Journal of Back and Musculoskeletal Rehabilitation - Volume 32, issue 2
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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: Computer users are at risk in terms of musculoskeletal disorders. It is known that ergonomics training prevents short-term injuries to the musculoskeletal system, but its long-term effect is unknown. OBJECTIVE: The aim of our study was to investigate the effect of receiving ergonomics training in undergraduate instruction on posture during computer usage. METHODS: The present study included 27 individuals who had received training previously and 58 individuals who had not received any training. Their posture was evaluated with Rapid Upper Limb Assessment (RULA) and Musculoskeletal Diseases in Computer Users Frequency and Risk…Factors Screening Form (MCFRF). RESULTS: The percentage of pain experienced at least once in four weeks was much higher in the untrained than the trained group. The RULA scores were 3.7 ± 2.1 and 3.3 ± 0.8 points for the lower body and upper extremity for the trained group, and 4.2 ± 2.2 and 3.9 ± 0.9 points for the lower body and upper extremity, respectively, for the untrained group. The MCFRF scores were 1.9 ± 1.0 and 1.7 ± 1.0 points for the lower body and upper extremity, respectively, for the trained group, and 1.6 ± 1.3 and 1.6 ± 0.8 points for the lower body and upper extremity for the untrained group. CONCLUSIONS: According to RULA scores, training on ergonomics was effective in reducing the risk level of musculoskeletal disorders. MCFRF scores showed that ergonomics training had no effect on posture during computer usage. Nevertheless, MCFRF evaluates only posture and does not calculate approximate forces that body parts were exposed to. Thus, these areas of MCFRF required improvement. Our study emphasized the importance of the long-term effects of ergonomics training for preventive purposes before musculoskeletal problems manifest.
Abstract: BACKGROUND: Patient satisfaction is a key point in evaluating the quality of physiotherapy services. OBJECIVE: The aim of this study was to determine the Turkish language validity and reliability of the Patient Satisfaction Scale in Physiotherapy (PSSP). METHODS: The study included 168 participants, aged 18–74 years, with musculoskeletal pain. The PSSP, which comprises 14 items in the four sub-dimensions of treatment, admission, logistics and general satisfaction, was applied to all participants. Structural validity was assessed using the principal components method with varimax rotation. Internal consistency and the intraclass correlation coefficient (ICC) were used…for the reliability analysis. The Patient Satisfaction Scale for Physical Therapy Outpatient Clinics (PCCPTO) was used to assess concurrent validity. RESULTS: The participants comprised of 71% females and 29% males with a mean age of 41.9 ± 14.9 years. The sampling competency index was 0.874. The Turkish version of the scale was found to be perfectly reliable (Cronbach’s alpha reliability coefficient = 0.922). Internal consistency ranged from 0.762 to 0.904 in the subscales. Factor analysis revealed that the 14-item scale had four factors explaining 75.59% of the total variance. Floor and ceiling effects were not determined. Concurrent validity analysis showed a strong correlation between the PSSP and PCCPTO (r = 0.78; p < 0.0005). CONCLUSION: The Turkish version of the PSSP is a valid, reliable and easily applicable measure.
Abstract: BACKGROUND: Core stability exercises have been widely advocated for management of patients with different musculoskeletal conditions, even though its effect on postpartum Lumbopelvic Pain (LPP) has not been fully investigated. OBJECTIVE: This study was conducted to investigate the effect of core stability exercises on postpartum LPP. METHODS: Thirty four women suffering from postpartum LPP were randomly assigned to the study or control group. The control group (n = 17) received traditional treatment (infrared radiation and continuous ultrasound) on lumbosacral region (L1-S5), whereas the study group (n =…17) received core stability exercises in addition to traditional treatment three sessions a week for six weeks. Pain Pressure Threshold (PPT), Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were assessed for all participants in both groups before and after the treatment program. RESULTS: There was a significant improvement in PPT, VAS and ODI post-treatment compared with the pre-treatment in both groups (p = 0.001). There was a significant improvement in participants who received core stability exercises in addition to traditional treatment as compared to participants treated with the traditional treatment only in PPT (P = 0.001), VAS (P = 0.001) and ODI (P = 0.009). CONCLUSIONS: Core stability exercises in addition to traditional treatment significantly decreased pain and improved function for women with postpartum LPP.
Abstract: BACKGROUND: Burns are traumatic injuries that result in severe tissue damage. A reduction in exercise capacity is the most common functional impairment, although it is not clear to what extent the severity of the burn injury affects the exercise capacity. OBJECTIVE: The aim of this study was to examine the physiological responses to exercise and to evaluate exercise capacity according to burn severity. METHODS: The study included a total of 64 burn patients, comprising 33 with moderate injuries (Total body surface area: 9.93 ± 4.73%; mean age: 37 ±…11.93 years) and 31 with major injuries (Total body surface area: 39.03 ± 10.36%; mean age: 41.09 ± 14.96 years). Heart rate, systolic blood pressure, diastolic blood pressure, double product, dyspnea level, oxygen saturation and leg fatigue before and after the shuttle walk test were recorded. Walking distances were measured after the shuttle walk test. RESULTS: A significant difference was determined between patients with major and moderate burn injuries in respect of the cardiovascular responses to the shuttle walk test. Major burn injury patients had a significantly shorter walking distance than the moderate burn injury patients (p < 0.05). CONCLUSIONS: Burn injury severity was seen to affect the functional capacity and cardiovascular responses to the shuttle walk test. Shuttle walk test can be preferred to evaluate moderate and major burn injury patients’ functional capacity in the acute period of injury.
Keywords: Burn injury, cardiovascular responses, exercise capacity, shuttle walk test
Abstract: BACKGROUND: Diabetes mellitus (DM) is associated with musculoskeletal disorders (MSDs) and is often not clinically diagnosed and managed. There are also no systematic reviews of literature relating to the prevalence of MSDs among people with diabetes. OBJECTIVE: To determine the prevalence and areas of the body affected by MSDs in diabetic patients. METHODS: A literature search of the electronic databases of CINAH, PubMed, Web of Science and Google Scholar using the keywords of “MSDs and DM” as the search term was conducted. Pooled estimates were calculated using a meta-analysis of proportion.…RESULTS: Five thousand and eighty-eight studies were identified from the databases; 21 studies fulfilled the inclusion criteria and were included in the review. Five studies were of high quality, 13 were of moderate quality and three were of low quality. The prevalence of all types of MSDs among patients with diabetes was 58.15% (95% CI 41.4%–73.9%). The hand was the most common area of the body affected being 33.05% (95% CI 21.1–46.13) followed by the shoulder. CONCLUSIONS: A high prevalence of MSDs was found among diabetic patients with the hand and shoulder being the most frequently reported areas affected. However, future studies with a larger sample and the relevant type of diabetes are required.
Abstract: PURPOSE: The aim of this study was to compare epicardial adipose tissue thickness (EATT), which is a novel cardiometabolic risk factor in patients with ankylosing spondylitis (AS), and carotid intima media thickness (CIMT) with healthy controls to assess the relationship between these markers and disease activity. MATERIALS AND METHODS: This study involved 38 patients with AS and 38 controls with no history of cardiovascular disease. CIMT was measured by Doppler ultrasound, and EATT by echocardiography, in all participants. Total cholesterol (TC), low density lipoprotein (LDL) cholesterol, high density lipoprotein cholesterol, triglycerides, thyroid stimulating hormone, erythrocyte sedimentation…rate, C-reactive protein, and hemogram measurements were performed in all subjects after 8 hours of fasting. In addition, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) scores of the patients with AS were recorded. RESULTS: EATT was significantly higher in patients with AS (0.45 ± 0.17 mm) compared with healthy (0.37 ± 0.10 mm) controls (p = 0.01). Significant positive correlations were detected between EAT thickness and BASFI, CIMT, and disease duration in patients with AS (p = 0.008, p = 0.024, and p = 0.012, respectively). Significant negative correlations were observed between EATT and TC and LDL cholesterol concentrations (p = 0.016 and p = 0.009, respectively). No significant difference was detected in CIMT between the patients (0.515 ± 0.08 mm) and the controls (0.517 ± 0.094 mm, p = 0.98). No significant correlation was observed between CIMT of the patients with AS and the BASDAI, BASFI, TC, HDL cholesterol, systolic blood pressure, or diastolic blood pressure values. Significant positive correlations were observed between CIMT and waist circumference, weight, body mass index, and LDL cholesterol in patients with AS and the controls. CONCLUSIONS: This study demonstrated increased EATT in patients with AS compared with a healthy population, which was positively correlated with disease duration and BASFI.
Abstract: BACKGROUND: The effect of core training on dynamic balance and agility has yet to be established in literature, especially among junior athletes. OBJECTIVE: To investigate the effect of core training on dynamic balance and agility among Indian junior tennis players. METHOD: Thirty junior tennis players from various parts of Delhi and the national capital region participated in the study. The study featured a pre-test/post-test experimental design. The subjects were divided into the experimental group (mean age = 15.20 ± 0.41, mean BMI = 20.23…± 1.54) and the control group (mean age = 15.53 ± 1.06, mean BMI = 20.71 ± 1.53). The control group performed regular training, and the experimental group followed a five-week core training program along with regular training. The subjects were evaluated with t-test for agility and the Star Excursion Balance Test (SEBT) for dynamic stability. RESULTS: A significant difference was found in the post-test values of agility (t-test p = 0.000) and dynamic balance using SEBT ((anterolateral; p = 0.00), (lateral; p = 0.02), (posterolateral; p = 0.00), (posterior; p = 0.00), (posteromedial; p = 0.01), (medial; p = 0.03), and (anteromedial; p = 0.03)] except in the anterior direction (p = 0.23)) between the experimental and the control group. The experimental group showed a significant difference in the pre- and post-test values of the t-test and SEBT except in the anterior direction. CONCLUSION: Core training programs can be incorporated safely with players’ regular training to improve their dynamic balance and agility, which can eventually lead to better performance.
Abstract: BACKGROUND: Vestibular, neurological and musculoskeletal functions are affected in patients with renal failure. These problems can in turn affect the balance system in peritoneal dialysis (PD) patients. Previously, postural balance changes were shown in hemodialysis patients. This is the first study that evaluates whether there are similar changes in patients with PD. OBJECTIVE: This study aimed to compare balance and fall risk between patients undergoing PD treatment and healthy subjects, and aimed to determine the correlation between biochemical parameters and fall risk and balance assessments in PD patients. METHODS: This controlled study included…58 patients receiving PD treatment (PD Group) and 75 healthy subjects (Control Group). The Berg Balance Scale (BBS) and Tetrax ® Interactive Balance System were used for the comparison of balance between groups. For patients in the PD Group, duration of PD, blood pressure, Kt/V urea (actual mass of urea removed via peritoneal dialysis), and serum biochemical parameters were recorded and correlation analysis was performed between these parameters and balance measurements. RESULTS: There were no statistically significant differences between groups in terms of demographics or BBS scores (p > 0.05). The fall risk of patients in the PD Group was significantly higher than those in the Control Group (p < 0.0001) according to Tetrax measurements. Female gender, older age, higher BMI, and higher blood glucose levels were negatively correlated with balance parameters of PD patients (r > 0.3). There was no statistically significant correlation between duration of PD, blood pressure, and Kt/V urea with balance parameters or fall risk. CONCLUSIONS: Balance was impaired in patients undergoing PD in comparison to healthy subjects. Fall risk may be evaluated using the Tetrax ® instead of BBS for this population. Serum glucose level, BMI and age appear to affect balance and fall risk. Therefore, optimization of body weight and normalization of serum glucose levels are important factors for improving balance. The duration of PD, blood pressure, and Kt/V urea do not affect balance system.
Keywords: Postural balance, risk of fall, peritoneal dialysis, static posturography
Abstract: OBJECTIVE: To compare outcomes of unipedicular versus bipedicular approach for percutaneous vertebroplasty for the treatment of thoracolumbar acute osteoporotic vertebral compression fracture (AOVCF). METHOD: From November 2014 to September 2015, 382 patients with AOVCF were randomly assigned to the unipedicular and bipedicular groups. Clinical outcomes and complications were compared. RESULTS: Both groups were comparable with respect to bone cement leakage and adjacent vertebral fractures (P > 0.05). Although the bipedicular approach was found to be superior in terms of reduction of kyphosis and loss of reduction, frequency of…x-ray fluoroscopy, VAS and ODI scores, the volume of cement injected and operating time, the between-group differences were not statistically significant (P > 0.05). Nerve root stimulation was more frequent in the unipedicular group (P < 0.05). CONCLUSIONS: The clinical and radiological outcomes of both procedures were comparable. The unipedicular approach was associated with more nerve root stimulation.
Abstract: OBJECTIVE: Vertebral fractures are the most common osteoporotic fractures occurring due to low bone mineral density, as well as other risk factors. The aim of the paper is to investigate risk factors for vertebral osteoporotic fracture occurrence in postmenopausal women. METHODS: Retrospective analysis of data pertaining to 651 postmenopausal women obtained from the National Osteoporosis Registry of Serbia was conducted. Further analyses were performed on 217 osteoporotic women identified from those records, whereby those in the experimental group (n = 110) had a vertebral fracture, while those assigned to the control…group (n = 107) did not. The two groups were comparable in terms of age (t = 0.450; p > 0.01). Risk factors that could serve as the best predictors of vertebral fracture occurrence were investigated. Multivariate logistic regression analysis was used for testing effect of several factors on vertebral fracture occurrence as the dependent variable. RESULTS: Patients that have never suffered a vertebral fracture had a significantly higher bone mineral density (t = 8.161; p < 0.01) in comparison to those with a verified vertebral fracture. Factors that significantly contributed to the risk of vertebral fracture were presence of kyphosis (OR 708.338; 95% CI 19.238–26.081.950), use of glucocorticoids (OR 87.618; 95% CI 9.175–836.707), and presence of comorbidities (OR 7.327; 95% CI 1.500–35.793). Moreover, a unit increase in body mass index (BMI) was found to lower the probability of vertebral fracture by a factor of 0.846. Women that entered menopause later have lower chance of suffering a vertebral fracture (OR = 0.539; 95% CI 0.400–0.726). CONCLUSION: Lower body mass index, presence of kyphosis, use of glucocorticoids, early menopause onset, and presence of comorbidities are the factors that contribute the most to vertebral osteoporotic fracture occurrence.