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: This narrative review will summarise a clinical approach to the investigation of back pain in children and adolescent patients, including a discussion of the epidemiology, presentation, investigation and clinical management of back pain in children and adolescents. This will assist the prompt and accurate diagnosis of spinal disorders that require significant medical intervention. Existing evidence suggests a relatively high incidence of non-specific back pain among young people; 27–48% of presentations of back pain in children and adolescents are attributed to non-specific back pain. Low back pain among schoolchildren is often linked to psychosocial factors and only occasionally requires medical attention,…as pain is benign and self-limiting. Nonetheless, those young patients who seek medical assistance exhibit a higher incidence of organic conditions underlying the major symptom of spinal pain. A cautious and comprehensive strategy – including a detailed history, examination, radiographic imaging and diagnostic laboratory studies – should be employed, which must be accurate, reliable, consistent and reproducible in identifying spinal pathologies. A specific diagnosis can be reached in 52–73% of the cases. For cases in which a specific diagnosis cannot be made, re-evaluation after a period of observation is recommended. At this later stage, minor symptoms unrelated to underlying pathology will resolve spontaneously, whereas serious pathologies will advance and become easily identified.
Keywords: Back pain, clinical assessment, management, children, adolescents
Abstract: BACKGROUND: Core-strength is vital for Greco-Roman wrestling, although studies have yet to establish the effectives of core-specific training in this sport. PURPOSE: To examine the effect of core-specific strength training on determinants of Greco-Roman wrestling performance in elite junior athletes. METHODS: Twenty state-level, junior, Greco-Roman wrestlers were randomized into a core-specific training group (COR; n = 12) and a control group (CON; n = 8). The COR group undertook a 4-week, core-specific training program concurrently with their typical training program, whilst the CON group completed…4 weeks of typical training only. Both groups completed overhead medicine ball throw (OMBT), Suplexes, bridges and medicine ball chest throw (MBCT) prior to and following the intervention. RESULTS: The COR group demonstrated significantly greater improvement in bridges (p = 0.037; F = 5.046) and OMBT (p < 0.001; F = 26.43) than the CON group, with moderate to large between-group effect sizes (ES = 0.79–2.35). In addition, the effect size calculations were moderate-to-large (0.79–0.87) for Suplex and MBCT, with measures for the COR group greater than the CON group. CONCLUSION: Accordingly, core-specific training programs should be combined with wrestling-specific conditioning programs to improve back and hip extensor performance in junior Greco-Roman wrestlers.
Abstract: BACKGROUND: Facet syndrome is defined as pain that arises from any structure of the facet joints, including the fibrous capsule, synovial membrane, hyaline cartilage, and bone. OBJECTIVES: To compare the effectiveness of US-guided and blind injections on clinical outcome in facet syndrome. MATERIALS AND METHODS: Forty-seven patients with the diagnosis of facet syndrome were included. Patients were consecutively randomized into one of the two groups. The patient’s history, physical examination and routine laboratory parameters were obtained and diagnose was established based on physical findings. Two injections (mixture of 2 ml of 1% lidocaine hydrochloride and…20 mg of triamcinolone, to a single or maximum two sites depending on the clinical characteristics of the facet joint) were performed with 15 days apart, as blinded or US-guided manner. Clinical outcome assessments were carried out at 0, 2nd and 6th weeks, using Visual Analog Scale (VAS), Oswestry Disability Index (ODI) and State-Trait Anxiety Inventory (STAI). RESULTS: The patients’ initial VAS and ODI were not significantly different. When the two groups were compared in the 6th week in terms of VAS scores, improvement was more pronounced in the US-guided injection group (US-guided group (n = 23) before 7.6 (2.2) cm, after 3.0 (1.7) cm, P = 0.0001 vs blind group (n = 24) before 7.2 (1.3) cm, after 5.2 (2.0) cm, P = 0.0001). The improvement in initial and 6th week ODI was statistically significant in the US-guided injection group (P = 0.006). Except STAI I for US-group, trait anxiety scale scores was significant in both groups. CONCLUSION: The US-guided local injections offer better clinical outcome in the treatment of facet syndrome.
Keywords: Facet joint, injection, ultrasound, low back pain
Abstract: BACKGROUND: Soccer as a sport has a very high injury rate and low back pain (LBP) is considered to be the most common overuse injury typically occurring in the back and spine in elite soccer players. OBJECTIVE: This study aimed to investigate differences in knee muscle strength and muscle imbalances in soccer players according to lower back pain. METHODS: One hundred and thirty-six male professional soccer players (20.49 ± 3.73 years, 76.57 ± 8.24 kg, 182.63 ± 6.73 cm) volunteered for the study. The isokinetic dynamometer PrimaDOC (EASYTECH,…Italy) was used to assess the hamstring and quadriceps strength at the selected speeds of 60 ∘ /s, whereas the Roland-Morris Disability Questionnaire (RDQ) was used as a health status measure to assess physical disability caused by low back pain. RESULTS: A univariate analysis of variance has shown that there is a statistically significant difference among the groups divided into Absolut peak torque right knee flexors, Absolut peak torque left knee flexors, Ratio between hamstrings and quadriceps strength right leg, Ratio between hamstrings and quadriceps strength left leg based on the RDQ scores. On the other hand, no other significant differences among the groups were found in other parameters CONCLUSION: The current study indicates that knee muscle strength variables, resulting from an isokinetic testing, have the potential to discriminate between soccer players with and without a history of low back pain. However, low back pain is a multidimensional phenomenon and knee muscle strength or imbalance alone cannot be expected to explain low back pain.
Abstract: BACKGROUND AND OBJECTIVE: In the available literature there are no reports on the effectiveness of Kinesio Taping (KT) in the conservative treatment of patients with anterior instability of the knee. The purpose of the present research was to evaluate the influence of the selected KT technique in limiting the anterior translation of the tibia by performing a biomechanical analysis of the gait cycle of patients with anterior instability of the knee. METHODS: A total of 31 patients qualified for the single group study. In all patients, a total tear of the anterior cruciate ligament was…diagnosed. The research tool was a three-dimensional motion analysis BTS SMART system. The effectiveness of KT of the knee with an anterior cruciate ligament tear was assessed based on angular changes in the movement of the knee in three planes of motion during specific phases of the gait cycle. RESULTS: The results show that KT does not significantly affect angular values of the knee joint in the sagittal and transverse planes of the affected and healthy limb during selected phases of the gait cycle. CONCLUSIONS: Due to only observed changes in the frontal plane, the KT method should be modified to also improve knee function in other planes.
Abstract: BACKGROUND: The prevalence of radiographic knee osteoarthritis (OA) in Japan is high, with an estimated 25,300,000 affected individuals. OBJECTIVE: The purpose of this study was to clarify the characteristics of knee osteoarthritis by comparing differences between patients with knee osteoarthritis and healthy elderly individuals with respect to alignment of the pelvis and lower extremities and range of motion. METHODS: Twenty-six women (13 with medial knee osteoarthritis and 13 healthy elderly) participated in this study. Pelvic tilt, knee extension angle, femoro-tibial angle, quadriceps angle, navicular drop, and leg-heel alignment were measured. In addition, the…range of motion was measured at the hip, knee, and ankle joints. RESULTS: Patients with knee osteoarthritis showed a posterior pelvic tilt, knee flexion, varus, and foot pronation alignment compared to healthy subjects. The range of motion for hip extension, adduction, knee flexion, extension, and ankle dorsiflexion was significantly smaller while the range of motion for eversion was significantly larger in the knee osteoarthritis group. CONCLUSION: People with medial knee OA have different static alignment and ROM compared to those without knee OA. The results clarify the comprehensive characteristics of the pelvis and lower extremities in knee osteoarthritis.
Keywords: Knee osteoarthritis, range of motion, lower extremity, Japanese
Abstract: BACKGROUND: It is known that pain has emotional and behavioral consequences that influence the development of problems and outcome of treatment. Patients’ attitudes and coping mechanisms seem to play a causal role in the chronification of low back pain (LBP) and augment a cycle of chronic pain and disability. OBJECTIVE: To examine pain catastrophizing, stress coping strategies and disability among patients with low back pain in rehabilitation practice in Latvia. METHODS: Seventy-four patients participated in the study. We used the Demographic questionnaire, Visual Analogue Scale, The Oswestry Low Back Disability Questionnaire, Pain Catastrophizing…Scale and “The Ways of Coping scale”. RESULTS: According to our data there is a strong interrelationship of disability and pain catastrophizing. The research data shows significantly higher scores of pain catastrophizing in patients with a more severe disability. CONCLUSIONS: Achieved research highlights the importance of a multifactorial approach to pain management and the enormous significance of pain catastrophizing in patients with low back pain.
Keywords: Disability, low back pain, rehabilitation, pain catastrophizing
Abstract: BACKGROUND: Up until now, assessment of physical functioning in patients with low back pain is mostly completed with the use of patient reported outcome measurements (PROMs). There are however limitations to the use of these measurements such as inaccuracies due to recall bias, social desirability bias and errors in self-observation. A recent review indicated seven clinical tests as having good test retest reliability. These tests can now be further investigated for their validity. OBJECTIVES: To investigate the convergent validity of seven clinical tests (extensor endurance, flexor endurance, 5 minute walking, 50 foot walking, shuttle walk, sit…to stand and the loaded forward reach test) in patients with nonspecific chronic low back pain (CLBP). METHODS: Patients filled in a series of PROMs and performed all included clinical tests during a specific test moment. Convergent validity was firstly investigated by assessing Pearson correlations between the seven included clinical tests and secondly by assessing the correlations between the predefined PROMs and the clinical tests. RESULTS: Twenty-five patients were included in this study representing a power of 84%. The best overall evidence for convergent validity could be identified for the extensor endurance, sit to stand and the loaded forward reach test. However, when all study results were combined, evidence for convergent validity was found for all included clinical tests except for the shuttle walk test. CONCLUSION: The current study was able to provide evidence that multimethod and multidimensional approaches should be used as a more comprehensive assessment of physical function in patients with nonspecific CLBP.
Abstract: BACKGROUND AND OBJECTIVE: The purpose of this study is to determine whether patients, classified by their treating consultant in rehabilitation medicine as avoider or persister, show differences in a large set of detailed outcomes of actual, objectively measured daily physical behaviour. METHODS: In this explorative cross-sectional study, 16 patients were included; 9 patients were categorized as avoider and 7 patients as persister. Subjects wore the VitaMove activity monitor, a high-end accelerometry-based device that allowed automatic detection of a large set of body postures and motions. Physical behaviour was assessed in detail by total duration of body…postures and motions as percentages of 24 hours, as well as by the number of sit-to-stand transfers, overall activity level, walking speed, and the distribution of bouts of physical activity and sedentary behaviour. Differences between groups were tested with the Mann Whitney U test. RESULTS: There were no significant differences between groups in any of the physical behaviour outcomes. CONCLUSIONS: Our study showed that activity-related behavioural style categorization by consultants in rehabilitation medicine is not expressed in objectively measured detailed outcomes of daily physical behaviour.
Abstract: BACKGROUND: Shoulder involvement is frequently observed in chronic renal disease (CRD) and hemodialysis patients. OBJECTIVE: Our aim is to compare shoulder Magnetic Resonance Imaging (MRI) findings of stage 4 CRD patients naive to dialysis, hemodialysis patients and healthy controls. METHODS: Twenty hemodialysis patients with shoulder pain (Group 1), 30 hemodialysis patients without shoulder pain (Group 2), 20 patients with stage 4 CRD (Group 3) and 30 healthy controls (Group 4) were enrolled. Urea, creatinine and β 2 microglobulin were measured. Thickness, homogeneity and integrity of rotator cuff and presence of effusion were…examined by MRI. RESULTS: Supraspinatus tendon was thicker in Group 1 compared to other groups, whereas infraspinatus tendon was thicker in Group 1 compared to Groups 2 and 4. Although all tendons thickness was higher in Group 3 than Group 4, there was no significant difference. Most effusion areas were present in Group 1, followed by Groups 2 and 3. There was a significant correlation between glomerular filtration rate and thickness of supraspinatus, infraspinatus tendons and between β 2 microglobulin and thickness of infraspinatus, subscapularis tendons and total number of areas with effusion. CONCLUSIONS: Increased shoulder tendon thickness and effusion were detected in symptomatic dialysis patients, while greater effusion areas were detected in asymptomatic dialysis patients and in stage 4 CRD patients who do not require dialysis compared to healthy controls.