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: Shoulder involvement is frequently observed in chronic renal disease (CRD) and hemodialysis patients. OBJECTIVE: Our aim is to compare shoulder Magnetic Resonance Imaging (MRI) findings of stage 4 CRD patients naive to dialysis, hemodialysis patients and healthy controls. METHODS: Twenty hemodialysis patients with shoulder pain (Group 1), 30 hemodialysis patients without shoulder pain (Group 2), 20 patients with stage 4 CRD (Group 3) and 30 healthy controls (Group 4) were enrolled. Urea, creatinine and β 2 microglobulin were measured. Thickness, homogeneity and integrity of rotator cuff and presence of effusion were…examined by MRI. RESULTS: Supraspinatus tendon was thicker in Group 1 compared to other groups, whereas infraspinatus tendon was thicker in Group 1 compared to Groups 2 and 4. Although all tendons thickness was higher in Group 3 than Group 4, there was no significant difference. Most effusion areas were present in Group 1, followed by Groups 2 and 3. There was a significant correlation between glomerular filtration rate and thickness of supraspinatus, infraspinatus tendons and between β 2 microglobulin and thickness of infraspinatus, subscapularis tendons and total number of areas with effusion. CONCLUSIONS: Increased shoulder tendon thickness and effusion were detected in symptomatic dialysis patients, while greater effusion areas were detected in asymptomatic dialysis patients and in stage 4 CRD patients who do not require dialysis compared to healthy controls.
Abstract: BACKGROUND: The literature on physical activity practice through sports as a protective factor for back pain in adolescents is conflicting. However, few studies have aimed to verify if continuity of the practice of physical activity from childhood to adolescence may be related to lower chances of back pain in adolescents. OBJECTIVES: The objective of this study was to analyze the association between physical activity practice from childhood to adolescence and back pain in adolescents. METHODS: The random sample was composed of 870 adolescents with a mean age of 13.7 ±…2.0 years. The continuity of physical activity practice was assessed through the continuity of sports practice from childhood to adolescence. Pain in the neck and low back were evaluated through a questionnaire. RESULTS: The prevalence of neck pain and low back pain in boys was 17.5% and in girls was 20.9% for neck pain and 21.9% for low back pain. Physical activity practice during childhood to adolescence was a protective factor for neck pain (OR = 0.57 [CI = 0.35–0.94]) and low back pain (OR = 0.53 [CI = 0.33–0.86]) in girls and neck pain in boys (OR = 0.52 [CI = 0.30–0.90]), even after adjusting for confounding factors. CONCLUSION: Girls with physical activity practice during childhood to adolescence were less likely to develop neck pain and back pain when compared to girls who did not maintain practice of physical activity. Similar results were observed in boys considering neck pain.
Keywords: Physical activity, sports, back pain, musculoskeletal disorders, adolescents
Abstract: BACKGROUND: Lower limb compensation for spinal sagittal malalignment and its impact on quality of life (QOL) and low back pain (LBP) have not been well studied. OBJECTIVE: To clarify postural compensation and the impact of spinal and lower limb sagittal alignment and muscle strength on QOL and LBP in persons > 50 years old. METHODS: In this cross-sectional study, 122 rural community-dwelling, healthy adults (56 males, 66 females; average age 71.1 years; age range, 52–88 years) underwent assessments of QOL (36-Item Short-Form Health Survey; SF-36), LBP (Roland-Morris Disability Questionnaire; RDQ),…thoracic kyphosis (TK), lumbar lordosis (LL), sacral inclination (SI), grip strength, lower limb strength, and back extensor strength (BES). On univariate and multivariate analyses, variables that correlated with QOL and the RDQ were identified. RESULTS: LL was moderately correlated with SI and weakly correlated with the knee flexion angle (KFA). LL, KFA, C7-L5D, and BES were correlated with SF-36 subscales and the RDQ. KFA contributed to the physical component summary of the SF-36. Female sex and BES contributed to the RDQ. CONCLUSIONS: Knee flexion compensated for lumbar kyphosis, but affected physical QOL scores negatively; BES was the most reliable contributor to QOL and the RDQ.
Abstract: OBJECTIVES: To compare pelvis, hip and knee kinematics during gait and extensibility of hip muscles between low back pain (LBP) and asymptomatic subjects. METHODS: Forty adult volunteers (11 men and 29 women) between 18 to 30 years from university population were included in this study. Twenty patients with LBP formed the LBP group, and 20 asymptomatic subjects formed the control group. Pelvic tilt and knee valgus, peak hip and knee joint excursion, and temporo-spatial variables were assessed during gait with Kinovea software. Extensibility of hip muscles was measured by Active Knee Extension test (AKE), modified Ober…test, and Thomas test. RESULTS: There was a significant increase in pelvic tilt (p < 0.01), valgus angle (p < 0.01), and a significant decrease in hip extension (p < 0.01) in the LBP group compared to the control group. There was a significant decrease in extensibility of the hip flexors (p < 0.05) of the dominant leg and in the hip abductors (p < 0.01) in the LBP group compared to the control group. CONCLUSIONS: The findings of this study suggest that non-specific mechanic LBP patients present differences in the pelvis, hip and knee kinematics in sagittal and frontal plane during gait and less hip flexors and abductors muscles extensibility compared to asymptomatic subjects.
Keywords: Low back pain, lower limb, biomechanics, gait
Abstract: BACKGROUND: IVD degeneration is a widespread problem all over the world, which a variety of inflammatory cytokines have been implicated in, while Sphingosine 1-phosphate (S1P) is an important lipid mediator that may play a role in IVD degeneration. OBJECTIVE: To study the expression and role of S1PRs in the intervertebal disc (IVD) degeneration to enhance understanding of disc degeneration. METHODS: Degenerated and normal IVD were harvested from patients through surgery. Expression of S1P receptor subtypes was evaluated using real-time PCR, immunohistochemistry, and western blotting. The effect of S1PR on inflammation induced by interleukin-1β…in nucleus pulposus (NP) cells was also assessed by real time PCR and western blotting. RESULTS: The nucleus pulposus mainly expressed the S1PR1/2/3, and the expression decreased in the severe degenerated nucleus pulposus cells. The ligand, S1P, inhibited the up-regulation of matrix metallopeptidase-3 (MMP-3) and ADAM metallopeptidase with thrombospondin type 1 motif 4 (ADAMTS4) induced by IL-1β . CONCLUSIONS: The results show that an the expression of S1PRs in degenerative discs is down-regulated as degeneration, and S1P can inhibit the inflammation response induced by IL-1β in NP cells, implicating that S1P/S1PR may contribute to IVD degeneration.
Abstract: BACKGROUND AND OBJECTIVE: Musculoskeletal problems are a common health problem with professional and ergonomic features. This study’s purpose was to investigate the musculoskeletal problems distribution and related factors among academicians. METHODS: This study was performed by using a personal and professional information questionnaire, the Extended Nordic Musculoskeletal Questionnaire and International Physical Activity Questionnaire Short Form. RESULTS: The study was completed with 142 academicians (89 female, 53 male). Mean age was 39.91 ± 8.90 years, physical activity level was 1067.31 ± 1866.95 MET-minute/week, and work time was 13.73…± 9.15 years. Neck and lower back pain were mostly seen in academicians and their incidence was equal (63.4%). The most experienced pain the previous year was neck pain (39.4%), and upper back pain is the most experienced pain today (19%). The body part that mostly caused the use of medication is neck pain (23%), and mostly caused limitation and sick-leave was low back in the past 12 months (respectively 19.7% and 9.2%). Gender, body mass index, weekly workload, physical activity level, and marital status have been determined to have an effect on musculoskeletal problems in academicians (p < 0.05). CONCLUSION: The most common musculoskeletal problems reported by academicians were in the upper back and neck regions, which have low level physical activity.
Abstract: Arthrofibrosis is a common complication for patients with bone fracture following external and internal fixation. In this review, we summarize the related factors and significant pathways for joint adhesion following fracture surgery. Moreover, the different types of treatments and related preventive measures are also discussed. Many factors related to the development and treatment of arthrofibrosis are discussed in this review in order to provide possible clues for the prospective targets to develop new medication or treatments for preventing or reducing the joint adhesion following orthopedic surgery.
Abstract: BACKGROUND: Low back pain (LBP) has become increasingly common, but the prevalence of this complaint and associated factors in young people remains controversial. OBJECTIVE: This study aimed to identify the prevalence of LBP and to explore the existence of associated factors (sex, physical activity, sedentary lifestyle, sleep, body mass index and waist circumference). METHODS: This study considered all complaints of the lumbar region (acute or chronic) as LBP, which can irradiate to the backside and legs, lasting a minimum of 24 hours. Youngsters aged 15 to 18 years from a school in…the south of Brazil were evaluated. Descriptive statistics was used, in particular Chi-square, Mann-Whitney U tests and binary logistic regression. A significance level of p < 0.05 was adopted. RESULTS: A total of 330 youngsters answered a questionnaire and had their anthropometric measurements measured (response rate 84%). The prevalence of LBP in the present was 30%, quarterly 63% and throughout life 77%. There was a significant association between LBP and sex: girls have an increased risk of LBP in the last three-month period (PR = 1.3, 95% CI 1.06–1.56) and throughout life (PR = 1.2, 95% CI 1.04–1.43). The practice of physical activities was also associated with LBP, but as a protection factor in the present and in the last three-month period (PR = 0.7, 95% CI 0.47–0.90). Physical education at school has demonstrated a protective factor regarding LBP throughout life (PR = 0.9, 95% CI 0.77–0.97). Most of the students did not comply with recommendations related to sleep and time spent doing activities in front of a screen, and no association of these factors with LBP was detected. This exposure (physical activity, sleep time, sedentarism) did not present significant association with LBP when adjusted by the confusion factors (sex, age, BMI). CONCLUSIONS: Youngsters reported a high prevalence of LBP. Girls were at greater risk of LBP than boys. It is recommended that prevention strategies focus on the practices of physical activities and scholar physical education. No association of LBP with sedentary lifestyle (TV and computer use time, sleep time), anthropometric measures and sleeping duration was observed.
Keywords: Adolescent, back pain, prevalence, physical activity, overweight
Abstract: BACKGROUND: Abnormal sagittal spinal curvature is associated with pain, decreased mobility, respiratory problems and increased mortality. Time-of-flight technology of the Microsoft Kinect sensor can reconstruct a three-dimensional image of the back quickly and inexpensively. OBJECTIVE: To estimate the extent of the reproducibility of sagittal spine curvature measurement using the Microsoft Kinect sensor. METHODS: Simultaneous measurement of thoracic and lumbar spine using the Microsoft Kinect sensor in 37 participants. Two investigators gave standardised instructions and each captured 3 images. Thoracic kyphosis and lumbar lordosis angle indexes were calculated using maximum height divided by the…length. RESULTS: Adult participants (mean age in years (SD) = 51.7 (20.6); 57% female; BMI in kg/m 2 (SD) = 24.9 (3.3)) kyphosis and lordosis indexes showed high intra-rater and inter-rater ICC values (0.960–0.973). The means of the first images from both raters had significantly larger kyphosis indexes compared to the second and third images, yet no difference between means in lordosis data. CONCLUSIONS: The results indicate that the Microsoft Kinect sensor has a reproducible method with high intra-rater and inter-rater reliability. The difference between the means over repeated measures suggest the second image capture is more consistent. It is a reproducible and quick method in clinical and research settings.
Abstract: BACKGROUND: Shoulder pain is one of the most common problems affecting people older than 60 years. Among the shoulder pathologies, the disorders of the periarticular soft tissue (e.g. rotator cuff) are considered to be the most common; moreover, these disorders are found in approximately 75% of patients with seropositive rheumatoid arthritis. The incidence of structural rotator cuff tendon pathology, including full-thickness rotator cuff tendon tears, increases with age. Recent researchers suggested that non-operative treatment of full-thickness rotator cuff tears could be successful in some patients; furthermore, in rheumatoid arthritis patients, there was a greater possibility of developing surgical complications…compared with non-rheumatoid arthritis patients. MATERIALS AND METHODS: A case report of a woman, 72 years old, with rheumatoid arthritis, shoulder pain and pseudo-paralytic arm presented with a massive tear of Supraspinatus and Infraspinatus tendon. In accordance with evidence, the case was managed using pain education and exercise therapy for 2.5 months. The shoulder pain, the function and the range of motion improved following a physiotherapy program. CONCLUSION: Pain education in combination with exercise therapy was effective for improving pain and function in a full-thickness tear of Supraspinatus and Infraspinatus tendon in a patient also suffering from rheumatoid arthritis.