Journal of Back and Musculoskeletal Rehabilitation - Volume 30, issue 6

Authors: Raya, Cristian Rodolfo | Plaza-Manzano, Gustavo | Pecos-Martín, Daniel | Ferragut-Garcías, Alejandro | Martín-Casas, Patricia | Gallego-Izquierdo, Tomás | Romero-Franco, Natalia

Article Type: Research Article

Abstract: BACKGROUND: Temporomandibular disorders (TMDs) are prevalent multifactorial pathologies in which the actual role of the cervical region position is controversial. OBJECTIVE: To analyze the relationship between the position of the upper cervical rachis and the symptoms of TMD. METHODS: Sixty women were recruited to this study. All of them completed a questionnaire and were subjected to a temporomadibular exploration to create two different groups: a TMD Group (n = 30) – women who suffered TMD symptoms according to the evaluation; and a control group (n = …30) – women who were free from TMD symptoms. Two X-ray examinations were performed in all the women: a lateral one and a frontal one with mouth open to assess the C1–C0 distance and the craniocervical angle. RESULTS: ANOVA showed that the TMD and control women had similar C1–C0 distances and craniocervical angles (p > 0.05). Pearson correlation did not indicate any relationship between the craniocervical position and the symptomatology of TMD (r = - 0.070). CONCLUSIONS: TMD symptomatology is unrelated to alterations in craniocervical position (C0–C1 distance and craniocervical angle). Women with and without TMD showed a similar prevalence of alteration in the craniocervical position. Show more

Keywords: Cervical vertebrae, temporomandibular joint disorders, upper cervical spine

DOI: 10.3233/BMR-169620

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1245-1250, 2017

Authors: Yıldırım, Azad | Nas, Kemal

Article Type: Research Article

Abstract: PURPOSE: There are limited studies related to the rehabilitation of neglected Monteggia fracture-dislocations. This study reports the results of the rehabilitation of neglected Monteggia fractures and dislocations and the best treatment options available. MATERIAL AND METHODS: Thirteen children were rehabilitated between 2009 and 2012. A retrospective chart review was conducted to record the following: age, gender, anatomic region of fractures, time delay from symptom onset to fracture, Bado classification, Mayo Elbow Performance Index (MEPI) which includes pain, range of motion and daily life comfort, surgeries, length of hospitalization, location and pattern of fracture, length of follow-up …and complications. RESULTS: The study group included thirteen children and adolescents; eleven males and two females with a mean age of 8.5 (range 2–15) years. According to the Bado classification, 11 patients had type 1, one had type 3 and one had type 4 fracture-dislocations. For Mayo Elbow Performance Index (MEPI) scales, patients that were less than ten years old had greater mean scores. Two patients had superficial infection, one had subluxation, one had osteoarthritis, one had delayed bone union and two had rigidity at the elbow. CONCLUSION: The goals of elbow rehabilitation following Neglected Monteggia cases include restoring function by restoring motion and muscle performance; influencing scar remodeling and preventing joint contracture; and restoring or maintaining joint stability. Patients aged younger than 10 years and intervals of less than one-year, between trauma and diagnosis, as well as early and effective rehabilitation were found as important parameters regarding favorable outcomes. Show more

Keywords: Monteggia, Bado, dislocation, rehabilitation

DOI: 10.3233/BMR-169621

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1251-1257, 2017

Authors: Dibai-Filho, Almir Vieira | de Jesus Guirro, Rinaldo Roberto | Rezende, Monique Silva | Rangon, Flávia Belavenuto | Ferreira, Vânia Tie Koga | de Oliveira Guirro, Elaine Caldeira

Article Type: Research Article

Abstract: BACKGROUND: Baropodometric evaluation has been used in research and clinical environments by professionals who are working on the physical rehabilitation of patients. However, to date, there is no published data on the use of baropodometry in patients with chronic neck pain. OBJECTIVE: To analyze peak plantar pressure and center of pressure oscillation in individuals with chronic neck pain compared to a control group. METHODS: This was a blind cross-sectional study. It included 44 participants of both genders, between 18 and 45 years old, distributed into a chronic neck pain group (n = …22) and a control group (n = 22). Participants were assessed by means of baropodometry, the Numeric Rating Scale, the Neck Disability Index, and the Pain-Related Self Statement Scale. The Mann-Whitney test was used for comparison of baropodometric variables between the two groups, and the Spearman correlation coefficient was used to check possible associations between the variables. RESULTS: No significant differences (p > 0.05) in peak plantar pressure or center of pressure oscillation were detected in the comparisons between the chronic neck pain and control groups. In addition, no significant correlation was observed (p > 0.05) between baropodometric variables and neck pain. CONCLUSION: Individuals with chronic neck pain with mild disability did not differ from a control group in terms of peak plantar pressure or center of pressure oscillation. Show more

Keywords: Chronic pain, postural balance, musculoskeletal equilibrium

DOI: 10.3233/BMR-169629

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1259-1264, 2017

Authors: Alahmari, Khalid A. | Reddy, Ravi Shankar | Silvian, Paul | Ahmad, Irshad | Nagaraj, Venkat | Mahtab, Mohammad

Article Type: Research Article

Abstract: BACKGROUND: Evaluation of cervical joint position sense in subjects with chronic neck pain has gained importance in recent times. Different authors have established increased joint position error (JPE) in subjects with acute neck pain. However, there is a paucity of studies to establish the influence of chronic neck pain on cervical JPE. OBJECTIVE: The objective of the study was to understand the influence of chronic neck pain on cervical JPE, and to examine the differences in cervical JPE between young and elderly subjects with chronic neck pain. METHODS: Forty-two chronic neck pain patients (mean age …47.4) were compared for cervical JPE with 42 age-matched healthy subjects (mean age 47.8), using a digital inclinometer. The cervical JPE were measured in flexion, extension, and rotation in right and left movement directions. RESULTS: The comparison of JPE showed significantly larger errors in subjects with chronic neck pain when compared to healthy subjects (p < 0.001). The errors were larger in all of the movement directions tested. Comparison between young and older subjects with chronic neck pain revealed no significant differences (P > 0.05) in cervical JPE. CONCLUSIONS: Cervical joint position sense is impaired in subjects with chronic neck pain. Show more

Keywords: Age, neck proprioception, neck pain

DOI: 10.3233/BMR-169630

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1265-1271, 2017

Authors: Oostendorp, Rob A.B. | Elvers, Hans | Mikolajewska, Emilia | Laekeman, Marjan | Roussel, Nathalie | van der Zanden, Olaf | Nijs, Jo | Samwel, Han

Article Type: Research Article

Abstract: BACKGROUND: Manual physical therapists (MPTs) working in primary care get limited information about patient’s courses of (chronic) low back pain (LBP). Identification of kinesiophobia is mostly based on clinical perception. OBJECTIVE: The aim of this study was to evaluate the association between the scores with which manual physical therapists in a primary care setting identify kinesiophobia in patients with low back pain, and the patients’ self-reported measures of kinesiophobia. METHODS: The cross-sectional study comprised 104 patients with LBP and 17 MPTs. Patients first independently completed the Tampa Scale for Kinesiophobia (TSK-17). The therapists, …blinded to the TSK-scores, rated their perception of a patient’s kinesiophobia using the Visual Analogue Scale-Estimation (VAS-est) and the accuracy of their ratings using the Visual Analogue Scale-Accuracy (VAS-ac). Kendall’s tau b was used to determine the level of correlation between scores on the TSK-17 and the VAS-est. Show more

DOI: 10.3233/BMR-169651

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1273-1284, 2017

Authors: Senthil, P. | Sudhakar, S. | Radhakrishnan, R. | Jeyakumar, S.

Article Type: Research Article

Abstract: BACKGROUND: Age-related hyperkyphosis causes deleterious effects on health, physical function, and quality of life. Recently, health care providers recognized it as a major health concern. OBJECTIVE: To identify the effect of corrective exercise strategy on hyperkyphosis and compare it with that of conventional exercise. METHODS: Subjects were randomly categorized into two groups. Each group comprised 30 subjects. Group A received the corrective exercise strategy, and group B received conventional exercises for 8 weeks of the study duration (15 repetitions of each exercise for three sessions/day for a total duration of 45 min and 4 …days/week. Pre- and post-interventional hyperkyphosis were analyzed according to posture number using the Posture Pro 8 postural analysis software. In addition, pectoralis minor flexibility was assessed using the ruler scale method in centimeters. RESULTS: Both groups showed highly significant postural alteration and changes in pectoralis minor muscle length (p < 0.001) CONCLUSIONS: The corrective exercise strategy seems to promote scapular stability and produce a more upright posture of the upper thoracic spine. Show more

Keywords: Hyperkyphosis, corrective exercise strategy, postural analysis, pectoralis minor muscle length test

DOI: 10.3233/BMR-169668

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1285-1289, 2017

Authors: Almhdawi, Khader A. | Mathiowetz, Virgil | Al-Hourani, Zeid | Khader, Yousef | Kanaan, Saddam F. | Alhasan, Mustafa

Article Type: Research Article

Abstract: BACKGROUND: Very few articles, comprehensively, investigated musculoskeletal pain symptoms (MPS) among wide variety of allied health professions (AHP) students. OBJECTIVES : This study aimed to investigate the prevalence of MPS and their associated factors among different AHP majors’ students. METHOD: A cross-sectional design was conducted. A sample of AHP students from nine majors (n = 838, Mean age = 21.3 years) completed a validated structured self-administrated questionnaires including Nordic Musculoskeletal Questionnaire, Depression Anxiety Stress Scale (DASS 21), and specific questions regarding demographics and life style. MPS prevalence …rate were compared between males and females and between majors. Logistic regression was conducted to identify predictors of MPS. RESULTS: MPS in neck, lower back, and shoulder 12-month were the most prevalent (67.1%, and 61.4%, 58.8% respectively). MPS prevalence was significantly higher in females and statistically different among majors. MPS were significantly associated with increased clinical training load, mental stress symptoms, and smartphone average use time. CONCLUSIONS: MPS in AHP students are prevalent and statistically higher among females. Students are advised to adhere to different conservative precautions and follow prevention programs. Future studies are needed to assess actual mechanisms causing MPS among AHP students and designing effective prevention programs specific to AHP students. Show more

Keywords: Occupational therapy, occupational safety, allied health, musculoskeletal pain, medical education

DOI: 10.3233/BMR-169669

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1291-1301, 2017

Authors: Ulger, Ozlem | Demirel, Aynur | Oz, Müzeyyen | Tamer, Seval

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVES: To determine the effects of spinal stabilization exercises (SSE) and manual therapy methods on pain, function and quality of life (QoL) levels in individuals with chronic low back pain (CLBP). METHODS: A total of one-hundred thirteen patients diagnosed as CLBP were enrolled to the study. The patients allocated into Spinal Stabilization group (SG) and manual therapy group (MG), randomly. While SSE performed in SG, soft tissue mobilizations, muscle-energy techniques, joint mobilizations and manipulations were performed in MG. While the severity of pain was assessed with Visual Analog Scale (VAS), Oswestry Disability Index (ODI) …and Short Form 36 (SF-36) assessments were performed to evaluate the functional status and QoL, respectively. All assessments were repeated before and after the treatment. Results: Intragroup analyses both treatments were effective in terms of sub parameters of pain, function and life quality (p < 0.05). Inter group analyses, there was more reduction in pain and improvement in functional status in favor of MG (p < 0.05). CONCLUSIONS: This study showed that SSE and manual therapy methods have the same effects on QoL, while the manual treatment is more effective on the pain and functional parameters in particular. Show more

Keywords: Low back pain, pain, rehabilitation, exercise, quality of life

DOI: 10.3233/BMR-169673

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1303-1309, 2017

Authors: Kapetanakis, S. | Giovannopoulou, E. | Charitoudis, G. | Kazakos, K.

Article Type: Research Article

Abstract: BACKGROUND: Lumbar discectomy is among the most frequently performed procedures in spinal surgery. Transforaminal percutaneous endoscopic discectomy (TPED) is a minimally invasive technique that gains ground among surgeons in the recent years. TPED has been studied in terms of effectiveness, however little is known about its overall impact on health-related quality of life (HRQoL) of the patients. OBJECTIVE: To investigate the progress of HRQoL following TPED. PATIENTS AND METHODS: Seventy-six (76) patients were enrolled in the study. Mean age was 56.5 ± 12.1 years with 38 (50%) males and 38 (50%) …females. All patients underwent TPED at L3-L4 (27.6%), L4-L5 (52.6%) and L5-S1 (19.7%). SF-36 was used for the assessment of HRQoL preoperatively and at 6 weeks, at 3, 6 and 12 months after the procedure. RESULTS: All aspects of SF-36 questionnaire showed statistically significant improvement one year after the procedure (p < 0.001). Role limitations due to physical problems, bodily pain and role limitations due emotional problems showed the highest improvement, followed by physical functioning, vitality, social functioning, mental health and general health. CONCLUSIONS: TPED for lumbar disc herniation is associated with significant improvement in all aspects of health-related quality of life within 6 weeks postoperatively and the improvement remains significant one year after surgery, as measured by the SF-36 questionnaire. Show more

Keywords: Lumbar hernia, discectomy, endoscopy, transforaminal, health-related quality of life

DOI: 10.3233/BMR-169702

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1311-1317, 2017

Authors: Muyor, José M. | Arrabal-Campos, Francisco M. | Martínez-Aparicio, Carmen | Sánchez-Crespo, Antonia | Villa-Pérez, Manuel

Article Type: Research Article

Abstract: OBJECTIVE: To evaluate the test-retest reliability and validity of the MOCAP system for measuring spinal sagittal thoracic and lumbar curvatures and sacral inclination in a standing posture. METHODS: Twenty-five male adults were evaluated on lateral standing radiographs. The thoracic and lumbar curvatures were calculated by Harrison’s posterior tangent method. The sacral inclination was defined as the angle between the tangent line of the sacral and vertical plane. In addition, MOCAP was used to calculate the spinal curvatures and sacral inclination. RESULTS: The thoracic and lumbar spine and sacral inclination demonstrated excellent reliability, with …mean ICCs levels greater than 0.980 and low CVs (mean: 2.15%). Systematic biases were not significant and were very near 0, and the mean standard errors were 0.257 ∘ . ANOVA of the radiographic and MOCAP measures did not report any statistically significant differences in the comparisons. The systematic biases and mean random errors were lower than 1 ∘ , with CVs lower than 5% and mean ICCs higher than 0.90 between sessions. CONCLUSION: The MOCAP system delivered consistently reliable and valid results for standing curvatures compared with a radiographic technique. This system could be used with confidence in research and clinical environments for sagittal spinal curvature measurements. Show more

Keywords: Optitrack, kyphosis, lordosis, spine, posture

DOI: 10.3233/BMR-169750

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1319-1325, 2017

Authors: Koura, Ghada Mohamed | Elimy, Doaa Ayoub | Hamada, Hamada Ahmed | Fawaz, Hossam Eddien | Elgendy, Mohamed Hussein | Saab, Ibtissam M.

Article Type: Research Article

Abstract: OBJECTIVE: To investigate the effect of foot pronation on the postural stability through measuring the dynamic balance including overall stability index (OAI), anteroposterior stability index (APSI) and mediolateral stability index (MLSI). METHODS: Forty participants from both sexes were selected from the Faculty of Physical Therapy, Cairo University, with a mean age of 23.55 ± 1.74 years. Subjects were divided into two groups: group A (8 males and 12 females) with foot pronation, and group B (9 males and 11 females) with normal feet. The Navicular Drop Test (NDT) was used to determine if …the feet were pronated and Biodex Balance System was used to assess dynamic balance at level 8 and level 4 for both groups. RESULTS: No significant difference was found in dynamic balance, including OAI, APSI and MLSI at stability level 8 (p > 0.05) but, there was a significant difference at stability level 4 (p < 0.05) between the two groups with lower stability in group A. CONCLUSION: Foot pronation affects the postural stability at stability level four and not affects stability level eight compared with those in the control group. Show more

Keywords: Flat feet, foot pronation, dynamic balance, biodex balance system

DOI: 10.3233/BMR-170886

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1327-1332, 2017

Authors: Callens, Christian | Nisand, Michaël | Isner-Horobeti, Marie-Eve

Article Type: Research Article

Abstract: BACKGROUND: Patellofemoral pain syndrome particularly impairs quality of life in young, physically active subjects. The exact etiology remains unknown, and so this syndrome is a challenging condition to treat. Some patients continue to experience pain and dysfunction after receiving one or more guidelines-compliant conservative treatments. Reducing the likelihood of patellofemoral pain syndrome is an important way of preventing the onset of debilitating anterior knee pain at all ages of life. CASE: A 24-year-old sportswoman with a 15-month history of anterior knee pain and failure of previous guidelines-compliant treatments. We treated this patient with techniques derived …from the paradigm of inductive physiotherapy, in which tone disorders with a central origin may contribute to musculoskeletal disorders. One distinctive feature of inductive physiotherapy relates to the fact that the painful area is not manipulated directly. RESULTS: The effects of physiotherapy were evaluated after ten weekly sessions and then 15 months later. The changes in the visual analogue pain scale score and the Knee Lequesne Index were clinically significant. We also observed an unexpected reduction in the static varus misalignment. CONCLUSION: This case could pave the way to an innovative neurological approach to the management of patellofemoral pain syndrome in the young adult. Show more

Keywords: Musculoskeletal disorders, patellofemoral pain syndrome, varus misalignment

DOI: 10.3233/BMR-150336

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1333-1338, 2017