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) has become increasingly common, but the prevalence of this complaint and associated factors in young people remains controversial. OBJECTIVE: This study aimed to identify the prevalence of LBP and to explore the existence of associated factors (sex, physical activity, sedentary lifestyle, sleep, body mass index and waist circumference). METHODS: This study considered all complaints of the lumbar region (acute or chronic) as LBP, which can irradiate to the backside and legs, lasting a minimum of 24 hours. Youngsters aged 15 to 18 years from a school in…the south of Brazil were evaluated. Descriptive statistics was used, in particular Chi-square, Mann-Whitney U tests and binary logistic regression. A significance level of p < 0.05 was adopted. RESULTS: A total of 330 youngsters answered a questionnaire and had their anthropometric measurements measured (response rate 84%). The prevalence of LBP in the present was 30%, quarterly 63% and throughout life 77%. There was a significant association between LBP and sex: girls have an increased risk of LBP in the last three-month period (PR = 1.3, 95% CI 1.06–1.56) and throughout life (PR = 1.2, 95% CI 1.04–1.43). The practice of physical activities was also associated with LBP, but as a protection factor in the present and in the last three-month period (PR = 0.7, 95% CI 0.47–0.90). Physical education at school has demonstrated a protective factor regarding LBP throughout life (PR = 0.9, 95% CI 0.77–0.97). Most of the students did not comply with recommendations related to sleep and time spent doing activities in front of a screen, and no association of these factors with LBP was detected. This exposure (physical activity, sleep time, sedentarism) did not present significant association with LBP when adjusted by the confusion factors (sex, age, BMI). CONCLUSIONS: Youngsters reported a high prevalence of LBP. Girls were at greater risk of LBP than boys. It is recommended that prevention strategies focus on the practices of physical activities and scholar physical education. No association of LBP with sedentary lifestyle (TV and computer use time, sleep time), anthropometric measures and sleeping duration was observed.
Keywords: Adolescent, back pain, prevalence, physical activity, overweight
Abstract: BACKGROUND: Abnormal sagittal spinal curvature is associated with pain, decreased mobility, respiratory problems and increased mortality. Time-of-flight technology of the Microsoft Kinect sensor can reconstruct a three-dimensional image of the back quickly and inexpensively. OBJECTIVE: To estimate the extent of the reproducibility of sagittal spine curvature measurement using the Microsoft Kinect sensor. METHODS: Simultaneous measurement of thoracic and lumbar spine using the Microsoft Kinect sensor in 37 participants. Two investigators gave standardised instructions and each captured 3 images. Thoracic kyphosis and lumbar lordosis angle indexes were calculated using maximum height divided by the…length. RESULTS: Adult participants (mean age in years (SD) = 51.7 (20.6); 57% female; BMI in kg/m 2 (SD) = 24.9 (3.3)) kyphosis and lordosis indexes showed high intra-rater and inter-rater ICC values (0.960–0.973). The means of the first images from both raters had significantly larger kyphosis indexes compared to the second and third images, yet no difference between means in lordosis data. CONCLUSIONS: The results indicate that the Microsoft Kinect sensor has a reproducible method with high intra-rater and inter-rater reliability. The difference between the means over repeated measures suggest the second image capture is more consistent. It is a reproducible and quick method in clinical and research settings.
Abstract: BACKGROUND: Shoulder pain is one of the most common problems affecting people older than 60 years. Among the shoulder pathologies, the disorders of the periarticular soft tissue (e.g. rotator cuff) are considered to be the most common; moreover, these disorders are found in approximately 75% of patients with seropositive rheumatoid arthritis. The incidence of structural rotator cuff tendon pathology, including full-thickness rotator cuff tendon tears, increases with age. Recent researchers suggested that non-operative treatment of full-thickness rotator cuff tears could be successful in some patients; furthermore, in rheumatoid arthritis patients, there was a greater possibility of developing surgical complications…compared with non-rheumatoid arthritis patients. MATERIALS AND METHODS: A case report of a woman, 72 years old, with rheumatoid arthritis, shoulder pain and pseudo-paralytic arm presented with a massive tear of Supraspinatus and Infraspinatus tendon. In accordance with evidence, the case was managed using pain education and exercise therapy for 2.5 months. The shoulder pain, the function and the range of motion increased following a physiotherapy program. CONCLUSION: Pain education in combination with exercise therapy was effective for improving pain and function in a full-thickness tear of Supraspinatus and Infraspinatus tendon in a patient also suffering from rheumatoid arthritis.
Abstract: OBJECTIVES: This study aimed to gain an overview of patient education and the effects of patient education for older people with low back pain (LBP). METHODS: The search strategies were performed via EBSCO MEDLINE, EBSCO CINAHL, Science Direct, PubMed, and PEDro databases from 2006 to 2016. The keywords “patient education”, “low back pain”, “elderly”, “older adults”, “older persons” and “older people” were used during the literature search. Boolean operators were used to expand or limit the searching scope and manual exclusion were performed to choose articles eligible for this study. RESULTS: A total…of 2799 articles were retrieved but only five articles were related with patient education for older people with LBP. Findings suggest that patient education for older people may differ in terms of its contents such as health education, self-management, video education, and postural education. The high methodological quality of the studies revealed that patient education showed improvement in terms of pain, disability and quality of life among older people with LBP. CONCLUSIONS: Patient education improved pain and had positive effects on disability and quality of life among older people with LBP. However, due to the limited number of RCTs more studies are needed to provide evidence for its effectiveness.
Keywords: Patient education, low back pain, older people
Abstract: BACKGROUND: There is a growing need to identify patient pre-treatment characteristics that could predict adherence and outcome following specific interventions. OBJECTIVE: To identify predictors of adherence and outcome to outpatient multimodal rehabilitation in chronic low back pain (CLBP). METHODS: A total of 273 CLBP patients participated in an exercise-based rehabilitation program. Patients who completed ⩾ 70% of the treatment course were classified as adherent. Patients showing a post-treatment reduction of ⩾ 30% in Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) back pain intensity scores were…assigned to the favorable outcome group. RESULTS: Multivariate logistic regression revealed that higher age, higher ability to perform low-load activities, and higher degrees of kinesiophobia increased the odds to complete the rehabilitation program. By contrast, lower levels of education and back pain unrelated to poor posture increased the odds for non-adherence. Furthermore, a favorable outcome was predicted in case the cause for LBP was known, shorter symptom duration, no pain in the lower legs, no difficulties falling asleep, and short-term work absenteeism. CONCLUSIONS: Assessment and consideration of patient pre-treatment characteristics is of great importance as they may enable therapists to identify patients with a good prognosis or at risk for non-responding to outpatient multimodal rehabilitation.
Abstract: OBJECTIVE: This study has been conducted to examine the effects of posture, cervical region and oropharyngeal exercises in patients with Obstructive Sleep Apnea Syndrome (OSAS). METHOD: Thirty patients with OSAS have been randomly divided into two groups. The first group received supervised exercise program including oropharyngeal, posture and cervical region exercises for 12 weeks. The patients in the control group have been informed about the posture but the exercise was not recommended. Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), Short Form 36 (SF-36), International Physical Activity Questionnaire-Short Form (IPAQ-SF) and…6 Minute Walk Test (6MWT) have been used in the evaluation of individuals participating in the study. Evaluations have been made at the beginning of the treatment and at the end of the 12-week exercise program. RESULTS: Statistically significant improvements have been observed in the exercise group in PSQI total value, ESS score, SF-36 General Health Subscale and 6MWT (p < 0.05). Statistical significance could not be reached for other parameters. CONCLUSIONS: Sleep quality, general health, and functional capacity have been found to improve in OSAS patients with oropharyngeal exercises.
Keywords: Obstructive Sleep Apnea Syndrome, exercise, posture, sleep, health
Abstract: BACKGROUND: The quality of life of breast cancer survivors who had a mastectomy may decrease due to potential physical problems and reduced upper extremity functions. OBJECTIVE: This study aimed to compare the physical characteristics, upper extremity functions and quality of life of breast cancer survivors and healthy women. METHODS: A total of 66 women participated in this study: breast cancer survivors (n = 33) and healthy counterparts (n = 33) participated in this study. The Lateral Scapular Dyskinesia Slide Test was used to…evaluate scapular dyskinesia, the hand-held dynamometer was used to measure upper extremity muscular strength, the Angle Reproduction Test was used to measure upper extremity position sense, the Disabilities of the Arm, Shoulder and Hand questionnaire was used to assess upper extremity functions, and the Short Form-36 was used to assess the quality of life. RESULTS: The findings showed that the prevalence of scapular dyskinesia, upper extremity muscle strength, shoulder joint position sense, and upper extremity functions were higher. Many sub-dimensions of quality of life reduced in breast cancer survivor women compared to the healthy women (p < 0.05). CONCLUSIONS: Several physical characteristics, upper extremity functions and quality of life of breast cancer survivor women who had a mastectomy were affected more in comparison to healthy women. Thus, these parameters should be included in physiotherapy assessment and treatment programs.
Keywords: Breast cancer survivor, scapular dyskinesia, muscle strength, position sense, functions, quality of life
Abstract: BACKGROUND: Many studies that investigated the correlation between muscle torque and joint position sense (JPS), but few studies have been performed on the correlation between torque ratio and JPS. OBJECTIVE: The aim of this study was to investigate JPS and muscle torque ratios of agonist and antagonist muscles in the ankle and knee joints of young adults. METHODS: A total of 38 right handed healthy participants, 12 males and 26 females, were recruited. All participants measured their peak torque of knee flexor/extensor and ankle dorsiflexor/plantar flexor by using a Biodex system. They also…used the Biodex to assess the proprioception through active joint reposition sense test in knee and ankle joint. Peak torque of each muscle, agonist/antagonist torque ratio and JPS error were collected, and Pearson’s correlation analysis was used to examine correlations between peak torque, torque ratio and JPS error. RESULTS: For knee joints, correlations were found between flexion and extension torque, extension torque and torque ratio, and torque ratio and JPS error (r = 0.825/p = 0.000, r = - 0.482/p = 0.002, and r = - 0.685/p = 0.000, respectively). For ankle joints, correlations were found between dorsiflexion and plantar flexion torques, plantar flexion torque and torque ratio, plantar flexion torque and JPS, and torque ratio and JPS (r = 0.654/p = 0.000, r = - 0.621/p = 0.000, r = - 0.563/p = 0.000, and r = - 0.761/p = 0.000, respectively). CONCLUSIONS: JPS error of lower extremity joint may be more related with agonist/antagonist torque ratio rather than peak torque. Therefore, people who will have training for reducing JPS error need to consider torque ratio, too.
Keywords: Torque ratio, joint position sense error, peak torque
Abstract: BACKGROUND: Spinal decompression therapy (SDT) has recently been used as a conservative treatment for lumbar disc prolapse (LDP). The effectiveness of SDT when compared with other conservative techniques with a well-designed randomized controlled trials is lacking. OBJECTIVE: To find the efficacy of SDT and core stabilization exercises (CSE) on pain and functional disability in individuals with chronic LDP, and to compare with CSE alone. METHODS: This single blind randomized controlled trial included thirty-one participants with a mean age of 38.68 ± 8.79 having chronic LDP with or without radiating symptoms were…included in the study. The study group received SDT with CSE and control group received CSE alone along with interferential therapy for both groups. Pain and disability were estimated by Numerical Rating Scale (NRS) and Modified Oswestry Questionnaire (mOQ). RESULTS: The results demonstrated significant within-group improvements in all outcomes in both groups, the mean differences between pre to post intervention in SDT with CSE group were (NRS: 4.75, t = 12.81, p ⩽ 0.001) and (mOQ: 45.13, t = 29.34, p ⩽ 0.001), while in CSE group (NRS: 2.60, t = 13.67, p ⩽ 0.001) and (mOQ: 27.67, t = 24.52, p ⩽ 0.001). CONCLUSIONS: A combination of SDT with CSE has proven to be more significant when compared with CSE alone to reduce pain and disability in subjects with chronic LDP.
Abstract: BACKGROUND: Many studies have presented lower limb kinematics in Western countries, but few have concentrated on gender and age differences for Chinese populations. OBJECTIVES: The purpose of this study was to investigate three-dimensional hip and knee kinematics especially for elderly Chinese during walking and running, as well as to analyze age differences. MATERIALS AND METHODS: Sixty healthy volunteers, including 40 young and 20 elderly adults, were divided into 2 groups by gender and instructed to perform walking and running in a comfortable manner. The hip and knee kinematics were obtained with 3D Motion…Capture System. Normalization was used to avoid the body size effect. Age differences were tested with independent t -test (p < 0.05). RESULTS: In non-sagittal planes, the hip and knee ranges of motion of young males are larger during running, but smaller during walking than those of elderly males. Young females reveal smaller non-sagittal planes hip and knee ranges of motion than elderly females, regardless of whether they are walking or running. There are also significant age differences in the peak hip and knee angles especially in frontal plane during running. Young adults reveal greatly higher peak hip and knee adduction angles than elderly adults. CONCLUSIONS: Walking speed and the hip and knee ROM for Chinese are different than Westerners. These kinematic differences can be used for reference to design better joint prostheses to meet various Chinese people’s needs.
Keywords: Age, gender, peak joint angles, ranges of motion