hamid abolhasani

Low back pain is one of the most common musculoskeletal problems. Various complications, such as disability, depression, anxiety, sleep disorders, stress, decreased sexual function and Quality of Life (QoL) are associated with chronic low back pain.The aim of this study was to compare the relationship between demographic, physical fitness, health status, socio-economic indicators, and sexual function indicators on the QoL of women with chronic non-specific low back pain.

The present cross-sectional study was performed in 2020 in the private center of Cyrus Physiotherapy in Tehran, Iran. Thirty married women with non-specific chronic low back pain who were sexually active and living in Tehran were included in the study based on inclusion and exclusion criteria. At first, the goals and process of the study were explained to them and they were given written consent to participate in the study. Then demographic information was recorded and pain, sexual function, and QoL were measured using relevant tools. SPSS software v. 22 was used for statistical tests. Pearson correlation test was used to examine the relationship between the above variables.

The Mean±SD age of participants was 38.6±7.48 years. Pearson correlation coefficient showed no statistically significant relationship between the QoL with age (r=-0.172, P=0.364), the number of children (r=-0.166, P=0.382), pain intensity (r=-0.181, P=0.339) and regular exercise (r=-0.159, P=0.402), but there was a statistcally significant relationship between QoL with body mass index (r=-0.406, P=0.026), sexual function score (r=0.379, P=0.039), general health status (r=0.436, P=0.026), education level (r=0.463, P=0.010), and physical fitness status (r=-0.406, P=0.026).

In women with chronic non-specific back pain participating in the present study, the lower the body mass index, the higher the level of education and sexual function score, the better overall health and physical fitness status, the better the QoL. However, the results of this study did not confirm the relationships between QoL and age, number of children, pain intensity, and regular exercise. Improving education, health status, fitness status, body mass index, and sexual  function index help improve QoL.

Osteoarthritis is a progressive disease and the most common form of joint inflammation. Moreover, it is the most common cause of functional disability in the elderly. Among the multiple and predisposing factors influencing the disease are demographic indicators and occupational factors. The present study aimed to investigate the relationship between age, pain severity, Body Mass Index (BMI), occupation, and educational level, and the severity of functional disability in patients with Knee Osteoarthritis (KO).

This descriptive study was performed on 97 KO patients referring to the Novin private physiotherapy clinic of Semnan University of Medical Sciences from April to March 2017. The study participants were selected through a simple nonprobability sampling technique. Literate individuals with the educational level of guidance school and above and diagnosed with KO were included in the study. Individuals with a history of inflammatory arthritis diseases, such as rheumatoid arthritis, soft tissue rheumatoid arthritis, fibromyalgia syndrome, bursitis, tendonitis, the neurological and vascular conditions of the lower extremity, mental problems, and malignancy were excluded from this research. The data related to the variables such as age, gender, occupation, history of osteoarthritis, pain intensity, involved side, educational level, and the Knee Injury and Osteoarthritis Outcome Score (KOOS) for knee disability were collected by a self-report questionnaire. This study was approved by the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences. Using SPSS, Spearman’s correlation coefficients were calculated to examine the relationship between the study variables.

Spearman’s correlation coefficients revealed no significant correlation between the KOOS scores and age, occupation, and educational level. The obtained results suggested a poor significant association between KOOS and BMI; however, there was a strong significant correlation between KOOS and pain intensity Visual Analogue Scale (VAS) (P<0.05).

The severity of functional disability in patients with KO based on KOOS questionnaire scores, was well correlated with pain severity, but poorly associated with age and BMI. The obtained data indicated no significant relationship between disability and occupation and educational level.

Alteration of scapular position and motion is called scapular dyskinesis. Scapular dyskinesis is a common clinical problem. Strength of shoulder girdle muscles is important in shoulder motions and stability, so their weakness may lead to scapular dyskinesis. The aim of this study was to compare the maximum voluntary isometric force of shoulder girdle movements in subjects with and without scapular dyskinesis
A case-control study was designed where the participants were selected by nonprobability sampling; 30 subjects with scapular dyskinesis and an average age of 22.95±2.62 years and 30 subjects without scapular dyskinesis and an average age of 22.43±2.50 years. The subjects were instructed to stand with their arms resting on each side of the body. The examiner stood behind them at a distance of 1.5 meter and asked them to elevate their arms to the highest level possible. Scapular dyskinesis test was used to visually examine alteration in scapulohumeral rhythm during arm elevation in sagittal and frontal planes. The shoulder flexion and abduction were repeated for 5 times. At the same time, the examiner rated the scapular movement as normal or observable dyskinesis. The maximal voluntary isometric force of shoulder internal and external rotation on both sides, such as “scaption with external rotation”, “scapular abduction and upward rotation”, “scapular adduction and downward rotation”, “scapular adduction” and “adduction and depression of scapula” were measured with manual Dynamometer. For determining the maximal shoulder isometric rotational force, subjects were positioned prone on tables, arm brought into 90º abduction in frontal plane with 90° elbow flexion and resistance given to distal forearm into shoulder external and internal rotations. The maximal isometric force of scaption (supraspinatus strength) was measured in seated position; shoulder elevated 70º into scapular plane abduction (scaption) with external rotation. The maximal isometric force of scapular abduction and upward rotation was determined in supine position while the arm was elevated to 90º flexion with elbow extension and resistance given against forward pushing. For determining the maximal isometric force of rhomboids and middle trapezius muscles, resistance was given against scapular adduction and downward rotation, and scapular adduction, respectively. The maximal isometric force of lower trapezius was determined in prone position while the arm was elevated to 135º shoulder elevation with elbow extension. Independent t-test was performed to compare the maximal voluntary isometric force of shoulder girdle motions in individuals with and without scapular dyskinesis.
The mean±SD of age, weight and height of the participants without and with scapular dyskinesis were 22.43±2.50 years/ 22.95±2.62 years, 64.39±13.38 kg/ 65.67(±12.2) kg and 171.35(±11.29) cm/ 173.43(±8.66) cm, respectively. No statistically significant differences were found between the participants of the two groups with regard to the age, weight and height. Our result showed that the isometric force of “scaption with external rotation”, “scapular abduction and external rotation”, “adduction and depression of scapula”, “scapular adduction and downward rotation” and “scapular adduction” were significantly different between the two groups (P Scapular dyskinesia or altered kinematics of the scapula (downward rotation, anterior tilt and internal rotation) contributes to impingement syndrome by decreasing the subacromial space. The tissues that occupy the subacromial space are the supraspinatus tendon, subacromial bursa and long head of the biceps brachii tendon. The supraspinatus is the major rotator cuff muscle that is susceptible to tendinopathy in subacromial space. The inflammatory processes or tension overload during shoulder activities, which may result from altered kinematics of the scapula and decrease in the subacromial space, may lead to supraspinatus weakness. It has been shown that scapular stabilizers, such as serratus anterior, rhomboids and middle and lower trapezius muscles are more prone to weakness than the other shoulder muscles. So, the weakness in these muscles may relate to scapular dyskinesis. Scapular muscle exercises are executed in the rehabilitation of patients with subacromial impingement syndrome and scapular dyskinesis, as the muscular system is one of the major contributors to scapular positioning, both at rest and during movements. It seems that improving the strength of shoulder girdle muscles especially supraspinatus, serratus anterior, rhomboids, and middle and lower trapezius muscles would be necessary in individual with scapular dyskinesis.