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Price: EUR 130.00Authors: Wu, Zhiming | Huang, Guoxin | Ai, Jinwei | Liu, Ying | Pei, Bin
Article Type: Research Article
Abstract: BACKGROUND: Low back pain is highly prevalent and the main cause of years lived with disability, but data on the burden and trends of low back pain (LBP) in adolescents and young adults (AYAs) are sparse. OBJECTIVE: To assess trends in the burden of LBP among AYAs aged 15–39 years at the global, regional and national levels from 1990 to 2019. METHODS: Data from the Global Burden of Disease (GBD) 2019 were used to analyze incidence, prevalence and Disability-adjusted life year (DALY) due to LBP at global, regional, and national levels. Joinpoint regression analysis …calculated the average annual percentage changes (AAPC). Then analyse the association between incidence, prevalence and DALYs and socioeconomic development using the GBD Socio-demographic Index (SDI). Finally, projections were made until 2030 and calculated in Nordpred. RESULTS: The incidence, prevalence and DALYs rates (95%UI) were 2252.78 (1809.47–2784.79), 5473.43 (4488.62–6528.15) and 627.66 (419.71–866.97) in 2019, respectively. From 1990 to 2019, the incidence, prevalence, and DALYs rates AAPC (95%CI) were - 0.49 (- 0.56 to - 0.42), - 0.58 (- 0.65 to - 0.51) and - 0.57 (- 0.64 to - 0.5), respectively. Incidence, prevalence, and DALYs rates in South Asia, East Asia, High-income North America, Western Europe, and Australasia decreased with SDI. Incidence, prevalence, and DALYs rates in Central Asia, Central Europe, and Eastern Europe decreased and then increased with SDI. At the national level, the incidence, prevalence, and DALYs rates are high in the United States and low in India and China. From the 2020 to 2030, most regions is predicted to decline. CONCLUSION: LBP in AYAs is a major global public problem with a high burden. There are large differences in incidence, prevalence and DALYs across SDIs, regions and countries. there is still a need to focus on LBP in AYAs and tailor interventions to reduce the future burden of this condition. Show more
Keywords: Low back pain, adolescent, young adult, global burden of disease
DOI: 10.3233/BMR-230215
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Liu, Yayun | Tang, Xiaozheng | Ding, Yuanjun | Li, Jingtang
Article Type: Research Article
Abstract: BACKGROUND: The clavicle is recognized as the bone most vulnerable to fractures. Moreover, approximately 80% of fractures occur in the middle third of the clavicle. Conservative treatment is associated with a higher rate of nonunion, while surgical treatment of fracture via internal fixation may have a variety of postoperative complications. Therefore, to improve patient satisfaction and reduce the complications related to internal fixation techniques, we modified the surgical approach to external fixation. OBJECTIVE: The purpose of this study was to assess the modified intervention’s prospects for clinical application. METHODS: A total of 36 patients …with middle clavicle fractures were treated with screw–rod external fixation between April 2015 and October 2019. We observed the operative time, intraoperative blood loss, length of hospital stay, and fracture healing time. The patients were followed up regularly, and the clinical efficacy of the modified intervention was evaluated. Finally, the patients’ shoulder function was assessed based on the disabilities of the arm, shoulder, and hand (DASH) score. RESULTS: For the screw–rod external fixation, the mean operative time was found to be 48.6 ± 6.8 min, the intraoperative blood loss was 30.6 ± 17.2 mL, the length of hospital stay was 4.5 ± 1.5 days, and the fracture healing time was 2.8 ± 0.4 months. Eventually, all the patients healed well, with the combined “excellent” and “good” rate of shoulder function being assessed to be as high as 94.44%. Furthermore, the DASH scores were all less than 10, with the average score being 4.65 ± 3.34. CONCLUSIONS: The screw–rod external fixation technique offers the advantages of convenience, reliability, and good aesthetics, suggesting that it could be used as an alternative treatment method for fractures of the middle third of the clavicle. Show more
Keywords: Treating fractures, middle third of the clavicle, screw–rod external fixation
DOI: 10.3233/BMR-220424
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-6, 2023
Authors: Çalışkan, Zehra | Alaca, Nuray | Kablan, Nilüfer
Article Type: Research Article
Abstract: BACKGROUND: In individuals with transfemoral amputation (TFA), adaptations caused by prosthesis use may adversely affect contractile/noncontractile structures. OBJECTIVE: To investigate the immediate effect of the thoracolumbar fascia (TLF) kinesiology taping (KT) on the tone and stiffness of the fascia, low back pain (LBP) and standing balance in individuals with TFA. METHODS: Syrian male participants with TFA were enrolled in the prospective, single-blind, randomised controlled trial. Participants were divided into two groups: Experimental (EG with KT, n = 15) and Control (CG with sham KT, n = …14). A 6-minute walk test (6MWT) was performed, after which KT was applied. Measurements were taken at baseline, immediately after the 6MWT and 30 minutes after KT. RESULTS: Although pain decreased below baseline in both groups at 30 minutes post intervention (p < 0.001), the rate of pain reduction was significantly higher in the EG (p = 0.016). Anterior-posterior sway with eyes open improved significantly 30 minutes after KT application only in the EG (p = 0.010). In the eyes closed condition, anterior-posterior and medio-lateral sway decreased significantly compared to baseline 30 minutes after taping in the EG (p = 0.010- 0.032). CONCLUSION: KT can be used as an effective method to support standing balance and reduce LBP in individuals with TFA. Show more
Keywords: Amputation, fascia, low back ache, standing balance
DOI: 10.3233/BMR-230314
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Zhong, Xiqiang | Shen, Guangjie | Qian, Yunfan | Li, Yimin | Tang, Chengxuan | Tang, Xiaojun | He, Shaoqi
Article Type: Research Article
Abstract: BACKGROUND: Percutaneous kyphoplasty (PKP) is the preferred treatment for osteoporotic vertebral compression fractures (OVCF) Currently, the preoperative anesthesia methods for PKP are mainly local anesthesia and tracheal intubation general anesthesia. OBJECTIVE: To assess whether patient sensitivity to pain measured preoperatively could predict the patients’ pain response during PKP treatment under local anesthesia, to facilitate the development of an optimal preoperative anesthesia plan for patients. METHODS: Fifty-five female patients diagnosed with osteoporotic single vertebral fracture who were treated with PKP under local anesthesia were selected. The patients’ pain sensitivities, including pain threshold and pain …tolerance threshold, were evaluated with a pain test device on the day before the operation in the ward. Heart rate (HR), mean arterial pressure (MAP), and blood oxygen saturation (SpO 2 ) were recorded before anesthesia, post-anesthesia, after needle puncture, and after balloon dilatation. At the same time, blood was drawn at the above time points to determine the level of norepinephrine (NA) as an indicator of intraoperative pain stress response. The numerical rating scale (NRS) during surgery was recorded at the end of the surgery. RESULTS: The preoperative pain tolerance threshold of 55 surgical patients was correlated with the intraoperative NRS score (r = - 0.768, P < 0.001), as well as with the preoperative and intraoperative changes in HR (r = - 0.791, P < 0.001), MAP (r = - 0.819, P < 0.001), and NA (r = - 0.553, P < 0.001). Thus, the lower the preoperative pain tolerance threshold, the more severe the patient’s response to pain during PKP treatment under local anesthesia, and the greater the hemodynamic changes. Consequently, the intraoperative experience becomes worse. However, there was no correlation between preoperative pain threshold and NRS scores (r = - 0.069, P = 0.616) nor between the preoperative and intraoperative changes in HR (r = 0.103, P = 0.453), MAP (r = 0.086, P = 0.535), and NA (r = - 0.058, P = 0.674). CONCLUSION: The results indicated that preoperative pain assessment could predict the level of pain response in OVCF patients during PKP surgery under local anesthesia. Show more
Keywords: PKP, OVCF, Pain threshold, Pain tolerance
DOI: 10.3233/BMR-230194
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-7, 2023
Authors: Dıracoglu, Demirhan | Sezikli, Selim | Dernek, Bahar | Yildirim, Mustafa Aziz | Sen, Ekin Ilke
Article Type: Research Article
Abstract: BACKGROUND: Many formulations and dosing regimens are available for hyaluronic acid (HA). OBJECTIVE: To compare different doses of linear, high-molecular weight (HMW) HA injections among patients with knee osteoarthritis (OA). METHODS: Hundred patients were included in this randomized, single-blinded trial and randomly divided into three HA injection groups. The first group received five weekly 20 mg HA injections, the second group received three weekly 32 mg HA injections, and the third group received a single 48 mg HA injection. Patients were evaluated at baseline, 1, 3, and 6 months after the last injection for pain, stiffness, and …function using the visual analog scale (VAS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire. Quality of life, patient’s global assessment, and Timed Up and Go (TUG) test scores were also evaluated. RESULTS: There was significant improvement in the WOMAC, VAS-pain, quality of life, patient’s global assessment, and TUG test mean scores at all follow-up time points (p < 0.001). However, the groups showed no significant differences in WOMAC, VAS-activity pain, and patient global scores at any follow-up point. CONCLUSION: Intra-articular injections of different doses of linear HMW HA can improve pain, stiffness, function, and quality of life in patients suffering from knee OA over a six-month period. Show more
Keywords: Hyaluronic acid, osteoarthritis, knee, intra-articular injection
DOI: 10.3233/BMR-230097
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Deniz, Volkan | Güzel, Nevin Atalay | Kelle, Bayram | Antmen, Ali Bülent
Article Type: Research Article
Abstract: BACKGROUND: Haemophilic arthropathy is likely to influence posture and muscle stiffness in adolescent male haemophilia patients (HP). OBJECTIVE: This study aimed to investigate the possible change in upright standing posture and stiffness of the superficial postural muscles in HP. METHODS: Twenty-two HP aged between 12 and 19 years and twenty-two healthy peers were included in the study. The photogrammetry was used to assess the upright standing posture from sagittal and frontal planes. Also, stiffness of the superficial postural muscles was evaluated using the myotonometry. RESULTS: A significant difference was found in …the craniovertebral, lumbar lordosis, knee flexion-valgus, and ankle plantar flexion angles between the groups (p < 0.05). Craniovertebral, knee flexion, and knee valgus angles were lower; whereas lumbar lordosis and ankle plantar flexion angles were higher in HP compared to the healthy peers. Stiffness of the rectus femoris muscle was lower in HP (p < 0.001). CONCLUSION: This study revealed that the ankle, knee, lumbar, and craniovertebral segments’ posture angles were changed and the stiffness of the rectus femoris muscle decreased in HP. Postural alterations and reduced rectus femoris stiffness should be considered in management of the musculoskeletal complications of haemophilia. Show more
Keywords: Alignment, bleeding disorders, muscle viscoelasticity, photogrammetry
DOI: 10.3233/BMR-230185
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Demoulin, Christophe | Timmermans, Annick | Grosdent, Stéphanie | Danneels, Lieven
Article Type: Other
DOI: 10.3233/BMR-230401
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-2, 2023
Authors: Hirota, Kento | Watanabe, Kota | Miyamoto, Hiroki | Negishi, Keisuke | Watase, Mako | Teramoto, Atsushi
Article Type: Research Article
Abstract: BACKGROUND: The intrinsic foot muscles play an important role in medial longitudinal arch support, as well as several extrinsic foot muscles. While various strength training methods specific to intrinsic foot muscles have been conducted, these exercises are associated with certain concerns regarding their effectiveness and difficulty. We developed a new exercise for the intrinsic muscles (MTP flexion exercise). OBJECTIVE: The aim was to compare the shear modulus of the toe flexors as the muscle contraction activity during MTP flexion and short-foot exercises using ultrasound shear wave elastography. METHODS: Eleven healthy participants were included …in this study. The shear modulus of the toe flexor muscles was measured during MTP flexion and short-foot exercises using ultrasound shear wave elastography. The muscle shear modulus was statistically compared between the resting phase, and during the two exercises. RESULTS: The shear modulus during MTP flexion exercise was significantly greater than in the resting phase in the abductor hallucis, flexor hallucis brevis, flexor digitorum brevis, quadratus plantae, and flexor digitorum longus. The flexor digitorum longus showed greater shear modulus during MTP flexion exercise than during short-foot exercise. CONCLUSION: MTP flexion exercise showed equivalent or greater contraction activity in certain intrinsic and extrinsic foot muscles when compared with short-foot exercise. This exercise is considered one of the training options for strengthening the intrinsic muscles of the foot. Show more
Keywords: Toe flexor strength, intrinsic foot muscle, foot exercise, shear modulus
DOI: 10.3233/BMR-230282
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-7, 2024
Authors: Zheng, Patricia | Ewing, Susan | Tang, Angelina | Black, Dennis | Hue, Trisha | Lotz, Jeffrey | Peterson, Thomas | Torres-Espin, Abel | O’Neill, Conor
Article Type: Research Article
Abstract: BACKGROUND: Tools, such as the STarTBack Screening Tool (SBT), have been developed to identify risks of progressing to chronic disability in low back pain (LBP) patients in the primary care population. However, less is known about predictors of change in function after treatment in the specialty care population. OBJECTIVE: We pursued a retrospective observational cohort study involving LBP patients seen in a multidisciplinary specialty clinic to assess which features can predict change in function at follow-up. METHODS: The SBT was administered at initial visit, and a variety of patient characteristics were available in …the chart including the presence of chronic overlapping pain conditions (COPCs). Patient Reported Outcomes Measurement Information System-10 (PROMIS-10) global physical health (PH) and global mental health (MH) were measured at baseline and at pragmatic time points during follow-up. Linear regression was used to estimate adjusted associations between available features and changes in PROMIS scores. RESULTS: 241 patients were followed for a mean of 17.0 ± 7.5 months. Mean baseline pain was 6.7 (SD 2.1), PROMIS-10 global MH score was 44.8 (SD 9.3), and PH score was 39.4 (SD 8.6). 29.7% were low-risk on the SBT, 41.8% were medium-risk, and 28.5% were high-risk. Mean change in MH and PH scores from baseline to the follow-up questionnaire were 0.86 (SD 8.11) and 2.39 (SD 7.52), respectively. Compared to low-risk patients, high-risk patients had a mean 4.35 points greater improvement in their MH score (p = 0.004) and a mean 3.54 points greater improvement in PH score (p = 0.006). Fewer COPCs also predicted greater improvement in MH and PH. CONCLUSIONS: SBT and the presence of COPC, which can be assessed at initial presentation to a specialty clinic, can predict change in PROMIS following treatment. Effort is needed to identify other factors that can help predict change in function after treatment in the specialty care setting. Show more
Keywords: Non-surgical spine care, precision medicine, specialty clinic, low back pain
DOI: 10.3233/BMR-230067
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Miçooğulları, Mehmet | Yüksel, İnci | Angın, Salih
Article Type: Research Article
Abstract: BACKGROUND: Cranio-cervico-mandibular (CCM) malalignment is associated with forward head posture (FHP) and temporomandibular joint (TMJ) disorders and affects masticatory muscles. OBJECTIVE: This randomized, double-blind controlled trial aimed to compare the efficacy of scapula-thoracic (ST) exercises on temporomandibular and cervical joint position sense and postural stability in individuals with CCM malalignment. METHODS: Fourty-nine participants with CCM malalignment were randomly assigned to the ST exercise group (STEG, n = 24) or the control group (CG, n = 25). STEG included progressive strengthening, proprioceptive, and stabilization …exercises. All participants were assessed before treatment, at the end of the 8th week treatment period and at the 12th week post-treatment follow-up. Cranio-vertebral angle measurement, Fonseca’s Questionnaire, Helkimo Clinical Dysfunction Index, TMJ position test, cervical joint position error test and postural stability assessment were used. RESULTS: The TMJ and cervical joint position sense, total sway degree, area gap percentage, sway velocity and antero-posterior body sway results showed significant improvement in the STEG compared to the CG (p < 0.05), however medio-lateral body sway did not differ between groups (p > 0.05). CONCLUSIONS: Postural stability, TMJ and cervical joint position sense appear to be affected in individuals with CCM malalignment. Our results showed that an exercise program including ST stabilization, proprioception and strengthening of the scapular muscles may be effective in the management of CCM malalignment and will allow clinicians to plan holistic treatment. Show more
Keywords: Temporomandibular joint disorders, exercise therapy, proprioception, posture
DOI: 10.3233/BMR-230323
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Hengsomboon, Ninwisan | Vongsirinavarat, Mantana | Bovonsunthonchai, Sunee | Thawalyawichachit, Laddawan | Hengsomboon, Pichaya
Article Type: Research Article
Abstract: BACKGROUND: The association between changes occurring in the spine and lower body parts is not well understood in adolescent idiopathic scoliosis (AIS). OBJECTIVES: The first aim of the study was to investigate the association of scoliosis with lower extremity (LE) alignments, foot characteristics, and muscle strengths in adolescents. Secondly, comparisons of the data among AIS with single and double curves and control groups were determined. METHODS: Thirty-one participants were recruited and classified into 3 groups; AIS with a single curve (n = 7), AIS with double curves (n …= 14), and controls (n = 10). Association of the presence of scoliosis with LE alignments (Q and TC angles), LE muscle strengths (hip, knee, and ankle), and foot characteristics (arch indexes) were examined using the point biserial correlation, and the data among three groups were compared using the ANOVA. RESULTS: Scoliosis was associated with Q angle, arch indexes, and all LE muscle strengths except for hip extensors and ankle plantar flexors strengths. Comparisons among the three groups showed significant increases in LE alignments and foot characteristics in AIS. Almost all LE muscle strengths decreased in AIS, especially for the single curve group. CONCLUSIONS: Apart from spinal deformity, the AIS has changed in LE alignments, muscle strengths, and foot characteristics. Therapists should consider these associations and alterations for designing proper management. Show more
Keywords: Scoliosis, spinal curvatures, lower extremity, muscle strength, flatfoot
DOI: 10.3233/BMR-230220
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Jiménez-Sánchez, Carolina | Cordova-Alegre, Paula | Carpallo-Porcar, Beatriz | Burgos-Bragado, Jose Manuel | Sanjuan-Sánchez, Daniel | Brandín-de la Cruz, Natalia
Article Type: Research Article
Abstract: BACKGROUND: Currently, the use of radiofrequency diathermy for the treatment of neck pain is booming. OBJECTIVE: This study aimed to evaluate the clinical efficacy of Digital Capacitive Diathermy (DCD® ) on stiffness, pain, cervical range of motion, and cervical disability and to compare it with ultrasound (US) in patients with latent myofascial trigger point (MTrP) in the upper trapezius. METHODS: Nineteen participants with latent MTrPs in the upper trapezius were included in the assessor-masked, randomized, clinical crossover trial. Subjects were exposed to both interventions: US and DCD® and treatment effectiveness was measured …by myotonometric variables, pressure pain threshold (PPT), visual analog scale (VAS), cervical side-bending flexion ranges, and the neck disability index scale (NDI). RESULTS: There were no significant differences between US and DCD® interventions regarding changes in outcome measures. The US group achieved a statistically significant difference of 2.16 to 1.13 points (p = 0.005; r = 0.646) for the VAS. The DCD® intervention showed a statistically significant improvement of 1.11 points for the NDI at 1-week following intervention (95% CI 0.14–2.07; p = 0.27; d = 0.217). CONCLUSION: Our findings suggest that DCD® and US can both be considered effective modalities for the treatment of latent MTrPs, having a longer duration of action with DCD® therapy. Show more
Keywords: Ultrasound therapy, diathermy, radiofrequency, myofascial trigger point, upper trapezius
DOI: 10.3233/BMR-230296
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Watanabe, Kota | Ashida, Yuzo | Hirota, Kento | Taniguchi, Tatsuya | Miyamoto, Hiroki | Teramoto, Atsushi
Article Type: Research Article
Abstract: BACKGROUND: Toe function is characterised by the strength and dexterity of toe motion. However, previous studies have mostly focused on the importance of toe strength. OBJECTIVE: This study aimed to investigate the relationships between flexion strength and dexterity of the toes and physical performance. METHODS: Twenty healthy participants were included in this study. The flexion force of each toe was measured using a digital force gauge, and the toe dexterity was evaluated using the marble pick-up and rock-paper-scissors tests. These parameters were statistically analysed in relation to physical performance, including repeated side step …and balance ability, which was evaluated using centre of pressure (COP) data during single-leg standing, tiptoe standing, and single-leg drop-jumping. RESULTS: A significant correlation was found between the first toe flexion force and the total trajectory length of the COP during one-leg standing and between the time required for marble pick-up and the rock-paper-scissors score and the COP during single-leg drop-jumping. CONCLUSION: The results underscore the importance of flexion strength and dexterity of the toes in human physical performance and the necessity for the evaluation and improvement of both functions. Show more
Keywords: Toe function, marble pick-up, rock-paper-scissors test, balance
DOI: 10.3233/BMR-230263
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-7, 2023
Authors: Yalfani, Ali | Abedi, Mitra | Raeisi, Zahra | Asgarpour, Azadeh
Article Type: Research Article
Abstract: BACKGROUND: Chronic low back pain (CLBP) is known as an important debilitating health condition among older women. OBJECTIVE: This study aimed to evaluate the effects of eight-week virtual reality training (VRT) exercises on postural sway and physical function performance (PFP) among older women suffering from CLBP. METHODS: Twenty-seven older women presenting with CLBP were randomized into experimental and control groups. The experimental group was instructed to perform 30-minute VRT exercises three times a week for eight weeks. Plantar pressure variables [sway velocity (SV) and anterior-posterior (AP) and medial-lateral (ML) fluctuations of the center …of pressure (CoP)], 30-second chair stand test (30CST), and timed up and go (TUG) test were recorded. RESULTS: The VRT group exhibited significant decreases in SV (p = 0.002), AP (p = 0.008), and ML (p = 0.02) fluctuations. Also, the performance of the VRT group in the 30CST and TUG tests significantly improved after the exercises (P < 0.001). CONCLUSION: According to the results, VRT and the program used in this study should be used to enhance balance and PFP in older women with CLBP who mostly prefer activities that are accessible and feasible in low-risk environments. Show more
Keywords: Aging, balance, exergaming, virtual reality exercises, COVID-19
DOI: 10.3233/BMR-230260
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Hernandez-Lucas, Pablo | Leirós-Rodríguez, Raquel | Lopez-Barreiro, Juan | García-Soidán, José L.
Article Type: Review Article
Abstract: BACKGROUND: Clinical practice guidelines stress the importance of prevention and treatment of non-specific back pain through exercise therapy. However, it has not yet been confirmed whether the combination of exercise plus education is more effective than such interventions taken separately. OBJECTIVE: To determine if the combination of exercise plus education is more effective for the prevention of non-specific back pain than exercise or education alone. METHOD: A systematic search of studies whose sample consisted of participants without non-specific back pain (primary prevention) and participants with non-specific back pain (secondary and tertiary prevention) was …conducted in the following databases in March 2023: PubMed, Scopus, Web of Science and Medline. RESULTS: A total of 16 articles were selected. Statistically significant results were found in the pain variable with SMD = - 2.02 (95% CI = - 2.71 to - 1.33; p < 0.001), the disability variable with SMD = - 1.14 (95% CI = - 1.63 to - 0.65; p < 0.001), and the kinesiophobia variable with SMD = - 1.8 (95% CI = - 2.54 to - 1.05; p < 0.001). CONCLUSION: Interventions that combine exercise and education seem to have a greater preventive effect on non-specific back pain, disability and kinesiophobia than those that include exercise or education in an isolated manner. Show more
Keywords: Exercise therapy, health education, primary prevention, secondary prevention, tertiary prevention
DOI: 10.3233/BMR-230252
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-14, 2023
Authors: Sekine, Chie | Yamamoto, Mayu | Hirabayashi, Ryo | Yokota, Hirotake | Edama, Mutsuaki
Article Type: Research Article
Abstract: BACKGROUND: Lumbar stabilization exercises (LSE) provide dynamic trunk stability, promote muscle strength and endurance, and improve low back pain rehabilitation and performance. OBJECTIVE: To clarify the differences in trunk muscle activity during LSEs on stable and different unstable surfaces. METHODS: Fifteen healthy males performed three exercises (elbow-toe, hand-knee, and side bridge) on stable (floor) and unstable surfaces. Muscle activity of the bilateral rectus abdominis, internal oblique, external oblique, and erector spinae were recorded. Data were compared using the Friedman test. Pairwise comparisons were performed using Wilcoxon’s signed rank test if significant differences were …observed. RESULTS: In the elbow-toe exercise, muscle activity of the rectus abdominis and right internal oblique increased in the following order: floor, low-difficulty, and high-difficulty unstable surface. In the hand-knee exercise, muscle activity of the internal oblique on the lower-extremity elevated side, external oblique, and erector spinae on the upper-extremity elevated side were greater on unstable surface exercise performance. In the side bridge exercise, rectus abdominis muscle activity was highest on a high-difficulty unstable surface. CONCLUSION: Trunk muscle activity increased during exercise on unstable surfaces. Since the effects of unstable surfaces vary depending on muscle and exercise types, exercise difficulty and surface stability must be considered accordingly. Show more
Keywords: Spine, electromyography, rehabilitation
DOI: 10.3233/BMR-230297
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Ikwuanusi, Stephanie | Tella, Abidemi | Akinbo, Sunday | Nwaedozie, Obianuju | Adje, Mishael
Article Type: Research Article
Abstract: BACKGROUND: Specific stabilisation exercises (SSE) can combat the debilitating effects of chronic non-specific low back pain (CLBP), improve disability, pain and fear-avoidance beliefs (FAB). OBJECTIVE: To elicit the determinants of outcome in patients with CLBP with associated FABs after treatment with SSE. METHOD: Twenty-nine patients (20 females) with CLBP were classified using FAB questionnaire into high or low Work and Physical Activity (PA) subscales. After 4-week treatment, evaluations were done for pain, disability and lumbar spine active range of motion (AROM). Data was analysed exploratory-descriptively with a significance level set at p < …0.05. RESULTS: Participants were aged 55.24 ± 11.91 years. They scored 19 (65.5%) and 5 (17.2%) respectively on Work and PA subscales. The post-intervention evaluation showed significant differences in all outcomes, but no significant difference between patients with high or low FAB scores for both subscales. PA scores correlated significantly with pain while work scores correlated significantly with disability. Participants’ gender predicted disability, pain and AROM with moderate to large effect sizes. CONCLUSION: SSE can potentially improve disability, pain and range of motion for patients with chronic low back pain regardless of FABQ status. Gender and baseline patient status are potential determinants of outcome of treatment using SSE. Show more
Keywords: Disability, kinesiophobia, chronic pain, lumbar stabilisation exercises
DOI: 10.3233/BMR-230312
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Ogrodzka-Ciechanowicz, Katarzyna | Kurzeja, Piotr | Sorysz, Tomasz
Article Type: Research Article
Abstract: BACKGROUND: Due to the systematically increasing number of shoulder replacement procedures among older people, the need to assess their quality of life is becoming more and more important. OBJECTIVE: The aim of the study was to functionally assess the shoulder joint and the quality of life of patients before and after reverse total shoulder arthroplasty (rTSA). METHODS: The observational study included 15 patients after the rTSA procedure (randomly selected). The quality of life and shoulder joint function before and after rTSA were assessed using the following scales: SF-36, Constant-Murley Score, Disabilities of the …Arm, Shoulder and Hand Scale (DASH) and the University of California-Los Angeles Shoulder Rating Scale (UCLA scale) and Simple Shoulder Test (SST). RESULTS: There were statistically significant differences (p < 0.001) between measurements in the overall scores of the SF-36 questionnaire. Statistically significant differences (p < 0.001) were found between measurements in terms of the Constant-Murley, DASH, UCLA and SST scales results. CONCLUSIONS: Reverse total shoulder arthroplasty significantly improved the patients’ quality of life and the functional condition of the operated limb. Show more
Keywords: Reverse total shoulder arthroplasty, quality of life, pain
DOI: 10.3233/BMR-230347
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2023
Authors: Ijiri, Tomohito | Suzuki, Toshiaki
Article Type: Research Article
Abstract: BACKGROUND: The normal value of the scapular muscle activity ratio during arm elevation is not clear. OBJECTIVE: To obtain normal values of the scapular muscle activity ratio during arm elevation in healthy individuals. METHODS: This cross-sectional study enrolled 47 healthy people. The participants performed shoulder flexion and lowered task with 90-degree movements every 2 seconds. Muscle activities of scapular muscles were measured. For normalization, the maximum isometric contraction of the shoulder flexion was measured at 90 ∘ (reference contraction). The integrated electromyographic value (IEMG) obtained during the task was …normalized by IEMG during the reference contraction and the relative IEMG value was calculated. Then, the scapular muscle activity ratio was computed. The relationship between muscle strength and other factors was also investigated. RESULTS: The median values for upper trapezius/serratus anterior and upper trapezius/lower trapezius were often approximately 1, and that for upper trapezius/middle trapezius was often between 1 and 2. The shoulder flexion isometric strength and scapular muscle activity ratio showed significant negative correlations in multiple phases. CONCLUSION: Normal values for upper trapezius/serratus anterior and upper trapezius/lower trapezius during arm elevation and lowering were generally 1. Low muscle strength may contribute to an abnormal scapular muscle activity balance. Show more
Keywords: Scapular muscle activity ratio, arm elevation, electromyography, muscle strength
DOI: 10.3233/BMR-230217
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2023
Authors: Afzal*, Muhammad Waqar | Ahmad, Ashfaq | Gilani, Syed Amir | Zulfaqar, Nimra | Fatima, Sahar | Mahmmod, Tahir
Article Type: Research Article
Abstract: BACKGROUND: Translation and validation of important scales in other languages reduce bias in reporting the functional status of the patient. OBJECTIVE: To translate the Back Pain Functional Scale into Urdu (BPFSu), adapt it for use in other cultures, and evaluate its psychometric properties. METHOD: According to Beaton guidelines, translation and cultural adaption was carried out. On 100 Urdu-literate men and women aged 18–60 years with lower back pain, the final BPFSu was assessed for psychometric qualities. First at baseline and again after 7 days, participants completed the BPFSu, the Functional Rating Index (FRI), and the …Numeric Pain Rating Scale (NPRS). RESULTS: Internal consistency of the BPFSu was excellent (Cronbach’s alpha: 0.937). No floor and ceiling effects were found Excellent test-retest reliability (ICC = 0.882, CI 95%; 0.830–0.919) was achieved. Spearman correlation coefficient showed criterion validity with the NPRS (rho = â 0.701, p ⩽ 0.001) and Pearson correlation coefficient showed construct validity with the FRI (r = â 0.740, p ⩽ 0.001). The minimum detectable changes were 9.96, while the standard error of measurement was 3.6. CONCLUSION: The BPFSu is a valid and reliable instrument for assessing physical function in individuals experiencing low back discomfort. Show more
Keywords: Back pain, back pain functional scale, translation, cross-cultural adaptation
DOI: 10.3233/BMR-230153
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2023
Authors: Özbudak, Pınar | Karataş, Özlem | Kaçar, Cahit
Article Type: Research Article
Abstract: BACKGROUND: Vitamin D deficiency is common in postmenopausal women and is associated with low vitamin D intake, increased age, decreased absorption. Especially at advanced age, vitamin D deficiency may increase muscle weakness and disbalance resulting in increased risk of fracture. OBJECTIVES: This study aims to explore the correlation between 25(OH) vitamin D3 levels and quadriceps muscle strength in postmenopausal women. METHODS: We evaluated bilateral qadriceps muscle strength in postmenopausal women with isokinetic test. We evaluated the correlation of muscle power with measurements of parathormone, vitamin D, Calcium, creatinine, alanine transaminase, alkaline phosphatase, total …creatine kinase. RESULTS: The mean vitamin D level of 95 participants included in the study was 18.24 ± 8.94 ng/ml. Vitamin D levels were found to be deficient (< 10 ng/ml) in 23 (24.1%), insufficient in 62 (65.26%) and normal in 10 (10.53%) of the 95 participants. A weak negative correlation was observed between participants’ vitamin D levels and PT values (r = - 0.271, p = 0.012). A moderate negative correlation was found between ALP and vitamin D levels (r = - 0.317, p = 0.002). However, there was no significant correlation between vitamin D levels and the 60 ∘ and 90 ∘ flexion and extension peak torque values (All p values > 0.05). CONCLUSIONS: Vitamin D levels and muscle strength weren’t statistically significant. Few studies are available in the related literature, highlighting the need for further research to achieve a clearer consensus. Show more
Keywords: Cholecalciferol, muscle strength correlation, postmenopause, vitamin D3
DOI: 10.3233/BMR-230172
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2023
Authors: Moreno-Navarro, Pedro | Sabido, Rafael | Barbado, David | Prat-Luri, Amaya | Vera-Garcia, Francisco J.
Article Type: Research Article
Abstract: BACKGROUND: Body tilt changes could affect the intensity/difficulty of core stability exercises, but there is still a lack of knowledge about its impact. OBJECTIVE: To analyse the trunk muscles activation during prone plank exercises at different body tilts. METHODS: Twenty-four young adults who performed recreational gymnastic activities participated in this study. Electromyography activity of the rectus abdominis (RA), external oblique (EO), internal oblique (IO) and erector spinae (ES) was recorded during the performance of six variations of the prone plank exercise (planking with feet supported on the ground [conventional horizontal position] and planking …with feet supported on wall bars at five different heights increasing the angle tilt) and an inverted position exercise. RESULTS: The RA, EO and IO activation in all prone plank variations were higher than those observed in the conventional prone plank. In addition, the coefficient of variation of the muscle activation increased with the declination angle, reaching the highest values in the inverted position for the RA and ES muscles. CONCLUSION: The results seem to indicate that the body tilt variation could be used as an easy and inexpensive strategy for modulating the neuromuscular demands and the motor control challenge during planking exercises. Show more
Keywords: Core stability, electromyography, load progression, training program
DOI: 10.3233/BMR-230209
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2023
Authors: de Sire, Alessandro | Lippi, Lorenzo | Calafiore, Dario | Marotta, Nicola | Mezian, Kamal | Chiaramonte, Rita | Cisari, Carlo | Vecchio, Michele | Ammendolia, Antonio | Invernizzi, Marco
Article Type: Research Article
Abstract: BACKGROUND: Vertebral fragility fractures (VFFs) commonly result from low bone mass and microarchitecture deterioration of bone tissue. spinal orthoses are common non-pharmacological options for managing vertebral fracture pain. However, the effects of spinal orthoses on pain, physical functioning, and quality of life (QoL) are still debated. OBJECTIVE: This survey aimed to investigate the patients-reported outcomes of a dynamic spinal orthosis prescribed in the routine clinical practice of VFFs management. METHODS: This multi-center national-wide prospective cohort study assessed older patients (aged > 60 years) diagnosed with acute VFFs and prescribed with a …dynamic spinal orthosis (Spinfast ® ). A survey questionnaire was realized and included sections on patient characterization, osteoporosis characterization, spinal orthosis, clinical outcomes, pain medications, and osteoporosis medications. The questionnaire was administered at baseline and after three months. A total of 68 patients completed the questionnaire at three months. Most patients had one or two VFFs and were treated with pain medications and osteoporosis medications. Compliance and tolerability of the spinal orthosis were assessed, and clinical outcomes such as pain intensity, physical functioning, and QoL were measured. RESULTS: The results showed no significant differences in outcomes between age subgroups. Italian physical medicine and rehabilitation physicians were commonly involved in the management of VFFs patients. Sixty-six patients completed the questionnaire. The results showed that pain intensity, physical functioning and QoL improved after three months of spinal orthosis wearing (p < 0.0001). CONCLUSION: The correct management of VFFs is mandatory to improve pain and reduce disability, and our findings suggested a positive role of dynamic spinal orthosis to improve the comprehensive management of VFFs patients. However, high-quality research trials are warranted to provide clear recommendations for the correct clinical management of VFF. Show more
Keywords: Osteoporosis, rehabilitation, spinal orthoses, spine, vertebral fractures
DOI: 10.3233/BMR-230177
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-13, 2023
Authors: Cihan, Emine | Şahbaz Pirinççi, Cansu | Leblebicier, Merve Akdeniz
Article Type: Research Article
Abstract: BACKGROUND: Osteoarthritis (OA) is a pathology that frequently affects the geriatric population. OBJECTIVE: To investigate the extent to which pain, functionality, and quality of life change over the progression of OA grades. METHOD: The study included 161 patients with bilateral OA, whose disease stages ranged from 1 to 4 according to the Kellgren-Lawrence radiographic classification system. Pain was assessed using the Visual Analog Scale (VAS), functionality using the two-minute walk test and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire, and quality of life using the Nottingham Health Profile (NHP). RESULTS: …There were significant differences between the groups in terms of age, weight, and body mass index. The VAS, two-minute walk test, and WOMAC scores also significantly differed between the groups (p < 0.05). There was a significant difference between the groups in all domains of the NHP, except for energy (p < 0.05). The two-minute walk test score was negatively correlated with all the remaining evaluation parameters (p < 0.05). No correlation was found between the energy domain of the NHP and body mass index, the VAS score, the two-minute walk test distance, or the total WOMAC score (p > 0.05). CONCLUSION: After grade 1, the functional impacts of OA on patients increased by an average of four times. Pain was one of the most basic symptoms, the severity of which started to increase in grade 2. With the added effect of diminishing walking capacity over time, the reduction in the quality of life of the patients accelerated as the OA grade progressed. Show more
Keywords: Osteoarthritis grade, function, pain, quality of life
DOI: 10.3233/BMR-230293
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-7, 2023
Authors: Chokphukiao, Pakwipa | Amatachaya, Sugalya | Poncumhak, Puttipong | Intaruk, Roongnapa | Thaweewannakij, Thiwabhorn | Somboonporn, Charoonsak | Peungsuwan, Punnee | Amatachaya, Pipatana | Sooknuan, Thanat
Article Type: Research Article
Abstract: BACKGROUND: Many older adults are at risk of sarcopenia, a gradual loss of muscle mass affecting muscle strength and physical function, which can lead to adverse health consequences deteriorating their independence. However, the detection could be delayed due to the requirement of many measures, including a complex imaging modality. Thus, an exploration for a practical community- or home-based measure would be helpful to identify at-risk older adults and begin the timely management. OBJECTIVE: To explore the ability of the upper limb loading during a seated push-up test (ULL-SPUT) to determine the presence of sarcopenia in community-dwelling …older adults. METHODS: Older adults (n = 110; 62 females, average age approximately 77 years) were cross-sectionally assessed for sarcopenia using standard measures (handgrip strength, appendicular skeletal muscle mass, and walking speed) and the ULL-SPUT. RESULTS: Data from standard measures indicated that 44 participants had sarcopenia. The ULL-SPUT index of < 16.9 kg/m 2 for females (sensitivity = 86%, specificity = 78%, area under the receiver operating characteristic curve [AUC] = 0.85) and < 19.7 kg/m 2 for males (sensitivity = 73%, specificity = 69%, AUC = 0.83) could optimally identify participants with sarcopenia. CONCLUSION: The ULL-SPUT index could be used to screen and monitor older adults with sarcopenia in various clinical, community, and home settings. This practical measure may be accomplished using a digital bathroom scale on a hard, even surface. Outcomes would identify an adult who should undergo further confirmation of sarcopenia through standard measures or the initiation of timely management to promote treatment effectiveness. Show more
Keywords: Body composition, community health services, frail elderly, muscle strength, health status
DOI: 10.3233/BMR-230143
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Park, Donghwi | Choi, Jin-Woo | Chang, Min Cheol
Article Type: Research Article
Abstract: BACKGROUND: Despite the application of various therapeutic methods, pain caused by complex regional pain syndrome (CRPS) is not sufficiently managed and often progresses to a chronic stage. For the systematic and effective treatment of CRPS, we developed an algorithm for multimodal medication therapy based on the established pathophysiology of CRPS to control CRPS-related pain. OBJECTIVE: In this study, we present the outcomes of our novel algorithm for multimodal medication therapy for patients with CRPS, consisting of three major components: multimodal oral medication, intravenous ketamine, and intravenous lidocaine therapy. METHODS: We retrospectively investigated patients …with CRPS who received multimodal therapy. Pain severity scores were evaluated using a numerical rating scale at four time points (P1, pain at initial consultation; P2, pain after oral medication; P3, pain after ketamine treatment; and P4, pain after lidocaine treatment). The effect of the multimodal medication therapy algorithm on pain management was evaluated at each time point. RESULTS: In patients with CRPS, multimodal oral medication, intravenous ketamine, and intravenous lidocaine therapies led to significantly improved pain control (p < 0.05). Additionally, the combination of these three therapies (through the multimodal medication therapy algorithm) resulted in significant pain relief in patients with CRPS (p < 0.05). CONCLUSIONS: Our multimodal medication therapy algorithm effectively controlled pain in patients with CRPS. However, further prospective studies with large sample sizes and randomized controlled trials are needed for more accurate generalization. Show more
Keywords: Complex regional pain syndromes, drug therapy, neuralgia, ketamine, lidocaine
DOI: 10.3233/BMR-230179
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Soares, Denise | Abbady, Karim | Kasap, Suat | Shabanliyski, Dimitar
Article Type: Research Article
Abstract: BACKGROUND: Weightlifting is an Olympic sport for dynamic strength and power, and requires the execution of different lifting techniques It is important to analyze the forces subjected to the lower back during weightlifting movements to prevent injuries. Digital Human Modeling (DHM) is a powerful tool that can be used to analyze and optimize the performance of humans while doing their work or activities. OBJECTIVE: The purpose of this study is to present a simulation analysis of the lower back forces during the execution of two weightlifting techniques: Snatch (SN) and Clean & Jerk (CJ), with different …loads and for both genders. METHODS: Digital Human modelling through JACK simulation package was used analyze the forces exerted on the lumbosacral area (L5-S1) of the lower back in order to determine the risk for low back injuries. The level of compression and shear forces recommended by the literature have been set as thresholds. The simulaitons were performed in male and female models, with loads from 20–100 kg. RESULTS: The results show that any weight higher than 60 kg in both movements poses risk for the weightlifters in terms of compression and shear forces. It has been observed that weightlifters can lift greater loads in the CJ technique compared to the SN technique. Furthermore, females are able to lift higher loads with lower risk of injuries. CONCLUSION: Weightlifting is a high-risk activity due to the high levels of shear and compression forces that the body is exposed to during the lifting techniques. Digital Human Modeling holds significant value due to their ability to facilitate the exploration of diverse conditions within a safe environment, devoid of any potential harm to human subjects. Show more
Keywords: Health, injury prevention, spine, female, male
DOI: 10.3233/BMR-230181
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Öztürk, Nazan | Öter, Emine Gerçek | Abacıgil, Filiz | Ersungur, Ecem
Article Type: Research Article
Abstract: BACKGROUND: Prolonged sitting and poor posture can contribute to musculoskeletal pain and have a negative effect on health-related quality of life (HRQoL) among young adults. Any prolonged posture leads to static loading of soft tissues and causes discomfort. Seated posture leads to inactivity causing an accumulation of metabolites, accelerating disk degeneration and musculoskeletal pain. Regular exercise has major contributions to the prevention and treatment of some health problems such as musculoskeletal disorders. OBJECTIVE: This study aimed to assess the impact of online posture exercises on musculoskeletal pain and health related quality of life among university students …receiving distance education during the COVID-19 pandemic. METHODS: This randomized controlled trial involved 72 students divided into intervention (n = 35) and control (n = 37) groups. The intervention group followed an 8-week online stretching and posture exercise program. Baseline and 8-week results were measured using the SF-36 QoL Questionnaire and Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). RESULTS: Students spent an average of 5.4 ± 2.5 hours daily at computers. While there was no difference between the scores of any region in the CMDQ in the control group, there was a decrease in the neck, right shoulder, left shoulder, waist, left upper leg, right lower leg, and left lower leg discomfort scores in the intervention group (p < 0.05). There was a significant difference between the intervention and control groups in the total score of SF-36 and the sub-dimensions of vitality and mental health (p < 0.05). CONCLUSION: The online posture exercise program led to notable reductions in musculoskeletal pain and improvements in QoL among university students. Examining the effectiveness of online exercise programs in different age groups is important for health benefits during quarantines. Show more
Keywords: Musculoskeletal pain, quality of life, posture, exercise
DOI: 10.3233/BMR-230279
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Pawłowska, Katarzyna Maria | Pawłowski, Jakub | Grochulska, Agnieszka
Article Type: Research Article
Abstract: BACKGROUND: Hip osteoarthritis is a major civilizational challenge of the ageing population, usually due to the reduced function of gait. In the light of this fact, gait analysis has become an important issue for the doctor, the physiotherapist and the patient, as it serves as a useful tool in diagnosis, recovery, and rehabilitation. Pedobarography is one of the most modern gait analysis methods. OBJECTIVE: The aim of this study is to assess the distribution of pressure forces of the foot on the ground during gait in patients with hip osteoarthritis. METHODS: Dynamic foot …tests were performed by means of a two-meter RSscan ® International platform, equipped with 16.384 sensors with the scanning frequency level exceeding 500 Hz. Patients were divided into two groups: the research group of N = 60 individuals with hip osteoarthritis, aged 52–84; and the control group of N = 32 individuals without hip osteoarthritis, aged 50–74. Data distribution analysis was performed with the Shapiro-Wilk test, followed by a non-parametric Mann-Whitney U test. RESULTS: The differences between the mean results of maximal peak values of pressure and force in such areas as the big toe, metatarsal I, III, IV, V, lateral and medial heel are significantly lower in the research group than in the control group. Only in the area of metatarsal II, the mean value of pressure is higher in the research group than in the control group. For all metatarsals, the midfoot and medial heel mean results of the contact area are significantly higher in the research group than in the control group. The differences between mean load rate were also tested. The test revealed statistical significance of metatarsal II and III, and the medial heel while metatarsal II displayed a higher mean value in the research group than in the control group. CONCLUSION: The distribution of the pressure forces of the foot can indicate imbalances which cause degenerative changes. Therefore, early detection of changes can help in prevention or delay of hip osteoarthritis in conjunction with proper therapy. Show more
Keywords: Hip osteoarthritis, gait, pedobarography
DOI: 10.3233/BMR-230195
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2023
Authors: Passos, Muana Hiandra Pereira dos | Pícon, Sol Patrícia Beltrán | Batista, Gabriel de Amorim | Nascimento, Vinícius Yan Santos | Oliveira, Felipe Augusto da Silva | Locks, Francisco | Pitangui, Ana Carolina Rodarti | de Araújo, Rodrigo Cappato
Article Type: Research Article
Abstract: BACKGROUND: Low back pain is prevalent in workers’ health and functional performance. OBJECTIVE: To evaluate the effects of a physical exercise program on low back pain and disability in fruit workers. METHODS: This randomized controlled trial assigned 44 workers (37 ± 9 years) to two groups. The experimental group consisted of 10 men and 12 women with an average age of 38 (± 9) years, and the control group consisted of 8 men and 14 women with an average age of 36 (± 10) years. The experimental group (EG) performed …a program of strength and flexibility exercises for eight weeks, twice a week. The control group (CG) received minimal care, with a booklet with guidelines for performing exercises. The primary outcomes included changes in perceived disability and the intensity of pain evaluated by the Rolland-Morris questionnaire and the Numerical Pain Scale, respectively. All outcomes were measured at baseline and after eight weeks of intervention. RESULTS: A significant difference was observed in the within-group analysis, with a mean reduction in pain intensity in the EG and CG of - 4.55 (95%CI - 7.01 to - 2.09) and - 3.81 (95%CI 1.72–5.90), respectively. For disability, a reduction of - 4.45 (95% CI - 8.89 to - 0.02) was observed in the EG and of - 4.43 (- 7.38 to - 1.48) in the CG. There were no significant differences in the between-groups analysis. CONCLUSIONS: The exercise program was not superior to using the educational booklet. However, both interventions showed substantial decreases in pain and disability levels. Show more
Keywords: Low back pain, occupational health, farmer, exercise
DOI: 10.3233/BMR-230201
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Kudo, Shintarou | Hatanaka, Mizuki | Kanazawa, Seiya | Hirakawa, Keisuke | Hara, Shigeyuki | Tsutsumi, Masahiro
Article Type: Research Article
Abstract: BACKGROUND: Short foot exercises (SFE) take a long time to master and require a feedback tool to improve motor learning. OBJECTIVE: This study aimed to investigate the effect of bio-feedback of talonavicular joint movements in learning SFE with ultrasound (US) imaging. METHODS: This study included thirty-one healthy volunteers and was designed as a double-blind randomized control trial. Subjects were randomly assigned to one of two groups: the control group, which performed SFE under verbal instruction, and the US bio-feedback (USBF) group, which performed SFE with real-time bio-feedback of the talonavicular joint alignment. All subjects …underwent two sessions of 5 minutes each, and SFE was performed as a self-exercise, between sessions, for one week. The difference in foot length and navicular height were assessed at baseline, after Session 1, before Session 2, and one week after Session 2. These differences were compared between the two groups using the Mann-Whitney U test. RESULTS: In terms of navicular height change, the USBF group (7.5 ± 4.3 mm) was significantly higher than the control group (4.2 ± 3.3 mm) one week after session 2 (p = 0.04, effect size = 0.86). CONCLUSION: SFE with USBF is an effective intervention for performing SFE. Show more
Keywords: Foot exercise, ultrasonography, motor learning, bio-feedback
DOI: 10.3233/BMR-230163
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2023
Authors: Deen, Nazar | Akhtar, Saeed | Qazi, Fawad Hafeez | Uzair, Rahila | Khan, Mohammad | Tasneem, Sharjeel
Article Type: Research Article
Abstract: BACKGROUND: Cervical radiculopathy is a common condition encountered in clinical practice and is characterized by compression or irritation of the nerve roots in the cervical spine. OBJECTIVE: To compare the effectiveness of manual intermittent cervical longitudinal mobilization (mICLM) and therapeutic modalities in managing acute, sub-acute and chronic radiculopathy pain. METHODS: This was a multicenter, double-blinded, randomized controlled trial. Individuals with radiculopathies were randomized into interventional; (IG, n = 18) receiving mICLM and control group; (CG, n = 17), receiving Microwave Diathermy (MWD) and …transcutaneous electrical nerve stimulation (TENS) at the cervico-dorsal area daily for two weeks. The neck pain disability index (NPDI), numeric pain rating scale (NPRS), and global rating of change score (GRoC) were used as outcome measures. Statistical analysis was conducted using SPSS version 23.0. RESULTS: Both mICLM and MWD with TENS were equally effective in reducing the pain and disability in either group. However, it was noted that mICLM had a better impact on acute, sub-acute and chronic cases of radiculopathy pain comparatively. Mean age was 42.3 (SD = ± 10.9) years. 54.3% were between the age group of 40–60 years out of which 51.4% were male and 48.6% were female. 51.4% were in IG and 48.6% were in CG. The mean comparison of NPAD and NPRS within groups was significant with p < 0.01 * . Post treatment mean comparison of NPAD outcomes in IG and CG remain significant with p = 0.004 * and p < 0.01 * respectively. The post NPAD and NPRS between IG and CG were found statistically insignificant with p = 0.75 and p = 0.57 respectively. CONCLUSION: mICLM and therapeutic modalities showed similar outcomes in managing radiculopathy pain. The study highlights the need for further research to understand the effectiveness of these interventions in larger patient populations. Show more
Keywords: Cervical pain, radiculopathy, pain stages, longitudinal mobilizations, therapeutic agents, exercises, and outcome measures
DOI: 10.3233/BMR-230154
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-12, 2023
Authors: Lee, Jun-Hyeok | Jeon, Hye-Seon | Park, Joo-Hee | Kim, Ji-Hyun | Kwon, Oh-Yun | Choi, Woochol Joseph | Kim, Young-Ho | Kim, Jong-Man
Article Type: Research Article
Abstract: BACKGROUND: Maintaining correct posture and optimal spine function has become an important issue due to the increased use of computers and smartphones. OBJECTIVE: To investigate the effect of a 4-week downhill treadmill exercise (DTWE) program on participants with thoracic kyphosis and forward head posture (FHP). METHODS: Twenty-eight male participants were randomly assigned to the DTWE (n = 14) or standard treadmill walking exercise (STWE) (n = 14) group. They performed 30-minute exercise three times a week for 4 weeks. The vertebral angle was measured …using a three-dimensional (3D) motion analysis system. Surface electromyography (EMG) was performed to record muscle activity in the thoracic erector spinae (TES), sternocleidomastoid muscle (SCM), and cervical erector spinae (CES). RESULTS: The DTWE group showed significant increases in the craniovertebral angle (CVA) and TES EMG activity and significant decreases in the thoracic kyphosis angle and SCM and CES EMG activity compared with those shown by the STWE group following the intervention (p < 0.05). However, lumbar lordosis or pelvic tilt angles did not differ significantly between the groups after the intervention (p > 0.05). CONCLUSIONS: DTWE can be effective in reducing thoracic kyphosis and FHP without causing compensatory movements of the lumbar spine and pelvis. Show more
Keywords: Electromyography, kinematics, rehabilitation
DOI: 10.3233/BMR-230187
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-7, 2023
Authors: Scaturro, Dalila | de Sire, Alessandro | Vitagliani, Fabio | Lo Nardo, Davide | Tomasello, Sofia | Ammendolia, Antonio | Letizia Mauro, Giulia
Article Type: Research Article
Abstract: BACKGROUND: Muscle injuries are common traumatic events in the clinical practice of the rehabilitation field. There is still a gap in the scientific literature on the effectiveness of physical agent modalities in the management of muscle injuries in athletes. OBJECTIVE: The aim of this study was to assess the effectiveness of cryo plus ultrasound therapy com-pared to diathermy in combination with high-intensity laser therapy (HILT) for pain relief in professional footballers with muscle injuries. METHODS: A case-control study was conducted on 31 professional footballers with a muscle injury of the lower limbs. Of these, …17 patients, assigned to a Group A (AG), were treated with HILT and cryoultrasound therapy; the remaining 14 patients, assigned to a Group B (BG), underwent HILT and diathermy. We assessed the extent of the pain, the size of the muscle injury, frequency of recurrence and number of days to recovery, at the time of recruitment, at the end of the rehabilitation and 3 months after the injury. RESULTS: Group A athletes had a greater benefit on pain (4.65 ± 0.61 vs 3.24 ± 0.63; p < 0.05) and muscle injury recurrence. The return to play in the athletes of group A took place 4.73 days earlier. CONCLUSION: HILT and cryo plus ultrasound therapy, in combination with therapeutic exercise, rep-resent a valid strategy in the treatment of muscle injuries in professional footballers. Show more
Keywords: Athletic injuries, physical therapies, rehabilitation, muscle performance, football
DOI: 10.3233/BMR-230265
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Yoon, Ji-Yeon | Shin, Sun-Shil
Article Type: Research Article
Abstract: BACKGROUND: Step width during walking can provide important information about aging and pathology. Although knee osteoarthritis (OA) is a common disease in elderly women, little is known about how different step widths influence gait parameters in patients with knee OA. OBJECTIVE: To address this, we investigated the differences between narrower and wider step width on the center of mass (CoM) and gait biomechanics of elderly women with knee OA. METHODS: Gait and CoM data were measured using a three-dimensional motion capture system and anthropometric data were acquired via standing full-limb radiography. Thirty elderly …women with knee OA were divided into two groups depending on the average step width value (0.16 m). Specifically, the narrower step width group included those with a below average step width (n = 15) and the wider step width group included those with an above average step width (n = 15). The differences between the two groups were analyzed using an independentt -test. RESULTS: Walking speed, step length, knee and ankle sagittal excursion, and medial-lateral CoM range were significantly greater in the narrower group. In contrast, the medial-lateral CoM velocity, medial-lateral ground reaction force (GRF), and foot progression angle were significantly higher in wider group. The external knee adduction moment, vertical GRF, and vertical CoM did not differ between the groups. CONCLUSIONS: Our data indicate that step width in women with knee OA is associated with trunk motion and gait patterns. People with a narrower step might improve their gait function by increasing trunk frontal control to maintain gait stability. In contrast, in those with a wider step, greater toe out angle and shorter step length might be a compensatory adaptation to reduce knee loading. Show more
Keywords: Knee osteoarthritis, step width, gait stability, center of mass, joint loading
DOI: 10.3233/BMR-230232
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Silver, Jacob | Mancini, Michael | Pavano, Colin | Bauer, Jordan | Barkay, Gal | Moss, Isaac | Mallozzi, Scott
Article Type: Case Report
Abstract: BACKGROUND: Distinguishing between cervical nerve root and intrinsic shoulder pathology can be a difficult task given the overlapping and often coexisting symptoms. OBJECTIVE: The objective of this study was to highlight the often-complicated presentation of these symptoms and the subsequent potential for delay in care regarding this subset of patients. METHODS: A total of 9 patients, managed by one of two different surgeons, were identified with a history of C5 nerve root palsy. A chart review was conducted, and the following information was recorded: presenting complaint, time from symptom onset to diagnosis, time from …symptom onset to presentation to a spine surgeon, first specialist seen for symptoms, non-spinal advanced imaging and treatment conducted before diagnosis, preoperative and postoperative exam, time to recovery, and type of surgery. RESULTS: We observed an average time from onset of symptoms to presentation to a spine surgeon to be 31.6 weeks. These patients’ time to full recovery after cervical decompression was 15 weeks. CONCLUSION : We observed a critical delay to presentation in this series of patients with C5 nerve palsy. C5 nerve palsy should remain an elemental part of the differential diagnosis in the setting of any shoulder or neck pain presenting with weakness. Show more
Keywords: C5 palsy, cervical radiculopathy, shoulder pain, neck pain, spine surgery
DOI: 10.3233/BMR-230182
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-5, 2023
Authors: Wator, Jennifer | Battis, Aurora | Vellucci, Chris | Beaudette, Shawn M.
Article Type: Research Article
Abstract: BACKGROUND: Rowing-related low back disorders may occur from inconsistent technique, high trunk flexion and training volumes, overactivation of paraspinal muscles, and fatigue. OBJECTIVE: To examine if kinesiology tape (KT) affixed to the trunk dorsum affects muscular co-activation and neuromuscular control to limit dangerous rowing movements and associated injuries. METHODS: Participants (n = 18) completed two 2000 m rowing trials under BASELINE and KT conditions. KT was applied to the skin superficial to the paraspinals bilaterally with 60% pre-strain. Participants were instructed to minimize any sensation of tension. Whole body …kinematics were obtained using inertial measurement units (IMUs), and surface electromyograms (EMGs) were recorded from trunk and lower extremity. Changes in joint range-of-motion (ROM) and co-activation indices (CAIs) were analyzed for shoulder, lumbar, hip, and knee. RESULTS: Responding participants (n = 5) were identified by reduced maximum lumbar flexion during the KT condition. As expected, significant differences occurred in maximum and minimum lumbar flexion/extension between responders and non-responders to KT. Additionally, there was significant reduction in mean trunk muscle co-activation in both those who did and did not respond to KT through reductions in maximum lumbar flexion. CONCLUSION: KT can be an effective at reducing mean trunk co-activation during a rowing trial in the flexed catch position. Variable responses suggest that further work is necessary to optimize the efficacy of sensory cues derived from KT during rowing movements. Show more
Keywords: Electromyography, lower back pain, lumbar, sensory feedback
DOI: 10.3233/BMR-230216
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2023
Authors: Abujaber, Sumayeh | Altubasi, Ibrahim | Hamdan, Mohammad | Al-Zaben, Raed | Bani-Ahmad, Omar
Article Type: Research Article
Abstract: BACKGROUND: Knee osteoarthritis (OA) is a debilitating condition that leads to functional limitations. Self-reported questionnaires and performance-based tests are tools commonly used for measuring physical function. OBJECTIVES: (1) To evaluate the impact of end-stage knee OA on functional outcomes and examine the association between self-reported and performance-based measures of function in patients with end-stage knee osteoarthritis awaiting total knee arthroplasty (2) To explore the interrelationships among pain, strength, and overall physical function in this patient population. METHODS: In this cross-sectional analysis, 33 patients with end-stage knee OA were recruited and completed the knee …Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) and executed performance-based tests including the Timed Up and Go, the 30-second chair stand test, and the Stair Climbing Test. Knee pain, and isometric hip and knee strength were evaluated. RESULTS: Patients perceived deficits in their physical functionwith a score of 35/100 on the KOS-ADLS and demonstrated functional limitations in all performed tasks. KOS-ADLs was weakly associated with TUG and 30s-CST (r = - 0.301, p = 0.047, and r = 0.39, p = 0.014. respectively). Knee pain was linked with the KOS-ADL score and GRS score (r = - 0.406, p = 0.010; r = - 0.343, p = 0.027; respectively), while the strength of the affected side was correlated with the performed (p = < 0.001) and reported function outcomes (p = 0.007). CONCLUSION: Participants exhibit declines in both perceived and executed functional abilities. Self-reported and performance-based functional measures are weakly correlated within our study group, highlighting the importance of incorporating both measures in clinical practice for a comprehensive evaluation of physical function. Pain was linked to subjective aspect of physical function, while strength was connected to perceived and performed functional capacity. Implementing a tailored rehabilitation program targeting muscle weakness and pain holds the potential to mitigate functional decline in individuals awaiting total knee arthroplasty (TKA). Show more
Keywords: Patient reported outcome, functional performance, muscle strength, pain
DOI: 10.3233/BMR-230256
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Bertelè, Laura | Giorgi, Valeria | Bellavite, Paolo | Apostolo, Giovanni | Ortolani, Riccardo | Fila, Alice | Zanolin, Elisabetta
Article Type: Research Article
Abstract: BACKGROUND: Adolescent idiopathic scoliosis is a complex condition whose pathogenesis may include inflammation and signs of joint and bone degeneration. OBJECTIVE: The main objective of this study is to evaluate the relationship between the severity of adolescent idiopathic scoliosis and inflammatory blood parameters. METHODS: The study recruited patients with adolescent idiopathic scoliosis who attended the Rehabilitation Center of the Apostolo Foundation in Merate (LC). The scoliosis curve (Cobb’s angle) was used as a severity index to compare with inflammatory blood parameters (white blood cells subpopulations, immunoglobulins, protein electrophoresis). In addition, the study used …an overall severity grading called “Scoliosis Score” which includes all spine angles and Risser’s score (bone development index). RESULTS: Thirty-four subjects were recruited (mean age 14 years, 2 months), 30 females and 2 males. A significant correlation was found between Cobb’s angle and the percentage values of beta-2 globulins in a directly proportional manner (r = 0.42, p = 0.01), and gamma globulins in an inversely proportional manner (r = - 0.366, p = 0.04). However, no significant correlation between Cobb’s angle and the absolute values of white blood cells and percentage subpopulations was found (r = 0.0821 p = 0.655). A moderate, inverse correlation was found between the Scoliosis Score and the percentage of neutrophils (r = - 0.385, p = 0.02), a direct correlation was found between the Scoliosis Score and the percentage of lymphocytes (r = 0.404, p = 0.02). In addition, there was a strong correlation of the Scoliosis Score with alpha-2 globulin (r = 0.564, p = 0.0012), beta-1 globulin (r = 0.478, p = 0.0074), and beta-2 globulin (r = 0.370, p = 0.044) and an inverse relationship with gamma globulin (r = - 0.625, p = 0.0002). The main correlations were confirmed by regression analysis. CONCLUSION: The correlation between beta-2 globulins and gamma globulins with Cobb’s angle and the Scoliosis Score suggests a link between spinal curvature and inflammation in scoliosis patients, This link may indicate the significance of these parameters for diagnosing, staging the disease, and monitoring therapies. Show more
Keywords: Beta 2 globulins, cobb’s angle, electrophoresis, inflammation, plasma proteins, scoliosis
DOI: 10.3233/BMR-230186
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Hou, Xiaofei | Hu, Hailiang | Kong, Chao | Zhang, Sitao | Wang, Wei | Lu, Shibao
Article Type: Research Article
Abstract: BACKGROUND: The factors affecting lumbar spinal function in patients with degenerative lumbar spinal stenosis (DLSS) are still unclear. OBJECTIVE: This study explored psoas major muscle morphology in patients with DLSS and its association with their functional status. METHODS: A retrospective study was conducted on 288 patients with DLSS and 260 control subjects. Psoas major muscle evaluation included three morphometric parameters at the L3/4 disc level: psoas major index (PMI), muscle attenuation, and psoas major morphological changes (MPM). The association between psoas major morphology and functional status was assessed using the Oswestry disability index (ODI). …RESULTS: Both female and male patients with DLSS had a higher PMI and lower muscle attenuation. PMI and muscle attenuation were inversely correlated with age in the DLSS group. After multivariable analyses, the PMI and psoas major muscle attenuation were positively correlated with patients’ functional status. CONCLUSION: The PMI and muscle attenuation were positively correlated with functional status in patients with DLSS. These findings have important implications for physiotherapy programs of postoperative rehabilitation and conservative management of DLSS. Show more
Keywords: Degenerative lumbar spinal stenosis, psoas major muscle, morphology, functional status, oswestry disability index
DOI: 10.3233/BMR-230138
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Xu, Hanxiao | Liu, Heng
Article Type: Research Article
Abstract: BACKGROUND: Patients with Parkinson’s disease frequently experience problems with balance and gait. OBJECTIVE: This study examined the influences of regular ankle isokinetic muscle strength training on muscle strength and balance ability amongst elderly women with mild Parkinson’s disease. METHODS: A total of 55 elderly women with mild Parkinson’s disease were randomly divided into the experimental group (n = 28) and the control group (n = 27) for 16 weeks. The experimental group was trained for 16 weeks by using isokinetic muscle strength training. RESULTS: …After 16 weeks of training in the experimental group, the peak torque (PT) of ankle (average of the left and right sides) dorsiflexion, plantarflexion, eversion and inversion, and the standing balance index revealed that the left and right stability and overall stability indexes significantly increased by 25.9%, 43.5%, 62.7%, 82.8%, 37.1% and 32.2%, respectively (p < 0.05). The experimental group exhibited significantly increased PT of ankle dorsiflexion, plantarflexion, eversion and inversion. Moreover, the left and right stability and overall stability indexes were significantly improved compared with those of the control group (p < 0.05). This study found a linear regression relationship between the PT of ankle inversion and overall stability index. CONCLUSION: This study determined that ankle isokinetic muscle strength training improved ankle dorsiflexion, plantarflexion, eversion and inversion muscle strength, and balance ability amongst elderly women with mild Parkinson’s disease. However, it did not improve stability in the anterior and posterior directions. Ankle inversion muscle strength is more likely to affect overall balance. Show more
Keywords: Isokinetic training, muscle strength, mild Parkinson’s disease, balance
DOI: 10.3233/BMR-230259
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Smeets, Yasemin | Soer, Remko | Chatziantoniou, Evangelia | Preuper, Rita H.R. Schiphorst | Reneman, Michiel F. | Wolff, André P. | Timmerman, Hans
Article Type: Review Article
Abstract: BACKGROUND: Central sensitization cannot be demonstrated directly in humans. Therefore, studies used different proxy markers (signs, symptoms and tools) to identify factors assumed to relate to central sensitization in humans, that is, Human Assumed Central Sensitization (HACS). The aims of this systematic review were to identify non-invasive objective markers of HACS and the instruments to assess these markers in patients with fibromyalgia (FM). METHODS: A systematic review was conducted with the following inclusion criteria: (1) adults, (2) diagnosed with FM, and (3) markers and instruments for HACS had to be non-invasive. Data were subsequently extracted, …and studies were assessed for risk of bias using the quality assessment tools developed by the National Institute of Health. RESULTS: 78 studies (n = 5234 participants) were included and the findings were categorized in markers identified to assess peripheral and central manifestations of HACS. The identified markers for peripheral manifestations of HACS, with at least moderate evidence, were pain after-sensation decline rates, mechanical pain thresholds, pressure pain threshold, sound ‘pressure’ pain threshold, cutaneous silent period, slowly repeated evoked pain sensitization and nociceptive flexion reflex threshold. The identified markers for central manifestations of HACS were efficacy of conditioned pain modulation with pressure pain conditioning and brain perfusion analysis. Instruments to assess these markers are: pin-prick stimulators, cuff-algometry, repetitive pressure stimulation using a pressure algometer, sound, electrodes and neuroimaging techniques. CONCLUSIONS: This review provides an overview of non-invasive markers and instruments for the assessment of HACS in patients with FM. Implementing these findings into clinical settings may help to identify HACS in patients with FM. Show more
Keywords: Fibromyalgia, central sensitization, nociplastic pain, non-invasive markers, pain threshold, electrophysiological techniques, human assumed central sensitization
DOI: 10.3233/BMR-220430
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-60, 2023
Authors: Berduszek, Redmar J. | Reneman, Michiel F. | Dekker, Rienk | van der Sluis, Corry K.
Article Type: Research Article
Abstract: BACKGROUND: The shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Patient Rated Wrist/Hand Evaluation (PRWHE) are commonly used questionnaires to assess patient-reported hand function. Information about the measurement properties of the Dutch versions is scarce. OBJECTIVE: To gain insight into the measurement properties of the Dutch language versions of the QuickDASH and the PRWHE in patients with (non)specific complaints of the hand, wrist, forearm and elbow. METHODS: Internal consistency, construct validity, test-retest reliability, responsiveness, and floor and ceiling effects were assessed according to COnsensus-based Standards for the selection …of health Measurement INstruments (COSMIN) recommendations. RESULTS: Questionnaires were filled out by 132 patients. Internal consistency of QuickDASH (Cronbach’s α = 0.92) and PRWHE (Cronbach’s α = 0.97) was high. Predefined hypotheses for construct validity were not confirmed for 75% for both QuickDASH and PRWHE (accordance with 62% of predefined hypotheses for both questionnaires). Test-retest reliability of QuickDASH (ICC = 0.90) and PRWHE (ICC = 0.87) was good. Both QuickDASH (AUC = 0.84) and PRWHE (AUC = 0.80) showed good responsiveness. No floor or ceiling effects were present. CONCLUSIONS: Measurement properties of the Dutch language versions of the QuickDASH and the PRWHE, applied to patients with (non)specific complaints of the hand, wrist, forearm and elbow, were very similar. Test-retest reliability and responsiveness were good for both QuickDASH and PRWHE. Construct validity could not be demonstrated sufficiently. Show more
Keywords: Hand, upper extremity, patient reported outcome measures, pain measurement, disability evaluation, psychometrics
DOI: 10.3233/BMR-230225
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Ylinen, Jari | Pasanen, Tero | Heinonen, Ari | Kivistö, Heikki | Kautiainen, Hannu | Multanen, Juhani
Article Type: Research Article
Abstract: BACKGROUND: Weakness and atrophy in trunk muscles have been associated with chronic low back pain (CLBP). OBJECTIVE: This study aimed to identify isometric exercises resulting the highest trunk muscle activity for individuals with and without CLBP. METHODS: Fourteen males with CLBP and 15 healthy age-matched healthy subjects were recruited for this study. Muscle activity during maximal voluntary isometric contraction (MVIC) was measured for a comparative reference with surface electromyography (sEMG) from six trunk muscles. Thereafter maximum EMG amplitude values were measured during eleven trunk stability exercises. The maximal EMG activity in each exercise …relative to the MVICs was analyzed using generalizing estimating equations (GEE) models with the unstructured correlation structure. RESULTS: The GEE models showed statistically significant differences in muscle activity between exercises within both groups (p < 0.001), with no significant differences between groups (p > 0.05). The highest muscle activity was achieved with the hip flexion machine for multifidus, side pull with a resistance band for lumbar extensors, side and single-arm cable pull exercises for thoracic extensors, rotary plank and the hip flexion machine for abdominal. CONCLUSION: This study found five isometric trunk exercises that exhibited highest muscle activity depending on muscle tested, with no significant difference between individuals with and without CLBP. Show more
Keywords: Electromyography, force measurement, isometric strength, resistance exercise, gym machine
DOI: 10.3233/BMR-230043
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Arias-Vázquez, Pedro Iván | Guzzardo, Mauro Nicolás | Guzzardo, Duilio Román | Castillo-Avila, Rosa Giannina | Tovilla-Zárate, Carlos Alfonso | Ake Montiel, Miguel Angel Nazul
Article Type: Research Article
Abstract: BACKGROUND: Corticosteroid injections are frequently used in the short-term treatment of musculoskeletal pain, but their use is controversial as repeated exposures to corticosteroids can lead to deleterious effects on musculoskeletal tissue. Ozone injections have been proposed as a possible treatment for musculoskeletal pain; however, their effectiveness has not been compared with corticosteroids. OBJECTIVE: To evaluate the effectiveness of ozone injections for reducing pain in individuals with musculoskeletal pain in comparison with corticosteroid injections through a meta-analysis. METHODS: An online systematic search was performed using electronic databases up to September 2023. We searched for studies …that compared corticosteroid injections with ozone injections in the treatment of musculoskeletal pain of diverse origins. RESULTS: Eleven studies were included comprising a total of 534 individuals. In the overall pooled analysis, a pain reduction in favor of corticosteroid injections was found in the short term (d = 0.31, 95% CI 0.01 to 0.60, p (z) 0.04, I2 = 32%). In the medium term, no significant differences were found in reducing pain between groups (d = - 0.17, 95% CI - 0.42 to 0.07, p (z) 0.15, I2 = 0%). CONCLUSIONS: Our results suggest that corticosteroids injections are more effective in reducing musculoskeletal pain in the short term, but equally effective in the medium term when compared with ozone injections. Nonetheless, better-quality clinical trials are necessary to corroborate these results. Show more
Keywords: Musculoskeletal diseases, osteoarthritis, tendinopathy, nerve compression syndromes
DOI: 10.3233/BMR-230173
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-17, 2023
Authors: Jellad, Anis | Kalai, Amine | Abbes, Ilef | Jguirim, Mahbouba | Boudokhane, Soumaya | Salah Frih, Zohra Ben | Bedoui, Mohamed Hedi
Article Type: Research Article
Abstract: BACKGROUND: Cervical traction is effective on pain and function in patients with cervical radiculopathy but its effectiveness on balance disorders has not yet been studied. OBJECTIVE: To evaluate the effect of mechanical intermittent cervical traction (MICT) on stabilometric parameters in patients with cervical radiculopathy. METHODS: This randomized crossover study assigned 20 patients with cervical radiculopathy to one of the two groups: Group effective traction (ET)/sham traction (ST) (n = 10) treated firstly with ET (traction force of 12 Kg) then with ST (traction force of 2 Kg) with one-week interval and …group ST/ET (n = 10) treated invertedly with a ST then ET. Each traction procedure was maintained for 10 minutes twice separated by 5 minutes of rest. Patients were assessed before and immediately after MICT procedure. Main outcome measures were stabilometric parameters: center of pressure, sway area and lateral and anteroposterior displacements using a force platform. Secondary outcome measures were pain intensity, grip strength and dizziness. RESULTS: ET has provided a significantly greater improvement in both groups and in the total population in terms of stabilometric parameters (p < 0.01), pain intensity, and grip strength (p < 0.05), compared to ST. CONCLUSION: MICT seems to have an immediate beneficial effect on stabilometric parameters, pain and grip strength in patients with cervical radiculopathy. Show more
Keywords: Cervical radiculopathy, postural balance, rehabilitation, clinical trial
DOI: 10.3233/BMR-230270
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Wang, Li | Huang, Bing-Yao | Xie, Xiao-Min | Sang, Di | Tan, Tian-Hui | Li, Guang-Lin | Cao, Xue-Mei | Jiang, Nai-Fu
Article Type: Research Article
Abstract: BACKGROUND: Chronic lower back pain (CLBP) is one of the most common disorders worldwide. Flash cupping has the ability to relieve CLBP; nevertheless, its impact on CLBP and the likely mechanism of action have not been studied. OBJECTIVE: The goal of this study was to assess the impact of a single, brief cupping session on CLBP and low back muscle activity using multichannel surface electromyography (sEMG). METHODS: In this randomized controlled trial, 24 patients with CLBP were enrolled and randomly assigned to the control group (treated by acupuncture) and cupping group (treated by acupuncture …and flash cupping). Acupuncture was applied on the shen shu (BL23), dachang shu (BL25), and wei zhong (BL40) acupoints in both the groups. A brief cupping treatment was applied to the shen shu (BL23), qihai shu (BL24), dachang shu (BL25), guanyuan shu (BL26), and xiaochang shu (BL27) acupoints on both sides of the lower back in the cupping group. The numeric rating scale (NRS) was used to assess therapy efficacy for lower back pain (LBP) before and after treatment. Surface EMG data collected during symmetrical trunk flexion-extension movements were utilized to measure lower back muscle activity and the effectiveness of LBP therapy. RESULTS: There was no statistically significant difference (P = 0.63) in pain intensity between the two groups before and after treatment. There was a statistically significant difference (P = 0.04) between the control group and the cupping group in the sEMG topographic map parameter CoGx-To-Midline. CONCLUSION: This study established a connection between the action mechanism of flash cupping and enhanced horizontal synchronization of lower back muscular activity. Show more
Keywords: Acupuncture, chronic lower back pain, electromyography, flash cupping, surface
DOI: 10.3233/BMR-230095
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: Cheng, Jinling | Han, Dongmiao | Qu, Jiayang | Liu, Zicai | Huang, Ying
Article Type: Review Article
Abstract: BACKGROUND: With lifestyle changes, the prevalence of flatfoot is increasing year by year, with a prevalence of 29%. Flatfoot will lead to an inevitable injury and reduce the quality of life. Short foot exercises can enhance the strength of the intrinsic muscles of the foot and improve the symptoms of flatfoot. However, there is controversy regarding its specific efficacy. OBJECTIVE: This meta-analysis quantitatively evaluates the effect of short foot training on patients with flatfeet and provides evidence to inform the clinical approach to short foot training in patients with flat feet. METHODS: A …total of eight databases were searched, including CNKI, WANFANG, VIP, and CBM in Chinese and PubMed, Cochrane, Web of Science, and Embase in English. The timeframe for searching the literature was March 2023 for each database build. English database search terms and search formulas were: (flat foot OR talipes valgus OR talipes calcaneovalgus) AND (short foot exercises OR physical therapy OR neurophysiotherapy). RESULTS: The current pooled results show no significant difference in the improvement of the navicular drop test and foot posture index with short foot exercises compared to controls; only short foot exercises greater than 6 w showed a significant improvement in the navicular drop test, and sensitivity analysis showed a significant improvement in the foot posture index with short foot exercises. CONCLUSION: This systematic review and meta-analysis showed that short foot exercises need a larger sample size to find their effect on improving flat feet; the duration of the intervention is a factor. As most studies are currently unclear whether the participants were patients with flat feet or asymptomatic individuals with flat feet the disease syndrome in patients with flatfoot may also be a factor. Show more
Keywords: Pes planus, flexible flatfoot, exercises
DOI: 10.3233/BMR-230226
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Li, Lin | Li, Ju | He, Mu
Article Type: Research Article
Abstract: BACKGROUND: Acupuncture, traditional Chinese herb hot compress and rehabilitation training is useful in post-stroke shoulder–hand syndrome (SHS), but it is less commonly used in combination. OBJECTIVE: To analyse the therapeutic efficacy of a combination of acupuncture, traditional Chinese herb hot compress and rehabilitation training in SHS patients. METHOD: Patients diagnosed with post-stroke SHS and treated from January 2022 to March 2023 at Beijing Friendship Hospital and Beijing Pinggu Hospital were selected and randomly divided into three groups (A, B and C). Group A received conventional rehabilitative treatment (35 cases), Group B underwent conventional …rehabilitative treatment + acupuncture (35 cases), and Group C received conventional rehabilitative treatment + acupuncture + traditional Chinese herb hot compress treatment (35 cases). The post-treatment effectiveness rate, visual analogue scale (VAS) score, activities of daily living (ADL) score, Fugel–Meyer assessment (FMA) score, SHS assessment scale (SHSS) score and shoulder joint mobility were compared among the three groups. RESULTS: The post-treatment VAS score (F VAS score = 232.512, P < 0.001), FMA score (F FMA score = 239.412, P < 0.001), ADL score (F ADL score = 412.634, P < 0.001), SHSS score (F SHSS score = 212.542, P < 0.001) and shoulder joint mobility (F Shoulder Joint Mobility = 197.531, P < 0.001) all showed statistically significant differences. The VAS and SHSS scores decreased in the order of Group A > Group B > Group C, while the FMA, ADL and shoulder joint mobility scores increased in the order of Group C > Group B > Group A. The post-treatment effectiveness rates (χ 2 = 48.510, P < 0.001) also exhibited statistically significant differences, decreasing in the order of Group C (94.29%) > Group B (82.86%) > Group A (71.43%). CONCLUSION: The treatment efficacy of the combined acupuncture, traditional Chinese herb hot compress and rehabilitation training for SHS patients is significant, warranting its clinical promotion. Show more
Keywords: Acupuncture therapy, stroke rehabilitation, shoulder joint
DOI: 10.3233/BMR-230267
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: 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
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