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: Low back pain (LBP) is a common problem that causes pain, disability, and gait and balance problems. Neurodynamic techniques are used in the treatment of LBP. OBJECTIVE: The aim of this study was to compare the effects of electrotherapy and neural mobilization on pain, functionality, gait, and balance in patients with LBP. MATERIALS AND METHODS: A total of 41 patients were randomly assigned to either the neural mobilization group (NMG, n = 20) or electrotherapy group (ETG, n = 21). Assessment tools…used were Visual Analogue Scale (VAS) for pain, Oswestry Disability Index (ODI) for functionality, straight leg raise test (SLRT) for neural involvement, and baropedographic platform (Zebris FDM-2 TM ) for gait and static balance measurements. RESULTS: Both groups showed a significant decrease in pain and functional disability, while only the NMG group showed a significant increase in SLRT scores (p < 0.05). However, there were no statistically significant pre- to post-treatment changes in gait or static balance parameters in either group (p < 0.05). CONCLUSION: Neural mobilization was effective in reducing pain and improving functionality and SLRT performance in patients with LBP, but induced no change in gait and static balance parameters. Neural mobilization may be used as self-practice to supplement standard treatment programs.
Keywords: Balance, disability, gait, low back pain, neurodynamics
Abstract: BACKGROUND: Adaptation to Turkish language and validation studies of Knee Injury and Osteoarthritis Outcome Score – Physical Function Short Form (KOOS-PS) and Hip Disability and Osteoarthritis Outcome Score – Physical Function Short Form (HOOS-PS) were done previously but responsiveness to changes of these questionnaires could not be tested in these studies. OBJECTIVE: The aim of this study was to assess the responsiveness of the Turkish versions of the KOOS-PS and HOOS-PS in a patient group who underwent knee or hip joint arthroplasty operation. METHODS: Sixty-three patients who underwent total knee arthroplasties and sixteen…patients who underwent total hip arthroplasties for primary osteoarthritis were included in this study. The preoperative and 3-month postoperative KOOS-PS, HOOS-PS, and Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index hip and knee scores were collected from the hospital records, and the effect sizes (ESs) and standardized response means (SRMs) were calculated. RESULTS: The ESs and SRMs, respectively, were as follows: - 1.954 and - 2.156 for the KOOS-PS, - 1.833 and - 2.464 for the HOOS-PS, - 4.848 and - 4.210 for the WOMAC-knee, and - 3.835 and - 4.625 for the WOMAC-hip. CONCLUSIONS: The Turkish versions of the KOOS-PS and HOOS-PS exhibited strong responsiveness to change in the arthroplasty patients.
Keywords: Responsiveness, Knee Injury and Osteoarthritis Outcome Score – Physical Function Short Form, Hip Disability and Osteoarthritis Outcome Score – Physical Function Short Form, KOOS-PS, HOOS-PS, arthroplasty
Abstract: BACKGROUND: Damage on the somatosensory system could cause sensation of dizziness, a condition known as cervicogenic dizziness (CD). Manual physical therapy has shown beneficial effects, relieving the symptoms of cervicogenic dizziness. However, the effect of upper cervical spine manipulation is unknown, as this is a technique that respects the International Federation of Orthopedic Manipulative Physical Therapists (IFOMPT) safety criteria. OBJETIVE: To assess the effects of upper cervical spine traction-manipulation in subjects with cervicogenic dizziness. METHODS: This was a descriptive case series study. Treatment focused on the upper cervical spine manipulation procedure. Evaluation was…performed before and after the treatment. Variables recorded include upper and lower cervical range of motion, Cervical Flexion-Rotation Test (CFRT), dizziness intensity and cervical pain (VAS), self-perceived dizziness measured with Dizziness Handicap Inventory (DHI) and subjective perception of outcome (GROC-scale). RESULTS: Ten subjects were recruited. After the treatment protocol, there was an increased range of movement towards the most restricted side, as measured by the CFRT (p < 0.001), decreased intensity of dizziness (p < 0.001) and intensity of pain (p < 0.001). Functional capacity also improved after the intervention (p < 0.011). CONCLUSION: Upper cervical spine manipulation may decrease dizziness intensity and cervical pain and improve functional ability and upper cervical spine mobility in patients with cervicogenic dizziness.
Keywords: Cervical spine, dizziness, manual therapy, range of movement and functional capacity
Abstract: PURPOSE: The present study aimed to estimate the reliability, standard error of measurement (SEM), and minimum detectable change (MDC) of the star excursion balance test (SEBT) in children with cerebral palsy (CP). METHODS: Eight children with CP (five boys and three girls, sixteen legs) participated in this study. Each child carried out the SEBT and was assessed by two examiners. To determine intra-rater reliability, the intra-class correlation coefficient (ICC) model (3, 3) was calculated. To determine the inter-rater reliability, the ICC model (2, 3) was computed. RESULTS: In terms of the intra-rater reliability…of the SEBT, the ICC varied from 0.98 to 0.99 and the total ICC score was 0.99 (p < 0.001). For the inter-rater reliability, the ICC varied from 0.98 to 1.00 and the total ICC score was 0.99 (p < 0.001). The SEBT had an SEM of 2.63 and an MDC of 7.31. CONCLUSION: The SEBT is not only reliable with a small SEM, but is also a simple and cheap assessment of dynamic balance in children with CP.
Keywords: Cerebral palsy, reliability, star excursion balance test
Abstract: BACKGROUND: The curl-up exercise is widely used in clinical practice for strengthening abdominal muscles, but has been applied without a systematic method. OBJECTIVE: The purpose of this study was to determine the most effective method considering the angle and muscle contraction direction during the curl-up exercise. METHODS: Fourteen healthy males performed the curl-up exercise according to contraction direction (concentric and eccentric) and angle (30 ∘ , 60 ∘ , and 90 ∘ ). The muscle activity of the rectus abdominis (RA), external oblique (EO),…internal oblique (IO), and iliopsoas (IP) was measured using electromyography (EMG), and the muscle thickness of transversus abdominis (TrA) was measured using ultrasonography. RESULTS: The activities of the abdominal muscles (RA, EO, and IO) decreased with increasing angles (30 ∘ , 60 ∘ , and 90 ∘ ) (p < 0.05). There was no significant difference between eccentric and concentric contractions. The thickness ratio of TrA was the largest at an eccentric curl-up at 30 ∘ , and the smallest at a concentric curl-up at 30 ∘ (p < 0.05). CONCLUSIONS: The most effective angle for curl-up was 30 ∘ . Although there is no difference in the direction of muscle contraction, eccentric curl-up at 30 ∘ could be considered the most effective posture for abdominal strengthening considering the importance of TrA.
Abstract: BACKGROUND: Up to now there is not enough evidence that supports the use of electrotherapy in the treatment of Bell’s palsy. OBJECTIVE: Through a systematic review, we aimed to verify whether the use of electrotherapy is effective for treating Bell’s palsy or peripheral paralysis. METHODS: Publications were searched in PubMed, EBSCO and Web of Science. The present systematic review included studies that analyzed the electrotherapy as a therapeutic method for treating individuals with Bell’s palsy, in order to recover the function of facial muscles. RESULTS: Seven studies involving a total…of 131 cases and 113 controls were included in this systematic review. In the studies analyzed, patients received electrotherapy combined with other treatments such as hot-wet facial napkins, massages and muscle reeducation. Although the effect of electrotherapy alone was not evaluated, the use of electrotherapy combined with other treatments produced a significant improvement in the individuals evaluated. CONCLUSIONS: Due to the diverse methodologies used and the small number of individuals included in the studies, we could not fully prove the efficacy of electrotherapy for treating Bell’s Palsy. Future studies with larger samples and homogenous populations should be performed to obtain conclusive results.
Abstract: BACKGROUND: There is little evidence on intra-articular (IA) treatment in knee osteoarthritis (KOA) and there is a lack of long-term follow-up studies. OBJECTIVE: To assess the long-term effectiveness and safety of IA oxygen-ozone (O 2 O 3 ) and hyaluronic acid (HA) in terms of functioning in KOA patients over a 31-week period. METHODS: Patients aged ⩾ 60 years with KOA were randomly allocated to receive 4 IA knee injections (1/week) of O 2 O 3 or…HA (T0–T3) and a follow-up visit 4 weeks after the fourth injection (T4). In this extension study we assessed VAS and safety in patients with Visual Analogue Scale (VAS) ⩾ 4 at the at 6-month follow-up visit (T5), undergoing a second treatment cycle (T5–T8) and 1-month follow-up visit (T9). RESULTS: Forty-two patients (aged 70.5 ± 5.8 years) were randomly allocated to O 2 O 3 (n = 22) or HA group (n = 20). Twenty-three underwent another IA cycle: 12 (54.6%) in the O 2 O 3 group and 11 (55.0%) in the HA group. Both groups showed significant reduction in VAS (p < 0.013) compared to baseline during both cycles. At follow-up visits (T4 and T9), VAS was significantly lower in the HA group (p < 0.013). There were no differences in adverse events occurrence between groups. CONCLUSIONS: IA O 2 O 3 might be comparable to HA in terms of effectiveness and safety in reducing pain in KOA patients, although at both follow-up visits (T4 and T9) VAS was significantly lower in the HA group.
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 therapy, isometric training therapy 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: 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: 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.