Trunk stability exercises that focus on either deep or superficial muscles might produce different effects on lumbar segmental motion. This study compared outcomes in 34 lumbar instability patients in two exercises at 10 weeks and 12 months follow up. Participants were divided into either Core stabilization (deep) exercise, incorporating abdominal drawing-in maneuver technique (CSE with ADIM), or General strengthening (superficial) exercise (STE). Outcome measures were pain, muscle activation, and lumbar segmental motion. Participants in CSE with ADIM had significantly less pain than those in STE at 10 weeks. They showed significantly more improvement of abdominal muscle activity ratio than participants in STE at 10 weeks and 12 months follow-up. Participants in CSE with ADIM had significantly reduced sagittal translation at L4-L5 and L5-S1 compared with STE at 10 weeks. Participants in CSE with ADIM had significantly reduced sagittal translations at L4-L5 and L5-S1 compared with participants in STE at 10 weeks, whereas STE demonstrated significantly increased sagittal rotation at L4-L5. However, at 12 months follow-up, levels of lumbar sagittal translation were increased in both groups. CSE with ADIM which focuses on increasing deep trunk muscle activity can reduce lumbar segmental translation and should be recommended for lumbar instability.

University students have the highest smartphone-use addiction, which coincides with a rising number in instances of neck pain. As the time in smartphone use increases, neck flexion tends to increase. These positions can affect the spinal cord by the direct and indirect mechanisms which lead to cervical myelopathy. Thus, the current study aimed to determine the prevalence and associated factors of clinical myelopathic signs in smartphone-using university students with neck pain. A total of 237 smartphone-using university students with neck pain participated in the study. They were 20 to 25 years old. Their clinical myelopathic signs were evaluated using standardized test procedures. The prevalence of the clinical myelopathic sign was the Trömner sign at 41.35%, the finger escape sign at 28.27%, Hoffmann’s sign at 25.74%, and the inverted supinator sign at 18.14%. Smartphone usage ≥9.15 h per day was associated with ≥1 of a positive clinical myelopathic sign (adjusted OR = 1.85, 95% CI = 1.05 to 3.26, p = 0.05). The current study highlighted that prolonged smartphone usage may affect the spinal cord. Long duration (≥9 h per day) was associated with at least one positive clinical myelopathic sign. Therefore, smartphone-using university students need to keep their duration of smartphone use to less than 9 h per day. More attention should be given to increasing awareness about the importance of having healthy positions when using smartphones and using them for restricted durations in order to control the increasing prevalence of cervical myelopathy among smartphone-using university student in our societies.

The aim of this study was to assess the prevalence of static balance impairment in university student smartphone users with subclinical neck pain and identify the associated risk factors. Because of rapid and widespread smartphones use, and the subsequent effect on neck pain in university students, it is essential to determine the prevalence of balance impairment and associated factors in this population. Simple random sampling was completed among eighty-one participants in this cross-sectional study. A self-reported questionnaire, fitted precisely for smartphone users, was used prior to clinical assessment by the Balance Error Scoring System. Both simple and multiple logistic regressions were used to analyze the prevalence of static balance impairment and associated factors. The prevalence of static balance impairment in university student smartphone users with subclinical neck pain was 74.07% (95% CI: 64.32 to 83.82). The significant risk factors were “daily smartphone use ≥ 4 h’’ (AOR: 19.24 (95% CI 4.72 to 78.48) p = 0.000), “≥4 years of smartphone use” (AOR: 5.01 (95% CI 1.12 to 22.38) p = 0.035), and “≥7 neck disability index score’’ (AOR: 12.91 (95% CI 2.24 to 74.45) p = 0.004). There was a high prevalence of static balance impairment in university smartphone users with subclinical neck pain. University student smartphone users with subclinical neck pain who met at least one of the risk factors should realize their static balance impairment.

To enhance stature recovery, lumbar spine stabilization by stimulating the deep trunk muscle activation for compensation forces originating from the upper body was introduced. The abdominal drawing-in maneuver (ADIM) technique has been found mainly to activate deep trunk muscles. The purpose of the current study was to determine whether 5 weeks of training of deep trunk muscles using the ADIM technique could improve stature recovery, delay trunk muscle fatigue, and decrease pain intensity during prolonged sitting. Thirty participants with chronic low back pain (CLBP) conducted a core stabilization exercise (CSE) with the ADIM technique for 5 weeks. Participants were required to sit for 41 min before and after the exercise intervention. Stature change was measured using a seated stadiometer with a resolution of ±0.006 mm. During sitting, the stature change, pain intensity, and trunk muscle fatigue were recorded. A comparison between measurements at baseline and after 5 weeks of training demonstrated: (i) stature recovery and pain intensity significantly improved throughout the 41 min sitting condition; (ii) the bilaterally trunk muscle showed significantly decreased fatigue. The CSE with the ADIM technique was shown to provide a protective effect on detrimental reductions in stature change and trunk muscle fatigue during prolonged sitting in young participants under controlled conditions in a laboratory. This information may help to prevent the risk of LBP from prolonged sitting activities in real life situations.

Diaphragm is crucial for respiration and plays a significant role in trunk stabilization, particularly during postural tasks. Several studies have focused primarily on trunk muscles in lumbar instability (LI) patients. However, the role of diaphragm remains underexplored. Therefore, this study aimed to compare diaphragm excursion, diaphragm thickness, and lung function represented by predicted percentage of forced vital capacity (%FVC predicted) during a load-lifting at tidal breathing between CLBP patients with (CLBP_LI) and without LI (CLBP_NLI). Ninety-six participants with CLBP, aged between 20 and 59 years, were divided into CLBP_LI and age-matched CLBP_NLI groups based on screening tools and clinical tests. Diaphragm excursion and diaphragm thickness were assessed using real-time ultrasound imaging during load-lifting with tidal breathing. Additionally, lung function was measured using a spirometer. CLBP_LI group had significantly decreased total diaphragm excursion (p-value = 0.003) and diaphragm thickness at inspiration (p-value = 0.027) and expiration (p-value = 0.34) compared to CLBP_NLI group. There were no differences between the groups in excursions during inspiration and expiration, total thickness, thickness change, and %FVC predicted. Individuals with CLBP_LI exhibited decreased diaphragm excursion and diaphragm thickness during inspiration and expiration. Addressing diaphragm training in rehabilitation programs may lead to more effective treatment outcomes for LI patients.

Background: Lumbar instability has been extensively reported; however, the risk factors for lumbar instability remain poorly defined, and understanding this condition better would help health professionals and their patients. Proposal: To determine the prevalence of lumbar instability in Thai people with chronic low back pain (CLBP) and explore the factors associated with lumbar instability in these patients. Patients and Methods: Using multistage random sampling methods, 1762 participants with CLBP were enrolled in the study from six regions of Thailand. Data were collected using a paper-based questionnaire. Participants were interviewed by physical therapists in the hospital they attended. They were classified as having lumbar instability when they attained ≥ 7/14 items on the lumbar instability screening tool. Univariate and multivariate regression analysese were used to determine the possible factors associated with lumbar instability. Results: There were 961 (54.54%) participants with lumbar instability and 801 (45.46%) participants without. The eight factors associated with lumbar instability were: (i) age ≥ 40 years (AOR: 1.36; 95% CI: 1.09– 1.69); (ii) body mass index ≥ 25 kg/m² (AOR: 1.42; 95% CI: 1.16– 1.74); (iii) having an underlying disease (AOR: 1.32; 95% CI: 1.06– 1.65); (iv) frequent lifting ≥ 5 kg in occupational habits (AOR: 1.69; 95% CI: 1.36– 2.09); (v) prolonged walking ≥ 4 hours per day (AOR: 1.31; 95% CI: 1.04– 1.64); (vi) gardening in leisure time (AOR: 1.37; 95% CI: 1.10– 1.71); (vii) other area of pain (AOR: 1.24; 95% CI: 1.01– 2.52): and (viii) other area of numbness (AOR: 1.85; 95% CI: 1.50– 2.27). When considering only women, prior pregnancy was associated with lumbar instability with OR of 1.76 (95% CI: 1.36– 2.22), p-value < 0.0001. Conclusion: When treating patients with CLBP who are suspected to have lumbar instability, healthcare professionals should consider associated factors that might be modifiable targets for interventions to improve outcomes.