Search Results (65)

Background: Transcutaneous Randomized Pulsed Radiofrequency (TCPRF-STP) is a non-invasive therapeutic approach increasingly explored for managing spine-related pain, particularly in cases involving disc herniations and degenerative spine conditions. Objectives: To evaluate the use of transcutaneous PRF-STP in the treatment of spine pathologies and its evolution in short-term follow-up. Methods: This case series examines the outcomes of three patients treated with TCPRF-STP for varying spine pathologies, including lumbar and cervical disc herniations, lumbar stenosis, and radiculopathy. All patients had previously undergone conventional conservative therapies without a satisfactory improvement and were unwilling or unable to undergo invasive procedures. The treatment involved the application of electromagnetic fields through adhesive skin patches at targeted sites. Patients underwent three sessions of TCPRF-STP, with follow-up assessments evaluating pain and MRI. Results: Transcutaneous PRF-STP showed notable reductions in pain (VAS 0 in most cases), improvements in movement, and the restoration of normal daily activities. Follow-up MRI scans demonstrated positive structural changes in the treated discs. Although long-term recurrence occurred in one case, the patient remained active without functional limitations. Conclusions: Transcutaneous PRF-STP offers a promising, minimally invasive alternative for patients seeking to avoid surgery, though further studies with larger cohorts and longer follow-up periods are necessary to establish more robust evidence of its efficacy. This technique could become an important adjunct in managing chronic spinal pain conditions, offering patients an option with minimal risk and hospital demands. Full article

Monitoring posture and movement accurately and efficiently is essential for both physical therapy and athletic training evaluation and interventions. Motion Tape (MT), a self-adhesive wearable skin-strain sensor made of piezoresistive graphene nanosheets (GNS), has demonstrated promise in capturing low back posture and movements. However, to address some of its limitations, this work explores alternative materials by replacing GNS with multi-walled carbon nanotubes (MWCNT). This study aimed to characterize the electromechanical properties of MWCNT-based MT. Cyclic load tests for different peak tensile strains ranging from 1% to 10% were performed on MWCNT-MT made with an aqueous ink of 2% MWCNT. Additional tests to examine load rate sensitivity and fatigue were also conducted. After characterizing the properties of MWCNT-MT, a human subject study with 10 participants was designed to test its ability to capture different postures and movements. Sets of six sensors were made from each material (GNS and MWCNT) and applied in pairs at three levels along each side of the lumbar spine. To record movement of the lower back, all participants performed forward flexion, left and right bending, and left and right rotation movements. The results showed that MWCNT-MT exceeded GNS-MT with respect to consistency of signal stability even when strain limits were surpassed. In addition, both types of MT could assess lower back movements. Full article

Background/Objectives: This paper analyzes the movement and relationships within the lumbopelvic–hip complex during forward trunk bending in young women with chronic low back pain. Methods: This study involved 24 women aged 20–24 with chronic low back pain. They were randomly divided into two equal-sized groups: Group 1 participated in a 12-week functional training program, and Group 2 was a control without any intervention. The level of perceived pain was assessed using the Visual Analog Scale (VAS). Qualitative motion analysis was performed using the BTS SMART-D system. Custom indicators were developed to evaluate the angular relationships and ranges of motion in the lumbar spine and the lumbopelvic–hip complex. The functional training program consisted of three sections: motor control and stabilization, muscle strengthening, and stretching exercises. Statistical analysis was performed using Statistica 13.3. Results: The therapy resulted in a reduction in perceived pain levels reported by the participants. There was a significant improvement in the quality of the forward trunk bending pattern in women who underwent functional training. Conclusions: Significant modifications in the quality, technique, and angular relationships within the lumbopelvic–hip complex were observed during the forward trunk bending pattern in women undergoing functional training. It has proven to be an effective form of therapy for chronic low back pain. Full article

Passive back-support exoskeletons commonly employ elastic components to assist users during dynamic tasks. However, these designs are ineffective in providing sustained assistance for prolonged static bending postures, such as those required in surgery, assembly, and farming, where users experience continuous lumbar flexion. To address this limitation, a novel passive back-support exoskeleton inspired by the human spine is proposed in this work. The exoskeleton integrates a five-bar linkage mechanism with vertebrae-mimicking units, allowing for both dynamic flexion–extension movements and rigid support at various flexion angles. During the experiments, subjects are instructed to perform a 30-min forward-bending assembly task under two conditions: with and without wearing the exoskeleton. Compared to the free condition, the electromyography results indicate a 10.1% reduction in integrated EMG (IEMG) and a 9.78% decrease in root mean square (RMS) values of the erector spinae with the exoskeleton. Meanwhile, the metabolic rate is decreased by 11.1%, highlighting the effectiveness of the exoskeleton in mitigating muscle fatigue during prolonged static work. This work provides a promising solution for reducing musculoskeletal strain in occupations requiring sustained forward bending, making it a valuable advancement in passive exoskeleton technology. Full article

Background: Anorexia nervosa is an eating disorder characterised by distorted eating behaviour, physical and mental health problems, and the highest mortality rate among psychiatric disorders. Although anorexia nervosa appears to be associated with alterations in the spine, studies investigating the characteristics of spinal postures and mobility in individuals with anorexia nervosa are scarce to date. The present study aims to examine the relationship between anorexia nervosa and spinal posture and mobility by comparing people with anorexia nervosa to age-matched, normal-weight controls. Methods: Spinal posture and mobility were evaluated using a radiation-free back scan, the Idiag M360 (Idiag, Fehraltorf, Switzerland). Between-group differences were assessed using a two-way analysis of variance. Results: Adult females suffering from anorexia nervosa exhibited reduced lumbar [difference between groups (Δ) = 10.5°, 95% CI 4.6°–16.5°, p < 0.001] and thoracic (Δ = 8.8°, 95% CI 2.4°–15.2°, p = 0.007) curvatures compared to normal-weight controls. The only difference observed in spinal movements between the two groups was thoracic flexion, which was greater in individuals with anorexia nervosa (Δ = 8.4°, 95% CI 2.1°–14.4°, p = 0.009). Conclusions: These findings emphasise the need to consider spinal posture and thoracic mobility in the musculoskeletal assessment of anorexia nervosa. Interventions aimed at improving spinal postures may help to develop effective rehabilitative strategies for addressing spinal problems associated with anorexia nervosa and thus contributing to counteract the possible further worsening with advancing age. Full article

Current routine diagnostic procedures for back pain mainly focus on static spinal analyses. Dynamic Surface Topography (DST) is an easy-to-use, radiation-free addition, allowing spine analyses under dynamic conditions. Until now, it is unclear if this method is applicable to back pain patients, and data reports are missing. Within a prospective observational study, 32 patients suffering from thoracic and lumbar back pain were examined while walking, randomized at four speeds (2, 3, 4, 5 km/h), using a DST measuring device (DIERS 4Dmotion^® Lab). The measurement results were compared with those of a healthy reference group. We calculated the intrasegmental rotation for every subject and summed up the spinal motion in a standardized gait cycle. The Mann–Whitney U Test was used to compare the painful and healthy reference groups at the four different speeds. In a subgroup analysis, the painful group was divided into two groups: one with less pain (≤3 points on the Visual Analogue Scale) and one with more pain (>3 points on the Visual Analogue Scale). The Kruskal–Wallis Test was used to compare these subgroups with the healthy reference group. Of the 32 included patients, not all could walk at the intended speeds (5 km/h: 28/32). At speeds of 2–4 km/h, our results point to greater total segmental rotation of back pain patients compared to the healthy reference group. At a speed of 3 km/h, we observed more movement in the patients with more pain. Overall, we monitored small differences on average between the groups but large standard deviations. We conclude that the DST measuring approach is eligible for back pain patients when they feel confident enough to walk on a treadmill. Initial results suggest that DST can be used to obtain interesting therapeutic information for an individual patient. Full article

Knowledge of realistic loads is crucial in the engineering design process of medical devices and for assessing their interaction with the spinal system. Depending on the type of modeling, current numerical spine models generally either neglect the active musculature or oversimplify the passive structural function of the spine. However, the internal loading conditions of the spine are complex and greatly influenced by muscle forces. It is often unclear whether the assumptions made provide realistic results. To improve the prediction of realistic loading conditions in both conservative and surgical treatments, we modified a previously validated forward dynamic musculoskeletal model of the intact lumbosacral spine with a muscle-driven approach in three scenarios. These exploratory treatment scenarios included an extensible lumbar orthosis and spinal instrumentations. The latter comprised bisegmental internal spinal fixation, as well as monosegmental lumbar fusion using an expandable interbody cage with supplementary posterior fixation. The biomechanical model responses, including internal loads on spinal instrumentation, influences on adjacent segments, and effects on abdominal soft tissue, correlated closely with available in vivo data. The muscle forces contributing to spinal movement and stabilization were also reliably predicted. This new type of modeling enables the biomechanical study of the interactions between active and passive spinal structures and technical systems. It is, therefore, preferable in the design of medical devices and for more realistically assessing treatment outcomes. Full article

Swimming is a widely practiced sport with significant physical demands, placing athletes at a considerable risk of injury, particularly in the shoulder, due to repetitive high-intensity movements. The aim of this systematic review was to analyze the patterns and frequency of injuries associated with swimming. Methods: A systematic search of the Web of Science, PubMed, Scopus, and SportDiscus databases identified nine relevant studies. Results: The findings revealed a higher incidence of injuries in female swimmers compared to males, with the shoulder being the most frequently affected joint. This disparity is partially attributed to the Female Athlete Triad, a syndrome characterized by low energy availability, menstrual dysfunction, and poor bone health, which increases injury susceptibility. Other commonly affected regions include the knee, often associated with the biomechanical demands of breaststroke, and the lumbar spine, which is impacted by degenerative changes resulting from high training volumes. However, variability in the injury measurement protocols across studies limits their comparability and highlights the need for standardized methods. Conclusions: Based on these findings, professionals in the field can identify injury patterns to enhance diagnosis and treatment, design personalized prevention programs, implement early interventions, and innovate equipment and training methods to improve swimmer safety and performance. Full article

Background/Objectives: The purpose of this study was to assess the body posture of kickboxing players. Methods: The study group included people training as kickboxers who actively participated in the training camp of the broad national junior team in the K1 and low-kick kickboxing leagues. The control group consisted of non-training people. The age of the study group ranged from 15 to 23 years. The ages of the control group participants varied from 14 to 20 years. A body posture test was performed by using the Moiré method, in accordance with the guidelines of the manufacturer of the Moiré 4G device. Results: The body posture test performed using the Moiré method showed statistically significant differences between the kickboxing training group and the control group. The parameters that showed statistically significant differences included the size of lordosis (KLL) and the depth of lordosis (GLL) in the lumbar spine. Higher values were observed in the kickboxing training group compared to the control group. There was no statistically significant difference between the kickboxing group and the control group in other parameters. Conclusions: The asymmetrical and flexed posture required during kickboxing training did not negatively influence the competitors’ spinal curvatures. Kickboxers had increased lumbar lordosis, which may be related to the specificity of the given discipline (stretching of the hamstrings and specific movements). This is a beneficial phenomenon that may reduce the risk of lower back pain. Kickboxing training did not affect the asymmetry of body posture in the sagittal plane. Full article

Background/Objectives: Three-dimensional accelerometry data from the lower trunk during running is associated with intervertebral disc degeneration. The kinematic function known as the lumbo–pelvic–hip complex involves movements in the sagittal plane during running. If pelvic movement and acceleration in the anteroposterior direction are correlated, improving running mechanics may reduce the load on the intervertebral disc. This study investigated the relationship between the anteroposterior acceleration of the lower lumbar spine and pelvic tilt movements during running. Methods: Sixteen healthy male college students were enrolled and asked to run on a treadmill for 1 min at 16 km/h, and the acceleration data for their lower lumbar region and running motion in the sagittal plane were recorded. The pelvic tilt angle during running was calculated through two-dimensional motion analysis. Subsequently, a simple linear regression analysis was employed to clarify the relationship between the acceleration data of the lower lumbar region and the pelvic tilt angle during running. Results: The simple linear regression analysis indicated that the root mean squares of the anteroposterior acceleration of the lower lumbar spine were associated with the maximum pelvic tilt angle (r  =  0.32, p  =  0.003, adjusted R² = 0.09) and its range (r  =  0.42, p  =  0.0001, adjusted R² = 0.16). Conclusions: However, the adjusted R² value was low, indicating that although the pelvic tilt angle during running may be related to acceleration in the anteroposterior direction, the effect is small. Full article

Background: Low back pain (LBP) is the leading cause of lost productivity, absenteeism, disability, and early retirement worldwide. LBP treatment should be comprehensive, including prevention, education, diagnosis, and various treatment methods. Management can be divided into pharmacological and non-pharmacological. The role of physiotherapy in the comprehensive treatment of LBP is very important. Elastic therapeutic tape, also called kinesiology tape or therapeutic kinesiology tape, has been used for about 50 years. Purpose: The aim of this study was to evaluate the effectiveness of Kinesio taping in patients suffering from (LBP), and its possible effect on the swing of the center of pressure (COP), balance, gait, improvement of coordination, and pain reduction. Methods: A total of 60 patients aged 20 to 83 years (54% women) were examined, all of whom fulfilled the requirements for admission and rejection. The L1–L5 spine of the experimental group underwent Kinesio taping in addition to thorough rehabilitation. The control group underwent balance control training based on visual feedback (VFB). The research tools used included the Bohannon single-leg standing test, the FAC (Functional Ambulatory Category) scale, the Podsiadlo and Richardson Standing and Walking Test called “Timed Up and Go” (TUG), evaluation of lumbar spine movement, Lasegue’s test and examination of neurological deficit symptoms, and self-assessment of pain using the Visual Analog Scale (VAS). Results: The effects of Kinesio taping on pain, gait, coordination, postural control, and balance are statistically significant. The main parameter influencing the effects of Kinesio taping was age (below 55 years); this relationship was also observed in the control group. Conclusions: Kinesio taping is an effective method in the treatment of LBP. It improves postural control, balance, gait, coordination, and pain. Full article

Introduction: Painful legs and moving toes (PLMT) syndrome is a rare movement disorder characterized by defuse lower limb neuropathic pain and spontaneous abnormal, involuntary toe movements. Objective: The objective was to present a rare case of PLMT syndrome with a triggering area in an adult patient due to multilevel discogenic pathology, to make a thorough review of this disorder and to provide a practical approach to its management. Case presentation: A 59-years-old male was admitted to the neurology ward with symptoms of defuse pain in the lower-back and the right leg accompanied by involuntary movements for the right toes intensified by tactile stimulation in the right upper thigh. Magnetic resonance imaging (MRI) revealed a multilevel discogenic pathology of the lumbar and cervical spine, with myelopathy at C5-C7 level. A medication with Pregabalin 300 mg/daily significantly improved both the abnormal toe movements and the leg pain. The clinical effect was constant during the 90-day follow-up without any adverse effects. Conclusion: Painful legs and moving toes (PLMT) is a condition that greatly affects the quality of life of patients, but which still remains less known by clinicians. Spontaneous resolution is rare, and oral medications are the first-line treatment. Pregabalin is a safe and effective treatment option for PLMT that should be considered early for the management of this condition. Other medication interventions, such as botulinum toxin injections, spinal blockade, or non-pharmacological treatment options like spinal cord stimulation, and surgical decompressions, are also recommended when the conservative treatment is ineffective in well-selected patients. Full article

Background/Objectives: There is emerging evidence that task-specific pain-related psychological measures may better predict movement behaviour in chronic low back pain (CLBP) than general pain-related psychological measures. Currently, little is known regarding the prediction of movement duration and movement velocity. Methods: Baseline data from a previously published randomized controlled trial were used (clinicaltrials.gov NCT02773160). Fifty-five patients with CLBP and 54 pain-free persons performed a lifting task while kinematic measurements were obtained to calculate movement velocity of the L1 vertebra, S1 vertebra, and the lumbar spine, as well as the time to complete the lifting task. Scores on the Photograph Daily Activities Series-Short Electronic Version (PHODA-SeV), Tampa Scale for Kinesiophobia (TSK), and its Activity Avoidance and Somatic Focus subscales were used as general pain-related psychological measures. The score on a picture of the PHODA-SeV, showing a person lifting an object with a bent back (PHODA-Lift), was used as task-specific measure of perceived harmfulness. Results: The task-specific measure best predicted movement duration and movement velocity of L1 and the lumbar spine, and explained 35%, 19%, and 25% of the respective movement parameters. Although general perceived harmfulness predicted S1 velocity and movement duration, it only explained 6% and 8% of the respective movement parameters. General measures of pain-related fear were not predictive for any of the movement parameters. It took patients with CLBP significantly longer to complete the lifting task when compared to the pain-free participants (ES = 1.01, p < 0.0001), and patients with CLBP also moved significantly slower at L1 (ES = 0.85, p < 0.0001) and the lumbar spine (ES = 1.01, p < 0.0001). These between-groups differences were larger for CLBP subgroups with higher scores on the PHODA-Lift, and to some extent for subgroups with higher total scores on the PHODA-SeV. Conclusions: Task-specific perceived harmfulness best predicts movement velocity. General pain-related fear measures (i.e., TSK and its subscales) do not predict these movement parameters. Full article

Background: Physiological curvature changes of the lumbar spine and disc herniation can cause abnormal biomechanical responses of the lumbar spine. Finite element (FE) studies on special weightlifter models are limited, yet understanding stress in damaged lumbar spines is crucial for preventing and rehabilitating lumbar diseases. This study analyzes the biomechanical responses of a weightlifter with lumbar straightening and L4-L5 disc herniation during symmetric bending and lifting to optimize training and rehabilitation. Methods: Based on the weightlifter’s computed tomography (CT) data, an FE lumbar spine model (L1-L5) was established. The model included normal intervertebral discs (IVDs), vertebral endplates, ligaments, and a degenerated L4-L5 disc. The bending angle was set to 45°, and weights of 15 kg, 20 kg, and 25 kg were used. The flexion moment for lifting these weights was theoretically calculated. The model was tilted at 45° in Abaqus 2021 (Dassault Systèmes Simulia Corp., Johnston, RI, USA), with L5 constrained in all six degrees of freedom. A vertical load equivalent to the weightlifter’s body mass and the calculated flexion moments were applied to L1 to simulate the weightlifter’s bending and lifting behavior. Biomechanical responses within the lumbar spine were then analyzed. Results: The displacement and range of motion (ROM) of the lumbar spine were similar under all three loading conditions. The flexion degree increased with the load, while extension remained unchanged. Right-side movement and bending showed minimal change, with slightly more right rotation. Stress distribution trends were similar across loads, primarily concentrated in the vertebral body, increasing with load. Maximum stress occurred at the anterior inferior margin of L5, with significant stress at the posterior joints, ligaments, and spinous processes. The posterior L5 and margins of L1 and L5 experienced high stress. The degenerated L4-L5 IVD showed stress concentration on its edges, with significant stress also on L3-L4 IVD. Stress distribution in the lumbar spine was uneven. Conclusions: Our findings highlight the impact on spinal biomechanics and suggest reducing anisotropic loading and being cautious of loaded flexion positions affecting posterior joints, IVDs, and vertebrae. This study offers valuable insights for the rehabilitation and treatment of similar patients. Full article

Within rowing, lower back disorders (LBDs) are common, but the mechanisms underpinning LBDs are poorly understood. Considering this, it is essential to understand how coordination and motor control change under different constraints such as ergometer rowing and fatigue. This can help better inform movement features linked to LBDs. Measurement of the continuous relative phase (CRP) is a method used to quantify body segment and joint coordination, as CRP measures the spatiotemporal control of multi-joint movement. The purpose of this study was twofold: to examine the general spatiotemporal coordination aspects of ergometer rowing in an unfatigued state, and to quantify how the spatiotemporal coordination of a rowing movement changes in response to a fatigue-inducing rowing trial. Wearable IMUs monitored 20 participants’ movement during a 2000 m ergometer row. The Borg-10 Rating of Perceived Exertion (RPE) scale was used to quantify perceived fatigue. Despite significant RPE increases across all athletes, the spatiotemporal coordination of rowing revealed prevailing strategies for the lumbar spine and lower extremity but no significant effects (α = 0.05) of fatigue on CRP outcomes (MARP, DP), cross-correlation lag (R_XY), or range of motion. These findings provide further insight into rowing movements and support the idea that heterogeneous responses to fatigue may exist, requiring further study. Full article