Journal of Back and Musculoskeletal Rehabilitation - Volume 20, 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: Medical providers managing the variety of back and musculoskeletal problems will at one time or another evaluate and treat a patient with sacroiliac joint (SIJ) pain. Establishing the diagnosis and deciding the treatment can be challenging. In the present paper we provide comprehensive review of the aetiology, diagnosis, and treatment options for sacroiliac joint pain, along with a systematic assessment of the available sacroiliac joint surgical arthrodesis techniques.
Abstract: Background and objective: Poor endurance of the back extensor muscles has been reported among more women than men. There are several reported reasons for its predilection but the influence of parity has not been investigated. The objective of this study was to investigate the influence of parity on back extensor muscles’ endurance between nulliparous and parous women. Methods and Results: 146 women whose ages ranged between 21 to 60 years were recruited into the study using sampling of convenience. This consisted of 77 nulliparous women group (21–42 years) with a mean age of 32.7 ± 5.7 years and…the parous women group (26–60 years) with a mean age of 41.2 ± 9.9 years. The participants performed the Biering-Sørenson test of Static Muscular Endurance (BSME) and their height, weight and percentage body fat were measured using standard procedures. Body Mass Index (BMI) and lean body mass (LBM) and body fat mass (BFM) were calculated. Data were summarized using the descriptive statistics of mean and standard deviation, Pearson’s Chi-square, Independent t-test, and Analysis of Variance were used as applicable. The α level was set at 0.05. The finding of this study showed that parous women were significantly older, heavier and had greater level of adiposity than their nulliparous counterparts. The result indicated a significant association between parity and endurance time (X2 = 88.05; P=0.020), nulliparous women have significantly greater back extensor muscles’ endurance (t=4.902; P=0.000) when compared to parous women. The results suggested that the significant age and anthropometric difference between the nulliparous and parous women could contribute to the endurance differences. Number of parity is much related to back extensor muscle endurance (F= 22.32; P=0.000). Back extensor muscles’ endurance decreases as the number of parity increases. Conclusion: Our results suggest that parity is an important factor in the aetiology of low back extensor muscles endurance among women.
Keywords: Back extensor muscles' endurance, nulliparous, parous, women
Abstract: Objective: Depression is a common disorder affecting 5–9% of women and 1–2% of men. Osteoporosis is a condition characterized by bone fragility and increased risk of bone fracture There might be some behavioral and neuroendocrine system changes in depression which are risk factors for decreased bone mineral density. This study was performed to determine whether women with current or past major depression have demonstrable decreases in bone density. Methods: We measured bone mineral density at the hip and spine in 20 premenopausal women with past or current major depression and 20 premenopausal healthy women matched for age and…body-mass index and using dual-energy x-ray absorptiometry. Results: The mean BMD values at lumbar region were 0.93 ± 0.09 gr/cm2 for the patient group and 0.98 ± 0.04 gr/cm2 for the control group. And the mean BMD values at left hip region were 0.85 ± 0.14 gr/cm2 for the patient group and 0.92 ± 0.07 gr/cm2 for the control group. The mean BMD values at lumbar region and at left hip region in patient group were both statistically lower than controls (p< 0.05). Conclusions: We concluded that patients with past or current major depression may have low bone mineral density so this may be a risk factor for osteoporosis.
Keywords: Depression, bone mineral density, osteoporosis
Abstract: Objective: Altered postural presentations have been associated with a variety of musculoskeletal disorders. Therapeutic exercise interventions are often utilized to manage patients with increased thoracic kyphosis or “round shoulders”, yet few controlled studies have evaluated their efficacy. Design: A prospective, randomized, controlled design was used to evaluate the influence of a home-based exercise regimen on these postural variances. Seventy-one patients with real or perceived concerns about their thoracic posture completed the 13-week study. Patients with 23–80° of thoracic kyphosis entered the study. Pre- and post-intervention flexicurve measurements of thoracic kyphosis were made. Patients were randomly assigned to…an exercise (n=32) or control group (n=39). A mixed design ANOVA tested main effects and interactions. Results: A statistically significant (p < 0.05) interaction was found between group assignment and delta kyphosis values. Post-hoc analysis of the multiple comparisons produced a marginal p-value (p =0.0557). Mean delta kyphosis values were (+) 0.5° (±7.0°) for the control group and (−) 3.0° (±6.1°) for the experimental group. Conclusions: This 13-week home exercise program targeting modification of thoracic kyphosis angles had a statistically significant impact. However, post-hoc statistical analyses and clinical implications are marginal.
Abstract: Objective: The effect of a newly developed training device on trunk muscle co-ordination patterns was investigated. Design: A cross sectional survey of 30 healthy volunteers was executed. The task was to maintain position and motion of a flexible pole that was set into oscillation. Oscillations were applied at three frequencies (3, 3.5, 4.5 Hz), in horizontal and vertical directions. SEMG signals of five trunk muscles were measured. Co-ordination was assessed by calculating mean relative amplitudes and mean, as well as, grand averaged muscle ratios during oscillation cycle for front over back (F/B), internal over external oblique (OI/OE), and…multifidus over erector spinae (MF/ES) muscles. Results: Vertical oscillation evoked increased mean MF relative amplitudes and mean F/B and MF/ES muscle ratios in comparison with horizontal oscillation. Grand averaged F/B ratio was phase shifted about 180° of relative cycle between both oscillation directions. With increasing oscillation frequency mean F/B ratio increased, but OI/OE ratio decreased. Amplitude range of grand averaged muscle ratios during oscillation cycle was augmented with increasing frequency. Conclusions: The gathered normative data can serve as an initial data basis for further investigations on low back pain patients. Relative to oscillation direction and frequency, demands on trunk muscles vary from primarily stabilizing towards mobilizing activities.
Keywords: Trunk muscle co-ordination, electromyography, human, task performance and analysis
Abstract: The natural history of isthmic spondylolisthesis involves degenerative changes in surrounding joint tissues, such as, facet joints or disc materials, due to segmental instability, and normally does not cause spontaneous fusion due to complete disc destruction. However, the author experienced a case of spontaneous interbody fusion without apparent symptoms or disease in an 83-year-old male patient with isthmic spondylolisthesis.