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Background and aim Health status is an independent predictor of mortality, morbidity and functioning in older people. The present study was designed to evaluate the link between socioeconomic status (SES), physical activity (PA), independence (I) and the health status (HS) of older people in Iran, using structural equation modelling. Methods Using computerized randomly selection, a representative sample of 851 75-year-olds living in Tehran (2007–2008), Iran, was included. Participants answered questions regarding indicators of HS, SES and also PA and I through interviews. Both measurement and conceptual models of our hypotheses were tested using Mplus 5. Maximum-likelihood estimation with robust standard errors (MLR estimator), chi-square tests, the goodness of fit index (and degrees of freedom), as well as the Comparative Fit Index (CFI), and the Root Mean Square Error of Approximation (RSMEA) were used to evaluate the model fit. Results The measurement model yielded a reasonable fit to the data, χ2 = 110.93, df = 38; CFI = 0.97; RMSEA = 0.047, with 90% C.I. = 0.037–0.058. The model fit for the conceptual model was acceptable; χ2 = 271.64, df = 39; CFI = 0.91; RMSEA = 0.084, with 90% C.I. = 0.074–0.093. SES itself was not a direct predictor of HS (β = 0.13, p = 0.059) but it was a predictor of HS either through affecting PA (β = 0.31, p

Background and purpose: The pattern of population aging is highly complex and contextually based. Cross-national comparisons are helpful to explore related factors. Two cross-sectional studies designed to compare physical activity level, physical functioning and certain health related factors in 75-year-old women and men in Sweden and Iran. Materials and methods: Cohorts of 637 Swedish and 851 Iranian 75-year-olds were investigated with the same methods regarding physical activity level, physical functioning and health related factors. Results: There were differences in physical activity level (p < 0.001), self-reported physical functioning (p < 0.001) objective physical functioning (p < 0.001), health status (p < 0.001) and most socio-demographic aspects between the two countries. Here the Swedish cohort had the advantage. There was no difference between the countries regarding prevalence of vertigo or falls. The only variables where the Iranian cohort had advantage over the Swedes were grip strength and smoking habits. There were larger gender differences in walking habits, self-selected walking speed, timed chair stand, and one-leg stance in Iran, and in grip strength in Sweden, all to the disadvantage of women. Conclusions: Iranian 75-years-olds had a lower physical activity level, a worse lower extremity physical function but a better grip strength, a worse physical health status, but smoked less than their Swedish counterparts. Despite this, there were no differences regarding vertigo or falls. In most aspects, the magnitude of gender differences was about the same and in disadvantage of women, although there were larger differences in Iran in some lower extremity functions. (C) 2012 Elsevier Ireland Ltd. All rights reserved.

Sagittal head excursions are frequently used as diagnostic and treatment tools by physiotherapists. Retractions are performed to promote good head-on-body orientation. This study examined the regional contribution of spinal movements to head pro- and retraction in addition to the effect of a more or less restrained sitting position in healthy women. Fourteen healthy women performed seven sagittal head excursions in a more or less restrained sitting position, during which time their kinematic response was measured with an optoelectronic system. Total anterior/posterior head excursion was smaller ( P = 0.005 ) in the more restrained sitting position. In both sitting positions, approximately 60% of the total anterior/posterior head excursion originated from the cervical spine, almost 30% from the cervicothoracic spine C7-T4, and approximately 10% from thoracic regions down to T12. Middle thoracic vertical displacement was smaller ( p = 0.005 ) in the more restrained sitting position. A high correlation was found between total head excursion and the cervicothoracic unit displacements in both sitting positions ( r = 0.79 , r = 0.85 , respectively). In each sitting position, the craniovertebral angle, and the tragus-C7-horizontal line decreased in protraction. Movements in the thoracic region contributed to the total head excursion. Therefore, clinicians should recognize the thoracic contribution to sagittal head excursion when using pro- and retraction as a diagnostic and treatment tool.

Objective The objective of this study was to determine whether applied force and time interval of force exposure varied within and between physiotherapists (PTs) when they used sacroiliac (SI) distraction testing to provoke pain among subjects with sacroiliitis. Methods Two force plates recording 3 orthogonal forces and time intervals were used during repetitive testing. Eleven subjects with sacroiliitis were examined with the use of distraction testing by each of 3 PTs. Subjects lay on an examination board equipped with one force plate for each SI joint. They indicated provoked pain by pressing a button that gave a mark in the data collection. Results Applied force and time interval of force exposure varied within and between PTs. Significant differences between PTs were found in the impulse (force × time) for the vertical and lateral force components ( P ≤ .05). A significant decrease was found in the amplitude of force during the time interval of force exposure ( P ≤ .05) for 2 of the 3 PTs. The median level of pain was lowest when examined by the PT who applied the least magnitude of force. Conclusions Recording force and time events indicates that variation in examination technique within and between PTs may influence the outcome of the distraction test. Such recording, simultaneously monitored by the investigator, would therefore seem to offer standardized testing and improve clinical evaluation of SI pain over time.

Commissaris DA, Nilsson-Wikmar LB, van Dieen JH, Hirschfeld H. Joint coordination during whole-body lifting in women with low back pain after pregnancy. Arch Phys Med Rehabil 2002;83:1279-89. Objective: To quantify differences in the kinematics of lifting between women with low back and/or pelvic pain after pregnancy and women without. Design: Comparison study. Setting: Research laboratory. Participants: Volunteer sample of 7 women with pain (positive pain drawing, no physical examination) and 9 female controls (not matched). Interventions: Not applicable. Main Outcome Measures: Duration of downward and upward phases, relative instant of box lift-off, joint angles, spatial angles of trunk and pelvis, pelvic angle relative to trunk, and phase angle relationships between joints. Results: The duration of the upward phase ± standard deviation was longer in the pain group (1731±290ms vs 1489±187ms, P =.031). At box lift-off, this group had less hip joint flexion (101.9°±20.8° vs 78.7°±12.4°, P =.015) but more backward pelvis tilt relative to the trunk, that is, more lumbar spine flexion (126.3°±16.8° vs 109.0°±12.3°, P =.031). The pain group showed an immediate transition from lumbar spine flexion to extension, whereas the controls maintained peak flexion for about 600ms. The peak phase lag between knee and hip joint extension in the upward phase was larger for the pain group (−29.7°±8.3° vs −17.2°±5.5°, P =.003). Conclusion: Women with low back and/or pelvic pain after pregnancy showed different kinematics of lifting. Further research is needed to determine the exact relationship between the altered kinematics and the underlying disorder. © 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Background: We know that acceptance-based therapies have evidence in the context of chronic pain. However, what is unknown is how individuals experience the meaning of acceptance before entering pain rehabilitation and howmultiprofessional teamwork influences the different meanings and processes of acceptance. Given the complexity of acceptance and adjustment to a chronic condition such as persistent pain, it is essential, for example, to further explore these processes using a bodily existential perspective. Purpose: The overall aim was to explore ways of living with chronic non-specific musculoskeletal pain and to understand the meaning and the process of acceptance in relation to the individuals’ bodily experiences and sense of self. Methods: Six women and 3 men (between 18 and 52 y/o) were interviewed at the beginning, in the middle and at the end of a sixteen week-long rehabilitation programme. To explore the embodied nature of acceptance and to bring out the diversity and variation in the individuals’ experience, interpretative phenomenological analysis (IPA) was chosen. Results:Three differentmeanings and processes of acceptance were found. First, acceptance as a process of personal empowerment, “the onlyway tomove onwith life”. The individuals expressed that the rehabilitation programme helped them to integrate the body in their sense of self – a trusting cooperation between self and body gave rise to hope. Secondly, acceptance as an equivocal project, “a possible but challenging way forward”. This placed the individuals in a challenging position of ambivalence. The hopeful insight was there, acknowledging that acceptance was the way to move forward, but there was also a feeling of uncertainty and doubt about one’s ability. In the rehabilitation programme focus should also be placed on the experiences of the ambiguous body. Thirdly, in acceptance as a threat and a personal failure, “no way forward”, the integration of the aching body in sense of self was impossible since pain was incomprehensible, unacceptable and unfair. No changes during the rehabilitation programme could be described. Conclusion(s):Acceptance canbe experienced as the only way forward, a possible but challenging way forward, or a threat and capitulation as well as a personal failure. Experiences of the lived body and the sense of self are related to the personal meaning of acceptance. Individuals with chronic pain have different ways of experiencing their body: as a guide and a resource, as something ambiguous and confusing, which is difficult but important to understand, or as something disappointing, entrapping and alien. Individuals with chronic pain have different ways of experiencing their sense of self: as pride in having accomplished difficult and necessary changes to go on with life, as uncertainty on how to manage responsibility including fear of failure, or as a feeling that pain is defining them and that they are entrapped. Implications:The study contributedwith valuable knowledge to develop clinical interventions with focus on the lived body and inspire the use of the full potential of the physiotherapists’ role in pain rehabilitation programmes.