Journal of Back and Musculoskeletal Rehabilitation - Volume 33, issue 4

Authors: Van Cant, Joachim | Dawe-Coz, Alexander | Aoun, Elie | Esculier, Jean-François

Article Type: Research Article

Abstract: OBJECTIVE: The purpose of this systematic review with meta-analysis was to compare the effects of low load resistance combined with blood flow restriction (BFR) versus conventional quadriceps strengthening on knee symptoms and function as well as knee extensor strength and muscle thickness in adults with knee conditions. LITERATURE SURVEY: Guidelines based on the latest evidence highlight the importance of quadriceps strengthening to reduce pain and improve function in patients with knee conditions. Blood flow restriction is based on brief periods of vascular occlusion which cause muscle hypertrophy and increased strength. Before it can be recommended for individuals …with knee conditions, quadriceps strengthening with low load resistance combined with BFR (LL-BFR) must show beneficial effects on clinical outcomes in addition to quadriceps strength and mass. METHODS: A systematic review with meta-analysis was conducted to identify relevant studies through PubMed, PEDro, and ScienceDirect up to January 2019. The protocol was registered on PROSPERO (CRD42019121306). Differences in pre- and post-intervention means and standard deviations were extracted to calculate the standardized mean difference for each intervention in each included study. SYNTHESIS: Eight studies were included. Limited evidence suggests that LL-BFR is more beneficial on quadriceps strength and thickness in patients with knee conditions than LL training alone or in addition to a rehabilitation program. Limited evidence indicates that LL-BFR training is equally effective in improving function and muscle thickness compared with a HL quadriceps strengthening program but elicits less knee pain, corresponding to additional benefits of 22 (95% confidence interval 1 to 43) mm on a 0–100 mm visual analogue scale. CONCLUSIONS: BFR could be a useful option for patients with knee conditions where conventional quadriceps strengthening program exacerbate knee symptoms. Future investigations should compare different BFR protocols to help establish better guidelines for clinicians. Show more

Keywords: Knee, quadriceps, strengthening, rehabilitation

DOI: 10.3233/BMR-191684

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 529-544, 2020

Authors: Thevenon, A. | de la Barge de Certeau, A.C. | Wieczorek, V. | Allart, E. | Tiffreau, V.

Article Type: Research Article

Abstract: BACKGROUND: Rehabilitation is currently the preferred first-line treatment for thoracic outlet syndrome (TOS). When physiotherapy fails, the next treatment option is usually surgery – a complex procedure with potential complications. OBJECTIVE: We sought to establish whether an intensive, multidisciplinary, day-hospital-based rehabilitation programme could reduce the symptoms of TOS after the failure of private-practice physiotherapy and before surgery was considered. METHODS: We performed a retrospective, single-centre study of 63 TOS patients admitted to our day hospital for 3 weeks (15 therapy sessions) between 2003 and 2014. The data were extracted from hospital records or …gathered in a phone interview. RESULTS: Immediately after discharge, the observed improvements in hand function were related to lifting a load, reaching a high shelf, sweeping the floor, cleaning windows, and combing hair. Three months after the end of the intensive rehabilitation program, 80% of the patients reported a reduction in their symptoms. Forty-one of the 63 patients were subsequently contacted by phone. The mean time interval between the end of the rehabilitation programme and the phone interview was 4.5 years (median: 3.5 years; range: 1–12 years). Twenty-seven patients (66%) reported a worsening in hand function, and 25% had undergone surgery. Twenty-three patients had kept the same job, 7 had changed jobs after retraining, 4 had stopped working before the programme but were able to return to work afterwards (including one patient in a part-time job), 4 had not returned to work, and 3 received disability benefits. CONCLUSION: An intensive, multidisciplinary, hospital-based rehabilitation programme was associated with improvements in the great majority of patients with TOS – even after private-practice physiotherapy had failed. Show more

Keywords: Thoracic outlet syndrome, rehabilitation, physical and rehabilitation medici

DOI: 10.3233/BMR-170906

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 545-552, 2020

Authors: Umehara, Takuya | Tanaka, Ryo | Nagao, Susumu | Tomiyama, Daisuke | Kawabata, Yuki | Nagano, Yoshihiro | Takeuchi, Yumi | Kakehashi, Masayuki

Article Type: Research Article

Abstract: BACKGROUND: Previous studies have examined when activities of daily living (ADL) recovery more than six months after surgery can be predicted, and how much accuracy the predictors have. OBJECTIVE: The purpose of this study was to determine the predictors of ADL decline and evaluate their accuracies one year post-operation for hip-fracture patients. METHODS: We studied patients who underwent hip fracture surgery and were able to walk independently pre-operatively. The predictors of ADL declined one year post-operation, as analyzed using data of the basic medical attributes of the patients, including pain, 30-s chair-stand test, …dementia [using the Revised Hasegawa Dementia Scale (HDS-R)], and walking/mobility style [using Barthel Index (BI)]. Using a receiver operating curve (ROC) curve, the cut-off value for each significant predictor was determined in the logistic regression analysis. To calculate the cut-off values and diagnostic performances of each of the extraction factors. RESULTS: The data of 36 patients were collected over a period of one year. The prior probability of ADL decline at one year post-operation was 44.4%. The results of logistic regression analyses showed that the score of HDS-R at admission and the walking/mobility BI score at three weeks post-operation were significant predictors of the one year post-operative decline in ADL. The results of the ROC analyses showed that the cut-off value of the HDS-R score at admission was < 23 points. The posterior probability increased to 62.0%. In contrast, the cut-off value of the walking/mobility BI score was 0 points. The posterior probability increased to 91.0%. CONCLUSION: The ADL decline of the patients who underwent hip fracture surgery at one year after surgery can be predicted at three weeks post-operation. Show more

Keywords: Hip fracture, one year post-operation, ADL, surgery

DOI: 10.3233/BMR-181126

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 553-560, 2020

Authors: Aprile, Irene | Iacovelli, Chiara | Cruciani, Arianna | Simbolotti, Chiara | Loreti, Simona | Galli, Giulia | Vulpiani, Maria Chiara | Padua, Luca

Article Type: Research Article

Abstract: BACKGROUND: Among new technological rehabilitation systems, there are proprioceptive platforms. These could be useful to improve static and dynamic balance. OBJECTIVE: To evaluate technological proprioceptive rehabilitation compared to conventional rehabilitation in patients after total hip arthroplasty (THA). METHODS: Sixty-four patients after THA were divided in two groups: a conventional group (CG) and a technological group (TG) treated with proprioceptive platforms. Before (T0) and after 20 sessions (T1), we recorded static and dynamic balance. Clinical and disability scales (Modified Harris Hip Score, Barthel Index, Deambulation Index), pain scales (ID-PAIN, DN4, VAS) and QoL scale …(SF-36) were administered to patients during T0 and T1. Mann-Whitney U test was used for stabilometric and dynamic assessments to detect differences between groups of patients and healthy subjects. The Wilcoxon signed-rank test was used for the within-group analysis and the ANCOVA test for the analysis between groups of patients. RESULTS: All scales improved significantly in both groups after treatment (p < 0.05). Static balance improved in both groups, but there were greater improvements in the TG than in the CG. All dynamic balance indexes showed significant improvements only in the TG after treatment. CONCLUSIONS: Both treatments improved the clinical, disability, pain, and QoL scales, as well as static balance, but only proprioceptive technological rehabilitation improved dynamic balance. Rehabilitation through proprioceptive platforms can indeed improve static and dynamic balance, which are both crucial for the patient’s safety and autonomy. Show more

Keywords: Total hip arthroplasty (THA), technological rehabilitation, proprioceptive conventional rehabilitation, static balance, dynamic balance

DOI: 10.3233/BMR-181211

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 561-568, 2020

Authors: Ocampo-Plazas, Mary Luz | Prieto-Mondragón, Laura del Pilar | Solorzano, Mónica Andrea | Escobar, Ferney Camilo

Article Type: Research Article

Abstract: BACKGROUND: During the rehabilitation phase, physical exercise is a key element that requires an assessment of the best alternatives for application since the pre-prosthetic phase (PPF) for an accurate prescription. Therefore, the assessment of fitness for health (FFH) shall be included in the initial rehabilitation process. OBJECTIVE: To develop a FFH evaluation battery (Evam1) for pre-prosthetic unilateral lower-limb amputees (PPULLA). METHOD: A descriptive study of the theoretical construction and validation of a FFH evaluation battery based on a review of international literature for tests that measure amputee physical capability. RESULTS: …During the scientific literature review, no batteries designed with this goal were found. We therefore designed a battery that was assembled of five tests for anthropometry, aerobic capacity, strength and flexibility. Combined leg and arm cycloergometrics, isokinetic dynamometry, and flexi test are the most reliable tests for the corresponding assessment of each component. CONCLUSIONS: PPF is of great importance, since the basic physical capabilities are altered due to long immobilization and hospitalization periods, inadequate postures, alteration of basic daily activities, and decrease in participation in sports, recreational, and work activities. This is a fundamental proposal, given that the procedures for FFH assessment of PPULLA have been rarely addressed, thus limiting the information on assessment methods, processes and/or tests established for these procedures. Show more

Keywords: Physical fitness, lower limb amputation, muscle strength, aerobic capacity, flexibility, anthropometry

DOI: 10.3233/BMR-181441

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 569-579, 2020

Authors: Yadollahpour, Nava | Zahednejad, Shahla | Yazdi, Mohammad Jafar Shaterzadeh | Esfandiarpour, Fatemeh

Article Type: Research Article

Abstract: BACKGROUND: The STarT Back Screening Tool (SBT) is a multidimensional questionnaire consisting of physical and psychological factors which categorizes the patients in the low, medium or high risk subgroups. OBJECTIVE: To investigate the relationship between SBT-based subgrouping and clustering of patients with LBP using uni-dimensional psychological, clinical and physical examination measures. METHODS: One hundred and fifty-seven patients with chronic LBP completed the SBT and uni-dimensional psychological, disability and pain questionnaires. Physical impairments were evaluated through the Physical Impairment Index (PII). Hierarchical and K-means methods were used for cluster analysis. Between-clusters differences and the …association between the clusters and SBT-based subgrouping were investigated. RESULTS: Three clusters were identified. The derived clusters were labeled severe, moderate and mild physical-psychological-distress clusters, because pain intensity, disability, psychological and physical factors were relatively high, moderate or low, respectively. Most of the patients in moderate and mild physical-psychological distress clusters were categorized as medium risk based on SBT. The mean difference for the PII was higher than that of psychological factors between moderate and mild physical-psychological-distress clusters. CONCLUSIONS: Patients in low and high risk subgroups of SBT were sufficiently differentiated, but patients in a medium risk subgroup had a different profile based on PII. Including additional physical factors in the SBT may be required to better differentiate among patients. Show more

Keywords: Physical factors, psychological factors, low back pain, clustering, STarT Back Screening Tool

DOI: 10.3233/BMR-181484

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 581-587, 2020

Authors: Qie, Shuyan | Li, Wei | Li, Xiangrong | Chen, Xuemei | Gong, Weijun | Xi, Jianing | Sun, Fenglong | Yue, Shouwei

Article Type: Research Article

Abstract: BACKGROUND: Lumbar disc herniation (LDH) can affect lower limb muscle function resulting in an abnormal gait. This study aims to use surface electromyography (SEMG) to evaluate patients with L 4 /L 5 and L 5 /S 1 LDH throughout muscle movement. METHODS: Twenty L 4 /L 5 LDH patients (L5 Group), twenty L 5 /S 1 LDH patients (S1 Group), and twenty healthy controls (Healthy) were recruited for …the study. SEMG of bilateral tibialis anterior (TA) and lateral gastrocnemius (LG) muscles of patients were recorded using the DELSYS Wireless EMG System (Trigno TM Wireless Systems, Delsys Inc., USA). Root-mean-square (RMS), mean power frequency (MPF), and median frequency (MF) were compared between bilateral limbs in each participant. RESULTS: Reduced MPF and MF was found in TA measurements of the L5 Group and LG measurements of the S1 Group. The MPF and MF of the TA of symptomatic limbs of the L5 Group were reduced when compared to asymptomatic limbs (p = 0.006, p = 0.012, p < 0.05), and there were no significant differences in LG measurements (p > 0.05). The LG MPF and MF of the S1 Group in symptomatic limbs were reduced when compared to asymptomatic limbs (p = 0.006, p = 0.017, p < 0.05), and there were no significant differences in TA measurements (p > 0.05). Although there were no significant differences in RMS between bilateral limbs of the L5 and S1 Groups, we found some changes in RMS curves. First, compared to asymptomatic limbs of L 4 /L 5 LDH patients, β -peaks in the TA of symptomatic limbs appeared earlier. Second, two peaks in the LG of symptomatic limbs were found in L 5 /S 1 LDH patients. CONCLUSION: TA is affected in patients with LDH of L 4 /L 5 , and LG is affected in patients with LDH of L 5 /S 1 . As demonstrated, SEMG can identify LDH-related muscle dysfunction. Show more

Keywords: Lumbar disc herniation, gait, surface electromyography, root mean square, median frequency

DOI: 10.3233/BMR-181308

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 589-596, 2020

Authors: Şen, Ekin İlke | Yıldırım, Mustafa Aziz | Yeşilyurt, Tuğba | Kesiktaş, Fatma Nur | Dıraçoğlu, Demirhan

Article Type: Research Article

Abstract: BACKGROUND: The interest in biological treatments that have the potential to modify cartilage biology has gradually increased in recent years. OBJECTIVE: The aim of our study was to investigate the effects of intra-articular platelet-rich plasma (IA-PRP) injections on the femoral cartilage thickness, pain, functional status, and quality of life of patients with knee osteoarthritis. METHODS : A total of 71 patients (109 knees) with knee osteoarthritis who were administered IA-PRP injections twice with two-week intervals were included in this study. The resting and activity pain values measured using a Visual Analogue Scale (VAS), the Western Ontario …and McMaster Universities Osteoarthritis Index (WOMAC) scores, the Lequesne index scores, and the quality of life scores measured using Short Form-36 (SF-36) were recorded before treatment and at 1 month, 3 months, and 6 months after treatment. The femoral cartilage thickness was measured via ultrasonography before treatment, and at 3-month and 6-month follow ups. Obtained results were analyzed by the Wilcoxon signed rank test. RESULTS: The mean age of the patients was 47.4 ± 10.4 years old. The resting and activity pain scores were significantly decreased at 1-month, 3-month and 6-month follow ups when compared to the pre-injection values (p < 0.05). Significant reductions were found in the Lequesne index and WOMAC pain, stiffness, and function scores at 1, 3, and 6 months (p < 0.05), while a significant increase was detected in the third month scores when compared to the first month. Significant improvements were determined in the physical functioning, physical role, pain, general health, and emotional role sub-scores during the 6-month period (p < 0.05). However, there was no significant difference with regard to the cartilage thickness at the follow ups (p > 0.05). CONCLUSIONS: The results of our study indicated that the IA-PRP injections improved the pain, stiffness, physical functioning, and quality of life of knee osteoarthritis patients; however, they did not seem to affect the cartilage thickness during the 6-month follow up period. Show more

Keywords: Cartilage, intra-articular injection, knee, osteoarthritis, platelet-rich plasma

DOI: 10.3233/BMR-181209

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 597-605, 2020

Authors: Neamtu, Marius Cristian | Neamtu, Oana Maria | Rusu, Mihai Robert | Marin, Mihnea Ion | Rusu, Ligia

Article Type: Research Article

Abstract: BACKGROUND: Chronic demyelinisation in multiple sclerosis (MS) involves changes in the muscle structure and development of motor disorders. OBJECTIVE: The aim of this research is to assess the muscle balance of thigh muscle in MS using a noninvasive method, to have information about the muscle status prior to the rehabilitation and to prevent muscle damage. METHODS: The studied group consisted of 20 patients: 9 men and 11 women, with a mean age of 42 years. The patients were diagnosed with MS in different stages. The clinical evaluation included clinical examination, neurological examination, functional …evaluation by using the Hamilton score, the activity daily living (ADL) scale and the Kurtze (EDSS) scale. For the muscle assessment we used tensiomyography (TMG), an evaluation method for the functional potential of the muscle, depending on the muscle composition. The TMG parameters are displacement (Dm), contraction time (Tc) and sustain time (Ts) for biceps femoris (mBF) and rectus femoris (mRF). RESULTS: The value of Dm shows low values for both studied muscle groups, but closer to the normal value for mBF. The average normal Tc values for mBF are 30.25 ± 3.5 ms and 32.83 ± 4.5 for mRF. The values are low values for mRF and high for mBF. The normal values of Ts are not standard values and can be compared healthy individuals’ values. These parameters could monitor the evolution and in our research have lower values for mRF. In the thigh, there was a significant difference in the Dm values, with higher values in mBF and also with higher values in the right lower limb. Analyzing the Ts results, we noticed a difference between the two muscle groups with a significant reduction in mRF, showing the inability to achieve anterior-posterior symmetry and the tendency to develop type I fibers at mBF level. CONCLUSIONS: Our study showed the presence of a structural and functional asymmetry explained by the tendency of increasing the tonus at mRF level in order to compensate the knee stability. We noticed a decrease in Tc value at the mRF level, but close to the value of the two lower limbs. TMG analysis revealed the asymmetry of the muscle composition at the level of the antagonist muscle groups of the thigh, with an increase in the percentage of type II fibers in the previous group, which became hyperton, and a decrease in the percentage of type I fibers in the posterior group. Show more

Keywords: Muscle balance, symmetry, assessment, multiple sclerosis

DOI: 10.3233/BMR-191518

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 607-612, 2020

Authors: Hofmann, Ulf Krister | Keller, Ramona Luise | von Bernstorff, Maximilian | Walter, Christian | Mittag, Falk

Article Type: Research Article

Abstract: BACKGROUND: Numerous classification systems have been proposed to interpret lumbar MRI scans. The clinical impact of the measured parameters remains unclear. To evaluate the clinical significance of imaging results in patients with multisegmental degenerative pathologies, treating specialists can perform image-guided local injections to target defined areas such as the epidural space. OBJECTIVE: The aim of this retrospective study was to evaluate the correlation between lumbar spinal stenosis measurements obtained by MRI and improvement obtained through local epidural injection. METHODS: In this retrospective study various measurement and classification systems for lumbar spinal stenosis were …applied to MRI scans of 100 patients with this pathological condition. The reported effect of epidural bupivacaine/triamcinolone injections at the site was recorded in these patients and a comparative analysis performed. RESULTS: MRI features assessed in this study did not show any relevant correlation with reported pain relief after epidural injection in patients with chronic lumbar stenosis, with the exception of posterior disc height with a weak Kendall’s tau of - 0.187 (p = 0.009). CONCLUSIONS: Although MRI is crucial for evaluating lumbar spinal stenosis, it cannot replace but is rather complementary to a good patient history and clinical examination or the results of local diagnostic injections. Show more

Keywords: Lumbar spinal stenosis, MRI, epidural injection, neuroforaminal stenosis, Schizas’ spinal stenosis classification, Sipola’s neuroforaminal cross-sectional area

DOI: 10.3233/BMR-181249

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 613-621, 2020

Authors: Alaca, Nuray

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVES: Internet addiction (IA), defined as excessive, time consuming, uncontrollable use of the internet, has become a widespread problem. In this study, we investigated the impact of internet addiction on depression, physical activity level, and latent trigger point sensitivity in Turkish university students. METHODS: A total of 215 university students (155 females and 60 males) who were between 18–25 years of age participated in the study. Using the Addiction Profile Index Internet Addiction Form (APIINT), we identified 51 people as non-internet-addicted (non-IA) (Group 1: 10 male/41 female) and 51 as internet-addicted (IA) (Group 2: …7 male/44 female). APIINT, International Physical Activity Questionnaire-Short-Form (IPAQ), Beck Depression Inventory (BDI), and Neck Disability Index (NDI) were administered to both groups, and the pressure-pain threshold (PPT) in upper/middle trapezius latent trigger points area was measured. RESULTS: The internet addiction rate was 24.3% in our students. Compared with the non-IA group, the daily internet use time and BDI and NDI scores were higher (all p < 0.05), while the IPAQ walking (p < 0.01), IPAQ total (p < 0.05), and PPT values (p < 0.05) were lower in the IA group. CONCLUSIONS: IA is a growing problem. This addiction may lead to musculoskeletal problems and can have consequences involving the level of physical activity, depression, and musculoskeletal disorders, particularly in the neck. Show more

Keywords: Internet addiction, depression, physical activity level, Neck Disability Index, pressure-pain threshold, latent trigger points

DOI: 10.3233/BMR-171045

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 623-630, 2020

Authors: Park, Kyue-Nam | Jung, Do-Young | Kim, Si-Hyun

Article Type: Research Article

Abstract: BACKGROUND: Weakness of the trapezius and serratus anterior (SA) muscle may be a risk factor for unilateral neck pain. OBJECTIVE: This study examined the trapezius (upper, middle, and lower) and SA muscle strength ipsilateral and contralateral to the painful side in violinists with unilateral neck pain. METHOD: Twenty-six female violinists with unilateral neck pain participated in this study. Participants reported the pain intensity and duration and completed the Neck Disability Index (NDI). The strengths of the upper (UT), middle (MT), and lower (LT) trapezius and SA muscles were measured using a handheld dynamometer. …Paired t-test was used to compare the strength of the muscles between ipsilateral and contralateral to the painful side within subjects. The relationship between pain intensity, pain duration, and neck disability and strength deficit of the muscle was demonstrated by Pearson’s correlation and Spearman’s rank correlation. RESULTS: The strengths of the UT, MT, LT, and SA muscles were significantly decreased on the painful side compared with the contralateral side (P < 0.05). Except for correlations between pain intensity and percent strength deficit of the UT and between pain duration and percent strength deficit of the MT (P < 0.05), there were no significant associations between pain intensity, pain duration, or NDI and the percent strength deficit of the UT, MT, LT and SA muscles (P > 0.05). CONCLUSIONS: These results suggest that decreased UT, MT, LT, and SA muscle strength on the side of the pain should be considered in the rehabilitation of violinists with unilateral neck pain. Show more

Keywords: Neck pain, serratus anterior muscle, strength, trapezius muscle, violinist

DOI: 10.3233/BMR-181147

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 631-636, 2020

Authors: Oh, Dong-Hwan | Park, Ji-Su | Kim, Hee-Jeong | Chang, Moon-Young | Hwang, Na-Kyoung

Article Type: Research Article

Abstract: OBJECTIVE: To examine the effects of neuromuscular electrical stimulation (NMES) on oropharyngeal swallowing function according to 2 types of placement, acting as assistance and as resistance, in stroke patients with dysphagia. METHODS: Thirty-eight stroke patients with dysphasia were randomly assigned to the suprahyoid group (SMG), or infrahyoid muscle group (IMG); 26 patients completed the intervention and were included in the analysis. In the SMG, the electrodes were placed on the region between the jaw and the hyoid bone, whereas in the IMG, the electrodes were placed on the region below the hyoid for the targeted infrahyoid …muscles. Both groups received NMES for 30 min/d, 5 d/wk, for 4 weeks and conventional dysphagia therapy. Swallowing function was measured using the Videofluoroscopic Dysphagia Scale and Penetration-Aspiration Scale based on videofluoroscopic swallowing study. Oral dietary intake was measured using the Functional Oral Intake Scale. RESULTS: Both groups showed significant improvements in oropharyngeal function and level of functional oral intake, but there was no significant difference between the two groups. However, the SMG showed a more reduced penetration-aspiration, compared with the IMG. CONCLUSIONS: Altogether, these data demonstrate that 2 types of NMES placements have a similar effect on improving swallowing function and oral diet intake in patients with dysphagia. Show more

Keywords: Dysphagia, stroke, electrical stimulation, rehabilitation

DOI: 10.3233/BMR-181133

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 637-644, 2020

Authors: Kim, Soo-Yong | Dvir, Zeevi | Oh, Jae-Seop

Article Type: Research Article

Abstract: BACKGROUD: Although the effect of exercise in patients during the subacute and/or chronic subacromial impingement syndrome has been reported, only a few studies have examined the effect of pain free exercise in the acute phase of this disorder. OBJECTIVE: To compare the effect of training using the Neurac technique which combines body segments suspension and vibration vs. manual therapy, on various relevant outcome parameters in patients with acute subacromial impingement syndrome (PASIS). METHOD: Twenty-six patients underwent a 4 week intervention program. Using random assignment, half of the patients were treated using the Neurac …device while the other half was treated using manual therapy. The outcome parameters consisted of shoulder pain, shoulder function, range of motion (ROM) and the isokinetic strength of the external and internal rotators at 60 and 180 ∘ /s. RESULTS: Following either modes of interventions, the pain, function, and ROM improved significantly compared to pre-intervention levels in both groups. Time-by-group interaction was observed for the rotational strength which increased significantly and exclusively in the Neurac group. CONCLUSIONS: Given its positive effect on shoulder pain, function, ROM and the isokinetic strength of the external and internal rotators, we recommend the application of the Neurac technique in PASIS. Show more

Keywords: Manual therapy, Neurac, shoulder impingement syndrome

DOI: 10.3233/BMR-170884

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 645-653, 2020

Authors: Lemos, Júlia Ribeiro | da Cunha, Felipe Amorim | Lopes, Agnaldo José | Guimarães, Fernando Silva | do Amaral Vasconcellos, Fabrício Vieira | dos Santos Vigário, Patrícia

Article Type: Research Article

Abstract: BACKGROUND: Respiratory muscle training (RMT) has been recommended to mitigate impacts of spinal cord injuries (SCI), but the optimal dosage in terms of the frequency, intensity, time, and type (FITT principle) to promote health in SCI individuals remains unclear. OBJECTIVE: To discuss research related to the effects of RMT on pulmonary function, respiratory muscle strength and cardiorespiratory fitness in athletes and non-athletes with SCI, presenting the FITT principle. METHODS: We performed a systematic review. PubMed, Lilacs, Scopus, Web of Science, PEDro, SciELO and Cochrane databases were searched between 1989 and August 2018. Participants …were athletes and non-athletes with SCI. RESULTS: 4,354 studies were found, of which only 17 met the eligibility criteria. Results indicated that RMT is associated with beneficial changes in pulmonary function and respiratory muscle strength and endurance among athletes and non-athletes, whereas no effect was reported for maximal oxygen uptake. It was not possible to establish an optimal RMT dose from the FITT principle, but combined inspiratory/expiratory muscle training seems to promote greater respiratory changes than isolated IMT or EMT. CONCLUSION: The use of RMT elicits benefits in ventilatory variables of athletes and non-athletes with SCI. However, it remains unclear which RMT type and protocol should be used to maximize benefits. Show more

Keywords: Rehabilitation, breathing exercises, sports, oxygen consumption, paraplegia, quadriplegia

DOI: 10.3233/BMR-181452

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 655-667, 2020

Authors: Park, Hyunju | Lim, Wootaek | Oh, Dasom

Article Type: Research Article

Abstract: BACKGROUND: Leaning forward has been accepted as a foundational approach to facilitate trunk-stabilizing muscles in the abdominal and lumbopelvic regions for patients with back pain during rehabilitation. However, how trunk muscles are activated and recruited during leaning forward performed under dynamic upper-extremity motion conditions is not completely understood. OBJECTIVE: To determine whether activation of selected trunk muscles changes depending on shoulder movements during leaning forward exercise in healthy young adults. METHODS: Twenty-four healthy adults (6 men and 18 women) participated in this study. The participants performed 3 types of leaning forward exercises: leaning forward …alone (leaning forward 1), leaning forward with horizontal shoulder abduction (leaning forward 2), and leaning forward with shoulder flexion (leaning forward 3). Surface electromyography (EMG) was used to record activation of the erector spinae (ES), multifidus (MF), rectus abdominis (RA), and internal oblique (IO) on the dominant side. RESULTS: There was a significant main effect of exercise type on the activation of the IO, RA, and MF muscles. Activation of the IO and MF during leaning forward 1 was significantly decreased compared to activation in leaning forward 2 and 3; the activation of IO and RA showed the greatest increase during leaning forward 3. Furthermore, the IO/RA ratio was significantly increased during leaning forward 2 and 3 in comparison to leaning forward 1; the MF/ES ratio was also significantly increased during leaning forward 3, compared with leaning forward 1. CONCLUSION: The integration of shoulder movements during leaning forward exercises could be effective in the facilitation of EMG activity of IO and MF muscles, especially with shoulder flexion. Show more

Keywords: Leaning exercise, trunk stability, upper-extremity movement

DOI: 10.3233/BMR-181235

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 669-675, 2020

Authors: Kato, Satoshi | Inaki, Anri | Murakami, Hideki | Kurokawa, Yuki | Mochizuki, Takafumi | Demura, Satoru | Yoshioka, Katsuhito | Yokogawa, Noriaki | Yonezawa, Noritaka | Shimizu, Takaki | Kinuya, Seigo | Tsuchiya, Hiroyuki

Article Type: Research Article

Abstract: OBJECTIVE: We developed an innovative exercise device for the abdominal trunk muscles (ATMs) that has a built-in system to measure muscle strength. We aimed to examine the reliability of the strength measurement as well as the effect of strengthening using the device. METHODS: Twenty healthy adults participated in a reliability study of the muscle strength measurement. The first and second measurement were done in one day with an hour rest interval by raters 1 and 2, and the third by rater 1 following a one-week interval. We calculated the intraclass correlation coefficient (ICC). Another seven healthy …men participated in a training program using the device, consisting of strengthening twice a week for 5 weeks. ATM strength was measured before and after the training period, and a positron emission tomography (PET) scan series was performed, consisting of examinations during rest before training (control condition) and during exercise after training (training condition). RESULTS: The intra-rater (ICC = 0.95) and inter-rater (ICC = 0.99) reliability of the strength measurement were excellent. ATM strength was significantly higher after training than before. 18 F-fluorodeoxyglucose accumulation within the diaphragm, abdominal rectus, abdominal external and internal oblique, transverse abdominal, and levator ani muscles was significantly higher in the training condition than in the control. CONCLUSIONS: Our innovative device showed excellent reliability to quantify ATM strength. Strengthening using the device increased strength and activated the abdominals, diaphragm, and pelvic floor muscles. Show more

Keywords: Abdominal trunk muscle, innovative exercise device, muscle strength measurement, strengthening exercise

DOI: 10.3233/BMR-181419

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 677-684, 2020

Authors: Boudreau, Nicolas | Brochu, Felix-Olivier | Dubreuil, Louis-Michel | Laurendeau, Thierry | Leblanc, Olivier | De Vette, Emmanuelle | Tousignant-Laflamme, Yannick

Article Type: Research Article

Abstract: BACKGROUND: Recent technologies, such as the iPod, are often equipped with an accelerometer and magnetometer, which, through software applications, can perform various inclinometric functions. These applications have the potential to measure and quantify range of motion (ROM). OBJECTIVE: The purpose of this study was to estimate the iPod “Gyroscope” application intra- and inter-rater reliability as well as its criterion validity in healthy participants lumbar ROM assessment. METHODS: The sample consisted of 29 healthy participants. For the estimation of intra- and inter-reliability, two examiners measured the lumbar ROM of each participant twice using the …iPod. To estimate the criterion validity, the measures were compared to those obtained with the Back Range of Motion Device (BROM; lateral flexion) and the double inclinometer (flexion and extension). Reliability and validity were then established using the intraclass correlation coefficient (ICC). RESULTS: We observed a moderate to high intra-rater reliability (ICCs = 0.67–0.91) and a moderate to high inter-rater reliability for each movement (ICCs = 0.72–0.89). For the criterion validity, the ICCs were all high (ICCs = 0.65–0.89). CONCLUSION: Our results provide evidence that the iPod “Gyroscope” application can be used to assess lumbar ROM for all movements. Show more

Keywords: Range of motion, outcome measures, reliability, criterion validity, iPod, lumbar spine, digital inclinometer

DOI: 10.3233/BMR-181184

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 685-692, 2020

Authors: Celik, Derya | Argut, Sezen Karaborklu | Türker, Nilgün | Kilicoglu, Onder Ismet

Article Type: Research Article

Abstract: BACKGROUND: Patellofemoral pain (PFP) is one of the most common disorders of the knee. Neuromuscular electrical stimulation (NMES) is often assumed by clinicians to be an effective adjunctive therapy to quadriceps strengthening. OBJECTIVE: The aim of this study was to assess the efficacy of superimposed NMES combined with strengthening exercises to improve the recovery of quadriceps strength and function in patients with PFP. METHODS: This study was planned as a single blind randomized controlled pilot study. A total of twenty-seven patients diagnosed with PFP were randomly assigned into 2 groups. Patients received superimposed …NMES in addition to the standardized program (Group I) or only the standardized program (Group II). The patients in both groups were treated 3 times a week for 6 weeks and followed at 12 weeks. Primary outcome measure was quadriceps isokinetic muscle strength. The changes in dependent variables before treatment, 6 th , and 12 th weeks were analyzed using a 2 × 3 mixed-model analysis of variance. RESULTS: There were significant improvements in the within groups statistics of all parameters for both groups (p < 0.05). No differences in quadriceps strength, Kujala and Lysholm scores between groups were found at the different time points [F (2, 21) = 0.86; p = 0.12, F (2, 21) = 0.001; p = 0.97, F (2, 21) = 0.12; p = 0.73, respectively]. CONCLUSIONS: The results indicate that superimposed NMES combined with the standardized rehabilitation program has no clinically significant superiority to standardized rehabilitation program alone. Show more

Keywords: Muscle strength, anterior knee pain, electrical stimulation, electrotherapy, NMES

DOI: 10.3233/BMR-181339

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 693-699, 2020

Authors: Demirhan, Bilal | Günay, Mehmet | Canuzakov, Kanat | Kılıç, Mehmet | Güzelbektes, Hasan | Patlar, Süleyman

Article Type: Research Article

Abstract: BACKGROUND: Regular exercise activities affect blood cells. OBJECTIVE: The purpose of this study was to evaluate the seasonal evaluation of some hematological and biochemical parameters of the Olympic Greco-Roman wrestlers. METHODS: A total of three measurements were performed on wrestlers: immediately before the training period, three months and six months after the training session. Hematological and biochemical parameters were analyzed by taking sufficient blood samples from the athletes before and after exercise. RESULTS: The total leukocyte, lymphocyte, and neutrophil values were found to be significantly higher (p < …0.05) in all three measures (beginning, 3rd and 6th months) in comparison with the values before exercise. When biochemical analyses were examined, blood glucose levels were significantly decreased after exercise in all three measures compared to before exercise. Post-exercise HDL cholesterol concentrations significantly increased (p < 0.05) while LDL cholesterol concentrations significantly decreased (p < 0.05). CONCLUSION: On all three measures fatigue exercise has significantly increased the total leukocyte, lymphocyte and neutrophil values of wrestlers, while other, hematological parameters were not affected evenly. Fatigue exercise also significantly reduced blood glucose levels and LDL cholesterol concentrations, while HDL cholesterol concentrations were increased. The six-month period training did not have a significant effect on both hematologic and biochemical parameters in all three measurements. Show more

Keywords: Biochemical parameters, exercise, hematological parameters, skeletal muscle damage, wrestling

DOI: 10.3233/BMR-181363

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 701-709, 2020

Authors: Kandemirli, Guzin Cakir | Basaran, Murat | Kandemirli, Sedat | Inceoglu, Lale Altan

Article Type: Research Article

Abstract: BACKGROUND: Pain is a significant cause of disability in knee osteoarthritis. Conventional radiography is widely used in the assessment of knee osteoarthritis, however radiographic findings do not correlate well with pain. Ultrasonography can be used to evaluate the soft tissue structures of the knee that can be related to pain. OBJECTIVE: To evaluate pain-related soft tissue structures of the knee with ultrasonography. METHODS: This cross-sectional study included a total of 198 knees from 99 patients with knee osteoarthritis. Knee pain and functional status were evaluated by performing visual analogue scale (VAS) and Western …Ontario and McMaster Universities Osteoarthritis Index (WOMAC). On the ultrasound, cartilaginous thickness, knee effusion and presence of Baker’s cyst were assessed and the correlation to pain was investigated. RESULTS: Baker’s cyst was significantly more frequent in symptomatic knees (13.9%) compared to asymptomatic knees (2.5%). Patients with Baker’s cyst had a significantly more limited degree of knee flexion, significantly higher resting VAS pain scores and worse WOMAC scores compared to patients without Baker’s cyst. In log-linear analysis, presence of Baker’s cyst increased the risk of pain by 2.94 times. CONCLUSION: Ultrasound as a modality that is easily accessible, inexpensive and without radiation exposure is helpful to demonstrate factors related to pain in knee osteoarthritis by allowing assessment of soft tissue structures. Show more

Keywords: Baker’s cyst, ultrasonography, knee pain, effusion, WOMAC

DOI: 10.3233/BMR-191504

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 4, pp. 711-717, 2020