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Price: EUR 130.00Authors: Invernizzi, Marco | de Sire, Alessandro
Article Type: Editorial
DOI: 10.3233/BMR-245005
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1423-1426, 2024
Authors: Sadiq, Samreen | Noor, Rabiya | Akram, Rizwan
Article Type: Review Article
Abstract: BACKGROUND: Total knee arthroplasty (TKA) is a widely performed surgical procedure aimed at alleviating pain and restoring functionality in individuals suffering from knee osteoarthritis. Despite substantial benefits of TKA, patients are exposed to potential risks, including the occurrence of falls during their recovery period following discharge from the hospital. OBJECTIVE: This integrative review endeavors to comprehensively investigate the existing body of literature to identify and assess the diverse factors that contribute to occurrence of post-discharge falls among TKA patients. Through the synthesis of available research, this study seeks to offer valuable insights that can guide clinical …practices and interventions designed to mitigate the incidence of post-TKA falls, ultimately enhancing patient outcomes and quality of healthcare. METHODS: An integrative review was conducted and databases were searched including Pubmed, PEDro, Cochrane, and SPORTDiscus from 2000 to 2024. A thorough search was performed to retrieve articles missed through databases as well as unpublished grey literature. Methodological quality assessment was performed using Newcastle-Ottawa Scale for Case Control and Cohort studies and AXIS tool for cross-sectional study. RESULTS: Eleven articles finally met the inclusion criteria and were included in the review based on eligibility. There were 8 cohort studies (7 prospective cohorts, 1 retrospective cohort), 2 case control studies, and 1 cross-sectional study. The prospective cohort studies included in the review collected data in real-time as events occurred, making them particularly relevant for studying post-TKA falls. CONCLUSION: Patients who underwent TKA are at risk of post-discharge falls. Several key risk factors have been identified, including advancing age, female gender, reduced proprioception, psychiatric disorders, living alone, and knee pain in the operated knee. It is important to recognize that the significance of these risk factors can vary depending on individual circumstances and contexts. Show more
Keywords: Balance, discharge planning, risk of falls, total knee replacement
DOI: 10.3233/BMR-230165
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1427-1439, 2024
Authors: Sia, Lee Lee | Sharma, Shobha | Ing, Janet Bong May | Kumar, Saravana | Singh, Devinder Kaur Ajit
Article Type: Review Article
Abstract: BACKGROUND: The growing use of telerehabilitation within the healthcare community has garnered substantial attention. In congruence with other healthcare fields, examining perceptions, barriers, and facilitators assumed paramount significance in the continuation and fortification of telerehabilitation practices among physiotherapists. OBJECTIVE: In this scoping review, we aimed to systematically map the literature on the perceptions of physiotherapists as well as the barriers and enablers of telerehabilitation in their daily practice. METHODS: The five-stage methodological framework recommended by Arksey and O’Malley (2005) was used for this scoping review. In the framework, eight databases were searched using …key search terms such as “telerehabilitation”, “physiotherapists”, “readiness”, “enablers” and “barriers” All findings were organised into perceptions and readiness, enablers, and barriers. RESULTS: Fourteen articles met the inclusion criteria and were categorized as: (1) perception and readiness, (2) enablers, and (3) barriers. In the perception and readiness category, new trends in healthcare, advancement in physiotherapy practices and the benefits to clients were identified. The enablers identified included prior training, personal experience, familiarity with technology, functional equipment and space, and client selection. The barriers to the adoption of telerehabilitation in physiotherapy practice are pinpointed to poor technology, communication hurdles, limited availability, lack of familiarity, and client-related concerns. CONCLUSION: While initial evidence suggests a generally positive perceptions it is important to consider both facilitators and barriers when understanding adoption. This review’s findings revealed a wide research gap, with unequal weightage towards barriers compared to enablers, and highlights the need for further research. Developing telerehabilitation guidelines that cater to both physiotherapists and clients is necessary. Show more
Keywords: Physiotherapists, telerehabilitation, perceptions, enablers, barriers
DOI: 10.3233/BMR-240009
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1441-1454, 2024
Authors: Aslan, Sefa Gümrük | de Sire, Alessandro | Köylü, Sinem Uyar | Tezen, Özge | Atar, Merve Örücü | Korkmaz, Nurdan | Lippi, Lorenzo | Invernizzi, Marco | Longo, Umile Giuseppe | Kesikburun, Serdar
Article Type: Research Article
Abstract: BACKGROUND: Osteoarthritis (OA) is a widely-known disease distinguished by the breakdown of joint cartilage, leading to pain and morning stiffness. In this context, the role of corticosteroids is well known, but there is still a gap of knowledge on the duty of oxygen-ozone therapy (O2-O3). OBJECTIVE: To evaluate for effectiveness of ultrasound-guided O2-O3 injections compared with corticosteroid injections among patients diagnosed with knee OA. METHODS: This randomized controlled clinical trial was conducted on participants with knee OA who were randomly sorted into two groups: group A, undergoing corticosteroid group (n = …47) and group B, undergoing O2-O3 (n = 49) were injected within the knee joint under ultrasound guidance. The primary outcome measure was the change in the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score between baseline and 12-weeks post-injection. Secondary outcome measures included visual analog scale scores, joint effusion and a knee flexion ROM. Assessments were recorded at baseline and 4-weeks and 12-weeks post-injection. For the examination of intra- and inter-group variations at various time points, a repeated-measure analysis of variance (two-way ANOVA) was employed. RESULTS: Ninety-six participants completed this study. Based on repeated measurement analysis of variance, a significant effect of time was found for all outcome measures in both groups. Both groups showed clinically significant improvements in knee pain, quality of life and, function. Baseline, 4-week post-injection and 12-week post-injection WOMAC scores (mean ± standard deviation) were 72.54 ± 18.89, 45,95 ± 13.30 and 37.10 ± 19.87 (p = 0.00, p = 0.00, p = 0.00; respectively) in the corticosteroid group, respectively and 68.23 ± 20.18, 42.99 ± 18.67, and 33.43 ± 18.24 (p = 0.00, p = 0.00, p = 0.00; respectively) in the ozone group, respectively. However, no significant group × time interaction was determined regarding all outcome measures. CONCLUSION: The study demonstrates the efficacy of O2-O3 compared to steroid injections regarding functioning and pain relief among patients with diagnosed knee OA. Show more
Keywords: Ozone, knee osteoarthritis, corticosteroids, rehabilitation, oxygen-ozone therapy
DOI: 10.3233/BMR-240023
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1455-1466, 2024
Authors: Roberts, Katharine E. | Ho, Emma | Gassen-Fritsch, Carolina | Halliday, Mark | Mattinty, Manasi Murthy | Ferreira, Paulo
Article Type: Research Article
Abstract: BACKGROUND: Initiating and maintaining physical activity is particularly difficult for at-risk groups such as those with chronic low back pain (LBP). OBJECTIVE: This study aimed to assess whether there is a relationship between perceived social support (e.g., emotional and physical support) in individuals recently discharged from treatment for chronic LBP and the number of exercise sessions and total amount of exercise they perform over a 6-month period. This study also aimed to investigate a possible mediation effect of exercise self-efficacy on the relationship between perceived social support and exercise adherence (number of exercise sessions and total …amount of exercise). METHODS: This prognostic study employed a secondary analysis of data collected for The Buddy Study; Data was collected through online weekly diaries over a 6-month period. Poisson regression analyses were used to quantify the relationship between social support at baseline and total number of exercise sessions, and total amount of exercise performed (frequency and duration) in the 6-month follow-up period. Where a relationship was observed, the Stata SEM command was used for the mediation analysis. RESULTS: A positive relationship was found between participants’ perceived levels of social support at baseline and the total number of exercise sessions they performed (IRR = 1.56, 95%CI: 1.18 to 2.06) and the total amount of exercise they performed (IRR = 1.57, 95%CI: 1.05 to 2.35) during the 6-month follow-up period. No mediating relationship was found between exercise self-efficacy at 3-months and the total number of exercise sessions performed (β 3.96, 95% CI: - 4.91 to 12.84), or the total amount of exercise performed (β 243.96, 95% CI: - 258.08 to 746.01). CONCLUSION: Social support is potentially an important aspect of exercise adherence, following discharge from treatment, for those with chronic LBP. People’s self-efficacy to exercise does not appear to mediate this relationship. Harnessing social support following physiotherapy treatment may increase exercise adherence and may therefore improve long term outcomes for those with chronic LBP. Show more
Keywords: Exercise therapy, rehabilitation, perceived social support, self-efficacy, physiotherapy
DOI: 10.3233/BMR-230239
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1467-1477, 2024
Authors: Santos, Ruben | Pires, Diogo
Article Type: Research Article
Abstract: BACKGROUND: Musculoskeletal conditions are the leading cause of disability, requiring continuous outcome measurement, including the utilization of patient-reported outcome measures (PROMs). OBJECTIVE: The aims of the study were a) to characterize the use PROMs by Portuguese physiotherapists in patients with musculoskeletal conditions; b) to analyze the associated factors of their use and; c) to identify the barriers and facilitators to their implementation. METHODS: A cross-sectional online survey was carried out with musculoskeletal physiotherapists working in Portugal. Closed questions were used to describe the use of PROMs. The factors associated with the non-use of …PROMs were analysed through logistic regression models (p = 0.05). Barriers and facilitators were assessed through open questions and analyzed using thematic analysis. RESULTS: One hundred and fifty-six physiotherapists answered the online survey. Most physiotherapists do not use outcome measures consistently and physical tests are often chosen (70.5%) over PROMs (17.3%). The work sector (p = 0.01; p = 0.015; p = 0.009). the workplace stimulus (p = 0.001) and the physiotherapists’ knowledge about PROMs (p = 0.017) were identified as factors associated with the non-use of PROMs. Barriers and facilitators to the use of PROMs are related to physiotherapists’ skills, the patients’ characteristics, the workplace conditions, and the instruments’ characteristics. CONCLUSION: This study showed the poor use of PROMs by musculoskeletal physiotherapists and identified the associated factors, barriers, and facilitators that should be considered to increase its future use by musculoskeletal physiotherapists in Portugal. Show more
Keywords: Outcome measurement, patient reported outcome measures, musculoskeletal pain
DOI: 10.3233/BMR-230208
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1479-1488, 2024
Authors: Abiko, Teppei | Murata, Shin | Shigetoh, Hayato | Ohyama, Michie | Sakata, Eiji
Article Type: Research Article
Abstract: BACKGROUND: Caregivers in Japan experience a high prevalence of low back pain (LBP), with age, sex, individual pain experiences, and central sensitization symptoms potentially influencing its chronic progression. OBJECTIVE: To determine the prevalence of LBP among caregivers, as well as its relation to age and sex, and explore work status, psychological factors, and central sensitization symptoms as contributing factors to chronic LBP (CLBP). METHODS: A large-scale cross-sectional survey was conducted among 1214 caregivers in 35 geriatric healthcare facilities. The survey assessed LBP and CLBP prevalence, work status, psychological factors, and central sensitization-related symptoms. …Multivariate logistic regression analysis was used to identify factors influencing CLBP. RESULTS: Among 936 valid respondents, the LBP prevalence was 69.2%. No significant sex differences were found in the prevalence of LBP and CLBP. Old age, higher pain severity, and severe symptoms related to central sensitization increased the risk of CLBP. However, work status and psychological factors did not significantly contribute to CLBP. CONCLUSION: There is a high prevalence of LBP among caregivers, age and individual pain experience significantly impact CLBP. These findings emphasize the need for therapeutic strategies to manage pain intensity, especially in the acute phase, to prevent the progression to chronicity. Show more
Keywords: Chronic pain, central nerve system sensitization, prevalence, risk factors, psychology
DOI: 10.3233/BMR-230319
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1489-1498, 2024
Authors: Yang, Zhen | Liu, Qiping | Bi, Yongyan | He, Yongping | Wang, Miaomiao | Gao, Qiang | Xiang, Lian | Li, Xiaoliu
Article Type: Research Article
Abstract: BACKGROUND: Scoliosis secondary to cerebral palsy is one of the common complications of cerebral palsy in children with cerebral palsy. OBJECTIVE: This study aimed to explore the efficacy of rehabilitation combined with brace correction in patients with scoliosis secondary to cerebral palsy. METHODS: A total of 52 patients with scoliosis secondary to cerebral palsy were selected from our hospital from April 2019 to April 2022 and divided into the control group and experimental group according to the statistical randomization method (n = 26 in each group). Control group: …mean age (14.28 ± 2.31) years; 16 males and 10 females. Experimental group: average age (14.24 ± 2.35) years; 15 males and 11 females. The control group wore scoliosis orthopedic brace, while the experimental group was treated with rehabilitation manipulation and rehabilitation training (including gymnastic training and weight training) on the basis of the control group for 1 year. The clinical efficacy of the two groups was compared and observed; the number of degrees of scoliosis (Cobb angle), the angle of vertebral rotation (AVR) and the distance of the parietal vertebrae from the sacral midline (AVT) were compared before and after treatment; the incidence of adverse events during treatment was observed in the two groups. RESULTS: After treatment, both groups showed significant improvement in the overall effectiveness of treatment, Cobb’s angle, AVR and AVT compared with those before treatment (P < 0.05). The experimental group had a significantly higher overall effective rate of treatment than the control group (P < 0.05), a significantly smaller Cobb’s angle and AVR than the control group (P < 0.05) and a significantly shorter AVT than the control group (P < 0.05). The incidence of adverse events during treatment was lower in both groups and was not significantly different (P > 0.05). CONCLUSION: The combination of rehabilitation physiotherapy and bracing is effective in optimizing the clinical outcome of patients with scoliosis secondary to cerebral palsy, improving their scoliosis dysfunction and providing a high level of safety in treatment. Show more
Keywords: Rehabilitation, brace correction, cerebral palsy, scoliosis, outcome
DOI: 10.3233/BMR-230336
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1499-1506, 2024
Authors: Amin, Doaa I. | Mohamed, Ghada I. | ElMeligie, Mohamed M.
Article Type: Research Article
Abstract: BACKGROUND: Chronic nonspecific neck pain is a common disorder that causes disability and reduced quality of life. Effective conservative treatment options are needed to manage this condition. OBJECTIVE: This randomized trial compared the efficacy of McKenzie exercises alone versus McKenzie plus cervical and scapulothoracic stabilization training for patients with chronic nonspecific neck pain. METHODS: A randomized controlled trial was conducted in an outpatient physical therapy clinic. 76 patients with chronic (> 3 months) neck pain were randomized to 6 weeks of either McKenzie exercises alone (n = …38) or McKenzie plus stabilization exercise (n = 38). The McKenzie protocol included posture correction, range of motion exercises, and lateral neck stretches. The stabilization program added targeted exercises for the neck and scapula. RESULTS: The combination of McKenzie plus stabilization exercises resulted in significantly greater reduction in current neck pain intensity compared to McKenzie alone at 6 weeks (mean difference: - 1.2 points on 0–10 scale, 95% CI - 1.8 to - 0.6; p < 0.001). Neck disability improved in both groups. Cervical range of motion also improved more with the addition of stabilization, except for extension. CONCLUSION: Adding specific cervical and scapulothoracic stabilization exercises to a standard McKenzie protocol led to clinically meaningful reductions in neck pain compared to McKenzie therapy alone in patients with chronic nonspecific neck pain. This combined approach can improve outcomes. Show more
Keywords: Musculoskeletal diseases, Cervicalgia, exercise therapy, manual therapy, randomized controlled trial
DOI: 10.3233/BMR-230352
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1507-1517, 2024
Authors: Kim, Tae-Gyu | Kim, Young-Hoon | Ma, Rui | Kim, Soo-Yong
Article Type: Research Article
Abstract: BACKGROUND: An evaluation of scapula position is important to predict spine curvature and shoulder function in patients with adolescent idiopathic scoliosis (AIS). Therefore, a reliable scapula position is required to assess posture in patients with AIS. OBJECTIVE: This study investigated the reliabilities of scapula position tests and differences in scapula position and shoulder function between individuals with and without AIS. METHODS: The study compared 18 patients with AIS and 18 healthy controls to identify differences in scapula position and shoulder function. The acromion-table distance, lateral displacement of the scapula, acromion depression, winged scapula, …upward rotation of the scapula, and anterior tilt of the scapula were measured. Scapula position test reliabilities were assessed using the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimum clinically important difference (MCID). Shoulder function was measured using the Shoulder Pain and Disability Index. RESULTS: The reliabilities of scapula position tests (ICC 0.85–0.93, SEM 0.1–1.2, and MCID 0.2–2.5) were good. There were significant differences in scapula position and shoulder function between patients with AIS and healthy controls (p < 0.05). CONCLUSION: Scapula position tests were highly reliable in patients with AIS; they can be used to evaluate scapula position during clinical assessment of posture in patients with AIS. Show more
Keywords: Muscle strength, posture, spine
DOI: 10.3233/BMR-230357
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1519-1528, 2024
Authors: Oxfeldt, Martin | Tegner, Heidi | Björklund, Martin | Christensen, Jan
Article Type: Research Article
Abstract: BACKGROUND: Low back pain (LBP) is the leading cause of disability and an increasing sick leave in Denmark. Psychosocial risk factors have been linked to the development of LBP-related disability and work-absenteeism. The short form Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ-sf) was developed to screen for psychosocial risk factors and assess the risk of long-term disability and work-absenteeism. OBJECTIVE: To translate and cross-culturally adapt ÖMPSQ-sf into Danish and evaluate test-retest reliability with relative and absolute reliability and internal consistency in LBP-patients in a secondary setting. METHODS: A six-step translation and cross-culturally adaptation process …was used. Forty-four patients with subacute and chronic LBP were recruited at an outpatient clinic. RESULTS: Test-retest reliability (n = 37) was found to be excellent (ICC2.1 = 0.92), Internal Consistency (n = 44) was adequate (Cronbach’s alpha = 0.72). Absolute reliability included Standard Error of Measurement (SEM = 3.97 points), 95% Limits of Agreement (95% LOA = 0.08, - 15.90–15.74), and Smallest Detectable Change (SDC = 10.87 points). CONCLUSION: The Danish ÖMPSQ-sf showed acceptable measurements properties in subacute and chronic LBP-patients. Further research is needed to assess other measurement properties of the ÖMPSQ-sf, in relation to validity, responsiveness, and the predictive ability before application in research or clinical practice. Show more
Keywords: Low back pain, Örebro questionnaire, reliability, psychosocial risk factors, disability, work absenteeism
DOI: 10.3233/BMR-230363
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1529-1536, 2024
Authors: Cobanoglu, Gamze | Guzel, Nevin A. | Ecemis, Zeynep Berfu | Demirkan, M. Yusuf
Article Type: Research Article
Abstract: BACKGROUND: The Band Pull-Apart (BPA) exercise is used to strengthen the periscapular muscles. It was recently stated that the lower extremity and trunk movements should be included in the shoulder rehabilitation programs to optimize an effective energy transfer throughout the kinetic chain. OBJECTIVE: The aim of this study is to investigate the effects of kinetic chain based BPA exercise on the muscle activations of the sternocleidomasteideous (SCM) and the trapezius muscles in individuals with and without forward head posture (FHP). METHODS: Eighteen individuals with FHP and 18 individuals without FHP were included. Photographic …measurements were made to identify individuals with FHP. The muscle activations of SCM, Upper Trapezius (UT), Middle Trapezius (MT), and Lower Trapezius (LT) were measured with surface EMG. BPA exercise was performed in the standing, unipedal standing, squat, unipedal squat, and Bulgarian split squat (BSS). RESULTS: There was no Group × Exercise interaction for the SCM, UT, MT, LT muscle activations, or for the UT/MT and UT/LT ratios (p > 0.05). While there was a difference in the activation of all muscles between individuals with and without FHP (p < 0.05), both ratios were similar (p > 0.05). There was a statistically significant difference between exercises for SCM, MT, and LT muscle activations (p < 0.000 for these muscles), UT/MT (p < 0.000) and UT/LT ratios (p = 0.004). SCM muscle activation in squat was lower than activation in standing (Mean Difference (MD) = 2.5% Maximal Voluntary Isometric Contractions (MVIC); p = 0.004) and in unipedal standing (MD = 2.1% MVIC; p = 0.002). MT muscle activation in squat was higher than activation in standing (MD = 9.7% MVIC), unipedal standing (MD = 7.8% MVIC), unipedal squat (MD = 6.9% MVIC) and BSS (MD = 9.4% MVIC; p < 0.000 for these positions). LT muscle activation in the squat was higher than activation in the standing (MD = 8.5% MVIC) and unipedal squat (MD = 8.1% MVIC; p < 0.004 for these positions). UT/MT ratio in the squat was lower than standing (MD = 0.3), unipedal standing (MD = 0.2) and BSS (MD = 0.3; p < 0.000 for these positions). UT/LT ratio in squat was lower than unipedal squat (MD = 0.5) and BSS (MD = 0.6; p = 0.002; for these positions). CONCLUSION: Performing the BPA exercise in the squat position is suggested in cases where lower SCM and UT muscle activation, lower UT/MT, and UT/LT ratios and higher MT and LT muscle activations are needed for individuals with and without FHP. Show more
Keywords: Shoulder, superficial back muscles, electromyography, exercise therapy, posture
DOI: 10.3233/BMR-230397
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1537-1549, 2024
Authors: Shin, Sun-Shil | Yoo, Won-Gyu
Article Type: Research Article
Abstract: BACKGROUND: Trunk rotation is important in many sporting activities The thoracic spine has reciprocal relationships with the lumbar and pelvic spines, such that reduced flexibility in the lumbar or thoracic spine can lead to abnormal patterns of trunk movement and pain. However, few studies have investigated the relative trunk rotation mobilities of the thorax, lumbar, and pelvis. OBJECTIVE: To compare thoracic, lumbar, and pelvic rotation angles during the lumbar-locked rotation test between hyper and normal thoracic rotation groups. METHODS: Thirty-two young, active participants were enrolled in this study. After the attachment of inertial …measurement units at the T1, T7, T12, L3, and S2 levels, the participants were required to stand in a comfortable upright posture for 5 s to allow postural measurements before performing the lumbar-locked rotation test. The participants were then divided into hyper thoracic rotation and normal thoracic rotation groups based on T1 angle measurements obtained during the lumbar-locked rotation test. RESULTS: The hyper thoracic rotation group had significantly higher thoracic rotation angles on both the right (p < 0.05) and left (p < 0.05) sides compared with the normal thoracic rotation group. Furthermore, we observed flat lumbar lordosis in the hyper thoracic rotation group compared with the normal thoracic rotation group, particularly in the lower lumbar region in standing posture. CONCLUSION: Our data suggest that evaluations of thoracic mobility should consider relative thoracic, lumbar, and pelvic motions, rather than the T1 angle alone. This study provides a basis for health professionals to evaluate movement dysfunctions associated with thoracic hypermobility. Show more
Keywords: Flat lumbar, lumbar-locked rotation test, relative movement, thoracic hypermobility
DOI: 10.3233/BMR-230404
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1551-1559, 2024
Authors: Mikkonen, Jani | Luomajoki, Hannu | Airaksinen, Olavi | Goubert, Liesbet | Pratscher, Steven | Leinonen, Ville
Article Type: Research Article
Abstract: BACKGROUND: Exercise is a first-line treatment for chronic non-specific low back pain (CNSLBP). Exercise combined with specific breathing techniques have the potential to improve multifactorial outcomes. No previous studies, however, have compared outcomes between identical exercises with or without a specific breathing protocol in a uniform clinical study setting. OBJECTIVES: 1) To investigate the feasibility of combining synchronized breathing with movement control exercises and evaluate eligibility criteria, randomization procedures, and dropout rates. 2) To study the preliminary efficacy of the interventions on multifactorial outcome measures. METHODS: Thirty subjects with CNSLBP were randomized into …two groups. Both groups had four contact clinic visits where they received personalized home movement control exercises to practice over two months. The experimental group included a movement control exercise intervention combined with synchronized breathing techniques. Trial registration number: NCT05268822. RESULTS: Feasibility was demonstrated by meeting the recruitment goal of 30 subjects within the pre-specified timeframe with enrolment rate of 24.8% (30/121). Synchronized breathing techniques were successfully adhered by participants. Home exercise adherence was nearly identical between the groups without any adverse events. Preliminary efficacy findings on pain intensity, disability, and self-efficacy in the experimental group exceeded the minimal clinically important difference. No such findings were observed in any outcome measures within the control group. Overall, multifactorial differences were consistent because nine out of eleven outcome measures showed greater improvements for the experimental group. CONCLUSION: The synchronized breathing with movement control exercises protocol was feasible and may be more beneficial for improving multifactorial outcomes compared to identical exercises alone. Results suggested progression to a full-scale trial. Show more
Keywords: Chronic musculoskeletal pain, feasibility, breathing exercises, specific breathing technique, motor control exercises, yoga, pilates
DOI: 10.3233/BMR-230413
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1561-1571, 2024
Authors: Lu, Yang | Li, Yalei | Wang, Jingru | Zhao, Feng | Zhu, Chaohua | Wang, Hui | Ji, Xiaoli | Zhang, Haijing | Ping, Ya
Article Type: Research Article
Abstract: BACKGROUND: The knee joint anatomical structure is susceptible to external forces, which can lead to functional break down, profoundly affecting the quality of life and daily functioning of individuals. OBJECTIVE: To investigate the effects of continuous nursing intervention on walking function, quality of life, and treatment satisfaction in patients undergoing unicondylar knee replacement. METHODS: This prospective study included 90 patients who underwent unicondylar knee arthroplasty due to unicondylar osteoarthritis. Participants were divided into two groups based on their nursing methods: the control group (n = 45) and the observation …group (n = 45). RESULTS: Three months post-intervention, the observation group demonstrated significant improvements in knee joint range of motion, Hospital for Special Surgery Knee Score score, and Lysholm knee joint score compared to the control group (P < 0.05). The observation group also had a shorter completion time for the Timed Up and Go test and significantly higher SF-36 scores (P < 0.05 for both). Additionally, Knee Injury and Osteoarthritis Outcome Score scores in the observation group were significantly higher after three months of intervention (P < 0.05). And the observation group reported higher satisfaction rates and lower dissatisfaction rates compared to the control group (P < 0.05). CONCLUSION: Early postoperative rehabilitation guidance, regular reviews, and rehabilitation exercise guidance result in better rehabilitation outcomes, enhanced knee joint function, improved walking ability, and overall quality of life for patients undergoing unicondylar knee replacement. Show more
Keywords: Nursing, arthroplasty, replacement, knee, quality of life
DOI: 10.3233/BMR-230414
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1573-1580, 2024
Authors: Kondo, Yu | Higuchi, Daisuke | Miki, Takahiro | Watanabe, Yuta | Takebayashi, Tsuneo
Article Type: Research Article
Abstract: BACKGROUND: There is a paucity of data on physical activity and its effects in patients after cervical spine surgery. OBJECTIVE: This study aimed to examine the association between physical activity and disability in patients after cervical spine surgery while also considering age, sex, pain, and central sensitization (CS)-related symptoms. METHODS: Participants included individuals with a cervical degenerative condition who had undergone surgery. Neck disability index, physical activity frequency, numerical rating scale for pain intensity, and short form of the CS inventory were recorded more than 1 year postoperatively. The linear mixed model was …performed to examine the association between physical activity and disability. RESULTS: The responses of 145 participants were analyzed. The linear mixed model results showed that the stretching and light-intensity exercise frequency (β = - 0.14, p = 0.039) was independently associated with disability, adjusted for age, sex, pain, and CS-related symptoms. Conversely, other physical activities, such as walking and muscle strength exercises, were not associated with a disability. CONCLUSION: The findings emphasize the importance of performing regular physical activity, regardless of pain and CS-related symptoms. Show more
Keywords: Degenerative cervical disease, disability, physical activity, pain
DOI: 10.3233/BMR-230428
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1581-1589, 2024
Authors: Xie, Xing-Wen | Wang, Chun-Xiao | Zhao, Yong-Li | Luo, Yong-Sheng | Wang, Zhong-Hua | Liu, Jing | Li, Hui | Li, Ding-Peng
Article Type: Research Article
Abstract: BACKGROUND: In China, Tongluo-Qutong rubber plaster (TQRP) is commonly used for cervical spondylotic radiculopathy, but lacks high-quality trials. OBJECTIVE: This study aimed to conduct a multicenter, open-label, parallel-group, randomized controlled trial in China to investigate the practical efficacy and safety of TQRP in the treatment of CSR. METHODS: A total of 240 patients diagnosed with CSR were recruited for the investigation from multiple hospitals in Gansu province, China. The patients were randomly assigned to either an experimental or a control group. The experimental group received treatment with TQRP, whereas the control group was …administered a diclofenac sodium patch (DSP) for a maximum duration of 21 days. The visual analogue scale (VAS) score for pain, the proportion of patients experiencing 50% or more pain relief, the neck disability index (NDI), changes as per the Eaton trial, and recurrence during the follow-up period were evaluated for both groups. The safety and adverse events associated with the concurrent drug therapy were also evaluated. RESULTS: At each time point, the mean VAS and NDI scores of both groups demonstrated a downward trend. The experimental group exhibited a greater decline in VAS score at each time point compared to the control group (P < 0.01). In the Eaton trial, both the percentage of patients experiencing pain relief of 50% or more and the number of abnormal results exhibited improvement. However, the outcomes in the 21 ± 3d experimental group were significantly superior to those in the control group (P < 0.01). During the follow-up period, the recurrence events in the experimental group were reduced compared to the control group. The difference between the two groups was statistically significant (P < 0.05). The incidence of adverse reactions was 1.74% for TQRP and 3.54% for DSP. CONCLUSION: TQRP is effective and safe in the treatment of CSR. Show more
Keywords: Cervical spondylotic radiculopathy, Chinese traditional medicine, TQRP, rubber plaster
DOI: 10.3233/BMR-230431
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1591-1599, 2024
Authors: Son, Aria | Johnson, James | Leachman, Jennifer | Bloyder, Joseph | Brant, Jeannine M.
Article Type: Research Article
Abstract: BACKGROUND: Low back pain (LBP) is a significant source of disability and decreased quality of life. The Self-Natural Posture Exercise (SNPE) intervention can be used effectively in many cases, but feasibility and impact has not been fully explored. OBJECTIVE: The current study explores the feasibility and efficacy of face-to-face (FtF) and virtual (Vir) SNPE programs on chronic low back pain. METHODS: This is a randomized single-blinded waitlist control study with 10 participants in the FtF group (age 45.8 ± 2.89) and 9 in the Vir group (age 52.2 ± …2.3). Participants had low to moderate low back pain for > 3 months. Those who would eventually become the Vir group served initially as a waitlist control (Con) group. The FtF group received 12 weeks of in-person exercise training sessions conducted and the Vir group received weekly recorded training videos created by and featuring the same instructor. Measured outcomes included feasibility assessed by rate of retention and rate of attendance, level of low back pain (Oswestry Disability Index, Visual Analogue Scale), quality of life (36-Item Short Form Health Survey 1.0), muscular pressure pain threshold, and muscle tone. Analysis was done via repeated measures ANOVA and Wilcoxon tests. RESULTS: Rates of retention were 80% in the FtF group and 78% in the Vir group. Attendance rates were 88% in the FtF group and 60% in the Vir group. ODI, VAS, and some SF-36 domains improved in both the FtF and Vir groups. Overall, the FtF group improved in more domains and by a larger degree than the Vir group and both groups improved relative to Con. CONCLUSION: A 12-week SNPE program, done virtually or in person, shows promise in improving ODI, VAS, and some SF-36 domains. FtF appears to be more effective. Future studies would benefit from sampling a larger and more diverse population. Show more
Keywords: Chronic low back pain, rehabilitation, tele-rehabilitation, self-natural posture exercise, physical therapy
DOI: 10.3233/BMR-230441
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1601-1616, 2024
Authors: Zengi, Hakan | Safran, Elif Esma | Şevgin, Ömer
Article Type: Research Article
Abstract: BACKGROUND: Clinical research on the management and rehabilitation of work-related upper spinal pain in bus drivers is sparse, indicating a gap in knowledge and treatment strategies. This highlights the growing need for innovative approaches to rehabilitation programs in this area. OBJECTIVE: To examine the effects of kinesio taping (KT) on pain, functionality, and work performance in bus drivers experiencing neck pain. METHODS: The study involved 44 participants who were randomised into two different groups: the exercise group (n = 22) and the kinesio tape group (n = …22), with participants in both groups undertaking exercise interventions. Evaluations were made before and after 6 weeks of treatment. At the end of the 6-week, the participants’ ROM, pain evaluations and functional scales were evaluated with disability, and work functionality. RESULTS: Neck pain severity decreased in both groups (p < 0.001 for each value), but there was no difference between the groups (p : 0.071). When disability scores were evaluated, improvement was noted in both groups (p : 0.001 for each value), but no statistically significant difference was found (p : 0.754). When the improvements in ROM values before and after the treatment were examined, the difference between the groups was recorded only in the neck extension ROM value (p : 0.011). Significant improvement was noted in all sub-steps of job performance in both groups (p < 0.05). CONCLUSION: KT added to ergonomic training and home exercise programmes is effective in controlling work-related musculoskeletal pain in drivers with neck pain. However, the addition of KT to exercise therapy was found to be no more effective than exercise therapy alone in improving pain control, functionality and work performance. Show more
Keywords: Ergonomics, muscle stretching exercises, occupational diseases
DOI: 10.3233/BMR-240001
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1617-1630, 2024
Authors: Kim, Jun-Hee
Article Type: Research Article
Abstract: BACKGROUND: Low back pain (LBP) is one of the most frequently occurring musculoskeletal disorders, and factors such as lifestyle as well as individual characteristics are associated with LBP. OBJECTIVE: The purpose of this study was to develop and compare efficient low back pain prediction models using easily obtainable demographic and lifestyle factors. METHODS: Data from adult men and women aged 50 years or older collected from the Korean National Health and Nutrition Examination Survey (KNHANES) were used. The dataset included 22 predictor variables, including demographic, physical activity, occupational, and lifestyle factors. Four machine …learning algorithms, including XGBoost, LGBM, CatBoost, and RandomForest, were used to develop predictive models. RESULTS: All models achieved an accuracy greater than 0.8, with the LGBM model outperforming the others with an accuracy of 0.830. The CatBoost model had the highest sensitivity (0.804), while the LGBM model showed the highest specificity (0.884) and F1-Score (0.821). Feature importance analysis revealed that EQ-5D was the most critical variable across all models. CONCLUSION: In this study, an efficient LBP prediction model was developed using easily accessible variables. Using this model, it may be helpful to identify the risk of LBP in advance or establish prevention strategies in subjects who have difficulty accessing medical facilities. Show more
Keywords: Chronic pain, artificial intelligence, risk assessment, health surveys, physical activity, quality of life
DOI: 10.3233/BMR-240059
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1631-1640, 2024
Authors: Zhang, Yan | Zhou, Xiuling | Zhu, Yulan | He, Kai | Li, Xueqi | Chen, Hao | Cheng, Yi | Ding, Hong
Article Type: Research Article
Abstract: BACKGROUND: Morphological changes in the abdominal wall muscle in diastasis recti abdominis (DRA) patients with low back pain (LBP) symptoms and whether there is a wider interrectus distance (IRD) remain unclear. OBJECTIVE: The aim of this study was to determine the correlation between DRA severity and LBP and the morphological differences in abdominal wall muscles between patients who presented with symptoms of LBP and those who were asymptomatic. METHODS: A total of 57 postpartum DRA patients were enrolled, including 21 without LBP, 36 with LBP, and 30 healthy nulliparous women. The numerical rating …scale (NRS) was used to evaluate the degree of LBP. The IRD and muscle thickness of the abdominal muscles were measured via an ultrasonography device at the end of a natural breathing cycle. RESULTS: The abdominal muscles of the rectus abdominis (RA), external oblique muscle (EO), and transversus abdominis (TrA) in the DRA patients were significantly thinner than those in the control group (p < 0.05), whereas the difference in the internal oblique muscle (IO) was not significant (p > 0.05). There were no statistically significant differences in abdominal muscle thickness or the IRD regardless of whether the patients with DRA had LBP symptoms, with similar findings between the NRS score and DRA severity (P > 0.05). CONCLUSION: In DRA patients within one year postpartum, no significant difference was found in the severity of DRA or abdominal muscles, regardless of whether they were complicated by LBP symptoms. Shortening the IRD alone may not be beneficial for improving LBP symptoms in DRA patients. The relationship between DRA and LBP and the role of the abdominal muscles in postpartum LBP should be interpreted with caution. Show more
Keywords: Diastasis recti abdominis, low back pain, abdominal wall muscles, ultrasound, interrectus distance
DOI: 10.3233/BMR-240074
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1641-1647, 2024
Authors: Ijaz, Madiha | Ahmad, Sajid Rashid | Akram, Muhammad
Article Type: Research Article
Abstract: BACKGROUND: The construction of buildings is risky for workers’ musculoskeleton. OBJECTIVE: This study aims to calculate the significance of risk associated with work-related musculoskeletal disorders. METHOD: 600 workers from 20 construction sites were surveyed using the Nordic Musculoskeletal Questionnaire (modified) and their performance was assessed at seven construction-tasks using RULA and REBA sheets. SPSS v. 26 and R programming were used for statistical analysis. RESULTS: The mean value of workers’ age was 28.4381 years, with 8.8205 working months/year and 65USDs monthly earnings. Maximum reporting of body discomfort was by workers …of window/door framing. Workers’ BMI (35–44 kg/m2 ) and break duration (< 15 minutes) prompted neck pain with OR 7.79 (95% CI 1.135-53.587) and OR 1.179 (95%CI 0.231–6.014) respectively. Bagging was dangerous for the ankle with OR 9.881 (95% CI 5.140–18.994), and window/door framing for feet with OR 2.057 (95% CI 1.196–3.539). The mean value of the RULA grand score ranged from 5.89 (lowest for ‘leveling’) to 9.25 (highest for ‘demolishing’), and the REBA sheet between 8–11 for all seven studied work-stages. CONCLUSION: Workers’ upper and lower limbs are affected by the work-stages they perform and the social lifestyle they live in. These findings from 600 workers are sufficient to be generalized for intervention. Show more
Keywords: Work-related musculoskeletal disorders, construction buildings, socioeconomic plights, upper extremity deformities, arthrogryposis, lower extremity deformities, multiplex congenital
DOI: 10.3233/BMR-240078
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1649-1661, 2024
Authors: Shi, Chencui | Zou, Qiangdong | Wei, Hong
Article Type: Research Article
Abstract: BACKGROUND: During pregnancy, structural and functional changes usually occur in the body, which has various consequences, including lower back pain (LBP) and hypothyroidism. One of the risk factors for these problems is physical inactivity. OBJECTIVE: This study aimed to investigate the association of back pain and physical inactivity, weight gain, and hypothyroidism in pregnant women. METHODS: In this cohort study, 420 pregnant women (26.333 ± 5.820 years old) were included. At first, participants answered this question: “Do you have any plans for pregnancy in the next month?” If the answer …was yes, further evaluations were performed. The physical activity and pain intensity were measured by the International Physical Activity Questionnaire Short Form (IPAQ-S) and Visual Analogue Scale. Serum TSH was measured by automated chemiluminescence and commercial kits. Measurements were conducted before, the first, second, and third trimester of pregnancy. RESULTS: Women reporting LBP were less engaged in physical activities and weight gained in the second and third trimesters of pregnancy was significantly higher than pregnant women without LBP (p < 0.05). TSH level and weight gained in pregnant women with low physical activity level was significantly higher than pregnant women with moderate and high physical activity (p < 0.05) (without significant difference in TSH and BMI). The physical inactivity (before: OR: 1.11 95% CI: 0.89 to 1.22; first trimester: OR: 1.09 95% CI: 1.02 to 1.59; second trimester: OR: 0.92 95% CI: 0.87 to 1.31; third trimester: OR: 1.12 95% CI: 1.02 to 1.39), TSH (OR: 0.85 95% CI: 0.57 to 1.29), and weight gain (second trimester: OR: 0.87 95% CI: 0.92 to 1.59; third trimester: OR: 1.44 95% CI: 1.02 to 1.98; p < 0.05) did predict increased pain intensity. CONCLUSION: Using health-oriented approaches to increase physical activity and normalize thyroid function and weight gain during pregnancy can have beneficial effects on LBP. Show more
Keywords: Musculoskeletal disorders, pregnancy, sedentary, thyroid
DOI: 10.3233/BMR-240086
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1663-1671, 2024
Authors: Huang, Shiming | Wang, Qiang | Chen, Daohua | Zhan, Peng | Chen, Dongfeng
Article Type: Research Article
Abstract: BACKGROUND: Advanced knee osteoarthritis (KOA) impacts both knees, resulting in pain, deformity, and substantial restrictions in joint mobility. OBJECTIVE: This study aims to examine the effectiveness of combining arthroscopic debridement with functional exercise in treating advanced KOA. METHODS: A total of 296 patients diagnosed with advanced KOA were divided into two groups: the observation group (n = 152) received arthroscopic debridement combined with functional exercise, while the control group (n = 144) underwent arthroscopic debridement only. The study compared and observed the outcomes between …the two groups. RESULTS: There were no significant differences in knee joint function, inflammation level, and oxidative stress between the two groups before treatment (P > 0.05). Following treatment for six months, the observation group exhibited significantly lower visual analog scale (VAS) score, tissue inhibitors of metalloproteinase-1 (TIMP-1), tumor necrosis factor-alpha (TNF-α ), interleukin-1 (IL-1), matrix metalloproteinase-3 (MMP-3), and malondialdehyde (MDA) levels compared to the control group (P < 0.05). Meanwhile, the observation group showed significantly higher levels of Lysholm score, hospital for special surgery (HSS) score, range of motion (ROM) of knee, peak torque (PT) and total work (TW) for knee extension and flexion, superoxide dismutase (SOD), total antioxidant capacity (T-AOC), and glutathione (GSH) compared to the control group (P < 0.05). Besides, the effective treatment rate in the observation group was notably higher than that in the control group (80.92% vs. 69.44%, P < 0.05). CONCLUSION: The combination of arthroscopic debridement with functional exercise is an effective treatment for advanced KOA. This approach not only enhances the function and strength of knee joint and reduces inflammatory response but also boosts the body’s antioxidant capacity. The treatment exhibits encouraging outcomes and warrants broad implementation. Show more
Keywords: Arthroscopic debridement, Functional exercise, Advanced knee osteoarthritis, Therapeutic effects, Retrospective observation
DOI: 10.3233/BMR-240106
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1673-1683, 2024
Authors: Tapajčiková, Táňa | Líška, Dávid | Slapšinskaitė Dackevičienė, Agnė | Skladaný, L’ubomír
Article Type: Research Article
Abstract: BACKGROUND: Individuals diagnosed with liver cirrhosis typically experience a variety of symptoms. Decompensation, a critical stage in the disease’s progression, is characterized by the emergence of prominent clinical signs. These signs typically include ascites, bleeding tendencies, hepatic encephalopathy, and jaundice. Furthermore, it is noteworthy that regions in the sensorimotor cortex responsible for practical and gnostic functions are closely situated within the parieto-occipital part of the cortex. Liver cirrhosis may also have an impact on this aspect of human motor function. OBJECTIVES: The main objective of the study is to compare the gnostic function and stereognostic function …in individuals with liver cirrhosis and those in a healthy population. METHODS: The patients included in our registry, known as RH7, were enrolled in our study. The first group consisted of 74 liver cirrhosis patients (including 25 women and 49 men). The control group consisted of a 63 healthy population (including 23 women and 40 and men). Both groups underwent both the Petrie and kinaesthesia tests. RESULTS: The results of the Petrie test, which compared healthy participants with those with liver cirrhosis, indicate that the healthy population achieved a significant difference in both right and left upper limb compared to those with liver cirrhosis patients (p < 0.05). The healthy population showed a significant difference compared to liver cirrhosis patients in the kinesthesia test (p < 0.05), except for the second attempt with the left upper limb (p = 0.267). According to the LFI, there was no significant difference in either upper limb during both the initial and second attempts of Petrie test (p > 0.05). CONCLUSION: Patients with liver cirrhosis exhibited significantly poorer gnostic functions compared to the healthy population. This condition also leads to notable impairments in motor functions, affecting both the precision and coordination of movements. Despite these deficits, frailty alone does not appear to be an indicator of worsened gnostic or stereognostic functions. Therefore, while liver cirrhosis has a clear negative impact on motor and cognitive abilities, the presence of frailty does not necessarily exacerbate these specific cognitive deficits. This distinction is crucial for clinical assessments and interventions targeting motor and cognitive rehabilitation in patients with liver cirrhosis. Show more
Keywords: Liver cirrhosis, gnostic and stereognostic function, frailty, rehabilitation
DOI: 10.3233/BMR-240114
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1685-1694, 2024
Authors: Depreli, Ozde | Angin, Ender
Article Type: Research Article
Abstract: BACKGROUND: The hand is the most frequently used part of the body during daily life activities. Any musculoskeletal problem that may occur in the hand can lead to loss of function. OBJECTIVE: This study examined the relationship between the wrist and elbow position adapted during smartphone use, pain and discomfort, smartphone addiction, and hand function. METHODS: Pain and discomfort were evaluated with the visual analog scale, wrist and elbow angle during phone use were evaluated with a universal goniometer, smartphone addiction was evaluated with the Smartphone Addiction Scale-Short Version, and functional status of …the hand was evaluated with the Michigan Hand Outcomes Questionnaire. RESULTS: A total of 120 university students (female: n = 60), with an average age of 22.71 ± 2.7 years, were included in this cross-sectional study. A relationship was found between the angle of the wrist and elbow during smartphone use and pain/discomfort (r = 0.692, p = 0.001), smartphone addiction (r = 0.575, p = 0.001), and hand function parameters (r = 0.20–0.55, p ⩽ 0.05). CONCLUSION: Due to the increased use of smartphones in today’s environment, a preventive program should be developed in which texting for extended periods is avoided, along with frequent breaks to rest the hands, and stretching exercises for the upper extremities during rest. Show more
Keywords: Students, hand joints, elbow joints, visual analog pain scale
DOI: 10.3233/BMR-240154
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1695-1704, 2024
Authors: Yilmaz, Kamil | Sert, Ozlem Akkoyun | Unuvar, Bayram Sonmez | Gercek, Hasan
Article Type: Research Article
Abstract: BACKGROUND: Chronic pain can affect body perception at the central level by causing the somatosensory cortex to rearrange. Additionally, cervical afferent abnormalities in individuals with neck pain can impair proprioceptive sensitivity, potentially leading to alterations in body alignment and biomechanics. Nevertheless, there are insufficient studies exploring these notions. OBJECTIVE: The main objective of this study was to compare the head posture and neck proprioceptive sense of individuals with chronic neck pain and healthy controls. METHODS: Utilizing a cross-sectional study, a total of 76 volunteers comprising 38 individuals with neck pain and 38 matched …healthy controls participated in the study. Head posture and cervical joint position sense were measured using a Cervical Range of Motion Deluxe (CROM) device. Firstly, the deviation angles of the head in three planes were evaluated, then the Head Repositioning Accuracy (HRA) test was performed to determine the joint position error. Visual Analogue Scale (VAS) was used to determine the severity of pain in individuals with neck pain. RESULTS: The deviation angles of the head in all three planes were significantly lower in the healthy control group (p < 0.05). Joint position error values were significantly higher in all directions (flexion-extension, right-left lateral flexion, and rotation) in the neck pain group (p < 0.001). CONCLUSION: The findings show that the proprioceptive sensation of the cervical region in individuals with neck pain was adversely affected, with changes were observed in the head posture. NOTE: The abstract of this study was presented as a verbal declaration at the International Congress of Health Sciences-ICHES-IDU 2020 that was held in İzmir on 20–21 June 2020. Show more
Keywords: Neck pain, position sense, posture, proprioception, proprioceptive disorders
DOI: 10.3233/BMR-240155
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1705-1713, 2024
Authors: Haklıgil, Gizem Vaiz | Oksüz, Sevim | Angın, Ender
Article Type: Research Article
Abstract: BACKGROUND: Although guidelines and systematic reviews recommend the use of exercise in the treatment of chronic pain and neck pain, there are no clear recommendations for conservative treatments frequently used in clinics. The effect of supporting clinical Pilates exercises with passive physiotherapy methods on biopsychosocial status is still unknown. OBJECTIVE: The objective was to investigate the effects of conventional treatment (CT) in addition to clinical Pilates on pain levels, physical condition, functional status, and psychosocial status in individuals with chronic neck pain. METHODS: Fifty women were randomly divided into 2 groups, the clinical Pilates …group (Pilates, n = 25), and the group receiving CT in addition to clinical Pilates (Pilates-CT, n = 25). Both groups received treatment 3 days a week for 6 weeks. The CT program involved the implementation of hot pack (HP) application, Transcutaneous Electrical Nerve Stimulation (TENS), and therapeutic ultrasound (US) to the cervical area. RESULTS: CT in addition to Pilates was more effective in reducing the Visual Analog Scale (at rest and during activity), Neck Disability Index, Fear-Avoidance Beliefs Questionnaire, NeckPix Scale, Hospital Anxiety and Depression Scale-depression, and Cognitive Exercise Therapy Approach–Biopsychosocial questionnaire scores (p < 0.05) and in increasing the degree of change in the extension range of motion (ROM) and cervical flexor endurance values and scores in the energy parameter of Short Form-36 (p < 0.05). CONCLUSION: CT provided in addition to Pilates was more effective in reducing pain levels, disability, fear of movement, depression levels, and negative biopsychosocial status and improving extension ROM and cervical flexor endurance, neck awareness, and the energy/vitality parameter of quality of life in individuals with chronic neck pain. Show more
Keywords: Chronic pain, exercise, physical therapy modalities, endurance, core stability, rehabilitation
DOI: 10.3233/BMR-240170
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1715-1727, 2024
Authors: Longo, Umile Giuseppe | de Sire, Alessandro | De Salvatore, Sergio | Zollo, Giuliano | Di Matteo, Vincenzo | Corradini, Alessandra | Ceccaroli, Alice | Ammendolia, Valerio | Calabrese, Giovanni | D’Hooghe, Pieter
Article Type: Research Article
Abstract: BACKGROUND: Glenohumeral degenerative joint disease may affect up to 20% of the population. There are several classification systems of this disease in the scientific literature. OBJECTIVE: The aim of this study is to determine the reliability and reproducibility of glenohumeral osteoarthritis classification systems. METHODS: We assessed glenohumeral plain radiographs performed in a University Hospital. These radiographs were graded into nine radiological classification systems by two observers on two evaluations. Patients who have performed CT/MRI scan were staged according to the Walch classification. The intra-observer and inter-observer reliability of the classification schemes were determined …by using Cohen’s weighted kappa coefficient. RESULTS: A total of 752 patients were included in the study (52.4% females and 47.6% males), mean aged 66.2 ± 16.3 years. The intra-observer and inter-observer reliabilities were 0.543 (observer 1), 0.630 (observer 2), and 0.760 (inter-observer) for the Weinstein grading system; 0.661, 0.706, and 0.761 for the Guyette grading system; 0.575, 0.679 and 0.704 for the Kellgren and Lawrence classification; 0.817, 0.816 e 0.871 for the Samilson and Prieto classification; 0.791, 0.811 and 0.847 for the Allain modification; 0.797, 0.842 and 0.860 for the Gerber modification; 0.773, 0.827 and 0.828 for the Buscayret modification; 0.584, 0.648 and 0.755 for the Hawkins and Angelo classification; 0.661, 0.749 and 0.764 for the Rosenberg classification. Intra-observer reliability for MRI was 0.757 (observer 1) and 0.675 (observer 2), while intra-observer reliability for CT was 0.811 (observer 1) and 0.653 (observer 2). Inter-observer reliabilities were 0.790 for MRI and 0.673 for CT. CONCLUSION: The classification systems according to Weinstein, Guyette, Hawkins and Angelo, Rosenberg and the modifications of the Samilson and Prieto classification according to Allain, Gerber and Buscayret showed a comparable reliability with the commonly used glenohumeral osteoarthritis grading systems, Samilson and Prieto and Kellgren and Lawrence. Thus, they are recommended for clinical and especially scientific purposes. Show more
Keywords: Shoulder, glenohumeral osteoarthritis, radiological classifications, Walch classification, CT/MRI scan
DOI: 10.3233/BMR-240187
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1729-1739, 2024
Authors: Fatima, Sahar | Asif, Mohammad Musa | Zaheer, Anna | Arslan, Syed Asadullah | Qurat-Ul-Ain, Asifa | Farooq, Ayesha Ahmad
Article Type: Research Article
Abstract: BACKGROUND: The Avoidance Endurance Questionnaire (AEQ) successfully measures the fear-avoidance and endurance-related responses to chronic pain. OBJECTIVE: The objective of this study was to translate, cross-culturally adapt AEQ into Urdu and assess the reliability and validity of the Urdu version. METHOD: For the translation and cross-cultural adaptation process, the Beaton Guidelines were followed. A total of 103 participants responded to the Urdu version of the AEQ SF-12, Pain Catastrophizing Scale (PCS) and Numeric Pain Rating Scale (NPRS) at baseline and after 48 hours. The test-retest reliability was assessed using the intraclass correlation coefficient …(ICC). Cronbach’s alpha was used to measure internal consistency. To measure validity, Pearson’s correlation between the subscales of AEQ-Urdu and other outcome measures (SF-12, PCS and NPRS scores) were used (p < 0.05). RESULTS: The mean age of the total 103 participants was 32.7 ± 10.90 among which 45 (43.6%) were male and 58 (56.3%) were female. The pre-final version of the translated AEQ was tested on 40 Urdu speaking participants and no major changes were made. The Cronbach’s alpha for all subscales of the AEQ-Urdu ranged from 0.848–0.990. AEQ-U showed an excellent test-retest reliability with the ICC ranging from 0.775–0.996. The majority of the subscales of AEQ showed significant (p < 0.05) positive correlation with pain scales (PCS and NPRS) and negative correlation with the domains of SF-12. CONCLUSION: The AEQ-U has reliable and valid construct validity, good internal consistency, and test-retest reliability, indicating that it has adequate psychometric features and can be a useful tool for evaluating pain responses in patients with chronic musculoskeletal pain. Show more
Keywords: AEQ, chronic pain, NPRS, PCS, validity, reliability
DOI: 10.3233/BMR-240197
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1741-1748, 2024
Authors: Sahin, Tülay | Sacaklidir, Rekib | Sancar, Mert | Öztürk, Ekim Can
Article Type: Research Article
Abstract: BACKGROUND: Human assumed central sensitization (HACS) is a potential pathophysiological mechanism underlying a group of musculoskeletal disorders. HACS may negatively influence the outcomes of surgical or interventional procedures. OBJECTIVE: The present study aimed to investigate the impact of HACS on treatment outcomes of transforaminal epidural steroid injection (TFESI). METHODS: Patients who received fluoroscopy-guided single-level lumbosacral TFESI between January 2020 and January 2021 were included in the study. The patients were divided into two groups with respect to the existence of HACS. Patients were assessed before the procedure, at the third week, and at …the third month after the procedure. The presence of HACS was investigated by central sensitization inventory (CSI). The Numerical Rating Scale (NRS), Oswestry Disability Index (ODI), and Beck Depression Inventory (BDI) were used for patient assessment. RESULTS: A total of 65 patients were included in the study. Thirty-one of the patients had HACS. There was no difference between the groups in terms of demographic data. Significant improvement in NRS was found at 3rd week and 3rd month compared to the baseline. BDI and ODI scores were also significantly reduced at the end of 3 months (p < 0.001). NRS scores at all time points were significantly lower in patients without HACS (p < 0.05). CONCLUSION: The presence of HACS has a negative effect on pain scores, disability, and mental state in patients undergoing TFESI. Show more
Keywords: Lumbar disc herniation, epidural injections, central sensitization, central sensitization inventory
DOI: 10.3233/BMR-240231
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 6, pp. 1749-1755, 2024
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