The reliability of a handheld myotonometer when used in a clinical setting to assess paraspinal muscle mechanical properties is unclear. This study aimed to investigate the between-session intra-rater reliability of a handheld myotonometer in young adults with low back pain (LBP) in a clinical environment. One assessor recorded lumbar paraspinal muscle tone and stiffness in an outpatient department on two occasions. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), smallest real difference (SRD) and Bland-Altman analysis were conducted to assess reliability. The results indicated acceptable between-days intra-rater reliability (ICC > 0.75) for all measurements. The SEM of the muscle tone and stiffness measurements ranged between 0.20–0.66 Hz and 7.91–16.51 N/m, respectively. The SRD was 0.44–1.83 Hz for muscle tone and 21.93–52.87 N/m for muscle stiffness. SEM and SRD at L1-L2 were higher than those at other levels. The magnitude of agreement appeared to decrease as muscle tone and stiffness increased. The myotonometer demonstrated acceptable reliability when used in a clinical setting in young adults with chronic LBP. Measurements of the upper lumbar levels were not as reliable as those of the lower lumbar levels. The crural attachment of the diaphragm at L1 and L2 may affect paraspinal muscle tone and stiffness during respiratory cycles.
BackgroundChronic musculoskeletal neck and back pain are disabling conditions among adults. Use of technology has been suggested as an alternative way to increase adherence to exercise therapy, which may improve clinical outcomes.ObjectiveThe aim was to investigate the self-perceived benefits of an artificial intelligence (AI)–embedded mobile app to self-manage chronic neck and back pain.MethodsA total of 161 participants responded to the invitation. The evaluation questionnaire included 14 questions that were intended to explore if using the AI rehabilitation system may (1) increase time spent on therapeutic exercise, (2) affect pain level (assessed by the 0-10 Numerical Pain Rating Scale), and (3) reduce the need for other interventions.ResultsAn increase in time spent on therapeutic exercise per day was observed. The median Numerical Pain Rating Scale scores were 6 (interquartile range [IQR] 5-8) before and 4 (IQR 3-6) after using the AI-embedded mobile app (95% CI 1.18-1.81). A 3-point reduction was reported by the participants who used the AI-embedded mobile app for more than 6 months. Reduction in the usage of other interventions while using the AI-embedded mobile app was also reported.ConclusionsThis study demonstrated the positive self-perceived beneficiary effect of using the AI-embedded mobile app to provide a personalized therapeutic exercise program. The positive results suggest that it at least warrants further study to investigate the physiological effect of the AI-embedded mobile app and how it compares with routine clinical care.
A myotonometer can objectively quantify changes in muscle tone. The between-days intra-rater reliability in a ward setting for the acute stroke population remains unknown. This study aimed to investigate the device’s between-days intra-rater reliability when used in a ward setting for acute stroke participants. Muscle tone of biceps brachii, brachioradialis, rectus femoris, and tibialis anterior was recorded in the ward at bedside by one physiotherapist on two consecutive days. This study included participants who were within 1 month of their first stroke occurrence. Participants who were medically unstable or who suffered from brain stem injury were excluded. Reliability was assessed by the intraclass correlation coefficient (ICC), standard error of measurement (SEM), smallest real difference (SRD), and the Bland-Altman limits of agreement. The results indicated excellent between-days intra-rater reliability (ICC > 0.75). SEM and SRD show small differences between measurements. The Bland-Altman analysis indicated a tendency of overestimation of the rectus femoris. MyotonPRO demonstrated acceptable reliability when used in a ward setting in those patients with acute stroke. However, results should be interpreted with caution, due to the limitations of the study and the varying level of consistency observed between different muscles.
Background: Although pre-performance massage is frequently used in sports settings, the evidence regarding its effects on muscle strength and functional performance is equivocal. Purpose:The purpose of this systematic review was to synthesize the findings of randomized controlled trials (RCTs) investigating the effects of pre-performance massage on strength and functional performance.Study Design: Systematic review with qualitative analysis.Methods: Eight electronic databases were searched from inception until June 2017. Methodological quality of included studies were assessed using Physiotherapy Evidence Database scale. Data was synthesized qualitatively.Results: Nine crossover RCTs with varied methodological qualities met inclusion criteria. Six out of nine studies had low quality, while two were of moderate-quality and one was high-quality. Following the descriptive analysis using within-group effect sizes of interventions used in included studies, no evidence was found to support the use of any kind of massage interventions (passive manual massage or self-massage) to enhance maximal strength, sprint or jump performances of young healthy subjects. In fact, there appears to be limited evidence which implies the negative effects of passive manual massage. In particular, longer-duration (> 9 minutes) of massage interventions tended to result in negative effects on lower-limb maximal strength, sprint performance and jump height. Conclusion:In conclusion, the use of longer-duration pre-performance massage cannot be recommended for enhancing young athletes' strength and performance in sprint and vertical jump. More high-quality RCTs are necessary to examine overall effects of pre-performance massage on athletes' performance.
ObjectivesLumbar disc herniation (LDH) is a musculoskeletal disease that contributes to low back pain, sciatica, and movement disorder. Existing studies have suggested that the immune environment factors are the primary contributions to LDH. However, its etiology remains unknown. We sought to identify the potential diagnostic biomarkers and analyze the immune infiltration pattern in LDH.MethodsThe whole-blood gene expression level profiles of GSE124272 and GSE150408 were downloaded from the Gene Expression Omnibus (GEO) database, including that of 25 patients with LDH and 25 healthy volunteers. After merging the two microarray datasets, Differentially Expressed Genes (DEGs) were screened, and a functional correlation analysis was performed. The Least Absolute Shrinkage and Selection Operator (LASSO) logistic regression algorithm and support vector machine recursive feature elimination (SVM-RFE) were applied to identify diagnostic biomarkers by a cross-validation method. Then, the GSE42611 dataset was used as a validation dataset to detect the expression level of these diagnostic biomarkers in the nucleus pulposus and evaluate their accuracy. The hub genes in the network were identified by the CIBERSORT tool and the Weighted Gene Coexpression Network Analysis (WGCNA). A Spearman correlation analysis between diagnostic markers and infiltrating immune cells was conducted to further illustrate the molecular immune mechanism of LDH.ResultsThe azurophil granule and the systemic lupus erythematosus pathway were significantly different between the healthy group and the LDH group after gene enrichment analysis. The XLOC_l2_012836, lnc-FGD3-1, and scavenger receptor class A member 5 were correlated with the immune cell infiltration in various degrees. In addition, five hub genes that correlated with LDH were identified, including AQP9, SIRPB2, SLC16A3, LILRB3, and HSPA6.ConclusionThe XLOC_l2_012836, lnc-FGD3-1, and SCARA5 might be adopted for the early diagnosis of LDH. The five identified hub genes might have similar pathological mechanisms that contribute to the degeneration of the lumbar disc. The identified hub genes and immune infiltrating pattern extend the knowledge on the potential functioning mechanisms, which offer guidance for the development of therapeutic targets of LDH.
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