Reliability of Ultrasonography in Measuring Deep Abdominal and Lumbar Multifidus Muscle Dimensions in Patients with Unilateral Lumbar Disc Herniation

Introduction: The purpose of this study was to assess the within-day and between-day reliability of abdominal and lumbar multifidus muscle size in patients with unilateral lumbar disc herniation (LDH) using ultrasonography (US). Materials and methods: In this study, 15 patients with unilateral LDH (20-60 years old) were recruited. To assess within-day and between-day reliability, three images were taken with one hour and one week intervals respectively. The images were taken at rest and during contraction. Results: The within-day and between-day reliability of abdominal muscle thickness measurements using US in patients with unilateral lumbar disc herniation (LDH) in both rest and contraction state was found to be high with ICC=0.87 for within and ICC=0.75 for between-day rates of transverse abdominis (TrA) muscles at rest and ICC=0.78 and 0.75, respectively, in contraction state. For internal oblique muscles, ICC=0.70 at rest and 0.79 in contraction state and ICC=0.73 at rest and 0.77 in contraction state were found for within-day and between-day, respectively. Within-day and between-day reliability at rest with ICC=0.76 and 0.76 and in contraction state with ICC=0.75 and 0.74 were demonstrated for the external oblique muscle. Within-day and between-day reliability rates at rest with ICC=0.88 and 0.84, respectively, and in contraction state with ICC=0.84 and 0.80, respectively were demonstrated for the lumbar multifidus muscle. Conclusion: The results of the present study suggest that US is a reliable method for evaluating the thickness of the abdominal and lumbar multifidus muscles. However, further research is recommended to support the findings of the present study.Keywords: Ultrasonography, disc herniation, abdominal muscles, lumbar multifidus muscle, reliabilit

Survey on monthly variations of water quality in the Tajan River (Sari, Iran)

The aims of the study were to evaluate water quality of Tajan River in Sari in terms of chemical pollution and the impact of pollutant sources near the river by considering the climate, hydrological and hydraulic condition on it. In this study, 10 critical points of river were selected as sampling stations from dam to sea. Sampling was randomly done monthly from Apr 2009 to Mar 2010. Samples were analyzed in terms of chemical parameters after transferring to the laboratory according to standard methods. The results showed that the pH and temperature were within acceptable ranges of 6.5 to 8.5 and < 20°C, respectively. The minimum dissolved oxygen (DO) concentrations were above 6 mg/L along the river. Fish can survive because DO content was high. The maximum levels of biochemical oxygen demand (BOD), chemical oxygen demand (COD), phosphate (PO4) and nitrate (NO3) were at or below 30, 17, 0.5 and 0.7 mg/L, respectively. In general, the results showed that the physical and chemical qualities of water from Tajan River were within the acceptable limits for agricultural consumptions. In addition, Tajan River water can be classified in Class II.Keywords: Water quality, Tajan River, river pollution, water pollution.African Journal of Biotechnology Vol. 12(25), pp. 3984-399

Urdu version of the neck disability index: a reliability and validity study

Abstract Background Despite the wide use of the neck disability index (NDI) for assessing disability in patients with neck pain, the NDI has not yet been translated and validated in Urdu. The first purpose of the present study was to translate and cross-culturally adapt the NDI into the Urdu language (NDI-U). The second purpose was to investigate the reliability, validity and responsiveness of the NDI-U in Urdu-speaking patients experiencing chronic mechanical neck pain (CMNP). Methods Translation and cross-cultural adaptation of the original version of the NDI were carried out using previously described procedures. Seventy-six patients with CMNP and thirty healthy participants were recruited for the study. NDI-U and visual analogue scales for pain intensity (VASpain) and disability (VASdisability) were administered to all the participants at baseline and to the patients 3 weeks after receiving physiotherapy intervention. The global rating of change scale (GROC) was also administered at this time. Test-retest reliability and internal consistency were carried out on forty-six randomly selected patients two days after they completed the NDI-U. The NDI-U was evaluated for factor analysis, content validity, construct validity (discriminative and convergent validity) and responsiveness. Results An intra-class correlation coefficient (ICC2,1) revealed excellent test-retest reliability for all items (ICC2,1 = 0.86–0.98) and total scores (ICC2,1 = 0.99) of the NDI-U. The NDI-U was found internally consistent with a Cronbach’s alpha of 0.90 and a fair to good correlation between single items and the NDI-U total scores (r = 0.34 to 0.89). Factor analysis of the NDI-U produced two factors explaining 66.71% of the variance. Content validity was good, as no floor or ceiling effects were detected for the NDI-U total score. To determine discriminative validity, an independent t-test revealed a significant difference in the NDI-U total scores between the patients and healthy controls (P < 0.001). For convergent validity, Pearson’s correlation coefficient showed a strong correlation between NDI-U and VASdisability (r = 0.83, P < 0.001) and a moderate correlation between NDI-U and VASpain (r = 0.62, P < 0.001). To measure responsiveness, an independent t-test showed a significant difference in the NDI-U change scores between the stable and the improved groups (P < 0.001). Furthermore, moderate correlations were found between the NDI-U change scores and the GROC (r = 0.50, P < 0.001), VASdisability change scores (r = 0.58, P < 0.001) and VASpain change scores (r = 0.55, P < 0.001). Conclusion The results showed that the NDI-U is a reliable, valid and responsive questionnaire to measure disability in Urdu-speaking patients with CMNP

Reliability and validity of an iPhone® application for the measurement of lumbar spine flexion and extension range of motion

Background: Measurement of lumbar spine range of motion (ROM) is often considered to be an essential component of lumbar spine physiotherapy and orthopedic assessment. The measurement can be carried out through various instruments such as inclinometers, goniometers, and etc. Recent smartphones have been equipped with accelerometers and magnetometers, which, through specific software applications (apps) can be used for inclinometric functions. Purpose: The main purpose was to investigate the reliability and validity of an iPhone® app (TiltMeter© -advanced level and inclinometer) for measuring standing lumbar spine flexion-extension ROM in asymptomatic subjects. Design: A cross-sectional study was carried out. Setting: This study was conducted in a physiotherapy clinic located at School of Rehabilitation Sciences, Iran University of Medical Science and Health Services, Tehran, Iran. Subjects: A convenience sample of 30 asymptomatic adults (15 males; 15 females; age range = 18-55 years) was recruited between August 2015 and December 2015. Methods: Following a 2-minute warm-up, the subjects were asked to stand in a relaxed position and their skin was marked at the T12-L1 and S1-S2 spinal levels. From this position, they were asked to perform maximum lumbar flexion followed by maximum lumbar extension with their knees straight. Two blinded raters each used an inclinometer and the iPhone® app to measure lumbar spine flexion-extension ROM. A third rater read the measured angles. To calculate total lumbar spine flexion-extension ROM, the measurement from S1-S2 was subtracted from T12-L1. The second (2 hours later) and third (48 hours later) sessions were carried out in the same manner as the first session. All of the measurements were conducted 3 times and the mean value of 3 repetitions for each measurement was used for analysis. Intraclass correlation coefficient (ICC) models (3, k) and (2, k) were used to determine the intra-rater and inter-rater reliability, respectively. The Pearson correlation coefficients were used to establish concurrent validity of the iPhone® app. Furthermore, minimum detectable change at the 95 confidence level (MDC95) was computed as 1.96 � standard error of measurement � �2. Results: Good to excellent intra-rater and inter-rater reliability were demonstrated for both the gravity-based inclinometer with ICC values of �0.84 and �0.77 and the iPhone® app with ICC values of �0.85 and �0.85, respectively. The MDC95 ranged from 5.82°to 8.18°for the intra-rater analysis and from 7.38°to 8.66° for the inter-rater analysis. The concurrent validity for flexion and extension between the 2 instruments was 0.85 and 0.91, respectively. Conclusions: The iPhone®app possesses good to excellent intra-rater and inter-rater reliability and concurrent validity. It seems that the iPhone® app can be used for the measurement of lumbar spine flexion-extension ROM. © 2016 Pourahmadi et al

Evaluation of microbiological and chemical parameters during wastewater Sludge and Sawdust Co-composting

Environmental specialists classified sewage sludge as a hazardous waste because of high organic compounds and pathogenic microorganisms. Therefore sewage sludge should be stabilized before disposal. Composting is an effective and economical method to stabilize sewage sludge. The object of this study is determining the optimum conditions of co- composting of dewatered sewage sludge and sawdust. Pilot scale study was performed in Isfahan municipal wastewater treatment plant. To perform this study, the dewatered sewage sludge with humidity between 78-82 percent was mixed with sawdust. Turning over did once a week for aeration. Temperature was monitored at different depths daily. Other parameters such as N, C, organic matters, pH, heavy metals, total and fecal Coliform and Salmonella were determined three times a week. The results of this study showed that after about 15th days, temperature of the mixture reached up to 55\ub0C, and was stabled for fifteen days. Humidity, organic matter, organic carbon and C/N ratio of the mixture decreased during of the study, due to increasing the temperature. Also organic matter and humidity mainly decreased in thermophilic phase. The number of total and fecal coliforms and also Salmonella decreased to A class standards of U.S. EPA at the end of the operation. The result indicated that co-composting of sewage sludge with sawdust is a reliable and simple method to schedule, with high flexibility and low odor production. Organic compounds and pathogenic microorganisms reduced and EPA standards were met during this method. @ JASEM

Measurement of superficial and deep abdominal muscle thickness: an ultrasonography study

BACKGROUND: Real-time ultrasound imaging is a valid method in the field of rehabilitation. The ultrasound imaging allows direct visualization for real-time study of the muscles as they contract over the time. Measuring of the size of each abdominal muscle in relation to the others provides useful information about the differences in structure, as well as data on trunk muscle activation patterns. The purpose of this study was to assess the size and symmetry of the abdominal muscles at rest in healthy adults and to provide a reference range of absolute abdominal muscle size in a relatively large population. METHOD: A total 156 healthy subjects with the age range of 18–44 years were randomly recruited. The thickness of internal oblique, external oblique, transverse abdominis, and rectus abdominis muscles was measured at rest on both right and left sides using ultrasound. Independent t test was used to compare the mean thickness of each abdominal muscle between males and females. Differences on side-to-side thicknesses were assessed using paired t test. The association between abdominal muscle thicknesses with gender and anthropometric variables was examined using the Pearson correlation coefficient. RESULTS: A normal pattern of increasing order of mean abdominal muscle thickness was found in both genders at both right and left sides: transverse abdominis < external oblique < internal oblique < rectus abdominis. There was a significant difference on the size of transverse abdominis, internal oblique, and external oblique muscles between right and left sides in both genders. Males had significantly thicker abdominal muscles than females. Age was significantly correlated with the thickness of internal oblique, external oblique, and rectus abdominis muscles. Body mass index was also positively correlated with muscle thickness of rectus abdominis and external oblique. CONCLUSIONS: The results provide a normal reference range for the abdominal muscles in healthy subjects and may be used as an index to find out abnormalities and also to evaluate the effectiveness of different interventions

The Effects of Vestibular Stimulations on Neurodevelopment, Growth and Vital Signs of Preterm Infants: A Systematic Review

Background: The purpose of the present study was to systematically review all published studies investigating the effects of only vestibular interventions on neurodevelopment, growth and vital signs in preterm infants (PIs).Method: PubMed, SCOPUS, Web of Science, CINAHL and EMBASE databases were searched to find relevant studies published from 1980 and June 2022. In addition, reference lists of the articles were also checked.Results: Twenty articles met the inclusion criteria. Fifteen of these articles reported studies conducted on stable preterm infants and five on unstable ones. Waterbed, rocking, hammock, air mattress and Vestibu_Guide stimulations were applied in eight, four, six, one, and one study, respectively. Twelve studies evaluated neurobehavioral development, five studies assessed neuromotor development, five studies evaluated the growth and fifteen studies assessed the vital signs in preterm infants using vestibular stimulations.Conclusions: The results indicate that vestibular stimulations may improve neurodevelopment, growth and vital signs in premature infants, but there are still some disagreements among researchers, and further research is recommended

Reliability of real�time ultrasound imaging for the assessment of trunk stabilizer muscles: A systematic review of the literature

Rehabilitative ultrasound (US) imaging is one of the popular methods for investigating muscle morphologic characteristics and dimensions in recent years. The reliability of this method has been investigated in different studies. As studies have been performed with different designs and quality, reported values of rehabilitative US have a wide range. The objective of this study was to systematically review the literature conducted on the reliability of rehabilitative US imaging for the assessment of deep abdominal and lumbar trunk muscle dimensions. The PubMed/MEDLINE, Scopus, Google Scholar, Science Direct, Embase, Physiotherapy Evidence, Ovid, and CINAHL databases were searched to identify original research articles conducted on the reliability of rehabilitative US imaging published from June 2007 to August 2017. The articles were qualitatively assessed; reliability data were extracted; and the methodological quality was evaluated by 2 independent reviewers. Of the 26 included studies, 16 were considered of high methodological quality. Except for 2 studies, all high�quality studies reported intraclass correlation coefficients (ICCs) for intra�rater reliability of 0.70 or greater. Also, ICCs reported for inter�rater reliability in high�quality studies were generally greater than 0.70. Among low�quality studies, reported ICCs ranged from 0.26 to 0.99 and 0.68 to 0.97 for intra� and inter�rater reliability, respectively. Also, the reported standard error of measurement and minimal detectable change for rehabilitative US were generally in an acceptable range. Generally, the results of the reviewed studies indicate that rehabilitative US imaging has good levels of both inter� and intra�rater reliability. © 2018 by the American Institute of Ultrasound in Medicine

Motor Developmental Delay in 7500 Iranian Infants: Prevalence and Risk Factors

ObjectiveThe purpose of this study was to determine the prevalence and the most common risk factors of motor developmental delay in infants.Materials &amp; MethodsFollowing ethical approval, a study was carried out on the prevalence and risk factors of infants with motor developmental delay. The first stage was conducted through a cross-sectional study to determine the prevalence of motor developmental delay on 7500 infants and the second stage was an analytic case - control survey to identify the most common risk factors on 140 infants, aged one month to three years with motor developmental delay. Data was collected using a demographic questionnaire, the Parents Evaluation of Developmental Status questionnaire, the Denver Developmental Screening Test II, a neurological assessment form, and the movement and tone assessment form.ResultsThe prevalence of motor developmental delay in 7500 infants was 18.7/1000. The most common risk factors in infants with motor developmental delay were prematurity (25.6%), low birth weight (19.2%), neonatal seizures (7.5%), hyaline membrane disease (6.7%), systemic infections of mothers during pregnancy (5.9%), severe neonatal hyperbilirubinemia (5%) in sequence. Motor developmental delay was significantly correlated with consanguinity of parents (p=0.001), prematurity (p=0.046), abnormal head circumference at birth (p=0.038), and low birth weight (p=0.026).ConclusionThe prevalence of motor developmental delay appears to be high and further studies should focus on different preventive strategies, controlling the most common risk factors and emphasizing on early detection and treatment of high risk infants.

Effectiveness of dry needling for improving pain and disability in adults with tension-type, cervicogenic, or migraine headaches: Protocol for a systematic review

Background: Headache is the most common neurological symptoms worldwide, as over 90% of people have noted at least one headache during their lifetime. Tension-type headaches, cervicogenic headaches, and migraines are common types of headache which can have a significant impact on social, physical, and occupational functioning. Therapeutic management of headaches mainly includes physical therapy and pharmacological interventions. Dry needling is a relatively new therapeutic approach that uses a thin filiform needle without injectate to penetrate the skin and stimulate underlying tissues for the management of neuromusculoskeletal pain and movement impairments. The main objective of this systematic review and meta-analysis is to evaluate the effectiveness of dry needling in comparison to other interventions on pain and disability in patients with tension-type headache, cervicogenic headache, and migraine. Methods/design: We will focus on clinical trials with concurrent control group(s) and comparative observational studies assessing the effect of dry needling in patients with tension-type headache, cervicogenic headache, and migraine. Electronic databases from relevant fields of research (PubMed/ Medline, Scopus, Embase®, PEDro, Web of Science, Ovid, AMED, CENTRAL, and Google Scholar) will be searched from inception to June 2019 using defined search terms. No restrictions for language of publication or geographic location will be applied. Moreover, grey literature, citation tracking, and reference lists scanning of the selected studies will be searched manually. Primary outcomes of this study are pain intensity and disability, and secondary outcomes are cervical spine ROM, frequency of headaches, health-related quality of life, and TrPs tenderness. Studies will be selected by three independent reviewers based on prespecified eligibility criteria. Three reviewers will independently extract data in each eligible study using a pre-piloted Microsoft Excel data extraction form. The assessment of risk of bias will be implemented using the Cochrane Back and Neck Review Group 13-item criteria and NOS. Direct meta-analysis will be performed using a fixed or random effects model to estimate effect size such as standardized mean difference (Morris's d ppc ) and 95% confidence intervals. Statistical heterogeneity will also be evaluated using the I 2 statistic and the χ2 test. All meta-analyses will be performed using Stata V.11 and V.14 softwares. The overall quality of the evidence for the primary outcomes will be assessed using GRADE. Discussion: All analyses in this study will be based on the previous published papers. Therefore, ethical approval and patient consent are not required. The findings of this study will provide important information on the value of dry needling for the management of tension-type headache, cervicogenic headache, and migraine