Short-term effects of manual therapy plus capacitive and resistive electric transfer therapy in individuals with chronic non-specific low back pain : a randomized clinical trial study

Background and Objectives: Chronic non-specific low back pain (CNSLBP) is defined as back pain that lasts longer than 12 weeks. Capacitive and resistive electric transfer (TECAR) therapy utilizes radiant energy to generate endogenous heat and is widely used for the treatment of chronic musculoskeletal pain. The aim of this study was to investigate the efficacy of manual therapy (MT) program combined with TECAR therapy in individuals with CNSLBP. Materials and Methods: Sixty adults with CNSLBP were randomly divided equally into three groups. The first group followed an MT protocol in the lumbar region (MT group), the second group followed the same MT protocol combined with TECAR therapy (MT + TECAR group) using a conventional capacitive electrode as well as a special resistive electrode bracelet, and the third group (control group) received no treatment. Both intervention programs included six treatments over two weeks. Pain in the last 24 h with the Numeric Pain Rating Scale (NPRS), functional ability with the Roland–Morris Disability Questionnaire (RMDQ), pressure pain threshold (PPT) in the lumbar region with pressure algometry, and mobility of the lumbo-pelvic region through fingertip-to-floor distance (FFD) test were evaluated before and after the intervention period with a one-month follow-up. Analysis of variance with repeated measures was applied. Results: In the NPRS score, both intervention groups showed statistically significant differences compared to the control group both during the second week and the one-month follow-up (p 0.05). Conclusions: The application of an MT protocol with TECAR therapy appeared more effective than conventional MT as well as compared to the control group in reducing pain and disability and improving PPT in individuals with CNSLBP. No further improvement was noted in the mobility of the lumbo-pelvic region by adding TECAR to the MT intervention

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Clinical exercise protocol in secondary falls in older adults: effects on quality of life and health

The aim of this study was to evaluate the potential effect of clinical exercise onfunctional ability, secondary falls prevention and quality of life in older withintramedullary nailing (g nail) after intertrochanterichip fracture.Subjects aged between 65-74 years and divided in two groups: experimentalgroup (n=35) and controlled group (n=24). The clinical training program includedstrength training, stretching and balance training, for twelve weeks, three sessions perweek for sixty minutes. We recorded Berg scale, Tinetti assessment, SF-36questionnaire and postural adaptation pre-post clinical exercise six and twelve monthsfollow up. Our results suggested significant improvements in EC post twelve weeks ofclinical exercise on Berg and Tinetti scale (p<.001) and follow-up period. Moreover,significant improvements are presented in SF-36 questionnaire (p<.001) and posturaladaptation (p<.001).We conclude that clinical exercise demonstrates significant improvements onquality of life and health in elderly with previous fall, post twelve weeks of specifictraining program.Σκοπός της παρούσας έρευνας ήταν η μελέτη της επίδρασης, στα πλαίσιαδευτερογενούς πρόληψης,ενός ειδικά σχεδιασμένου πρωτοκόλλου κινησιοθεραπευτικήςπαρέμβασης στη λειτουργική ικανότητα και στην ποιότητα ζωής ατόμων τρίτηςηλικίας, που έχουν υποστεί χειρουργική επέμβαση ενδομυελικής ήλωσης (τύπου g nail)μετά από διατροχαντήριο κάταγμα ισχίου λόγω πτώσης.Το δείγμα αποτελούνταν από εξήντα (n=60) ηλικιωμένους ηλικίας 65-74 ετώνπου είχαν υποστεί χειρουργική επέμβαση ενδομυελικής ήλωσης (τύπου g nail) μετά απόδιατροχαντήριο κάταγμα ισχίου λόγω πτώσης κατά το τελευταίο έτος. Τα άτομαχωρίστηκαν με τυχαίο τρόπο σε δυο ομάδες: την πειραματική ομάδα (ΠΟ) (n=35) πουακολούθησε συνδυασμένο θεραπευτικό πρόγραμμα άσκησης στατικού και δυναμικούτύπου, ισορροπίας και ευλυγισίας και την ομάδα ελέγχου (ΟΕ) (n=24). Από τηστατιστική ανάλυση αποκλείστηκε ένας συμμετέχοντας λόγω πειραματικήςθνησιμότητας. Το θεραπευτικό πρόγραμμα είχε συνολική διάρκεια δώδεκα εβδομάδων,με τρεις συνεδρίες εβδομαδιαίως όχι πέραν των εξήντα λεπτών για κάθε συνεδρία.Περιλάμβανε ασκήσεις ισορροπίας, ευλυγισίας και ενδυνάμωσης. Για την αξιολόγησητου θεραπευτικού προγράμματος χρησιμοποιήθηκε η κλίμακα λειτουργικής ισορροπίαςBerg, η δοκιμασία κινητικότητας Tinetti, η επισκόπηση υγείας SF-36 και σύστημαφορητής πελματογραφίας. Ακολούθησε εξάμηνη και ετήσια επαναμέτρηση μετά τηλήξη του θεραπευτικού προγράμματος που ακολούθησε η ΠΟ.Τα αποτελέσματα της μελέτης φανέρωσαν ότι η ΠΟ βελτίωσε στατιστικάσημαντικά την ισορροπία (p<.001) διατηρώντας τις βελτιώσεις μετά από έξι και δώδεκαμήνες. Στατιστικά σημαντική βελτίωση στην ΠΟ υπήρξε τόσο στις κλίμακες Berg καιTinetti (p<.001) όσο και στην επισκόπηση υγείας SF-36 (p<.001), αποτελέσματα τα οποία διατηρήθηκαν και μετά το πέρας των 6 και 12 μηνών. Στατιστικά σημαντικήδιαφορά μεταξύ της ΠΟ και της ΟΕ παρατηρήθηκε και στην απόκλιση των αξόνων x(p<.001) και y (p<.001) κατά την δοκιμασία στατικής ισορροπίας στον πελματογράφο. Το συνδυαστικό θεραπευτικό πρωτόκολλο συνολικής διάρκειας 12 εβδομάδωνβελτίωσε ξεκάθαρα την λειτουργική ικανότητα και την ποιότητα ζωής ατόμων τρίτηςηλικίας κατά την διαδικασία της δευτερογενούς πρόληψης πτώσεων ηλικιωμένων, πουείχαν υποστεί χειρουργική επέμβαση ενδομυελικής ήλωσης (τύπου g nail) μετά απόδιατροχαντήριο κάταγμα ισχίου.

EFFECTS OF A 12-WEEK AEROBIC EXERCISE PROGRAM COMBINED WITH MUSIC THERAPY AND MEMORY EXERCISES ON COGNITIVE AND FUNCTIONAL ABILITY IN PEOPLE WITH MIDDLE TYPE OF ALZHEIMER'S DISEASE

Background: The Alzheimer's disease is the most common form of dementia and represents 60% of its cases. The disease is characterized by cognitive, non-cognitive and functional deficits and it’s incurable. The main of this study was to examine the effects of the aerobic exercise in combination with the music therapy and memory exercises in functional and cognitive ability on a patient with that have been affected by middle type (Second stage) of Alzheimer's disease. Methods: Thirty patients from Chronic Diseases Center, with Alzheimer's disease, divided between an intervention and a control group, participated in this randomized controlled study. (Thirty patients with Alzheimer's were chosen from chronic disease center, and are divided into an intervention and a control group). The intervention requires 30 minutes of aerobic exercise, 10 minutes of memory games and music therapy, three times a week, for the duration of 12 weeks. The outcome measures the “Mini Mental State Examination” (MMSE) scale and the “Alzheimer's Disease Assessment Scale cognitive test” (ADAS) for the cognitive ability, “Katz Index Independence in Activities of Daily Living” (ADL), “Get up and Go test” and “One leg standing balance test” (OLST) for the functionality. A three-way analysis of variance designs was applied to compare changes in each outcome measure before and after the intervention between the groups. Results: The MMSE score decrease significantly for the control group (males: 16.00 ± 4.04 to 15.14 ± 4.01 and for females: 16.00 ± 1.85 to 15.25 ± 1.98 before and after intervention) but not for the intervention group (p > 0.05) (males: 16.25 ± 2.71 to 16.12 ± 2.94 and females: 12.85 ± 2.67 to 12.57 ± 2.93). The ADAS score on intervention experimental therapy group was significantly low (males: 39.00 ± 7.98 to 37.50 ± 8.12 and females: 49.85 ± 6.54 to 48.28 ± 6.79). In the Get up and Go test (males: 18.87 ± 5.24 to 17.87 ± 4.15 and females: 19.85 ± 4.94 to 18.57 ± 4.64) and in the OLST(males: 4.57 ± 3.10 to 6.00 ± 2.77 and females: 4.00 ± 3.26 to 5.28 ± 3.40) there was a sign of progress in the results, while in the ADL no difference was observed in any group. (experimental group males: 3.50 ± 1.19 to 3.50 ± 1.19 and females: 2.57 ± 1.13 to 2.57 ± 1.13, control group males: 3.57 ± 1.51 to 3.57 ± 1.51 and females: 3.50 ± 0.75 to 3.50 ± 0.75). Conclusion: The aerobic exercise combined with the music therapy and the memory tests offer some improvement in cognitive and functional ability and contribute to the deteriorating delay of the symptoms of patients that suffer from Alzheimer and are hospitalized

Effects of Manual Therapy Plus Pain Neuroscience Education with Integrated Motivational Interviewing in Individuals with Chronic Non-Specific Low Back Pain: A Randomized Clinical Trial Study

Background and Objectives: Chronic non-specific low back pain (CNLBP) persists beyond 12 weeks. Manual therapy recommended for CNLBP demonstrates short-term efficacy. Pain Neuroscience Education (PNE) teaches patients to modify pain perception through explanations, metaphors, and examples, targeting brain re-education. Motivational Interviewing (MI) enhances motivation for behavioral change, steering patients away from ambivalence and uncertainty. These approaches collectively address the multifaceted nature of CNLBP for effective management. The aim of this study was to investigate a manual therapy intervention combined with PNE with MI on pain, pressure pain threshold (PPT), disability, kinesiophobia, catastrophizing, and low back functional ability in individuals experiencing CNLBP. Materials and Methods: Sixty adults with CNLBP were randomly divided into three equal groups (each n = 20). The first group received manual therapy and PNE with integrated MI (combined therapy group), the second group underwent only manual therapy (manual therapy group), and the third group followed a general exercise program at home (control group). Pain in the last 24 h was assessed using the Numeric Pain Rating Scale (NPRS), functional ability with the Roland–Morris Disability Questionnaire (RMDQ), PPT in the lumbar region through pressure algometry, kinesiophobia with the Tampa Scale for Kinesiophobia (TSK), catastrophizing with the Pain Catastrophizing Scale (PCS), and performance using the Back Performance Scale (BPS) at baseline, in the fourth week, and six months post-intervention. Results: Statistically significant differences between the intervention groups and the control group were found in both the fourth-week measurement and the six-month follow-up, as evident in the NPRS and RMDQ scores, as well as in the total values of tested PPTs (p p p p p Conclusions: The addition of PNE with integrated MI enhanced the positive effects of a manual therapy intervention in all outcome measures. The combination of manual therapy plus PNE with integrated MI appeared to provide greater improvements compared to the isolated application of manual therapy, and these improvements also lasted longer. These short- and long-term positive effects are likely attributed to the combination of PNE with integrated MI, which contributed to increasing the effectiveness of the treatment. Further studies are required to investigate the optimum dosage of manual therapy and PNE with integrated MI in individuals with CNLBP

Recording of Falls in Elderly Fallers in Northern Greece and Evaluation of Aging Health-Related Factors and Environmental Safety Associated with Falls: A Cross-Sectional Study

Background. Elderly falls constitute a global problem with huge social and economic aspects. Fall risk factors are both intrinsic (physical and psychological) and extrinsic (related with environmental safety). Aim. To record both intrinsic and extrinsic risk factors and their correlation in elderly fallers in order to suggest specific guidelines for their medical care and environmental modification inside and outside the home. Method. The study involved 150 elderly fallers (median age 70 (67-74)), who completed a record containing information on known risk factors related to their health status, as well as information on the conditions and causes that led to the fall. Each fall was considered an independent event, while measurements were performed regarding balance, strength, their functional ability, and the fear of a possible fall. Descriptive analysis and frequency analysis were used to record the health and activity status of the participants as well as the fall-related environmental factors. Severity of each fall event across a variety of locations was examined using the Kruskal-Wallis one-way analysis of variance. Multiple linear regression was applied to examine the effect of the mean values of functional tests and medical records on the number of fall events. Results. In the span of 12 months, a total of 304 fall events were recorded. Regarding location, 77.6% occurred indoors; more frequent were the bedroom (28.6%) and the bathroom (28%). The interior stairs (10.5%), the kitchen (4.9%), and the living room (3.3%) were the less frequent locations. Concerning danger, falling on the interior stairs caused the longest hospitalization, followed by the kitchen and the bathroom. Extrinsic factors that led to both indoor and outdoor falls were the administration of psychotropic medication, poor space ergonomics, lack of basic safety standards, and poor lighting conditions. Vision problems and dizziness resulted in more falls than other intrinsic factors. Furthermore, reduced performance in the FICSIT-4 test and the 30-Second Chair Stand Test, as well as high scores in the CONFbal–GREEK questionnaire and the Short FES-I, shows a linear relationship with an increased number of falls. Conclusions. Ergonomic interventions can help prevent indoor elderly falls. Poor construction and lack of adequate lighting mainly cause outdoor falls. Regular eye examinations, management of vertigo, improvement of the balance and strength of the lower limbs, and reduction of fear of impending falls are the intrinsic factors that help prevent falls the most

Hemodynamic Responses to a Handgrip Exercise Session, with and without Blood Flow Restriction, in Healthy Volunteers

Exercising at submaximal intensity with a hand dynamometer causes mild hemodynamic adaptations that can improve cardiovascular function. However, hemodynamic responses and fatigue have not been adequately studied in an isometric exercise protocol combined with blood flow restriction (BFR). Our study aimed to examine and compare acute hemodynamic responses and muscle fatigue after an isometric exercise session using a handgrip dynamometer, with and without BFR. Twelve volunteers performed the exercise protocol, with and without BFR, at random, with the BFR pressure set at 140 mmHg. Arterial blood pressure (BP), heart rate (HR), oxygen saturation (SpO2), and muscle fatigue were measured before, during, and 15 min after the completion of the exercise session. Without BFR, we noticed a slight, albeit statistically insignificant, HR increase. The variations found in systolic and diastolic pressure were small and statistically insignificant. Furthermore, blood oxygen saturation (SpO2) did not change significantly. Significantly higher levels of fatigue were found in exercise with BFR, compared to without BFR, at the end of each set of isometric contractions. In conclusion, a handgrip exercise session with mild BFR does not alter the acute hemodynamic responses to exercise in healthy volunteers. However, it results in higher muscle fatigue compared to that experienced after exercise without BFR