Postural Defects Research Articles

Longitudinal observation of psychophysiological data as a novel approach to personalised postural defect rehabilitation

Postural defects are one of the main diseases reported to be at the top of the list of diseases of civilisation. The present study aimed to develop a novel approach to defining a set of measurable physiological biomarkers and psychological characteristics with identifiable information content and data analysis, enabling the determination of the adaptation period and conditioning the effectiveness of the treatment in personalised rehabilitation. During the rehabilitation, multimodal physiological signals (electrodermal activity, blood volume pulse) and psychological data (anxiety as a state and as a trait, temperament) were recorded on a group of 20 subjects over a period of three months (120 measurement sessions). Preprocessing of the physiological signals and psychological data was performed. A stepwise forward regression method was used to determine a set of successive statistically significant predictors of the model. For each group, a matrix of coefficients for fitting a linear regression of changes in the value of a given predictor in subsequent measurement was determined. Adaptive Boosting was chosen to develop a mathematical model of the patient. The analysis of the results of the psychological tests enabled the participants to be divided into five new, previously undefined subgroups, which were both labels for the classifier. Using the dimensionality reduction method, 8 significant, statistically important features were extracted. AdaBoost classifier allowed the creation of a prediction model for therapy parameters with 84% accuracy, and the Pseudo-Random Number Generator was used to check the validity of it. The AdaBoost algorithm was used again to check the dynamics of changes in regression coefficients for individual groups—a set of psychophysiological characteristics identified as the basis for personalised therapeutic interventions. Each individual requires time to adapt to a new situation, conditioned by their characteristics. An appropriate interdisciplinary approach to professional rehabilitation influences the therapeutic process’s quality, duration, and effectiveness. Physiological features determine the patient’s involvement in the rehabilitation process, allowing robust personalisation of therapy in a closed feedback loop. The fusion of psychophysiological data and multimodal measurements enables the development of a unique behavioral-physiological profile of the patient undergoing rehabilitation.

Treatment Algorithms for Continuous Low-Level Heat Wrap Therapy for the Management of Musculoskeletal Pain: An Italian Position Paper.

Musculoskeletal pain (MSP), which impacts bones, muscles, tendons, and ligaments, is a substantial worldwide pain disorder, characterized by muscle soreness, fatigue, inflammation, muscle spasms, sleep disruptions, and functional limitations. MSP is predominantly managed within the primary care setting. Recent consensus recognizes that heat therapy (HT) may provide potential benefits, especially in treating chronic MSP. To develop shared algorithms for the treatment of MSP through local superficial HT (SHT) using continuous low-level heat wrap therapy, a four-member board of experts was designated. Three anatomical sites have been deemed of particular interest regarding potential response to exogenous SHT. Neck and shoulder pain are commonly attributed to traumatic experiences, muscle spasms, postural defects, or poor posture as common potential causes. HT may be helpful for painful contractures, although treatment should be limited in duration to prevent instability. Low back pain, the leading cause of disability, may have either specific or non-specific etiology. SHT, physical therapy, instrumental therapy, manual therapy, therapeutic exercise, motor activity, and trunk orthoses are all potential treatment options. SHT should be considered in chronic degenerative disc disease, non-specific LBP with muscle spasm or contracture, postural and overuse myalgia, and osteoarthritis (OA), excluding the inflammatory phase. Assessment of knee pain includes both a review of the patient's medical history and a careful physical examination. SHT of the knee should be considered in case of muscle spasms, overuse pathology, early OA, and indirect muscle lesions. Patients who receive SHT may experience a reduction in pain, restoration of muscle strength, loosening of stiffness, and an overall improvement in their quality of life. This expert opinion proposes shared algorithms for MSP treatment via local SHT with the aiming to provide practical guidance on its proper application, highlighting specific potentialities as well as contraindications.

Risk Factors Involved in Postural Disorders in Children and Adolescents.

Postural disorders in children and adolescents have an increasing incidence. The aim of this study was to identify the type of postural defects in school-age and preschool children, as well as the external risk factors determined by an inadequate lifestyle. The research included 134 children aged between 5 and 18 years, in whom postural defects were identified. The project involved an examination of the children's body posture, a survey of the parents to determine the children's lifestyle, blood tests, and spinal X-rays. A significant percentage (76%) of the children included in the study were underweight. The examination of postural defects in the students revealed scoliosis in 21% of the patients, kyphosis in 7.5%, and lordosis in 1.5%, while 70% of the patients presented an association between at least two postural defects. As far as risk factors are concerned, we identified the presence of rickets sequelae in 70% of the patients, the presence of pectus excavatum in 43% of the patients, genu varum in 15%, and flat foot in 12%. Additionally, 90% of the children had an incorrect posture at the desk, while 42% incorrectly carried their backpack on one shoulder only. In terms of diet quality, associations between an inadequate diet and postural disorders were found for kyphosis, scoliosis, and other deformities. In conclusion, postural abnormalities in children have an increased incidence from an early age and are a result of the change in lifestyle in recent years, represented by sedentarism, a lack of physical activity, the excessive use of electronic devices, stress, and an inadequate diet.

The Assessment of Postural-Motor, Coordination, and Reflex Functions in Children and Adolescents with a History of Premature Verticalization and Ontogeny Disorders in Their First Year of Life.

(1) Background: Contracting diseases or being exposed to adverse environmental factors in the first year of life may impair the development of body posture and motor coordination. The purpose of this study was to evaluate the correlation between data on the speed of passive verticalization, the number of risk factors and the quality of development in the first year of life, and the results of the functional examination of these individuals in adolescence. (2) Methods: Two groups of 60 volunteers, aged 9-14 years, were examined by performing functional tests and the retrospective analysis of their development up to the age of 1 year. The first group consisted of patients diagnosed with postural defects. The control group consisted of healthy people of the same age who volunteered for this study. (3) Results: Statistical analysis showed statistically significant differences between groups in terms of posture (p = 0.001), motor coordination (p = 0.001), and accumulated primitive reflexes (p = 0.001), as well as a high correlation between these disorders and the quality of development in the first year of life. In the first group, for the ages of 3-6 months (r = 0.96; p = 0.001), 6-9 months (r = 0.871; p = 0.001), and 9-12 months (r = 0.806; p = 0.001), no significant correlations were found with the age of 0-3 months. In the second group, the results were as follows: 0-3 months (r = 0.748; p = 0.001), 3-6 months (r = 0.862 p = 0.001), 6-9 months (r = 0.698; p = 0.001), and 9-12 months (r = 0.740; p = 0.001). In the group of adolescents with posture defects, we observed an earlier time of passive verticalization and sitting, as well as more frequent use of loungers, seats, and walkers (p = 0.026). (4) Conclusions: The analysis of this study's data indicates that the development of body posture and motor coordination may be impaired due to accelerated and passive verticalization in the first year of life.

COMPLEX USE OF PHYSICAL THERAPY MEANS IN THE REHABILITATION OF SCHOOL-AGE CHILDREN WITH POSTURE DISORDERS

Relevance of the research topic. The problem of using physical therapy means in rehabilitation of school-age children with posture disorders becomes especially relevant in the context of the threat of serious spinal diseases, which can negatively affect the health and physical development of children in the future.Purpose and methods of the study. The aim of the work is to reveal the essence of complex use of physical therapy means in rehabilitation of school- age children with posture disorders. The research consisted of the analysis of scientists' works and description of the use of therapy for correction of school-age children's posture. Research methods and statistical analysis. We used both general scientific and special methods of research, namely: analysis, synthesis, structural-functional, description, generalization.Results. The article presents an analysis of the integrated use of physical therapy in the rehabilitation of school-age children with postural disorders. Various methods and techniques of physical therapy aimed at restoring optimal physical functioning and correcting postural defects are described. It is described that the main methods of physical therapy used in rehabilitation are therapeutic physical culture, correction of body position, therapeutic massage, hardening, hydrokinesitherapy and physiotherapy. Particular attention is paid to physical exercises that specialize in correcting specific types of posture disorders. Key findings. It has been shown that symmetrical and asymmetrical exercises, known as corrective exercises, are used to equalize the tone of the trunk muscles and strengthen relaxed muscles, helping to return the spine to its correct position. It has been proven that therapeutic massage, as an effective means of functional therapy, is used at all stages of medical and physical therapy to treat various diseases and injuries. The article analyzes the effectiveness of these methods and their role in achieving positive results in the rehabilitation of children with postural disorders.

Pluridisciplinary approaches in global postural rehabilitation

The global postural imbalances relationship is frequently encountered in recent medical practice, requiring multidisciplinary approaches to bring patients to function as close as possible according to the physiological limit. About half of the world’s population experi-ences pain and dysfunction induced by postural imbalances during their lifetime. This re-port aimed to assess the nonpainfull and currative effect of the electropuncture technique complemented by massage and active postural kinetotherapy of global posture imbalances and acute or chronical pain at various levels. This research provide an insight into the re-port of evidence available for the analgesic uses of TENS in postural defects. Correlations regarding imbalances at various levels was found in various studies regarding analyze or diagnosis, without addressing the non-invasive multidisciplinary treatment. In these stud-ies, we are hoping to raise the non-invasive reabilitation treatment and increase their use in pathologies with involves global postural imbalances. The discomfort and pain experi-enced by people with generalized postural disorder on a daily basis can have a negative impact on quality of life and, if left untreated, can lead to significant worsening of the con-dition over time. Global rehabilitation with non-invasive and non-pharmacological meth-ods, without adverse effects, including electropuncture (TENS) applied to the refferal points in conjunction with proprioceptive kinetotherapy techniques, massage and psycho-therapy is the path to the success of occlusion-postural rehabilitation with significant re-sults on painful suffering global postural imbalances. Keywords: global posture, postural imbalance, correlation, rehabilitation, multidisciplinary, electropuncture

Development and Reliability of Parents' Body Posture Literacy Questionnaire (PBPLQ)

Introduction: Postural defects are a serious problem in modern society. In research on the subject, it is indicated that parents should pay special attention to their children's body posture. Basic knowledge in the field of posture defects and prevention will help prevent and deal with postural defects in children.Objectives: The aim of the study is to design and determine the reliability of a questionnaire examining parents' knowledge of postural health.Material and methods: The questionnaire development process consisted of the following steps: content and face validation, as well as reliability analysis. The questionnaire contains items assessing parents' literacy of body posture and was conducted among 55 Polish parents of school-age children and adolescents.Results: Initial results (first test-retest) for 37 participants revealed substantial reliability (0.61 to 1.00), however, it was exhibited that modifications were needed for some specific questions. After revisions and retesting (second test-retest of 18 participants), the updated questionnaire demonstrated significantly improved reliability (Cohen's kappa coefficient ranged from 0.85 to 1.00).Conclusions: The developed questionnaire is valid in terms of face and content validity, as well as reliability for assessing parents' literacy of body posture, and can potentially be used in clinical trials and practical settings.

Manganese Overexposure Alters Neurogranin Expression and Causes Behavioral Deficits in Larval Zebrafish.

Manganese (Mn), a cofactor for various enzyme classes, is an essential trace metal for all organisms. However, overexposure to Mn causes neurotoxicity. Here, we evaluated the effects of exposure to Mn chloride (MnCl2) on viability, morphology, synapse function (based on neurogranin expression) and behavior of zebrafish larvae. MnCl2 exposure from 2.5 h post fertilization led to reduced survival (60%) at 5 days post fertilization. Phenotypical changes affected body length, eye and olfactory organ size, and visual background adaptation. This was accompanied by a decrease in both the fluorescence intensity of neurogranin immunostaining and expression levels of the neurogranin-encoding genes nrgna and nrgnb, suggesting the presence of synaptic alterations. Furthermore, overexposure to MnCl2 resulted in larvae exhibiting postural defects, reduction in motor activity and impaired preference for light environments. Following the removal of MnCl2 from the fish water, zebrafish larvae recovered their pigmentation pattern and normalized their locomotor behavior, indicating that some aspects of Mn neurotoxicity are reversible. In summary, our results demonstrate that Mn overexposure leads to pronounced morphological alterations, changes in neurogranin expression and behavioral impairments in zebrafish larvae.

The effect of HVLA manipulation on static and dynamic postural parameters – a case study of a patient with a blocked atlanto-occipital transition

Objective. The study aimed to assess the effects of high velocity low amplitude (HVLA) manipulations on force distribution, pressures, and balance in individuals with atlanto-occipital blockage, focusing on post-treatment improvements. Research methods. Diagnostic tests (cervical spine compression, Spurling, de Kleyn) and pedobarography (using an EPS/R2 mat and BIOMECH STUDIO software) assessed functionality and postural parameters pre and post HVLA therapy. Results. Initial diagnosis showed significant disturbances in force distribution, balance, and gait. Post-HVLA therapy improvements included: 1. Balanced forefoot load during standing, with a decrease in heel load percentage. 2. Improved global body pressure distribution, with a notable decrease in left-side body pressure. 3. Enhanced anteroposterior and lateral body oscillation ranges, with a reduced ratio of extreme deflection distances to deflection surface and a decreased average speed of displacements. 4. Normalization of the right foot abduction angle, with no significant change in the left foot's visitation angle. 5. Slight improvements in foot vault index (AI) and average foot pressure during gait, with minimal changes in maximum foot pressure during gait. Conclusions. HVLA manipulation significantly improves static balance parameters but shows minimal improvement in gait parameters. This indicates a complex relationship between atlanto-occipital blockage and postural disorders, suggesting the need for further research to explore the association between postural defects and atlanto-occipital transition blockage, as well as the impact of these blockages on postural changes. Keywords atlanto-occipital blockage, HVLA manipulation, postural disorders, balance improvement, pedobarography

Evaluation of the Kinesio Taping and Real-Time External Feedback Effects on Lower Extremity Function During Single-Leg Squat in Individuals With Tibiofemoral Varus Alignment

Background and Aims People with postural malalignment such as tibiofemoral varus (TFRV) may experience movement patterns dysfunction during functional activities that are related to non-contact lower extremity injuries. Training protocols should be designed for these people to control and improve their functional dysfunctions. The present study aimed to investigate the effect of posterior X-taping (PXT) and real-time external feedback (RTF) on kinematic and electromyographic indices of the lower extremities during the single-leg squat task in individuals with TFRV. Methods Electromyographic and kinematic information of the lower extremities of 24 recreational athletes with TFRV (PXT=12, RTF=12) were recorded while participants in both groups performed single-leg squat 5 times consecutively and took a 2-minute rest between two different conditions (before and after the intervention). To analyze the data, 2-way analysis of variance and Bonferroni post hoc test were used at the significant level of P≤0.05. Results The present study results indicated an increase in gluteus medius muscle activity (P=0.013) in the eccentric phase and a decrease in hip adduction (P=0.001) in maximal knee flexion (P=0.034) after the intervention compared to before the intervention in the RTF group. Also, there was a reduction in external tibiofemoral rotation of the knee after the intervention compared to before intervention in maximal knee flexion (P=0.034), eccentric phase (P=0.001), and concentric phase (P=0.001) in the PXT group. In addition, there was a decreased ankle pronation after the intervention compared to before the intervention in the eccentric phase (P=0.001) and concentric (P=0.001) in the PXT group and in the eccentric phase (P=0.004) in the RTF group. Besides, there was an increased ankle abduction after the intervention compared to before the intervention in the concentric phase (P=0.001), eccentric phase (P=0.001), and maximum knee flexion (P=0.004) in the PXT group, and in the eccentric phase in the RTF group (P=0.006). Finally, there was a decrease in ankle flexion dorsiflexion at maximum knee flexion after the intervention compared to before the intervention (P=0.017) in the RTF group. Conclusion The results of the present study showed that PXT and RTF interventions can affect the kinematic parameters of individuals with TFRV malalignment in different ways and can be used to correct immediately postural defects during the single-leg squat task.

Effect of global postural reeducation on chronic low pain patients with lower cross syndrome

BackgroundToday, low back pain is a serious global health issue. Currently, 85% of low back pain is caused by muscular imbalance and is a result of Lower cross syndrome (LCS), which are chronic postural defects. The physical therapy techniqueknown as Global Postural Re-education (GPR) was created in France and is based on the concept that muscle chains make up the entire muscular system.AimThe purpose of this study was to investigate the effect of global postural re-education on low back pain patients with lower cross syndrome.DesignProspective pre and post-test, single-blind randomized controlled trial.SettingOutpatient physio therapy clinic at Damanhur teaching hospital.PopulationFifty participants (25 to 40 years old) suffer from low back pain with lower cross syndrome.MethodsParticipants were randomly assigned to two equal groups: global posture re-education approach and conventional physiotherapy was given to study group "A" and conventional physiotherapy was given to control group "B" throughout the courseof 15 treatment sessions, twice sessions weekly. The patients' pre- and post-treatment progress was assessed using the clinometer digital smartphone application to measure anterior pelvic tilting, flexible ruler to measure lumbar lordosis, Modified Thomas test to measure hip flexor flexibility, Visual analogue scale (VAS) to measure pain and Oswestry Low Back Pain Disability Questionnaire Arabic version to measure function disability.ResultsComparing the study group and the control group after treatment showed that the study group had a significantly lower anterior pelvic tilting (P = 0.001), lower lumbar lordosis (p = 0,024), higher flexibility of hip flexor muscle (p = 0,001), lower VAS (p = 0,001) and improving in function disability (p = 0,001) compared to the control group.ConclusionAdding a Global postural re-education approach is thought to be effective in treating low back pain patients with lower cross syndrome.Clinical Rehabilitation ImpactGlobal postural re-education approach decreases anterior pelvic tilting angle, lumbar lordotic angle, pain, and disability caused by low back pain and increase hip flexor flexibility.

Locomotory Behavior of Water Striders with Amputated Legs.

The stability of the body during locomotion is a fundamental requirement for walking animals. The mechanisms that coordinate leg movement patterns are even more complex at water-air interfaces. Water striders are agile creatures on the water surface, but they can be vulnerable to leg damage, which can impair their movement. One can assume the presence of certain compensatory biomechanical factors that are involved in the maintenance of postural balance lost after an amputation. Here, we studied changes in load distribution among the legs and assessed the effects of amputation on the locomotory behavior and postural defects that may increase the risk of locomotion failure. Apparently, amputees recover a stable posture by applying leg position modifications (e.g., widening the stance) and by load redistribution to the remaining legs. Water striders showed steering failure after amputation in all cases. Amputations affected locomotion by (1) altering motion features (e.g., shorter swing duration of midlegs), (2) functional constraints on legs, (3) shorter travelled distances, and (4) stronger deviations in the locomotion path. The legs functionally interact with each other, and removal of one leg has detrimental effects on the others. This research may assist the bioinspired design of aquatic robots.

The Importance of Body Posture in Adolescence and its Relationship with Overall Well-being

Abstract Adolescence is a phase of life with specific health and developmental needs. This is the time to develop self-image and self-esteem, learn to manage emotions and relationships, acquire attributes and abilities, and also physiologically form body posture. An efficient, erect posture of the human body is defined as the alignment of particular body segments that are not affected by pathological changes. Body posture is influenced by a variety of physiological, occupational, and biomechanical factors. It is very important to know these factors and their influence on posture to prevent the appearance of postural deviations and its consequence in their daily lives. This study is a review of articles related to the formation, defects, and corrective measures of body posture during adolescence and identifying its relationship with different aspects of health. This study identified 207 studies on the various aspects of posture in children and adolescents using search engines such as Google Scholar, Science Direct, and PubMed, of which 11 studies met the eligibility criteria for the review. Postural defects are no longer confined to medicine and affect society as a whole. It plays a significant role in defining the social personality of an individual and is responsible for his upbringing. Since these disorders are prevalent in children, it is necessary to emphasize the importance of prevention programs. Thus, children should be taught the habit of maintaining proper posture along with increasing their physical activity levels and promoting healthy lifestyles.

Significant Role of Leadership Quality in Physical Education

Abstract: Leadership in Physical schooling may be very critical in order that in order that he can lead and manipulate the agencies/ groups at play fields. He should be in function to manual the pupil to come across their bodily defects. A accurate chief could make his college students apprehend psychologically concerning the complexes at the playground. He is capable of discover the postural defects and remedial measures and recognize the way to deal with those defects with bodily sporting events. He should be conversant with bodily sports in fashionable and must have mastery over a few games. He additionally develops self assurance, feel of field and capacity to take choices. A accurate chief in bodily schooling takes the groups for opposition from one vicinity to another. They prepare exercise fits for diverse groups/ agencies. All gamers have the possibility to guide the crew. They revel in at the same time as taking the groups for picnic and trekking etc. They are capable of prepare the sports activities meet in small agencies and on the school/university degree and feature self assurance.

An Analysis of the Risk Factors for Postural Defects among Early School-Aged Children.

This study was conducted on a group of 141 children aged 7-10, attending the first to third grades at a primary school in Białystok (northeastern Poland). This study involved measuring the children's height and weight, assessing the children's body posture based on the FITS method (Functional Individual Scoliosis Therapy) by Białek and M'hango (the authors of this study), and administering a diagnostic survey addressed to parents and guardians of the children (n = 104) using a self-designed questionnaire. Almost all defects were more prevalent in boys, especially in the case of stature triangles (p = 0.0489) and knee alignment in the sagittal plane (p = 0.038). The age of the subjects differentiated the incidence of defects in the scapulae (p = 0.0037) and shoulder (p = 0.0129) alignment, correlating negatively with age. The risk of postural defects for knees (p = 0.0391) and abdominal arching (p = 0.0240) was significant with a higher BMI. The following lifestyle-related factors were significant: the seat for doing homework (stature triangles p = 0.0253), time spent in front of a computer (positioning of the scapulae in relation to each other p = 0.0233; vertical view of the intergluteal cleft p = 0.0324), and snacking between meals (feet p = 0.0003; shoulder positioning p = 0.0013; stature triangles p = 0.0186; positioning of the scapulae in relation to each other p = 0.0404). The body posture of the examined children was closed with the head pushed forward and drooped, rounded shoulders, hyperlordosis, and pelvic anteversion. Most exhibited various types of abnormalities related to the feet. The recognized risk factors for posture defects are overweight/obesity, the male gender, children who are older, lack of an adjustable work chair, 2 h a day or more spent using the computer, and snacking between meals.

Characteristics of Pressure on the Apophysis in the Course of Paediatric Heel Pain—Preliminary Report

Increased pressure on the heel apophysis is often implicated as a cause of paediatric heel pain. However, there are few reports on the causes of the increased pressure and its origin. Therefore, the aim of this study was to analyse the distribution of pressure on the feet in children with heel pain. The study included 33 paediatric patients with non-traumatic heel pain, i.e., 24 boys (73%) and 9 girls (27%), aged on average 11.2 years (±3 years). Pedobarographic diagnostics proved a decrease in the pressure on the heels in relation to the ground and the transfer of the projection of the centre of gravity to the forefoot. While standing, the average contribution of the pressure on the heel was 0.52, SD = 0.14 in children with normal and reduced weight. In overweight children, the average pressure on the heel was higher (0.60, SD = 0.08), but the small number of children with this characteristic (n = 4) did not allow conclusions to be drawn in this area. Heel underload was also demonstrated during gait. However, the assessment of this aspect requires additional observational analyses in the field of propulsion and gait phases. The reduced pressure on the heel promotes apophysis traction, causing intracanal compression. Studies have shown that the causes of apophysis traction may be postural defects (in particular, forward inclination of body posture) and overpronation of the foot, or defects in the metatarsal area.

Multimodal programmes in the treatment of myofascial pain syndrome (MPS) – a two-step review

Myofascial pain syndrome (MPS) is one of the most common ailments associated with the human musculoskeletal system, characterised by the presence of the so-called trigger points (TrP – trigger point; MTrPs – myofascial trigger points). The International Association for the Study of Pain indicates that MPS may affect approximately one-third of people with chronic musculoskeletal pain, and that there is a lack of appropriate classification which can be attributed to a misunderstanding and/or misinterpretation of the pathophysiology. Given the diverse causes of pain syndromes in myofascial structures, it is vital to properly select and integrate therapeutic methods. The scientific literature indicates that treatment programmes should include a variety of manual therapy methods and rehabilitation exercises. Trigger point therapies, such as dry needling or dry cupping, are also widely used. At the heart of the success of rehabilitation programmes, in the opinion of the authors of this publication, is their multimodality, i.e. selection of therapeutic methods based on the cause of the pain, providing for measurable, reproducible diagnostic methods in therapy. Aim of the study. The aim of this study is to analyse and infer conclusions on multimodal myofascial pain therapy programmes. Material and methods. Given the complex research problem set as the aim, the study was carried out through a literature review in terms of two criteria: Criterion I (C I): analysis of the literature on the etiology and pathogenesis of myofascial pain (i.e. causes and triggers, symptoms, social and environmental factors determining the onset of MPS), diagnostic procedures (initial diagnosis and ongoing monitoring of treatment outcomes), and therapeutic methods used in the course of MPS. Criterion II (C II): a literature study of research publications addressing multimodal programmes for myofascial pain therapy, with their qualitative evaluation using the modified PEDro scale, and empirical testing of hypotheses based on the literature study and the analysis made in Part I. Data sources: PubMed, SCOPUS, Science Direct, MEDLINE, PEDro, Cochrane, Embase, Web of Science Core Collection, Google Scholar electronic databases were searched systematically, restricting the languages to English and German only. Results. The analysis of the literature showed that the causes, symptoms and associations of myofascial pain have been described in detail. There are also numerous reports on a variety of therapeutic methods, together with a precisely described methodology for their implementation. It is not uncommon to recommend combining methods into multimodal programmes, which unfortunately does not mean that there are many such programmes or that studies on MPS are consistent. The literature study on multimodal treatment programmes for MPS revealed that there is no correlation between its pathogenesis and a purposeful selection of specific therapeutic methods. In a small number of cases, a complex etiopathogenesis led to the formation of multidisciplinary teams. This may be associated with the absence of strict recommendations on the diagnostic methods applicable to the assessment of MPS. Conclusions. 1. Multimodal programmes for the treatment of musculoskeletal pain, notably MPS and MTrPs, should include a detailed and comprehensive diagnosis (structural, biochemical, psycho-emotional) which should serve as the basis for the formation of interdisciplinary rehabilitation teams. 2. Musculoskeletal diagnosis, in addition to radiological assessment, should include measurable techniques of postural and functional assessment (such as pedobarography, wearable sensors, assisted anthropometry, i.e. photogrammetry, videogrammetry, etc.), aimed primarily at the ongoing assessment of posture. 3. The choice of therapeutic methods and patient education should be based on the causes of the patient’s pain, taking into account systemic diseases, postural defects, lifestyle and psycho-emotional state. 4. Scientific research in multimodal treatment programmes should be carried out in randomised groups, with due attention to the methodologies of diagnostic and therapeutic procedures and group selection.

Comparison of The Effectiveness of Exercise Therapy and Electroacupuncture in Patients with Forward Head Abnormalities and Myofascial Pain Syndrome: A Randomized Clinical Trial.

Forward Head Posture (FHP), which refers to the head being more forward than the shoulder, is one of the most common postural defects of all ages. Therefore, in this study, we aimed to compare the effectiveness of exercise therapy and electroacupuncture in patients with FHP and myofascial pain syndrome (MPS). The present study was an open-label randomized clinical trial. A total of 61 patients with FHP and MPS who were referred to the physical medicine clinic of Besat Hospital between 2020 and 2021 were analyzed. Patients in one group were treated with electroacupuncture, and another one was treated with exercise therapy. The primary outcomes were FHP angles (CVA, CA, and shoulder angle), pain intensity (VAS), and quality of life (SF-12). Paired t-test was used to compare the results obtained in the pre-test and post-test. To detect differences over time, the analysis of variance models was used to repeat the observations. If the p-test result is less than the test significance level of 0.05, the null hypothesis is not confirmed. The rate of final CVA and increase in CVA in the exercise therapy group were significantly higher than in the electroacupuncture group (P < 0.001). The average shoulder angle in the exercise therapy group increased from 47.1° ± 3.0° to 51.9° ± 3.3° (P < 0.001) and in the electroacupuncture group from 47.9° ± 3.1° to 51.0° ± 2.8° (P < 0.001). A significant difference was observed between the two groups in terms of pain intensity changes during the study. Overall, the results of this study showed that both exercise therapy and electroacupuncture significantly improved patients' posture, reduced pain intensity, and increased quality of life in FHP patients with MPS; But exercise therapy was more effective in improving FHP angles and electroacupuncture was more successful in reducing patients' pain intensity.

Changes in body posture parameters: a four-year follow-up study

Body posture is an alignment of its segments relative to each other in a certain way and the relations between them. Abnormalities in the alignment of body segments or the cooperation of systems may cause postural defects. Scientific evidence showed that children of school age are more exposed to abnormalities in body posture so posture should be monitored because it is a key aspect of their body's physical health. This study aimed to evaluate changes in body posture parameters in the frontal plane in the same children at 5 and then 9 years of age. This four-year follow-up study included 67 children (29 girls and 38 boys) in preschool-age and school-age phases (the first examination at 5 years of age and the second examination at 9 years of age). Measurements of body weight and height were recorded. The computerized assessment of body posture was performed with the photogrammetric method (MORA 4 Generation). The normality of the distribution of variables was assessed with the Shapiro-Wilk test. Analysis of qualitative data was carried out using Pearson’s chi-squared test. The highest percentage of children were characterized by the deterioration in the position of the lower corners of the scapulae, taking into account the division into sex (respectively in girls 51.7 % and boys 50.0 %) and the analysis of the whole group (50.7 %). There were statistically significant differences in the position of the lower corners of scapulae (UL) between the first and second examinations in all examined children (p = 0.005). The difference in the height of the waist and in the position of the shoulders improved and deteriorated in a similar percentage in children (above 30-40 %). Generally, an improvement in body posture was observed, however, the occurred abnormalities of body posture indicate the need to continuously monitor the children's posture and implementation of preventive and corrective measures.

Correlation Analysis between Leg-length Discrepancy and Lumbar Scoliosis Using Full-length Standing Radiographs.

When a leg-length discrepancy (LLD) is severe enough, it can result in lumbar scoliosis and other postural defects. To our knowledge, no study has demonstrated associations between LLD and lumbar curvature using full-length standing radiographs of the lower limbs and lumbar spine. This study aimed to examine the correlations between LLD and lateral curvature of the lumbar spine using standing radiographs. Full-length standing radiographs of the lower limbs and spinal column of 113 participants (age range: 10-65 years) obtained between November 2006 and September 2019 were reviewed. Leg length was measured as the linear distance from the centre of the femoral head to the centre of the tibial plafond and converted to millimetres using a radiographic ruler captured in the images. Leg-length discrepancy was analysed as the absolute difference (mm) between the left and right leg lengths. Inequality was also evaluated as leg-length discrepancy ratio (LLDR), calculated as leg-length discrepancy/length of the unaffected (longer) leg × 100 (%). Lateral lumbar curvature was evaluated with the Cobb angle (°). The association between LLD or LLDR and lumbar Cobb angle was analysed by correlation analysis. Statistical analysis was performed by simple regression in SPSS. Both LLD and LLDR exhibited a robust and positive correlation with lumbar Cobb angle (γ = 0.53, γ = 0.62), as illustrated by the following regression equations: lumbar Cobb angle (°) = 0.316 × leg-length discrepancy (mm) + 2.83 and lumbar Cobb angle (°) = 2.19 × leg-length discrepancy ratio (%) + 3.0. Using objective imaging data, we found that the lumbar Cobb angle tends to be >10° if the difference in leg lengths is >20 mm. Hamada T, Matsubara H, Kato S, et al. Correlation Analysis between Leg-length Discrepancy and Lumbar Scoliosis Using Full-length Standing Radiographs. Strategies Trauma Limb Reconstr 2022;17(3):144-147.