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Dear Editor, We are truly obliged to be able to read articles in your esteemed journal. We recently read an article published in your prestigious Journal of Clinical and Diagnostic Research under the Physiotherapy Section in 2023;17(5):YC01-YC06 by Bali NK et al., titled “Correlation between BMI and Static Biomechanical Lower Extremity Kinetic Chain Variables in Overweight Young Adults: A Cross-sectional Study” [1]. The authors’ meticulous work is extremely beneficial in evaluating variables related to the lower extremity kinetic chain, including pronated feet, femoral anteversion, Q-angle, tibial torsion, plantar arch index, angle of the toe, and pelvic inclination. However, we would like to draw the attention of the authors to a few concerns.

Background: Elite swimmers may be predisposed to disturbances in the range of motion (ROM) of hip joints and spinal curvatures, which are a factor that induces body's compensatory mechanisms that may have an impact on sports training, athletic performance and health. This study aimed to identify compensatory mechanisms in body posture of elite Para and able-bodied swimmers (spinal curvatures, ROM), to indicate the dominant locations of the compensatory mechanisms in the groups of Para and able-bodied athletes, and to identify and compare the prevalence and location of musculoskeletal pain from the last week and the last six months in the context of compensatory mechanisms. Methods: Thirty-five (nF = 8; nM = 27; age = 20.51 ± 4.24) elite Para and able-bodied swimmers from the Polish national team took part in the study and were divided into: study group (SG) of Para swimmers and control group (CG) of able-bodied swimmers. Depth of the anteroposterior spinal curvatures and sagittal spinal mobility testing were evaluated with a Medi Mouse device. The prevalence and locations of musculoskeletal pain were assessed with a Nordic Musculoskeletal Questionnaire for the last seven days (NMQ-7) and the last six months (NMQ-6). Results: In both groups lumbar hypolordosis, anterior pelvic tilt and pain in the shoulders, lower back and hips/thighs (NMQ-7) were reported the most frequent. In SG several significant relationships were found between duration of sport-specific training experience (years) and depth of angle the lumbar lordosis, the depth of the angle of pelvic inclination the ROM in the lumbar spine and thoracic spine, what was not reported in CG. Conclusions: Extrinsic compensatory mechanism was identified in both study groups, however only in SG it occurred as structural (depth of the angle of lumbar lordosis and pelvic inclination) and functional changes (ROM in the thoracic and lumbar spine) in the body posture. Internal compensatory mechanism was identified in SG, however external compensation showed only partially suppressive character regarding to internal compensation. The locations of the musculoskeletal complaints seems to result from both internal compensatory mechanism (SG) and continuous overload of the anatomy trains as a result of swimming training (SG, CG). [ABSTRACT FROM AUTHOR]

This document is a correspondence to an article titled "Correlation between BMI and Static Biomechanical Lower Extremity Kinetic Chain Variables in Overweight Young Adults: A Cross-sectional Study." The authors express their appreciation for the article and highlight a few concerns. They note discrepancies in the description and illustration of pelvic inclination, suggest the use of more reliable measurement techniques, and question the statistical analysis methods used. The authors provide references to support their suggestions. In response, the authors of the original article acknowledge the errors and provide explanations for their choices. They also provide additional references to support their methods. [Extracted from the article]

Objective: To determine the relationship between hamstring tightness and pelvic inclination in middle-aged subjects with and without low back pain. Methods: An analytical cross-sectional study was conducted at two hospitals in New Delhi, India from December 2018 to May 2019. Subjects were divided equally into two groups each group formed on the basis of presence and absence of non-specific low back pain. Both males and females between 25-40 years and having nonspecific chronic low back pain with 4 months were included in the study. Hamstring muscle tightness and pelvic inclination angle were the outcome measures. Hamstring tightness was assessed by the right popliteal angle and left popliteal angle Results: Of the total 70 subjects (35 with low back pain and 35 without low back pain), the mean age of the group with low back pain was 32.51 ± 4.31 years, and of the group without low back pain was 32.4 ± 4.51 years. Mean pelvic inclination was found significantly higher in the group with low back pain as compared to the group without low back pain i.e, 15.57° ± 2.86 vs. 13.11° ± 1.34 (p-value < 0.001). Similarly, the mean right popliteal angle and left popliteal angle were also found significantly higher in the group with low back pain as compared to the group without low back pain i.e., 29.23° ± 6.68 vs. 12.94° ± 4.25 (p-value < 0.001) and 25.0° ± 6.73 vs. 13.05° ± 4.30 (p-value < 0.001) respectively.

Abstract Background Children with spastic diplegia experience gait abnormalities and problems caused by deficits in balance, motor control, and spasticity. Abnormal pelvic inclination is common in patients with diplegia which may result in poor pelvic balance. Purpose This study was conducted to investigate the relation between pelvic inclination and standing balance in children with spastic diplegia. Subjects and methods Thirty children with spastic diplegic cerebral palsy from both sexes, aged from 5 to 14 years participated in this study. Their degree of spasticity ranged from 1 to 1+ according to Modified Ashworth Scale and they were on level I or II on Gross Motor Function Classification System. Pelvic inclination angle was measured by using the formetric instrumentation system during standing position while standing balance was assessed by the Biodex Balance System. Results There was a statistically significant relation between pelvic inclination and the overall, anteroposterior, and mediolateral stability indices of standing balance (P < 0.05). Conclusion The obtained results suggested that there was significant correlation between balance and pelvic inclination in children with diplegic cerebral palsy.

Abstract Background With the dynamic development of professional Paralympic sport, the prevalence of musculoskeletal pain and structural and/or functional disturbances in Para athletes constantly increases. The aim of the study was to evaluate the impact of internal compensatory mechanisms on selected aspects of body structure and function in elite sitting volleyball players. Methods The study included eighteen elite sitting volleyball players (male; n = 12, female; n = 6, age; 36.0 ± 6.1, body mass; 76.6 ± 16.1, body height; 179.3 ± 0.1) from the Polish national team. Retrospective and direct participatory observation methods were used in the study. NMQ-7 was used to assess the current prevalence and location of musculoskeletal pain. The evaluation of spinal curvature and pelvic inclination was performed using a non-invasive Medi Mouse method (Idiag M360) in three different trunk positions. All statistical analyses were performed using Statistica 13.3 software package. Results Lumbar hypolordosis was a predominant sagittal deviation of spinal curvature (n = 15;83%). Low back pain (LBP) and neck pain were the most frequent complaints (50%). Statistically significant differences in the values of thoracic kyphosis angle, pelvic inclination, and spine length (SL) in sagittal standing flexion and extension were found. However, there was no statistically significant difference in sagittal standing flexion for the lumbar lordosis angle with a simultaneous significant change in pelvic inclination (66.9°). Moreover, a tendency to interpenetration of relationships between variables that characterize (a) body structure and (b) function of the spine and musculoskeletal pain were observed. Shoulder pain correlated with SL (R = 0.6; p

Background: Lower back pain (LBP) is a major cause of disability and a common musculoskeletal disorder encountered at some point in life. Dysfunction of the lumbar vertebrae has been associated with decreased flexibility of the hamstrings, which exhibited a strong positive correlation with LBP. Hamstring tension affects lumbar pelvic rhythm. We aimed to activate pelvic stability with compression by Active Therapeutic Movement (ATM), muscle energy technique (MET) was applied to increase the flexibility of the hamstring. Objects: In this study, we aimed to investigate the effects of MET with ATM and general MET were applied to the hamstring of adults, who were in their twenties with nor without LBP, on their pelvic inclination and the length of their hamstring. Methods: A total of 32 subjects were briefed about the purpose of this study and agreed to participate voluntarily. Before the experiment, all subjects were pre-examined, and they were divided into an LBP group and a no lower back pain group accordingly. Thereafter, all subjects participated in both in a crossover manner. After at least one week, they switched to another group and participated in the same experiment. Results: The study results revealed that both groups demonstrated significant results in the modified active knee extension test (p < 0.01) and the sit and reach test (p < 0.01) performed to assess the hamstring flexibility; an interaction (p < 0.05) was noted. Moreover, a more significant difference was observed between the MET with ATM and the general MET. Although significant results were obtained for the pelvic inclination (p < 0.01), interaction was not noted. Conclusion: Conclusively, in this study, when the MET with ATM was applied to the two groups, there was a significant difference compared to the general MET for hamstring flexibility, but it was confirmed that there was no significant difference for the pelvic inclination.

Abstract Background Stroke results in an impaired sit to stand (STS) task. Pelvic movements are essential in daily living activities. Few studies investigated the effect of spine and pelvis separately on functional activities in stroke patients. Objective The study aimed to assess the angles of pelvic inclination (anterior and posterior pelvic tilt angles) (APT and PPT) during sitting position and during STS movement. It aimed also to determine the influence of sagittal pelvic tilt angles on STS performance in stroke patients. Patients and methods Thirty male hemi-paretic stroke patients (GI) and 15 matched healthy volunteer subjects (GII) represented the sample of this study. Stroke patients were assigned into two equal groups (group Ia and Ib). Sagittal pelvic tilt angles were measured by using the palpation meter inclinometer during sitting position and during initiation and mid of STS by using two dimensional (2D) video-based motion analysis system. Time of five repetitions STS test was used to assess the ability to perform STS task. Results The results showed a significant increase of PPT angle during static sitting, a significant decrease in APT angle during initiation and mid of STS task and a significant increase in time taken for five repetitions STS test in both stroke groups (P < 0.05). Conclusion Abnormal pelvic alignment and movements affect the functional performance of stroke patients during sitting and sit to stand task. Trial registration NCT03053154. Registered January 22, 2017. Retrospectively registered.

Background Investigations regarding the role of high-heeled shoes in the alteration of the spinopelvic profile attempted to identify a correlation with pain in the lower back. Conclusions from these studies, however, are controversial. In authors knowledge no studies were carried out to investigate the effect of heels on male population, which has been overlooked due to gender-related customs. Research question What is the immediate effect of the height of heels on the sagittal back profile (trunk inclination (TI), pelvic inclination, lordotic lumbar angle (ITL-ILS), kyphotic dorsal angle, lumbar arrow, and cervical arrow) in females and males, not used to wearing high-heeled shoes? Methods One hundred healthy young adult subjects were enrolled. Three were excluded. The remaining 97 subjects (48 female and 49 male) underwent a three-dimensional analysis of the posterior surface of the trunk, using rasterstereography. The spinopelvic profile in the barefoot condition, and with the heel raised by 3 and 7 cm, was recorded. To evaluate the reproducibility of the measure, the neutral evaluation was repeated twice in 23 subjects (13 males, 10 females). Results The change of heel height did not show statistically significant differences for any of the variables used; instead, significant differences were found stratifying the results according to the sex of the subjects tested. Test-retest evaluation in the neutral condition showed no significant differences using the Student's t-test (p > 0.05). Repeatability was excellent and significant for all data used (minimum TI r = 0.85, maximum ITL-ILS r = 0.97). Significance Studying the effect of heels on the spino-pelvic profile also in the male population is crucial for promoting gender-inclusive healthcare, enhancing occupational health practices and developing possible preventive measures. Nevertheless, in the sample of females and males evaluated in this study, the different heights of heel lift did not immediately induce significant changes in pelvis and spine posture. If there is therefore a correlation between low-back pain and the use of heels, it should not reasonably be sought in the immediate change of the spino-pelvic profile caused by raising the heels. However, the variables analyzed differed according to sex., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Colonna et al.)

Background: Stroke results in an impaired sit to stand (STS) task. Pelvic movements are essential in daily living activities. Few studies investigated the effect of spine and pelvis separately on functional activities in stroke patients. Objective: The study aimed to assess the angles of pelvic inclination (anterior and posterior pelvic tilt angles) (APT and PPT) during sitting position and during STS movement. It aimed also to determine the influence of sagittal pelvic tilt angles on STS performance in stroke patients. Patients and methods: Thirty male hemi-paretic stroke patients (GI) and 15 matched healthy volunteer subjects (GII) represented the sample of this study. Stroke patients were assigned into two equal groups (group Ia and Ib). Sagittal pelvic tilt angles were measured by using the palpation meter inclinometer during sitting position and during initiation and mid of STS by using two dimensional (2D) video-based motion analysis system. Time of five repetitions STS test was used to assess the ability to perform STS task. Results: The results showed a significant increase of PPT angle during static sitting, a significant decrease in APT angle during initiation and mid of STS task and a significant increase in time taken for five repetitions STS test in both stroke groups (P < 0.05). Conclusion: Abnormal pelvic alignment and movements affect the functional performance of stroke patients during sitting and sit to stand task. Trial registration: NCT03053154. Registered January 22, 2017. Retrospectively registered. [ABSTRACT FROM AUTHOR]

Osteoarthritis of the hip joint as a complication of limb length discrepancy (LLD) caused by lower extremity deformity is rarely reported in the literature. We report two such cases of osteoarthritic changes of the long leg hip joint due to severe LLD but no developmental dysplasia of the hip. Both underwent limb lengthening, and the symptoms were improved without further treatment. The osteoarthritic changes are secondary to functional acetabular dysplasia resulting in insufficient acetabular coverage of the femoral head and lateral inclination of the pelvis caused by LLD. Thus, lengthening treatment may be one option for such patients with osteoarthritis due to functional acetabular dysplasia.

Background: A pronated foot can produce changes in the lower limb kinetic chain. This can affect the gait and increase energy expenditure. However, the relationship between pronated foot and other static alignment factors remains poorly understood. Hence, the objective was to correlate pronated foot with pelvic inclination, femoral anteversion, Q-angle and tibial torsion. Method: An observational study was performed on 60 subjects in the age group of 18-30 years with a BMI of not more than 30. Foot Posture Index was performed on the subjects, and people with a score of +6 or more were selected. Pelvic inclination, femoral anteversion, Q-angle and tibial torsion were measured. Correlation between the Foot Posture Index score and the above four static alignment factors was done using Graph Pad Prism 7 (Pearson’s correlation coefficient and Spearman’s correlation coefficient). Results: There was no significant correlation between Pronated foot and Pelvic inclination (r-value = 0.03309, p-value = 0.8018), Pronated foot and Femoral anteversion (r-value = 0.2185, p-value = 0.0934) Pronated foot and Q-angle (r-value = 0.1801, p-value = 0.1685), Pronated foot and Tibial torsion (r- value = -0.1285, p-value = 0.3277). Conclusion: There is no significant correlation between foot pronation and pelvic inclination, femoral anteversion, Q-angle and tibial torsion. However, the correlation between these factors cannot be completely ignored, and thus, further studies and literature are required to prove the same.

The aim of this study was to compare the thoracic and lumbar curvatures and pelvic tilt in relaxed standing and maximal trunk flexion among highlytrained young athletes from three different sports disciplines. Thirty-two male canoeists, 30 male kayakers and 24 male tennis players were recruited for the study. The Spinal Mouse® system was used to measure the thoracic and lumbar sagittal spinal curvatures and pelvic tilt in relaxed standing and maximal trunk flexion in sitting with the flexed (McRae & Wright test) and extended knees (sit-and-reach test). Significant differences were found in maximal trunk flexion tests among athletes. Kayakers and canoeists showed increased anterior pelvic tilt compared to tennis players in the McRae & Wright (p<.01) and decreased posterior pelvic tilt in the sit-and-reach (p< 001) tests; however, canoeists had increased posterior pelvic tilt compared to kayakers in the sit-and-reach test (p< 01). Canoeists had increased thoracic kyphosis curvature compared to kayakers (p<.01) and tennis players (p<.001) in the sit-and-reach test. Spinal sagittal curvatures and pelvic tilt in relaxed standing did not show significant differences. In conclusion, specific sports training may be associated with adaptations in the sagittal spinal curvatures and pelvic tilt when maximal trunk flexion positions are performed. [ABSTRACT FROM AUTHOR]

Purpose: Dislocation after total hip arthroplasty (THA) is a major postoperative complication. Even if the cup is in the safe zone, dislocation caused by implant impingement may occur during postural changes. The aim of the present study was to investigate the spinopelvic factors that influence pelvic inclination changes from standing to sitting in patients with hip diseases who were candidates for THA.Methods: 74 patients who underwent primary THA were included according to our criteria. The analysis of the sagittal balance of the spinopelvic complex was performed on standing and sitting lateral radiographs. Pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis angle (LLA), thoracic kyphosis angle (TK), and sagittal vertical axis (SVA) were measured. The differences between the standing and sitting positions regarding the spinal and pelvic parameters were analyzed. Correlations between the variables of the spinopelvic parameters were examined using Spearman's rank correlation coefficient.Results: The changes in SVA, TK, LLA, SS, PT, and PI from the standing to sitting positions, respectively, were -3.9 ± 48.2 mm, -0.1° ± 6.4°, 21.4° ± 17.7°, 22.2° ± 12.2°, -22.3° ± 13.2°, and 0.4° ± 6.9°. The lumbar lordosis was reduced and pelvic rotation was extended from the standing to the sitting position. The correlation coefficient between the change in the SS and that in the LLA was 0.72 (p < 0.0001). The correlation coefficient between the change in PT and that in the LLA was -0.68 (p < 0.0001).Conclusions: The change in pelvic inclination from standing to sitting is strongly related to the mobility of the lumbar spine in patients with hip diseases. [ABSTRACT FROM AUTHOR]

Background Cam-type femoroacetabular deformity in acetabular dysplasia (AD) has not been well clarified. The primary purpose of this study was to determine the prevalence and characteristics of femoroacetabular deformity in symptomatic AD patients. Methods We retrospectively reviewed the cases of 86 women (92 hips) and eight men (eight hips) with symptomatic AD. The mean patient age was 37.9 (range, 14-60) years. All participants underwent lateral cross-table and lateral whole-spine radiographic examinations to measure the alpha angle and pelvic tilt. Pelvic computed tomography scans were used to measure femoral anteversion. The patients were classified into two groups: AD only group, containing hips with an alpha angle less than 55°; and AD with cam-type femoroacetabular deformity (AD + cam-type deformity) group, containing hips with an alpha angle greater than or equal to 55°. Results Of the patients with AD, 40 hips displayed additional radiographic evidence of cam-type morphology, while 60 hips had exclusive AD morphology. The patients in the AD + cam- type deformity group had significantly increased forward pelvic tilt in the standing position (p =0.023) and decreased femoral anteversion (p =0.047) compared with the AD only group. Conclusions Our data revealed that 40% of patients with AD also had radiographic evidence of cam-type femoroacetabular deformity. Greater forward pelvic tilt in the standing position and decreased femoral anteversion seemed to be associated with the cam-type deformity in these patients. These results indicate the morphological features that are most likely to induce secondary symptoms to developmental hip dysplasia. It is suggested that the symptoms in the AD + cam-type deformity group could arise through femoroacetabular impingement (FAI) after periacetabular osteotomy, because a predisposition was present preoperatively. [ABSTRACT FROM AUTHOR]

Background Stroke is the second leading reason for death and the third most common reason for disability. Stroke is a source of possible substantial harm and is often more disabling than lethal. Common stroke defects include stiffness, tiredness, loss of balance on the afflicted side, as well as gait impairment, resulting in an inability to sustain postural alignment. Pelvic proprioceptive neuromuscular facilitation (PNF) is a physical rehabilitation that combines functionally dependent diagonal activity patterns with neuromuscular facilitator strategies to improve motor behaviour, endurance, and muscle activity and control. This protocol was created to describe the experimental study design for evaluating the combined impact of pelvic PNF and task-oriented exercises in chronic stroke patients to improve balance and gait parameters. Aim and objective The purpose of our study is to investigate the effectiveness of pelvic PNF as well as task-oriented exercises on balance, gait parameters, and in pelvic asymmetry. Methods The participants (n=30) were stroke survivors who fulfilled the inclusion criteria for research and were divided into two groups. The regimen lasted four weeks and took 30 minutes each day. Patients were evaluated at the beginning and end of their treatment. In both groups, pre- and post-intervention outcome measures were recorded and the data was analyzed. Result Following four weeks of rehabilitation, subjects showed remarkable improvement in balance, gait parameters, and pelvic inclination in both groups, i.e., pelvic PNF and task-oriented exercises in group A and task-oriented exercises in group B, but Group A showed a major improvement in outcome measures. A p-value of less than 0.05 was considered significant. Despite the fact that both treatment regimens were successful for the patient, pelvic PNF combined with task-oriented exercises exhibits a statistically significant difference from task-oriented exercises. Conclusion Pelvic PNF along with task-oriented exercises proved to be beneficial and can help in the restoration of balance and gait parameters as a result of normalisation in the geometry and symmetry of the pelvis in stroke patients. The pelvis, which is a connecting link between the trunk and lower limbs, plays a crucial role in balance and also in lower limb performance exclusively in gait., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Boob et al.)

Objective: To investigate the effect of bilateral, flexible, second-degree flatfoot on pelvic and spinal mechanics in young females. Methods: A case-control trial was conducted at the Faculty of Physical Therapy, Cairo University, Egypt, on 60 female participants who were assigned into two groups. Group A (the control group) included 31 healthy subjects, and group B (the study group) included 29 subjects with bilateral, flexible, second-degree of flatfoot deformity. For each subject in both groups, using lateral weight-bearing radiographs, foot assessments were performed bilaterally to measure the talus-first metatarsal angle. Using the formetric-II device, 3D assessments of the pelvis were performed on the frontal and sagittal planes in addition to lumbar and thoracic curvatures on the sagittal plane. Outcome measures were pelvic inclination, pelvic tilt, and lumbar lordotic and thoracic kyphotic angles. Results: There was a significant difference in pelvic inclination and in lumbar and thoracic angles (P=0.012, 0.009, and 0.028, respectively) between both groups. There was no significant difference between both groups in pelvic tilt (P=0.688). Conclusion: Subjects with bilateral, flexible, second-degree flatfoot demonstrated increased pelvic inclination, lumbar lordotic and thoracic kyphotic angles than normal subjects. Foot assessments should be performed as an essential part of the evaluation of female patients with spine and pelvic problems. Bilateral, flexible second-degree flatfoot may act as a predictor for pelvic organs prolapse in their later lives. [ABSTRACT FROM AUTHOR]

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The purpose of this study was to consider the discrepancy between the trunk-based and the pelvis-based hip joint angles, and the difference between the MTC lengths estimated on the basis of the two types of hip joint angles during dynamic movement. Ten male athletes performed CMJ. Joint kinematics and the MTC length of long head of biceps femoris were compared between the trunk based hip angle and the pelvis-based hip angle. In the CMJ, the angular displacements of the trunk-based were significantly higher than that of pelvis-based hip oints. There were no significant correlations between the two types of hip joint angles except at initial position. As for long head of biceps femoris, in contrast with the trunk-based-hip joint angle derived MTC length, which shows stretching in the descending phase and shortening in the ascending phase, the pelvis-based hip joint angle derived MTC length shows little changes. These results suggest that the trunk-based and pelvis-based hip joint angles have similar patterns of fluctuation; however, the angular displacement of each type is not equivalent. These results also suggest that we may misinterpret the type of muscle contraction because the definitions of hip joint angle are different even for the same muscle type. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to investigate the relationship of cup position versus pelvic lateral tilt and inclination. While computer assisted navigation systems use only the pelvic frontal plane for cup placement, it is important to realize the effect of leg length differences or increased pelvic inclination, i.e., caused by contracted hip flexors. Materials and Methods: Using a sawbone model of the pelvis, cup position measurements were performed with different pelvic inclination and lateral tilt angles. The measured values were compared with outcome variables from a mathematical model. A computer program was developed to perform a reverse calculation to verify the mathematical model. Results: The mathematical model proved correct in the sawbone pelvis experiment. The cup position changed from 15° anteversion in 0° pelvic inclination to 0.5° retroversion in 15° pelvic inclination. Regardless of pelvic inclination, the vertical cup projection stayed in a safe range of 37-47°. Leg length differences greater than 3 cm have significant effects on the positioning of acetabular cups in the frontal plane. Conclusions: Using computer navigation, it is possible to determine pelvic inclination and lateral tilt during an operation by calculating the angular difference between the anatomic frontal plane and the "real world" frontal plane (i.e., the OR table). This method may be helpful in increasing the accuracy of positioning of acetabular cups. [ABSTRACT FROM AUTHOR]

Objective: Pelvic alignment asymmetry in stroke patients negatively affects postural control ability. This study aimed to investigate the effect of posterior pelvic tilt taping on pelvic inclination, muscle strength, and gait ability in stroke patients. Methods: Forty stroke patients were recruited and randomly divided into the following two groups: the posterior pelvic tilt taping (PPTT) group (n = 20) and the control group (n = 20). All participants underwent sitting-to-standing, indoor walking, and stair walking training (30 min per day, 5 days per week, for 6 weeks). The PPTT group applied posterior pelvic tilt taping during the training period, while the control group did not receive a tape intervention. Pelvic inclination was measured using a palpation meter (PALM). A hand-held dynamometer and the 10-meter walk test were used to measure muscle strength and gait ability. Results: Significantly greater improvements in the pelvic anterior tilt were observed in the PPTT group than in the control group (p < 0.05). Muscle strength in the PPTT group was significantly increased compared to the control group (p < 0.05). Significantly greater improvements in gait speed were observed in the PPTT group than the control group. Conclusions: According to our results, posterior pelvic tilt taping may be used to improve the anterior pelvic inclination, muscle strength, and gait ability in stroke patients. [ABSTRACT FROM AUTHOR]

Electrical stimulation is commonly used as a modality for physical therapy in human and veterinary medicine. However, studies measuring the movement generated by electrical stimulation in horses are rare. The present study therefore evaluates the range of movement provoked by a commercially available physical therapy unit (FES310) and contrasts it with the movement generated by manually induced pelvic inclination (back rounding). Ten horses were tested on three measurement days over one week. Electrical stimulation was applied via a back treatment pad (belonging to the FES310 system) containing six electrodes (three on either side of the spine) placed over the lumbosacral region. This system produced a pulsed, biphasic electrical stimulation in a rectangular waveform which was gradually increased to a maximum of 10 volts. Before and after electrical stimulation testing, manual pelvic inclination was achieved by pressure on two points lateral to the root of the tail. Muscle tone and lameness were evaluated before and after treatments. Skinfold thickness, body condition score, and body mass were measured to detect possible confounding factors. Using kinematics, the angle ranges during movement of ten three-dimensional angles of the trunk, the pelvis, and the hind limbs were further analyzed. Movement was produced with manual stimulation in every tested individual on all measurement days and with electrical stimulation on at least one measurement day. The electrical stimulation led to significantly (P <.05) smaller angle ranges which were 15 %–57 % of the median of the manually stimulated movement. Strong positive correlations between angle ranges of the electrically generated movement were found for the hind limbs implicating their involvement in the movement created. Correlations between skinfold thickness, body condition score, and body mass with the angle ranges were weak and not significant. Before and after electrical and manual stimulation, muscle tone and lameness were similar. In the present study, both electrical and manual stimulation were proven to produce significant trunk and hind limb movement. Within this study's electrical stimulation treatment protocol, the movement generated by electrical stimulation was significantly less than the movement caused by manual pelvic inclination. However, electrical stimulation could easily be applied over a longer period and in a higher frequency than it would be possible for manual pelvic inclination. This treatment shows potential for stabilization and or mobilization of the lumbosacral region, although its efficiency as a therapeutic tool and its effect on specific orthopedic problems and is to be evaluated in further research. • Electrical stimulation over the lumbosacral region produces significant rhythmical pelvic movement. • Flexion and extension movements of the hind limb joints are correlated with this movement. • Pelvic inclination triggered by manual stimulation produces significantly more movement than electrical stimulation at 10 volts. • The range and frequency of movement caused by electrical stimulation may create training effects of initial mobilization and later stabilization. [ABSTRACT FROM AUTHOR]