Journal of Back and Musculoskeletal Rehabilitation - Volume 31, issue 1
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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: Most stroke survivors are suffering from physical motor impairments and confronting with the risk of falls, and well trunk stability is essential for balance during daily functional activities. OBJECTIVES: Current fall prevention devices have various limits to the efficient recovery of balance function of the trunk. To provide hemiplegic patients after stroke with the retraining of trunk position sense and a safety environment, a novel fall prevention device is proposed. METHODS: Firstly, the structure of the device is introduced and this work is a first effort towards restoring trunk balance function through…retraining of trunk position sense. Secondly, the kinematic and static model of the device are developed. Lastly, kinematic and static analysis are carried out to study the motion characteristics, and a contrast experiment was derived to show the effectiveness of robot. RESULTS: No obvious difference in balance ability between two groups prior treatment (P > 0.05). Fugl-Meyer assessment in all the cases were improved in different extent (P < 0.05). The robot group had significantly higher Fugl-Meyer scores after treatment than the control group (P < 0.05). CONCLUSIONS: The results show that the fall prevention device has good kinematic dexterity within the prescribed workspace and markedly improves balance function.
Keywords: Trunk position sense, kinematics, fall prevention device, statics, force field
Abstract: BACKGROUND: The Quality of Life Profile for Spinal Deformities (QLPSD) is the first specific questionnaire to evaluate health-related quality-of-life (HRQoL) in adolescents with spinal deformities. Measuring HRQoL is important because spinal deformities and their management may negatively affect quality of life (QoL), thereby importantly affecting treatment effectiveness. OBJECTIVE: This study aimed to examine the validity and reliability of a Persian version of the QLPSD through patients with adolescent idiopathic scoliosis and Scheuermann’s kyphosis. METHODS: A cross-sectional design was used to determine the validity and reliability of the Persian version of the QLPSD based…on the IQOLA protocols. RESULTS: The QLPSD was successfully culturally adapted, showing acceptable internal consistency (cronbach’s α = 0.88) and intraclass correlation coefficients (ICC = 0.91). Concurrent validity was supported by comparing scores on corresponding dimensions of the Persian versions of QLPSD and the Scoliosis Research Society-22r (SRS-22r) questionnaires (function, pain, and body-image). Discriminant validity was supported though observation of significant differences between participants who had different clinical characteristics (p < 0.05). CONCLUSIONS: The Persian QLPSD is valid and reliably measures QoL among adolescents with spinal deformities; it may be used in clinical evaluations and future research.
Keywords: QLPSD, quality of life, spinal deformities, adaptation, validity, reliability
Abstract: BACKGROUND: Young athletes at the stage of growth acceleration tend to exhibit increased susceptibility to postural abnormalities, especially in the trunk region. The aim of this study was to assess and compare the posture in male adolescent handball players over two years of regular training sessions. METHODS: The study group comprised 21 handball players. At the start of the study 15 participants were aged 14 and 6 participants were aged 15 (mean 14.25 ± 0.58). The measurements were repeated three times. Posture was assessed with a photogrammetric method based on the moiré phenomenon.…RESULTS: The analysis of posture relative to symmetry in the frontal and transverse planes did not reveal any significant differences between posture indicators obtained during the successive measurements. Sagittal plane posture indicators revealed significant changes in torso forward inclination angle and the shape of anteroposterior spinal curvatures. The latter consisted of significant deepening of the upper thoracic curve (angle α ) and flattening of the lumbosacral curve (angle γ ). CONCLUSIONS: A two-year period of handball training did not result in posture asymmetries in young male handball players. The observed changes in the shape of anteroposterior spinal curvatures might be related both to sports training and somatic parameters.
Abstract: OBJECTIVE: This study aims to evaluate the effect of high intensity laser therapy (HILT) in patients with lumbar disc protrusion (LDP). METHODS: This study included 63 patients suffering from protrusion of lumbar intervertebral disc; they were divided into Groups 1 (n = 32) and 2 (n = 31). Group 1 was treated with HILT and spinal decompression system (SDS). Patients in Group 2 received SDS alone. Evaluations were conducted on oswestry disability index (ODI), lumbosacral portion pain, and lower limb radiation pain with visual analogue scale (VAS)…of two patient groups before treatment, two weeks after treatment, and 1 month after follow-up visit. Lumbar flexion range and angle of straight leg raising before treatment and 2 weeks after treatment. RESULTS: After two weeks of treatment of two patient groups, ODI, VAS, lumbar flexion range and angle of straight leg raising significantly improved compared with their conditions before treatment (P < 0.01). A significant difference was noted in ODI, lumbar flexion range, and angle of straight leg raising between groups after two weeks of treatment (P < 0.05). Non-statistical significant difference was observed in lumbosacral portion pain and lower limb radiation pain with VAS (P > 0.05). However, difference in was VAS smaller in Group 1. All groups showed significantly different results in terms of ODI, lumbosacral portion pain, and lower limb radiation pain with VAS. CONCLUSION: As one of available treatments for LDP, HILT can speed up improvement in lumbar segment motion, angle of straight leg raising, and overall function and allow early return of patients to their family and society. Treatment effect is long-lasting and can be widely promoted and applied clinically.
Keywords: High intensity laser, lumbar disc protrusion, spinal decompression system
Abstract: BACKGROUND: Low back pain is a common complaint in emergency departments (ED), where deviations from standard of care have been noted. OBJECTIVE: To relate the ordering of advanced imaging and opioid prescriptions with the presentation of low back pain in ED. METHODS: Six hundred adults with low back pain from three centers were prospectively analyzed for history, examination, diagnosis, and the ordering of tests and treatments. RESULTS: Of 559 cases the onset of pain was less than one week in 79.2%; however, most had prior low back pain, 63.5% having…warning signs of a potential serious condition, and 83.9% had psychosocial risk factors. Computer tomography (CT) or magnetic resonance imaging (MRI) were ordered in 16.6%, opioids were prescribed in 52.6%, and hospital admission in 4.5%. A one-year follow-up of 158 patients found 40.8% received subsequent spine care and 5.1% had a medically serious condition. Caucasian race, age 50 years or older, warning signs, and radicular findings were associated with advanced imaging. Severe pain and psychosocial factors were associated with opioid prescribing. CONCLUSIONS: Most patients present to the ED with acute exacerbations of chronic low back pain. Risk factors for a serious condition are common, but rarely do they develop. Racial disparities and psychosocial factors had concerning relationships with clinical decision-making.
Keywords: Low back pain, emergency medicine, radiology, opioids, evidence based medicine, racial disparity, magnetic resonance imaging, computer tomography, work disability
Abstract: BACKGROUND: Postpartum low back pain harmfully affects all parts of women’s life. OBJECTIVE: To investigate the effect of kinesiotape on women with postnatal backache. METHODS: Thirty participants were randomly allocated to either group (A; n = 15), treated by kinesiotape with exercise program, or the group (B; n = 15), treated by exercise program. Visual analogue scale (VAS) and Back Pain Function Scale (BPFS) were evaluated.at baseline and after 2 weeks of intervention. RESULTS: There were no statistically significant changes…between group A and group B for baseline characteristics (p > 0.05). After two-week intervention, within group analyses revealed that VAS decreased (p < 0.05), with significant increase in BPFS (p > 0.05) in the two groups. Between group analyses showed that there was significant reduction of VAS (p < 0.05) and significant increase of BPFS (p < 0.05) in favor to group A than group B. CONCLUSIONS: Kinesiotape and postural correction exercises can be recommended as effective treatment methods for women’s postnatal back pain with better effect of kinesiotape and postural correction exercises than exercise alone.
Abstract: BACKGROUND AND OBJECTIVE: We report the case of a patient who presented with right dorsal scapular neuropathy after a trigger point injection into the right rhomboid major muscle. Through a nerve conduction study and electromyography, we demonstrated dorsal scapular nerve injury in this patient. CASE REPORT: A 38-year-old man complained that his right shoulder functioned less optimally during push-up exercises after a trigger point injection 4 weeks prior. Physical examination revealed mildly reduced right shoulder retractor muscle strength compared with the left side. We performed a nerve conduction velocity test and electromyography 5 weeks after the injection. The…compound muscle action potential of the right dorsal scapular nerve showed low amplitude (left vs. right side: 5.2 vs. 1.6 mV) and delayed latency (left vs. right side: 4.9 vs. 6.8 ms). Positive sharp wave (1+ ) and mildly reduced recruitment were seen on electromyography of the rhomboid major muscle. The findings of the nerve conduction velocity test and electromyography indicated partial right dorsal scapular neuropathy. The nerve injury seemed to have been caused by the needle inserted during trigger point injection. CONCLUSION: Clinicians should pay attention to the occurrence of dorsal scapular nerve injury when performing trigger point injection into the rhomboid muscle.
Abstract: Clinically, it is difficult to differentiate osteoid osteoma, more than 50% of which occur in the fibia or tibia, from other diseases, i.e. spinal degenerative diseases, inflammatory and noninflammatory arthritis. In this case report, we presented an unusual case of lumbar osteoid osteoma in a 38-year-old male, who experienced low back pain and sciatica as initial symptoms. The patient was initially misdiagnosed as lumbar disc herniation for more than 10 years. With the usage of computed tomography (CT) and magnetic resonance imaging (MRI), the patient was finally diagnosed as osteoid osteoma in L5. To our knowledge, spinal osteoid osteoma with…sciatica as initial symptoms has never been reported. Although lumbar vertebra osteoid osteoma is clinically uncommon, it should be taken into consideration especially when patients experience long duration of pain in lumbar.
Keywords: Osteoid osteoma, L5, lumbar disc herniation, misdiagnosis, case report