Background Gut–brain axis (GBA) is a system widely studied nowadays, especially in the neuropsychiatry field. It is postulated to correlate with many psychiatric conditions, one of them being attention-deficit hyperactivity disorder (ADHD). ADHD is a disorder that affects many aspects of life, including but not limited to financial, psychosocial, and cultural aspects. Multiple studies have made a comparison of the gut microbiota between ADHD and healthy controls. Our aims were to review the existing studies analyzing the gut microbiota between human samples in ADHD and healthy individuals. Methods The literature was obtained using Google Scholar, Pubmed, and Science Direct search engine. The keywords used were “ADHD”, “gut microbiota”, “stool”, “gut”, and “microbiota”. The selected studies were all case–control studies, which identify the gut microbiota between ADHD and healthy individuals. Result We found six studies which were eligible for review. The model and methods of each study is different. Forty-nine bacterial taxa were found, yet none of them can explain the precise relationship between ADHD and the gut microbiota. Bifidobacterium was found in higher amount in ADHD patients, but other study stated that the abundance of this genus was lower in ADHD with post-micronutrient treatment. This may suggest that micronutrient can modulate the population of Bifidobacterium and improve the behavior of ADHD patients. Other notable findings include a significantly lower population of Dialister in unmedicated ADHD, which rose after patients were medicated. A smaller amount of Faecalibacterium were also found in ADHD patients. This may explain the pathogenesis of ADHD, as Faecalibacterium is known for its anti-inflammatory products. It is possible the scarcity of this genera could induce overproduction of pro-inflammatory cytokines, which is in accordance with the high level of pro-inflammatory cytokines found in children with ADHD. Conclusion There were no studies that examined which bacterial taxa correlated most to ADHD. This might occur due to the different model and methods in each study. Further study is needed to identify the correlation between gut microbiota and ADHD.

AIM: Low back pain (LBP) is a widespread complaint of all age groups. The economic burden of LBP is high, and physiotherapy has proven to reduce this. Unfortunately, physiotherapy or exercise regimen is rarely prescribed to LBP patients by doctors. Until now, there was no study regarding the application of physiotherapy exercise in Indonesia. This study aims to evaluate the effect of Williams flexion exercise (WFE) toward people with LBP. METHODS: This was a pretest-posttest experimental study design of PROLANIS participants with LBP complaints in one of the primary health-care centers in Jombang, East Java, Indonesia, on June 2018–July 2018. The total sampling method was used in this study. Participants’ basic clinical data and Oswestry Disability Index (ODI) were obtained through a self-administered questionnaire. WFE was taught to the participants through a presentation, video, and live demonstration. After 1 month, ODI of the participants was reassessed. RESULTS: There were 42 participants included in this study. There was a significant ODI difference between pre- and post-WFE implementation (31.05 ± 17.40 vs. 14.10 ± 11.78, p = 0.019). Higher exercise frequency (>1 times/day) was associated with further reduction in ODI compared to lower exercise frequency group (1 time/day) (22.09 ± 19.09 vs. 7.38 ± 12.58, p = 0.017). There was no significant difference in ODI reduction between geriatric and non-geriatric participants (p = 0.24). CONCLUSION: WFE improves functional symptoms of LBP regardless of age. This exercise could be implemented in a primary health-care setting in future to reduce the cost for LBP treatment.

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Objectives: Low Back Pain (LBP) is prevalent in most people of working age. The morbidity it causes cannot be taken lightly, as is its economic burden. Physiotherapy has long been prescribed to LBP patients, but treatment outcome measurements, along with the factors influencing it, have not been widely evaluated. In this study, we aim to assess the correlation between patient’s expectation and LBP physical therapy outcome. Methods: This was a cross sectional study conducted at physical rehabilitation outpatient clinic in September-December 2019. Participants were patients with LBP who were treated with physical therapy. One series of physical therapy consists of 5 sessions of modality only or modality with exercise therapy; one patient underwent 2 sessions per week. Oswestry disability index (ODI) score was used to evaluate treatment outcome and Stanford Expectation of Treatment Scale score was used to evaluate patient’s expectation. Data was collected twice, before and after 1 series of therapy. Results: There were 91 participants included in this study, most of whom were female. Most patients reported a significant decrease in ODI score, irrespective of the LBP chronicity or nutritional status. However, patients who received a combination of physical exercises and modalities reported lower after therapy ODI than those who only received modalities (p=0.009). No correlation was found between positive (p=0.567) or negative (p=0.910) expectations with ODI improvement. Conclusion: Our study did not find any correlation between positive or negative expectations towards ODI score improvement. Keywords: Low back pain; Physical therapy; Treatment outcome; Patient expectation; ODI score