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: Osteoarthritis is one of the most common joint disorders. It causes pain, stiffness and a decreased range of motion which have a significant impact on daily activities and gait, consequently leading to disability. OBJECTIVE : The aim of this study is to compare hip mobilization with non-weight bearing exercises. METHODS: A total of 57 females aged between 55–65 were divided into 2 groups. In the control group non-weight bearing exercises were conducted, whereas the research group received hip mobilization. RESULTS: The Lequesne index significantly improved in the research group as…compared with the control group. Hip function improved both in the control and research groups. Active hip extension increased by 0.54, while active abduction rose by 2.14 after non-weight bearing exercises. In the control group after mobilization both passive and active hip extension increased significantly by 3.53, active abduction by 5 and passive by 4.41, while active and passive internal rotation by 3.82 and 4.56, respectively. In both groups pain decreased. CONCLUSIONS: Mobilization increases hip range of motion, decreases pain and improves hip function more than non-weight bearing exercises.
Keywords: Hip osteoarthritis, mobilization, manual therapy, therapeutic exercises
Abstract: BACKGROUND: For patients with nonspecific chronic low back pain CLBP, exercise therapy is stated to be the most effective intervention strategy but it is unclear which kind of exercise therapy is most beneficial. OBJECTIVE: To identify preliminary prognostic indicators that predict outcome for exercise therapy in patients with nonspecific CLBP. METHODS: Patients were recruited in two hospitals and received 18 intervention sessions: stabilization, isometric training or a combination therapy. The primary outcome measure was the change in the Modified Low Back Pain Disability Questionnaire after nine weeks. RESULTS: A total…of 59 patients completed the study which represents a statistical power of 90%. In total, 30 patients were categorized as having treatment success and 29 as treatment failure. After using regression analyses to determine the association between standardized examination variables and treatment response status, prognostic indicators were identified for predicting therapy success (positive likelihood ratio [LR], 3.8) and failure (negative LR, 0.19). CONCLUSIONS: The most important variables were the prone instability test, pelvic tilt test, straight leg raise, body weight, visual analogue scale and the short form 36 health survey.
Abstract: BACKGROUND: Trunk stabilization contributes to the efficient control of body movements in daily life, and it plays an important role in maintaining the proper alignment of the body and preventing low back pain. OBJECTIVE: This study aimed to identify the effectiveness of breathing exercises and lumbar segmental exercises on the vital capacity of lumbar instability patients. METHOD: Fifty-nine patients suffering from chronic low back pain participated in this study. They were randomly divided into three groups: experiment group 1 performed breathing and segmental stabilization exercises (n = 20),…experiment group 2 performed segmental stabilization exercises (n = 20), and the control group performed the modality treatment (n = 19). The measurements were assessed on vital capacity. RESULTS: The difference in the forced vital capacity, maximal expiratory pressure, and maximal inspiratory pressure at pre- and post-intervention was significant in the RE+ LSSE and LSSE groups (p < 0.05) and among all groups (p < 0.05). The difference in the forced expiratory volume at one second of each group was significant (p < 0.05) but was not significant among groups (p > 0.05). CONCLUSION: In conclusion, the lumbar segmental stabilization exercise activates the deep muscle and improves the respiratory function, and respiratory pressure, when used for chronic low back pain patients with segmental instability.
Abstract: BACKGROUND: Independent walking is important for individuals who have undergone lower limb amputation. Recently, robot-assisted gait training has been widely used for individuals with abnormal gait. However, no study has evaluated the effect of the Honda Walking Assist Device ® (HWA) on the gait of patients who have undergone transfemoral (TF) amputation. OBJECTIVE: This study aimed to investigate the safety, feasibility, and effect of gait training using the HWA for individuals who underwent lower limb amputation. METHODS: This study included two elderly patients who underwent TF amputation due to…a nontraumatic reason. Gait training interventions using the HWA were performed for a week (5 training sessions). Self-selected walking speed (SWS), step length, cadence, hip kinematic parameters, and symmetricity of single support time ratios during SWS were measured before and after the HWA interventions. RESULTS: SWS, step length, cadence, and hip angle range improved after the HWA interventions in both patients. Symmetricity of single support time ratios and maximum hip extension angle improved in patient 1, but not in patient 2. There were no adverse events in either patient. CONCLUSIONS: Gait training using the HWA was safe and effective for improving the gait of two TF amputees.
Abstract: BACKGROUND: Spinal pain is an important public health issue that brings biopsychosocial problems. Among its treatments, we have the Global Postural Re-education (GPR). OBJECTIVE: Evaluate the effects of GPR on pain, flexibility, and posture of individuals with non-specific low back pain and/or neck pain for more than six weeks. METHODS: The study enrolled 18 individuals, which were randomized into two groups: GPR group (GPRG; n = 09), submitted to 10 sessions of GPR and control group (CG; n = 09), not submitted to…any technique. The evaluations were done before and after the GPRG sessions, for pain perception (Visual Analogue Scale – VAS), flexibility (finger-floor test) and posture (SAPO). The re-evaluation was done in the GPRG after the end of 10 treatment sessions and, in the GC, after the time equivalent to 10 sessions. The level of significance was set at p < 0.05. RESULTS: This pilot study has no homogeneity between groups. GPRG presented improvement in pain and flexibility, but showed no changes in posture. In the CG, there was no difference in the variables evaluated in this study. CONCLUSION: GPR had positive effects on pain and flexibility, but did not present a significant effect on posture.
Keywords: Low back pain, neck pain, flexibility, posture
Abstract: BACKGROUND AND PURPOSE: This case report describes the long-term effect of the high-intensity laser therapy (HILT) in a patient with chronic shoulder pain refractory in comparison to other treatments. CASE DESCRIPTION: Ten sessions of HILT were applied in a thirty-one-year-old woman diagnosed with subacromial syndrome. Assessment was carried out through different tests: Shoulder Pain and Disability Index (SPADI), Numeric Pain Rating Scale (NPRS) and pressure pain threshold (PPT). All measurements were taken at four different points: at the end of the 10 sessions, after one month, three months after the intervention and nine months after the…initial intervention. RESULTS: There was a clinically significant improvement in NPRS (decrease of 5 points), PPT (increase of 1.5 kg/cm 2 ) and SPADI (decrease of 24 points) one month after the intervention. After three months, the increase of NPRS and SPADI required a 5-session intervention to support the clinical improvement. Six months after these booster sessions an increase in PPT and a decrease in NPRS and SPADI were observed. DISCUSSION: Results indicate the suitability of developing new research lines which will optimize the use of HILT.
Keywords: Shoulder pain, shoulder impingement syndrome, high intensity laser therapy, high power laser therapy
Abstract: BACKGROUND: One of the complications of obesity is low back pain, frequently associated with postural disorders. Body adiposity index (BAI) can be calculated without weighing, which may be rendered useful in settings where measuring accurate body weight is problematic. OBJECTIVE: The aim of this study was to compare two indices of somatic structure, i.e., BAI and BMI regarding their accuracy (specific and sensitive) in predicting postural aberrations. METHODS: The study group comprised of 1281 participants aged 20–22 years, who were students from universities in southern Poland. Anteroposterior spinal curvatures were measured using the…Rippstein plurimeter. All subjects were measured for body height (BH) and mass, waist and hip circumference (WC and HC, respectively). RESULTS: In both male and female groups classified according to BAI cut-off points, a significant linear relationship was noted for the lumbar lordosis angle, i.e., the latter increased along with the BAI increase. The analysis of variance confirmed statistically significant differences in lordosis angles in both groups (women f = 19.6, p < 0.001; men f = 21.18, p < 0.001). These data evidenced a weak relationship between LL and the BAI. Pearson correlation coefficient (r) between LL and BAI was 0.2 and 0.21 for men and women, respectively. CONCLUSIONS: We concluded that, contrary to BAI, BMI value did not indicate a significant difference in lumbar lordosis angle between normal weight and obese participants (women and men).
Keywords: Body adiposity index, Rippstein plurimeter, thoracic kyphosis, increments of angles spine
Abstract: BACKGROUND: Mortality rates among immigrant patients undergoing rehabilitation for musculoskeletal backache are unknown. OBJECTIVE: To study the association between marital status, severe psychosocial strain, receiving long-term time-limited sickness allowance (TLSA) and all-cause mortality (ACM) in a cohort of immigrants aged 20–45 years with long-standing backache in Sweden. METHODS: We studied 318 patients (92% foreign-born, 76% non-European) of known marital status on sick-leave for musculoskeletal backache. They were followed up for ACM until 2015. Socio-demographic data, TLSA and psychosocial strain, including major depression, severe psychosocial stressors and pessimistic thoughts, were analysed using multiple-imputation Cox…regression. RESULTS: Over a mean (standard deviation) follow-up time of 15 (5.0) years, 11 (3.5%) participants died. At baseline, 34% were unmarried, 19% were receiving TLSA, and 71% had ⩾ 1 psychosocial strain component (38% depression; 47% severe stressors; 35% pessimistic thoughts). After concomitant risk factors were adjusted for, being unmarried and receiving TLSA were associated with higher mortality by factors of 6.2 (p = 0.005) and 5.8 (p = 0.006), respectively. Psychosocial strain was only significantly associated with higher mortality in the unadjusted analyses. CONCLUSIONS: Being unmarried and receiving TLSA were associated with significantly higher ACM in this highly marginalized group of immigrant patients.
Abstract: BACKGROUND: Many previous studies have explored the effects of manual massage on back muscle fatigue, and most of the mechanical massage techniques imitate manual massage. However, it is unknown whether mechanical and manual massage have the same functions for exercise-induced back muscle fatigue. OBJECTIVE: To investigate the effects of mechanical bed massage on the biochemical markers of exercise-induced back muscle fatigue in male collegiate athletes. METHODS: Twenty-eight male collegiate athletes who met the experimental criteria were recruited in this randomized controlled trial, and randomly assigned to a mechanical bed massage group (experimental group)…or resting group (control group). The subjects performed eight bouts of reverse sit-up in the prone position and received 20 minutes of the intervention. Creatine kinase, blood lactate, and serum cortisol levels were measured at baseline, after fatigue, after intervention, and after 24 hours. RESULTS: The level of serum cortisol of the control group was significantly higher than that of the experimental group after the intervention (p < 0.05). The comparison of the two groups for blood lactate levels showed no significant differences at any of the measurement time-points (p > 0.05). There was no significant difference in creatine kinase levels immediately after the intervention (p > 0.05), but a significant difference in creatine kinase level was observed between the two groups 24 hours later (p < 0.05). CONCLUSIONS: Significant differences were observed between mechanical bed massage and rest condition on serum cortisol and creatine kinase for exercise-induced muscle fatigue. Therefore, mechanical bed massage may reduce stress and muscle damage for the athlete after training or competition.
Keywords: Mechanical bed massage, exercise-induced back muscle fatigue, biochemical marker