Abstract
Background
Therapeutic exercises are used in clinical practice for patients with low back pain (LBP). Core stabilization exercises can retrain the important function of local trunk muscles ...and increase the accuracy of the sensory integration process for stability of the spine in individuals with LBP. The aim of this study was to compare the effects of two different exercise regimes, Core stabilization exercises (CSE) and Strengthening exercise (STE), on proprioception, balance, muscle thickness and pain-related outcomes in patients with subacute non-specific low back pain (NSLBP).
Methods
Thirty-six subacute NSLBP patients, mean age, 34.78 ± 9.07 years; BMI, 24.03 ± 3.20 Kg/m
2
; and duration of current pain, 8.22 ± 1.61 weeks, were included in this study. They were randomly allocated into either CSE (
n
= 18) or STE groups (n = 18). Exercise training was given for 30 min, three times per week, for up to 4 weeks. Proprioception, standing balance, muscle thickness of transversus abdominis (TrA) and lumbar multifidus (LM), and pain-related outcomes, comprising pain, functional disability and fear of movement, were assessed at baseline and after 4 weeks of intervention.
Results
The CSE group demonstrated significantly more improvement than the STE group after 4 weeks of intervention. Improvements were in: proprioception mean difference (95% CI): − 0.295 (− 0.37 to − 0.2), effect size: 1.38, (
p
< 0.001), balance: single leg standing with eyes open and eyes closed on both stable and unstable surfaces (
p
< 0.05), and percentage change of muscle thickness of TrA and LM (
p
< 0.01). Although both exercise groups gained relief from pain, the CSE group demonstrated greater reduction of functional disability effect size: 0.61, (
p
< 0.05) and fear of movement effect size: 0.80, (
p
< 0.01). There were no significant adverse effects in either type of exercise program.
Conclusion
Despite both core stabilization and strengthening exercises reducing pain, core stabilization exercise is superior to strengthening exercise. It is effective in improving proprioception, balance, and percentage change of muscle thickness of TrA and LM, and reducing functional disability and fear of movement in patients with subacute NSLBP.
Trial registration
Thai Clinical Trial Registry (
TCTR20180822001
; August 21, 2018).
The number of smartphone users globally is rapidly increasing. This study aimed to assess the level of ergonomic risk to smartphone users, and to evaluate the correlation between any self-reported ...musculoskeletal disorders and the level of ergonomic risk. Thirty participants completed a questionnaire, tailored specifically for smartphone users, to determine any musculoskeletal disorders. Participants were given a seated smartphone texting task and their postures were video recorded during the task. The video scenarios were evaluated by three independent researchers to determine the level of ergonomic risk using the Rapid Upper Limb Assessment (RULA) tool. RULA is an observation-based screening tool which has been widely used to assess the postural risk of IT device users. However, it has not yet been specifically utilized with smartphone users. The RULA tool scores identified ergonomics risks from using smartphones to text. Most smartphone users had a total RULA Grand Score of 6 for both sides (left side: 80.00%, right side: 90.00%), indicating the need for further investigation and changes (Action Level 3). Notably, no participants had acceptable RULA Grand Scores of 1 or 2. The correlation between musculoskeletal disorders and the ergonomic risk among smartphone users was determined using the Chi-Square test and Fisher's exact test; p<0.05 was considered statistically significant. There was a significant correlation between right RULA Grand Score and neck musculoskeletal disorder (χ2 = 9.424 at p value = 0.009) and right RULA Grand Score and upper back musculoskeletal disorder (χ2 = 31.717 at p value <0.001). RULA Score B (combination of neck, trunk and leg postures) and RULA Score D (combination of Score B, muscle use and force scores for group B) were also significantly correlated with neck musculoskeletal disorders (χ2 = 19.286 at p value<0.001 and χ2 = 9.310 at p value = 0.002 respectively). The RULA results identified the high ergonomics risk of smartphone users, this resulted from two key risk factors: posture and muscle use. The neck, trunk and leg postures had a combined effect on neck musculoskeletal disorders. Future investigations should consider these factors when designing ergonomic interventions for smartphone users.
Neck pain has been found to affect the somatosensory system, which can lead to impaired balance control. To assess the balance of patients with neck pain and other conditions, the balance error ...scoring system (BESS) is commonly used as a static balance measurement tool. However, this tool is seldom used in Thailand due to its English language format.
To translate and determine the content, convergent validity, and reliability of a Thai version of the BESS tool.
A process of cross-cultural adaptation was utilized to translate BESS into a Thai version, called BESS-TH. To assess content validity, five physical therapy lecturers specializing in the musculoskeletal field used BESS to measure balance in participants with neck pain. For the convergent validity process, 130 patients diagnosed with chronic non-specific neck pain (CNSNP) were randomly assessed using four static balance tests (BESS, Single-leg balance test (SLBT), Romberg test, and Tandem stance test). For reliability, two assessors with varying years of work experience independently assessed videos of the participants twice using the BESS-TH, with a minimum 7-day interval between assessments.
The BESS-TH used to assess balance of patients with neck pain demonstrated acceptable content validity (index of item objective congruence (IOC) = 0.87). The Spearman's Rank Correlation Coefficient was calculated between the BESS-TH and three other measures: the SLBT with eyes open and eyes closed, the Romberg test with eyes open and eyes closed, and the Tandem stance test with eyes open and Tandem stance test with eyes closed. The values obtained were as follows: -0.672, -0.712, -0.367, -0.529, -0.570, and -0.738, respectively. The inter-rater and intra-rater reliability were 0.922 (95% CI = 0.864-0.956) and 0.971 (95% CI = 0.950-0.983), respectively. Minimum detectable change (MDC) for the total BESS score of inter-rater and intra-rater reliability were 7.16 and 4.34 points, respectively.
The BESS-Thai version was acceptable, reliable, and valid for evaluating balance performance in patients with CNSNP. This tool can be used and applied to clinically evaluate postural control in Thailand.
Occupational health and safety (OHS) education is integral to healthcare practice. Nurses/nursing students are particularly vulnerable during their work in this high-risk industry. Current clinical ...teaching appears to focus on individual risks rather than provide a broader overview of the complex issues involved. A novel educational resource, the Safety Assessment Framework for Evaluation and Assessment (SAFER), is presented, addressing a gap in current education resources for nursing students to broaden understanding about OHS. The study re-examined pilot focus group data from first- and third- year student OHS focus groups in an Australian university School of Nursing. The SAFER framework was informed by student nurses impressions/ experiences of OHS (published in 2015 and 2016), supported by a literature review. Central to the SAFER framework is OHS ‘risk management’. It incorporates stakeholders and Australian legislation, all in relation to ‘responsibility’ and ‘trust’. Examples use focus group participant voice, linked with researcher interpretation and supporting documentation. Clinical educators now have a broad resource to facilitate student group discussions about OHS from multiple perspectives. SAFER’s value beyond face validity should be tested, to confirm its applicability as a teaching resource in various university and training environments. Keywords: occupational health, education, nursing, curriculum, student
Purpose To determine the short-term effects of thoracic manipulation, used alone or in conjunction with the Rungthip massage technique, on pain and neural extensibility in patients with chronic ...mechanical neck pain. Participants and Methods Thirty participants were randomly allocated to the aforementioned two groups. Outcome measures were neck pain at rest assessed using the Visual Analog Scale, and elbow extension range of motion evaluated using Upper Limb Neurodynamic Test 1 prior to treatment and three weeks after it. Results A statistically significant reduction in resting neck pain, and an improvement in elbow extension range of motion was reported by both groups shortly after the moment when the pain was first felt (threshold level). However, an improvement in elbow extension range of motion was not observed in either group at the maximum level of pain (tolerance level). A significant reduction in resting neck pain was seen in the thoracic manipulation plus Rungthip massage group, compared to that achieved using thoracic manipulation alone. Conclusion The use of thoracic manipulation and Rungthip massage is recommended to reduce resting neck pain and increase pain-free neural tissue extensibility.
Purpose The aim of this study was to investigate the prevalence of low back pain and associated factors in Thai rice farmers during the rice transplanting process. Subjects and Methods Three hundred ...and forty-four farmers, aged 20–59 years old, were asked to answer a questionnaire modified from the Standard Nordic Questionnaire (Thai version). The questionnaire sought demographic, back-related, and psychosocial data. Results The results showed that the prevalence of low back pain was 83.1%. Farmers younger than 45 years old who worked in the field fewer than six days were more likely to experience low back pain than those who worked for at least six days. Farmers with high stress levels were more likely to have low back pain. Conclusion In the rice transplanting process, the low back pain experienced by the farmers was associated with the weekly work duration and stress.
Purpose To investigate effects of thoracic manipulation versus mobilization on chronic neck pain. Methods Thirty-nine chronic neck pain subjects were randomly assigned to single level thoracic ...manipulation, single level thoracic mobilization, or a control group. The cervical range of motion (CROM) and pain ratings (using a visual analog scale: VAS) were measured before, immediately after and at a 24-hour follow-up. Results Thoracic manipulation significantly decreased VAS pain ratings and increased CROM in all directions in immediate and 24-hour follow-ups. The thoracic mobilization group significantly increased in CROM in most directions at immediate follow-up and right and left rotational directions at the 24-hour follow-up. Comparisons between groups revealed the CROM for the manipulation group to increase significantly more than for control subjects in most directions at immediate follow-up and flexion, left lateral flexion and left rotation at the 24-hour follow-up. The CROM for the thoracic mobilization group significantly increased in comparison to the control group in flexion at immediate follow-up and in flexion and left rotation at the 24-hour follow-up. Conclusion The study demonstrated reductions in VAS pain ratings and increases in CROM at immediate and 24-hour follow-ups from both single level thoracic spine manipulation and thoracic mobilization in chronic neck pain.
The University of South Australia's Bachelor of Physiotherapy course, 'Work Health and Safety (WHS) Practice', provides students with introductory practical WHS experience. Students undertake 80-hour ...effort WHS projects for industry, culminating in a report for hosts.
To establish the types of industry that host WHS undergraduate physiotherapy placements and the nature of activities that students conduct.
Reports were retrospectively, systematically classified using a descriptive, document content analysis approach. Demographic data were collected: report and student numbers, placement locations and industry types. Selected reports were used as a subset for further analysis with definitions created to classify the nature of placement activities.
Most reports were written by a pair of students (88%, n = 269), with placements based in metropolitan Adelaide (91%, n = 284). Various industries hosted students, including healthcare and social assistance (40%, n = 117) and manufacturing (30%, n = 89). Reports primarily included risk management activities as required by WHS legislation (97%, n = 229).
Physiotherapy student WHS activities maintain close links with industry, involving stakeholders (workforce, students, University of South Australia and academics). At an entry-level standard, the student WHS activities align well with some criteria set as key competencies for Australian Occupational Health physiotherapy practitioners.
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