Effectiveness of slump stretching on low back pain: A systematic review and meta-analysis

Background. The slump test is a type of neurodynamic test that is believed to evaluate the mechanosensitivity of the neuromeningeal structures within the vertebral canal. The objective of this review was to investigate the effectiveness of slump stretching on back pain and disability in patients with low back pain (LBP). Methods. We searched eight electronic databases (PubMed/Medline, Scopus, Ovid, CINAHL, Embase, PEDro, Google Scholar, CENTRAL). The publication language was restricted to English, and we searched the full time period available for each database, up to October 2017. Our primary outcomes were pain and disability, and the secondary outcome was range of motion (ROM). Results. We identified 12 eligible studies with 515 LBP patients. All included studies reported short-term follow-up. A large effect size (standardized mean difference SMD ¼ �2.15, 95% confidence interval CI ¼ �3.35 to � 0.95) and significant effect were determined, favoring the use of slump stretching to decrease pain in patients with LBP. In addition, large effect sizes and significant results were also found for the effect of slump stretching on disability improvement (SMD ¼ �8.03, 95% CI ¼ �11.59 to �4.47) in the LBP population. A qualitative synthesis of results showed that slump stretching can significantly increase straight leg raise and active knee extension ROM. Conclusions. There is very low to moderate quality of evidence that slump stretching may have positive effects on pain in people with LBP. However, the quality of evidence for the benefits of slump stretching on disability was very low. Finally, it appears that patients with nonradicular LBP may benefit most from slump stretching compared with other types of LBP. © 2018 American Academy of Pain Medicine. All rights reserved

The reliability and concurrent validity of a new iPhone® application for measuring active lumbar spine flexion and extension range of motion in patients with low back pain

Objective: To investigate the reliability and validity of an iPhone® application (iHandy® Level) for measuring active lumbar flexion-extension range of motion (ROM) in chronic nonspecific low back pain (CNLBP) patients. Methods: Fifteen CNLBP patients were recruited. The participants stood in a relaxed position and the T12-L1 and S1-S2 spinal levels were identified through palpation and were marked on the skin. Two blinded examiners used a gravity-based inclinometer and the application in order to measure ROM. The instruments were lined up appropriately and the participants were asked to perform maximum lumbar flexion following by maximum extension. First, each examiner placed the instruments over the T12-L1 level and then over the S1-S2 level during the movements. In order to calculate flexion-extension ROM, the measurement which was obtained from T12-L1 was subtracted from S1-S2. Intraclass correlation coefficient (ICC) models (3, k) and (2, k) were used in order to determine the intrarater and inter-rater reliability, respectively. The Spearman�s correlation coefficients (rs) and Bland-Altman plots were used in order to examine the validity. Results: Fair-to-excellent intrarater (ICC = 0.39�0.89) and moderate-to-good inter-rater reliability (ICC = 0.55�0.77) were observed using the inclinometer. Moreover, poor-to-good intrarater (ICC = 0.30�70) and inter-rater (ICC = 0.13�0.70) reliability were found with the application. The Spearman�s correlation coefficients demonstrated low-to-moderate associations between the measures of the two instruments (rs � 0.22). The Bland-Altman plots indicated that there was a significant difference between the instruments for measuring flexion ROM. The difference was not significant for measuring extension ROM. Conclusion: The iHandy® Level application does not have sufficient validity for measuring active lumbar flexion ROM in CNLBP patients. © 2019 Taylor & Francis

The effect of action observation on weight distribution and dynamic balance index improvement in hemiparetic patients based on mirror neuron theory

Background and Objective: Cerebrovascular accident (CVA) is a severe debilitating neurological condition in adults. This study sought to assess the effect of observation and mimicking functional activities on weight distribution and dynamic balance index improvement in lower limbs of hemiparetic patients based on mirror neuron theory. Materials and Methods: This clinical trial was performed on 36 males and females aged 45-60 years who suffered ischemic CVA for the first time. Subjects were randomly divided into 3 groups as follows: viewers of functional film, viewers of non-functional (symbol) film and the control group (not watching any film). The physiotherapy treatments in all groups were similar. Results: Weight percentage distribution was not significant. The values prior to and after dynamic balance index were statistically significant in all 3 groups. Significant differences were found between group 1 and the other 2 groups in terms of balance index percentage change (level 6). Conclusion: Observation and imitation of action along with rehabilitation exercises and functional activities had a positive effect on the improvement of balance Index in post-stroke patients. © 2015, Zanjan University of Medical Sciences and Health Services. All Rights Reserved

The reliability and concurrent validity of a new iPhone® application for measuring active lumbar spine flexion and extension range of motion in patients with low back pain

Objective: To investigate the reliability and validity of an iPhone® application (iHandy® Level) for measuring active lumbar flexion-extension range of motion (ROM) in chronic nonspecific low back pain (CNLBP) patients. Methods: Fifteen CNLBP patients were recruited. The participants stood in a relaxed position and the T12-L1 and S1-S2 spinal levels were identified through palpation and were marked on the skin. Two blinded examiners used a gravity-based inclinometer and the application in order to measure ROM. The instruments were lined up appropriately and the participants were asked to perform maximum lumbar flexion following by maximum extension. First, each examiner placed the instruments over the T12-L1 level and then over the S1-S2 level during the movements. In order to calculate flexion-extension ROM, the measurement which was obtained from T12-L1 was subtracted from S1-S2. Intraclass correlation coefficient (ICC) models (3, k) and (2, k) were used in order to determine the intrarater and inter-rater reliability, respectively. The Spearman�s correlation coefficients (r s ) and Bland-Altman plots were used in order to examine the validity. Results: Fair-to-excellent intrarater (ICC = 0.39�0.89) and moderate-to-good inter-rater reliability (ICC = 0.55�0.77) were observed using the inclinometer. Moreover, poor-to-good intrarater (ICC = 0.30�70) and inter-rater (ICC = 0.13�0.70) reliability were found with the application. The Spearman�s correlation coefficients demonstrated low-to-moderate associations between the measures of the two instruments (r s � 0.22). The Bland-Altman plots indicated that there was a significant difference between the instruments for measuring flexion ROM. The difference was not significant for measuring extension ROM. Conclusion: The iHandy® Level application does not have sufficient validity for measuring active lumbar flexion ROM in CNLBP patients. © 2019, © 2019 Taylor & Francis