Journal of Back and Musculoskeletal Rehabilitation - Volume 23, 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: This review explores the prevalence and determinants of musculoskeletal disorders in ambulance officers, and the limitations of the current epidemiological evidence to inform the development of interventions. Relevant studies were selected using defined word search terms and inclusion criteria. Existing research shows a high annual prevalence of back, neck and shoulder musculoskeletal disorders in ambulance officers and emergency medical technicians, whilst limited research has demonstrated significant associations between individual, physical and psychosocial demands, and musculoskeletal disorders of the low-back and neck-shoulder area. However, methodological issues will need to be addressed in future epidemiological research in order to inform the development…of industry specific risk assessment tools that will assist in identifying the complex array of interactive risk factors involved in ambulance work. The accurate identification of risk factors will in turn, better inform the establishment of multifaceted interventions to reduce the prevalence of musculoskeletal disorders in ambulance officers.
Abstract: Osteoarthritis is a degenerative joint disease. The knee and hip joints are the most frequently affected. Treatments fall into three main categories: pharmacological, non-pharmacological, and surgical. Treatments can be applied alone or in combination. In the last few years, within the non-pharmacological category have been a growing importance of physical exercise programs aimed to reduce pain in knee and hip joints. The purpose of this review was to summarize evidence for the effectiveness and structure of exercise programs on pain in patients with hip and knee osteoarthritis. To that end, several databases were searched, retrieving 33 studies that evaluated the…influence of different exercise programs on pain. These studies were grouped according to the characteristics of the exercise program: land-based intervention (strength program, Tai Chi, aerobic program), aquatic intervention (hydrotherapy), and mixed exercise programs. The main conclusions drawn were: (i) despite recommendations for the use of exercise programs as pain therapy in patients with hip and knee osteoarthritis, very few randomized clinical studies were conducted; (ii) the structure of the exercise programs (content, duration, frequency and duration of the session) is very heterogeneous; (iii) on overall, exercise programs based on Tai Chi have better results than mixed exercise programs, but without clear differences.
Keywords: WOMAC, strength, tai chi, hydrotherapy, aerobic
Abstract: Background: Myofascial pain syndrome (MPS) is characterized by myofascial trigger points in a palpable taut band of skeletal muscle. Objective: We aimed to investigate serum trace elements, vitamin B12 , folic acid levels and their correlations with clinical findings and functional status in patients with MPS. Methods: Thirty eight patients with at least one trigger point located on shoulder muscles, and at least 6 months duration, were included in this study. The demographic data, disease duration of patients were noted. Serum copper, zinc, magnesium and iron levels, vitamin B12 and folic acid levels were measured.…Visual analogue scale (VAS) was implemented to estimate daily severity of pain. Pain pressure threshold of subjects and control groups were assessed by using Fischer’s tissue compliancemeter. The Turkish version of the Beck Depression Inventory (BDI) was administered for the presence of any depressive disorder. Results: The mean age of patients in MPS group and control group were 33.1 and 37.8 years respectively. Serum levels of zinc (p< 0.006) were significantly decreased in patients with MPS. VAS, total myalgic and BDI scores of patients were significantly higher than the control group (Respectively p< 0.000, p< 0.012, p< 0.000). Association between TMS and magnesium, vitamin B12 levels was found statistically significant. BDI score correlated significantly with the serum zinc level (r:–0.548, p< 0.001) and VAS in patients with MPS (r:0.641, p< 0.000). Conclusion: According to the results of this study, it was asserted that trace elements, vitamins may play an important role in the pathophysiology of MPS and psychological factors may also have additional effect.
Abstract: Purpose: The hands and wrists are very important for performing the activities of daily life independently. The spaghetti wrist may involve major nerves and arteries, as well as the wrist and finger flexors. The purpose of this study was to evaluate the rehabilitation results of postoperative early mobilization in patients with repaired flexor tendons of the wrist. Methods: Thirty-three patients with repaired flexor tendon injuries were included. Patients were divided into two groups due to ethylogy. Group 1 included 23 patients who incurred tendon injuries during fights with their family members or friends or due to broken glass…after fighting. Two patients had cut their hands with a razor. The other patient had cut his hands during discussion. The Group 2 included 10 patients. The injuries in this group were due to work and home accidents. Results: The functional result was excellent in 46% of fingers, good in 22%, fair in 17%, and poor in 15% in the Group 1 patients. The results were excellent in 55% of fingers, good in 17%, fair in 18%, and poor in 10% in the Group 2 patients. Conclusion: Early primary repair and effective rehabilitation are of great importance during the postoperative period for successful results in the treatment of extensive volar wrist lacerations.
Abstract: Objective: To investigate the predictive validity of fear avoidance beliefs as assessed by the Work Subscale (FABQ-W) of the Fear Avoidance Beliefs Questionnaire in a sample of 117 patients with a work-related musculoskeletal disorder, and identify two FABQ-W cut off points that identified participants as high or low risk of non return to work, following an interdisciplinary rehabilitation program. Methods: A retrospective analysis of patient data collected in conjunction with the Victorian Workcover Authority “Sprains and Strains” program. Sequential logistic regression analysis was used to construct a model of prediction from the baseline variables of age, disability (using…the Pain Disability Index), gender and FABQ-W scores. Receiver Operator Characteristic (ROC) curves were used to identify FABQ-W cut off points that best predicted the return to work outcome. Results: Age and initial FABQ-W scores significantly improved the predictive capabilities of the model, but gender and disability did not. The model explained between 13.1% and 18.2% of the variability in the RTW outcome. ROC curves showed maximum sensitivity was 100% for a score of ≤ 27.5, with a score of > 39.5 identified as having optimum specificity (81.9%). Conclusion: Individuals with low FABQ-W scores are likely to return to work, however those with high scores will not necessarily have a poor outcome. This study supports the limited utility of the FABQ-W score for screening for risk of a poor return to work outcome in patients with a work related musculoskeletal disorder.
Abstract: Purpose: The purposes of this study were to: 1) investigate the inter-rater and intra-rater reliability of use of the Flexicurve for measurement of spinal length (L), thoracic (TL) and lumbar length (LL), thoracic (TW) and lumbar width (LW), and 2) quantify measurement error and minimal detectable change at the 95% CI (MDC95 ) for the same measurements. Methods: Flexicurve measurements of the thoracolumbar spine were recorded by two examiners in standing. Intra-class correlation coefficients were calculated to determine the intra- and inter-rater reliability. Measurement error and MDC95 were calculated to determine length and width measurements that would…constitute real change in spinal curvature. Results: Thoracolumbar length (L) measurements had the highest degree of intra-rater reliability (0.93), while TL, TW, LL, LW showed moderate to good intra-rater reliability (0.61–0.80). Inter-rater reliability for all measurements was moderate (0.58–0.72). Measurement error was moderate to high for TW, LL, and LW (15–25%), and low for L and TL (1–6%). The %MDC95 for TW, LL, and LW found in this study was high (>40%), but was low for L (3.5%). Conclusion: Thoracolumbar length measurement with the Flexicurve showed good intra-rater reliability, low measurement error, and low MDC95 and may be a useful measure in clinical practice.