Comparison of Muscle Recruitment Patterns During Sit-to-Stand and Stand-to-Sit in “Movement System Impairment” Subgroups of Low Back Pain and Healthy Women

Background: While various studies have examined motor control differences between subjects with and without low back pain (LBP), only a few have investigated the muscle recruitment pattern in classified LBP patients during functional activity. The aim of this study was to investigate the firing pattern of the main muscles involved in sit-to-stand (STD) and stand-to-sit (STS) tasks in two prevalent LBP subgroups based on movement system impairment (MSI) classification. Methods: A total of 37 women between 18 and 50 years of age voluntarily participated in this cross-sectional study. They were divided into three groups (15 healthy, 15 lumbar extension rotation syndrome (LERS), and seven lumbar flexion rotation syndrome (LFRS)). Surface electromyography was recorded bilaterally from the trunk stabilizer muscles—i.e. the internal oblique (IO), lumbar erector spine (ES), and hip mobilizer muscles—and the medial (MH) and lateral (LH) hamstring muscles during STD and STS tasks. The variations in EMG onset muscle timing and asymmetry in side-to-side muscle timing were measured. Results: The firing sequence during the STD task showed no significant difference among groups. However, in the healthy and LFR groups the trunk stabilizer muscles were activated before the hip mobilizer muscles, and in the LERS group an insignificant delay was shown in the onset of the ES activity. There was no significant difference of bilateral muscle timing during STD. In the STS task no consistent order of pattern was found even in the healthy group. The bilateral muscle timing of IO (mean difference, -427.00; P=0.021) and ES (mean difference, 1964.57; P=0.000) had significant difference in the LFRS group during STS. Conclusion: The cumulative effects of recruitment pattern impairment may contribute to continuing the cycle of lumbar movement impairments and subsequent persistence of LBP

Comparison of Lumbopelvic Movement Patterns in People with and Without Low Back Pain During Stair Descending Task

Background: Decreased lumbar spine control may be associated with early and/ or excessive lumbopelvic motion with trunk and lower extremity movements during functional and daily activities. This study investigated differences in lumbopelvic movement patterns in people with and without low back pain (LBP) during a stair descending (SD) task. Methods: A total of 36 subjects, 18 females with non-specific chronic low back pain (NSCLBP) and 18 healthy females, participated in this study. A threedimensional motion capture system was used to record kinematics during the SD task. Results: The results showed that in the LBP group, the start-time of the lumbar muscles occurred early in the movement (P=0.015). Additionally, subjects with LBP showed excessive lumbar spine and pelvic movement during the SD task (P<0.05). Conclusion: LBP patients make early and excessive lumbopelvic movements during a SD task, and this can be an important factor contributing to the development or persistence of their LBP problem. This finding should be considered by clinicians when evaluating functional tasks as part of movementbased examinations and rehabilitation programs for people with LB

Rehabilitation Educators′ Perceptions of Clinical Education Challenges in Iran: Is COVID-19 Having Redundant Effects?

Background: Clinical education is a core component of the curriculum of undergraduate rehabilitation students. Nevertheless, this field more than any other field of education has many shortcomings that should be addressed.Methods: The aim of this study was to explore the challenges of clinical education from the perspective of rehabilitation educators with particular focus on the new challenges created bythe COVID-19 outbreak. This qualitative study was conducted through purposeful sampling. Semi-structured interviews were conducted with 12 rehabilitation clinical educators of Ahvaz Jundishapur University of Medical Sciences, Iran. Data analysis was accomplished according to conventional content analysis. To prove the trustworthiness of the data, credibility, dependability, confirmability, and transferability were assessed.Results: Through data analysis, 240 initial codes were extracted in three main categories and nine sub-categories, indicating redundant challenges imposed by COVID-19 comprising restricted clinical resources (inadequate patient number and diversity, inadequate equipment, limited clinical space, inadequate manpower), an inefficient clinical education system (poor management of clinical education programs, insufficient clinical evaluation), and personal and professional characteristics of the students (lack of students’ practical knowledge, lack of motivation, fear).Conclusion: The results of this study provide deeper insight into the perceptions and experiences of rehabilitation educators regarding clinical education challenges. At present, an accidental and unexpected problematic event (COVID-19 pandemic) has inflicted detrimental effects on various aspects of clinical rehabilitation sciences. It is necessary to implement changes in future plans which include adaptations for COVID-19