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: The effect of core training on dynamic balance and agility has yet to be established in literature, especially among junior athletes. OBJECTIVE: To investigate the effect of core training on dynamic balance and agility among Indian junior tennis players. METHOD: Thirty junior tennis players from various parts of Delhi and the national capital region participated in the study. The study featured a pre-test/post-test experimental design. The subjects were divided into the experimental group (mean age = 15.20 ± 0.41, mean BMI = 20.23…± 1.54) and the control group (mean age = 15.53 ± 1.06, mean BMI = 20.71 ± 1.53). The control group performed regular training, and the experimental group followed a five-week core training program along with regular training. The subjects were evaluated with t-test for agility and the Star Excursion Balance Test (SEBT) for dynamic stability. RESULTS: A significant difference was found in the post-test values of agility (t-test p = 0.000) and dynamic balance using SEBT ((anterolateral; p = 0.00), (lateral; p = 0.02), (posterolateral; p = 0.00), (posterior; p = 0.00), (posteromedial; p = 0.01), (medial; p = 0.03), and (anteromedial; p = 0.03)] except in the anterior direction (p = 0.23)) between the experimental and the control group. The experimental group showed a significant difference in the pre- and post-test values of the t-test and SEBT except in the anterior direction. CONCLUSION: Core training programs can be incorporated safely with players’ regular training to improve their dynamic balance and agility, which can eventually lead to better performance.
Abstract: PURPOSE: The aim of this study was to compare epicardial adipose tissue thickness (EATT), which is a novel cardiometabolic risk factor in patients with ankylosing spondylitis (AS), and carotid intima media thickness (CIMT) with healthy controls to assess the relationship between these markers and disease activity. MATERIALS AND METHODS: This study involved 38 patients with AS and 38 controls with no history of cardiovascular disease. CIMT was measured by Doppler ultrasound, and EATT by echocardiography, in all participants. Total cholesterol (TC), low density lipoprotein (LDL) cholesterol, high density lipoprotein cholesterol, triglycerides, thyroid stimulating hormone, erythrocyte sedimentation…rate, C-reactive protein, and hemogram measurements were performed in all subjects after 8 hours of fasting. In addition, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) scores of the patients with AS were recorded. RESULTS: EATT was significantly higher in patients with AS (0.45 ± 0.17 mm) compared with healthy (0.37 ± 0.10 mm) controls (p = 0.01). Significant positive correlations were detected between EAT thickness and BASFI, CIMT, and disease duration in patients with AS (p = 0.008, p = 0.024, and p = 0.012, respectively). Significant negative correlations were observed between EATT and TC and LDL cholesterol concentrations (p = 0.016 and p = 0.009, respectively). No significant difference was detected in CIMT between the patients (0.515 ± 0.08 mm) and the controls (0.517 ± 0.094 mm, p = 0.98). No significant correlation was observed between CIMT of the patients with AS and the BASDAI, BASFI, TC, HDL cholesterol, systolic blood pressure, or diastolic blood pressure values. Significant positive correlations were observed between CIMT and waist circumference, weight, body mass index, and LDL cholesterol in patients with AS and the controls. CONCLUSIONS: This study demonstrated increased EATT in patients with AS compared with a healthy population, which was positively correlated with disease duration and BASFI.
Abstract: BACKGROUND: A small body of data exists concerning psychosocial issues in adolescent idiopathic scoliosis (AIS) subjected to soft braces. No study was yet performed on the detailed psychosocial implications in AIS patients. OBJECTIVE: To compare the psychosocial implications of the flexible SpineCor with the Cheneau orthosis in AIS females. METHODS: Patients (aged 10–18 years) deliberately assigned to undergo SpineCor (SC group, 30 patients) or Cheneau brace (Ch group, 41 patients) intervention completed the Scoliosis Research Society-22 (SRS-22), the Spinal Appearance Questionnaire (SAQ), the Brace Questionnaire (BrQ) and the Pediatric Outcomes Data Collection Instrument…(PODCI). RESULTS: Concerning the BrQ, study groups differ in regards to emotional functioning (p = 0.014), vitality (p = 0.022) and social functioning (p = 0.048), indicating better functioning in the Ch group. Considering the SAQ, the Ch group assesses body curve (p = 0.024) less critically. Regarding the PODCI, the Ch group scored higher in the Global Functioning Scale (p = 0.023), the Upper Extremity and Physical Function Scale (p = 0.000), the Transfer and Basic Mobility Scale (p = 0.088), the Pain/Comfort Scale (p = 0.009) and the Happiness Scale (p = 0.022). CONCLUSIONS: This study shows that patients treated with the rigid brace assess their vitality, physical function, emotional and social functioning better and are less critical towards body curve, in comparison to patients treated with the SpineCor.
Keywords: Adolescent idiopathic scoliosis, SpineCor, Cheneau brace, self-esteem, health perception
Abstract: BACKGROUND: For treatment of chronic musculoskeletal disorders pains to be successful, drug interventions are required. OBJECTIVE: In this study, we aimed to evaluate the Rational Drug Use Knowledge Level (RDUKL) in patients with musculoskeletal disorders and some relevant factors. METHOD: The study was carried out in October 2017 on patients treated in the Physical Therapy Rehabilitation Hospital in Turkey. The prepared questionnaire and RDUKL scale were administered to 239 patients by face-to-face interviews. The ANOVA test, chi-squared test and logistic regression model were used for the statistical evaluation. RESULTS: Forty-three…percent of the study group was found to have Rational Drug Use Knowledge (RDUK). The patients who used medicines under family supervision had twice as much RDUK as those who did not use medicines under family supervision, and those who were university graduates had six times as much RDUK as those who had primary education or below. Scale score was found to be low in patients with fibromyalgia and high in patients with rheumatoid arthritis (p < 0.05). CONCLUSION: RDUKL was found to be low in the group with chronic diseases and high average age. Besides training, it is important to provide patients with family support about their illness and its treatment. Thus, positive contributions can be made to the increase of the RDUKL.
Abstract: BACKGROUND: Vestibular, neurological and musculoskeletal functions are affected in patients with renal failure. These problems can in turn affect the balance system in peritoneal dialysis (PD) patients. Previously, postural balance changes were shown in hemodialysis patients. This is the first study that evaluates whether there are similar changes in patients with PD. OBJECTIVE: This study aimed to compare balance and fall risk between patients undergoing PD treatment and healthy subjects, and aimed to determine the correlation between biochemical parameters and fall risk and balance assessments in PD patients. METHODS: This controlled study included…58 patients receiving PD treatment (PD Group) and 75 healthy subjects (Control Group). The Berg Balance Scale (BBS) and Tetrax ® Interactive Balance System were used for the comparison of balance between groups. For patients in the PD Group, duration of PD, blood pressure, Kt/V urea (actual mass of urea removed via peritoneal dialysis), and serum biochemical parameters were recorded and correlation analysis was performed between these parameters and balance measurements. RESULTS: There were no statistically significant differences between groups in terms of demographics or BBS scores (p > 0.05). The fall risk of patients in the PD Group was significantly higher than those in the Control Group (p < 0.0001) according to Tetrax measurements. Female gender, older age, higher BMI, and higher blood glucose levels were negatively correlated with balance parameters of PD patients (r > 0.3). There was no statistically significant correlation between duration of PD, blood pressure, and Kt/V urea with balance parameters or fall risk. CONCLUSIONS: Balance was impaired in patients undergoing PD in comparison to healthy subjects. Fall risk may be evaluated using the Tetrax ® instead of BBS for this population. Serum glucose level, BMI and age appear to affect balance and fall risk. Therefore, optimization of body weight and normalization of serum glucose levels are important factors for improving balance. The duration of PD, blood pressure, and Kt/V urea do not affect balance system.
Keywords: Postural balance, risk of fall, peritoneal dialysis, static posturography
Abstract: BACKGROUND: Trunk pelvic mal-alignment and postural control deficit are common problems facing children with cerebral palsy. OBJECTIVE: The aim of this study was to investigate the relation of trunk and pelvic alignment with postural control in children with diplegic cerebral palsy. METHODS: Seventy seven children with spastic diplegic cerebral palsy (CP), aged 6 to 8 years with level II on Gross Motor Function Classification System, participated in this study. Trunk imbalance, lateral deviation of the spine and pelvic tilt were evaluated by using Formetric instrumentation system while postural control was assessed by using…Pediatric Balance Scale. RESULTS: The results showed that there is a moderate negative correlation of trunk imbalance, lateral deviation of the spine and pelvic tilt with postural control (- 0.44, - 0.59 and - 0.57, respectively). CONCLUSIONS: Increased trunk imbalance, lateral deviation of the spine and pelvic tilt may be associated with decreased postural control ability in children with diplegic CP.
Keywords: Cerebral palsy, diplegia, postural control, trunk and pelvic alignment
Abstract: BACKGROUND: Patient satisfaction is a key point in evaluating the quality of physiotherapy services. OBJECIVE: The aim of this study was to determine the Turkish language validity and reliability of the Patient Satisfaction Scale in Physiotherapy (PSSP). METHODS: The study included 168 participants, aged 18–74 years, with musculoskeletal pain. The PSSP, which comprises 14 items in the four sub-dimensions of treatment, admission, logistics and general satisfaction, was applied to all participants. Structural validity was assessed using the principal components method with varimax rotation. Internal consistency and the intraclass correlation coefficient (ICC) were used…for the reliability analysis. The Patient Satisfaction Scale for Physical Therapy Outpatient Clinics (PCCPTO) was used to assess concurrent validity. RESULTS: The participants comprised of 71% females and 29% males with a mean age of 41.9 ± 14.9 years. The sampling competency index was 0.874. The Turkish version of the scale was found to be perfectly reliable (Cronbach’s alpha reliability coefficient = 0.922). Internal consistency ranged from 0.762 to 0.904 in the subscales. Factor analysis revealed that the 14-item scale had four factors explaining 75.59% of the total variance. Floor and ceiling effects were not determined. Concurrent validity analysis showed a strong correlation between the PSSP and PCCPTO (r = 0.78; p < 0.0005). CONCLUSION: The Turkish version of the PSSP is a valid, reliable and easily applicable measure.
Abstract: BACKGROUND: Home-based exercise therapy is effective in reducing pain and improving function in adults with osteoarthritis of the knee. OBJECTIVE: To investigate and compare the effectiveness of the home exercise program and the home exercise program taught by a physiotherapist in knee osteoarthritis. METHODS: The study was conducted with 80 patients with knee osteoarthritis. The patients were randomized into two groups. The first group was given the home exercise brochure by the orthopedist, while the second group did home exercises under the guidance of the physiotherapist. The goniometer for the range of motion…(ROM) of the knee, Myometer for evaluation of the quadriceps and hamstring muscles strength, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Short Form Health Survey (SF-36) were used for evaluation. RESULTS: Statistically significant improvements were found in the post-treatment ROM, VAS, quadriceps and hamstring muscles strength, WOMAC and SF-36 values in both groups (p < 0.05). When the change values were compared, the evaluation results of group II were better than group I statistically (p < 0.05). CONCLUSIONS: This study proved that home exercises taught by a physiotherapist were more useful for patients with knee osteoarthritis. When the home exercise program is implemented, a new role is created for a physiotherapist.
Keywords: Knee osteoarthritis, physiotherapy, home exercise, exercise education
Abstract: BACKGROUND: Burns are traumatic injuries that result in severe tissue damage. A reduction in exercise capacity is the most common functional impairment, although it is not clear to what extent the severity of the burn injury affects the exercise capacity. OBJECTIVE: The aim of this study was to examine the physiological responses to exercise and to evaluate exercise capacity according to burn severity. METHODS: The study included a total of 64 burn patients, comprising 33 with moderate injuries (Total body surface area: 9.93 ± 4.73%; mean age: 37 ±…11.93 years) and 31 with major injuries (Total body surface area: 39.03 ± 10.36%; mean age: 41.09 ± 14.96 years). Heart rate, systolic blood pressure, diastolic blood pressure, double product, dyspnea level, oxygen saturation and leg fatigue before and after the shuttle walk test were recorded. Walking distances were measured after the shuttle walk test. RESULTS: A significant difference was determined between patients with major and moderate burn injuries in respect of the cardiovascular responses to the shuttle walk test. Major burn injury patients had a significantly shorter walking distance than the moderate burn injury patients (p < 0.05). CONCLUSIONS: Burn injury severity was seen to affect the functional capacity and cardiovascular responses to the shuttle walk test. Shuttle walk test can be preferred to evaluate moderate and major burn injury patients’ functional capacity in the acute period of injury.
Keywords: Burn injury, cardiovascular responses, exercise capacity, shuttle walk test
Abstract: BACKGROUND: The origin of about 10% of tumors located in the intracranial region is the cerebellopontine angle. Therefore Cerebellopontine Angle (CPA) tumors affect patients’ balance. OBJECTIVE: The aim of this study was to compare the balance in individuals who underwent surgery for CPA tumors with healthy individuals. METHODS: Thirty patients who were being followed-up by the Department of Neurosurgery and had been operated on CPA tumor and 31 healthy individuals were included in the study as group 1 and group 2, respectively. The participants were evaluated using Romberg Test, Sharpened Romberg Test, One-leg…Stance (OLS), Tandem Walking, Walk Across, Berg Balance Scale (BBS), Dizziness Handicap Inventory (DHI) and Short Form 36 (SF-36). RESULTS: In comparison of the groups, OLS tests (p < 0.001), BBS (p < 0.05) and DHI (p < 0.05) were significantly different in favor of healthy group. SF-36 results revealed a significant difference between the groups, except for Bodily Pain and Vitality (p < 0.05). CONCLUSIONS: The results of this study demonstrated a decrease in balance parameters and quality of life in individuals who underwent CPA tumor surgery in comparison to healthy individuals. Evaluation of balance in the preoperative and postoperative period should not be ignored in these patients and they are suggested to start rehabilitation in the early postoperative period.