Journal of Back and Musculoskeletal Rehabilitation - Volume 31, 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: BACKGROUND: Cranio-cervical flexion exercise (CCFE) is a representative exercise that activates the deep muscles of neck pain patients. However, there is a lack of studies that propose specific exercise methods to examine the more effective activity level of the deep cervical flexor. OBJECTIVE: The objective of this study is to propose a more effective exercise method through effect comparison based on an optimal degree of mouth-opening, a mouth-open versus mouth-closed position, eye gaze, and body position change during CCFE. METHODS: As a result of examining the optimal degree of mouth-opening during CCFE using…a pressure biofeedback unit with 50 subjects conforming to a selection standard, sternocleidomastoid muscle activity was examined. An optimal degree of mouth-opening during CCFE was examined as well. In addition, muscle thickness and muscle activity were measured based on eye gaze. Then, the effect of the exercise based on body position was examined. RESULTS: The lowest sternocleidomastoid activity was presented at a mouth-opening of 20 mm. A significant difference was presented in sternocleidomastoid and longus colli muscle activity at a mouth-opening of (p < 0.05). The eye gaze of 45 ∘ below presented the lowest sternocleidomastoid activity. CONCLUSIONS: The results suggest a new type of exercise method with the accompaniment of an optimal degree of mouth-opening of (20 mm), along with an eye gaze of 45 ∘ below, and an exercise method in the seated position without spatial restriction in order to increase the effect of CCFE, one of the conventional neck stabilization exercise methods.
Abstract: BACKGROUND: Identifying the functional status of patients after total knee arthroplasty is important. This study aimed to examine the differences in sit-to-stand and static standing ability balance between patients who underwent total knee arthroplasty and healthy participants. METHODS: Twenty patients (mean age 70.05 years) who underwent total knee arthroplasty and 20 healthy participants (mean age 69.20 years) participated in this study. To assess the participants’ sit-to-stand, the Good Balance System (Metitur Ltd, Finland) was used to measure each participant’s mediolateral center of pressure (COP) displacement and time required to complete the sit-to-stand movement. To assess the…participants’ static standing balance, the Good Balance System was used to measure each patient’s mediolateral COP displacement, anteroposterior COP displacement, and velocity moment when standing with eyes open and with eyes closed. RESULTS: A significant difference was found in the mediolateral COP displacement and the time required to complete the sit-to-stand movement in the two groups (P < 0.05). A significant difference was also found in the mediolateral and anteroposterior COP displacement and the velocity moment when standing with eyes open and with eyes closed in the two groups (P < 0.05). CONCLUSIONS: Patients who had total knee arthroplasty showed decreased sit-to-stand and static standing balance ability compared with the control group in the initial period after surgery.
Keywords: Balance, center of pressure, sit-to-stand, total knee arthroplasty
Abstract: BACKGROUND: Trunk muscle endurance exercises are commonly used for correcting the postural alterations. However, there is no study investigating the relationship between postural alignment and trunk muscle endurance in healthy young adults. OBJECTIVE: The aim of this study was to examine whether the three-dimensional (3D) body posture is related to trunk muscle endurance in healthy young adults. METHODS: Forty-two healthy young adults enrolled in this study. For 3D evaluation of the body posture, an internet-based postural assessment system was used. Alterations in posture (head, ribcage, and pelvis) were evaluated by using the Posture…Index which represents the total score of postural displacements. The higher Posture Index scores indicate more severe displacements in the posture. Trunk muscle endurance measurements included side bridge, trunk flexors and trunk extensors endurance tests. Spearman’s rho was used to evaluate the associations between measured parameters. RESULTS: The median age of the participants were 22 (IQR: 21.0–23.0) years. The only significant correlation was detected between the side bridge endurance test and the total Posture Index score (rho = - 0.402, p = 0.008). CONCLUSIONS: These results indicated that the alterations of the body posture was significantly related to lower lateral trunk muscle endurance scores. These findings support the importance of trunk muscles, especially lateral trunk musculature to have a better body posture.
Abstract: BACKGROUND: Following ankle sprain, residual symptoms are often apparent, and proprioceptive training is a treatment approach. Evidence, however, is limited and the optimal program has to be identified. OBJECTIVE: To investigate the effects of two post-acute supervised proprioceptive training programs in individuals with ankle sprain. METHODS: Participants were recruited from a physiotherapy center for ankle sprain rehabilitation. In a pre-post treatment, blinded-assessor design, 22 individuals were randomly allocated to a balance or a proprioceptive neuromuscular facilitation (PNF) group. Both groups received 10 rehabilitation sessions, within a six-week period. Dorsiflexion range of motion (ROM),…pain, functional and balance performance were assessed at baseline, at the end of training and eight weeks after training. RESULTS: Follow-up data were provided for 20 individuals. Eight weeks after training, statistically significant (p < 0.017) improvements were found in dorsiflexion ROM and most functional performance measures for both balance and PNF groups. Eight weeks after training, significant (p < 0.017) improvements in the frontal plane balance test and pain were observed for the balance group. CONCLUSIONS: Balance and PNF programs are recommended in clinical practice for improving ankle ROM and functional performance in individuals with sprain. Balance programs are also recommended for pain relief.
Keywords: Ankle sprain, proprioceptive training, range of motion, function, dynamic balance, pain
Abstract: BACKGROUND: Breast cancer survivors have side effects from surgical treatment and adjuvant that may acutely or chronically compromise the musculoskeletal system, resulting in loss of muscle strength. OBJECTIVE: Handgrip strength and electromyography of the upper limbs and its relationship with dominance in women submitted to surgery for breast cancer. METHODS: Were evaluated 28 women. The handgrip strength was measured through dynamometer associated with electromyographic, in the muscles: descending trapezius, biceps brachial, triceps brachial, extensor carpi ulnaris, radial extensor carpi and superficial flexor of wrist and fingers. RESULTS: Reduction in…grip strength on the side affected by the surgery, that occurred when the surgery was performed on the non-dominant side. The electromyographic showed significant differences in affected side. This shows the need to consider the affected side by surgery and dominance. CONCLUSIONS: Decreased grip strength and lower electromyographic activity of upper limb affected by surgery for breast cancer, when the side affected was not the dominant this loss was greater.
Keywords: Hand therapy, rehabilitation, breast cancer, EMG, handgrip strength
Abstract: BACKGROUND: Kinesio taping (KT) is a new taping modality frequently used in the clinical setting. However there is contradictory evidence about its effectiveness in patients with neck pain. OBJECTIVE: To determine the effectiveness of KT as a supplementary treatment in addition to conventional rehabilitation in patients with neck pain. METHODS: Forty-five subjects with neck pain were included in this controlled trial and were assigned to the following groups: Kinesio Taping, placebo (P), and conventional rehabilitation control (CR). A daily self-assessment record of perceived pain, medication intake, quality of life and range of motion…was registered at baseline, posttreatment and follow-up. RESULTS: Cohen’s coefficient showed large effects in terms of reducing pain perception in all three groups. ANOVAs showed that the course of treatment differed across groups only for neck flexion (p = 0.043). We found significant differences in neck flexion when comparing baseline and one-month follow-up values and neck flexion significantly increased in all three groups: KT (p = 0.05); P (p = 0.01); and CR (p = 0.04). Between-group analyses showed no significant differences for any of the measurements. CONCLUSIONS: A protocol of manual therapy and physical exercises, significantly improved pain and mobility in patients with neck pain. We obtained no evidence of additional benefits from the use of KT in this population.
Abstract: PURPOSE: We compared a goniometer method in a non-weight-bearing position with a tape measure method in a weight-bearing position to determine which was more reliable for assessing dorsiflexion range of motion (ROM) in children with cerebral palsy (CP). METHODS: Ankle dorsiflexion ROM was measured using goniometer and tape measure methods in non-weight- and weight-bearing positions, respectively. RESULTS: In the test-retest reliability of ankle dorsiflexion ROM using a universal goniometer, the intraclass correlation coefficient (ICC) varied from 0.75 to 0.96 and the overall ICC score was 0.91 (p <…0.001). In the test-retest reliability of ankle dorsiflexion ROM using a tape measure, ICC varied from 0.98 to 0.99 and the overall ICC score was 0.99 (p < 0.001). Ankle dorsiflexion ROM using a universal goniometer had a standard error of measurement (SEM) of 2.86 and a minimum detectable change (MDC) of 7.94. Ankle dorsiflexion ROM using a tape measure had an SEM of 1.01 and a MDC of 2.80. CONCLUSIONS: The tape measure method in a weight-bearing position was more reliable than using a universal goniometer in a non-weight-bearing position in children with CP.
Keywords: Goniometry, minimum detectable change, weight-bearing lunge test
Abstract: BACKGROUND: Multiple sclerosis patients may suffer muscle changes that involve gait disorders of the kinetic and kinematic parameters also their gait may be clinically symmetrical or asymmetrical. OBJECTIVE: The aim of this study is to analyze how the muscle change, could affect the biomechanical parameters of foot stability during the gait, by disturb the motor control. METHODS: The study group consisted of 13 patients diagnosed with multiple sclerosis, presenting clinically detectable abnormal gait. The biomechanical evaluation included the foot axes and angles -external and internal rotation; the foot angle deviation from…the gait direction; the subtalar angle . RESULTS: The values of the foot angle were between - 10.74 ∘ to 26.38 ∘ for the left foot and between - 11.16 ∘ to 30.04 ∘ for the right foot. The foot axis angle is the axis of the foot in relation to the gait direction, and the subtalar angle is in relation to the vertical axis of the foot. The rotation of the right foot into pronation during the initial contact phase was followed by supination in the semi-support phase, to return to the neutral position during the propulsion phase, which meant being in free zone of minimal risk. CONCLUSIONS: Biomechanical analysis of the foot angle and of subtalar angle in the patients with multiple sclerosis allows us to objectify the existence of a right-left asymmetry, the behavior ankle-foot during the gait. At the same time this evolution is closely correlated with the contact surface that tends to increase, which means involving the reflex mechanisms that place the foot in the zone of minimum risk and assure the stability of the body.
Abstract: OBJECTIVE: To compare how disability, fear of movement, psychosocial status and quality of life are affected in terms of low back-neck health status in three occupational groups using different work postures. METHOD: Three hundred thirty-nine individuals participated in this study from the following three different occupational groups: group A, where the individuals worked in a prolonged sitting position (secretaries), group B, where the individuals performed dynamic activities in a standing position (cleaning workers) and group C, where the individuals worked in a prolonged standing position (private security officers). The participants were evaluated by Million Visual Analog Scale,…Neck Disability Index, Oswestry Disability Index, Nottingham Health Profile, Hospital Anxiety and Depression Scale and Tampa Kinesiophobia Scale. RESULTS: It was found that disability, emotional status and the quality of life were minimally affected, but kinesiophobia was increased in all of the occupational groups. In the group C, low back pain disability, quality of life and fear of movement were more affected than the other groups (p < 0.05). CONCLUSION: For the occupational groups with long working years, the presence of kinesiophobia should be considered and cognitive-behavioural treatment methods should be recommended. In cleaning workers, low back pain is an important risk factor. Therefore, its awareness should be increased, and preventive programmes should be offered.
Keywords: Occupational groups, working postures, musculoskeletal disorders, disability, quality of life
Abstract: BACKGROUND: Patients suffering from low back pain (LBP) have been reported to alter muscle contraction strategies. OBJECTIVE: To compare activity and thickness of the trunk muscles (external oblique (EO), internal oblique (IO), transversus abdominis (TrA), and lumbar multifidus (LM)) during static stoop lift at different lifting loads between the subjects with and without LBP. METHODS: Twenty eight subjects with LBP and twenty eight healthy subjects were recruited. The stoop lifting was performed in three conditions in 0%, 10%, and 20% of body weight. RESULTS: The activity of EO (F =…9.513) and IO (F = 7.781) was significantly increased with increasing lifting loads in subjects with LBP (p < 0.05) but not significantly in subjects without LBP. The activity of the LM (F = 124.980) was significantly increased in response to lifting loads in both groups (p < 0.05). The percent change of TrA (F = 8.797) and LM (F = 48.170) muscles thickness was significantly increased with increasing lifting loads in both groups (p < 0.05). The percent change of TrA (F = 3.780) and LM (F = 16.314) muscles thickness in subjects without LBP was greater than those in subjects with LBP at all three lifting loads (p < 0.05). CONCLUSIONS: The results of this study suggest that more activation of EO in subjects with LBP may contribute to increase the compressive force on the lumbar spine during stoop lift. Also, less activation of TrA and LM in subjects with LBP may contribute to decrease the lumbar stabilization during stoop lift.