Einas Al-Eisa

Effects of pelvic asymmetry and low back pain on trunk kinematics during sitting: a comparison with standing.

Study Design. A prospective study was conducted on a group of patients with unilateral nonspecific low back pain (LBP) and healthy controls. Objectives. To answer 3 questions: (1) Does pelvic asymmetry measured in standing affect the dynamics of motion performed in sitting? (2) Do patients with LBP perform trunk motions differently from non-LBP participants in sitting position? and (3) Do the kinematics of lateral flexion and axial rotation differ between sitting and standing positions? Summary of Background Data. The effect of pelvic asymmetry on trunk motion while sitting remains unclear. LBP has been associated with altered trunk kinematics in standing; however, there is limited information available describing trunk kinematics in sitting position in comparison to standing. Methods. Pelvic asymmetry was measured in 54 patients with unilateral nonspecific LBP and 59 control subjects. A motion-analysis system was used to test the range and symmetry of lateral flexion and axial rotation in sitting and standing positions. Bivariate correlations, regression, multivariate analysis of variance, and paired sample t tests were used to test for associations between variables and differences between groups. Results. We found significant: (1) correlations between pelvic asymmetry and asymmetric trunk motion performed in sitting, (2) differences between the LBP and control groups in patterns of trunk motion performed in a sitting posture, and (3) differences between kinematics of motions performed in sitting versus standing postures. Conclusions. This study shows a link between pelvic asymmetry and altered trunk motion in sitting position. We suggest that people with LBP may have a distinct compensatory mechanism, secondary to pelvic asymmetry, which puts the lumbar spine under higher stress. Movement asymmetry, rather than range of motion, may be a better indicator of disturbed function for people with LBP. Structural and functional asymmetries are factors that may be considered in the seating design and work environment.

Effects of pelvic skeletal asymmetry on trunk movement: three-dimensional analysis in healthy individuals versus patients with mechanical low back pain.

Study Design. Comparative analysis and correlational research design were used to investigate the association between anthropometry and biomechanical performance among asymptomatic subjects and patients with low back pain (LBP). Objectives. To examine the association between pelvic asymmetry and patterns of trunk motion in asymptomatic and LBP subjects. Secondary objective was to investigate the association between restricted trunk motion, laterality of referred pain, and pelvic asymmetry. Summary of Background Data. Subtle pelvic asymmetry (exhibited as either lateral pelvic tilt or iliac rotational asymmetry), which is common among normal individuals, has not been convincingly linked to abnormalities in back movements. Given the difficulty in diagnosing most LBP, a classification using pelvic asymmetry and patterns of movement could be helpful in establishing a rational treatment plan. Methods. Fifty-nine subjects with no history of LBP and 54 patients with mechanical unilateral LBP were tested. An anthropometric frame was used to measure pelvic asymmetry in standing. Dynamic motion data, comprised of the principal and coupled movements, were collected using the Qualysis Motion Capture System. Results. While the groups did not differ in the total range of lumbar movement, the LBP group exhibited significantly higher asymmetry in the principal motion. The groups differed significantly in the pattern of coupled rotation during lateral flexion. Asymmetry in lumbar lateral flexion was highly related to two types of pelvic asymmetry: lateral pelvic tilt (LPT) and iliac rotation asymmetry (IRA). Asymmetry in lumbar axial rotation was highly related to IRA but weakly related to LPT. Conclusions. This study demonstrates objective differences in patterns of lumbar movement between asymptomatic subjects and patients with LBP. The study also demonstrates that subtle anatomic abnormality in the pelvis is associated with altered mechanics in the lumbar spine. We suggest that asymmetry of lumbar movement may be a better indicator of functional deficit than the absolute range of movement in LBP.

Fluctuating asymmetry and low back pain

Fluctuating asymmetry (FA), a pattern of bilateral variation that is normally distributed around a mean of zero, appears to correlate inversely with fitness and health. In this study, we compared the FA of asymptomatic control subjects (n=51) and patients with low back pain (n=44). We measured eight traits, from the upper and lower limbs, and used them to obtain asymmetry indices for each subject. We also measured pelvic asymmetry in standing subjects. The low back pain (LBP) group showed significantly higher asymmetry in the pelvis, and in ulnar length and bistyloid breadth. Our results demonstrate a link between LBP and asymmetry not only in a weight-bearing trait (i.e., pelvic configuration), but in two traits that are not functionally related to the back (i.e., ulnar length and bistyloid breadth). We can now consider LBP as another health and fitness measure correlated with FA.

Physical Activity and Health Beliefs among Saudi Women

Background. Physical activity (PA) is associated with health benefits and disease prevention and is often prescribed in managing many health conditions. Understanding the cultural influences is relevant in order to effectively promote PA. The objective of this study was to assess the level of PA among Saudi women, measured by daily step count, and the association between PA and health beliefs. Methods. A total of 161 eligible participants were asked to complete two questionnaires to assess health beliefs: Health Locus of Control (HLC) and Self-Efficacy Assessment Scale. Each participant was given a pedometer and a diary to record their daily PA for two weeks. Results. One hundred and five participants completed the two weeks pedometer data (mean age 26.3 ± 7.1 years, BMI 25 ± 4.2 kg/m2). The average pedometer score over two weeks was 5114 ± 2213 steps. Step count had strong correlation with self-efficacy (r s = 0.75), mild correlation with internal HLC (r s = 0.42), and mild negative correlation with external HLC (r s = −0.35). Conclusion. The study demonstrates high level of inactivity among Saudi females in reference to the international recommendation for minimum activity. The data also reveal an association between PA and health beliefs. Ultimately, such information can be used to design gender- and culture-sensitive interventions that could enhance adherence to PA.

Physical activity and lifestyle effects on bone mineral density among young adults: sociodemographic and biochemical analysis.

[Purpose] The purpose of this study was to assess the possible role of physical activities, calcium consumption and lifestyle factors in both bone mineral density and bone metabolism indices in 350 young adult volunteers. [Subjects and Methods] All volunteers were recruited for the assessment of lifestyle behaviors and physical activity traits using validated questioners, and bone mineral density (BMD), serum osteocalcin (s-OC), bone-specific alkaline phosphatase (BAP), and calcium were estimated using dual-energy X-ray absorptiometry analysis, and immunoassay techniques. [Results] Male participants showed a significant increase in BMD along with an increase in bone metabolism markers compared with females in all groups. However, younger subjects showed a significant increase in BMD, OC, BAP, and calcium compared with older subjects. Osteoporosis was more common in older subjects linked with abnormal body mass index and waist circumference. Bone metabolism markers correlated positively with BMD, physically activity and negatively with osteoporosis in all stages. Also, moderate to higher calcium and milk intake correlated positively with higher BMD. However, low calcium and milk intake along with higher caffeine, and carbonated beverage consumption, and heavy cigarette smoking showed a negative effect on the status of bone mineral density. Stepwise regression analysis showed that life style factors including physical activity and demographic parameters explained around 58–69.8% of the bone mineral density variation in young adults especially females. [Conclusion] body mass index, physical activity, low calcium consumption, and abnormal lifestyle have role in bone mineral density and prognosis of osteoporosis in young adults.

Therapeutic Effects of Whole-Body Vibration Training in Knee Osteoarthritis: A Systematic Review and Meta-Analysis

OBJECTIVE To examine the current evidence regarding the effects of whole-body vibration (WBV) training in individuals with knee osteoarthritis (OA). DATA SOURCES We searched PubMed, CINAHL, Embase, Scopus, Physiotherapy Evidence Database (PEDro), and Science Citation Index for research articles published prior to January 2015 using the keywords whole body vibration, vibration training, and vibratory exercise in combination with the Medical Subject Heading osteoarthritis knee. STUDY SELECTION This meta-analysis was restricted to randomized controlled trials published in the English language. The quality of the selected studies was assessed by the PEDro Scale. The risk of bias was assessed using the Cochrane collaborations tool in the domain-based evaluation. We also evaluated the quality of each study based on the criteria given by the International Society of Musculoskeletal and Neuronal Interactions for reporting WBV intervention studies, consisting of 13 factors. DATA EXTRACTION Descriptive data regarding subjects, design, intervention, WBV parameters, outcomes, and conclusions were collected from each study by 2 independent evaluators. The mean and SD of the baseline and final endpoint scores for pain, stiffness, and function were extracted from the included studies. DATA SYNTHESIS A total of 83 studies were found in the search. Of these, 5 studies met the inclusion criteria and were further analyzed. Four of these 5 studies reached high methodologic quality on the PEDro Scale. Overall, studies demonstrated mixed results in favor of additive effects of WBV for reducing pain and improving function in knee OA. There was considerable variation in the parameters of the WBV included in this systematic review. CONCLUSIONS WBV training reduces pain and improves function in individuals with knee OA.

Correlation between vitamin D levels and muscle fatigue risk factors based on physical activity in healthy older adults

Purpose The purpose of this study was to investigate the relationship of serum vitamin D levels with physical activity, obesity, muscle fatigue biomarkers, and total antioxidant capacity (TAC) in healthy older adults. Methods A total of 85 healthy older subjects aged 64–96 years were recruited in this study. Based on estimated energy expenditure scores, the participants were classified into three groups: inactive (n=25), moderate (n=20), and physically active (n=35). Serum 25(OH)D (25-hydroxy vitamin D) levels, metabolic syndrome parameters, TAC activity, muscle fatigue biomarkers (Ca, creatine kinase, lactic acid dehydrogenase, troponin I, hydroxyproline), physical activity, body fatness, and fatigue score (visual analog scale) were estimated using immunoassay techniques and prevalidated questionnaires, respectively. Results Physical activity was estimated in 64.6% of the participants. Males showed higher physical activity (42.5%) compared to females (26.25%). Compared to participants with lower activity, significant reduction in body mass index, waist circumference, hips, fasting blood sugar, triglycerides, total cholesterol, HDL-cholesterol, and LDL-cholesterol were observed in moderate and physically active participants. Also, significant increase in the levels of serum 25(OH)D concentrations, calcium, and TAC activity along with reduction in the levels of muscle fatigue biomarkers: creatine kinase, lactic acid dehydrogenase, troponin I, hydroxyproline, and fatigue scores (visual analog scale) were reported in physically active participants compared to those of lower physical activity. In all participants, serum 25(OH)D concentrations correlated positively with Ca, TAC, physical activity scores, and negatively with body mass index, lipid profile, fatigue scores (visual analog scale), and muscle fatigue biomarkers. Stepwise regression analysis showed that serum 25(OH)D concentrations, physical activity, Ca, TAC, and demographic parameters explained approximately 61.4%–85.8% of reduction in both fatigue scores and muscle fatigue biomarkers with substantial improvement in muscle performance in healthy older adults. Conclusion The data showed that considerable levels of 25(OH)D concentrations, calcium intake, and lower obesity positively correlated with the improvement in the muscle relief and performance of physically active participants. These results demonstrate that 25(OH)D concentrations and calcium might prevent muscle fatigue by regulation of the biosynthesis of creatine kinase, lactic acid dehydrogenase, troponin I, and hydroxyproline via a proposed antifree radical mechanism reported by higher TAC activity. It was suggested that vitamin D status could be reported as a marker of the improvement of muscle performance, especially in healthy older adults with lower physical activity.

Effects of Moderate Aerobic Exercise on Cognitive Abilities and Redox State Biomarkers in Older Adults

We used a moderate aerobic exercise program for 24 weeks to measure the positive impact of physical activity on oxidative stress and inflammatory markers and its association with cognitive performance in healthy older adults. A total of 100 healthy subjects (65–95 Yrs) were randomly classified into two groups: control group (n = 50) and exercise group (n = 50). Cognitive functioning, physical activity score, MDA, 8-OHdG, TAC, and hs-CRP were assessed using LOTCA battery, prevalidated PA questionnaire, and immunoassay techniques. LOTCA 7-set scores of cognitive performance showed a significant correlation with physical activity status and the regulation of both oxidative stress free radicals and inflammatory markers in all older subjects following 24 weeks of moderate exercise. Physically active persons showed a higher cognitive performance along with reduction in the levels of MDA, 8-OHdG, and hs-CRP and increase in TAC activity compared with sedentary participants. Cognitive performance correlated positively with the increase in TAC activity and physical fitness scores and negatively with MDA, 8-OHdG, and hs-CRP, respectively. There was a significant improvement in motor praxis, vasomotor organization, thinking operations, and attention and concentration among older adults. In conclusion, moderate aerobic training for 24 weeks has a positive significant effect in improving cognitive functions via modulating redox and inflammatory status of older adults.

Correlation between bone mineral density and serum trace elements in response to supervised aerobic training in older adults.

Background Life style and physical activity play a pivotal role in prevention and treatment of osteoporosis. The mechanism for better bone metabolism and improvement of physical disorders is not clear yet. Trace minerals such as Ca, Mn, Cu, and Zn are essential precursors for most vital biological process, especially those of bone health. Objective The main target of this study was evaluating the effective role of supervised aerobic exercise for 1 hour/day, 3 days/week for 12 weeks in the functions of trace elements in bone health through measuring bone mineral density (BMD), osteoporosis (T-score), bone markers, and trace element concentrations in healthy subjects aged 30–60 years with age average of 41.2±4.9. Methods A total of 100 healthy subjects (47 males, 53 females; age range 30–60 years) were recruited for this study. Based on dual-energy x-ray absorptiometry (DEXA) scan analysis, the participants were classified into three groups: normal (n=30), osteopenic (n=40), and osteoporotic (n=30). Following, 12 weeks of moderate aerobic exercise, bone-specific alkaline phosphatase (BAP), BMD, T-score, and trace elements such as Ca, Mn, Cu, and Zn were assessed at baseline and post-intervention. Results Significant improvement in serum BAP level, T-score, and BMD were observed in all participants following 12 weeks of moderate exercise. Participants with osteopenia and osteoporosis showed significant increase in serum Ca and Mn, along with decrease in serum Cu and Zn levels following 12 weeks of aerobic training. In control group, the improvements in serum trace elements and body mass index were significantly linked with the enhancement in the levels of BAP, BMD hip, and BMD spine. These results supported the preventive effects of moderate exercise in healthy subjects against osteoporosis. In both sexes, the changes in serum trace elements significantly correlated (P<0.05) with the improvement in BAP, BMD hip, BMD spine, and body mass index in all groups. Conclusion The observed changes in the levels of Ca, Mn, Cu, and Zn were shown to be positively correlated with improved bone mass density among control and osteoporosis subjects of both sexes. These results demonstrate that aerobic exercise of moderate intensity might protect bone and cartilage by regulation of body trace elements which are involved in the biosynthesis of bone matrix structures and inhibition of bone resorption process via a proposed anti-free radical mechanism.

Effectiveness of Non-Pain-Contingent Spine Rehabilitation in Females with Chronic Low Back Pain: A Randomized Controlled Trial

Background: Evidence suggests that intensive rehabilitation programs (>100 hours) are effective in treating chronic low back pain (CLBP). However, less intensive, effective interventions are needed. Non-pain-contingent spine rehabilitation (NCSR) incorporating lifting training has been suggested, but its efficacy remains questionable. Objective: This study aimed to evaluate the effectiveness of NCSR, based on cognitive-behavioral therapy and lifting training, in decreasing pain and functional disability and in improving physical performance in females with CLBP. Methods: Fifty-four females with CLBP were randomized to receive either NCSR (n=28) or conventional physiotherapy (CPT) (n=26). Both groups received treatment twice a week for 6 weeks. Primary outcome measures were the visual analogue scale for pain and the Oswestry Disability Index. Secondary outcome measures included the range of motion for trunk flexion and extension, straight leg raising, Ito and Shirado tests, and progressive isoinertial lifting evaluation. Outcomes were assessed at baseline, week 4, and at discharge. Results: Both groups had a significant improvement in pain, functional disability measures, and all physical measures, but clinically relevant improvement was achieved only in the NSCR group. The NSCR group also showed a significantly greater improvement in trunk muscle endurance and lifting capacity scores. Conclusion: Patterns of improvement suggest that the NCSR approach is more effective than CPT in this subgroup of patients.