Journal of Back and Musculoskeletal Rehabilitation - Volume 32, issue 1

Authors: Keskinruzgar, Aydin | Kucuk, Ayse Ozcan | Yavuz, Gunay Yapici | Koparal, Mahmut | Caliskan, Zeynep Gizem | Utkun, Mustafa

Article Type: Research Article

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. Show more

Keywords: Kinesio taping, kinesiology, occlusal splint, myofascial pain, tooth grinding, sleep bruxism

DOI: 10.3233/BMR-181329

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 1-6, 2019

Authors: Keklicek, Hilal | Kırdı, Elif | Yalcin, Ali | Yuce, Deniz | Topuz, Semra

Article Type: Research Article

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. Show more

Keywords: Learning effect, balance, postural stability, health

DOI: 10.3233/BMR-181172

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 7-14, 2019

Authors: Simsek, Sule | Yagci, Nesrin

Article Type: Research Article

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. Show more

Keywords: Distal fibular taping, Chronic Ankle Instability, balance

DOI: 10.3233/BMR-181132

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 15-20, 2019

Authors: Kordi Yoosefinejad, Amin | Ghaffarinejad, Farahnaz | Hemati, Mahbubeh | Jamshidi, Narges

Article Type: Research Article

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. Show more

Keywords: Kyphosis, grip, pinch, strength, flexible ruler

DOI: 10.3233/BMR-170932

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 21-26, 2019

Authors: Sperry, Megan M. | Phillips, Andrew T.M. | McGregor, Alison H.

Article Type: Research Article

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. Show more

Keywords: Lower back pain, balance, electromyography, posture, kinematics

DOI: 10.3233/BMR-170808

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 27-35, 2019

Authors: Kim, Eun-Kyung | Kim, Seong-Gil

Article Type: Research Article

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. Show more

Keywords: Head posture, plantar pressure, Bodyblade

DOI: 10.3233/BMR-160748

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 37-42, 2019

Authors: Gonçalves, Carlos Eduardo Amaral | Silva, Priscila Oliveira | Soares, Mauricio Santos | Bunn, Priscila Santos | Lima, Carla Martins Araujo | Lopes, Agnaldo José

Article Type: Research Article

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. Show more

Keywords: Sickle cell anaemia, muscle strength, isokinetic dynamometry, rehabilitation

DOI: 10.3233/BMR-171027

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 43-53, 2019

Authors: Abd Elghany, Salwa Elmorsy | Al Ashkar, Doaa S. | El-Barbary, Amal M. | El Khouly, Radwa M. | Aboelhawa, Marwa A. | Nada, Doaa W. | Darwish, Nivine F. | Hussein, Manal S. | Rageh, El Sayed | Abo-Zaid, Mohamed H. | Eldesoky, Islam F. | Afifi, Samah

Article Type: Research Article

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. Show more

Keywords: Regenerative injection therapy, repetitive transcranial magnetic stimulation, fibromyalgia syndrome

DOI: 10.3233/BMR-181127

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 55-62, 2019

Authors: Demirel, Aynur | Oz, Muzeyyen | Ulger, Ozlem

Article Type: Research Article

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. Show more

Keywords: Low back pain, rehabilitation, exercise, facet denervation, geriatrics

DOI: 10.3233/BMR-171113

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 63-70, 2019

Authors: Tanrıverdi, Müberra | Hoşbay, Zeynep | Candan Algun, Z.

Article Type: Research Article

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. Show more

Keywords: Carpal tunnel syndrome, physiotherapy, rehabilitation, pain, functionality, quality of life

DOI: 10.3233/BMR-171097

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 71-76, 2019

Authors: Rosser, Crystal A. | David Punt, T. | Ryan, Cormac G.

Article Type: Research Article

Abstract: PURPOSE: Working body schema (WBS) of the limbs may be indirectly assessed using left/right limb judgement (LRLJ) task performance. This study aimed to investigate if: 1) Total Knee Replacement (TKR) patients perform LRLJ tasks with reference to their WBS; 2) patients have a disrupted WBS following a TKR for the replaced knee compared to the contralateral knee; and 3) lower limb-based LRLJ task performance changes following post-surgical rehabilitation using change in upper limb-based LRLJ task performance as a control. METHODS: In a convenience sample (n = 18, age 69 ± …7 yrs, 12F 6M) of TKR patients < 1 month post-surgery, WBS was assessed using LRLJ task performance for the upper (pictures of the hand) and lower limb (pictures of the foot) before and after rehabilitation. Accuracy and response time (RT) were analysed using a series of 2 × 2 × 2 ANOVAs. RESULTS: LRLJ task performance for images corresponding with the operated and non-operated side were comparable for accuracy (p = 0.83) and RT (p = 0.28). Accuracy for hand images was comparable from baseline to post-rehabilitation (p = 0.54) whereas accuracy for feet images increased significantly (p = 0.03). Responses for awkward posture images were significantly slower than for more natural posture images (p = 0.001). CONCLUSIONS: LRLJ task performance data reflected the typical biomechanical constraints indicative of implicit motor imagery being performed by patients. There was no evidence of a disrupted LRLJ task performance for the replaced knee compared to the contralateral knee. Following post-surgical rehabilitation, patients’ lower limb LRLJ task performance improved whilst upper limb LRLJ task performance remained unchanged. These findings are the first to show that WBS improves with rehabilitation following TKR, and this may explain some of the clinical improvements observed. Undertaking LRLJ tasks could theoretically be a useful adjunct to current post-TKR rehabilitation. Show more

Keywords: Total knee replacement, working body schema, implicit motor imagery

DOI: 10.3233/BMR-171104

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 77-84, 2019

Authors: Xu, Zeqin | Gu, Yongquan | Li, Jianxin | Wang, Chunmei | Wang, Rong | Huang, Ying | Zhang, Jian

Article Type: Research Article

Abstract: OBJECTIVE: Stroke is the most common neurological disease that is associated with deglutition disorders. The aim of this study was to analyze dysphagia and aspiration pneumonia risk factors in post-stroke elderly inpatients. METHOD: We consecutively enrolled 212 stroke patients over sixty years of age from July 2014 to June 2015. Seventeen patients were eliminated. Stroke patients’ demographics, clinical symptoms and biochemistry data were collected. Modified water swallowing test was used for the assessment of deglutition difficulty. These inpatients were classified into two groups: territorial anterior circulation infarction (n = 114) and territorial posterior circulation …infarction (n = 82). Finally, dysphagia and aspiration pneumonia risk factor were analyzed between these two groups. RESULT: Number of previous cerebral infarction, National Institutes of Health Stroke Scale (NIHSS) score, masticatory muscle paralysis, abolition of gag reflex were correlated with the deglutition difficulty in these patients. In addition, NIHSS score (p = 0.017) and dysphagia (p = 0.02) were correlated with aspiration pneumonia. CONCLUSION: In stroke inpatients over sixty years of age, it is necessary to distinguish the patients with multiple previous cerebral infarctions, high NIHSS score, masticatory muscle paralysis, and abolition of gag reflex for early detection and rehabilitation of dysphagia. Show more

Keywords: Stroke, dysphagia, deglutition disorders, aspiration pneumonia

DOI: 10.3233/BMR-170801

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 85-91, 2019

Authors: Canbaz, Nurayet | Atılgan, Esra | Tarakcı, Ela | Papaker, Meliha Gündağ

Article Type: Research Article

Abstract: BACKGROUND: The origin of about 10% of tumors located in the intracranial region is the cerebellopontine angle. Therefore Cerebellopontine Angle (CPA) tumors affect patients’ balance. OBJECTIVE: The aim of this study was to compare the balance in individuals who underwent surgery for CPA tumors with healthy individuals. METHODS: Thirty patients who were being followed-up by the Department of Neurosurgery and had been operated on CPA tumor and 31 healthy individuals were included in the study as group 1 and group 2, respectively. The participants were evaluated using Romberg Test, Sharpened Romberg Test, One-leg …Stance (OLS), Tandem Walking, Walk Across, Berg Balance Scale (BBS), Dizziness Handicap Inventory (DHI) and Short Form 36 (SF-36). RESULTS: In comparison of the groups, OLS tests (p < 0.001), BBS (p < 0.05) and DHI (p < 0.05) were significantly different in favor of healthy group. SF-36 results revealed a significant difference between the groups, except for Bodily Pain and Vitality (p < 0.05). CONCLUSIONS: The results of this study demonstrated a decrease in balance parameters and quality of life in individuals who underwent CPA tumor surgery in comparison to healthy individuals. Evaluation of balance in the preoperative and postoperative period should not be ignored in these patients and they are suggested to start rehabilitation in the early postoperative period. Show more

Keywords: Cerebellopontine angle tumors, dizziness, balance

DOI: 10.3233/BMR-181198

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 93-99, 2019

Authors: Misterska, Ewa | Glowacki, Jakub | Kołban, Maciej

Article Type: Research Article

Abstract: BACKGROUND: A small body of data exists concerning psychosocial issues in adolescent idiopathic scoliosis (AIS) subjected to soft braces. No study was yet performed on the detailed psychosocial implications in AIS patients. OBJECTIVE: To compare the psychosocial implications of the flexible SpineCor with the Cheneau orthosis in AIS females. METHODS: Patients (aged 10–18 years) deliberately assigned to undergo SpineCor (SC group, 30 patients) or Cheneau brace (Ch group, 41 patients) intervention completed the Scoliosis Research Society-22 (SRS-22), the Spinal Appearance Questionnaire (SAQ), the Brace Questionnaire (BrQ) and the Pediatric Outcomes Data Collection Instrument …(PODCI). RESULTS: Concerning the BrQ, study groups differ in regards to emotional functioning (p = 0.014), vitality (p = 0.022) and social functioning (p = 0.048), indicating better functioning in the Ch group. Considering the SAQ, the Ch group assesses body curve (p = 0.024) less critically. Regarding the PODCI, the Ch group scored higher in the Global Functioning Scale (p = 0.023), the Upper Extremity and Physical Function Scale (p = 0.000), the Transfer and Basic Mobility Scale (p = 0.088), the Pain/Comfort Scale (p = 0.009) and the Happiness Scale (p = 0.022). CONCLUSIONS: This study shows that patients treated with the rigid brace assess their vitality, physical function, emotional and social functioning better and are less critical towards body curve, in comparison to patients treated with the SpineCor. Show more

Keywords: Adolescent idiopathic scoliosis, SpineCor, Cheneau brace, self-esteem, health perception

DOI: 10.3233/BMR-181121

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 101-109, 2019

Authors: Dogu, Beril | Usen, Ahmet | Kuran, Banu | Yilmaz, Figen | Sirzai, Hulya

Article Type: Research Article

Abstract: OBJECTIVE: Patient-reported outcome measures assessing self-reported disability, pain, and function are primary endpoints for determination of optimal treatment strategies in hand-related conditions. In this study, we aimed to compare responsiveness of Michigan Hand Outcomes Questionnaire (MHQ), Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH), and Duruöz Hand Index (DHI) in patients with traumatic hand injury. METHODS: Consecutive patients with traumatic hand injury who were referred to our polyclinic for rehabilitation were included in the study. Depending on clinical status, patients underwent at least 14 sessions of physical therapy consisting of infrared heating, water submersion ultrasound, …electrical stimulation, and exercise. MHQ, DASH, and DHI questionnaires were filled in by all patients both before and 3 months after physical therapy. RESULTS: A total of 60 patients were enrolled in the study. MHQ (ES = - 1.89; SRM = - 1.84), DASH (ES = 1.66; SRM = 1.40), and DHI (ES = 1.68; SRM = 1.48) were all highly responsive in traumatic hand injuries. CONCLUSION: Our study demonstrated that MHQ, DASH, and DHI are very responsive questionnaires for detection of treatment-induced changes in patients with traumatic hand injury. We suggest that when it is only intended to assess hand disability or when a quick assessment is desirable, DASH or DHI are more suitable, whereas MHQ will be more useful when a more detailed assessment including pain and aesthetical concerns is required. Show more

Keywords: Michigan Hand Outcomes Questionnaire, Disabilities of the Arm, Shoulder and Hand Questionnaire, Duruöz Hand Index, responsiveness, traumatic hand injury

DOI: 10.3233/BMR-181255

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 111-117, 2019

Authors: Arikan, İnci | Özyigit, Filiz

Article Type: Research Article

Abstract: BACKGROUND: For treatment of chronic musculoskeletal disorders pains to be successful, drug interventions are required. OBJECTIVE: In this study, we aimed to evaluate the Rational Drug Use Knowledge Level (RDUKL) in patients with musculoskeletal disorders and some relevant factors. METHOD: The study was carried out in October 2017 on patients treated in the Physical Therapy Rehabilitation Hospital in Turkey. The prepared questionnaire and RDUKL scale were administered to 239 patients by face-to-face interviews. The ANOVA test, chi-squared test and logistic regression model were used for the statistical evaluation. RESULTS: Forty-three …percent of the study group was found to have Rational Drug Use Knowledge (RDUK). The patients who used medicines under family supervision had twice as much RDUK as those who did not use medicines under family supervision, and those who were university graduates had six times as much RDUK as those who had primary education or below. Scale score was found to be low in patients with fibromyalgia and high in patients with rheumatoid arthritis (p < 0.05). CONCLUSION: RDUKL was found to be low in the group with chronic diseases and high average age. Besides training, it is important to provide patients with family support about their illness and its treatment. Thus, positive contributions can be made to the increase of the RDUKL. Show more

Keywords: Rational drug, knowledge, scale, musculoskeletal disorders

DOI: 10.3233/BMR-181252

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 119-124, 2019

Authors: Abd El-Nabie, Walaa Abd El-Hakiem | Saleh, Marwa Shafiek Mustafa

Article Type: Research Article

Abstract: BACKGROUND: Trunk-pelvic mal-alignment and postural control deficit are common problems facing children with cerebral palsy (CP). OBJECTIVE: The aim of this study was to investigate the relation of trunk and pelvic alignment with postural control in children with diplegic CP. METHODS: Seventy seven children with spastic diplegic CP, aged from 6 to 8 years with level II on Gross Motor Function Classification System, participated in this study. Trunk imbalance, lateral deviation of the spine and pelvic tilt were evaluated by using Formetric instrumentation system while postural control was assessed by using Pediatric Balance …Scale. RESULTS: The results showed that there was a moderate negative correlation of trunk imbalance, lateral deviation of the spine and pelvic tilt with postural control (- 0.44, - 0.59 and - 0.57, respectively). CONCLUSIONS: Increased trunk imbalance, lateral deviation of the spine and pelvic tilt may be associated with decreased postural control ability in children with diplegic CP. Show more

Keywords: Cerebral palsy, diplegia, postural control, trunk and pelvic alignment

DOI: 10.3233/BMR-181212

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 125-130, 2019

Authors: Dincer, Fitnat | Kesikburun, Serdar | Ozdemir, Oya | Yaşar, Evren | Munoz, Susana | Valero, Raquel | Juocevidius, Alvydas | Quittan, Michail | Lukmann, Aet | Winkelman, Andreas | Vetra, Anita | Gerdle, Björn | Kiekens, Carlotte | Branco, Catarina Aguiar | Smith, Eimear | Delargy, Mark | Ilieva, Elena | Boyer, François Constant | Grubisic, Frane | Damjan, Hermina | Krüger, Liisamari | Kankaanpää, Markku | Dimitrova, Erieta Nikolikj | Delic, Marina | Lazovic, Milica | Tomic, Natasa | Roussos, Nikolaos | Michail, Xanthi | Boldrini, Paolo | Negrini, Stefano | Takac, Peter | Tederko, Piotr | Angerova, Yvona

Article Type: Research Article

Abstract: BACKGROUND: Low back pain (LBP) is the most common type of musculoskeletal pain, thus it is one of the most commonly encountered conditions in Physical and Rehabilitation Medicine. The physicians who are primarily responsible for the nonsurgical management of LBP are physiatrists. OBJECTIVE: The present study aimed to investigate the approaches of physiatrists to low back pain across Europe. Preferences, tendencies, and priorities in the diagnosis, management, and treatment of LBP, as well as the epidemiological data pertaining to LBP in PRM practice were evaluated in this Europe-wide study. METHODS: The study was …conducted under the control of the European Society of Physical and Rehabilitation Medicine (ESPRM) Musculoskeletal Disorders Research Committee. A total of 576 physiatrists from most European countries participated in the survey. RESULTS: The results show that physiatrists frequently deal with patients with LBP in their daily practice. Most patients are not referred to other departments and are treated with various conservative methods. Less than one-fifth of patients are primarily referred for surgery. The physiatrists believe that a clear diagnosis to account for cases of low back pain is rarely established. The most common diagnosis is discopathy. History and physical examination remain the most valuable clinical evaluation tools for low back pain according to physiatrists. Less than half the patients require a magnetic resonance imaging. Non-steroidal anti-inflammatory drugs are the most commonly prescribed drugs for low back pain. Exercise, back care information, and physical therapy are the preferred conservative treatments. More than half of the physiatrists offer interventional treatments to patients with low back pain. CONCLUSION: The present study is a preliminary report that presents the attitudes of European physiatrists in the management of low back pain. Further researches are warranted to standardize the conservative management of LBP. Show more

Keywords: Low back pain, physiatrist, conservative management, rehabilitation

DOI: 10.3233/BMR-171001

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 131-139, 2019

Authors: Özdinç, Sevgi | Ünsar, Serap | Akgün Kostak, Melahat

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVE: Footwear preferences and habits may be related to musculoskeletal system problems. This study was designed to determine the relationship between the selection of footwear, musculoskeletal problems and the affecting factors among university students from that different division. METHODS: Four hundred and sixty-six university students in the divisions of Physiotherapy Rehabilitation, Nursing and Business Administration participated in this study. The data was collected using a questionnaire developed by the researchers and the Extended Nordic Musculoskeletal Questionnaire. RESULTS: Of the participants, 68.5% preferred to wear sports shoes; 24.0% of the participants had …foot pain. Comfort, robustness and quality come to the fore in the behavioural patterns of young and healthy individuals regarding footwear. Those who experienced foot and lower back pain considered such parameters as quality, fitness for foot health, flexibility and lightness in footwear. CONCLUSIONS: While patterns such as foot health, flexibility and lightness are reflected in the footwear preferences of those who have lower back pain, those who have pain or problems in their feet take into consideration the quality, lightness, fitness to foot health. The relationship determined in the present study shows that those who experience pain are more selective in their footwear preferences. Show more

Keywords: Footwear, pain, musculoskeletal pain, shoe

DOI: 10.3233/BMR-171036

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 141-147, 2019

Authors: Waseem, Muhammad | Karimi, Hossein | Gilani, Syed Amir | Hassan, Danish

Article Type: Research Article

Abstract: BACKGROUND: Chronic non-specific low back is the most common musculoskeletal complaint that significantly affects the general population. Exercises are advocated as the main part of treatment for chronic low back pain. OBJECTIVE: The purpose of this study was to compare the effects of workouts of the core musculature and routine physical therapy exercise training for the treatment of disability caused by chronic low back pain. METHODS: In this single-blinded, randomized, controlled trial, 120 patients with non-specific low back pain were examined in Lahore, Pakistan. They were randomly allocated into treatment groups A and …B. Group A performed core stabilization workouts and Group B had routine physical therapy. The Oswestry Disability Index (ODI) was used to evaluate the outcome of each treatment. Statistical analysis was performed using SPSS v16.0 and a p value < 0.05 was considered significant. RESULTS: Significant reduction in disability was observed in both groups at the end of the second, fourth, and sixth week of treatment (p value < 0.05). The mean reduction in disability as measured by ODI score was 39.44 ± 14.64 for Group A and 31.91 ± 12.31 for Group B. CONCLUSION: A larger reduction in disability was observed for subjects treated with core stabilization exercises in comparison to those treated with routine physical therapy. Show more

Keywords: Chronic low back pain, disability, Oswestry Disability Index

DOI: 10.3233/BMR-171114

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 149-154, 2019

Authors: Demirel, Adnan | Baykara, Murat | Koca, Tuba Tülay | Berk, Ejder | Gençay, Ökkeş Alparslan

Article Type: Research Article

Abstract: BACKROUND: The effect of different exercise modalities on the vascular structure has been the subject of clinical trials but there is not enough data about wrestlers. OBJECTIVE: This study aimed to compare the arterial stiffness parameters in adolescent wrestlers with those of age-matched sedentary controls to show the effects of long and heavy training. METHODS: This study was carried out as a case-control study. Thirty three (N = 33) elite male adolescent wrestlers (12–18 years) and 35 age and sex-matched control subjects (P = …0.438) with a sedentary lifestyle were included the study. The data was obtained by using sonography and a sphygmomanometer. Systolic and diastolic diameters and intima media thickness (IMT) measurements were performed from the carotid arteries of the subjects. The arterial tension was measured in the same session, and arterial stiffness parameters were calculated using specific formulas. RESULTS: The mean age range was 15.9 ± 0.9 years and 16.0 ± 0.8 years for the wrestlers and control subjects, respectively (P = 0.43). Statistically, the Body Mass Index (BMI) was significantly higher in wrestlers (mean = 23.7 ± 4.0 kg/m 2 ; P = 0.00). The groups had no difference in height (P = 0.80) and weight (P = 0.05). The systolic blood pressure (SBP) was significantly higher in wrestlers (mean = 120 ± 13.4 mmHg; P = 0.00); the pulse was significantly lower in wrestlers (mean = 69.61 ± 17.2 beats/min; P = 0.00); the IMT was significantly lower in wrestlers (IMT mean = 0.288 ± 0.1 mm; P = 0.01); the diastolic wall stress (DWS) was significantly higher in wrestlers (DWS mean = 933.64 ± 298.0 mmHg; P = 0.03) than controls. No significant differences were found in the elastic modulus (P = 0.11), compliance (P = 0.86), and distensibility (P = 0.86) parameters between the groups. CONCLUSION: Bradycardia is an expected condition for athletes. SBP and DWS were found to be high in wrestlers, suggesting that arterial tissue is more susceptible to stress. The low IMT indicates the protective effect of regular exercise against atherosclerosis. It is known that regular exercise is good for the vascular structure while heavy exercise puts a load on the vascular structure. The fact that the elastic modulus, compliance, and distensibility do not differ between the groups suggests that structural changes in the adolescents have no effect on the vascular wall. Show more

Keywords: Exercise, arterial stiffness, sonography, wrestling

DOI: 10.3233/BMR-171083

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 155-160, 2019

Authors: Yilmaz, Merve | Sahin, Mustafa | Algun, Z. Candan

Article Type: Research Article

Abstract: BACKGROUND: Home-based exercise therapy is effective in reducing pain and improving function in adults with osteoarthritis of the knee. OBJECTIVE: To investigate and compare the effectiveness of the home exercise program and the home exercise program taught by a physiotherapist in knee osteoarthritis. METHODS: The study was conducted with 80 patients with knee osteoarthritis. The patients were randomized into two groups. The first group was given the home exercise brochure by the orthopedist, while the second group did home exercises under the guidance of the physiotherapist. The goniometer for the range of motion …(ROM) of the knee, Myometer for evaluation of the quadriceps and hamstring muscles strength, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Short Form Health Survey (SF-36) were used for evaluation. RESULTS: Statistically significant improvements were found in the post-treatment ROM, VAS, quadriceps and hamstring muscles strength, WOMAC and SF-36 values in both groups (p < 0.05). When the change values were compared, the evaluation results of group II were better than group I statistically (p < 0.05). CONCLUSIONS: This study proved that home exercises taught by a physiotherapist were more useful for patients with knee osteoarthritis. When the home exercise program is implemented, a new role is created for a physiotherapist. Show more

Keywords: Knee osteoarthritis, physiotherapy, home exercise, exercise education

DOI: 10.3233/BMR-181234

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 161-169, 2019

Authors: Menek, Burak | Tarakci, Devrim | Algun, Z. Candan

Article Type: Research Article

Abstract: BACKGROUND: Mulligan mobilization techniques cause pain and affect the function in patients with Rotator cuff syndrome. OBJECTIVE: The aim of the study was to investigate the effect of Mulligan mobilization on pain and quality of life in individuals with Rotator cuff syndrome. METHODS: This study was conducted on 30 patients with Rotator cuff syndrome. The patients were randomized into Mulligan and control group. All the patients participating in this study were treated with conventional physiotherapy. Additionally, the Mobilization with movement (MWM) technique was used in the Mulligan group. Visual Analog Scale (VAS), Disabilities …of the Arm, Shoulder, and Hand (DASH), goniometer for the normal range of motion (ROM) and Short Form-36 (SF-36) questionnaires were used for assessment. RESULTS: Statistically significant improvement was found in the post-treatment VAS, DASH, SF-36, and ROM values significantly improved in both groups (p < 0.05). However, the Mulligan group showed much better results when compared to the control group in ROM, VAS, DASH (p < 0.05). In the SF-36 questionnaire, significant results were obtained for both groups, except the social function parameter. For the SF-36 parameters, both groups performed equally. CONCLUSIONS: Mulligan mobilization was more effective than general treatment methods for pain as well as normal joint motion, DASH scoring and some parameters of SF-36 compared with general treatment methods. Show more

Keywords: Rotator cuff syndrome, Mulligan mobilization, pain, quality of life

DOI: 10.3233/BMR-181230

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 171-178, 2019

Authors: Bohannon, Richard W. | Tudini, Frank | Constantine, Deborah

Article Type: Research Article

Abstract: OBJECTIVE: Our purpose was to summarize the literature on the applicability, procedures for performing, and clinimetric findings related to the measurement of tragus-to-wall (TTW) distance. METHOD: Pubmed, Scopus, and CINAHL databases were systematically searched using the key words “tragus” AND “wall”. Articles were examined for information on the participants whose TTW distance was measured, the procedures used for measuring TTW, and findings regarding TTW distances measured and the clinimetric properties of the measurements. RESULTS: Thirty-nine articles were identified that described use of the TTW test. Most used the test with patients with ankylosing …spondylitis. We found evidence for the convergent and known groups validity and reliability of the TTW measurements. Limited support for the responsiveness of TTW measurements was found. Two studies provided normative reference values. CONCLUSIONS: The TTW test is a simple objective indicator of forward flexed posture supported by research on its validity and reliability. More specific information on responsiveness and age-specific norms would increase the value of this nonspecific postural indicator. Show more

Keywords: Tragus and wall, posture, ankylosing spondylitis

DOI: 10.3233/BMR-171090

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 1, pp. 179-189, 2019