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Price: EUR 130.00Authors: Ege, Ferhat
Article Type: Research Article
Abstract: BACKGROUND: Low back pain is an important widespread health problem that can occur at any age, causing serious socioeconomic losses. OBJECTIVE: The objective of this study is to investigate the relationship between kinesiophobia severity and pain severity, depression, and quality of life in patients with mechanical low back pain. METHODS: The study sample consisted of 155 patients, of whom 72 were female and 83 were male, aged between 18 and 75 years with mechanical low back pain. Quality of life was assessed with the 36-Item Short Form Health Survey (SF-36), pain intensity with the …Visual Analogue Scale (VAS), kinesiophobia with the Tampa Kinesiophobia Scale (TKS), and depression with the Beck Depression Inventory (BDI). Patients were divided into the low (TKS ⩽ 37) and high kinesiophobia (TKS > 37) groups according to the scores they obtained from TKS. RESULTS: VAS-pain severity and BDI scores were significantly higher in the high kinesiophobia group than in the low kinesiophobia group (p < 0.001). On the other hand, the SF-36 subscale scores were significantly higher in the low kinesiophobia group than in the high kinesiophobia group (p < 0.001). The TKS scores were moderately correlated with VAS-pain severity (r = 0.470; p < 0.001) and BDI scores (r = 0.584; p < 0.001) in the positive direction, and strongly correlated with all sub-parameters of quality of life in the negative direction (p < 0.001). CONCLUSION: The results indicated that the severity of kinesiophobia in patients with non-inflammatory low back pain is associated with pain severity, depression, and poor quality of life. Show more
Keywords: Kinesiophobia, pain, quality of life, depression
DOI: 10.3233/BMR-220365
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Zhong, Zhinian | Jin, Kang | Qin, Fengling | Nie, Rongrong
Article Type: Research Article
Abstract: BACKGROUND: Lumbar disc herniation (LDH) is a common clinical disease of the skeletal system, and its prevalence has been on a rise. OBJECTIVE: To evaluate the efficacy of Huoxue Tongluo decoction plus acupuncture in the treatment of lumbar disc herniation and its effectiveness in improving the functional recovery of the patients’ affected joints and mitigating their pain. METHODS: In this prospective study, 110 patients with lumbar disc herniation enrolled in our Hospital from June 2019 to June 2021 were collected and randomized to receive either conventional treatment (control group) or Huoxue Tongluo Decoction …plus acupuncture (study group). RESULTS: Huoxue Tongluo Decoction plus acupuncture resulted in more rapid mitigation of lower extremity symptoms and lumbar symptoms versus conventional treatment (P < 0.05). Patients receiving traditional Chinese medicine (TCM) showed milder inflammatory responses than those with conventional medication, as evidenced by the lower serum concentrations of tumor necrosis factor-α (TNF-α ), interleukin (IL)-6, and high-sensitivity C-reactive protein (hs-CRP) (P < 0.05). After treatment, the study group had higher Japanese Orthopedic Association (JOA) scores and lower visual analogue scale (VAS) scores than the control group (P < 0.05), suggesting that the combination of the herbal decoction and acupuncture provided better functional recovery of the affected joints and pain mitigation for the patients. Furthermore, the lower Pittsburgh sleep quality index (PSQI) scores in patients in the study group indicated better sleep quality of patients after TCM intervention than after conventional treatment (P < 0.05). Huoxue Tongluo Decoction plus acupuncture was associated with a significantly higher efficacy (94.55%) versus conventional treatment (80%) (P < 0.05). CONCLUSIONS: Huoxue Tongluo Decoction combined with acupuncture significantly offers a viable treatment alternative for lumbar disc herniation with promising treatment outcomes, mitigates patients’ limb pain, and improves their lumbar function and sleep quality. Further trials are, however, required prior to general application in clinical practice. Show more
Keywords: Clinical disease, effectiveness, functional recovery
DOI: 10.3233/BMR-220347
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-7, 2023
Authors: Sariyildiz, Mustafa Akif | Batmaz, Ibrahim | Hattapoğlu, Salih
Article Type: Research Article
Abstract: BACKGROUND: Epidural steroid injections are common procedures used to treat lumbosacral radicular pain due to lumbar disc herniation (LDH). It is crucial for the clinician to anticipate which patients can benefit from interventional treatment options. OBJECTIVE: This study aimed to examine the effect of radiological and clinical parameters on lumbar transforaminal epidural steroid injections (TFESI)/local anesthetic injection outcomes in patients with LDH. METHODS: This study included 286 patients with LDH (146 males and 140 females). All patients received a fluoroscopically guided TFESI (triamcinolone acetonide 40 mg, lidocaine 2%, and 2.5 ml of physiological …saline). Patients were evaluated according to radicular pain, the Oswestry Disability Index (ODI) and the Hospital Anxiety and Depression Scale at baseline and 3 months after the injections. Demographic, clinical and magnetic resonance imaging (MRI) findings were recorded to assess the predictive factors for TFESI outcomes. Pfirrmann Grades 1 and 2 were classified as low-grade nerve root compression and Grade 3 was classified as highgrade nerve root compression. RESULTS: Compared to baseline measurements there were significant improvements in radicular pain, ODI score, Laseque angle, and Schober test scores 3 months after injection. Improvements of at least 50% in radicular pain relief and the ODI functionality index were (n = 214) 82%, (n = 182) 70% respectively at 3 months. Correlation analyses revealed that a shorter duration of symptoms, lowgrade nerve root compression and foraminal/extraforaminal location on MRI findings were associated with a favorable response. CONCLUSIONS: Lowgrade nerve root compression was a predictor of a favorable response to TFESI. Show more
Keywords: Epidural injection, lumbar disc herniation, MRI imaging, treatment response, nerve root compression
DOI: 10.3233/BMR-230051
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Lim, Wootaek
Article Type: Research Article
Abstract: BACKGROUND: To measure hamstring flexibility, the active knee extension (AKE) test is preferred over the straight leg raise (SLR) test as it can be used to measure hamstring flexibility more selectively. However, hamstring stretching is primarily conducted in the SLR position (maximal hip flexion in the supine position) as it allows for maximal hip flexion in the supine position. OBJECTIVE: This study evaluates the effects of proprioceptive neuromuscular facilitation (PNF) stretching in the AKE position (maximal knee extension with 90 ∘ flexion of the hip in the supine position) on hip, knee, and …ankle flexibility. METHODS: SLR, AKE, and active dorsiflexion (ADF) tests were used to determine the range of motion (ROM) before (pre-ROM) and after (post-ROM) stretching. PNF stretching consisted of maximal isometric knee flexion at the end range with external resistance to prevent knee flexion. One set of PNF stretches (five trials of six seconds each) was conducted. RESULTS: The post-ROMs of hip, knee, and ankle measured via the SLR, AKE, and ADF tests, respectively, were significantly higher than the pre-ROMs. CONCLUSIONS: The improvement in knee flexibility was greater than the improvement in hip and ankle flexibility. The AKE position is recommended in clinical settings during PNF stretching for individuals with hamstring tightness. Furthermore, PNF stretching in the AKE position increases the ADF ROM. Show more
Keywords: Ankle flexibility, hip flexibility, knee flexibility, proprioceptive neuromuscular facilitation, stretching
DOI: 10.3233/BMR-230110
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-6, 2023
Authors: Li, Yameng | Mo, Pu-Chun | Peng, Fang | Guo, Jiaqi | Sheng, Zhongzhen | Lyu, Shaojun | Jan, Yih-Kuen
Article Type: Research Article
Abstract: BACKGROUND: The local hemodynamic response after cupping therapy has been considered as a contributing factor for improving muscle tissue health; however, the effects of cupping pressure and duration on the spatial hemodynamic response have not been investigated. OBJECTIVE: The objective of this study was to investigate the hemodynamic response inside and outside the cupping cup under various pressures and durations of cupping therapy. METHODS: A 3-way factorial design with repeated measures was used to investigate the main and interaction effects of the location (areas inside and outside the cup), pressure (- …225 and - 300 mmHg) and duration (5 and 10 min) on the hemodynamic response of the biceps muscle. A functional near-infrared spectroscopy was used to assess hemodynamic changes in 18 participants. RESULTS: A significant three-way interaction of the location, pressure, and duration factors was observed in oxyhemoglobin (p = 0.023), deoxy-hemoglobin (p = 0.013), and blood volume (p = 0.013). A significant increase was observed in oxyhemoglobin, blood volume, and oxygenation compared to pre-cupping (p < 0.05) in the area outside the cup. CONCLUSION: Our findings indicate that an appropriate combination of cupping pressure and duration can effectively affect the spatial hemodynamic response of the biceps. Show more
Keywords: Blood volume, dose response, hemoglobins, negative pressure, oxygen, oxyhemoglobins, skeletal muscle
DOI: 10.3233/BMR-230158
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-13, 2023
Authors: Igawa, Tatsuya | Ito, Riyaka | Takeuchi, Ayaka | Arai, Shiori | Kaga, Nanaka | Mashimo, Noa | Miyamae, Ruka | Urata, Ryunosuke | Kubo, Akira
Article Type: Research Article
Abstract: BACKGROUND: Elastic taping that applies shear force affects joint movement. However, it remains uncertain whether elastic taping or stretching is more effective in improving flexibility. OBJECTIVE: We investigated whether elastic taping for flexibility improvement is comparable to traditional stretching. METHODS: In this randomized controlled trial, 64 university students were randomly allocated to two groups: elastic taping on the sole or 30 s of static stretching. The primary outcome measures were the straight leg raising angle, tested with an equivalence margin (± 9.61 ∘ on changes), and …the fingertip-to-floor distance. Secondary outcomes were the hip flexor and knee extensor strength, two-step distance, adverse events, and pain intensity during the intervention, which were compared using conventional statistical methods. RESULTS: The mean differences in straight leg raising between the two groups after the interventions were not greater than the equivalence margin (mean [95% CI]: 1.4 [- 6.9, 9.5]; equivalence margin, - 9.61 ∘ to 9.61 ∘ ). There were no consistent differences between groups in terms of secondary outcomes except for pain intensity during the intervention (p > 0.05). Elastic taping did not induce pain. CONCLUSION: Elastic taping augments the flexibility-improving effect comparable to static stretching, based on an equivalence margin. Elastic taping of the sole appears to be an alternative method of improving flexibility. Show more
Keywords: Athletic tape, Muscle stretching exercises, Range of motion, articula, Randomized controlled trials as topic
DOI: 10.3233/BMR-230127
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Kim, Jin Seong | Hwang, Ui Jae | Chung, Kyu Sung | Yi, Chung Hwi | Choi, Woochol Joseph | Kwon, Oh Yun
Article Type: Research Article
Abstract: BACKGROUND: The restoration and management of the uninvolved side have been emphasized to prevent a second anterior cruciate ligament (ACL) injury and to ensure that athletes return to sports after ACL reconstruction. OBJECTIVE: To determine the factors influencing the single leg hop test (SLHT) and single leg vertical jump test (SLVJT) at 1 year postoperatively after ACL reconstruction in both the involved and uninvolved sides. METHODS: Ninety-four patients who underwent ACL reconstruction were assessed at 1 year postoperatively. Multiple regression models included eight independent variables with two dependent variables (SLHT and SLVJT.), each …on the involved and uninvolved side. RESULTS: On the involved side, the Y balance test (YBT), extensor peak torque per body weight (PT/BW), Biodex balance system anteroposterior index (BBS-API), and sex accounted for 53.9% of the variance in SLHT (P = 0.002), and extensor PT/BW and YBT accounted for 26.3% of the variance in SLVJT (P = 0.027). On the uninvolved side, YBT, sex, age, BBS-API, and flexor PT/BW accounted for 47.0% of the variance in SLHT (P = 0.046), and flexor PT/BW, YBT, and age accounted for 44.9% of the variance in SLVJT (P = 0.002). CONCLUSION: Knee extensor strength on the involved side and flexor strength on the uninvolved side influence the two functional performance tests. The YBT was an important factor in the two functional performance tests in both sides. Anteroposterior stability was the only factor that influenced the SLHT bilaterally. Show more
Keywords: Rehabilitation, posture control, torque
DOI: 10.3233/BMR-230121
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: ALJawaee, Madawi | Williams, Jonathan M. | Jones, Michael D.
Article Type: Research Article
Abstract: BACKGROUND: Despite wobble board use being common in physiotherapy the effect of certain factors, essential to clinical reasoning, have not been investigated. OBJECTIVE: To determine the effect of biological sex, anthropometrics, footwear and dual tasking (DT) on wobble board balance performance. METHODS: Eighty-six healthy participants (44 females) had their wobble board performance measured during double-leg-stance (DLS) with eyes open (DLSEO), closed (DLSEC) and single-leg-stance (SLS) tasks, with and without footwear and a DT added. Anthropometrics were also measured. RESULTS: Females outperformed males during most tasks, with some large effect sizes …(ES). Performance was moderately related to weight and shoulder, waist and hip circumference. Overall, there were no differences between footwear and no footwear, except for males during SLS. DT made little difference, except during DLSEO and SLS, where single task was better than DT, though only females had a large ES. CONCLUSION: During wobble board tasks, biological sex differences were observed and a modest correlation between anthropometrics and performance noted. DT and footwear had minimal effect. Show more
Keywords: Wobble board, dual task, footwear, gender, correlation
DOI: 10.3233/BMR-230020
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Maeda, Noriaki | Tsutsumi, Shogo | Arima, Satoshi | Ikuta, Yasunari | Ushio, Kai | Komiya, Makoto | Tashiro, Tsubasa | Nishikawa, Yuichi | Kobayashi, Toshiki | Nakasa, Tomoyuki | Adachi, Nobuo | Urabe, Yukio
Article Type: Research Article
Abstract: BACKGROUND: Foot arch dynamics play an important role in dynamic postural control. Association between foot arch dynamics and postural control among adolescent athletes remains poorly explored. OBJECTIVE: To examine the relationship between foot arch dynamics, intrinsic foot muscle (IFM) morphology, and toe flexor strength and dynamic postural stability after jump landing and repetitive rebound jump performance in competitive adolescent athletes. METHODS: Based on foot arch dynamics, evaluated from relative change in the foot arch height in sitting and standing positions, 50 adolescent athletes were classified as stiff, normal, or flexible. IFM morphology was …evaluated by ultrasonography. Dynamic postural stability index (DPSI) was measured as participants jumped and landed with the right leg onto a force plate, whereas repetitive rebound jumping performance was assessed using the jump height and reactive jump index. RESULTS: The stiff group had a significantly worse DPSI and vertical stability index than the normal group (p = 0.26, p = 0.44, respectively), and worse anteroposterior stability index (APSI) values than the flexible group (p = 0.005). Multivariate regression models of the relationship between the APSI and foot arch dynamics showed adequate power (probability of error = 0.912). CONCLUSIONS: Increased foot arch stiffness negatively affects dynamic balance during jump-landing, which may deteriorate their performance. Show more
Keywords: Jump, postural balance, ultrasonography
DOI: 10.3233/BMR-230122
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2023
Authors: Cha, Kyoung Hyeon | Yeo, Seung Mi | Son, Ju-Hyun | Kim, Young-Joon | Lee, Chang-Hyung
Article Type: Research Article
Abstract: BACKGROUND: Chronic low back pain (LBP) can lead to muscle spasms, limited range of motion, and abnormal posture, resulting in trunk muscle asymmetry. OBJECTIVE: This study aimed to assess the intra- and inter-rater reliability of a quantitative measurement of trunk coronal asymmetry in patients with chronic LBP, minimizing unnecessary gravity and friction force using a manual table in the prone position. METHODS: This prospective study was conducted at a single center, targeting patients with chronic LBP to measure trunk coronal asymmetry on a manual table in the prone position. The intra-class correlation coefficient …(ICC) was calculated using one-way random-effects and two-way mixed-effects models. RESULTS: Fifty-eight patients who had LBP for more than three months were enrolled from May 1, 2021, to December 31, 2021. The intra- and inter-rater reliabilities of the two examiners’ measurements were 0.872 and 0.899, and 0.852, respectively. Based on pain severity, the participants were classified into mild and severe groups, with ICCs of 0.823 and 0.889, and 0.936 and 0.918, respectively. CONCLUSION: Measurement of trunk coronal asymmetry in the prone position using a manual table demonstrates high intra- and inter-rater reliability. In addition, the reliability increases with greater pain severity. Show more
Keywords: Low back pain, prone position, visual analogue scale, spasm
DOI: 10.3233/BMR-230042
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Ashida, Yuzo | Miki, Takahiro | Kondo, Yu | Takebayashi, Tsuneo
Article Type: Research Article
Abstract: BACKGROUND: No study to date has concurrently evaluated the impact of radiological factors, psychosocial factors, and central sensitization (CS) related symptoms in a single lumbar spinal canal stenosis (LSS) patient cohort. OBJECTIVE: To investigate the associations between these factors and clinical symptoms in LSS patients. METHODS: We recruited 154 patients with LSS scheduled for surgery. Patient-reported outcome measures and imaging evaluation including clinical symptoms, psychosocial factors, CS-related symptoms, and radiological classifications. Spearman’s rank correlation coefficient and multiple regression analyses were employed. RESULTS: Spearman’s correlation revealed CS-related symptoms positively correlated with …low back pain (r = 0.25, p < 0.01), leg pain (r = 0.26, p < 0.01), and disability (r = 0.32, p < 0.01). Pain catastrophizing positively correlated with leg pain (r = 0.23, p < 0.01) and disability (r = 0.36, p < 0.01). Regression analysis showed that pain catastrophizing was associated with disability (β = 0.24, 95%CI = 0.03–0.18), and CS-related symptoms with low back pain (β = 0.28, 95%CI = 0.01–0.09). Radiological classifications were not associated with clinical symptoms. CONCLUSION: Our findings suggest that psychosocial factors and CS-related symptoms, rather than radiological factors, seem to contribute to clinical symptoms in patients with LSS. Show more
Keywords: Lumbar spinal canal stenosis, radiological factors, psychosocial factors, central sensitization
DOI: 10.3233/BMR-230093
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Zhong, Xiqiang | Shen, Guangjie | Qian, Yunfan | Li, Yimin | Tang, Chengxuan | Tang, Xiaojun | He, Shaoqi
Article Type: Research Article
Abstract: BACKGROUND: Percutaneous kyphoplasty (PKP) is the preferred treatment for osteoporotic vertebral compression fractures (OVCF) Currently, the preoperative anesthesia methods for PKP are mainly local anesthesia and tracheal intubation general anesthesia. OBJECTIVE: To assess whether patient sensitivity to pain measured preoperatively could predict the patients’ pain response during PKP treatment under local anesthesia, to facilitate the development of an optimal preoperative anesthesia plan for patients. METHODS: Fifty-five female patients diagnosed with osteoporotic single vertebral fracture who were treated with PKP under local anesthesia were selected. The patients’ pain sensitivities, including pain threshold and pain …tolerance threshold, were evaluated with a pain test device on the day before the operation in the ward. Heart rate (HR), mean arterial pressure (MAP), and blood oxygen saturation (SpO 2 ) were recorded before anesthesia, post-anesthesia, after needle puncture, and after balloon dilatation. At the same time, blood was drawn at the above time points to determine the level of norepinephrine (NA) as an indicator of intraoperative pain stress response. The numerical rating scale (NRS) during surgery was recorded at the end of the surgery. RESULTS: The preoperative pain tolerance threshold of 55 surgical patients was correlated with the intraoperative NRS score (r = - 0.768, P < 0.001), as well as with the preoperative and intraoperative changes in HR (r = - 0.791, P < 0.001), MAP (r = - 0.819, P < 0.001), and NA (r = - 0.553, P < 0.001). Thus, the lower the preoperative pain tolerance threshold, the more severe the patient’s response to pain during PKP treatment under local anesthesia, and the greater the hemodynamic changes. Consequently, the intraoperative experience becomes worse. However, there was no correlation between preoperative pain threshold and NRS scores (r = - 0.069, P = 0.616) nor between the preoperative and intraoperative changes in HR (r = 0.103, P = 0.453), MAP (r = 0.086, P = 0.535), and NA (r = - 0.058, P = 0.674). CONCLUSION: The results indicated that preoperative pain assessment could predict the level of pain response in OVCF patients during PKP surgery under local anesthesia. Show more
Keywords: PKP, OVCF, Pain threshold, Pain tolerance
DOI: 10.3233/BMR-230194
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-7, 2023
Authors: Dıracoglu, Demirhan | Sezikli, Selim | Dernek, Bahar | Yildirim, Mustafa Aziz | Sen, Ekin Ilke
Article Type: Research Article
Abstract: BACKGROUND: Many formulations and dosing regimens are available for hyaluronic acid (HA). OBJECTIVE: To compare different doses of linear, high-molecular weight (HMW) HA injections among patients with knee osteoarthritis (OA). METHODS: Hundred patients were included in this randomized, single-blinded trial and randomly divided into three HA injection groups. The first group received five weekly 20 mg HA injections, the second group received three weekly 32 mg HA injections, and the third group received a single 48 mg HA injection. Patients were evaluated at baseline, 1, 3, and 6 months after the last injection for pain, stiffness, and …function using the visual analog scale (VAS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire. Quality of life, patient’s global assessment, and Timed Up and Go (TUG) test scores were also evaluated. RESULTS: There was significant improvement in the WOMAC, VAS-pain, quality of life, patient’s global assessment, and TUG test mean scores at all follow-up time points (p < 0.001). However, the groups showed no significant differences in WOMAC, VAS-activity pain, and patient global scores at any follow-up point. CONCLUSION: Intra-articular injections of different doses of linear HMW HA can improve pain, stiffness, function, and quality of life in patients suffering from knee OA over a six-month period. Show more
Keywords: Hyaluronic acid, osteoarthritis, knee, intra-articular injection
DOI: 10.3233/BMR-230097
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Deniz, Volkan | Güzel, Nevin Atalay | Kelle, Bayram | Antmen, Ali Bülent
Article Type: Research Article
Abstract: BACKGROUND: Haemophilic arthropathy is likely to influence posture and muscle stiffness in adolescent male haemophilia patients (HP). OBJECTIVE: This study aimed to investigate the possible change in upright standing posture and stiffness of the superficial postural muscles in HP. METHODS: Twenty-two HP aged between 12 and 19 years and twenty-two healthy peers were included in the study. The photogrammetry was used to assess the upright standing posture from sagittal and frontal planes. Also, stiffness of the superficial postural muscles was evaluated using the myotonometry. RESULTS: A significant difference was found in …the craniovertebral, lumbar lordosis, knee flexion-valgus, and ankle plantar flexion angles between the groups (p < 0.05). Craniovertebral, knee flexion, and knee valgus angles were lower; whereas lumbar lordosis and ankle plantar flexion angles were higher in HP compared to the healthy peers. Stiffness of the rectus femoris muscle was lower in HP (p < 0.001). CONCLUSION: This study revealed that the ankle, knee, lumbar, and craniovertebral segments’ posture angles were changed and the stiffness of the rectus femoris muscle decreased in HP. Postural alterations and reduced rectus femoris stiffness should be considered in management of the musculoskeletal complications of haemophilia. Show more
Keywords: Alignment, bleeding disorders, muscle viscoelasticity, photogrammetry
DOI: 10.3233/BMR-230185
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Watanabe, Kota | Ashida, Yuzo | Hirota, Kento | Taniguchi, Tatsuya | Miyamoto, Hiroki | Teramoto, Atsushi
Article Type: Research Article
Abstract: BACKGROUND: Toe function is characterised by the strength and dexterity of toe motion. However, previous studies have mostly focused on the importance of toe strength. OBJECTIVE: This study aimed to investigate the relationships between flexion strength and dexterity of the toes and physical performance. METHODS: Twenty healthy participants were included in this study. The flexion force of each toe was measured using a digital force gauge, and the toe dexterity was evaluated using the marble pick-up and rock-paper-scissors tests. These parameters were statistically analysed in relation to physical performance, including repeated side step …and balance ability, which was evaluated using centre of pressure (COP) data during single-leg standing, tiptoe standing, and single-leg drop-jumping. RESULTS: A significant correlation was found between the first toe flexion force and the total trajectory length of the COP during one-leg standing and between the time required for marble pick-up and the rock-paper-scissors score and the COP during single-leg drop-jumping. CONCLUSION: The results underscore the importance of flexion strength and dexterity of the toes in human physical performance and the necessity for the evaluation and improvement of both functions. Show more
Keywords: Toe function, marble pick-up, rock-paper-scissors test, balance
DOI: 10.3233/BMR-230263
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-7, 2023
Authors: Yalfani, Ali | Abedi, Mitra | Raeisi, Zahra | Asgarpour, Azadeh
Article Type: Research Article
Abstract: BACKGROUND: Chronic low back pain (CLBP) is known as an important debilitating health condition among older women. OBJECTIVE: This study aimed to evaluate the effects of eight-week virtual reality training (VRT) exercises on postural sway and physical function performance (PFP) among older women suffering from CLBP. METHODS: Twenty-seven older women presenting with CLBP were randomized into experimental and control groups. The experimental group was instructed to perform 30-minute VRT exercises three times a week for eight weeks. Plantar pressure variables [sway velocity (SV) and anterior-posterior (AP) and medial-lateral (ML) fluctuations of the center …of pressure (CoP)], 30-second chair stand test (30CST), and timed up and go (TUG) test were recorded. RESULTS: The VRT group exhibited significant decreases in SV (p = 0.002), AP (p = 0.008), and ML (p = 0.02) fluctuations. Also, the performance of the VRT group in the 30CST and TUG tests significantly improved after the exercises (P < 0.001). CONCLUSION: According to the results, VRT and the program used in this study should be used to enhance balance and PFP in older women with CLBP who mostly prefer activities that are accessible and feasible in low-risk environments. Show more
Keywords: Aging, balance, exergaming, virtual reality exercises, COVID-19
DOI: 10.3233/BMR-230260
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Hernandez-Lucas, Pablo | Leirós-Rodríguez, Raquel | Lopez-Barreiro, Juan | García-Soidán, José L.
Article Type: Review Article
Abstract: BACKGROUND: Clinical practice guidelines stress the importance of prevention and treatment of non-specific back pain through exercise therapy. However, it has not yet been confirmed whether the combination of exercise plus education is more effective than such interventions taken separately. OBJECTIVE: To determine if the combination of exercise plus education is more effective for the prevention of non-specific back pain than exercise or education alone. METHOD: A systematic search of studies whose sample consisted of participants without non-specific back pain (primary prevention) and participants with non-specific back pain (secondary and tertiary prevention) was …conducted in the following databases in March 2023: PubMed, Scopus, Web of Science and Medline. RESULTS: A total of 16 articles were selected. Statistically significant results were found in the pain variable with SMD = - 2.02 (95% CI = - 2.71 to - 1.33; p < 0.001), the disability variable with SMD = - 1.14 (95% CI = - 1.63 to - 0.65; p < 0.001), and the kinesiophobia variable with SMD = - 1.8 (95% CI = - 2.54 to - 1.05; p < 0.001). CONCLUSION: Interventions that combine exercise and education seem to have a greater preventive effect on non-specific back pain, disability and kinesiophobia than those that include exercise or education in an isolated manner. Show more
Keywords: Exercise therapy, health education, primary prevention, secondary prevention, tertiary prevention
DOI: 10.3233/BMR-230252
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-14, 2023
Authors: Sekine, Chie | Yamamoto, Mayu | Hirabayashi, Ryo | Yokota, Hirotake | Edama, Mutsuaki
Article Type: Research Article
Abstract: BACKGROUND: Lumbar stabilization exercises (LSE) provide dynamic trunk stability, promote muscle strength and endurance, and improve low back pain rehabilitation and performance. OBJECTIVE: To clarify the differences in trunk muscle activity during LSEs on stable and different unstable surfaces. METHODS: Fifteen healthy males performed three exercises (elbow-toe, hand-knee, and side bridge) on stable (floor) and unstable surfaces. Muscle activity of the bilateral rectus abdominis, internal oblique, external oblique, and erector spinae were recorded. Data were compared using the Friedman test. Pairwise comparisons were performed using Wilcoxon’s signed rank test if significant differences were …observed. RESULTS: In the elbow-toe exercise, muscle activity of the rectus abdominis and right internal oblique increased in the following order: floor, low-difficulty, and high-difficulty unstable surface. In the hand-knee exercise, muscle activity of the internal oblique on the lower-extremity elevated side, external oblique, and erector spinae on the upper-extremity elevated side were greater on unstable surface exercise performance. In the side bridge exercise, rectus abdominis muscle activity was highest on a high-difficulty unstable surface. CONCLUSION: Trunk muscle activity increased during exercise on unstable surfaces. Since the effects of unstable surfaces vary depending on muscle and exercise types, exercise difficulty and surface stability must be considered accordingly. Show more
Keywords: Spine, electromyography, rehabilitation
DOI: 10.3233/BMR-230297
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Ikwuanusi, Stephanie | Tella, Abidemi | Akinbo, Sunday | Nwaedozie, Obianuju | Adje, Mishael
Article Type: Research Article
Abstract: BACKGROUND: Specific stabilisation exercises (SSE) can combat the debilitating effects of chronic non-specific low back pain (CLBP), improve disability, pain and fear-avoidance beliefs (FAB). OBJECTIVE: To elicit the determinants of outcome in patients with CLBP with associated FABs after treatment with SSE. METHOD: Twenty-nine patients (20 females) with CLBP were classified using FAB questionnaire into high or low Work and Physical Activity (PA) subscales. After 4-week treatment, evaluations were done for pain, disability and lumbar spine active range of motion (AROM). Data was analysed exploratory-descriptively with a significance level set at p < …0.05. RESULTS: Participants were aged 55.24 ± 11.91 years. They scored 19 (65.5%) and 5 (17.2%) respectively on Work and PA subscales. The post-intervention evaluation showed significant differences in all outcomes, but no significant difference between patients with high or low FAB scores for both subscales. PA scores correlated significantly with pain while work scores correlated significantly with disability. Participants’ gender predicted disability, pain and AROM with moderate to large effect sizes. CONCLUSION: SSE can potentially improve disability, pain and range of motion for patients with chronic low back pain regardless of FABQ status. Gender and baseline patient status are potential determinants of outcome of treatment using SSE. Show more
Keywords: Disability, kinesiophobia, chronic pain, lumbar stabilisation exercises
DOI: 10.3233/BMR-230312
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Ogrodzka-Ciechanowicz, Katarzyna | Kurzeja, Piotr | Sorysz, Tomasz
Article Type: Research Article
Abstract: BACKGROUND: Due to the systematically increasing number of shoulder replacement procedures among older people, the need to assess their quality of life is becoming more and more important. OBJECTIVE: The aim of the study was to functionally assess the shoulder joint and the quality of life of patients before and after reverse total shoulder arthroplasty (rTSA). METHODS: The observational study included 15 patients after the rTSA procedure (randomly selected). The quality of life and shoulder joint function before and after rTSA were assessed using the following scales: SF-36, Constant-Murley Score, Disabilities of the …Arm, Shoulder and Hand Scale (DASH) and the University of California-Los Angeles Shoulder Rating Scale (UCLA scale) and Simple Shoulder Test (SST). RESULTS: There were statistically significant differences (p < 0.001) between measurements in the overall scores of the SF-36 questionnaire. Statistically significant differences (p < 0.001) were found between measurements in terms of the Constant-Murley, DASH, UCLA and SST scales results. CONCLUSIONS: Reverse total shoulder arthroplasty significantly improved the patients’ quality of life and the functional condition of the operated limb. Show more
Keywords: Reverse total shoulder arthroplasty, quality of life, pain
DOI: 10.3233/BMR-230347
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2023
Authors: Ijiri, Tomohito | Suzuki, Toshiaki
Article Type: Research Article
Abstract: BACKGROUND: The normal value of the scapular muscle activity ratio during arm elevation is not clear. OBJECTIVE: To obtain normal values of the scapular muscle activity ratio during arm elevation in healthy individuals. METHODS: This cross-sectional study enrolled 47 healthy people. The participants performed shoulder flexion and lowered task with 90-degree movements every 2 seconds. Muscle activities of scapular muscles were measured. For normalization, the maximum isometric contraction of the shoulder flexion was measured at 90 ∘ (reference contraction). The integrated electromyographic value (IEMG) obtained during the task was …normalized by IEMG during the reference contraction and the relative IEMG value was calculated. Then, the scapular muscle activity ratio was computed. The relationship between muscle strength and other factors was also investigated. RESULTS: The median values for upper trapezius/serratus anterior and upper trapezius/lower trapezius were often approximately 1, and that for upper trapezius/middle trapezius was often between 1 and 2. The shoulder flexion isometric strength and scapular muscle activity ratio showed significant negative correlations in multiple phases. CONCLUSION: Normal values for upper trapezius/serratus anterior and upper trapezius/lower trapezius during arm elevation and lowering were generally 1. Low muscle strength may contribute to an abnormal scapular muscle activity balance. Show more
Keywords: Scapular muscle activity ratio, arm elevation, electromyography, muscle strength
DOI: 10.3233/BMR-230217
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2023
Authors: Afzal*, Muhammad Waqar | Ahmad, Ashfaq | Gilani, Syed Amir | Zulfaqar, Nimra | Fatima, Sahar | Mahmmod, Tahir
Article Type: Research Article
Abstract: BACKGROUND: Translation and validation of important scales in other languages reduce bias in reporting the functional status of the patient. OBJECTIVE: To translate the Back Pain Functional Scale into Urdu (BPFSu), adapt it for use in other cultures, and evaluate its psychometric properties. METHOD: According to Beaton guidelines, translation and cultural adaption was carried out. On 100 Urdu-literate men and women aged 18–60 years with lower back pain, the final BPFSu was assessed for psychometric qualities. First at baseline and again after 7 days, participants completed the BPFSu, the Functional Rating Index (FRI), and the …Numeric Pain Rating Scale (NPRS). RESULTS: Internal consistency of the BPFSu was excellent (Cronbach’s alpha: 0.937). No floor and ceiling effects were found Excellent test-retest reliability (ICC = 0.882, CI 95%; 0.830–0.919) was achieved. Spearman correlation coefficient showed criterion validity with the NPRS (rho = â 0.701, p ⩽ 0.001) and Pearson correlation coefficient showed construct validity with the FRI (r = â 0.740, p ⩽ 0.001). The minimum detectable changes were 9.96, while the standard error of measurement was 3.6. CONCLUSION: The BPFSu is a valid and reliable instrument for assessing physical function in individuals experiencing low back discomfort. Show more
Keywords: Back pain, back pain functional scale, translation, cross-cultural adaptation
DOI: 10.3233/BMR-230153
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2023
Authors: Özbudak, Pınar | Karataş, Özlem | Kaçar, Cahit
Article Type: Research Article
Abstract: BACKGROUND: Vitamin D deficiency is common in postmenopausal women and is associated with low vitamin D intake, increased age, decreased absorption. Especially at advanced age, vitamin D deficiency may increase muscle weakness and disbalance resulting in increased risk of fracture. OBJECTIVES: This study aims to explore the correlation between 25(OH) vitamin D3 levels and quadriceps muscle strength in postmenopausal women. METHODS: We evaluated bilateral qadriceps muscle strength in postmenopausal women with isokinetic test. We evaluated the correlation of muscle power with measurements of parathormone, vitamin D, Calcium, creatinine, alanine transaminase, alkaline phosphatase, total …creatine kinase. RESULTS: The mean vitamin D level of 95 participants included in the study was 18.24 ± 8.94 ng/ml. Vitamin D levels were found to be deficient (< 10 ng/ml) in 23 (24.1%), insufficient in 62 (65.26%) and normal in 10 (10.53%) of the 95 participants. A weak negative correlation was observed between participants’ vitamin D levels and PT values (r = - 0.271, p = 0.012). A moderate negative correlation was found between ALP and vitamin D levels (r = - 0.317, p = 0.002). However, there was no significant correlation between vitamin D levels and the 60 ∘ and 90 ∘ flexion and extension peak torque values (All p values > 0.05). CONCLUSIONS: Vitamin D levels and muscle strength weren’t statistically significant. Few studies are available in the related literature, highlighting the need for further research to achieve a clearer consensus. Show more
Keywords: Cholecalciferol, muscle strength correlation, postmenopause, vitamin D3
DOI: 10.3233/BMR-230172
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2023
Authors: Moreno-Navarro, Pedro | Sabido, Rafael | Barbado, David | Prat-Luri, Amaya | Vera-Garcia, Francisco J.
Article Type: Research Article
Abstract: BACKGROUND: Body tilt changes could affect the intensity/difficulty of core stability exercises, but there is still a lack of knowledge about its impact. OBJECTIVE: To analyse the trunk muscles activation during prone plank exercises at different body tilts. METHODS: Twenty-four young adults who performed recreational gymnastic activities participated in this study. Electromyography activity of the rectus abdominis (RA), external oblique (EO), internal oblique (IO) and erector spinae (ES) was recorded during the performance of six variations of the prone plank exercise (planking with feet supported on the ground [conventional horizontal position] and planking …with feet supported on wall bars at five different heights increasing the angle tilt) and an inverted position exercise. RESULTS: The RA, EO and IO activation in all prone plank variations were higher than those observed in the conventional prone plank. In addition, the coefficient of variation of the muscle activation increased with the declination angle, reaching the highest values in the inverted position for the RA and ES muscles. CONCLUSION: The results seem to indicate that the body tilt variation could be used as an easy and inexpensive strategy for modulating the neuromuscular demands and the motor control challenge during planking exercises. Show more
Keywords: Core stability, electromyography, load progression, training program
DOI: 10.3233/BMR-230209
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2023
Authors: de Sire, Alessandro | Lippi, Lorenzo | Calafiore, Dario | Marotta, Nicola | Mezian, Kamal | Chiaramonte, Rita | Cisari, Carlo | Vecchio, Michele | Ammendolia, Antonio | Invernizzi, Marco
Article Type: Research Article
Abstract: BACKGROUND: Vertebral fragility fractures (VFFs) commonly result from low bone mass and microarchitecture deterioration of bone tissue. spinal orthoses are common non-pharmacological options for managing vertebral fracture pain. However, the effects of spinal orthoses on pain, physical functioning, and quality of life (QoL) are still debated. OBJECTIVE: This survey aimed to investigate the patients-reported outcomes of a dynamic spinal orthosis prescribed in the routine clinical practice of VFFs management. METHODS: This multi-center national-wide prospective cohort study assessed older patients (aged > 60 years) diagnosed with acute VFFs and prescribed with a …dynamic spinal orthosis (Spinfast ® ). A survey questionnaire was realized and included sections on patient characterization, osteoporosis characterization, spinal orthosis, clinical outcomes, pain medications, and osteoporosis medications. The questionnaire was administered at baseline and after three months. A total of 68 patients completed the questionnaire at three months. Most patients had one or two VFFs and were treated with pain medications and osteoporosis medications. Compliance and tolerability of the spinal orthosis were assessed, and clinical outcomes such as pain intensity, physical functioning, and QoL were measured. RESULTS: The results showed no significant differences in outcomes between age subgroups. Italian physical medicine and rehabilitation physicians were commonly involved in the management of VFFs patients. Sixty-six patients completed the questionnaire. The results showed that pain intensity, physical functioning and QoL improved after three months of spinal orthosis wearing (p < 0.0001). CONCLUSION: The correct management of VFFs is mandatory to improve pain and reduce disability, and our findings suggested a positive role of dynamic spinal orthosis to improve the comprehensive management of VFFs patients. However, high-quality research trials are warranted to provide clear recommendations for the correct clinical management of VFF. Show more
Keywords: Osteoporosis, rehabilitation, spinal orthoses, spine, vertebral fractures
DOI: 10.3233/BMR-230177
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-13, 2023
Authors: Cihan, Emine | Şahbaz Pirinççi, Cansu | Leblebicier, Merve Akdeniz
Article Type: Research Article
Abstract: BACKGROUND: Osteoarthritis (OA) is a pathology that frequently affects the geriatric population. OBJECTIVE: To investigate the extent to which pain, functionality, and quality of life change over the progression of OA grades. METHOD: The study included 161 patients with bilateral OA, whose disease stages ranged from 1 to 4 according to the Kellgren-Lawrence radiographic classification system. Pain was assessed using the Visual Analog Scale (VAS), functionality using the two-minute walk test and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire, and quality of life using the Nottingham Health Profile (NHP). RESULTS: …There were significant differences between the groups in terms of age, weight, and body mass index. The VAS, two-minute walk test, and WOMAC scores also significantly differed between the groups (p < 0.05). There was a significant difference between the groups in all domains of the NHP, except for energy (p < 0.05). The two-minute walk test score was negatively correlated with all the remaining evaluation parameters (p < 0.05). No correlation was found between the energy domain of the NHP and body mass index, the VAS score, the two-minute walk test distance, or the total WOMAC score (p > 0.05). CONCLUSION: After grade 1, the functional impacts of OA on patients increased by an average of four times. Pain was one of the most basic symptoms, the severity of which started to increase in grade 2. With the added effect of diminishing walking capacity over time, the reduction in the quality of life of the patients accelerated as the OA grade progressed. Show more
Keywords: Osteoarthritis grade, function, pain, quality of life
DOI: 10.3233/BMR-230293
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-7, 2023
Authors: Chokphukiao, Pakwipa | Amatachaya, Sugalya | Poncumhak, Puttipong | Intaruk, Roongnapa | Thaweewannakij, Thiwabhorn | Somboonporn, Charoonsak | Peungsuwan, Punnee | Amatachaya, Pipatana | Sooknuan, Thanat
Article Type: Research Article
Abstract: BACKGROUND: Many older adults are at risk of sarcopenia, a gradual loss of muscle mass affecting muscle strength and physical function, which can lead to adverse health consequences deteriorating their independence. However, the detection could be delayed due to the requirement of many measures, including a complex imaging modality. Thus, an exploration for a practical community- or home-based measure would be helpful to identify at-risk older adults and begin the timely management. OBJECTIVE: To explore the ability of the upper limb loading during a seated push-up test (ULL-SPUT) to determine the presence of sarcopenia in community-dwelling …older adults. METHODS: Older adults (n = 110; 62 females, average age approximately 77 years) were cross-sectionally assessed for sarcopenia using standard measures (handgrip strength, appendicular skeletal muscle mass, and walking speed) and the ULL-SPUT. RESULTS: Data from standard measures indicated that 44 participants had sarcopenia. The ULL-SPUT index of < 16.9 kg/m 2 for females (sensitivity = 86%, specificity = 78%, area under the receiver operating characteristic curve [AUC] = 0.85) and < 19.7 kg/m 2 for males (sensitivity = 73%, specificity = 69%, AUC = 0.83) could optimally identify participants with sarcopenia. CONCLUSION: The ULL-SPUT index could be used to screen and monitor older adults with sarcopenia in various clinical, community, and home settings. This practical measure may be accomplished using a digital bathroom scale on a hard, even surface. Outcomes would identify an adult who should undergo further confirmation of sarcopenia through standard measures or the initiation of timely management to promote treatment effectiveness. Show more
Keywords: Body composition, community health services, frail elderly, muscle strength, health status
DOI: 10.3233/BMR-230143
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Park, Donghwi | Choi, Jin-Woo | Chang, Min Cheol
Article Type: Research Article
Abstract: BACKGROUND: Despite the application of various therapeutic methods, pain caused by complex regional pain syndrome (CRPS) is not sufficiently managed and often progresses to a chronic stage. For the systematic and effective treatment of CRPS, we developed an algorithm for multimodal medication therapy based on the established pathophysiology of CRPS to control CRPS-related pain. OBJECTIVE: In this study, we present the outcomes of our novel algorithm for multimodal medication therapy for patients with CRPS, consisting of three major components: multimodal oral medication, intravenous ketamine, and intravenous lidocaine therapy. METHODS: We retrospectively investigated patients …with CRPS who received multimodal therapy. Pain severity scores were evaluated using a numerical rating scale at four time points (P1, pain at initial consultation; P2, pain after oral medication; P3, pain after ketamine treatment; and P4, pain after lidocaine treatment). The effect of the multimodal medication therapy algorithm on pain management was evaluated at each time point. RESULTS: In patients with CRPS, multimodal oral medication, intravenous ketamine, and intravenous lidocaine therapies led to significantly improved pain control (p < 0.05). Additionally, the combination of these three therapies (through the multimodal medication therapy algorithm) resulted in significant pain relief in patients with CRPS (p < 0.05). CONCLUSIONS: Our multimodal medication therapy algorithm effectively controlled pain in patients with CRPS. However, further prospective studies with large sample sizes and randomized controlled trials are needed for more accurate generalization. Show more
Keywords: Complex regional pain syndromes, drug therapy, neuralgia, ketamine, lidocaine
DOI: 10.3233/BMR-230179
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Soares, Denise | Abbady, Karim | Kasap, Suat | Shabanliyski, Dimitar
Article Type: Research Article
Abstract: BACKGROUND: Weightlifting is an Olympic sport for dynamic strength and power, and requires the execution of different lifting techniques It is important to analyze the forces subjected to the lower back during weightlifting movements to prevent injuries. Digital Human Modeling (DHM) is a powerful tool that can be used to analyze and optimize the performance of humans while doing their work or activities. OBJECTIVE: The purpose of this study is to present a simulation analysis of the lower back forces during the execution of two weightlifting techniques: Snatch (SN) and Clean & Jerk (CJ), with different …loads and for both genders. METHODS: Digital Human modelling through JACK simulation package was used analyze the forces exerted on the lumbosacral area (L5-S1) of the lower back in order to determine the risk for low back injuries. The level of compression and shear forces recommended by the literature have been set as thresholds. The simulaitons were performed in male and female models, with loads from 20–100 kg. RESULTS: The results show that any weight higher than 60 kg in both movements poses risk for the weightlifters in terms of compression and shear forces. It has been observed that weightlifters can lift greater loads in the CJ technique compared to the SN technique. Furthermore, females are able to lift higher loads with lower risk of injuries. CONCLUSION: Weightlifting is a high-risk activity due to the high levels of shear and compression forces that the body is exposed to during the lifting techniques. Digital Human Modeling holds significant value due to their ability to facilitate the exploration of diverse conditions within a safe environment, devoid of any potential harm to human subjects. Show more
Keywords: Health, injury prevention, spine, female, male
DOI: 10.3233/BMR-230181
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Öztürk, Nazan | Öter, Emine Gerçek | Abacıgil, Filiz | Ersungur, Ecem
Article Type: Research Article
Abstract: BACKGROUND: Prolonged sitting and poor posture can contribute to musculoskeletal pain and have a negative effect on health-related quality of life (HRQoL) among young adults. Any prolonged posture leads to static loading of soft tissues and causes discomfort. Seated posture leads to inactivity causing an accumulation of metabolites, accelerating disk degeneration and musculoskeletal pain. Regular exercise has major contributions to the prevention and treatment of some health problems such as musculoskeletal disorders. OBJECTIVE: This study aimed to assess the impact of online posture exercises on musculoskeletal pain and health related quality of life among university students …receiving distance education during the COVID-19 pandemic. METHODS: This randomized controlled trial involved 72 students divided into intervention (n = 35) and control (n = 37) groups. The intervention group followed an 8-week online stretching and posture exercise program. Baseline and 8-week results were measured using the SF-36 QoL Questionnaire and Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). RESULTS: Students spent an average of 5.4 ± 2.5 hours daily at computers. While there was no difference between the scores of any region in the CMDQ in the control group, there was a decrease in the neck, right shoulder, left shoulder, waist, left upper leg, right lower leg, and left lower leg discomfort scores in the intervention group (p < 0.05). There was a significant difference between the intervention and control groups in the total score of SF-36 and the sub-dimensions of vitality and mental health (p < 0.05). CONCLUSION: The online posture exercise program led to notable reductions in musculoskeletal pain and improvements in QoL among university students. Examining the effectiveness of online exercise programs in different age groups is important for health benefits during quarantines. Show more
Keywords: Musculoskeletal pain, quality of life, posture, exercise
DOI: 10.3233/BMR-230279
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Pawłowska, Katarzyna Maria | Pawłowski, Jakub | Grochulska, Agnieszka
Article Type: Research Article
Abstract: BACKGROUND: Hip osteoarthritis is a major civilizational challenge of the ageing population, usually due to the reduced function of gait. In the light of this fact, gait analysis has become an important issue for the doctor, the physiotherapist and the patient, as it serves as a useful tool in diagnosis, recovery, and rehabilitation. Pedobarography is one of the most modern gait analysis methods. OBJECTIVE: The aim of this study is to assess the distribution of pressure forces of the foot on the ground during gait in patients with hip osteoarthritis. METHODS: Dynamic foot …tests were performed by means of a two-meter RSscan ® International platform, equipped with 16.384 sensors with the scanning frequency level exceeding 500 Hz. Patients were divided into two groups: the research group of N = 60 individuals with hip osteoarthritis, aged 52–84; and the control group of N = 32 individuals without hip osteoarthritis, aged 50–74. Data distribution analysis was performed with the Shapiro-Wilk test, followed by a non-parametric Mann-Whitney U test. RESULTS: The differences between the mean results of maximal peak values of pressure and force in such areas as the big toe, metatarsal I, III, IV, V, lateral and medial heel are significantly lower in the research group than in the control group. Only in the area of metatarsal II, the mean value of pressure is higher in the research group than in the control group. For all metatarsals, the midfoot and medial heel mean results of the contact area are significantly higher in the research group than in the control group. The differences between mean load rate were also tested. The test revealed statistical significance of metatarsal II and III, and the medial heel while metatarsal II displayed a higher mean value in the research group than in the control group. CONCLUSION: The distribution of the pressure forces of the foot can indicate imbalances which cause degenerative changes. Therefore, early detection of changes can help in prevention or delay of hip osteoarthritis in conjunction with proper therapy. Show more
Keywords: Hip osteoarthritis, gait, pedobarography
DOI: 10.3233/BMR-230195
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Passos, Muana Hiandra Pereira dos | Pícon, Sol Patrícia Beltrán | Batista, Gabriel de Amorim | Nascimento, Vinícius Yan Santos | Oliveira, Felipe Augusto da Silva | Locks, Francisco | Pitangui, Ana Carolina Rodarti | de Araújo, Rodrigo Cappato
Article Type: Research Article
Abstract: BACKGROUND: Low back pain is prevalent in workers’ health and functional performance. OBJECTIVE: To evaluate the effects of a physical exercise program on low back pain and disability in fruit workers. METHODS: This randomized controlled trial assigned 44 workers (37 ± 9 years) to two groups. The experimental group consisted of 10 men and 12 women with an average age of 38 (± 9) years, and the control group consisted of 8 men and 14 women with an average age of 36 (± 10) years. The experimental group (EG) performed …a program of strength and flexibility exercises for eight weeks, twice a week. The control group (CG) received minimal care, with a booklet with guidelines for performing exercises. The primary outcomes included changes in perceived disability and the intensity of pain evaluated by the Rolland-Morris questionnaire and the Numerical Pain Scale, respectively. All outcomes were measured at baseline and after eight weeks of intervention. RESULTS: A significant difference was observed in the within-group analysis, with a mean reduction in pain intensity in the EG and CG of - 4.55 (95%CI - 7.01 to - 2.09) and - 3.81 (95%CI 1.72–5.90), respectively. For disability, a reduction of - 4.45 (95% CI - 8.89 to - 0.02) was observed in the EG and of - 4.43 (- 7.38 to - 1.48) in the CG. There were no significant differences in the between-groups analysis. CONCLUSIONS: The exercise program was not superior to using the educational booklet. However, both interventions showed substantial decreases in pain and disability levels. Show more
Keywords: Low back pain, occupational health, farmer, exercise
DOI: 10.3233/BMR-230201
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Yang, Sen | Chen, Can | Tang, Yong | Li, Kai | Yu, Xueke | Tan, Jiulin | Zhang, Chengmin | Rong, Zhigang | Xu, Jianzhong | Luo, Fei
Article Type: Research Article
Abstract: BACKGROUND: Degenerative spinal deformity (DSD) is believed to originate from degeneration of the discs and facet joints and vertebral wedging. Currently, the nosogeny of DSD is not yet fully clarified and there has been no systematic study on the impact of their lower back muscle strength on quality of life. OBJECTIVE: To determine the characteristics of back extensor strength (BES) in different body positions and examine their correlations with health-related quality of life (HQOL) in degenerative spinal deformity (DSD) patients. METHODS: Participants comprised 60 DSD patients and 40 healthy volunteers. Maximal isometric BES …was evaluated by dynamometers with the subject in three different positions (standing, prone, sitting). The visual analogue scale (VAS) score, Oswestry Disability Index (ODI), Roland–Morris Disability Questionnaire (RMQ), and 36-item Short Form Health Survey (SF-36) score were used to evaluate patient HQOL. Correlations between the BES in different body positions and HQOL were analysed. RESULTS: The BES values in three body positions were significantly smaller in DSD patients than healthy subjects (P < 0.05). The standing BES was found to be negatively associated with ODI and RMQ (R = 0.313, p < 0.05 and R = 0.422, p < 0.01, respectively). A negative relationship between sitting BES and RMQ was also seen (R = 0.271, p < 0.05). In addition, the standing and prone BES were positively correlated with the physical functioning score of the SF-36 (R = 0.471, p < 0.01 and R = 0.289, p < 0.05, respectively), and the sitting BES was positively correlated with the role-physical score of the SF-36 (R = 0.436, p < 0.01). CONCLUSION: The results indicate that the back extensor muscle is compromised in DSD patients and there are differences in predicting the severity of disability and physical HQOL scores with BES in different positions. Standing BES was the most reliable contributor to HQOL among three body positions. Show more
Keywords: Back muscles, spine, spinal diseases
DOI: 10.3233/BMR-230206
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Kudo, Shintarou | Hatanaka, Mizuki | Kanazawa, Seiya | Hirakawa, Keisuke | Hara, Shigeyuki | Tsutsumi, Masahiro
Article Type: Research Article
Abstract: BACKGROUND: Short foot exercises (SFE) take a long time to master and require a feedback tool to improve motor learning. OBJECTIVE: This study aimed to investigate the effect of bio-feedback of talonavicular joint movements in learning SFE with ultrasound (US) imaging. METHODS: This study included thirty-one healthy volunteers and was designed as a double-blind randomized control trial. Subjects were randomly assigned to one of two groups: the control group, which performed SFE under verbal instruction, and the US bio-feedback (USBF) group, which performed SFE with real-time bio-feedback of the talonavicular joint alignment. All subjects …underwent two sessions of 5 minutes each, and SFE was performed as a self-exercise, between sessions, for one week. The difference in foot length and navicular height were assessed at baseline, after Session 1, before Session 2, and one week after Session 2. These differences were compared between the two groups using the Mann-Whitney U test. RESULTS: In terms of navicular height change, the USBF group (7.5 ± 4.3 mm) was significantly higher than the control group (4.2 ± 3.3 mm) one week after session 2 (p = 0.04, effect size = 0.86). CONCLUSION: SFE with USBF is an effective intervention for performing SFE. Show more
Keywords: Foot exercise, ultrasonography, motor learning, bio-feedback
DOI: 10.3233/BMR-230163
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2023
Authors: Zhang, Yafei | Chai, Tingting | Weng, Hao | Liu, Yang
Article Type: Research Article
Abstract: BACKGROUND: Previous studies have suggested an association between pelvic rotation (PR) and scoliotic deformity in severe adolescent idiopathic scoliosis (AIS), but none have investigated this relationship in mild to moderate AIS. OBJECTIVE: To investigate the relationship between PR and trunk rotation in mild to moderate AIS. METHODS: This was a case-control study. The cases were 32 AIS patients with PR in the opposite direction to the thoracic curve, and the controls were 32 AIS patients with PR in the same direction as the thoracic curve. All patients were assessed with the Adams forwards …bend test. Type II trunk rotation was selected as exposure. Logistic regression was used to estimate the association between PR direction and types of trunk rotation while accounting for confounders. Multiple linear regression was used to analyse the relationships between PR magnitude and the angle of trunk rotation (ATR). RESULTS: Logistic regression showed an unadjusted OR of 9.13 (95% CI 2.92–28.50, P < 0.001), and adjustment for sex and Cobb angle only slightly changed the OR (adjusted OR, 8.23; 95% CI, 2.51–27.01; P = 0.001). The concave/convex ratio was associated with ATR measurements in both cases (β = - 0.379; P = 0.030) and controls (β = - 0.468, P = 0.008). CONCLUSION: An association was found between PR and trunk rotation, which may help achieve more effective physiotherapy in mild to moderate AIS. Show more
Keywords: Anthropometry, pelvis, rotation, scoliosis
DOI: 10.3233/BMR-230070
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Deen, Nazar | Akhtar, Saeed | Qazi, Fawad Hafeez | Uzair, Rahila | Khan, Mohammad | Tasneem, Sharjeel
Article Type: Research Article
Abstract: BACKGROUND: Cervical radiculopathy is a common condition encountered in clinical practice and is characterized by compression or irritation of the nerve roots in the cervical spine. OBJECTIVE: To compare the effectiveness of manual intermittent cervical longitudinal mobilization (mICLM) and therapeutic modalities in managing acute, sub-acute and chronic radiculopathy pain. METHODS: This was a multicenter, double-blinded, randomized controlled trial. Individuals with radiculopathies were randomized into interventional; (IG, n = 18) receiving mICLM and control group; (CG, n = 17), receiving Microwave Diathermy (MWD) and …transcutaneous electrical nerve stimulation (TENS) at the cervico-dorsal area daily for two weeks. The neck pain disability index (NPDI), numeric pain rating scale (NPRS), and global rating of change score (GRoC) were used as outcome measures. Statistical analysis was conducted using SPSS version 23.0. RESULTS: Both mICLM and MWD with TENS were equally effective in reducing the pain and disability in either group. However, it was noted that mICLM had a better impact on acute, sub-acute and chronic cases of radiculopathy pain comparatively. Mean age was 42.3 (SD = ± 10.9) years. 54.3% were between the age group of 40–60 years out of which 51.4% were male and 48.6% were female. 51.4% were in IG and 48.6% were in CG. The mean comparison of NPAD and NPRS within groups was significant with p < 0.01 * . Post treatment mean comparison of NPAD outcomes in IG and CG remain significant with p = 0.004 * and p < 0.01 * respectively. The post NPAD and NPRS between IG and CG were found statistically insignificant with p = 0.75 and p = 0.57 respectively. CONCLUSION: mICLM and therapeutic modalities showed similar outcomes in managing radiculopathy pain. The study highlights the need for further research to understand the effectiveness of these interventions in larger patient populations. Show more
Keywords: Cervical pain, radiculopathy, pain stages, longitudinal mobilizations, therapeutic agents, exercises, and outcome measures
DOI: 10.3233/BMR-230154
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-12, 2023
Authors: Lee, Jun-Hyeok | Jeon, Hye-Seon | Park, Joo-Hee | Kim, Ji-Hyun | Kwon, Oh-Yun | Choi, Woochol Joseph | Kim, Young-Ho | Kim, Jong-Man
Article Type: Research Article
Abstract: BACKGROUND: Maintaining correct posture and optimal spine function has become an important issue due to the increased use of computers and smartphones. OBJECTIVE: To investigate the effect of a 4-week downhill treadmill exercise (DTWE) program on participants with thoracic kyphosis and forward head posture (FHP). METHODS: Twenty-eight male participants were randomly assigned to the DTWE (n = 14) or standard treadmill walking exercise (STWE) (n = 14) group. They performed 30-minute exercise three times a week for 4 weeks. The vertebral angle was measured …using a three-dimensional (3D) motion analysis system. Surface electromyography (EMG) was performed to record muscle activity in the thoracic erector spinae (TES), sternocleidomastoid muscle (SCM), and cervical erector spinae (CES). RESULTS: The DTWE group showed significant increases in the craniovertebral angle (CVA) and TES EMG activity and significant decreases in the thoracic kyphosis angle and SCM and CES EMG activity compared with those shown by the STWE group following the intervention (p < 0.05). However, lumbar lordosis or pelvic tilt angles did not differ significantly between the groups after the intervention (p > 0.05). CONCLUSIONS: DTWE can be effective in reducing thoracic kyphosis and FHP without causing compensatory movements of the lumbar spine and pelvis. Show more
Keywords: Electromyography, kinematics, rehabilitation
DOI: 10.3233/BMR-230187
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-7, 2023
Authors: Scaturro, Dalila | de Sire, Alessandro | Vitagliani, Fabio | Lo Nardo, Davide | Tomasello, Sofia | Ammendolia, Antonio | Letizia Mauro, Giulia
Article Type: Research Article
Abstract: BACKGROUND: Muscle injuries are common traumatic events in the clinical practice of the rehabilitation field. There is still a gap in the scientific literature on the effectiveness of physical agent modalities in the management of muscle injuries in athletes. OBJECTIVE: The aim of this study was to assess the effectiveness of cryo plus ultrasound therapy com-pared to diathermy in combination with high-intensity laser therapy (HILT) for pain relief in professional footballers with muscle injuries. METHODS: A case-control study was conducted on 31 professional footballers with a muscle injury of the lower limbs. Of these, …17 patients, assigned to a Group A (AG), were treated with HILT and cryoultrasound therapy; the remaining 14 patients, assigned to a Group B (BG), underwent HILT and diathermy. We assessed the extent of the pain, the size of the muscle injury, frequency of recurrence and number of days to recovery, at the time of recruitment, at the end of the rehabilitation and 3 months after the injury. RESULTS: Group A athletes had a greater benefit on pain (4.65 ± 0.61 vs 3.24 ± 0.63; p < 0.05) and muscle injury recurrence. The return to play in the athletes of group A took place 4.73 days earlier. CONCLUSION: HILT and cryo plus ultrasound therapy, in combination with therapeutic exercise, rep-resent a valid strategy in the treatment of muscle injuries in professional footballers. Show more
Keywords: Athletic injuries, physical therapies, rehabilitation, muscle performance, football
DOI: 10.3233/BMR-230265
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Yoon, Ji-Yeon | Shin, Sun-Shil
Article Type: Research Article
Abstract: BACKGROUND: Step width during walking can provide important information about aging and pathology. Although knee osteoarthritis (OA) is a common disease in elderly women, little is known about how different step widths influence gait parameters in patients with knee OA. OBJECTIVE: To address this, we investigated the differences between narrower and wider step width on the center of mass (CoM) and gait biomechanics of elderly women with knee OA. METHODS: Gait and CoM data were measured using a three-dimensional motion capture system and anthropometric data were acquired via standing full-limb radiography. Thirty elderly …women with knee OA were divided into two groups depending on the average step width value (0.16 m). Specifically, the narrower step width group included those with a below average step width (n = 15) and the wider step width group included those with an above average step width (n = 15). The differences between the two groups were analyzed using an independentt -test. RESULTS: Walking speed, step length, knee and ankle sagittal excursion, and medial-lateral CoM range were significantly greater in the narrower group. In contrast, the medial-lateral CoM velocity, medial-lateral ground reaction force (GRF), and foot progression angle were significantly higher in wider group. The external knee adduction moment, vertical GRF, and vertical CoM did not differ between the groups. CONCLUSIONS: Our data indicate that step width in women with knee OA is associated with trunk motion and gait patterns. People with a narrower step might improve their gait function by increasing trunk frontal control to maintain gait stability. In contrast, in those with a wider step, greater toe out angle and shorter step length might be a compensatory adaptation to reduce knee loading. Show more
Keywords: Knee osteoarthritis, step width, gait stability, center of mass, joint loading
DOI: 10.3233/BMR-230232
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Silver, Jacob | Mancini, Michael | Pavano, Colin | Bauer, Jordan | Barkay, Gal | Moss, Isaac | Mallozzi, Scott
Article Type: Case Report
Abstract: BACKGROUND: Distinguishing between cervical nerve root and intrinsic shoulder pathology can be a difficult task given the overlapping and often coexisting symptoms. OBJECTIVE: The objective of this study was to highlight the often-complicated presentation of these symptoms and the subsequent potential for delay in care regarding this subset of patients. METHODS: A total of 9 patients, managed by one of two different surgeons, were identified with a history of C5 nerve root palsy. A chart review was conducted, and the following information was recorded: presenting complaint, time from symptom onset to diagnosis, time from …symptom onset to presentation to a spine surgeon, first specialist seen for symptoms, non-spinal advanced imaging and treatment conducted before diagnosis, preoperative and postoperative exam, time to recovery, and type of surgery. RESULTS: We observed an average time from onset of symptoms to presentation to a spine surgeon to be 31.6 weeks. These patients’ time to full recovery after cervical decompression was 15 weeks. CONCLUSION : We observed a critical delay to presentation in this series of patients with C5 nerve palsy. C5 nerve palsy should remain an elemental part of the differential diagnosis in the setting of any shoulder or neck pain presenting with weakness. Show more
Keywords: C5 palsy, cervical radiculopathy, shoulder pain, neck pain, spine surgery
DOI: 10.3233/BMR-230182
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-5, 2023
Authors: Wator, Jennifer | Battis, Aurora | Vellucci, Chris | Beaudette, Shawn M.
Article Type: Research Article
Abstract: BACKGROUND: Rowing-related low back disorders may occur from inconsistent technique, high trunk flexion and training volumes, overactivation of paraspinal muscles, and fatigue. OBJECTIVE: To examine if kinesiology tape (KT) affixed to the trunk dorsum affects muscular co-activation and neuromuscular control to limit dangerous rowing movements and associated injuries. METHODS: Participants (n = 18) completed two 2000 m rowing trials under BASELINE and KT conditions. KT was applied to the skin superficial to the paraspinals bilaterally with 60% pre-strain. Participants were instructed to minimize any sensation of tension. Whole body …kinematics were obtained using inertial measurement units (IMUs), and surface electromyograms (EMGs) were recorded from trunk and lower extremity. Changes in joint range-of-motion (ROM) and co-activation indices (CAIs) were analyzed for shoulder, lumbar, hip, and knee. RESULTS: Responding participants (n = 5) were identified by reduced maximum lumbar flexion during the KT condition. As expected, significant differences occurred in maximum and minimum lumbar flexion/extension between responders and non-responders to KT. Additionally, there was significant reduction in mean trunk muscle co-activation in both those who did and did not respond to KT through reductions in maximum lumbar flexion. CONCLUSION: KT can be an effective at reducing mean trunk co-activation during a rowing trial in the flexed catch position. Variable responses suggest that further work is necessary to optimize the efficacy of sensory cues derived from KT during rowing movements. Show more
Keywords: Electromyography, lower back pain, lumbar, sensory feedback
DOI: 10.3233/BMR-230216
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Abujaber, Sumayeh | Altubasi, Ibrahim | Hamdan, Mohammad | Al-Zaben, Raed | Bani-Ahmad, Omar
Article Type: Research Article
Abstract: BACKGROUND: Knee osteoarthritis (OA) is a debilitating condition that leads to functional limitations. Self-reported questionnaires and performance-based tests are tools commonly used for measuring physical function. OBJECTIVES: (1) To evaluate the impact of end-stage knee OA on functional outcomes and examine the association between self-reported and performance-based measures of function in patients with end-stage knee osteoarthritis awaiting total knee arthroplasty (2) To explore the interrelationships among pain, strength, and overall physical function in this patient population. METHODS: In this cross-sectional analysis, 33 patients with end-stage knee OA were recruited and completed the knee …Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) and executed performance-based tests including the Timed Up and Go, the 30-second chair stand test, and the Stair Climbing Test. Knee pain, and isometric hip and knee strength were evaluated. RESULTS: Patients perceived deficits in their physical functionwith a score of 35/100 on the KOS-ADLS and demonstrated functional limitations in all performed tasks. KOS-ADLs was weakly associated with TUG and 30s-CST (r = - 0.301, p = 0.047, and r = 0.39, p = 0.014. respectively). Knee pain was linked with the KOS-ADL score and GRS score (r = - 0.406, p = 0.010; r = - 0.343, p = 0.027; respectively), while the strength of the affected side was correlated with the performed (p = < 0.001) and reported function outcomes (p = 0.007). CONCLUSION: Participants exhibit declines in both perceived and executed functional abilities. Self-reported and performance-based functional measures are weakly correlated within our study group, highlighting the importance of incorporating both measures in clinical practice for a comprehensive evaluation of physical function. Pain was linked to subjective aspect of physical function, while strength was connected to perceived and performed functional capacity. Implementing a tailored rehabilitation program targeting muscle weakness and pain holds the potential to mitigate functional decline in individuals awaiting total knee arthroplasty (TKA). Show more
Keywords: Patient reported outcome, functional performance, muscle strength, pain
DOI: 10.3233/BMR-230256
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Bertelè, Laura | Giorgi, Valeria | Bellavite, Paolo | Apostolo, Giovanni | Ortolani, Riccardo | Fila, Alice | Zanolin, Elisabetta
Article Type: Research Article
Abstract: BACKGROUND: Adolescent idiopathic scoliosis is a complex condition whose pathogenesis may include inflammation and signs of joint and bone degeneration. OBJECTIVE: The main objective of this study is to evaluate the relationship between the severity of adolescent idiopathic scoliosis and inflammatory blood parameters. METHODS: The study recruited patients with adolescent idiopathic scoliosis who attended the Rehabilitation Center of the Apostolo Foundation in Merate (LC). The scoliosis curve (Cobb’s angle) was used as a severity index to compare with inflammatory blood parameters (white blood cells subpopulations, immunoglobulins, protein electrophoresis). In addition, the study used …an overall severity grading called “Scoliosis Score” which includes all spine angles and Risser’s score (bone development index). RESULTS: Thirty-four subjects were recruited (mean age 14 years, 2 months), 30 females and 2 males. A significant correlation was found between Cobb’s angle and the percentage values of beta-2 globulins in a directly proportional manner (r = 0.42, p = 0.01), and gamma globulins in an inversely proportional manner (r = - 0.366, p = 0.04). However, no significant correlation between Cobb’s angle and the absolute values of white blood cells and percentage subpopulations was found (r = 0.0821 p = 0.655). A moderate, inverse correlation was found between the Scoliosis Score and the percentage of neutrophils (r = - 0.385, p = 0.02), a direct correlation was found between the Scoliosis Score and the percentage of lymphocytes (r = 0.404, p = 0.02). In addition, there was a strong correlation of the Scoliosis Score with alpha-2 globulin (r = 0.564, p = 0.0012), beta-1 globulin (r = 0.478, p = 0.0074), and beta-2 globulin (r = 0.370, p = 0.044) and an inverse relationship with gamma globulin (r = - 0.625, p = 0.0002). The main correlations were confirmed by regression analysis. CONCLUSION: The correlation between beta-2 globulins and gamma globulins with Cobb’s angle and the Scoliosis Score suggests a link between spinal curvature and inflammation in scoliosis patients, This link may indicate the significance of these parameters for diagnosing, staging the disease, and monitoring therapies. Show more
Keywords: Beta 2 globulins, cobb’s angle, electrophoresis, inflammation, plasma proteins, scoliosis
DOI: 10.3233/BMR-230186
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Hou, Xiaofei | Hu, Hailiang | Kong, Chao | Zhang, Sitao | Wang, Wei | Lu, Shibao
Article Type: Research Article
Abstract: BACKGROUND: The factors affecting lumbar spinal function in patients with degenerative lumbar spinal stenosis (DLSS) are still unclear. OBJECTIVE: This study explored psoas major muscle morphology in patients with DLSS and its association with their functional status. METHODS: A retrospective study was conducted on 288 patients with DLSS and 260 control subjects. Psoas major muscle evaluation included three morphometric parameters at the L3/4 disc level: psoas major index (PMI), muscle attenuation, and psoas major morphological changes (MPM). The association between psoas major morphology and functional status was assessed using the Oswestry disability index (ODI). …RESULTS: Both female and male patients with DLSS had a higher PMI and lower muscle attenuation. PMI and muscle attenuation were inversely correlated with age in the DLSS group. After multivariable analyses, the PMI and psoas major muscle attenuation were positively correlated with patients’ functional status. CONCLUSION: The PMI and muscle attenuation were positively correlated with functional status in patients with DLSS. These findings have important implications for physiotherapy programs of postoperative rehabilitation and conservative management of DLSS. Show more
Keywords: Degenerative lumbar spinal stenosis, psoas major muscle, morphology, functional status, oswestry disability index
DOI: 10.3233/BMR-230138
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Xu, Hanxiao | Liu, Heng
Article Type: Research Article
Abstract: BACKGROUND: Patients with Parkinson’s disease frequently experience problems with balance and gait. OBJECTIVE: This study examined the influences of regular ankle isokinetic muscle strength training on muscle strength and balance ability amongst elderly women with mild Parkinson’s disease. METHODS: A total of 55 elderly women with mild Parkinson’s disease were randomly divided into the experimental group (n = 28) and the control group (n = 27) for 16 weeks. The experimental group was trained for 16 weeks by using isokinetic muscle strength training. RESULTS: …After 16 weeks of training in the experimental group, the peak torque (PT) of ankle (average of the left and right sides) dorsiflexion, plantarflexion, eversion and inversion, and the standing balance index revealed that the left and right stability and overall stability indexes significantly increased by 25.9%, 43.5%, 62.7%, 82.8%, 37.1% and 32.2%, respectively (p < 0.05). The experimental group exhibited significantly increased PT of ankle dorsiflexion, plantarflexion, eversion and inversion. Moreover, the left and right stability and overall stability indexes were significantly improved compared with those of the control group (p < 0.05). This study found a linear regression relationship between the PT of ankle inversion and overall stability index. CONCLUSION: This study determined that ankle isokinetic muscle strength training improved ankle dorsiflexion, plantarflexion, eversion and inversion muscle strength, and balance ability amongst elderly women with mild Parkinson’s disease. However, it did not improve stability in the anterior and posterior directions. Ankle inversion muscle strength is more likely to affect overall balance. Show more
Keywords: Isokinetic training, muscle strength, mild Parkinson’s disease, balance
DOI: 10.3233/BMR-230259
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Zhang, Peng | Shen, Xiangyu | Zhang, Lin | Wang, Sheng | Wu, Qinfeng
Article Type: Research Article
Abstract: BACKGROUND: Adolescent idiopathic scoliosis (AIS) is the most common structural deformity of the spine during adolescence, which could cause varying degrees of physical and mental damage to patients. Schroth therapy and sling exercise are widely used in the treatment of patients with AIS currently, and have shown the significant therapeutic effect relatively. OBJECTIVE: To observe the efficacy of sling exercise combined with Schroth therapy on adolescents with mild idiopathic scoliosis (MIS). METHODS: Sixty patients with AIS were randomly divided into the Schroth+ sling group (n = …31) and the Schroth group (n = 29). Patients in both groups received Schroth therapy, and sling exercise was added in the Schroth+ sling group. Before and after 12 weeks of treatment, the Cobb angle, angle of trunk rotation (ATR), Scoliosis Research Society-22 (SRS-22) scale score and averaged electromyography (AEMG) of bilateral paraspinal muscles were evaluated. RESULTS: After the treatment, Cobb angle, ATR in both groups were decreased compared with those before (P < 0.001), and the decrease in the Schroth+ sling group was more obvious (P < 0.05). The AEMG of bilateral paraspinal muscles and the total score, posture, mental health of SRS-22 of the two groups improved compared with those before treatment (P < 0.05), and the Schroth+ sling group had a significant improvement than the Schroth group (P < 0.05). CONCLUSION: Schroth therapy improved the degree of scoliosis, torticollis, quality of life, and bilateral paraspinal strength on adolescents with mild idiopathic scoliosis. The effect was more pronounced when the sling exercise was included in the treatment regimens. Show more
Keywords: Adolescent, scoliosis, exercise therapy, electromyography
DOI: 10.3233/BMR-230102
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Srivastava, Shalini | Karvir, Sagar | Girandola, Robert N.
Article Type: Research Article
Abstract: BACKGROUND: Low back pain (LBP) has emerged as a major public health concern leading to significant work productivity loss and deterioration in the quality of life. OBJECTIVE: A randomized, double-blind, placebo-controlled parallel-group clinical trial was conducted to investigate the effect of E-PR-01, a proprietary blend of Vitex negundo leaves and Zingiber officinale rhizome, in individuals with LBP. METHODS: Seventy-two individuals aged 18 to 60 years with LBP were randomized in a 1:1 ratio in either the E-PR-01 or placebo group. The participants were instructed to take 2 capsules/day of the study products in …two divided doses for 30 days. The study outcomes were changes in functional activity, bending flexibility, pain intensity, work productivity, and sleep quality. The sustained effect of the study products was also evaluated on the pain and physical functioning for 7 days after stopping the product intake. The product’s safety was evaluated by adverse events reporting throughout the study. RESULTS: Compared to the placebo, the E-PR-01 demonstrated a statistically significant reduction in functional disability (mean RMQ score: - 5.47 vs. - 2.48), pain intensity (mean VAS score: - 31.29 vs. - 14.55) and improved bending flexibility (mean distance: - 5.60 vs. - 2.38 cm). In addition, a significant improvement in work productivity as well as sleep quality was also observed. In the E-PR-01 group, a statistically significant sustained effect was observed compared to the placebo for the pain intensity (p < 0.0005) and the functional activity (p < 0.0001) scores. No significant adverse event was reported in the study. CONCLUSION: E-PR-01 significantly improved low back pain and bending flexibility in adults without adverse effects. Moreover, the effect of E-PR-01 lasted 7 days after stopping the intervention. Show more
Keywords: Low back pain, Vitex negundo, zingiber officinale, physical function, work productivity, sleep quality
DOI: 10.3233/BMR-230197
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-16, 2023
Authors: Liu, Yaoyao | Kim, Minhee
Article Type: Research Article
Abstract: BACKGROUND: In the working environment of modern society, a poor sitting posture for a prolonged time may lead to abnormal spinal alignment such as thoracic kyphosis (TK). OBJECTIVE: This study aimed to evaluate the efficacy of taping for posture correction of patients with TK, providing theoretical and empirical guidance for clinicians attempting to rectify TK posture. METHODS: The study included 15 subjects aged 30–60 years, all with a TK angle of ⩾ 40 ∘ . Subjects were required to ascend and descend a set of three steps (a …low step, high step, and second low step) under three different conditions: without tape assistance, with taping assistance using 20% elongation, and with taping assistance using 40% elongation. A triaxial accelerometer was employed to measure and compare the anterior-posterior (AP), vertical (VT), and medial-lateral (MIL) movements of the thoracic vertebrae in the different conditions. RESULTS: There were no significant differences in the MIL (P = 0.903) or AP (P = 0.114) movements between the no tape assistance and 20% elongation taping conditions. However, a significant difference was found in the VT movement (P = 0.017). Comparing the no assistance condition to the 40% elongation taping condition, no significant changes were noted in the MIL movement (P = 0.650), but significant differences were detected in both the VT (P = 0.003) and AP movements (P = 0.016). No significant differences were found in any of the three measurements between 20% and 40% elongation taping. CONCLUSION: Taping serves as an effective method for immediately improving kyphotic posture. It corrects the position of the scapula and cervicothoracic line and exerts passive retraction on the relevant muscles, thus mitigating trunk imbalance. Show more
Keywords: Alignment, athletic tape, musculoskeletal pain, postural balance
DOI: 10.3233/BMR-230027
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2023
Authors: Sun, Zhenhui | Li, Nan | Yang, Zhi | Zhang, Wenhui | Liu, Jie
Article Type: Research Article
Abstract: BACKGROUND: Anatomical cup implantation is a promising approach in primary total hip arthroplasty (THA) and improves functional outcomes. OBJECTIVE: We aimed to evaluate the cup position and functional outcomes in primary THA with preoperative dynamic 3D planning. METHODS: We retrospectively reviewed 54 hips in 48 patients who underwent primary THA with anatomical cup implantation (mean follow-up time: 52 months). Cup positions were evaluated based on patient-specific morphology, the acetabular fossa and the combined anteversion test. Functional outcomes were assessed after THA. The paired-sample t -test was performed for surgical and contralateral native …hips among 42 patients who underwent unilateral THA. RESULTS: Two hips suffered intraoperative trochanteric fracture, but no hip dislocations occurred. No patients reported groin or thigh pain, and all patients were capable of deep squatting and one-leg standing. The mean Harris hip score, WOMAC score, and physical SF-36 score were 94.46 ± 6.16, 10.41 ± 3.62, and 95.19 ± 8.74, respectively. Except for acetabular offset, THA restored biomechanics to those of contralateral native hip, including cup anteversion, abduction, femoral offset and acetabular height (P > 0.05). CONCLUSION: This study provided evidence for the application of anatomical cup implantation assisted with dynamic 3D planning in primary THA, which restored morphology and improved functional outcomes. Show more
Keywords: Total hip arthroplasty, acetabular cup implantation, 3D planning, retrospective study
DOI: 10.3233/BMR-230004
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Soufivand, Parviz | Gandomi, Farzaneh | Assar, Shirin | Abbasi, Homayoun | Salimi, Mehran | Ezati, Mozhgan | Pournazari, Mehran | Shahsavari, Soodeh
Article Type: Research Article
Abstract: BACKGROUND: There has been a dearth of research into the benefits of water-based workouts for ankylosing spondylitis (AS) patients. OBJECTIVE: This study aimed to compare the effect of Aqua Stretch and Aqua Pilates in improving quality of life (QOL), function, and pain in AS patients. METHODS: This study was conducted on 40 patients, who were randomly assigned to the Aqua Pilates, Aqua Stretch, and control groups. The experimental groups attended interventions for six-week. QOL, pain intensity, function, and fatigue were measured before and after treatments. RESULTS: Except for the chest …expanding, all variables in the Aqua Stretch group changed significantly after six weeks (p < 0.05). QOL (p = 0.002), 6MWT (p = 0.016), and Schober flexion (p = 0.011) showed changes, while BASDAI (p = 0.0001), VAS (p = 0.0001), fatigue (p = 0.0001), and Schober extension (p = 0.028) showed significant decreases. Except for chest expansion and Schober extension, which did not alter significantly after six-week of Aqua Pilates (p > 0.05), all other variables did. There was an increasing trend in 6MWT and Schober flexion (p = 0.021) and a decreasing trend in BASDAI (p = 0.002), VAS (p = 0.0001) and fatigue (p = 0.002). Except for QOL (p = 0.016), no statistically significant differences were found between the groups. CONCLUSION: All variables had a significant change after six-week Aqua Stretch, except for the chest expanding. Chest expanding and Schober extension were the variables which had no significant change after six-week Aqua Pilates. With the exception of QOL, no statistically significant differences were found between the groups. Aqua Stretch had the greatest effect on the VAS, as measured by the minimum clinically relevant differences (MCID). Moreover, in Aqua Stretch alone, there was a notable impact on fatigue, QOL, and the BASDAI. Show more
Keywords: Spine, rheumatoid srthritis, disability, fatigue, patient
DOI: 10.3233/BMR-230077
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-12, 2023
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