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: OBJECTIVE: To investigate the effect of mirror therapy (MT) in conjunction with a standard physical therapy program on shoulder range of motion (ROM), pain and quality of life in patients with adhesive capsulitis (AC). METHOD: This prospective, randomized, controlled, single blind study included 30 patients with AC who were scheduled to undergo 10 sessions of standard physical therapy. The participants were divided into two identical groups, namely, The MT group and the control group. After each session, the MT group underwent active ROM exercises with the reflective side of the mirror while the control group underwent…active ROM exercises with the non-reflective side of the mirror. Pre-treatment and post-treatment shoulder pain (VAS), shoulder function (UCLA shoulder scale) and quality of life (SF-36) were assessed, and active and passive ROM were quantified with a goniometer. RESULTS: Both groups revealed a significant reduction of shoulder pain and significant improvement of shoulder function, active and passive ROM, and quality of life after the treatment. Post-treatment measurements showed that the MT group had a significantly lower amount of pain compared to the control group (p = 0.007). The UCLA scores were significantly higher in the MT group (p = 0.003). The MT group had significantly better post-treatment active flexion, active abduction, passive flexion, and passive abduction values (p = 0.001, p = 0.02, p = 0.002, and p = 0.02, respectively). The MT group had significant post-treatment improvement in physical function, physical role limitation and emotional role limitation, and pain parameters including SF-36 (p = 0.003, p = 0.01, p = 0.015, and p = 0.002, respectively). CONCLUSION: MT in conjunction with physical therapy appears to be an effective treatment modality that reduces shoulder pain and improves shoulder ROM, shoulder function, and quality of life among patients with AC.
Abstract: BACKGROUND: Hippotherapy is a form of therapeutic exercise for conservative treatment of lumbar spine segmental instability and/or hypomobility in subjects with low back pain (LBP). OBJECTIVE: The current study evaluates the effects of a hippotherapy simulator on pain, disability, and range of motion (ROM) of the spinal column in subjects with mechanical LBP. METHODS: In a randomized clinical trial, 80 subjects were randomly assigned to either the control or intervention groups. All subjects underwent routine physiotherapy. In addition, the intervention group underwent hippotherapy with a hippotherapy simulator for 15 sessions, each lasting 15…minutes. Pain, disability, and ROM of the lumbar spinal column of the subjects were measured in the first and last physiotherapy sessions respectively. RESULTS: Improvement in pain intensity was higher in the hippotherapy simulator group over the first eight days of treatment (Hippotherapy vs. Control Point changes: Day 12: p = 0.010; after treatment: p = 0.005). The hippotherapy simulator group had significantly higher improvement in disability score in comparison to the control group (p < 0.001); mean changes in the modified Schober test were not significant (p = 0.423). CONCLUSION: The hippotherapy simulator decreased pain and disability in subjects with LBP; however, no additional improvement in lumbar spine ROM was observed.
Keywords: Hippotherapy, low back pain, physiotherapy, Schober test
Abstract: BACKGROUND: Hypomobility on a cervical segment is a frequent finding which is sometimes asymptomatic. The effects of inhibitory suboccipital techniques on cervical mobility have not been evaluated. OBJECTIVE: To compare the effect on cervical mobility, of pressure maintained suboccipital inhibition manual technique versus a self-treatment using an Occipivot cushion, in asymptomatic subjects with limited mobility assessed by the flexion-rotation test. METHODS: Before-after randomized uncontrolled trial. Thirty-two subjects were recruited and randomized into two groups: Manual Group and Instrumental Group, receiving a single session of the assigned technique. Upper and overall cervical spine mobility…was measured. Subjective sensation during technique application and post-treatment, and number and intensity of headache episodes during the following 15 days after treatment were also registered. RESULTS: Comparing with the Instrumental Group, the Manual Group showed statistically significant improvements on flexion-rotation test (p < 0.01 to p < 0.03), upper cervical extension (p < 0.01), overall right rotation (p < 0.05) and overall right (p < 0.01) and left (p < 0.01) side-bending. CONCLUSION: In asymptomatic subjects with limited cervical mobility, pressure maintained suboccipital inhibition manual technique achieves further improvement on cervical range of motion than the technique using the Occipivot cushion.
Keywords: Range of motion, cervical vertebrae, atlantoaxial joint, suboccipital muscle inhibition
Abstract: OBJECTIVE: Muscle strength is usually measured using isometric hand-held dynamometers (HHDs) in the clinic. However, during functional activities, the muscle acts more dynamically. The aim of this study was to investigate the relation between clinically measured plantar flexor (PF) muscle strength (PFMS) and laboratory measurements of peak ankle plantar flexion power generation (APFPG), peak ankle moment (PAM), peak plantar flexion velocity (PFV) and mean gait velocity in healthy participants. METHODS: The maximum PFMS on non-dominant sides in 18 able-bodied persons 23.88 (SD 3.55 years) was measured before (Pre-S) and after a stretching (Post-S) procedure (135 sec.…× 13 rep. with 5 sec. rest) by using a HHD. The stretching procedure was used to generate temporary PF muscle weakness. Gait analysis was carried out for Pre-S and Post-S conditions. Normalized (by weight and height) and non-normalized HHD scores and differences for both conditions were correlated by Pearson correlation coefficient calculations (p < 0.05). RESULTS: Reduced PFMS (%23, p < 0.001) in Post-S, according to the HHD scores, has only a weak correlation with APFPG (r > 0.3, p < 0.5). Gait velocity was found to be strongly correlated with APFPG only in the Post-S condition (r = 0.68, p < 0.002). HHD scores and PAM were moderately correlated with the non-normalized Post-S condition (r = 0.44, p = 0.70) and strongly correlated with the non-normalized Pre-S condition (r = 0.62, p < 0.01). DISCUSSION: HHD scores of plantar flexor muscles give very limited information about the PF performance during walking in healthy individuals. Simple normalization did not improve the relations. Clinically measured isometric muscle strength and muscle weakness have only moderate strengths for establishing a treatment protocol and for predicting performance during walking in neurologically intact individuals.