Journal of Back and Musculoskeletal Rehabilitation - Volume 5, issue 1
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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: Many individuals continue to exercise train and experience athletic success well into the eighth and ninth decades of their lives. This paper examines the interaction between aging and athletic performance with specific reference to how regular exercise training attenuates the decrements in performance typically attributed to the aging process. The importance of rehabilitation of musculoskeletal injuries to facilitate continued participation in athletics is also addressed.
Abstract: Osteoporosis is a clinical syndrome of bone fragility resulting in fractures with minimal or no trauma. Bone strength is directly related to bone mass, therefore factors that influence bone mass will determine the subsequent risk of osteoporotic fracture. Estrogen loss at the menopause is the most common cause of osteoporosis. Factors that limit the process of bone formation during adolescence and early adulthood can interfere with reaching peak adult bone mass and thereby predispose to osteoporosis in later adult years. Bone remodeling (bone resorption followed by formation) during the early and mid-adult years may be altered by many diseases, medications…and lifestyle (alcohol, inadequate exercise, low calcium intake), resulting in reduced bone mass and increased risk for osteoporotic fracture. Extremes of physical training can also cause bone loss in women athletes, and can be reversed by estrogen and adequate calcium intake. More research is needed to determine which forms of training optimize the effects of exercise on bone mass.
Keywords: Training, Osteoporosis, Densitometry, Bone mass, Stress fracture, Calcium
Abstract: The aging knee presents significant problems to the mature athlete who wishes to continue participation in sports. The meniscus is a key structure in the knee and an injury to it may open the door to progressive arthritic changes. Because of our appreciation of the importance of the menisci, treatment options are geared toward salvaging as much of the meniscus as possible. The anterior cruciate ligament is a frequently injured structure which is associated with meniscus tears, articular cartilage damage and progressive degenerative changes. Once an athlete develops degenerative arthritis of their knee, their treatment options are mainly limited to…arthroscopic lavage and debridement or an osteotomy procedure. The new knowledge and treatment options have allowed physicians to increase their arsenal in their battle to keep the mature athlete participating in sports.
Abstract: Osteoarthritis (OA) is one of the most prevalent and disabling diseases in the elderly, a rapidly growing segment of the population. OA is typically treated with a combination of drugs and inactivity, with total joint arthroplasty as the final treatment alternative. This paper reviews the potential of a non-surgical intervention for patients with OA, namely exercise rehabilitation. Several types of exercise rehabilitation are considered: home exercise (HE), physical therapy (PT), cycle exercise (CE) and a new program, quantitative progressive exercise rehabilitation (QPER). The HE program demonstrated improvements in some physiological and functional variables; however, these improvements were minimal. PT had…a greater effect than HE on quadriceps and hamstring muscle strength and endurance and functional performance; however, PT had no effect on muscle contraction speed. The QPER program improved motor unit activation, quadriceps and hamstring muscle strength and endurance, contraction speed and all aspects of functional performance. In addition, QPER, although not aerobic, improved cardiorespiratory fitness and maximal workrate of VO2 . This program significantly reduced difficulty, dependency and pain (during rest, exercise and at night). It would appear that the therapy of choice would be QPER since it reduces symptoms, improves joint integrity and may lead to delays in arthroplasty. These changes could improve the quality of life of patients with OA, as well as other diseases, and reduce medical costs.
Keywords: Exercise, Home exercise, Knee, Osteoarthritis, Physical therapy
Abstract: This article deals with the problems associated with the spine in an aging athletic person or in an elderly person who may be interested in starting a sports activity. The anatomy and pathophysiology of the spine as regards aging is discussed, as are common diagnostic tests and physical examination procedures. Specific disorders such as spinal stenosis and radiculopathy are examined and special issues in various sports activities are described.
Abstract: This article describes the use of spine stabilization exercises for treating low back pain in the aging athlete. Spine stabilization exercises are appropriate for treating a variety of pathological conditions in the spine and can be effective during all phases of the rehabilitative process. The emphasis of spine stabilization exercises is on minimizing stress on the spine to gain optimal function.
Keywords: Aging athlete, Low back pain, Spine stabilization exercises
Abstract: The radiologic work-up of shoulder pain in the aging athlete should be tailored to meet the needs and expectations of the patient and physician. The value of high quality plain radiographs cannot be over-emphasized. When a more sophisticated imagine is necessary, the choice between arthrography, ultrasound, or MRI imaging is not straightforward. Arthrography is an excellent test to demonstrate full rotator cuff tears. In competitive athletes, a more sophisticated look at the rotator cuff and adjacent structures may be desired, which can be satisfied by MR imaging.
Abstract: Many seasoned athletes are more prone to injury than their younger counterparts due to the effects of aging, lack of coaching, and long intervals between workouts (‘weekend warriors’). This is compounded if the middle-aged athlete was not an athlete as a young adult and therefore lacks prior instruction in good training habits. The author reflects on his own recent injury and interactions with medical care providers. Advice for care-givers includes: (1) wasting no time in work-up if the odds of successful treatment depend on timely diagnosis; (2) remembering to inform the patient of what can be expected during diagnostic and…treatment procedures; (3) not forgetting the psychological well-being of your athlete-patient, and remembering you are treating the person, not just an injury; (4) helping the athlete-patient stay in shape during recovery; (5) involving the athlete-patient in decisions about treatment options, based on a mutual understanding of goals; (6) not assuming the seasoned athlete lacks the same aspirations as the young adult athlete; and (7) helping the athlete prevent other injuries for which he might be at risk.