Biomechanical and functional effects of abdominal obesity on activities of daily living in individuals with low back pain

Striking statistics on the prevalence of low back pain among the population are negatively reflected in the medical, insurance and pension statistics of the countries of in the civilised world, as well as in international legal acts on health care. It has been established that a high body mass index is one of the provoking risk factors for low back pain. This has been confirmed by a number of studies which demonstrate significant association between low back pain development and abdominal obesity. Based on the findings of these studies, researchers conclude that abdominal obesity is an independent risk factor for low back pain. This article is an overview of the current theories of the identification and explanation of bio-mechanical and functional roles of abdominal obesity in the low back pain development. Approach. Theoretical methods of systematisation, explanation, and generalisation of recent theories of identification and explanation of bio- mechanical and functional roles of abdominal obesity in the development of low back pain were used. Purpose. Analysis and description of potential gaps in modern theories of identification and explanation of the bio- mechanical role of abdominal obesity in the development of low back pain. Filling in these gaps would contribute to extend existing recommendations for low back pain therapy. Results. There are only a few studies on the musculoskeletal characteristics developed as a result of the significant association between low back pain development and abdominal obesity. Existing knowledge on the identification and explanation of bio-mechanical role of abdominal obesity in the low back pain development, description and evaluation of the movement patterns of people with low back pain and abdominal obesity, and their characteristics compared to the movement patterns of healthy adults need to be supplemented by new data. Conclusions. A study of the mechanisms of behaviour of the musculoskeletal structures, investigation of their function, postural tone, proper activation-deactivation patterns during performance of various daily basic and complex movements in adults with abdominal obesity and low back pain will qualitatively extend the existing recommendations for the low back pain therapy

Applying patient‑reported outcome measures (PROMs) in physiotherapy: an evaluation based on the QUALITOUCH Activity Index

Background: Patient-reported outcome measures (PROMs) are tools to screen a population, to monitor the subjective progress of a therapy, to enable patient-centred care and to evaluate the quality of care. The QUALITOUCH Activity Index (AI) is such a tool, used in physiotherapy. This study aimed to provide reference values for expected AI outcomes. Methods: A large data set uniting clinical routine data and AI outcomes was generated; it consisted of data of 11,948 patients. For four defined diagnoses, i.e. chronic lower back pain, tibia posterior syndrome, knee joint osteoarthritis and shoulder impingement, the AI responses related to the dimensions “maximum pain level” and “household activity” were analyzed. Reference corridors for expected AI outcomes were derived as linear trend lines representing the mean, 1st and 3rd quartile. Results: Reference corridors for expected AI outcomes are provided. For chronic lower back pain, for example, the corridor indicates that the initial average AI value related to maximum pain of 49.3 ± 23.8 points on a visual analogue scale (VAS multiplied by factor 10) should be improved by a therapeutic intervention to 36.9 ± 23.8 points on a first follow-up after four weeks. Conclusions: For four exemplary diagnoses and two dimensions of the AI, one related to pain and one related to limitations in daily activities, reference corridors of expected therapeutic progress were established. These reference corridors can be used to compare an individual performance of a patient with the expected progress derived from a large data sample. Data-based monitoring of therapeutic success can assist in different aspects of planning and managing a therapy

Sex-specific differences in neuromuscular activation of the knee stabilizing muscles in adults: a systematic review

Introduction The rupture of the anterior cruciate ligament (ACL) is one of the most common injuries of the knee. Women have a higher injury rate for ACL ruptures than men. Various indicators for this sex-specific difference are controversially discussed. Aim A systematic review of the literature that compares surface electromyography (EMG) values of adult female and male subjects to find out if there is a difference in neuromuscular activation of the knee stabilizing muscles. Methods This systematic review has been guided and informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Studies which examined sex-specific differences with surface EMG measurements (integral, root mean squares, mean values, analysis of time and amplitude) of the knee stabilizing muscles were retrieved via searches from the databases PubMed, CINAHL, Embase, CENTRAL and SPORTDiscus. The risk of bias of included studies was assessed with the National Heart, Lung and Blood Institute (NHLBI) study quality assessment tool. A synthesis of results was performed for relevant outcomes. Results Fifteen studies with 462 healthy participants, 233 women (mean age 21.9 (± 2.29) years) and 299 men (mean age 22.6 (± 2.43) years), were included in the systematic review. The methodological quality of the studies was mostly rated “fair” (40%). A significantly higher activity of the muscles vastus lateralis and vastus medialis was found in females, in three studies. Two studies found significantly lower neuromuscular activity in the muscles biceps femoris and semitendinosus in females. All other included studies found no significant differences or reported even contradicting results. Conclusion The controversial findings do not allow for a concluding answer to the question of a sex-specific neuromuscular activation. Further research with higher statistical power and a more homogeneous methodical procedure (tasks and data normalisation) of the included studies may provide insight into possibly existing sex-specific differences in neuromuscular activation. This systematic review could help to improve the methodical design of future studies to get a more valid conclusion of the issue. Trial registration CRD42020189504

Digitale Physiotherapie - Ein Zukunftsmodell in der Schweiz

Die schweizweiten Lockdowns aufgrund der Covid-19-Pandemie sorgten in der ambulanten Physiotherapie für einen Anstieg von digitalen Angeboten. Welche Auswirkungen das auf den Alltag der Physiotherapeut*innen und Patient*innen hatte, untersuchte die Berner Fachhochschule gemeinsam mit anderen Fachhochschulen

The effect of foot orthoses with forefoot cushioning or metatarsal pad on forefoot peak plantar pressure in running.

Background Foot orthoses are frequently used in sports for the treatment of overuse complaints with sufficient evidence available for certain foot-related overuse pathologies like plantar fasciitis, rheumatoid arthritis and foot pain (e.g., metatarsalgia). One important aim is to reduce plantar pressure under prominent areas like metatarsal heads. For the forefoot region, mainly two common strategies exist: metatarsal pad (MP) and forefoot cushioning (FC). The aim of this study was to evaluate which of these orthosis concepts is superior in reducing plantar pressure in the forefoot during running. Methods Twenty-three (13 female, 10 male) asymptomatic runners participated in this cross-sectional experimental trial. Participants ran in a randomised order under the two experimental (MP, FC) conditions and a control (C) condition on a treadmill (2.78 ms−1) for 2 min, respectively. Plantar pressure was measured with the in-shoe plantar pressure measurement device pedar-x®-System and mean peak pressure averaged from ten steps in the forefoot (primary outcome) and total foot was analysed. Insole comfort was measured with the Insole Comfort Index (ICI, sum score 0–100) after each running trial. The primary outcome was tested using the Friedman test (α = 0.05). Secondary outcomes were analysed descriptively (mean ± SD, lower & upper 95%-CI, median and interquartile-range (IQR)). Results Peak pressure [kPa] in the forefoot was significantly lower wearing FC (281 ± 80, 95%-CI: 246–315) compared to both C (313 ± 69, 95%-CI: 283–343; p = .003) and MP (315 ± 80, 95%-CI: 280–350; p = .001). No significant difference was found between C and MP (p = .858). Peak pressures under the total foot were: C: 364 ± 82, 95%-CI: 328–399; MP: 357 ± 80, 95%-CI: 326–387; FC: 333 ± 81 95%-CI: 298–368. Median ICI sum scores were: C 50, MP 49, FC 64. Conclusions In contrast to the metatarsal pad orthosis, the forefoot cushioning orthosis achieved a significant reduction of peak pressure in the forefoot of recreational runners. Consequently, the use of a prefabricated forefoot cushioning orthosis should be favoured over a prefabricated orthosis with an incorporated metatarsal pad in recreational runners with normal height arches

Gambaran Motivasi Kerja Dan Pelayanan Prima Perawat Di Rumah Sakit Umum Bethesda Gmim Tomohon

:Motivation of nurses is the important thing because motivation is the one of caused, to lead, and human support for someone to do the best and get the best result. Excellent Service is the first element in the hospital and health sector, that the patients need. The aims of the research to see the picture of work motivation and excellent service of nurses at Bethesda GMIM Tomohon Hospital. Desain research The study was descriptive-qualitative, the population was all of nurses and patients in Bethesda GMIM Tomohon Hospital This research sample 60 respondent (nurse and patient), with the purposive sampling. Data analysis used of this study was data processor software SPSS. The result: The result of the study showed that intrinsic motivation of good category (48,3%), less category (51,7%), extrinsic motivation of good category (50%), less category (50%). Excellent service nurse when first meet the patient of good category (71,7%), less category (28,3%), when will start of good category (53,3%), less category (46,7%), and after they do the excellent service in good category (70%), less category (30%). The conclution more nurses are motivated by extrisic than intrinsic, and patiens feel that is provided nurses already do the excellent service. Advice would be able to add more information to researcher and to the hospital to maintain the excellent service provided to patients

Reliability of the active knee joint position sense test and influence of limb dominance and sex

The output of a sensorimotor performance can be measured with the joint position sense (JPS) test. However, investigations of leg dominance, sex and quality measures on this test are limited. Therefore, these potential influencing factors as well as reliability and consistency measures were evaluated for angular reproduction performance and neuromuscular activity during the active knee JPS test in healthy participants. Twenty healthy participants (10 males; 10 females; age 29 ± 8 years; height 165 ± 39 cm; body mass 69 ± 13 kg) performed a seated knee JPS test with a target angle of 50°. Measurements were conducted in two sessions separated by two weeks and consisted of two blocks of continuous angular reproduction (three minutes each block). The difference between reproduced and target angle was identified as angular error measured by an electrogoniometer. During reproduction, the neuromuscular activity of the quadriceps muscle was assessed by surface electromyography. Neuromuscular activity was normalized to submaximal voluntary contraction (subMVC) and displayed per muscle and movement phase. Differences between leg dominance and sex were calculated using Friedman-test (α = 0.05). Reliability measures including intraclass correlation coefficient (ICC), Bland–Altman analysis (bias ± limits of agreement (LoA)) and minimal detectable change (MDC) were analysed. No significant differences between leg dominance and sex were found in angular error and neuromuscular activity. Angular error demonstrated inter-session ICC scores of 0.424 with a bias of 2.4° (± 2.4° LoA) as well as MDC of 6.8° and moderate intra-session ICC (0.723) with a bias of 1.4° (± 1.65° LoA) as well as MDC of 4.7°. Neuromuscular activity for all muscles and movement phases illustrated inter-session ICC ranging from 0.432 to 0.809 with biases between − 2.5 and 13.6% subMVC and MDC from 13.4 to 63.9% subMVC. Intra-session ICC ranged from 0.705 to 0.987 with biases of − 7.7 to 2.4% subMVC and MDC of 2.7 to 46.5% subMVC. Leg dominance and sex seem not to influence angular reproduction performance and neuromuscular activity. Poor to excellent relative reliability paired with an acceptable consistency confirm findings of previous studies. Comparisons to pathological populations should be conducted with caution

Work-family conflict, task interruptions, and influence at work predict musculoskeletal pain in operating room nurses

Background The aim of this study is to examine the prevalence of musculoskeletal complaints in Swiss operating room (OR) nurses, and to investigate how work–family conflict, work interruptions, and influence at work are related to lumbar and cervical back pain. Methods Participants in this correlational questionnaire study included 116 OR nurses from eight different hospitals in Switzerland. Results We found that 66% of the OR staff suffered from musculoskeletal problems. The most prevalent musculoskeletal complaints were lumbar (52.7%) and cervical pain (38.4%). Furthermore, 20.5% reported pain in the mid spine region, 20.5% in the knees and legs, and 9.8% in the hands and feet. Multiple linear regression analyses showed that work–family conflict (p < 0.05) and interruptions (p < 0.05) significantly predicted lumbar and cervical pain in OR nurses, while influence at work (p < 0.05) only predicted lumbar pain. Conclusion These results suggest that reducing the work–family conflict and interruptions at work, as well as offering opportunities to influence one's workplace, help to promote OR nurses' health

Editorial: COVID-19 pandemic:A curve ball for athletes

More than 30 months since the discovery of the novel respiratory coronavirus in 2019, COVID-19 related public health orders and restrictions remain active in many countries on the globe in late 2022. These measures, such as city lockdown, border closure, travel restrictions, social distancing practice, and mandatory use of facemasks, affect all segments of the population. During the pandemic, we have witnessed the most significant disruption to the worldwide sports calendar since the World War II. From a global perspective, many international sports events, such as The Olympic Games Tokyo 2020, SummerWorld University Games, and theWorld Games have been postponed; and more than 150 international sports events involving both professional and recreational sportsmen have been canceled. In this series, we cover original articles examining the effect of COVID-19 on the training routine and performance in five types of athletes, including distance runners (Chan et al.), soccer/football players (Wagemans et al.; Keemss et al.), bodybuilders (Imboden et al.; Iff et al.), volleyball players (Morath et al.), and paralympic athletes (Busch et al.). We are aware that this field of research is highly dynamic with new data available almost on a daily base. Hence, we aim to bemore inclusive in this Research Topic and involve a wider scope of research questions and different methodological approaches, which allow us a better coverage of this emerging and evolving Research Topic. These findings provide important information for athletes, coaches, physical trainers, and healthcare team members to identify potential health issues that may be related to the pandemic, plan specifically how we can minimize the negative influence, as well as design contingency training plan for postponed tournaments. Although COVID-19 attacks our respiratory system and potentially causes a decline in physical condition, we observed adverse findings from the studies in this Research Topic in terms of physical training. Iff et al. and Keemss et al. reported a pandemic related negative impact on the physical performance in body builders and youth soccer players, respectively. In contrast, Chan et al. and Wagemans et al. did not find any substantial differences in terms of physical function or training intensity in professional soccer players and recreational distance runners. Interestingly, it seems that COVID-19 and its related public health restrictions result in a greater influence on people’s mental than physical health. For example, Imboden et al., Busch et al., and Iff et al. reported that athletes exhibited poorer mood during the pandemic and this psychological impact may indeed lead to a change in living habits, such as increase alcoholic and cannabis intake. From a global perspective, this Research Topic also includes an investigation of COVID transmission within volleyball games. Morath et al. conducted contact tracing in a professional volleyball teamin Germany. They found that players who strictly adhere to the recommended hygiene guidelines and regulations during both training and matches are of lower risk contracting the virus, but coaches and players are advised to avoid nonessential interpersonal contacts outside the training hours to prevent the spread of infection. Although the guest editors would love to see more views, downloads, and citations of papers included in this series, we sincerely hope that athletes, coaches, and concerning healthcare professionals do not require the information presented in this Research Topic due to another wave of pandemic and disruption. May COVID-19 will be soon behind us and becomes a historical terminology in near future

Physical Activity, Nutritional Habits, and Sleeping Behavior in Students and Employees of a Swiss University During the COVID-19 Lockdown Period: Questionnaire Survey Study

Background: The new coronavirus SARS-CoV-2 led to the COVID-19 pandemic starting in January 2020. The Swiss Federal Council prescribed a lockdown of nonessential businesses. Students and employees of higher education institutions had to install home offices and participate in online lectures. Objective: The aim of this survey study was to evaluate lifestyle habits, such as physical activity (PA), sitting time, nutritional habits (expressed as median modified Mediterranean Diet Score mMDS), alcohol consumption habits, and sleeping behavior during a 2-month period of confinement and social distancing due to the COVID-19 pandemic. Survey participants were students and employees of a Swiss university of applied sciences. Methods: All students and employees from Bern University of Applied Sciences, Department of Health Professions (ie, nursing, nutrition and dietetics, midwifery, and physiotherapy divisions) were invited to complete an anonymous online survey during the COVID-19 confinement period. Information on the lifestyle dimensions of PA, sitting time, nutritional and alcohol consumption habits, and sleep behavior was gathered using adaptations of validated questionnaires. Frequency analyses and nonparametric statistical methods were used for data analysis. Significance was set at 5{\%} $\alpha$ level of error. Results: Prevalence of non-health-enhancing PA was 37.1{\%}, with participants of the division of physiotherapy showing the lowest prevalence. Prevalence of long sitting time (>8 hours/day) was 36.1{\%}. The median mMDS was 9, where the maximal score was 15, with participants of the division of nutrition and dietetics being more adherent to a Mediterranean diet as compared to the other groups. Prevalence of nonadherence to the Swiss alcohol consumption recommendations was 8.3{\%}. Prevalence of low sleeping quality was 44.7{\%}, while the median sleeping duration was 8 hours, which is considered healthy for adult populations. Conclusions: In the group analysis, differences in PA, sitting time, and mMDS were observed between different divisions of health professions as well as between Bachelor of Science students, Master of Science students, and employees. Therefore, public health messages regarding healthy lifestyle habits during home confinement should be more group specific. The results of this study may provide support for the implementation of group-specific health promotion interventions at universities in pandemic conditions. Trial Registration: ClinicalTrials.gov NCT04502108; https://www.clinicaltrials.gov/ct2/show/NCT0450210