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Background: In hallux valgus, morphological changes and functional weakness of intrinsic foot muscles occur, especially in the abductor hallucis muscle. Objectives: This study aimed to investigate how a conservative treatment with the addition of neuromuscular electrical stimulation affects the volume and strength of the muscle, the correction of deformity, passive range of motion, pain, and disability. Methods: Twenty-eight female participants (48 feet) were randomly assigned to two groups. The interventions included orthoses and exercise (Ortho) in both groups. One group received additional neuromuscular electrical stimulation of abductor hallucis muscle to activate it. Each group received the treatments for one month and was assessed two times, at baseline before starting and after one month of treatment. Mixed within-between ANOVA, analysis of covariance, and nonparametric tests were used for data analysis. Results: The muscle volume, abduction strength, goniometric angle, and passive hallux dorsi/plantar flexion showed significant changes in both groups (p <.001). Subscales of the foot and ankle ability questionnaire, significantly changed (p ≤.05). Pain decreased significantly in the two groups (p <.001 and p =.02). Intermetatarsal angle did not significantly differ between the two groups (p =.86, partial eta effect size = 0.001). But, the hallux valgus angle mean (on MRI) in the Ortho group was less than that of the orthoNMES group (p =.007, partial eta effect size = 0.15). Conclusion: Both groups showed nearly identical treatment effects in the primary volume and hallux valgus correction outcome measures. In this study, adding neuromuscular electrical stimulation did not have an additional effect compared to conservative in the treatment of hallux valgus. Trial registration number: The RCT Code is IRCT20200915048725N1. [ABSTRACT FROM AUTHOR]

Previous studies have demonstrated that respiratory dysfunction has a potential association with low back pain (LBP). Despite the role of the diaphragm for respiration and spinal stability, knowledge of the function of both sides of the diaphragm in subjects with LBP is still limited. This study aimed to compare the structural integrity and function of the right and left hemidiaphragm by ultrasonography (USG) in subjects with and without nonspecific chronic low back pain (NS-CLBP). A total of 37 subjects with NS-CLBP and 34 healthy subjects participated in this case-control study. The thickness, thickness change, and excursion of the right and left hemidiaphragm were compared within and between the groups during quiet breathing (QB) and deep breathing (DB) through B-mode and M-mode ultrasound imaging. The LBP group had a significantly smaller degree of right hemidiaphragm thickness change (P =.001) compared with the healthy control group, with a strong effect size. Nevertheless, there was no significant change for diaphragm thickness and excursion between the two groups. The result showed that, in the healthy group, the right hemidiaphragm had a significantly smaller thickness at expiration and larger thickness change compared with the left hemidiaphragm, with a moderate effect size. Based on the multivariate prediction analysis, the right hemidiaphragm thickness change might significantly predict LBP. We found that participants with LBP had a smaller degree of right hemidiaphragm thickness change. Also, the right hemidiaphragm thickness change might significantly predict LBP. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate lumbar lordosis during sit-to-stand (STS) and stand-to-sit (SIT) in individuals with and without chronic nonspecific low back pain (CNLBP). The second objective was to investigate sex-related differences in lumbar lordosis. Twenty-six patients with CNLBP and 26 controls were recruited. Controls were matched with cases using a frequency matching method. Reflective markers were placed over the spinous process of T 12 , L 3 , S 2 , and the anterior and posterior superior iliac spines. The participants were instructed to stand up at a self-selected pace and maintain their normal upright standing posture for 3 seconds, and then sit down. Kinematic data were recorded at a sampling frequency of 100 Hz using a motion capture system. Lumbar lordosis angle was calculated from the intersection between the line joining T 12 and L 3 , and the line joining L 3 to S 2. Lumbar lordosis was decreased in patients with CNLBP during STS and SIT compared with the asymptomatic group (mean difference = 2.68°-9.32°; P ≤.005). Furthermore, no differences were seen in lumbar lordosis at starting position between CNLBP and asymptomatic groups during STS and SIT (mean difference = 2.68°-3.75°; P ≥.099). Interestingly, the magnitude of the effect size suggested that the difference in lumbar lordosis values between female and male participants was relatively large (Cohen's d = -1.81 to 0.20). Decreased lumbar lordosis in patients with CNLBP during STS and SIT could be considered as an important point during rehabilitation. Moreover, the present study showed that there is a sex-related difference among women and men in lumbar lordosis during STS and SIT tasks. [ABSTRACT FROM AUTHOR]

BACKGROUND: Pain from myofascial trigger points is often treated by dry needling (DN). Empirical evidence suggests eliciting a local twitch response (LTR) during needling is essential. Muscle damage after eliciting LTR can increase the risk of tissue fibrosis in some cases. OBJECTIVE: This study aimed to compare two methods of DN including with and without LTR on clinical parameters. METHODS: Twenty-six participants suffering from chronic non-specific neck pain with an active trigger point (TrP) in their upper trapezius muscles were recruited via the convenience sampling method. Participants were randomly assigned in DN with LTR (control group) and without eliciting LTR or "de qi" (experimental group). Then, they received 3 sessions of dry needling, 3 days apart. We evaluated pain, pain pressure threshold, active cervical lateral flexion range of motion, and Neck Disability Index before the intervention and 4 weeks after the treatment. RESULTS: After the treatment, significant higher changes were seen in the experimental group compared to the control group (p < 0.05) regarding pain, pain pressure threshold, and active cervical lateral flexion. However, there was no significant difference between groups according to the disability (p > 0.05). CONCLUSION: DN without eliciting LTR has superiority over the DN along with eliciting LTR while the treatment aimed to receive long-term effects. [ABSTRACT FROM AUTHOR]

BACKGROUND: Latent myofascial trigger point (LMTP) is a small hypersensitive area in skeletal muscles that becomes painful under compression or stimulation. LMTPs are relevant for various musculoskeletal disorders. Although several treatments have been introduced to treat LMTP, the most efficient one is yet to be found. OBJECTIVE: The main purpose of the present study was to compare pressure release, phonophoresis of betamethasone and dry needling on the upper trapezius latent myofascial trigger point. METHODS: Sixty participants (mean ± SD age, 23.6 ± 2.1 y), with at least one latent myofascial trigger point in the upper trapezius muscle, participated in this study. Subjects were randomly divided into three groups (pressure release, phonophoresis with betamethasone and dry needling groups) for two weeks. Pain intensity, pain pressure threshold and active cervical range of motion were assessed. RESULTS: Significant pain decrease, active cervical range of motion and pain pressure threshold increase were observed in the three groups (p < 0.001). The dry needling and phonophoresis groups reported more significant improvement compared to the pressure release group (p < 0.001). There was no difference between the dry needling and phonophoresis groups. CONCLUSIONS: Considering the significant, positive effects of all three methods, dry needling and phonophoresis seem to be more effective than pressure release. [ABSTRACT FROM AUTHOR]

Background. Although there are frequent studies about normal range of thoracic kyphosis, there is still a controversy about the exact values of this curve. In nine reported studies on 10 to 20 years of age boys, the value ranged from 25.1° to 53.3°. Objectivefor the Study. The aim of the present research was investigation of normal ranges of thoracic kyphosis in school children in Kermanshah, western Iran. Methods. 582 male students aged 13 to 18 years old using cluster random sampling were recruited from schools in Kermanshah city, 97 students for each age. Thoracic curves were measured using the flexicurve method. Results. Mean thoracic kyphosis for whole population was 35.49° SD 7.83 and plus or minus two standard deviations ranged from 19.83° to 51.15°. It increased gradually from 13 to 16 and then there was a little decrease to 18 years. Mean values for each age (13-16) were 13 (34.41 SD 7.47°), 14 (34.86 SD 8.29°), 15 (35.79 SD 7.93°), 16 (36.49 SD 7.85°), 17 (35.84 SD 8.33°), and 18 (35.55 SD 7.07°). Conclusions. Our results are in agreement with previous reports and can be used as normal values for local and regional purposes. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to evaluate the changes occurring in the thickness of deep trunk muscles, measured using ultrasound imaging, after 4 wks of lumbosacral orthosis use in conjunction with routine physical therapy. Design: This parallel-group, randomized, controlled trial was conducted on 44 patients with nonspecific chronic low back pain, randomly allocated to the experimental and control groups. Both groups received eight sessions of physical therapy twice per week for 4 wks. The experimental group wore nonextensible lumbosacral orthosis, in addition to undergoing routine physical therapy. The thickness of the transversus abdominis, obliquus internus, and lumbar multifidus was measured by ultrasound before and after the 4-wk intervention. Results: The deep trunk muscles differed in thickness in various test positions. Four weeks of intervention with lumbosacral orthosis and routine physical therapy, however, did not change the thickness of the obliquus internus, transversus abdominis, and lumbar multifidus. Conclusions:Wearing lumbosacral orthosis for an average of 7.21 hrs/d for 4 wks in conjunction with routine physical therapy did not affect the thickness of obliquus internus, transversus abdominis, and lumbar multifidus. [ABSTRACT FROM AUTHOR]