Objective: To evaluate the efficacy of a newly developed evidence-based low back pain (LBP) management smartphone application. Design: A double-blinded randomized controlled trial where participants randomly assigned to either an experimental group (EG) or a control group (CG). Setting: Governmental and private institutions. Participants: About 40 office workers, aged 30 to 55 years, had pain due to non-specific LBP > 3 on Visual Analogue Scale, and with pain chronicity > 3 months. Interventions: The EG received full version of the application ‘Relieve my back’ included evidence-based instructions and therapeutic exercises for LBP management, whereas the CG received placebo version included instructions about nutrition. Main measures: Primary outcome measures included pain measured by Visual Analogue Scale (VAS), disability measured by Oswestry Disability Index (ODI), and quality of life measured by Short-Form Health Survey (SF-12). Results: Following six weeks of using the application, compared to CG, the EG group demonstrated significant decrease in pain intensity (−3.45 (2.21) vs −0.11 (1.66), P < 0.001), in ODI score (−11.05 (10.40) vs −0.58 (9.0), P = 0.002), and significant increase in physical component of SF-12 (12.85 (17.20) vs −4.63 (12.04), P = 0.001). Conclusion: ‘Relieve my back’ application might be efficacious in reducing pain and disability and improving the quality of life of office workers with non-specific LBP.

Background and Purpose Studies have shown that adults with Alzheimer’s disease (AD) have gait and balance deficits, however the focus has been on those with mild to severe disease. The purpose of this study was to determine if balance and gait deficits are present in those with very mild AD. Methods Thirteen adults (72.9 ± 4.7 years old) with very mild AD and thirteen age (72.6 ± 4.6 years old) and gender-matched (10 males, 3 females) participants in a control group without AD performed balance and gait tests. All participants were living in the community and independent in community ambulation. Results Participants with very mild AD had shorter times in the sharpened Romberg tests with eyes open (p<0.001) and with eyes closed (p=0.007) compared to participants in the control group. Those with AD also took longer to complete the Timed “Up & Go” Test (TUG), (p< 0.001). Gait deficits were found for those with AD as demonstrated by slower velocities in the 10-meter walk at a comfortable pace (p=0.029) and on an instrumented walkway (p<0.001). Stance times were longer for those with AD (p<0.001) and step length was shorter (p=0.001). There were no group differences in the 10-meter walk at a fast pace. The gait velocity of participants in the control group was faster on the instrumented walkway than in the 10-meter walk at a comfortable pace (p=0.031). In contrast, the gait velocity of those with AD was significantly slower on the instrumented walkway than in the 10-meter walk at a comfortable pace, (p=0.024). Discussion Balance and gait deficits may be present in those in the very early stages of AD. Novel surfaces may affect gait speed in those with very mild AD. Identifying mobility deficits early in the progression of AD may provide an opportunity for early physical therapy intervention, thus promoting continued functional independence. Conclusions Adults in the very early stages of AD may show signs of balance and gait deficits. Recognition of these problems early with subsequent physical therapy may slow the progression of further balance and gait dysfunction.

MPS in AHP students are prevalent and statistically higher among females. Students are advised to adhere to different conservative precautions and follow prevention programs. Future studies are needed to assess actual mechanisms causing MPS among AHP students and designing effective prevention programs specific to AHP students.

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Background context Length of hospital stay (LOS) after lumbar spine surgery (LSS) can be affected by many factors. However, few studies have evaluated predictors of LOS, and all have used limited number of variables as predictors. Purpose To identify pre-surgical, surgical, and post-surgical predictors of LOS following LSS. Study Design/Setting Retrospective review of consecutive patients who had LSS at the (Blinded) Hospital from October, 2008 to April, 2012. Patient Sample 593 patients who underwent LSS consisting of laminotomy, laminectomy, or arthrodesis. Outcome Measures Dependent variable: LOS. Multiple pre-surgical, surgical, and post-surgical variables were extracted from patients’ medical records and considered as possible predictors (independent variables) of LOS. Methods Potential predictors that were significantly correlated with LOS were used as indicators to construct three latent factors; pre-surgical, surgical, and post-surgical, which were in turn used to predict LOS in a structural equation model (SEM). Results The average LOS was 4.01±2.73 days. The pre-surgical factor was indicated by age (61.97±14.49 years), prior level of function (60.5% were totally independent), prior hemoglobin level (13.70±1.36 mg/dl), and use of assistive devices (60% were assistive device users). The surgical factor was indicated by severity of illness (50.2% had minor disease severity), presence of complications (1.9%), and stay in an intensive care unit (4.0%). The post-surgical factor was indicated by post-surgical walking distance (166.43±175.75 feet), level of assistance during walking (5.18±0.81 out of 7 points), balance scores (6.18 ±1.82 out of 10 points), and bed mobility and transfer dependency scores (9.81± 1.99 out of 14 points). These three latent factors explained 47% of variation in LOS. Conclusion Post-surgical factors predicted the highest variation in LOS in comparison to pre-surgical and surgical factors and should be taken into consideration for discharge planning. Post-surgical factors are related to the patient's function, modifiable with rehabilitation and can be improved to shorten LOS. Inclusion of more reliable and standardized pre-surgical variables could improve the predictability of the model.