Journal of Back and Musculoskeletal Rehabilitation - Volume 32, issue 5
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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: Back pain often develops in early childhood and becomes more frequent during adolescence. The aim of this study was to determine potential risk factors and the therapy effects on back pain in children. METHODS: This retrospective study included 96 boys and girls treated for back pain in outpatient and hospital setting in the 1.1.2016–31.12.2016 period at the Institute of Child and Youth Health Care of Vojvodina, Serbia. The influence of sex, age, physical activity and presence of concomitant locomotor system deformities, as well as applied therapies, on the back pain in children was analyzed using…SPSS ver. 21. RESULTS: The studied sample comprised of 56.3% girls. The average age of the subjects was 14.64 years, 43 (44.8%) of the children were physically active. In children suffering from back pain, spinal column deformities were also noted, mostly scoliosis (27.1%) and kyphosis (20.8%). Chronic pain was diagnosed in 54 children (56.3%). The average pain intensity, as measured on the VAS, was 5.72 and 0.92 before and after therapy, respectively (p < 0.05). CONCLUSION: Among the analyzed parameters, only lumboishialgia was a significant factor in the onset of back pain, which declined following ergonomic education and physical therapy.
Keywords: Low back pain, children, physical activity
Abstract: OBJECTIVE: To investigate the efficacy of a 4-week community aquatic physiotherapy program with Ai Chi or the Bad Ragaz Ring Method (BRRM) on pain and disability in adults with chronic low back pain (CLBP). METHODS: Adults with CLBP (n = 44; mean ± SD age, 52.6 ± 5.5 y; 37 women) were assigned to either an Ai Chi (n = 23) or BRRM (n = 21) program (4 weeks, twice weekly). RESULTS: Both…the Ai Chi (- 1.4; 95% CI - 2.6 to - 0.2; p = .025) and BRRM (- 2.0, 95% CI - 3.1 to - 0.8; p = 0.003) groups demonstrated significant pre- to post-treatment decreases in Roland-Morris Disability Questionnaire scores and improvements in prone bridge duration (Ai Chi: 11.7 s; 95% CI 1.6 to 21.8; p = 0.025; BRRM: 19.0 s; 95% CI 6.1 to 31.8; p = 0.006). The Ai Chi group revealed a significant improvement in single-leg stand test duration (2.9 s; 95% CI 0.1 to 5.7; p = 0.045) and the BRRM group reported significant decrease in pain intensity (- 11.6; 95% CI - 19.1 to - 4.2; p = 0.004). CONCLUSIONS: A 4-week aquatic physiotherapy program with Ai Chi or BRRM resulted in significant pre- to post-treatment improvements in disability and global core muscle endurance. Ai Chi appeared to have an additional benefit of improving single-leg standing balance and BRRM an additional benefit of reducing pain.
Keywords: Chronic low back pain, disability, Ai Chi, Bad Ragaz Ring Method, aquatic physiotherapy, water exercise
Abstract: BACKGROUND: Direct access physical therapy (DAPT) may result in improved patient outcomes and reduced healthcare costs. Prognostic factors associated with spine-related outcomes and insurance claims with DAPT are needed. OBJECTIVE: To identify factors that predict variations in outcomes for spine pain and insurance claims using DAPT. METHODS: Individuals (N = 250) with spine pain were analyzed. Outcomes were classified into High, Low, or Did Not Meet minimal clinically important difference (MCID) scores. Claims were categorized into low, medium, or high tertiles. Prognostic variables were identified from patient information.…RESULTS: Females were more likely to meet High MCID (odds ratio [OR] 2.84 (95% CI = 1.32, 6.11) and Low MCID (OR 2.86, 95% CI = 1.34, 6.10). Higher initial ODI/NDI scores were associated with High MCID (OR 1.04, 95% CI = 1.07, 1.22) and Low MCID (OR 0.91, 95% CI = 0.77, 1.07). Odds of a high claim were lowered by the absence of imaging (OR 0.04, 95% CI = 0.02, 0.09) and an active versus passive treatment (OR 0.38, 95% CI = 0.18, 0.80). CONCLUSION: Females and higher initial disability predicted favorable outcomes. The novel introduction of claims into the prognostic modeling supports that active interventions and avoiding imaging may reduce claims.
Keywords: Prognosis, low back pain, neck pain, health care costs, direct access
Abstract: BACKGROUND: Clinical, psychological and demographic variables have been investigated to determine factors involved in quality of life of patients with chronic pain. It has been stressed that chronic pain is more associated with beliefs about pain, than with pain intensity. OBJECTIVE: The main aim of this retrospective cross-sectional study was to examine differences between postoperative beliefs about pain control, perception of pain and mood disturbances in patients treated operatively due to neck or lumbar discopathy and degenerative spine disease. METHODS: Forty-four patients treated operatively due to lumbar and forty-one patients treated surgically due…to cervical discopathy filled in the Visual Analogue Scale (VAS), The Beck Depression Inventory (BDI-PL) and Beliefs about Pain Control Questionnaire (BPCQ-PL). Patients with lumbar and cervical discopathy additionally completed disease-specific outcome measures. RESULTS: The patient groups do not differ significantly in regards to BPCQ-PL, BDI-PL or VAS. Both study samples differ in regards to dependencies related to beliefs that pain is controlled by powerful others and about internal control of pain. CONCLUSIONS: Cognitive-behavioral interventions, concerning depression and beliefs about pain control, may be appropriate for both lumbar and cervical surgical populations, to improve post-surgical functioning.
Abstract: BACKGROUND: Various forms of trunk exercise have been used for increasing abdominal strength. The plank exercise and bilateral leg raise exercise are one of these trunk exercises. However, there are few studies that compared the effects of these exercise variations. OBJECTIVE: The present study aimed to investigate how effectively the trunk muscles during plank and bilateral leg raise exercises are activated. METHOD: Surface electromyography responses of the rectus abdominis, internal oblique, and erector spinae muscles were investigated during the plank and bilateral leg raise exercise with different hip position. A total of 18…healthy, physically active female volunteers completed the normal plank exercise, plank exercise with placing the lower leg in a horizontal condition, bilateral leg raise exercise, and bilateral leg raise with lower leg as horizontal condition. RESULTS: The horizontal condition caused significant increases in activity of the internal oblique muscles compared with the general condition (p < 0.05). The bilateral leg raise exercise showed significantly greater activation in the rectus abdominis compared to the plank exercise (p < 0.05). CONCLUSION: The present study showed that the horizontal condition had the advantage of activating the internal oblique muscles, and the leg raise exercise is effective in strengthening global muscle such as the rectus abdominis.
Keywords: Abdominal strengthening, electromyography, prone bridge, training
Abstract: BACKGROUND: Histological and histochemical analyses of muscle samples were used to determine the intensity of paraspinal muscle injury during open (OPEN) and minimally invasive (MIS) procedures due to spinal trauma. OBJECTIVE: A randomised prospective study design was chosen. According to our hypothesis, OPEN procedures will lead to more intensive microscopic changes than MIS. METHODS: Muscle samples were collected during the primary surgery – fracture surgery (FRS) from the left and during material extraction (EXS) from the right side. Complete samples were acquired from 17 OPEN and 18 MIS subjects. We compared them…histochemically and histologically; muscle fibre typing and statistical analysis were performed. RESULTS: We statistically confirmed that the increase in fibrosis in the OPEN EXS sample was significantly higher than in the MIS EXS sample, with p < 0.05 (p = 0.000322453). Fibre types in MIS did not differ almost at all in both samples; the changes were statistically insignificant. In OPEN samples, the number of type I fibres differed significantly. In EXS, it was significantly lower (46.23%) than in FRS (60.63%), at a statistically significant level, p < 0.05 (p = 0.0234375000) especially with the increase of the type IIA fibres, less in IIB fibres. CONCLUSIONS: These microscopic findings provide a statistically significant confirmation that OPEN procedures in spinal fracture lead, in most cases, to significant changes in the structure of the corset muscle at the fracture site and surgical access point than MIS procedures.
Abstract: BACKGROUND: Chronic neck pain is associated with various myofascial trigger points (MTrPs). OBJECTIVE: A single-blind randomized clinical trial was designed to compare the effects of extracorporeal shock wave therapy (ESWT) with dry needling (DN) techniques on the upper trapezius muscle trigger point in patients with non-specific neck pain (NSNP). METHODS: Seventy patients with NSNP and active MTrPs of the upper trapezius muscle were randomly divided into two groups: an ESWT group (n = 35) and a DN group (n = 35). Treatment sessions…were performed for three weeks and all participants received related intervention once a week. The outcome measures were pain intensity, measured by a numeric pain rating scale (NPRS), pain pressure threshold (PPT), measured with a digital algometer, and functional disability, evaluated by using the neck disability index (NDI). RESULTS: NPRS and NDI were significantly decreased in the DN group and ESWT group (P < 0.05). Also, the PPT was significantly increased in the DN group and ESWT. However, there was no significant difference in pain intensity, NDI, and the PPT between the two groups (P ⩾ 0.05). CONCLUSION: Both ESWT and DN can be employed to treat MTrPs of the upper trapezius muscle in patients with NSNP.
Abstract: BACKGROUND: Although a number of therapeutic interventions for trigger-point inactivation have been studied, it remains controversial which intervention is better. OBJECTIVE: To compare the effectiveness of the kinesio taping and dry needling methods in patients with trigger-point related myofascial pain syndrome of the upper trapezius muscle. METHODS: A total of 42 patients were randomly allocated to the kinesio taping group (n = 23) and dry needling group (n = 19). The patients were assessed for pain, pressure pain threshold (PPT), cervical range of…motion (CROM), and function at baseline, at short- and medium-term stages after treatment. To investigate the effects of the interventions over time, two-way repeated measures analysis of variance (ANOVA) was used. RESULTS: There was a significant improvement in pain intensity at rest and cervical motion, in the PPT readings (p < 0.05), in CROM (p < 0.05), and in function (p < 0.05) in both groups, with no superiority either (p > 0.05). CONCLUSIONS: Kinesio taping may be a choice of trigger point inactivation in patients who do not want to be needled or who show contraindication(s) to treatments other than kinesio taping.
Keywords: Myofascial pain, trigger point, dry needling, kinesio taping