Journal of Back and Musculoskeletal Rehabilitation - Volume 35, 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: Fibromyalgia (FM) is a chronic condition characterized by widespread muscular or musculoskeletal pain of at least 3 months’ duration, occurring above and below the waist, on both sides of the body. OBJECTIVE: The aim of this study was to evaluate the effectiveness of a rehabilitation program based on motor imagery versus a conventional exercise program in FM in terms of pain, functional and psychological outcomes. METHODS: Twenty-nine female subjects were randomly assigned to a group receiving motor imagery-based rehabilitation (MIG) or to a control group (CG) performing conventional rehabilitation. Outcome assessments were…performed before (T0) and after 10 sessions of treatment (T1) and at a 12-week follow-up (T2). Pain, function and psychological measurements were conducted by means of different questionnaires. RESULTS: Both treatments improved all outcomes at post-treatment (T1) and follow-up (T2). The MIG showed a significant improvement in anxiety disorder associated with FM with respect to the CG, as well as improvements in coping strategies. CONCLUSIONS: Rehabilitation treatment based on motor imagery showed a stronger effect on anxiety and coping behavior than traditional physiotherapy in patients with FM. Integrated psychological support would be desirable in this setting. Further research is needed to explore the aspects investigated in more depth.
Keywords: Motor imagery-based exercise, fibromyalgia, rehabilitation, pain
Abstract: BACKGROUND: The medial hamstring (MH) and lateral hamstring (LH) can be selectively trained through tibial internal and external rotation during prone knee flexion. However, no study has identified how a combined tibial rotation and lumbo-pelvic stability strategy influences MH and LH muscle activities. OBJECTIVE: To investigate the combined effects of tibial rotation and the abdominal drawing-in maneuver (ADIM) on MH and LH muscle activities as well as pelvic rotation during prone knee flexion. METHODS: Fifteen female volunteers performed prone knee flexion with tibial internal and external rotation, with and without the ADIM. Under…each condition, MH and LH muscle activities were measured by surface electromyography (EMG), and the pelvic rotation angle by a smartphone inclinometer application. RESULTS: The results showed increased MH (without the ADIM: p < 0.001, effect size (d ) = 2.05; with the ADIM: p < 0.001, d = 1.71) and LH (without the ADIM: p < 0.001, d = 1.64; with the ADIM: p = 0.001, d = 1.58) muscle activities under internal and external tibial rotation, respectively. However, addition of the ADIM led to increased MH (internal tibial rotation: p = 0.001, d = 0.67; external tibial rotation: p = 0.019, d = 0.45) and LH (internal tibial rotation: p = 0.003, d = 0.79; external tibial rotation: p < 0.001, d = 1.05) muscle activities combined with reduced pelvic rotation (internal tibial rotation: p < 0.001, d = 3.45; external tibial rotation: p < 0.001, d = 3.01) during prone knee flexion. CONCLUSIONS: These findings suggest that the ADIM could be useful for reducing compensatory pelvic rotation and enhancing selective muscle activation in the MH and LH, according to the direction of tibial rotation, during prone knee flexion.
Abstract: BACKGROUND: Lumbar radiculopathy is characterized by a significant amount of backache causing loss of workforce and is a significant health problem frequently seen in the general population. OBJECTIVE: The purpose of this study was to compare the effects of conventional physiotherapy (CT) and proprioception exercises (PE) on ankle proprioception and lumbar pain between patients with lumbar radiculopathy and a healthy control group. METHODS: In this randomized clinical trial, 89 patients referred to the Physical Medicine and Rehabilitation outpatient clinic were selected through convenience sampling. They were randomly assigned to three groups: CT (n =…27), PE (n = 31), CT&PE (n = 31). Thirty healthy volunteers were included in the study as the control group. Proprioception measurements were made with an isokinetic dynamometer at 10 ∘ dorsiflexion (DF), 11 ∘ , and 25 ∘ plantarflexion (PF) angles. Lumbar pain was assessed by using the Numerical Pain Rating Scale (NPRS). The data were analyzed by IBM SPSS Statistics version 22.0 via the Kruskal-Wallis and Mann-Whitney U tests. RESULTS: There was a statistically significant difference between the groups in terms of ankle proprioception and NPRS measurements in post-treatment evaluations (p < 0.05). Statistically significant differences were found between CT and PE groups and CT&PE and control groups. There was no statistically significant difference in comparing CT and PE groups and CT&PE and control groups within themselves (p > 0.05). CONCLUSION: The combined use of CT and PE is an effective method that can be used in the clinic to reduce angular differences in ankle proprioception which is one of the primary factors of balance and coordination and lumbar pain.
Abstract: BACKGROUND: The cranio-cervical flexion exercise and sub-occipital muscle inhibition technique have been used to improve a forward head posture among neck pain patients with straight leg raise (SLR) limitation. However, little is known about the cranio-vertebral angle (CVA) and cervical spine range of motion (CROM) after applying stretching methods to the hamstring muscle. OBJECTIVE: To compare the immediate effects of static stretching and proprioceptive neuromuscular facilitation stretching on SLR, CVA, and CROM in neck pain patients with hamstring tightness. METHODS: 64 subjects were randomly allocated to the static stretching (n 1 =…32) or proprioceptive neuromuscular facilitation (n 2 = 32) stretching group. The SLR test was performed to measure the hamstring muscle’s flexibility and tightness between the two groups, with CROM and CVA also being measured. The paired t-test was used to compare all the variables within each group before and after the intervention. The independent t-test was used to compare the two groups before and after the stretching exercise. RESULTS: There were no between-group effects for any outcome variables (P > 0.05). However, all SLR, CVA, and CROM outcome variables were significantly improved within-group (P < 0.05). CONCLUSIONS: There were no between-group effects for any outcome variable; however, SLR, CVA, and CROM significantly improved within-group after the one-session intervention in neck pain patients with hamstring tightness.
Keywords: Hamstring flexibility, neck pain, range of motion, straight leg raise limitation, stretching methods
Abstract: BACKGROUND: Carpal tunnel syndrome (CTS) is one of the most common forms of peripheral neuropathies due to median nerve compression. Occupational factors, such as repetitive hand motions are believed to be associated with this condition. OBJECTIVE: This clinical trial assessed the effect of Kinesio taping (KT) of hand flexor muscles on the management of mild to moderate CTS in Iranian manual laborers. METHODS: Thirty manual laborers with mild to moderate CTS participated in this clinical trial. They were assigned to an intervention or a control group. The treatment consisted of a 2-week KT…followed by a 4-week follow-up. The control group received sham KT without tension applied. Boston Carpal Tunnel Questionnaire scores, pinch and grip force tests, and electrophysiological examination of the median nerve were performed for each participant at baseline, 24 to 48 hours, and two to four weeks of follow-up. The statistical analysis of variance was performed (2 groups × 5 times) for all participants, comparing differences in the data within and between the two groups. RESULTS: The baseline assessment revealed no inter-group differences in the clinical outcomes (P > 0.05). Comparisons of the changes in the electro-physiological and functional variables indicated significantly greater improvement in the KT group than in the sham counterpart (P < 0.05). No statically significant improvement was evident by the electrodiagnostic criteria in the sham-KT group (P > 0.05). CONCLUSIONS: KT is an effective, safe, reliable, and conservative therapeutic choice for the management of patients with CTS. The treatment does not restrict the daily activities of patients nor has it any side effects.
Abstract: BACKGROUND: Rheumatoid arthritis (RA) mainly affects the joints of the upper and lower limbs, so evaluating functional exercise capacity in individuals with RA via dynamic tests of the locomotor system is essential. OBJECTIVES: To compare functional exercise capacity using the Glittre-activities of daily living (ADL) test (G-AT) in women with and without RA in the absence of RA pulmonary disease (RA-PD) and to correlate the findings with hand functioning, physical functioning, handgrip strength (HGS), and quadriceps strength (QS). METHODS: This cross-sectional pilot study evaluated 35 women with RA and 25 healthy controls by…assessing hand functioning using the Cochin Hand Functional Scale (CHFS), physical functioning with the Health Assessment Questionnaire Disability Index (HAQ-DI), muscle functioning using HGS and QS, and G-AT results. RESULTS: Compared to the women in the control group, the women with RA presented higher scores for the CHFS (p < 0.0001) and HAQ-DI (p < 0.0001) and lower HGS (p < 0.0001) and QS (p = 0.013) values. The median G-AT time was higher in the RA patients than in the healthy controls [300 (295–420) vs. 180 (155–203) s], p < 0.0001), and the greatest difficulty reported by patients after the G-AT was squatting to perform the shelving tasks. G-AT time was positively correlated with the HAQ-DI (r s = 0.668, p < 0.0001) and CHFS (r s = 0.586, p = 0.0007) and negatively correlated with QS (r s = - 0.429, p = 0.037). There was no significant correlation between the G-AT time and HGS. CONCLUSIONS: Women with RA take longer to perform G-AT tasks. Moreover, G-AT time was associated with hand functioning, physical functioning and QS, but not with HGS.