Journal of Back and Musculoskeletal Rehabilitation - Volume Pre-press, issue Pre-press
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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 (LE) is a common problem of the arm. Mulligan has proposed the use of mobilization with movement for LE. OBJECTIVES: To investigate the effects of Mulligan’s mobilization with movement (MWM) in LE. METHODS: Forty patients were included in the study and randomly assigned to group 1 (n = 20), who received MWM, exercise and cold therapy, or group 2 (n = 20), who received exercise and cold therapy. The sessions were conducted five times a week for two weeks. All…measures were conducted at baseline, after treatment, at 1st and 3rd months follow-ups. Mann-Whitney U test, a visual analogue scale (VAS) for pain intensity, Patient-rated Tennis Elbow Evaluation (PRTEE) Questionnaire for pain intensity and functional disability and a dynamometer for hand grip strength were applied. RESULTS: VAS activity pain significantly decreased in group 1 after treatment (p = 0.001), at the 1 st (p < 0.001) and 3 rd months (p = 0.040). There was a significant decrease in VAS night pain in group 1 (p = 0.024), and a significant increase in pain-free grip strength (p = 0.002) after treatment. PRTEE-Pain scores decreased in group 1 after treatment (p < 0.001), 1 st (p < 0.001) and 3 rd months (p = 0.001). CONCLUSIONS: MWM plus exercise and cold therapy is a safe and effective alternative with positive effects on elbow pain, functional capacity, and pain-free, maximum grip strength.
Abstract: BACKGROUND: Low back and pelvic pain in pregnant women is a clinical condition of which the etiology is multifactorial. Thus, various variables can influence the low back and pelvic pain’s intensity. OBJECTIVE: The purpose of this study was to analyze the influence of the gestational trimester, practice of physical activity and weight gain on the intensity of low back and pelvic pain in low risk pregnant women. METHODS: Two hundred and sixty-seven pregnant women participated in this study. The gestational age, body mass index, weight gain, physical activity practice and the low back…and pelvic pain were evaluated. RESULTS: We found a significant difference (P = 0.02) in pain intensity, when comparing active and sedentary pregnant women. No significant differences were found when comparing pain intensity between the gestational trimesters (2 nd versus 3 rd ; P = 0.60). There was no significant relation between the weight gain and pain intensity (r = 0.03 | P = 0.28). The multivariate analysis indicated that sedentary pregnant women have a higher risk (P = 0.001) of intense pain and the pain is not influenced by the weight gain (P = 0.08) and the gestational trimester (P = 0.98). CONCLUSIONS: Sedentary pregnant women have 30% more chances to have higher pain intensities when compared to the active women, regardless of the gestational trimester and weight gain.
Keywords: Pregnancy, low back pain, gestational age, exercises, body weight
Abstract: BACKGROUND: Cervical radiculopathy is a relatively common musculoskeletal disorder resulting in a significant social and occupational impact. Manual therapy is thought to provide relief in cervical radiculopathy; however, evidence is lacking regarding the comparison of different manual therapy concepts. OBJECTIVE: To determine the effects of Maitland’s oscillatory mobilization as compared to Kaltenborn’s sustained stretch mobilization in the management of cervical radiculopathy. METHODS: A randomized controlled trial was conducted at Fauji Foundation Hospital comprising of 46 patients randomized into oscillatory and sustained stretch mobilization groups. Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI)…and cervical range of motion (ROM) were used as outcome variables. RESULTS: No significant differences were observed at base line between the two groups (P > 0.05) except for ROM in extension and left side bending (P < 0.05). In terms of pre and post treatment comparison, P value of less than 0.05 was observed for both groups, indicating both treatments to be effective in isolation. However, post treatment comparison between both groups showed oscillatory mobilization to be superior to sustained stretch mobilization (P < 0.05) in the management of cervical radiculopathy except for the outcomes of pain and side bending. CONCLUSION: Both oscillatory and sustained stretch mobilization techniques are found to be effective in the management of cervical radiculopathy in terms of pain, range and disability. However, oscillatory mobilization is found to be superior in terms of functional ability and range of motion.
Abstract: BACKGROUND: Smartphone devices have been used to measure range of motion (ROM) in different joints. OBJECTIVE: To verify the concurrent validity of thoracolumbar ROM using a mobile application and a digital inclinometer, as well as the intrarater reliability of individuals with and without back pain. METHODS: One investigator was responsible for measuring the ROM during the evaluations performed on 20 asymptomatic subjects and 20 symptomatic subjects in two consecutive days. RESULTS: Regarding to the concurrent validity, the Intraclass Correlation Coefficients (ICC) were classified as very good for all analyzed movements.…For intrarater reliability, the mobile application had ICC varying between good and very good for the symptomatic subjects and very good for asymptomatic subjects. CONCLUSIONS: The mobile application may be considered a valid and reliable tool to assess thoracolumbar ROM for both asymptomatic and chronic low back pain subjects.
Keywords: Data accuracy, reproducibility of results, spine
Abstract: BACKGROUND : Adolescent idiopathic scoliosis (AIS) may change the physical orientation of body segments and affect balance in individuals. Spinal/trunk brace is commonly used for the management of idiopathic scoliosis. The aim of this study was to compare the standing stability of AIS patients with and without a brace, and to compare them with healthy subjects. METHOD : Twenty subjects (10 healthy subjects and 10 AIS with thoracolumbar/lumbar curve) were recruited for the study. Stability of the scoliotic subjects was evaluated while standing with and without orthosis. A Kistler force plate was employed to estimate the mediolateral and…anteroposterior displacements of center of pressure. RESULTS : The results of this study indicated that there was no significant difference between center of pressure variables in healthy subjects and scoliotic patients. Moreover, trunk bracing only influenced the center of pressure (CoP) excursion in mediolateral direction (p < 0.05). CONCLUSION : Although further research studies are needed, results showed that there was no difference between stability of scoliotic and normal subjects. Moreover, the use of orthosis did not improve their standing stability.
Abstract: OBJECTIVE: The aim of this study was to determine the effects of platelet-rich plasma (PRP) treatment on pain, functionality, quality of life, and cartilage thickness in patients with knee osteoarthritis (OA). METHODS: Sixty patients with chronic knee pain were randomly separated into two groups. The first group was administered 4-ml PRP intra-articularly (IA) in three doses at one-week intervals, and the second group had only one dose of a 4-ml saline solution IA. The patients’ pain was measured using the Visual Analogue Scale (VAS); functionality was measured using the Western Ontario and McMaster University Osteoarthritis Index…(WOMAC). The distal femur cartilage thickness was assessed using ultrasonography (USG). RESULTS: All baseline parameters were similar (p > 0.05). In the first and sixth months after the treatment, the VAS scores of the PRP group were significantly low (p < 0.001). In the same group, only the pain sub-score was low in the WOMAC assessment in the first month after treatment. However, in the sixth month, all parameters of the WOMAC score were lower than those of the placebo group (p < 0.05). Cartilage thickness measurements were similar in the two groups (p < 0.05). CONCLUSION: PRP treatment had positive effects on the pain, physical function, and quality of life of patients with knee OA, but it did not increase cartilage thickness.
Abstract: BACKGROUND: The resistive jaw opening exercise (RJOE) was suggested as a potential remedial treatment for patients with dysphagia. However, clinical evidence is insufficient. OBJECTIVE: To investigate the effect of RJOE on hyoid bone movement, aspiration, and oral intake level in stroke patients with dysphagia. METHODS: Forty stroke patients with dysphagia were randomly allocated into either the experimental group (n = 20) or placebo group (n = 20). The experimental group performed RJOE using a portable device, while the placebo group performed RJOE using…a sham device with fewer loads. Intervention was conducted five times a week for 4 weeks. Hyoid bone movement was analyzed by two-dimensional analysis of anterior and superior motion based on a videofluoroscopic swallowing study. Aspiration was assessed using a penetration aspiration scale (PAS), and oral intake level was assessed using functional oral intake scale (FOIS). RESULTS: Both groups showed statistically significant differences in hyoid movement, PAS, and FOIS scale (p < 0.05). However, after the intervention, there was no significant difference between the two groups except for the liquid type of PAS. Effect sizes (Cohen’s d) were 0.9 and 0.7, 0.6 and 0.6, and 1.1 for the anterior and superior movement of the hyoid bone, semisolid and liquid type of PAS, and FOIS scale respectively. CONCLUSIONS: This study suggests that RJOE helps in hyoid movement, aspiration reduction, and oral intake in patients with dysphagia after stroke.
Abstract: OBJECTIVES: Chronic obstructive pulmonary disease (COPD) may increase the risk of osteoporosis and resulting fractures can contribute to disability and mortality of patients. We intended to evaluate the frequency of osteoporosis in male smokers with and without COPD and study whether any correlation existed between osteoporosis and COPD. MATERIALS AND METHODS: This case-control study was carried out in the Department of Medicine, Sylhet M.A.G. Osmani Medical College Hospital, Sylhet, Bangladesh between July 2013 and June 2015. Seventy four male smokers with COPD and 66 age-matched male smokers without COPD were enrolled. All individuals underwent Bone Mass…Densitometry (BMD) by Dual-Energy X-Ray Absorptiometry (DEXA). RESULTS: COPD and non-COPD groups did not differ regarding age and smoking pack-years. Osteoporosis at femoral neck (48.6% versus 16.7%; p < 0.001) and lumbar spine (68.9% versus 37.9%; p < 0.01) was significantly higher in COPD compared to controls. Osteopenia did not differ significantly. Patients with COPD were 4.5 times more likely to develop osteoporosis than controls after adjusting age, smoking-pack years and BMI (adjusted OR = 4.5; 95% CI = 1.8–11.5). CONCLUSIONS: Osteoporosis is more frequent in male smokers with COPD compared to smokers without COPD. COPD is a risk factor of osteoporosis independent of age, smoking and BMI.
Keywords: Osteoporosis, male smokers, COPD, developing country, bangladesh
Abstract: OBJECTIVE: This study aimed to assess the effects of early enteral nutrition (EN) in elderly patients with hip fracture. METHODS: The patients were classified into two groups (with and without EN). We compared the pre- and postoperative albumin (ALB) and inflammatory marker levels of each group and the time spent in bed and quality of life 3 months after surgery between the two groups. RESULTS: The pre- and postoperative IL-6 levels of the experimental group (61.68 ± 51.80 pg/L) were lower than those of the control group (233.11 ±…206.31 pg/L) (P < 0.001). The experimental group spent a shorter period of time in bed (38.75 ± 14.26 days) in comparison to the control group (99.71 ± 56.87 days) (P < 0.001). Quality of life was better in the experimental group than in the control group (P < 0.001). CONCLUSIONS: Early EN reduced the increment of postoperative IL-6 levels and improved healing postoperatively.
Keywords: Hip fracture, ALB, inflamatory cytokines, inflamatory markers
Abstract: BACKGROUND AND OBJECTIVE: This study determined the hand muscle strength parameters and reference values in healthy subjects using the Nicholas Manual Muscle Tester (NMMT) and Manual Muscle Test (MMT) and compared these methods. METHODS: The study was carried out with 200 (102 males, 98 females) healthy adults aged between 18–25 years. Muscle strength evaluations of the hand were performed to determine hand motor ability using both NMMT and MMT. RESULTS: The mean values of age, weight, height and body mass index (BMI) were 19.48 ± 0.95 years, 60.66 ±…8.82 kg, 165.30 ± 7.95 cm and 22.14 ± 2.25 kg/m 2 , respectively, in females, whereas the same values were found as 20.40 ± 1.34 years, 72.53 ± 9.45 kg, 176.20 ± 6.29 cm and 23.25 ± 2.90 kg/m 2 , respectively, in males. There was a statistically significant difference in all demographic data between genders (p < 0.05). Furthermore, correlation coefficient in NMMT was found to be between 0.503 and 0.954. However, there was no correlation between the manual muscle test and NMMT results. CONCLUSION: The observations presented need to be taken into consideration for evaluate musculoskeletal problems and also can be used as reference values for evaluating treatment outcomes.
Keywords: Nicholas manual muscle tester, hand muscles, muscle strength, manual muscle test