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: 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
Abstract: OBJECTIVES: To evaluate the efficacy and safety of anterior column opening structural bone grafting with posterior column compression technique for the treatment of obsolete vertebral compression fractures with severe spinal kyphosis. METHODS: Fourteen patients with senile obsolete vertebral compression fractures and severe spinal kyphosis were admitted to our hospital. During the treatment processing, an “eggshell” osteotomy, anterior column opening structural bone grafting with posterior column compression, and pedicle screw internal fixation were performed in all patients. The Cobb angle, Visual Analogue Scale (VAS) score, Oswestry Disability Index (ODI) pre-operatively, post-operatively, and at the last follow-up were analyzed.…Moreover, the intra-operative blood loss and the operative time were also analyzed. RESULTS: The average osseous fusion time was 3.6 months (range from 3 to 5 months). The average operative time was 236 ± 20.1 min (range from 198 to 261 min). The average intra-operative blood loss was 1350.5 ± 70.2 ml (range from 809 to 2216 ml). The Cobb angle of localized kyphosis was 63.4 ± 12.4 ∘ pre-operatively, while 10.0 ± 2.1 ∘ post-operatively, and 12 ± 3.4 ∘ at the last follow-up evaluation, respectively. The average VAS score was decreased significantly from 8.7 ± 3.2 pre-operatively to 1.9 ± 0.4 post-operatively. The average ODI score was decreased from 78.3 ± 2.4% pre-operatively to 19.3 ± 5.3% post-operatively. CONCLUSIONS: Anterior column opening structural bone grafting with posterior column compression technique is effective, can effectively restore the sagittal balance of the spine, ease pain, and improve the quality of life of the patients with obsolete vertebral compression fractures and spinal kyphosis.
Abstract: This narrative review will summarise a clinical approach to the investigation of back pain in children and adolescent patients, including a discussion of the epidemiology, presentation, investigation and clinical management of back pain in children and adolescents. This will assist the prompt and accurate diagnosis of spinal disorders that require significant medical intervention. Existing evidence suggests a relatively high incidence of non-specific back pain among young people; 27–48% of presentations of back pain in children and adolescents are attributed to non-specific back pain. Low back pain among schoolchildren is often linked to psychosocial factors and only occasionally requires medical attention,…as pain is benign and self-limiting. Nonetheless, those young patients who seek medical assistance exhibit a higher incidence of organic conditions underlying the major symptom of spinal pain. A cautious and comprehensive strategy – including a detailed history, examination, radiographic imaging and diagnostic laboratory studies – should be employed, which must be accurate, reliable, consistent and reproducible in identifying spinal pathologies. A specific diagnosis can be reached in 52–73% of the cases. For cases in which a specific diagnosis cannot be made, re-evaluation after a period of observation is recommended. At this later stage, minor symptoms unrelated to underlying pathology will resolve spontaneously, whereas serious pathologies will advance and become easily identified.
Keywords: Back pain, clinical assessment, management, children, adolescents
Abstract: BACKGROUND: Core-strength is vital for Greco-Roman wrestling, although studies have yet to establish the effectives of core-specific training in this sport. PURPOSE: To examine the effect of core-specific strength training on determinants of Greco-Roman wrestling performance in elite junior athletes. METHODS: Twenty state-level, junior, Greco-Roman wrestlers were randomized into a core-specific training group (COR; n = 12) and a control group (CON; n = 8). The COR group undertook a 4-week, core-specific training program concurrently with their typical training program, whilst the CON group completed…4 weeks of typical training only. Both groups completed overhead medicine ball throw (OMBT), Suplexes, bridges and medicine ball chest throw (MBCT) prior to and following the intervention. RESULTS: The COR group demonstrated significantly greater improvement in bridges (p = 0.037; F = 5.046) and OMBT (p < 0.001; F = 26.43) than the CON group, with moderate to large between-group effect sizes (ES = 0.79–2.35). In addition, the effect size calculations were moderate-to-large (0.79–0.87) for Suplex and MBCT, with measures for the COR group greater than the CON group. CONCLUSION: Accordingly, core-specific training programs should be combined with wrestling-specific conditioning programs to improve back and hip extensor performance in junior Greco-Roman wrestlers.
Abstract: BACKGROUND: Facet syndrome is defined as pain that arises from any structure of the facet joints, including the fibrous capsule, synovial membrane, hyaline cartilage, and bone. OBJECTIVES: To compare the effectiveness of US-guided and blind injections on clinical outcome in facet syndrome. MATERIALS AND METHODS: Forty-seven patients with the diagnosis of facet syndrome were included. Patients were consecutively randomized into one of the two groups. The patient’s history, physical examination and routine laboratory parameters were obtained and diagnose was established based on physical findings. Two injections (mixture of 2 ml of 1% lidocaine hydrochloride and…20 mg of triamcinolone, to a single or maximum two sites depending on the clinical characteristics of the facet joint) were performed with 15 days apart, as blinded or US-guided manner. Clinical outcome assessments were carried out at 0, 2nd and 6th weeks, using Visual Analog Scale (VAS), Oswestry Disability Index (ODI) and State-Trait Anxiety Inventory (STAI). RESULTS: The patients’ initial VAS and ODI were not significantly different. When the two groups were compared in the 6th week in terms of VAS scores, improvement was more pronounced in the US-guided injection group (US-guided group (n = 23) before 7.6 (2.2) cm, after 3.0 (1.7) cm, P = 0.0001 vs blind group (n = 24) before 7.2 (1.3) cm, after 5.2 (2.0) cm, P = 0.0001). The improvement in initial and 6th week ODI was statistically significant in the US-guided injection group (P = 0.006). Except STAI I for US-group, trait anxiety scale scores was significant in both groups. CONCLUSION: The US-guided local injections offer better clinical outcome in the treatment of facet syndrome.
Keywords: Facet joint, injection, ultrasound, low back pain