Low-grade degenerative lumbar spondylolisthesis (DLS) is defined as less than 50% slippage of a lumbar vertebral body over the next most caudal vertebral body. Patients with DLS usually experience back pain, leg pain, and even falls.The pain intensity, static and dynamic balance, functional disability, and the spino-pelvic parameters of the radiography (pelvic incident, pelvis tilt, sacral slope, lumbar lordosis) were compared between the patients with DLS and without DLS (non-DLS).The results revealed that DLS patients were older, had greater angle of pelvic incidence and pelvic tilt, less stability and more low back pain than non-DLS patients.The pelvic tilt was the major compensating factor of spino-pelvic balance in both groups. Lumbar lordosis is positively related to body mass index. Sacral slope and lumbar lordosis contributed to partial compensation of balance of spinopelvic alignment in DLS patients, whereas sacral slope could be an indicator of fall risk in non-DLS patients. Objective: To evaluate the relationships among spino-pelvic parameters, trunk balance and functional disability in patients with degenerative lumbar spondylolisthesis. Design: Cross-sectional study. Subjects: Forty-five patients with degenerative lumbar spondylolisthesis and 32 patients without degenerative lumbar spondylolisthesis. Methods: Spino-pelvic parameters (pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis) and pain severity were evaluated. Biodex balance tests (postural stability, limits of stability, modified clinical test of sensory interaction and balance, fall risk) and Quebec Back Pain Disability Scale (QBDS) scores were measured. Results: Intergroup differences were found in age, low back pain, limits of stability, pelvic incidence, pelvic tilt and some subscales of QBDS. Correlations were found: (i) in the degenerative lumbar spondylolisthesis group: between pelvic incidence and sacral slope/pelvic tilt/lumbar lordosis/height/limits of stability; sacral slope and lumbar lordosis/height/ limits of stability/modified clinical test of sensory interaction and balance (eyes closed on foam); lumbar lordosis and body mass index/QBDS/postural stability/modified clinical test of sensory interaction and balance (eyes open and eyes closed on foam); (ii) in the non-degenerative lumbar spondylolisthesis group: between pelvic incidence and pelvic tilt; pelvic tilt and sacral slope/lumbar lordosis; sacral slope and lumbar lordosis/fall risk. All spino-pelvic parameters in the degenerative lumbar spondylolisthesis group and pelvic tilt in the non-degenerative lumbar spondylolisthesis group correlated with QBDS. Conclusion: Pelvic tilt was the major compensating factor in both groups (patients with and without degenerative lumbar spondylolisthesis). Sacral slope and lumbar lordosis contributed to partial compensation in the degenerative lumbar spondylolisthesis group. Lumbar lordosis correlated with body mass index. Sacral slope could be an indicator of fall risk in the non-degenerative lumbar spondylolisthesis group.

Background:Hemiplegic shoulder pain (HSP) is one of the most common comorbidities in stroke patients with flaccid shoulders. The pain limits functional motor recovery and affects the activities of daily living after acute stroke. This study investigated the effects of hyaluronic acid (HA) injection on pain reduction and motor function in subacute stroke patients with HSP and injury.Methods:A randomized, double-blinded controlled trial was conducted in a medical center. Twenty-six subacute stroke patients were enrolled and randomly divided into 2 groups: the experimental group (n = 16) received ultrasound-guided, subacromial HA injections once per week for 3 weeks and conventional rehabilitation, whereas the control group (n = 10) received 0.9% sodium chloride injections once per week for 3 weeks and conventional rehabilitation. Shoulder pain and motor function were evaluated before and after the intervention using the visual analog scale (VAS) and the Fugl–Meyer assessment for the upper extremity (FMA-UE), respectively.Results:In the experimental group, significant differences were found in VAS (P = 0.003), shoulder flexion (P = 0.03) and abduction (P = 0.02), and FMA-UE (P = 0.003) after treatment. In the control group, there were significant differences in VAS (P = 0.007), shoulder flexion (P = 0.035), and FMA-UE (P = 0.042) after treatment. The comparison of the changes in the parameters between the experimental and control groups, after each intervention, revealed a significant difference in VAS (P = 0.001).Conclusion:Subacromial HA injection could result in positive effects on shoulder pain and shoulder abduction in subacute stroke patients with HSP and injury.

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