Journal of Back and Musculoskeletal Rehabilitation - Volume 31, issue 6
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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: This study aimed to investigate the electrical activity of two muscles located at the dorsal surface during Islamic prayer (Salat ). Specifically, the electromyography (EMG) activity of the erector spinae and trapezius muscles during four positions observed while performing Salat , namely standing, bowing, sitting and prostration, were investigated. Seven adult subjects with an average age of 28.1 (± 3.8) years were included in the study. EMG data were obtained from their trapezius and erector spinae muscles while the subjects maintained the specific positions of Salat. The EMG signal was analysed using time and frequency domain…features. The results indicate that the trapezius muscle remains relaxed during the standing and sitting positions while the erector spinae muscle remains contracted during these two positions. Additionally, during the bowing and prostration positions of Salat , these two muscles exhibit the opposite activities: the trapezius muscle remains contracted while the erector spinae muscle remains relaxed. Overall, both muscles maintain a balance in terms of contraction and relaxation during bowing and prostration position. The irregularity of the neuro-muscular signal might cause pain and prevent Muslims from performing their obligatory prayer. This study will aid the accurate understanding of how the back muscles respond in specific postures during Salat .
Abstract: BACKGROUND: The aim of this study was to explore the effect of neural therapy on pain and functionality in patients with low back pain due to piriformis syndrome. It also aimed to find out any possible links between the clinical changes and demographic features. METHOD: One hundred and two patients were randomly divided into two groups (neural therapy and control). All patients were given stretching exercises for the piriformis muscle. The patients in the neural therapy group additionally received 6 sessions of neural therapy. The visual analog scale (VAS) and Oswestry Disability Index (ODI) were noted…before and after the treatment in both groups. RESULTS: The VAS and ODI improved in both groups. However, improvement of the VAS and ODI scores were more obvious in the neural therapy group. The changes of VAS and ODI values did not show any correlations with the demographic features. CONCLUSION: After the neural therapy, the patients with low back pain due to piriformis syndrome may have improvement in both pain and functioning.
Keywords: Neural therapy, piriformis syndrome, local anesthetics, low back pain
Abstract: BACKGROUND: Rice farming is done using manual methods and involves strenuous labour, which can lead to musculoskeletal disorders. OBJECTIVE: To identify the factors associated with knee musculoskeletal impairments and related pain among rice farmers complaining of knee pain. METHODS: The study employed a community-based, cross-sectional design. Full-time rice farmers (n = 201) were surveyed. A questionnaire was used to record demographics and details of farm work; followed by a physical examination of knee structures impairments. RESULTS: The prevalence of knee impairment was highest among farmers…with joint dysfunction (79.6%), followed by those with dysfunctional hamstring muscles (52.74%), quadriceps muscles (44.28%), neural tissue (38.81%), and ligaments (1.99%). It was lowest among farmers with meniscus dysfunction (1.49%). Stooping with twisting was strongly associated with knee joint and quadricep muscle impairment. Stooping with twisting and carrying loads were associated with hamstring muscle impairment. Stooping while twisting and being overweight was associated with neural tissue impairment. Being overweight was significantly associated with ligament impairment. There were no factors significantly associated with meniscus dysfunction. CONCLUSIONS: Knee musculoskeletal impairments is common among Thai rice farmers. Joint dysfunction was common. The factors associated with knee musculoskeletal impairments included being overweight, stooping while twisting and carrying heavy weight.
Keywords: Knee musculoskeletal impairments, knee pain, traditional rice farming
Abstract: BACKGROUND AND OBJECTIVE: The study determined the effects of females wearing high-heeled shoes on the lower extremity musculoskeletal system and somatometry. METHODS: The study was carried out with 136 females between 18 and 45 years old. The first group consisted of 66 females wearing 5 cm or higher high-heeled shoes, at least 5 hours a day, three days a week, and at least one year. The second group consisted of 70 females wearing shoes with heel height less than 5 cm for at least one year. RESULTS: Differences in length parameters may result…from the narrow and pointed toe of the high-heeled shoe. These shoes distribute the pressure on the caput ossis metatarsi I and compress the foot in this area. Differences in anthropometric measurements show that females wearing high-heeled shoes have more slender and smaller foot structure. CONCLUSION: These findings show that regular wearing of high-heeled shoes causes changes via the increased foot arch structure. These alterations result from regional, racial, gender, heel height, shoe type (shape), and shoe habits.
Keywords: Musculoskeletal system, high heeled shoes, foot print analysis
Abstract: BACKGROUND AND OBJECTIVE: Lumbar spinal stenosis (LSS) is a common spinal disorder that causes patients to assume a forward-trunk posture. Spinal alignment affects gait, muscle activity, and trunk-pelvis-limb coordination because the lumbar spine and muscles interact to allow load transfer between the lower back and pelvis during sagittal trunk movement. Therefore, we investigated the relationships among trunk and pelvic movement, swing toe clearance, and muscle coordination (isolated contraction ratios) of the stance limb during obstacle-crossing by patients with LSS. METHODS: Ten patients with LSS and ten control subjects were enrolled. All navigated an obstacle during walking.…Kinematic data from the trunk and lower extremities were monitored using a three-dimensional motion analysis system. In addition, we measured the isolated contraction ratios of the gluteus medius (GMed) and vastus lateralis (VL) using surface electromyography. RESULTS: The normalized lead limb distance was significantly lower in the LSS group than in controls. The spine flexion angle when the swinging limb toe was above the obstacle was higher, but the pelvic anterior tilting angle was lower, in the LSS group. LSS patients also had a significantly lower isolated contraction ratio of the GMed in the trailing stance limb but a significantly higher VL. CONCLUSIONS: Patients with LSS adapted a poor posture and their thoracic and spinal regions were hyperflexed with restricted pelvic obliquity. This created an inefficient gait, a shorter leading limb step, and less stable muscle coordination in the stance limb. Our findings may help healthcare professionals manage patients with LSS.
Abstract: BACKGROUND: Lateral abdominal muscles control the lumbar region and this manages the stability of the trunk through co-contraction. Abdominal drawing-in maneuver (ADIM) is the basis method for spine stabilization to restore proper neuromuscular control. OBJECTIVE: To investigate the effect of therapeutic abdominal drawing-in maneuver on abdominal muscle thickness and balance. METHODS: Twenty healthy adults were divided into 2 groups. The experimental group performed a bridging exercise with ADIM whereas the control group performed a bridging exercise without ADIM. The exercise was conducted 3 times a week for 4 weeks. Ultrasonography was used to…measure the thickness of abdominal muscles. Balance ability was evaluated using Tetrax device. The Wilcoxon signed ranks test for comparison of pre and post values and Mann Whitney U test for comparison between groups were used. RESULTS: After 4 weeks, there was a significant difference in the thickness of TrA between groups (p < 0.05) whereas no significant difference in IO and EO (p > 0.05). In stability values, the experimental group showed significant changes in stability indexes of standing with eyes open (NO) and standing on the pillow with eyes closed (PC) after the exercise period and there was a significant difference in NO between two groups. CONCLUSIONS: Performing the bridging exercise with abdominal drawing-in maneuver is a more effective way to strengthen the abdominal muscles and stabilize the body than bridging exercise only.
Abstract: AIM: Rheumatoid arthritis (RA) is a chronic disease of unknown etiology. Various cellular and molecular immunological factors are involved in the pathophysiology of RA. Recent studies suggest that neutrophils and alpha-defensins released from the neutrophils assume significant roles in the pathogenesis of RA. The aim of this study was to investigate the potential association between serum alpha-defensin levels and disease activity, functional status, radiological damage and several laboratory parameters in patients with RA. MATERIALS AND METHODS: A total of 42 patients with established RA who presented to the outpatient clinics of rheumatology of Dicle University Hospital…and 38 healthy control subjects were included in this study. Disease activity was assessed by using the Disease Activity Scale 28 (DAS28). Quality of life was assessed by using the Rheumatoid Arthritis Quality of Life (RAQoL) Questionnaire and the Nottingham Health Profile (NHP). Functional status was assessed by using the Stanford Health Assessment Questionnaire (HAQ). Laboratory examinations included the following tests: CBC, ESH, CRP, and HNP 1-3. RESULTS: Patients with an active disease exhibited higher HNP 1-3 levels compared to patients in remission. At a cut off value of 708 pg/ml, sensitivity and specificity of the tests for HNP 1-3 were 72% and 70.6%, respectively. CONCLUSION: In the present study, patients with an active disease had significantly higher serum HNP 1-3 levels compared to patients in remission. In this respect, serum HNP 1-3 can be a useful marker in the assessment of disease activity and remission in patients with RA.
Keywords: Rheumatoid arthritis, human neutrophil peptides, disease activity
Abstract: BACKGROUND: The core stability theory has emphasized symmetric co-contraction of both anterolateral abdominal muscles (AAM), but there is a lack of research on whether the symmetric co-contraction of AAM is related to the postural stability of the trunk. OBJECTIVE: This study aimed to investigate the correlation between the symmetric co-contraction of bilateral AAM and trunk angular displacement during sudden trunk perturbation. METHODS: Eighteen subjects were asked to maintain half-seated posture against backward trunk perturbation. Muscle thicknesses of external oblique (EO), internal oblique (IO), and transversus abdominis (TrA) were measured using ultrasound imaging. 3D…motion analysis system was utilized to calculate the amount of trunk angular displacement during perturbation. RESULTS: There were significant differences of side-to-side muscle thickness in TrA (P = 0.02) and EO (P = 0.02), but the difference disappeared during sudden external loading. No significant correlation was identified between the asymmetry of abdominal muscle thickness and the amount of trunk angular displacement. CONCLUSIONS: These findings indicate that the side-to-side asymmetry of AAM measured in a static position is rarely related to the core stability because the asymmetry can disappear during trunk stabilization.
Abstract: BACKGROUND: Weakness of trunk muscles is a common disorder in children with cerebral palsy (CP). They encounter decreased levels of endurance that can lead to diminished capacity of movement. OBJECTIVE: To evaluate the effect of core stability training on the endurance of trunk muscles and gait parameters in children with hemiplegic CP. METHODS: Thirty children with hemiplegic CP aged 10 to 12 years were randomly assigned to two groups of equal number; control group (A) and study group (B). Both groups underwent the same designed physical therapy program. Moreover, group B underwent core…stability training 3 times/week for 8 weeks. Endurance time of trunk muscles and gait parameters were measured before and after the intervention using the trunk endurance tests and the Biodex gait trainer respectively. RESULTS: Both groups showed statistically significant improvements in the endurance time of trunk flexors and extensors and gait parameters after treatment but only group B showed statistically significant improvement in the endurance time of lateral trunk muscles. There were post-treatment statistically significant differences between both groups in favor of group B regarding all measured variables. CONCLUSION: Addition of core stability exercises to the treatment program can effectively improve the endurance time of trunk muscles and gait in children with hemiplegic CP.
Abstract: BACKGROUND: Hamstring shortness is the most common musculoskeletal condition in sports athletes, which often contributes to hamstring strain injury. To effectively mitigate the hamstring shortness, contemporary HR, SCS, and IASTM soft tissue techniques have been used. The best practical evidence about the therapeutic effects and the biomechanical mechanisms underpinning these manual techniques remain unknown. OBJECTIVE: The purpose of this study was to compare the effects of HR, SCS, and IASTM techniques on improving hamstring and quadriceps muscle strength, related ratio, knee joint passive stiffness, and pain threshold. METHODS: Forty-five participants (21 males and…24 females) with hamstring shortness participated in this study. The participants were randomly assigned to each of the three soft tissue mobilization technique groups. A Biodex System Isokinetic Dynamometer was used to measure muscle strength and knee joint passive stiffness during knee extension and flexion. Pressure algometry was used to measure hamstring pain threshold. One-way ANOVA were used to determine the statistical significance of the hamstring and quadriceps strength, related ratios, knee joint passive stiffness, and pain threshold in each technique. The significance level was set at α = 0.05. RESULTS: The IASTM group showed greater improvement in the peak quadriceps strength (p = 0.000), the peak quadriceps and hamstring (Q:H) strength ratio (p = 0.004), passive knee stiffness (p = 0.000), and pain threshold (p = 0.017) than the HR or SCS groups. CONCLUSION: The present comparative study provided first clinical evidence that IASTM technique is a best soft tissue mobilization technique to improve the strength, associated strength ratio, knee joint passive stiffness, and pain threshold among individuals with hamstring shortness.