Journal of Back and Musculoskeletal Rehabilitation - Volume 22, issue 3
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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: Background: Research is limited and controversial on the effectiveness of various stretching methods on muscle lengthening. Objective: Studying the effectiveness of static stretch and muscle energy technique on the flexibility of hamstring muscles. Methods: Thirty young females (20–25 yrs old) participated voluntarily in this study. Subjects were randomly assigned to two groups: static stretch group (controls; n=15) and muscle energy technique (MET) group (experimental; n=15). The control group underwent ten sessions of static stretches of hamstring muscle, and the experimental group was assigned to ten sessions of MET at 50% voluntary isometric contraction. Hamstring flexibility was…evaluated by passive knee extension test at baseline and again following interventions. Results: Both treatment methods were capable of significantly improving the shortness of hamstring muscles (P< 0.01); and no considerable difference was observed between the methods. Conclusion: Ten sessions of hamstring stretches in normal young women using either static stretch or MET had similar effect on restoring flexibility to hamstrings.
Keywords: Hamstring flexibility, passive stretching, muscle energy technique, knee extension
Abstract: Background data: For center of rotation (COR) and centroid length variables in lumbar flexion-extension radiography, enough reliability information is not available. Objective: The objective of this study was to determine the intra-rater reliability of COR and centroid length of lumbar intervertebral movement. Methods: A methodological research for reliability was designed. Fifteen males with chronic non specific low back pain aged between 22–43 years participated in this study. Study variables included COR of full, flexion and extension arc and centroid length. The proposed method from Putto was used for flexion-extension radiography. Five x-rays were taken in neutral,…full flexion and extension, mid-flexion and mid-extension positions. The variables were calculated using Computer Aided Radiographic Analysis of Spine (CARA) software after scanning. The intraclass correlation coefficient (ICC) and standard error of measurement (SEM) were utilized for relative and absolute reliability respectively. Results: The results demonstrated high ICC values on x axis (range: 0.67–0.88) and y axis (range: 0.55–0.90) for full arc COR, high ICC values of flexion arc COR on x axis (range: 0.54–0.97) and y axis (range: 0.48–0.99). ICC values results of extension arc ranged between 0.19–0.60 for x axis and 0.16–0.83 for y axis. ICC values for centroid length ranged between 0.22–0.88. Conclusion: Results support previous studies which show very high reliability of full arc COR. In addition, flexion arc COR has desirable reliability and low measurement errors. But, extension arc COR and centroid length have moderate reliability and large measurement errors.
Keywords: Reliability, flexion-extension radiography, quality of motion, lumbar segmental instability
Abstract: Objectives: Limited lower trunk rotation, which includes rotation of the lumbar spine, may hinder or even prevent functional activities. Currently, due to the lack of reliable, valid, and clinically useful tests, there is no standard objective measure of lower trunk rotation that can be easily performed in the clinic. The purpose of this study was to establish a standard protocol and to determine inter-rater and intra-rater reliability for a goniometric measurement developed to measure lower trunk rotation. Methods: Lower trunk rotation was measured using a specific, goniometric method in 41 subjects. Each subject was measured 6 times by…2 different examiners for a total of 12 measurements. Results: Pearson correlation coefficients indicate good intra-rater reliability ranging from 0.59 to 0.82 for right rotation (P< 0.001) and 0.76 to 0.82 for left rotation (P< 0.001), as well as good inter-rater reliability ranging from 0.62 to 0.83 with right rotation (P< 0.001) and 0.75 to 0.77 for left rotation (P< 0.001). Conclusion: This measure of trunk rotation may be useful for objectively documenting lower trunk rotation.
Abstract: Objectives: Low back pain after load-carrying is the most important disorder in musculoskeletal system and a cause of dysfunction and economic problems. Holding materials can disturb spinal stability; nevertheless, there are few researches about the pattern of trunk muscle recruitment in patients with chronic low back pain (CLBP) during load holding. Methods: Ten female patients with CLBP and ten matched healthy subjects participated in this study. Normalized electromyography activation of trunk muscles during holding loads was analyzed. Results: The low back pain group demonstrated significantly higher activation levels of the External oblique abdominis muscle during loading…12 kg in flexed trunk position and lower activation levels of the Internal oblique abdominis muscle during loading 6 and 12 kg in neutral trunk position than the control group. With the highest external load and trunk flexion, the electrical activity of back muscles increased significantly in both groups. With increasing load, the activation of Rectus abdominis muscle in patients with CLBP and the activation of Rectus abdominis and Internal oblique muscles were increased significantly in healthy subjects. Conclusion: Higher activation of global and lower activation of local abdominal muscles in patients with CLBP may represent that pain changes neuromuscular control systems. The increased activity of extensor muscles during trunk flexion is probably needed for stability and controlling of flexion.
Abstract: Background and purpose: Assessment of spinal posture during physiotherapy practice is routine, yet few objective measures exist to this end. The Middlesbrough Integrated Digital Assessment System (MIDAS) is a low cost portable system able to record 3D information on posture. The purpose of this study was to assess both the intra-rater and inter-rater reliability of the MIDAS system. Methods: Twenty-five healthy subjects were recruited. A repeated measures design was used to record fifteen pre-palpated landmarks on the back of each subject. To limit the sources of variability, the principal researcher palpated the landmarks for each subject. Each of…three raters took two measurements on each subject in a standardized upright posture. X (medio-lateral), Y (antero-posterior) and Z (height) landmark positions were recorded via a computer interface. Results: Both intra-rater agreement (mean ICCs – rater 1 r=0.970, rater 2 r=0.965 and rater 3 r=0.965, p< 0.001) and inter-rater agreement (mean ICCs r=0.967, p< 0.001) was very high between repeated measures and between markers. Error values for the z-axis (height) were the lowest. Conclusions: The MIDAS demonstrated both high inter-rater and intra-rater reliability and provides an objective method for the assessment of posture in physiotherapy practice.
Abstract: Objectives: Some occupations are more prone to low back pain (LBP) due to their static work postures and work place design. Multidisciplinary pain programs have shown their effectiveness in the management of LBP in general population but which treatment and which segment of the population will be benefited more was not investigated yet. This study determines the effect of two treatment protocols on five occupationally subgrouped male LBP patients. Methods: A total of 102 occupational male, 20–40 yrs of age, with sub-acute or chronic nonspecific LBP were randomized and treated either with conventional treatment a combination of two…electrotherapy (ultrasound and short wave diathermy) and one exercise therapy (lumbar strengthening exercises) or dynamic muscular stabilization techniques (DMST) an active approach of stabilizing training. At the end of the treatment, subjects of both the groups were further stratified in five subgroups on the basis of their occupation. The pain was the primary outcome measure while physical strength [back pressure changes (BPC) and abdominal pressure changes (APC)] the secondary. Results: The Pain, BPC and APC of all subgroups improved significantly (P < 0.01) in the both treatments but more in DMST. For each variable, improvement in subgroups differed within and between the treatments. Overall improvement in all assessed variables were evident on Desk workers followed by Shop keepers the most while BPC of Movement job, APC of Others and Pain of Sedentary and Shop keepers improved the least. Conclusions: Study concluded that for the management of occupational LBP, DMST is more effective than conventional treatment. The Pain of Sedentary and Shopkeepers and physical strength of Movement job and Others may need more clinical attention. Findings of this study may be helpful in the management of occupational LBP.
Keywords: Back pain, physiotherapy, rehabilitation, occupational, subgroups, stabilization, strengthening exercises