Journal of Back and Musculoskeletal Rehabilitation - Volume 33, 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 AND OBJECTIVE: In the available literature there are no reports on the effectiveness of Kinesio Taping (KT) in the conservative treatment of patients with anterior instability of the knee. The purpose of the present research was to evaluate the influence of the selected KT technique in limiting the anterior translation of the tibia by performing a biomechanical analysis of the gait cycle of patients with anterior instability of the knee. METHODS: A total of 31 patients qualified for the single group study. In all patients, a total tear of the anterior cruciate ligament was…diagnosed. The research tool was a three-dimensional motion analysis BTS SMART system. The effectiveness of KT of the knee with an anterior cruciate ligament tear was assessed based on angular changes in the movement of the knee in three planes of motion during specific phases of the gait cycle. RESULTS: The results show that KT does not significantly affect angular values of the knee joint in the sagittal and transverse planes of the affected and healthy limb during selected phases of the gait cycle. CONCLUSIONS: Due to only observed changes in the frontal plane, the KT method should be modified to also improve knee function in other planes.
Abstract: BACKGROUND: Shoulder involvement is frequently observed in chronic renal disease (CRD) and hemodialysis patients. OBJECTIVE: Our aim is to compare shoulder Magnetic Resonance Imaging (MRI) findings of stage 4 CRD patients naive to dialysis, hemodialysis patients and healthy controls. METHODS: Twenty hemodialysis patients with shoulder pain (Group 1), 30 hemodialysis patients without shoulder pain (Group 2), 20 patients with stage 4 CRD (Group 3) and 30 healthy controls (Group 4) were enrolled. Urea, creatinine and β 2 microglobulin were measured. Thickness, homogeneity and integrity of rotator cuff and presence of effusion were…examined by MRI. RESULTS: Supraspinatus tendon was thicker in Group 1 compared to other groups, whereas infraspinatus tendon was thicker in Group 1 compared to Groups 2 and 4. Although all tendons thickness was higher in Group 3 than Group 4, there was no significant difference. Most effusion areas were present in Group 1, followed by Groups 2 and 3. There was a significant correlation between glomerular filtration rate and thickness of supraspinatus, infraspinatus tendons and between β 2 microglobulin and thickness of infraspinatus, subscapularis tendons and total number of areas with effusion. CONCLUSIONS: Increased shoulder tendon thickness and effusion were detected in symptomatic dialysis patients, while greater effusion areas were detected in asymptomatic dialysis patients and in stage 4 CRD patients who do not require dialysis compared to healthy controls.
Abstract: BACKGROUND: The treatment of ankylosing spondylitis (AS) patients requires a combination of non-pharmacological (education, exercise and physical therapy), as well as pharmacological treatment modalities. The optimal management of AS still remains unresolved. OBJECTIVE: The aim was to measure and compare the effects of whole-body cryotherapy (WBC) at - 110 ∘ C and at - 60 ∘ C and exercise therapy alone on disease activity and the functional parameters of patients with AS. METHODS: Ninety-two patients were allocated to three groups: with WBC at…- 110 ∘ C or at - 60 ∘ C (each concurrent with exercise therapy), or exercise therapy alone. Disease activity and the functional parameters of the patients were measured at study entry and at the end of the 8-day treatment. RESULTS: Supervised therapy, irrespective of the program, led to a significant reduction in disease activity (Bath Ankylosing Spondylitis Disease Activity Index: BASDAI, Ankylosing Spondylitis Disease Activity Score: ASDAS-CRP), disease-related back pain, fatigue, duration and intensity of morning stiffness and a significant improvement in the patient’s functional capacity (Bath Ankylosing Spondylitis Functional Index: BASFI), spine mobility (Bath Ankylosing Spondylitis Metrology Index: BASMI) and chest expandability, with no changes in the levels of CRP. It has been demonstrated that following therapy, the group that underwent cryotherapy at - 110 ∘ C manifested significantly reduced disease activity (BASDAI) compared with exercise therapy only (p = 0.024). CONCLUSION: Adding cryotherapy at - 110 ∘ C to exercise therapy led to significantly reduced disease activity expressed in BASDAI, compared with exercise therapy alone.
Abstract: OBJECTIVE: To investigate the efficacy of High Intensity Laser Therapy (HILT) and Transcutaneous Electrical Nerve Stimulation (TENS) in low back pain (LBP). METHODS: Forty patients aged between 18 to 60 were included in this study. The patients were randomized into two groups as TENS (Group I) and HILT (Group II). The severity of pain was measured by Visual Analog Scale (VAS), and the range of motion (ROM) of the joint was measured by goniometer. The Oswestry Disability Questionnaire (ODQ) was used to assess the effect of LBP on daily living activities, and the Beck Depression…Inventory (BDI) was used to assess depression. All patients were taken into physical therapy program for 5 days a week for a total of 20 sessions. Patients in Group I received ultrasound, hot pack and HILT, while the patients in Group II received ultrasound, hot pack and TENS. RESULTS: In the comparison of post-treatment improvements, among all parameters only VAS score had a significant difference in favor of Group I. CONCLUSIONS: The study demonstrated that HILT is more effective than TENS in terms of pain reduction and that HILT can be used as an alternative to TENS.
Keywords: Low back pain, electrotherapy, HILT, TENS
Abstract: BACKGROUND: Many studies have investigated the correlation between muscle torque and joint position sense (JPS), but few studies have been performed on the correlation between torque ratio and JPS. OBJECTIVE: The aim of this study was to investigate JPS and muscle torque ratios of agonist and antagonist muscles in the ankle and knee joints of young adults. METHODS: A total of 38 right handed healthy participants, 12 males and 26 females, were recruited. All participants measured their peak torque of knee flexor/extensor and ankle dorsiflexor/plantar flexor by using a Biodex system. They also…used the Biodex to assess the proprioception through active joint reposition sense test in knee and ankle joint. Peak torque of each muscle, agonist/antagonist torque ratio and JPS error were collected, and Pearson’s correlation analysis was used to examine correlations between peak torque, torque ratio and JPS error. RESULTS: For knee joints, correlations were found between flexion and extension torque, extension torque and torque ratio, and torque ratio and JPS error (r = 0.825/p = 0.000, r = - 0.482/p = 0.002, and r = - 0.685/p = 0.000, respectively). For ankle joints, correlations were found between dorsiflexion and plantar flexion torques, plantar flexion torque and torque ratio, plantar flexion torque and JPS, and torque ratio and JPS (r = 0.654/p = 0.000, r = - 0.621/p = 0.000, r = - 0.563/p = 0.000, and r = - 0.761/p = 0.000, respectively). CONCLUSIONS: JPS error of lower extremity joint may be more related with agonist/antagonist torque ratio rather than peak torque. Therefore, people who will have training for reducing JPS error need to consider torque ratio, too.
Keywords: Torque ratio, joint position sense error, peak torque
Abstract: OBJECTIVE: This study has been conducted to examine the effects of posture, cervical region and oropharyngeal exercises in patients with Obstructive Sleep Apnea Syndrome (OSAS). METHOD: Thirty patients with OSAS have been randomly divided into two groups. The first group received supervised exercise program including oropharyngeal, posture and cervical region exercises for 12 weeks. The patients in the control group have been informed about the posture but the exercise was not recommended. Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), Short Form 36 (SF-36), International Physical Activity Questionnaire-Short Form (IPAQ-SF) and…6 Minute Walk Test (6MWT) have been used in the evaluation of individuals participating in the study. Evaluations have been made at the beginning of the treatment and at the end of the 12-week exercise program. RESULTS: Statistically significant improvements have been observed in the exercise group in PSQI total value, ESS score, SF-36 General Health Subscale and 6MWT (p < 0.05). Statistical significance could not be reached for other parameters. CONCLUSIONS: Sleep quality, general health, and functional capacity have been found to improve in OSAS patients with oropharyngeal exercises.
Keywords: Obstructive Sleep Apnea Syndrome, exercise, posture, sleep, health
Abstract: BACKGROUND: Many studies have presented lower limb kinematics in Western countries, but few have concentrated on gender and age differences for Chinese populations. OBJECTIVES: The purpose of this study was to investigate three-dimensional hip and knee kinematics especially for elderly Chinese during walking and running, as well as to analyze age differences. MATERIALS AND METHODS: Sixty healthy volunteers, including 40 young and 20 elderly adults, were divided into two groups by gender and instructed to perform walking and running in a comfortable manner. The hip and knee kinematics were obtained with 3D Motion…Capture System. Normalization was used to avoid the body size effect. Age differences were tested with independent t -test (p < 0.05). RESULTS: In non-sagittal planes, the hip and knee ranges of motion of young males are larger during running, but smaller during walking than those of elderly males. Young females reveal smaller non-sagittal planes hip and knee ranges of motion than elderly females, regardless of whether they are walking or running. There are also significant age differences in the peak hip and knee angles especially in frontal plane during running. Young adults reveal greatly higher peak hip and knee adduction angles than elderly adults. CONCLUSIONS: Walking speed and the hip and knee ROM for Chinese are different from Westerners. These kinematic differences can be used for reference to design better joint prostheses to meet various Chinese people’s needs.
Keywords: Age, gender, peak joint angles, ranges of motion
Abstract: BACKGROUND: Spinal decompression therapy (SDT) has recently been used as a conservative treatment for lumbar disc prolapse (LDP). The effectiveness of SDT when compared with other conservative techniques with a well-designed randomized controlled trials is lacking. OBJECTIVE: To find the efficacy of SDT and core stabilization exercises (CSE) on pain and functional disability in individuals with chronic LDP, and to compare with CSE alone. METHODS: This single blind randomized controlled trial included thirty-one participants with a mean age of 38.68 ± 8.79 having chronic LDP with or without radiating symptoms were…included in the study. The study group received SDT with CSE and control group received CSE alone along with interferential therapy for both groups. Pain and disability were estimated by Numerical Rating Scale (NRS) and Modified Oswestry Questionnaire (mOQ). RESULTS: The results demonstrated significant within-group improvements in all outcomes in both groups, the mean differences between pre to post intervention in SDT with CSE group were (NRS: 4.75, t = 12.81, p ⩽ 0.001) and (mOQ: 45.13, t = 29.34, p ⩽ 0.001), while in CSE group (NRS: 2.60, t = 13.67, p ⩽ 0.001) and (mOQ: 27.67, t = 24.52, p ⩽ 0.001). CONCLUSIONS: A combination of SDT with CSE has proven to be more significant when compared with CSE alone to reduce pain and disability in subjects with chronic LDP.
Abstract: BACKGROUND: Low back pain (LBP) has become increasingly common, but the prevalence of this complaint and associated factors in young people remains controversial. OBJECTIVE: This study aimed to identify the prevalence of LBP and to explore the existence of associated factors (sex, physical activity, sedentary lifestyle, sleep, body mass index and waist circumference). METHODS: This study considered all complaints of the lumbar region (acute or chronic) as LBP, which can irradiate to the backside and legs, lasting a minimum of 24 hours. Youngsters aged 15 to 18 years from a school in…the south of Brazil were evaluated. Descriptive statistics was used, in particular Chi-square, Mann-Whitney U tests and binary logistic regression. A significance level of p < 0.05 was adopted. RESULTS: A total of 330 youngsters answered a questionnaire and had their anthropometric measurements measured (response rate 84%). The prevalence of LBP in the present was 30%, quarterly 63% and throughout life 77%. There was a significant association between LBP and sex: girls have an increased risk of LBP in the last three-month period (PR = 1.3, 95% CI 1.06–1.56) and throughout life (PR = 1.2, 95% CI 1.04–1.43). The practice of physical activities was also associated with LBP, but as a protection factor in the present and in the last three-month period (PR = 0.7, 95% CI 0.47–0.90). Physical education at school has demonstrated a protective factor regarding LBP throughout life (PR = 0.9, 95% CI 0.77–0.97). Most of the students did not comply with recommendations related to sleep and time spent doing activities in front of a screen, and no association of these factors with LBP was detected. This exposure (physical activity, sleep time, sedentarism) did not present significant association with LBP when adjusted by the confusion factors (sex, age, BMI). CONCLUSIONS: Youngsters reported a high prevalence of LBP. Girls were at greater risk of LBP than boys. It is recommended that prevention strategies focus on the practices of physical activities and scholar physical education. No association of LBP with sedentary lifestyle (TV and computer use time, sleep time), anthropometric measures and sleeping duration was observed.
Keywords: Adolescents, back pain, prevalence, physical activity, overweight
Abstract: OBJECTIVES: This study aimed to gain an overview of patient education and the effects of patient education for older people with low back pain (LBP). METHODS: The search strategies were performed via EBSCO MEDLINE, EBSCO CINAHL, Science Direct, PubMed, and PEDro databases from 2006 to 2016. The keywords “patient education”, “low back pain”, “elderly”, “older adults”, “older persons” and “older people” were used during the literature search. Boolean operators were used to expand or limit the searching scope and manual exclusion was performed to choose articles eligible for this study. RESULTS: A…total of 2799 articles were retrieved but only five articles were related with patient education for older people with LBP. Findings suggest that patient education for older people may differ in terms of its contents such as health education, self-management, video education, and postural education. The high methodological quality of the studies revealed that patient education showed improvement in terms of pain, disability and quality of life among older people with LBP. CONCLUSIONS: Patient education improved pain and had positive effects on disability and quality of life among older people with LBP. However, due to the limited number of RCTs more studies are needed to provide evidence for its effectiveness.
Keywords: Patient education, low back pain, older people