Journal of Back and Musculoskeletal Rehabilitation - Volume 34, 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: OBJECTIVE: In this study we investigate the effects of paravertebral ozone injections (POI), which have been used as a new treatment approach for lower back pain in recent years, on pain and physical activity in patients with acute lumbar disc herniation (LDH) as an additional treatment. METHODS: Thirty-eight patients were assigned into the ozone therapy (OT) group (n = 20) and placebo control (PC) group (n = 18). Both groups received two sessions per week, a total of 8 sessions of lumbar POI. The ozone concentrations…of 20–25 μ g/ml (30 ml) and 0.1 μ g/ml (30 ml) were administered to the OT and PC groups, respectively. The patients were assessed with the visual analog scale (VAS) and Oswestry Disability Index (ODI) before the treatment (V1), 15 (V2) and 30 (V3) days after the treatment started, and one month (V4) after the treatment ended. RESULTS: A significant improvement was seen in the VAS and ODI scores in the final follow-up (V4) as compared with the baselines scores (V1) in both groups (P < 0.05). The patients in the OT group had lower mean VAS and ODI scores in V2, V3, and V4 follow-ups compared with the patients in the PC group. This significant difference reached its peak in the final follow-up (V4) (P < 0.05). CONCLUSION: As an additional treatment combined with conservative treatment, lumbar POI can lessen pain and disability in patients with acute LDH.
Abstract: BACKGROUND: Performing thoracic manipulations for neck pain can result in immediate improvements in neck function. OBJECTIVE: The aim of this study was to investigate the immediate effects of thoracic manipulation on cervical joint position sense and cervical range of motion in individuals with chronic mechanical neck pain. METHODS: Eighty male volunteers between 18–25 years and having chronic or recurrent neck or shoulder pain of at least 3 months duration with or without arm pain were randomized into two groups: Thoracic Manipulation Group (TMG:50) and Control Group (CG:30), with a pretest-posttest experimental design. The TMG…was treated with thoracic extension manipulation while the CG received no intervention. Cervical joint position error and cervical range of motion of the individuals were assessed at baseline and 5 minutes later. RESULTS: There was no difference in demographic variables such as age (p = 0.764), Body Mass Index (p = 0.917) and Neck Pain Disability Scale (NPDS) scores (p = 0.436) at baseline outcomes between TMG and CGs. Joint position error outcomes between the two groups following intervention were similar in all directions at 30 and 50 degrees. Differences in range of motion following intervention in neck flexion (p < 0.001) and right rotation (p = 0.004) were higher in TMG compared to CG. CONCLUSIONS: A single session of thoracic manipulation seems to be inefficient on joint position sense in individuals with mild mechanical neck pain. However, thoracic manipulation might be an effective option to increase flexion and rotation of the cervical region as an adjunctive to treatment.
Abstract: BACKGROUND: Aquatic exercise can improve strength, flexibility, and aerobic function while safely providing partial weight-bearing support through viscosity and buoyancy. OBJECTIVE: The aim of the present study was to compare the effects of water-based exercise with land-based exercise before and after a 10-week exercise intervention and again at one-year follow-up. METHODS: Eighty participants aged 65 years and older were randomly assigned to either a water- or a land-based 10-week exercise program. Assessment included the Senior Fitness Test (SFT), the Modified Falls-Efficacy Scale, and the 36-Item Short-Form Health Survey (SF-36). Hip and knee strength…was also measured. All assessments were completed at three time points: pre- (T1), post- (T2), and at 1-year follow-up (T3). RESULTS: Significant differences were observed between the two groups on three parameters: the SFT timed up-and-go test; lower hip muscle strength in extension, adduction, and external rotation; and quality of life (QoL) measured by the SF-36 (p < 0.05). No significant differences were observed in the SFT chair stand test, dominant arm curl test, two-minute step test, chair sit-and-reach test, back scratch test, and Modified Falls-Efficacy Scale. CONCLUSION: Aquatic exercise provided greater improvement of physical health and QoL among older people than land-based exercise.
Keywords: Aquatic exercise, fear of falling, land exercise, older adults
Abstract: BACKGROUND: Due to a significant burden associated with training sessions and matches, female football players often suffer from lumbar pain. Physical exercise is considered an effective form of therapy for this condition. The exercises in the Kinetic Control concept are one of the forms of motor control training. OBJECTIVE: The aim of the study was to evaluate the effectiveness of motor control training according to the Kinetic Control concept on the level of lumbar spine pain, degree of disability, functional level and load distribution of lower limbs in football players. METHODS: The study…included 18 football players, randomly divided into two study groups: A – female players implementing their training plan with additional Kinetic Control training (n = 9) and B (control) – female players implementing their training plan only (n = 9). Pain intensity was measured using Visual Analogue Scale (VAS) and Laitinen’s questionnaire. Functional disability was assessed using Oswestry Disability Index (ODI) and Back Pain Functional Scale (BPFS). The asymmetry index was assessed in a balance test with open and closed eyes and a countermovement jump (CMJ). RESULTS: There was a significant statistical difference between the groups (p < 0.05) in measurements using VAS, ODI and BPFS, in favor of group A. Asymmetry index values in tests on the dynamometer platform did not differ significantly between the groups (p > 0.05). A statistically significant correlation was found between the asymmetry index score in the closed-eye balance test (r = 0.567, p = 0.049) and the CMJ landing phase (r = 0.641, p = 0.033), and the level of pain measured using VAS. CONCLUSIONS: Motor control training in the Kinetic Control concept reduced the pain symptoms of the lumbar spine and the degree of disability and increased the functional level in football female players.
Keywords: Back pain, football, exercise therapy, exercise movement techniques
Abstract: BACKGROUND: Symptomatic degenerative meniscus tears are common in middle and old age. Arthroscopic partial meniscectomy (APM), physical therapy (PT) and hyaluronic acid injection (HAI) are the most commonly used treatment options. OBJECTIVES: The aim of our study is to compare the effectiveness of APM and PT in degenerative meniscus tears and to investigate the effect of HAI with a prospective, randomized, single-blind study. METHODS: The study included 192 patients with symptomatic degenerative meniscus tears. The patients were randomly divided into the four groups. The first group consisted of patients who underwent APM, the…second group received HAI with APM, the third group received PT, and the fourth group received HAI with PT. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analog Scale (VAS) scores, and range of motion (ROM) values were used for evaluation. RESULTS: There was no difference between four groups according to age, gender, BMI, affected side, grade of osteoarthritis. In the 4 groups, WOMAC and VAS results at the 2nd and 6th months were better than pre-treatment. There was no difference between the groups in terms of WOMAC and VAS. In terms of ROM, the results were found better in PT group (Group 3, Group 4) at the 2nd and 6th months. However, the results were found worse in APM group (Group 1, Group 2). In addition, it was found that HAI applied with APM and PT had no effect on VAS, WOMAC, and ROM. It was determined that the increase of knee osteoarthritis negatively affected both the results of APM treatment and PT. VAS, WOMAC, and ROM results were found worse in patients with stage 3 osteoarthritis than grade 1 and 2, but there was no difference between grade 1 and 2. CONCLUSIONS: APM and PT give good results in terms of pain and functional results. However, ROM limitation develops after APM. Conversely, there is an increase in ROM after PT. Administration of HAI with these treatments has no effect on the results. PT is an easily applicable noninvasive method. Adding HAI to the treatment has no effect on the results and increases the cost.
Abstract: BACKGROUND: In 1973, Dr. Kenzo Kase developed Kinesio taping from the hypothesis that this external component could aid the functions of muscles and other tissues. There are different studies on this issue, but none has completely clarified the research question. OBJECTIVE: To study the application of Kinesio taping in the variation of isometric muscle strength of the hand extension and grip, isokinetic strength of the pronation and supination movements, and the time it takes to reach that strength in patients with lateral epicondylalgia. METHODS: An analytical, experimental, randomized study was carried out with…104 subjects with lateral epicondylalgia. The subjects were randomly distributed among two groups: one received Kinesio taping and the other a placebo material. A pre- and post-intervention measurement was performed. The post-measurement was carried out 24 hours later so as to completely eliminate the fatigue effect produced by the first day measurements, as well as to ensure that the intervention was effective, and not immediate. The measurements were made using a dynamometer. RESULTS: No significant differences were found between the application of Kinesio taping and placebo material in subjects with lateral epicondylalgia regarding the variation of muscle strength in any of the study variables (p > 0.05 for all studied variables). CONCLUSIONS: Kinesio taping produces no change in strength after application and exerts an effect similar to that of a placebo.
Abstract: BACKGROUND: The 6-minute walk test (6-MWT) is commonly used to measure functional capacity in clinical and research settings. The reference equations for predicting the 6-minute walk distance (6-MWD) in different populations have been established; however, there is a lack of information regarding healthy Saudi individuals over 50 years old. OBJECTIVES: This study aimed to establish the reference values of 6-MWD in a sample of healthy Saudi adults aged 50–80 years, develop regression equations for the established 6-MWD, and compare the measured 6-MWD in the present study with the predicted 6-MWD derived from the previously published regression equations.…METHODS: In total, 210 healthy Saudi volunteers aged 50–80 years participated in this cross-sectional study. The 6-MWT was performed according to the American Thoracic Society (ATS) guidelines. Lung function, physical activity, blood pressure, heart rate, oxygen saturation, exertion level of leg fatigue, and sensation of dyspnea were measured. RESULTS: The mean 6-MWD was 396.2 ± 69.4 m. It was significantly correlated with age, sex, height, body mass index (BMI), and physical activity. The predictors of 6-MWD were age and BMI for men, while they were age, BMI, and height for women. They accounted for 25% and 35% of the total variance of 6-MWD for men and women, respectively. The measured 6-MWD was significantly shorter than the predicted 6-MWD. CONCLUSION: Saudi populations have significantly shorter 6-MWDs than those reported in other ethnic groups. The sex-specific equations developed in this study are expected to provide a useful measure of 6-MWT for Saudi adults. However, further investigation is required to validate the application of these equations to individuals living in different regions of Saudi Arabia.
Keywords: 6-minute walk distance, functional exercise capacity test, reference values, regression equations, healthy Saudi adults
Abstract: BACKGROUND and OBJECTIVE: Caring for a child with a disability affects musculoskeletal system pain, fatigue, sleep quality, and anxiety of the mothers. The purpose of the study was to determine the effectiveness of breathing exercises in mothers with chronic non-specific low back pain (NLBP). METHODS: Forty-three mothers with chronic NLBP were randomly assigned to the experimental group (n = 23) and the control group (n = 20). The experimental group received breathing exercises with core stabilization exercises (BSET) for three sessions a week for 8 weeks,…and the control group performed stabilization exercises (SET) only, for the same period. Pain severity, fatigue, anxiety, and sleep quality were evaluated before and after the treatment programs. RESULTS: After the treatment programs, significant differences were observed in pain, fatigue, and sleep quality in both groups (p < 0.05). However, the BSET group showed a significantly better improvement in anxiety levels and sleep quality than the SET group (p < 0.05). CONCLUSIONS: The improvements in pain, fatigue and sleep quality were seen in both groups after treatment programs. It is recommended breathing exercises are added to core stabilization programs to provide greater improvements in anxiety level and sleep quality for mothers of children with disabilities, who have NLBP.
Keywords: Low back pain, breathing exercises, core stabilization, anxiety, sleep
Abstract: BACKGROUND: Transcutaneous electrical nerve stimulation (TENS) is one of the most common methods for managing shoulder pain, and high voltage pulsed currents (HVPS) may be used for reducing pain. However, their immediate effects on resting pain and pain-free active range of shoulder motion (pfROM) in patients with subacromial pain syndrome (SAPS) have not been studied comparatively, yet. OBJECTIVES: The aim of this study was to compare the immediate effects of TENS, HVPS and placebo stimulation on shoulder resting pain and pfROM in patients with SAPS. METHODS: Randomized, placebo-controlled, double-blind, crossover study. One hundred…and six patients with SAPS received placebo (predetermined 1st day application), TENS and HVPS with 1-day interval, in a random sequence. Before and after each application, resting pain and pfROM were evaluated by 0–10 cm visual analogue scales and a digital inclinometer, respectively. RESULTS: Intensity of pain decreased significantly after TENS, HVPS and placebo interventions (p < 0.05). While pfROMs increased significantly after TENS and HVPS (p < 0.05), remained unchanged after placebo, except for internal and external rotations (p > 0.05). The most obvious effects on pain and pfROMs occurred after HVPS (p < 0.05). CONCLUSION: In patients with SAPS, both HVPS and TENS, but preferably HVPS can be used effectively to decrease pain and increase pfROM.
Keywords: Shoulder pain, joint range of motion, electrotherapy, physiotherapy, orthopedics, transcutaneous electrical nerve stimulation, high voltage pulsed currents