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Price: EUR 130.00Authors: Di Gesù, Marco | Alito, Angelo | Borzelli, Daniele | Romeo, Domenico | Bonomolo, Fabio | Calafiore, Dario | de Sire, Alessandro
Article Type: Research Article
Abstract: BACKGROUND: Ultrasound-guided galvanic electrolysis technique (USGET) is an innovative mini-invasive intervention with the potential to optimise outcomes in the treatment of Achille’s tendinopathy (AT). OBJECTIVE: The aim of this pilot study is to evaluate the efficacy of adding USGET to conventional eccentric exercise treatment in patients with chronic AT. METHODS: Inclusion criteria were patients with unilateral non-insertional AT, pain lasting > 3 months, aged 25–60 years. Patients were randomised in two groups receiving the same physiotherapy treatment (2 sessions per week for 8 weeks). In addition, the experimental group received three USGET stimulations, one …every 15 days. Outcome measures were assessment of Achilles tendinopathy severity using the Victorian Institute of Sport Assessment-Achilles (VISA-A) and pain intensity using the Visual Analogue Scale (VAS). Assessment points occurred at the onset of treatment (T0), its conclusion (T1), and subsequent follow-ups at one (T2) and two months (T3). RESULTS: Out of the 52 patients who met the study inclusion criteria, two participants withdrew from the study, resulting in a total of 50 subjects who completed the research. None of the parameters showed a different distribution at T1 (p > 0.337). At T2, there was a statistical difference in VISA-A (p = 0.010) and its subscales and VAS (p = 0.002) in the USGET group. At T3, both groups improved with a statistical difference observed in VISA-A (p < 0.001) and its subscales Pain (p = 0.004), Function (p = 0.003) and Sport (p = 0.002), but the EG patients showed a greater improvement. No adverse events were reported. CONCLUSION: The effect of USGET combined with eccentric exercise appears to be a safe and effective technique for achieving pain relief and functional recovery in the medium term, supporting the integrated use of USGET as a rehabilitative treatment option for patients with chronic AT. Show more
Keywords: Achilles tendon, exercise therapy, interventional ultrasound, physical and rehabilitation medicine, tendinopathies
DOI: 10.3233/BMR-230255
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Unuvar, Bayram Sonmez | Tufekci, Osman | Gercek, Hasan | Torlak, Mustafa Savas | Erbas, Onur
Article Type: Research Article
Abstract: BACKGROUND: Unilateral osteoarthritis (OA) affects single knees and presents a unique scenario where individuals experience varying degrees of symptoms between their affected and unaffected knees. OBJECTIVE: This study aims to investigate differences in muscle tightness between symptomatic and asymptomatic knees in individuals with unilateral knee OA while exploring the interplay among pain, functionality, and muscle tightness. METHODS: In this cross-sectional study, thirty knee OA patients underwent assessments for hamstring (Active Knee Extension, Straight Leg Raise), iliotibial band (Ober Test), and quadriceps tightness (Modified Thomas Test). Pain intensity was measured using the Visual Analog …Scale (VAS), and functional limitations were evaluated via the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). RESULTS: A negative correlation was observed between participants’ pain and AKE (p = 0.004, r = - 0.515), ASLR (p = 0.27, r = - 0.403), Ober (p = 0.010, r = - 0.461) values. However, no significant correlation was found with the Modified Thomas value (p = 0.204, r = - 0.239). There was also a negative correlation between participants’ WOMAC scores and AKE (p = 0.019, r = - 0.427), OBER (p = 0.004, r = - 0.510), and Modified Thomas (p = 0.022, r = - 0.416) values, while ASLR (p = 0.286, r = - 0.202) values showed no significant correlation. Comparisons between AKE, Ober, and Modified Thomas values showed higher values in asymptomatic extremities (AKE: p = 0.025, Ober: p = 0.021, Modified Thomas: p = 0.030). CONCLUSION: This study emphasizes the significance of muscle tightness in the symptomatic extremities of individuals with unilateral knee OA. The results indicate that increased muscle tightness makes pain worse and limits movement. It’s crucial for healthcare providers treating OA to focus on improving muscle flexibility, reducing pain, and enhancing overall function. Show more
Keywords: Hamstring muscles, knee, muscle tightness, osteoarthritis, quadriceps muscle
DOI: 10.3233/BMR-230373
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Hwang, Byeong-Hun | Jeon, In-Cheol
Article Type: Research Article
Abstract: BACKGROUND: Sufficient shoulder flexor strength is necessary for accurate movement of the shoulder joint because several factors can cause compensatory movements of the scapula. OBJECTIVE: We investigated the influence of external fixation on the isometric shoulder flexors strength (ISFS) in individuals with and without scapular elevation (SE) during shoulder flexion. METHODS: The healthy and SE groups included 29 individuals. The ISFS was measured using a tensiometer (kg) under conditions of with and without external fixation, in a random order. The change in the ISFS (the strength difference with and without external fixation) was …compared between the healthy and SE groups using an independent t -test. RESULTS: The change in the ISFS differed significantly between the healthy and SE groups (3.5% and 32.3%, respectively; p = 0.001). CONCLUSION: These findings suggest that external fixation should be considered during shoulder flexion to determine the ISFS accurately in individuals with compensated SE. Show more
Keywords: Compensation, scapular elevation, shoulder flexor, strength
DOI: 10.3233/BMR-230288
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-7, 2024
Authors: Zhang, Nannan | Chen, Jianmin | Wang, Zhiyong | Ni, Jun
Article Type: Research Article
Abstract: BACKGROUND: After undergoing fibula-free flap harvest, patients may experience complications such as ankle instability. It remains unclear whether these patients have deficits of proprioception, and the recovery process is also uncertain. OBJECTIVE: This study aimed to objectively evaluate proprioception on the donor and normal side of surgical patients during long-term follow-up using the Pro-kin system. METHODS: This study enrolled 36 patients who underwent reconstruction of the head and neck using osseous free flaps harvested from the fibula. Each patient underwent pre-operative evaluations and was subsequently evaluated at postoperative months 1, 3, 6, and …12. The study assessed the proprioceptive evaluation of the lower limbs, muscle function, range of motion of the ankle, and donor side complications. RESULTS: On the donor side, the average trace error (ATE) at postoperative month 1 was significantly higher than pre-operation, postoperative months 6 and 12 (P < 0.05). The test execution time (TTE) at postoperative month 1 was significantly increased by 9.875s compared to the pre-operative levels (P = 0.012, 95% confidence interval [CI] 4: 1.877–17.873) and by 11.583s compared to postoperative month 12 (P = 0.007, 95% CI: 2.858–20.309). The reduction in range of motion of ankle dorsiflexion was most pronounced at postoperative month 1, exhibiting an 11.25∘ decrease compared to pre-operative levels (P < 0.001, 95% CI: 6.304–16.16). Although the range of motion of ankle dorsiflexion gradually improved over time at postoperative months 3, 6, and 12, it remained lower than pre-operative levels (P < 0.05). CONCLUSION: The study revealed that the patients exhibited proprioceptive disturbances in both lower limbs at postoperative month 1. The proprioceptive function gradually improved over time, with a gradual decrease in donor site complications. Show more
Keywords: Fibula-free flap harvest, proprioception, pro-kin system, ankle instability, rehabilitation
DOI: 10.3233/BMR-230436
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Koca, Tuba Tülay | Özer, Alev
Article Type: Research Article
Abstract: BACKGROUND: During pregnancy, many pregnant women experience lumbopelvic pain due to mechanical, systemic, and hormonal reasons and this pain and fear of movement (kinesiophobia) causes daily life limitations. OBJECTIVE: To examine low back pain (LBP), kinesiophobia, disability, and related conditions that develop together during pregnancy. METHODS: The was a cross-sectional and analytical study. The presence, severity, and duration of pain in the lumbopelvic region were questioned. Postpartum LBP was evaluated using a self-administered questionnaire, disability using the Oswestry Disability Index (ODI), pain intensity using a visual analog scale (VAS), physical activity levels using …the physical activity level during pregnancy questionnaire and the international physical activity questionnaire short form, and kinesiophobia was evaluated using the Tampa Scale for Kinesiophobia. RESULTS: The study comprised 120 pregnant women with a mean age of 27.4 ± 6.1 years. It was observed that 42.3% of the pregnant had LBP (n = 69). The mean body mass index (BMI) was 73.6 ± 16.2 kg/m2 , and the mean VAS score was 5.5 ± 2 cm. When we divided the group according to the presence of LBP, age (p = 0.49), gestational week (p = 0.75), and gravida (p = 0.81) were similar. BMI (p = 0.038) and ODI scores (p < 0.001) were higher in the group with LBP. CONCLUSION: LBP in pregnant women has a higher frequency than in the normal population, regardless of age, gestational week, and gravida. Obesity appears to be a risk factor for LBP and increases disability. Kinesiophobia in pregnant women is significantly associated with obesity and disability. Unless there are contraindications, a physically active pregnancy process and regular exercise should be recommend. Show more
Keywords: Lumbopelvic pain, disability, exercise, pregnancy
DOI: 10.3233/BMR-240006
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Nakata, Akimi | Osuka, Satoshi | Ishida, Tomoya | Saito, Yuki | Koshino, Yuta | Samukawa, Mina | Kasahara, Satoshi | Tohyama, Harukazu
Article Type: Research Article
Abstract: BACKGROUND: Lumbopelvic movement patterns during prone hip extension has been proposed as a clinical screening method for trunk muscle dysfunction in patients with chronic low back pain (CLBP). However, correlations between trunk muscle onset and pelvic kinematics have not been investigated. OBJECTIVE: To examine the correlation between trunk muscle onset and pelvic kinematics during prone hip extension in participants with CLBP. METHODS: Fifteen patients with CLBP and 15 healthy individuals participated. We evaluated the muscle activities of the lumbar multifidus, the longissimus, and the semitendinosus via electromyogram and the displacement angles of the …pelvic tilt, oblique and rotation. RESULTS: The onset of the multifidus at the ipsilateral side of hip extension was significantly delayed in the patients with CLBP compared to the control group (P < 0.001). The onset of the ipsilateral multifidus in the control group was significantly correlated with increased anterior pelvic tilt angle (P = 0.019, r = 0.597), whereas no significant correlation was observed in the CLBP group (P = 0.810, r = - 0.068). CONCLUSION: The results suggest that pelvic kinematics during prone hip extension does not predict the delayed trunk muscle onset in patients with CLBP. Show more
Keywords: Biomechanics, electromyography, pelvis, paraspinal muscles, rehabilitation
DOI: 10.3233/BMR-240028
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Ewertowska, Paulina | Formella, Oskar | Poniatowski, Łukasz | Zielińska, Afrodyta | Krzysztofik, Michał | Czaprowski, Dariusz
Article Type: Research Article
Abstract: BACKGROUND: Whole-body vibration (WBV) is being used in rehabilitation and sport. Studies confirm its positive impact on muscle strength and power or regulating muscle hypertension. However, there are some uncertainties regarding its influence on postural stability. This issue seems particularly interesting in the case of individuals with generalized joint hypermobility (GJH), for whom proprioceptive training and muscle strengthening exercises are recommended while techniques that decrease muscle tension are not advised. OBJECTIVE: The aim of the study was to evaluate the acute effect of WBV on postural stability in adults with GJH. METHODS: 60 …participants were categorized into the groups: 1) hypermobility with vibration (GJH+ WBV), 2) hypermobility without vibration (GJH–WBV), 3) control group with vibration (CTRL+ WBV), 4) control group without vibration (CTRL–WBV). The first and the third group completed WBV (frequency: 15 Hz and 30 Hz, amplitude 3 mm, 3 × 3 min). The second and fourth groups participated only in measurement sessions. GJH was assessed using the Beighton test. Postural stability was measured as the overall stability index (OSI) on the Biodex Balance System on the stable and unstable platform with open and closed eyes. Measurements were taken before and after WBV for two weeks. RESULTS: At a frequency of 15 Hz, a significant time effect was observed for measurements Before and After in CTRL–WBV on the stable platform with open eyes (p = 0.012) and on the unstable platform with closed eyes (p = 0.000) for the GJH+ WBV and CTRL+ WBV groups. There were no significant interactions (p > 0.05) between factors. At a frequency of 30 Hz, there was a significant time effect Before and After (p = 0.047) on the stable platform with open eyes, but no interaction was found between factors (p = 0.835). CONCLUSION: There is no positive acute effect of WBV on postural stability in adults with and without GJH. Show more
Keywords: Joint instability, vibration, postural control, balance
DOI: 10.3233/BMR-240004
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Shi, Tao | Shou, Fenyong | Xia, Qun | Zhang, Tao | Teng, Donghui | Jing, Wanli | Zhou, Qiang
Article Type: Research Article
Abstract: BACKGROUND: The effect of anti-osteoporosis treatment in elderly patients with osteoporosis and lumbar discectomy and fusion (LIF) for lumbar degenerative diseases is not well known. OBJECTIVE: This study aimed to evaluate the effect of perioperative anti-osteoporosis treatment in the patients with osteoporosis and LIF. METHODS: From January to December 2022, patients were divided into three groups according to the inclusive criteria: the normal group (Group A), the osteopenia group (Group B) and the osteoporosis group (Group C). Quantitative computed tomography (QCT), height of the intervertebral space (HIS), segmental sagittal angle (SSA), visual analogue …scale (VAS) score and Oswestry Disability Index (ODI) were compared between the groups at the follow-up time. The serum Ca2 + , osteocalcin (OC), propeptide of type I procollagen (PINP) C-terminal cross-linking telopeptide of type I collagen (β -CTX) and 25-OH vitamin D (25-OH VD ) levels were compared between the groups at the time of follow-up. Interbody fusion was graded on the X-ray and CT images at the follow-up time. RESULTS: There were 165 patients in this study. There were significant differences in the mean age, mean score, HIS and SSA between the groups at the different follow-up times. There were significant differences in the concentrations of serum Ca2 + , OC, β -CTX, 25-OH VD and PINP at the sixth month after surgery between the groups. There were significant differences in the concentrations of serum Ca2 + , β -CTX and 25-OH VD between the pre-surgery and at six months after surgery in Group B and β -CTX and 25-OH VD in Group C. There was a significant difference in the degree of fusion between Group B and C (χ 2 = 5.6243, P < 0.05). CONCLUSION: In elderly patients with LIF and osteoporosis, anti-osteoporosis therapy could reduce bone resorption and thus facilitate fusion. Anti-osteoporosis medication tends to enhance radiological, functional, and fusion short-term outcomes. Show more
Keywords: Elderly patients, degenerative lumbar disease, lumbar discectomy and fusion, osteoporosis, anti-osteoporosis
DOI: 10.3233/BMR-230381
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Masoudi, Mona | Ehsani, Fatemeh | Hedayati, Rozita | Ramezani, Mona | Jaberzadeh, Shapour
Article Type: Research Article
Abstract: BACKGROUND: Impairment in both the motor and cognitive aspects of postural control is a critical issue in patients with chronic low back pain (CLBP) who experience high pain anxiety (HPA). OBJECTIVE: This study aimed to compare the effects of cathodal and anodal transcranial direct current stimulation (c-tDCS and a-tDCS) over the dorsolateral prefrontal cortex (DLPFC) on postural control during cognitive postural tasks in CLBP patients with HPA. METHODS: This study included 66 patients randomly assigned to three groups: DLPFC a-tDCS, DLPFC c-tDCS, and sham tDCS. All groups received 20 minutes of tDCS, but …the stimulation was gradually turned off in the sham group. Postural stability indices were assessed using the Biodex Balance System. RESULTS: Both the a-tDCS and c-tDCS groups showed a significant reduction in most postural stability indices at static and dynamic levels after the interventions (immediately, 24 hours, and one-week follow-up) during the cognitive postural task (P < 0.01). Additionally, there was a significant improvement in postural balance in the a-tDCS and c-tDCS groups compared to the sham tDCS group (P < 0.01). Furthermore, the a-tDCS group showed significantly greater improvement than the c-tDCS group (P < 0.01). CONCLUSION: Based on the results, both a-tDCS and c-tDCS over the DLPFC had positive effects on postural control during cognitive postural tasks in CLBP patients with HPA. Show more
Keywords: Chronic low back pain, pain-related anxiety, cathodal transcranial direct current stimulation, anodal transcranial direct current stimulation, dorsolateral prefrontal cortex, postural stability
DOI: 10.3233/BMR-230229
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Jung, Do Hun | Lee, Sang-Eok | Park, Dougho | Lee, Jang Woo
Article Type: Research Article
Abstract: BACKGROUND: An electrodiagnostic evaluation is conducted to diagnose carpal tunnel syndrome (CTS) and evaluate its severity. OBJECTIVE: This study proposes a revised approach for classifying the severity of electrophysiological findings for patients with CTS. METHODS: This retrospective cross-sectional study included patients with CTS confirmed through electrodiagnostic evaluations. Based on the Stevens’ classification, the patients were divided into three groups (mild/moderate/severe). A new intermediate group was defined to identify patients with normal motor nerve conduction studies and abnormal electromyographic results. CTS pain was evaluated using a numeric rate scale. Physical examinations and sonographic evaluation …were performed to detect anatomical abnormalities. RESULTS: Overall, 1,069 CTS hands of 850 CTS patients were included. The mean age was 57.9 ± 10.8 years, and 336 (39.5%) were men. There were 522 (48.8%) mild cases; 281 (26.3%) moderate cases; and 266 (24.9%) severe cases. In the severe group, 49 cases were reclassified into the intermediate group. The median cross-sectional area in the intermediate group significantly differed from that in the severe group. However, the pain score significantly differed from that of the moderate group. CONCLUSION: The intermediate CTS group showed clinical features that were intermediate to those of the moderate and severe CTS groups. Show more
Keywords: Nerve compression syndromes, classification, neurophysiology, ultrasonography
DOI: 10.3233/BMR-230275
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Cai, Congcong | Gazali, Nurul Adliah | Tan, Xin Ning | Soon, Benjamin | Lee, Adrian Thian Huat | Aw, Qian Wen Simone | Dana, Dharini D/O | Kwok, Joanne Ching Tung | Kwa, Mei Jun
Article Type: Research Article
Abstract: BACKGROUND: The psoas major (PM) has been identified as a potential contributor to chronic low back pain (LBP). However, few studies have investigated the effects of upright functional movement on PM activation in cLBP individuals. OBJECTIVE: This cross-sectional study aims to compare PM muscle activation characteristics in chronic LBP (cLBP) and healthy subjects during the transition from quiet double-leg standing to standing hip flexion. METHODS: Ultrasound Imaging was used to assess PM thickness at the lumbar vertebral level of L4–5 in 12 healthy and 12 cLBP participants. The changes in thickness between the test positions …were utilized as a proxy for PM activation. RESULTS: The cLBP group exhibited greater thickness changes on the non-dominant side PM during contralateral hip flexion but not ipsilateral hip flexion (p = 0.369) compared to their healthy counterparts (p = 0.011; cLBP: resting 27.85 mm, activated 34.63 mm; healthy: resting 29.51 mm, activated 29.00 mm). There were no significant differences in dominant side PM thickness changes between the two groups during either contralateral or ipsilateral hip flexion (p = 0.306 and p = 0.077). CONCLUSION: Our findings suggest a potential overactivation of the PM in the cLBP population. This insight may aid in the development of tailored rehabilitation programs. Show more
Keywords: Low back pain, psoas muscles, muscle contraction, ultrasonography
DOI: 10.3233/BMR-230384
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Alzahrani, Abdullah | Alshehri, Mansour Abdullah | Alzahrani, Hosam
Article Type: Research Article
Abstract: BACKGROUND: Physiotherapists must identify potential red flags that may impede recovery and function in individuals with low back pain (LBP) or put them at risk. OBJECTIVES: This study aimed to (1) investigate physiotherapists’ awareness and use of red flags for individuals with LBP in Saudi Arabia and (2) identify factors associated with their awareness and use of LBP red flags. METHODS: This cross-sectional study collected data using an anonymous online questionnaire (February–July 2023). It included physiotherapists working in private/public hospitals in Saudi Arabia. The questionnaire asked about the participants’ characteristics, their awareness of …LBP red flags, and their use of red flags for LBP assessment. RESULTS: A total of 643 participating physiotherapists (26.2 ± 3.8 years), 63.8% of whom were females, completed the survey. Most participants (94.4%) had adequate awareness of LBP red flags, and more than half (61%) had good utilization of red flags when assessing individuals with LBP. There was a positive correlation between the physiotherapists’ awareness and use of LBP red flags. CONCLUSION: The majority of the participating physiotherapists in Saudi Arabia were aware of LBP red flags, and many reported to have good use of red flags in clinical practice when assessing and managing individuals with LBP. Show more
Keywords: Low back pain, red flags, physiotherapists, awareness, cross-sectional
DOI: 10.3233/BMR-230410
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Zhang, Bin | Zeng, Jiahao | Zhang, Jiayi | Song, Keyan | Kuang, Liang | Wu, Xiangbo | Zhao, Guang | Shang, Huijuan | Ni, Zhenhong | Chen, Lin
Article Type: Review Article
Abstract: BACKGROUND: Ultrasound has a long history as a diagnostic and therapeutic tool. Low-intensity pulsed ultrasound (LIPUS), whose intensity is below 300 mW/cm2 , has been widely used in orthopedic rehabilitation treatment. However, the detailed bioeffects and underlying mechanisms of LIPUS treatment need to be explored. OBJECTIVE: To make a comprehensive view of the field, bibliometric and visualization analysis was used to reveal the global research trends of LIPUS in orthopedics and rehabilitation treatment between 1994 and 2023. METHODS: All literature data on LIPUS were retrieved from the Web of Science Core Collection database. …VOSviewer and CiteSpace were applied for the bibliometric and visualization analysis. RESULTS: A total of 760 publications were included. The distribution of publications generally showed an unstable rising trend. China had the highest number of publications (28.0%), and Chong Qing Medical University was the organization with the highest number of publications (5.8%). Ultrasound in Medicine and Biology had the highest number of publications (8.8%), while BMJ-British Medical Journal had the highest impact factor among the retrieved journals. Ling Qin from the Chinese University of Hong Kong was the most active researcher. Our overlay visualization map showed that the keywords such as pain, knee osteoarthritis, apoptosis, chondrocytes, cartilage, and autophagy, which link to osteoarthritis, have becoming the new research trends and hotspots. CONCLUSION: LIPUS is a popular and increasingly important area of orthopedic rehabilitation, and collaboration of authors from different countries should be further strengthened. Predictably, clinical application of LIPUS on chronic inflammation-related diseases and regenerative medicine, and in-depth biological mechanisms are the orientations of LIPUS in orthopedic rehabilitation treatment. Show more
Keywords: LIPUS, bone, fracture, cartilage, rehabilitation research
DOI: 10.3233/BMR-230273
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-15, 2024
Authors: Riaz, Saima | Rehman, Syed Shakil Ur | Hassan, Danish | Hafeez, Sana
Article Type: Research Article
Abstract: BACKGROUND: Escala de Calidad de vida Osteoporosis (ECOS-16) was originally developed in Spanish to evaluate the quality of life (QoL) in post-menopausal women (PMW) with osteoporosis or osteopenia based on the osteoporosis-specific QoL instruments. ECOS-16 has been translated into several languages, but the Urdu version is not yet available. OBJECTIVE: To translate the ECOS-16 Questionnaire into Urdu and determine its validity and reliability in PMW with osteopenia. METHODS: This was a linguistic validity and reliability study. ECOS-16 was translated into Urdu using Beaton’s guidelines. Content validity was examined using Waltz’s four-point ordinal scale. …Twenty osteopenia-afflicted PMW aged 48–70 underwent pilot testing for face validity. Discriminant validity was determined by an independent T-test between PMW women with and without osteopenia. Convergent validity was assessed using Spearman’s correlation coefficient. Cronbach’s alpha and Intraclass correlation coefficient (ICC2,1 ) assessed internal consistency and test-retest reliability. The factor analysis was used to describe the factors. RESULTS: Each question’s content validity ratio (CVR) was 0.83–1.00, while the scale’s S-CVR was 0.96. Each question’s Likert scale content validity index (CVI) was 0.91–0.93, while the scale’s S-CVI was 0.91. Significant discriminant validity was found between groups in weeks I and II (p -value < 0.001). A correlation coefficient of 0.89 and 0.96 (p -value < 0.001) between Urdu ECOS-16 total score and SF-36 and EQ-5D scores suggests convergent validity. One component explained 83.86% of Urdu ECOS-16’s variance in factor analysis. Excellent test-retest reliability (ICC2,1 = 0.990, 95% CI, 0.985–0.994, p -value < 0.001). Cronbach’s alpha for standardized items was 0.995. CONCLUSION: ECOS-16 translated in Urdu is a valid and reliable questionnaire to assess QoL in PMW with osteopenia. It has a simple and easy language that can be understood easily by the Urdu-speaking population. Show more
Keywords: Bone diseases, post-menopausal period, osteoporosis, quality of life, spinal fracture
DOI: 10.3233/BMR-230342
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Rossini, Bianca | Anstruther, Meagan | Fortin, Maryse
Article Type: Research Article
Abstract: BACKGROUND: Student circus artists put constant stress on their back. However, the presence of low back pain (LBP) and related disability in this population remains unclear. OBJECTIVES: To 1) examine LBP history in circus artists and compare related disability scores using the Oswestry Disability Index (ODI) and the Athlete Disability Index (ADI), and 2) examine the correlation between LBP-related disability scores, pain intensity and pain catastrophizing. METHODS: Thirty-three circus students completed an online survey on demographics, training history, and LBP. Participants reporting LBP filled the ODI, ADI, numerical pain rating scale (NPRS), and …Pain Catastrophizing Scale (PCS). Descriptive statistics and Pearson’s correlation coefficients were used to assess the correlations between the ODI, ADI, NPRS, and PCS. RESULTS: There was a significant positive correlation between the ODI and ADI (r = 0.77, p < 0.001) and between the NPRS and ADI (r = 0.52, p = 0.03), but no correlation between NPRS and ODI. While the PCS scores were significantly correlated with the NPRS ((r = 0.71; p < 0.001) and the ADI (r = 0.51; p = 0.032), no correlation was observed between the PCS and ODI scores (p = 0.088). Based on the ODI scores, 94.44% of the artists reporting LBP were classified with mild disability, 5.56% moderate, and 0% severe disability as compared to 66.67%, 27.78% and 5.55% with the ADI, respectively. CONCLUSION: Our study highlights the potential of the ADI as an effective tool for assessing LBP-related disability in circus artists, supported by a strong correlation with the NPRS. Show more
Keywords: Circus artists, low back pain, oswestry disabilty index, athletes disability index
DOI: 10.3233/BMR-230213
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Park, Eunjin | Lee, Yeon Soo | Yi, Jin-Seok | Choi, Eunseok
Article Type: Case Report
Abstract: BACKGROUND: Cervicogenic headache is characterized by chronic posterior neck pain radiating to one side of the head, resulting from cervical spine bone or soft tissue diseases. Cervical ganglioneuroma (GN), a rare benign neuroblastic tumor, especially in the cervical spine, may cause cervicogenic headache-like symptoms. OBJECTIVE: We report a case of GN which was surgically removed successfully to relieve the symptom. CASE REPORT: A 68-year-old male presented with right posterior neck pain with referred pain to the ipsilateral occipital area in May 2020. Despite administration of medications, physical therapy, and spine interventions, the symptoms …intermittently recurred over one year. In July 2021, the patient complained of painful limitation of neck motion, especially on right-sided bending; no motor or sensory deficits, except for subjective numbness of the finger tips, were detected. Plain radiography of the cervical spine showed moderate degenerative changes in the mid-cervical spine. Cervical MRI revealed a cystic mass (1.5 cm × 0.5 cm × 1 cm-in size) around the right C2 dorsal root ganglion adjacent to the C1–C2 facet joint. His symptoms significantly improved after complete tumor excision. CONCLUSION: GN of the upper cervical spine should be considered when persistent cervicogenic headache is refractory to conservative management. In such a case, advanced imaging studies such as MRI should be performed for early diagnosis and appropriate treatment. Show more
Keywords: Chronic neck pain, upper cervical spine pain, cervical dorsal root ganglia
DOI: 10.3233/BMR-230330
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-6, 2024
Authors: Labanca, Luciana | Berti, Lisa | Tedeschi, Roberto | D’Auria, Lucia | Platano, Daniela | Benedetti, Maria Grazia
Article Type: Research Article
Abstract: BACKGROUND: Among non-pharmacological interventions, Multiwave Locked System (MLS) Laser therapy has been used in patients with several musculoskeletal pathologies and in combination with other therapeutical interventions. The effects of sole MLS therapy on pain and function in patients with chronic non-specific low-back pain are unknown. OBJECTIVE: The objective of this study was to investigate the effects of MLS Laser therapy on pain, function, and disability in patients with chronic non-specific low back pain in comparison to a placebo treatment group. METHODS: Forty-five patients were randomized into two groups: the MLS Laser group and …the Sham Laser group, undergoing 8 sessions of either a MLS Laser therapy or a Sham Laser therapy, respectively. At the beginning of the therapy (T0), at the end of the therapy (T1), and 1 month after the end of therapy (T2) patients were assessed for low back pain (by means of a VAS scale), function (by means of kinematic and electromyographic assessment of a forward bending movement) and self-reported disability (by means of the Roland-Morris and Oswestry Disability questionnaires). RESULTS: There was a significant reduction of pain and disability in both groups at T1 and T2 in comparison with T0. At T2 patients in the MLS group showed a significantly lower pain in comparison with patients in the Sham group (VAS = 2.2 ± 2 vs. 3.6 ± 2.4; p < 0.05). No differences between the two groups were found for function and disability. CONCLUSION: Both MLS Laser and Sham Laser therapies lead to a significant and comparable reduction in pain and disability in patients with chronic non-specific low back pain. However, one month after treatment, MLS Laser therapy has been found to be significantly more effective in reducing pain as compared to sham treatment. Show more
Keywords: Flexion-relaxation phenomenon, multifidus, forward bending, electromyography, kinematics
DOI: 10.3233/BMR-230383
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Bastos de Oliveira, Viviane | Albuquerque Brandão, Maria Clara | Coelho de Albuquerque Pereira, Wagner | Fernandes de Oliveira, Liliam
Article Type: Research Article
Abstract: BACKGROUND: Multifidus is an important lumbar muscle with distinct superficial and deep fibers responsible for torque production and stabilization, respectively. Its mechanical properties change when transitioning from lying to sitting positions, necessitating enhanced stability. It holds crucial clinical relevance to assess these layers separately, especially in the sitting posture, which demands increased neuromuscular control compared to the prone position. OBJECTIVE: To compare lumbar multifidus stiffness in lying versus sitting postures, analyzing both superficial and deep layers. METHODS: Supersonic Shear Imaging captured elastographic images from 26 asymptomatic volunteers in prone and seated positions. …RESULTS: Left multifidus shear modulus in lying: 5.98 ± 1.80/7.96 ± 1.59 kPa (deep/superficial) and sitting: 12.58 ± 4.22/16.04 ± 6.65 kPa. Right side lying: 6.08 ± 1.97/7.80 ± 1.76 kPa and sitting: 13.25 ± 4.61/17.95 ± 7.12 kPa. No side differences (lying p = 0.99, sitting p = 0.43). However, significant inter-postural differences occurred. CONCLUSION: Lumbar multifidus exhibits increased stiffness in sitting, both layers affected, with superior stiffness in superficial versus deep fibers. Applying these findings could enhance assessing multifidus stiffness changes, for classifying tension-induced low back pain stages. Show more
Keywords: Shear modulus, mechanical properties, ergonomic, ultrasound, muscle
DOI: 10.3233/BMR-230333
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Li, Mengshi | Shi, Qiongfang | Che, Xinle | Du, Xingyan | Wang, Dongming | Song, Yufeng
Article Type: Research Article
Abstract: BACKGROUND: Patients who underwent total knee arthroplasty (TKA) often experience muscle loss due to pain and limited mobility. Nutritional supplementation and rehabilitation may positively affect the decline in muscle function. OBJECTIVE: The purpose of this study is to evaluate whether whey protein intervention, in addition to conventional rehabilitation training, is beneficial in improving muscle function and quality of life in patients after TKA. METHODS: 72 patients who met the criteria were selected for this randomized controlled study. For the experimental group, whey protein was used as a daily supplement for 12 weeks, while …the control group was given a placebo, during which both groups received conventional rehabilitation training. Muscle strength and each of the secondary observables needed to be measured and statistically analyzed preoperatively and at 4, 8, and 12 weeks post-intervention. RESULTS: In total, 62 subjects completed the study: 32 in the experimental group and 30 in the control group. Both groups showed significant improvement in muscle strength, VAS, ROM, AKS and leg circumference after 12 weeks of treatment. Compared to the control group, patients in the experimental group showed significant improvement in muscle strength, VAS, ROM, AKS and leg circumference (p = 0.001, p = 0.002, p = 0.001, p = 0.001, p = 0.001, respectively) after 12 weeks of treatment. CONCLUSION: The 12-week intervention of whey protein nutritional supplement showed significant improvement in muscle mass and function among post-TKA patients besides aiding with conventional rehabilitation exercise. Show more
Keywords: Nutritional supplementation, isometric muscle strength, rehabilitation
DOI: 10.3233/BMR-240013
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Do, Junghwa | Lim, Woo-Taek | Kim, Dae Yul | Ko, Eun Jae | Ko, Myoung-Hwan | Kim, Geon Woo | Kim, Ji Hye | Kim, SooBin | Kim, Hwal
Article Type: Research Article
Abstract: BACKGROUND: Chronic stroke can impair cardiopulmonary function, mobility, and daily activities. This study assessed the impact of robot-assisted gait training (RAGT) on such impairments. OBJECTIVE: To investigate the effects of robot-assisted gait training on cardiopulmonary function, walking ability, lower extremity function and strength, activities of daily living (ADLs), and blood test results among individuals with chronic stroke. METHODS: A multicenter, prospective, single-blinded, randomized controlled trial with 22 chronic stroke participants compared RAGT against a control exercise regimen. RAGT involved three days weekly sessions of high-intensity interval training for 8 weeks (24 sessions) with …a Morning Walk® device. The control group also performed home exercises. (24 sessions) Measures included VO2 max, Functional Ambulatory Category, 2-minute walk test, 10-meter walk test, Motricity Index-Lower, Korean version of the Fugl-Meyer Assessment Scale, Modified Barthel Index, Berg Balance Scale, muscle strength, InBody body composition, and blood tests (cholesterol, lipid, glucose). RESULTS: RAGT significantly improved VO2 max, gait, balance, and lower limb strength compared with controls, with significant improvements in 2-minute walk test, 10-meter walk test, Motricity Index-Lower, and Fugl-Meyer Assessment outcomes. No changes were seen in muscle mass or blood markers. CONCLUSION: RAGT enhances cardiopulmonary function and ambulatory capacity in chronic stroke patients, underscoring its potential in stroke rehabilitation. Show more
Keywords: Cerebrovascular accident, robotics, high-intensity interval training, rehabilitation
DOI: 10.3233/BMR-230385
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: de Sire, Alessandro | Marotta, Nicola | Prestifilippo, Emanuele | Zito, Roberta | Bartalotta, Isabella | Lippi, Lorenzo | Mezian, Kamal | Vecchio, Michele | Invernizzi, Marco | Ammendolia, Antonio
Article Type: Review Article
Abstract: BACKGROUND: Fibromyalgia is a debilitating condition marked by persistent pain and reduced functionality. Various therapeutic methods have been suggested to alleviate symptoms in individuals with fibromyalgia, yet the impact of diverse rehabilitation strategies remains unclear. OBJECTIVE: This systematic review and meta-analysis aimed at assessing the efficacy of rehabilitation interventions in improving functioning in fibromyalgia patients. METHODS: We conducted a comprehensive literature search of multiple international databases (PubMed, Scopus, and Web of Science) from their inception until November 22nd , 2023. We identified 23 randomized controlled trials (RCTs) assessing multiple rehabilitation strategies. The primary …outcome was the Fibromyalgia Impact Questionnaire (FIQ). Study quality was assessed using the Cochrane Risk-of-Bias Tool for Randomized Trials (RoB 2). The study protocol was registered in PROSPERO (CRD42020197666). RESULTS: Our meta-analysis rehabilitation interventions significantly reduce FIQ scores (MD = - 11.74, 95% CI: - 16.88 to - 6.59, p < 0.0001). Notably, the subgroup analysis showed that different rehabilitation modalities seem to induce different therapeutic responses. CONCLUSIONS: Rehabilitation strategies hold promise in addressing the functional impairments and improving the overall well-being of individuals with fibromyalgia. The study underscores the need for further research to determine the optimal rehabilitation approach and its potential impact on the multilevel disability characterizing patients with fibromyalgia. Show more
Keywords: Fibromyalgia, rehabilitation, pain management, physical therapy, functioning
DOI: 10.3233/BMR-230382
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-27, 2024
Authors: Sia, Lee Lee | Sharma, Shobha | Ing, Janet Bong May | Kumar, Saravana | Singh, Devinder Kaur Ajit
Article Type: Review Article
Abstract: BACKGROUND: The growing use of telerehabilitation within the healthcare community has garnered substantial attention. In congruence with other healthcare fields, examining perceptions, barriers, and facilitators assumed paramount significance in the continuation and fortification of telerehabilitation practices among physiotherapists. OBJECTIVE: In this scoping review, we aimed to systematically map the literature on the perceptions of physiotherapists as well as the barriers and enablers of telerehabilitation in their daily practice. METHODS: The five-stage methodological framework recommended by Arksey and O’Malley (2005) was used for this scoping review. In the framework, eight databases were searched using …key search terms such as “telerehabilitation”, “physiotherapists”, “readiness”, “enablers” and “barriers” All findings were organised into perceptions and readiness, enablers, and barriers. RESULTS: Fourteen articles met the inclusion criteria and were categorized as: (1) perception and readiness, (2) enablers, and (3) barriers. In the perception and readiness category, new trends in healthcare, advancement in physiotherapy practices and the benefits to clients were identified. The enablers identified included prior training, personal experience, familiarity with technology, functional equipment and space, and client selection. The barriers to the adoption of telerehabilitation in physiotherapy practice are pinpointed to poor technology, communication hurdles, limited availability, lack of familiarity, and client-related concerns. CONCLUSION: While initial evidence suggests a generally positive perceptions it is important to consider both facilitators and barriers when understanding adoption. This review’s findings revealed a wide research gap, with unequal weightage towards barriers compared to enablers, and highlights the need for further research. Developing telerehabilitation guidelines that cater to both physiotherapists and clients is necessary. Show more
Keywords: Physiotherapists, telerehabilitation, perceptions, enablers, barriers
DOI: 10.3233/BMR-240009
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Kondo, Yu | Higuchi, Daisuke | Miki, Takahiro | Watanabe, Yuta | Takebayashi, Tsuneo
Article Type: Research Article
Abstract: BACKGROUND: There is a paucity of data on physical activity and its effects in patients after cervical spine surgery. OBJECTIVE: This study aimed to examine the association between physical activity and disability in patients after cervical spine surgery while also considering age, sex, pain, and central sensitization (CS)-related symptoms. METHODS: Participants included individuals with a cervical degenerative condition who had undergone surgery. Neck disability index, physical activity frequency, numerical rating scale for pain intensity, and short form of the CS inventory were recorded more than 1 year postoperatively. The linear mixed model was …performed to examine the association between physical activity and disability. RESULTS: The responses of 145 participants were analyzed. The linear mixed model results showed that the stretching and light-intensity exercise frequency (β = - 0.14, p = 0.039) was independently associated with disability, adjusted for age, sex, pain, and CS-related symptoms. Conversely, other physical activities, such as walking and muscle strength exercises, were not associated with a disability. CONCLUSION: The findings emphasize the importance of performing regular physical activity, regardless of pain and CS-related symptoms. Show more
Keywords: Degenerative cervical disease, disability, physical activity, pain
DOI: 10.3233/BMR-230428
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Chang, Min Cheol | Choo, Yoo Jin | Denis, Isabelle | Mares, Christopher | Majdalani, Carl | Yang, Seoyon
Article Type: Review Article
Abstract: BACKGROUND: Low back pain and sciatica caused by herniated lumbar discs (HLDs) are common complaints among patients visiting pain clinics. Among the various therapeutic methods, intradiscal ozone injections have emerged as an effective alternative or additional treatment option for HLDs. OBJECTIVE: This meta-analysis aimed to investigate the effectiveness of intradiscal ozone injections in the treatment of HLDs. METHODS: We searched the PubMed, Embase, Cochrane Library, and Scopus databases for relevant studies published until January 25, 2024. We included studies that investigated the efficacy of intradiscal ozone injections in patients with HLDs. We evaluated …the methodological quality of individual studies using the Cochrane Collaboration tool. RESULTS: At ⩾ 6 months after treatment, the therapeutic effect of intradiscal ozone injections in patients with HLDs was greater than that of steroid injections (treatment success rate, 6 months: odds ratio = 3.95, 95% confidence interval [CI] [2.44, 6.39], P < 0.01) or conventional medications (changes in the Visual Analog Scale [VAS], 6 months: standardized mean difference [SMD] = 1.65, 95% CI [1.08, 2.22], P < 0.01; 12 months: SMD = 1.52, 95% CI [0.96, 2.08], P < 0.01) but similar to that of microdiscectomy (changes in VAS, 18 months: SMD = - 0.05, 95% CI [- 0.67, 0.57], P = 0.87). At < 6 months after treatment, the reduction in the VAS score after intradiscal ozone injections was higher than that after steroid injections (changes in VAS, 1 month: SMD = 2.53, 95% CI [1.84, 3.21], P < 0.01). CONCLUSION: Intradiscal ozone injections may be a useful therapeutic tool in patients with HLDs. Compared with other conventional treatment methods such as steroid injections and oral medications, intradiscal ozone injection has great long-term (⩾ 6 months) effectiveness. Show more
Keywords: Injections, pain management, intervertebral disc displacement, low back pain, pain, meta-analysis
DOI: 10.3233/BMR-240024
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Xue, Youdi | Xia, Jihua | Ma, Chao | Dai, Weixiang | Zhang, Zhaochuan
Article Type: Research Article
Abstract: BACKGROUND: Osteoporosis is the most common disease in postmenopausal women and the elderly, which can lead to vertebral compression fracture. OBJECTIVE: To investigate the related factors of severe osteoporotic vertebral compression fracture (SOVCF) and evaluate the long-term outcomes of percutaneous kyphoplasty (PKP) for treating SOVCF through comparison with mild OVCF (MOVCF). METHODS: From September 2015 to March 2019, 294 osteoporotic vertebral compression fracture (OVCF) patients treated with PKP were analyzed. Compression of the anterior margin of the fractured vertebral body beyond 2/3 of the original height was defined as SOVCF. Baseline data, clinical …and imaging findings before and after surgery and at the last follow-up were recorded. Numerical Rating Scale (NRS) was used to evaluate low back pain, the Oswestry Disability Index (ODI) was used to evaluate activity of daily life. Anterior vertebral height (AVH) and local kyphosis angle (LKA) was used to evaluate radiographic outcomes. During the follow-up, patients with recurrent back pain were examined by MRI to identify new fractures and the incidence of adjacent vertebral fracture (AVF) was recorded. Age, sex, body mass index (BMI), dual energy X-ray absorptiometry based T value, duration of symptom, history of trauma, steroid use, and fracture site were collected for univariate logistic regression analysis Variables with a P -value of less than 0.05 were then included in multivariate analysis to determine the related factors for SOVCF. RESULTS: Logistic regression analysis indicated that longer duration of symptom (OR = 1.109, 95%CI: 1.038–1.185, P = 0.002), lower T value (OR = 0.332, 95%CI: 0.139–0.763, P = 0.001), and steroid use (OR = 31.294, 95%CI: 1.020–960.449, P = 0.049) were related factors of SOVCF. Compared with the MOVCF group, the SOVCF group had longer operation time (57.3 ± 13.51 minutes vs 44.9 ± 8.13 minutes, P < 0.001), more radiation exposure (39.9 ± 7.98 times vs 25.5 ± 4.01 times, P < 0.001), and higher cement leakage rate (55.81% vs 18.73%, P < 0.001). At the last follow-up, the SOVCF group had higher NRS (2.28 ± 0.85 vs 1.30 ± 0.71, P < 0.001), and ODI (16.23 ± 4.43 vs 12.88 ± 3.34, P < 0.001). After operation and at the last follow-up, the SOVCF group had higher LKA and lower AVH (all P < 0.05). The AVF rate at the last follow-up was higher in the SOVCF group at the last follow-up (4.78% vs 18.60%, P < 0.001). CONCLUSION: Lower T value, longer duration of disease, and steroid use were related factors of SOVCF. Compared with MOVCF, PKP for SOVCF had longer operation time, more radiation exposure, and higher cement leakage rate, and the long-term outcomes were worsen. Show more
Keywords: Kyphoplasty, bone mineral density, bone cement
DOI: 10.3233/BMR-230324
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Ortiz, Ralph | Motyka, Thomas | Petterson, Stephanie | Krystofiak, Jason
Article Type: Research Article
Abstract: BACKGROUND: Sustained acoustic medicine (SAM) is a noninvasive long-term treatment that provides essential mechanical and thermal stimulus to accelerate soft tissue healing, alleviate pain, and improve physical activity. SAM increases localized deep tissue temperature, blood flow, cellular proliferation, migration, and nutrition exchange, resulting in reduced inflammation and an increased rate of tissue regeneration. OBJECTIVE: To assess the efficacy of SAM treatment of discogenic back pain in the lower spinal column to reduce pain, improve quality of life, and lower pharmacotherapy use. METHODS: Sixty-five subjects with chronic low back pain were randomly assigned to …SAM (N = 33) or placebo (N = 32) groups. Subjects self-applied SAM device bilaterality on the lower lumbar region for 4 hours daily for 8 weeks and completed daily pain diaries before, during, and after treatment. Subjects recorded pain reduction using a numeric rating scale (NRS), medication use, and physical activity using the Global Rating of Change (GROC) and Oswestry Disability Index (ODI). RESULTS: SAM treatment significantly reduced chronic lower back pain from baseline relative to placebo treatment (p < 0.0001). SAM treated subjects reported significantly lower back pain at 4 weeks, with the highest pain reduction (- 2.58 points NRS, p < 0.0001) reported at 8 weeks. Similar trends were observed in improved physical activity (3.48 GROC, p < 0.0001, 69–88% ODI, p < 0.0001) and 22.5% (15.2 morphine milligram equivalent) reduction in the use of opioid medication from baseline to 8 weeks. CONCLUSION: Daily, home-use SAM treatment significantly improves the clinical symptoms of chronic lower back pain, improves physical mobility, and reduces daily medication use. SAM treatment is well-tolerated by patients and may be considered a safe, non-invasive treatment option for chronic discogenic, lower back pain. Show more
Keywords: Low back pain, low-intensity continuous ultrasound, ultrasound therapy, sustained acoustic medicine, mechanotransduction, herniated discs, chronic pain, durable medical equipment
DOI: 10.3233/BMR-230402
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Koca, Tuba Tülay | Berk, Ejder | Özel, Elif | Yılmaz, Ahmet Said | Ertürk, Zeynel
Article Type: Research Article
Abstract: BACKGROUND: Sarcopenia and frailty may develop at varying rates depending on the metabolic, structural, and functional changes in the muscle structure after stroke. OBJECTIVE: To evaluate the prevalence of sarcopenia and frailty in patients with stroke and affecting clinical parameters. METHODS: This was a cross-sectional and analytical study. Twenty-six (49.1%) women and 27 men (50.9%) with stroke with an average age of 60.2 ± 10.3 (median = 62) years were included in the study. To evaluate physical performance, balance, and mobility, we used the 4-meter walk test …(4-MWT), timed up and go test, chair sit and stand test, and the Berg Balance Scale (BBS). Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 criteria. The SARC-F scale was used for sarcopenia. RESULTS: The average stroke duration was 21.6 ± 18.2 months. Prefrailty was present in 14 (26.4%) patients, frailty was present in 34 (64.2%) patients, and two (3.8%) patients were normal. Sarcopenia was detected in 28 (52.8%) patients. According to handgrip strength, the prevalence of low muscle strength was 17% (n = 9). In the sarcopenic group, female sex (p = 0.005) was more frequent, 4-MWT was longer (p = 0.003), chair stand test results were lower (p < 0.001), the clinical frailty scale (CFS) was higher (p < 0.001), fall risk was higher compared with the BBS (p < 0.001), there was lower HG strength (p = 0.009), lower malnutrition scores (PNI, prognostic nutritional index, p < 0.001), and lower lymphocyte counts (p = 0.037). EAT-10 scores and dysphagia presence (p = 0.026), the presence of malnutrition (p < 0.021) and Nottingham Health Profile score (p < 0.001) were higher in the sarcopenic group. CONCLUSION: Sarcopenia and frailty frequently develop in patients with chronic stroke, with low lymphocyte counts, physical performance, muscle strength, and mobility and balance scores, and it is associated with poor prognostic factors including high disease severity, dysphagia, malnutrition, risk of falling, and poor quality of life. Show more
Keywords: Stroke, sarcopenia, frailty
DOI: 10.3233/BMR-230423
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Zengi, Hakan | Safran, Elif Esma | Şevgin, Ömer
Article Type: Research Article
Abstract: BACKGROUND: Clinical research on the management and rehabilitation of work-related upper spinal pain in bus drivers is sparse, indicating a gap in knowledge and treatment strategies. This highlights the growing need for innovative approaches to rehabilitation programs in this area. OBJECTIVE: To examine the effects of kinesio taping (KT) on pain, functionality, and work performance in bus drivers experiencing neck pain. METHODS: The study involved 44 participants who were randomised into two different groups: the exercise group (n = 22) and the kinesio tape group (n = …22), with participants in both groups undertaking exercise interventions. Evaluations were made before and after 6 weeks of treatment. At the end of the 6-week, the participants’ ROM, pain evaluations and functional scales were evaluated with disability, and work functionality. RESULTS: Neck pain severity decreased in both groups (p < 0.001 for each value), but there was no difference between the groups (p : 0.071). When disability scores were evaluated, improvement was noted in both groups (p : 0.001 for each value), but no statistically significant difference was found (p : 0.754). When the improvements in ROM values before and after the treatment were examined, the difference between the groups was recorded only in the neck extension ROM value (p : 0.011). Significant improvement was noted in all sub-steps of job performance in both groups (p < 0.05). CONCLUSION: KT added to ergonomic training and home exercise programmes is effective in controlling work-related musculoskeletal pain in drivers with neck pain. However, the addition of KT to exercise therapy was found to be no more effective than exercise therapy alone in improving pain control, functionality and work performance. Show more
Keywords: Ergonomics, muscle stretching exercises, occupational diseases
DOI: 10.3233/BMR-240001
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Mengi, Alper | Bulut, Gül Tugba
Article Type: Research Article
Abstract: BACKGROUND: There are no data on the additional contribution of dry needling (DN) for trigger points (TPs) accompanying patients with cervical spondylosis (CS). OBJECTIVE: To analyse the contribution of DN applied to concomitant active TPs in the upper trapezius muscle on the treatment outcomes of physiotherapy in CS. METHODS: In this prospective randomized controlled study, 70 patients with CS and active TPs in the upper trapezius muscle were included. The first group received physiotherapy for 5 days per week for 3 weeks. The second group received DN with the same program. All participants …were evaluated before treatment (day 0) and at the end of treatment (day 21) in terms of pain, functional status, quality of life, anxiety/depression scores, and number of TPs. RESULTS: 33 patients in the first group and 32 patients in the second group completed the study. While the change over time was found significant in all variables, the change was not different between groups. The group-time interaction effect was not found to be statistically significant in any variable. Percentage changes of all variables were similar between the groups. CONCLUSION: DN treatment added to the physiotherapy did not contribute to recovery in patients with CS. Show more
Keywords: Cervical spondylosis, myofascial pain, neck pain, trigger point
DOI: 10.3233/BMR-230287
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Moreno-Mateo, Fernando | Maniega, Silvia Santiago | Peris, Almudena Llorente | Ramajo, Rubén Hernádez | González, David César Noriega
Article Type: Research Article
Abstract: BACKGROUND: During the last two decades, there has been a growing interest in spinal sagittal alignment. Most published studies have focused on the role of spinopelvic parameters in patients with adult spinal deformity or in those with previous spinal fusion. OBJECTIVE: The aim of this study was to explore possible association between disability related to back pain and spinopelvic parameters in the absence of coronal deformity or previous spinal surgery. METHODS: In the setting of a larger study involving patients with low back pain (LBP), those without previous surgery or spinal deformity in …the coronal plane were selected. A total of 52 patients (mean age 59 years, range 21–86, 23 men and 29 women) were found. The visual analogic scale (VAS) and Oswestry Disability Index questionnaire (ODI) were recorded. Surgimap software was used to measure the sagittal vertical axis (SVA), pelvic tilt (PT), pelvic incidence (PI), sacral slope (SS), and lumbar lordosis (LL). Statistical analysis was performed with SPSS Statistics software. Pearson or Spearman correlation were the test of choice depending on the specific variables. RESULTS: A statistically significant association was found between SVA and ODI (r 0.59, p < 0.03). Increased pelvic tilt was also associated with more severe disability related to back pain (r 0.48, p < 0.03). PI-LL mismatch showed moderate association with disability and severity of back pain, although this association did not reach statistical significance (r 0.52, p < 0.08). CONCLUSION: Our findings suggest that sagittal misalignment may be related with more severe disability and back pain in patients with minor or null deformity in the coronal plane. Show more
Keywords: Spinopelvic parameters, sagittal alignment, back pain
DOI: 10.3233/BMR-230242
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-6, 2024
Authors: Oxfeldt, Martin | Tegner, Heidi | Björklund, Martin | Christensen, Jan
Article Type: Research Article
Abstract: BACKGROUND: Low back pain (LBP) is the leading cause of disability and an increasing sick leave in Denmark. Psychosocial risk factors have been linked to the development of LBP-related disability and work-absenteeism. The short form Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ-sf) was developed to screen for psychosocial risk factors and assess the risk of long-term disability and work-absenteeism. OBJECTIVE: To translate and cross-culturally adapt ÖMPSQ-sf into Danish and evaluate test-retest reliability with relative and absolute reliability and internal consistency in LBP-patients in a secondary setting. METHODS: A six-step translation and cross-culturally adaptation process …was used. Forty-four patients with subacute and chronic LBP were recruited at an outpatient clinic. RESULTS: Test-retest reliability (n = 37) was found to be excellent (ICC2.1 = 0.92), Internal Consistency (n = 44) was adequate (Cronbach’s alpha = 0.72). Absolute reliability included Standard Error of Measurement (SEM = 3.97 points), 95% Limits of Agreement (95% LOA = 0.08, - 15.90–15.74), and Smallest Detectable Change (SDC = 10.87 points). CONCLUSION: The Danish ÖMPSQ-sf showed acceptable measurements properties in subacute and chronic LBP-patients. Further research is needed to assess other measurement properties of the ÖMPSQ-sf, in relation to validity, responsiveness, and the predictive ability before application in research or clinical practice. Show more
Keywords: Low back pain, Örebro questionnaire, reliability, psychosocial risk factors, disability, work absenteeism
DOI: 10.3233/BMR-230363
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Abiko, Teppei | Murata, Shin | Shigetoh, Hayato | Ohyama, Michie | Sakata, Eiji
Article Type: Research Article
Abstract: BACKGROUND: Caregivers in Japan experience a high prevalence of low back pain (LBP), with age, sex, individual pain experiences, and central sensitization symptoms potentially influencing its chronic progression. OBJECTIVE: To determine the prevalence of LBP among caregivers, as well as its relation to age and sex, and explore work status, psychological factors, and central sensitization symptoms as contributing factors to chronic LBP (CLBP). METHODS: A large-scale cross-sectional survey was conducted among 1214 caregivers in 35 geriatric healthcare facilities. The survey assessed LBP and CLBP prevalence, work status, psychological factors, and central sensitization-related symptoms. …Multivariate logistic regression analysis was used to identify factors influencing CLBP. RESULTS: Among 936 valid respondents, the LBP prevalence was 69.2%. No significant sex differences were found in the prevalence of LBP and CLBP. Old age, higher pain severity, and severe symptoms related to central sensitization increased the risk of CLBP. However, work status and psychological factors did not significantly contribute to CLBP. CONCLUSION: There is a high prevalence of LBP among caregivers, age and individual pain experience significantly impact CLBP. These findings emphasize the need for therapeutic strategies to manage pain intensity, especially in the acute phase, to prevent the progression to chronicity. Show more
Keywords: Chronic pain, central nerve system sensitization, prevalence, risk factors, psychology
DOI: 10.3233/BMR-230319
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Shi, Chencui | Zou, Qiangdong | Wei, Hong
Article Type: Research Article
Abstract: BACKGROUND: During pregnancy, structural and functional changes usually occur in the body, which has various consequences, including lower back pain (LBP) and hypothyroidism. One of the risk factors for these problems is physical inactivity. OBJECTIVE: This study aimed to investigate the association of back pain and physical inactivity, weight gain, and hypothyroidism in pregnant women. METHODS: In this cohort study, 420 pregnant women (26.333 ± 5.820 years old) were included. At first, participants answered this question: “Do you have any plans for pregnancy in the next month?” If the answer …was yes, further evaluations were performed. The physical activity and pain intensity were measured by the International Physical Activity Questionnaire Short Form (IPAQ-S) and Visual Analogue Scale. Serum TSH was measured by automated chemiluminescence and commercial kits. Measurements were conducted before, the first, second, and third trimester of pregnancy. RESULTS: Women reporting LBP were less engaged in physical activities and weight gained in the second and third trimesters of pregnancy was significantly higher than pregnant women without LBP (p < 0.05). TSH level and weight gained in pregnant women with low physical activity level was significantly higher than pregnant women with moderate and high physical activity (p < 0.05) (without significant difference in TSH and BMI). The physical inactivity (before: OR: 1.11 95% CI: 0.89 to 1.22; first trimester: OR: 1.09 95% CI: 1.02 to 1.59; second trimester: OR: 0.92 95% CI: 0.87 to 1.31; third trimester: OR: 1.12 95% CI: 1.02 to 1.39), TSH (OR: 0.85 95% CI: 0.57 to 1.29), and weight gain (second trimester: OR: 0.87 95% CI: 0.92 to 1.59; third trimester: OR: 1.44 95% CI: 1.02 to 1.98; p < 0.05) did predict increased pain intensity. CONCLUSION: Using health-oriented approaches to increase physical activity and normalize thyroid function and weight gain during pregnancy can have beneficial effects on LBP. Show more
Keywords: Musculoskeletal disorders, pregnancy, sedentary, thyroid
DOI: 10.3233/BMR-240086
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Cobanoglu, Gamze | Guzel, Nevin A. | Ecemis, Zeynep Berfu | Demirkan, M. Yusuf
Article Type: Research Article
Abstract: BACKGROUND: The Band Pull-Apart (BPA) exercise is used to strengthen the periscapular muscles. It was recently stated that the lower extremity and trunk movements should be included in the shoulder rehabilitation programs to optimize an effective energy transfer throughout the kinetic chain. OBJECTIVE: The aim of this study is to investigate the effects of kinetic chain based BPA exercise on the muscle activations of the sternocleidomasteideous (SCM) and the trapezius muscles in individuals with and without forward head posture (FHP). METHODS: Eighteen individuals with FHP and 18 individuals without FHP were included. Photographic …measurements were made to identify individuals with FHP. The muscle activations of SCM, Upper Trapezius (UT), Middle Trapezius (MT), and Lower Trapezius (LT) were measured with surface EMG. BPA exercise was performed in the standing, unipedal standing, squat, unipedal squat, and Bulgarian split squat (BSS). RESULTS: There was no Group × Exercise interaction for the SCM, UT, MT, LT muscle activations, or for the UT/MT and UT/LT ratios (p > 0.05). While there was a difference in the activation of all muscles between individuals with and without FHP (p < 0.05), both ratios were similar (p > 0.05). There was a statistically significant difference between exercises for SCM, MT, and LT muscle activations (p < 0.000 for these muscles), UT/MT (p < 0.000) and UT/LT ratios (p = 0.004). SCM muscle activation in squat was lower than activation in standing (Mean Difference (MD) = 2.5% Maximal Voluntary Isometric Contractions (MVIC); p = 0.004) and in unipedal standing (MD = 2.1% MVIC; p = 0.002). MT muscle activation in squat was higher than activation in standing (MD = 9.7% MVIC), unipedal standing (MD = 7.8% MVIC), unipedal squat (MD = 6.9% MVIC) and BSS (MD = 9.4% MVIC; p < 0.000 for these positions). LT muscle activation in the squat was higher than activation in the standing (MD = 8.5% MVIC) and unipedal squat (MD = 8.1% MVIC; p < 0.004 for these positions). UT/MT ratio in the squat was lower than standing (MD = 0.3), unipedal standing (MD = 0.2) and BSS (MD = 0.3; p < 0.000 for these positions). UT/LT ratio in squat was lower than unipedal squat (MD = 0.5) and BSS (MD = 0.6; p = 0.002; for these positions). CONCLUSION: Performing the BPA exercise in the squat position is suggested in cases where lower SCM and UT muscle activation, lower UT/MT, and UT/LT ratios and higher MT and LT muscle activations are needed for individuals with and without FHP. Show more
Keywords: Shoulder, superficial back muscles, electromyography, exercise therapy, posture
DOI: 10.3233/BMR-230397
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Mikkonen, Jani | Luomajoki, Hannu | Airaksinen, Olavi | Goubert, Liesbet | Pratscher, Steven | Leinonen, Ville
Article Type: Research Article
Abstract: BACKGROUND: Exercise is a first-line treatment for chronic non-specific low back pain (CNSLBP). Exercise combined with specific breathing techniques have the potential to improve multifactorial outcomes. No previous studies, however, have compared outcomes between identical exercises with or without a specific breathing protocol in a uniform clinical study setting. OBJECTIVES: 1) To investigate the feasibility of combining synchronized breathing with movement control exercises and evaluate eligibility criteria, randomization procedures, and dropout rates. 2) To study the preliminary efficacy of the interventions on multifactorial outcome measures. METHODS: Thirty subjects with CNSLBP were randomized into …two groups. Both groups had four contact clinic visits where they received personalized home movement control exercises to practice over two months. The experimental group included a movement control exercise intervention combined with synchronized breathing techniques. Trial registration number: NCT05268822. RESULTS: Feasibility was demonstrated by meeting the recruitment goal of 30 subjects within the pre-specified timeframe with enrolment rate of 24.8% (30/121). Synchronized breathing techniques were successfully adhered by participants. Home exercise adherence was nearly identical between the groups without any adverse events. Preliminary efficacy findings on pain intensity, disability, and self-efficacy in the experimental group exceeded the minimal clinically important difference. No such findings were observed in any outcome measures within the control group. Overall, multifactorial differences were consistent because nine out of eleven outcome measures showed greater improvements for the experimental group. CONCLUSION: The synchronized breathing with movement control exercises protocol was feasible and may be more beneficial for improving multifactorial outcomes compared to identical exercises alone. Results suggested progression to a full-scale trial. Show more
Keywords: Chronic musculoskeletal pain, feasibility, breathing exercises, specific breathing technique, motor control exercises, yoga, pilates
DOI: 10.3233/BMR-230413
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Kim, Jun-Hee
Article Type: Research Article
Abstract: BACKGROUND: Low back pain (LBP) is one of the most frequently occurring musculoskeletal disorders, and factors such as lifestyle as well as individual characteristics are associated with LBP. OBJECTIVE: The purpose of this study was to develop and compare efficient low back pain prediction models using easily obtainable demographic and lifestyle factors. METHODS: Data from adult men and women aged 50 years or older collected from the Korean National Health and Nutrition Examination Survey (KNHANES) were used. The dataset included 22 predictor variables, including demographic, physical activity, occupational, and lifestyle factors. Four machine …learning algorithms, including XGBoost, LGBM, CatBoost, and RandomForest, were used to develop predictive models. RESULTS: All models achieved an accuracy greater than 0.8, with the LGBM model outperforming the others with an accuracy of 0.830. The CatBoost model had the highest sensitivity (0.804), while the LGBM model showed the highest specificity (0.884) and F1-Score (0.821). Feature importance analysis revealed that EQ-5D was the most critical variable across all models. CONCLUSION: In this study, an efficient LBP prediction model was developed using easily accessible variables. Using this model, it may be helpful to identify the risk of LBP in advance or establish prevention strategies in subjects who have difficulty accessing medical facilities. Show more
Keywords: Chronic pain, artificial intelligence, risk assessment, health surveys, physical activity, quality of life
DOI: 10.3233/BMR-240059
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Amin, Doaa I. | Mohamed, Ghada I. | ElMeligie, Mohamed M.
Article Type: Research Article
Abstract: BACKGROUND: Chronic nonspecific neck pain is a common disorder that causes disability and reduced quality of life. Effective conservative treatment options are needed to manage this condition. OBJECTIVE: This randomized trial compared the efficacy of McKenzie exercises alone versus McKenzie plus cervical and scapulothoracic stabilization training for patients with chronic nonspecific neck pain. METHODS: A randomized controlled trial was conducted in an outpatient physical therapy clinic. 76 patients with chronic (> 3 months) neck pain were randomized to 6 weeks of either McKenzie exercises alone (n = …38) or McKenzie plus stabilization exercise (n = 38). The McKenzie protocol included posture correction, range of motion exercises, and lateral neck stretches. The stabilization program added targeted exercises for the neck and scapula. RESULTS: The combination of McKenzie plus stabilization exercises resulted in significantly greater reduction in current neck pain intensity compared to McKenzie alone at 6 weeks (mean difference: - 1.2 points on 0–10 scale, 95% CI - 1.8 to - 0.6; p < 0.001). Neck disability improved in both groups. Cervical range of motion also improved more with the addition of stabilization, except for extension. CONCLUSION: Adding specific cervical and scapulothoracic stabilization exercises to a standard McKenzie protocol led to clinically meaningful reductions in neck pain compared to McKenzie therapy alone in patients with chronic nonspecific neck pain. This combined approach can improve outcomes. Show more
Keywords: Musculoskeletal diseases, Cervicalgia, exercise therapy, manual therapy, randomized controlled trial
DOI: 10.3233/BMR-230352
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Sadiq, Samreen | Noor, Rabiya | Akram, Rizwan
Article Type: Review Article
Abstract: BACKGROUND: Total knee arthroplasty (TKA) is a widely performed surgical procedure aimed at alleviating pain and restoring functionality in individuals suffering from knee osteoarthritis. Despite substantial benefits of TKA, patients are exposed to potential risks, including the occurrence of falls during their recovery period following discharge from the hospital. OBJECTIVE: This integrative review endeavors to comprehensively investigate the existing body of literature to identify and assess the diverse factors that contribute to occurrence of post-discharge falls among TKA patients. Through the synthesis of available research, this study seeks to offer valuable insights that can guide clinical …practices and interventions designed to mitigate the incidence of post-TKA falls, ultimately enhancing patient outcomes and quality of healthcare. METHODS: An integrative review was conducted and databases were searched including Pubmed, PEDro, Cochrane, and SPORTDiscus from 2000 to 2024. A thorough search was performed to retrieve articles missed through databases as well as unpublished grey literature. Methodological quality assessment was performed using Newcastle-Ottawa Scale for Case Control and Cohort studies and AXIS tool for cross-sectional study. RESULTS: Eleven articles finally met the inclusion criteria and were included in the review based on eligibility. There were 8 cohort studies (7 prospective cohorts, 1 retrospective cohort), 2 case control studies, and 1 cross-sectional study. The prospective cohort studies included in the review collected data in real-time as events occurred, making them particularly relevant for studying post-TKA falls. CONCLUSION: Patients who underwent TKA are at risk of post-discharge falls. Several key risk factors have been identified, including advancing age, female gender, reduced proprioception, psychiatric disorders, living alone, and knee pain in the operated knee. It is important to recognize that the significance of these risk factors can vary depending on individual circumstances and contexts. Show more
Keywords: Balance, discharge planning, risk of falls, total knee replacement
DOI: 10.3233/BMR-230165
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Yilmaz, Kamil | Sert, Ozlem Akkoyun | Unuvar, Bayram Sonmez | Gercek, Hasan
Article Type: Research Article
Abstract: BACKGROUND: Chronic pain can affect body perception at the central level by causing the somatosensory cortex to rearrange. Additionally, cervical afferent abnormalities in individuals with neck pain can impair proprioceptive sensitivity, potentially leading to alterations in body alignment and biomechanics. Nevertheless, there are insufficient studies exploring these notions. OBJECTIVE: The main objective of this study was to compare the head posture and neck proprioceptive sense of individuals with chronic neck pain and healthy controls. METHODS: Utilizing a cross-sectional study, a total of 76 volunteers comprising 38 individuals with neck pain and 38 matched …healthy controls participated in the study. Head posture and cervical joint position sense were measured using a Cervical Range of Motion Deluxe (CROM) device. Firstly, the deviation angles of the head in three planes were evaluated, then the Head Repositioning Accuracy (HRA) test was performed to determine the joint position error. Visual Analogue Scale (VAS) was used to determine the severity of pain in individuals with neck pain. RESULTS: The deviation angles of the head in all three planes were significantly lower in the healthy control group (p < 0.05). Joint position error values were significantly higher in all directions (flexion-extension, right-left lateral flexion, and rotation) in the neck pain group (p < 0.001). CONCLUSION: The findings show that the proprioceptive sensation of the cervical region in individuals with neck pain was adversely affected, with changes were observed in the head posture. NOTE: The abstract of this study was presented as a verbal declaration at the International Congress of Health Sciences-ICHES-IDU 2020 that was held in İzmir on 20–21 June 2020. Show more
Keywords: Neck pain, position sense, posture, proprioception, proprioceptive disorders
DOI: 10.3233/BMR-240155
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Saleh, Marwa Shafiek | Mohamed, Walaa Mohsen | Elsayed, Walaa Hamdy | Abdelatief, Emad Eldin Mohamed
Article Type: Research Article
Abstract: BACKGROUND: Proprioceptive neuromuscular facilitation (PNF) stretching exercises have been widely advocated for the management of patients with different musculoskeletal conditions. However, its effect on the treatment of temporomandibular dysfunction (TMD) in patients with forward head posture (FHP) has not been fully investigated. OBJECTIVE: To investigate the effect of PNF stretching exercises on the treatment of TMD in patients with FHP. METHODS: A prospective, randomized, double-blinded clinical trial. Twenty-four patients with TMD and FHP aged from 18–40 years were randomly assigned to PNF or control group. The PNF group composed of 12 patients received …PNF stretching exercises of masticatory muscles in addition to routine physical therapy treatment (FHP correction exercises and ultrasound for the temporomandibular joint); the control group composed of 12 patients received routine physical therapy treatment only. Interventions were conducted twice a week for six weeks. Craniovertebral angle, pain threshold, pain intensity, temporomandibular joint ROM, and temporomandibular joint function were assessed for all participants before and after the intervention. The outcomes were analyzed using Two-way mixed MANOVA. For further multiple comparisons, post-hoc tests with the Bonferroni correction were performed. RESULTS: There was no significant difference between both groups pre-treatment (p > 0.05). Comparison between groups post-treatment revealed statistically significant differences in all outcome measures (p < 0.05) in favor of the PNF group. CONCLUSION: Adding PNF stretching exercises of masticatory muscles to routine physical therapy programs is an effective method for management of TMD in patients with FHP more than routine physical therapy programs alone. Show more
Keywords: Neck posture, craniovertebral angle, neuromuscular facilitation, craniomandibular disorders
DOI: 10.3233/BMR-230358
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
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