Journal of Back and Musculoskeletal Rehabilitation - Volume Pre-press, issue Pre-press

Authors: Kandeel, Mahmoud | Morsy, Mohamed A. | Khodair, Khalid M. Al | Alhojaily, Sameer

Article Type: Research Article

Abstract: BACKGROUND: Cognitive functional therapy (CFT) aims to address low back pain (LBP) comprehensively by considering physical, psychological, and social factors. OBJECTIVE: The objective was to evaluate the effectiveness of CFT in reducing pain and disability in individuals with LBP over various time intervals. METHOD: A comprehensive literature search was conducted to identify relevant randomized controlled trials (RCTs) assessing the effects of CFT on LBP. RESULTS: In this study, 1510 records were initially identified, and 7 studies were included in the analysis. Disability scores were significantly reduced after CFT had been …applied for 6 to 8 weeks (SMD = - 0.46, 95% CI [- 0.74, - 0.19]), 12 weeks to 3 months (SMD = - 0.54, 95% CI [- 0.72, - 0.36]), 6 months (MD = - 5.82, 95% CI [- 9.82, - 1.82]), and 12 months (SMD = - 0.4, 95% CI [- 0.55, - 0.26]). There were also significant reductions in pain scores observed after 12 weeks to 3 months (SMD = - 0.49, 95% CI [- 0.68, - 0.3]), 6 months (MD = - 0.75, 95% CI [- 1.5, - 0.0001]), and 12 months (SMD = - 0.27, 95% CI [- 0.42, - 0.12]). CONCLUSION: CFT showed potential for improving disability scores for individuals with LBP across various time intervals. However, its impacts on pain scores varied. Show more

Keywords: Cognitive functional therapy, low back pain, randomized controlled trials, meta-analysis, pain scores, disability scores

DOI: 10.3233/BMR-240230

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2024

Authors: Lv, Xing | Su, Yu | Wu, Chou | Gu, Chin-Yi | Li, Jia-Qi | Wang, I-Lin

Article Type: Research Article

Abstract: BACKGROUND: Chronic nonspecific low back pain (CNLBP) is a leading cause of disability and remains a major burden for many public health systems. Acupuncture is a nonpharmacological treatment for CNLBP that can be effective in improving low back pain; nevertheless, its effect on improving back muscle endurance in patients with CNLBP and its duration of effect have not been studied. OBJECTIVE: The goal of this study was to assess the impact of acupuncture on lower back muscle activity in CNLBP patients. METHODS: This was a single-blind, randomized, crossover experimental study. Thirty female patients …were randomized into Group A (15 patients) or Group B (15 patients). Patients in Group A were assigned to receive real acupuncture (RA) in the first phase and sham acupuncture (SA) in the second phase, while those in Group B received SA first and then RA, with a 1-week washout period between phases. Two-way repeated ANOVA was used to evaluate the effect of group and time on isokinetic parameters, Surface electromyography (sEMG) data, and blood data. RESULTS: Significant interaction effects were identified between group * time on the isokinetic parameters of the lumbar extensor muscles, sEMG values of the erector spinae, blood lactate levels, and blood ammonia levels (all p < 0.05). Compared with those of the SA group, the isokinetic parameters of the lumbar extensor muscles, sEMG values of the erector spinae, blood lactate levels, and blood ammonia levels of the RA group were significantly different (all p < 0.05). CONCLUSION: RA improves lumbar extensor endurance in patients with CNLBP and lasts approximately 9 minutes. RA can improve blood circulation to reduce blood lactic acid and blood ammonia produced during exercise. Show more

Keywords: Acupuncture points, muscle strength, surface electromyography, paraspinal muscles

DOI: 10.3233/BMR-240213

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-19, 2024

Authors: Yang, Yuming | Zhao, Ben | Xue, Youdi | Dai, Weixiang

Article Type: Research Article

Abstract: BACKGROUND: Severe osteoporotic vertebral compression fracture (SOVCF) is frequently complicated by endplatedisc complex (EDC) injury. While percutaneous kyphoplasty (PKP) can offer rapid analgesia and facilitate early activity, it does not restore vertebral height and may result in intervertebral leakage and untreated EDC injury. OBJECTIVE: This study aimed to evaluate the clinical outcomes of percutaneous functional spinal unit cementoplasty (PFSUP) for SOVCF complicated by EDC injury and compare its clinical and imaging outcomes with PKP. METHODS: This was a retrospective case-control study. Patients with SOVCF complicated with EDC injury between January 1, 2018, and December …31, 2019, were recruited and assigned to the PKP group and PFSUP group based on their treatment procedures Back pain was evaluated using the visual analog scale (VAS) and daily life activities were assessed using the Oswestry disability index (ODI). X-rays were employed to observe the presence and location of cement leakage, as well as to measure the sagittal vertical axis (SVA) and local kyphosis angle (LKA). Loss of correction was calculated by subtracting the LKA after surgery from that at the final follow-up visit Subsequent vertebral fracture (SVF) was confirmed using the Genant semi-quantitative method and/or MRI. RESULTS: A total of 64 patients were included in this study. Among them 41 cases were assigned to the PKP group (28 females, 74.8 years on average), while the remaining 23 cases were assigned to the PFSUP group (15 females, 76.3 years on average). All surgical interventions were successfully completed without major complications. Compared to the PKP group, the PFSUP group had longer operation time (70.28 ± 11.44 vs 44.5 ± 10.12, P < 0.001) higher frequencies of radiation exposure (97.6 ± 19.85 vs 38.6 ± 9.53, P < 0.001), and a lower cement leakage rate (26.1% vs. 41.5%, P < 0.001). One day after surgery and at the final follow-up the PFSUP group had lower VAS and ODI scores, as well as lower LKA and Sva values compared with the PKP group (all P < .001). At the final follow-up visit, the PFSUP group demonstrated a lower loss of correction (4.38 ± 2.71 vs. 10.19 ± 3.41 P < 0.001) and a lower SVF rate compared to the PKP group (21.7% vs. 31.7%, P < 0.001). CONCLUSION: PFSUP outperformed PKP in alleviating pain restoring and maintaining sagittal balance, and lowering the incidence of cement leakage and SVF for SOVCF with EDC injury However, PFSUP was associated with longer operation time and high radiation exposure frequencies. Show more

Keywords: Osteoporosis, spinal fractures, vertebral endplate, bone cement

DOI: 10.3233/BMR-240145

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2024

Authors: Lara-Palomo, Inmaculada Carmen | Capel-Alcaraz, Ana María | García-López, Héctor | Castro-Sánchez, Adelaida María | Querol-Zaldívar, María de los Ángeles | Fernández-Sánchez, Manuel

Article Type: Research Article

Abstract: BACKGROUND: Chronic low back pain can severely affect quality of life. While several treatments are available, the combination of therapies often results in better outcomes. OBJECTIVE: This study delves into the comparative effectiveness of combining monopolar dielectric diathermy radiofrequency (MDR) with supervised therapeutic exercise against the latter treatment alone. METHODS: A randomized single-blind controlled trial was conducted. The intervention group (n = 30) received MDR with supervised therapeutic exercises for eight weekly sessions for four weeks. The control group (n = 30) received …only the same exercise protocol. The following self-report measures were assessed before the first treatment session, at four, and 12 weeks: disability, pain, kinesiophobia, quality of life, sleep quality, emotional distress, isometric trunk strength, and trunk flexion range. RESULTS: Repeated ANOVA measures revealed significant time*group interactions for the McQuade test (p = 0.003), the physical role (p = 0.011), vitality (p = 0.023), social function (p = 0.006), and mental health subscales (p = 0.042). Between-group analyses showed significant differences for all outcomes at each follow-up: RMDQ (post-treatment, p = 0.040), ODI (post-treatment and 12-week, p = 0.040), VAS (p < 0.001), TSK (p < 0.001), and McQuade Test (p < 0.020). CONCLUSION: The combination of diathermy radiofrequency with supervised therapeutic exercise significantly surpasses the efficacy of supervised therapeutic exercise alone, showcasing improvements in pain, disability, kinesiophobia, lumbar mobility in flexion, and overall quality of life in patients with chronic low back pain. Show more

Keywords: Chronic low back pain, diathermy, electrophysical agents, radiofrequency, physiotherapy, therapeutic exercise

DOI: 10.3233/BMR-240118

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-14, 2024

Authors: Kulinkumar, Rutwa Pandya | Yasin, Faris Bani | Singh, Om Prakash | Abdulla, Fuad A. | Balaganapathy, Murugananthan | Madhanagopal, Jagannathan

Article Type: Research Article

Abstract: BACKGROUND: Many independent studies have investigated the role of normalized maximal voluntary isometric strength (MVIS) of lower limb muscle groups (MVISLLMG) by body weight and summed knee and ankle muscle strength in predicting the risk of falling among older persons. However, it is unknown which MVISLLMG is better at predicting the fall risk. OBJECTIVE: This study aimed to compare different MVISLLMG in predicting fall-risk among older persons against the reference standard (history of falls). METHODS: This study had a cross-sectional retrospective diagnostic research design. 47 fallers and 93 non-fallers were recruited from Anand …district, Gujarat, India, using sequential sampling. The MVISLLMG was measured with a microFET® 2 hand-held dynamometer. Following feature selection, four machine learning (ML) models (Random Forest (RF), k-Nearest Neighbors (KNN), Navie Bayes (NB), and Kernel Support Vector Machines (SVM)), were utilized to assess the diagnostic characteristics of every measured MVISLLMG in comparison to the reference standard. The best ML model was chosen based on the highest diagnostic performance in predicting fall-risk. RESULTS: Among the ML models, the NB revealed that the non-normalized summed MVIS of knee and ankle muscle (Sensitivity (Se) = 87%, Specificity (Sp) = 91%, Accuracy (Ac) = 90%, Precision (Pr) = 84%) has the best diagnostic characteristics in fall-risk prediction against the fall history, followed by non-normalized MVIS of hip abductor, knee extensor, plantar flexor, and dorsiflexor, normalized summed MVIS of hip sagittal and knee muscle, and normalized MVIS of hip sagittal and frontal, knee, and plantar flexor. CONCLUSION: These results suggest that non-normalized summed MVIS of knee and ankle muscles is the better fall predictor in older persons compared to other index measures. This finding may assist clinicians in playing a better role in selecting suitable MVISLLMG data for fall risk assessment and predicting falls. Show more

Keywords: Muscle strength, fall, sensitivity, older persons, prediction

DOI: 10.3233/BMR-240142

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2024