Journal of Back and Musculoskeletal Rehabilitation - Volume Pre-press, issue Pre-press
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Journal of Back and Musculoskeletal Rehabilitation is a journal whose main focus is to present relevant information about the interdisciplinary approach to musculoskeletal rehabilitation for clinicians who treat patients with back and musculoskeletal pain complaints. It will provide readers with both 1) a general fund of knowledge on the assessment and management of specific problems and 2) new information considered to be state-of-the-art in the field. The intended audience is multidisciplinary as well as multi-specialty.
In each issue clinicians can find information which they can use in their patient setting the very next day. Manuscripts are provided from a range of health care providers including those in physical medicine, orthopedic surgery, rheumatology, neurosurgery, physical therapy, radiology, osteopathy, chiropractic and nursing on topics ranging from chronic pain to sports medicine. Diagnostic decision trees and treatment algorithms are encouraged in each manuscript. Controversial topics are discussed in commentaries and rebuttals. Associated areas such as medical-legal, worker's compensation and practice guidelines are included.
The journal publishes original research papers, review articles, programme descriptions and cast studies. Letters to the editors, commentaries, and editorials are also welcomed. Manuscripts are peer reviewed. Constructive critiques are given to each author. Suggestions for thematic issues and proposed manuscripts are welcomed.
Abstract: BACKGROUND: Low frequency vibrations from motorized vehicles and heavy equipment have been associated with musculoskeletal disorders. Spine degeneration on diagnostic imaging provides direct and objective measures of the possible effects of such exposures on the spine. OBJECTIVE: The objective of this systematic review was to evaluate the association of exposure to whole-body vibration (WBV) with spine degeneration on imaging. METHODS: We conducted electronic searches in MEDLINE, CINAHL, EMBASE, and Web of Science to July 2021. Two reviewers independently screened search results, assessed quality, and extracted data. Studies evaluating the exposure to WBV and…lumbar spine degeneration on imaging were included. RESULTS: Fifteen studies (16 manuscripts) were included. Seven studies including a meta-demonstrated moderate quality evidence of no association between WBV and disc degeneration. There was also moderate quality evidence of no association between WBV and disc height narrowing and osteophytes. Overall, there was low level evidence of no association between WBV and other degenerations findings. CONCLUSIONS: There was moderate to low quality evidence suggesting no association between WBV exposures with spine degeneration on imaging. The results of this study currently do not support assertion that motorized vehicle and WBV exposure accelerates degeneration and causes structural damage to the spine.
Keywords: Whole body vibration, driving, occupational load, spine degeneration, disc degeneration, disc height, imaging, magnetic resonance imaging
Abstract: BACKGROUND: Adherence to treatment is one of the most common problems in patients suffering from chronic disease such as osteoporosis, and special commitment is required to patients, especially regarding rehabilitation. There is increasing evidence that physical interventions aimed at relieving pain and reducing physical impairments could play a crucial role in improving the quality of life and reducing the risk of fractures in patients with severe osteoporosis. OBJECTIVE: The aim of this study was to assess the compliance and determine the acceptability of a home-self-managed exercises program in patients with vertebral fractures, one of the most…frequent and serious consequences of osteoporosis. METHODS: We conducted a retrospective observational study of patients undergoing a home exercise program, monitoring them with clinical scales, questionnaires, and routine visits. RESULTS: 62.86% of the patients were compliant with the treatment; the absence of supervision by health personnel was the primary cause of non-compliance, followed by the lack of time and the lack of motivation. Compliant patients showed a significant reduction in lumbar pain (p 0.011), an improvement in posture with a reduction of dorsal kyphosis (occipital-wall distance T0-T1, p -value = 0.02) and an improvement in QoL (p -value = 0.001) and physical performance at the 20 m walking test (p -value = 0.003). CONCLUSIONS: A home exercise program is feasible and could improve signs and symptoms in patients with vertebral fractures due to OP.
Abstract: BACKGROUND: Thoracic mobilisation improves thoracic hyperkyphosis and respiratory function. Diaphragmatic excursion is associated with respiratory function; however, limited studies have assessed the effect of thoracic mobilisation on diaphragmatic excursion. OBJECTIVE: This study aimed to investigate the effects of thoracic mobilisation on diaphragmatic excursion and respiratory function in individuals with thoracic hyperkyphosis. METHODS: Participants were recruited through Internet advertising and participated voluntarily. Nineteen healthy participants (age: 33.37 ± 6.56 years; height: 170.32 ± 7.92 cm; weight: 69.77 ± 14.70 kg) with thoracic hyperkyphosis underwent thoracic mobilisation for 8 weeks.…Diaphragmatic excursion, thoracic kyphosis, and respiratory function were measured. Thoracic mobilisation was provided using a mechanical massage device. RESULTS: Thoracic mobilisation for 8 weeks significantly improved diaphragmatic excursion during deep breathing (p = 0.015), forced vital capacity (p < 0.01), and thoracic hyperkyphosis (p < 0.01). CONCLUSIONS: Thoracic mobilisation can be recommended in respiratory rehabilitation programs to increase diaphragmatic excursion and respiratory function for the management and prevention of respiratory dysfunction in individuals with thoracic hyperkyphosis.
Abstract: BACKGROUND: To restore core stability, abdominal drawing-in maneuver (ADIM), abdominal bracing (AB), and dynamic neuromuscular stabilization (DNS) have been employed but outcome measures varied and one intervention was not superior over another. OBJECTIVE: The purpose of this study was to compare the differential effects of ADIM, AB, and DNS on diaphragm movement, abdominal muscle thickness difference, and external abdominal oblique (EO) electromyography (EMG) amplitude. METHODS: Forty-one participants with core instability participated in this study. The subjects performed ADIM, AB, and DNS in random order. A Simi Aktisys and Pressure Biofeedback Unit (PBU) were…utilized to measure core stability, an ultrasound was utilized to measure diaphragm movement and measure abdominal muscles thickness and EMG was utilized to measure EO amplitude. Analysis of variance (ANOVA) was conducted at P < 0.05. RESULTS: Diaphragm descending movement and transverse abdominis (TrA) and internal abdominal oblique (IO) thickness differences were significantly increased in DNS compared to ADIM and AB (P < 0.05). EO amplitude was significantly increased in AB compared to ADIM, and DNS. CONCLUSIONS: DNS was the best technique to provide balanced co-activation of the diaphragm and TrA with relatively less contraction of EO and subsequently producing motor control for efficient core stabilization.
Abstract: BACKGROUND: Low back pain (LBP) causes disability in daily life, and presents not only a health but also a socio-economic problem. New treatment options need to be tested and confirmed. OBJECTIVE: Compare the effect of the McKenzie method and spiral stabilization in patients with LBP. METHODS: Sixty patients with an average age of 47 years, which were included in our prospective, comparative study were randomly divided into two 30-member groups. One group exercised according to the McKenzie method (MDT), the other one according to the Spiral Stabilization Method (SPS). During the initial examination the…Aberdeen Back Pain Scale was used to determine the degree of managing with daily activities and functionality, and the Roland-Morris Disability Questionnaire was used to determine the degree of disability. Check- up was performed after 2 and 6 weeks of treatment. RESULTS: In both groups, there was a significant improvement in results after 2 and 6 weeks of treatment (p < 0.05). When comparing the effect of 2 and 6 weeks of treatment of both therapeutic procedures (MDT and SPS), the difference was insignificant (p > 0.05). CONCLUSIONS: None of these two treatment methods achieved better results, as they both have a comparable effect on reducing disability and improving the management of daily activities and physical functions. Therefore, both are equally effective in patients with LBP.
Keywords: Disability, low back pain, mckenzie method, spine
Abstract: BACKGROUND: In order to administer the International Knee Documentation Committee Subjective Knee Form (IKDC) questionnaire to Arabic speakers, a rigorous process of cross-cultural adaptation and validation is required in order to reach equivalence between the original publication and target version of the questionnaire. OBJECTIVES: The main aim of this study is to translate and culturally adapt the IKDC into Arabic to suit the Arabic population. The secondary aim is to assess the Arabic version of the IKDC in order to test the psychometric characteristics (reliability, validity and dimensionality). METHODS: The translation process has…been carried out according to cross-cultural adaptation guidelines in accordance with the American Orthopaedic Society for Sports Medicine guidelines with forward/backward translations and pre-testing. The Arabic IKDC, Knee injury and Osteoarthritis Outcome Score (KOOS), RAND-36-Item Health Survey (RAND-36) questionnaire, and visual analogue scales (VAS) of pain were tested in 105 ACLR patients. Test-retest reliability, internal consistency, construct validity and content validity were evaluated. RESULTS: The test-retest reliability proved excellent with a high value for the intraclass correlation coefficient (r = 0.95). The internal consistency was strong (Cronbach’s α = 0.91). Good construct validity by the strong correlations between similar component of the KOOS subscales, Rand-36 subscales and VAS, and good content validity with absence of floor and ceiling effects. CONCLUSIONS: The Arabic version of the IKDC is a valid and reliable instrument for Arabic patients with ACLR. However, further research is required with a more varied knee sample in order to enable generalisation to a wider population.
Abstract: BACKGROUND: Functional stability of the shoulder requires a balance of active forces, passive forces, and control subsystems of the joint complex. Although whole-body vibration enhances shoulder muscle function and proprioception, the impact of vibration on the sensorimotor control of the shoulder joint remains unclear. OBJECTIVE: To investigate the acute effect of vibratory stimuli on the sensorimotor control of the shoulder joint. METHODS: Fifteen male participants (age, 22.7 ± 2.3 years) were included and performed the exercise in a modified push-up position with partial weight-bearing on a vibration platform with and without…vibratory stimuli. The vibration protocol included six sets lasting for 30 s each with a 30-s rest between sets. The main outcome measures included the upper limb static stability test, Upper Quarter Y Balance Test (UQYBT), and electromyography data of the upper limb. RESULTS: Vibratory stimuli resulted in an increased UQYBT score (all directions; P < 0.01) and infraspinatus, serratus anterior, and lower trapezius muscle activity (P < 0.05) between pre- and post-exercise versus the control condition. Stabilometric parameters showed no significant interaction between condition and time. CONCLUSIONS: Vibratory stimuli could maximize training benefits while limiting injury risk for athletes. Our findings could guide the development of rehabilitation programs for patients with shoulder instability.
Abstract: BACKGROUND: The first-line contact for patients seeking care for low back pain (LBP) can potentially change the disease course. The beliefs and attitudes of healthcare providers (HCPs) can influence LBP management. Although referring patients with LBP to physical therapy is common, the first-line contact for patients with LBP in Saudi Arabia is the primary care physician (PCP). Physical therapy will soon be integrated into primary care; therefore, it is rational to compare physical therapists’ (PTs) beliefs and attitudes regarding LBP with those of PCPs. OBJECTIVE: We compared PCPs’ and PTs’ attitudes and beliefs regarding LBP management.…METHODS: We employed a cross-sectional, voluntary response sample research design using the Pain Attitudes and Beliefs Scale (PABS). Participants were PTs and PCPs practicing in Saudi Arabia. RESULTS: In total, 153 participants completed the PABS (111 PTs and 52 PCPs). PCPs demonstrated significantly higher PABS biomedical subscale scores than did the PTs. CONCLUSIONS: HCPs in Saudi Arabia should receive additional training to adopt a biopsychosocial approach to managing LBP. In this study, the HCPs’ treatment recommendations may not correspond with contemporary clinical guidelines. Research to facilitate the implementation of optimal professional education and training to adopt a biopsychosocial approach is an urgent priority.
Keywords: Primary care physicians, physical therapists, low back pain, pain attitudes and beliefs scale, cross-sectional study
Abstract: BACKGROUND: The effects of stretching exercises in fibromyalgia (FM) deserves further study. OBJECTIVE: To evaluate the effectiveness of a Physical Self-Care Support Program (PSCSP), with emphasis on stretching exercises, in the treatment of FM. METHODS: Forty-five women with FM were randomized to the PSCSP (n = 23) or to a control group (n = 22). The PSCSP consisted of weekly 90-minute learning sessions over 10 weeks, providing instructions on wellness, postural techniques, and active stretching exercises to be done at home. The control group…was monitored through 3 medical appointments over 10 weeks and included in a waiting list. The primary outcomes were the Fibromyalgia Impact Questionnaire (FIQ), the Visual Analogue Scale (VAS) for pain, and the Sit and Reach Test (SRT) at the end of the study. RESULTS: Nineteen and 21 patients completed the trial in PSCSP and control groups, respectively. After 10 weeks, the PSCSP group showed significantly better FIQ (difference between adjusted means, - 13.64, 95% CI, - 21.78 to - 5.49, P = 0.002) and SRT scores (7.24 cm, 3.12 to 11.37, P = 0.001) than the control group, but no significant difference in pain VAS (- 1.41, - 3.04 to 0.22, P = 0.088). Analysis using multiple imputation (MI) and delta-adjusted MI for missing outcomes rendered similar results. CONCLUSIONS: A PSCSP emphasizing stretching exercises significantly improved FIQ and SRT scores, and may be a helpful therapy for FM.
Abstract: BACKGROUND: Numerous studies on the comparison of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and open-transforaminal lumbar interbody fusion (O-TLIF) for the treatment of lumbar disc herniation (LDH) have been published, but there is no clear conclusion. OBJECTIVE: The aim of this study was to evaluate the efficacy of MIS-TLIF compared with O-TLIF in the treatment of LDH in the Chinese population by meta-analysis. METHODS: Studies on the treatment of LDH by MIS-TLIF versus O-TLIF were searched in Pubmed, Web of Science, Medline, Embase, CNKI, VIP and China Wanfang databases from the establishment…of the databases to January 2020. The meta-analysis was used to analyze the pooled operation time, intraoperative blood loss, postoperative drainage, postoperative ground movement time, Waist and leg Visual Analogue Scale (VAS) score, Oswestry Disability Index (ODI) score and Japanese orthopaedic association (JOA) score. Mean difference (MD) and standard mean difference (SMD) were used as the effect size. RESULTS: Eleven studies with 1132 patients were included. The results showed that MIS-TLIF compared with O-TLIF, MD = - 133.82 (95% CI: - 167.10 ∼ - 100.53, P < 0.05) in intraoperative blood loss, MD = - 114.43 (95% CI: - 141.12 ∼ - 87.84, P < 0.05) in postoperative drainage, MD = - 3.30 (95% CI: - 4.31 ∼ - 2.28, P < 0.05) in postoperative ground movement time, SMD = - 1.44 (95% CI: - 2.63 ∼ - 0.34, P < 0.05) in postoperative low back pain VAS score, SMD = 0.41 (95% CI: 0.15 ∼ 0.66, P < 0.05) in postoperative JOA score, MD = 4.12 (95% CI: - 11.64 ∼ 19.87, P > 0.05) in the average operation time, SMD = - 0.00 (95% CI: - 0.36 ∼ 0.36, P > 0.05) in leg pain VAS score, and SMD = - 0.59 (95% CI: - 1.22 ∼ 0.03, P > 0.05) in ODI score. CONCLUSION: MIS-TLIF was superior to O-TLIF in the treatment of LDH, especially in the intraoperative blood loss, postoperative drainage, postoperative ground movement time and low back pain in the Chinese population.