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Abstract Background Altered movement pattern has been associated with the development of low back pain (LBP). The purpose of this study was to investigate the activity pattern of the ipsilateral erector spinae (IES) and contralateral erectorspinae (CES), gluteus maximus (GM) and hamstring (HAM) muscles during prone hip extension (PHE) test in women with and without LBP. A cross-sectional non-experimental design was used. Methods Convenience sample of 20 female participated in the study. Subjects were categorized into two groups: with LBP (n = 10) and without LBP (n = 10). The electromyography (EMG) signal amplitude of the tested muscles during PHE (normalized to maximum voluntary electrical activity (MVE)) was measured in the dominant lower extremity in all subjects. Results Statistical analysis revealed greater normalized EMG signal amplitude in women with LBP compared to non-LBP women. There was significant difference in EMG activity of the IES (P = 0.03) and CES (P = 0.03) between two groups. However, no significant difference was found in EMG signals of the GM (P = 0.11) and HAM (P = 0.14) among two groups. Conclusion The findings of this study demonstrated altered activation pattern of the lumbo-pelvic muscles during PHE in the women with chronic LBP. This information is important for investigators using PHE as either an evaluation tool or a rehabilitation exercise.

BACKGROUND: Bee honey is a functional food which has a unique composition, antimicrobial properties and bifidogenic effect. In order to assess whether honey can inhibit the toxic effect of mycotoxins, the present study was undertaken. METHODS: Production of biomass and toxins by Aspergillus parasiticus and Aspergillus ochraceus were followed in media without and with honey. Although aflatoxins and ochratoxin A. were administrated to male Swiss albino mice up to 1 mug and 10 ng/kg body weight/day respectively. The experimental animals were fed diets without our with 10% honey for two months. The changes in colonic probiotic bacteria, determintal colon enzyme glucuronidases, and genotoxicity were followed. RESULTS: Addition of 32% in its media increased the biomass of A parasiticus, while the biomass of A. ochraceus decreased and Ochratoxin A. was not produced. When the honey was added at the ratio of 32 and 48% in the medium. No relationship was found between mycelium weight and production of mycotoxins. Oral administration of aflatoxins (mixture of B1, B2, G1 and G2) and Ochratoxin A. induced structural and numerical chromosomal aberrations in bone marrow and germ cells of male mice, whereas, honey treatment reduced the genotoxicity of mycotoxins. Also both toxins induced histopathological changes in liver and kidney. Feeding on diet supplemented with honey improved the histopathological changes in case of aflatoxin group, but not in the case of ochratoxin A. group (except of kidney in two cases). No significant differences were found in the activity of colon beta-glucuronidase between group fed diet with or without honey. On the other hand, the colon bifido bacteria and lactobacilli counts were increased markedly in group receiving diet supplemented with honey. CONCLUSION: Substituting sugars with honey in processed food can inhibit the harmful and genotoxic effects of mycotoxins, and improve the gut microflora. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate the 3-dimensional movement kinematics of pelvic and lower limb joints in CLBP subjects, compared to healthy individuals, utilizing a functional data analysis (FDA) approach., Methods: In this study, a 7-camera Qualisys motion capture system was employed to record the kinematics of the pelvic, hip, knee, and ankle joints in 20 patients with low back pain (LBP) and 20 control subjects on both sides during the sit-to-stand motion. An FDA statistical approach was utilized to compare the data collected over time between the 2 groups. The STS task was divided into two distinct phases: the prelift off phase (pre-Lo) and the postlift off phase (post-Lo)., Results: During the "pre-Lo phase" of the STS motion, our statistical analysis revealed that the only significant difference between the two groups was a decreased medial rotation (P = .00) in the hip joint position of LBP patients on their dominant side, in comparison to healthy subjects. As for the "post-Lo phase," the LBP group exhibited a more anterior pelvic tilt position (P = .00) and increased pelvic counterclockwise rotation (P = .03) in the sagittal and transverse planes when compared to the control group. Regarding hip joints, the LBP group demonstrated a more flexed position (indicative of reduced extension) on both the dominant (P = .00) and nondominant (P = .00) sides, coupled with diminished abduction (P = .04) and internal rotation (P = .03) of the hip on the dominant side. In relation to the knee and ankle joints, the results indicated a more adducted knee position (P = .00) and decreased ankle joint flexion (P = .02) on the dominant side in CLBP subjects when compared to the healthy group during the STS motion., Conclusion: Our findings indicate that patients with CLBP exhibited distinct kinematic patterns in the pelvic and lower limb joints during the STS motion. These kinematic alterations primarily manifest in the joints of the dominant limb, with most of the differences observed during the second phase (postlift off phase) of the motion. It appears that these changes in pelvic and lower limb joint kinematics should be taken into account when planning future rehabilitation programs for CLBP patients engaged in this task., (Copyright © 2024. Published by Elsevier Inc.)

Objectives: It is crucial to investigate the daily functions commonly utilized by individuals with low back pain (LBP) due to their implications for recurrence and chronicity. Stand-to-sit (StTS) task is one of the more repetitive functions in human daily life. This study aims to evaluate pelvic and lower limb joint kinematics during the StTS task in individuals with Non-Specific Chronic Low Back Pain (NSCLBP) compared to a healthy control group., Methods: Pelvic and lower limb joint kinematic data in all three planes were recorded from 20 individuals with LBP and 20 healthy individuals using a Qualisys motion capture system during the StTS task. A Functional Data Analysis statistical approach was employed to compare the kinematic data between the two groups., Results: In the initial phase of the movement, we observed a greater anterior pelvic tilt (P=0.028) and an altered pelvic frontal plane motion pattern (P=0.029) in the LBP compared to the healthy group. The only significant differences between the lower limb joint kinematics of the two groups were a less hip external rotation position (P=0.025) and a more knee adduction pattern (P=0.002) on the right side in the LBP subjects compared to the healthy group., Conclusion: Considering a few differences noted between the two groups across various joints and planes evaluated, it appears that the kinematic pattern of the lower limbs does not significantly differ between the NSCLBP and healthy groups during the StTS task in most comparisons. However, distinct kinematic patterns have been observed in the pelvic region, particularly in the sagittal and frontal planes, between the two groups., Competing Interests:  The author(s) do NOT have any potential conflicts of interest for this manuscript., (2024 © BY THE ARCHIVES OF BONE AND JOINT SURGERY.)

Opium smoking has been a common practice in Iran for many years, with people often smoking for long hours. During the COVID-19 pandemic, there was an increase in opium smoking due to false beliefs about its protective effects against COVID-19 infection. In this study, we aimed to examine the association between the non-ergonomic positions associated with traditional opium smoking in Iran and the development of neck pain and disability, forward head posture (FHP), and hyperkyphosis (HK). In this cross-sectional, correlational study, a total of 120 individuals who smoked opium were selected based on the inclusion criteria. They were interviewed about their addiction profile using the Lite version of the Addiction Severity Index and the Leeds Dependence Questionnaire. The presence of neck pain and disability was also evaluated using the Visual Analog Scale and the Neck Disability Index. The participants were examined for FHP via side-view photography and for HK using a flexible ruler. Data were analyzed using correlation coefficient tests and stepwise linear regression analysis. Based on the results, homelessness, the lifetime duration of opium smoking (in months), the duration of daily opium smoking (in minutes), and the severity of drug dependence had significant relationships with the severity of neck pain, neck disability, FHP, and HK. Homelessness was the strongest predictor of neck pain and disability (R 2 = 0.367, p < 0.001), FHP (R 2 = 0.457, p < 0.001), and HK (R 2 = 0.476, p < 0.001), followed by the lifetime duration of opium smoking and the duration of daily opium smoking, respectively, in which R 2 increased to 0.505 ( p = 0.011), 0.546 ( p = 0.022), and 0.570 ( p = 0.004) with the addition of two other variables. Overall, an increase in the duration of sitting in non-ergonomic positions could lead to neck pain and disability, FHP, and HK due to the non-neutral posture of opium smokers.

Objectives: Opium smoking is commonly practiced via traditional and novel routes in Iran. Both smoking methods are practiced in a non-ergonomic position. According to previous studies and our hypothesis, it can be potentially harmful to the cervical spine. Thus, the present study aimed to investigate the relationship between opium smoking and neck range of motion and neck muscle strength., Methods: In this cross-sectional and correlational study, the range of motion and strength of the neck muscles of 120 men with drug use disorder were measured by a CROM goniometer and a hand-held dynamometer. Other data gathering was performed using a demographic questionnaire, the Maudsley Addiction Profile, and the Persian version of Leeds Dependence Questionnaire. The obtained data were analyzed by Shapiro-Wilks test, Pearson's correlation coefficient and stepwise linear regression., Results: There was no significant correlation between the age of drug use onset and range of motion and muscle strength of the neck; however, the daily duration of opium smoking and the number of years of opium smoking were inversely and significantly correlated with the range of motion and muscle strength of the neck in some directions. Daily opium smoking time for decreasing in neck range of motion and total duration of opium smoking for reduction of neck muscles strength are stronger predictor variables., Conclusion: Opium smoking by traditional routes causes non-ergonomic positions and has a moderate significant correlation with reduced range of motion and neck muscle strength, in Iran., Highlights: - The harm of drug use disorder is not only AIDS and hepatitis, and harm reduction programs should go beyond the prevention of AIDS and hepatitis. According to more than 90% of smoking use of drug compared to other methods (oral and injectable, etc.) musculoskeletal disorders caused by the smoking use of drugs, have a greater cost burden in reducing the quality of life and the need for rehabilitation.- Drug abuse treatment and harm reduction programs should focus more seriously on replacing smoking use of drugs with oral medications assisted treatment.- Although in Iran and some countries in the region, a large number of people smoke opium for many years and sometimes all their lives, daily in a completely non-ergonomic position, but studying the deformation of the posture and musculoskeletal disorders related to the body position in them, is not a scientific concern and neither physical therapy researchers have paid attention to it nor addiction researchers.- Neck muscles strength and range of motion in opium addicts are correlated to the number of years of opium smoking and daily minutes of opium smoking, but not to its oral use.- There is no significant correlation between the onset age of continues and permanent opium smoking and substance dependence severity with neck range of motion and muscles strength.- People with drug use disorder (especially smoking users) as a large group of vulnerable people, should be the target population of musculoskeletal disorders researchers and addiction harm reduction researchers, and more experimental, comparative, cohort, etc. researches should be designed and implemented for them., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Massah, Arab, Farhoudian, Noroozi and Hashemirad.)

This study utilized both experimental testing and machine learning (ML) strategies to assess the effectiveness of waste glass powder (WGP) on the compressive strength (CS) of cement mortar. The cement-to-sand ratio was kept 1:1 with a water-to-cement ratio of 0.25. The superplasticizer content was 4% by cement mass, and the proportion of silica fume was 15%, 20%, and 25% by cement mass in three different mixes. WGP was added to cement mortar at replacement contents from 0 to 15% for sand and cement with a 2.5% increment. Initially, using an experimental method, the CS of WGP-based cement mortar at the age of 28 days was calculated. The obtained data were then used to forecast the CS using ML techniques. For CS estimation, two ML approaches, namely decision tree and AdaBoost, were applied. The ML model's performance was assessed by calculating the coefficient of determination (R 2 ), performing statistical tests and k-fold validation, and assessing the variance between the experimental and model outcomes. The use of WGP enhanced the CS of cement mortar, as noted from the experimental results. Maximum CS was attained by substituting 10% WGP for cement and 15% WGP for sand. The findings of the modeling techniques demonstrated that the decision tree had a reasonable level of accuracy, while the AdaBoost predicted the CS of WGP-based cement mortar with a higher level of accuracy. Utilizing ML approaches will benefit the construction industry by providing efficient and economic approaches for assessing the properties of materials., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

The corrosion of steel reinforcement necessitates regular maintenance and repair of a variety of reinforced concrete structures. Retrofitting of beams, joints, columns, and slabs frequently involves the use of fiber-reinforced polymer (FRP) laminates. In order to develop simple prediction models for calculating the interfacial bond strength (IBS) of FRP laminates on a concrete prism containing grooves, this research evaluated the nonlinear capabilities of three ensemble methods—namely, random forest (RF) regression, extreme gradient boosting (XGBoost), and Light Gradient Boosting Machine (LIGHT GBM) models—based on machine learning (ML). In the present study, the IBS was the desired variable, while the model comprised five input parameters: elastic modulus x thickness of FRP (EfTf), width of FRP plate (bf), concrete compressive strength (fc′), width of groove (bg), and depth of groove (hg). The optimal parameters for each ensemble model were selected based on trial-and-error methods. The aforementioned models were trained on 70% of the entire dataset, while the remaining data (i.e., 30%) were used for the validation of the developed models. The evaluation was conducted on the basis of reliable accuracy indices. The minimum value of correlation of determination (R2 = 0.82) was observed for the testing data of the RF regression model. In contrast, the highest (R2 = 0.942) was obtained for LIGHT GBM for the training data. Overall, the three models showed robust performance in terms of correlation and error evaluation; however, the trend of accuracy was obtained as follows: LIGHT GBM > XGBoost > RF regression. Owing to the superior performance of LIGHT GBM, it may be considered a reliable ML prediction technique for computing the bond strength of FRP laminates and concrete prisms. The performance of the models was further supplemented by comparing the slopes of regression lines between the observed and predicted values, along with error analysis (i.e., mean absolute error (MAE), and root-mean-square error (RMSE)), predicted-to-experimental ratio, and Taylor diagrams. Moreover, the SHAPASH analysis revealed that the elastic modulus x thickness of FRP and width of FRP plate are the factors most responsible for IBS in FRP.

Background: Previous studies have demonstrated that respiratory dysfunction has a potential association with low back pain (LBP). Despite the role of the diaphragm for respiration and spinal stability, knowledge of the function of both sides of the diaphragm in subjects with LBP is still limited., Objective: This study aimed to compare the structural integrity and function of the right and left hemidiaphragm by ultrasonography (USG) in subjects with and without nonspecific chronic low back pain (NS-CLBP)., Methods: A total of 37 subjects with NS-CLBP and 34 healthy subjects participated in this case-control study. The thickness, thickness change, and excursion of the right and left hemidiaphragm were compared within and between the groups during quiet breathing (QB) and deep breathing (DB) through B-mode and M-mode ultrasound imaging., Results: The LBP group had a significantly smaller degree of right hemidiaphragm thickness change ( P = .001) compared with the healthy control group, with a strong effect size. Nevertheless, there was no significant change for diaphragm thickness and excursion between the two groups. The result showed that, in the healthy group, the right hemidiaphragm had a significantly smaller thickness at expiration and larger thickness change compared with the left hemidiaphragm, with a moderate effect size. Based on the multivariate prediction analysis, the right hemidiaphragm thickness change might significantly predict LBP., Conclusion: We found that participants with LBP had a smaller degree of right hemidiaphragm thickness change. Also, the right hemidiaphragm thickness change might significantly predict LBP.

The safety and economy of an infrastructure project depends on the material and design equations used to simulate the performance of a particular member. A variety of materials can be used in conjunction to achieve a composite action, such as a hollow steel section filled with concrete, which can be successfully utilized in the form of an axially loaded member. This study aims to model the ultimate compressive strength (P u ) of concrete-filled hollow steel sections (CFSS) by formulating a mathematical expression using gene expression programming (GEP). A total of 149 datapoints were obtained from the literature, considering ten input parameters, including the outer diameter of steel tube (D), wall thickness of steel tube, compressive strength of concrete (f c '), elastic modulus of concrete (E c ), yield strength of steel (f v ), elastic modulus of steel (E s ), length of the column (L), confinement factor (ζ), ratio of D to thickness of column, and the ratio of length to D of column. The performance of the developed models was assessed using coefficient of regression R 2 , root mean squared error RMSE, mean absolute error MAE and comparison of regression slopes. It was found that the optimal GEP Model T3, having number of chromosomes N c = 100, head size H s = 8 and number of genes N g = 3, outperformed all the other models. For this particular model, R 2 overall equaled 0.99, RMSE values were 133.4 and 162.2, and MAE = 92.4 and 108.7, for training (TR) and testing (TS) phases, respectively. Similarly, the comparison of regression slopes analysis revealed that the Model T3 exhibited the highest R 2 of 0.99 with m = 1, in both the TR and TS stages, respectively. Finally, parametric analysis showed that the P u of composite steel columns increased linearly with the value of D, t and f y .

The useful life of a concrete structure is highly dependent upon its durability, which enables it to withstand the harsh environmental conditions. Resistance of a concrete specimen to rapid chloride ion penetration (RCP) is one of the tests to indirectly measure its durability. The central aim of this study was to investigate the influence of different variables, such as, age, amount of binder, fine aggregate, coarse aggregate, water to binder ratio, metakaolin content and the compressive strength of concrete on the RCP resistance using a genetic programming approach. The number of chromosomes (N c ), genes (N g ) and, the head size (H s ) of the gene expression programming (GEP) model were varied to study their influence on the predicted RCP values. The performance of all the GEP models was assessed using a variety of performance indices, i.e., R 2 , RMSE and comparison of regression slopes. The optimal GEP model (Model T3) was obtained when the N c = 100, H s = 8 and N g = 3. This model exhibits an R 2 of 0.89 and 0.92 in the training and testing phases, respectively. The regression slope analysis revealed that the predicted values are in good agreement with the experimental values, as evident from their higher R 2 values. Similarly, parametric analysis was also conducted for the best performing Model T3. The analysis showed that the amount of binder, compressive strength and age of the sample enhanced the RCP resistance of the concrete specimens. Among the different input variables, the RCP resistance sharply increased during initial stages of curing (28-d), thus validating the model results.

This study aimed to determine how radiation attenuation would change when the thickness, density, and compressive strength of clay bricks, modified with partial replacement of clay by fly ash, iron slag, and wood ash. To conduct this investigation, four distinct types of bricks-normal, fly ash-, iron slag-, and wood ash-incorporated bricks were prepared by replacing clay content with their variable percentages. Additionally, models for predicting the radiation-shielding ability of bricks were created using gene expression programming (GEP) and artificial neural networks (ANN). The addition of iron slag improved the density and compressive strength of bricks, thus increasing shielding capability against gamma radiation. In contrast, fly ash and wood ash decreased the density and compressive strength of burnt clay bricks, leading to low radiation shielding capability. Concerning the performance of the Artificial Intelligence models, the root mean square error (RMSE) was determined as 0.1166 and 0.1876 nC for the training and validation data of ANN, respectively. The training set values for the GEP model manifested an RMSE equal to 0.2949 nC, whereas the validation data produced RMSE = 0.3507 nC. According to the statistical analysis, the generated models showed strong concordance between experimental and projected findings. The ANN model, in contrast, outperformed the GEP model in terms of accuracy, producing the lowest values of RMSE. Moreover, the variables contributing towards shielding characteristics of bricks were studied using parametric and sensitivity analyses, which showed that the thickness and density of bricks are the most influential parameters. In addition, the mathematical equation generated from the GEP model denotes its significance such that it can be used to estimate the radiation shielding of burnt clay bricks in the future with ease.

The depletion of natural resources of river sand and its availability issues as a construction material compelled the researchers to use manufactured sand. This study investigates the compressive strength of concrete made of manufactured sand as a partial replacement of normal sand. The prediction model, i.e., gene expression programming (GEP), was used to estimate the compressive strength of manufactured sand concrete (MSC). A database comprising 275 experimental results based on 11 input variables and 1 target variable was used to train and validate the developed models. For this purpose, the compressive strength of cement, tensile strength of cement, curing age, Dmax of crushed stone, stone powder content, fineness modulus of the sand, water-to-binder ratio, water-to-cement ratio, water content, sand ratio, and slump were taken as input variables. The investigation of a varying number of genetic characteristics, such as chromosomal number, head size, and gene number, resulted in the creation of 11 alternative models (M1-M11). The M5 model outperformed other created models for the training and testing stages, with values of (4.538, 3.216, 0.919) and (4.953, 3.348, 0.906), respectively, according to the results of the accuracy evaluation parameters root mean square error (RMSE), mean absolute error (MAE), and coefficient of determination (R2). The R2 and error indices values revealed that the experimental and projected findings are in extremely close agreement. The best model has 200 chromosomes, 8 head sizes, and 3 genes. The mathematical expression achieved from the GEP model revealed that six parameters, namely the compressive and tensile strength of cement, curing period, water−binder ratio, water−cement ratio, and stone powder content contributed effectively among the 11 input variables. The sensitivity analysis showed that water−cement ratio (46.22%), curing period (25.43%), and stone powder content (13.55%) were revealed as the most influential variables, in descending order. The sensitivity of the remaining variables was recorded as w/b (11.37%) > fce (2.35%) > fct (1.35%).

Nowadays, concretes blended with pozzolanic additives such as fly ash (FA), silica fume (SF), slag, etc., are often used in construction practices. The utilization of pozzolanic additives and industrial by-products in concrete and grouting materials has an important role in reducing the Portland cement usage, the CO 2 emissions, and disposal issues. Thus, the goal of the present work is to estimate the compressive strength (CS) of polyethylene terephthalate (PET) and two supplementary cementitious materials (SCMs), namely FA and SF, blended cementitious grouts to produce green mix. For this purpose, five hybrid least-square support vector machine (LSSVM) models were constructed using swarm intelligence algorithms, including particle swarm optimization, grey wolf optimizer, salp swarm algorithm, Harris hawks optimization, and slime mold algorithm. To construct and validate the developed hybrid models, a sum of 156 samples were generated in the lab with varying percentages of PET and SCM. To estimate the CS, five influencing parameters, namely PET, SCM, FLOW, 1-day CS (CS 1D ), and 7-day CS (CS 7D ), were considered. The performance of the developed models was assessed in terms of multiple performance indices. Based on the results, the proposed LSSVM-PSO (a hybrid model of LSSVM and particle swarm optimization) was determined to be the best performing model with R 2 = 0.9708, RMSE = 0.0424, and total score = 40 in the validation phase. The results of sensitivity analysis demonstrate that all the input parameters substantially impact the 28-day CS (CS 28D ) of cementitious grouts. Among them, the CS 7D has the most significant effect. From the experimental results, it can be deduced that PET/SCM has no detrimental impact on CS 28D of cementitious grouts, making PET a viable alternative for generating sustainable and green concrete. In addition, the proposed LSSVM-PSO model can be utilized as a novel alternative for estimating the CS of cementitious grouts, which will aid engineers during the design phase of civil engineering projects.

We observed our newly developed tetrahydro-1,2,4-triazines, including triazene moieties ( THTA ), namely, 6-((1E)-1-((2E)-(4-(((Z)-1-(2,4-diphenyl-2,3,4,5-tetrahydro-1,2,4-triazin-5-yl) ethylidene) triaz-1-en-1-yl)piperazin-1-yl) triaz-2-en-1-ylidene) ethyl)-2,4-diphenyl-2,3,4,5-tetrahydro-1,2,4-triazine ( THTA-I ), and 1-((E)-((E)-1-(2,4-diphenyl-2,3,4,5-tetrahydro-1,2,4-triazin-6-yl) ethylidene) triaz-1-en-1-yl) naphthalen-2-ol ( THTA-II ), as effective inhibitors for the corrosion protection of N80 carbon steel metal in 5% sulfamic acid as the corrosive medium via electrochemical approaches such as potentiodynamic polarization and electrochemical impedance spectroscopy. Furthermore, the tested steel exterior was monitored using X-ray photoelectron spectroscopy after the treatment with the investigated components to verify the establishment of the adsorbed shielding film. The investigated compounds acted as mixed-type inhibitors, as shown by Tafel diagrams. The compounds considered obey the Langmuir adsorption isotherm, and their adsorption on the steel surface was chemisorption. When the tested inhibitors were added, the double-layer capacitances, which can be determined by the adsorption of the tested inhibitors on N80 steel specimens, decreased compared with that of the blank solution. At 10 -4 M, the inhibitory efficacy of THTA-I and THTA-II achieved maximum values of 88.5 and 86.5%, respectively. Density-functional theory computations and Monte-Carlo simulation were applied to determine the adsorption attributes and inhibition mechanism through the studied components. Furthermore, the investigated inhibitors were considered to adsorb on the Fe (1 1 0) surface. The adsorption energy was then measured on steel specimens., Competing Interests: The authors declare no competing financial interest., (© 2022 The Authors. Published by American Chemical Society.)

Objective: This study aimed to determine within-day intra-rater reliability of ultrasound measurements of the right and left hemidiaphragm thickness and contractility (quantified by percentage thickness change) in supine position during deep breathing in individuals with nonspecific chronic neck pain., Methods: Seventeen volunteers (20-55 years of age) participated in this observational study. Bilateral diaphragm muscle thickness and contractility (percentage thickness change) were compared between 2 measurement sessions administered by a radiologist using B-mode real-time ultrasound (30 minutes apart). Intraclass correlation coefficient (ICC [3, 3]) as well as the standard error of measurement (SEM), minimal detectable change (MDC), and the coefficient of variation (CV) were used to determine the intra-rater reliability., Results: The right and left hemidiaphragm thickness showed good to excellent reliability at the end of deep inspiration (ICC, 0.90; 95% confidence interval [CI], 0.72-0.96; and ICC, 0. 93; 95% CI, 0.81-0.97, respectively) as well as at the end of deep expiration (ICC, 0.91; 95% CI, 0.75-0.96; ICC, 0.91; 95% CI, 0.77-0.97; SEM, 0.19; MDC, 0.54; and CV, 7.84%, respectively) and the percentage thickness change (ICC, 0.83; 95% CI, 0.54-0.94; and ICC, 0.93; 95% CI, 0.82-0.97, respectively)., Conclusion: This study found that diagnostic ultrasound measurements of the right and left hemidiaphragm thickness and contractility in supine position during deep breathing in individuals with nonspecific chronic neck pain was reliable. The SEM, MDC, and CV reported may allow for accurate interpretation of diaphragm assessment in a clinical research setting., (© 2022 by National University of Health Sciences.)

Rebars made of fiber-reinforced plastic (FRP) might be the future reinforcing material, replacing mild steel rebars, which are prone to corrosion. The bond characteristics of FRP rebars differ from those of mild steel rebars due to their different stress-strain behavior than mild steel. As a result, determining the bond strength (BS) qualities of FRP rebars is critical. In this work, BS data for FRP rebars was investigated, utilizing non-linear capabilities of gene expression programming (GEP) on 273 samples. The BS of FRP and concrete was considered a function of bar surface ( Bs ), bar diameter ( d b ), concrete compressive strength ( f c '), concrete-cover-bar-diameter ratio ( c / d ), and embedment-length-bar-diameter ratio ( l / d ). The investigation of the variable number of genetic parameters such as number of chromosomes, head size, and number of genes was undertaken such that 11 different models (M1-M11) were created. The results of accuracy evaluation parameters, namely coefficient of determination (R 2 ), mean absolute error (MAE), and root mean square error (RMSE) imply that the M11 model outperforms other created models for the training and testing stages, with values of (0.925, 0.751, 1.08) and (0.9285, 0.802, 1.11), respectively. The values of R 2 and error indices showed that there is very close agreement between the experimental and predicted results. 30 number chromosomes, 9 head size, and 5 genes yielded the optimum model. The parametric analysis revealed that d b , c / d , and l / d significantly affected the BS. The FRP rebar diameter size is greater than 10 mm, whereas a l / d ratio of more than 12 showed a considerable decrease in BS. In contrast, the rise in c / d ratio revealed second-degree increasing trend of BS.

Reinforced concrete structures are subjected to frequent maintenance and repairs due to steel reinforcement corrosion. Fiber-reinforced polymer (FRP) laminates are widely used for retrofitting beams, columns, joints, and slabs. This study investigated the non-linear capability of artificial intelligence (AI)-based gene expression programming (GEP) modelling to develop a mathematical relationship for estimating the interfacial bond strength (IBS) of FRP laminates on a concrete prism with grooves. The model was based on five input parameters, namely axial stiffness ( E f t f ), width of FRP plate ( b f ), concrete compressive strength ( f c '), width of groove ( b g ), and depth of the groove ( h g ), and IBS was considered the target variable. Ten trials were conducted based on varying genetic parameters, namely the number of chromosomes, head size, and number of genes. The performance of the models was evaluated using the correlation coefficient (R), mean absolute error (MAE), and root mean square error (RMSE). The genetic variation revealed that optimum performance was obtained for 30 chromosomes, 11 head sizes, and 4 genes. The values of R, MAE, and RMSE were observed as 0.967, 0.782 kN, and 1.049 kN for training and 0.961, 1.027 kN, and 1.354 kN. The developed model reflected close agreement between experimental and predicted results. This implies that the developed mathematical equation was reliable in estimating IBS based on the available properties of FRPs. The sensitivity and parametric analysis showed that the axial stiffness and width of FRP are the most influential parameters in contributing to IBS.

Objective: The purpose of this study was to establish within-day intrarater reliability values of ultrasound measurements (excursion and resting thickness)., Methods: Seventeen volunteers met the inclusion criteria for this preliminary study. The right and left hemidiaphragm excursion and resting thickness were compared between 2 measurement sessions using M-mode and B-mode real-time ultrasound, respectively (30 min apart). Intraclass coefficients, coefficients of variation, standard errors of measurement, and minimal detectable changes were calculated to determine intrarater reliability., Results: The intraclass coefficients of right hemidiaphragm excursion were 0.91 and 0.94 during quiet and deep breathing, respectively. The intraclass coefficient of left hemidiaphragm excursion was 0.95 during quiet breathing. The intraclass coefficients of diaphragm resting thickness were 0.99 and 0.97 in the right and left hemidiaphragm, respectively, which showed high intrarater reliability for ultrasound measurements of both sides of the diaphragm., Conclusion: This preliminary study suggests that diagnostic ultrasonography could be used as a potential method for measuring the resting thickness and excursion of the right and left hemidiaphragm in people with chronic low back pain. Future research with a larger sample size is needed to confirm these findings., (© 2022 by National University of Health Sciences.)

Purpose: This study aimed to investigate the altered ultrasonographic activity of abdominal muscles during breathing in males with and without nonspecific chronic low back pain (NSCLBP)., Design: Cross-sectional study., Methods: Twenty males with NSCLBP and 20 males without NSCLBP were recruited. Muscle thickness change was measured by ultrasonography during breathing in the end-inspiration and end-expiration phases for the transverse abdominis (TrA), internal oblique (IO), external oblique (EO), and rectus abdominis (RA) muscles. The data were normalized to the end-inspiration thickness. An independent t test was run to analyze the data at a confidence level of 95% (p < 0.05)., Results: The participants with NSCLBP had thicker IO muscles in the end-inspiration (p = 0.030) and end-expiration (p = 0.017) phases as well as greater RA (p = 0.006) and smaller EO (p = 0.003) normalized thickness changes during breathing., Conclusion: The normalized thickness changes during breathing differed between the participants with and without NSCLBP. Reduced EO and increased RA activity may predispose the spine to further injuries. Therefore, normalizing the breathing pattern should be considered in the management of people with NSCLBP., (© 2020. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)

Introduction: Chronic functional constipation (CFC) is the most prevalent type of constipation. Considering the proven effect of pelvic floor muscles dysfunction in these patients' symptom and the fascial connection between pelvic floor and abdominal and lumbopelvic muscles, this study aimed to examine the possible relationship between this muscles and CFC., Method: We conveniently selected 100 patients with CFC and 100 healthy participants based on the Rome IV criteria. Two groups were asked to complete the international physical activity questionnaire and food frequency questionnaire. Then both groups were assessed for the presence of trigger points in more prevalent pain sites for each muscle by pressure algometer with 50% of their caught pressure pain threshold., Results: There were no statistical differences between two groups in the intake of calories, carbohydrates, proteins, sugar, fiber, vegetables, and wheat products. Patients had a higher consumption of fat and dairy products. for the physical activity level, a statistical difference showed that patients were less physically active. The comparison of the presence and the number of trigger points for each muscle in patients and control groups indicated more than 50% impairment, and there was a significant difference between two groups., Conclusions: This study revealed that the relationship between myofascial trigger points of abdominal and lumbopelvic muscles and constipation. In addition to that, it seems that a sedentary life may influence CFC patients' condition. Moreover, it seems that the results of the dietary condition in patients could be because of conscious consumption of some certain foods., Competing Interests: Declaration of competing interest None., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Several investigators have suggested the presence of a link between Chronic Low Back Pain (CLBP) and lower limbs kinematics that can contribute to functional limitations and disability. Moreover, CLBP has been connected to postural and structural asymmetry. Understanding the movement pattern of lower extremities and its asymmetry during walking can provide a basis for examination and rehabilitation in people with CLBP. The present study focuses on lower limbs kinematics in individuals with CLBP during walking. Three-dimensional movements of the pelvic, hip, knee and ankle joints were tracked using a seven-camera Qualysis motion capture system. Functional dada analysis (FDA) was applied for the statistical analysis of pelvic and lower limbs motion patterns in 40 participants (20 CLBP and 20 controls). The CLBP group showed significantly different hip motion pattern in the transvers plane, altered knee and ankle motion pattern in the sagittal plane on the dominant side and different hip motion pattern in the transvers and frontal planes on the non-dominant side in comparison with the control group over the stance phase. In terms of symmetry, in the CLBP group, hip and knee moved through a significantly different motion patterns in the transvers plane on the dominant side in comparison with the non-dominant side. In the control group, knee moved through a significantly different motion pattern in the transvers plane on the dominant side in comparison with the non-dominant side. In conclusion, low back pain lead to altered movement patterns of the main joints of lower limbs especially on the dominant side during stance phase. Therefore, care should be taken to examine dominant lower limb movement pattern in CLBP to make a better clinical decision., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objective: The aim was to assess the abdominal muscle activities during inspiration and expiration at different sitting positions in individuals with and without chronic low back pain (CLBP)., Methods: This study was conducted on 36 participants (18 with CLBP and 18 healthy controls). Ultrasound imaging was used to assess thickness changes of the transverse abdominis, internal oblique, rectus abdominis, and external oblique muscles. Muscle thickness was measured during inspiration and expiration under 3 different stability levels: sitting on a chair, sitting on a gym ball, and sitting on a gym ball with lifting the left foot. The muscle thickness measured in these positions was normalized to the actual muscle thickness at rest in supine lying and presented as a percentage of thickness change., Results: Both groups displayed greater abdominal muscle activities as the stability of the surface decreased during both respiratory phases. However, compared with the healthy controls, the CLBP group showed smaller muscle thickness changes in all abdominal muscles, except the external oblique, in both respiration phases while sitting on a gym ball with lifting the left foot. The CLBP group displayed overactivity of the rectus abdominis muscle relative to the healthy controls while sitting on a chair in both respiratory phases., Conclusion: The findings of the study indicate that as the stability of the support surface decreases, individuals with CLBP had more difficulty activating all abdominal muscles in a similar manner compared to healthy controls in both respiratory phases, which might affect both respiration and postural stability., (Copyright © 2020. Published by Elsevier Inc.)

Objective: The aim of the study was to determine whether strength and range of motion deficits are present in patients with unilateral chronic neck pain at contralateral side to pain and at other regions., Design: Forty-nine patients with unilateral chronic neck pain and 98 asymptomatic subjects participated in this case-control study. Range of motion and muscle strength of the cervical, shoulder, trunk, and hip regions were assessed bilaterally using inclinometer and dynamometer, respectively., Results: Chronic neck pain patients demonstrated reduced cervical, shoulder, and trunk range of motion in their ipsilateral side to pain comparing the asymptomatic participants (P < 0.05). The ipsilateral side to pain cervical and shoulder range of motion were also significantly lower than the contralateral side to pain (P < 0.05). Significant differences were also observable in the contralateral side to pain comparing the asymptomatic group (P < 0.05). Cervical, shoulder, and scapulothoracic muscles were found weaker both in the ipsilateral side to pain and contralateral side to pain comparing the asymptomatic group (P < 0.05). Ipsilateral side to pain and contralateral side to pain in hip flexors were also found to be significantly weaker than the asymptomatic group (P < 0.01)., Conclusions: The results revealed range of motion and strength deficits in the pain-free regions of the body in unilateral chronic neck pain patients. Findings support the regional interdependence theory and emphasize the need for managing seemingly intact neighboring and more remote regions in unilateral chronic neck pain patients.

Objective: Impairments present in chronic pain conditions have been reported not to be limited to the painful region. Pain-free regions have also been proposed to be adversely affected as a cause or consequence of the painful condition. The aim of this study was to investigate the association between muscle strength in painful and pain-free regions and chronic neck pain., Design: A cross-sectional study., Setting: Rehabilitation hospital laboratory., Subjects: One hundred twenty-two patients with chronic neck pain (87 female) and 98 asymptomatic volunteers (52 female) were included in the study., Methods: Maximal isometric strength measures of the neck, scapulothoracic, shoulder, trunk, and hip muscles were assessed using a hand-held dynamometer in all participants. Pain intensity and pain-related disability were also assessed in patients through visual analog scale and Neck Disability Index scores, respectively., Results: Principal component analysis revealed one component for each of the studied regions. Multivariate analysis of variance found neck (d = 0.46), scapulothoracic (d = 0.46), shoulder (d = 0.60), trunk flexor (d = 0.38), extensor (d = 0.36), and hip (d = 0.51) strength components to be lower in the neck pain patients compared with asymptomatic participants (P < 0.01). Logistic and linear regression analyses found the shoulder strength component both to be a significant predictor for neck pain occurrence (β = 0.53, P < 0.01) and to have a considerable effect on pain intensity score (β=-0.20, P = 0.02), respectively., Conclusions: The results found that some pain-free regions in addition to the cervical spine to exhibit lower levels of muscular strength in neck pain patients. These findings support the regional interdependence theory, which proposes that impairments are not limited to the painful area and are possibly mediated by central mechanisms., (© 2019 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction and Hypothesis: Lumbo-pelvic pain (LPP) is a common disorder in women after pregnancy due to ligament laxity and postural changes. Transverse abdominis (TrA) and pelvic floor muscle (PFM) activity is important for lumbo-pelvic stability. The purpose of this study was to compare the effect of stabilization exercise (SE) and general exercise (GE) on TrA and PFM muscle activity and pain intensity in women with postpartum LPP., Methods: A randomized controlled trial study was conducted on 68 women with postpartum LPP. Patients were randomly divided into two groups of stabilization exercise (SE) and general exercise (GE) and received either SE or GE exercise for 8 weeks three times a week. Ultrasound imaging was utilized to measure the thickness change of TrA muscles during abdominal hollowing (AH) and bladder base displacement. These measurements were used as an indicator of TrA and PFM muscle activity. Pain intensity, thickness changes of the TrA muscle and bladder base displacement were measured pre- and post-intervention., Results: The results showed that there was no significant difference in pain relief after intervention between groups. The differences in TrA and PFM activity between groups were significant (P < 0.05). PFM and TrA muscle activity was significantly increased after SE in women with postpartum LPP (P < 0.05)., Conclusions: SE improved both PFM and TrA muscle function more than GE in women with postpartum LPP. However, the clinical outcome of pain relief was not greater in the SE group.

Introduction: Neck pain is a very common musculoskeletal complaint in industrialized countries. Theoretically, chronic neck pain is thought to possibly change biomechanics and muscle activation patterns of the shoulder complex, causing its pain and dysfunction in the long term., Purpose: The present cross-sectional study was conducted to compare shoulder complex muscle activation characteristics in patients with chronic non-specific neck pain, compared to healthy participants., Method: Twenty patients with chronic neck pain and twenty healthy participants were recruited for the present study. Surface Electromyographic (sEMG) activity was recorded from four selected muscles (anterior and middle deltoid, upper and lower trapezius) during shoulder elevation with a predetermined load (25-30% of an individual's maximum voluntary exertion)., Result: Results revealed only two significant increased onset delays in the anterior and middle deltoid,and a peak delay in the upper trapezius in chronic neck pain patients. Furthermore, increased onset delay for other muscles and decreased peak normalized amplitude (MVE%) for all muscles were found in chronic neck pain patients; however, these findings were not statistically significant., Conclusion: There were relationships between chronic non-specific neck pain and the shoulder muscle activation characteristic; hence, the alteration may be considered a predisposing factor for the shoulder dysfunction in future studies., (Copyright © 2019. Published by Elsevier Ltd.)

Purpose: The purpose of this study was to compare kinematics of the lower extremity and lumbar spine during a single leg landing task between female volleyball athletes with and without persistent low back pain (LBP)., Methods: In this cross sectional study, 36 volunteer female volleyball athletes with (n = 18) and without (n = 18) LBP were recruited. Two specifically trained physical therapists selected only athletes with a specific movement-based subgroup of LBP for inclusion. Three dimensional kinematic and ground reaction force data were recorded for each athlete across three single leg landing trials by utilizing a Vicon 6-camera motion capture system and one in-floor embedded Kistler force plate, respectively. Independent t-tests compared data between the two groups., Results: Lumbar lordosis when standing (p = 0.046) as well as on initial contact (p = 0.025) and at the time which the maximal vertical ground reaction force occurred (p = 0.020) were significantly greater in the LBP group. There were no other significant differences., Conclusions: The tendency for this specific subgroup of athletes to consistently adopt more extended lumbar postures in both static and dynamic tasks may be worth considering by those involved in coaching, performance optimizing and injury prevention., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objectives : The purpose of this randomized controlled trial was to investigate the long-term clinical effect of dry needling with two-week and three-month follow up, on individuals with myofascial trigger points in the upper trapezius muscle. Methods : A sample of convenience (33 individuals) with a trigger point in the upper trapezius muscle, participated in this study. The individuals were randomly assigned to two groups: trigger point compression ( N  = 17) or dry needling ( N  = 16). Pain intensity, neck disability, and disability of the arm, hand, and shoulder (DASH) were assessed before treatment, after treatment sessions, and at two-week and three-month follow ups. Results : The result of repeated measures ANOVA showed significant group-measurement interaction effect for VAS ( p  = .02). No significant interaction was found for NPQ and DASH ( p  > .05). The main effect of measurements for VAS, NPQ, and DASH were statistically significant ( p  < .0001). The results showed a significant change in pain intensity, neck disability, and DASH after treatment sessions, after two weeks and three months when compared with before treatment scores in both groups.  There was no significant difference in the tested variables after two-week or three-month as compared to after treatment sessions between the two groups. However, pain intensity after treatment sessions was significantly different between the two groups ( p  = .02). Discussion : Dry needling and trigger point compression in individuals with myofascial trigger point in the upper trapezius muscle can lead to three-month improvement in pain intensity and disability.

Purpose: The present study investigated group differences between the thickness changes of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles, during performance of the isometric supine chest raise and the supine double leg-straight leg raise tests in women with and without low back pain (LBP)., Method: Twenty women with LBP and 20 women without LBP participated in this case-control study. The thickness of the right TrA, IO, and EO muscles was measured using B-mode ultrasound (US) at rest, immediately at the beginning of performing the tests and when participants in both groups self-reported fatigue. The percentage of change in thickness of the abdominal muscles from rest to the initiation and fatigue stages of both tests was measured., Results: The results indicate a statistically significant difference in the pattern of changes in deep (TrA) and superficial (EO) abdominal muscles thickness at the fatigue stage of the supine double straight-leg raise (SDSLR) test between groups (P < 0.05). There was no significant difference between groups for the abdominal muscles thicknesses change at rest or during stages of the clinical isometric endurance tests (P > 0.05)., Conclusions: An altered activation pattern in the deep (TrA) and superficial (EO) muscles of LBP participants during fatigue stage of the SDSLR test as compared to controls indicates motor control dysfunction in the LBP group. Comparison of the activity of TrA and EO muscles during fatigue stage of SDSLR test can be used to assess alterations in motor control of abdominal muscles.

Objective: The purpose of this study was to examine the relationship between hip extensor strength and back extensor length in patients with low back pain (LBP) and healthy controls., Methods: In 266 patients with LBP and 215 matched controls, back extensor length and hip extensor strength were measured and compared in the 2 groups using an independent t test. The Pearson correlation coefficient was used to determine correlation between these 2 variables. Multivariate logistic regression was used to test the risk of sustaining LBP with having these muscle insufficiencies., Results: A significant difference in hip extensor strength was found between patients with LBP and controls (P < .001). Back extensor length was different in healthy men compared with the patients with LBP (P < .001) but was not significant between women with and without LBP (P = .34). The results showed a significant relationship between back extensor length and hip extensor strength in men with LBP (r = 0.6, P = .01). Multivariate logistic regression revealed that having a weak hip extensor (P = .001) or shortened back extensor (P = .01) could increase the risk of LBP occurrence., Conclusion: The findings support the assumptions of the presence of muscle imbalance of hip extensor weakness and back extensor tightness in male patients with LBP and that each muscle impairment may contribute to LBP., (Copyright © 2019. Published by Elsevier Inc.)

Objective: The purpose of this study was to assess muscle thickness changes in the deep and superficial abdominal muscles, during sitting on stable and unstable surfaces in subjects with and without chronic low back pain (CLBP)., Method: A cross-sectional study was conducted involving 40 participants (20 CLBP and 20 healthy). Ultrasound imaging was used to assess changes in the thickness of the Transversus abdominis (TrA), Internal Oblique (IO), Rectus abdominis (RA) and External oblique (EO) muscles. Muscle thickness under two different sitting postures; (sitting on a chair and sitting on a Swiss ball), was normalized to actual muscle thickness at rest in the supine lying position and was expressed as a percentage of thickness change of muscles., Result: The results showed significantly greater thickness changes in RA muscle in the CLBP patients compared to the healthy subjects, during both stable and unstable sitting positions. Also, significantly lower thickness changes in TrA muscle was observed in subjects with CLBP compared to those without CLBP, during unstable sitting position., Conclusion: There was an imbalance between the automatic activity of TrA and RA muscles in the subjects with CLBP, compared to the pain-free controls, during an unstable sitting position. Therefore, it is necessary to pay attention, to the altered automatic activity of the abdominal muscles while utilizing a Swiss ball, for rehabilitation of subjects with CLBP., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Objective: The aim of this case report is to describe the use of Dry Needling (DN) in myofascial tracks related to the pelvic floor (PF) in the management of a male with Non-Relaxing Pelvic Floor Dysfunction (NRPFD)., Clinical Features: A 42-year-old man, with a 20-year history of frequent urination, was referred to the physical therapy clinic by a urologist with diagnosis of NRPFD. The patient was suffering from a sense of incomplete evacuation and difficulty to start urination. He had to urinate every 30 min. The initiation of urination was so difficult that patient had to facilitate it by splashing warm water on his penis., Intervention and Outcome: DN was performed for 10 sessions. The first three sessions were performed every other day in the same week. In the second week, DN was performed twice at three-day intervals, and the other sessions were performed such that one session was held per week. Selected stretching exercises were prescribed in the first session. The results showed that the patient had reported no urination during sleep, and urination six to eight times when was awake. A three-month follow-up with a telephone-based interview showed that the symptoms did not recur., Conclusion: This study showed the possible efficacy of prescribing DN in myofascial tracks in the management of a male with NRPFD. More studies are required to clarify the issue., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Objective: The purpose of this study was to compare the relationship between flexion endurance capacity and joint position error in participants with or without chronic neck pain (CNP)., Methods: Sixty-one CNP and 60 asymptomatic volunteers participated in this cross-sectional, case-control, and correlational analysis study. The measured variables included absolute and constant joint repositioning errors in the sagittal and horizontal directions, clinical flexor endurance test score, pain intensity, and neck disability index., Results: The groups did not statistically differ in flexion endurance (P > .05). The CNP group had a smaller absolute error on the right (P < .01) and left (P = .01) rotation and an overshooting error pattern in the flexion direction (P < .05). But the asymptomatic group did not exhibit any over-/undershooting pattern tendency (P > .05). Although flexion endurance was not correlated with any of the joint repositioning error components in either group, pain and disability scores were significantly correlated with left rotation absolute error (r = -0.34 and ρ = -0.37, respectively)., Conclusion: The clinical cervical flexor endurance test, ignoring the relative contribution of the deep and superficial groups of muscles, may not efficiently characterize CNP patients., (Copyright © 2018. Published by Elsevier Inc.)

Study Design: Randomized clinical trial., Introduction: KinesioTape (KT) is a noninvasive method to treat pain and muscular dysfunction., Purpose: To investigate the effect of KT with and without tension on pain intensity, pain pressure threshold, grip strength and disability in individuals with lateral epicondylitis, and myofacial trigger points in forearm muscles., Methods: Thirty women with lateral epicondylitis and myofacial trigger point in forearm muscles were randomly assigned to KT with tension and placebo (KT without tension). The treatment was provided 3 times in one week, and outcome measures were assess pre-post treatment., Results: The mean score of visual analogue scale (VAS) during activity decreased significantly from 6.4 and 6 pretest to 2.53 and 4.66 posttest, respectively, for the KT with and without tension groups. The mean score of Disabilities of the Arm, Shoulder and Hand decreased significantly from 16.82 and 22.79 pretest to 8.65 and 8.29 posttest, respectively, for the KT with and without tension groups. A paired t-test revealed a significant reduction in VAS during activity and Disabilities of the Arm, Shoulder and Hand before and after treatment in both groups (P < .05). Pain pressure threshold, grip strength, and VAS using an algometer revealed no significant differences. The study showed no significant difference in variables immediately after intervention., Discussion: Improvements in functional disability were superior when KT was used with tension, than obtained with a placebo-no tension application., Conclusion: The application of KT produces an improvement in pain intensity and upper extremity disability in subjects with LE and MTP in forearm muscles, and KT with tension was more effective than placebo group., Level of Evidence: NA., Trial Registration Number: 100-216., (Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.)

Background: Changes in the orientation of ultrasound (US) transducer relative to the body surface during dynamic standing tests can affect US measurements., Objective: The purpose of the study was to evaluate ultrasound imaging transducer motion while measuring the lateral abdominal muscle thickness during standing tasks with and without using transducer fixator (TF)., Design: Cross-sectional experimental study., Methods: A digital optical motion analysis system was used to assess the motions of US transducer during double-leg stance in different levels of platform stability of Biodex Balance System (BBS) (static, levels 6 and 3) with and without using TF in 45 healthy individuals. In addition, lateral abdominal muscle thickness was evaluated by US imaging., Results: The results indicated that the amount of angular and linear transducer motions during static and dynamic standing tasks significantly decreased by the use of TF as compared to the conditions without TF (P < 0.001, effect size> 0.84)., Conclusion: TF can significantly control US transducer motions within acceptable threshold limits during standing postural task. This may improve the clinical application of US imaging., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Ankle sprain is one of the most common injuries among athletes and the general population. Most ankle injuries commonly affect the lateral ligament complex. Changes in postural sway and hip abductor muscle strength may be generated after inversion ankle sprain. Therefore, the consequences of ankle injury may affect proximal structures of the lower limb. The aim is to describe and compare the activity patterns of distal and proximal lower limb muscles following external perturbation in individuals with and without functional ankle instability. The sample consisted of 16 women with functional ankle instability and 18 healthy women were recruited to participate in this research. The external perturbation via body jacket using surface electromyography, amplitude and onset of muscle activity of gluteus maximums, gluteus medius, tibialis anterior, and peroneus longus was recorded and analyzed during external perturbation. There were differences between the onset of muscles activity due to perturbation direction in the two groups (healthy and functional ankle instability). In the healthy group, there were statistically significant differences in amplitude of proximal muscle activity with distal muscle activity during front perturbation with eyes open and closed. In the functional ankle instability group; there were statistically significant differences in amplitude of proximal muscle activity with distal muscle activity during perturbation of the front and back with eyes open. There were statistically significant differences in the onset of muscle activity and amplitude of muscle activity, with-in and between groups (P<0.05). Therefore, in the presence of functional ankle instability, activation patterns of the lower limb proximal muscles may be altered., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: Dynamic tasks over unstable surfaces are commonly done in daily activities., Objective: A number of studies indicated positive effect of doing postural tasks over unstable surface on trunk muscle activities in patients with low back pain (LBP), while the others reported opposite effects. Due to lack of consensus in the findings in this area of research, we aimed to systematically review studies, which investigated the effect of surface instability on trunk muscle activity in patients with LBP as compared to healthy individuals., Methids: A literature search was performed using the PubMed, Science Direct, OVID, CINAHL, PEDro, Cochrane, Scopus and MEDLINE databases. Low back pain, unstable surface, posture or stability and trunk muscle activity were applied as keywords. The methodological quality was examined using valid assessment tools., Results: The activity of superficial trunk muscles is impaired in patients with LBP during dynamic tasks over unstable surfaces. Differences in the methodology of included studies could be considered as reasons behind the inconsistencies in the findings in included studies. These studies included investigation of superficial or deep muscles, the timing of recorded muscle activity, the level of surface instability and the length of time over unstable surfaces., Conclusion: Dynamic tasks over unstable surfaces could decrease pre-program reaction (PPR) and increase voluntary reaction (VR) of superficial trunk muscles in patients with LBP, which may reduce the ratio of deep versus superficial muscles, compared to healthy individuals.

Background: The sacroiliac joint (SIJ) has been implicated as a potential source of low back and buttock pain. Several types of motion palpation and pain provocation tests are used to evaluate SIJ dysfunction., Objective: The purpose of this study was to investigate the relationship between motion palpation and pain provocation tests in assessment of SIJ problems., Design: This study is Descriptive Correlation., Methods: 50 patients between the ages of 20 and 65 participated. Four motion palpation tests (Sitting flexion, Standing flexion, Prone knee flexion, Gillet test) and three pain provocation tests (FABER, Posterior shear, Resisted abduction test) were examined. Chi-square analysis was used to assess the relationship between results of the individuals and composites of these two groups of tests., Results: No significant relationship was found between these two groups of tests., Conclusions: It seems that motion palpation tests assess SIJ dysfunction and provocative tests assessed SIJ pain which do not appear to be related., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background: Prone hip extension (PHE) is a common and widely accepted test used for assessment of the lumbo-pelvic movement pattern. Considerable increased in lumbar lordosis during this test has been considered as impairment of movement patterns in lumbo-pelvic region. The purpose of this study was to investigate the change of lumbar lordosis in PHE test in subjects with and without low back pain (LBP)., Method: A two-way mixed design with repeated measurements was used to investigate the lumbar lordosis changes during PHE in two groups of subjects with and without LBP. An equal number of subjects ( N  = 30) were allocated to each group. A standard flexible ruler was used to measure the size of lumbar lordosis in prone-relaxed position and PHE test in each group., Result: The result of two-way mixed-design analysis of variance revealed significant health status by position interaction effect for lumbar lordosis ( P  < 0.001). The main effect of test position on lumbar lordosis was statistically significant ( P  < 0.001). The lumbar lordosis was significantly greater in the PHE compared to prone-relaxed position in both subjects with and without LBP. The amount of difference in positions was statistically significant between two groups ( P  < 0.001) and greater change in lumbar lordosis was found in the healthy group compared to the subjects with LBP., Conclusions: Greater change in lumbar lordosis during this test may be due to more stiffness in lumbopelvic muscles in the individuals with LBP.

Background: Multiple sclerosis (MS) is the most widespread disabling neurological condition in young adults around the world. The purpose of this study was to investigate the impact of explicit information (EI) on motor-sequence learning in MS patients., Methods: Thirty patients with relapsing-remitting MS (RRMS), age: 29.5 (SD = 5.6) years and 30 healthy gender-, age-, and education-matched control group participants, age: 28.8 (SD = 6.0) years, were recruited for this study. The participants in the healthy group were then randomly assigned into an EI ( n = 15) group and a no-EI ( n = 15) group. Similarly, the participants in the control group were then randomly assigned into EI ( n = 15) and no-EI ( n = 15) groups. The participants performed a serial reaction time (SRT) task and reaction times. A retention test was performed after 48 hours., Results: All participants reduced their reaction times across acquisition (MS group: 46.4 (SD = 3.3) minutes, P < 0.001, and healthy group: 39.4 (SD = 3.3) minutes, P < 0.001). The findings for the within-participants effect of repeated measures of time were significant (F (5.06, 283.7) = 71.33. P < 0.001). These results indicate that the interaction between group and time was significant (F (5.06, 283.7) = 6.44. P < 0.001), which indicated that the reaction time in both groups was significantly changed between the MS and healthy groups across times (B1 to B10). The main effect of the group (MS and healthy) (F (1, 56) = 22.78. P < 0.001) and also the main effect of no-EI vs EI (F (1, 56) = 4.71. P < 0.001) were significant., Conclusion: This study demonstrated that that RRMS patients are capable of learning new skills, but the provision of EI prior to physical practice is deleterious to implicit learning. It is sufficient to educate MS patients on the aim and general content of the training and only to provide feedback at the end of the rehabilitative session., Competing Interests: Conflict of Interests The authors did not have any conflicts of interests.

The aim of this study was to systematically review the evidence on respiratory function changes in patients with chronic neck pain. MEDLINE, Elsevier, ProQuest, PubMed, Scopus, Springer, and Google scholar electronic databases were explored thorough December 2015. English-language studies investigating cervical musculoskeletal and respiratory parameters in patients with chronic neck pain were included. Characteristics of the patients, sampling method and size, musculoskeletal and respiratory parameters studied, and appropriateness of the statistical tests were considered. Studies were rated based on study design and performance. Of the 68 studies reviewed, 9 observational studies met our inclusion criteria. Significant difference in maximum inspiratory and expiratory pressures were reported in patients with chronic neck pain compared to asymptomatic subjects. Some of the respiratory volumes were found to be lower in patients with chronic neck pain. Muscle strength and endurance, cervical range of motion, and psychological states were found to be significantly correlated with respiratory parameters. Lower Pco2 in patients and significant relationship between chest expansion and neck pain were also shown. Respiratory retraining was found to be effective in improving some cervical musculoskeletal and respiratory impairment. Functional pulmonary impairments accompany chronic neck pain. Based on the observed association, investigation of the effectiveness of management of CNP on respiratory function is strongly suggested.

Objective: The purpose of this study was to compare the effect of abdominal hollowing (AH) and abdominal bracing (AB) maneuvers on the activity pattern of lumbopelvic muscles during prone hip extension (PHE) in participants with or without nonspecific chronic low back pain (CLBP)., Methods: Twenty women with or without CLBP participated in this cross-sectional observational study. The electromyographic activity (amplitude and onset time) of the contralateral erector spinae (CES), ipsilateral erector spinae (IES), gluteus maximus, and biceps femoris muscles was measured during PHE with and without abdominal maneuvers. A 3-way mixed model analysis of variance and post hoc tests were used for statistical analysis., Results: Between-group comparisons showed that the CES onset delay during PHE alone was greater (P = .03) and the activity level of IES, CES, and biceps femoris in all maneuvers (P < .05) was higher in patients with CLBP than in asymptomatic participants. In asymptomatic participants, PHE + AH significantly decreased the signal amplitude (AMP) of IES (P = .01) and CES (P = .02) muscles. In participants with CLBP, IES muscle AMP was lower during PHE + AH compared with PHE + AB and PHE alone. With regard to onset delay, the results also showed no significant difference between maneuvers within either of the 2 groups (P > .05)., Conclusions: Performance of the AH maneuver decreased the erector spinae muscle AMP in both groups, and neither maneuver altered the onset delay of any of the muscles in either group. The low back pain group showed higher levels of activity in all muscles (not statistically significant in gluteus maximus during all maneuvers). The groups were similar according to the onset delay of any of the muscles during either maneuver., (Copyright © 2016. Published by Elsevier Inc.)

Background: Ultrasound (US) imaging can be used for the measurement of trunk muscle activity. The displacements of US transducer, especially during more dynamic situations, however, may disturb the measurement results. To control this variable, some studies have used transducer fixator (TF), but no study evaluated the effect of using TF on US reliability in dynamic situations. The present study discriminated this issue., Objective: To investigate the intrasession and intersession reliability of lateral abdominal muscle thickness measurement in dynamic standing postural tasks by using US with and without TF in participants with and without chronic low back pain (CLBP)., Design: An intersession and intrasession reliability study., Setting: Biomechanics laboratory, Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran., Participants: Twenty-three patients with CLBP and 23 healthy matched individuals., Methods: Abdominal muscle thickness of all the subjects was evaluated with use of US imaging with the patient in the supine position and double-leg stance at different levels of platform stability of BBS (static, levels 6 and 3), with and without using TF. Intraclass correlation coefficients (ICCs), standard errors of measurement, minimal metrically detectable changes, and coefficients of variation were calculated to determine intersession and intrasession reliability of muscle activity measure., Main Outcome Measurements: Lateral abdominal muscle thickness., Results: The intersession ICCs in the conditions with TF ranged from 0.93 to 0.98 and 0.97 to 0.99 in CLBP and healthy individuals, respectively. The intersession ICCs in the conditions without TF ranged from 0.67 to 0.79 and 0.7 to 0.86 in CLBP and healthy groups, respectively. In addition, smaller standard errors of measurement and minimal metrically detectable change values were observed with US measurement in both the groups when TF was used., Conclusion: US imaging appears to have acceptable reliability for the assessment of abdominal muscle thickness during dynamic standing tasks in individuals with and without CLBP. The use of TF results in greater levels of reliability during US measurement of abdominal muscle., Level of Evidence: III., (Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.)

Objective: The purpose of this study was to investigate the effect of dry needling (DN) on pain intensity and pressure pain threshold (PPT) compared with ischemic compression (IC) immediately and 48 hours after each treatment session in individuals with myofascial trigger points in the upper trapezius muscle., Methods: Thirty-one patients with myofascial trigger points in the upper trapezius muscle participated in this study. Patients were randomly assigned to a standard (N = 17) or experimental group (N = 14). The treatment protocol for the standard group consisted of IC, whereas the patients in the experimental group received DN., Results: The results indicated that the effect size of the DN methods for pain intensity and PPT was considerably greater after 2 days compared with immediately after the treatment session. In contrast, the effect of the IC for PPT was greater immediately after treatment compared with the measures after 2 days. There was also no noticeable difference in the effect size for IC on pain intensity between the scores obtained immediately and 2 days after treatment. However, our data also revealed a greater effect size for DN on PPT after 2 days compared with the IC technique., Conclusions: In this study, DN improved the pain intensity and PPT after 2 days. However, it had no clinical improvement immediately after application because of muscle soreness. Thus, assessment of the effect of DN immediately after application can be criticized, and the results should be interpreted with caution.

Objective: The purpose of this study was to investigate the relationship between flexion-rotation test and ultrasound (US) thickness measurement of the antero-lateral abdominal muscles., Design: Following ethical approval, a convenience sample of 55 subjects between the ages of 20 and 30 years participated in this study. Endurance of the abdominal muscles was measured using the flexion-rotation test in all subjects. US thickness measurement for the transversus abdominis (TrA), internal oblique (IO) and external oblique (EO) muscles was performed on the right side at rest in a supine position., Results: Pearson correlation coefficient between the variables of the study showed no significant relationship between the flexion-rotation test and US thickness measurements of the TrA (r = -0.03, P = 0.80), IO (r = -0.13, P = 0.32), and EO (r = -0.14, P = 0.31) muscles. The significance level of 0.05 was chosen., Conclusion: It seems that there is no significant relationship between the flexion-rotation test and US measurement of abdominal muscles thickness.

Objectives: Biofield treatments have been used for pain control in patients with cancer and chronic pain. However, research on the effect of biofield treatment on specific somatic disorders is lacking. This study intends to investigate the effect of oscillating biofield therapy (OBFT) on symptoms of carpal tunnel syndrome., Design: Randomized, placebo-controlled, double-blind study., Participants: Thirty patients with chronic carpal tunnel syndrome participated in the study., Intervention: Patients were randomly assigned to active or placebo treatment groups. Those in the treatment group received six sessions of OBFT with intention to treat during a period of 2 weeks. Patients in the placebo group had the same number of treatment sessions with mock OBFT treatment., Outcome Measure: The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire; Symptom Severity Scale (SSS); and Functional Status Scale (FSS) were used for outcome assessment., Results: Both clinically and statistically significant changes in intensity of pain with activity (95% confidence interval [CI], 2.5-4.2; p = 0.000), night pain (p = 0.000, 95% CI, 3.2-5.7), DASH questionnaire (95% CI, 12.0-21.9; p = 0.000), SSS (95% CI, 0.64-1.15; p = 0.003), and FSS (95% CI, 0.41-0.97; p = 0.029) were found between the treatment and placebo groups. Statistically significant reduction in number of patients with positive results on the Phalen test (87%; p = 0.000), Tinel sign (73%; p = 0.000), and hand paresthesia (80%; p = 0.000) was noted in the treatment group. During 6-month follow-up, 86% of patients in the treatment group remained pain free and had no functional limitations., Conclusion: OBFT can be a viable and effective treatment for improving symptoms and functional limitations associated with chronic carpal tunnel syndrome., Competing Interests: Author Disclosure Statement No competing financial interests exist.