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Back pain may be related to an improper sitting position. The aim of the study was to assess the sagittal curvatures of the spine in a sitting position in children with generalized joint hypermobility (GJH). The study included 302 children aged 8–14 years. The sagittal curvatures of the spine (sacral slope, lumbar lordosis, thoracic kyphosis with its lower and upper part) were assessed using the Saunders digital inclinometer. In order to assess GJH a 9-point Beighton scale was used. The study revealed no significant differences (p > 0.05) in sagittal curvatures of the spine in a relaxed sitting position between children with and without GJH. Regardless of the occurrence of GJH, kyphotic alignment of the spine was noted in a relaxed sitting. GJH does not affect the position of the trunk in a sagittal plane in a relaxed sitting position in children aged 8–14 years. A relaxed sitting position in children with and without GJH is characterized by a kyphotic position of the spine caused by an improper position of pelvis and lumbar segment of the spine.

Background Carrying a schoolbag is a daily activity for most children and adolescents.The perception of a schoolbag’s weight depends upon the individual and is a relevant theme in schoolchildren. Describing the association between the perception of heaviness in carrying a schoolbag and NLBP can facilitate the planning of preventive programs, quite different from those based on specific weight limits for schoolbags in children and youth. Objective To determine the prevalence of non-specific low back pain (NLBP) and to analyse the association between the perception of heaviness in carrying of schoolbags and NLBP in Polish children and youth aged 10–19. Methods This study included 11,423 children and youth (6,252 girls and 5,171 boys) from Poland. An original questionnaire was used to assess NLBP prevalence. Results Among 11,423 of the respondents, 41.5% of the respondents admitted that they had experienced NLBP in the period of the last 12 months. The percentage of individuals reporting NLBP increased with age of participants, p p Conclusion In the examined group of schoolchildren a frequent occurrence of NLBP (41.5%) was noted. Its occurrence was related to female sex and age. Students who thought that their backpacks weighed too much manifested higher probability to develop NLBP.

BackgroundRespiratory system diseases are some of the most common pathologies worldwide. Although osteopathic manual therapy (OMT) is used predominantly to treat other pathologies, certain OMT techniques have been shown to improve patients' respiratory function.ObjectivesThe aim of this study was to assess the influence of osteopathic techniques on breathing.MethodsTests were performed with the use of a spirometer and the results were expressed as Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), and Peak Expiratory Flow (PEF). Thirty healthy males and females between the age of 18 and 50 took part in the research. Fifteen individuals were randomly assigned to the experimental group and fifteen persons were assigned to the placebo group. The participants from the experimental group were treated with such osteopathic techniques aimed at the pulmonary system as the thoracic thrust (manipulations of vertebral joints and ribs), the sternal pump technique and stretching of the diaphragm. The placebo group was treated with soft tissue therapy (STT) techniques for the masseter muscle.ResultsThe described set of osteopathic techniques exerts an influence on PEF in healthy individuals; however, it does not affect FVC and FEV1.ConclusionOsteopathic techniques do not seem to improve lung health, as reflected in FEV1 and FVC, but they improve the respiratory function aspects reflected by PEF in the participants without any history of lung disease.

Introduction Due to a high prevalence of low back pain (LBP) among children and adolescents, it is significant to seek effective prevention and therapeutic procedures. One idea for the programmes is a potential relation between the occurrence of LBP and the level of physical activity. The aim of this review was to analyse the current knowledge regarding the association between physical activity and LBP among children and adolescents. Methods Publications were retrieved by searching the following databases: PubMed, The Cochrane library, Web of Science, Medline and SportDiscus with Full Text (EBSCO). The search strategy included keywords related to physical activity and LBP. The studies included were assessed for methodological quality. PRISMA guidelines were followed for the systematic review. Results The total sample size of the nine included studies consisted of 75,233 subjects, with an age range of 9–19 years. All the studies were assessed to be of high quality. One cohort study and five cross-sectional studies found the association between physical activity and LBP in children and adolescents. The remaining studies found no relationship between physical activity and LBP. These findings showed that both extremes of activity levels (i.e. being very low and very high physically active) are associated with LBP. Conclusion There is moderate evidence for the association between physical activity and LBP in children and adolescents. The results highlight the need for continued research. It seems that for clear evaluation of the analysed association the prospective cohort studies should be conducted.

Background The aim of the study was (1) to characterise back pain in physically inactive students as well as in trained (with a high level of physical activity) and untrained (with an average level of physical activity) physical education (PE) students and (2) to find out whether there exist differences regarding the declared incidence of back pain (within the last 12 months) between physically inactive students and PE students as well as between trained (with a high level of physical activity) and untrained (with an average level of physical activity) PE students. Methods The study included 1321 1st-, 2nd- and 3rd-year students (full-time bachelor degree course) of Physical Education, Physiotherapy, Pedagogy as well as Tourism and Recreation from 4 universities in Poland. A questionnaire prepared by the authors was applied as a research tool. The 10-point Visual Analogue Scale (VAS) was used to assess pain intensity. Prior to the study, the reliability of the questionnaire was assessed by conducting it on the group of 20 participants twice with a shorter interval. No significant differences between the results obtained in the two surveys were revealed (p 0.05). Back pain was more common in the group of trained students than among untrained individuals (p 0.05). The trained students declared back pain more often than their untrained counterparts (p

Objectives. The aim of the study was to assess the change of sagittal spinal curvatures in children with generalized joint hypermobility (GJH) instructed with “straighten your back” command (SYB).Methods. The study included 56 children with GJH. The control group consisted of 193 children. Sacral slope (SS), lumbar lordosis (LL), global thoracic kyphosis (TK), lower thoracic kyphosis (LK), and upper thoracic kyphosis (UK) were assessed with Saunders inclinometer both in spontaneous positions (standing and sitting) and after the SYB.Results. Children with GJH after SYB presented the following: in standing, increase in SS and decrease in TK, LK, and UK (P<0.01), with LL not significantly changed; in sitting: decrease in global thoracic kyphosis (35.5° (SD 20.5) versus 21.0° (SD 15.5),P<0.001) below the standards proposed in the literature (30–40°) and flattening of its lower part (P<0.001). The same changes were observed in the control group.Conclusions. In children with generalized joint hypermobility, the “straighten your back” command leads to excessive reduction of the global thoracic kyphosis and flattening of its lower part. Therefore, the “straighten your back” command should not be used to achieve the optimal standing and sitting positions.

Introduction The aim of the study was to determine the frequency of low back pain episodes (over a period of 12 months) and everyday functioning of students suffering from it. Material and methods The study enrolled 1321 students of the 1st, 2nd and 3rd year of Bachelor-level programmes in Physical Education, Physiotherapy, Pedagogics, and Tourism and Recreation at 4 universities in Poland. An original questionnaire was used. A 10-point VAS scale was used to assess pain intensity. The reliability of the questionnaire had been assessed before commencing the study by administering it twice at a month's interval to a group of 20 people. No significant differences were noted between the results obtained in the two tests (p Results Our analysis of the frequency of low back pain episodes showed that the respondents who experienced pain rarely (1-2 episodes per year) constituted the biggest group. With regard to pain intensity, mild pain, reported by 43.4% of the respondents, was most common. Over 20% of the subjects reported severe pain. A considerable percentage of the respondents (over 20%) limited their physical activity because of low back pain and 4.4% had to give up physical activity altogether. Nearly 60% of the subjects reported that the low back pain made it difficult for them to sit for prolonged periods, while nearly 50% had difficulty standing. Conclusions 1. This study of a group of students from eastern Poland revealed that low back pain is common. 2. Low back pain interferes with or limits daily activities of the students, such as sitting, standing or physical activity.

Introduction : Infectious complications in patients with implanted pacemakers are divided into infections of the generator pocket (PI) and lead-dependent infective endocarditis (LDIE). Aim of the research: Identification of risk factors for developing different types of infections and evaluation of the extent of infectious complications. Material and methods : We compared two groups of patients with infectious complications, who underwent transvenous lead extraction (TLE) in the Reference Centre between March 2006 and July 2013. The groups consisted of 414 patients with LDIE and 205 with PI. We analysed risk factors, clinical manifestations, inflammatory markers, microbiology, and echocardiography results. Results : The coexistence of LDIE and PI was observed in 62.1% patients. There were no significant differences in the presence of host-dependent risk factors. Patients with LDIE significantly more frequently had abrasion of leads (35.1.% vs. 21.0%; p = 0.0001) connected with other procedural risk factors: a larger number of the leads (2.2 vs. 2.0; p = 0.004) lead loops (24.6% vs. 13.2%; p = 0.001), and longer time interval from the last procedure prior to TLE (28.7 vs. 22.6 months; p = 0.005). Fever and pulmonary infections, higher level of erythrocyte sedimentation rate, C-reactive protein, procalcitonin, vegetation presence, and higher pulmonary systolic pressure were also revealed in patients with LDIE. Positive blood and leads culture were observed in 34.5% and 46.4% patients with LDIE. Conclusions: The frequent coexistence of LDIE and PI confirms their common pathogenesis, but the phenomenon of abrasion suggests also another mechanism for the development of LDIE. Intensity of clinical syndromes, high inflammatory parameters, echocardiography, and microbiology findings are helpful in assessment of the extensity of the infection.

Objectives To assess abdominal muscles (AM) activity during prone, side, and supine bridge on stable and unstable surfaces (BOSU, Swiss Ball). Design Prospective comparison study. Setting Research laboratory. Participants Thirty-three healthy volunteers from a university population. Main outcome measures Surface electromyography of the rectus abdominis (RA), the external oblique (EO) and the internal oblique with the transversus abdominis (IO-TA). Results The AM exhibited the highest activity during prone bridge on a Swiss Ball (RA, EO, IO-TA 44.7 ± 19.2, 54.7 ± 22.9, 36.8 ± 18.6 in % of MVC, respectively). The lowest activity was observed during supine bridge on a stable surface and a BOSU (under 5.0). The lowest ratio analyzed on the basis of the relation of EO and IO-TA activity to RA was obtained during prone bridge on the Swiss Ball (1.4 ± 0.7 for EO, 0.9 ± 0.5 for IO-TA). The highest ratio was obtained during prone bridge on stable surface and supine bridges. Conclusions The highest level of activity in the abdominal muscles is achieved during prone bridge on a Swiss Ball. However, this exercise provided the lowest activity of the EO and IO-TA in relation to RA. It is essential to conduct further studies verifying the usefulness of using Swiss Ball during core stability training.

The study sought to characterize back pain (BP) (in the period of 12 months) in children and youth aged 10 to 19 from eastern Poland. The study included 11619 children and youth (6254 girls and 5365 boys) aged 10 to 19 from eastern Poland. An original questionnaire was applied as a research tool. Before the study, the reliability of the questionnaire had been assessed. The Kappa coefficient value for all the analyzed variables was equal to or higher than 0.91. Over 74.4% of the respondents admitted that within the last 12 months, they had experienced BP which was usually located in the lumbar spine (55.8%). The percentage of individuals reporting BP increased with age of participants. Girls reported BP more often than boys (82.8% vs 64.3%). The main circumstances in which BP occurred included lifting heavy objects, carrying school backpack and maintaining a sedentary position (70.7% vs 67.4% vs 67.8%). Over 67% of the respondents declared they did not know ergonomic principles. High prevalence of BP was noted. The declared BP was mainly located in the lumbar spine. Girls reported BP more often than boys. The students presented a very low level of knowledge about ergonomics. Therefore, the appropriate education should be included at school.

ObjectiveThe aim of the study was to evaluate whether the clinical assessment of the pelvic-hip complex muscle and trunk flexibility is sufficient for diagnosing generalized joint hypermobility (GJH).DesignA cross-sectional study.SettingCenter of Body Posture in Olsztyn, North East Poland.ParticipantsThe study included 136 females and 113 males aged 10-13 years.Main outcome measuresIn order to assess muscle flexibility, the straight leg raise (SLR) test (for hamstring) and modified Thomas test for one- (O-JHF) and two-joint (T-JHF) hip flexors were performed. To evaluate trunk flexibility the fingertip-to-floor (FTF) and lateral trunk flexion (LTF) tests were used. The GJH occurrence was assessed with the use of nine-point Beighton scale (threshold value ≥5 points for females, ≥4 for males). The analysis was carried out separately for females and males.ResultsThere were no significant differences between females with versus without GJH, and males with versus without GJH regarding SLR (p = 0.86, p = 0.19 for females and males, respectively), O-JHF (p = 0.89, p = 0.35 for females and males, respectively), T-JHF (p = 0.77, p = 0.4 for females and males, respectively), FTF (p = 0.19, p = 0.84 for females and males, respectively) and LTF (p = 0.58, p = 0.35 for females and males, respectively) tests results.ConclusionsClinical examination of the pelvic-hip complex muscles and trunk flexibility by use of SLR, O-JHF, T-JHF, FTF and LTF revealed to be insufficient in diagnosing GJH in children aged 10-13 years. Thus, the Beighton scale should be considered a standard element of physiotherapeutic examination of the musculoskeletal system in children and youth.

Background and Objective. The limitations of muscle flexibility are a common dysfunction of the musculoskeletal system. Therefore, various therapeutic techniques are used in rehabilitation programs to increase their flexibility. The aim of this prospective, randomized, single-blind study was to evaluate the changes in the flexibility of hip flexors in children who participated in a 6-week therapeutic program consisting of one physiotherapy session per week with a physiotherapist and daily home exercises. Material and Methods. A total of 94 children aged 10–13 years were randomly assigned to 3 experimental groups: postisometrical relaxation group (PIR group), static stretching combined with stabilizing exercise group (SE/SS group), and stabilizing exercise group (SS group). To assess the flexibility of one- and two-joint hip flexors, the modified Thomas test was used. The examination was conducted by blinded observers. Results. A significant improvement in the flexibility of one-joint hip flexors was documented in all 3 groups (P0.05). Conclusions. The 6-week therapeutic program regardless of the technique applied (postisometrical muscle relaxation, static stretching with stabilizing exercises, and stabilizing exercises only) resulted in the increased flexibility of one-joint hip flexors. Only static stretching combined with stabilizing exercises led to a significant increase in the flexibility of two-joint hip flexors.

Methods 94 children (46 boys and 48 girls) aged 10-13 years (11.5 ±0.5), were randomly divided into 3 groups. Each group underwent a 6-week therapeutic programme aiming to correct muscles flexibility. The first group-GI (31 children) realized the programme of post isometric muscle relaxation (PIR), the second one-GII (31 children) performed static stretching with stabilization exercises, the third group-GIII (32 children) realized only stabilization exercises. The shortening of hamstring, one-joint and two-joint hip flexors was assessed clinically according to Kendall. The straight leg raise (SLR test) angle and the popliteal angle were measured for hamstrings, the angle in sagittal plane in hip for one-joint and the knee flexion was measured for twojoint hip flexors. Fingertips-to-floor distance (FTF test) in trunk flexion was also noted. The examination was conducted twice – before therapy and a week after its completion, by the blinded observers.

Objective. The aim of this work was to define the prevalence of back pain in children and youth aged 10–19 from the southeast of Poland.Material and Methods. The cross-sectional study included 1089 students (547 girls and 542 boys) aged 10–19. The prevalence of back pain, its intensity, location, and situations in which it occurred were assessed with a questionnaire.Results. Among 1089 respondents, 830 (76.2%) admitted that they had experienced back pain at various frequencies within the year preceding the study. Back pain was located mainly in the lumbar segment (74.8%). Mild pains were dominant, which was declared by 44.7% of the respondents. Girls experienced back pain significantly more frequently than boys (52.2% versus 47.8%,P<0.05).Conclusions. The research revealed that back pain is a common phenomenon. The prevalence of back pain in children and youth living in southeast Poland is similar to the frequency of occurrence of such complaints occurring in peers in other countries. It seems significant to monitor the remaining regions of Poland in order to define the scale of the problem and to look for the risk factors of back pain in children and youth to undertake efficient prophylactic actions.