Study Design.
Systematic review with meta-analysis.
Objective.
To examine the association between proprioception and pain and disability in people with non-specific low back pain (NSLBP) and the impact of potential moderators on the strength of the association.
Summary of Background Data.
NSLBP is a common musculoskeletal disorder and a leading cause of disability. Proprioception deficit has been associated with low back pain and correlated with pain and disability; however, the correlation coefficients presented are conflicting.
Methods.
Systematic literature search was performed in eight databases and Google scholar. Two independent reviewers assessed the literature and extracted data. Data of interest included participant characteristics of NSLBP group, pain and disability, proprioception test protocol, and the correlation coefficient between proprioception and pain/disability. Meta-analysis of data from homogeneous studies was performed according to proprioception test methods. Subgroup of movement directions was analyzed. The methodological quality of studies was assessed.
Results.
The literature search identified 3067 records of which 14 studies were included for meta-analysis. Proprioception was measured by active joint repositioning sense (AJRS), passive joint repositioning sense (PJRS), and threshold to detect passive motion (TTDPM). Meta-analysis revealed no significant correlation coefficient between any proprioception measures and pain or disability (P > 0.05). The subgroup analysis showed little correlation between absolute error (AE) of passive lumbar flexion and pain (r = 0.225, 95% CI 0.040–0.395), and between AE of passive lumbar extension and disability (r = 0.196, 95%CI 0.010–0.369).
Conclusion.
AJRS and TTDPM are not correlated with pain and disability in people with NSLBP. The AE of passive lumbar movement is correlated to a small degree with pain and disability. However, the degree of correlation is small and should be interpreted with caution. Therefore, the differences in proprioception observed between people with pain and people without pain seem to be independent of the symptoms.
Level of Evidence: 1
There is a high level of work related stress among the resident doctors registered for postgraduate clinical studies at a tertiary Municipal hospital in Mumbai. One of the perceived stress busters is regular physical exercise that is structured and under supervision.
Power training has been proposed as a more effective type of resistance training for older adults for functional performance. It is not yet known whether older adults respond appropriately to instructions for power versus strength training. The purpose of this study was to determine the velocity during strength and power training, with elastic resistance bands, in older adults attending a geriatric rehabilitation day program. It was hypothesized that power training would be faster than strength training, but that there would be large interindividual differences. Nine older patients (70 to 86 years) performed power and strength training of the ankle dorsiflexor and plantar flexor muscles using elastic resistance bands. Training sessions were filmed to assess the velocity of training. Power training occurred at faster velocities as compared to strength training (P < 0.01) for both muscle groups. However, a wide variation was observed between participants in the training velocities. Older adults attending geriatric rehabilitation do have the potential to develop faster contractions during power training as compared to strength training. Nevertheless, the actual velocities achieved differed between individuals. This could explain some of the mixed findings of studies on power training. Hence, researchers should monitor velocity when comparing different types of resistance training.
Background: Importance of community rehabilitation in India has been emphasized in previous research. There is ample research that has been published for different communities in the country. However, the precise role of physiotherapy in community rehabilitation is unclear.The objective of the current brief report is to look into the role of physiotherapy in community rehabilitation.
Methods: Relevant literature search was done using databases namely Medline, Scopus, PubMed, PEDro and CINAHL using search terms- India, community rehabilitation, home rehabilitation, home exercises and physiotherapy. Studies that followed the PICO format, published in English,after 2005 and that had specifically mentioned the role of physiotherapy in community projects were included.
Results: While there are handful of studies that have mentioned the contribution of physiotherapy in the community, most of the interventions are targeted toward management of chronic health conditions. More work needs to be done to outline the importance and precise role of physiotherapy in the rehabilitation of communities in India, especially in preventive care.A model has been created to emphasize the holistic approach of physiotherapy in the Indian setting.
Conclusion: Physiotherapy has a pivotal position in community rehabilitation in India.However, published research for the same is lacking. While physiotherapy interventions have been designed to target chronic health conditions in the community, emphasis on preventive care is lacking.
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