Correction and prevention of lumbosacral osteochondrosis in elderly women based on the use of exercise complexes in water

The study is devoted to identifying the effectiveness of exercise complexes in water for the correction and prevention of lumbosacral osteochondrosis in elderly women, which was proven and expressed in a significant improvement in systolic blood pressure, the Stange and Gencha test, spinal mobility in the Tomayer test and the Schober test, lateral flexion of the spine to the left and right, maintaining stability of balance in the Romberg test, quality of life. Keywords: elderly age, osteochondrosis, exercises in water.

Robot for Ligament Tensioning and Assessment of Spinal Stability

Study Design An in vitro human cadaveric biomechanics study. Objective A proof-of-concept study to quantify whether or not differences in segmental mobility associated with spinal instability could be detected by a robotic distraction system. Methods Testing was performed in fresh human cadaveric tissue. A prototype Robotic Middle Column Distractor was attached unilaterally to the pedicles of L3-4. Distraction forces up to 150 N were applied first in the intact state, and following discectomy of L3-4. Motions were recorded by time-indexed visual and fluoroscopic images, and analyzed to measure actual motions achieved. Functions of the robot unit were monitored during the procedure and evaluated qualitatively. Results A difference of 2.5 mm in z-axis motion was detected at 150 N load between the intact and post-discectomy states. The robot coupled with the image analysis method was able to clearly detect the difference between the intact (“stable”) and post-discectomy (“unstable”) spine. Data analysis of fluoroscopic images taken during the procedure showed greater motion than perceived by the investigators from qualitative review of visual data. All monitored robot functions performed within design parameters without error. Conclusion The study demonstrates the feasibility and utility of utilizing an intraoperative robotic distractor to measure the amount of spinal mobility present at a level. This could lead to an important clinical tool for both diagnostic functions as well as operative assist functions.

Objective Measurements of Physical Activity and Sedentary Behavior Using Wearable Devices in Patients With Axial Spondyloarthritis: Protocol for a Systematic Review

Background Axial spondyloarthritis (axSpA) is a subgroup of inflammatory rheumatic diseases. Practicing regular exercise is critical to manage pain and stiffness, reduce disease activity, and improve physical functioning, spinal mobility, and cardiorespiratory function. Accordingly, monitoring physical activity and sedentary behavior in patients with axSpA is relevant for clinical outcomes and disease management. Objective This review aims to determine which wearable devices, assessment methods, and associated metrics are commonly used to quantify physical activity or sedentary behavior in patients with axSpA. Methods The PubMed, Physiotherapy Evidence Database (PEDro), and Cochrane electronic databases will be searched, with no limit on publication date, to identify all the studies matching the inclusion criteria. Only original English-language articles published in a peer-reviewed journal will be included. The search strategy will include a combination of keywords related to the study population, wearable devices, physical activity, and sedentary behavior. We will use the Boolean operators “AND” and “OR” to combine keywords as well as Medical Subject Headings terms. Results Search strategy was completed in June 2020 with 23 records obtained. Data extraction and synthesis are currently ongoing. Dissemination of study results in peer-reviewed journals is expected at the end of 2021. Conclusions This review will provide a comprehensive and detailed synthesis of published studies that examine the use of wearable devices for objective assessment of physical activity and sedentary behavior in patients with axSpA. Trial Registration PROSPERO CRD42020182398; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=182398 International Registered Report Identifier (IRRID) PRR1-10.2196/23359

Potential Role of Yoga in the Management of Ankylosing Spondylitis: A Retrospective Study

Background: Ankylosing spondylitis (AS) is a chronic autoimmune inflammatory spondyloarthropathy with unclear pathogenesis. The inflammatory pain in AS leads to restricted spinal mobility and significant disability. Yoga is a nonpharmacological intervention that has positive effects on various musculoskeletal-related problems. However, its role in AS is unknown. Objective: The present retrospective study assessed the efficacy of a two-week residential yoga intervention on spinal flexibility among AS patients. Methods: The records for 24 male AS patients within the age range 30 to 50 years (average age 38.3 ± 10.5 years) who underwent a two-week residential yoga retreat between 2015 and 2020 were obtained from a yoga center located in South India. Yoga intervention consisted of yoga postures, breathing practices, meditation, a healthy diet, and devotional sessions. Pre and Post data of the sit-and-reach test, blood pressure, heart rate, and symptom score were analyzed using Statistical Package for Social Sciences (SPSS). Results: Compared to the baseline, the post scores of the sit-and-reach test, systolic blood pressure and heart rate were found to be significantly ( P < .05) lower. The symptom score and analgesic medication score also showed significant improvement after two-weeks compared to the baseline. Conclusion: This retrospective study indicates the positive impact of on and analgesic use among AS patients. However, additional studies using robust research designs are warranted.

Pain Control Affects the Radiographic Diagnosis of Segmental Instability in Patients with Degenerative Lumbar Spondylolisthesis

Background: Diagnosing intervertebral instability is crucial for the treatment of degenerative lumbar spondylolisthesis (DLS). Disabling back pain will reduce spinal mobility which leads to an underestimate of the incidence of intervertebral instability. We hypothesized that adequate analgesia could alter the flexion/extension exam performance, and thus increase the diagnostic accuracy of segmental instability. Materials and methods: One hundred patients with low-grade DLS were prospectively enrolled in the before–after cohort study. Standing lateral flexion/extension radiographs of lumbar spines were examined and analyzed before and after intramuscular injections of 30 mg ketorolac. Results: Pain score decreased significantly after analgesic injections (p < 0.001). Dynamic slip (DS), dynamic segmental angle (DA), dynamic lumbar lordosis, and slip percentage (SP) were significantly increased after pain reduction (all p < 0.001). According to the diagnostic criteria for segmental instability (DS > 4.5mm, DA>15°, or SP >15%), there were 4%, 4%, and 0.7% of total motion segments fulfilling the criteria which markedly increased to 42%, 32%, and 16.7% after analgesia was administered. The incidence of instability also increased from 6% to 38% after analgesia. Conclusions: The diagnosis rate of intervertebral instability is commonly underestimated in the presence of low back pain. This short-term pain relief facilitates reliable functional imaging adding to the diagnosis of intervertebral instability.

Relationship between Trunk Position Sense and Trunk Control in Children with Spastic Cerebral Palsy: A Cross-Sectional Study

Background and Aim. Children with spastic cerebral palsy (CP) have impaired trunk control. Joint position sense, a component of proprioception, plays a crucial role in maintaining spinal mobility and stability. The current study is aimed at analysing the relationship between trunk control and trunk position sense in children with spastic CP. Methods. In this study, 24 children with spastic CP aged between 8 and 15 years were recruited. They were classified based on their functional performance using Gross Motor Function Classification System (GMFCS). Trunk control and trunk position sense were assessed using the trunk control measurement scale (TCMS) and digital goniometer, respectively. The correlation between these variables was tested using Spearman’s correlation coefficient. Results. Significant negative correlation was found between trunk position sense and TCMS score. Similarly, a significant moderate correlation was found between trunk position sense and GMFCS. A strong negative correlation was also found between GMFCS and TCMS. Conclusion. Children with spastic CP with better trunk position sense had better trunk control. Similarly, children with higher functional performance had better trunk control and lesser error in trunk position sense. The current findings imply the relevance of proprioceptive training of the trunk for enhancing trunk motor control in children with spastic CP.

Successful evaluation of spinal mobility measurements with the Epionics SPINE device in patients with axial spondyloarthritis compared to controls

Objective To evaluate ES for quantification of spinal mobility in patients with axSpA. Methods A total of 153 individuals, 39 females and 114 males, were examined:134 axSpA patients, 40 non-(nr-) and 94 radiographic (r)-axSpA, and 19 healthy controls (HC), respectively. The results were compared using mean ES scores and modeling was performed using multivariable logistic regression models resulting in good validity and high discriminative power. Results ES measurements showed meaningful differences between axSpA patients and HC (all p<0.001) as well as between r- and nr-axSpA (p<0.01). In axSpA patients a negative correlation between ES and BASMI values was found: -0.76≤r≤-0.52 (p<0.05). BASFI scores showed a similar trend (r > -0.39). Patients with r-axSpA had a more limited and slower spinal mobility than those with nr-axSpA. Other patient reported outcomes did almost not correlate. Conclusion This study shows that the ES is an objective performance measure and a valid tool to assess spinal mobility in axSpA, also based on OMERACT criteria. RoK and RoM scores provide additional information on physical function of axSpA patients.