Journal of Back and Musculoskeletal Rehabilitation - Volume 32, 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: OBJECTIVES: To evaluate the efficacy of Kinesio taping (KT) in patients with sleep bruxism (SB) and to determine whether KT may be an alternative for occlusal splint (OS) for the treatment of SB. MATERIALS AND METHODS: Sixteen patients with SB were treated with KT (kinesio group) and 18 patients were treated with OS (splint group). Masseter and temporal muscle pressure pain thresholds (MPPT and TPPT), visual analogue scale (VAS) values and mouth opening measurements of patients were compared before treatment, and at the 1 st and 5 th…weeks of treatment. RESULTS: Both KT and OS treatments significantly reduced muscle pain, decreased VAS values, and increased mouth opening measurements. No statistically significant difference was found between the kinesio and splint groups in terms of MPPT, TPPT, VAS and mouth opening values before treatment and at the 1 st and 5 th weeks of treatment except for TPPT values at 1 st week of treatment where the TPPT values of the kinesio group were significantly higher than the splint group (p < 0.05). CONCLUSIONS: KT was identified as an easy-to-use treatment method for bruxism and was found to reduce muscle pain and increase mouth opening. KT is at least as effective as OS for the treatment of SB.
Abstract: BACKGROUND: Repeated exposure to a given perturbation of the postural control system has been shown to cause learning of more efficient postural strategies for maintaining balance both within a session and over time. It is important to show whether outcomes from treatment strategies are related to the effectiveness of training or are the result of the learning of the test process. OBJECTIVE: To investigate the learning effect of the dynamic postural stability evaluation system. METHODS: We studied 20 healthy young subjects (13 females and 7 males), with a mean age of 22.3 ±…1.9 years. Limits of stability and postural sway were assessed. All participants completed the standardized dynamic postural stability evaluation test (Bertec, Bertec Corporation, Columbus, OH, USA) seven times. The test was performed in both eyes open and eyes closed conditions. RESULTS: There were differences in the limits of stability scores for backward (p = 0.042), left side (p = 0.05), and the total score (p = 0.04). There were significant differences in postural sway anteroposterior direction in perturbed surface with eyes closed condition (p = 0.004) and total limits of stability scores of perturbed surface with eyes closed condition (p = 0.046). CONCLUSIONS: The study showed that balance test scores stabilized at different sessions from 1 st to 3 rd assessment period. Maximum normalized scores were reached at the third trial.
Keywords: Learning effect, balance, postural stability, health
Abstract: BACKGROUND: Chronic Ankle Instability (CAI) is characterized by altered muscle activation, reduced range of motion (ROM) and balance deficits. OBJECTIVE: The aim of this study was to determine whether fibular taping technique influenced the pain intensity, dorsiflexion ROM and dynamic balance in participants with CAI. METHODS: Twenty-six participants (16 males and 10 females; age 28.8 ± 5.74 y) with unilateral CAI who scored 85 points or less on the Foot and Ankle Outcome Score (FAOS) were included in our study. Mulligan distal fibular taping technique was applied. Visual Analog Scale,…Star Excursion Balance Test in anterior, posteromedial and posterolateral directions and a Weight Bearing Lunge Test were taken before, after, 1 hour after and 24 hours after taping. RESULTS: Distal fibular taping technique decreases pain intensity (at rest, during range of motion and weight bearing conditions), while it increases forward lunge distance and reach distance in anterior, posteromedial and posterolateral directions (p = 0.001). CONCLUSIONS: Our study showed that distal fibular taping reduces pain intensity, postural control and dorsiflexion range of motion in individuals with CAI. Further studies are needed with participants with a lower functional level and a higher pain intensity.
Abstract: BACKGROUND: Hyperkyphosis is a common postural defect with high prevalence in the 20 to 50 year old population. It appears to compromise proximal scapular stability. Grip and pinch strength are used to evaluate general upper extremity function. OBJECTIVE: The aim of this study was to compare pinch and grip strength between young women with and without hyperkyphosis. METHODS: Thirty young women (18–40 years old) with hyperkyphosis and 30 healthy women matched for age and body mass index participated in the study. Hyperkyphosis was confirmed by measuring the kyphosis angle with a flexible ruler.…Grip strength was measured with the Waisa method and a dynamometer. Pinch strength was assessed with a pinch meter. RESULTS: Grip (P = 0.03) and pinch strength (P = 0.04) were significantly lower in women with hyperkyphosis compared to the control group. Kyphosis angle correlated weakly with grip (r = 0.26) and pinch strength (r = 0.23). CONCLUSIONS: Hyperkyphotic posture has led to decreased grip and pinch strength compared to people without hyperkyphosis.
Abstract: BACKGROUND: It is hypothesized that inherent differences in movement strategies exist between control subjects and those with a history of lower back pain (LBP). Previous motion analysis studies focus primarily on tracking spinal movements, neglecting the connection between the lower limbs and spinal function. Lack of knowledge surrounding the functional implications of LBP may explain the diversity in success from general treatments currently offered to LBP patients. OBJECTIVE: This pilot study evaluated the response of healthy controls and individuals with a history of LBP (hLBP) to a postural disturbance. METHODS: Volunteers (n =…26) were asked to maintain standing balance in response to repeated balance disturbances delivered via a perturbation platform while both kinematic and electromyographic data were recorded from the trunk, pelvis, and lower limb. RESULTS: The healthy cohort utilized an upper body-focused strategy for balance control, with substantial activation of the external oblique muscles. The hLBP cohort implemented a lower limb-focused strategy, relying on activation of the semitendinosus and soleus muscles. No significant differences in joint range of motion were identified. CONCLUSIONS: These findings suggest that particular reactive movement patterns may indicate muscular deficits in subjects with hLBP. Identification of these deficits may aid in developing specific rehabilitation programs to prevent future LBP recurrence.
Keywords: Lower back pain, balance, electromyography, posture, kinematics
Abstract: BACKGROUND: Oscillatory stimulation provides strong sensory stimulation, which can activate muscle spindles, strengthening proprioceptive sense and, therefore, helping to strengthen the muscles involved in posture stability. OBJECTIVE: This study aimed to investigate the difference in average distribution of plantar pressure resulting from changes in the forward head position (FHP) angle caused by controlling muscle activity in the neck and shoulders through Bodyblade. METHODS: The subjects were divided into an experimental group (Bodyblade, n = 15) and a control group (general physiotherapy, n =…15). Eighteen sessions of exercise were implemented. Craniovertebral angle (CVA) and cranial rotation angle (CRA) were measured to evaluate the change of FHP. The Gaitview AFA-50 (Alfoots Co, Korea) was used to measure the plantar pressure distribution. RESULTS: The experimental group showed a larger increase in CVA than the control group (p < 0.05). Only the experimental group showed a significant decrease in CRA (p < 0.05). Both the anterior pressure and posterior pressure showed a significant improvement only in the experimental group (p < 0.05). The experimental group showed a larger increase in anterior/posterior ratio than the control group (p < 0.05). CONCLUSIONS: Bodyblade improves the angle of FHP, thus positively affecting the average ratio of plantar pressure.
Keywords: Head posture, plantar pressure, Bodyblade
Abstract: BACKGROUND: It is known that episodes of microvascular obstruction and oxidative stress in sickle cell anaemia (SCA) can damage muscle tissue. As a consequence, deterioration in muscle function may potentially contribute to poor health-related quality of life (HRQoL) in subjects with SCA, particularly those who do not use long-term treatment. OBJECTIVES: To evaluate muscle function in adults with SCA, to study the correlations between muscle function and HRQoL and to analyse the impact of hydroxyurea treatment. METHODS: Twenty-two adults with SCA and 20 matched controls were subjected to Short Form-36 (SF-36), respiratory muscle…strength measurement, isometric hand grip strength (iHGS) measurement and knee isokinetic dynamometry. RESULTS: In relation to their healthy peers, adults with SCA had lower SF-36 scores, respiratory muscle strength and iHGS. Regarding the isokinetic test, adults with SCA showed lower values, especially in the variables measured in flexion and with an angular velocity of 240 ∘ /s. There was a significant correlation between the peak torque (PT) at 240 ∘ /s and the physical component summary (SF-36 PCS ) in both extension (r = 0.77; p < 0.001) and flexion (r = 0.82; p < 0.001). Significant correlations were also observed between the agonist/antagonist ratio at 240 ∘ /s and the SF-36 PCS (r = 0.50; p < 0.001). The use of hydroxyurea led to higher scores on the SF-36 and higher values in knee isokinetic dynamometry. CONCLUSIONS: Adults with SCA have muscle dysfunction, especially with regard to endurance of the knee flexor muscles. In these patients, there is a significant association between muscle function and HRQoL. Moreover, the use of hydroxyurea is associated with better HRQoL and less muscle dysfunction.
Abstract: OBJECTIVE: This study compared the effectiveness of regenerative injection therapy (RIT), i.e. prolotherapy, and repetitive transcranial magnetic stimulation (rTMS) in the treatment of fibromyalgia syndrome. PATIENTS AND METHODS: This study included 120 female, age-matched fibromyalgia patients. All patients underwent a clinical examination, pain assessment by VAS, assessment of tender points, psychiatric and functional assessment using the Beck Depression Inventory (BDI), Fibromyalgia Impact Questionnaire Revised (RFIQ), and measurement of cortical auditory evoked potentials CAEPs elicited at 1000 Hz. Patients were divided into two equal groups; Group 1 received prolotherapy three times, two weeks apart, and Group 2…received rTMS sessions every other day for one month. Assessment was performed before treatment, immediately after treatment, and one month later. RESULTS: A significant improvement of pain measured by the mean score of VAS was remarked in Group 1 compared to Group 2 immediately after treatment and one month later. There was statistically significant difference of mean scores for the number of tender points in Group 1 compared to Group 2 after treatment and one month later. The patients improved functionally, with a statistically significant difference in mean score of RFIQ, in Group 1 compared to Group 2 one month after treatment. However, there was a significant difference in mean score of BDI in Group 2 compared to Group 1 after treatment and one month later. Further, CAEPs showed better improvement, with a significant difference in Group 2, one month after treatment. CONCLUSION: RIT had the advantage in clinical and functional improvement in fibromyalgia patients, while rTMS had better results regarding depression and the cortical component of AEPs. These results might draw attention to the evaluability of a combination of both techniques for a better therapeutic response.
Keywords: Regenerative injection therapy, repetitive transcranial magnetic stimulation, fibromyalgia syndrome
Abstract: BACKGROUND: Low back pain is one of the major musculoskeletal problems seen in elderly, and it’s the fifth common cause for hospitalization. OBJECTIVE: This retrospective study has determined whether minimal invasive techniques or physiotherapy methods are effective for decreasing pain and improving functions in the geriatric population. METHODS: A retrospective design was used in this study. Sixty-one patients aged ⩾ 65, who were referred to physiotherapy enrolled in the study. The patients were divided into 2 groups; Group 1 received minimal invasive techniques, whereas Group 2 had no surgery or…no minimal invasive application. Pressure Pain Threshold (PPT) was used for perceived pain intensity, Semmes Weinstein Monofilaments (SWM) was used to assess tactile sensitivity, and Oswestry Disability Index (ODI) was used to determine perceived functional disability. Physiotherapy methods including soft tissue mobilizations, muscle-energy techniques and spinal stabilization exercises were used in the treatment of all patients. The outcomes were evaluated pre- and post-physiotherapy applications. RESULTS: Significant improvements in PPT were shown in both groups after physiotherapy treatment as to baseline (p < 0.05). Despite the significant improvements in PPT values of all muscles in Group 1, Group 2 had significant improvements in PPT except Hamstring muscles (p < 0.05). Functional disability levels of both groups reduced acc. to ODI, improvement in disability scores was only significant in Group 1 (p < 0.05). CONCLUSION: Although both treatments showed pain relief, functional restoration and improvement in hypoesthesia existence; there was no superiority of physiotherapy alone over physiotherapy added minimal invasive treatments in terms of parameters.
Keywords: Low back pain, rehabilitation, exercise, facet denervation, geriatrics
Abstract: BACKGROUND AND OBJECTIVES: The aim of study was researching the relationship of pain in patients with carpal tunnel syndrome on Quality of Life (QoL) and upper limb functionality. METHODS: Demographical and physical measurements were performed by a physiotherapist. Pain levels were measured by Visuel Analog Scale at rest, on motion and in fatique, and the patients’ results were recorded. Functionality levels were evaluated by ‘Boston Carpal Tunnel Syndrome Questionnaire’ and QoL by ‘Short Form 12’ (SF-12). Patients had 10 sessions of the physiotherapy and rehabilitation program. Assessments were repeated 1 month later. RESULTS:…The mean age 49.97 ± 11.15 years of 28 patients were included. While pre- and post-treatment between pain and functionality evaluation found a significant relationship (p < 0.05); there was no significant relationship in QoL (SF-12 p > 0.05). CONCLUSIONS: As a result while we found statistical differences between pain and symptomatic status; there were no statistical differences between functionality, daily living activities and QoL. Appropriate rehabilitation programs should be taken into consideration to help patients obtain functionality, daily living activities and QoL.
Keywords: Carpal tunnel syndrome, physiotherapy, rehabilitation, pain, functionality, quality of life