Rehabilitative Ultrasound Imaging to Study the Gastrocnemius Muscles Morphology in Patients with Genu Varum and Valgum Deformities

Introduction: Genu varum and genu valgum deformities are highly prevalent in Iran. These deformities bring about changes in the structure and function of muscles around the knees. The aim of the present investigation was to study the structure of medial and lateral gastrocnemius muscles in patients with primary genu varum and genu valgum deformities and individuals with normal knee alignment, using rehabilitative ultrasound imaging. Method and Materials: : A Honda 2100 (Honda Co., Japan) real time ultrasound scanner was used in the current the study. The dominant legs of 18 women, 6 with genu varum (mean age: 22.00±1.78 years), 6 with genu valgum (mean age: 21.67±1.03 years), and 6 with normal alignment (mean age: 21.83±1.72 years) were examined. The morphological parameters like muscle thickness, pennation angle and fascicle length of medial and lateral gastrocnemius muscle were compared among groups. Results: In participants with genu varum, the medial gastrocnemius was thinner, closer and shorter in terms of muscle thickness, pennation angle, and fascicle lengths when compared to the lateral gastrocnemius (P<0.05). However, in participants with genu valgum, it was the other way around (P<0.05). In participants with normal alignment, there was no statistically significant difference between the medial and lateral gastrocnemius muscle structures. Conclusions: The rehabilitative ultrasound imaging is highly recommended for studying the structure of gastrocnemius muscle. The structural differences between medial and lateral gastrocnemius muscles may be due to the long term neuromuscular adaptation to knee joint alignment in both genu varum and genu valgum deformities.Key words: Genu, Valgum, Varum, Rehabilitative, Ultrasound, Imagin

The Reliability of Standing Sagittal Measurements of Spinal Curvature and Range of Motion in Older Women With and Without Hyperkyphosis Using a Skin-Surface Device.

OBJECTIVE:The purpose of this study was to investigate the intrarater reliability of a skin-surface instrument (Spinal Mouse, Idiag, Voletswil, Switzerland) in measuring standing sagittal curvature and global mobility of the spine in older women with and without hyperkyphosis. METHODS:Measurements were made in 19 women with hyperkyphosis (thoracic kyphosis angle ≥50°), mean age 67 ± 5 years, and 14 women without hyperkyphosis (thoracic kyphosis angle <50°), mean age 63 ± 6 years. Sagittal thoracic and lumbar curvature and mobility of the spine were assessed with the Spinal Mouse during neutral standing, full spinal flexion, and full spinal extension. Tests were performed by the same examiner on 2 days with a 72-hour interval. The intrarater reliability of the measurements was analyzed using the intraclass correlation coefficient, standard error of measurement and minimal detectable change. RESULTS:Intraclass correlation coefficients ranged from 0.89 to 0.99 in both groups. The standard errors of measurement ranged from 1.02° to 2.06° in the hyperkyphosis group and from 1.15° to 2.22° in the normal group. The minimal detectable change ranged from 2.85° to 5.73° in the hyperkyphosis group and from 3.20° to 6.17° in the normal group. CONCLUSIONS:Our results indicated that the Spinal Mouse has excellent intrarater reliability for the measurement of sagittal thoracic and lumbar curvature and mobility of the spine in older women

The reliability and validity of a designed setup for the assessment of static back extensor force and endurance in older women with and without hyperkyphosis.

ObjectiveThe purpose of this study was to investigate the intra-rater reliability and validity of a designed load cell setup for the measurement of back extensor muscle force and endurance.ParticipantsThe study sample included 19 older women with hyperkyphosis, mean age 67.0 ± 5.0 years, and 14 older women without hyperkyphosis, mean age 63.0 ± 6.0 years.MethodsMaximum back extensor force and endurance were measured in a sitting position with a designed load cell setup. Tests were performed by the same examiner on two separate days within a 72-hour interval. The intra-rater reliability of the measurements was analyzed using intraclass correlation coefficient (ICC), standard errors of measurement (SEM), and minimal detectable change (MDC). The validity of the setup was determined using Pearson correlation analysis and independent t-test.ResultsUsing our designed load cell, the values of ICC indicated very high reliability of force measurement (hyperkyphosis group: 0.96, normal group: 0.97) and high reliability of endurance measurement (hyperkyphosis group: 0.82, normal group: 0.89). For all tests, the values of SEM and MDC were low in both groups. A significant correlation between two documented forces (load cell force and target force) and significant differences in the muscle force and endurance among the two groups were found.ConclusionThe measurements of static back muscle force and endurance are reliable and valid with our designed setup in older women with and without hyperkyphosis

Effect of electrical stimulation on abdominal local fat thickness in young healthy women

Introduction: Despite the high prevalence of obesity, there is no safe and low cost method for losing weight (especially local). Electrical stimulation has been suggested as an efficient method in decreasing the thickness of local fat. The objective of this study was to determine the effect of electrical stimulation on abdominal subcutaneous fat thickness in healthy women. Materials and Methods: This quasi experimental research was conducted on 30 young healthy women (20 in study group and 10 in control group). In the control group, the abdominal fat thickness was measured without any therapeutic intervention at the beginning and after two weeks. In the experimental group, electrical stimulation to rectus abdominis muscles was applied 10 sessions (at 5 sessions per week) and the subject's abdominal fat thickness was measured at the baseline, and at the end of 2nd week. Comparison has been made across sessions and also between both groups. Results: In control group, the fat thickness changed from 2.17±.7(cm) at the first session to 2.18 ±.69 (cm) at the end of the 2nd week which was not significant, but in the experimental group there was a significant decrease in fat thickness from 2.59±.74 (cm) at the first session to 2.25 ± .68 (cm) at the end of the 2nd week (P=0.0001). Conclusion: This work indicated that electrical stimulation in 10 sessions is effective in reduction of abdominal fat thickness in healthy women

Relationship between the medial longitudinal arch and the thoracic and lumbar curvatures with the static and dynamic stability in obese females

Background and Aim: Reviewing the literature reveals a possible correlation between the obesity and the potential foot, spine and stability problems. Investigating the important parameters affecting the balance of obese people and prevention from falling are of high importance to reduce the resulting expenditures. This study aimed to assess the acts and the counter acts between the medial longitudinal arch (MLA) and the thoracic and lumbar curvatures with the static and dynamic stability in obese females. Materials and Methods: Twenty eight obese females (age= 25±8 years old, BMI=37±4) and twenty nine non-obese females (age= 23±4 years old, BMI=23±3) were recruited in this case-control study with the cross-sectional technique. The MLA, spinal curve angles and the static or dynamic balance index of the subjects were measured using the navicular drop, flexible ruler and Biodex balance system tools, respectively. The static balance test was carried out using a modified Clinical Test of Sensory Interaction and Balance (CTSIB) test in both the open and closed eyes while the subjects stood on their dominant legs. The order of the dynamic and static tests was selected randomly.Results: The findings of this study showed that in closed eye condition, most changes happened between the global Stability Index (SI) and BMI; while in open eye condition, most changes occurred between the lateral-medial stability index and BMI (r=0.5). Also during an open eye condition, a moderate correlation was found between the navicular drop and lateral-medial stability index (r=0.05). In closed eyes condition, no significant changes were found between the SI and lumbar lordosis (r=0.0004); while a weak correlation was found between the thoracic curve angle and lateral-medial stability index (r=0.04).Conclusion: The dynamic stability is not only correlated to their BMI, but is highly dependent on their foot curvature types and slightly on their thoracic curve angle. Abdominal obesity always played a significant role in antero-posterior stability index. Lumbar curvature showed a minor effect on static index value

Comparison of thorasis kyphosis and postural stiffness between elderly females and males in Tehran elderly recreation association

Background and Aim: Hyperkyphosis can lead to reduced respiratory capacity, postural disturbance and increased risk of falling. Despite the evidences about the more postural stiffness and kyphosis in elderly compared with young subjects and despite the known role of sex hormones and menopause in lowering the bone density, there is not any study about the effect of sex on the amount of thoracic kyphosis. The objective of this study is measuring and comparing the amount of spinal thoracic kyphosis and postural stiffness between the old females and males.Methods and Materials: In this descriptive-analytical study, in 36 healthy old subjects (21 female and 15 male) the amount of spinal thoracic kyphosis was measured by flexible ruler mounted between the spinous process T12 and C7 during, relaxed and erect postures. The difference of the kyphosis in relaxed and erect posture was used as an index of postural stiffness. The kyphosis and postural stiffness was compared between the females and males.Results: The average amount of kyphosis in relaxed and erect standing didn’t have statistically significant difference between females and males. The subjects in both groups could decrease theirs kyphosis in standing erect position (P=0.0001), but the amount of this decrease (postural stiffness) was not different between the females and males. Conclusion: In old women (which aren’t osteoporotic) hormonal changes due to menopause didn’t induce a statistically significant difference compared to old men in kyphosis and postural stiffness.Postural stiffness was increased by increasing the BMI that could suggest the BMI as an efficient factor in reducing the mobility of the spine

Studying the knee joint proprioception in generalized joint hypermobility as compared to healthy subjects

Introduction: The role of joint hypermobility in musculoskeletal injuries has been emphasized. In recent studies, proprioception defects have been reported in patients with hypermobility syndrome. In contrast to patients with general hypermobility, those with joint hypermobility syndrome have musculoskeletal disorders which may themselves cause proprioception disorders. So, these reports cannot purely confirm the effect of joint hypermobility on proprioception. The objective of this study was to assess the effect of generalized joint hypermobility on knee joint position sense in subjects with generalized joint hypermobility. Materials and Methods: In this case-control study, 20 subjects with generalized joint hypermobility who suffered from knee hypermobility in their dominant lower limb and 20 healthy subjects were recruited from available population of male and female college students through a simple convenient sampling. All subjects fell within the age range of 18 to 30 years. The position sense error was measured at three angles of knee extension -15°, -40° and -65° in sitting position via goniometry of digital pictures using Auto-CAD software. These errors were compared between two groups and also between different angles. Kolmogrov-Smirnov test confirmed the normal distribution of variables. Results: The results of this study showed that the position sense of knee joint in young subjects with generalized joint hypermobility was less accurate than in healthy subjects. Also the results indicated that the knee joint position sense in both groups was more accurate for angles at the end of range of knee extension that for those at inner range. Conclusion: The results of this study confirmed the existence of knee joint position sense defect in subjects with generalized joint hypermobility who have knee joint hypermobility. It is recommended to evaluate position sense of these joints in such subjects especially when they intend to enter sport activities in which the risk of joint injuries may elevate. Moreover, it is required to design training protocols for improving joint position sense in such cases. Keywords: Position sense, Proprioception, Generalized joint hypermobility, Knee join

The Effects of Dual Task on Healthy Adults Balance Index in Age and Gender groups

Background and Aim: Falls are the leading cause of accidental death among older adults. Recent studies have demonstrated that an impaired ability to maintain balance while simultaneously performing cognitive tasks is associated with increased rates of adverse outcomes, such as falls in elderly people. Because interventions designed to improve dual-task balance performance have the potential to reduce falling rate and functional decline, they are a critical health care need.Material & Methods: 60 healthy adults in four equal groups (mean age in: young men=22.1±1.9, old men =68.3±4.1, young women =22.6±1.8, old women =66.9±2.6) participated in this study. All subjects experienced four test conditions including: single- task with eyes open (O1), single- task with eyes closed (C1), dual-task with eyes open (O2) and dual-task with eyes closed (C2). Postural task in this study included standing on 8 instability level of biodex balance SD machine plate and cognitive task was backward counting by three.Results: balance index mean in older group was significantly higher in comparison with young group in all test conditions (O1 P=.000, C1 P=.003, O2 P=.000, C2 P=.000). There are not any significant differences between gender groups balance index mean, in test conditions. In Young women group O2 overall (OL), antroposterior (AP) and mediolateral (ML) balance indexes means were significantly higher than corresponding amounts in C2 (OL P=.014, AP P=.030, ML P=.017). In old women group C2 ML balance index mean was significantly higher than O2 ML balance index mean (P=.034). There are not significant differences between single- and dual-task conditions in other within group comparisons.Conclusion: In young men, young women and old women balance index means are different between single and dual eyes closed condition. Older adults balance index in single- and dual-task conditions is higher than young adults balance index. There is not any difference between men and women balance index in single and dual-task conditions

Studying the reliability of evaluating the force reproduction error of elbow extensor muscles in healthy young men

Abstract Introduction: The proprioception is good protector of joints against movement injuries and saves joint stability and is their natural co-ordinator during movement. As the force sense reproduction  is one of the common methods for evaluating the proprioception,its reliability must be evaluated .So the objective of this study is surveing the reliability of evaluating the force reproduction error of dominant and non dominant elbow extensor muscles in healthy young men . Methods & materials: in this study ,12 healthy young men between 18-30 years old which were selected by simple convenient non probability sampling from students of rehabilitation faculty of  Shahid Beheshti university of medical sciences in 1391 were recruited .The intratester and intertester reliability was astudied  .For analizing the sense of force reproduction error in elbow extensor muscles using forcemeter ,we instructed the specified percent (30%) of maximal isometric contraction to the subjects and then asked them to reproduce the instructed force. After two minutes we asked the subjects to repeatedly reproduce the instructed force.The test was repeated 3 times in each  order .The error of sense of force was computed using the difference of target force and reproducted force during three repetitions in first and second orders .The study was repeated randomly in dominat and non dominant limbs .Relative reliability (ICC) ,absolute reliability (SEM) and comparing the measures of two repetitions by paired t-test used for studying the reliability. Results: the amounts of ICC for constant error ,absolute error and variable error in dominant(right) limb and non dominant (left) limb were from 0.76 to 0.94 which shows high reliability.The SEM measures were from 0.004 to 0.02. Conclusion: based  on  the results of this sudy ,it was concluded that the method of evaluating the error of  sense of force in both limbs of healthy young men has high reliability .So it can be used as a reliable method in evaluating the force reproduction error. Keywords : proprioception, reliability, force  reproduction error, elbow