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Abstract Objective Spinopelvic alignment is increasingly considered as an essential factor for maintaining an energy-efficient posture in individuals with normal or pathological status. Although several previous studies have shown that changes in the sagittal spinopelvic alignment may occur in patients undergoing total hip arthroplasty (THA), no review of this area has been completed so far. Thus, the objective of this scoping review was to summarize the evidence investigating changes in spinopelvic alignment and low back pain (LBP) following THA. Data sources We adhered to the established methodology for scoping reviews. Four electronic databases were systematically searched from inception-December 31, 2021. Study selection We selected prospective or retrospective observational or intervention studies that included patients with THA. Data extraction Data extraction and levels of evidence were independently performed using standardized checklists. Data synthesis A total of 45 papers were included in this scoping review, involving 5185 participants with THA. Pelvic tilt was the most common parameter measured in the eligible studies (n = 26). The results were not consistent across all studies; however, it was demonstrated that the distribution of pelvic tilt following THA had a range of 25° posterior to 20° anterior. Moreover, decreased sacral slope and lower pelvic incidence were associated with increased risk of dislocation in patients with THA. Lumbar spine scoliosis did not change significantly after THA in patients with bilateral hip osteoarthritis (5.50°(1.16°) vs. 3.73°(1.16°); P-value = 0.29). Finally, one study indicated that LBP improvement was not correlated with postoperative changes in spinopelvic alignment parameters. Several methodological issues were addressed in this study, including no sample size calculation and no type-I error adjustment for outcome multiplicity. Conclusions Changes in spinopelvic alignment may occur after THA and may improve with time. Patients with a THA dislocation usually show abnormal spinopelvic alignment compared to patients without a THA dislocation. LBP usually improves markedly over time following THA.

Abstract Background Headache is the most common neurological symptoms worldwide, as over 90% of people have noted at least one headache during their lifetime. Tension-type headaches, cervicogenic headaches, and migraines are common types of headache which can have a significant impact on social, physical, and occupational functioning. Therapeutic management of headaches mainly includes physical therapy and pharmacological interventions. Dry needling is a relatively new therapeutic approach that uses a thin filiform needle without injectate to penetrate the skin and stimulate underlying tissues for the management of neuromusculoskeletal pain and movement impairments. The main objective of this systematic review and meta-analysis is to evaluate the effectiveness of dry needling in comparison to other interventions on pain and disability in patients with tension-type headache, cervicogenic headache, and migraine. Methods/design We will focus on clinical trials with concurrent control group(s) and comparative observational studies assessing the effect of dry needling in patients with tension-type headache, cervicogenic headache, and migraine. Electronic databases from relevant fields of research (PubMed/ Medline, Scopus, Embase®, PEDro, Web of Science, Ovid, AMED, CENTRAL, and Google Scholar) will be searched from inception to June 2019 using defined search terms. No restrictions for language of publication or geographic location will be applied. Moreover, grey literature, citation tracking, and reference lists scanning of the selected studies will be searched manually. Primary outcomes of this study are pain intensity and disability, and secondary outcomes are cervical spine ROM, frequency of headaches, health-related quality of life, and TrPs tenderness. Studies will be selected by three independent reviewers based on prespecified eligibility criteria. Three reviewers will independently extract data in each eligible study using a pre-piloted Microsoft Excel data extraction form. The assessment of risk of bias will be implemented using the Cochrane Back and Neck Review Group 13-item criteria and NOS. Direct meta-analysis will be performed using a fixed or random effects model to estimate effect size such as standardized mean difference (Morris’s d ppc ) and 95% confidence intervals. Statistical heterogeneity will also be evaluated using the I 2 statistic and the χ2 test. All meta-analyses will be performed using Stata V.11 and V.14 softwares. The overall quality of the evidence for the primary outcomes will be assessed using GRADE. Discussion All analyses in this study will be based on the previous published papers. Therefore, ethical approval and patient consent are not required. The findings of this study will provide important information on the value of dry needling for the management of tension-type headache, cervicogenic headache, and migraine. Trial registration PROSPERO registration number: CRD42019124125.

Objectives: Sensory neuropathy is the major cause of ulceration in diabetic patients. Periodical sensory examination is an appropriate method to detect neuropathy and decrease the risk of diabetic foot ulcer. Semmes–Weinstein Monofilaments (SWM) and tuning fork on/off test are widely used to assess pressure and vibration sensitivity. The present study evaluated the inter- and intra-rater reliability of SWM and tuning fork to measure pressure and vibration sensations in diabetic patients. Methods: Following ethical approval, 34 diabetic patients without foot ulceration were recruited. Feet kit SWM and tuning fork were used for pressure and vibration sensation evaluation, respectively. Measurements were performed twice on the first session with an hour interval to assess within-day reliability and the third one was demonstrated 7 days later to assess between-days reliability. Results: Within-day Intra-class Correlation Coefficient (ICC) analysis indicated excellent levels of inter- and intra- rater reliability (ICC>0.75) for feet kit SWM in all foot regions and 128 Hz and 256 Hz tuning forks. Excellent between-days intra-rater reliability (ICC>0.75) was also obtained for SWM; however, the ICC of tuning fork was moderate. Between-days inter-rater reliability of SWM and tuning fork were high and poor, respectively. Discussion: The obtained results indicated that SWM and tuning fork seemed to be highly reliable to measure pressure and vibration sensations in diabetic patients. However, further studies are required to support the results of current study.

Introduction: Based on the literature, unihemispheric concurrent dual-site anodal transcranial Direct Current Stimulation (a-tDCSUHCDS) of primary Motor cortex (M1) and Dorsolateral Prefrontal Cortex (DLPFC) would be more efficient than conventional a-tDCS of M1 to induce larger and longer-lasting M1 corticospinal excitability. The main objective of the present study was to compare the effects of a-tDCSUHCDS and conventional M1 a-tDCS on the extent and durability of the motor sequence acquisition in healthy individuals. Methods: In this randomized sham-controlled study, healthy volunteers were randomly divided into three groups: experimental (a-tDCSUHCDS), control (M1 a-tDCS), and sham stimulation groups. The participants practiced serial response time task over three consecutive days when they simultaneously received a-tDCS. Using the skill measure, we assessed motor learning up to 4 weeks after the completion of experimental conditions. Results: Data analysis revealed that all groups exhibited the improved trend over the training course (P0.05), while a significant improvement was observed between experimental and sham group at the retention time (P0.05). Conclusion: These results revealed a significant increase in the skill acquisition by a-tDCSUHCDS technique with regard to retention issue, which could be a valuable finding in neuro-rehabilitation field.

Background and Objective: Previous studies demonstrated that the prevalence of lumbar disc herniation (LDH) is relatively high. This investigation aimed to evaluate the size of lumbar multifidus (LM) muscle in patients with different degrees of LDH compared to healthy group, during rest and contraction, using ultrasonography. Materials and Methods: In this non-experimental, analytic, and case control study, ultrasound imaging was used to assess cross-sectional area (CSA) and thickness of the LM muscle in 15 healthy subjects and 60 patients with different stages of LDH (bulging group = 15, protrusion group = 15, extrusion group = 15, sequestration group = 15). Measurements were taken bilaterally at the L4–L5 level, during rest and contraction and results were compared between groups. Results: There was a significant difference between healthy subjects and the extrusion and sequestration groups during rest and contraction for LM muscle CSA and thickness (p = 0.001), as LM muscle CSA and thickness were significantly smaller in extrusion and sequestration patient groups compared to healthy subjects. LM atrophy was greater in patients with extrusion and sequestration groups than in patients with bulging and protrusion, both at rest and during contraction. Significant correlations were also observed between functional disability and intensity of pain with LM CSA and thickness measurements. Conclusions: Patients with extrusion and sequestration LDH had smaller LM muscle at rest and during contraction compared to healthy subjects. Larger LDH lesions were associated with decreased LM muscle size. Patient with more pain, disability, and extrusion and sequestration LDH had greater LM size changes. LM muscle size was not correlated with symptom duration. Further investigation with greater sample size is warranted.

Objectives: Ankle Foot Orthoses (AFOs) are widely utilized to improve walking ability in hemiplegic patients. The present study aimed to evaluate the effect of Rocker bar Ankle Foot Orthosis (RAFO) on functional mobility in post-stroke hemiplegic patients. Methods: Fifteen hemiplegic patients (men and women) who were at least 6-months poststroke and able to walk without an assistive device for at least 10 meters voluntarily participated in this study. The patients were examined for three conditions: shoes only, with SAFO and with RAFO. Their functional mobility was evaluated through 10-meter walk test and Timed Up and Go (TUG) test. In addition, paired t-test was used to analyze the obtained data. Results: When the patients used RAFO, their gait speed significantly increased (P

Background Measurement of lumbar spine range of motion (ROM) is often considered to be an essential component of lumbar spine physiotherapy and orthopedic assessment. The measurement can be carried out through various instruments such as inclinometers, goniometers, and etc. Recent smartphones have been equipped with accelerometers and magnetometers, which, through specific software applications (apps) can be used for inclinometric functions. Purpose The main purpose was to investigate the reliability and validity of an iPhone® app (TiltMeter© -advanced level and inclinometer) for measuring standing lumbar spine flexion–extension ROM in asymptomatic subjects. Design A cross-sectional study was carried out. Setting This study was conducted in a physiotherapy clinic located at School of Rehabilitation Sciences, Iran University of Medical Science and Health Services, Tehran, Iran. Subjects A convenience sample of 30 asymptomatic adults (15 males; 15 females; age range = 18–55 years) was recruited between August 2015 and December 2015. Methods Following a 2–minute warm-up, the subjects were asked to stand in a relaxed position and their skin was marked at the T12–L1 and S1–S2 spinal levels. From this position, they were asked to perform maximum lumbar flexion followed by maximum lumbar extension with their knees straight. Two blinded raters each used an inclinometer and the iPhone ® app to measure lumbar spine flexion–extension ROM. A third rater read the measured angles. To calculate total lumbar spine flexion–extension ROM, the measurement from S1–S2 was subtracted from T12–L1. The second (2 hours later) and third (48 hours later) sessions were carried out in the same manner as the first session. All of the measurements were conducted 3 times and the mean value of 3 repetitions for each measurement was used for analysis. Intraclass correlation coefficient (ICC) models (3, k) and (2, k) were used to determine the intra-rater and inter-rater reliability, respectively. The Pearson correlation coefficients were used to establish concurrent validity of the iPhone® app. Furthermore, minimum detectable change at the 95% confidence level (MDC95) was computed as 1.96 × standard error of measurement × $\sqrt{2}$ 2 . Results Good to excellent intra-rater and inter-rater reliability were demonstrated for both the gravity-based inclinometer with ICC values of ≥0.84 and ≥0.77 and the iPhone® app with ICC values of ≥0.85 and ≥0.85, respectively. The MDC95 ranged from 5.82°to 8.18°for the intra-rater analysis and from 7.38°to 8.66° for the inter-rater analysis. The concurrent validity for flexion and extension between the 2 instruments was 0.85 and 0.91, respectively. Conclusions The iPhone®app possesses good to excellent intra-rater and inter-rater reliability and concurrent validity. It seems that the iPhone® app can be used for the measurement of lumbar spine flexion–extension ROM. Level of evidence IIb.

Kienbock's disease, which is an idiopathic osteonecrosis and collapse of the lunate bone, is an uncommon disease in children. This report describes a case of an 11-year-old girl, who presented with avascular necrosis of lunate bone confirmed by radiographic and magnetic resonance imaging evidence. After a short period of casting, the case was fully recovered within one year. The signal change was confirmed by magnetic resonance imaging, and the deformity of lunate that was demonstrated by avascular necrosis. The patient wore a long arm cast for six weeks, and after one year radiographic pattern was normalized

Introduction: Motor skills play an important role during life span, and older adults need to learn or relearn these skills. The purpose of this study was to investigate how aging affects induction of improved movement performance by motor training. Methods: Serial Reaction Time Test (SRTT) was used to assess movement performance during 8 blocks of motor training. Participants were tested in two separate dates, 48 hours apart. First session included 8 blocks of training (blocks 1-8) and second session comprised 2 blocks (blocks 9, 10). Results: Analyses of data showed that reaction times in both online and offline learning were significantly shorter in older adults compared to younger adults (P

Objective: Low back pain (LBP) is one of the most common and prevalent work-related conditions. The aim of this study was to estimate the prevalence and risk factors associated with LBP in dentists and to analyze the association between individual and occupational characteristics and LBP., Methods: Following ethical approval, 300 dentists from Tehran Iran have voluntarily participated. Different questionnaires were completed to collect personal, occupational characteristics and the prevalence and risk factors of LBP. Visual analogue scale and Oswestry disability questionnaires were used to determine pain intensity and level of functional disability., Results: The results indicated that point, last month, last six month, last year and lifetime prevalence of LBP were 24.6%, 24.9%, 27.7%, 28.1% and 31.4%, respectively. A significant correlation was found between the prevalence of LBP and preventive strategies, general health condition, having an assistant and job satisfaction. Body mass index, age and gender were not significantly correlated with the prevalence of Low back pain., Conclusions: The prevalence of Low back pain in dentists appears to be high. Further studies focusing on the effectiveness of different preventive strategies are recommended., Competing Interests: Declaration of interest: None.