Gali Dar | University of Haifa (original) (raw)

Papers by Gali Dar

Journal of Athletic Training, Jul 18, 2023

Context: Ankle instability can include various impairments, including perceived instability (PI),... more Context: Ankle instability can include various impairments, including perceived instability (PI), mechanical instability (MI), and recurrent sprains (RS), alone or combined.

Journal of Back and Musculoskeletal Rehabilitation, Apr 27, 2016

BACKGROUND: Dry needling of muscles is mainly used for the management of pain in musculoskeletal ... more BACKGROUND: Dry needling of muscles is mainly used for the management of pain in musculoskeletal disorders. Yet, the association between dry needling and motor performance of muscles is still unclear. OBJECTIVE: To investigate the immediate effect of dry needling on lumbar multifidus muscles' function in healthy subjects. METHODS: Twenty-eight volunteers were divided randomly into: study group (13 subjects) and control group (15 subjects) who underwent no intervention. Study group received dry needling to the lumbar multifidus muscles using a deep insertion technique with 4 needles (2 on each side of the spine). The needles were left in situ for 10 minutes. Ultrasound imaging was used to measure multifidus muscles' thickness, pre and post-procedure during rest in a prone position and during contralateral active straight leg extension. RESULTS: Significant difference was found in the percentage of change of muscle activation post needling between groups on the right side at level L4-5. A slight increase in the percentage of muscle activity, post procedure was observed in the dry needling group compared with the control group, although not significant in other segments examined. CONCLUSION: An improvement of back muscle function following dry needling procedure in healthy individuals was found. This implies that dry needling might stimulate motor nerve fibers and as such increase muscle activity.

Physiotherapy Theory and Practice, May 3, 2023

Journal of Orthopaedic & Sports Physical Therapy, 2014

Randomized controlled trial. To determine the validity of a previously suggested clinical predict... more Randomized controlled trial. To determine the validity of a previously suggested clinical prediction rule (CPR) for identifying patients most likely to experience short-term success following lumbar stabilization exercise (LSE). Background Although LSE is commonly used by physical therapists in the management of low back pain, it does not seem to be more effective than other interventions. A 4-item CPR for identifying patients most likely to benefit from LSE has been previously suggested but has yet to be validated. One hundred five patients with low back pain underwent a baseline examination to determine their status on the CPR (positive or negative). Patients were stratified by CPR status and then randomized to receive an LSE program or an intervention consisting of manual therapy (MT) and range-of-motion/flexibility exercises. Both interventions included 11 treatment sessions delivered over 8 weeks. Low back pain-related disability was measured by the modified version of the Oswestry Disability Index at baseline and upon completion of treatment. The statistical significance for the 2-way interaction between treatment group and CPR status for the level of disability at the end of the intervention was P = .17. However, among patients receiving LSE, those with a positive CPR status experienced less disability by the end of treatment compared with those with a negative CPR status (P = .02). Also, among patients with a positive CPR status, those receiving LSE experienced less disability by the end of treatment compared with those receiving MT (P = .03). In addition, there were main effects for treatment and CPR status. Patients receiving LSE experienced less disability by the end of treatment compared to patients receiving MT (P = .05), and patients with a positive CPR status experienced less disability by the end of treatment compared to patients with a negative CPR status, regardless of the treatment received (P = .04). When a modified version of the CPR (mCPR) containing only the presence of aberrant movement and a positive prone instability test was used, a significant interaction with treatment was found for final disability (P = .02). Of the patients who received LSE, those with a positive mCPR status experienced less disability by the end of treatment compared to those with a negative mCPR status (P = .02), and among patients with a positive mCPR status, those who received LSE experienced less disability by the end of treatment compared to those who received MT (P = .005). The previously suggested CPR for identifying patients likely to benefit from LSE could not be validated in this study. However, due to its relatively low level of power, this study could not invalidate the CPR, either. A modified version of the CPR that contains only 2 items may possess a better predictive validity to identify those most likely to succeed with an LSE program. Because this modified version was established through post hoc testing, an additional study is recommended to prospectively test its predictive validity. Prognosis, level 1b-.

International Archives of Occupational and Environmental Health, Mar 17, 2021

To compare the effect of combined aerobic exercise (AE) and neck-specific exercise to neck-specif... more To compare the effect of combined aerobic exercise (AE) and neck-specific exercise to neck-specific exercise alone on the work ability of individuals complaining of neck pain. Secondary analysis of data from a previous randomized controlled trial was conducted to compare AE and neck-specific exercise (AE group, n = 69) to neck-specific exercise alone (control group, n = 70). The Work Ability Index (WAI) was administered after the 6-week intervention, and Global Rating of Change (GROC) was assessed after the 6-week intervention and at 12- and 24-week follow-ups. Repeated-measure analyses of variance between groups indicated a significant time × group interaction on the GROC at 12- and 24-week follow-ups. The AE group showed better improvement on the GROC (mean ± SD) from 6 to 24 weeks than controls: 4.7(± 0.12) to 5.3 (± 0.13) vs. 4.4 (± 0.13) to 4.1(± 0.13), respectively, (P < 0.001). There was a significant group × time interaction on the WAI (P < 0.001): the AE group showed better improvement (mean ± SD) from baseline to 6-weeks than controls: 34.9 (± 4.4) to 39.2 (± 3.6) vs. 34.4 (± 4.9) to 35.8 (± 4.9), respectively, (P < 0.001). Work ability of participants with poor/moderate baseline scores improved more (P < 0.001) than those with good/excellent baseline scores (P = 0.48). Combining moderate AE and neck-specific exercise improved the work ability of patients with NP more than neck-specific exercise alone. The combination should be recommended in health promotion programs, particularly for workers with low baseline work ability. Registered at ClinicalTrial.gov: NCT02451267; date of registration: 21 May 2015. https://clinicaltrials.gov/ct2/home

International Journal of Environmental Research and Public Health, Sep 23, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Journal of Bodywork and Movement Therapies, 2021

OBJECTIVE To examine the effects of dynamic tape on balance control in subjects with chronic ankl... more OBJECTIVE To examine the effects of dynamic tape on balance control in subjects with chronic ankle instability (CAI). METHODS This two group experimental pre- and post-treatment design included 18 individuals with CAI and 18 controls. The single-limb stance test with eyes open and closed, standing on a force plate (Accusway Plus; AMTI) for 30 s, was conducted before, 10 min (T1) and 24 h (T24) after a dynamic tape application over the gastrocnemius muscle. Outcome measurements were: mean sway velocity, sway area (circular area), and standard deviation of the body center of pressure path length in both mediolateral and anteroposterior directions. Individuals with poor (unable to perform a single leg test for at least 30 s, eyes closed) vs. good postural stability, were also compared. RESULTS In both groups, a repeated analysis of variance demonstrated a significant time main effect on sway velocity (F = 14.95; p < 0.001) and path length (F = 14.95; p < 0.001) during eyes closed. Post-hoc analysis revealed a significant decrease in T1 values compared to baseline. When comparing individuals with poor vs good stability amongst the CAI group, a statistically significant interaction was observed between group, time on sway velocity and path length (F = 3.92; p < 0.05) during eyes closed. In the poor postural group, most T1 values were significantly lower than baseline. CONCLUSIONS Dynamic tape when applied to posterior calf muscles, enhanced balance control with no difference between CAI individuals and controls. The contribution of the tape was greater in those with poor postural stability.

Journal of Dance Medicine & Science, 2020

This study examined whether maturation status, body physique, and the impact of training are rela... more This study examined whether maturation status, body physique, and the impact of training are related to the development of Achilles tendon structure in young dancers. Seventy-one pre- and post-menarche dancers (12 to 15 years of age) were recruited. The Achilles tendon of each dancer was examined via ultrasonography tissue characterization (UTC) imaging. The cross-sectional area (CSA) and the fibrillar structure (echo types I to IV) were measured. The participants were screened for anthropometric parameters (weight, height, and leg length) with body mass index (BMI) and BMI percentile calculated; for hours and impact of training; for Tanner pubertal maturation; and for pain in their Achilles tendon (VAS scale). In addition, age and age at onset of menarche were documented. Tendon structure was found to differ between pre- and post-menarche dancers. Post-menarche dancers had a significantly lower percentage of echo type I fibers and a significantly higher percentage of echo type II, ...

Journal of Back and Musculoskeletal Rehabilitation, 2018

BACKGROUND: The concept of myofascial continuity suggests that muscles activate along kinematic c... more BACKGROUND: The concept of myofascial continuity suggests that muscles activate along kinematic chains with common fascial coverings. Yet, the literature lacks evidence in regards to the function of anatomical chains in populations suffering from low back pain (LBP). OBJECTIVE: To examine muscle activations along the superficial back line in LBP patients compared to healthy controls. METHODS: The sample study included 20 males with chronic LBP (mean age 28.7 (± 3.05) years, mean BMI 24.91 (± 2.76)) and 17 healthy controls (mean age 31.06 (± 7.76) years, mean BMI 23.46 (± 3.43)). Muscle activation (gastrocnemius, hamstrings, erector spine, and upper trapezius) along the superficial back line was measured using surface EMG. All subjects underwent five test conditions: Conditions 1-3 involved passive movement, active movement and active movement against maximum isometric resistance of the right gastrocnemius muscle. Conditions 4 and 5 involved neck extension without and with isometric resistance from the prone position. The main outcome was relative muscle activation amplitude between research and control subjects. RESULTS: Muscle activation along the posterior anatomical chain was observed during distal movement (plantar flexion or neck extension). LBP patients showed significant lower muscle activation in the erector spine of lower back region compared with the control group during active plantar flexion and active neck extension (p < 0.05). Lower muscle activation in other regions (gastrocnemius, hamstrings, erector spine level T6) was observed in the research group (although not significant). CONCLUSION: LBP may causes or result in a lower muscle activation of the posterior kinematic myofascial chain muscles.

European Radiology, Apr 15, 2023

Applied sciences, Feb 10, 2023

Kinesiology, 2021

The Pilates method is often used in the treatment of nonspecific low back pain (NSCLBP). The effe... more The Pilates method is often used in the treatment of nonspecific low back pain (NSCLBP). The effect of Pilates group exercising (mat and apparatus combined) on women with NSCLBP is unknown. Studies on the Pilates method often use ultrasound (US) to measure transversus abdominis (TrA) thickness in one anatomical location. We recruited 40 women, 22 with NSCLBP and 18 healthy women (active control group), to join five weeks of biweekly Pilates group exercising (apparatus and mat). Measurements included TrA thickness (left and right) at rest, during active draw-in maneuver (ADIM), and its TrA% change in three anatomical areas; Roland-Morris disability questionnaire (RMDQ); and pain level (VAS). Before the study, no asymmetry in TrA thickness was noted as well as no between-group differences in TrA-thickness in three anatomic areas (in rest and ADIM). Following the intervention, TrA thickness increased during rest in the healthy group in two areas. No differences were noted between the t...

Clinical Rehabilitation, 2020

Objective:To examine the effect of adding aerobic exercise (AE) to neck-specific exercise treatme... more Objective:To examine the effect of adding aerobic exercise (AE) to neck-specific exercise treatment for patients with neck pain (NP) to reduce pain and disability.Design:A prospective multicentre randomized controlled trial.Setting:Physiotherapy outpatient clinics.Subjects:Patients with nonspecific NP.Intervention:Patients with NP were randomly assigned to six weeks of neck-specific exercise with and without the addition of AE.Measures:Patients were classified as having a successful or non-successful outcome according to the Global Rating of Change (GROC). Outcome measures included Visual Analogue Scale (VAS), Neck Disability Index (NDI), Fear Avoidance Beliefs Questionnaire (FABQ) and cervicogenic headache. Assessments were performed at six-week, and three- and six-month follow-ups.Results:A total of 139 participants (mean age: 54.6 ± 10.5 years) were recruited ( n = 69 AE, n = 70 control). According to GROC, 77.4% of the AE group reported a successful outcome at six months vs. 40%...

Journal of Athletic Enhancement, 2013

Calf muscle injuries are common among athletes. While rupture of the medial head of the gastrocne... more Calf muscle injuries are common among athletes. While rupture of the medial head of the gastrocnemius muscle is the most diagnosed entity, isolated rupture of the plantaris muscle is a rare condition with limited documentation in the literature. The plantaris assists ankle plantar flexion, and is an important contributor to proprioceptive mechanisms vital for normal athletic function of the ankle and knee. This case study reports of an elite triathlete who complained of proximal right calf pain without any specific trauma. The pain appeared during running and following practice and prevented him from carrying out his scheduled training. Diagnostic ultrasound examination revealed a fluid collection between the gastrocnemius and the soleus indicating a partial rupture of the plantaris tendon. A rehabilitation program was designed to address specific aspects relevant to plantaris muscle roles as outlined above. The patient was able to resume full athletic activity following this six week program. This case report shows that isolated rupture of the plantaris muscle may occur and should be considered as a possible etiology in patients with calf muscle complains. Moreover, the specific diagnosis will allow the clinician to design appropriate treatment that will assure full anatomical and functional recovery.

Scientific Reports, 2021

The intervertebral disc’s (IVD) annulus fibrosus (AF) retains the hydrostatic pressure of the nuc... more The intervertebral disc’s (IVD) annulus fibrosus (AF) retains the hydrostatic pressure of the nucleus pulposus (NP), controls the range of motion, and maintains the integrity of the motion segment. The microstructure of the AF is not yet fully understood and quantitative characterization is lacking, leaving a caveat in modern medicine’s ability to prevent and treat disc failure (e.g., disc herniation). In this study, we show a reconstruction of the 3D microstructure of the fibers that constitute the AF via MRI diffusion tensor imaging (DTI) followed by fiber tracking. A quantitative analysis presents an anisotropic structure with significant architectural differences among the annuli along the width of the fibrous belt. These findings indicate that the outer annuli's construction reinforces the IVD while providing a sufficient degree of motion. Our findings also suggest an increased role of the outer annuli in IVD nourishment.

Healthcare

In this study, the self-perception of pelvic floor muscle (PFM) contractions amongst women receiv... more In this study, the self-perception of pelvic floor muscle (PFM) contractions amongst women receiving repeated verbal instructions during exercise classes was examined. The prevalence and severity of urinary stress incontinence were also assessed. This cross-sectional observational study included 46 women (mean age 48 (±8.6)), who regularly participated in Pilates classes where repeated instruction was given to contract PFM (“instruction group”; N = 22) or not (controls, N = 24). PFM function was evaluated using transabdominal ultrasound. Simultaneously, the participant described her personal evaluation of her PFM contraction ability. The International Consultation on Incontinence Questionnaire–Short Form was also utilized. Most women (80%) correctly contract PFM; however, 95% did not perform a voluntary contraction during leg movement, without differences observed between groups. A higher perception of PFM contraction was found in the “instruction group” when performing knee flexion...

Medicine & Science in Sports & Exercise, 2015

Physical Therapy, 2021

Objective A previous randomized controlled trial revealed that combined aerobic and neck-specific... more Objective A previous randomized controlled trial revealed that combined aerobic and neck-specific exercises yielded greater improvement than neck-specific exercises alone after a 6-month intervention in outpatients with nonspecific neck pain. The aim of this secondary analysis was to identify subgroups of patients in the combined-exercises group most likely to benefit from the intervention. Methods Sixty-nine patients were included. The original trial was conducted in multiple physical therapy outpatient clinics, twice a week for 6 weeks; follow-up was 6 months after assignment. The primary outcome was the therapeutic success rate (Global Rating of Change Score ≥ +5, “quite a bit better”) after 6 weeks’ training and at the 6-month follow-up. Candidate predictors from patients’ medical history and physical examination were selected for univariable regression analysis to determine their association with treatment response status. Multivariable logistic regression analysis was used to ...

BMC Musculoskeletal Disorders, 2021

Background Many young girls with generalized joint hypermobility (GJH) choose to participate in d... more Background Many young girls with generalized joint hypermobility (GJH) choose to participate in dance because their bodies are suited for this activity. Scoliosis tends to occur often in thin girls, who also are more likely to choose dance. Both anomalies (GJH and scoliosis) may be related to reduced abilities such as diminished strength and insufficient postural balance, with increased risk for musculoskeletal conditions. The main objectives of the present study were to determine the prevalence of dancers with GJH, the prevalence of dancers with scoliosis, and the prevalence of dancers with these two anomalies; and, to determine differences in physical abilities and the presence of patellofemoral pain (PFP) between young female dancers with and without such anomalies. Methods One hundred thirty-two female dancers, aged 12–14 years, were assessed for anthropometric parameters, GJH, scoliosis, knee muscle strength, postural balance, proprioception ability, and PFP. Results GJH was id...