Journal of Back and Musculoskeletal Rehabilitation - Volume 25, 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: Background: Low back pain (LBP) has multi-factorial origin and its treatment varies considerably. Multidisciplinary pain programs have shown their effectiveness in the management of LBP but it is not documented whether subjects with difference in chronicity (duration) of pain will respond differently to these regimes. Dynamic muscular stabilization technique (DMST) is an active approach of stabilizing training for lumbar area which involves the training for the co-contraction of the transverse abdominis and multifidus muscles. Aim: This study determines the efficacy of Dynamic Muscular Stabilization Technique (DMST) in LBP of different durations. Design: Follow-up, comparative study.…Setting: Physical medicine and rehabilitation department (PMR) of university. Methods: Total 72 patients were categorized in 5 groups on the basis of duration (chronicity) of their low back pain. The documentation of chronicity was done on the basis of subjective questionnaire. All subjects were treated with DMST. Pain was the primary outcome measure while physical strength (back pressure change: BPC, abdominal pressure changes: APC), physical ability (walking, stair climbing, stand ups) and quality of life (QOL) were the secondary. Variables were assessed at baseline (day 0), 3 months (day 90) and at the end of the follow up (day 180). Results: Variables (Pain, BPC, APC, Walking, Stair climbing, Stand ups and QOL) significantly improved on 90th and 180th day while compared to the baseline. Therefore irrespective of the chronicity of pain, all chronic pain patients will respond positively to the DMST treatment. Conclusions: This study concludes that DMST intervention is an effective rehabilitation technique for all chronic low back pain patients irrespective of the duration (chronicity) of their pain.
Keywords: Low back pain, physiotherapy, rehabilitation, stabilization
Abstract: Objective: There are limited number of documents showing the relations between cardiovascular fitness and muscle strength. This study aimed to determine the effects of two different quadriceps strengthening exercise approaches on cardiovascular fitness in healthy female subjects. Methods: Forty female university students participated in this study on a voluntary basis. The participants were randomly assigned to do either isokinetic exercise (IE) or progressive resistive exercise (PRE) in two different groups. Both training schemes were performed three times a week for a period of two weeks. The subjects were given a maximum symptom limited exercise test on a treadmill…before and after (each) training period. Results: Total exercise duration increased and Borg scale level decreased significantly after training in the two groups (p < 0.05). Maximal systolic blood pressure, recovery heart rate, and recovery diastolic blood pressure decreased significantly in the IE Group (p < 0.05). Resting and recovery systolic blood pressure decreased significantly in the PRE Group (p < 0.05). Compared to PRE group, improvement for Borg Scale level, recovery heart rate and recovery diastolic blood pressure were more obvious in IE Group (p < 0.05). Conclusions: This study demonstrated that both quadriceps strengthening methods have displayed improvements in cardiovascular fitness. Further research with larger sample groups may need to be carried out.
Abstract: Objective: The purpose of this study was to develop a Turkish version of the mini Osteoporosis Quality of Life Questionnaire (mini-OQLQ), and assess its reliability and validity. Material and method: Sixty-four women with postmenopausal osteoporosis were included in the study. Patients who were diagnosed with secondary osteoporosis through clinical and laboratory examinations were excluded from the study. After translation process, the Turkish version of the scale was applied to each participant twice with an interval of 2 weeks. For reliability study, internal consistency (Cronbach’s α ) of mini-OQLQ total score and test-retest intraclass correlation coefficient (ICC) were calculated.…Validation study was assessed by correlating the scale with QUALEFFO 41. Results: The mean age at menopause and age of patients were 45.61 ± 6.04 and 59.91 ± 8.69 years, respectively. Cronbach’s α of the Turkish version of the mini-OQLQ was 0.898. The test-retest reliability (ICC) of the Turkish version of the mini-OQLQ was determined as 0.81 for the total score, and ranged between 0.71 and 0.84 for individual items. In terms of validity, the Turkish version of mini-OQLQ showed significant negative correlation with QUALEFFO 41 (r= –0.756; p < 0.0001). Conclusion: The Turkish version of the mini-OQLQ was found to be reliable and valid in the evaluation of life quality of patients with postmenopausal osteoporosis.
Keywords: Mini-Osteoporosis Quality of Life Questionnaire, osteoporosis, validation
Abstract: Background and objectives: The common description of muscular fatigue is the failure of muscle in maintaining a target force. Even in sustained contraction, when muscle force is held at a stable level, physiological, biomechanical and electromyographic changes can occur. The purpose of this study is to compare the effects of triceps surae (TS) fatigue on the torque, falling slope and electromyographic (EMG) parameters between athletes and non-athletes. Materials and methods: Nineteen healthy women (10 non-athletes and 9 basketball players) participated in this study. After warm-up, subjects performed one maximum voluntary contraction (MVC) followed by fatigue test including sustained…maximum isometric contraction of TS until the peak torque (PT) decreased to 50% of maximum value. Immediately after the test, subjects were asked to perform one MVC; then, root mean square (RMS), median frequency (MDF), median frequency slope (MDF slope), PT, falling slope (FSL) and the amount of pain were measured. Results: In both groups shift of MDF slope to negative values, significant decrease of MDF and RMS occurred at the end of the fatigue test (P < 0.05). Immediately after the test, PT decreased significantly in both groups (P < 0.05), however, decrease of FSL was significant in non-athletes (P < 0.05) but not in athletes. After fatigue test, increase in Pain was significant in both groups (P < 0.05). Before fatigue test, at the end, and immediately after the test, MDF of non-athletes was more than athletes. There was no significant difference in RMS between the two groups. Conclusion: Our findings suggest that TS fatigue affects EMG parameters, PT and pain in athletes and non-athletes similarly.
Abstract: Musculoskeletal (formerly manipulative) physiotherapy is widely used for the rehabilitation of patients with common musculoskeletal pain and related disability. As part of its progress from largely empirical beginnings to becoming basic sciences informed this sub-specialty of the physiotherapy profession has developed a profound interest in pain mechanisms, causal and therapeutic. It is of some concern, however, that the use of pain terminology and classification among the fraternity has tended to be typically idiosyncratic and at times inaccurate. This is not only confusing to followers of the wider medical science literature. It also compromises clear communication between the physiotherapist and fellow…orthodox health care professionals. This ‘note’ restates the acknowledged pain terminology and its applicability to recognised pain categories.
Abstract: Background and objectives: The aim was to assess and compare the postural stability effects of the “Progressive Dynamic Spine Stabilization Exercise Protocols” (PDSSEP) which were designed for different spinal segments. Material and Method: The asymptomatic, sedentary, and female volunteers (21.26 ± 1.30 years old) were allocated randomly into Cervical (n=22), Lumbar (n=21), Thoracic (n=20), Combined (n=20), and Control (n=21) Groups. All training groups participated into the related PDSSEP for six weeks, 3 days/week. The assessments were carried out at the baseline, after 6th week, and on the 12th week. “Tetrax Interactive Posturography and Balance System” (Tetrax System, Ramat…Gan, Israel) was used to assess the overall postural stability (SI), weight distribution (WDI) and somatosensory reactions. “Kruskal Wallis Test” for the differences of the pre-6th weeks, pre-12th weeks within the groups, “Mann-Whitney U Test” for control and inter-group comparisons were used. Results: The differences were observed for eyes closed SI, and WDI in head right rotated position (p< 0.05) between the baseline and after completing the programs. Eyes closed SI in solid surface was shown statistically different in Thoracic group in comparison to controls (p< 0.02). SI on soft surface, SI head left rotated position and somatosensory reactions with head flexed position improved in Thoracic Group at the 12th week (p< 0.01). WDI significantly improved in Cervical Group (p< 0.01). Conclusion: Thoracic spine can be considered as a hidden source for improving overall postural stability. It may be appropriate to focus on thoracic region in the kinetic chain for the treatment or training. Level of evidence: A prospective randomized controlled trial, Level 1.
Abstract: Objective: Osteo-arthropathy (OA) is one of the most common diseases of the knee joint, but functional information is limited on imaging analyses. We aimed to clarify the functional pathology based on vibroarthrography (VAG) signals at the knee joint during standing-up and sitting-down movements in patients with OA of the knee joints. Materials and methods: VAG signals and angular changes of the knee joint during standing-up and sitting-down movements were recorded in 145 knees, including 46 knees with OA in 27 patients, 49 knees in 26 age-matched healthy senior subjects, and 50 knees in 25 healthy young subjects.…Results: The level of VAG signals was greater in the knees with OA at 50–99 and 100–149 Hz compared to the age-matched control knees during movements. Conclusions: We considered that the increase in VAG signals in these ranges of frequency suggested the pathological change of OA during weight-loaded movements. This method of VAG recording is fully noninvasive, and can be used by therapists during interventions to obtain physical information regarding functional pathological changes of the knee joint.
Abstract: Objectives: Previous research has shown inconsistent findings regarding muscle endurance in chronic low back pain (CLBP). Questions also remain about muscle endurance in patients with clinical instability. The aim of this study was to investigate trunk muscles strength and endurance in CLBP patients with and without clinical instability. Methods: 32 CLBP patients (15 with and 17 without clinical instability) and 39 matched healthy subjects participated in this study. The standing extension test was performed to assess the strength and endurance of the lumbar extensors while recording their electromyographic activity. The patients’ disability was evaluated using the Oswestry and…Roland-Morris Disability Questionnaires. Results: Patients with clinical instability showed lower maximal voluntary exertion (MVE) and higher time to fatigue (TTF) compared to healthy subjects (P=0.000 and P=0.008, respectively) and patients without instability (P=0.002 and P=0.02, respectively). There was no difference in these variables between patients without instability and healthy controls. A negative relationship between MVE and TTF and a positive correlation between disability and pain intensity were seen. Conclusion: Strength training of trunk extensor muscles can be considered as part of the treatment protocol for CLBP patients with clinical instability. Although patients without instability suffered from pain or disability, they showed more similarity to healthy subjects in terms of trunk muscles strength and endurance.
Keywords: Instability, low back pain, muscle strength, endurance
Abstract: Lateral epicondylitis (Tennis Elbow) is the most frequent type of myotendinosis and can be responsible for substantial pain and loss of function of the affected limb. Muscular biomechanics characteristics and equipment are important in preventing the conditions. This article present on overview of the current knowledge on lateral Epicondylitis and focuses on Etiology, Diagnosis and treatment strategies, conservative treatment are discussed and recent surgical techniques are outlined. This information should assist health care practitioners who treat patients with this disorder.