Spinal Mobility Research Articles

Biology and mechanobiology of the intervertebral disc : Challenges for regenerative therapies

The fibrocartilaginous intervertebral discs between the vertebrae give the spine mobility and flexibility. Age and degeneration contribute to tissue changes that affect the composition and structure of the intervertebral discs and can lead to loss of function and back pain. The intervertebral disc cells are responsible for the formation and maintenance of the tissue and are influenced by the physiological load. Degenerative changes that promote tissue degradation are influenced by cellular responses to overuse, inflammation and nutrient deficiency. The mechanobiology of intervertebral discs deals with the interrelationships of the functional adaptation of this organ down to the cellular and molecular level and contributes to the understanding of the causes and consequences of degeneration. Based on these findings, the challenges for suitable regenerative therapy concepts can be understood.

The Effect of a Single Temporomandibular Joint Soft Tissue Therapy on Cervical Spine Mobility, Temporomandibular Joint Mobility, Foot Load Distribution, and Body Balance in Women with Myofascial Pain in the Temporomandibular Joint Area—A Randomized Controlled Trial

In contemporary times, a significant portion of the population experiences symptoms of temporomandibular joint (TMJ) dysfunction. The objective of this study was to evaluate the effects of a single-session TMJ soft tissue therapy on the TMJ and cervical spine mobility as well as on body balance and the foot load distribution. This study was a parallel-group, randomized, controlled trial with a 1:1 allocation ratio. Fifty women aged 20–30 years diagnosed with myofascial pain in the TMJ area were included in the study and divided into two groups. The experimental group received TMJ soft tissue therapy. The following research tools were used: a Hogetex electronic caliper, a CROM Deluxe, and a FreeMed Base pedobarographic platform. In the experimental group, an increase in mobility within all assessed jaw and cervical spine movements was observed. This change was statistically significant (p < 0.05) for lateral movement to the left, abduction, and protrusion of the jaw (an increase of 10.32%, 7.07%, and 20.92%, respectively) and for extension, lateral bending to the right and left, and rotation to the right and left, of the cervical spine (an increase of 7.05%, 7.89%, 10.44%, 4.65%, and 6.55%, respectively). In the control group, no significant differences were observed. No significant changes were observed in the load distribution and body balance assessment. A single session of TMJ soft tissue therapy increases jaw and cervical spine mobility but does not impact body balance or foot load distribution in static conditions in women diagnosed with myofascial pain in the TMJ area.

A STUDY TO COMPARE THE EFFECTIVENESS OF SPINAL MOBILIZATION WITH ARM MOVEMENT VERSUS NEURAL TISSUE MOBILIZATION ALONG WITH MUSLE ENERGY TECHNIQUE AMONG CERVICAL RADICULOPATHY PATIENTS

Background: Cervical Radiculopathy is a disease of the cervical spine and a space occupying lesion that occurs because of pathological problems with cervical nerve roots. It usually causes the pain in the neck ,radiating to one arm with reduced motor function and reflex changes in the affected nerve root and commonly affect the middle aged to elderly person. Objective: A study to compare the effectiveness of spinal mobilization with arm movement versus neural tissue mobilization along with muscle energy technique among cervical radiculopathy patients. Method: Comparative study, 30 patients were selected from Sri Venkateshwara group of institution. They were allocated into two groups, group A(n=15) spinal mobilization with arm movement along with MET, group B (n= 15) neural tissue mobilization with MET given for 3 days per week for 6 weeks, the outcome measures NPRS and goniometric measurement were used. Result: Data analysis was done by paired ‘t’ test for within the group and unpaired ‘t’ test for between the group analysis respectively. The statistical analysis shows that the group A had significant improvement than group B. It has been concluded that group A showed reduction in the pain and improvement in ROM than group B. Conclusion: This study concludes that spinal mobilization with arm movement along with MET for group A shows more significant in reducing the pain and improve ROM among cervical radiculopathy patients than neural tissue mobilization with MET in group B.

Cervical spine sensorimotor deficits persist in people post-concussion despite minimal symptoms

Background The mechanisms of a concussion place stress on the cervical spine like that of a whiplash event, which can result in cervical spine dysfunction. This study aimed to determine if underlying cervical spine mobility and sensorimotor function deficits occur in individuals who are post-concussion with near resolution of symptoms. Methods Twenty-five participants with a self-reported concussive event within a year (PC group: post-concussion 157 + 120 d, 9 men, age: 25 ± 8 yr) and 26 comparable peers (Peer group, 9 men, age: 25 ± 7 yr) were tested. The Post-Concussion Symptom Scale (PCSS) quantified residual concussion symptoms. Participants completed cervical joint position error (JPE) and cervical spine joint mobility tests blinded from each other. Group mean differences were analyzed using t-tests. Results The PC group had minimal symptoms (PCSS = 6.8 ± 6.5) but substantial differences in JPE tests compared to the Peer group (PC = 7.4 ± 1.8 cm; PG = 5.6 ± 1.1 cm; p < .001). Those PC participants with pain during joint testing (n = 15) had worse JPE (Painful = 8.1 ± 1.8 cm, No-pain = 6.3 ± 1.6 cm; p = .02) and less averaged lower cervical spine joint mobility compared to PC participants without pain (Painful = 0.66 ± 0.22, No-pain = 0.87 ± 0.19; p = .02, Normal motion = 1.0). Conclusion Following a concussion, it is a reasonable recommendation to screen the cervical spine to identify impairments in joint mobility and JPE that contribute to neck dysfunction.

Shape of the Sagittal Curvatures of the Spine in Young Female Volleyball Players

Background: The issue of the relation betweeen training loads on the shape of the spine of young players is of significant importance, as with the advancement of training seniority, unfavorable changes may be perpetuated resulting in possible consequences in the next stages of ontogenesis. The aim of this study was to assess the formation of the sagittal curvatures of the spine in girls practicing volleyball versus their nonpractising peers. Methods: We examined 60 girls aged 10–13 years, including 30 volleyball players and 30 untrained peers. The Baseline Bubble inclinometer was applied as a research. The data were analyzed based on Mann–Whitney U test and Pearson Chi-square test. Results. There were statistically significant intergroup differences in lumbar lordosis curvature values (Z = −2.67; p = 0.007). The prevalence of correctness values of the thoracic kyphosis curvature, was group-dependent (χ2(1) = 4.34; p = 0.037). Group also determined the prevalence of lumbar lordosis normalities (χ2(1) = 5.41; p = 0.020). Conclusions. Volleyball has a beneficial effect on the formation of the thoracic kyphosis, while the lumbar lordosis is shallowed under the influence of training. This indicates the need for a holistic approach to player training and the need to supplement the technique and tactics training with exercises to strengthen the muscles that stabilize the lumbar spine, improve spinal mobility, learn how to control the anterior tilt of the pelvis and train the fascia.

Neuroprotective component of outpatient rehabilitation of patients with lumbosciatica and depression

The aim of the study was to investigate the effectiveness of including cytoflavin in complex outpatient rehabilitation therapy for patients suffering from lumboschialgia and depression .Material and methods. 86 patients (38 men and 48 women, average age — 53.2 ± 5.9 years) with lumboschialgia and depression were examined. All patients underwent dynamic somatic and neurological status examination (before and after therapy), laboratory and instrumental studies were performed. To assess the neurological profile, the following were used: digital rating scale (DRS) of pain, Oswestry questionnaire (version 2.1a), hospital anxiety and depression scale (HADS), CGI-S scale, DN4 and SF-36 questionnaires. All patients underwent dynamic diagnostics of spinal mobility using the following parameters: Thomayer test (spinal flexion, distance floor – fingers (FF)), distance fingers legs (FL), backward bend while standing and lying on the stomach. In addition to standard treatment, patients in the main group (n = 44) were prescribed cytoflavin: 2 tablets 2 times a day regardless of food intake, 30-day course. The subjects from the control group (n = 42) received only standard treatment.Results. Inclusion of cytoflavin in the regimens contributed to a more pronounced reduction in pain syndrome compared to the control group: by 5 times according to the Oswestry questionnaire (version 2.1a), by 1.7 times versus 1.3 times according to the DN4 questionnaire, respectively (p &lt; 0.05). The disappearance or significant reduction of pain syndrome contributed to the expansion of motor activity due to the increase in mobility in the spine — a more pronounced positive dynamics in terms of extension: 34.2 % and 22.9% in the main group versus 15.9% and 17.7% in the control group (p &lt; 0.05). The inclusion of the drug contributed to a more significant reduction in neurological symptomatology disorders than in patients in the control group: anxiety indicators (according to the HADS scale) in the control group decreased by 5.3 times, while in the control group they decreased only by 1.75 times (p &lt; 0.05); signs of depression — by 2 and 1.5 times, respectively (p &lt; 0.05). At the same time, the subjects to a greater extent noted a decrease in fatigue, an improvement in night sleep, an increase in activity and performance. The effectiveness of the presented outpatient rehabilitation scheme was confirmed by the positive dynamics of the patients’ quality of life indicators on all SF-36 scales: the most significant increase on the scales of “role functioning due to physical condition” and “pain intensity” — on average by 25.9 points in the control and 26.3 points in the main, respectively (p ≥ 0.05).Conclusion. The inclusion of cytoflavin in the complex treatment of patients with this pathology helps to reduce the intensity of pain, increase spinal mobility and eliminate the neuropathic component, which improves the quality of life of patients. The results obtained can serve as a basis for further research in this area.

A machine learning approach for the design optimization of a multiple magnetic and inertial sensors wearable system for the spine mobility assessment

BackgroundRecently, magnetic and inertial measurement units (MIMU) based systems have been applied in the spine mobility assessment; this evaluation is essential in the clinical practice for diagnosis and treatment evaluation. The available systems are limited in the number of sensors, and neither develops a methodology for the correct placement of the sensors, seeking the relevant mobility information of the spine.MethodsThis work presents a methodology for analyzing a system consisting of sixteen MIMUs to reduce the amount of information and obtain an optimal configuration that allows distinguishing between different body postures in a movement. Four machine learning algorithms were trained and assessed using data from the range of motion in three movements (Mov.1—Anterior hip flexion; Mov.2—Lateral trunk flexion; Mov.3—Axial trunk rotation) obtained from 12 patients with Ankylosing Spondylitis.ResultsThe methodology identified the optimal minimal configuration for different movements. The configuration showed good accuracy in discriminating between different body postures. Specifically, it had an accuracy of 0.963 ± 0.021 for detecting when the subject is upright or bending in Mov.1, 0.944 ± 0.038 for identifying when the subject is flexed to the left or right in Mov.2, and 0.852 ± 0.097 for recognizing when the subject is rotated to the right or left in Mov.3.ConclusionsOur results indicate that the methodology developed results in a feasible configuration for practical clinical studies and paves the way for designing specific IMU-based assessment instruments.Trial registration: Study approved by the Local Ethics Committee of the General Hospital of Mexico “Dr. Eduardo Liceaga” (protocol code DI/03/17/471).

Safety and Feasibility of Internal Fixation Using Bioabsorbable Versus Titanium Materials for Short-Level Lamina Reimplantation: A Comparative Clinical Study.

Lamina-implantation is gradually becoming the main surgical method for the treatment of intraspinal tumors. Traditional titanium (Ti) internal fixation not only produces artifacts, which affects the observation of tumors and dural sac closure, but also faces the problem of secondary surgical removal. In this study, absorbable material were used in lamina replantation for the first time and was evaluated for its efficacy and safety. We retrospectively enrolled patients who underwent short-segment lamina replantation for intraspinal tumors in our center from February 2020 to November 2022. After condition matching of the number of fixation segment and fixation position, the baseline information, complications, neurological function, quality of life, spinal mobility and bone healing rate of the absorbable group and the Ti group were compared. Fisher exact, Chi-square, or rank sum test were used for categorical variables, and t-test was used for continuous variables to distinguish differences between groups. Cerebrospinal fluid leak was the most common complication, with no difference between the two groups (12.9% vs. 19.4%, p = 0.366). The bone healing rates of the two groups at 3 months after surgery were 77.4% and 87.1%, respectively, and there was no significant difference (p = 0.508). At 1 year after surgery, the resorbable group showedlower levels of anxiety/depression (1.20 ± 0.41 vs. 1.61 ± 0.61, p = 0.050), however, it did not affect the overall quality of life of the patients at 1 year. Both titanium and absorbable internal fixation have shown good clinical results in the treatment of intraspinal tumors by laminareplantation. Regardless of cost, absorbable screws and plates are also suitable optionsfor patients undergoing lamina replantation, because it has no stress shielding effect and does not require secondary removal. In addition, there are no artifacts in the image, which is more conducive to observing the recurrence of the tumor and the closure of the dural sac.

The efficacy of combined physiotherapeutic scoliosis-specific exercises and manual therapy in adolescent idiopathic scoliosis

BackgroundAdolescent idiopathic scoliosis (AIS) is a pathological condition characterized by vertebral curvature and associated trunk deformities in adolescents. The clinical efficacy of conservative treatment in alleviating spinal curvature of AIS remains a topic of ongoing debate. The objective of this study was to investigate the impact of combined physiotherapeutic scoliosis-specific exercises (PSSE) and manual therapy (MT) on trunk deformity, spinal function, mobility, and mental health in patients with AIS.MethodsThirty-one participants who were diagnosed with AIS whose Cobb angle was between 10–45°were enrolled in the study. Participants in the intervention group received 50 min of PSSE combined with 10 min of MT, while the control group performed 50 min of PSSE as their home exercise program. Both treatments were implemented three times a week for four weeks. Cobb angle, spinal mobility, trunk morphology (vertebral rotation angle, apical deviation, pelvic obliquity distance and angle), movement capability, and quality of life (QOL) were assessed at baseline and post intervention. The treatment effects between the intervention and control groups were analyzed using a two-way repeated measures ANOVA.ResultsFollowing a 4-week treatment period, Cobb angle was significantly reduced from 21.58° to 18.58° in intervention group and increased from 18.00° at baseline and 19.14° post intervention in the control group. Significant improvements were also observed in spinal mobility, movement capability, quality of life, and some of the trunk morphology indices in the intervention group compared to baseline (p < 0.05). Improvements were significantly higher in the intervention group than the control group.ConclusionCombining PSSE and MT shows potential benefits in alleviating AIS symptoms and improving QOL. Further studies to substantiate these findings are warranted.Trial registrationThe trial was retrospectively registered in the Chinese Clinical Trial Registry (https://www.chictr.org.cn) with the registration number: ChiCTR2300071357, (Date: 12/05/2023).

The effectiveness of intramuscular dry needling stimulation in treating trigger points: A case series

Myofascial trigger points are a common presentation in clients with chronic spinal pain. Various techniques are used to manage trigger points and are considered a vital part of chronic spinal pain management. Reducing pain caused by trigger points may be effective in improving function. Case series can provide preliminary evidence and assist in feasibility assessment. The objective of this case series is to document the feasibility of intramuscular dry needling stimulation in managing trigger-point-induced chronic pain. Three individuals aged 35, 33, and 28 years presented to a private clinic with chief complaints of scapular region muscular pain, and their management is reported in this case series. Initial physical examination revealed tenderness over D6 and D8. There was a palpable para spinal muscle hypertonicity and reduced thoracic spine mobility to both sides in all the three clients. The presence of multiple trigger points bilateral to the spine indicated postural dysfunction, which altered pain on changing thoracic posture. Clients were treated with dry needling with intramuscular stimulation over trigger points, paraspinal muscle and inferior to scapula by a therapist trained in the technique. The frequency was kept at 1.5 Hz and intensity was as tolerated by the patient. Outcome measures were taken using VAS, RMDQ and digital inclinometer for thoracic spine rotation. Subject one reported a change of 22 mm in VAS after the first week and 40 mm in the fourth week. It also reported an improvement in mobility to both side rotations by 20 degrees in the first week and full towards the fourth week. Subject two and three improved VAS by 10 mm in week one and 35 mm towards the fourth week. Full mobility was achieved in the fourth week in both cases. RMDQ scores improved significantly in the three cases. The three cases demonstrate significant improvement in both symptoms and function based on outcome measures. This indicates the efficacy of treating thoracic spine myofascial trigger points with dry needling and intramuscular stimulation, but a large-scale study is recommended.

ANALYSIS OF THE SPINAL CURVATURE IN RHYTHMIC GYMNASTICS ATHLETES OF DIFFERENT COMPETITIVE LEVELS AND WITH DIFFERENT POSTURES

Rhythmic gymnastics is characterized by high mobility demands on the spine, which can lead to structural changes and associated injuries or pain. The aim of this study is to assess and compare spinal posture in different positions, mobility, and pain perception among RG athletes. The sample consisted of 34 gymnasts (age: 14.18 ± 2.17) of grassroots and federation levels. Spinal posture and mobility were analyzed using the Spinal Mouse® system, along with pain perception (location and intensity) and body composition. Most gymnasts exhibited normal spinal curvature in both standing and sitting positions. Significant differences (p&lt;0.05) were only found in the sacral curve during extension. Regarding lumbar mobility, differences in sacral mobility from standing to extension were noted, with the federation-level gymnasts showing a greater tendency for hyperlordosis in extension. In terms of pain, the lumbar region was the most affected, with 32.4% of cases reporting pain. It was observed that gymnasts experiencing pain displayed more pronounced lumbar hyperlordosis in the standing position. A low but significant correlation was found between lumbar pain and its intensity (p=0.045), and a moderate correlation was observed between hip pain and pelvic tilt. The gymnasts demonstrated a greater tendency for lumbar hyperlordosis in the standing position and during the transition from standing to extension, which was more pronounced among federation-level gymnasts. Furthermore, there appears to be a stronger correlation between hyperlordosis and the occurrence of lumbar pain, as well as the intensity of pain.

Results of distraction and ligamentotaxis in thoracolumbar fractures without decompression

Background: Thoracolumbar fractures are common spinal injuries often requiring surgical intervention. Traditionally, decompression surgery has been used to relieve neural pressure. This study evaluates the effectiveness of ligamentotaxis with pedicular screw fixation, which minimizes the need for decompression, in treating thoracolumbar fractures. Methods: A retrospective cohort study was conducted at a Government Medical College, Aurangabad involving 30 patients aged 18 and older with thoracolumbar fractures treated with ligamentotaxis and pedicular screw fixation. Clinical outcomes were assessed using the visual analog scale (VAS) for pain, the American spinal injury association (ASIA) impairment scale for neurological function, and forward flexion degrees for spinal mobility. Patients were followed up for 12 months post-operatively. Results: Significant pain reduction was observed, with VAS scores decreasing from 8.5 pre-operatively to 2.5 at 12 months (p&lt;0.001). Neurological function improved, with many patients advancing from ASIA category A pre-operatively to category D by 12 months (p&lt;0.001). Spinal mobility showed considerable recovery, with forward flexion increasing from 0 degrees pre-operatively to 80 degrees at 12 months (p&lt;0.001). Conclusion: Ligamentotaxis with pedicular screw fixation is an effective treatment for thoracolumbar fractures, providing substantial pain relief, neurological improvement, and restored spinal function. While outcomes are generally positive, patient selection remains critical to avoid poor neurological results. Further research is needed to refine indications and optimize treatment protocols.

Evaluation of functional measures and laboratory parameters to portend limitations of spinal mobility in patients with radiographic axial spondyloarthritis

Aim of the workTo specify clinical and laboratory parameters related to limited spinal mobility in radiographic axial spondyloarthritis (r-axSpA) patients. Patients and methodsThe study included 202 adult r-axSpA patients. Clinical characteristics, medications, investigations including serum C-reactive protein (CRP) and human leukocytic antigen-B27 positivity were noted. Lateral lumbar flexion (LLF), chest expansion (CE) and tragus-to-wall distance (TWD) were measured. Values <2.5 percentile in LLF, CE and TWD were noted as reduced mobility of lumbar, thoracic and cervical spine, respectively. ResultsThe median age of patients was 43 years, male:female was 3.7:1. The time to diagnosis was 7.5 (3–40) years and were followed-up for 7.2 (4–22) years. Disease duration and high baseline CRP (>10 mg/L) were critical risk factors for reduced spinal mobility (p = 0.001 and p < 0.01). The duration to impaired LLF was significantly shorter in smokers (n = 105) (10.3;0–30.5 years) vs non-smokers (15.2;4.5–35 years) (p = 0.001) and in those with positive family history (n = 50) (9.7;0–20 years) compared to those without (12.9;4–35 years) (p = 0.09). LLF, CE and TWD were impaired in 40 % vs 75 %, 10 % vs 55 % and 12 % vs 60 % of patients with symptom duration of 10 vs 30 years respectively. Those with delayed introduction of biologics had significantly more impaired LLF, CE and TWD: 10.1(2–25) vs 14(3–33) years; 10.4(3–26) vs 17.5(8–33) years; 10.7(3–27) vs 16.7(5–33) years; p = 0.001 for all, respectively). ConclusionsThe most prominent factors affecting spinal mobility were the duration of symptoms and high serum CRP levels. The decreased spinal mobility was markedly less in patients with the early introduction of biologic therapy.

Comparative analysis of the frequency of comorbid diseases in axial psoriatic arthritis and other variants of axial spondyloarthritis. Data from a hospital cohort

Objective: to compare the frequency of comorbid diseases in axial psoriatic arthritis (axSpA) and in other variants (OV) of axial spondyloarthritis (axSpA).Material and methods. We studied 60 patients, 30 with axPsA (15 men and 15 women, mean age – 49.1±10.4 years, disease duration – 12.6±6.9 years) and 30 with OV axSpA (16 men and 14 women, mean age – 42.9±9.7 years, disease duration – 16.30±8.3 years). All patients underwent a standard rheumatological examination. The diagnosis of comorbid diseases was confirmed using ICD-10 codes. The Cumulative Illness Rating Scale (CIRS), Charlson comorbidity index (CCI) and the weighted version of Functional Comorbidity Index (w-FCI) were used to assess comorbidity.Results and discussion. Comparative analysis of the two groups revealed that axPsA patients were older than OV axSpA patients (p &lt;0.05). Occurrence of back pain before the age of 40 was observed in 60% of axPsA cases, compared to 86.7% in OV axSpA (p&lt;0.05). The limitation of spinal and hip mobility was less severe in axPSA than in OV axSpA. The median side flexion was 12.3 [10; 15] and 9.5 [8; 11] cm, the Schober test was 4.2 [3; 5] and 3.0 [2; 4] cm and intermalleolar distance was 95.9 [86; 102] and 83.0 [75; 100] cm, respectively (p&lt;0.05). Patients with axPsA were more likely to have peripheral arthritis compared to patients with OV axSpA: 27 (90%) and 11 (36.7%) cases, respectively (p&lt;0.05) and higher laboratory indices of activity: median ESR, 31.9 [10; 38] and 20.4 [5; 14] mm/h, and CRP, 20.5 [2.8; 20.7] and 13.6 [0.9; 12.0] mg/L, respectively (p&lt;0.05). In the axPsA and OV axSpA groups, circulatory system diseases were found in 50 and 50% of patients, metabolic disorders in 76.6 and 76.6%, and gastrointestinal diseases in 46.7 and 70 %. Obesity was more common in axPsA than in OV axSpA – in 40 and 16.7% of patients, respectively (p&lt;0.05).Conclusion. A high frequency of comorbidities, mainly cardiovascular and metabolic diseases, was found in both groups. These data should be considered in the choice of therapy and optimization of existing treatment algorithms.

Correlations among quality of life, spinal mobility, and disease activity in early-treated axial spondyloarthritis: a single-center cross-sectional study

BackgroundAxial spondyloarthritis (axSpA) significantly impacts patients’ lives. The ASAS-OMERACT guideline was formulated for the multidimensional evaluation of axSpA patients, employing a specific set of tools. Given the pivotal role of patient perception, comprehensive correlation among these tools, especially concerning quality of life, may provide a clinically relevant perspective and enhance treatment efficacy in the early stages of the disease. This study aims to investigate the correlation among disease activity, functional ability, and quality of life in early-treated axSpA patients. In addition, the association between high disease activity and clinical characteristics was explored.MethodsThis cross-sectional study was conducted in a tertiary hospital in Thailand. Patients diagnosed with axSpA according to ASAS classification criteria and receiving treatment from rheumatologists within three years of onset of symptoms were included. Clinical and laboratory data were retrieved from a hospital database. Disease activity was assessed using the Ankylosing Spondylitis Disease Activity Score with ESR or CRP (ASDAS-ESR/CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Spinal mobility was measured using the Bath Ankylosing Spondylitis Metrology Index (BASMI), while quality of life and function were evaluated using the ASAS Health Index (ASAS-HI) and Bath Ankylosing Spondylitis Functional Index (BASFI), respectively. The correlation between these measurements was analyzed using the Pearson correlation coefficient (r). Additionally, factors associated with high disease activity (ASDAS/CRP > 2.1) were explored using multivariate regression analysis.ResultsSixty-six patients (41 males; mean age 49.3 ± 13.3 years) were enrolled between April to December 2022. Disease activity (ASDAS-CRP) was significantly inversely correlated with spinal mobility (BASMI), function (BASFI), and quality of life (ASAS-HI). High disease activity was associated with obesity (BMI ≥ 30 kg/m^2) and a longer duration of symptoms before treatment (≥ 2 years).ConclusionIn early-treated axSpA patients, ASDAS-CRP showed significant correlations with functional ability, quality of life, and spinal mobility. High disease activity was associated with obesity and a longer pre-treatment symptom duration in our study. Early treatment may enhance patients’ function, mobility, and quality of life, with weight reduction being possibly beneficial for obese axSpA patients.Clinical trial numberNot applicable.

More neck pain, less spinal mobility, altered sitting posture: Sagittal spinal alignment and mobility in women with chronic neck pain

BackgroundIncreasing evidence suggests that people with chronic neck pain (CNP) may display altered biomechanics beyond the cervical spine. However, whether spinal alignment and mobility are associated with neck pain is not clarified. ObjectivesTo investigate whether there is a significant association between neck pain intensity and sagittal spinal alignment and mobility in people with CNP, and to examine whether sagittal spinal alignment and mobility differ according to pain intensity. DesignA cross-sectional study. MethodForty-four women with CNP were included. The neck pain intensity at rest and during neck movements was assessed with the visual analogue scale (VAS). A skin-surface measurement device was used to assess sagittal alignment and mobility while sitting and standing. Linear regression analysis was used to assess associations. Participants were divided into two groups according to the pain intensity as group with mild pain (VAS≤4.4 cm) and group with moderate to severe pain (VAS>4.4 cm) and compared using the analysis of covariance. ResultsGreater resting pain was associated with a more forward trunk during sitting (Beta = 0.433, p < 0.05). Greater pain during neck movements was associated with increased lumbar lordosis during sitting (Beta = −0.376, p < 0.05). Classified by pain intensity at rest, trunk mobility while sitting was lower and forward trunk inclination and sacral kyphosis while sitting were higher in those with moderate/severe pain (η2p = 0.093–0.119, p < 0.05). By pain intensity during neck movements, women with moderate/severe pain exhibited lower sacral mobility while sitting (η2p = 0.129, p < 0.05). ConclusionsAddressing the entire spine in the assessment and management of CNP may help reduce pain.

Survey of Knowledge, Attitudes, and Levels of Confidence Regarding Age-Related Hyperkyphosis and Its Management among Thai Physiotherapists.

Thorough knowledge of the management of age-related hyperkyphosis is crucial to physiotherapists' effective handling of complex spinal deformities. This cross-sectional study investigated the knowledge, attitudes, and confidence of Thai physiotherapists regarding age-related hyperkyphosis. An online questionnaire with demographic, work-related, knowledge, attitude, and confidence questions was employed. The data analysis involved descriptive statistics, chi-square tests, and independent t-tests. Complete responses were obtained from 314 physiotherapists. The correct responses amounted to 68.79% for the definition, 90.00% for causes, 14.97% for age of onset, 22.38% for prevalence, and 64.65% for the gold-standard diagnosis of hyperkyphosis. Most of the diagnostic methods involved visual examination. The respondents reported that hyperkyphosis disrupts respiratory function. The aim of treatment, according to 88.85%, was to increase spine mobility. Corrective posture exercises were the most common treatment strategy, but the range of treatments was diverse. Many cited undergraduate education as their primary evidence source. Respondents had conflicting attitudes towards "age-related hyperkyphosis is a normal aging process" but mostly positive attitudes towards the need for physiotherapy treatment. Approximately 22% reported fair confidence in treating hyperkyphosis. This study highlights the importance of raising awareness and enhancing knowledge, attitudes, and confidence among physiotherapists to improve care for older adults with hyperkyphosis.

Author response to Eric Saedt “Spinal mobilization in infants reconsidered”

Author response to Eric Saedt “Spinal mobilization in infants reconsidered”

Relationship between Climacteric Symptom Intensity, Physical Activity Level, Spine Mobility, Balance, and Quality of Life in Women

Objective: The climacteric period contains more than 1/3 of a woman's life and causes various symptoms stemming from physiological and hormonal changes. Our study investigated the relationship of climacteric symptom intensity with physical activity level, spine mobility, balance, and quality of life. Methods: 64 women (49,5 ± 4,24 years) in the climacteric period were included in the study. Climacteric symptom severity was assessed with the Blatt-Kupperman Index, physical activity levels with the International Physical Activity Questionnaire, quality of life with the Menopause-Specific Quality of Life Questionnaire, and balance with the single-leg stance test. The correlations between the variables were analyzed with the Pearson and Spearman Correlation analysis. Results: Of the participants, 15.6% had minor severe symptoms, 59.4% had mild severe symptoms, 18.8% had moderately severe symptoms and 6.3% had severe climacteric symptoms. The climacteric duration was negatively correlated to spinal mobility measures (r= -0.26 - -0.30) and the quality of life (r= 0.26) (p

Examining spinal mobility, aerobic capacity and functional movement in patients with non-specific chronic low back pain: a case-control study

Background/Aims The increasing cost and incidence of non-specific chronic low back pain means that many physiotherapists are reconsidering the management of this condition. The primary aim of this study was to examine spinal mobility, aerobic capacity and functional movement screen in patients with non-specific chronic low back pain. The secondary aim was to determine the factors affecting the disability level. Methods Participants aged between 18–65 years old diagnosed with non-specific chronic low back pain for &gt;3 months were recruited as a study group, while those without low back pain in the last 3 months were the control group. Outcome measures included the Functional Movement Screen for functional movement, the 2-Minute Step Test for aerobic capacity, the Spinal Mouse for spinal mobility and Oswestry Disability Index for disability level. Results A total of 60 participants, 30 people with non-specific chronic low back pain (42.7 ± 10.6 years) and 30 people without low back pain (42.0 ± 7.3 years), were included in this study. There were statistically significant differences in the total sagittal plane angle (P&lt;0.001), total frontal plane angle (P=0.03), 2-Minute Step Test (P&lt;0.001) and Functional Movement Screen (P&lt;0.001) scores between groups. Pain and aerobic capacity explained 42.4% of the variance as determinants of disability in the study group. Conclusions In people with non-specific chronic low back pain, sagittal and frontal plane range of motion and aerobic capacity were decreased and their functional movements were impaired. Pain intensity and aerobic capacity affect the disability level of non-specific chronic low back pain. Implications for practice People with non-specific chronic low back pain have reduced spinal mobility, aerobic capacity and functional movement. These parameters should be included when determining treatment programmes. At the same time, the level of disability can be reduced by decreasing pain intensity and increasing aerobic capacity of people with low back pain.