Fragestellung: Die Evaluierung der posturalen Stabilität mittels Posturographie wird häufig als Diagnoseinstrument und auch zur Überprüfung des Therapieergebnisses im rehabilitativen Management bei chronischen, idiopathischen Rückenschmerzen (CLBP) eingesetzt. Ziel dieser Studie war die Überprüfung der Kurz- und Langzeit-Reliabilität posturographischer Messungen bei Patienten mit CLBP.
The Brief International Classification of Functioning, Disability and Health (ICF) Core Sets for chronic low-back pain (cLBP) have included the three body functional categories sensation of pain, muscle functions, and emotional functions. As the latter two categories represent umbrella terms, the objective of this research was to identify those clinical tests that most expediently substantiate these two categories.This case-control study included 32 consecutive cLBP patients and 19 nonathletic healthy controls (HC), matched in age, body mass index, and sex. All patients and HCs underwent a comprehensive standardized clinical examination, with objective muscle functions tests that measured trunk muscle strength, endurance, and postural performance. Assessment of the category emotional functions included the Symptom Checklist 90-Revised, the Beck depression inventory, the Fear-Avoidance Beliefs Questionnaire (FABQ-D), and body experience (Borg category ratio scales about exertion, tension, fear of harm, and (re-)/injury).Logistic regression analyses revealed back muscle endurance and somatization to explain 50% of the between-group variances. Furthermore, the variables of Sensory Organization Test (SOT) composite score and FABQ were best associated with disablement in cLBP.In the Brief ICF Core Set for cLBP, back muscle endurance tests best examined the category muscle functions, whereas somatization best examined that of emotional functions. Furthermore, both the SOT and the FABQ would, in addition to the aforementioned tests, optimize the functional diagnostic relevance of the two ICF categories for cLBP.
We describe a parallel hybrid symbolic-numerical solution to the problem of reliably plotting a plane algebraic curve. The original sequential program is implemented in the software library CASA on the basis of the computer algebra system Maple. The new parallel version is based on Distributed Maple, a distributed programming extension written in Java. We describe the mathematical foundations of the algorithm, give sequential algorithmic improvements and discuss our parallelization approach.
To examine whether a whole-body vibration (mechanical oscillations) in comparison to a placebo administration leads to better postural control, mobility and balance in patients with multiple sclerosis.Double-blind, randomized controlled trial.Outpatient clinic of a university department of physical medicine and rehabilitation.Twelve multiple sclerosis patients with moderate disability (Kurtzke's Expanded Disability Status Scale 2.5-5) were allocated either to the intervention group or to the placebo group.In the intervention group a whole-body vibration at low frequency (2.0-4.4 Hz oscillations at 3-mm amplitude) in five series of 1 min each with a 1-min break between the series was applied. In the placebo group a Burst-transcutaneous electrical nerve stimulation (TENS) application on the nondominant forearm in five series of 1 min each with a 1-min break between the series was applied as well.Posturographic assessment using the Sensory Organization Test, the Timed Get Up and Go Test and the Functional Reach Test immediately preceding the application, 15 min, one week and two weeks after the application. The statistical analysis was applied to the change score from preapplication values to values 15 min, one week and two weeks post intervention.Compared with the placebo group the intervention group showed advantages in terms of the Sensory Organization Test and the Timed Get Up and Go Test at each time point of measurement after the application. The effects were strongest one week after the intervention, where significant differences for the change score (p = 0.041) were found for the Timed Get Up and Go Test with the mean score reducing from 9.2 s (preapplication) to 8.2 s one week after whole-body vibration and increasing from 9.5 s (preapplication) to 10.2 s one week after placebo application. The mean values of the posturographic assessment increased from 70.5 points (preapplication) to 77.5 points one week after whole body vibration and increased only from 67.2 points (preapplication) to 67.5 points one week after the placebo application. No differences were found for the Functional Reach Test.The results of this pilot study indicated that whole-body vibration may positively influence the postural control and mobility in multiple sclerosis patients.
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