Journal of Back and Musculoskeletal Rehabilitation - Volume 30, issue 3

Authors: Castrillon, Tabitha | Hanney, William J. | Rothschild, Carey E. | Kolber, Morey J. | Liu, Xinliang | Masaracchio, Michael

Article Type: Research Article

Abstract: BACKGROUND: An alternative approach to facilitate movement and control through the trunk and pelvis is belly dancing. Investigations of belly dancing mechanics indicate similar muscular activation patterns of those known to influence chronic low back pain (cLBP). However, no documented studies have examined its effectiveness as a treatment for cLBP. OBJECTIVE: The purpose of this study was to investigate the influence of a standardized belly dance program in women with cLBP. METHODS: A single subject design was used to evaluate weekly outcomes during a three-week baseline period, six-week belly dance program, and again …at a two-month follow-up. Outcome measures for pain, disability, function, and fear-avoidance beliefs were utilized. RESULTS: Two subjects completed the program. No significant differences were noted during the baseline assessment period. At two months, subject one demonstrated change scores of -1.12, -1%, and 2.2 for pain, disability, and function respectively while subject two demonstrated change scores of 5.4, 5%, and 1.1 for pain, disability, and function, respectively. Subject one showed a clinically significant change score for both fear avoidance of work and physical activity, with score changes of 4 and 3.3, respectively. CONCLUSION: The results of this study suggest a standardized belly dance program may positively influence pain and function in women with cLBP. Show more

Keywords: Complementary and alternative medicine, lumbago, core stabilization, lumbopelvic

DOI: 10.3233/BMR-150504

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 477-496, 2017

Authors: Horsak, Brian | Wunsch, Rüdiger | Bernhart, Philipp | Gorgas, Anna-Maria | Bichler, Romana | Lampel, Kerstin

Article Type: Research Article

Abstract: BACKGROUND: To ensure accurate implementation of stabilization exercises in rehabilitation, physical therapists need to understand the muscle activation patterns of prescribed exercise. OBJECTIVE: Compare muscle activity during eight trunk and lumbar spine stabilization exercises of the Functional Kinetics concept by Klein-Vogelbach. METHODS: A controlled laboratory study with a single-group repeated-measures design was utilized to analyze surface electromyographic intensities of 14 female and 6 male young healthy participants performing eight exercises. Data were captured from the rectus abdominis, external/internal oblique and lumbar paraspinalis. The normalized muscle activation levels (maximum voluntary isometric contraction, MVIC) for …three repetitions during each exercise and muscle were analyzed. RESULTS: Side bridging (28 ± 20%MVIC) and advanced planking (29 ± 20%MVIC) reached the highest activity in the rectus abdominis. For external and internal oblique muscles, side bridging also showed the greatest activity of 99 ± 36%MVIC and 52 ± 25%MVIC, respectively. Apart from side bridging (52 ± 14%MVIC), the supine roll-out (31 ± 12%MVIC) and prone roll-out (31 ± 9%MVIC) showed the greatest activity for the paraspinalis. The advanced quadruped, seated back extension and flexion on chair/Swiss Ball, prone roll-out and advanced one-leg back bridging only yielded negligible muscle activities for the rectus abdominis (< 5%MVIC). CONCLUSION: Based on the data obtained, recommendations for selective trunk muscle activation during eight stabilization exercises were established, which will guide physical therapists in the development of exercises tailored to the needs of their patients. Show more

Keywords: EMG, low back/lumbar spine, abdominal muscles, functional kinetics by Klein-Vogelbach

DOI: 10.3233/BMR-140259

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 497-508, 2017

Authors: Grosman-Rimon, Liza | Clarke, Hance | Chan, Aaron K. | Mills, Patricia Branco | Rathbone, Alasdair Timothy Llewelyn | Kumbhare, Dinesh

Article Type: Research Article

Abstract: INTRODUCTION: Myofascial pain syndrome (MPS) is one of the most common chronic musculoskeletal pain disorders. However, MPS is often under-diagnosed. The purpose of this study was to characterize practicing clinicians' perspectives of the current diagnostic criteria for MPS. METHODS: A cross-sectional study design was used with a self-administered questionnaire. The questionnaire evaluated clinicians' perspective of the current diagnostic criteria for MPS. The sample population (n= 119) consisted of 40% family physicians, 31% physical medicine (PM) and rehabilitation specialists, 11% rheumatologists, 10% emergency room (ER) physicians, and 8% anesthesiologists specializing in chronic pain. RESULTS: …Our findings demonstrated that participating clinicians agree that ``point tenderness'' and ``pain reproduction'' are criteria for MPS. In contrast, the clinicians do not consider ``autonomic symptoms'' as an important criterion for MPS. The anesthesiologists view ``restricted range of motion'' as a criterion for MPS more than the other groups, and they tend to consider ``referred pain'' and ``pain reproduction'' as criteria. Physical medicine and rehabilitation specialists and anesthesiologists tend to view ``local twitch response'' more as a criterion for MPS compared with the other groups. Most groups of clinicians consider ``weakness without atrophy'' as an important MPS criterion except for family physicians. It is important to note that ``poor sleep'', ``daytime fatigue'' and ``cognitive symptoms'', which are not considered as MPS symptoms, are often mistaken for MPS among practicing clinicians. CONCLUSION: Our findings suggest that the diagnostic criteria are not well known, highlighting the need for an expert consensus to determine the importance of each criterion for MPS diagnosis. Show more

Keywords: Myofascial pain syndrome, questionnaire, MPS diagnosis

DOI: 10.3233/BMR-150380

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 509-514, 2017

Authors: Raj, Retheep | Sivanandan, K.S.

Article Type: Research Article

Abstract: BACKGROUND: Estimation of elbow dynamics has been the object of numerous investigations. OBJECTIVE: In this work a solution is proposed for estimating elbow movement velocity and elbow joint angle from Surface Electromyography (SEMG) signals. METHODS: Here the Surface Electromyography signals are acquired from the biceps brachii muscle of human hand. Two time-domain parameters, Integrated EMG (IEMG) and Zero Crossing (ZC), are extracted from the Surface Electromyography signal. The relationship between the time domain parameters, IEMG and ZC with elbow angular displacement and elbow angular velocity during extension and flexion of the elbow are …studied. A multiple input-multiple output model is derived for identifying the kinematics of elbow. A Nonlinear Auto Regressive with eXogenous inputs (NARX) structure based multiple layer perceptron neural network (MLPNN) model is proposed for the estimation of elbow joint angle and elbow angular velocity. The proposed NARX MLPNN model is trained using Levenberg-marquardt based algorithm. RESULTS: The proposed model is estimating the elbow joint angle and elbow movement angular velocity with appreciable accuracy. The model is validated using regression coefficient value (R). The average regression coefficient value (R) obtained for elbow angular displacement prediction is 0.9641 and for the elbow anglular velocity prediction is 0.9347. CONCLUSION: The Nonlinear Auto Regressive with eXogenous inputs (NARX) structure based multiple layer perceptron neural networks (MLPNN) model can be used for the estimation of angular displacement and movement angular velocity of the elbow with good accuracy. Show more

Keywords: Surface electromyography, time domain features, NARX model, Levenberg-marquardt algorithm, neural network, elbow joint angular displacement, elbow angular velocity, integrated EMG, zero crossing

DOI: 10.3233/BMR-160525

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 515-525, 2017

Authors: Zhao, Xiaoguang | Tsujimoto, Takehiko | Kim, Bokun | Katayama, Yasutomi | Tanaka, Kiyoji

Article Type: Research Article

Abstract: BACKGROUND: Different characteristics of foot morphology are commonly accompanied by altering lower extremity biomechanical characteristics and foot function. Clarifying what factors affect foot morphology is helpful in understanding the basis of foot deformity and foot dysfunction. OBJECTIVE: The aim of this study was to investigate characteristics of foot morphology and whether related factors such as gender, age, body mass index (BMI) and bilateral asymmetry have an impact on foot morphology. METHODS: One hundred and eighty adults without exercise habit were included in this cross-sectional study. Participants were categorized by gender, age, BMI, and …left and right foot respectively to compare foot morphology differences. The characteristics of foot morphology were measured using a 3D foot scanner. RESULTS: Compared with females, males had longer, larger and higher feet. In terms of age differences, older adults had shorter and stiffer feet. Regarding BMI differences, the value of height and width parameters of foot was larger, and the value of height of arch also larger in those with greater BMI. Regarding bilateral asymmetry, the right foot had a higher foot than the left foot. Multiple linear regression models indicated that gender, age and BMI significantly affected length and girth parameters of foot together. CONCLUSIONS: This study showed that gender has a bigger impact on length, width, height and girth parameters of foot than BMI or age. BMI has an impact on both arch height and stiffness. Besides, bilateral asymmetry affects values of height parameters of foot and arch. Show more

Keywords: Foot length, foot width, foot girth, foot arch, foot deformities

DOI: 10.3233/BMR-150501

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 527-535, 2017

Authors: Mortada, Mohamed A. | Ezzeldin, Nillie | Abbas, Samah F. | Ammar, Hanan A. | Salama, Nahla A.

Article Type: Research Article

Abstract: BACKGROUND: Suprascapular nerve block (SSNB) is used in the management of frozen shoulder. There are no evidences from the literature that can determine how many blocks and the interval between them. OBJECTIVE: To compare between single and multiple (nine) SSNB in the treatment of diabetic frozen shoulder. METHODS: Ninety six patients with Type 2 diabetic and a frozen shoulder divided into 2 equal groups. Patients in group1 were subjected to single SSNB. Patients in group 2 were subjected to multiple (nine) SSNB. Participants were assessed clinically and by ultrasound at baseline and after …3 weeks and 4 months. RESULTS: After 3 weeks, there was a significant improvement of all clinical & ultrasound parameters in both groups. But the improvement in group 2 was significantly better than the improvement in group 1. Also after 4 months, all parameters in both groups showed a further improvement in comparison with the base line parameters but still there was a highly significant improvement in group 2 versus group1. CONCLUSION: A course of multiple (nine) injections for suprascapular nerve block gave a better outcome than a single injection for suprascapular nerve block. Show more

Keywords: Ultrasound, suprascapular nerve block, frozen shoulder, diabetic patients

DOI: 10.3233/BMR-150322

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 537-542, 2017

Authors: Keles, Betul Yavuz | Yalcinkaya, Ebru Yilmaz | Gunduz, Berrin | Bardak, Ayşe Nur | Erhan, Belgin

Article Type: Research Article

Abstract: BACKGROUND: Lumbar disc herniation (LDH) causes pain and working day loss when activated. Patients spend most of their time in the hospital. And also it may limit patients' daily living activities. Kinesio Taping (KT) is a method that can be easily applied to the patients and does not interfere with their daily activities or movements of body. OBJECTIVE: This study investigated the effects of KT in patients with low back pain due to LDH. METHODS: Randomised-placebo controlled double blind clinical trial. Sixty Patients with low back pain due to LDH were randomised as …KT group or placebo taping group. Taping was performed once a week for three weeks. Patients were followed up during twelve weeks. Numeric rating scale (NRS), lumbar flexion, Health Assessment Questionnaire (HAQ), Oswestry Disability Index (ODI) and paracetamol tablets taken were used for outcome measurements. RESULTS: Demographic and clinical features of the groups were similar. There were significant improvements in all parameters during intervention period in groups. Improvements in NRS-activity, HAQ and ODI continued to twelfth weeks only in KT group. In KT group, analgesic need was significantly less at follow-up. CONCLUSIONS: KT reduced analgesic need of patients with LDH when compared with placebo taping. Show more

Keywords: Lumbar disc herniation, low back pain, Kinesio Taping, randomised controlled study

DOI: 10.3233/BMR-150491

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 543-550, 2017

Authors: van Tilburg, Cornelis W.J. | Groeneweg, Johannes G. | Stronks, Dirk L. | Huygen, Frank J.P.M.

Article Type: Research Article

Abstract: BACKGROUND/OBJECTIVE: Several diagnostic criteria sets are described in the literature to identify low back pain subtypes, but very little is known about the inter-rater reliability of these criteria. We conducted a study to determine the reliability of diagnostic tests that point towards SI joint-, disc- or facet joint pain. METHODS: Inter-rater reliability study alongside three randomized clinical trials. Multidisciplinary pain center of general hospital. Patients aged 18 or more with medical history and physical examination suggestive of sacroiliac joint-, disc- and facet joint pain on lumbar level. Making use of nowadays most common used diagnostic …criteria, a physical examination is taken independently by three physicians (two pain physicians and one orthopedic surgeon). Inter-rater reliability (Kappa (κ) measure of agreement) and significance (p) between raters are presented. Strengths of agreement, indicated with κ values above 0,20, are presented in order of agreement. RESULTS: One hundred patients were included. None of the parameters from the physical investigation had κ values of more than 0.21 (fair) in all pairs of raters. Between two raters (C and D), there was an almost perfect agreement on three parameters, more specifically ``Abnormal sensory and motor examination, hyperactive or diminished reflexes'', ``Sitting exam shows no reflex, motor or sensory signs in the legs'' and ``Straight leg raising (Laségue) negative between 30 and 70 degrees of flexion''. The ``Drop test positive'' parameters had moderate strength of agreement between raters A and D and fair strength between raters A and B. The ``Digital interspinous pressure test positive'' had moderate strength of agreement between raters C and D and fair strength of agreement between raters A and B as well as raters B and C. Three other parameters had a fair strength of agreement between two raters, all other parameters had a slight or poor strength of agreement. Inter-rater reliability, confidence intervals and significance of pooled items for SI joint-, disc- and facet joint pain are represented; κ values for the pooled parameters of the physical examination suggestive of SI joint pain stayed below 0.20 between all raters. The same applies for the pooled parameters of the physical examination suggestive of facet joint or disc pain. CONCLUSIONS: The poor reliability of the diagnostic parameters seriously limits their predictive validity, and as such their use in patients with low back pain for more than 3 months. Show more

Keywords: Reliability and validity, reliability of results, diagnostic equipment, low back pain, sacroiliac joint, facet joint

DOI: 10.3233/BMR-150495

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 551-557, 2017

Authors: Sui, Wenyuan | Yang, Junlin | Huang, Zifang | Wang, Qifei | Fan, Hengwei | Deng, Yaolong

Article Type: Research Article

Abstract: STUDY DESIGN: A retrospective study in Chinese Han people. PURPOSE: To explore whether promoter polymorphisms of matrix metalloproteinases-3 (MMP-3) (rs3025058) and interleukin-6(IL-6) (rs1800795) genes are associated to AIS gender bias. METHODS: A total of 200 patients (100 boys and 100 girls) with AIS and 200 healthy age-matched adolescents were recruited from July 2008 to August 2013 in our scoliosis center. All AIS patients had Cobb angles larger than 20°, average 43 ± 3.6° (range 24-72°). A case-control study using genotypic technique was conducted to explore whether promoter polymorphisms of MMP-3 and IL-6 …were associated to AIS gender bias. In addition, to confirm the association between gene variants of MMP-3 and IL-6 and AIS. Statistical analysis of genotype frequencies between AIS patients and normal controls was performed by X^2 test. RESULTS: The frequency of 5A/5A genotype of MMP-3 gene in patients with AIS was higher than in controls (19% versus 9.5% p= 0.007), in the sub-divided groups depend on gender, no significant difference was found between AIS girls and boys in the frequency of 5A/5A genotype of MMP-3 (20% in girls versus 18% in boys p= 0.718). No significant difference was found between AIS and controls in the frequency of G/G genotype of IL-6 (97.5% versus 98%). In the sub-divided groups depend on gender, no significant difference was found between AIS girls and boys in the frequency of G/G genotype of the IL-6 gene (98% in girls versus 97% for boys). CONCLUSIONS: The promoter polymorphism of the MMP-3 gene was confirmed to have an association with AIS and the promoter polymorphism of the IL-6 gene was lack of association with AIS. Besides, both gene variants of MMP-3 and IL-6 were not associated to AIS gender bias. Show more

Keywords: Adolescent idiopathic scoliosis, matrix metalloproteinases-3, interleukin-6, gender

DOI: 10.3233/BMR-150309

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 559-563, 2017

Authors: Kara, Bilge | Küçük, Fadime | Poyraz, Esra coşkuner | Tomruk, Melda Soysal | İdıman, Egemen

Article Type: Research Article

Abstract: BACKROUND: The aim of our study is to examine effects of aerobic and Pilates exercises on disability, cognition, physical performance, balance, depression and fatigue in relapsing-remitting Multiple Sclerosis (MS) patients as compared to healthy controls. METHODS: The subjects were divided as aerobic exercise (n = 26), Pilates (n = 9), and the healthy control group (n = 21). We used MSFC, physical performance, Berg balance scale, Beck depression scale, fatigue impact scale. All evaluations were performed before and after exercise training. RESULTS: There are statistically meaningful differences between Nine hole testing, PASAT 3, …physical performance and fatique impact scale before and after aerobic exercise. Also we found significant difference for physical performance in the Pilates group. There are no significant differences in measures of fatique impact scale and depression between aerobic exercise group and the healthy controls after exercise. We found significant differences between Pilates and control group's after measurements except depression. There were significant differences between the Pilates and aerobic group for cognitive tests in favor of the Pilates group. CONCLUSION: Aerobic exercise and clinical Pilates exercises revealed moderate changes in levels of cognitive, physical performance, balance, depression, fatigue in MS patients. Show more

Keywords: Multiple Sclerosis, aerobic exercises, clinical Pilates, cognition, physical performance, balance

DOI: 10.3233/BMR-150515

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 565-573, 2017

Authors: Orr, Lindsay C. | George, Steven Z. | Simon, Corey B.

Article Type: Research Article

Abstract: BACKGROUND: Pain sensitivity has been negatively associated with physical activity levels. Few studies have examined associations between experimentally induced pain sensitivity and physical activity in adults with chronic low back pain and pain-free controls. OBJECTIVE: The objective of this study was to examine associations between physical activity levels and how an individual processes pain using experimentally induced pain stimuli. METHODS: Seventy subjects (CLBP = 49; mean age = 46.8 ± 14.9; Pain-free = 21; mean age = 45.3 ± 18.2, n of females = 46) participated. A self-report questionnaire derived from …the International Physical Activity Questionnaire (IPAQ) was used to calculate an activity level index. Pain sensitivity was assessed via quantitative sensory testing (QST) at the right lower extremity. RESULTS: Moderate (U = 688, p< 0.05) and vigorous (U = 649, p< 0.05) physical activity levels were higher in pain-free vs. individuals with CLBP. Activity level was not associated with pain sensitivity (Pain-free: R2 = 0.02, p> 0.05; CLBP: R2 = 0.01, p> 0.05). Both moderate (R2 = 0.49, p< 0.05) and vigorous (R2 = 0.68, p< 0.01) physical activity were associated with pain modulation amongst pain-free individuals. CONCLUSIONS: Findings suggest that physical activity influences pain modulation amongst pain-free individuals, however no relationship exists once CLBP is present. However, future investigation will elucidate the extent to which physical activity level either prevents CLBP or is effective in alleviating CLBP. Show more

Keywords: Physical activity, pain modulation, chronic low back pain

DOI: 10.3233/BMR-150429

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 575-581, 2017

Authors: Hotfiel, T. | Carl, H.D. | Wendler, F. | Jendrissek, A. | Heiß, R. | Swoboda, B.

Article Type: Research Article

Abstract: BACKGROUND: Plantar pressure leads to stress on plantar tissue and can be seen as risk factor for metatarsal stress fractures or plantar ulcers and is associated with prolonged and complicated recurrence of existing tissue damages. A clear demarcation of a systematic raise of body load regarding its effect on plantar pressure has not been described. OBJECTIVE: Assessing plantar pressure patterns in different conditions of body weight, comparing data to initial body weight. METHODS: Seventeen healthy volunteers were asked to participate. Peak pressure values were assessed during walking with dynamic pedobarography and analysed from …three foot sections. Body weight was loaded up gradually with 10%, 20% and 30% of the individual initial weight by using a weighted vest. RESULTS: We were able to detect a statistically significant increase of plantar pressure for all foot regions in case of loaded body weight of 20% and 30% comparing to initial weight (p< 0.05). The midfoot area displays a significant increase for peak pressure for the preferred foot even for 10% body load. CONCLUSIONS: Peak plantar pressure increases with loaded body weight. The midfoot area seems to be a sensitive area in case of adapting increasing foot load. Considering the clinical relevance, loaded body weight has to be seen as risk factor for increasing plantar pressure patterns and should be considered in recurrence of plantar ulcers or stress fractures. Show more

Keywords: Plantar pressure, body weight, stress fractures, plantar ulcers

DOI: 10.3233/BMR-150442

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 583-589, 2017

Authors: Bornemann, R. | Jansen, T.R. | Otten, L.A. | Sander, K. | Wirtz, D.C. | Pflugmacher, R.

Article Type: Research Article

Abstract: BACKGROUND: In case of complex vertebral fractures, posterior fixation is often required for correction of deformity and instability. Fixation is commonly supported by balloon kyphoplasty (BKP) anterior. A development of BKP is radiofrequency-targeted vertebral augmentation (RF-TVA), which leads to comparable results for augmentation and pain relief. OBJECTIVE: This prospective study evaluates the outcome of posterior fixation combined with RF-TVA or BKP, respectively. METHODS: VAS, ODI, kyphosis angle and vertebral height of 44 patients were evaluated preoperatively, 3 and 12 months postoperatively. RESULTS: Both treatments improved vertebral height and kyphosis angle. …At 12 months, vertebral height restoration was still significantly better in the BKP group (p < 0.001) and the improvement of kyphosis angle was comparable between both groups (p = 0.71). VAS and ODI improvements were significantly better in the RF-TVA group (p < 0.001). 8% of BKP patients had cement extravasations, compared to 10.5% in the RF-TVA group (p = 1.0). CONCLUSIONS: Combining posterior fixation with RF-TVA leads to better results of VAS and ODI, whereas the vertebral height restoration was favorable for patients treated with BKP. Cement leakage was comparable between both groups. It was asymptomatic and within reported ranges. Limitations of this study are the patient number and different stabilization instrumentation. Show more

Keywords: Radiofrequency kyphoplasty, balloon kyphoplasty, vertebral fractures, posterior fixation, RFK, RF-TVA, BKP

DOI: 10.3233/BMR-140224

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 591-596, 2017

Authors: Çolak, Tuğba Kuru | Akgül, Turgut | Çolak, ılker | Dereli, Elif Elçin | Chodza, Mehmet | Dikici, Fatih

Article Type: Research Article

Abstract: BACKGROUND: Quality of life and cosmethic appearance have gained importance as outcomes in AIS treatment. Improving aesthetic appearance and quality of life are defined as the primary aims of scoliosis treatment by health professionals. Studies that assess and compare the different treatment results in the field of quality of life and cosmethics are some what limited. OBJECTIVE: A cross-sectional study was designed to compare quality of life and deformity perception in patients with adolescent idiopathic scoliosis (AIS) received conservative (exercise or exercise + brace) or surgical treatment. METHODS: A total of 68 (58 …females) patients aged 10-18 years with AIS received conservative (exercise or exercise+brace) or surgical treatment were invited to participate in the study. Quality of life (Scoliosis Research Society-23 (SRS-23)) and perception of deformity (Walter Reed Visual Assessment (WRVAS)) were assessed. RESULTS: Conservatively treated patients had significantly superior scores in function domain of SRS-23 than surgically treated patients (exercise/surgery, exercise+brace/surgery; p= 0.009, 0.004). Otherwise, surgically treated patients had significantly superior scores in self-image (p= 0.000, 0.000), and satisfaction with management (p= 0.001, 0.006) domains of SRS-23, and WRVAS (p= 0.000, 0.000) than conservative groups. CONCLUSION: In addition to radiographic assessments, quality of life, aesthetic perception, functionality, satisfaction with management, psycho-social status should carefully be taken into consideration by health professionals in the teratment of AIS. Show more

Keywords: Adolescent idiopathic scoliosis, quality of life, perception, exercise, brace, surgery

DOI: 10.3233/BMR-160564

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 597-602, 2017

Authors: Resorlu, Hatice | Zateri, Coskun | Nusran, Gurdal | Goksel, Ferdi | Aylanc, Nilufer

Article Type: Research Article

Abstract: PURPOSE: To investigate the relation between chondromalacia patella and the sulcus angle/trochlear depth ratio as a marker of trochlear morphology. In addition, we also planned to show the relationship between meniscus damage, subcutaneous adipose tissue thickness as a marker of obesity, patellar tilt angle and chondromalacia patella. METHODS: Patients with trauma, rheumatologic disease, a history of knee surgery and patellar variations such as patella alba and patella baja were excluded. Magnetic resonance images of the knees of 200 patients were evaluated. Trochlear morphology from standardized levels, patellar tilt angle, lateral/medial facet ratio, subcutaneous adipose tissue thickness …from 3 locations and meniscus injury were assessed by two specialist radiologists. RESULTS: Retropatellar cartilage was normal in 108 patients (54%) at radiological evaluation, while chondromalacia patella was determined in 92 (46%) cases. Trochlear sulcus angle and prepatellar subcutaneous adipose tissue thickness were significantly high in patients with chondromalacia patella, while trochlear depth and lateral patellar tilt angle were low. The trochlear sulcus angle/trochlear depth ratio was also high in chondromalacia patella and was identified as an independent risk factor at regression analysis. Additionally, medial meniscal tear was observed in 35 patients (38%) in the chondromalacia patella group and in 27 patients (25%) in the normal group, the difference being statistically significant (P = 0.033). CONCLUSIONS: An increased trochlear sulcus angle/trochlear depth ratio is a significant predictor of chondromalacia patella. Medial meniscus injury is more prevalent in patients with chondromalacia patella in association with impairment in knee biomechanics and the degenerative process. Show more

Keywords: Chondromalacia patella, meniscal tear, trochlear morphology

DOI: 10.3233/BMR-160536

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 603-608, 2017

Authors: Reyhan, Aycan Çakmak | Dereli, Elif Elçin | Çolak, Tuğba Kuru

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVE: Low back pain is a common problem during pregnancy. Although the pain usually occurs in the third trimester, it might be seen in the first trimester, too. There are various types of applications for the treatment of low back pain during pregnancy. However, there is a lack of evidence for the effectiveness of each method. If there is not an obvious deficit, bed rest, exercise, conventional physiotherapy, using protective principles for the lumbar area are recommended, since the main and the only complaint is low back pain. It is aimed in the current review to investigate …the use of Kinesio tape in the low back pain seen during pregnancy and to review the literature related to this subject. CONCLUSION: There are only a few studies investigating the effect of Kinesio tape during pregnancy in the literature and they mostly did not aim to study the low back pain, further evidence and studies are needed to investigate the use of Kinesio tape for the low back pain seen during pregnancy as there is not evidence strong enough. Kinesiotape application aims to increase circulation and mobility, and regarding these gains decreased pain and increased performance are expected. Show more

Keywords: Kinesiotape, low back pain, physiotherapy, pregnancy

DOI: 10.3233/BMR-160584

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 609-613, 2017

Authors: Hauswirth, Jürg | Ernst, Markus J. | Preusser, Marianne Lanz | Meichtry, André | Kool, Jan | Crawford, Rebecca J.

Article Type: Research Article

Abstract: BACKGROUND: Lateral gliding cervical spine mobilisation is shown to improve shoulder pain, disability and function. However, despite common clinical-use, no study reports the effect of unilateral anterior-posterior (A-P) cervical mobilisation on shoulder pain and function, and particularly in patients after arthroscopic shoulder surgery. OBJECTIVE: Examine the immediate effect of single-level Grade III cervical unilateral A-P mobilisation on shoulder pain, flexion and abduction range of motion (ROM) and external rotator strength compared to placebo cervical unilateral A-P light touch pressure. METHODS: Single session intervention with a crossover design in 32 (15 women) postoperative arthroscopic …shoulder patients. RESULTS: Immediate and superior treatment effects were shown for A-P cervical mobilisation in improving flexion ROM, isometric strength of external rotation, and pain intensity during flexion (all p< 0.05) when compared to the placebo. However, effects may not be considered clinically meaningful. CONCLUSION: Unilateral A-P mobilisation applied to the cervical spine shows a tendency toward positively influencing post-arthroscopy shoulder pain and function. Further study examining cervical mobilisations directed in different planes to influence shoulder motion appear warranted. Show more

Keywords: Shoulder arthroscopy, cervical spine mobilisation, pain, range of motion, isometric strength

DOI: 10.3233/BMR-160566

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 615-623, 2017

Authors: Feng, Qiang | Jiang, Chongmin | Zhou, Yu | Huang, Yun | Zhang, Ming

Article Type: Research Article

Abstract: CONTEXT: Non-specific back pain has become a public health problem affecting adolescent health. OBJECTIVE: To examine the relationships between abnormalities in spinal morphology and non-specific back pain among adolescents. DESIGN: Cross-sectional study. SETTING: Junior and senior high schools. PATIENTS: Participants were screened using a questionnaire regarding back pain. Students in the pain group (n= 273, 121 boys and 152 girls) reported experiencing upper and/or lower back pain within the previous month, and those who did not report pain were assigned to the group without pain (n= 127, …63 boys and 64 girls). Participants who had experienced acute upper and/or lower back injuries within the previous month or received a definitive diagnose of disease were excluded. METHODS: The SpinalMouse® was used to measure the thoracic kyphosis angle (TKA), lumbar lordosis angle (LLA), sacrum/hip angle (SA), and incline angle (INA) in both the standing position and sitting position. The SpinalMouse® also was used to measure the sacral, thoracic, and lumbar range of motion (ROM) in the fully flexed position and fully extended position in the sagittal plane. The thoracic and lumbar ROM in left/right lateral flexion was recorded. The Matthiass test was used to assess changes in the measured angles upon loading. RESULTS: Among junior high school students, 47.0% of boys and 53% of girls had an abnormal TKA. Among senior high school students, 52.6% of boys and 46.99% of girls had an abnormal TKA. The incidence of LLA abnormality was significantly higher among junior high boys than girls (p< 0.05), as was the incidence of hypolordosis (p< 0.05). Significantly fewer senior high boys than girls had a normal LLA value (p< 0.05). An excessive TKA (p< 0.05, odds ratio = 1.236) and limited lumbar ROM (p< 0.01, odds ratio = 0.975) were correlated with back pain in adolescents. CONCLUSIONS: The incidences of TKA and LLA abnormality are high among Chinese adolescents, and an excessive TKA and insufficient total lumbar ROM may be risk factors for non-specific back pain in adolescents. Show more

Keywords: Adolescence, lumbar lordosis angle, non-specific back pain, spinal morphology, spinal function, SpinalMouse, thoracic kyphosis angle

DOI: 10.3233/BMR-160544

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 625-633, 2017

Authors: Mishra, Sudhir Ramkishore | Shastri, Mona | Ramesh, Jaishree

Article Type: Case Report

Abstract: Hurler syndrome is an inherited autosomal recessive disorder of lysosomal accumulation of un-degraded glucosaminoglycan secondary to deficiency of a-L-Iduronidase enzyme. It is most severe form of Mucopolysaccharidosis with incidence of 1:100 000. It has multisystemic involvement leading to multiple deformity, disability and death within 10th years of life. A 2 year old boy presented with umbilical hernia, gross developmental delay and a progressive spinal deformity. On detailed clinical, radiological and laboratory investigation he was diagnosed as Hurler's syndrome. Till date only treatment available is enzyme replacement therapy which is neither cost effective nor easily available. Thus a multidisciplinary rehabilitation …team set a goal oriented and well-coordinated approach and successfully rehabilitated the patient. To conclude early diagnosis, multidisciplinary, goal oriented and well-coordinated, rehabilitation team can be key in management of hurler syndrome. Show more

Keywords: Hurler syndrome, mucopolysaccharidosis, a-L-Iduronidase

DOI: 10.3233/BMR-150317

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 635-639, 2017

Authors: Shariat, Ardalan | Lam, Eddie T.C. | Shaw, Brandon S. | Shaw, Ina | Kargarfard, Mehdi | Sangelaji, Bahram

Article Type: Research Article

Abstract: STUDY DESIGN: True experimental design. BACKGROUND: The back squat is an integral aspect of any resistance training program to improve athletic performance. It is also used for injury prevention of the lower limbs. OBJECTIVE: The purpose of this study was to examine the effect of back squat training at different intensities on strength and flexibility of the hamstring muscle group (HMG). METHODS: Twenty-two male recreational bodybuilders with at least two years of experience in resistance training were recruited to participate in a nine-week training program. They were randomly …assigned to a heavy back squat group (90-95% of one repetition maximum) or a moderate-intensity back squat group (60-65% of one repetition maximum). RESULTS: The heavy back squat group resulted in a significantly (p < 0.001) increased in one repetition maximum strength but a significant (p < 0.001) reduction in HMG flexibility when compared to their counterparts. The results of the study indicate that while a heavy back squat training program is effective in improving strength, it has an adverse effect on the flexibility of the HMG. CONCLUSION: The implication of this study is that there is a tradeoff between strength and flexibility and trainers should select the appropriate training protocols for their athletes to maximize athletic performance. Show more

Keywords: High-intensity, injury, resistance training, maximum strength, multi-joint

DOI: 10.3233/BMR-160526

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 641-647, 2017