Journal of Back and Musculoskeletal Rehabilitation - Volume 19, issue 4
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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 aim of this study was to investigate the relationship between estrogen deficiency and hand functions with the evaluation of the depression state at the same time. Randomized selected 35 postmenopausal women (n=35, mean age; 46.6 ± 2.8 years), 30 premenopausal controls (n=30, mean age; 45.4 ± 2.7 years) were included in this study. The hand grip strength (JAMAR), the pinch strength and manual dexterity (Purdue peg-board test) were evaluated as hand functions by the same investigator. The DASH score (Disability of Arm, Shoulder and Hand) and the Beck Depression score were determined in each patient. The hand grip…strength and manual dexterity were better in premenopausal women than postmenopausal ones. The lower level of estrogen was associated with decreased manual dexterity, increased disability and increased depression. There was no association between estrogen defiency and hand grip strength but we found a correlation between depression score and hand grip strength. Depression has been decreased hand grip/pinch strength and dexterity. We need prospective long term trials about the effect of estrogens on the hand functions and depression.
Abstract: A prospective randomized controlled trial with a 1-week interval was conducted in order to evaluate the effect of one deep cross-friction massage with the aid of Japanese-made copper myofascial T-bars or "roptrotherapy" and applied on the lumbo-pelvic region in patients with subacute non-specific low back pain (LBP). Patients with LBP were randomly allocated to a control group (no treatment, n=20), a placebo group (endermology as a massage-like treatment, n=20), and to a roptrotherapy group (n=20). Primary outcomes were pressure pain thresholds (PPT) measured at the level of the Erector spinae of L1 & L3, and Gluteus maximus. Secondary outcomes were…the pain Visual Analogue Scale (VAS) and the Oswestry Disability Questionnaire (ODQ). The results revealed that the disability and pain related measurements were significantly decreased and a minimum clinical change occurred in the group treated with roptrotherapy at the 1-week interval session, while in the placebo and control group no tendency of improvement was noted. The results of this study provide direct evidence that one roptrotherapy session can reduce effectively pain sensitivity and disability in patients with non-specific LBP. Nevertheless in future, evidence for long term effects are needed after different weekly sessions.
Abstract: Objective: Specific patterns of muscle impairments, known as Pelvic Cross Syndrome (PCS), in the lumbo-pelvic region have been attributed to causing chronic Low Back Pain (LBP). In PCS, based on their primary functions, muscles are categorized as “postural” or “phasic”, and it has been assumed that phasic (abdominal and gluteal muscle weakness) or postural (decreased flexibility in the hip flexor and back extensor) muscle impairments could lead to an exaggerated Lumbar Lordosis (LL), which in turn might cause chronic low back pain. PCS theory also indicates that exaggerated lordosis in impaired subjects is controlled by hamstring muscle shortening. The purpose…of this study was to examine the relationship among Pelvic Cross Syndrome, degree of lumbar lordosis and chronic low back pain. Design: A total of 600 subjects between the ages of 20 and 65 were selected. Subjects were categorized into four groups of males and females with and without low back pain. The degree of LL, the strength of abdominal and gluteal muscles and the extensibility of iliopsoas, erector spine, and hamstring muscles were measured in each group. The cut-off values obtained from Receiver Operating Characteristic (ROC) curve analysis were used to categorize subjects as having weak or short muscles in accordance with the PCS assumptions. The degree of lumbar lordosis in subjects with and without patterns of muscle impairments, and the association between lumbar lordosis and low back pain and the effects of hamstring muscle length on lordosis were assessed. Results: The results of this study showed no significant difference in the degree of LL in subjects with and without patterns of muscle impairment, or in subjects with and without LBP, or in those with and without short hamstring muscles. However, a significant difference in the strength of abdominal and gluteal; and in the length of hip flexor and hamstring muscles was found between subjects with and without LBP. Conclusions: The findings of this study did not support the assumptions of the PCS theory that certain patterns of muscle impairment would lead to exaggerated LL and LBP. Our data indicated that certain muscle impairments could contribute to chronic LBP, but probably not via changing the degree of lumbar lordosis as has been proposed in PCS theory.
Keywords: Low back pain, lumbar lordosis, muscle, flexibility, strength
Abstract: The purpose of this study was to investigate the external risk factors that contribute to sports injuries experienced by Volleyball players. 114 Greek Volleyball players (61 male and 53 female) who participate in the Volleyball Championship including the A1 and A2 national division and the local championships, age 22.77 (SD=4.85) participated in this study. A questionnaire survey was used for data collection purposes and the interviews were conducted on a personal level. Of the 114 volley ball players (94.5 response rate), reported 363 injuries, during a total exposure time of 34200 h/year for 5 years, representing an overall incidence of…0.63 injuries per player. The majority of the injuries were located in the ankle region (51.3%), followed by the knee (18.2%) and the back (12.4%). Most injuries (58.1%) were classified as being of moderate severity. Most injuries occurred during training (52.3%), and the 69.1% of them during the competitive season. The present study indicates that the risk of suffering an injury in volleyball is relatevly high therefore more researches are needed to accomplish in order practitioners and clinics prevent injuries in training period and competitions.
Abstract: Aim: To investigate the efficacy of low level laser therapy (LLLT) in fibromyalgia patients. Materials and Methods: Thirty-four fibromyalgia patients were randomly assigned to LLLT (n=16) and placebo laser groups (n=16). Outcome measures included number of tender points (NTP), Fibromyalgia Impact Questionnaire (FIQ), morning stiffness, global improvement as reported on a verbal scale (VSGI), and total myalgia score. Clinical evaluations were performed before, immediately after, and six months after the treatment. Results: In the LLLT group, significant improvement was observed in clinical parameters at the end of the treatment (p<0.01). On the other hand, significant improvements…were observed only in the number of tender points and morning stiffness in the placebo group (p<0.05). In comparing the groups, significant improvements were detected in scores of FIQ, VSGI, and total myalgia in the active laser group (p<0.05). The clinical evaluations performed after six months demonstrated improvements in the clinical parameters only in the LLLT group (p<0.05). When the groups were compared with each other, significant improvements were found in the LLLT group (p<0.05). Conclusion: Our results suggest that LLLT has both short- and long-term effectiveness in the treatment of fibromyalgia.
Keywords: Fibromyalgia, low level laser therapy, and placebo
Abstract: Objectives: To determine the effect of leg immersion in cold water after stretch-shortening exercise (SSE) on the time-course of indirect indicators of exercise-induced muscle damage (EIMD). Methods: Twenty healthy untrained men twice performed SSE consisting of 100 drop jumps (DJs) from 0.75 m height performed with maximal intensity with an interval of 20 s between the jumps. DJs were performed with counter-movement to 90 degrees angle in the knee and with immediate maximal rebounds. After SSE the subject’s legs immediately, as well as after 4 h, 8 h and 24 h, were immersed into a bath filled with…water at 15 ± 1°C. Quadriceps muscle voluntary contraction force (MVCF) and force evoked by electrostimulation (ESF) at different frequencies and at different muscle length, jump height (H), muscle soreness and creatine kinase (CK) activity in the blood were measured before SSE, immediately after SSE and within 72 h of recovery. Results: After stretch-shortening exercise MVCF, ESF and H were significantly (P<0.001) decreased and were not restored even after 72 h in the group that did not receive the cooling. Within 24–48 h after SSE the subjects felt great muscle pain and CK activity in their blood was increased (P<0.001). The cooling significantly accelerated the disappearance of all these indicators, except for low-frequency fatigue, but only within 24–72 h after SSE. Conclusion: Cold water immersion after SSE accelerates the disappearance of the majority of indirect indicators of EIMD.