Noureddin Karimi

Assessment of pelvic floor muscle contraction in stress urinary incontinent women: comparison between transabdominal ultrasound and perineometry

Introduction and hypothesisTransabdominal (TA) ultrasound and perineometry have been currently used to assess lifting aspect and squeezing action of pelvic floor muscles (PFM) function, respectively, in women with stress urinary incontinence (SUI). However, no study has directly compared these measurements. The purpose of this study was to investigate the reliability and correlation between perineometry and TA ultrasound as measurements of different aspect of PFM function.MethodsA total of 28 women with SUI participated in the study. Vaginal squeeze pressure using a perineometer and bladder base movement on TA ultrasound was measured. Scattergram was depicted to determine the correlation between variables. Intraclass correlation coefficient and Bland–Altman plot were used to assess reliability.ResultsScatter diagram depicted significant correlation of TA ultrasound with vaginal squeeze pressure (r = 0.72, R2 = 0.52, p < 0.0001). High reliability was found for measurements.ConclusionTA ultrasound measurement may be an alternative measurement to perineometry when assessing PFM function.

Reliability of ultrasound thickness measurement of the abdominal muscles during clinical isometric endurance tests

The study was designed to evaluate the intra-examiner reliability of ultrasound (US) thickness measurement of abdominal muscles activity when supine lying and during two isometric endurance tests in subjects with and without Low back pain (LBP). A total of 19 women (9 with LBP, 10 without LBP) participated in the study. Within-day reliability of the US thickness measurements at supine lying and the two isometric endurance tests were assessed in all subjects. The intra-class correlation coefficient (ICC) was used to assess the relative reliability of thickness measurement. The standard error of measurement (SEM), minimal detectable change (MDC) and the coefficient of variation (CV) were used to evaluate the absolute reliability. Results indicated high ICC scores (0.73-0.99) and also small SEM and MDC scores for within-day reliability assessment. The Bland-Altman plots of agreement in US measurement of the abdominal muscles during the two isometric endurance tests demonstrated that 95% of the observations fall between the limits of agreement for test and retest measurements. Together the results indicate high intra-tester reliability for the US measurement of the thickness of abdominal muscles in all the positions tested. According to the studys findings, US imaging can be used as a reliable method for assessment of abdominal muscles activity in supine lying and the two isometric endurance tests employed, in participants with and without LBP.

Evaluation of pelvic floor muscles activity with and without abdominal maneuvers in subjects with and without low back pain

BACKGROUND There was controversy in finding of studies related pelvic floor muscle (PFM) rehabilitation of subjects with low back pain (LBP), while this issue is very important for treatment of subjects with LBP. OBJECTIVE The purpose of this study was to evaluate PFM contraction in three conditions of alone and with abdominal hollowing (AH) or abdominal bracing (AB) maneuvers in subjects with and without chronic LBP. METHODS Subjects were divided into two groups: subjects with LBP (N = 25) and without LBP (N = 27). PFM contraction alone and during contraction with AH or AB maneuvers was measured. The amount of bladder base movement was measured as an indicator of PFM activity. RESULTS There were no differences in PFM activity between subjects with and without chronic LBP, when PFM contracted alone (P = 0.60), contracted with AH (P= 0.12) and AB maneuver (P = 0.54). Our data revealed that contraction of the PFM alone produce greater displacement of the bladder base than contraction of the PFM with AH (P = 0.005) or AB maneuver (P = 0.001) in both groups. However, no significant difference was found between contraction of the PFM with AH and AB maneuver in individuals with LBP (P = 0.31). CONCLUSION It seems that PFM contraction alone is more effective than PFM contraction with AH or AB maneuvers in lifting the pelvic floor in subjects with and without LBP.

Change in lumbar lordosis during prone lying knee flexion test in subjects with and without low back pain

BackgroundProne lying knee flexion (PLKF) is one of the clinical tests used for assessment of the lumbo-pelvic movement pattern. Considerable increase in lumbar lordosis during this test has been considered as impairment of movement patterns in lumbar-pelvic region. However, no study has directly evaluated the change in lordosis during active PLKF test in subjects with low back pain (LBP). The purpose of this study was to investigate the change of lumbar lordosis in PLKF test in subjects with and without LBP.MethodsA convenience sample of 80 subjects participated in the study. Subjects were categorized into two groups: those with chronic non-specific LBP (N = 40, mean age: 40.84 ± 17.59) and with no history of LBP (N = 40, mean age: 23.57 ± 10.61). Lumbar lordosis was measured with flexible ruler, first in prone position and then on active PKF test in both subjects with and without LBP. Data was analyzed by using statistical methods such as, independent t-test and paired t-test.ResultsThere were statistically significant differences in lumbar lordosis between prone position and after active PLKF in both subjects with and without LBP (P < 0.0001). The amount of change in lordosis during PLKF test was not significant between the two groups (P = 0.65). However these changes were greater among patients with LBP.ConclusionIncrease in lumbar lordosis during this test may be due to excessive flexibility of movement of the lumbar spine in the direction of extension and abnormal movement patterns in the individuals with LBP.

Scapular Upward Rotator Morphologic Characteristics in Individuals With and Without Forward Head Posture: A Case-Control Study: Scapular Upward Rotators in Forward Head Posture

There are several reports suggesting that forward head posture contributes to alterations in scapular kinematics and muscle activity, leading to the development of shoulder problems. Currently, it is unknown whether forward head posture alters the thickness of the scapular muscles. The aim of this study was to compare the thickness of the serratus anterior and upper and lower trapezius muscles at rest and during loaded isometric contractions in individuals with and without forward head posture.

Differential Activation of the Dorsal Neck Muscles During a Light Arm-Elevation Task in Patients With Chronic Nonspecific Neck Pain and Asymptomatic Controls: An Ultrasonographic Study

Disturbance in neck muscle function is a well‐known complication of chronic nonspecific neck pain (CNNP). It is, however, unclear which muscles are more susceptible to functional impairment in patients with CNNP during upper limb tasks.

The Effects of Forward Head Posture on Neck Extensor Muscle Thickness: An Ultrasonographic Study

Objective: This study aimed to compare neck extensor muscle thickness, thickness changes, and strength between participants with forward head posture (FHP) and controls with normal head posture (NHP). Methods: Twenty college students with FHP (mean age 21.30 ± 2.36 years) and 20 students with NHP (mean age 21.85 ± 2.78 years) participated in this case‐control study. The thickness of neck extensor muscles was measured at rest and at maximal voluntary isometric contraction (MVIC). In addition, the craniovertebral angle (CVA) was calculated. To compare thickness changes between the 2 groups and among 5 muscles, a 2‐way repeated measures analysis of variance was applied. In addition, Pearsons correlation test was performed to investigate the relationship between neck extensor MVIC and CVA. Results: The FHP group demonstrated lower MVIC compared with the NHP group (P = .03). Semispinalis capitis showed the smallest thickness changes during neck extensor MVIC in FHP compared with the controls (P < .001). However, no significant difference in terms of muscle thickness was observed between the 2 groups at the state of rest (P = .16‐.99). A positive association was also found between the MVIC and CVA (P = .02). Conclusions: Semispinalis capitis had less thickness changes during MVIC of neck extensors in individuals with FHP compared with those with NHP. This indirectly implies lower activity of this muscle in FHP condition. This study finding may help researchers develop therapeutic exercise protocols to manage FHP.

Association between composites of selected motion palpation and pain provocation tests for sacroiliac joint disorders

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.