Journal of Back and Musculoskeletal Rehabilitation - Volume 17, 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: To determine the reliability and validity of a new ultrasound bone densitometry instrument, we studied 41 healthy volunteers (27 females and 14 males, mean age 33.8 yrs, range 22–45 yrs), who underwent ultrasound measurements with QUS-2 (Metra Biosystems Instrument [Quidel]). The measurements were repeated three times in the same visit (mean coefficient of variation 3.4%, range 0.64–10.87%). Fifteen of these subjects repeated the three measurements in two subsequent visits, 7 days apart from each other. There was a significant variability between subjects (p = 0.0001) and within subjects (p = 0.004). To compare the measurement performed with the new equipment…with that of the gold standard, 19 subjects underwent a bone mass measurement by dual X-ray photon absorptiometry (DXA, Hologic QDR 4500A). The broadband ultrasound attenuation correlated with the total femur and femoral neck bone mineral density (r = 0.61, p = 0.005; r = 0.4, p = 0.09, respectively), but not with lumbar spine r = 0.34, p = 0.15). The mean coefficient of variation of the three ultrasound measurements performed in each of the subjects was 3.4% (range 0.64–10.87%). QUS-2 Metra Biosystems ultrasound densitometer does not seem at the moment a useful tool to assess bone mass in clinical setting, because of its high coefficient of variation and its high intra- subject variability.
Abstract: Study design: Objective. To examine the effects of a four-week anti-gravity exercise program on cervical strength. Background. Home exercise programs are widely prescribed by physical therapists. This study tested the effectiveness of an unsupervised home exercise program designed to increase cervical muscle strength. Methods and measures: In this randomized, controlled clinical trial, a convenience sample of 48 male and female subjects was randomly assigned to receive a home exercise program (experimental group, n = 21) or no treatment (control group n = 27). Cervical muscle strength was measured before and after the intervention period using a MicroFET2 hand-held…dynamometer. The experimental group was instructed to perform the cervical anti-gravity exercises, at home three, times a week for four weeks. Results: The treatment group demonstrated increased cervical muscle strength while strength of control group subjects remained essentially unchanged. The difference in the change in strength was statistically significant for motions except left rotation (p = 0.07). Strength gains in the treatment group ranged from 20 Conclusion: The home exercise program of anti-gravity cervical muscle strengthening exercises was effective in increasing cervical muscle strength in healthy young adults.
Keywords: cervical musculature, hand-held dynamometer, exercise program
Abstract: Thirty mothers of children with muscular dystrophies who had a minimum of 2 years of low back pain were reviewed. The purpose was to determine whether subjects with physical impairments are more susceptible to back pain as a result of cumulative trauma stemming from carrying their disabled children. Specifically, this study was performed to investigate the occurrence of low back pain and disability in mothers of children with neuromuscular disorders. Physical impairment has not previously been associated with mothers' back pain. There are, however, relationships between the mother's weight, the child's weight and VAS. The mothers' muscle strength of trunk…flexion and extension, flexibility of trunk flexion and lateral flexion, and endurance of abdominal muscles were measured. Body Mass Index of the mothers and children were calculated. In order to assess low back pain, the Oswestry Low Back Pain Disability Questionnaire and Visual Analogue Scale were used. There were statistically positive correlations between body mass index of children, body mass index of mothers, weight of mothers, Oswestry Scores of mothers and visual analogue scale. As mothers who are responsible for all the daily activities of their disabled children, evaluation of related musculoskeletal problems should be addressed and the appropriate protective back care programs should be explained and prescribed in order to help them in their caregiver roles.
Keywords: low back pain, neuromuscular disorders, impairment
Abstract: A study to compare the therapeutic efficacy of aerobic exercise and paroxetine in fibromyalgia syndrome. The aim of this study is to compare the therapeutic efficacy of aerobic exercises versus paroxetine in a randomized, controlled study. Sixty female patients between ages 18–50, diagnosed as fibromyalgia syndrome by the 1990 American College of Rheumatology criteria were randomly allocated to one of three groups. Group I was given aerobic exercises on bicycle ergometer for 40 minutes, 3 times a week for 6 weeks, group II was given paroxetine 20 mg daily for 6 weeks and group III was given placebo Transcutaneous Electrical…Nerve Stimulation for 20 minutes, 3 times a week for 6 weeks as a control group. All groups were evaluated at admission, termination and at the end of 6 months by Visual Analog Scale (VAS), pressure algometric testing, weekly analgesic consumption for pain intensity. They were also evaluated for psychological and social status, Beck Depression Inventory. Statistical analysis was done by the SPSS (Statistical Package for Social Sciences) program with T-test, Oneway-Anova, Mann-Whitney U, Wilcoxon Rank Sum Test and post-hoc. Pain threshold with pressure algometer, pain intensity by VAS and BDI scores showed significant decrease compared to scores of the group III at termination of the study and at 6 months follow-up while base-line evaluation parameters demonstrate no significant statistical differences between groups. Analgesic consumption was reduced only in group I. As a result this study shows that paroxetine and aerobic exercises have better therapeutic effect when compared to placebo group on short and long-term follow-up with no significant difference on evaluation parameters in two groups.
Abstract: Low back pain is one of the most common health problems facing the developed countries of the world and 75% of the population suffer from back problem at some time during their lives. Sixty-two patients with mechanical low back pain were evaluated for presence of pes planus and hallux valgus deformities. We grouped our patients as the foot deformity and normal feet groups according to the presence of hallux valgus and/or pes planus. Patients with at least one deformity were accepted as the deformity group. VAS, Quebec back pain disability scale and Oswestry disability questionnaire were inquired to assess disability…and pain. Thirty-eight of 62 patients had pes planus and/or hallux valgus in their bilateral feet. There was significant difference between Quebec and Oswestry scores of normal and deformity groups. Our analysis displayed good correlation between indicators of pain and disability: VAS and Quebec and Oswestry scores. We observed that presence of foot deformities increases disability levels in low back pain patients.
Keywords: low back pain, Oswestry, Quebec, disability, foot deformity
Abstract: This study investigates the relationship between psychological distress and disturbed sleep characteristics in patients with chronic low-back pain. Higher levels of psychological distress are expected to be related to lower sleep quality, more pain and stiffness in the morning and a different physical activity pattern during the night. Patients were divided into a group with a high level (PD-subjects, n = 13) and a group with a low level (ND-subjects, n = 13) of psychological distress, using the Distress-and-Risk-Assessment-Method. Also, 12 non-symptomatic subjects (NS-subjects) participated. Pain intensity, stiffness and sleep quality when waking up were measured alongside activity pattern…during the night. Results showed relationships between psychological distress and sleep quality; PD-subjects experienced significantly more pain and stiffness in the low back when waking up and a lower sleep quality compared to ND and NS-subjects. PD-subjects also had a significant lower lying time, a higher general activity level but moved less while lying down.
Abstract: This study sought to examine the ability of motion analysis to detect long and short-term changes in performance following lumbar decompression surgery. These changes were compared with changes in more traditional questionnaire based assessments of outcome. Fifty-two patients from an original pool of 84 patients who underwent spinal surgery were assessed pre-operatively using spinal motion analysis and standard questionnaires of pain and function. These assessments were repeated at 6 weeks, and 6 months post-operatively. Significant Improvements in back and leg pain were noted at 6 weeks (p < 0.001) with no further improvements occurring at 6 months. Changes…in the Oswestry Disability Score were noted only at the 6-month review, and only certain constructs of the SF-36 reported improvement. Of the motion analysis measures only measures of sagittal posture and anterior-posterior flexion appeared sensitive to change in the patient's condition. However, change in motion was not correlated with change in functional disability scales or pain. Measures of posture and range of motion of flexion may provide useful indices of objective performance in future outcome studies, however, they do not correlate with changes in subjective function or pain, thus their full relevance remains uncertain.
Keywords: spinal motion, spinal surgery, outcome, function