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Objective The purpose of the present study was to compare the reliability of sonography in the evaluation of abdominal and multifidus muscles size between healthy subjects and patients with scoliosis. Methods In this study, 20 healthy males and 20 male patients with scoliosis (20–50 years old) were recruited. Multifidus and abdominal muscles (transversus abdominis, internal and external oblique) size were assessed by sonography. Three images were recorded; the first and second images were taken on the same day with an hour interval to evaluate within-day reliability, and the third image was taken one-week later to assess between-day reliability. Results Intraclass correlation coefficient (ICC = 0.82–0.91) demonstrated high within-day reliability of sonography in the assessment of abdominal muscle thickness in both groups. In addition, high between-day reliability was observed for these muscles in both healthy and patient groups (ICC = 0.80–0.89). Within-day and also between-day reliability of multifidus muscle were shown to be high in the healthy group (ICC = 0.81–0.88) and the patient group (ICC = 0.78–0.85). Overall, within-day reliability was higher than between-day reliability and also the reliability of sonography in healthy subjects was greater than of those suffering from scoliosis. Conclusions According to the results, sonography was shown to be a highly reliable imaging technique for assessment of abdominal and multifidus muscle size in healthy males and those suffering from scoliosis.

To determine the effect of mobilization and routine physiotherapy on pain, disability, neck range of motion (ROM) and neck muscle endurance (NME) in patients having chronic mechanical neck pain (NP).Sixty eight patients with chronic mechanical NP were randomly allocated into two groups by using a computer generated random sequence table with 34 patients in the multi-modal mobilization group and 34 patients in the routine physiotherapy group. Baseline values for pain, disability, NME, and neck ROM were recorded using visual analogue scale (VAS), neck disability index (NDI), neck flexor muscle endurance test and universal goniometer respectively, before the treatment. Each patient received 10 treatment sessions over a period of four weeks and at the end of four weeks all the outcome measures were recorded again.A paired t-test revealed significant pre to post treatment differences for all outcome measures in both groups (p ≤ 0.001 in all instances). An independent t-test revealed statistically significant differences for pain, disability, NME, and neck ROM in favor of the multi-modal mobilization group with a between group difference of 1.57 cm for VAS (p 0.001), 11.74 points for NDI (p = 0.001), 18.45 s for NME (p 0.001) and 6.06-8.24° for neck ROM (p 0.05).The results suggest that a combination of cervical mobilization with routine physiotherapy is more effective for reducing pain and disability and improving NME and neck ROM in patients with chronic mechanical NP compared to routine physiotherapy alone.

Neck pain (NP) is a common occupational health problem associated with a number of professions. Many studies indicate that NP is common among teachers, yet no published study was found to address the prevalence and risk factors of NP in Iranian school teachers. The purpose of the current study was to assess the prevalence and risk factors for NP among school teachers in Iran. A cross-sectional study was conducted on 586 randomly selected primary and high schools teachers from 22 schools in Tehran, Iran. Point, last month, last 6 months, annual, and lifetime prevalence rates of NP were 24%, 29%, 33%, 37%, and 43%, respectively. There was a significant association and increased prevalence of NP with a number of risk factors such as; being female, age, general health, length of employment, regular exercise and job satisfaction (P < 0.05 in all instances). Therefore, some individual and occupational factors may make conditions relevant for the development of NP among teachers.

Objectives To evaluate Ultrasound Imaging (USI) reliability for measurement of lumbar multifidus (LMF) muscle thickness and cross sectional area (CSA) at rest and during contraction in patients with unilateral lumbar disc herniation. Setting Laboratory. Design Reliability Study. Participants Thirty patients, aged 25–50 years (37.55 ± 9.55), with unilateral L4-L5 lumbar disc herniation participated in this study. Main outcome measures Thickness and CSA of LMF were measured using B-mode ultrasound by two raters in prone position. Results Same day and multiple day inter-rater and same day intra-rater reliability showed good to excellent reliability (intraclass correlation coefficients ranged from 0.70 to 0.91). Also standard error of measurement and minimal detectable change for USI reliabilities ranged from 0.06 to 0.57 and 0.16 to 1.31, respectively. Conclusions Reliability of USI for measurements of LMF muscle thickness and CSA was high, and consistent with previous studies conducted on reliability of USI to measure LMF dimensions in other populations.

Objective: To evaluate the eligibility of the movement-based classification systems in the diagnosis of patients with low back pain. Methods: The present systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta -Analysis guidelines. Different databases including PubMed, Science Direct, OVID, MEDLINE, CINAHL, EMBASE, ProQuest and Google Scholar were searched from January 1990 to December 2017. All studies assessed the reliability and validity of the movement-based classification systems to diagnose patients with low back pain were included. The keywords used to search the studies were: �reliability�, �validity�, �classification�, �movement impairment� and �low back pain�. Study selection and data extraction were performed by two independent reviewers. Results: Sixteen articles were met the inclusion criteria. Of these articles, 13 studies assessed the reliability and validity of movement-based classification systems to categorize patients with low back pain. Two out of 16 articles compared patients with low back pain and healthy subjects and one article had no control group. Conclusions: The results of the reviewed studies demonstrated that movement-based classification systems are valid and reliable enough to categorize patients with low back pain. © 2020 Elsevier Ltd

The aim of the study was to compare the dimensions of cervical multifidus muscle (CMM) in different conditions.Twenty five women with neck pain and 25 healthy subjects participated in this study. The dimensions of the CMM were measured at rest, 50% and 100% maximum isometric voluntary contraction (MIVC) at six directions of neck movements, using ultrasonography.The size of multifidus was smaller in patients than healthy individuals at rest state (P 0.05). A significant smaller CMM dimension was found in the affected side compared with unaffected side in patients group (P 0.05). The result of ANOVA for MLD showed a significant difference for contraction levels (P 0.001) and neck movements (P 0.001) in both groups. The MLD of the CMM was significantly different between CMM at rest and 50%, and 100% MIVC (P 0.001). No significant differences were found between the groups at 50% and 100% MIVC (P 0.05 in both instances). The most prominent CMM size change was observed during neck extension, flexion, ipsilateral lateral-flexion, and ipsilateral rotation, respectively (P 0.05).Results of the present study indicate that the size of CMM was decreased in patients with neck pain in rest state. The size of CMM changes in all directions of neck movements, although the most prominent was during neck extension. This points out CMM stabilization role's in different directions of neck movements.

Objective The purposes of this study were; a) to compare multifidus muscle cross sectional area (CSA) in male adolescents suffering from low back pain (LBP) with healthy male adolescents using ultrasonography (US), and b) to assess the correlation between multifidus muscle size and demographic variables. Methods A random sample of 40 healthy boys (as a control group) and 40 boys with LBP (as an experimental group) at the age range of 15–18 years was recruited in the present cohort study. Multifidus muscle dimensions including CSA, antero-posterior and medio-lateral dimensions were measured at level of L5 in both groups using US. Results The results of an independent t-test to compare multifidus muscle size between the experimental and control groups showed a significant difference between the two groups in terms of CSA, antro-posterior and medio-lateral dimensions so that the experimental group had smaller muscle size than the control group. A significant correlation was found between height, weight and body mass index (BMI) and multifidus muscle size, but no significant correlation was observed between age and muscle size. Pain intensity and functional disability index was significantly correlated with muscle size in the experimental group. Conclusions According to the results, multifidus muscle size was decreased in 15–18 years old male adolescents suffering from LBP compared with their healthy counterparts. Further studies are needed to support the findings of the present study.

Pronated of the foot is one of the important factors contributing to musculoskeletal problems affecting the lower extremities. It is known that in a pronated foot, excessive mechanical load is applied to the lower limb structures which may result in altered biomechanics and muscle activation patterns. The aim of this study was to determine changes in the muscle activation pattern of the lower extremities in individuals with pronated, compared to normal, feet, using the voluntary response index (VRI).In this cross sectional study, 15 asymptomatic pronated foot individuals (mean age 23.27 ± 3.28 years) and 15 normal subjects (mean age 23.40 ± 3.11 years) were recruited by simple non-random sampling. Electrical activities of gluteus medius (GM), vastus lateralis (VL), vastus medialis (VM), biceps femoris, semitendinosus (ST), and medial gastrocnemius (MG) muscles were recorded during a forward jump landing task. Voluntary response index (VRI) variables, included similarity index (SI) and magnitude (Mag) were also evaluated.Muscle activity of VM (p 0.001) and ST (p = 0.010) were significantly higher but VL (p = 0.039) and MG (p = 0.001) were significantly lower in pronated foot, compared to normal subjects. Similarity index was found to be different (p 0.001) between pronated foot and healthy individuals. No significant difference was found in terms of Mag between the two groups (p = 0.576).The altered pattern of lower limb muscle activation identified in the pronated foot during landing may be attributed to the different activation involving VL, VM, MG and ST muscles. Adaptations to the biomechanical effects, due to the pronated foot causing altered activation of VL, VM, MG, and ST muscles, results in an altered pattern of muscle activation. This change in activation pattern may harm the effectiveness of movement control processes; and might also predispose individuals with pronated feet, to injuries. It seems that an altered motor strategy with the aim of minimizing biomechanical changes, predisposes individuals to injuries. However, further large scale studies are needed to support the findings of the present study.

Despite different studies on the reliability of pelvic floor muscle assessment, there is still no general consensus on the most valid and reliable method. The purpose of this study was to investigate the intra-rater (within-day and between-days) reliability of perineometer in the assessment of pelvic floor muscle strength and endurance. Following ethical approval, 15 healthy women aged from 22 to 50-years old, with no history of low back pain were recruited. The Peritron perineometer instrument was used to measure pelvic floor muscle strength and endurance. Two measurements were taken on the same day with an hour interval to assess within-day reliability and the third measurement was taken five days later to determine between-days reliability. Intraclass Correlation Coefficients (ICCs) and the level of agreement between measurements were used for data analysis. The high ICC values (0.95 for strength and 0.94 for endurance) and high level of agreement between measurements indicated high within-day reliability for pelvic floor muscle strength and endurance. The perineometer was also shown to be reliable for between-days measurements with high ICC (0.88 for strength and 0.83 for endurance) and high level of agreement between measurements. The results demonstrated that the perineometer appears to be a highly reliable method of measuring pelvic floor muscle strength and endurance when measurements are taken in healthy subject by the same investigator.

Dysfunction of spinal stability seems to be one of the causes of low back pain (LBP). It is thought that a large number of muscles have a role in spinal stability including the pelvic floor muscle (PFM). The purpose of this study was to investigate the effect of PFM exercise in the treatment of chronic LBP. After ethical approval, a randomized controlled clinical trial was carried out on 20 women with chronic LBP. Patients were randomly allocated into two groups: an experimental and a control group. The control group was given routine treatment including electrotherapy and general exercises; and the experimental group received routine treatment and additional PFM exercise. Pain intensity, functional disability and PFM strength and endurance were measured before, immediately after intervention and at 3 months follow-up. In both groups pain and functional disability were significantly reduced following treatment (p0.01), but no significant difference was found between the two groups (p0.05). All measurements were improved in both groups (p0.01) although patients in the experimental group showed greater improvement in PFM strength and endurance (p0.01). It seems that the PFM exercise combined with routine treatment was not superior to routine treatment alone in patients with chronic LBP.

Summary In this study, the reliability of the longus colli muscle (LCM) size was assessed in a relaxed state by a real time ultrasonography (US) device in a group of healthy subjects and a group of patients with chronic neck pain. Fifteen healthy subjects (19–41years old) and 10 patients with chronic neck pain (27–44years old) were recruited for the purpose of this study. LCM size was measured at the level of thyroid cartilage. Two images were taken on the same day with an hour interval to assess the within day reliability and the third image was taken 1week later to determine between days reliability. Cross sectional area (CSA), anterior posterior dimension (APD), and lateral dimension (LD) were measured each time. The shape ratio was calculated as LD/APD. Intraclass correlation coefficients (ICC) and standard error of measurement (SEM) were computed for data analysis. The ICC of left and right CSA for within day and between days reliability in healthy subjects were (0.90, 0.93) and (0.85, 0.82), respectively. The ICC of left and right CSA for within day and between days reliability in patients with neck pain were (0.86, 0.82) and (0.76, 0.81), respectively. The results indicated that US could be used as a reliable tool to measure the LCM dimensions in healthy subjects and patients with chronic neck pain.