Lumbar Area Research Articles

Não foi só ensinar: alterações osteomusculares em docentes no sistema home office de ensino

Covid-19 led to changes in face-to-face education, replaced by remote teaching, leading teachers to health consequences. The pandemic may have generated new musculoskeletal changes in teachers or intensified pre-existing ones. The objective was to evaluate the time during which professors worked remotely, analyzing the incidence of musculoskeletal alterations. Data collection took place in 2021 using Google forms. There were 92 responses, of those teaching between one and two years (76.1%), with more than 60% staying for more than six hours in front of the computer screen, 96.7% of professors have some type of musculoskeletal pain, and 33.7% claim that the pain started after they started working in front of the computer. The main regions with pain are the cervical area, houlders, and lumbar area. Inadequate posture combined with non-ergonomic furniture affect postural muscles, leading to fatigue and pain. The change in the way of working led to a biopsychosocial imbalance and shall be further investigated.

Brace and core stabilization to decrease vertebral curve in scoliosis cases scoliometer parameter and taps: a case study

Introduction: Scoliosis is a disorder characterized by lateral curvature and rotation of the spine. The initial phase begins with a triggering event during the growth period. Characteristics that can be seen in scoliosis patients are differences in posture on the right and left sides, the rotation of the spine, the presence of hump, and other complications, namely pain and tightness.
 Methods: This study was a case study with a brace method accompanied by CSE, which was carried out for approximately three months with an intensity of exercise 2 times a week and a home exercise program. The modified Borg scale measures shortness of breath. Pain is calculated using a visual analog scale. While scoliosis disorders are measured using two tools, namely the scoliometer and the Trunk Appearance Perception Scale (TAPS).
 Results: Using objective parameters, namely the scoliometer. The degree of a scoliosis curve decreases in the thoracic part, with the initial value at 10° to 7°. Then there is no significant reduction in the lumbar region, with the initial interpretation at 6° and back to 6°. The result obtained through TAPS is also a stagnant number which is interpreted as no change in numbers too large or small, which means that the patient does not feel any significant changes in posture after going through an exercise program.
 Conclusions: It can be concluded that there was a change in the scoliosis curve of the thoracic part by giving a brace accompanied by core stability exercises. However, this technique was less effective in the lumbar area. Behind that, when viewed during activities, patients felt a decrease in the intensity of tightness and pain.

Relationship between deep and superficial sensitivity assessments and gait analysis in diabetic foot patients.

Peripheral neuropathy is a prevalent complication of diabetes that can lead to gait impairment and its adverse consequences. This study explored the potential utility of different parameters of gait analysis using a single sensor unit as a simple tool to detect peripheral neuropathy in 85 diabetic patients (DP) with diabetic foot in whom different somato-sensitivity tests in the feet were performed. Gait spatiotemporal parameters were examined by sensor inertial measurement placed in the lumbar area, while the superficial sensitivity pathway was assessed by nociception tests and deep sensitivity was examined by light touch-pressure and vibration sensitivity tests. Correlations between each sensory test and gait parameters were analysed in a logistic regression model in order to assess if gait parameters are associated with two different sensory pathways. Impaired deep sensory pathways were significantly (P < .05) correlated with lower gait speed, reduced cadence, smaller stride length, longer stance periods, and a higher risk of falling on the Tinetti Scale, while all gait parameters were significantly (P < .01) correlated with the superficial sensory pathway. Type 2 diabetics have significantly (P < .05) higher impairment in vibratory sensitivity than type 1 diabetics, and the years with diabetes mellitus (DM) diagnosis have a significant (P < .05) association with reduced vibration sensitivity. These findings indicate relationships between the deep sensory pathway and gait impairments in DP measured by inertial sensors, which could be a useful tool to diagnose gait alterations in DP and to evaluate the effect of treatments to improve gait and thus the risk of falls in diabetic patients.

Athena: Specialty Certificate Examination case for cutaneous allergy.

This is an Athena case highlighting a patient with dermatitis affecting the back with sparing of the lumbar area. We discuss common allergens and highlight important distinguishing features among them.

Результаты проспективного сравнительного рандомизированного исследования по изучению эффективности и безопасности биологически активного комплекса «Нефробак»® в комплексном лечении пациентов с хроническим пиелонефритом.

Introduction. Chronic pyelonephritis is the most common kidney disease. In accordance with the chronic nature of the infection, an important aspect of the treatment of recurrent uncomplicated urinary tract infections is antibiotic resistance. The aim of this work is to evaluate dynamics of the number of relapses and severity of symptoms of chronic pyelonephritis against the background of the complex drug «Nephrobac»®. Materials and methods. The study included 60 patients aged 24 to 56 years with complaints of pain in the lumbar area, fever, and dysuria. Based on the examination, the patients were diagnosed with chronic pyelonephritis. The patients were randomized into two groups: the first group received only antibacterial therapy, the second group received antibacterial therapy in combination with the biologically active complex «Nephrobac»® 1 capsule 2 times a day for 1 month. Patients of both groups were observed for 6 months from the start of therapy. Results. Fewer cases of leukocyturia were observed in the group receiving the antibiotic in combination with «Nephrobac»®, 45% and 75% after 3 and 6 months, respectively. In addition, in the same group, there were significantly fewer patients with bacteriuria after 3 visits in the main group compared with the control group receiving antibiotic therapy. There were no relapses registered 6 months after the start of the study in the group receiving combination therapy, including «Nephrobac»®, there were three patients with 1 relapse each in the control group. Conclusions. «Nephrobac»® can be recommended as a part of the complex therapy of chronic pyelonephritis, which has an anti-relapse and anti-inflammatory effect, enhancing antibiotics.

Shouldering the load: musculoskeletal hazards in shoulder arthroplasty

HypothesisOrthopedic reconstructive surgery can be physically demanding. The musculoskeletal related demands related to performing shoulder arthroplasty are unknown. This study investigates the prevalence of musculoskeletal injuries associated with performing shoulder arthroplasty. MethodsAn anonymous online survey based on the validated Nordic Musculoskeletal Questionnaire (NMQ) was distributed to society members of the American Shoulder and Elbow Surgeons. The REDCap based branching chain logic survey consisted of four main sections including: 1) personal demographics, 2) practice demographics, 3) NMQ questionnaire, and 4) effects of injury. A novel addition to the nine-region NMQ survey evaluated these areas for bothersome subclinical symptoms with no formal treatment requirement. ResultsOverall, 71% of 87 responding surgeons reported musculoskeletal symptoms related to performing shoulder arthroplasty. Within this group, 72% reported primary subclinical pain and 9% reported secondary exacerbation of a previous injury. Symptomatic regions and diagnoses were most often wrist/hand discomfort (20.7%) due to carpal tunnel syndrome and basilar thumb arthritis. Other associated symptoms included spine discomfort due to degenerative disc disease in the cervical (9.4%) or lumbar (18.4%) regions and elbow pain (6.7%) due to lateral epicondylitis or posterior interosseus nerve entrapment. The most common factors related to symptoms were case volume (24%), patient beach-chair operative positioning (17%), and table height (17%). Twenty-five surgeons required time off for work-related symptoms: 23 required <1 week and two required >1 week. Nine surgeons pursued nonoperative treatment and four surgeons underwent surgical intervention. Among all factors assessed, private practice surgeons reported symptoms significantly less frequently than those at tertiary referral (academic) centers. DiscussionA high percentage of orthopedic surgeon’s experience musculoskeletal symptoms related to shoulder arthroplasty. The three most commons areas of work-related pain in shoulder arthroplasty are wrist/hand discomfort, degenerative changes in the cervical and lumbar areas, and elbow pain.

The effect of hip exoskeleton weight on kinematics, kinetics, and electromyography during human walking

In exoskeleton research, transparency is the degree to which a device hinders the movement of the user, a critical component of performance and usability. Transparency is most often evaluated individually, thus lacking generalization. Our goal was to systematically evaluate transparency due to inertial effects on gait of a hypothetical hip exoskeleton. We predicted that the weight distribution around the pelvis and the amount of weight applied would change gait characteristics. We instructed 21 healthy individuals to walk on a treadmill while bearing weights on the pelvis between 4 and 8 kg in three different configurations, bilaterally, unilaterally (left side) and on the lumbar portion of the back (L4). We measured kinematics, kinetics, and muscle activity during randomly ordered trials of 1.5 min at typical walking speed. We also calculated the margin of stability to measure medial–lateral stability. We observed that loading the hips bilaterally with 4 kg had no changes in kinematics, kinetics, dynamic stability, or muscle activity, but above 6 kg, sagittal joint power was increased. Loading the lumbar area increased posterior pelvic tilt at 6 kg and decreased dynamic stability at 4 kg, with many individuals reporting some discomfort. For the unilateral placement, above 4 kg dynamic stability was decreased and hip joint power was increased, and above 6 kg the pelvis begins to dip towards the loaded side. These results show the different effects of weight distribution around the pelvis. This study represents a novel, systematic approach to characterizing transparency in exoskeleton design (clinicaltrials.gov: NCT05120115).

Spinal alignment measurement with Kinect sensor is valid for thoracic kyphosis but not for lumbar lordosis

BackgroundSpinal alignment evaluation is commonly performed in the clinical setting during rehabilitation. However, there is no simple method for its quantitative measurement. Recently, the depth cameras in Kinect sensors have been employed in various commercial and research projects in the healthcare field. We hypothesized that the time-of-flight technology of the Kinect sensor could be applied to quantitatively evaluate spinal alignment. The purpose of this study was to develop a simple and noninvasive evaluation for spinal alignment using the Kinect sensor and to investigate its validity.MethodsTwenty-four healthy men participated in the study. Measurement outcomes were the thoracic kyphosis and lumbar lordosis angles in the standing position, using a Spinal Mouse, the validity of which has been previously reported, and the Kinect sensor. In the measurement by the Kinect sensor, a program was created to obtain the three-dimensional coordinates of each point within an area marked on the monitor, and the sums of the angles at each vertebral level were calculated for the thoracic and lumbar areas. Pearson's correlation coefficient was used to analyze the relationship between the Kinect sensor and Spinal Mouse measurements of thoracic kyphosis and lumbar lordosis angles.ResultsThere was a significant positive and moderate correlation between the thoracic kyphosis measurements taken by each device. Contrarily, there was no significant correlation in the lordosis angle between measurements using the Kinect sensor and Spinal Mouse.ConclusionsOur results demonstrated the validity of measuring the thoracic kyphosis angle using the Kinect sensor. This indicates that the depth camera in the Kinect sensor is able to perform accurate thoracic alignment measurements quickly and noninvasively.

Thermography and rasterstereography as a combined infrared method to assess the posture of healthy individuals

The demand for noninvasive methods to assess postural defections is increasing because back alterations are more common among the healthy population. We propose a combined infrared method of rasterstereography and thermography to assess the back without harmful effects. This study aims to provide reference data on rasterstereography and thermography to evaluate the back of a healthy population and to further study the correlation between these two methods. This cross-sectional research involved 175 healthy individuals (85 males and 90 females) aged 22 to 35 years. There is a large Cohen’s d effect size in the cervical depth (males = 43.77 ± 10.96 mm vs. females = 34.29 ± 7.04 mm, d = 1.03), and in the lumbar lordosis angle (males = 37.69 ± 8.89° vs. females = 46.49 ± 8.25°, d = − 1.03). The back temperature was different for gender in the cervical area (males = 33.83 ± 0.63 °C vs. females = 34.26 ± 0.84 °C, d = − 0.58) and dorsal area (males = 33.13 ± 0.71 °C vs. females = 33.59 ± 0.97 °C, d = − 0.55). Furthermore, in the female group there was a moderate correlation of lumbar temperature with lumbar lordosis angle (r = − 0.50) and dorsal temperature with shoulders torsion (r = 0.43). Males showed a moderate correlation for vertebral surface rotation RMS with cervical (r = − 0.46), dorsal (r = − 0.60), and lumbar (r = − 0.50) areas and cervical temperature with shoulders obliquity (r = 0.58). These results highlight a possible correlation between rasterstereography and thermography, which may elucidate the underlying mechanics of spinal alterations and thermal muscle response. Our findings may represent reference data for other studies using noninvasive methods to assess postural alterations.

Dimensions of bony Kambin's triangle pertaining to endoscopic procedure

BackgroundEndoscopic procedures nowadays are successful, minimally invasive, and safer, with fewer intraoperative and postoperative complications and shorter hospital stays. Kambin's triangle (KT) is the three-dimensional configuration that is used as a transforaminal anatomical corridor for epidural steroid injections and endoscopic surgeries for various lumbar pathologies. This study aims to estimate the dimensions of KT and diameter of the cannula for the transforaminal surgical approaches using KT in the Chhattisgarh population. MethodsSeven human cadavers (three males and four females) were included in the study for observing KT. Dissection was done to carefully clear landmarks, including the vertebral bodies, intervertebral disc, exiting nerve root, and superior articular process. Base (a horizontal plane passing through the superior border of the caudal vertebra) and height (along the superior articular process of the inferior vertebra in line with the articular facet) were measured. Hypotenuse, semiperimeter of the triangle, area of triangle, diameter, and area of the inscribed circle were calculated. ResultsHeight, base, and inscribed circle diameter increased from L1-L2 to L4-L5 then decreased to L5-S1. There was no statistically significant difference between males and females. The safest admissible cannula diameter according to the current study that can be used at all levels in KT was 6.06 mm. ConclusionThis study provides the safest cannula size to be considered in the patients of the Chhattisgarh population during transforaminal approaches in the lumbar area. Minimally invasive surgery and shorter hospitalization are vital criteria to evaluate any surgery these days.

Left Gluteal Maximus Neuroma Causing Long-Standing Gluteal Pain.

Diagnosing buttock pain is a challenge due to complex anatomy and multiple causes. Potential pathologies range from common and benign to rare and life-threatening. Common causes for buttock pain include referred pain from the lumbar spine and sacroiliac joint, hamstring origin tendinopathy, myofascial pain, ischiogluteal bursitis, gluteal pathology, and piriformis syndrome. Rarer causes include malignancy, bone infection, vascular anomalies, and spondyloarthropathies. Other conditions may be present concurrently in the lumbar and gluteal area, which can cloud the clinical picture. Correct diagnosis and early treatment may improve quality of life by providing a targetable reason for their distress, improving pain, and allowing the patient to get back to their activities of daily living. When treating a patient with buttock pain, it is essential to reevaluate the diagnosis when symptoms fail to improve despite appropriate intervention.Here, we discuss a case of a peripheral nerve sheath tumor found in the left gluteus medius muscle of a patient that caused persistent, debilitating buttock pain. After years of treatment for piriformis syndrome and possible spinous causes, the patient was ultimately diagnosed with a peripheral nerve sheath tumor through magnetic resonance imaging with contrast. Peripheral nerve sheath tumors are a diverse group of mostly benign tumors that can occur sporadically or associated with certain disease processes. These tumors usually present with pain, a soft tissue mass, or focal neurological deficits. Upon removal of the tumor, her gluteal pain completely resolved.

Wearable sensors for assessing disease severity and progression in Progressive Supranuclear Palsy

IntroductionProgressive supranuclear palsy (PSP) is an atypical parkinsonism characterized by prominent gait and postural impairment. The PSP rating scale (PSPrs) is a clinician-administered tool to evaluate disease severity and progression. More recently, digital technologies have been used to investigate gait parameters. Therefore, object of this study was to implement a protocol using wearable sensors evaluating disease severity and progression in PSP. MethodsPatients were evaluated with the PSPrs as well as with three wearable sensors located on the feet and lumbar area. Spearman coefficient was used to assess the relationship between PSPrs and quantitative measurements. Furthermore, sensor parameters were included in a multiple linear regression model to assess their ability in predicting the PSPrs total score and sub-scores. Finally, differences between baseline and three-month follow-up were calculated for PSPrs and each quantitative variable. The significance level in all analyses was set at ≤ 0.05. ResultsFifty-eight evaluations from thirty-five patients were analyzed. Quantitative measurements showed multiple significant correlations with the PSPrs scores (r between 0.3 and 0.7; p < 0.05). Linear regression models confirmed the relationships. After three months visit, significant worsening from baseline was observed for cadence, cycle duration and PSPrs item 25, while PSPrs item 10 showed a significant improvement. ConclusionWe propose wearable sensors can provide an objective, sensitive quantitative evaluation and immediate notification of gait changes in PSP. Our protocol can be easily introduced in outpatient and research settings as a complementary tool to clinical measures as well as an informative tool on disease severity and progression in PSP.

Optimal sensor location and direction to accurately classify people with early-stage multiple sclerosis using gait stability

BackgroundThe local divergence exponent (LDE) has been used to assess gait stability in people with multiple sclerosis (pwMS). Although previous studies have consistently found that stability is lower in pwMS, inconsistent methodologies have been used to assess patients with a broad range of disability levels. QuestionsWhat sensor location and movement direction(s) are better able to classify pwMS at early stages of the disease? Methods49 pwMS with EDSS ≤ 2.5 and 24 healthy controls walked overground for 5 min while 3D acceleration data was obtained from sensors placed at the sternum (STR) and lumbar (LUM) areas. Unidirectional (vertical [VT], mediolateral [ML], and anteroposterior [AP]) and 3-dimensional (3D) LDEs were calculated using STR and LUM data over 150 strides. ROC analyses were performed to assess classification models using single and combined LDEs, with and without velocity per lap (VELLAP) as a covariate. ResultsFour models performed equally well by using combinations of VELLAP, LUM3D, LUMVT, LUMML, LUMAP, STRML, and STRAP (AUC = 0.879). The best model using single sensor LDEs included VELLAP, STR3D, STRML, and STRAP (AUC = 0.878), whereas using VELLAP + STRVT (AUC = 0.869) or VELLAP + STR3D (AUC=0.858) performed best using a single LDE. SignificanceThe LDE offers an alternative to currently insensitive tests of gait impairment in pwMS at early stages, when deterioration is not clinically evident. For clinical purposes, the implementation of this measure can be simplified using a single sensor at the sternum and a single LDE measure, but speed should be considered. Longitudinal studies to determine the predictive power and responsiveness of the LDE to MS progression are still needed.

Clival Chordoma, Arising in Pre-existing Benign Notochordal Cell Tumor, Case Report

Lesions of notochordal origin are unusual surgical cases that have a broad spectrum of differentiation, from remnants to benign tumors -namely “benign notochordal cell tumor BNCT”- to malignant chordoma. These lesions arise within the vertebral bodies at the ends of axial skeleton, clivus and lumbar areas. Chordoma, is a malignant destructive lesion extending from bone to surrounding soft tissue. It is hypothesized to arise from its rare benign counterpart, BNCT as evidenced by their co-existence in rare case reports, in lumbar area, an even more rare in clival region. These benign forms are even scarce to see in surgical pathology specimen and carry a histological resemblance in morphology to malignant chordoma if not recognized. Here, we report a case of chordoma arising from a benign notochordal cell tumor (BNCT), which was discovered in a 35 years old male who presented with diplopia, diagnosed as 6^th nerve palsy. MRI imaging showed an expansile clival lesion with sclerotic borders invading the cavernous sinus and encasing the carotid. Histopathology showed features of chordoma within BNCT. This case highlights the rarity of the entity especially in the clival region, the wide differential diagnosis of clear cell tumor arising in the clival region and the importance of radio-pathological correlation.

Air-refill phenomenon-A simple confirmatory adjunct for loss of resistance technique in labour epidural analgesia.

Air-refill phenomenon-A simple confirmatory adjunct for loss of resistance technique in labour epidural analgesia.

MINIMIZING THE RISK FACTORS FOR LOW BACK PAIN IN THE CREATIVE INDUSTRY WORKERS

Low back pain (LBP) felt in the anatomical area of ??a person's body is affected by a load or pressure outside the tolerance limit, with various variations in the length of time the pain complaint process occurs. This pain is felt in the lumbar or lumbo-sacral area. Workers in the batik industry may be at risk of LBP caused by work activities, such as bending, repetitive or monotonous movements, using work equipment and a non-ergonomic work environment. This study aims to minimize the risk factors for LBP in batik creative industry workers. The population of this study were all batik artisans in the written batik industry in Wukirsari Village, Imogiri District, Bantul Regency, Yogyakarta Special Region, totaling 1,021 people. The sample of this study was obtained by random sampling, to determine the sample using a lottery number and the name of the batik maker, totaling 60 batik people. The inclusion criteria for the sample of this study included female gender, writing batik work, working sitting using a chair. The sample consisted of a treatment group and a control group, each consisting of 30 batik makers, hereinafter referred to as respondents. The research instruments include: meter, microthoice, scales, chair, batik hurdle, and NBM questionnaire. Ergonomic work chair design for batik size: height of seat holder = 30 cm; length of seat holder = 40 cm; seat width = 37 cm; high back of chair = 43 cm; seat back width = 37 cm. Modification of batik gawangan is to redesign batik gawangan, material from bamboo diameter of about 3 cm, with size: height = 88 cm, width = 158 cm, 4-legged pieces, equipped with 3 watt LED lights. The results of the NBM in the treatment group decreased skeletal muscle complaints into criteria: low 96.7% and moderate 3.3%. The control group had skeletal muscle disorders criteria: low 23.3%, moderate 46.7%, high 20% and very high 10%. While the results of the t-test from the NBM data each of the 30 respondents between the treatment group and the control group, the value of p = 0.000 means that there are significant differences between respondents who use chairs and ergonomic modification modifications with respondents who use dingklik and gawangan which is old. The conclusion is that the use of chairs and modifications of the ergonomic batik wrestling can minimize the risk factors for LBP in the workers of the written batik creative industry

Posterior only for Approach Total EN Bloc Spondylectomy: A Case Report

Total en bloc spondylectomy (TES) is a surgical technique that removes the tumor in a margin-free surgical resection of an entire vertebral body in primary malignant tumors, which can be used by multiple approaches to surgery and is beneficial in reducing complications and totally removing the vertebral column. Although the primary technique requires maximally exposed normal anatomy, our technique can be applied to many lesions in the lumbar area. We reported the first case in Vietnam with a single malignant spinal tumor that was successfully treated with TES surgery. The patient was admitted to our hospital with the primary complaint of back pain that had not responded to conventional treatment as well as neurogenic bowel dysfunction. He was treated with preoperative embolization and underwent TES in L1 by only one posterior approach. Postoperative histological examination revealed myeloid sarcoma. This technique still has many challenges with lumbar vertebrae lesions due to the complex neuroanatomy and vascular structure.

Prevalence of Pelvic Crossed Syndrome in Females with Primary Dysmenorrhea and its Impact on Physical Activity: An Observational Study

Context: Pelvic crossed syndrome (PCS) often known as lower crossed syndrome, which is a clinical pattern of muscle imbalance around the pelvis, has been reported more frequently in females than males of the same age. Primary dysmenorrhea (PD), which is another prevalent condition in females, is a leading cause of work absenteeism. As menstrual pain has been reported with change in musculoskeletal structure around the pelvis and lumbar area, this syndrome could be a missing link, which describes the severity of the condition, and may have an impact on physical activity. Aims: The objective of the current study is to find the prevalence of PCS in females with PD and its impact on physical activity. Settings and Design: This was an observational study undertaken in colleges of Belagavi City for a period of 6 months. Subjects and Methods: A total of 305 females with PD were recruited based on the inclusion criteria. They were assessed for PCS using Thomas test and modified Schober’s test for muscle length and manual muscle testing grades for muscle strength, after which were subjected to Simple Physical Activity Questionnaire. Statistical Analysis: The data were analyzed using SPSS version 23 software descriptive statistics and Chi-square test. Results: The prevalence of PCS in females with PD is 28.5% with 44% of those experiencing severe PD, whereas 23% of those with moderate-to-severe PD. The impact of the same on physical activity was found significant with 67% of females with PD involving in only 1 h of physical activity for every 24 h. Conclusions: Pelvic cross syndrome affects physical activity significantly and is prevalent in 28.5% of females with PD.

Effects of a non-randomized educational intervention on knowledge, postural habits and trunk muscle endurance related to back health: A 6-month follow-up study

Low back pain (LBP) prevalence in children and adolescents is high during their lives. School-based interventions have reported effectiveness on back health. The study aimed to determine the effect of an educational back-health intervention on knowledge, postural habits and trunk muscle endurance regarding low back pain prevention for a group of 12 to 13-year-old students using a 6-month follow-up. A non-randomized experimental design. Three groups of 1st-grade secondary school students were selected. A control group (CG), and two experimental groups (EG1 and EG2) who participated in a back-health educational program (BHEP); only one of the experimental groups was given a follow-up learning contract (EG2). Assessments were performed at three different time points: before the intervention (baseline), after (post-test) and 6 months after (follow-up). The level of general knowledge of the experimental groups improved after the intervention. The level of postural habits improved in EG1 and EG2 compared to the CG after the follow-up period (p &lt; .001 in both). An improvement in the level of endurance of the trunk musculature after the intervention was observed only for boys between EG2 and the CG (p &lt; .05). A lower percentage of problems in the lumbar area in EG2 was observed after the 6-month follow-up. Teaching students to take care of their spines seems to have positive effects concerning knowledge, postural habits, and back health

Comparative Assessment of Gait and Balance in Patients with Parkinson's Disease and Normal Pressure Hydrocephalus.

We aim to compare balance and gait parameters in patients diagnosed with Parkinson's disease (PD) and normal pressure hydrocephalus (NPH). A total of 13 patients with NPH, 20 with PD, and 13 healthy controls (HC) recruited in the study. Three IMU sensors (Ambulatory PD Monitoring Inc., OR, USA) were placed on the lumbar area and the feet of the participants. The balance evaluations comprised eight successive standing tasks; the modified clinical test of sensory interaction on balance test. These tasks involved standing with feet apart and eyes open as well as eyes closed on a firm and foam surface, standing with feet together and eyes open as well as eyes closed, and tandem stance with the right foot front and the left foot front. Functional evaluations of gait were conducted using the 10-M Walk Test (10 MWT), the 2 min-Walk Test (2 MWT), and the timed-up and go (TUG). Parameters of the gait and balance were analyzed and then compared. NPH patients displayed a notable decrease in both stride length and gait speed as compared with both PD patients and healthy participants. The balance tests revealed that the NPH group demonstrated significantly poorer performance, specifically in the feet-apart eyes-closed foam-surface test, and the tandem stance test. During the tasks while eyes were open on firm and foam surfaces, PD and NPH groups showed an increase in root mean square sway, range, and mean velocity (p<0.05) of sway in the anteroposterior plane. In addition, during the TUG test, the NPH group exhibited a significant prolongation in the time needed to complete the task and a decline in turning velocity as compared to PD, but no notable difference was seen in comparison to the HC group. Our study indicated that the patients with NPH exhibited notably worse gait and balance measurements in comparison to both the PD patients and HC groups. These findings emphasize the significance of monitoring and managing gait and balance impairments in NPH patients. Sensor-based technologies may offer objective parameters for a more precise and efficient follow-up of these patients in terms of gait and balance.