Background In this study, we aimed to compare the efficacy of corticosteroid trigger point injection (TPI) versus extracorporeal shock wave therapy (ESWT) on inferior trigger points in the quadratus lumborum (QL) muscle. Methods In this single-blind randomized clinical trial, 54 low back pain patients with myofascial trigger points on QL muscle were investigated. Participants were randomly allocated into two groups with A and B pockets. Patients in group A underwent radial ESWT and received 5 treatment sessions (1 per week) and actually were not followed-up. However, patients in group B received corticosteroid TPI and received one session of corticosteroid treatment and followed-up for 4 weeks after injection. Oswestry Disability Index (ODI), visual analogue scale (VAS), pain pressure threshold (PPT) and short form (36) health survey (SF-36) were measured in both groups before, two weeks after and four weeks after intervention. Results The between group comparison indicated that corticosteroid TPI leaded to significant higher improvements of ODI (P-value< 0.01), VAS (P value< 0.001), and PPT (P-value = 0.001) scores compared to the ESWT group at two-week follow-up time-point. ESWT group recorded significant higher improvement of ODI (P-value< 0.01) and SF-36 (P-value< 0.001) compared to the corticosteroid TPI at 4th week post treatment evaluation. At four-week follow-up time-point, the patients in the ESWT group were 1.46 times more likely to achieve 30% reduction in VAS, 2.67 times more likely to achieve 30% reduction in ODI, and 2.30 times more likely to achieve 20% improvement in SF-36 compared to the participants in corticosteroid TPI group. These results refer to large effect size for all study outcomes in ESWT group (d = 4.72, d = 1.58, d = 5.48, and d = 7.47 for ODI, PPT, SF-36, and VAS, respectively). Conclusion Corticosteroid TPI was more effective compared to ESWT in short-term controlling of pain and disability caused by myofascial pain syndrome of QL muscle. However, after 4 weeks treatment, ESWT further improved the quality of life and disability and was related with more probability of achievement the minimal clinically important difference concerning pain, disability and quality of life and large effect size for all study outcomes in treated patients compared to corticosteroid TPI. Trial registration www.irct.ir, IRCT20100827004641N14, retrospectively registered 2019-01-19.

SummaryStudy aim: The aim of this study was to determine the prevalence of postural disorders and their associated risk factors among high school girls in the city of Tabriz, Iran.Material and methods: A cross-sectional study was conducted on 400 female students aged 14 to 18 years. Students were examined using a scoliometer, a Debrunner kyphometer, and a flexible ruler, and were directly studied for genu varum/valgum. The information about possible risk factors such as age, BMI, school bag, study time, use of social networks, and physical activity was collected through demographic survey and the International Physical Activity Questionnaire. Data were analyzed by SPSS ver. 22 through independent t-test, chi-square, and logistic regression.Results: 181 participants (45%) had one or more abnormalities such as scoliosis (4%), kyphosis (5%), genu varum (5.7%), genu valgum (9.7%), hyperlordosis (11.2%), and asymmetrical shoulder (24.5%). The risk of hyperlordosis increased with increase in weight (OR: 1.08, 95%CI: 1.02 to 1.15; p = 0.014) and BMI (OR: 1.37, 95%CI: 1.13 to 1.67; p = 0.002). Moreover, the odds for genu valgum increased with increase in weight (OR: 1.07, 95%CI: 1.01 to 1.13; p = 0.045) and BMI (OR: 1.84, 95%CI: 1.29 to 2.62; p < 0.001); but it decreased with increase in age (OR: 0.62, 95%CI: 0.39 to 0.98; p = 0.039) and not using a study table (OR: 0.31, 95%CI: 0.12 to 0.78; p = 0.013).Conclusions: Forty-five percent of female students had one or more postural abnormalities. Asymmetrical shoulder was the most common disorder. Weight and BMI were associated with genu valgum and hyperlordosis.

ObjectivesNormal posture is considered to be an indicative of good musculoskeletal health in school aged adolescents. Little is known about the body composition indices in relation with postural deformities in adolescents. The aim of this study was to assess relation of body composition analysis indices with postural deformities in a sample of female high school adolescents.ResultsIn this case–control study, 37 eligible female adolescents with any postural deformities and 33 normal posture subjects enrolled in the study by random cluster sampling. Body composition analysis performed by bioelectrical impedance analysis (BIA) method to quantity body fat mass (BFM), soft lean mass (SLM) and lean body mass (LBM). The binary logistic regressions were performed to evaluate the associations of body composition indices which were significantly different between two groups at significance level of 0.05 with postural disorders in the two groups. There was no significant difference between subjects with postural disorders with their normal controls concerning demographic variables. We observed an inverse association between postural deformity risk and LBM (OR = 0.803; 95% CI 0.690–0.934) and SLM (OR = 0.774; 95% CI 0.649–0.922) after adjusting the analysis by height of participants.