Journal of Back and Musculoskeletal Rehabilitation - Volume 30, issue 5
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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 one of the most important causes of morbidity. OBJECTIVE: This study was designed to evaluate the effect of Kinesio ® taping on pain, functionality, mobility and endurance in chronic low back pain treatment. METHODS: Patients with chronic low back pain were randomly divided into three groups. Therapeutic ultrasound, hot packs, and transcutaneous electrical nerve stimulation were applied to each group for ten sessions during two weeks, and therapeutic exercises were applied in the clinic under physiotherapist supervision starting from the sixth session. Kinesio ®…tape was applied to the patients in the first group after each treatment session, and placebo tape was applied to the patients in the second group. No taping was applied to the third group, which constituted the control group. All the patients were evaluated pre and post-treatment in respect of pain, functional status (Oswestry scale), flexibility and endurance. RESULTS: The study included 60 patients (32 females). When the initial demographic and clinical characteristics of the groups were evaluated, all assessment results, except the Oswestry scores, were similar (p = 0.000). When the average changes in the clinical evaluations were evaluated after the treatment, a statistically significant improvement demonstrating the superiority of the taping group was observed in pain, functionality, flexibility and endurance values (p = 0.000, 0.000, 0.000, 0.000). CONCLUSIONS: Kinesio ® taping in chronic low back pain is an easy and effective method which increases the effectiveness of the treatment significantly in a short period when applied in addition to exercise and electrotherapy methods.
Keywords: Back pain, Kinesio® taping, physiotherapy
Abstract: PURPOSE: The aim of this study was to evaluate the effectiveness of PNF and manual therapy methods in the treatment of patients with cervical spine osteoarthritis, especially their efficacy in reducing pain and improving functionality in everyday life. Long-term results were also compared in order to determine which method of treatment is more effective. SUBJECTS AND METHODS: Eighty randomly selected females aged 45–65 were included in the study. They were randomly divided into two groups of 40 persons. One group received PNF treatment and the other received manual therapy (MAN.T). To evaluate functional capabilities, the Functional…Rating Index was used. To evaluate changes in pain, a shortened version of the McGill Questionnaire was used. RESULT: The PNF group achieved a greater reduction in pain than the MAN.T group. The PNF group showed a greater improvement in performing daily activities such as sleeping, personal care, travelling, work, recreation, lifting, walking and standing as well as decreased intensity and frequency of pain compared to the MAN.T group. CONCLUSION: The PNF method proved to be more effective in both short (after two weeks) and long (after three months) term.
Abstract: BACKGROUND: Among all musculoskeletal disorders back pain is the most common reason for functional limitation in working age. It is due to low back pain (LBP) that the ODI has become one of the principal outcome measures for evaluation of disability and has been widely used in research as well as in clinical practice. So far, validated Gujarati version of the ODI 2.1a has not been reported. OBJECTIVE: To accomplish the translation and validation of the Oswestry Disability Index (ODI) version 2.1a into the Gujarati language. STUDY DESIGN: Cross-sectional study. METHODS:…The validation of the ODI-Gujarati was tested in 120 patients diagnosed with non-specific LBP, who were receiving physiotherapy at a clinic in Gujarat, India. Data was collected at on initial visit and after 48 hours. During both visits, patients completed the Oswestry Disability Index-Gujarati (ODI-G), Roland-Morris Disability Questionnaire-Gujarati (RMDQ-G), and Visual Analogue Scale-Pain (VAS-P). RESULTS: Internal consistency was measured by Cronbach’s alpha. The Gujarati version indicated high internal consistency (α = 0.96). Test-retest reliability was measured by intra-class correlation coefficient and it revealed very high correlation (ICC = 0.92). Construct validity was confirmed by strong correlation with RMDQ-G (r = 0.76), and concurrent validity indicated moderate correlation with VAS-P (r = 0.50). Factor analysis explained that the ODI was loaded on 1 factor. CONCLUSION: The Oswestry disability index version 2.1a was successfully translated into Gujarati language, showing excellent psychometric properties. Therefore, it can be used in evaluating the disability amongst Gujarati population with LBP for both clinical and research purposes.
Keywords: ODI-Gujarati version 2.1a, low back pain, reliability, validity
Abstract: OBJECTIVE: The aim of this study was to compare the biochemical parameters of the urine and blood in spinal cord injury (SCI) patients and healthy subjects. METHODS: Thirty male patients with SCI were enrolled. Biochemical features of the urine and blood of the SCI patients were compared to healthy subjects. Extracted stones were analyzed by X-ray diffraction. RESULTS: A total of 30 patients with SCI (mean age of 28.77 ± 7.3 years) and 10 healthy subjects (mean age of 27.6 + 6.2 years) were included. Among the patients…with SCI; 12 of them (40%) had urinary stones and 18 of them (60%) did not. Urinary stone was localized in the kidneys and bladder in 25% and 75% of the subjects, respectively. The mean duration of cord injury at diagnosis of urinary stone was 9.2 ± 6 months. Urine cultures obtained on admission were negative for the control group, while the microorganism isolation rate was 73.3% in the SCI group. The urinary excretion of citrate and Mg were lower in the patient group compared with control group (p = 0.008, p = 0.001, respectively). As for the diffraction analysis of eight stones; five (62.5%) of the stones were calcium oxalate, two (25%) of them were calcium phosphate, and one (12.5%) was magnesium ammonium phosphate. CONCLUSION: Both infection and metabolic changes play an important role in stones formation in SCI patients. The urinary excretion of citrate and Mg was decreased and urinary PH was increased in SCI patients.
Abstract: Hysterical paralysis, a type of conversion disorder, presents with the loss of motor or sensory function. Although this disorder is nonorganic, it resembles the symptoms of a structural disease of the nervous system. It is generally associated with a traumatic or social event. The patients often require excessive testing and comprehensive assessment in exposing this psychogenic ailment. We reported the most dramatic type of conversion disorder, hysterical paralysis, in which full recovery was obtained with early recognition and rehabilitation approach including faradic stimulation.
Keywords: Hysterical paralysis, conversion motor disorder, rehabilitation, faradic stimulation
Abstract: BACKGROUND: Osteoarthritis (OA) of the knee is a degenerative, painful pathology, needing conservative treatment for symptoms’ relief. OBJECTIVE: Comparing the effects of Extracorporeal shockwave therapy (ESWT) and Kinesiotherapy (KIN) on perceived health and range of motion (ROM) of the affected knee. METHOD: A pilot randomized controlled trial with concealed allocation, assessor blinding, intention-to-treat analysis. Forty participants, aged 40–75 with OA of the knee were randomized to an ESWT and a KIN groups. The ESWT group completed 5 interventions for 5 weeks, the KIN group completed the same number of interventions. All evaluations were…performed at baseline and after the treatment for: perceived health (Western Ontario and McMaster Universities questionnaire – WOMAC), range of motion (ROM). RESULTS: After the intervention the statistical significant between groups differences favoring the ESWT were found in the WOMAC with regard to pain (p < 0.000), stiffness (p = 0.018), physical function (p < 0.000), total score (p < 0.000), extension and flexion of the affected knee (p = 0.015, p < 0.000) respectively. CONCLUSIONS: ESWT improves WOMAC and ROM better then KIN on the affected knee in patients with OA of the knee.
Keywords: Extracorporeal shockwave therapy, kinesiotherapy, osteoarthritis of the knee
Abstract: BACKGROUND: Malignant peripheral nerve sheath tumor (MPNST) arising in benign schwannoma with multiple intraosseous spinal metastasis is extremely rare, having a highly aggressive progression and poor prognosis. In such cases, the malignant cells of MPNST usually have an epithelioid morphology. Here, the authors present a very rare case of spindle cell type MPNST arising in benign schwannoma. CASE: A 47-year-old woman had a history of wide marginal excision of right buttock spindle cell sarcoma previously. However, metastatic lesions to C7, L1 body, and the right lung were detected during follow-up. Total spondylectomy and stabilization of…the C7 and L1 tumors were performed within an interval of 5 months. However, the patient expired 6 months after the last surgery. From analysis and study of three tumor specimens (right buttock, cervical and lumbar spine), the pathological diagnosis based on histomorphologic and immunohistochemical studies was spindle cell sarcoma, high grade, most consistent with MPNST arising in schwannoma. RESULTS : It is important that pathologists and surgeons recognize that spindle cell type MPNST may arise in benign schwannoma, as this recognition aids in assessment of patients with schwannoma and contributes to the pathologist making a more precise diagnosis, and the surgeon better determining the appropriate therapeutic options and surgical methods.
Abstract: Pustulotic arthro-osteitis is a rare disease involving the skin and musculoskeletal system that was first described by Sonozaki. Onset is frequently seen at age 30–40. The prevalences between the sexes are similar. Palmoplantar pustulosis and sternoclavicular joint involvement are the most typical findings. It may be difficult to distinguish seronegative spondyloarthropathies and SAPHO syndrome due to sacroiliac joint, vertebral column and peripheral joint involvement. Arthritis being non-erosive and short-lived in character and the absence of deformity or contracture in the joints are significant clinical characteristics. Anti-inflammatory and immunesuppressive drugs are used in the treatment of the disease, the course of…which involves remission and flare-ups. We describe the case of a 43-year-old male patient diagnosed with pustulotic arthro-osteitis.
Abstract: BACKGROUND AND OBJECTIVE: Nowadays, pulsed radiofrequency (PRF) is being used to control several types of musculoskeletal pain. Herein, we report a successful application of ultrasound (US)-guided PRF for a patient with refractory sciatic neuropathic pain. CASE REPORT: We applied US-guided PRF to a 50-year-old man, suffering from refractory neuropathic pain on the left foot following sciatic neuropathy for a period of approximately 6 months. We performed PRF on the level of piriformis muscle because the lesion of the sciatic nerve was presented digitally from the level of piriformis muscle on the magnetic resonance images. Under US…guidance, the catheter needle was placed close to the left sciatic nerve, and dysesthesia and tingling sensation were reported to be less than 0.2 V. The PRF treatment was administered at 5 Hz and 5 ms pulsed width for 360 seconds at 45 V. After PRF on the left sciatic nerve, pain intensity – based on a numeric rating scale – decreased from 8 to 2. The reduction of pain was sustained for at least 6 months after the PRF procedure. CONCLUSION: We concluded that the PRF treatment is a very useful treatment technique for patients with refractory sciatic neuropathy.