Effect of Adding Stretching Techniques to Standardized Intervention on Nonspecific Mechanical Neck Pain

Mechanical neck pain is becoming one of the leading causes of musculoskeletal disorders in the general adult population. Mobilization intervention is considered one of the most effective therapeutic techniques to treat non-specific neck pain. The purpose of this study was to investigate the benefit of adding stretching exercises as part of a rehabilitation program for patients with non-specific mechanical neck pain. Methods: Thirty-eight subjects with non-specific neck pain for at least 2 weeks with mean± SD age 30.9±8.1 years and body mass index (BMI) 26.8±6.7 kg/m2 participated in the study. Participants were randomly assigned to either the combined intervention (passive cervical mobilization and stretching techniques) (n1=18) or standard intervention group (n2=20). The outcome measures were Cervical range of motion (CROM), Numeric Pain Rating scale, Neck Disability Index, Global Rating of Change (GROC), and pressure pain threshold. Results: There was a significant difference in mean CROM during extension over time (p=0.002, η2=0.20), and a significant group by time interaction (p=0.02). The percent improvement from baseline to 4 weeks later was significant between the combined intervention and standard intervention groups (18.9% vs. 3.0%; p=0.02). Also, there was a significant difference in mean CROM during right lateral flexion over time (p\u3c0.001, η2=0.30), and a significant group by time interaction (p=0.04). The percent improvement from baseline to 4 weeks was significant between the combined intervention and standard intervention groups (23.2% vs. 10.8%; p=0.04). However, subjective outcome measures including pain, patient’s satisfaction and neck disability index significantly improved overtime with no significant differences between the two study groups. Over time, there was a significant difference in mean right upper trapezius muscle pain threshold (p=0.02), and for GROC (p\u3c0.001, η2=0.54), however, there was no significant group by time interaction, and the improvement over time did not differ by study group (p\u3e0.05). Conclusions: Four weeks of combined techniques (cervical mobilization plus stretching exercises) showed to be more effective than standard intervention in terms of improving cervical extension and lateral flexion CROM

Fatigue effect on landing biomechanics among individuals with anterior cruciate ligament reconstruction: a systematic review

It is well established that knee stability can be altered during fatigue, which may increase the risk of anterior cruciate ligament (ACL) injury. This is due to a reduction in neuromuscular control that leads to abnormal movement patterns. This study aims to review the impact of fatigue on landing biomechanics among individuals who have undergone anterior cruciate ligament reconstruction. Four databases (Scopus, EBSCO, Web of Science, and Google Scholar) were searched for relevant articles, with a focus on full-text English-language research articles published between 2012 and 2022. The quality of the included studies was evaluated using the McMaster Critical Review Form for Quantitative Studies, and two independent reviewers were involved in the study evaluation, with a third reviewer resolving any discrepancies. Data on study demographics, fatigue simulation methods, landing tasks, outcome measures, and results were extracted from included studies. Eight studies met the inclusion criteria and were included in the analysis. The results of these studies showed that fatigue simulation reduced knee flexion only in two studies and increased hip flexion moment only in two studies during landing among individuals with ACLR. These inconclusive results show that fatigue may negatively impact landing biomechanics in people who have had an ACLR, potentially increasing their risk of re-injury. Fatigue did not affect the landing strategies adopted by individuals who have undergone ACLR. Some of these changes, such as reduced knee flexion and reduced hip flexion moment, could potentially increase the risk of re-injury. However, other changes, such as an increased hip flexion angle, may protect the joint from further injury. More research is needed to better understand the impact of fatigue on landing strategies in this population and to identify strategies that can minimize the risk of re-injury

Serum cortisol as a predictor of major adverse outcomes in patients with COVID-19

BackgroundSeveral biomarkers were found to predict the severity and outcome of COVID-19 infection.AimsTo determine the serum cortisol response in patients with Coronavirus Disease 2019 (COVID-19) and its correlation with disease outcomes.Methods A prospective study among confirmed COVID-19 patients aged 18 years old and above. Morning cortisol levels were measured within 24 hours of admission. Relationship between cortisol levels and outcomes (intensive care unit (ICU) admission, intubation, and death) were analysed.Results A total of 206 patients positive for COVID-19 (mean age of 53.6±15.2 years) were included in the study. Mortality was recorded in 21 (30.4 per cent) patients with cortisol levels of ≥570nmol/L, 6 (8.8 per cent) among patients with 181–569nmol/L cortisol level, and 8 (11.6 per cent) among patients with ≤180nmol/L cortisol. Patients with cortisol levels of ≥570nmol/L were more likely to be admitted to the ICU, be intubated and longer hospital stay. Serum cortisol and ferritin levels were the most significant predictors of mortality. ConclusionOn admission, the morning cortisol level was predictive of mortality, ICU admission, intubation, and length of hospital stay in patients with COVID-19 and may be listed as an independent predictor for worse outcomes of COVID-19 infection

Low Back Pain Prevalence among Distance Learning Students

Background: Low back pain as a symptom affects many individuals around the globe regardless of their economic status or sociodemographic characteristics. During the 2019 COVID-19 pandemic, students found themselves obligated to sit down for long periods of time. The aim of this current study is to investigate the impact of these prolonged periods of sitting down in front of computers on developing a new episode of low back pain. Methods and Materials: This research adopted an observational cross-section study design. Students who are currently enrolled or had experienced distance learning classes in the last 6 months were eligible to participate. An online-based questionnaire was developed by the investigators through reviewing the literature with relevant objectives. McNemar’s test was used to compare certain variables between two periods before and during online distance learning. We used paired t-tests to compare pain intensity before, during, and after online learning, while a chi-square test was used to investigate correlations between factors influencing low back pain. Results: A total of 84 students participated in the study—46 (54.8%) females and 38 (45.2%) males. Before online distance learning, only 42.9% of participants reported low back pain, while only 20% had a back injury. The mean pain scores before, during, and after online distance learning were (2.85 ± 2.16, 4.79 ± 2.6, and 4.76 ± 2.7), respectively. The pain scores before online learning were significantly lower than pain scores during and after online distance learning (p < 0.05), respectively. Conclusion: The study findings suggested that low back pain prevalence increased among students during the COVID-19 pandemic. Future research should study participants’ behavior during the online learning and assess the long-run impact of distance learning among high-school and undergraduate students

The Perception of Physical Therapy Students towards Their Profession in Jordan

Background: The physical therapy profession has grown rapidly in less than a century, increasing its importance, techniques, settings, and the responsibilities provided to its practitioners. Objectives: The aim of the study was to explore how undergraduate physiotherapy students view physiotherapy as their future career and their perception of the educational physiotherapy programs in Jordan. Methods: A cross-sectional study was conducted. A questionnaire designed to collect data on students’ perceptions of their profession was delivered to 222 undergraduate physiotherapy students at Jordan University of Science and Technology in Irbid, Jordan. The response rate was 157 (70.72%). Descriptive statistics and the chi-square test were used to analyse the data. Results: Among 157 physiotherapy students, results were collected. Although students were satisfied with being physiotherapy students (p < 0.001), most of the study participants knew about physical therapy from their families, and they were not satisfied with the job opportunities in Jordan. Conclusions: Physiotherapy education in Jordan is rising rapidly. The public, patients, parents, and clinical preceptors in physiotherapy settings must recognize this educational and professional practice. It is noted that some levels of occupational awareness are intermediate. However, it would be beneficial to organize activities such as seminars and interviews in order to increase the level of professional awareness

Awareness and Knowledge Regarding the Consumption of Dietary Fiber and Its Relation to Self-Reported Health Status in an Adult Arab Population: A Cross-Sectional Study

The objective of this study was to examine the awareness, knowledge, and habits regarding dietary fiber intake and to analyze its relationship with self-reported health status among Saudi adults. A survey-based study using face-to-face interview was designed, and 1363 apparently healthy adult Saudi males and females participated. Most participants were females (81.2%), aged 25 and above (87.2%), and were educated at least up to the secondary level of education (80.8%). The majority of the participants were aware of the role of fiber-rich foods in health conditions such as obesity (70.5%), cardiovascular diseases (68.9%), and regulation of blood sugar (68.9%), with females significantly having higher nutrition knowledge than males. A disconnect in translating this nutrition knowledge was observed particularly in food choices when eating out, where preferences for white bread (84.4%), fried potatoes (69.9%) and peeled fruits (60.6%) were significantly higher than preferences for cooked vegetables (29.6%) and brown bread (18.1%). The most common reason for this disconnect was due to perception that foods rich in dietary fibers were expensive (72.1%), have less health benefits (56.5%), were not readily available (51.6%), and participants’ disliking of the taste (52.8%). Participants in the highest quartile (Q4) for dietary fiber consumption reported a lower prevalence of constipation (odds ratio, 95% confidence interval of 0.40, 0.28–0.57, p < 0.01), high cholesterol (0.43, 0.27–0.68, p < 0.01) and obesity (0.67, 0.44–0.98, p = 0.03) than participants in the lowest quartile (Q1). Dietary fiber intake appears to be protective against constipation, high cholesterol and obesity in Saudi adults. However, a disparity observed between knowledge and attitude towards intake of dietary fibers could limit its health benefits. Further studies including adolescents should be conducted to impart knowledge on the emotional, cognitive and sensory factors related to food choices in order to minimize the gap between nutrition knowledge and the consumption of healthy high-fiber diets

Effectiveness of the Pelvic Clock and Static Bicycle Exercises on Wisconsin Gait Scale and Trunk Impairment Scale in Chronic Ambulatory Hemiplegic Patients: A Single Group Pre-Post Design

Background: Most Hemiplegic patients achieve ambulatory function during the sub-acute stage of stroke. Though ambulatory, they still perform an unpleasant awkward gait with remarkable compensations requiring more energy expenditure. Fatigue arises at an early duration as a result of increased energy expenditure. The walking pattern becomes circumduction, featured by asymmetry with an extensor synergy of the lower limb. Each step is rotated away from the body then towards the body, forming a semicircle. This leads to changes in various parameters of gait (spatiotemporal, kinematic, and kinetic) in hemiparetic patients. Purpose: Many studies reveal the effectiveness of various therapeutic techniques in managing hemiplegic circumduction gait. Pelvic clock exercises aid in improving pelvic rotation components and cause dissociation in impaired pelvic mobility due to spasticity. A static bicycle helps in enhancing proper control between the hamstrings and quadriceps. It also helps in improving knee flexion range. As the patient places the foot in the cycle’s petals, it helps to enhance dorsiflexion and eversion functions as well. As the lower body is exercised, there could be relative changes in the upper body, i.e., the trunk. Thus, this study aimed to determine the changes in gait functions and trunk performance of chronic ambulatory hemiplegic patients in response to the above therapies for four weeks. Method: Twenty-five subjects (post-stroke duration (2.8 ± 0.6) years) who could walk 10 m independently without assistance or support of aid participated in a pelvic clock and static bicycle exercise intervention. The session duration was 30 min a day, and therapy was delivered six days a week and continued for four weeks. The entire program was carried out in an outpatient neurorehabilitation center. Results: After the intervention with pelvic clock and static bicycle exercises, there was a remarkable change in gait and trunk functions in chronic hemiplegic patients. Conclusion: The exercises comprising pelvic clock and static bicycle showed positive differences in gait and trunk functions in chronic stage hemiplegic patients. Later, randomized controlled studies involving larger sample sizes, advanced activation techniques, and increased intervention duration will explore in-depth information on their effectiveness and clinical significance