Sit-to-stand (STS) is an important functional task affected by low back pain (LBP). It requires fundamental coordination among all segments of the body to control important performance variables such as body's center of mass (CM) and head positions. This study was conducted to determine whether LBPs could coordinate their multiple joints to achieve the task stability to the same extent as healthy controls. About 11 non-specific chronic LBP and 12 healthy control subjects performed STS task at three postural difficulty levels: rigid surface — open eyes (RO), rigid surface — closed eyes (RC) and narrow surface — closed eyes (NC). Motion variability of seven body segments, CM and head positions were calculated across 15 trials, and uncontrolled manifold (UCM) approach was used to investigate joint coordination. This approach partitioned segment angle variations into component that stabilizes a given performance variable and leads to task performance flexibility (UCM variability: V UCM ) and that which does not stabilize the performance variable and leads to task performance error (orthogonal variability: V ORT ). The results showed that LBPs demonstrated significantly less V UCM regarding the control of horizontal CM position and greater V ORT regarding the control of horizontal head position. The current findings revealed that multijoint coordination was impaired in the LBP subjects. These altered motor coordination strategies would make their postural control system less adaptive to altered postural demands and may predispose these subjects to re-injury.

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Background: Impairment of cervical sensory input in patients with neck pain may disturb postural stability. The purpose of present study was to assess the dynamic postural stability of subjects with chronic neck pain compared to a matched control group. Methods: In this case-control study, 22 chronic non-specific neck pain and 22 healthy individuals participated. Postural stability was measured with Techno-body Prokin tilting platform. Subjects performed balance tests under two conditions: eyes open and closed. The parameters for assessment of postural stability were total stability index (TSI), anteroposterior stability index (APSI), mediolateral stability index (MLSI), and trunk deviation which demonstrated total trunk sway in medio-lateral and antero-posterior. We used a separate 2 (group) by 2 (postural difficulty) mixed-design analysis of variance (ANOVA) for analysis of postural performance. Results: There were significant differences between the chronic neck pain and matched control groups in APSI, MLSI, and TSI, p<0.001 in both eyes opened and closed conditions. The trunk deviation was greater for non-specific neck pain in comparison to healthy subjects, p<0.05 in both conditions of eyes open and closed. Conclusion: The results of this study showed that patients with chronic neck pain have poorer postural control than healthy subjects. The findings suggest that clinicians take into account the importance of dynamic postural stability assessment in patients with chronic non-specific neck pain and consider the application of intervention programs for improvement of the dynamic balance.

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Sit to stand (STS) task requires variability of all body segments to achieve the stability of the important control variables (i.e., center of mass (CM) and head positions). In this study, the possible differences in the variability patterns of various body segments were investigated between 11 chronic low back pain (LBP) and 12 control subjects during STS task through two types of variability analyses; first by calculating the variability of seven limb angles, CM and head positions across 15 trials and second by principal component analysis (PCA) of seven limb angles. Participants performed the task at 3 postural difficulty levels: rigid surface, open eyes (RO), rigid surface, close eyes (RC) and narrow surface, close eyes (NC). The results revealed that LBPs could stabilize the CM and head positions same as controls. Also there was more than 1 synergic combination of whole body segments in both LBP and healthy groups. But the number of PCs accounting for the major part of variance was reduced in the LBPs in the most unstable phase of movement (50%–80% trajectory) in the RO and RC conditions. This may indicate that LBPs have reduced flexibility in the most unstable phase of task.

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Increased lumbopelvic motion during limb movements' tests was reported in low back pain (LBP) patients with and without rotational demand activities. The aim of this study was to compare lumbopelvic movement pattern between two groups of LBP patients with and without rotational demand activity during active hip external rotation test. Thirty nine patients with non-specific chronic LBP participated in this study. Patients were allocated into two groups, in first group 15 subjects (mean age ¼ 31:5 years) with rotational demand activities such as tennis, squash and golf, and in second group 24 subjects (mean age ¼ 31:2) without rotational demand activities participated in current study. Kinematic data from lumbopelvic-hip region during active hip external rotation test (AHER) were collected by a 3D motion analysis system. Variables including range of motion (ROM) of hip external rotation, pelvic rotation, pelvic rotation during first half of hip rotation motion and timing of pelvic-hip movement were calculated by MATLAB software for both sides and after this, independent t-test was used to compare the variables between 2 groups of study. The mean lumbopelvic rotation in lower extremities tests for both sides and lumbopelvic rotation in the dominant limb external J. Mech. Med. Biol. Downloaded from www.worldscientific.com by UNIVERSITY OF QUEENSLAND on 06/21/16. For personal use only. rotation test in the patients with rotational demand activities were significantly more than other group (p < 0:05). During dominant lower limb movement test, pelvic rotation in first half of movement and in patients with rotational activities was greater than in non-rotational group but hip rotation was statistically lesser than other group (p < 0:05). Other variables between the two groups were not significantly different (p > 0:05). The result of the study suggest that LBP patients who have rotational demand sports activities may move their lumbopelvic region in a greater magnitude during the AHER test than LBP people without rotational demand activities. Therefore, Lumbopelvic movement pattern in the different groups of the patients with LBP and based on their specific activities is different with each other.

BackgroundCarpal tunnel syndrome (CTS) is the most common entrapment neuropathy. A recent systematic review described limited or no evidence about the conservative interventions. Literature has expressed that more proximal area such as the cervical spine is involved in CTS. Therefore, the aim of this study is to examine the effects of combination cervical manual therapy and conventional physical therapy on pain, self-reported function, and electrophysiological findings in the management these patients.MethodsThis study will be a double-blind, parallel-group, randomized, controlled trial (RCT) in which carpal tunnel syndrome subjects randomize to either conventional or combined exercise groups. The conventional group take routine physical therapy treatments, while patients in combine exercise group receive cervical manual therapy plus routine physical therapy treatments. All patients receive 10 sessions of supervised intervention. The outcome measures included visual analogue scale (VAS), Boston Carpal Tunnel and DASH questionnaire, motor distal latencies and sensory nerve conduction velocity of median nerve. They obtain pre- and post-intervention. DiscussionThe findings of this study will provide knowledge about the comparison effectiveness of conventional physical therapy with and without cervical manual therapy on symptom severity, functional status, disability, velocity and latency median nerve in patients with CTS.Trial registrationIranian Registry of Clinical Trials, IRCT20201201049565N1. Registered on 15 December 2020.