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Objectives: This study aimed to assess the voice quality of patients with temporomandibular disorders (TMDs) compared with healthy subjects using cepstral analysis and investigate the relationship between the TMD severity and the values of cepstral analysis. Methods: Subjects who met the inclusion criteria completed a general health questionnaire and the Fonseca Anamnestic Index. Patients who had TMDs with FAI were subjected to an examination based on the Diagnostic Criteria for Temporomandibular Disorders. The final sample included 65 subjects, 31 TMDs patients (with a mean age ± standard deviation of 36.64 ± 13.67 years), and 34 healthy individuals in the control group (with a mean age ± standard deviation of 30.35 ± 7.78 years). Cepstral Peak Prominence (CPP) and Smoothened Cepstral Peak Prominence (CPPS) of a sustained vowel and connected speech were computed using Praat software. Results: TMD patients indicated lower cepstral values and lower voice quality compared to the control group. Significant differences were found between TMD and control groups for all cepstral parameters (P <.001) and cepstral measurements showed a moderate to strong negative correlation with TMD severity (P <.001, rho = − 0.57 to − 0.88). Conclusion: The outcomes of the present study indicate that cepstral analysis can accurately distinguish the reduced voice quality of TMD patients from normal voice. [ABSTRACT FROM AUTHOR]

The purpose of study was to compare the kinematic patterns of the thoracic, lumbar, and pelvis segments and hip joints between 2 low back pain subgroups and healthy women during sit-to-stand and stand-to-sit. Kinematic data of 44 healthy women and 2 subgroups of females with low back pain in 2 subgroups of movement system impairment model (rotation-extension [Rot.Ext] and rotation-flexion [Rot.Flex]) were recorded. Participants performed sit-to-stand and stand-to-sit at a preferred speed. Each task was divided into a pre buttock lifted off/on (pre-BOff/n) phase and a post-BOff/n phase. The Rot.Ext subgroup showed greater range of motion in the thoracic during pre-BOff phase of sit-to-stand (P <.001) and pre-BOn phase of stand-to-sit (P =.01) compared to the other 2 groups. The Rot.Flex subgroup displayed limited left hip joint excursion during sit-to-stand pre-BOff (P =.04) and stand-to-sit post-BOn phases (P =.02). The Rot.Flex subgroup showed greater pelvis tilt excursion during sit-to-stand post-BOff (P =.04) and stand-to-sit pre-BOn (P =.01) and post-BOn phases (P =.01). In subgroups of women with chronic low back pain, there were kinematic changes in adjacent body segments/joints of lumbar spine during sit-to-stand and stand-to-sit tasks. [ABSTRACT FROM AUTHOR]

Mini-Balance Evaluation Systems Test (mini-BESTest) is a widely used measure to assess balance impairments. This study aimed to assess the validity, reliability, responsiveness, and minimal clinically important change (MCIC) of the Persian mini-BESTest among ambulatory People with Multiple Sclerosis (PwMS). Fifty ambulatory PwMS participated in this study. Persian mini-BESTest validated against Berg Balance Scale (BBS) and Timed-Up and Go (TUG) with/without a cognitive task. To assess the reliability, the Persian mini-BESTest was re-administered for a sample of 30 participants after 1 week. Also, 32 PwMS were tested before and after a 4-week of balance and gait training to assess the responsiveness. No floor/ceiling effect was found for the mini-BESTest total score. There were significant excellent correlations (p <.001) between mini-BESTest and BBS (r = 0.71), TUG (r = −0.76), and cognitive TUG (r = −0.73). No strong correlations were observed between the subscales (r = 0.37–0.55). Test–retest reliability and internal consistency of Persian mini-BESTest total score were excellent, with Intra-class Correlation Coefficient (ICC3,1 and Cronbach's alpha level of 0.89 and 0.80, respectively. The minimal detectable change was 4 points. The Persian mini-BESTest had acceptable responsiveness (AUC = 0.83), and MCIC was 5 points. The Persian mini-BESTest is a valid, reliable, and responsive measure of balance performance in Iranian ambulatory PwMS. [ABSTRACT FROM AUTHOR]

The Subgrouping for Targeted Treatment (STarT) musculoskeletal (MSK) tool stratifies patients with MSK disorders (MSDs) into prognostic categories based on poor outcomes. This study aimed at investigating the validity and reliability of the Persian STarT MSK tool in people suffering from painful MSDs in Iran. A total of 593 subjects with painful MSDs including neck, shoulder, low back, knee, and multisite pain received and completed the STarT MSK tool, visual analog scale (VAS), EuroQol five-dimensions three-levels questionnaire (EQ-5D-3 L), short form-36 health survey questionnaire (SF-36), and Örebro musculoskeletal pain screening questionnaire (ÖMPSQ) in the first visit. To examine test–retest reliability, 234 patients completed the STarT MSK tool 2 days after the initial visit. In this study, 139 (23.5%), 266 (44.9%), and 188 (31.7%) participants were classified as low-, medium-, and high-risk groupings for poor outcomes, respectively. Spearman's correlation coefficient showed a strong relationship among Persian STarT MSK tool and EQ-5D-3 L (−0.78), SF-36 (−0.76), and OMPSQ (0.70). The results of known-group validity indicated that this tool could distinguish among the participants in different risk subgroups based on the scores of the ÖMPSQ, VAS, SF36, and EQ-5D-5 L (p <.001). No ceiling and floor effects were observed. Cronbach's alpha and intra-class correlation coefficient (ICC2,1) were acceptable (0.71) and excellent (0.98), respectively. The Persian version of STarT MSK tool has shown to be a valid and reliable instrument to stratify people with painful MSDs into low-, medium-, and high-risk subgroups based on persistent pain disability. [ABSTRACT FROM AUTHOR]

To determine the effects of Perturbation-based Balance Training (PBT) on postural responses and falls in people with multiple sclerosis (PwMS) and compare the results with conventional balance training (CBT). Thirty-four PwMS were randomized to receive 4 weeks of PBT or CBT. Latency of postural responses to external perturbations, Timed-Up-and-Go (TUG), 10-meter-walk (10MW), Berg Balance Scale (BBS), and Activities-specific Balance Confidence Scale (ABC) were measured at baseline and post-training. Also, the proportion of fallers and fall rate were assessed at a 3-month follow-up. The latency of postural responses significantly decreased in PBT compared to CBT. TUG, 10MW, BBS, and ABC, at post-training, and relative risk of falls and fall rate at 3-month follow-up had no statistically significant between-group differences. The results show that PBT is at least as effective as CBT in improving balance and decreasing falls, while it has superiority over CBT whenever the clinicians mainly aim to improve reactive balance strategies. Future studies with a larger sample size are warranted to complement the results of this study. Perturbation-based Balance Training is at least as effective as conventional balance training (CBT) in improving proactive postural control in people with multiple sclerosis (PwMS). Perturbation-based Balance Training has superiority over CBT in improving reactive postural control in PwMS. Perturbation-based Balance Training has no superiority over CBT in improving fall-related outcomes. [ABSTRACT FROM AUTHOR]

To compare the effects of exergaming versus conventional exercises on cognition, lower-limb functional coordination, and stepping time in people with multiple sclerosis (PwMS). Thirty-six PwMS were randomly assigned to either intervention (n = 18) or control (n = 18) group and received 18 training sessions during six weeks. The intervention group performed exergames that required multidirectional timed-stepping, weight-shifting, and walking while the control group performed conventional matched exercises. Trail making test (TMT part A, B; TMT-A, TMT-B, TMT B-A), six-spot step test (SSST), and choice stepping reaction time (CSRT-including reaction time (RT), movement time (MVT), and total response time (TRT)) were assessed pre- and post-intervention (short-term), and after three-month follow-up (mid-term). The intervention group showed faster TMT-B (p = 0.003) and TMT B-A (p = 0.002) at post-intervention and faster SSST at both post-intervention (p = 0.002) and follow-up (p = 0.04). The CSRT components showed no between-group differences at post-intervention; however, at follow-up, the intervention group had lower TRT (p = 0.046) and MVT (p = 0.015). TMT-A and RT had no significant between-group differences. In short-term, exergames led to more improvements in complex attention, executive function, and lower-limb functional coordination comparing to the matched conventional exercises. In mid-term, exergaming was more effective for improving stepping time and lower-limb functional coordination. However, the two approaches did not show any superiority over each other for improving simple attention and RT. When designed properly, exergames have great potential to improve attention and executive function of people with multiple sclerosis (PwMS), at least in the short-term. Exergames seem like an appropriate option for improving lower limb coordination and decreasing choice stepping response time among PwMS in the mid-term. Exergames do not have superiority in improving the choice stepping reaction time compared to their matched conventional treatment. [ABSTRACT FROM AUTHOR]

Proprioception deficit has been suggested as a possible mechanism contributing for the impaired postural control in low back pain (LBP) patients. Whether proprioception deficit is a result of or a cause of LBP has not been investigated. The purpose of this study was to compare proprioceptive postural control strategies between prolonged standing induced low back pain developers (PDs) and non-pain developers (NPDs). Thirty-two healthy subjects performed 1-h prolonged standing and their ratings of perceived LBP have been recorded. Eight quiet standing trials for 60 s performed immediately before and after the prolonged standing. Postural control was challenged by muscle vibration and different postural conditions during quiet standing. Data were recorded using a force platform. Forty percentage of participants is classified as PD. Before the prolonged standing, relative proprioceptive weighting was greater in the PD compared to NPD group (P =.029). Main effect of postural condition (F1,24 = 5.21, P =.032) and interaction of time by group (F1,24 = 8.08, P =.009) were significant for COP displacement in anteroposterior direction. Interaction of postural condition by group (F1,26 = 7.82, P =.010) and time by group (F1,26 = 9.71, P =.004) were significant for COP displacement in mediolateral direction. Main effect of postural condition (F1,26 = 6.31, P =.018) and interaction of postural condition by group (F1,26 = 7.07, P =.013) were significant for mean velocity in mediolateral direction. The PD group has altered proprioceptive postural control strategies before and after prolonged standing. Proprioception deficit should not be considered to be solely an adaptive response and may be causal for LBP development. [ABSTRACT FROM AUTHOR]

Background and Purpose: The Multiple sclerosis walking scale-12 (MSWS-12) and the Modified Fatigue Impact Scale (MFIS) are two popular outcome measures applied widely for assessing self-perceived walking ability and fatigue in people with multiple sclerosis (PwMS). The present study aimed to examine responsiveness and clinically meaningful changes for the Persian versions of the MSWS-12 and the MFIS following balance and gait rehabilitation in PwMS. Methods: Fifty-eight PwMS completed the Persian versions of the MSWS-12 and the MFIS before and after 4 weeks of balance and gait rehabilitation. Also, a 7-point global rating scale as an external criterion of change was completed at the post-intervention evaluation. The area under the receiver operating characteristics curve (AUC) and the correlation analysis were used to assess the responsiveness. In addition, the minimally clinically important change (MCIC) was measured to determine clinically meaningful changes following rehabilitation. Results: The AUC values for the Persian MSWS-12 and MFIS were 0.74 and 0.73, respectively. There were good to excellent correlations between the global rating scale of change and the Persian MSWS-12 (Gamma = 0.77) also MFIS (Gamma = 0.80) change scores (p =.001). Moreover, the MCICs of 7.5 and 4 points were obtained for the Persian MSWS-12 and MFIS, respectively. Conclusion: The Persian versions of the MSWS-12 and the MFIS were responsive outcome measures for monitoring changes in walking and fatigue after balance and gait rehabilitation in PwMS. The calculation of MCIC values would enhance the interpretation of changes in clinical and research settings. [ABSTRACT FROM AUTHOR]

To evaluate the responsiveness and determine the minimal clinically important changes (MCICs), anchored by the patient response to a 7-point global rating scale, for Knee Injury and Osteoarthritis Outcome Score (KOOS), and Tegner activity scale in athletes undergoing physiotherapy treatment after anterior cruciate ligament reconstruction (ACL-R). Methods: Fifty-four patients undergoing physiotherapy completed the Persian versions of KOOS and Tegner scales at weeks 6 and 10 post ACL-R. The 7-point global rating of change was also completed at week 10. Responsiveness was calculated via receiver operating characteristic curve and correlation analysis. Results: Acceptable responsiveness was reached by the KOOS sports and recreation subscale (Sport/Rec) (area under the curve (AUC) = 0.72; Gamma = 0.37) and Tegner scale (AUC = 0.75; Gamma = 0.59). The MCIC scores of KOOS subscales and Tegner scale were reported. Conclusion: Our findings demonstrated that the KOOS Sport/Rec subscale and Tegner scale have adequate responsiveness between weeks 6 and 10 of physiotherapy. Therefore, these scales should be used to evaluate the effects of physiotherapy treatment and the changes in activity levels in this population. The MCIC scores of the KOOS and Tegner scale can be used to detect changes significant to the patient while avoiding limitations of other methods. [ABSTRACT FROM AUTHOR]