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Purpose: To evaluate the influence of different arm postures from the physiological standing position using force plate analysis of the gravity line. Methods: Forty healthy volunteered university students were enrolled. Each subject assumed different standing positions including standing with arms resting on the side (control), with fist over the clavicle (clavicular position), with active shoulder flexion in 30°, 60° and 90° with elbows extended (active flexion A), with hand rest on a bar with a static support (passive flexion P), and with hand rest on a bar with a drip stand (passive flexion D). The offset of the gravity line from the heel was measured by force plate analysis. The offset of the gravity line in different arm positions was compared with the control using paired t -test. Results: The mean anterior offset of the gravity line in control position is 39.80% of the foot length. All testing positions showed anterior shift of the gravity line compared with the control position from 0.51% to 7.50%. There were statistically significant changes of the gravity line from the control position in all ( p < 0.05), except in the clavicular position ( p = 0.249). Conclusion: All testing positions cause anterior shifting of the center of gravity from the physiological standing position. Clavicular position is the best comparable posture to the physiological standing position in taking a lateral radiograph. We recommend using the clavicular position as the standard testing position in the assessment of the sagittal profile.

Introduction: The efficacy of integrated physiotherapy work rehabilitation program to occupational non-specific low back pain (NSLBP) patients triaged by Orebro Musculoskeletal Pain Questionnaire (OMPQ) for psychosocial risks was investigated. Methods: 47 subjects were recruited and randomly allocated to either the integrated physiotherapy group or the conventional group. Red flags signs were screened out. The range of the age of the patients was between 18 and 55. They either had history injuries at work or were on sick leave upon recruitment with moderate psychosocial risk. Results: Statistics was performed on an intention-to-treat analysis. At discharge, the patients of integrated physiotherapy group displayed significant improvement of work recovery expectation, pain self-efficacy, overall subjective progress and satisfaction in comparison with the conventional group (p < 0.05). Both groups demonstrated significant improvement of all outcome measures except the recovery expectation showed no difference in the conventional group. Conclusion: The work related treatment components of integrated physiotherapy group adopted a cognitive behavioral approach may contribute to better improvement.

Three Chinese patients suffered from severe lumbar spinal stenosis with debilitating symptoms due to a rare condition of ligamentum flavum cysts in the midline of the lumbar spine. This disease is distinct from synovial cyst of the facet joints or ganglion cysts, both intraoperatively and histopathologically. Magnetic Resonance imaging features of the ligamentum flavum cyst are also demonstrated. We share our surgical experiences of identification of the ligamentum flavum cysts, decompression and excision for two of the patients with demonstrably good recovery. This disease should be considered in the differential diagnosis of an extradural instraspinal mass in patients with lumbar spinal stenosis. [ABSTRACT FROM AUTHOR]