The Effect of Lower-Limb Exercise on Pain Management of the Patients Undergoing Posterior Lumbar Fusion Surgery: A Retrospective Case-Control Study

Purpose. The purpose of this study is to investigate the clinical effect of lower-limb exercise, when combined with celecoxib, on pain management of patients undergoing posterior lumbar fusion surgeries. Methods. The patients undergoing posterior lumbar fusion surgeries between 01/2018 and 06/2021 were retrospectively identified, with their data collected. After surgery, some patients took celecoxib for analgesia (celecoxib group, 200 mg/day) while the others took celecoxib together with lower-limb exercise (combined group, celecoxib-200 mg/day). On postoperative days (POD) 1, 3, 7, and 14, data were collected and analyzed regarding the following items: patient satisfaction, lower-limb muscle force, lumbar JOA score (29 points), Oswestry Disability Index (ODI), and visual analog scale (VAS) score. Results. A total of 225 participants were included in this study. Specifically, 120 cases were admitted into in the celecoxib group and 105 were included in the combined group. Comparisons of baseline data did not indicate any difference between the combined group and the celecoxib group. Data analysis showed that patient satisfaction in the combined group was significantly higher than the celecoxib group on POD 3, 7, and 14, respectively (all p < 0.001 ). Moreover, the combined group had less VAS score compared with the celecoxib group on POD 3, 7, and 14, respectively (all p < 0.01 ). In addition, lower-limb muscle force in the combined group was significantly stronger than that in the celecoxib group on POD 3 and POD 7, respectively (both p < 0.01 ). Furthermore, the combined group achieved less ODI score than the celecoxib group on POD 3, 7, and 14, respectively (all p < 0.05 ). Comparisons of the lumbar JOA score did not suggest any statistical difference during the whole follow-up period. Conclusions. In conclusion, postoperative lower-limb rehabilitation exercise can help to release pain after lumbar fusion surgeries. Additionally, postoperative lower-limb exercise can facilitate the recovery of lower-limb muscle force, as well as improving patient satisfaction.

Kinesiophobia and Outcomes of Lower Extremity Exercise Regime in Subjects with Knee Osteoarthritis: A Case Series

Aim: To estimate the effectiveness of lower limb exercise regime in subjects with knee osteoarthritis in terms of Kinesiophobia. Methodology: This was a case series, conducted in the Physiotherapy Department Health Centre University of the Punjab Lahore after ethical approval from June 2018 to February 2019 on 44 patients with knee Osteoarthritis. Non-probability purposive sampling technique was used to enroll the participants according to predefined inclusion and exclusion criteria. Lower limb exercise regime was applied for eight weeks, thrice a week. TAMPA scale for Kinesiophobia (TSK), KOOS and 6 min walk test (6MWT) were used to measure the outcomes. Paired sample T test was applied to find the difference before and after LLEP. Statistical significance was set at P= 0.05 Results: Mean age of the participants was 52±6.54 years ranging from 41-65 years. The mean difference in pre and post treatment KOOS Score was 15.13±12.38 (P=.000), 14.34±7.97 (P=.000) for TAMPA Score and 196.00±94.01 (P=.000) for 6 Mint walk distance. Conclusion: Lower limb exercise program is found effective in the management of knee osteoarthritis. Subjects undergoing in 8 weeks lower limb exercise program showed improvement in KOOS Score, reduction in TAMPA Score, and improvement in 6 mint walk distance. Keywords: Knee Osteoarthritis, Kinesiophobia, TAMPA, knee osteoarthritis outcome score (KOOS), Lower limb exercise regime,

Joint Angle, Range of Motion, Force, and Moment Assessment: Responses of the Lower Limb to Ankle Plantarflexion and Dorsiflexion

There is limited research on the biomechanical assessment of the lower limb joints in relation to dynamic movements that occur at the hip, knee, and ankle joints when performing dorsiflexion (DF) and plantarflexion (PF) among males and females. This study investigated the differences in joint angles (including range of motion (ROM)) and forces (including moments) between the left and right limbs at the ankle, knee, and hip joints during dynamic DF and PF movements in both males and females. Using a general linear model employing multivariate analysis in relation to the joint angle, ROM, force, and moment datasets, the results revealed significant main effects for gender, sidedness, phases, and foot position with respect to joint angles. Weak correlations were observed between measured biomechanical variables. These results provide insightful information for clinicians and biomechanists that relate to lower limb exercise interventions and modelling efficacy standpoints.

EFFECT OF LOWER LIMB EXERCISE ON POSTURE STABILITY AND BRAIN ACTIVITY DURING WHOLE BODY VIBRATION FOR THE ELDERLY

This study aimed to investigate the effect of lower limb exercise on electroencephalogram (EEG) activity and posture stability during whole body vibration (WBV) for healthy elderly people. Subjects were composed of 20 elderly people who were over 60 years old and had no disease. They were subjected to WBV of 30[Formula: see text]Hz and strength intensity of 20 (total 5 sets, 20[Formula: see text]s/set, rest time: 20[Formula: see text]s, except for the final set). The subjects were grouped into two groups. One group of 11 subjects was WBVSt (WBV of upright stance) and the other group of nine subjects was WBVSq (WBV of squat posture). In the WBVSt group, the subjects were requested to maintain a standing position, whereas those in the WBVSq group were asked to perform 60∘-knee flexion squat at 2[Formula: see text]s intervals during WBV stimulation. In this study, the electromyography (EMG) was measured on the right and left erector spinae, rectus femoris, vastus lateralis, vastus medialis, tibialis anterior to evaluate lower limb muscle activity and postural stability during timed up and go (TUG) test before and after WBV. The EEG was measured on frontal (F3, F4, F7, F8), central (Cz, C3, C4), temporal (T3, T4, T5, T6), parietal (P3, P4), and occipital (O1, O2) lobes to evaluate brain activity during the check of mini-mental state examination for dementia screening (MMSE-DS) before and after WBV. The results of this study showed improved postural stability and muscle activation for the healthy elderly during lower limb and WVB exercises. The WBVSq group showed higher changes in TUG-test ([Formula: see text]) and iEMG analysis by EMG ([Formula: see text]) compared with the WBVSt group. However, there was no significant change in MMSE-DS ([Formula: see text]). Because of the increase in relative SMR power by EEG, the central (C4), frontal (F7) and parietal (P3, P4) lobes were activated in WBVSt group ([Formula: see text]); however, all regions, except the parietal lobe, were activated in WBVSq group ([Formula: see text]). Lower limb exercise with WBV stimulation improved postural stability, lower limb muscle, and brain activation for the elderly. These results may be helpful to the protocol of exercise using WBV for the healthy elderly.

Correlation of Exercise Capacity with Functional Disability in Patients with Osteoarthritis of Knee

Introduction: Osteoarthritis of knee is a progressive joint disease which produces pain, inflammation and destruction of joint which in turn leads to range of motion limitation and walking disabilities. Affection in physical functioning is determined not only by just activities involving lower limb capacity but also by the activities which require use of upper extremities. Hence in this study, 6MWD and no. of rings moved in 6 minutes were taken as an outcome measures for determining the exercise capacity. KOOS is a self-administered questionnaire which was used in its cross culturally adapted format for determining the functional disability in patients. Objectives: 1. To study correlation of exercise capacity with functional disability in patients with osteoarthritis of knee. 2. To study correlation of upper limb exercise capacity with lower limb exercise capacity in patients with osteoarthritis of knee. Methods: Cross sectional, observational study including 30 patients of either gender having unilateral osteoarthritis of knee conducted in a tertiary care hospital. Results: No. of rings moved in 6 minutes and global KOOS score showed no statistically significant correlation. 6MWD and global KOOS score showed no statistically significant correlation. 6 minute walk distance and 6 minute peg board ring test showed no statistically significant correlation. Conclusion: The study suggests that there is no correlation of exercise capacity with functional disability in patients with osteoarthritis of knee. Also, there is no correlation found between upper limb exercise capacity and lower limb exercise capacity in patients with osteoarthritis of knee. KEY WORDS: Knee osteoarthritis, Knee pain, squat depth, functional disability, cardiorespiratory endurance, Knee Injury and Osteoarthritis Outcome Score, Quality of life.