Journal of Back and Musculoskeletal Rehabilitation - Volume 28, 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 is commonly reported to be a very frequent disorder in rowing, but it is still unclear if its prevalence is higher than in other sports or even in a non-athletes group. Objectives: To determine prevalence of low back pain (LBP) with and without irradiated pain and possibly related risk factors in a group of elite Italian rowers. Methods: The study was conducted during the 2010 Italian Indoor Rowing Championship held in Bari from 30th to 31st January. All the 415 rowers who qualified for the national championship were asked to complete a…three-page questionnaire on LBP, assisted by a physiotherapist. Results: One hundred and thirty-three athletes (32%) completed the assessment. LBP was very common, with a lifetime and 1 year prevalence of 64.7% and 40.6% respectively. During the last episode, the LBP intensity, measured by a numeric rating scale (NRS), presented a median value of 6/10, and 40% of rowers reported some limitation in daily living activities (ADL). Odds ratio (OR) to suffer from LBP was 2.62 in males compared to females; athletes who row both in sculling and sweep or only sweep showed an OR of 4.43 and 3.32 respectively. Conclusions: The prevalence of low back pain among rowers seems to be comparable to the one of the general population, even if the recovery appears to be faster. The risk of developing LBP is associated with the rowing typology and the gender, but a prospective study with an adequate sample size is necessary to clearly identify risk factors for LBP in rowers and to implement effective prevention strategies.
Keywords: Low back pain, rowing, prevalence, athletes
Abstract: Background: The clinical importance of F-wave inversion in the diagnosis of Carpal Tunnel Syndrome (CTS) is not yet well known. Objective: This study aims to investigate the value of F-wave inversion in diagnosing CTS, and to evaluate the relationship of F-wave inversion with age, gender, diabetes mellitus, body mass index (BMI), wrist or waist circumferences. Methods: Patients (n = 744 ) who were considered to have CTS with clinical findings were included in the study. In order to confirm the diagnosis of CTS, standard electrophysiological parameters were studied with electroneuromyography. In addition, median nerve…F-wave measurements were done and we determined if F-wave inversion was present or not. Sensitivity and specificity of F-wave inversion were investigated for its value in showing CTS diagnosed by electrophysiological examination. Results: CTS diagnosis was confirmed by routine electrophysiological parameters in 307 (41.3%) patients. The number of the patients with the presence of F-wave inversion was 243 (32.7%). Sensitivity of F-wave inversion was found as 56% and specificity as 83.8%. BMI and wrist circumference values were significantly higher in patients with F-wave inversion present than those with F-wave inversion absent (p = 0.0033 , p = 0.025 respectively). Conclusions: F-wave inversion can be considered as a valuable electrophysiological measurement for screening of CTS.
Keywords: F-wave inversion, carpal tunnel syndrome, anthropometric measurements, median nerve, ulnar nerve, body mass index
Abstract: Background: Previous trials of yoga therapy for nonspecific low back pain (nsLBP) (without sciatica) showed beneficial effects. Objective: To test effects of yoga therapy on pain and disability associated with lumbar disc extrusions and bulges. Methods: Parallel-group, randomised, controlled trial. Sixty-one adults from rural population, aged 20–45, with nsLBP or sciatica, and disc extrusions or bulges. Randomised to yoga (n = 30 ) and control (n = 31 ). Yoga: 3-month yoga course of group classes and home practice, designed to ensure safety for disc extrusions. Control: normal medical care.…Outcome Measures (3–4 months): Primary: Roland Morris Disability Questionnaire (RMDQ); worst pain in past two weeks. Secondary: Aberdeen Low Back Pain Scale; straight leg raise test; structural changes. Results: Disc projections per case ranged from one bulge or one extrusion to three bulges plus two extrusions. Sixty-two percent had sciatica. Intention-to-treat analysis of the RMDQ data, adjusted for age, sex and baseline RMDQ scores, gave a Yoga Group score 3.29 points lower than Control Group (0.98, 5.61; p = 0.006 ) at 3 months. No other significant differences in the endpoints occurred. No adverse effects of yoga were reported. Conclusions: Yoga therapy can be safe and beneficial for patients with nsLBP or sciatica, accompanied by disc extrusions and bulges.
Abstract: Background and Objectives: Cervicogenic headache (CGH) originated from impaired cervical musculoskeletal structures. Dysfunction of deep neck flexor muscles has been reported in CGH subjects. The purpose of this study was to assess relationship between the size of these muscles and headache laterality in CGH subjects. Material and Method: A cross sectional single blind study designed to investigate 37 CGH subjects compared with 37 healthy controls. Longus colli (LC) muscle Cross Sectional Area (CSA) in both sides was measured in supine position utilizing diagnostic ultrasonography. Results: The mean CSA of LC muscle in healthy subjects was 0.74…± 0.06 cm2 and in patients suffering from CGH was 0.74 ± 0.06 cm2 in left and 0.75 ± 0.06 cm2 in right side. No significant difference was found between subjects suffering from CGH compared with healthy controls. Also no difference was found between muscle size of affected and non-affected side in unilateral CGH subjects. Conclusions: Results indicated that there was no relationship between size of LC muscle and pain laterality in patients with CGH.
Abstract: Background: The London Handicap Scale (LHS) was found to be a valid and reliable scale for measuring participation restrictions in adults. Objective: This paper describes the development and assesses the construct-related validity of a Dutch version of the London Handicap Scale (DLHS). Methods: The DLHS was tested in 798 adults (mean age: 50.7 years, SD = 14.5, range 16 to 85) and validated with the ‘Impact on Participation and Autonomy’ (IPA) questionnaire, the Dutch version of the EQ-5D and questions concerning comorbidity and use of medical devices. The study population consisted of patients with rheumatoid arthritis,…chronic obstructive pulmonary disease (COPD), epilepsy, laryngectomy and multiple sclerosis. Results: Feasibility was satisfactory. Large correlations (ρ > 0.6 ) for the DLHS sum score were found with the IPA subscales ‘autonomy outdoors’, ‘perceiving problems’, ‘family role’, autonomy indoors’, ‘work and education’ and with the EQ-5D. The DLHS sum score differs significantly between subgroups based on the number of chronic diseases, number of medical devices and self-reported burden of disease or handicap (p < 0.001 ). Conclusions: Based on this evaluation the questionnaire seems feasible and valid for assessing differences in level of participation between subgroups of chronically ill or disabled persons in the Netherlands.
Keywords: Disability, London handicap scale, Dutch, quality of life, construct-related validity
Abstract: Background: The incidence of low back pain (LBP) is high in patients with hip osteoarthritis (OA). Evidence from previous studies suggests that lumbar alignments and hip range of motion (ROM) are important etiological factors for LBP. However, no studies have investigated which factors that have the greatest influence on LBP. Objective: This investigation aimed to collectively examine factors related to LBP in patients with hip OA, including lumbar lordosis angle (LLA), leg length discrepancy (LLD), and hip ROM. Methods: Thirty-five patients participated in this study. LBP was treated as a dependent variable, whereas hip ROMs were…treated as independent variables. Patients’ age and body mass index (BMI) were recorded as confounding factors, as were LLA and LLD. A logistic regression model was performed to determine the most accurate set of variables to predict LBP. Results: BMI and ROM of hip flexion on the affected side were identified as significant variables. Conclusions: Our results suggest that BMI and ROM of hip flexion on the affected side are related to LBP in patients with hip OA and need to be assessed.
Keywords: Low back pain, osteoarthritis of the hip, prediction
Abstract: Reported here is a 50-year-old man with cubital tunnel syndrome due to heterotopic ossification after traumatic brain injury. Herein, underscoring the role of ultrasonographic evaluations in the diagnosis of our patient, we suggest that ultrasono- graphic imaging can be a useful first-line diagnostic method for the possibility of HO and its complications. Further, due to its high spatial resolution, lack of radiation and easy applicability, we imply that US seems to overweigh in the daily practice of rehabilitation physicians.
Keywords: Ultrasonography, ulnar nerve, head trauma, 3D computed tomography
Abstract: Background and Objectives: This report aimed to present a case of lateral antebrachial cutaneous neuropathy (LACNP) that occurred after a steroid injection in the lateral epicondyle to treat lateral epicondylitis in a 40-year-old woman. Material and Method: A 40-year-old woman presented with decreased sensation and paresthesia over her right lateral forearm; the paresthesia had occurred after a steroid injection in the right lateral epicondyle 3 months before. Her sensation of light touch and pain was diminished over the lateral side of the right forearm and wrist area. Results: The sensory action potential amplitude of the right…lateral antebrachial cutaneous nerve (LACN) (6.2 µV) was lower than that of the left (13.1 µV). The difference of amplitude between both sides was significant because there was more than a 50% reduction. She was diagnosed with right LACNP (mainly axonal involvement) on the basis of the clinical manifestation and the electrodiagnostic findings. Her symptoms improved through physical therapy but persisted to some degree. Conclusion: This report describes the case of a woman with LACNP that developed after a steroid injection for the treatment of lateral epicondylitis. An electrodiagnostic study, including a nerve conduction study of the LACN, was helpful to diagnose right LACNP and to find the passage of the LACN on the lateral epicondyle.