lumbar Spinal Stenosis: A Prospective Randomized Study.

In the current study, we investigated the usefulness of the quick response (QR) code linked to the source of a video of home-based therapeutic exercise to promote home-based therapeutic exercise in patients with LDH and LSS. Forty patients with LDH and LSS were included in this study. The patients were randomly assigned to one of two groups: QR codes or control groups (20 patients per group). The QR code group received QR code stickers linked with a video that includes a demonstration on how to exercise for the back muscles. We instructed the patients to perform home-based therapeutic exercises three or more days a week. Patients in the control group were asked to perform the therapeutic exercise without providing a QR code to them. The primary outcome was the number of exercises per week. The scores of the numeric rating scale (NRS) and Oswestry disability index (ODI) were investigated as secondary outcomes. The patients in the QR code group exercised for the lower back muscles on average about two times a week, and 40% of the patients in the QR code group performed the exercise three or more days a week. However, almost no patients in the control group performed therapeutic exercises. Patients in the QR code group showed significantly lower ODI scores at the 1-month and 2-month follow-ups compared with the control group. In addition, the patients who exercised ≥3 times per week showed more improvement in the disability than those who exercised <3 times per week. The NRS scores for lower back pain and radicular leg pain were not significantly different between the QR code and control groups. We found that QR codes can be useful for encouraging patients with LDH or LSS to perform home-based therapeutic exercises.

Rehabilitación de piso pélvico: mensajes para médicos generales, especialistas y fisioterapeutas

Description: Pelvic floor therapy is a fundamental part of the rehabilitation process for patients. According to the American College of Physicians, techniques such as Kegel exercises are part of the rehabilitation of the pelvic floor, these are used in the non-pharmacological management of female urinary incontinence. in patients with multiple clinical conditions that affect the quality of life of patients. In this article, it is intended to review the importance of pelvic floor muscle therapy in urinary incontinence, pregnancy, and chronic pelvic pain, as well as to focus on the concept of therapy itself. Relevance: Pelvic floor muscle therapy is a low-cost tool, indicated in international guidelines and which, to date, has not reported large deleterious effects for people who practice it as a treatment for urinary incontinence. It is vitally important not only to emphasize the pelvic muscles, as stated in the text, since working the muscles in the center of the body, which includes the abdominal and lower back muscles, provide better results for people in this type of exercise. treatment. Conclusions: This review allows providing clear concepts and perspectives within the reach of medical personnel and physiotherapists in general.

NON-SPECIFIC BACK PAIN: DIAGNOSIS AND THERAPY FROM THE POSITION OF EVIDENTIAL MEDICINE (REVIEW OF LITERATURE)

The purpose of this publication is an attempt to systematize modern data based on the principles of evidence-based medicine (controlled randomized trials, systematic reviews, meta-analyses) in the field of diagnosis and treatment of non-specific low back pain. It is shown that non-specific lumbar pain is the predominant type of lumbar pain syndrome. The basis for the diagnosis of nonspecific low back pain should be a detailed history taking and a thorough physical and neurological examination. The value of imaging diagnostic methods is limited to patients with red flags. Both in the case of acute and chronic non-specific low back pain, the basis of therapy with well-proven effectiveness is patient education, manipulative techniques and special physical therapy. In the case of chronic non-specific low back pain, behavioral therapy is highly effective. Non-steroidal anti-inflammatory drugs have proven efficacy in relation to pain and functioning of the patient. In the case of chronic non-specific low back pain, muscle relaxants and antidepressants may be additionally prescribed.

Study on diagnosis and treatment of lumbar disc herniation and related factors based on dynamic electromyography

To analyze dynamic electromyography characteristics and related factors of lumbar back muscle activity in patients with lumbar disc herniation, and to clarify the clinical significance of dynamic electromyography in the diagnosis and treatment of patients with lumbar disc herniation(LDH). From September 2014 to March 2021, 40 patients with lumbar disc herniation(LDH group) were detected by surface electromyography telemeter. There were 14 males and 26 females, aged from 20 to 61 years old, with an average of(40.68±10.56) years old, the course of illness was from 1 to 120 months, with an average of (17.75±27.56) months. In addition, 12 normal people were recruited as the control group. There were 2 males and 10 females. The age ranged from 24 to 53 years old, with an average of(36.50±10.30) years old. All subjects were subjected to dynamic electromyographic tests of the subthoracic erector spinae, lumbar erector spinae, and multifidus muscles during static standing and trunk flexion and extension. Compare the EMG activity data (average EMG amplitude, median frequency, original EMG graph) of the tested muscles between patients with lumbar disc herniation and normal people, and analyze the correlation between the general data of patients with lumbar disc herniation and the tested muscle EMG data. When standing still, the average electromyographic amplitude of the erector spinal muscle of the right and left thoracic segments of the subjects in the LDH group increased compared with the control group, and the difference was significant(P<0.05). In the trunk flexion and extension, the average electromyographic amplitude of the right and left proximal thoracic erector spinae, the right left lumbar erector spinae, and the right left multifidus muscle of the subjects in the LDH group are all larger than the control group, and the difference was significant(P<0.05). In the trunk flexion and extension, the median frequencies of the right left proximal thoracic erector spinae、the right left lumbar erector spinae, and the right left multifidus muscle of the subjects in the LDH group were all larger than the normal control group, and the difference was significant (P<0.05). During trunk flexion and extension, the original electromyographic patterns of subjects in the LDH group were significantly different from those in the control group. During the maintenance of the maximum trunk flexion of the subjects in the LDH group, there was a high level of electromyographic activity of the lower back muscles, and the electromyographic static signals that should appear regularly in the original signal could not be distinguished. When the trunk was flexed and extended, had gender, age, weight and height of subjects in the LDH group were not significantly correlated with the average EMG amplitude and median frequency of bilateral proximal thoracic, lumbar erector spinae and bilateral multifidus muscles respectively(P>0.05). Patients with lumbar disc herniation have characteristic surface EMG changes in the back muscles that are different from those of normal people. These features can more objectively reflect the patient's muscle condition and can be an effective indicator for the diagnosis and treatment effect evaluation of patients with lumbar disc herniation. It can be seen that surface electromyography is not only a detection method, it can be considered in the routine diagnosis and treatment plan of LDH to guide clinical work.

LESÕES NO EXERCÍCIO AERÓBICO: CAUSAS E PREVENÇÃO

ABSTRACT Introduction: Professional aerobic exercises require high performance from exercisers. Injuries are common during their execution. Understanding the causal reasons is essential for prevention methods to reduce athletes’ injuries. Objective: Investigate the influential factors of ligament injuries caused by aerobic exercise. Methods: This paper analyzes the injuries caused by aerobic exercise through mathematical statistics. Time, course, degree of injury, location of the injury, cause, early treatment time, primary approach, treatment methods, recovery conditions, and speed in recovery time of sports injuries were investigated. Results: Injuries are mainly concentrated at the hip, knee, and ankle joint level; sprains are the first injuries, followed by muscle strains, lower back muscle contractures, kneecap deformities, and joint ligament injuries. The leading causes of injuries were poor warm-up, excessive load, technical errors, and fatigue. Conclusion: Various physiotherapy methods can improve the recovery rate from ligament injuries. This method can also improve sports ligament injuries’ prevention and treatment effects. Evidence Level II; Therapeutic Studies - Investigating the result.

Edukasi Self-Care Management Dan Positioning Untuk Mengatasi Nyeri Punggung Bawah Pada Pembatik Di Kampung Batik Laweyan

Low back pain is a complaint in the form of pain or discomfort felt in the lower back and some spread to the legs, both right and left legs. Low back pain is often complained of by workers who sit a lot (sedentary jobs) such as batik craftsmen. Batik craftsmen or batik artisans are jobs that are carried out in a monotonous position, namely mostly sitting so that many complain of lower back pain. Sitting for long periods of time can cause tension in the lower back muscles. So that this tense muscle over time can cause complaints in the form of pain. The purpose of this activity is to provide education to the batik community about how to independently treat low back pain and the correct position when working as a batik maker. The target of this activity is batik in the village of Batik Laweyan, namely the Teko batik factory and Mahkota batik. The method used in this program is that students make observations or observations directly in the field, conduct dialogues and interviews using a screening form to 20 batik craftsmen. The results obtained are. The average batik maker in Batik Laweyan village complains of lower back pain. The conclusion of this activity is that the monotonous work position factor is very influential on lower back pain, especially those who work as batikmakers

Reducing Lower Back Pain Using the Muscle Energy Technique Versus Transcutaneous Electrical Nerve Stimulation

Working from home for a long time during the Covid-19 pandemic led to many complaints of musculoskeletal disorders, such as lower back pain. This is caused by stress or spasm in the back muscles which makes the stability of the abdominal and lower back muscles decrease. Treatments include the muscle energy technique (MET) and transcutaneous electrical nerve stimulation (TENS). MET can reduce pain through the provision of post-isometric relaxation stimulation, stimulating the proprioception and neurophysiology, and causing a hypoalgesic effect in the lower back area, while TENS blocks pain-conducting nerves. Studies have not yet determined conclusively which treatment is most effective. In this literature review, relevant articles published from 2015-2020 were found by searching in Google Scholar and PubMed. The keywords used included low back pain, muscle energy technique and transcutaneous electrical nerve stimulation. The population, intervention, comparison group, outcome and study design were considered in the selection of the articles. There were 6 journal articles that met the research criteria, namely 3 that examined the MET intervention and 3 for the TENS intervention. The results showed that MET with a dose of 3-5x/session can reduce pain after the second day, while TENS, when placed locally, can take roughly a month to reduce lower back pain. The findings showed that MET is more effective in reducing lower back pain than TENS.&#x0D; Keywords: low back pain, muscle energy technique, transcutaneous electrical nerve stimulation

Spatiotemporal characteristics of lower back muscle fatigue during a ten minutes endurance test at 50% upper body weight in healthy inactive, endurance, and strength trained subjects.

In modern developed societies, heavy physical demands are decreasing and getting replaced by longer periods of static, low-exertion activities such as sitting or standing. To counteract this lack of physical activity, more and more people are engaging in physical activity through exercise and training. Virtually opposite training modalities are endurance and strength. We asked if back muscle endurance capacity is influenced by training mode. 38 healthy male subjects (age range 19–31 years, mean age 22.6 years) were investigated: sedentary (Control, n = 12), endurance trained (ET, n = 13), and strength trained participants (ST, n = 13). They underwent a ten-minutes isometric extension task at 50% of their upper body weight. Surface EMG was measured in the low-back region utilizing quadratic 4*4 monopolar electrode montages per side. Relative amplitude and mean frequency changes were analysed with respect to electrode position and group during the endurance task. Eight ST subjects failed to complete the endurance task. Relative amplitude and frequency changes were largest in the ST group, followed by Control and ET groups (amplitude: F 6.389, p 0.004, frequency: F 11.741, p<0.001). Further, independent of group largest amplitude increase was observed for the most upper and laterally positioned electrodes. Mean frequency changes showed no systematic spatial distribution pattern. Although, in the light of an aging population, strength training has its merits our results question the functional suitability of frequent and isolated high-impact strength training for everyday endurance requirements like doing the dishes. Fatigue related amplitude elevations are systematically distributed in the back region, showing least fatigue signs for the most caudal and medial, i.e. the lumbar paravertebral region.

Quality of life, vestibular discoordination and violation of the walking pattern of amateur athletes with long-term consequences of traumatic brain injury

Among the participants in the hostilities in the East of Ukraine, military personnel receive a brain contusion three times more often than other injuries. The main problem of closed craniocerebral injury is that complications appear after some time. The aim of the work was to investigate the consequences of traumatic brain injury accompanied by brain contusion in amateur athletes. All the tested athletes had the main neurological syndromes that limited their vital activity: vegetative disorders and discoordination of the vestibular genesis. Under observation were 12 men aged 25-42 years with long-term consequences of a closed craniocerebral injury in the late long-term period. The duration of the post-traumatic period is from six months. The cause of disability was wounds and contusions associated with military operations. In all patients, complications after TBI were a decrease in muscle strength in the lower extremities, impaired coordination and balance, and a walking pattern. According to the International Classification of Functioning, limitation of vital activity and health in subjects in the domain "Structure and functions of the body" was observed mono- or hemiparesis of the lower extremities. In the activity and participation domain, patients complained about being able to return to amateur sports. When assessing the quality of life on the VAS scale, a low level of quality of life was revealed. According to the Lovett manual muscle test, it was found that in the subjects in the late long-term period after injury, there is a decrease in muscle strength of both the anterior and posterior thigh and lower back muscle groups. The results of the Bohannon test showed an increased risk of falling due to imbalance. «Timed Up and Go» testing indicated a statistically significant decrease in vestibular coordination and gait pattern compared to the norm.

Structural, Functional and Neurochemical Cortical Brain Changes Associated with Chronic Low Back Pain.

Chronic low back pain (CLBP) is one of the most prevalent musculoskeletal disorders, being one of the leading contributors to disability worldwide and involving an important economic and social burden. Up to 90% of CLBP is non-specific (not associated with specific injuries), with a chronicity expectation estimated at 10%. Currently, motivational and emotional central circuits are being investigated due to their role in CLBP persistency and chronification. Therefore, this narrative review aimed to summarize the evidence regarding the cortical brain changes described for proposing novel multidisciplinary approaches. Novel advances in neuroimaging techniques demonstrated structural (e.g., decrease in the grey matter located at the dorsolateral prefrontal cortex), functional (e.g., connectivity impairments in those areas involved in pain processing), and neurochemical changes (e.g., decrease in cerebral metabolites). In addition, significant changes were found in the primary somatosensory and motor cortex, contributing to the alteration of low back muscles activation and function.

P16. Biomechanical assessments of the spine during a 2000M ergometer row test

<h3>BACKGROUND CONTEXT</h3> Ergometer rowing has gained popularity as a "low-impact" form of exercise. Lumbar spine injuries are the most common injury in rowers. Previous studies have shown ergometer training to be associated with an increased risk of injury. Muscular fatigue and spine range of motion may correlate to pain or injury in ergometer rowing. <h3>PURPOSE</h3> The purpose of the present study is to utilize 3D motion capture and electromyography (EMG) assessments to 1) evaluate how muscular activation relates to lumbar spine mechanics; 2) determine the impact of fatigue on back muscle activation and biomechanics. <h3>STUDY DESIGN/SETTING</h3> Prospective analysis. <h3>PATIENT SAMPLE</h3> Seventeen rowers (M=8, F=9) with a mean age of 38 ± 9.1 years and a VO2 max of 44.4 ± 7.8 ml·kg·min-1. <h3>OUTCOME MEASURES</h3> Pull force, kinematics and muscle activation were recorded at 200m, 600m, 1000m, 1400m and 1800m distances. Spine flexion (degrees) was investigated. <h3>METHODS</h3> Seventeen rowers (m=8, F=9; age=38±9.1 years, VO2max=44.4±7.8 ml·kg·min-1) participated and performed a 2000-meter row on an ergometer. Pull force, kinematics and muscle activation were recorded using a load cell, motion capture system and a wireless EMG, respectfully. Data was recorded at 200m, 600m, 1000m, 1400m and 1800m distances. Spine flexion was calculated at three points in the sagittal plane and labeled as upper-, mid- and lower-spine. A mixed-model ANOVA repeated on row distance and a Tukey's post-hoc test was used to compare biomechanical assessments. Type-I error was set at a=0.05. <h3>RESULTS</h3> Average time to complete the test was 8.4 ± 1.0 min. Trapezius and mid-spinal erector activation was maintained through the row. A steady decrease in mean and peak latissimus dorsi activation was observed with increasing distance (p < 0.05), paired with an increase in peak lumbar spinal erector activation (p < 0.05), indicating fatigue of the upper back musculature followed by compensatory reliance on low back muscles to maintain/increase force. Upper spinal flexion (min and max) increased by 1000m, indicating an increase in the overall state of flexion with progressing distance (p < 0.05). Mid-spinal flexion demonstrated increased min flexion (indicating reduced peak extension) beginning at 1400m (P < 0.05). Lumbar spine flexion was maintained throughout the row, indicating that the primary mechanics fatigue change was a result of upper back rounding due to upper back muscle fatigue. Results indicate that low back pain and injuries associated with rowing may not be because of altered flexion/extension of the lumbar spine but rather, a result of increased workload placed on low back musculature to compensate fatiguing muscles and changes in the row mechanics of the upper and mid spine. Although ergometer rowing is often considered "low-impact," given the high number of contractions over a short time (<10min), it may be advisable for rowers to avoid multiple days of fatiguing row ergometer training per week. <h3>CONCLUSIONS</h3> The present findings will provide greater insight into the potential mechanisms of fatigue during ergometer rowing. Results will also give medical professionals a better understanding of the origins and presentation of soft tissue injuries in the spine in recreational rowers. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.

Effects of a Core Strengthening Program on Muscle Activity Patterns, Strength, and Endurance in People with and without a History of Low Back Pain: A Randomized Controlled Trial

Background of Study: Altered patterns of abdominal and low back muscle activity have been reported in people in the sub-acute phase of low back injury. Specifically, higher overall muscle activity and less ability to match activity to task demands have been found. Objective: This study determined if an 8-week group exercise intervention would alter muscle activity, strength, and endurance in people with/without a history of low back pain (LBP). Method: In this randomized controlled trial 46 participants (age 19-55) with a history of LBP were randomized to exercise (LBPEx, n=24) and no-exercise (LBPCon, n=22) groups. 27 participants without a history of LBP (NoLBP) also exercised. 17 LBPEx and 19 NoLBP participants completed the intervention. 19 LBPCon were tested at 8-week follow-up. The exercise intervention was an 8-week, choreographed, 30-minute group exercise intervention (Les Mills CoreTM) focused on building core strength, stability, and endurance. Pre and post-intervention surface electromyograms from abdominal and low back muscles were recorded during a trunk stability task (TST), and analyzed using Principal Component Analysis to extract patterns corresponding to overall amplitude and relative activation during the TST loading phase. Abdominal and back extensor strength and endurance were also measured. Results: It was found that overall abdominal activity decreased for left anterior external oblique (p=0.019 for TST level 3), left lateral external oblique (p=0.012 for TST level 3), and right posterior external oblique (p=0.035 for TST level 3) in LBPEx and for right lateral external oblique (p=0.009 for TST level 2 and p=0.004 for TST level 3) and left posterior external oblique (p=0.014 for TST level 2 and p=0.011 for TST level 3) in NoLBP during the TST. Abdominal strength and endurance, and back extensor endurance increased for LBPEx and NoLBP (p0.05). Back extensor strength increased for NoLBP (p0.05). Relative abdominal activation during the TST level 2 loading phase increased for right upper rectus abdominus (p=0.05), right lateral external oblique (p=0.002), and left posterior external oblique (p=0.006) for NoLBP, and for left anterior external oblique (p=0.042) for LBPEx. Conclusion: Les Mills CoreTM is readily available and may be recommended as a safe, accessible, and effective intervention to increase abdominal strength and endurance, and back extensor endurance, even for people with a history of LBP.

Preliminary Study of Postural Safety and Ergonomics Analysis Related to Cycling Activity

Introduction: In cycling activity, having a good proper posture can reflect good performance and comfort of the cyclist. Incorrect posture will lead to future health problems such as back pain. On some occasions, the muscle activity of the cyclist also can be affected due to improper posture, non-ergonomic posture. Design and load can be major factors of injury as well. This preliminary study helped to identify and investigate the postural safety and ergonomic analysis of cyclist muscle activity during cycling. Methods: A questionnaire was used to get an overview and prior knowledge of postural safety and ergonomic of random cyclists on the university campus. Then, Surface Electromyography sEMG and postural angle from Kinovea software were used to measure and compare the results with and without load among cyclists. In this study, there was a significant effect of saddle height and pedalling on the cyclist’s body posture. This showed an optimum power and effectiveness performance while cycling. This led to comfort and reduce the chance of injury such as back pain towards cyclist. Results: Based on the results, the lower back muscles activity pattern for cyclists with the load was higher compared to cyclists without the load (the optimum saddle height was applied). The cyclist’s lower back muscles activity showed an increasing pattern overtime. Conclusion: Therefore, this study will be helpful to the cyclist to get awareness regarding correct posture safety and feel more comfortable when cycling. Further improvement should be taken for future enhancement of the findings.

Low back muscle action potential conduction velocity estimated using high-density electromyography

While a decreasing spectral content of surface electromyography reflects low back muscle fatigue development, reliability of these decreases may be insufficient. Decreasing frequency content is largely determined by decreasing average motor unit action potential conduction velocities (CV), which is considered a more direct measure of muscle fatigue development. However, for the low back muscles it has been proven difficult to identify propagating potentials and consequently estimate the CV. The aim of this study was to estimate the low back muscle CV from high-density multi-channel electromyography by using peak-delay and cross-correlation methods. Fourteen healthy male participants without a history of low-back pain performed a 30 degrees lumbar flexion trial until exhaustion while standing. For 10 out of the 14 participants (118 out of 560 sites) realistic CV estimates were obtained using both methods, the majority likely over the iliocostalis lumborum muscle. Between-method CV differences appeared to be small. Close to the spine a considerable number of sites (79) yielded systematically overestimated low back muscle CV values. Estimating low back muscle CV may allow additional insight into low back muscle fatigue development and potentially improve its monitoring using (high-density) surface electromyography.

Why multi-tier surgical instrument table matters? An ergonomic analysis from mento-physical demand perspectives

Using traditional back tables (BT) in operating rooms (OR) can lead to high physical/cognitive demand on nurses due to repetitive manual material handling activities. A multi-tier table (MTT) has been developed to relieve such stressors by providing extra working surfaces to avoid stacking the instrument trays and facilitate access to surgical tools. In this study, sixteen participants performed lifting/lowering and instrument findings tasks on each table, where kinematics, kinetics, subjective, and performance-related measures were recorded. Results indicated that MTT required lesser shoulder flexion (p-value<0.001), ∼14% lower shoulder loads (0.012), task completion time (<0.001), and cognitive/physical workloads (<0.004). Although peak low-back demands were ∼15% higher using MTT, the number of lifts to complete the same task was 60% lower, leading to lower cumulative demand on the low-back musculature. Utilizing MTT in OR could reduce demand and increase nurses' efficiency, leading to reduced risk of WMSDs and the total time of surgery.

Pilate mat exercise versus muscle energy technique on chronic non specific low back pain

Background: Many studies have been performed to evaluate the best physical therapy technique for treating chronic nonspecific low back pain. Pilate exercises and muscle energy techniques showed favorable results in many trials. Yet, no comparisons were conducted to compare their effects. Purpose: To compare between the effects of pilate mat exercise (PME) and Muscle energy technique (MET) on pain intensity, functional disability, trunk range of motion, and flexibility in patients with chronic non specific low back pain. Subjects: seventy-eight patients diagnosed, by their orthopedist, with chronic non specific low back pain participated in this study. Methods: Patients were divided randomly into three groups: Pilate group: consisted of 29 patients who received PME and standard treatment, MET group: consisted of 29 patients who received MET treatment and standard treatment, Control group: consisted of 29 patients who received standard treatment only. 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 visual analogue scale for pain intensity, V-sit and reach test (VSR) for flexibility of hamstring and lower back muscles.

Prevalence of Musculoskeletal Disorders among Pregnant Women: Cross-Sectional Study

Aim: To identify the prevalence of most common musculoskeletal disorders in pregnant women according to trimester. Method: A cross-sectional study was conducted from September 2019 to February 2020. The study was conducted after taking approval from the study setting and by the research ethics committee. The data was collected from the Family health hospital Islamabad. Data was raised through non-probability convenient sampling technique. Pregnant females with the age group of 20 to 40 years were included in the study. Those who had a chronic musculoskeletal conditions and previous history of orthopedic surgery were excluded. Data was collected after taking written informed consent. Data was collected using semi structured questionnaire which included demographic information, questions related to pregnancy and questions about musculoskeletal problems during pregnancy. Results: The mean age of 385 participants was 27±4.76. Low back pain (38.7%) was the most prevalent musculoskeletal disorder among pregnant women. In first trimester, low back pain and muscle cramps were found to be (33.3%) and (20%). In second trimester the most frequent problem was low back pain (37.6%), leg muscle cramps (17.6%), pedal edema (10.3%) and carpel tunnel syndrome (9.1%) respectively. Whereas, in third trimester 40.5% mentioned pain in low back, 16.3% leg muscle cramps, 10% pedal edema, 8.4% had reported carpal tunnel syndrome. Conclusion: Low back pain, leg muscle cramps and pedal edema were the most experienced musculoskeletal problems in pregnant woman. Key words: Pregnancy, Low back pain, muscle cramps, musculoskeletal disorders, ankle swelling.

Effect of Forefoot–Rearfoot and Pelvic–Scapular Weight Shifts on Lower-Limb and Lumbar Muscle Activity during Static Wall-Squat Exercises

(1) Background: The static body-weight wall-squat (SBWS) exercise is often included in the early rehabilitation stages of the lower limb. To establish its effectiveness and optimise its application, it is important to precisely quantify the muscle contribution to different versions of this exercise. (2) Methods: We analysed the electromyographic activity of lower limb and lumbar muscles during the SBWS with knees flexed at 45° by manipulating three different variables: horizontal distance of the ankles from the wall; scapular or pelvic location of the centre of pressure Cwall of the force exerted by the wall on the back; rearfoot or forefoot location of the centre of pressure CGR of the ground reaction force. (3) Results: The forefoot-to-rearfoot CGR shift significantly increased the vastus medialis, vastus lateralis, and tibialis anterior activity up to 23%, 26%, and 44% of the maximum voluntary isometric contraction (MVIC). The lumbar muscle activity was maximised (23% MVIC) shifting CGR at the forefoot, Cwall at the scapular zone, and placing the feet far from the wall. (4) Conclusions: These SBWS methods might be effective for quadriceps, tibialis anterior, and lumbar muscles strengthening in the early phase of rehabilitation intervention as soon as the patient can tolerate partial weight-bearing. The exercise appears suitable for patients with low back pain and limited lumbar muscle endurance, or quadriceps weakness and inhibition secondary to a knee injury.

Evaluation of vertical and multi-axial suspension seats for reducing vertical-dominant and multi-axial whole body vibration and associated neck and low back joint torque and muscle activity

The primary aim of this laboratory-based human subject study was to evaluate the biomechanical loading associated with mining vehicles’ multi-axial whole body vibration (WBV) by comparing joint torque and muscle activity in the neck and low back during three vibration conditions: mining vehicles’ multi-axial, on-road vehicles’ vertical-dominant, and no vibration. Moreover, the secondary aim was to determine the efficacy of a vertical passive air suspension and a prototype multi-axial active suspension seat in reducing WBV exposures and associated biomechanical loading measures. The peak joint torque and muscle activity in the neck and low back were higher when exposed to multi-axial vibration compared to the vertical-dominant or no vibration condition. When comparing the two suspension seats, there were limited differences in WBV, joint torque, and muscle activity. These results indicate that there is a need to develop more effective engineering controls to lower exposures to multi-axial WBV and related biomechanical loading. Practitioner Summary: This study found that mining vehicles’ multi-axial WBV can increase biomechanical loading in the neck and back more so than on-road vehicles’ vertical-dominant WBV. While a newly-developed multi-axial active suspension seat slightly reduced the overall WBV exposures, the results indicate that more effective engineering controls should be developed. Abbreviation: APDF: amplitude probability density function; Aw: weighted average vibration; BMI: body mass index; C7: The 7th cervical vertebra; EMG: electromyography; ES: erector spinae; IRB: institutional review board; ISO: International Organization for Standardization; L5/S1: the fifth lumbar vertebra (L5)/the first sacral vertebra(S1); MSDs: musculoskeletal disorders; MVC: maximum voluntary contraction; PSD: power spectral density; RVC: reference voluntary contraction; SCM: sternocleidomastoid; SD: standard deviation; SPL: splenius capitis; TRAP: trapezius; VDV: vibration dose value; WBV: whole body vibration

Σύγχρονη φυσιοθεραπευτική αντιμετώπιση της διάστασης του ορθού κοιλιακού σε γυναίκες μετά την εγκυμοσύνη

Diastasis recti abdominis (DRA) is a connective tissue impairment commonly seen in pregnant and postpartum women, causing significant physical and cosmetic concerns. Possible connections of DRA to several musculoskeletal dysfunctions, such as pelvic floor dysfunctions, pregnancy-related low back pain and impaired abdominal muscle strength have been postulated; thus, making DRA management important for the functionality and the quality of life of women following pregnancy. According to international guidelines, conservative management of DRA is the gold standard approach nowadays. However, there is no consensus in literature, about the most effective type of rehabilitation exercises for DRA. The aim of this review is to report current evidence on DRA rehabilitation as well as make suggestions for future clinical research.