Journal of Back and Musculoskeletal Rehabilitation - Volume 36, 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: Ischemic compression is widely used to clinically treat neck pain. However, no meta-analysis has been conducted to evaluate the effects of this process on neck pain. OBJECTIVE: This study aimed to evaluate the effects of ischemic compression on the myofascial trigger points for improving neck pain-related symptoms (mainly pain, joint mobility limitation and function limitation) and to compare ischemic compression with other therapies. METHODS: Electronic searches were conducted in PubMed, OVID, Web of Science, EBSCO, SCOUPS, Cochrane Library, PEDro, Wanfang, CNKI and Chinese VIP Database in June 2021. Only randomised controlled trials…on the effects of ischemic compression on neck pain were included. The major outcomes were pain intensity, pressure pain threshold, pain-related disability and range of motion. RESULTS: Fifteen studies involving 725 participants were included. Significant differences were observed between ischemic compression and sham/no treatment group in pain intensity, pressure pain threshold and range of motion immediately and in the short term. Significant effect sizes of dry needling were observed over ischemic compression in terms of improving pain intensity (SMD = 0.62; 95% CI: 0.08 to 1.16; P = 0.02), pain-related disability (SMD = 0.68; 95% CI: 0.19 to 1.17; P = 0.007) and range of motion (MD = - 2.12; 95% CI: - 2.59 to - 1.65; P < 0.001) immediately after treatment. Dry needling also showed a significant small effect size for the short-term reduction of pain (SMD = 0.44; 95% CI: 0.04 to 0.85; P = 0.03). CONCLUSION: Ischemic compression can be recommended in the immediate and short-term pain relief and increase in the pressure pain threshold and range of motion. Dry needling is superior to ischemic compression in relieving pain and improving pain-related disability and range of motion immediately after treatment.
Abstract: BACKGROUND: The benefits of combining supervised exercise in the non-surgical treatment of lumbar spinal stenosis (LSS) is unclear. OBJECTIVE: To compare the effectiveness of non-surgical treatments with and without supervised exercise for pain intensity, symptom severity, functional impairment/disability, walking distance, and quality of life (QOL) in LSS patients. METHODS: Randomized controlled trials (RCTs) evaluating combinations of supervised exercises were searched using four electronic databases up to August 13, 2020. Meta-analysis was conducted for immediate and long-term results. RESULTS: Three studies were identified, including 244 participants. Immediate-term results showed that leg…pain intensity (mean distance [MD]: - 0.94, 95% confidence intervals [95% CI]: - 1.60 to - 0.29, p < 0.01) and symptom severity (MD: - 0.29, 95% CI: - 0.50 to - 0.08, p < 0.01) were lower in the study group than in the control group, and walking distance (MD: 415.83, 95% CI: 298.15 to 533.50, p < 0.001) and QOL were higher in the study group. Long-term results showed that functional disability/impairment (MD: - 0.27, 95% CI: - 0.49 to - 0.04, p < 0.05) was lower in the study group than in the control group, and walking distance and QOL were higher in the study group. CONCLUSION: The number of studies on this topic was small and limited. Combinations of non-surgical treatment and supervised exercise may not provide significant benefits.
Keywords: Spinal stenosis, exercise therapy, systematic review as topic, meta-analysis as topic
Abstract: BACKGROUND: Low back pain is a highly prevalent musculoskeletal disorder that leads to functional incapacity and absence from work. OBJECTIVE: To analyze warehouse workers’ prevalence and factors associated with low back pain. METHODS: Cross-sectional study design with 204 male warehouse workers (stocker, separator, checker, and packer) from motor parts companies. Age, body mass, marital status, education, the practice of physical exercise, presence of pain, low back pain intensity, comorbidities, time away from work, handgrip strength, flexibility, and trunk muscle strength were collected and analyzed. Data are presented as mean, standard deviation, absolute and…relative frequency. A binary logistic regression was performed, with low back pain (yes or no) as the dependent variable. RESULTS: 24.0% of the workers reported low back pain with an average intensity of 4.7 (± 2.4) points. The participants were young, had completed high school education, were single and married, and had normal body weight. There was a more likely low back pain presence in separator tasks. Greater handgrip strength in the dominant (right) hand and trunk muscle is associated with no low back pain. CONCLUSION: Low back pain prevalence was 24% among young warehouse workers, more likely in separation tasks. A greater handgrip and trunk strength can be a protective factor to no low back pain.
Abstract: BACKGROUND: Electrical muscle stimulation (EMS) has been applied in many rehabilitation settings for muscle strengthening, facilitation of muscle contraction, re-education of muscle action, and maintenance of muscle strength and size during prolonged immobilization. OBJECTIVE: The purpose of this study was to investigate effect of 8 weeks of EMS training on abdominal muscle function and to determine whether the training effect could be maintained after 4 weeks of EMS detraining. METHODS: Twenty-five subjects performed EMS training for 8 weeks. Before and after 8 weeks of EMS training, and after 4 weeks of EMS detraining,…muscle size (cross-sectional area [CSA] of the rectus abdominals [RA] and lateral abdominal wall [LAW]), strength, endurance, and lumbopelvic control (LC) were measured. RESULTS: There were significant increases in CSA [RA (p < 0.001); LAW (p < 0.001)], strength [trunk flexor (p = 0.005); side-bridge (p < 0.05)], endurance [trunk flexor (p = 0.010); side-bridge (p < 0.05)], and LC (p < 0.05) after 8 weeks of EMS training. The CSA of the RA (p < 0.05) and the LAW (p < 0.001) were measured after 4 weeks of detraining and they were greater than that of the baseline. There were no significant differences in abdominal strength, endurance, and LC between baseline measurements and post-detraining. CONCLUSION: The study indicates that there is less of a detraining effect on muscle size than on muscle strength, endurance, and LC.
Abstract: BACKGROUND: Low back pain (LBP) in sedentary workers is an increasing problem. Hyperlordosis or hypolordosis of the lumbar spine may be one of the causes of LBP. Various exercise programs are used in the prevention of LBP, but they do not consider individualization for diagnosed hyperlordosis or hypolordosis of the lumbar spine. OBJECTIVE: The purpose of this study was to evaluate the effect of the authors’ original exercise program aimed at reducing hyperlordosis or increasing hypolordosis. METHODS: Sixty women aged 26 to 40 working in a sedentary position participated in the study. The…sagittal curvature and the range of motion of the lumbar spine flexion were measured with the Saunders inclinometer, and the level of LBP was evaluated using the VAS scale. Subjects were randomly divided into two groups that participated in a 3-month exercise program developed by the authors. The first group performed exercises adjusted to the diagnosed hyperlordosis or hypolordosis, and the second group performed the same exercises regardless of the lumbar lordosis angle. The study was conducted again after completing the exercises. RESULTS: There was a statistically significant difference between the groups (p < 0.0001) in the level of pain, with better results in the group where individualized exercise was used – 60% of the participants reported complete absence of LBP. The lumbar lordosis angle was within normal limits in 97% of the subjects in the first group, and in 47% of the subjects in the second group. CONCLUSION: The results of this study confirm the validity of using individualized exercises with regard to diagnosed hyperlordosis or hypolordosis of the lumbar spine in order to achieve better analgesic and postural correction effects.
Abstract: BACKGROUND: Low back pain (LBP) is a common musculoskeletal condition that necessitates public health concerns. It also attracts considerable research interest among physiotherapists. OBJECTIVE: This study conducted a bibliometric analysis to reveal the affinity of Indian physiotherapists toward research on LBP using the Scopus database. METHODS: An electronic search was performed on December 23, 2020, using specific keywords. The data was downloaded in a Scopus plain text file (.txt) format and were analyzed using R studio (biblioshiny) software. RESULTS: Two hundred and thirteen articles concerning LBP published from 2003 to…2020 were retrieved from the Scopus database. Among those articles (N = 213), 85.45% (n = 182) were published between 2011 and 2020. An article published by “James SL (2018)” in the Lancet had the highest citation of 1439. The highest collaboration was between India and the United Kingdom, and India and the United States of America jointly accounted for 12.2% (n = 26) of the entire articles (N = 213). CONCLUSION: Indian physiotherapists have shown an interest through gradually increasing their research output on LBP since 2015. They contributed effectively to various journals and international collaboration. Nevertheless, there is room to improve the quality and quantity of LBP articles in high-quality journals, thereby enhancing the citation count. This study recommends improving the scientific output of Indian physiotherapists on LBP by expanding their international networks.
Keywords: Bibliometrics, India, Low Back Pain, Physical therapists
Abstract: BACKGROUND: Body composition decline, lower limb impairments, and mobility deficits affect independence of older people. The exploration for a practical measure involving upper extremities may offer an alternative tool to be used by primary healthcare (PHC) providers for these individuals. OBJECTIVE: To explore reliability and validity of seated push-up tests (SPUTs) among older participants when used by PHC providers. METHODS: Older participants (n = 146) with an average age of > 70 years were cross-sectionally assessed using various demanding forms of SPUTs and standard measures…to assess validity of the SPUTs. Reliability of the SPUTs were assessed in nine PHC raters, including an expert, health professionals, village health volunteers, and care givers. RESULTS: The SPUTs demonstrated very good agreement, with excellent rater and test-retest reliability (kappa values > 0.87 and ICCs > 0.93, p < 0.001). Moreover, the SPUT outcomes significantly correlated with lean body mass, bone mineral contents, muscle strength and mobility of older participants (r , r p b = - 0.270 to 0.758, p < 0.05). CONCLUSION: SPUTs are reliable and valid for older adults when used by PHC members. The incorporation of such practical measures is particularly important during this COVID-19 pandemic with limited people’s hospital access.
Keywords: Clinical measure, community service, caregiver, primary healthcare, mobility
Abstract: BACKGROUND: Scapular muscles changes, as increased upper trapezius activity and decreased middle and lower trapezius and serratus anterior muscle activity, have been demonstrated in shoulder pain specific or non-specific conditions. Shoulder external rotation exercises have been recommended to improve scapular activity in shoulder pain. OBJECTIVE: To evaluate the relative scapular muscles activity during multi-joint exercises combining shoulder external rotation, trunk rotation and scapular squeeze. METHODS: Forty-one participants with and without shoulder pain were assessed in a cross-sectional study. They performed isometric multi-joint exercises at 0 ∘ and 90 ∘…of shoulder abduction with and without support. The relative activity of upper, middle, and lower trapezius and serratus anterior (upper/middle and lower portions) was measured through electromyography. The scapular muscular balance was assessed by the ratio between relative activity of the upper trapezius and the other muscles. RESULTS: Both groups presented similar results. The exercise at 90 ∘ abduction led to increased relative muscle activity against maximal voluntary contraction in both groups for upper trapezius (with support: 4% MVIC, p = 0.001 or 15% MVIC, p < 0.0001; and without support: 11% MVIC, p < 0.0001 or 13%, p < 0.0001, for asymptomatic and symptomatic group, respectively) and lower trapezius (with support: 66% MVIC, p < 0.0001 or 62% MVIC, p < 0.0001, for asymptomatic and symptomatic group,
Abstract: BACKGROUND: Pregnancy-related low back pain (LBP) and pelvic girdle pain (PGP) significantly affect the quality of life of pregnant women. Understanding their severity and risk factors may help prevent and alleviate such pain and their resulting dysfunction. OBJECTIVE: This study investigated the prevalence, severity, and biopsychosocial risk factors of pregnancy-related LBP and PGP in Zhengzhou, China. METHODS: The Numeric Pain Rating Scale (NPRS), Chinese version of the Roland-Morris Disability Questionnaire (RMDQ), and other questionnaires were self-administered by 1020 pregnant women undergoing treatment at a tertiary hospital between July and December 2019. Binary logistic…regression was used to identify factors associated with pregnancy-related LBP and/or PGP. RESULTS: The prevalence of LBP and/or PGP during pregnancy was 63.0%, and most participants (80.4%) had both. The mean NPRS and RMDQ disability scores were 2.44 ± 2.10 and 6.66 ± 4.65, respectively. A higher gestational body mass index, LBP and/or PGP during menstruation, history of pregnancy-related LBP and/or PGP, and constant pressure were significantly associated with pregnancy-related LBP and/or PGP. Subjective support was a protective factor against LBP and/or PGP. CONCLUSION: The prevalence of LBP and/or PGP was high. The risk factors should be included in routine prenatal care to identify patients at risk of LBP and/or PGP.