Effectiveness of exercise therapy and manipulation on sacroiliac joint dysfunction: A randomized controlled trial

Background: The sacroiliac joint dysfunction (SIJD) has been found to be the primary culprit for lower back pain (LBP), but it is still overlooked and treated as LBP. There are no guidelines or appropriate therapeutic protocols for SIJD. Thus, there is a need for an effective treatment strategy for SIJD. Objective: To compare exercise therapy (ET), manipulation therapy (MT), and a combination of the 2 (EMT) in terms of their effectiveness in treating SIJD. Study Design: A comparative, prospective, single-blind randomized controlled trial. Setting: Sports Medicine Department of Rasoul Akram Hospital. Methods: A total of 51 patients with lower back or buttock pain resulting from SIJD were randomly assigned to 1 of 3 study groups: ET, MT, or EMT. The ET group received posterior innominate self-mobilization, sacroiliac joint stretching, and spinal stabilization exercises. The MT group underwent posterior innominate mobilization and SIJ manipulation. Lastly, the EMT group received manipulation maneuvers followed by exercise therapy. Pain and disability were assessed at 6, 12, and 24 weeks after the interventions. Results: All 3 groups demonstrated significant improvement in pain and disability scores compared to the baseline (P < 0.05). The difference among these therapeutic protocols was found to be a function of time. At week 6, MT showed notable results, but at week 12, the effect of ET was remarkable. Finally, at week 24, no significant difference was observed among the study groups. Limitations: A major limitation of the present study is lack of a control group receiving a type of intervention other than the experimental protocols. Another limitation is the short duration of follow-ups. Conclusions: Exercise and manipulation therapy appear to be effective in reducing pain and disability in patients with SIJD. However, the combination of these 2 therapies does not seem to bring about significantly better therapeutic results than either approach implemented separately. © 2019, American Society of Interventional Pain Physicians. All rights reserved

Allograft or autograft in skeletally immature anterior cruciate ligament reconstruction: A prospective evaluation using both partial and complete transphyseal techniques

Objective: We compared autografts and allograft using partial and complete transphyseal anterior cruciate ligament (ACL) reconstruction techniques among skeletally immature individuals. Methods: Male and females younger than 18 and 16 years old, respectively, diagnosed with ACL tear from April 2006 to March 2012 entered the study. One group had four-strand hamstring autograft, and the other had tibialis posterior allograft reconstruction. Those who had allografts either had hyper-laxity or recurvatum. Results: Achieved mean (± SD) 2000 International Knee Documentation Committee subjective score was not statistically different (P = 0.385) between allograft (n = 13) (84.3 ± 3.2) and autograft groups (n = 18) (85.6 ± 4.4). Mean Knee injury and Osteoarthritis Outcome Score (KOOS) subscale Knee-Related Quality of Life at 2 years was 78.0 ± 7.2 and 75 ± 7.4 for allograft and autograft groups, respectively (p = 0.261). Mean 2-year KOOS subscale Sports and Recreation was 82.1 ± 5.8 and 84.8 ± 6.6 for allograft and autograft groups, respectively (p = 0.244). No patient reported instability, giving way, or locking of the knee. Pivot shift test was negative in all patients; however, a minor positive Lachman test was found in six cases (46) within the allograft group and seven cases (39) in the autograft group. One postoperative septic arthritis was documented in the autograft group. Conclusion: Considering existing concern that joint laxity and recurvatum are among the precursors of non-contact ACL injury in adolescents, bone-patellar-bone autografts are not applicable in this age group because of the open physis; furthermore, considering that hamstring autografts are insufficient (size thickness and stretchability), we recommend soft tissue allografts for ACL reconstruction in skeletally immature patients. © 2019 The Author(s)

Laboratory Evaluation of Fluoride Varnish Effect on Ionomer Glass Color Using a Digital Camera and Spectrophotometer

BACKGROUND AND OBJECTIVE: The impact of external factors on color of ionomer glass as a restorative material is important due to its beauty. The aim of this study was to evaluate discoloration of conventional and resin-modified ionomer glass, after the application of fluoride varnish. METHODS: In this study, 16 samples of each ionomer glass Chemfil Superior (C) and (F) Fuji II LC were prepared. Then fluoride varnish Dura shield (Sultan, USA) was used on samples (Cf, Ff). The color of each sample was measured using a spectrophotometer (Gretage Macbeth, Color-eye7000A) and digital camera (Sony Cyber-shot DSC N1) before and after the application of fluoride varnish. Obtained data from camera was converted to color space Lab CIE by MATLAB software. Discoloration (&Delta;E) of each sample was calculated in spectrophotometer and digital camera and statistical analysis was performed. FINDINGS: Using spectrophotometer &Delta;E in Cf and Ff groups was obtained 4.44 and 5.8, respectively, but with a digital camera was 2.37 and 4.21, respectively in the same group. The application of fluoride varnish in the evaluation of a spectrophotometer and a digital camera resulted in a statistical significant color change in samples (respectively p<0.001 and p=0.028). In addition, the data showed a significant correlation in obtained results from spectrophotometer and digital camera (p=0.045 and r=0.357). CONCLUSION: Based on the results of this study in evaluation by spectrophotometry, application of fluoride varnish (Dura shield) led to an apparent color change in both ionomer glass. According to the same results, digital camera for evaluation of color is relatively reliable

Evaluation of relationship between trunk muscle endurance and static balance in male students

Purpose: Fatigue of trunk muscle contributes to spinal instability over strenuous and prolonged physical tasks and therefore may lead to injury, however from a performance perspective, relation between endurance efficient core muscles and optimal balance control has not been well-known. The purpose of this study was to examine the relationship of trunk muscle endurance and static balance. Methods: Fifty male students inhabitant of Tehran university dormitory (age 23.9±2.4, height 173.0±4.5 weight 70.7±6.3) took part in the study. Trunk muscle endurance was assessed using Sørensen test of trunk extensor endurance, trunk flexor endurance test, side bridge endurance test and static balance was measured using single-limb stance test. A multiple linear regression analysis was applied to test if the trunk muscle endurance measures significantly predicted the static balance. Results: There were positive correlations between static balance level and trunk flexor, extensor and lateral endurance measures (Pearson correlation test, r=0.80 and P<0.001; r=0.71 and P<0.001; r=0.84 and P<0.001, respectively). According to multiple regression analysis for variables predicting static balance, the linear combination of trunk muscle endurance measures was significantly related to the static balance (F (3,46)=66.60, P<0.001). Endurance of trunk flexor, extensor and lateral muscles were significantly associated with the static balance level. The regression model which included these factors had the sample multiple correlation coefficient of 0.902, indicating that approximately 81 of the variance of the static balance is explained by the model. Conclusion: There is a significant relationship between trunk muscle endurance and static balance. © 2013 by Sports Medicine Research Center