Journal of Back and Musculoskeletal Rehabilitation - Volume 34, issue 4
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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: Many non-drug interventions for decreasing non-specific chronic low back pain (NSCLBP) in nurses have been extensively studied, but the most effective approach is still unclear. OBJECTIVE: This systematic review and network meta-analysis evaluated the efficacies of 12 non-drug interventions in reducing NSCLBP in nurses. METHODS: PubMed, ScienceDirect, Web of Science, Cochrane, EMBASE, CINAHL, Medline, WANFANG, VIP, China Knowledge Integrated, and SinoMed were searched from their establishment to July 2019. Randomized controlled trials (RCTs) comparing non-drug interventions for NSCLBP in nurses were included and analyzed using Stata v15 statistical software. RESULTS:…A total of 31 RCTs (n = 7116) and 12 non-drug interventions were included. The first three results with the highest surface areas under the curve ranking area (SUCRAs) were low back exercise plus healthy education, single low back exercise, and yoga (SUCRAs: 79.4%, 76.2%, and 75.1%, respectively). In addition, single yoga was inferior to protective equipment (standardized mean difference [SMD] = 3.88, 95% confidence interval [CI]: 0.92 to 6.84) and multidisciplinary intervention (SMD = - 4.06, 95% CI: - 7.33 to - 0.78). CONCLUSIONS: Low back exercise plus health education may be the best approach to reduce NSCLBP in nurses. Considering the heterogeneity, our findings need to be confirmed in future multicenter large sample RCTs in different countries.
Abstract: BACKGROUND: Explaining pain to patients through pain neuroscience education (PNE) is currently a widespread treatment studied in the musculoskeletal context. Presently, there is sufficient evidence supporting the effectiveness of PNE in patients with chronic musculoskeletal disorders. However, clinicians must pay attention to the actual possibility to transfer research findings in their specific clinical context. OBJECTIVE: We analysed the applicability of results of studies focused on PNE, which has not been done previously. METHODS: A detailed discussion on PNE applicability is provided, starting from published randomized controlled trials that investigated the effectiveness of PNE.…RESULTS: This paper markedly points out the awareness of clinicians on the need for an accurate contextualization when choosing PNE as an intervention in clinical practice.
Abstract: BACKGROUND AND OBJECTIVE: This study investigated whether equine riding affects static or dynamic mechanical contractions on the thighs and trunk muscles in inactive women. METHODS: Participants consisted of 30 women with a mean (SD) age of 21.06 (0.44) years. They were randomly allotted as follows: equine group (EQG, n = 15) and control group (CON, n = 15). Two types of muscle contraction properties in their thighs and trunk were measured through a tensiomyography (static muscle tester) and an isokinetic device (dynamic muscle tester), respectively. Using…the body weights of EQG and CON as covariates, a 2-way between-groups multivariate analysis of covariance was used to investigate group differences in the mechanical quantification of the thighs and trunk. RESULTS: The effectiveness of 8 weeks of equine riding was hardly observed in a static muscle test, whereas in the dynamic muscle test, the dominant and non-dominant hip extensor/flexor, the dominant hip abductor/adductor, and trunk extensor in the EQG showed a significant increase, compared to no changes in the CON. CONCLUSIONS: This study did not find any particular differences in a static muscle test in inactive women, but showed improvements in the dynamic mechanical properties of the thighs and trunk, which are major muscle groups related to spinal alignment.
Abstract: BACKGROUND: Neuromuscular diseases are characterized by the compromise of respiratory muscles, thoracic ventilation, muscle strength and coughing capacity. Patients have low quality of life and increased morbidity and mortality mostly due to respiratory impairment. OBJECTIVE: To assess the benefits of adding inspiratory muscle training to neuromuscular patients’ treatment and their compliance to the approach. METHODS: We conducted a single-center prospective study with neuromuscular patients with decreased maximal inspiratory pressure. We developed an inspiratory muscle training protocol with three-month duration and once-daily training. The protocol had a progressive intensity that was individually tailored based…on patients’ baseline characteristics and tolerance. We used Powerbreathe Medic Classic devices to perform the training. RESULTS: There were 21 patients who met the inclusion criteria and were enrolled in the study. Muscular dystrophy (n = 12, 57.3%) and amyotrophic lateral sclerosis (n = 4, 19%) were the most common diseases. After three months of training, patients increased their maximal inspiratory muscle pressure (p = 0.002) and peak cough flow (p = 0.011). Compliance to the protocol was 99 ± 5.5%. CONCLUSIONS: This protocol showed significant improvements on pulmonary muscles function and might be considered as an adjunct treatment to neuromuscular treatment. However, these positive results require larger further studies to validate the clinical benefits long-term.
Abstract: BACKGROUND: Although carpal tunnel syndrome (CTS) is a common neuromuscular disorder, studies on its conservative treatment are inadequate and contradictory. OBJECTIVES: This study aimed to investigate and compare the effectiveness of low power laser therapy (LPLT) and Kinesio taping (KT) for the treatment of CTS. METHODS: Sixty patients with CTS were included in this study. One group received 15 sessions of KT, and the second group underwent 15 sessions of LPLT within three weeks. All patients were assessed with hand grip strength (HGS), Visual Analogue Scale (VAS)-pain, Douleur Neuropathique-4 (DN4) score, Boston Questionnaire…(BQ), and electroneuromyography before and after treatment. RESULTS: Before treatment, all clinical and neurophysiological parameters were similar between the groups. After treatment, both groups significantly improved in terms of HGS, VAS-pain, DN4, and BQ. However, the LPLT group had significantly better HGS, VAS-pain, DN4, and BQ than the KT group. In addition, while median nerve motor distal latency and median nerve sensory conduction velocity improved significantly with treatment in both groups, the LPLT group’s improvement was significantly better than that of the KT group. CONCLUSIONS: In patients with CTS, both LPLT and KT were effective treatments. However, the LPLT group had significantly better improvements than the KT group.
Abstract: BACKGROUND: Neck is one of the most common sites of musculoskeletal symptoms, and muscle shortening and weakness is observed to be a common cause of neck pain and disability. OBJECTIVE: To compare the immediate and short term effects of static stretching (SS), autogenic inhibition (AI) and reciprocal inhibition (RI) muscle energy techniques (MET) on isometric muscle strength in the management of mechanical neck pain. METHODS: A randomized controlled trial was conducted on 78 participants with neck pain randomly allocated to SS, AI-MET and RI-MET groups. All the participants received Trans Cutaneous Electrical Nerve…Stimulation (TENS), hot pack and unilateral postero-anterior glide, followed by 3–5 repetitions of either SS, AI-MET or RI-MET for five consecutive sessions. Numeric pain rating scale (NPRS) and Modified Sphygmomanometer Dynamometry (MSD) were used as outcome measurement tools. One way ANOVA and repeated measures ANOVA were used for inter-group and intra-group comparison. RESULT: In terms of MSD scores, a significant difference (p < 0.05) was observed between the groups. Both AI-MET and RI-MET were found to be comparatively more effective than SS, however AI-MET was found to be the most effective. CONCLUSION: AI-MET is more effective than SS and RI-MET in terms of improving isometric muscle strength in patients with mechanical neck pain.
Abstract: BACKGROUND: Persisting shoulder stiffness adversely affects quality of life by causing pain and motion restrictions especially in patients with diabetes. OBJECTIVE: The aim of this study was to evaluate the outcomes of arthroscopic capsular release in patients with idiopathic shoulder stiffness. METHOD: A literature search was conducted in electronic databases and studies were selected by following precise eligibility criteria. Random-effects meta-analyses were performed to estimate the changes at latest follow-up in scores of the Constant, American Shoulder and Elbow Surgeons (ASES), and University of California at Los Angelis (UCLA) scales, Visual Analogue Scale…(VAS), and shoulder range of motion. RESULTS: Nineteen studies were included. The follow-up duration was 42 months [95% confidence interval (CI): 32, 51]. Improvements in scores of the Constant, ASES, UCLA scales, and VAS were 48.3 [95% CI: 38.0, 58.6], 44.6 [95% CI: 24.6, 64.6], 19.3 [95% CI: 16.6, 22.0], and - 6.1 [95% CI: - 6.9, - 5.4] respectively (P < 0.05 all). Improvements in the shoulder range of motion were: abduction 82.0 [95% CI: 65.0, 98.9]; forward flexion 75.9 [95% CI: 59.7, 92.1]; external rotation 43.2 [95% CI: 37.5, 49.0]; and internal rotation 25.4 [95% CI: 15.2, 35.5] degrees; P < 0.05 all). CONCLUSION: Arthroscopic capsular release effectively improves shoulder function in patients with idiopathic shoulder stiffness.
Keywords: Shoulder, stiffness, capsular release, arthroscopy, range of motion
Abstract: BACKGROUND: Studies investigating the association between developmental dysplasia of the hip (DDH) and risk factors in Saudi Arabia are rare. OBJECTIVE: Investigate the association between DDH and several risk factors among Saudi children. METHODS: The medical records of 82 children born in or admitted to King Abdul Aziz Medical City in Riyadh, Saudi Arabia with clinical suspicion of hip dislocation (HD) were included. The association between DDH and the following risk factors was investigated: age < 3 y, female-gender, twinning, first-born child, C-section, breech presentation, prematurity, positive family history and…presence of associated abnormalities. RESULTS: HD was confirmed in 73 (89%) children (Positive HD) and excluded in 9 (11%) children (Negative HD). Eleven (13.4%) children were excluded from the positive cases as it was confirmed that they have paralytic hip dislocation not DDH. DDH was confirmed in 62 children (75.6%). The Chi square test (χ 2 ) and odds ratios (OR) revealed that the positive family history, female-gender, age < 3 years, and presence of associated abnormalities had significant associations with the presence of DDH with P values and OR equal 0.00 (16.4), 0.002 (3.1), 0.005 (2.6), and 0.04 (1.9) respectively. Breech presentation, twinning, first-born children, prematurity, and C-section were not associated with DDH with P values and OR equal 0.93 (1.1), 0.46 (0.4), 0.11 (0.4), 0.08 (0.3), and 0.002 (0.3) respectively. CONCLUSIONS: Positive family history, female-gender, age < 3 years, and presence of associated abnormalities had approximately 16, 3, 2.5, and 2 times increased risk for DDH.
Keywords: Developmental dysplasia of the hip, risk factors, twinning, first-born, C-section, breech, prematurity, positive family history
Abstract: BACKGROUND: Lumbar X-rays are usually preferred in patients with lower back pain, but lumbar spinal stenosis (LSS) cannot be directly observed on lumbar X-ray films. OBJECTIVE: The purpose of this study is to explore the correlation between the degree of single-segment central LSS and lumbar X-ray measurements. METHODS: The data of 60 male patients aged 39–78 years with single-segment central LSS were analyzed. Linear correlation analysis was used to determine the correlation between the single-segment central LSS and the various measurement parameters. Multiple linear regression analysis was used to analyze the factors affecting…single-segment central LSS. RESULTS: There were significant differences in S 1 /S 0 , E, B, L 1 - 5 Cobb, and M among the three groups (p < 0.05). S 1 /S 0 was positively correlated with E, B, L 1 - 5 Cobb, and M (p < 0.05), but was not correlated with D (p = 0.66). After multiple linear regression analysis, B, L 1 - 5 Cobb, and M were independently associated with S 1 /S 0 . CONCLUSIONS: The B, L 1 - 5 Cobb, and M parameters were independently associated with single-stage central LSS, and would likely be of particular value in evaluating the degree of single-segment central LSS; B, L 1 - 5 Cobb, and M served as independent predictors of the degree of LSS. These findings will guide clinicians’ decision-making in the future.