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Disability and Rehabilitation Mar 2023To review the effects of external lumbar supports on various aspects of sensorimotor function including joint position sense (JPS), postural control, anticipatory...
PURPOSE
To review the effects of external lumbar supports on various aspects of sensorimotor function including joint position sense (JPS), postural control, anticipatory postural adjustments (APAs), and compensatory postural adjustments (CPAs).
METHODS
A systematic literature search was performed in PubMed, EMBASE, Scopus, Ovid, Cochrane library, and Web of Science. Two reviewers selected studies which assessed the effect of lumbosacral orthosis or kinesio-tape on JPS, postural control or APAs/CPAs in subjects with and without low back pain (LBP). The methodological quality of included studies was assessed using a modified version of Downs and Black's checklist.
RESULTS
Findings demonstrated moderate effects of lumbosacral orthosis on specific aspects of sensorimotor control including JPS and to a lesser extent standing stability. These domains were not or minimally affected by application of kinesio-tape. Both orthosis and kinesio-tape had negligible effects on APAs and CPAs.
CONCLUSIONS
The positive effects of lumbar orthosis on JPS or postural control were mostly observed in conditions where sources of proprioceptive feedback are impaired (such as LBP) or absent (standing with eyes closed on an unstable surface). However, evidence does not prove significant positive effects for the application of kinesio-tape to improve sensorimotor control.IMPLICATIONS FOR REHABILITATIONWearing lumbar orthosis leads to an improvement in joint position sense.Postural stability seems to be affected to some extent by utilizing lumbar orthosis.Clinicians can administer orthosis to improve sensorimotor adaptation, especially in conditions with poor proprioception.Kinesio-tape had negligible effects on all domains of sensorimotor control.Improvement of sensorimotor function as a result of application of kinesio-tape is questionable.
Topics: Humans; Postural Balance; Lumbosacral Region; Proprioception; Low Back Pain; Athletic Tape
PubMed: 35259058
DOI: 10.1080/09638288.2022.2043464 -
Journal of Back and Musculoskeletal... 2022Imbalance or decreased trunk strength has been associated with non-specific low back pain (NSLBP). (Review)
Review
BACKGROUND
Imbalance or decreased trunk strength has been associated with non-specific low back pain (NSLBP).
OBJECTIVE
This systematic review aimed (I) to evaluate the quality of evidence of studies evaluating the reliability of trunk strength assessment with an isokinetic dynamometer in NSLBP patients, (II) to examine the reliability of trunk strength assessment using an isokinetic dynamometer in NSLBP patients and (III) to determine the most reliable protocol for trunk strength assessment in NSLBP patients.
METHOD
PRISMA guidelines were followed. Three databases were used: PubMed, Scopus, and Web of Science with the following keywords: Isokinetic, Dynamometer, Trunk strength testing, Muscle testing, Isokinetic measurement, CORE, Abdominal muscles, Abdominal wall, Torso, Trunk, Spine, Reliability and, Reproducibility. We included only test-retest studies, focused on the reliability of isometric and isokinetic strength assessed with an isokinetic dynamometer in NSLBP adults' patients, published in English and from inception to March 30, 2021. The methodological quality was evaluated with the CAT scale and QAREL checklist.
RESULTS
Five hundred and seventy-seven articles were retrieved, of which five are included in this review. Three articles provide good quality of evidence, the reliability of trunk strength assessment in NSLBP patients is excellent, and the most reliable protocol for isometric assessment is in a seated position (ICC = 0.94-0.98) and for isokinetic strength in standing position, at 60∘/s and 120∘/s (ICC = 0.98).
CONCLUSION
There is good quality evidence regarding the trunk strength assessment's reliability. Reliability is excellent in NSLBP patients; however, a familiarization process should be considered to obtain clinically reliable data. The most reliable protocol is in a seated position for isometric strength and a standing position for isokinetic strength.
Topics: Humans; Low Back Pain; Muscle Strength; Muscle Strength Dynamometer; Muscle, Skeletal; Reproducibility of Results
PubMed: 35213350
DOI: 10.3233/BMR-210261 -
World Neurosurgery Apr 2022To analyze cervical spine injuries resulting from recreational activity in shallow ocean water amid high-energy breaking waves.
OBJECTIVE
To analyze cervical spine injuries resulting from recreational activity in shallow ocean water amid high-energy breaking waves.
METHODS
Single-center 10-year review of patients who sustained cervical injuries at the beach in Long Island, New York, USA. A systematic review following the PRISMA guidelines was also performed.
RESULTS
Nineteen patients (age 17-79 years) sustained cervical injury from high-energy breaking waves while in shallow beach water. Six patients dived into a wave; 6 patients were struck by a large wave while standing upright; and 7 tumbled in the waves while engaged in nonspecified recreational activity. All 7 patients with subaxial cervical AO Spine Injury Score (AO-SIS) >10 had cervical spine injury with cord signal change and required operative management. Diving mechanism, AO-SIS >10, and cord signal change all predicted significant disability or death at 12 months (P < 0.01). The present study and 7 additional studies reporting on 534 patients (mean age, 45.4 years) were analyzed. Within the reported literature, most patients (94.2%) sustained a spinal cord injury. On long-term follow-up, an estimated 64.8% of patients had permanent neurologic injury and 12.5% had permanent quadriplegia.
CONCLUSIONS
We offer the first description of cervical injuries sustained in water-related recreational activity using the AO-SIS. The morphology of injuries varied significantly and seemed to depend on body position and wave kinetic energy. Patients presenting with cervical injury in this setting and yielding AO-SIS >10 are likely to have poor functional recovery.
Topics: Adolescent; Adult; Aged; Cervical Vertebrae; Humans; Middle Aged; Retrospective Studies; Spinal Cord Injuries; Spinal Fractures; Spinal Injuries; Trauma Centers; Young Adult
PubMed: 35074543
DOI: 10.1016/j.wneu.2022.01.055 -
International Journal of Environmental... Oct 2021The objective of this systematic review and meta-analysis was to examine the reliability of isokinetic measurements of hip strength in flexion and extension in healthy... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The objective of this systematic review and meta-analysis was to examine the reliability of isokinetic measurements of hip strength in flexion and extension in healthy subjects and athletes.
METHODS
The databases used were Web of Science, SCOPUS, Medline and PubMed. R was used for all statistical analyses.
RESULTS
Hip flexion shows moderate reliability in the supine position (ICC = 0.72; 95% CI: 0.46-0.99) and good reliability in the standing position (ICC = 0.79; 95% CI: 0.54-1.04). Hip extension shows excellent reliability in the supine position (ICC = 0.90; 95% CI: 0.85-0.96) and moderate reliability in the standing position (ICC = 0.72; 95% CI: 0.48-0.96). Flexion of 120°/s and 180°/s showed excellent reliability (ICC = 0.93; 95% CI: 0.85-1.00), (ICC = 0.96; 95% CI: 0.92-1.01). The 60°/s and 120°/s extension showed good reliability (ICC = 0.90; 95% CI: 0.82-0.98), (ICC = 0.87; 95% CI: 0.75-0.99). The 180°/s extension presented excellent reliability (ICC = 0.93; 95% CI: 0.82-1.03).
CONCLUSIONS
The standing position shows good reliability for hip flexion and the supine position shows excellent reliability for hip extension, both movements have excellent reliability at velocities between 120°/s to 180°/s.
Topics: Athletes; Healthy Volunteers; Humans; Muscle Strength; Muscle Strength Dynamometer; Muscle, Skeletal; Range of Motion, Articular; Reproducibility of Results
PubMed: 34769842
DOI: 10.3390/ijerph182111326 -
Nutrients Oct 2021Caffeine ingestion may influence balance control via numerous mechanisms. Although previously investigated using various study designs and methods, here we aimed to...
Caffeine ingestion may influence balance control via numerous mechanisms. Although previously investigated using various study designs and methods, here we aimed to create the first evidence-based consensus regarding the effects of caffeine on the control of upright stance via systematic review (PROSPERO registration CRD42021226939). Embase, PubMed/MEDLINE, SPORTDiscus and Web of Science databases were searched on 27 January 2021 to identify placebo-controlled trials investigating caffeine-induced changes in human standing balance. Reference lists of eligible studies were also searched. Overall, nine studies involving a total of 290 participants were included. All studies were moderate to strong in quality according to the QualSyst tool. Balance-related outcome measures were collected across a range of different participant ages, stances and sensory conditions. The results show that younger participants' balance was generally unaffected by caffeine ingestion. However, a significant balance impairment was observed following caffeine ingestion in all studies involving older participants (average age >65 years). Our results therefore suggest an age-dependent effect of caffeine ingestion on human standing. Further research into this effect is warranted as only one study has directly compared younger and older adults. Nonetheless, an important implication of our findings is that caffeine ingestion may increase fall risk in older adults. Furthermore, based on our findings, caffeine ingestion should be considered as a potential confounding factor when assessing human standing balance, particularly in older adults.
Topics: Adult; Aged; Caffeine; Drinking; Female; Humans; Male; Middle Aged; Postural Balance; Randomized Controlled Trials as Topic; Sensation Disorders; Standing Position
PubMed: 34684527
DOI: 10.3390/nu13103527 -
PloS One 2021Sedentary behaviour (SB) research has grown exponentially but efficacy for interventions to reduce sedentary behaviour is often contaminated by interventions primarily... (Meta-Analysis)
Meta-Analysis
Efficacy, characteristics, behavioural models and behaviour change strategies, of non-workplace interventions specifically targeting sedentary behaviour; a systematic review and meta-analysis of randomised control trials in healthy ambulatory adults.
BACKGROUND
Sedentary behaviour (SB) research has grown exponentially but efficacy for interventions to reduce sedentary behaviour is often contaminated by interventions primarily or co-targeting other behaviours and outcomes. The primary aim of this research therefore, was to systematically review the efficacy of interventions specifically targeting sedentary behaviour reduction, as a sole primary outcome, from randomised control trials in healthy ambulatory adults. This research also sought to identify the successful interventions characteristics, behaviour change techniques (BCT's) and underlying theories, and their relation to intervention effectiveness.
METHODS
We followed PRISMA reporting guidelines for this systematic review. Six electronic databases were searched and a grey literature review conducted. Only randomised or cluster randomised controlled trials, from 2000 to 2020, in adult populations with a sole primary outcome of change in sedentary behaviour were included. Data codebooks were developed, data were extracted, and a narrative synthesis and meta-analysis was conducted using mixed methods random effects models.
RESULTS
Of 5589 studies identified, 7 studies met the inclusion criteria. Six studies reported activPAL3 measures of mean daily sitting time, and four reported mean daily standing time, stepping time and number of sedentary breaks. Pooled analysis of weighted mean differences revealed a reduction in mean daily sitting time of -32.4mins CI (-50.3, -14.4), an increase in mean daily standing time of 31.75mins CI (13.7, 49.8), and mean daily stepping time of 9.5mins CI (2.8, 16.3), and an increase in rate of sedentary breaks per day of 3.6 (CI 1.6, 5.6). BCTs used exclusively in two of the three most effective interventions are 'feedback on behaviour' and 'goal setting behaviour' whilst all three most effective interventions included 'instruction on how to perform the behaviour' and 'adding objects to the environment', BCTs which were also used in less effective interventions.
CONCLUSIONS
Although limited by small sample sizes and short follow up periods, this review suggests that interventions specifically designed to change sedentary behaviour, reduce overall daily sitting time by half an hour, with an equivalent increase in standing time, in the short to medium term. Effective characteristics and behaviour change strategies are identified for future development of high quality interventions targeting change in sedentary behaviour.
PROSPERO REGISTRATION
PROSPERO 2020 CRD42020172457 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020172457.
Topics: Exercise; Female; Humans; Male; Randomized Controlled Trials as Topic; Risk Factors; Sedentary Behavior; Sitting Position; Standing Position; Time Factors; Workplace
PubMed: 34492051
DOI: 10.1371/journal.pone.0256828 -
Journal of Back and Musculoskeletal... 2022A validated method to assess sitting and standing posture in a clinical setting is needed to guide diagnosis, treatment and evaluation of these postures. At present, no... (Review)
Review
BACKGROUND
A validated method to assess sitting and standing posture in a clinical setting is needed to guide diagnosis, treatment and evaluation of these postures. At present, no systematic overview of assessment methods, their clinimetric properties, and usability is available.
OBJECTIVE
The objective of this study was to provide such an overview and to interpret the results for clinical practice.
METHODS
A systematic literature review was performed according to international guidelines. Two independent reviewers assessed risk of bias, clinimetric values of the assessment methods, and their usability. Quality of evidence and strength of recommendations were determined according to the Grading of Recommendations Assessment, Development and Evaluation working group (GRADE).
RESULTS
Out of 27,680 records, 41 eligible studies were included. Thirty-two assessment instruments were identified, clustered into five categories. The methodological quality of 27 (66%) of the articles was moderate to good. Reliability was most frequently studied. Little information was found about validity and none about responsiveness.
CONCLUSIONS
Based on a moderate level of evidence, a tentative recommendation can be made to use a direct visual observation method with global posture recorded by a trained observer applying a rating scale.
Topics: Humans; Posture; Reproducibility of Results; Sitting Position
PubMed: 34366318
DOI: 10.3233/BMR-200073 -
Work (Reading, Mass.) 2021Previous studies have shown high rates (47-72%) of self-reported work-related musculoskeletal disorders (WRMDs) in surgeons of the head and neck. Physical requirements... (Review)
Review
BACKGROUND
Previous studies have shown high rates (47-72%) of self-reported work-related musculoskeletal disorders (WRMDs) in surgeons of the head and neck. Physical requirements in the workplace, individual factors (e.g. poor posture, obesity) and psychosocial factors have been identified as risk factors. Establishing biomechanical risk factors may help prevent further development of WRMDs in this population.
OBJECTIVE
The purpose of this critical review was to source studies that identified the biomechanical risk factors for WRMDs in this surgical sub-specialty.
METHODS
Searches were conducted of Medline, CINAHL, and AMED databases from 1980 until September 2018.
RESULTS
A total of 182 article were identified. Exclusion criteria lead to 163 full-text articles being screened, generating a total of 6 articles for review. The aims of the included studies varied significantly. Surgeons spend the majority of operating time in static, asymmetrical positions. Surgical loupes/headlamps significantly increased cervical spine loading. Articulated surgical arm supports provided optimal ergonomic conditions. Performing surgical operations with the surgeon in standing or sitting had no effect on task performance or demand. Physical fatigue was also measured in both positions.
CONCLUSIONS
A combination of equipment-based and patient/surgeon position-based factors predispose surgeons to biomechanical risk factors. Studies of greater methodological quality are required.
Topics: Ergonomics; Humans; Musculoskeletal Diseases; Occupational Diseases; Risk Factors; Surgeons
PubMed: 33998586
DOI: 10.3233/WOR-213474 -
PloS One 2021To synthesise and analyse the current evidence regarding changes in joint position sense (JPS) and standing balance in people with whiplash-associated disorder (WAD)... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To synthesise and analyse the current evidence regarding changes in joint position sense (JPS) and standing balance in people with whiplash-associated disorder (WAD) taking the presence or absence of dizziness into account.
DATA SOURCES
PubMed, CINAHL Plus, Web of Science, Embase, MEDLINE and APA PsycINFO were searched by two independent reviewers from inception until August 2020 and reference lists of all included studies were also reviewed.
STUDY SELECTION
Only cross-sectional studies that measured JPS and/or standing balance between people with WAD vs. healthy controls (HC) or people with WAD complaining of dizziness (WADD) vs. those not complaining of dizziness (WADND) were selected.
DATA EXTRACTION
Relevant data were extracted using specific checklists and quality assessment was performed using Downs and Black Scale (modified version).
DATA SYNTHESIS
Twenty-six studies were included. For JPS, data were synthesized for absolute error in the primary plane of movement for separate movement directions. For standing balance, data were synthesized for traditional time- and frequency domain sway parameters considering the conditions of eyes open (EO) and eyes closed (EC) separately. For meta-analysis, reduced JPS was observed in people with WAD compared to HC when the head was repositioned to a neutral head position (NHP) from rotation (standardised mean difference [SMD] = 0.43 [95%: 0.24-0.62]) and extension (0.33 [95%CI: 0.08-0.58]) or when the head was moved toward 50° rotation from a NHP (0.50 [0.05-0.96]). Similarly, people with WADD had reduced JPS compared to people with WADND when the head was repositioned to a NHP from rotation (0.52 [0.22-0.82]). Larger sway velocity and amplitude was found in people with WAD compared to HC for both EO (0.62 [0.37-0.88] and 0.78 [0.56-0.99], respectively) and EC (0.69 [0.46-0.91] and 0.80 [0.58-1.02]) conditions.
CONCLUSION
The observed changes of JPS and standing balance confirms deficits in sensorimotor control in people with WAD and especially in those with dizziness.
Topics: Animals; Cross-Sectional Studies; Dizziness; Head; Humans; Movement; Postural Balance; Whiplash Injuries
PubMed: 33831060
DOI: 10.1371/journal.pone.0249659 -
International Journal of Environmental... Mar 2021The purpose of this systematic review was to examine the effects of active desks in the school setting on sedentary behavior, physical activity, academic achievements... (Review)
Review
The purpose of this systematic review was to examine the effects of active desks in the school setting on sedentary behavior, physical activity, academic achievements and overall health among children and adolescents aged 5-17 years. A systematic literature search was conducted using five databases until October 2020. Twenty-three studies were included. Studies reported an increase of around 36% in energy expenditure for cycling desks and between 15% and 27.7% for upright active desks. Children increased inhibitory control and selective attention capacity while using cycling desks. A heterogeneous quality of design and of results were observed limiting comparisons and conclusions for each active desk. Despite the lack of strong methodology for the included studies, active desks appear to be a promising intervention in classrooms to improve health-related outcomes in children aged 5-17 years. Due to weak methodology, future studies with stronger study designs and methodology are needed to better inform policy and practice about the role of classroom active desks on health-related outcomes in children and adolescents.
Topics: Academic Success; Adolescent; Child; Child, Preschool; Exercise; Humans; Schools; Sedentary Behavior; Standing Position
PubMed: 33802133
DOI: 10.3390/ijerph18062828