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: Chronic Ankle Instability (CAI) is characterized by altered muscle activation, reduced range of motion (ROM) and balance deficits. OBJECTIVE: The aim of this study was to determine whether fibular taping technique influenced the pain intensity, dorsiflexion ROM and dynamic balance in participants with Chronic Ankle Instability. METHODS: Twenty-six participants (16 males and 10 females; age 28.8 ± 5.74 y) with unilateral Chronic Ankle Instability who scored 85 points or less on the Foot and Ankle Outcome Score (FAOS) were included in our study. Mulligan distal fibular taping technique was…applied. Visual Analog Scale, Star Excursion Balance Test in anterior, posteromedial and posterolateral directions and a Weight Bearing Lunge Test were taken before, after, 1 hour after and 24 hours after taping. RESULTS: Distal fibular taping technique decreases pain intensity (at rest, during range of motion and weight bearing conditions), while it increases forward lunge distance and reach distance in anterior, posteromedial and posterolateral directions (p = 0.001). CONCLUSIONS: Our study showed that distal fibular taping reduces pain intensity, postural control and dorsiflexion range of motion in individuals with Chronic Ankle Instability. Further studies are needed with participants with a lower functional level and a higher pain intensity.
Abstract: OBJECTIVES: The aim of this study was to investigate the relationship between the parameters of fatigue, quality of life and leisure time physical activity in prostate cancer (PCa) patients. This is the first study in the literature to report interaction between these parameters from the perspective of physiotherapy and rehabilitation. MATERIALS AND METHODS: Fifty-eight out-patients were enrolled in this study. In an oncologic rehabilitation unit, Functional Assessment of Chronic Illness Therapy-Fatigue Questionnaire (FACIT-F), Functional Assessment of Cancer Therapy-Prostate Questionnaire (FACT-P) and Godin Leisure Time Exercise Questionnaire (GLTEQ) were utilized to evaluate fatigue, quality of life and…physical activity, respectively. Frequencies and the relationships between the results of the parameters were analyzed. RESULTS: The average age of patients was 67.68 ± 7.54 years. Mean scores of FACIT-F [42.94 ± 8.25] and FACT-P [118.81 ± 13.39] were determined. The median score of GLTEQ was 14 (0–70). There were positive correlations between FACIT-F and FACT-P (r = 0.633, p < 0.001); GLTEQ and FACT-P (r = 0.275, p < 0.05) and; FACIT-F and GLTEQ (r = 0.297, p < 0.05). CONCLUSION: Increased fatigue and decreased leisure time physical activity level may affect quality of life negatively. Moreover, it was observed that decreasing leisure time physical activity level affects fatigue negatively. Accordingly, physiotherapists with PCa patients may focus on developing physical activity levels in various ways to address the multidimensional problems of fatigue and quality of life.
Keywords: Prevention, cancer control strategies, modifiable and predicted risk factors
Abstract: BACKGROUND: The asymmetric loading of trunk muscles in sports like golf or tennis may cause side-to-side imbalances in rotational muscle strength and endurance. Such imbalances may be compounded by the presence of low back pain (LBP) and related injuries. However, trunk rotational power is a better predictor of athlete performance, and therefore its ability to reveal these asymmetries/dysbalances should be investigated. OBJECTIVE: This study compares peak and mean values of power during trunk rotations on the dominant and non-dominant side in golfers, ice-hockey players, tennis players, and an age-matched control group of fit individuals.…METHODS: Groups of 17 golfers, 17 ice-hockey players, 21 tennis players, and 39 fit individuals performed standing trunk rotations to each side with a bar weight of 5.5, 10.5, 15.5, and 20 kg placed on the shoulders. Peak power and mean power in the acceleration phase of trunk rotations were measured using the FiTRO Torso Premium system. RESULTS: Peak power and mean power in the acceleration phase of trunk rotations were significantly higher on the dominant (D) than non-dominant (ND) side at weights of 5.5 kg (14 and 14%), 10.5 kg (17 and 14%), 15.5 kg (16 and 15%), and 20 kg (16 and 16%) in ice-hockey players, at 5.5 kg (14 and 13%), 10.5 kg (17 and 14%), and 15.5 kg (15% – only peak power) in tennis players, and at 5.5 kg (17 and 18%) and 10.5 kg (19 and 17%) in golfers. However, their values did not differ significantly at these weights (< 10%) in the age-matched control group. The D/ND ratio was the highest in ice-hockey players (1.18, 1.19), followed by golfers (1.16, 1.17) and finally tennis players (1.12, 1.16). CONCLUSION: Taking into account significantly higher trunk rotational power on the dominant than the non-dominant side in golfers, tennis players and ice-hockey players at lower and/or higher weights and no significant side-to-side differences in a control group of fit individuals, this parameter may be considered specific to their asymmetric loading during trunk rotations. However, whether these asymmetries/dysbalances expressed by the D/ND ratio could also identify the likelihood of LBP, needs to be proven.
Abstract: BACKGROUND: Latent myofascial trigger point (LMTP) is a small hypersensitive area in skeletal muscles that becomes painful under compression or stimulation. LMTPs are relevant for various musculoskeletal disorders. Although several treatments have been introduced to treat LMTP, the most efficient one is yet to be found. OBJECTIVE: The main purpose of the present study was to compare pressure release, phonophoresis of betamethasone and dry needling on the upper trapezius latent myofascial trigger point. METHODS: Sixty participants (mean ± SD age, 23.6 ± 2.1 y), with at least…one latent myofascial trigger point in the upper trapezius muscle, participated in this study. Subjects were randomly divided into three groups (pressure release, phonophoresis with betamethasone and dry needling groups) for two weeks. Pain intensity, pain pressure threshold and active cervical range of motion were assessed. RESULTS: Significant pain decrease, active cervical range of motion and pain pressure threshold increase were observed in the three groups (p < 0.001). The dry needling and phonophoresis groups reported more significant improvement compared to the pressure release group (p < 0.001). There was no difference between the dry needling and phonophoresis groups. CONCLUSIONS: Considering the significant, positive effects of all three methods, dry needling and phonophoresis seem to be more effective than pressure release.
Keywords: Trigger point, trapezius muscle, phonophoresis, betamethasone, needles
Abstract: BACKGROUND: The aim of this study was to determine the relationship between bone mineral density (BMD), gluteus maximus muscle volume, and hip fracture type in patients with hip trauma. METHODS: A total of 134 patients were included in the study; 76 were in the study group [mean age 71.89 (65–80)] (hip fracture group), and 58 were in the control group [mean age 71.27 (65–80)] (hip trauma without fracture). The fracture type, femoral head diameter (FHD), and body mass index (BMI) were assessed. Fracture type was evaluated according to AO/OTA classification. The total gluteus maximus volume t…(GMV) was evaluated via computed tomography (CT). RESULTS: In both groups, there were significant positive correlations between BMD and tGMV/FHD, tGMV/BMI, and tGMV. When comparing the groups regarding total muscle volume, the muscle volume in the control group was significantly higher. CONCLUSION: According to this study, GMV have an impact on bone mineral density. The risk of hip fracture should not be assessed by only examining bone density in patients over 65 years of age. The clinical relevance is that increasing the gluteal muscle volume above cut-off value in elderly individuals may help to reduce hip fracture risk.
Keywords: Muscle volume, osteosarcopenia, osteoporosis, hip fracture
Abstract: BACKGROUND: Sacroiliac joint dysfunction (SIJD) accounts for up to 30% of patients with low back pain. Rigid taping techniques are often used for conservative treatment of SIJD related symptoms; however, its effectiveness has not been systematically evaluated. OBJECTIVES: The aim of our study was to investigate the effect of rigid tape on pain, malalignment and mobility deficits associated with anterior innominate SIJD. METHODS: Two groups (n = 37; experimental and control) diagnosed with SIJD participated in a randomized, controlled trial. Tape was applied for 2 weeks in the…experimental group, whereas the control group received no treatment. 2 × 2 (group × time) GLM-MANOVA assessed effects of tape on pain; innominate rotation; and hip rotation range of motion. Chi-square and McNemar tests assessed the effect of tape on Gillet and Sitting forward flexion mobility tests; the Patrick, Posterior shear and Gaenslen pain provocation tests were used to test pain. Variables were assessed before (PRE) and after (POST) two weeks. RESULTS: No group differences were observed for any variable PRE. Pain intensity and innominate rotation (p < 0.05) and number of positive mobility and pain provocation tests (p < 0.05) decreased from PRE versus POST in the experimental group. No differences were observed in the control group. CONCLUSION: Two weeks of rigid tape for anterior innominate correction successfully reduced symptoms related to SIJD.
Abstract: BACKGROUND: Aquatic exercises are often recommended for people with osteoarthritis (OA), however, there is a lack of evidence about the effects of these exercises. OBJECTIVES: The purpose of this study was to investigate the effects of two different aquatic exercise trainings on cardiopulmonary endurance and emotional status in patients with knee osteoarthritis. METHODS: Eighty-nine patients who had been diagnosed with knee osteoarthritis were divided into three groups: into two different aquatic exercise training groups (only lower extremity training vs. lower extremity + upper extremity and trunk exercises) or into the…control group. All groups have received the conventional therapy which consisted of a hotpack, ultrasound, transcutaneous electrical nerve stimulation (TENS), and home exercises. Six-minute walk test (6MWT) and the Hospital Anxiety and Depression Scale (HAD) were used for assessing cardiopulmonary endurance and emotional status, respectively. RESULTS: Following the treatment, all groups improved in terms of systolic blood pressure, walking distance and total HAD scores. Group 1 showed extra improvements in diastolic blood pressure, heart rate and perceived exertion and Group 2 showed extra improvements only in perceived exertion. Greater changes before and after the treatment in diastolic blood pressure at rest and following 6MWT, perceived exertion following 6MWT, walking distance, HAD depression scores and HAD anxiety scores were observed in Group 1. CONCLUSIONS: Exercise therapy consisting of only lower extremity exercises in water might be more effective in improving exercise capacity and depression levels in comparison to upper extremity and trunk added exercises or conventional physical therapy.
Keywords: Osteoarthritis, exercise, exercise capacity, emotional status
Abstract: BACKGROUND: Chronic low back pain (CLBP) is a public health problem that causes high levels of disability. Psychological and physical factors could play a critical role in the disability perception of patients. OBJECTIVE: The objective was to identify the psychological and physical factors associated with CLBP disability in patients and assess differences between asymptomatic subjects and CLBP patients through physical tests and psychological self-reports. METHODS: A cross-sectional study was performed. Total sample of 80 participants were classified into two groups: patients with CLBP (n = 49) and asymptomatic…subjects (i.e. the control group) (n = 31). The physical tests included lower back range of motion (LBROM), postural stability, lower back strength (LBS), and lumbopelvic motor control tests. The psychological self-reports included low back disability (Roland Morris Disability Questionnaire), self-efficacy, pain catastrophizing, and pain-related fear. RESULTS: Self-efficacy and LBS displayed moderate negative correlations with disability in patients with CLBP (R = - 0.47 and - 0.40, respectively). Disability was predicted by self-efficacy and LBROM (β = - 0.45 and - 033 respectively, p < 0.01), explaining 30% of the variance in these patients. The comparative analysis showed statistically significant differences between groups in the physical/psychological variables (p < 0.01); however, the effect-sizes were small for all these variables. CONCLUSIONS: The results of this study highlight the relevance of psychological and physical factors in CLBP patient disability. Evaluation and treatment in CLBP patients should take these factors into account.
Keywords: Low back pain, chronic pain, disability, range of motion, self-efficacy
Abstract: BACKGROUND: Although commonly utilized treatments, no study has directly compared the effectiveness of joint mobilization and stabilization exercise in individuals with forward head posture (FHP). OBJECTIVE: This study aimed to investigate the effects of upper cervical and upper thoracic spine mobilization versus deep cervical flexors exercise (DCFE) in individuals with FHP. METHODS: Thirty-one participants with FHP were randomized into the mobilization (n = 15) or exercise (n = 16) group. The treatment period was 4 weeks with follow-up assessment at 4 weeks and 6…weeks after the initial examination. Outcomes assessed included the craniovertebral angle (CVA), numeric pain rating scale (NPRS), respiratory function, and the global rating of change (GRC). RESULTS: Participants in the mobilization group demonstrated significant improvements (p < 0.05) in CVA, NPRS, and respiratory function, as compared to those in the exercise group. In addition, 9 of 15 (60%) participants in the mobilization group, as compared to 4 of 16 participants (25%) in the exercise group, had a GRC score of + 4 or higher. CONCLUSIONS: The combination of upper cervical and upper thoracic spine mobilization indicated better overall short-term outcomes in CVA, NPRS, respiratory function, and GRC compared with DCFE in individuals with FHP.
Keywords: Forward head posture, mobilization, exercise, neck pain, respiration
Abstract: BACKGROUND: Shoulder pain in wheelchair (WC) basketball players is common. Yet there was no scale to define shoulder pain. OBJECTIVE: This study was performed to develop a shoulder pain scale for WC basketball players. METHODS: A five-step procedure was followed: Identifying the feature, writing down the items and drafting the form, formulating the final form, pre-pilot-pilot implementation, and validity-reliability analyses. The final form of the scale consisted of 15 items about self-care and sport-specific activities. RESULTS: External factor analysis showed that the scale had a two-factor structure which is “Shoulder…Pain during Sports” and “Shoulder Pain during Self-care Activities”. Pre-rotation results of factor analysis showed that if all of the items were loaded on the first factor, it would have an eigenvalue more than 7 times larger than the eigenvalue of the second factor. Therefore, it can be concluded that the scale can be used as a one-dimensional scale. The Cronbach’s Alpha values were found to be 0.94 and 0.92 for the shoulder pain factor during sports and self-care activities, respectively. Total value was found to be 0.95. The corrected item-total correlation values were all above 0.60. CONCLUSIONS: This newly developed valid, reliable scale allows assessment of the shoulder pain of WC basketball players.