Postural Changes Research Articles

Therapeutic Effectiveness of Postural Treatment on Youth Swimmers’ Anterior Shoulder Pain—An Interventional Study

The aim of our study was to investigate the effects of a 24-week-long training program on changes in static body posture, as well as the characteristics of anterior shoulder pain in youth swimmers, and the relationship between changes in whole-body posture and the frequency and intensity of anterior shoulder pain. Competitive young swimmers (n = 54, 13.9 ± 1.79 years) were divided into experimental group and control group and both groups performed their usual swimming training. In addition, the experimental group performed a 24-week-long whole-body posture correction program. Before and after the implemented training, whole-body posture was analyzed using the PostureScreen (version 13.7) mobile application, and subjective intensity of pain was determined using the swimmer’s functional pain scale. Significant changes were found between the two groups in numerous measured postural parameters. A significant reduction in the prevalence of shoulder pain and score of the pain scale was observed after the posture correction program in the experimental group. Our results may imply that more optimal biomechanical conditions may indirectly reduce the incidence of swimmer’s shoulder in terms of prevention. Analysis and monitoring of body posture of swimmers using an on-field mobile application continuously, and the application of preventive training programs, may help to avoid developing injuries.

The Efficacy of Muscle Energy and Mulligan Mobilization Techniques for the Upper Extremities and Posture after Breast Cancer Surgery with Axillary Dissection: A Randomized Controlled Trial.

Background: Breast cancer surgeries affect the upper extremities and posture. This study aimed to examine the efficacy of muscle energy and Mulligan mobilization techniques on the upper extremities and posture after breast cancer surgery with axillary dissection. Methods: A total of 90 female participants who had undergone breast cancer surgery with axillary dissection were recruited and randomly assigned to three groups. Group A received a combination of the Mulligan and muscle energy techniques, while Groups B and C received either the Mulligan or muscle energy techniques for six weeks, respectively. The study measured the shoulders' range of motion, posture, and upper-extremity disabilities. Outcome measurements were taken at three different time points: baseline, post-intervention, and at eight-week follow-up. Results: All the interventions significantly improved the study outcomes. The combination of the Mulligan and muscle energy techniques was significantly better than a single intervention. Mulligan mobilization was superior to the muscle energy techniques in terms of improving the shoulders' range of motion and disability. The interventions showed a significant effect pre-post-treatment and pre-follow-up but not post-follow-up. Conclusions: The Mulligan mobilization and muscle energy techniques have been found beneficial in improving the postural changes and shoulder outcomes after breast cancer surgery with axillary dissection. The superior effectiveness of the combined interventions points out the importance of integrating multiple therapeutic approaches for optimal outcomes. Regular examination and long-term follow-up assessment are important for studying the effect of rehabilitation interventions in people after the late stages of breast surgery.

The Acute and Long-Term Effects of Olympic Karate Kata Training on Structural and Functional Changes in the Body Posture of Polish National Team Athletes.

The aim of this study was to assess the acute and long-term effects of karate kata training on body posture (range of motion (ROM)) and musculoskeletal pain in elite karate athletes. Twelve kata athletes from the Polish national team participated in the study. A cross-sectional study protocol was used, with direct participatory observation (NMQ-7/6 questionnaire, spinal curvatures and spinal ROM testing, ROM of joints) and natural experiment (225 min of kata training) methods of assessment. Age and number of weekly kata sessions were found to correlate with ROM of the lumbar spine (R = (-0.6), p < 0.05). High increase in the prevalence of lumbar hypolordosis and posterior pelvic tilt was noted after karate training sessions. ROM of the inclination in the sagittal plane differed significantly between the first and second trials, by 10.0 degrees on average. Kata stances and their movement pattern seem to be related to the occurrence of disturbances in the ROM of the internal and external rotations of the hip joints and decreased depth of the lumbar lordosis, pelvic tilt, and their ROM. The locations of the long-term musculoskeletal complaints (NMQ-6) seem to result from compensatory changes that occur in the musculoskeletal structures as a result of elite-level kata training.

Impact of Sudden Sit-Stand Postural Switch on Electroencephalogram

Postural changes are inevitable motor behavior and physiological phenomenon. The study recorded electroencephalographic findings characterizing sudden switch from sitting to standing posture. 15 young adult males who satisfied inclusion criteria were recruited for the study. Baseline electroencephalographic tracings were obtained using Powerlab 26T at sitting position using scalp electrodes and during sudden switch from sitting to standing. The results of the study revealed sudden switch from sitting had no significant effect on alpha wave amplitude, beta wave amplitude and beta wave frequency. However, both alpha wave frequency and alpha/beta ratio decreased with sudden switch from sitting to standing position. The findings of the study indicated that sudden sitting to standing posture caused reductions in alpha wave and alpha/beta ratio.

Correlation between temporomandibular joints and craniocervical posture in patients with bilateral anterial disc displacement

ObjectiveTo study the changes of temporomandibular joints and craniocervical posture in adult patients with bilateral anterior disc displacement, and to explore their correlation, which may provide some clinical value for clinical diagnosis and treatment planning.MethodsNinety-eight adult patients were divided into 3 groups: 29 patients in bilateral disc normal position group (BN), 33 patients in bilateral Anterior Disc Displacement With Reduction group (ADDWR) and 36 patients in bilateral Anterior Disc Displacement Without Reduction group (ADDWoR). Dolphin and Uceph software were used to measure 14 items of temporomandibular joint and 11 items of craniocervical posture for comparison and correlation analysis between groups.ResultsThere were significant differences in bilateral joint space between three groups. Compared with the BN, the anteroposterior diameter of the condyle was significantly reduced, the condyle was significantly displaced posteriorly and superiorly in the ADDWR and ADDWoR, but the joint fossa width and joint fossa depth did not change significantly. Cervical curvature and inclination were greater in patients with anterior disc displacement than BN, indicating that the craniocervical posture of adult patients with anterior disc displacement was extended and protrusive.ConclusionAnterior disc displacement of the temporomandibular joint can displace the condyle upwards and posteriorly and reduce the anteroposterior diameter of condyle, and then make the condyle closer to the wall of articular fossa to induce joint symptoms. Additionally, craniocervical postural position is significantly affected, which may be related to compensate for the effects of airway space.

Influence of posture during gliding flight in the flying lizard Draco volans

The agamid lizards of the genus Draco are undoubtedly the most renown reptilian gliders, using their rib-supported patagial wings as lifting surfaces while airborne. Recent investigations into these reptiles highlighted the role of body posture during gliding, however, the aerodynamics of postural changes in Draco remain unclear. Here, we examine the aerodynamics and gliding performances of Draco volans using a numerical approach focusing on three postural changes: wing expansion, body camber, and limb positioning. To this aim, we conducted 70 three-dimensional steady-state computational fluid dynamics simulations of gliding flight and 240 two-dimensional glide trajectory calculations. Our results demonstrate that while airborne, D. volans generates a separated turbulent boundary layer over its wings characterized by a large recirculation cell that is kept attached to the wing surface by interaction with wing–tip vortices, increasing lift generation. This lift generating mechanism may be controlled by changing wing expansion and shape to modulate the generation of aerodynamic force. Furthermore, our trajectory simulations highlight the influence of body camber and orientation on glide range. This sheds light on how D. volans controls its gliding performance, and conforms to the observation that these animals plan their glide paths prior to take off. Lastly, D. volans is mostly neutral in pitch and highly maneuverable, similar to other vertebrate gliders. The numerical study presented here thus provides a better understanding of the lift generating mechanism and the influence of postural changes in flight in this emblematic animal and will facilitate the study of gliding flight in analogous gliding reptiles for which direct observations are unavailable.

PENERAPAN METODE KINESIO TAPPING UNTUK MENGURANGI NYERI PUNGGUNG BAWAH PADA IBU HAMIL TRIMESTER III

Low back pain is common in pregnancy with reported incidence varying from approximately 50% in the UK and Scandinavia to close to 70% in Australia. Factors that cause back pain in pregnant women are weight gain, rapid changes in posture, previous back pain, repeated stretching, many children, high levels of relaxin. One of the midwives' efforts to reduce the intensity of low back pain is by providing kinesio tapping. Research Objectives To provide midwifery care to pregnant women in a comprehensive manner by applying the kinesio tapping method to reduce lower back pain in third trimester pregnant women. The type of research used in the preparation of practice reports is descriptive research using a case study method. The research was conducted at the Tanjung Balai Karimun Health Center in March 2023. The subjects used in this case study were third trimester pregnant women with low back pain problems. This method is used 3 to 5 days of use depending on conditions. Kinesio Tapping can be applied as a complementary therapy in midwifery care services in pregnancies with back pain, especially in the third trimester

Association between Body Composition, Physical Activity Profile, and Occurrence of Knee and Foot Postural Alterations among Young Healthy Adults

Knee and foot deformities refer to structural abnormalities in the knee and foot bones, joints, ligaments, or muscles. Various factors, including genetics, injury, disease, or excessive use, can cause these deformities. These musculoskeletal conditions can significantly impact individuals’ quality of life. This study examined foot and knee deformities in 231 young healthy adults (165 men, 66 women) aged 22.6 ± 4.9 years and their association with physical activity and body composition. The postural assessment was performed by two Physiotherapists, with the subject standing in three views: side, anterior, and posterior. Physical activity (Baecke’s Habitual Physical Activity Questionnaire) and body composition (InBody 770) were assessed. Results showed that the most common foot deformity was pes planus, while the genu recurvatum was the most common knee deformity among the individuals. Physical activity level was negatively associated with knee and foot deformities. Conversely, body composition differed with the presence of genu recurvatum. These findings present a starting point to understand the occurrence of knee and foot postural alterations according to the individuals’ body composition and physical activity profiles, which could support the deployment of tailored interventions among healthy adults. In addition, early detection of postural changes is crucial in mitigating their negative long-term impact on physical well-being.

Unraveling the hierarchical structure of posture and muscle activity changes during mating of Caenorhabditis elegans.

One goal of neurobiology is to explain how decision-making in neuromuscular circuits produces behaviors. However, two obstacles complicate such efforts: individual behavioral variability and the challenge of simultaneously assessing multiple neuronal activities during behavior. Here, we circumvent these obstacles by analyzing whole animal behavior from a library of Caenorhabditis elegans male mating recordings. The copulating males express the GCaMP calcium sensor in the muscles, allowing simultaneous recording of posture and muscle activities. Our library contains wild type and males with selective neuronal desensitization in serotonergic neurons, which include male-specific posterior cord motor/interneurons and sensory ray neurons that modulate mating behavior. Incorporating deep learning-enabled computer vision, we developed a software to automatically quantify posture and muscle activities. By modeling, the posture and muscle activity data are classified into stereotyped modules, with the behaviors represented by serial executions and transitions among the modules. Detailed analysis of the modules reveals previously unidentified subtypes of the male's copulatory spicule prodding behavior. We find that wild-type and serotonergic neurons-suppressed males had different usage preferences for those module subtypes, highlighting the requirement of serotonergic neurons in the coordinated function of some muscles. In the structure of the behavior, bi-module repeats coincide with most of the previously described copulation steps, suggesting a recursive "repeat until success/give up" program is used for each step during mating. On the other hand, the transition orders of the bi-module repeats reveal the sub-behavioral hierarchy males employ to locate and inseminate hermaphrodites.

The effect of passive leg raising test on intracranial pressure and cerebral autoregulation in brain injured patients: a physiological observational study

BackgroundThe use of the passive leg raising (PLR) is limited in acute brain injury (ABI) patients with increased intracranial pressure (ICP) since the postural change of the head may impact on ICP and cerebral autoregulation. However, the PLR use may prevent a positive daily fluid balance, which had been recently associated to worse neurological outcomes. We therefore studied early and delayed effects of PLR on the cerebral autoregulation of patients recovering from ABI.Materials and methodsThis is a Prospective, observational, single-center study conducted in critically ill patients admitted with stable ABI and receiving invasive ICP monitoring, multimodal neuromonitoring and continuous hemodynamic monitoring. The fluid challenge consisted of 500 mL of crystalloid over 10 min; fluid responsiveness was defined as cardiac index increase ≥ 10%. Comparisons between different variables at baseline and after PLR were made by paired Wilcoxon signed-rank test. The correlation coefficients between hemodynamic and neuromonitoring variables were assessed using Spearman’s rank test.ResultsWe studied 23 patients [12 patients (52.2%) were fluid responders]. The PLR significantly increased ICP [from 13.7 (8.3–16.4) to 15.4 (12.0–19.2) mmHg; p < 0.001], cerebral perfusion pressure (CPP) [from 51.1 (47.4–55.6) to 56.4 (49.6–61.5) mmHg; p < 0.001] and the pressure reactivity index (PRx) [from 0.12 (0.01–0.24) to 0.43 (0.34–0.46) mmHg; p < 0.001]. Regarding Near Infrared Spectroscopy (NIRS)-derived parameters, PLR significantly increased the arterial component of regional cerebral oxygen saturation (O2Hbi) [from 1.8 (0.8–3.7) to 4.3 (2.5–5.6) μM cm; p < 0.001], the deoxygenated hemoglobin (HHbi) [from 1.6 (0.2–2.9) to 2.7 (1.4–4.0) μM cm; p = 0.007] and total hemoglobin (cHbi) [from 3.6 (1.9–5.3) to 7.8 (5.2–10.3): p < 0.001]. In all the patients who had altered autoregulation after PLR, these changes persisted ten minutes afterwards. After the PLR, we observed a significant correlation between MAP and CPP and PRx.ConclusionsIn ABI patient with stable ICP, PLR test increased ICP, but mostly within safety values and thresholds. Despite this, cerebral autoregulation was importantly impaired, and this persisted up to 10 min after the end of the maneuvre. Our results discourage the use of PLR test in ABI even when ICP is stable.

Literature Review: Efektivitas Elastic Therapeutic Taping (Ett) Terhadap Pengurangan Skala Nyeri Punggung Bawah Pada Kehamilan Trimester Iii

One of the physiological changes in pregnant women in the third trimester is the gradual musculoskeletal changes associated with the occurrence of low back pain due to increased body weight and changes in body posture. One of the new technologies in physical therapy is the use of elastic therapeutic bandages. This literature review aims to determine the effectiveness of elastic therapeutic taping (ett) against LBP in the third trimester of pregnancy. Of the 11 studies reviewed by the authors, it was shown that ETT support for low back pain relief was usually installed in the lumbar region 5 (L5) and sacrum (S1) with a band pattern I. ETT can be done 2 times a week and the ETT is replaced 3 days every 3 weeks for best results. optimally with a duration of 24-72 hours. ETT can reduce pain scores more significantly when combined with other therapies such as Paracetamol plus ETT, TENS plus ETT, ETT with oblique pelvic exercises, back exercises with ETT. The conclusion is that ETT can relieve low back pain and have a very real effect in reducing low back pain intensity in the last trimester of pregnancy.

Effects of vibration-based biofeedback on multifidus muscle activity and pelvic tilt angle in subjects with hip flexion limitation.

Sedentary work may lead to low back pain. In particular, a slumped sitting position may exacerbate low back pain because of tissue damage caused by excessive lumbar flexion and posterior pelvic tilting. Subjects with low back pain may have excessive changes in the lumbopelvic posture and back muscle activity in the sitting position. The purpose of this study was to compare the effects of vibration-based biofeedback using a motion sensor belt and no biofeedback on multifidus (MF) muscle activity and pelvic tilt angle during typing. Thirty subjects with low back pain accompanied by hip flexion limitation (15 each in the biofeedback and non-biofeedback groups) were enrolled. Electromyography was used to investigate MF muscle activity before and after typing for 30 min. Pelvic tilt was measured after typing in a sitting position for 30 min. Independent t-tests were used to compare MF muscle activity, and pelvic and second sacrum tilt angles, between the biofeedback and non-biofeedback groups. After typing for 30 min, changes in MF muscle activity (11.45% and -7.19% for the biofeedback and nonbiofeedback groups, respectively) and pelvic and second sacrum tilt angles (3.15∘ and 4.12∘ for the biofeedback group and -11.05∘ and -18.16∘ for the non-biofeedback group, respectively) were significantly smaller in the biofeedback than non-biofeedback group (p< 0.05). Vibration-based biofeedback minimizes the reduction in MF muscle activity and changes in pelvic and second sacrum tilt angles during typing in individuals with low back pain accompanied by hip flexion limitation.

Comparison of cardiovascular autonomic functions between type 2 diabetes mellitus patients and healthy individuals

Background: Type 2 diabetes mellitus is increasing day by day across the world. Cardiac autonomic neuropathy (CAN) is the most overlooked but the most debilitating complication of diabetes mellitus. If the chance of a diabetic patient to develop CAN in the future is diagnosed at an early stage of the disease, proper measures can be suggested which will delay the development of the complication. Aim and Objectives: The aim and objective of the study are to compare the cardiovascular autonomic functions between type 2 diabetes mellitus patients and normal individuals and to find whether cardiac autonomic neuropathy is present in type 2 diabetes mellitus patients. Materials and Methods: This cross-sectional study included 80 male individuals. Study participants were selected from patients attending diabetic clinics based on the inclusion criteria. A total of 80 subjects were selected out of which 40 were diabetic group and 40 were normal individuals. Cardiac autonomic functions were assessed using heart rate response to a change in posture and during the Valsalva maneuver, blood pressure response to a change in posture and during sustained isometric handgrip and heart rate variability (HRV) measurements were done using Kubios HRV analyzer software version 1.1. Results: Results were analyzed using IBM SPSS version 20 software. It was found that the resting systolic and diastolic blood pressure was found to have statistically significant higher values in the diabetic group. The mean and standard deviation of the Valsalva ratio were found to have statistically significant higher values in the diabetic group. The frequency domain parameters of HRV showed significant sympathetic predominance in the diabetic group. Conclusion: The need for early identification of cardiac autonomic neuropathy by various tests as well as the importance of lifestyle modifications were emphasized among all the participants of the study.

Revolutionizing “Text Neck Syndrome” Management: Paradigm Shifting from “Posture Correction” to “Posture Change”

Purpose: The pervasive use of mobile devices has precipitated an increase in musculoskeletal disorders, notably “text neck syndrome” (TNS), characterized by neck pain, stiffness, and dysfunction due to prolonged forward head posture. Traditional management strategies have focused on static posture correction exercises, but recent research advocates for a paradigm shift towards a dynamic and holistic approach, emphasizing joint-specific mobility and stability. This technical note critiques the limitations of conventional posture correction and explores the scientific basis for the joint-by-joint approach (JBJA) training program, which prioritizes mobility restoration to promote sustainable posture change. Conclusions: The JBJA model highlighted the necessity of addressing the entire kinetic chain, particularly the thoracic spine and shoulder girdle, to alleviate cervical spine strain. Evidence from recent studies supports the efficacy of this approach in reducing TNS symptoms and improving overall posture. Implementing posture change into TNS management involves education, technology-assisted reminders, environmental modifications, and movement-based interventions. This shift not only addresses the biomechanical imbalances that contribute to TNS but also empowers patients to actively manage their condition, fostering long-term well-being.

Blood Pressure Regulation in Persons with a Transfemoral Amputation: Effects of Wearing a Prosthesis

ABSTRACT INTRODUCTION The purpose of this study was to investigate the effect of wearing a transfemoral prosthesis (FP) on blood pressure regulation in response to postural change. METHODS We enrolled seven persons with a transfemoral amputation who underwent a head-up tilt test while wearing an FP (PROS test) and without wearing an FP (control [CON] test). Systolic blood pressure (SBP), heart rate variability, and muscle blood flow using near-infrared spectroscopy were measured continuously. RESULTS In the CON (no FP) test, SBP decreased from supine to standing positions in all participants (P = 0.001). In contrast, in the PROS (wearing an FP) test, SBP increased (P = 0.001) during the postural change. CONCLUSIONS The findings suggest that a transfemoral prosthesis increases peripheral vascular resistance in the lower limbs and stimulates the baroreflex, helping to stabilize the circulatory dynamics upon postural change. CLINICAL RELEVANCE Because circulatory dynamics may be hampered in persons with a transfemoral amputation, wearing a prosthesis not only assists in ambulation but can also play a significant role in blood pressure regulation during activities of daily living.

Maternal posture-physiology interactions in human pregnancy: a narrative review.

There are several well-known medical conditions in which posture and gravity interact with natural history, including pregnancy. In this review, we provide a comprehensive overview of interactions between maternal posture and maternal physiology and pathophysiology at rest during pregnancy. We conducted a systematic literature search of the MEDLINE database and identified 644 studies from 1991 through 2021, inclusive, that met our inclusion criteria. We present a narrative review of the resulting literature and highlight discrepancies, research gaps, and potential clinical implications. We organize the results by organ system and, commencing with the neurological system, proceed in our synthesis generally in the craniocaudal direction, concluding with the skin. The circulatory system warranted our greatest and closest consideration-literature concerning the dynamic interplay between physiology (heart rate, stroke volume, cardiac output, blood pressure, and systemic vascular resistance), pathophysiology (e.g., hypertension in pregnancy), and postural changes provide an intricate and fascinating example of the importance of the subject of this review. Other organ systems discussed include respiratory, renal, genitourinary, gastrointestinal, abdominal, and endocrine. In addition to summarizing the existing literature on maternal posture-physiology interactions, we also point out gaps and opportunities for further research and clinical developments in this area. Overall, our review provides both insight into and relevance of maternal posture-physiology interactions vis à vis healthcare's mission to improve health and wellness during pregnancy and beyond.

Effects of arousal and valence on center of pressure and ankle muscle activity during quiet standing.

Emotion affects postural control during quiet standing. Emotional states can be defined as two-dimensional models comprising valence (pleasant/unpleasant) and arousal (aroused/calm). Most previous studies have investigated the effects of valence on postural control without considering arousal. In addition, studies have focused on the center of pressure (COP) trajectory to examine emotional effects on the quiet standing control; however, the relationship between neuromuscular mechanisms and the emotionally affected quiet standing control is largely unknown. This study aimed to investigate the effects of arousal and valence on the COP trajectory and ankle muscle activity during quiet standing. Twenty-two participants were instructed to stand on a force platform and look at affective pictures for 72 seconds. The tasks were repeated six times, according to the picture conditions composed of arousal (High and Low) and valence (Pleasant, Neutral, and Unpleasant). During the task, the COP, electromyogram (EMG) of the tibialis anterior and soleus muscles, and electrocardiogram (ECG) were recorded. The heart rate calculated from the ECG was significantly affected by valence; the value was lower in Unpleasant than that in Neutral and Pleasant. The 95% confidence ellipse area and standard deviation of COP in the anterior-posterior direction were lower, and the mean power frequency of COP in the anterior-posterior direction was higher in Unpleasant than in Pleasant. Although the mean velocity of the COP in the medio-lateral direction was significantly lower in Unpleasant than in Pleasant, the effect was observed only when arousal was low. Although the EMG variables were not significantly affected by emotional conditions, some EMG variables were significantly correlated with the COP variables that were affected by emotional conditions. Therefore, ankle muscle activity may be partially associated with postural changes triggered by emotional intervention. In conclusion, both valence and arousal affect the COP variables, and ankle muscle activity may be partially associated with these COP changes.

Changes in Parameters of Arterial Stiffness with Posture in 41 Hypertensive Patients on Anti-Hypertensive Treatment

1.1. Objective: To determine changes in parameters of arterial stiffness with posture in 41 hypertensive patients on anti-hypertensive treatment 1.2. Method: Postural variations of parameters of arterial stiffness are measured in hypertensive patients on anti-hypertensive medication (n=41). Operator index, central aortic systolic pressure (ASP), central aortic pulse pressure (APP), Augmentation Index (AI) and brachial systolic pressure (SP) and brachial diastolic pressure (DP) were measured in supine and sitting positions. Parameters of arterial stiffness were obtained through Sphygmo-Cor device between 8am to 10am initially on supine position. After three minutes, values in sitting position were obtained. Ethics approval was taken. Demographics such as age, race, gender, height and BMI were noted. Differences between BP characteristics in supine and sitting were compared using non-parametric paired test of Wilcoxon Signed-rank test. 1.3. Results: A statistically significant decrease in median APP (38(35-54) vs 38(31-48), p=0.0058) and a significant increase in median DP (74(69-83) vs 76(69-87), p=0.023) was observed in hypertensive subjects on medications when moved from supine into sitting position. 1.4. Conclusions: Parameters of arterial stiffness vary with postural changes in hypertensive subjects on anti-hypertensive medications. The parameters of arterial stiffness reduce in sitting position compared to supine position. The significance of these variations is not well known but it may indicate reduction in cardiovascular events when patient is in sitting positon and may be on activity or exertion.

Development and pilot of equine facilitated physical therapy outcome measure tool for chronic low back pain patients

Equine Facilitated Physical Therapy (EFPT) lacks consistent documentation due to being an unconventional physical therapy treatment to chronic low back pain patients (LBP) and lacking rehabilitation outcome measure tools for a stable (equestrian) environment. The objectives were to develop an online evaluation tool as well as to define inter- and intra-rater reliability to validate the outcome measurement tool “Evaluation of maintaining sitting position (on a horse) and walking (short distances)” designed for LBP patients in EFPT”.A total of 48 movement related functions (n = 48), were derived from the International Classification of Functioning (ICF) and organized to an online evaluation tool. Depending on the state of validation two to six (2–6) raters scored randomized patient (n = 22) video material, recorded during a 12-week EFPT intervention, with the designed tool.Inter-rater agreement level between the experts reached good (α = 87) reliability for the scoring of the items and calculated per patient excellent (α = 100). Intra-rater reliability reached good (α = 87) and per patient good (α = 80) repeatability. For the healthy adults the reliability between raters reached acceptable (α = 72) levels and per rated excellent (α = 100). The developed assessment tool was found satisfactory to fulfil the requirement for the therapeutic practice.With the use of the tool physical therapist may detect postural changes for LBP patients as outcome report in EFPT. The tool may be used to identify treatment progress and to help design home exercises. The created tool will help to collect similar outcome measures from LBP patients in EFPT and to validate the treatment within industry.

Patient Repositioning during Hospitalization and Prevention of Pressure Ulcers: a Narrative Review.

This article presents a literature review to explore and analyze the current situation of pressure ulcers or lesions or decubitus ulcers, pathophysiological, epidemiological aspects, and risk factors. The progress in evidence of the effectiveness of preventive repositioning in the appearance of these lesions in vulnerable hospitalized patients is also evaluated. Databases were reviewed in non-systematic manner, including the Cochrane Wounds Specialized Register; Medline, Scopus, PubMed, the Cochrane Central Register of Controlled Trials; MEDLINE (Ovid); EMBASE (Ovid), Web of Science, SciELO, and Lilacs. The general search terms included [pressure ulcers or pressure lesions or decubitus ulcers] and [prevention or preventive] and [repositioning or positioning or position changes or postural change] and [patient at risk or vulnerable] and [hospitalized or ICU or intensive care]. Systematic literature reviews, randomized clinical trials, observational studies, cost-effectiveness and qualitative studies in English or Spanish were included. Although globally, the incidence, prevalence, and years of disability associated to these lesions has diminished between 1990 and 2019, the high impact on health persists. Evidence found on the effectiveness of repositioning in preventing pressure ulcers and health associated costs has been evaluated with certainty between low and very low, as a result of conducting research with serious methodological limitations that report results with high inaccuracy. The findings reported present that these lesions persist at hospital level and continue being a global social and health problem with high impact on health budgets. Likewise, there is a need to develop greater quality research on prevention strategies, such as repositioning, which validate their effectiveness, and justify their use.