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: OBJECTIVE: To examine the effects of neuromuscular electrical stimulation (NMES) on oropharyngeal swallowing function according to 2 types of placement, acting as assistance and as resistance, in stroke patients with dysphagia. METHODS: Thirty-eight stroke patients with dysphasia were randomly assigned to the suprahyoid group (SMG), or infrahyoid muscle group (IMG); 26 patients completed the intervention and were included in the analysis. In the SMG, the electrodes were placed on the region between the jaw and the hyoid bone, whereas in the IMG, the electrodes were placed on the region below the hyoid for the targeted infrahyoid…muscles. Both groups received NMES for 30 min/d, 5 d/wk, for 4 weeks and conventional dysphagia therapy. Swallowing function was measured using the Videofluoroscopic Dysphagia scale and Penetration-Aspiration scale based on videofluoroscopic swallowing study. Oral dietary intake was measured using the Functional Oral Intake Scale. RESULTS: Both groups showed significant improvements in oropharyngeal function and level of functional oral intake, but there was no significant difference between the two groups. However, the SMG showed a more reduced penetration-aspiration, compared with the IMG. CONCLUSIONS: Altogether, these data demonstrate that 2 types of NMES placements have a similar effect on improving swallowing function and oral diet intake in patients with dysphagia.
Abstract: BACKGROUND: Heating the skin and muscles is a commonly accepted method of pain relief and a modality to increase relaxation in muscles and increase tissue blood flow. OBJECTIVE: The purpose of the present study was to examine the effect of heat applied to trigger points and to determine if there was pain relief in the neck and plantar fascia. METHODS: Forty adults were divided into 2 different groups according to their pain; twenty subjects had plantar foot pain and the other 20 had nonspecific neck pain. The 20 subjects in each group were…randomly subdivided into a heat and a sham group. Sensitivity to pressure was measured with an algometer. A stopwatch was given to the subject and started when either the heat patch or placebo was applied. Heat cells were applied at trigger points on the pain area. RESULTS: Subjective pain significantly decreased in both sham and heat group patients with neck pain (p < 0.05), however, the change was greater in the heat group and there was a significant difference between the heat and sham groups (p = 0.002, d = 0.81). For the plantar pain group, a significant decrease in subjective pain was found in the heat group but not in the sham group. Pressure pain threshold significantly decreased in the heat group patients both with neck and plantar pain but for the sham group there was an increase in the pressure after sham treatment. Pain relief during the intervention was also significantly different between the heat and sham group in both patients with neck and plantar pain. CONCLUSION: The effect of single cell heat on trigger points of the body on pain relief was significantly better in the heat groups than in the sham groups. This finding is significant because using heat on trigger points could be an alternative to dry needling performed by healthcare professionals. This modality is a perfect alternative for home use and avoids opioids.
Keywords: Heat, neck, pain, plantar fascia, trigger point
Abstract: BACKGROUND: The treatment of ankylosing spondylitis (AS) patients requires a combination of non-pharmacological (education, exercise and physical therapy), as well as pharmacological treatment modalities. The optimal management of AS still remains unresolved. OBJECTIVE: The aim was to measure and compare the effects of whole-body cryotherapy (WBC) at - 110 ∘ C and at - 60 ∘ C and exercise therapy alone on disease activity and the functional parameters of patients with ankylosing spondylitis (AS). METHODS: Ninety-two patients were allocated to three groups: with…WBC at - 110 ∘ C or at - 60 ∘ C (each concurrent with exercise therapy), or exercise therapy alone. Disease activity and the functional parameters of the patients were measured at study entry and at the end of the 8-day treatment. RESULTS: Supervised therapy, irrespective of the program, led to a significant reduction in disease activity (Bath Ankylosing Spondylitis Disease Activity Index: BASDAI, Ankylosing Spondylitis Disease Activity Score: ASDAS-CRP), disease-related back pain, fatigue, duration and intensity of morning stiffness and a significant improvement in the patient’s functional capacity (Bath Ankylosing Spondylitis Functional Index: BASFI), spine mobility (Bath Ankylosing Spondylitis Metrology Index: BASMI) and chest expandability, with no changes in the levels of CRP. It has been demonstrated that following therapy, the group that underwent cryotherapy at - 110 ∘ C manifested significantly reduced disease activity (BASDAI) compared with exercise therapy only (p = 0.024). CONCLUSION: Adding cryotherapy at - 110 ∘ C to exercise therapy led to significantly reduced disease activity expressed in BASDAI, compared with exercise therapy alone.
Abstract: BACKGROUND: Despite the increasing emergence of modern facilities, the ancient practice of writing on a teaching board is still common in the teaching profession. Ergonomic guidelines of this practice are required for the prevention of work-related neck musculoskeletal disorders inherent of teachers. OBJECTIVE: This study investigated the effects of varying teaching board heights on the activities of the neck muscles. METHODS: Thirty participants (15 males and 15 females) participated in this experimental study. Each performed writing tasks on a teaching board set at five different heights derived from their standing height (SH) [(D…10 = SH minus 10% of SH; Norm H = SH; Sum 10 = SH plus 10% of SH; Sum 20 = SH plus 20% of SH; Sum 25 = SH plus 25% of SH)]. Electromyographic (EMG) activities of both components of the sternocleidomastoid and upper trapezius muscles were measured during each task. Asymmetry ratio of right and left muscle components were determined. Data were analyzed with one-way ANOVA. RESULTS: EMG activities of the four muscles as well as their asymmetry ratios significantly (p < 0.01) increased with increasing board heights. CONCLUSION: Teaching board-related tasks have increased possibilities of inducing neck disorders when performed beyond Norm H vertical heights.
Abstract: BACKGROUND: Evaluation of the effect of a pad on foot morphologies in patients with MTSS requires more reliable and objective methods, rather than conventional subjective observations. OBJECTIVE: The objective of this study was to investigate the effect of pads on foot morphologies during quiet standing in athletes with medial tibial stress syndrome (MTSS). METHODS: We measured three-dimensional foot morphologies in 30 feet with MTSS and 40 healthy feet. RESULTS: The analysis showed that Hallux valgus degree, calcaneal angle, arch height, and arch height ratio differed significantly as a result of…the pad support, compared to no pad support in the MTSS group. The pad support only resulted in significant differences in arch height, compared to no support in the control group. Furthermore, thumb side angle, calcaneal angle, and arch height ratio were significantly different between the MTSS and control groups. CONCLUSIONS: Our study results suggest that changes in foot morphologies because of the use of a pad can be measured objectively in patients with MTSS.
Abstract: BACKGROUND: Tools for functional assessment of chronic low back pain (LBP) are lacking. OBJECTIVE: To determine the correlations and the responsiveness of the 400 m comfortable walk test (400 mCWT) and the 200 m fast-walk test (200 mFWT) in the functional assessment of a multimodal program. METHODS: One hundred and twenty-seven participants (68 females) with LBP and with or without radicular pain completed a Quebec back pain scale, a Sorensen test, a Shirado test, a 400 mCWT and a 200 mFWT, at baseline and at the end of the program. RESULTS:…No significant side effect was reported during walk tests. Walking speed was significantly increased after the program (0.18 ± 0.15 m.s - 1 for the 400 mCWT and 0.17 ± 0.17 m.s - 1 for the 200 mFWT). Clinical parameters were also significantly improved (82.02 ± 83.1 seconds for the Shirado, 92.1 ± 100.1 seconds for the Sorensen, - 14.0 ± 12.9 for the Quebec scale). A significant relationship was found between the increase in walking speed for the two walk tests and the improvement of the Quebec scale. The gait speed improvement was close to the minimal clinically important change (95% confidence interval: 0.14–0.22) determined from the Quebec Scale threshold (minimum detectable change). CONCLUSIONS: Both 400 mCWT and 200 mFWT are correlated with functional parameters and are responsive for the functional assessment of LBP.
Keywords: Chronic low back pain, multimodal pain management, rehabilitation, walk speed, walk test
Abstract: OBJECTIVE: The aim of this study was to assess the cerebral blood flow velocity as a marker by using transcranial Doppler (TCD) ultrasonography in patients with ankylosing spondylitis (AS). METHODS: A total of 30 patients aged 20 to 50 with AS were enrolled in the AS group (male/female: 4/26, mean age: 34.7 ± 5.9) consecutively. The control group (non-AS group; male/female: 4/26, mean age: 32.3 ± 4.7) consisted of 30 age- and sex-matched, randomly selected patients without AS who had other diagnoses such as fibromyalgia and did not have risk…factors for atherosclerosis. Bilateral middle cerebral artery (MCA) peak-systolic, end-diastolic, and mean blood flow velocities, Gosling’s pulsatility index values, and Pourcelot’s resistance index values were recorded with TCD by a neurosonologist blinded to the AS and control groups. RESULTS: The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels and cerebral blood flow velocities of bilateral MCA were significantly higher in the AS group than in the control group. CONCLUSIONS: This study highlights that the increased cerebral blood flow is indirectly associated with atherosclerosis regarding persistent inflammation in patients with AS.
Abstract: BACKGROUND: Systematic observations of fetal posture show that, although for most of the time the fetus does not have a preferred posture, it has a certain repertoire of repeated active postures. The observed postures cannot be considered random configurations of head and limb position: the fetus and the young infant have an active, but variable posture that is relatively unrelated to the orientation of the force of gravity. MATERIALS AND METHOD: The study included 101 children, aged 6–7, including 50 preterm children, 48 boys and 53 girls (research group) and 51 full-term children; 22 boys and…53 girls (control group). The photogrammetric method with moire effect on Mora 4G CQ Elektronik was used to examine the body posture. RESULTS: Significant statistical differences in GAMMA (p < 0.001) and KLL (p = 0.020) parameters in preterm children and in control group were noted. Both parameters presented higher value in the control group. CONCLUSIONS: The posture of preterm children is characterized by a smaller angle of upper thoracic curvature and smaller angle of lumbar lordosis. The posture of preterm children in sitting position is characterized by a smaller angle of thoracic kyphosis. Preterm birth disturbs the development of proper antigravitational mechanism and causes possible posture dysfunctions at the age of 6.
Keywords: Body posture, spine, photogrammetric method, preterm infant
Abstract: BACKGROUND: The Hybrid Assistive Limb (HAL) is a robotic exoskeleton designed to support impaired limbs. OBJECTIVE: We aimed to evaluate whether active exercise using a single-joint HAL (HAL-SJ) following total knee arthroplasty can facilitate the recovery of knee flexion. METHODS: Twenty-two patients who underwent total knee arthroplasty were randomly allocated to the HAL-SJ group (n = 12) or conventional physical therapy (CPT) group (n = 10). On postoperative day 5, patients performed active knee flexion exercises either with or without HAL-SJ assistance every second day. Outcome…measures included active and passive knee flexion range of motion (ROM), muscle strength, and pain intensity, as assessed by the visual analog scale, and were assessed on postoperative days 5 (pre-treatment) and 10 (post-treatment). Active ROM was measured at 6-months postoperatively; further long-term follow-up was performed by telephone interview. RESULTS: Both groups showed significant improvement between postoperative days 5 and 10 in all outcome measures. Improvements in active ROM (p < 0.01), passive ROM (p < 0.01), muscle strength (p < 0.01), and pain (p < 0.01) were significantly greater in the HAL-SJ group than in the CPT group. Long-term outcomes were also significantly better in the HAL-SJ group. CONCLUSIONS: HAL therapy enables patients to perform painless active movements and facilitates the recovery of knee function.
Keywords: Feasibility, HAL-SJ-assisted training, Hybrid Assistive Limb, HAL therapy, knee, knee function
Abstract: BACKGROUND: Individualized exercise programs should be prepared according to duration and intensity. OBJECTIVE: The current study focused on the effect of different types of exercises regularly done for eight weeks on sedentary young women’s body components and lipid profile. METHODS: The sample of the study was composed of 30 sedentary women recruited from Afyon Kocatepe University. The participants were randomly sorted into three groups and received combined exercises (aerobic + resistance exercises), aerobic exercises and cardio tennis exercises three days a week for eight weeks but no dietary program…was given. Before and after the exercise programs, participants’ body weights, heights, waist and hip circumferences were measured and their body components were analyzed through the bioelectrical impedance method. For the lipid profile analyses, 5 cc. of blood samples were drawn from forearm veins of the participants with the help of health specialists, and a biochemical doctor analyzed lipid profile markers such as total cholesterol, triglyceride, HDL, LDL, and VLDL. RESULTS: It was found that exercises regularly done for eight weeks affected young women’s body components considerably while it did not influence their lipid profile. CONCLUSIONS: The effect on body components depended on time. No difference was found in terms of exercise type.
Keywords: Exercise, body composition, lipid profile