Journal of Back and Musculoskeletal Rehabilitation - Volume 35, issue 3
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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: Lateral epicondylitis is a tendinopathy with a prevalence of between 1–3% of the population aged 35–54 years. It is a pathology with a favorable evolution, but with frequent recurrences (which imply an economic extra cost). OBJECTIVE: The objective of this review was to determine the efficacy of physiotherapy treatment for the treatment of epicondylitis and, if any, to identify the most appropriate techniques. METHODS: A systematic search was carried out in October 2020 in the databases of PubMed, Cinahl, Scopus, Medline and Web of Science using the search terms: Physical therapy modalities, Physical…and rehabilitation medicine, Rehabilitation, Tennis elbow and Elbow tendinopathy. RESULTS: Nineteen articles were found, of which seven applied shock waves, three applied orthoses, three applied different manual therapy techniques, two applied some kind of bandage, one applied therapeutic exercise, one applied diacutaneous fibrolysis, one applied high intensity laser, and one applied vibration. CONCLUSIONS: Manual therapy and eccentric strength training are the two physiotherapeutic treatment methods that have the greatest beneficial effects, and, furthermore, their cost-benefit ratio is very favorable. Its complementation with other techniques, such as shock waves, bandages or Kinesio ® taping, among others, facilitates the achievement of therapeutic objectives, but entails an added cost.
Abstract: BACKGROUND: The anterior cruciate ligament (ACL) reconstruction (ACLR) under the arthroscopy is a widespread procedure for ACL rupture, which could stabilize knee and promote recovery. However, one of its complications is the injury of infrapatellar branch of saphenous nerve (IBSN). In traditional Chinese medicine, acupotomy functions via releasing and stripping adhesion tissues. Accordingly, acupotomy is suitable for the treatment of entrapped nerve injury and tissues adhesion. CASE DESCRIPTION: A 14-year-old man, who had ACLR before and returned to normal activity, presented with severe pain after a mild strain two weeks ago. The physical and imaging examinations…revealed the compression injury of IBSN. METHODS: We provided the ultrasound-guided perineural injection of 0.4% lidocaine, while it only alleviates the symptoms temporally and partially. Acupotomy using a small needle knife (0.4*40 mm) was performed. RESULTS: The severe pain was immediately resolved. The visual analog pain scale (VAS) decreased from 10 to 1 and return to normal walking. The diameter of IBSN became smaller and the signal of peripheral soft tissue became hypoechoic in ultrasound. CONCLUSION : In this case, the combined treatments of ultrasound-guided perineural injection and acupotomy are thought to be innovative procedures for IBSN entrapment with relative long-lasting therapeutic effects.
Abstract: BACKGROUND: Low back pain (LBP) is one of the most common reasons for visiting the doctor. The Mézières method (MM) emphasises body awareness and uses a global postural rehabilitation approach. It is used in the management of LBP, but its effectiveness has received limited formal evaluation. OBJECTIVE: To determine the effects of MM on quality of life, pain and functional disability in people with LBP and understand the patient’s bodily experience during the MM intervention. METHODS: This protocol study of single-blind randomised controlled trial with a mixed methods design will include 54 people…with LBP aged 18 to 65 years. Participants will be randomised into two groups, one will receive MM and the other will receive a control intervention, administered through 10 treatment sessions. Participants will also construct a narrative to provide an understanding of their bodily experience. RESULTS: The assessed outcomes will include pain, back pain-related disability assessed using the Roland Morris Questionnaire, and quality of life related to health assessed using the SF12. Outcomes will be assessed at baseline, after the intervention and at a 6 weeks follow-up.
Keywords: Low back pain, Mézières method, exercise, physical therapy
Abstract: BACKGROUND: The effects of stretching exercises in fibromyalgia (FM) deserves further study. OBJECTIVE: To evaluate the effectiveness of a Physical Self-Care Support Program (PSCSP), with emphasis on stretching exercises, in the treatment of FM. METHODS: Forty-five women with FM were randomized to the PSCSP (n = 23) or to a control group (n = 22). The PSCSP consisted of weekly 90-minute learning sessions over 10 weeks, providing instructions on wellness, postural techniques, and active stretching exercises to be done at home. The control group…was monitored through 3 medical appointments over 10 weeks and included in a waiting list. The primary outcomes were the Fibromyalgia Impact Questionnaire (FIQ), the Visual Analogue Scale (VAS) for pain, and the Sit and Reach Test (SRT) at the end of the study. RESULTS: Nineteen and 21 patients completed the trial in PSCSP and control groups, respectively. After 10 weeks, the PSCSP group showed significantly better FIQ (difference between adjusted means, - 13.64, 95% CI, - 21.78 to - 5.49, P = 0.002) and SRT scores (7.24 cm, 3.12 to 11.37, P = 0.001) than the control group, but no significant difference in pain VAS (- 1.41, - 3.04 to 0.22, P = 0.088). Analysis using multiple imputation (MI) and delta-adjusted MI for missing outcomes rendered similar results. CONCLUSIONS: A PSCSP emphasizing stretching exercises significantly improved FIQ and SRT scores, and may be a helpful therapy for FM.
Abstract: BACKGROUND: Numerous studies on the comparison of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and open-transforaminal lumbar interbody fusion (O-TLIF) for the treatment of lumbar disc herniation (LDH) have been published, but there is no clear conclusion. OBJECTIVE: The aim of this study was to evaluate the efficacy of MIS-TLIF compared with O-TLIF in the treatment of LDH in the Chinese population by meta-analysis. METHODS: Studies on the treatment of LDH by MIS-TLIF versus O-TLIF were searched in Pubmed, Web of Science, Medline, Embase, CNKI, VIP and China Wanfang databases from the establishment…of the databases to January 2020. The meta-analysis was used to analyze the pooled operation time, intraoperative blood loss, postoperative drainage, postoperative ground movement time, Waist and leg Visual Analogue Scale (VAS) score, Oswestry Disability Index (ODI) score and Japanese orthopaedic association (JOA) score. Mean difference (MD) and standard mean difference (SMD) were used as the effect size. RESULTS: Eleven studies with 1132 patients were included. The results showed that MIS-TLIF compared with O-TLIF, MD = - 133.82 (95% CI: - 167.10 ∼ - 100.53, P < 0.05) in intraoperative blood loss, MD = - 114.43 (95% CI: - 141.12 ∼ - 87.84, P < 0.05) in postoperative drainage, MD = - 3.30 (95% CI: - 4.31 ∼ - 2.28, P < 0.05) in postoperative ground movement time, SMD = - 1.44 (95% CI: - 2.63 ∼ - 0.34, P < 0.05) in postoperative low back pain VAS score, SMD = 0.41 (95% CI: 0.15 ∼ 0.66, P < 0.05) in postoperative JOA score, MD = 4.12 (95% CI: - 11.64 ∼ 19.87, P > 0.05) in the average operation time, SMD = - 0.00 (95% CI: - 0.36 ∼ 0.36, P > 0.05) in leg pain VAS score, and SMD = - 0.59 (95% CI: - 1.22 ∼ 0.03, P > 0.05) in ODI score. CONCLUSION: MIS-TLIF was superior to O-TLIF in the treatment of LDH, especially in the intraoperative blood loss, postoperative drainage, postoperative ground movement time and low back pain in the Chinese population.
Abstract: BACKGROUND: Thoracic mobilisation improves thoracic hyperkyphosis and respiratory function. Diaphragmatic excursion is associated with respiratory function; however, limited studies have assessed the effect of thoracic mobilisation on diaphragmatic excursion. OBJECTIVE: This study aimed to investigate the effects of thoracic mobilisation on diaphragmatic excursion and respiratory function in individuals with thoracic hyperkyphosis. METHODS: Participants were recruited through Internet advertising and participated voluntarily. Nineteen healthy participants (age: 33.37 ± 6.56 years; height: 170.32 ± 7.92 cm; weight: 69.77 ± 14.70 kg) with thoracic hyperkyphosis underwent thoracic mobilisation for 8 weeks.…Diaphragmatic excursion, thoracic kyphosis, and respiratory function were measured. Thoracic mobilisation was provided using a mechanical massage device. RESULTS: Thoracic mobilisation for 8 weeks significantly improved diaphragmatic excursion during deep breathing (p = 0.015), forced vital capacity (p < 0.01), and thoracic hyperkyphosis (p < 0.01). CONCLUSIONS: Thoracic mobilisation can be recommended in respiratory rehabilitation programs to increase diaphragmatic excursion and respiratory function for the management and prevention of respiratory dysfunction in individuals with thoracic hyperkyphosis.
Abstract: BACKGROUND: Quadratus lumborum (QL) discrete region extensions might change depending on whether leg length discrepancy (LLD) individually has any extra erector spinae action in the lumbar spine, which can result in serious injury to the lower extremities and lumbar vertebrae. OBJECTIVE: This study aims to investigate the effect of QL muscle activity on LLD by using electromyography (EMG) signals. METHODS: The study employed a randomized controlled design. A total of 100 right-handed volunteers were included in this study. All participants were assessed manually by tape measurement for LLD. EMG signals were recorded during…the resting and maximal isometric contraction positions to determine QL muscle activity. The power spectral density (PSD) methods were applied to compute EMG signals. RESULTS: In maximal isometric contraction position, comparing the short right LLD (Right side = 0.00064 ± 0.00001, Left side = 0.00033 ± 0.0006) and short left LLD (Right side = 0.00001 ± 0.00008, Left side = 0.00017 ± 0.0001), it was found that the short right LLD group had significantly increased PSD of EMG values. In resting position, the short right LLD (Right side = 0.0002 ± 0.0073, Left side = 0.00016 ± 0.0065) had significantly increased PSD of EMG compared to the short left LLD (Right side = 0.00004 ± 0.0003, Left side = 0.0001 ± 0.0008) values of the QL muscle activity. The results of both groups were also statistically significant (p < 0.05). CONCLUSIONS: The present study showed that it is possible to determine effective experimental interventions for functional LLD using EMG signal analysis of QL muscle activity on an asymptomatic normal population.
Keywords: Pelvic asymmetry, leg length discrepancy, discrete Fourier transform, quadratus lumborum, electromyography signal
Abstract: BACKGROUND: Shortening of tensor fasciae latae is one factor that causes a functional leg length discrepancy. A shoe lift has been used to correct the compensatory posture resulting from the discrepancy. Despite the potential therapeutic benefit of a shoe lift, the mechanism by which it exerts its effect is unclear. OBJECTIVE: To investigate the effect of a shoe lift on tensor fasciae latae length during standing with an artificial functional leg length discrepancy using ultrasonic shear wave elastography. METHODS: Twenty-two healthy individuals performed static standing under three conditions: drop of the pelvis and…flexion of the leg resulting from fixing in the hip abduction position using a hip orthosis (functional leg length discrepancy condition); drop of the pelvis by the orthosis, but no flexion of the leg due to a shoe lift (shoe lift condition); and normal bilateral standing condition. The shear elastic modulus of tensor fasciae latae was calculated using ultrasonic shear wave elastography. RESULTS: The shear elastic modulus was significantly lower in the functional leg length discrepancy condition than in the shoe lift and normal conditions (p = 0.038). CONCLUSIONS: Using a shoe lift for the functional leg length discrepancy can result in a functional hip position that elongates tensor fasciae latae.
Abstract: BACKGROUND: Calcaneal spur and hallux valgus are common foot deformities and both conditions have been shown to disrupt foot biomechanics. OBJECTIVES: This study aimed to investigate the association between calcaneal spur and hallux valgus using radiographic and demographic data. METHODS: A total of 1375 patients (1083 women; mean age: 45.5 years) with standard ankle lateral and foot conventional anteroposterior radiographs were evaluated. The following data were obtained: age, gender, laterality, hallux valgus angle (HVA), intermetatarsal angle (IMA), and calcaneal spur. Patients with a HVA of 15 ∘ and above were…considered to have hallux valgus. Patients with hallux valgus were classified into three different groups according to the HVA. RESULTS: The prevalence of calcaneal spur was higher in older age and women (45.8%, 30.2%; p < 0.01, p < 0.01, respectively). Subjects with and without calcaneal spurs had similarities in terms of their laterality, having a HVA of ⩾ 15 ∘ and an IMA of ⩾ 11 ∘ (p > 0.05). Hallux valgus severity was not associated with calcaneal spur (p > 0.05). In addition, the hallux valgus prevalence was higher in patients who were over 50 years old (58.2%, p = 0.046). CONCLUSIONS: The presence of calcaneal spurs does not affect the prevalence of hallux valgus. The severity of hallux valgus determined according to the HVA was similar in patients with and without calcaneal spurs. In addition, female gender and older age were identified as risk factors for calcaneal spurs, while only older age was a risk factor for hallux valgus.