Journal of Back and Musculoskeletal Rehabilitation - Volume 26, 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: Recent evidences suggest functional thoracic hyperkyphosis (FTH) could be a different approach in the management of subacromial impingement syndrome (SIS). This case study aims firstly with the development of evidence informed FTH model for SIS. Secondly this study aimed to develop well defined multimodal physical therapy intervention for FTH and its related mechanical consequences in elderly patient with chronic SIS. As a result, Level IV positive evidence was found in both the short and long-term pain and disability of chronic SIS, using FTH model with 26 months of follow-up.
Abstract: Osteopoikilosis (OPK) is a rare, autosomally inherited, benign sclerosing bone dysplasia of unknown etiology. It is usually found incidentally on radiological examination, presenting as multiple, small, well-defined, variably shaped and widely distributed sclerotic areas throughout the skeleton. In this study, we present a case report of a 56-year-old man suffering from low back pain who was radiologically diagnosed with OPK. His daughter was likewise diagnosed with OPK.
Keywords: Bone dysplasia, familial occurrence, osteopoikilosis, pain
Abstract: We present the first case of concomitant intramedullary traumatic neuroma and spinal cord herniation. A 57-year-old woman injured her cervical spine with subluxation and cord compression at the C5–C6 level. After the operation, the patient received intensive rehabilitation for one year with well response. Unfortunately, she experienced weakness and progressive numbness extending to all the limbs later. Cervical magnetic resonance imaging revealed spinal cord herniation at the C5–C6 level and pathology proved intramedullary traumatic neuroma. After the second operation, the paresthesia over the trunk and limbs persisted, and the patient was nearly totally assisted in her activities of daily living.…The intramedullary traumatic neuroma and spinal cord herniation are rare causes in patients with spinal cord dysfunction. The case presented here indicates the possibility of the coexisting conditions leading to progressive neurologic deficits in patients with old spinal cord injury.
Abstract: Study Design: Case report. Objective: To document the case of isolated metastasis in an isthmic spondylolisthesis in the adult. Summary of Background Data: The progression of isthmic spondylolisthesis occurs infrequently in the adult. Previous reports have pointed out the pathogenic responsibility of the progressive disc collapse. Methods: A 58-year-old woman was evaluated for severe back and bilateral leg pain. Standing radiographs of her lumbar spine showed L5-S1 spondylolisthesis. CT and MRI scans demonstrated a tumor infiltration of the L5 listhetic vertebra. Results: Bilateral interruption of the posterior arch was noted at surgery.…A posterior decompression with an L3-S1 pedicle screw fixation was performed without complication. Leg pain and paraparesis promptly regressed. A solitary localization of an undifferentiated adenocarcinoma of unknown origin was diagnosed. The patient refused further surgery and died three years after the operation. Conclusions: The progression of isthmic spondylolisthesis occurs infrequently in the adult. This case shows that tumor infiltration is a potential cause for the onset/progression of spondylolisthesis in the adult. An MRI or CT scan of the spine is recommended in skeletally mature patients with isthmic spondylolisthesis who sustain severe and acute exacerbation of their back pain.
Abstract: Background and Objectives: Segmental stabilization training and electrical stimulation are used as a treatment for patients with low back pain. There is limited information on the efficacy of two interventions in the literature. In this study, the efficacy of the two interventions on the multifidus muscle activation and fatigue, segmental stabilization training and electrical stimulation, were examined and compared. Material and Methods: Our sample consists of 30 asymptomatic individuals, randomly assigned to one of three groups: the group that was given segmental stabilization training, the group that was given electrical stimulation and the control group that received no…treatment. The muscle activity and fatigability of the multifidus were recorded by the surface electromyography before and after the intervention. Results: No difference is detected for any of the multifidus muscle activation and fatigue characteristics either within or between groups. Conclusion: Both techniques did not improve multifidus activation capacity. An effort at submaximal and maximal level affects and increases the activity of multifidus.
Abstract: Objectives: The aim of this study was to compare the upper extremity musculoskeletal complications in the patients who had been receiving hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). Material and Methods: The patients who had been receiving HD (n = 17 ) or CAPD (n = 15 ) were included to the study. The age, gender, duration of dialysis were recorded. The physical findings related to musculoskeletal system in the upper extremity were researched. The cervical, shoulder, hand standard radiographies and shoulder magnetic resonance imaging were investigated. Results: The mean duration…of HD and CAPD were 53.60 ± 36.03 and 49.17 ± 33.14 months, respectively (p = 0.720 ). Only 6.3% of the CAPD group had signs of carpal tunnel syndrome (CTS). There were not any differences in the frequency of cervical destructive spondyloarthropathy, decreased height of vertebral corpus in the examination of cervical radiography (p = 0.579 ) and also in the frequency of erosions in the humeral head and bones of hand, cyst in the clavicula, erosive osteoarthropathy and osteoporosis detected in the bones of hands (p > 0.005 ). In the examination of shoulder MR imaging, 80% of the HD group and 47.1% of the CAPD group had supraspinatus tendinitis (p = 0.059 ). The frequency of subscapularis, biceps and infraspinatus tendinitis were not different in HD and CAPD groups (p > 0.05 ). Conclusion: The musculoskeletal system complications of the upper extremity were common in the patients undergoing dialysis therapy. The most common complications were osteoporosis of the hand region and supraspinatus tendinitis. Level of Evidence: Prospective, Level 2b.
Abstract: Objectives: To determine the relative frequency of sacroiliac joint dysfunction in a sample of patients with image proven lumbar disc herniation. Methods: A single group cross-sectional study was conducted in a three year period from 2007 in an outpatient clinic at a university hospital. Overall, 202 patients aged more than or equal to 18 years with image proven herniated lumbar disc and with physical findings suggestive of lumbosacral root irritation were included. Results: Overall, 146 (72.3%) participants had sacroiliac joint dysfunction. The dysfunction was significantly more prevalent in females (p < 0.001 , adjusted…OR=2.46, 95% CI=1.00 to 6.03), patients with recurrent pain (p < 0.005 , adjusted OR=2.33 with 95% CI=1.10 to 4.89) and patients with positive straight leg raising provocative test (p < 0.0001 , adjusted OR=5.07, 95% CI=2.37 to 10.85). There was no significant relationship between the prevalence of SIJD, and working hours, duration of low back pain, or body mass index. Conclusions: Sacroiliac joint dysfunction is a significant pathogenic factor with high possibility of occurrence in low back pain. Thus, regardless of intervertebral disc pathology, sacroiliac joint dysfunction must be considered in clinical decision making.
Keywords: Sacroiliac joint, low back pain, lumbar disc herniation
Abstract: Background and Objectives: During pregnancy or postpartum period, several women experience some degree of pelvic girdle pain (PGP). In India, information is lacking about the prevalence and possible risk factors of PGP evaluated during postpartum period. This study aims to determine the prevalence of PGP in postpartum women who underwent vaginal or caesarean mode of delivery and to estimate possible associated factors with or without PGP in both modes of deliveries. Methods: In this cross-sectional study, 284 postpartum women answered questionnaires and underwent clinical examinations. Clinical examination included pain provocation tests for the pelvis as well as the…active straight leg raise (ASLR) test. Probable associated factors were studied using non-parametric tests and logistic regression analysis. Results: In this study of 284 women, 41% reported pain in the pelvic girdle during postpartum period. Overall, 33% of the women experienced PGP after caesarean delivery as compared with 8.3% of women after vaginal delivery. Low back pain (LBP) before pregnancy, parity, active straight leg raise test score ⩾4, bilateral P4 test, and sitting position during breast-feeding were significantly associated with vaginal delivery group and caesarean delivery group during postpartum period. In both modes of delivery, the association of PGP with these common factors remained after adjustment for other study factors. Conclusion: We found high prevalence of PGP in women who had caesarean delivery than those who had a vaginal delivery. Our finding suggests that, during postpartum period, LBP before pregnancy, parity, ASLR test score ⩾4, bilateral P4 test, and sitting position during breast-feeding were significantly associated with increased risk of PGP in both vaginal and caesarean modes of deliveries, but further studies are needed for definitive conclusions.
Keywords: Pelvic girdle pain, posture, breast-feeding, mode of delivery, low back pain
Abstract: Purpose: The purpose of the study was to evaluate the influence of Kinesio-Tex tape on force-velocity parameters (F-V) of the rectus abdominis muscle immediately following application. Methods: The study group selected consisted of 52 women with a BMI below 23 [kg/m2 ]. The study involved measuring the force-velocity parameters of trunk flexor muscles twice using the Biodex System 3 Pro Set. Analyzed parameters included peak torque [N/m], total work [J], power [W] and percentage ratio of trunk flexor and extensor peak torque. Results: Comparing the results obtained in both tests, for a majority there were no…statistically significant differences found in both the study group and control group. Conclusions: 1. Short-term Kinesiology Taping on the rectus abdominis muscle does not cause a change in force-velocity parameters of trunk flexors. 2. Isolated application on the rectus abdominis muscle may be insufficient to cause a change in force-velocity parameters following such a short application time.