Journal of Back and Musculoskeletal Rehabilitation - Volume 33, 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: BACKGROUND: The co-contraction of the core muscles has been reported as the key mechanism towards spinal stability. Classic Pilates exercises aimed at these muscles are known to improve the stability and strength of the trunk without damaging the deep structures of the spine. OBJECTIVE: To evaluate the co-contraction of the mobilizing (rectus abdominis; longissimus) and stabilizing (multifidus; internal oblique) trunk muscles during Pilates exercises – going up front, mountain climber, and swan. METHODS: Sixteen women, all Pilates practitioners, participated in the study. The stabilizing and mobilizing muscles of the trunk (right side) were…submitted to electromyography to calculate the percentage of co-contraction during the exercises. One-way repeated measures analysis of variance (ANOVA) was used to verify the difference in %COCON between stabilizers and mobilizers among the three exercises. The post-hoc Bonferroni test (P < 0.01) was applied when necessary. The paired t -test (P < 0.01) was used to verify the difference in %COCON between stabilizers and mobilizers separately for each exercise. RESULTS: The co-contraction values of the stabilizers were higher than those of the mobilizers for all exercises. The going up front (stabilizers) and the swan (mobilizers) exercises showed the highest %COCON values. CONCLUSIONS: The Pilates method is effective for either rehabilitating pathologies or training the trunk muscles in healthy individuals and athletes.
Abstract: BACKGROUND: Previous studies have indicated that the kinematics of the knee joint affect the trunk and pelvis during gait. However, the factors that influence trunk movement in knee osteoarthritis patients during gait after surgery remain unclear. OBJECTIVE: To examine the effect of total knee arthroplasty (TKA) on trunk movement during gait by comparing knee osteoarthritis patients with healthy controls. METHODS: Fourteen medial knee osteoarthritis patients who underwent initial unilateral TKA and 11 controls participated in this study. Knee and hip joint flexion and trunk and pelvic tilts during gait were acquired using a…three-dimensional motion analysis system. Knee joint range of motion, pain, and kinematic data were collected preoperatively and 1 year postoperatively for knee osteoarthritis patients. RESULTS: Knee extension limitation and pain significantly improved postoperatively compared with preoperative stages. Preoperatively, the peak anterior trunk tilt during the stance phase was significantly larger in osteoarthritis patients than in controls. The peak anterior trunk tilt during the stance phase was significantly smaller postoperatively than at preoperative stages. CONCLUSIONS: These results suggest that after TKA, the trunk movements of knee osteoarthritis patients were approximately equal to those of controls, with improvement in clinical outcomes such as knee extension limitation and pain.
Abstract: BACKGROUND: Balance and mobility impairments, declined musculoskeletal strength and performance, limited range of motion, and poor flexibility are fairly common among older adults. OBJECTIVES: To determine the lower extremity muscle force and to verify the correlation with the gait characteristics and balance in community dwelling older adults. METHODS: Seventy-five adults with a mean age of 75.07 ± 6.28 years were included in the study. All participants were evaluated with the following tests: half squat (HS), decline squat (DS), foot print analysis (step length, step wide, stride length, walking velocity and…cadence) and Tinetti Performance Oriented Mobility Assessment (POMA). RESULTS: HS and DS test scores were significantly correlated with Tinetti Balance and Gait Assessment scores and gait characteristics, except step wide (p < 0.01). The results of this study showed that the participants who have higher scores in the squat tests, showed higher scores in terms of POMA (p < 0.01). CONCLUSION: Appropriate and direct assessment of lower limb power and performance in balance and gait tests should be done to identify functioning of the older adults. Half and eccentric decline squat tests used in this study were useful, cheap and easy. The squat tests can be used to determine the relationship between balance and gait characteristics, in addition to predicting the musculoskeletal performance in older adults.
Abstract: INTRODUCTION: The effect of the absence or presence of the Palmaris longus tendon on pinch and grip strength was investigated in this study. Similarly, the effect of the presence or absence of the fifth superficial flexor digitorum on grip strength in the hand was studied. The aim of the present study was to assess the combined effect of these anatomical variations on pinch and grip strength. MATERIALS AND METHODS: In this cross-sectional study, 523 volunteers and their 1046 hands were enrolled. Each hand was assessed for the presence or absence of the Palmaris longus tendon and…for variations in the fifth superficial flexor digitorum function. Then the grip and pinch power of the hands were measured with the Jammar Dynamometer. RESULTS: The presence or absence of Palmaris longus had no effect on grip strength in the individuals studied. Likewise, variations in fifth superficial flexor digitorum function had no effect on grip and pinch strengths. But the results of statistical testing showed the effect of the presence of Palmaris longus on pinch strength (25.38 lbs in hands with Palmaris present vs 24.43 lbs in hands without Palmaris). Pinch and grip power was higher in men than in women and in the right hand than in the left. CONCLUSION: Based on the findings of the present study, it seems that absence of the Palmaris longus tendon is associated with a reduction in pinch strength but has no effect on grip strength, and the variations in the fifth superficial flexor digitorum (flexor digitorum superficialis, or FDS) have no effect on pinch and grip strengths.
Abstract: BACKGROUND: Cervicogenic headache (CeH) is among the common types of headache which has an undesirable influence on the quality of life. The myofascial trigger point (MTrP) within the sternocleidomastoid (SCM) muscle is one of the most important causes of CeH. OBJECTIVE: The purpose of this study was to compare the effect of dry needling (DN) and ischemic compression (IC) on the headache symptoms as well as MTrP-related features in subjects with CeH originating from MTrPs of the SCM muscle using a sonographic method. METHODS: A total of 29 female subjects aged 35.34 ±…12.19 on average with a clinical diagnosis of CeH originating from MTrP in the SCM muscle were randomly divided into the DN, IC, and control groups. Both DN and IC groups received 4 treatment sessions. Headache intensity, duration, frequency, MTrP elastic modulus, MTrP area, and pressure pain threshold (PPT) were assessed 2 weeks before and after treatments. RESULTS: In both DN and IC groups, a significant improvement was found in the headache intensity, duration, frequency, PPT, and MTrP area (P < 0.05). No significant differences were observed between DN and IC (P > 0.05). Pearson correlation revealed a significant correlation between headache intensity and the MTrP elastic modulus (P < 0.05). CONCLUSIONS: Both interventions could reduce headache symptoms, PPT, and MTrP area. Neither intervention was found to be superior to the other in short-term follow-up. IC may be preferred since it has fewer unwanted side effects compared to DN. Based on the data, it may be concluded that some MTrP biomechanical features such as stiffness may influence the produced headache symptoms.
Keywords: Cervicogenic headache, myofascial trigger point, physiotherapy, stiffness, ultrasonography
Abstract: BACKGROUND: Few studies have explored the relationship between muscle strength, range of motion (ROM), and balance in the horizontal plane of the hip joint using three-dimensional (3D) motion analysis. OBJECTIVE: We investigate the relationships of hip internal rotation (IR) and external rotation (ER) ROM, measured using a 3D motion capture system, with hip internal and external rotator strength and single-leg standing balance. METHODS: The participants were 40 healthy adults. Kinematic data on hip ROM were collected using an eight-camera motion analysis system. Hip rotational strength measurements were obtained using hand-held isometric dynamometry. A…Single-leg standing test and a pendular test were conducted to evaluate static and dynamic balance ability using BioRescue. RESULTS: Significant correlations were found between hip strength and each variable measured during hip ROM assessments (p < 0.05). Significant positive correlations were found between the hip IR/ER strength ratio and the IR/ER ROM ratio (r = 0.72, p < 0.01). The subgroup with a normal IR/ER ratio of hip rotator strength and ROM showed significantly better dynamic balance ability than the subgroup with a hip rotator muscle imbalance (p < 0.05). CONCLUSIONS: There is a significant relationship between hip IR/ER strength and IR/ER ROM with a normal hip IR/ER strength and ROM ratio positively affecting dynamic balance ability.
Keywords: Hip rotator muscle, hip rotation range, dynamic balance
Abstract: BACKGROUND: Restoration of functionality in patients with low back pain is one of the most important rehabilitation and societal problems. The aim of this study was to verify the results of the DBC (Documentation Based Care) method used in elderly men. METHOD: This study evaluated the efficiency of DBC treatment on the basis of spinal mobility in sagittal, frontal and transverse planes and a subjective assessment of pain. There were two research groups: one with 187 men over the age of 65, and the other with 187 men under the age of 65. The patients in…the study were carefully selected. All subjects suffered from chronic, non-specific low back pain lasting for a period of at least three months. CONCLUSION: The conducted analyses confirmed that a functional restoration process improved spinal mobility in all planes of movement, decreased pain and functional limitations, and reduced the level of depression.
Keywords: Spine disorders, active therapy, back pain, elderly people, DBC method
Abstract: BACKGROUND: There is a wide range of rehabilitation protocols after knee arthroscopic procedures, mainly based on specialist exercises. They comprise of specific stages and key moments but should also be individualized and adjusted to the patient’s needs. OBJECTIVE: The aim of the study was to evaluate the BodyFlow device impact on physical and psychological functioning of the subjects after knee arthroscopy. METHODS: Ninety three patients were randomly divided into the study and control group. Each study group subject performed mild electrostimulation using the BodyFlow device for three weeks, five times a day for…20 minutes along with the standard rehabilitation protocol. Control group subjects were treated according to the standard rehabilitation protocol after knee arthroscopy. Healthy and operated lower limb size, a range of the knee joint motion, and the flexor and extensor strength were measured 3, 6, and 9 weeks after arthroscopy. At each measurement, the SF-36 and KOOS surveys were collected. RESULTS: On study day 21, a positive, statistically significant, difference in the knee joint size, range of flection and extension, flexor and extensor strength as well as all KOOS survey subscales and physical functioning categories included in the SF-36 survey was observed. On study day 63, positive effects persisted and significant differences in other categories included in the SF-36 survey were observed. CONCLUSION: Application of mild electrostimulation using the BodyFlow device has a positive impact on the swelling in the knee joint region, range of motion, extensor and flexor strength as well as physical, psychological, and social functioning.
Keywords: Electrostimulation, arthroscopy, knee, surgery
Abstract: BACKGROUND AND OBJECTIVES: Low back pain (LBP) is one of the leading forms of chronic pain and is among the leading causes of pain and disability. In this study, we investigated the associations between the severity of disability and fear of movement and pain beliefs as well as the impact of the fear of movement and pain beliefs on the quality of life in patients with chronic LBP. METHODS: A total of 89 patients (42.29 ± 16.05 years) with chronic low back pain were included in the study. The instruments used in the assessments include…the Visual Analogue Scale (VAS), the Oswestry Disability Index (ODI), the Tampa Kinesiophobia Scale (TKS), the Pain Belief Questionnaire (PBQ), and the SF 36-Short Form. Patients were assigned into three groups by disability severity based on ODI scores. Statistical analysis was performed using SPSS 15. RESULTS: No statistically significant intergroup differences were found in TKS and PBQ scores (p > 0.05). A positive correlation was found between TKS scores, age (r : 0.227/p < 0.05), PBQ organic (r : - 0.250/p < 0.05) scores. CONCLUSIONS: Our study revealed high levels of kinesiophobia and similar pain beliefs, independent of the severity level of disability. We believe that cognitive-behavioral therapy that may reduce fear-avoidance behaviors and convert negative pain beliefs into positive ones should be added to rehabilitation procedures for LBP.
Keywords: Low back pain, kinesiophobia, pain belief, disability, quality of life
Abstract: BACKGROUND: Many previous studies have explored the effects of manual massage on back muscle fatigue, and most of the mechanical massage techniques imitate manual massage. However, it is unknown whether mechanical and manual massage have the same functions for exercise-induced back muscle fatigue. OBJECTIVE: To investigate the effects of mechanical bed massage on the biochemical markers of exercise-induced back muscle fatigue in male collegiate athletes. METHODS: Twenty-eight male collegiate athletes who met the experimental criteria were recruited in this randomized controlled trial, and randomly assigned to a mechanical bed massage group (experimental group)…or resting group (control group). The subjects performed eight bouts of reverse sit-up in the prone position and received 20 minutes of the intervention. Creatine kinase, blood lactate, and serum cortisol levels were measured at baseline, after fatigue, after intervention, and after 24 hours. RESULTS: The level of serum cortisol of the control group was significantly higher than that of the experimental group after the intervention (p < 0.05). The comparison of the two groups for blood lactate levels showed no significant differences at any of the measurement time-points (p > 0.05). There was no significant difference in creatine kinase levels immediately after the intervention (p > 0.05), but a significant difference in creatine kinase level was observed between the two groups 24 hours later (p < 0.05). CONCLUSIONS: Significant differences were observed between mechanical bed massage and rest condition on serum cortisol and creatine kinase for exercise-induced muscle fatigue. Therefore, mechanical bed massage may reduce stress and muscle damage for the athlete after training or competition.
Keywords: Mechanical bed massage, exercise-induced back muscle fatigue, biochemical markers