Journal of Back and Musculoskeletal Rehabilitation - Volume 10, issue 2
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Journal of Back and Musculoskeletal Rehabilitation is a journal whose main focus is to present relevant information about the interdisciplinary approach to musculoskeletal rehabilitation for clinicians who treat patients with back and musculoskeletal pain complaints. It will provide readers with both 1) a general fund of knowledge on the assessment and management of specific problems and 2) new information considered to be state-of-the-art in the field. The intended audience is multidisciplinary as well as multi-specialty.
In each issue clinicians can find information which they can use in their patient setting the very next day. Manuscripts are provided from a range of health care providers including those in physical medicine, orthopedic surgery, rheumatology, neurosurgery, physical therapy, radiology, osteopathy, chiropractic and nursing on topics ranging from chronic pain to sports medicine. Diagnostic decision trees and treatment algorithms are encouraged in each manuscript. Controversial topics are discussed in commentaries and rebuttals. Associated areas such as medical-legal, worker's compensation and practice guidelines are included.
The journal publishes original research papers, review articles, programme descriptions and cast studies. Letters to the editors, commentaries, and editorials are also welcomed. Manuscripts are peer reviewed. Constructive critiques are given to each author. Suggestions for thematic issues and proposed manuscripts are welcomed.
Abstract: The purpose of this study was to investigate changes in gait variables while transporting a load at a self-selected velocity in two asymmetric positions, shoulder carry and hand carry, as they compare to the unloaded condition. Thirty-two healthy individuals (16 male and 16 female) with a mean age of 29 years participated in the study. The participants walked for a distance of 5 m at a self-selected velocity on the GAITRite™ mat, carrying a load equivalent to 25% of their body weight. The gait parameters investigated were cadence, step-to-extremity-length ratio, stride length, step time, heel to heel base of support…and velocity. A two-way analysis of variance for gender and carrying technique was performed. The results of the study demonstrated that men and women display significantly different gait parameters under the three load conditions. The means showed trends in increased cadence, decreased heel to heel base of support, step-to-extremity-length ratio, stride length and step time, when the unloaded, hand carry and shoulder carry were compared. Transporting an asymmetric load with either a shoulder carry or hand carry showed significant difference in cadence and right and left step time when compared to walking without a load. Based on the trends noted, carrying asymmetric loads for short distances should incorporate the shoulder carry technique, since the gait parameters deviate the least from walking without a load.
Abstract: Current estimates indicate that between 50 and 90% of patients with cancer experience pain. The World Health Organization has outlined a three-step analgesic ladder, that, if followed will result in close to 90% pain relief. Opioids should not be withheld for fear of addiction or respiratory depression and are clearly the most effective systemic analgesic available for patients with cancer-related pain. Unfortunately, opioids can also cause side effects including, but not limited to, constipation and mental cloudiness. Interventional therapies and physical modalities can decrease pain without systemic side effects associated with opioids and should be considered a useful adjunct in…the battle against pain. It is likely that by incorporating interventional and non-pharmacologic approaches, the success rate of pain control and the quality of life can be improved.
Abstract: This article reviews the medical literature and describes the author's personal experience with the physician's role in workers' compensation. Work disability costs approach $150 billion in the United States. Legal aspects of workers' compensation and the Americans with Disabilities Act are reviewed. The physician specializing in industrial medicine and occupational rehabilitation can be involved in any or all of several components of care: prevention, new employee screens, urgent care, rehabilitation of chronically disabled employees and determination of work-relatedness and disability. Each of these components is discussed in detail.
Keywords: Workers' compensation, Americans with Disabilities Act, Cumulative trauma disorder, Low back pain
Abstract: Purpose: To review literature regarding clinical response to injections of botulinum toxin type A for a variety of painful disorders of involuntary muscular contraction. Methods: A MEDLINE search for the headings ‘botulinum toxin’, ‘myofascial pain’ and ‘pain’ was performed for the period 1966 to September 1997. Results: Eighteen references including 463 subjects were generated. Seven studies included ‘pain’ or ‘myofascial pain’ within the article title, while the remaining references reported pain response within the context of treatment for underlying spasticity, cervical dystonia, fibromyalgia, focal dystonia, hemifacial spasm, painful dystonia of Parkinson’s disease, pain of chronic pancreatitis,…writer’s cramp and masseteric hypertrophy. Results of pain response in the cited studies were favorable in all except in fibromyalgia and chronic pancreatitis. The authors discuss instruments to measure pain intensity and physical functioning for future research and introduce a new instrument that includes self-reported pain assessment linked to joint position. Conclusion: Evidence suggests that BTX-A effectively reduces painful muscular contractions associated with a variety of neurologic conditions. Further research is needed to define conditions in which injections will be most effective.