Reduction in isometric strength of the scapulohumeral muscles is a commonly seen impairment in overhead athletes afflicted with shoulder impingement syndrome (SIS). The purpose of this study was to compare the effects of two different treatment programs: progressive resistance exercises plus manual therapy (PRE plus MT) and motor control exercises (MCE), on isometric strength of upper trapezius (UT), middle trapezius (MTr), lower trapezius (LT), serratus anterior (SA), supraspinatus (Supr.), anterior deltoid (A.D), and latissimus dorsi (LD). 80 male university-level overhead athletes clinically diagnosed with SIS were randomly allocated into either of the two groups: PRE plus MT and MCE group. Athletes in the PRE plus MT group underwent graduated exercises with resistance elastic band, stretching exercises, and mobilization of the thoracic and shoulder joints. MCE group was submitted to motor control exercises in varied planar positions. Athletes in both groups underwent management 3 times a week for 8 weeks. Isometric strength of UT, MTr, LT, Supr, A.D, SA, and LD was measured at three-time points: baseline, 4th week, and 8th week. Relative to baseline, both interventions were found to be effective in increasing and optimizing the isometric strength of muscles ( p < 0.05 ) except for supraspinatus in the MCE group ( p > 0.05 ). However, athletes in PRE plus MT group presented a more pronounced increase in isometric strength than those in the MCE group. Between groups analysis found the largest isometric strength improvement in PRE plus MT group for A.D, followed by Supr. and UT muscles ( p < 0.05 ; effect size: 0.39 to 0.40). The study concluded that compared to MCE, PRE plus MT provides greater improvement in the isometric strength of scapulohumeral muscles.

The objective was to investigate the electromyographic activity of the lumbar multifidus (MF) muscle and longissimus thoracis muscle, along with their activity ratio (MF longissimus thoracis ratio), during quadruped stabilization exercise performed with neutral posture and with increased lumbar lordosis in patients with chronic low back pain (CLBP). A total of 23 patients with CLBP (12 females and 11 males) were recruited based on inclusion and exclusion criterion. Each patient performed 4 exercises in random order, with surface electromyography electrodes and an electrogoniometer attached. A cross-sectional study design was used to measure the amplitude of muscle activation (as a percentage of maximum voluntary contraction) in each patient across the 2 muscles (MF and longissimus thoracis) during quadruped stabilization exercise with neutral posture and with increased lumbar lordosis. A 2-way analysis of variance was conducted, which demonstrated a statistically significant increase in the recruitment of MF with increased lumbar lordosis in patients with CLBP during quadruped exercise. An increase of 9.7% and 16.9% maximum voluntary contraction in MF electromyographic activity was observed in lumbar lordosis posture during the quadruped leg raise and quadruped leg-arm raise exercise, respectively (P < .01), when compared to the neutral posture. The increased recruitment of MF with lumbar lordosis in the quadruped position has strong implications in the assessment and management of patients with CLBP.

IntroductionChronic low back pain is an important clinical, social, economic, and public health problem, with low treatment success rates. Retro-walking works on multiple factors of the causative agents of low back pain. Therefore the aim of the current study was to investigate the effect of retro-walking on pain, functional disability, quality of life and sleep problems in patients with chronic low back pain.MethodsIt was a two parallel arm, single blinded, randomized, controlled clinical trial. Thirty-one patients both males and females with chronic low back pain were recruited from December 2016 till April 2017 out of which twenty-nine completed the study. The experimental group had 16 patients (aged 24.7 ± 5.56 with 22.7 ± 4.28 Body Mass Index) whereas the control group had 15 patients (aged 25.9 ± 5.61with and 22.1 ± 3.15 Body Mass Index). Pain, Functional Disability, Quality of Life and Sleep Problems were measured by Numerical pain rating scale, Oswestry Disability Index, Short Form Health Survey 36 and sleep diary Both the groups received same conventional treatment for three physiotherapy sessions per week for three weeks. Experimental group additionally participated in 15 minutes of retro-walking at the comfortable walking speed which was determined prior to the commencement of the intervention along with the conventional treatment.ResultsAll variables of the sleep diary, i.e., sleeping hours/week [Time effect (<i>p</i> = 0.004), time × group interaction effect (<i>p</i> = 0.001)], sleep efficiency [Time effect (<i>p</i> = 0.024), time × group interaction effect (<i>p</i> = 0.004)] and restoration post sleep [Time effect (<i>p</i> = 0.014), time × group interaction effect (<i>p</i> = 0.034)] showed significant differences in the experimental group. The experimental group also demonstrated significant differences over time (<i>p</i> = 0.001) in all the other outcome measures such as pain, pain disability, quality of life and sleep patterns and habits.ConclusionsConventional physiotherapy is an effective means of treatment for Chronic Low back pain. However, there was a added advantage of retro-walking as the experimental group showed a faster recovery. Thus, making it an effective treatment adjunct.

Various lines of evidence suggest that a bidirectional relationship exists between poor sleep quality and chronic pain, with each condition tending to promote and exacerbate the other. This has led to the hypothesis that the two conditions may be linked by common underlying mechanisms. It has thus been suggested that inadequate sleep and

Background: Many physiological and psychological factors could play a significant role in acute and chronic neck pain, and they may delay the recovery process. Understanding the predictors for acute and chronic neck pain is essential to establishing effective management strategies for this population. Aims: To identify the risk factors for acute and chronic neck pain, to compare the variables (sleep quality, daytime sleepiness, fatigue, depression, anxiety, and disability) between acute and chronic stage of neck pain, and to examine the gender differences between these variables. Methods: Patients ([Formula: see text]= 436) with acute and chronic neck pain were included. They completed baseline questionnaires to report on the intensity of pain, sleep quality, sleepiness, fatigue, anxiety, depression, and disability. Results: Data analysis was performed using a linear regression and multivariate analysis of covariance to evaluate the predictors of acute and chronic neck pain, and to compare the study variables between acute and chronic neck pain as well as to explore the presence of a gender bias. Poor sleep quality was the only predictor of acute neck pain. Poor sleep quality, sleepiness, and fatigue were significant predictors of chronic neck pain. Also, the score of these predictors was higher among chronic neck patients compared to acute conditions. Conclusion:Sleep disturbances, sleepiness, and fatigue are important predictors of chronic neck pain. The findings highlight the importance of addressing these factors in the assessment and management of neck pain conditions.