Journal of Back and Musculoskeletal Rehabilitation - Volume 28, 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: OBJECTIVE: This study was planned to compare of pain, emotional status and disability level in patients with chronic neck pain and low back pain. METHODS: In this study, fifty patients with chronic low back pain (Group I) and fifty patients with chronic neck pain (Group II) at least 6 months were evaluated. A Visual Analog Scale was used to describe pain intensity. To determine emotional status of the subjects, the Beck Depression Scale was used The Oswestry Disability Index and the Neck Disability Index were used to evaluate disability level. RESULTS: The mean age…of the patients with low back pain and neck pain were 39.70 ± 9.71 years, 45.44 ± 10.39 years, respectively. It was not found a significant difference between in low back pain (Group I) and neck pain (Group II) in results of pain intensity (p= 0.286) and pain duration (p= 0.382). It was found a significant difference between group I and group II in results of emotional status (p= 0.000) and disability level (p= 0.000). The emotional status and disability level scores were found highest in patient's with low back pain. CONCLUSION: Chronic low back pain is affect in patients than chronic neck pain as a emotional status and disability level.
Keywords: Chronic low back pain, neck pain, Oswestry Disability Index, Neck Disability Index
Abstract: BACKGROUND: Stair climbing is an important but neglected aspect of independent living. Clinicians should pay attention to the ability to negotiate stairs in elderly and disabled patients. OBJECTIVE: The aim of this study was to determine the effects of age, gender, medication use, cognitive status, lower extremity pathology and pain on the activities of stair negotiation in the elderly population in Turkish society. METHODS: Volunteer elderly people (254) were included the study. Participants were assessed in terms of their medication use, cognitive status, lower extremity pathology and pain and the activity of climbing the…stairs. RESULTS: Significant differences were found on the activities of stair negotiation between the elderly with and without lower extremity pathology, with and without lower extremity pain, with and without medication use (p< 0.05). A positive and moderate correlation was found between age and the activity of stair climbing (r= 0.24, p< 0.01). CONCLUSIONS: Activity of stair climbing is affected by age, medication use, the presence of lower extremity pathology and pain. We consider that this information will be helpful for planning an appropriate and effective rehabilitation programme for elderly people for decreasing their risk of falling and increasing their independence level during their activities of daily living.
Keywords: Aging, stair negotiation, lower extremity, activities of daily living
Abstract: BACKGROUND: The most common disease of the older age group in Turkey is degenerative articular disease and pain associated with the disease. Analgesics and physical therapy are preferred treatment for geriatric chronic pain but suffering from multiple medical and nutritional problems in old ages can limit treatment options with analgesics due to an increased risk of adverse effects and drug interactions. OBJECTIVES: We aim to show the effect of acupuncture on back-pain and knee-pain treatment of elderly people. METHODS: The study includes 34 patients, 24 female and 8 male. The mean age…was 69.0417 ± 8.95 years for females and 73.12 ± 8.95.24 years for males. Every two days for a total of 10 sessions acupuncture treatment to Yintang, Ht 7 (Shenmen), LI 4 (Hegu), Ki 3 (Taixi) and Ki 6 were found to significantly reduce pain scores of patients. RESULTS: Mean back pain scores (8.8696 ± 1.546) and mean knee pain scores (9.1304 ± 1.4239) of patients were reduced significantly to 2.1739 ± 1.466 and 1.455 ± 0.7; p< 0.001 respectively after the acupuncture treatment. CONCLUSION: These are important results as they give rationale to use acupuncture treatment widely in chronic low back pain and knee pain in the geriatric group of patients to reduce the side effects of polypharmacy in elderly.
Keywords: Acupuncture, complementary therapy, low back pain, knee pain
Abstract: BACKGROUND AND OBJECTIVES: Though core muscles strengthening using upper limbs in various positions and lower limbs in lying have been studied previously in patients with chronic low back pain (CLBP), no study has specifically looked in to the effects of a training program that requires prior motor planning in standing (functional position). The objective of this study was to evaluate the effectiveness of star excursion balance test (SEBT) grid training in improving the outcomes in patients with CLBP. MATERIALS AND METHOD: Sixty patients with mechanical CLBP who fulfilled our criteria were randomized in to two groups;…experimental group received physical diagnostic specific interventions, core muscles strengthening and muscles training using the SEBT grid. The participants in control group received stationary cycling instead of SEBT grid training and the other interventions were uniform. The duration of study was 4 weeks. The dependent variables were analyzed using repeated measures 2 × 3 ANOVA. RESULTS: At the end of study, both the groups showed a significant reduction in disability and improvement in strength and endurance (p< 0.05). Post-hoc analysis showed that SEBT grid training was better than conventional exercises. Follow-up at 16 weeks revealed a statistically insignificant loss in strength and endurance in control group patients. This reduction was not associated with an increase in disability score. The experimental group patients continued showing improvement. CONCLUSION: The results of our study show that core muscles strengthening using a SEBT grid are more effective than conventional programs. We hypothesize SEBT training to have a significant role in skill learning. We recommend SEBT grid training to be incorporated in the treatment planning of persons with CLBP.
Keywords: Low back pain, exercise, muscle strength, musculoskeletal manipulations, motor skills
Abstract: OBJECTIVE: To evaluate knee proprioception in patients with anterior cruciate ligament (ACL) injuries and to assess the effectiveness of an exercise program consisting mainly of proprioception exercises addressing pain, proprioception, and functional status following ACL reconstruction. MATERIALS AND METHODS: Twenty male patients, diagnosed with unilateral ACL injury and scheduled for reconstruction, participated in the study along with 16 age- and sex-matched healthy volunteers. Arthroscopic reconstruction of the ACL using autologous hamstring tendon was performed in every case by the same surgeon. After the operation, a six-month rehabilitation program was initiated. Knee proprioception, pain, and functional status…were evaluated before and six months after the reconstruction. An isokinetic dynamometer was used to evaluate proprioception and a visual analog scale (VAS) and the Tegner Lysholm Knee Scoring Scale were used to evaluate pain and functional status respectively. RESULTS: Preoperative proprioception loss was detected on the patients' injured side when compared to the uninjured side and to healthy volunteers (p = 0.00). A significant improvement was found in pain severity, proprioception, and functional capacity after the postoperative six-month rehabilitation program (p = 0.00). CONCLUSION: Preoperative proprioception loss was detected in ACL-injured patients. The rehabilitation program predominantly consisting of proprioception exercises provided considerable improvement on knee proprioception and functional status.
Keywords: Anterior cruciate ligament injury, proprioception, functional status
Abstract: BACKGROUND: Hospital workers with physically demanding jobs are at risk for developing recurrent LBP. There is a lack of studies evaluating multidisciplinary prevention of low back pain (LBP) in hospital workers. OBJECTIVE: This randomized controlled trial evaluates the effect of a multidisciplinary prevention program, focusing on a client-centred approach, on hospital workers at risk for developing LBP. METHODS: Caregiving hospital workers were allocated to an experimental (12-week lasting multidisciplinary prevention program) or control group (no intervention). They were evaluated prior to the intervention and after a 6 months follow-up period. Primary outcome measures included…incidence of LBP, work absenteeism and general health. Secondary outcomes included daily physical activity, job satisfaction and coping strategies. RESULTS: A significant improvement was seen for passive coping after 6 months follow-up, but no significant differences were observed between groups in primary or other secondary outcome measures (p> 0.05). CONCLUSIONS: A multidisciplinary prevention program fitting into a bio-psychosocial context may not have been intensive enough to promote a change in daily habitudes, and had no effect on work absenteeism, incidence of LBP or general health. Further research should determine whether prevention of LBP is possible in caregiving personnel.
Keywords: Pain, therapy, primary prevention, occupational disability, behaviour, health promotion, health care sector
Abstract: BACKGROUND: Occurrence of musculoskeletal pain in dance sport dancers is often a cause for longer discontinuation of training, which affects the competition results. OBJECTIVE: The aim of the research project was to determine the age-specific pain experience among male dance sport competitors by defining the proportions of pain status of fourteen body regions. METHODS: The subject sample of 200 male dancers from 44 different countries and with international competitive experience was divided into three subsamples according to age. Three online questionnaires translated into eight world languages were used for data collection: (1) basic data…questionnaire, (2) self-estimated functional inability because of pain questionnaire designed for dancers, and (3) health care-related questionnaire. RESULTS: After examining the 14 topological regions, it was established that dancers most often report pain in the lower back region (53.5%), followed by knee (43%) and toe regions (40.5%). Significant differences were found using the Chi-square test between the groups of dancers of different ages in the prevalence of pain in the lower back (χ 2 = 12.6), shoulders (χ 2 = 9.7), and hip region (χ 2 = 7), with the highest, age-related progressive differences in the lower back region (36.2-54.9-63.4%) so older dancers had more pain. Often reported reasons for discontinuation of training increased with age are overuse syndrome/tendinitis (6.4-15.9-22.5%) and strain (14.9-29.3-31%). Most common causes for longer discontinuation of training are absence of partner (37%), injuries (24%), and overuse syndrome (10%). CONCLUSION: Lower back pain is propounding health problem in male dancers and increases with age that cannot be resolved by decreasing training intensity. This research reveals that only 28% of male dancers will seek medical help because of occurrence of musculoskeletal pain. Multidisciplinary approach with the aim of long-term health protection and prolongation of dancing careers is required in future studies.
Keywords: Health care, pain prevalence, pain topology
Abstract: BACKGROUND: Examination of practice patterns compared to existing evidence identifies knowledge to practice gaps. OBJECTIVES: To describe the utilization of pharmacological, patient education, primary psychological interventions and relaxation therapies in patients with neck pain by clinicians. METHODS: An international cross-sectional survey was conducted to determine the use of these interventions amongst 326 clinicians treating patients with neck pain. RESULTS: Nineteen countries participated. Results were analyzed by usage amongst physical therapists (39%) and chiropractors (35%), as they were the predominant respondents. Patient education (95%) and relaxation therapies (59%) were the most utilized interventions.…Tests of subgroup differences determined that physical therapists used patient education significantly more than chiropractors. Use of medications and primary psychological interventions were reported by most to be outside of scope of practice. The high rate of patient education is consistent with supporting evidence. However, usage of relaxation therapies is contrary to evidence suggesting no benefit for improved pain or function for chronic neck pain. CONCLUSION: This survey indicates that patient education and relaxation therapies are common treatments provided by chiropractors and physical therapists for patients with neck pain. Future research should address gaps associated with variable practice patterns and knowledge translation to reduce usage of interventions shown to be ineffective.
Keywords: Survey, neck pain, treatment, practice patterns, patient education, psychology
Abstract: The skeletal dysplasias are a large, heterogeneous group of genetic disorders characterised by abnormal growth, development and remodelling of the bones and cartilage that comprise the human skeleton. They typically present with disproportionate short stature in childhood, or premature osteoarthritis in adulthood. The latest classification lists 456 disorders under 40 group headings differentiated by specific clinical, radiographic and molecular criteria. Establishing an accurate diagnosis is important to predict final height, expected complications and treatment, and for specific genetic and psychological counselling. In addition to the skeletal disorder, individuals frequently demonstrate abnormalities of hearing, vision, neurological, pulmonary, renal or cardiac function…that require multidisciplinary assessment. This review provides a guide to diagnosis and discusses management principles for the common limb and spinal abnormalities that affect quality of life for the majority.
Abstract: BACKGROUND: There are many types of treatments and recommendations for restoring back deformities depending on doctors' knowledge and opinions. The purpose of the exercises is to reduce pain and to ensure stability of the lower trunk by toning the abdominal muscles, buttocks and hamstrings. Given the duration of flares and relapses rate, it is important to apply an efficient and lasting treatment. OBJECTIVE: To evaluate the effects of 8 weeks of William's training on flexibility of lumbosacral muscles and lumbar angle in females with Hyperlordosis. METHODS: Forty female students with lumbar lordosis more than…normal degrees (Hyperlordotic) that were randomly divided into exercise and control groups were selected as the study sample. The lumbar lordosis was measured using a flexible ruler, flexibility of hamstring muscles was measured with the active knee extension test, the hip flexor muscles strength was measured using Thomas test, the lumbar muscles flexibility measures by Schober test, abdominal muscles strength measured by Sit-Up test and back pain was measured using McGill's Visual Analogue Scales (VAS) questionnaire. Data were compared before and post-test using independent and paired t-testes. RESULTS: Results showed that 8 weeks of William's exercise led to significant decreases in lumbar angle and back pain, increases in flexibility of hamstring muscles, hip flexor muscles flexibility, lumbar extensor muscles flexibility and abdominal muscles strength. CONCLUSION: The findings show that William's corrective training can be considered as a useful and valid method for restoring and refining back deformities like as accentuated back-arc and became wreaked muscles' performance in lumbar areas.
Keywords: Lumbar angle, flexibility, hyperlordosis, William's training