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: OBJECTIVE: The purpose of this study was to investigate the most effective ankle joint position for squat exercise by comparing muscle activities of lower extremity and erector spinae muscles in different ankle joint positions. METHODS: Thirty-seven normal healthy adults in their 20s participated in this study. Muscle activities of dominant vastus medialis oblique, vastus lateralis, biceps femoris, and erect spinae were measured in three ankle joint positions; dorsiflexion, neutral, and plantar flexion. RESULTS: Muscle activities of the vastus medialis oblique, vastus lateralis, and erector spinae muscles were statistically different in the three ankle…joint positions during squat exercise (p < 0.05). Vastus medialis oblique muscles showed higher muscle activity in ankle plantar flexion than in the dorsiflexion or neutral positions (plantar flexion > neutral position, + 3.3% of maximal voluntary isometric contraction (MVIC); plantar flexion > dorsiflexion, + 12.2% of MVIC, respectively). Vastus lateralis muscles showed 7.1% of MVIC greater muscle activity in the neutral position than in dorsiflexion, and erector spinae muscles showed higher muscle activity in dorsiflexion than in plantar flexion or in the neutral position (dorsiflexion > neutral position, + 4.3% of MVIC; dorsiflexion > plantar flexion, + 7.1% of MVIC, respectively). CONCLUSION: In squat exercises designed to strengthen the vastus medialis oblique, ankle joint plantar flexion is probably the most effective ankle training position, and the dorsiflexion position might be the most effective exercise for strengthening the erector spinae muscle.
Keywords: Squat exercise, muscle activity, ankle joint position, multi-joint position
Abstract: BACKGROUND: Hyperkyphosis (HKP) and forward head posture (FHP) occur due to prolonged poor postures and repetitive activities. OBJECTIVE: The present study aimed to compare the effects of the National Academy of Sports Medicine (NASM) and Sahrmann corrective exercises on HKP and FHP correction. METHODS: This quasi-experimental study was conducted on 30 subjects with HKP and FHP, who were randomly assigned to the NASM (n = 15) and Sahrmann groups (n = 15). The ImageJ software and a spinal mouse device were used to…measure FHP and HKP deformities, and neck and shoulder muscle strength, range of motion (ROM), and pulmonary function were assessed as the secondary outcomes before and after the eight-week intervention. RESULTS: FHP improved more significantly in the Sahrmann group compared to the NASM group (P < 0.05), while no significant difference was observed between the groups in HKP (P > 0.05). The improvement in the neck and shoulder muscle strength was more significant in the Sahrmann group compared to the NASM (P < 0.05), except for the neck flexors. In addition, the neck extension ROM enhanced more significantly in the Sahrmann group compared to the NASM group (P < 0.05). CONCLUSION: According to the results, the Sahrmann corrective exercises that focused on the correction of imbalanced muscle stiffness had more significant effects on the correction of FHP, neck and shoulder muscle strength and neck extension ROM.
Keywords: Forward head posture, hyperkyphosis, corrective exercises, pulmonary function
Abstract: BACKGROUND: The multifidus muscle is located near the spine and controls the erection of the spine and stabilization during movements of the spine and extremities, and assists in all other spinal movements. Differences in paraspinal muscles between sides and levels, particularly in he multifidus, have been proposed as possible indicators of low back pain or spinal pathology. OBJECTIVE: This study aims to examine the cross-sectional area of the lumbar multifidus muscle at L4-L5 vertebral levels on ultrasound images of athletes in Olympic-style weightlifting, judo athletes and sedentary individuals. METHODS: This study included asymptomatic…male athletes (athletes in Olympic-style weightlifting, n = 17, age: 19.24 ± 1.88, judo athletes, n = 17, age: 19.18 ± 1.23) and sedentary individuals (n = 17, age: 19.88 ± 1.31). The cross-sectional area of lumbar multifidus muscles was assessed bilaterally at the L4-L5 segments level in prone and using ultrasound imaging. RESULTS: Lumbar multifidus muscle cross-sectional areas of athletes in Olympic-style weightlifting and judo athletes were larger than those of sedentary individuals (p < 0.004). No asymmetric development was observed in cross-sectional areas of right-left lumbar multifidus muscle at L4-L5 levels of athletes in Olympic-style weightlifting and sedentary individuals (p > 0.008). The cross-sectional areas of the right and left lumbar multifidus muscle at L5 segment of individuals in judo athletes was found to be asymmetrical (p < 0.008). CONCLUSION: Our study shows that the cross-sectional areas of athletes in Olympic-style weightlifting and judo athletes are larger than that of sedentary individuals. The difference in the cross-sectional area of the lumbar multifidus muscle of athlete and sedentary groups might be said to result from hypertrophic effect of trainings of these athletes on the cross-sectional area of the lumbar multifidus muscle.
Abstract: OBJECTIVE: The main objective of this study was to identify general and military-related factors that are associated with the level of recovery in Dutch service members with chronic low back pain (CLBP) who followed a rehabilitation program. MATERIAL AND METHOD: One hundred five consecutive service members with CLBP were included in this study. The level of disability, was used to distinguish a recovered and non-recovered group. Level of pain and self-perceived recovery were used as secondary outcome measurements. Differences were evaluated within and between the groups using the Student’s t -test Bivariate logistic regression…analyses were used for identifying the prognostic factors related to various outcomes of recovery RESULTS: After following the rehabilitation program, 64.8% of the service members recovered from CLBP. The recovered group, demonstrated significant effect sizes in disability and in pain The non-recovered group showed on disability a non-significant effect and in pain a significant effect. The self-perceived recovery in the recovered group was “much improved” and the non-recovered group “slightly improved”. The results of the bivariate regression analyses showed no significant independent prognostic factors related to recovery. CONCLUSIONS: In this study, no significant independent prognostic factors could be identified that were associated to the various outcomes of recovery in service members with CLBP who followed a rehabilitation program.
Keywords: Prognostic, rehabilitation, service members
Abstract: BACKGROUND: Kinematic analysis has been a dominant tool for addressing the neuromuscular and proprioceptive alterations that occur in Low Back Pain (LBP) patients. Movement variability is a crucial component of this analysis. In the recent years application of non-linear indices seems to be showing the way. OBJECTIVE: The aim of the study was to compare movement variability, as expressed mainly by non-linear indices, at the pelvis and lumbar spine between LBP patients and healthy participants during gait. METHODS: Sixteen (16) LBP patients and thirteen (13) healthy control subjects (non-athletes) participated in the study.…Participants walked on a treadmill at different walking conditions while recorded by a 6-infrared camera optoelectronic system. Kinematic variability of pelvic and lumbar movement was analyzed using linear (standard deviation – SD) and non-linear indices (Maximal Lyapunov Exponent – LyE and Approximate Entropy – ApEn). RESULTS: Healthy subjects were found to have significantly greater mean values than LBP patients at seven pelvic and lumbar components in LyE, ApEn and SD. Specifically, the calculated LyE at the pelvis during normal gait was proven to have a sensitivity of 92.3% and a specificity of 90% in the discrimination of healthy subjects from LBP patients. Female subjects presented with higher variability in gait measures than males. CONCLUSION: Healthy participants presented with higher movement variability in their kinematic behavior in comparison to LBP patients. Lower variability values may be partly explained by the attempt of LBP patients to avoid painful end of range of motion positions. In this perspective non-linear indices seem to relate to qualitive characteristics of movement that need to be taken into consideration during rehabilitation.
Keywords: Low back pain, movement variability, gait kinematics, Maximal Lyapunov Exponent, Approximate entropy
Abstract: BACKGROUND: Hallux valgus, one of the most common foot disorders, contributes to the formation of pain and changes foot biomechanics. OBJECTIVE: To assess the impact of Kinesiology Taping (KT) on foot loading during gait in patients with hallux valgus. METHODS: Forty feet with hallux valgus were examined. Patients wore the KT for a month and the parameters of the foot during gait on a baropodometric platform were measured three times: before taping, immediately after application of taping and after one month’s use. RESULTS: The taping had a statistically significant effect…on dynamic foot measurements. The maximum and mean foot load (p < 0.001), foot surface (p < 0.001), ratio of forefoot to hindfoot load (p < 0.01) and the proportions of the lateral and medial foot loading (p < 0.05) all changed. During gait cycle, taping significantly increased the load and surface at the first metatarsal head (p < 0.001) while there was a decrease around the second to fifth (p < 0.001) metatarsal heads. CONCLUSIONS: Using KT to correct a hallux valgus is a procedure that has an impact on the dynamic parameters of the foot during gait. The use of this method could become an alternative to surgical treatment for those patients, who have any contraindication for surgery.
Keywords: Hallux valgus, Kinesiology Taping, gait, biomechanics of foot