Shihab Asfour

Stretching in the rehabilitation of low-back pain patients

The major objective of this investigation was to study the effectiveness of the physical conditioning program used at the University of Miami Comprehensive Pain and Rehabilitation Center in restoring certain elements of the functional abilities of individuals suffering from chronic low-back pain and to evaluate the effectiveness of using a systematically applied, aggressive stretching maneuver as an add-on therapy in the treatment of chronic low-back pain patients. The effect(s) of the proposed stretching maneuver was evaluated. Twenty-eight chronic low-back pain patients were randomly assigned to one of two groups. The control group underwent a multimodal rehabilitation program, and the experimental group underwent the same rehabilitation program in addition to the systematic stretching maneuver under investigation. The results obtained showed that patients undergoing the multimodal rehabilitation program with and without the proposed systematic stretching maneuver showed a significant improvement in their functional abilities as seen from the significant increase in the static strength of the back extensors, with corresponding significant increase in back muscle myoelectric signals. Also, a significant decrease in their pain level was reported after 2 weeks of continuous treatment. The use of the systematic stretching maneuver enhanced the functional gains of chronic low-back pain patients compared to the control group.

A comparison of isometric strength and dynamic lifting capability

A laboruiory study was conducted to determine if job specific static strength can be used to predict dynamic lifting capability (maximum acceptable weight of lift) based on psychophysical methodology. Nine male college students were required to lift three different tote boxes (containers) from a 38 cm height to a 81 cm high table using a semi-squat body posture. For each tote boxsialic strength was measured in three different ways. These were (i) maximum voluntary isometric strength (MVIS) measured at the origin in a vertical direction, (ii) MVIS measured close to the body in a vertical direction, and (iii) maximum acceptable weight that a subject could hold for 3 s at the origin of the dynamic lift, MVIS al the origin of lift, MVIS close to the body and holding the tote box explained 24.32 and 62% variation, respectively, in dynamic lifting capability. On the average, MVIS al the origin of lift, MVIS close to the body and holding the tote box were 46. 120. 72%, respectively, of dynamic lifting strength. ...

Development of Strength and Capacity Norms for Manual Materials Handling Activities: The State of the Art

Literature related to manual materials handling activities is reviewed and recommendations are made for the maximum acceptable weight of lift for male and female workers, based on the psychophysical approach.

Review, Evaluation, and Comparison of Models for Predicting Lifting Capacity

Models related to lifting activities have been classified and reviewed. Predictive models are grouped under psychophysical capacity modeling, physiological energy requirement modeling, and biomechanical stress modeling. Within each group, the models have been compared and evaluated. In addition, psychophysical and physiological model groups have been compared.

Pilot Study Comparing Changes in Postural Control After Training Using a Video Game Balance Board Program and 2 Standard Activity-Based Balance Intervention Programs

OBJECTIVE To compare the impacts of Tai Chi, a standard balance exercise program, and a video game balance board program on postural control and perceived falls risk. DESIGN Randomized controlled trial. SETTING Research laboratory. PARTICIPANTS Independent seniors (N=40; 72.5±8.40) began the training, 27 completed. INTERVENTIONS Tai Chi, a standard balance exercise program, and a video game balance board program. MAIN OUTCOME MEASURES The following were used as measures: Timed Up & Go, One-Leg Stance, functional reach, Tinetti Performance Oriented Mobility Assessment, force plate center of pressure (COP) and time to boundary, dynamic posturography (DP), Falls Risk for Older People-Community Setting, and Falls Efficacy Scale. RESULTS No significant differences were seen between groups for any outcome measures at baseline, nor were significant time or group × time differences for any field test or questionnaire. No group × time differences were seen for any COP measures; however, significant time differences were seen for total COP, 3 of 4 anterior/posterior displacement and both velocity, and 1 displacement and 1 velocity medial/lateral measure across time for the entire sample. For DP, significant improvements in the overall score (dynamic movement analysis score), and in 2 of the 3 linear and angular measures were seen for the sample. CONCLUSIONS The video game balance board program, which can be performed at home, was as effective as Tai Chi and the standard balance exercise program in improving postural control and balance dictated by the force plate postural sway and DP measures. This finding may have implications for exercise adherence because the at-home nature of the intervention eliminates many obstacles to exercise training.

Discrete wavelet transform: a tool in smoothing kinematic data.

Motion analysis systems typically introduce noise to the displacement data recorded. Butterworth digital filters have been used to smooth the displacement data in order to obtain smoothed velocities and accelerations. However, this technique does not yield satisfactory results, especially when dealing with complex kinematic motions that occupy the low- and high-frequency bands. The use of the discrete wavelet transform, as an alternative to digital filters, is presented in this paper. The transform passes the original signal through two complementary low- and high-pass FIR filters and decomposes the signal into an approximation function and a detail function. Further decomposition of the signal results in transforming the signal into a hierarchy set of orthogonal approximation and detail functions. A reverse process is employed to perfectly reconstruct the signal (inverse transform) back from its approximation and detail functions. The discrete wavelet transform was applied to the displacement data recorded by Pezzack et al., 1977. The smoothed displacement data were twice differentiated and compared to Pezzack et al.s acceleration data in order to choose the most appropriate filter coefficients and decomposition level on the basis of maximizing the percentage of retained energy (PRE) and minimizing the root mean square error (RMSE). Daubechies wavelet of the fourth order (Db4) at the second decomposition level showed better results than both the biorthogonal and Coiflet wavelets (PRE = 97.5%, RMSE = 4.7 rad s-2). The Db4 wavelet was then used to compress complex displacement data obtained from a noisy mathematically generated function. Results clearly indicate superiority of this new smoothing approach over traditional filters.

Solar–hydrogen energy system for Egypt

Abstract A model for a solar–hydrogen energy system for Egypt has been developed by obtaining relationships for and between the main energy and energy related parameters. The magnitude and trends of the parameters, with and without hydrogen introduction, have been investigated over a period of time. The results indicate that the fossil fuel resources in Egypt could be exhausted within one to two decades. They also indicate that adopting the solar–hydrogen energy system would extend the availability of fossil fuel resources, reduce pollution, and establish a permanent energy system for Egypt. They show that Egypt could become an exporter of hydrogen.

Acceptable maximum effort (AME): a psychophysical measure of strength in back pain patients

A new quantitative method for measuring functional abilities of chronic low-back pain patients is introduced. The method is based upon a psychophysical model referred to as acceptable maximum effort (AME). AME is the highest level of voluntary effort that a person can achieve without inducing unacceptable pain. In the current study, the AME method was applied to strength measurement. By use of a static strength measurement procedure, arm, leg, shoulder, back, and composite strengths were assessed upon admission to and discharge from a 4-week, nonsurgical comprehensive pain treatment program. The reliability of the AME method for each strength measure was assessed. In addition, the method was used to evaluate preto post-treatment changes in strength. Results indicate the AME method to be highly reliable and useful in determining treatment outcome. Reliability coefficients for all strength measures were above .90. The results are discussed in terms of their implications for standardized functional ability measurement in the area of chronic pain.

Effects of an endurance and strength training programme on lifting capability of males

Abstract Back injuries resulting from manual materials handling are one of the major sources of compensation claims and time lost from work. One of the possible means of reducing human susceptibility to musculoskeletal injuries is by increasing the individuals lifting capability by prior training. This paper describes a 6 week training programme that successfully increased the maximal oxygen uptake, isometric strength and lifting capability of 10 male subjects. The programme trained subjects for flexibility, muscle strength (by applying the concept of progressive resistance exercise), muscle endurance (by lifting light loads at high frequency of lift) and cardiovascular endurance (by exercising on a bicycle ergometer). The training programme resulted in significant increase in the maximal oxygen uptake and isometric back, arm, leg and shoulder strengths of the subjects. The maximum acceptable weight lifted, using a compact box for different heights of lift, also increased significantly.

Biofeedback in back muscle strengthening.

This study was undertaken to investigate the use of electromyography (EMG) biofeedback as an add-on therapy to standard exercise in the restoration of the functional abilities of the trunk extensor muscles in patients suffering from chronic low-back pain (CLBP). A controlled experimental investigation was conducted to study the effectiveness of using the proposed treatment modality in the management of the low-back pain problem. The results obtained indicate that the proposed methodology was an effective tool to achieve a significant improvement in the strength of lumbar paraspinal muscles of chronic low-back pain patients.