Journal of Back and Musculoskeletal Rehabilitation - Volume 33, issue 3
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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: There is little evidence on intra-articular (IA) treatment in knee osteoarthritis (KOA) and there is a lack of long-term follow-up studies. OBJECTIVE: To assess the long-term effectiveness and safety of IA oxygen-ozone (O 2 O 3 ) and hyaluronic acid (HA) in terms of functioning in KOA patients over a 31-week period. METHODS: Patients aged ⩾ 60 years with KOA were randomly allocated to receive 4 IA knee injections (1/week) of O 2 O 3 or…HA (T0–T3) and a follow-up visit 4 weeks after the fourth injection (T4). In this extension study we assessed VAS and safety in patients with Visual Analogue Scale (VAS) ⩾ 4 at the at 6-month follow-up visit (T5), undergoing a second treatment cycle (T5–T8) and 1-month follow-up visit (T9). RESULTS: Forty-two patients (aged 70.5 ± 5.8 years) were randomly allocated to O 2 O 3 (n = 22) or HA group (n = 20). Twenty-three underwent another IA cycle: 12 (54.6%) in the O 2 O 3 group and 11 (55.0%) in the HA group. Both groups showed significant reduction in VAS (p < 0.013) compared to baseline during both cycles. At follow-up visits (T4 and T9), VAS was significantly lower in the HA group (p < 0.013). There were no differences in adverse events occurrence between groups. CONCLUSIONS: IA O 2 O 3 might be comparable to HA in terms of effectiveness and safety in reducing pain in KOA patients, although at both follow-up visits (T4 and T9) VAS was significantly lower in the HA group.
Abstract: BACKGROUND: The prevalence of sexual problems is very high among women with fibromyalgia. OBJECTIVE: To evaluate the prevalence of sexual problems in women with FM and the potential association among physical activity, quality of life and sexual function. We aimed to contribute in the understanding of the relationships between sexual function and the symptoms of FM. METHODS: The sample of this cross-sectional study comprised 113 women with FM and 116 age-matched women without FM. Sexual function was assessed using the 15D questionnaire. Health-related quality of life (using EQ-5D-5L and 15D questionnaires), impact of…fibromyalgia and physical activity were also assessed. RESULTS: The prevalence of sexual problems among women with fibromyalgia was 76%, while it was 15% in healthy controls. This prevalence was even higher among those aged 50 or over. Sexual function was significantly associated with quality of life, distance walked, impact of fibromyalgia and four of the symptoms: depression, anxiety, tenderness and memory problems. CONCLUSION: More than three out of four women with fibromyalgia have any kind of sexual problem. Depression, anxiety and tenderness seems to be the most relevant symptoms associated with sexual function. Physical activity may be protective and reduce the risk of having sexual problems.
Keywords: Chronic pain, physical activity, sex, quality of life, walking
Abstract: BACKGROUND: We hypothesized that cervical radiculopathy (CR) has a role in subacromial impingement syndrome (SAIS) etiology, which cannot be directly connected to anatomical causes. OBJECTIVE: We aimed to investigate the presence of cervical radiculopathy in patients with SAIS diagnosed clinically and radiologically. METHODS: Patients who had a clinical and radiological SAIS diagnosis between 2014 and 2016 were included in the study. Patients with secondary causes that led to SAIS were excluded. Cervical MRI of all patients with SAIS was examined for cervical radiculopathy. RESULTS: A significant (p <…0.05) relationship was found between SIAS and the presence of root compression on the same side. 35% of the patients with SIAS had root compression on the same side. CONCLUSIONS: Cervical radiculopathy and shoulder impingement syndrome can be easily confused due to the similarity of the symptoms and the anatomical proximity of the lesions. Although both diseases can occur with different mechanisms, we believe that there is a cause and effect relationship between them.
Abstract: BACKGROUND: Osteopathic manipulation treatment is widely used in the clinical practice in the care of patients with chronic nonspecific low back pain, however, its benefits still seem uncertain. OBJECTIVE: This study aimed to verify the efficacy of osteopathic manipulation for chronic nonspecific low back pain. MATERIALS AND METHODS: Forty-two participants with chronic nonspecific low back pain were selected and randomized into two groups: active control group (ACG – n = 19) and osteopathic manipulation treatment group (OMTG – n = 23). Therapeutic exercises…were performed with the ACG and osteopathic manipulation techniques with the OMTG. The interventions were carried out over 5 weeks of treatment, totaling 10 treatments for the ACG and 5 for the OMTG. The visual analogue scale (VAS) was used to measure chronic nonspecific low back pain and the Oswestry Disability Index 2.0, Tampa Scale of Kinesiophobia and Beck Depression Inventory were used to measure disability, kinesiophobia and depression, respectively. RESULTS: The final chronic nonspecific low back pain in both groups was significantly lower than the initial low back pain (p ⩽ 0.01) and the final chronic nonspecific low back pain of the OMTG was significantly lower than that of the ACG (p = 0.001). CONCLUSION: This study demonstrated that the treatments were effective in both groups. However, the efficacy of the osteopathic manipulation treatment was greater than that of the therapeutic exercises.
Keywords: Osteopathy, osteopathic manipulation treatment, chronic nonspecific low back pain
Abstract: BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a progressive disease negatively affecting health-related quality of life. The related scales in Turkish are limited in number and generalizability. OBJECTIVE: To perform validity and reliability studies of the Turkish version of the Clinical Chronic Obstructive Pulmonary Disease Questionnaire (CCQ). METHODS: This study was conducted at the Department of Chest Diseases, with 100 volunteer COPD patients with a mean age of 67.72 ± 9.78 years. After obtaining the necessary permission, translation procedures were applied for Turkish cultural adaptation. Finally, a single Turkish translation…was created, and this questionnaire was evaluated by linguists. Incomprehensible items were corrected in a pilot study. Baseline and test-retest measurements after two weeks were performed. Internal consistency analysis was made for validity, and correlations were calculated with the 36-Item Short Form Health Survey (SF-36), the modified Medical Research Council (mMRC) Dyspnea Scale and Respiratory Function Tests (RFTs). RESULTS: Cronbach’s alpha value was found to be 0.90 for the first obtained data and 0.91 for the second obtained data. There was similarity at the rate of 0.97 between the first and second measurements in terms of total scores of the CCQ. The questionnaire significantly correlated with the SF-36, mMRC and RFTs (- 0.85 ⩽ r ⩽ 0.69, p < 0.05). CONCLUSIONS: As a result of this study, the Turkish version of CCQ was determined to be reliable and valid. The CCQ is an easy-to-use questionnaire in terms of application-calculation and can be safely used for the clinical assessment and monitoring of patients.
Keywords: Chronic obstructive pulmonary disease, quality of life, reproducibility of results, dyspnea, Respiratory Function Test, cross-cultural adaptation
Abstract: BACKGROUND: Injections are a good alternative to conventional treatment-resistant cases with rotator cuff (RC) lesions before operation. Currently, different injection methods are used in RC lesions. OBJECTIVE: To evaluate the efficacy of different injection methods (platelet-rich plasma [PRP], corticosteroid [COR] and prolotherapy [PRO]) in RC tendon lesions. METHODS: One hundred and twenty-nine patients were divided into 4 groups as PRP, COR, PRO and the lidocaine group. Subacromial injection was applied to all groups. They were evaluated using the Visual Analogue Scale (VAS), American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), and…Western Ontario Rotator Cuff Index (WORC) at 3, 12 and 24 weeks post-injection. RESULTS: In the COR group in the 3rd week, VAS and WORC scores were significantly lower than the other groups (p < 0.01 and p < 0.05 respectively). In the PRP group in the 24 th week, VAS and WORC scores were found to be significantly lower than the COR group (p < 0.01 and p < 0.05 respectively). In the COR group in the 3rd week the ASES score was found to be significantly higher than the PRP and PRO group (p < 0.01). CONCLUSION: In patients with RC lesions, corticosteroid injection provides short-term relief for pain, function, and quality of life, while PRP injection works for long-term wellbeing. For all types of applied injections, improvement in pain, function and quality of life were observed.
Abstract: OBJECTIVE: We aimed to evaluate the efficacy of the treatment of knee osteoarthritis (OA) patients by using microfracture technique in combination with autologous bone marrow stem cell transplantation. METHODS: A clinical study was conducted between November 2011 and January 2015 and involved 46 patients (aged from 46 to 69) with primary knee OA grade II and III (according to Kellgren-Lawrence classification) at the Orthopedic Trauma Department, Vietnam-Germany Friendship Hospital. Patients were randomly assigned to receive knee arthroscopy and then bone-marrow stem cells from their pelvic bones via injection. RESULTS: The mean Visual Analogue…Scale (VAS) score of present pain decreased from 5.68 before surgery to 1.7 24 months after surgery. The mean preoperative Knee Injury and Osteoarthritis Outcome Score (KOOS) was 36.34 (± 3.13), which increased to 74.62 (± 2.86) 24 months after surgery. On the MRI scans, the average Noyes score decreased from 12 (± 1.46) to 7 (± 1.50). Cartilage volume increased on average from 0.4512 (± 0.26) cm 3 to 0.5463 (± 0.29) cm 3 12–24 months after surgery. CONCLUSION: Treatment of osteoarthritis by a combination of arthroscopic microfracture and transplantation of autologous bone-marrow stem cells was an invasive, safe and effective method which showed an improvement in the clinical symptoms (VAS score) and knee functions (KOOS points).
Keywords: Osteoarthritis, bone marrow stem cell, arthroscopy, microfracture
Abstract: OBJECTIVE: The study aims to measure the cross-sectional area of the lumbar erector spinae muscles from L3–L4 intervertebral disc levels by using magnetic resonance images of Olympic style weightlifting athletes (male n = 15, female n = 15) and sedentary individuals (male n = 15, female n = 15). METHODS: A 1.5 Tesla device was used for the magnetic resonance imaging process of all participants. The images were then executed in ImageJ software and the cross-sectional…area was measured after the required synchronization steps were conducted. RESULTS: On the images taken from L3–L4 intervertebral disc levels, we observed that right-left cross-sectional area measurements of erector spinae muscles of sedentary males and females in the control groups were smaller than those of male and female athletes in Olympic style weightlifting. We also found a symmetry between right-left cross-sectional area measurements of groups of athletes. CONCLUSIONS: From the study findings, we might conclude that trainings of Olympic style weightlifting possess a hypertrophic effect on the cross-sectional area of erector spinae muscles of Olympic style weightlifting athletes.
Abstract: BACKGROUND: The Hybrid Assistive Limb (HAL) is a robotic exoskeleton designed to support impaired limbs. OBJECTIVE: We aimed to evaluate whether active exercise using a single-joint HAL (HAL-SJ) following total knee arthroplasty can facilitate the recovery of knee flexion. METHODS: Twenty-two patients who underwent total knee arthroplasty were randomly allocated to the HAL-SJ group (n = 12) or conventional physical therapy (CPT) group (n = 10). On postoperative day 5, patients performed active knee flexion exercises either with or without HAL-SJ assistance every second day. Outcome…measures included active and passive knee flexion range of motion (ROM), muscle strength, and pain intensity, as assessed by the visual analog scale, and were assessed on postoperative days 5 (pre-treatment) and 10 (post-treatment). Active ROM was measured at 6 months postoperatively; further long-term follow-up was performed by telephone interview. RESULTS: Both groups showed significant improvement between postoperative days 5 and 10 in all outcome measures. Improvements in active ROM (p < 0.01), passive ROM (p < 0.01), muscle strength (p < 0.01), and pain (p < 0.01) were significantly greater in the HAL-SJ group than in the CPT group. Long-term outcomes were also significantly better in the HAL-SJ group. CONCLUSIONS: HAL therapy enables patients to perform painless active movements and facilitates the recovery of knee function.
Keywords: Feasibility, HAL-SJ-assisted training, Hybrid Assistive Limb, HAL therapy, knee, knee function
Abstract: BACKGROUND: Core-strength is vital for Greco-Roman wrestling, although studies have yet to establish the effectives of core-specific training in this sport. OBJECTIVE: To examine the effect of core-specific strength training on determinants of Greco-Roman wrestling performance in elite junior athletes. METHODS: Twenty state-level, junior, Greco-Roman wrestlers were randomized into a core-specific training group (COR; n = 12) and a control group (CON; n = 8). The COR group undertook a 4-week, core-specific training program concurrently with their typical training program, whilst the CON group completed…4 weeks of typical training only. Both groups completed overhead medicine ball throw (OMBT), Suplexes, bridges and medicine ball chest throw (MBCT) prior to and following the intervention. RESULTS: The COR group demonstrated significantly greater improvement in bridges (p = 0.037; F = 5.046) and OMBT (p < 0.001; F = 26.43) than the CON group, with moderate to large between-group effect sizes (ES = 0.79–2.35). In addition, the effect size calculations were moderate-to-large (0.79–0.87) for Suplex and MBCT, with measures for the COR group greater than the CON group. CONCLUSION: Accordingly, core-specific training programs should be combined with wrestling-specific conditioning programs to improve back and hip extensor performance in junior Greco-Roman wrestlers.