Journal of Back and Musculoskeletal Rehabilitation - Volume 34, 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: Health anxiety is often associated with musculoskeletal symptoms and gender, but there are limited studies that investigate these relationships during the COVID-19 pandemic. OBJECTIVE: We aimed to compare the genders regarding health anxiety and musculoskeletal symptoms during the COVID-19 pandemic and to investigate the relationship of musculoskeletal symptoms with physical activity and health anxiety. METHODS: Assessments were performed through an online questionnaire. Eighty-five males and eighty-five females were included by matching genders in terms of age, body mass index, education level, number of days spent at home during the pandemic, and physical…activity. The Short Health Anxiety Inventory, the International Physical Activity Questionnaire-Short Form, and the Nordic Musculoskeletal Questionnaire were used to assess health anxiety, physical activity, and musculoskeletal symptoms, respectively. RESULTS: Females had a higher level of health anxiety and more musculoskeletal symptoms than males (p < 0.05). There were weak to moderate correlations in females and weak correlations in males between musculoskeletal symptoms and health anxiety (p < 0.05). Also, a weak negative correlation was found between physical activity and musculoskeletal symptoms in both genders (p < 0.05). CONCLUSIONS: Females are more anxious and have more musculoskeletal symptoms during the pandemic than males. Also, health anxiety is related to musculoskeletal symptoms in both genders.
Keywords: Pandemic, COVID-19, health anxiety, musculoskeletal pain, musculoskeletal symptoms
Abstract: BACKGROUND: Femoral neck fractures often occur in the elderly, which usually results in hip pain. OBJECTIVE: The purpose of this study was to evaluate the difference in the treatment of Pauwels type III femoral neck fractures with medial femoral support plate combined with cannulated screws and cannulated screws alone. METHODS: PubMed, ScienceDirect, China Academic Journals Full-text Database (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), Embase and Cochrane Library were used to collect clinical controlled trials of the medial femoral support plate combined with hollow screw internal fixation and simple hollow screw internal…fixation for Pauwels type III femoral neck fracture. RESULTS: Seven articles (n = 409 cases) were evaluated for quality and included in this meta-analysis. Four hundred and nine patients with Pauwels type III femoral neck fractures were included: 202 in the experimental group and 207 in the control group. The results showed that, compared with simple hollow screw internal fixation, the medial femoral support plate combined with hollow screw internal fixation has a longer operation time (MD = 23.05, 95% CI = 13.86–32.24), and more intraoperative blood loss (MD = 91.55, 95% CI = 50.72–132.39), shorter healing time (MD = - 1.48, 95% CI (- 1.71, - 1.26)), lower incidence of complications (RR = 0.34, 95% CI = 0.19–0.61), lower VAS score (MD = - 1.28, 95% CI (- 1.83, - 0.72)), and higher Harris score (MD = 8.49, 95% CI (4.15, 12.83)). CONCLUSION: Medial femoral plate combined with cannulated screw for Pauwels type III femoral neck fracture can shorten healing time, reduce postoperative complications, and improve the postoperative Harris score.
Keywords: Internal fixation, Pauwels type III, femoral neck fracture, meta-analysis
Abstract: BACKGROUND: The Muscle Energy Technique (MET) is one of the treatments of choice for the management of chronic mechanical low back pain (MLBP); however, there is a paucity of evidence to justify its effectiveness. OBJECTIVES: The objectives of this review are to explore, analyze and summarize the available evidence related to the effectiveness of MET in the management of chronic MLBP. METHOD: The scoping review methodology was adopted based on a recommendation from the work of Arksey and O’Malley, to systematically appraise literature and map the existing evidence on the effectiveness of MET…in the management of chronic MLBP. A systematic search was performed comprising of an electronic search of online databases using key search terms and subsided by a hand search to identify the existing literature on the topic which was summarized and discussed. RESULT: Initially 25,195 hits were identified which were screened to examine their eligibility based on predetermined inclusion criteria after removing duplicate articles. Eleven articles met the inclusion criteria and were discussed. CONCLUSIONS: Generally there exists a scarcity of published articles on the effect of MET in chronic MLBP. However, the analysis of the retrieved articles showed that the MET procedure is a favourable intervention that is safe (i.e. no adverse effects) and can be effective as a standalone treatment or in combination with other treatment strategies for patients with chronic MLBP with the potential to provide numerous physical and psychosocial benefits.
Keywords: Muscle Energy Technique, manual therapy, chronic mechanical low back pain, dysfunction, disability and health
Abstract: BACKGROUND: Adhesive capsulitis is a debilitating condition which causes the capsule of the gleno-humeral joint to thicken and contract progressively. The effectiveness of various non-operative methods has been demonstrated to improve the pain, range of motion (ROM) and functional status of patients with adhesive capsulitis. OBJECTIVE: This study aims to review recent evidence on the efficacy of physiotherapy interventions in the treatment of adhesive capsulitis. METHODS: PubMed, Physiotherapy Evidence Database (PEDro), Science Direct and Cochrane databases were searched for studies published since 2013. The search terms included: Frozen shoulder, adhesive capsulitis, physical therapy,…rehabilitation, manual therapy, mobilization, exercise, education, and electrotherapy. The search was limited to studies published in English and studies that used human subjects. RESULTS: Quality scores of 33 articles were reviewed according to the Sackett’s critical appraisal criteria and the grades of recommendation were determined for physiotherapy interventions used in the studies. CONCLUSION: The empirical evidence suggests that certain physical therapy techniques and modalities are strongly recommended for pain relief, improvement of ROM, and functional status in patients with adhesive capsulitis, while others are either moderately or mildly recommended. However, the efficacy of one treatment modality over another is uncertain. The poor methodological rigors demonstrated in most of the reviewed studies emphasize the urgent need of properly conducted, adequately sampled randomized controlled trials with adequate follow up to determine the superior combination of treatment.
Keywords: Bursitis, exercise, outcome assessment, pain, physical therapy modalities, range of motion, adhesive capsulitis, frozen shoulder
Abstract: BACKGROUND: The struggle with pain often interferes with the ability of chronic low back pain (CLBP) patients to pursue important life values due to psychological inflexibility. OBJECTIVE: This research examined life values, related inhibitors and facilitators relevant to personalized therapy planning. METHODS: Two hundred and forty-four CLBP patients completed the Chronic Pain Values Inventory (CPVI). Of these, 68 patients were interviewed to assess inhibitors and facilitators related to life values. Mixed-effects models quantitatively examined differences in the values, structuring content analysis served to qualitatively analyze the interviews. RESULTS: Participants rated…the value “family” as being of highest importance and success. The largest discrepancy between importance and success was found for “health”. Content analyses revealed a broad range of inhibitors and facilitators related to the examined life values with the highest number of inhibitors related to “work”. Facilitators were also found to be of relevance to all life values, but to a lower extent than inhibitors. CONCLUSIONS: The perceived importance and success of life values and their related inhibitors and facilitators may differentially affect CLBP patients. Considering such individual aspects is therefore of utmost importance to improve patient care, as they enable treatment goals and the therapeutic strategies to be adapted accordingly.
Keywords: Low back pain, life values, psychological flexibility, inhibitors, facilitators
Abstract: BACKGROUND: Despite the fact that non-specific low back pain (LBP) is a frequent symptom, its management remains suboptimal in primary care. A plausible reason is the persistence of erroneous fears and beliefs among general practitioners (GPs). OBJECTIVE: We aimed to determine the core qualities an educational program should have to reduce erroneous fears and beliefs about LBP among GPs. METHODS: We used a two step-approach. In the first step, meaningful qualities were collected using comprehensive data source triangulation from GPs, experts and literature. In the second step, qualities were extracted by three independent…investigators in a standardized manner using the Template for Intervention Description and Replication checklist. RESULTS: Qualities were collected from 8 GPs, 24 experts and 15 articles. Extraction revealed a wide range of qualities depending on participants’ background and literature. After consensus between investigators, the most meaningful qualities included evidence-based messages and web-based interventions (videos and classes) delivered by a multidisciplinary panel of experts. We found no systematic trend for when and how much, and how to tailor the intervention. CONCLUSIONS: Data source triangulation revealed that the core qualities of an educational program targeting fears and beliefs about LBP among GPs should include evidence-based information, web-based interventions and a multidisciplinary panel of experts. Our findings will help us to design a provisional targeted educational intervention. This will be further assessed in a mixed-method feasibility study and then in a randomized controlled trial.
Keywords: Non-specific low back pain, fears and beliefs, education, general practitioners
Abstract: BACKGROUND: Patients with fibromyalgia syndrome (FMS) often have sleep problems and balance disorders. OBJECTIVE: The aim of the study was to examine sleep quality and balance disorders and the relationship between sleep quality and balance, functional status and the frequency of falls in patients with FMS. METHODS: Fifty women with FMS and 50 healthy women were included in the study. Sleep quality was assessed with the numeric rating scale (NRS) and the Pittsburgh Sleep Quality Index (PSQI) and balance and balance self-confidence were assessed with the Berg Balance Scale (BBS) and Activities-Specific Balance…Confidence (ABC) Scale, respectively. Functional status and symptom severity of patients were assessed with the Fibromyalgia Impact Questionnaire (FIQ) and the Symptom Impact Questionnaire (SIQR). The number of falls in the last six months were recorded. RESULTS: In the patient group, sleep quality scores were significantly higher, and BBS and ABC scores were significantly lower than the control group. NRS scores were significantly correlated with the BBS, FIQ, and SIQR scores, and the PSQI scores were significantly correlated with the BBS and ABC scores and the number of falls in FMS. CONCLUSION: This study showed that the prevalence of sleep and balance disorders is higher in FMS patients. A relationship was reported between the sleep quality and balance and functional status and frequency of falls.
Abstract: BACKGROUND: The straight leg raise test (SLR) is one of the most performed physical tests for mechanosensitivity and impairment of the nervous system. According to the anatomy of the tibial nerve, ankle dorsiflexion and eversion movements could be used to perform the tibial neurodynamic test (TNT). To date, no study has documented the normal responses of the TNT. OBJECTIVE: To document normal responses of the TNT in asymptomatic individuals and to investigate influences from sex and leg dominance. METHODS: A cross-sectional study with 44 asymptomatic volunteer subjects, a total of 88 lower limbs,…was carried out. The range of motion (ROM), quality, and distribution of sensory responses were recorded. The hip flexion ROM was measured when subjects reported an intensity of their symptoms of 2/10 (P1) and 8/10 (P2). RESULTS: The mean ROM for hip flexion at P1 was 44.22 ± 13.13 ∘ and 66.73 ± 14.30 ∘ at P2. Hip flexion was significantly greater at P2 than P1 (p < 0.001). However, it was not different between sex or limbs (p > 0.05). The descriptor of the quality of sensory responses most often used by participants was stretching (88.6% and 87.5% for P1 and P2, respectively) in the popliteal fossa and posterior calf. CONCLUSIONS: This study describes the sensory responses of asymptomatic subjects resulting from the TNT. Our findings indicate that TNT responses are independent of the influence of sex or leg dominance.
Keywords: Tibial nerve, sensory response, leg dominance, sex
Abstract: BACKGROUND: Musculoskeletal disorders are of multi-factorial origin, including individual, physical, and psychosocial factors. An effective education program for musculoskeletal disorders should include predisposing factors. OBJECTIVE: This study aimed to examine the effect of risk factor education on pain intensity and disability levels compared to a home-based exercise program in office workers with nonspecific neck or low back pain. METHODS: A pilot cluster randomized clinical trial was conducted in 46 workers with neck or low back pain. The education group received checklists of risk factors and handbooks providing information on how to manage them.…The exercise group received a home-based exercise program to manage their neck or low back pain. The primary outcome measures were pain intensity and disability levels. RESULTS: There was no significant difference in pain intensity or disability level between groups at baseline and follow-ups. However, neck and low back pain intensity, but not disability level, at the 3-month and 6-month follow-ups was significantly lower than those at baseline in both groups. CONCLUSION: Risk factor education was not more effective than the home-based exercise program in terms of pain intensity or disability reduction in workers with nonspecific neck or low back pain.