Knee injury is one of the major problems in sports medicine, and the use of prophylactic knee braces is an attempt to reduce the occurrence and/or severity of injuries to the knee joint ligament(s) without inhibiting knee mobility. The aim of the present study was to examine the effect of one recently designed prophylactic knee brace and two neoprene knee sleeves upon performance of healthy athletes. Thirty-one healthy male athletes (age = 21.2±1.5) volunteered as participants to examine the effect of prophylactic knee brace/sleeves on performance using isokinetic and functional tests. All subjects were tested in four conditions in a random order: 1. nonbraced (control) 2. using a neoprene knee sleeve 3. using a knee sleeve with four bilateral metal supports and 4. using a prophylactic knee brace. The study design was a crossover, randomized, controlled trial. Subjects completed single leg vertical jump, cross-over hop, and the isokinetic knee flexion and extension (at 60, 180, 300°/sec). Data were collected from the above tests and analyzed for jump height, cross-over hop distance, peak torque to body weight ratio and average power, respectively. Comparisons of these variables in the four testing conditions revealed no statistically significant difference (p>0.05). The selected prophylactic brace/sleeves did not significantly inhibit athletic performance which might verify that their structure and design have caused no complication in the normal function of the knee joint. Moreover, it could be speculated that, if the brace or the sleeves had any limiting effect, our young healthy athletic subjects were well able to generate a mean peak torque large enough to overcome this possible restriction. Further studies are suggested to investigate the long term effect of these prophylactic knee brace and sleeves as well as their possible effect on the adjacent joints to the knee.

Background Evidenced-based clinical guidelines for the treatment of low back pain (LBP) consistently suggest educating patients about their back pain, its natural course, and providing advice to keep active and continue working. Despite this evidence, clinicians routinely do not follow these recommendations resulting in ineffective and fragmented care. GLA:D® Back, a standardized care package, was originally developed in Denmark to assist clinicians in implementing evidence-based care. This study will evaluate the feasibility of implementing the English version of the Danish GLA:D® Back program in Alberta, Canada. Methods Thirty-five clinicians from nineteen clinics in Alberta, Canada, participated. Feasibility of program implementation, our primary objective, was evaluated within 3 months. Feasibility success was defined as 50% clinician/clinic adoption in addition to 66–88 enrolled participants registered in the database. Our secondary objectives included collecting data pertaining to clinician confidence, attitudes and behaviour of treating patients, perceived barriers and facilitators of program in addition to collecting patient-data regarding pain, function, general health and self-efficacy. Results The majority of the clinics (15/19, 79%) offered GLA:D® Back to their patients within the study period. Of the participating clinicians, GLA:D® Back was delivered by (25/35, 71%) of clinicians. In total, 78 patients were enrolled in the program and (69/78, 88%) participants attended the final assessment. Secondarily, clinicians demonstrated a biomedical and behavioural orientation along with high confidence when treating LBP patients while patient outcomes trended toward improvement. Conclusion The English translation of the Danish GLA:D Back program was feasible for Albertan clinicians to implement into practice in both urban and rural settings.

Background: Different types of foot orthoses have been prescribed for patients with flatfoot. Results of several studies have shown that orthoses were able to change balance parameters in people with flatfoot. However, the possible effect of orthosis flexibility on balance has not yet been investigated. Objectives:The aim of the current study was to investigate the immediate effect of a rigid University of California Berkeley Laboratory (UCBL) foot orthosis, a modified foot orthosis, and a normal shoe on the postural sway of people with flexible flatfoot. Study design: Quasi-experimental. Methods: In all, 20 young adults with flatfoot (aged 23.5 ± 2.8 years) were invited to participate in this study. The Biodex Stability System was employed to perform standing balance tests under three testing conditions, namely, shoe only, UCBL, and modified foot orthosis. Total, medial-lateral, and anterior-posterior sway were evaluated for each condition. Results:The results of this study revealed no statistical difference in the medial-lateral and anterior-posterior stability indices between foot orthoses and shoed conditions. The overall stability index with the UCBL foot orthosis, however, was significantly lower than that with the modified foot orthosis. Conclusion: The UCBL foot orthosis was able to decrease total sway and improve balance in people with flexible flatfoot. Clinical relevanceResults of previous studies have indicated that foot orthoses were able to affect the balance of people with flatfeet. However, the possible effects of flexible orthoses on balance have not been examined. The results of this study may provide new insight into material selection for those people with balance disorders.

Magnetic resonance imaging findings often do not distinguish between people with and without low back pain (LBP). However, there are still a large number of people who undergo magnetic resonance imaging to help determine the etiology of their back pain. Texture analysis shows promise for the classification of tissues that look similar, and machine learning can minimize the number of comparisons. This study aimed to determine if texture features from lumbar spine magnetic resonance imaging differ between people with and without LBP. In total, 14 participants with chronic LBP were matched for age, weight, and gender with 14 healthy volunteers.A custom texture analysis software was used to construct a gray-level cooccurrence matrix with one to four pixels offset in 0°direction for the disc and superior and inferior endplate regions. The Random Forests Algorithm was used to select the most promising classifiers. The linear mixed-effect model analysis was used to compare groups (pain vs. pain-free) at each level controlling for age. The Random Forest Algorithm recommended focusing on intervertebral discs and endplate zones at L4-5 and L5-S1. Differences were observed between groups for L5-S1 superior endplate contrast, homogeneity, and energy (p = .02). Differences were observed for L5-S1 disc contrast and homogeneity (p < .01), as well as for the inferior endplates contrast, homogeneity, and energy (p < .03). Magnetic resonance imaging textural features may have potential in identifying structures that may be the target of further investigations about the reasons for LBP.

Disc height has been a focus of research on disc degeneration and low back pain (LBP). However, choosing an appropriate method to quantify disc height remains controversial. The aim of the present study was to determine the reliability and construct validity of disc height quantification methods. Repeated semi-automatic measurements of L4-5 and L5-S1 discs were obtained from 43 T2-weighted mid-sagittal 3T magnetic resonance (MR) images of 22 subjects with LBP (43±13 years), blinded to prior measurements. Heights were calculated with area-based methods (using 60%, 80% and 100% of the disc width), and point-based methods (Hurxthal's, Dabbs' and combining the two). Intra-class correlation coefficients (ICC) and standard error of measurement (SEM) were estimated. Construct validity was assessed using correlation coefficients. Intra-rater ICC(3,1) of the area-based disc height measurements ranged from 0.84 to 0.99 with an inter-rater ICC(2,1) of 0.99. Measurements with point-based methods had lower intra- and inter-rater reliability ranging between 0.76 and 0.96 and between 0.84 and 0.98, respectively. Inter-rater SEM varied between 0.2 and 0.3 mm for area-based methods and between 0.3 and 0.7 mm for point-based methods. Excluding Dabbs', high correlations (r>0.9) were observed between methods. Area-based height measurements using partial disc width demonstrated excellent reliability and construct validity and outperformed point-based methods.