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: Lateral abdominal muscles control the lumbar region and this manages the stability of the trunk through co-contraction. Abdominal drawing-in maneuver (ADIM) is the basis method for spine stabilization to restore proper neuromuscular control. OBJECTIVE: To investigate the effect of therapeutic abdominal drawing-in maneuver on abdominal muscle thickness and balance. METHODS: Twenty healthy adults were divided into 2 groups. The experimental group performed a bridging exercise with ADIM whereas the control group performed a bridging exercise without ADIM. The exercise was conducted 3 times a week for 4 weeks. Ultrasonography was used to…measure the thickness of abdominal muscles. Balance ability was evaluated using Tetrax device. The Wilcoxon signed ranks test for comparison of pre and post values and Mann Whitney U test for comparison between groups were used. RESULTS: After 4 weeks, there was a significant difference in the thickness of TrA between groups (p < 0.05) whereas no significant difference in IO and EO (p > 0.05). In stability values, the experimental group showed significant changes in stability indexes of standing with eyes open (NO) and standing on the pillow with eyes closed (PC) after the exercise period and there was a significant difference in NO between two groups. CONCLUSIONS: Performing the bridging exercise with abdominal drawing-in maneuver is a more effective way to strengthen the abdominal muscles and stabilize the body than bridging exercise only.
Abstract: BACKGROUND: Overhead work-activities and repetitive use of arm in occupational tasks are known risk factors to cause shoulder injury that often develops to functional disability. Rehabilitation exercises (REs) are capable of slowing this development. OBJECTIVE: The main objective of the present work is to experiment with common REs and to identify those which produce significant integrated electromyography (iEMG) activation of selected shoulder muscles namely, posterior deltoid, infraspinatus, teres minor, upper trapezius, middle trapezius and lower trapezius. METHODS: Ten healthy male occupational workers, exposed to the risk shoulder injury, performed six REs while iEMG…activities of concerning muscles are recorded using Biopac MP 150 system. REs are cross-examined statistically to select those which yield higher iEMG activations. RESULTS: Results indicate that upper trapezius presents the highest iEMG activity in exercise 6 (standing ER at 90 ∘ abduction and 90 ∘ elbow flexion). Middle trapezius and lower trapezius show highest activation in exercise 1 (prone horizontal abduction at 90 ∘ with full external rotation with thumb right up). Also, posterior deltoid, infraspinatus, and teres minor have the highest iEMG activity in this exercise. CONCLUSIONS: Results provide basic information to select appropriate rehabilitation programs for occupational workers exposed to the risk of shoulder injury.
Abstract: BACKGROUND AND OBJECTIVE: The study determined the effects of females wearing high-heeled shoes on the lower extremity musculoskeletal system and somatometry. METHODS: The study was carried out with 136 females between 18 and 45 years old. The first group consisted of 66 females wearing 5 cm or higher high-heeled shoes, at least 5 hours a day, three days a week, and at least one year. The second group consisted of 70 females wearing shoes with heel height less than 5 cm for at least one year. RESULTS: Differences in length parameters may result…from the narrow and pointed toe of the high-heeled shoe. These shoes distribute the pressure on the caput ossis metatarsi I and compress the foot in this area. Differences in anthropometric measurements show that females wearing high-heeled shoes have more slender and aesthetic foot structure. CONCLUSION: These findings show that regular wearing of high-heeled shoes causes changes via the increased foot arch structure. These alterations result from regional, racial, gender, heel height, shoe type (shape), and shoe habits.
Keywords: Musculoskeletal system, high heeled shoes, foot print analysis
Abstract: BACKGROUND AND OBJECTIVE: Lumbar spinal stenosis (LSS) is a common spinal disorder that causes patients to assume a forward-trunk posture. Spinal alignment affects gait, muscle activity, and trunk-pelvis-limb coordination because the lumbar spine and muscles interact to allow load transfer between the lower back and pelvis during sagittal trunk movement. Therefore, we investigated the relationships among trunk and pelvic movement, swing toe clearance, and muscle coordination (isolated contraction ratios) of the stance limb during obstacle-crossing by patients with LSS. METHODS: Ten patients with LSS and ten control subjects were enrolled. All navigated an obstacle during walking.…Kinematic data from the trunk and lower extremities were monitored using a three-dimensional motion analysis system. In addition, we measured the isolated contraction ratios of the gluteus medius (GMed) and vastus lateralis (VL) while standing. RESULTS: The normalized lead limb distance was significantly lower in the LSS group than in controls. The spine flexion angle when the swinging limb toe was above the obstacle was higher, but the pelvic anterior tilting angle was lower, in the LSS group. LSS patients also had a significantly lower isolated contraction ratio of the GMed in the trailing stance limb but a significantly higher VL. CONCLUSIONS: Patients with LSS adapted a poor posture and their thoracic and spinal regions were hyperflexed with restricted pelvic obliquity. This created an inefficient gait, a shorter leading limb step, and less stable muscle coordination in the stance limb. Our findings may help healthcare professionals manage patients with LSS.
Abstract: BACKGROUND: Rice farming is done using manual methods and involves strenuous labour, which can lead to musculoskeletal disorders. OBJECTIVE: To identify the factors associated with knee musculoskeletal impairments and related pain among rice farmers complaining of knee pain. METHODS: The study employed a community-based, cross-sectional design. Full-time rice farmers (n = 201) were surveyed. A questionnaire was used to record demographics and details of farm work; followed by a physical examination of knee structures impairments. RESULTS: The prevalence of knee impairment was highest among farmers…with joint dysfunction (79.6%), followed by those with dysfunctional hamstring muscles (52.74%), quadriceps muscles (44.28%), neural tissue (38.81%), and ligaments (1.99%). It was lowest among farmers with meniscus dysfunction (1.49%). Stooping with twisting was strongly associated with knee joint and quadricep muscle impairment. Stooping with twisting and carrying loads were associated with hamstring muscle impairment. Stooping while twisting and being overweight was associated with neural tissue impairment. Being overweight was significantly associated with ligament impairment. There were no factors significantly associated with meniscus dysfunction. CONCLUSIONS: Knee musculoskeletal impairments is common among Thai rice farmers. Joint dysfunction was common. The factors associated with knee musculoskeletal impairments included being overweight, stooping while twisting and carrying heavy weight.
Keywords: Knee musculoskeletal impairments, knee pain, traditional rice farming
Abstract: BACKGROUND AND OBJECTIVE: Footwear preferences and habits may be related to musculoskeletal system problems. This study was designed to determine the relationship between the selection of footwear, musculoskeletal problems and the affecting factors among university students from that different division. METHODS: Four hundred and sixty-six university students in the divisions of Physiotherapy Rehabilitation, Nursing and Business Administration participated in this study. The data was collected using a questionnaire developed by the researchers and the Extended Nordic Musculoskeletal Questionnaire. RESULTS: Of the participants, 68.5% preferred to wear sports shoes; 24.0% of the participants had…foot pain. Comfort, robustness and quality come to the fore in the behavioural patterns of young and healthy individuals regarding footwear. Those who experienced foot and lower back pain considered such parameters as quality, fitness for foot health, flexibility and lightness in footwear. CONCLUSIONS: While patterns such as foot health, flexibility and lightness are reflected in the footwear preferences of those who have lower back pain, those who have pain or problems in their feet take into consideration the quality, lightness, fitness to foot health. The relationship determined in the present study shows that those who experience pain are more selective in their footwear preferences.
Abstract: BACKGROUND: The aim of this study was to explore the effect of neural therapy on pain and functionality in patients with low back pain due to piriformis syndrome. It also aimed to find out any possible links between the clinical changes and demographic features. METHOD: One hundred and two patients were randomly divided into two groups (neural therapy and control). All patients were given stretching exercises for the piriformis muscle. The patients in the neural therapy group additionally received 6 sessions of neural therapy. The visual analog scale (VAS) and Oswestry Disability Index (ODI) were noted…before and after the treatment in both groups. RESULTS: The VAS and ODI improved in both groups. However, improvement of the VAS and ODI scores were more obvious in the neural therapy group. The changes of VAS and ODI values did not show any correlations with the demographic features. CONCLUSION: After the neural therapy, the patients with low back pain due to piriformis syndrome may have improvement in both pain and functioning.
Keywords: Neural therapy, piriformis syndrome, local anesthetics, low back pain
Abstract: BACKGROUND: The core stability theory has emphasized symmetric co-contraction of both anterolateral abdominal muscles (AAM), but there is a lack of research on whether the symmetric co-contraction of AAM is related to the postural stability of the trunk. OBJECTIVE: This study aimed to investigate the correlation between the symmetric co-contraction of bilateral AAM and trunk angular displacement during sudden trunk perturbation. METHODS: Eighteen subjects were asked to maintain half-seated posture against backward trunk perturbation. Muscle thicknesses of external oblique (EO), internal oblique (IO), and transversus abdominis (TrA) were measured using ultrasound imaging. 3D…motion analysis system was utilized to calculate the amount of trunk angular displacement during perturbation. RESULTS: There were significant differences of side-to-side muscle thickness in TrA (P = 0.02) and EO (P = 0.02), but the difference disappeared during sudden external loading. No significant correlation was identified between the asymmetry of abdominal muscle thickness and the amount of trunk angular displacement. CONCLUSIONS: These findings indicate that the side-to-side asymmetry of AAM measured in a static position is rarely related to the core stability because the asymmetry can disappear during trunk stabilization.
Abstract: BACKGROUND: Altered lower limb movement patterns (LLMP) during the forward step down (FSD) test have been studied in people suffering from knee instability. However, ankle dorsiflexion range of motion (ADROM) seems to be related to LLMP but no causal inference has been defined between those variables. OBJECTIVE: Our goals were to evaluate (1) psychometric quality of the FSD test in healthy people and (2) the influence of experimental restricted ADROM on LLMP. METHODS: Kinematics were measured by a motion capture system. Angular displacement and speed were calculated as well as center of mass…(COM) and knee linear displacement. Forty-two healthy participants; firstly, performed the test three times to assess reliability, and secondly the same test in an experimental condition limiting the ADROM. RESULTS: Reliability was excellent for all parameters (ICC: 0.75–0.99, SEM%: 2.0–34.0%, MDC%: 5.7–94.3%). ADROM limitation significantly decreased Knee flexion range of motion (ROM) (- 3.8 ∘ ), increased Hip flexion ROM (6 ∘ ), Hip adduction ROM (6.1 ∘ ), Pelvis drop ROM (3.5 ∘ ), Pelvic rotation ROM (3.1 ∘ ). No significant effect was found for Hip rotation ROM. CONCLUSIONS: LLMP was affected by this experimental ADROM limitation in healthy people. As this limitation is often encountered in post-traumatic ankle sprain patients, clinicians should consider this point during FSD assessment test.
Keywords: Lower limb, movement pattern, functional tests, kinematics, biomechanics
Abstract: BACKGROUND AND OBJECTIVE: Sleep disorders should be routinely evaluated and treated in low back pain (LBP) patients because they represent an important contributor to pain. However, no study thus far has investigated the potential benefit to LBP management of a device improving the sleep quality. Therefore, aim of this study was to assess the effectiveness of an innovative mattress overlay as add-on treatment to LBP rehabilitation. METHODS: Thirty eight LBP patients were randomized to standard rehabilitation plus mattress overlay use (cases) or standard rehabilitation only (controls). The intervention duration was 2 months and the following assessments…were performed before and after: pain intensity; level of perceived back disability and sleep health; spine mobility; thickness and echo intensity of the lumbar multifidus. RESULTS: Significant pre-post-intervention improvements were observed in cases for resting and movement pain, perceived back disability, sleep, fingertip-to-floor distance, multifidus thickness (∼ 6% increase) and echo intensity (∼ 13% decrease). On the contrary, all these variables remained constant between the two experimental phases in controls. CONCLUSIONS: A combination of rehabilitation and mattress overlay use seems an effective approach for improvement of pain, perceived back disability, sleep, spine mobility, and lumbar multifidus size and structure of LBP patients.