Journal of Back and Musculoskeletal Rehabilitation - Volume Pre-press, issue Pre-press

Authors: Bernhoff, Gabriella | Huhmar, Helena | Käll, Lina Bunketorp

Article Type: Research Article

Abstract: BACKGROUND: Persistent symptoms in patients with systemic joint laxity (SJL) are often equivalent with complications. Screening for SJL is an important part of the assessment of musculoskeletal phenotype. The common measuring tool, the Beighton score (BS), still has unclear evidence. OBJECTIVE: To assess the Beighton score in a clinical context for (1) ability to classify SJL as absent or present (criterion validity), and (2) interrater reliability (physician-physiotherapist), for a dichotomous cut-off (yes/no), as well as for interpretation in categories (no, some, clear SJL). METHODS: This real-world observational study included 149 consecutive patients seeking …secondary care for investigation of possible myalgic encephalomyelitis/chronic fatigue syndrome. Assessment was done during a routine examination. Data were evaluated with Cohen’s kappa and Spearman’s rho. RESULTS: BS criterion validity showed poor agreement with the assessment of SJL: percentage agreement was 74 % and kappa 0.39 (3-cut level), 73 % and kappa 0.39/0.45 (4-/5-cut level). The best interrater reliability was moderate (rho 0.66) for interpretation in categories. CONCLUSIONS: The BS alone was not a reliable proxy for SJL and should be supplemented with a targeted history. Nevertheless, its interrater reliability was acceptable, and the categorised score appears to have greater clinical relevance than the dichotomous score. Show more

Keywords: Beighton score, hypermobility, joint laxity, somatosensory disorders, physical examination, connective tissue, primary health care

DOI: 10.3233/BMR-210081

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2021

Authors: Takahashi, Naoto | Takatsuki, Kozue | Kasahara, Satoshi | Yabuki, Shoji

Article Type: Research Article

Abstract: BACKGROUND: Because regular visits to distant hospitals may be a burden to patients, both in terms of time and cost, some patients with chronic musculoskeletal pain may discontinue multidisciplinary pain treatment, unable to maintain motivation to attend. OBJECTIVE: To evaluate and compare the pre-program characteristics of patients who dropped out and patients who continued treatment, thereby clarifying the characteristics of patients at risk of dropping out. METHODS: A multidisciplinary pain management treatment program was implemented for patients at the Pain Management Center, Hoshi General Hospital. From April 2015 to March 2018, 23 patients …participated in the program. Twelve of the 23 patients lived outside the prefecture where the hospital is located. Of these 12 patients, five completed the program, while seven did not. We compared the dropout and continuation groups in terms of patient characteristics, pain severity, pain-related psychosocial factors, and quality of life. RESULTS: We found significant differences (p < 0.05) in median age, Japanese Orthopaedic Association Back Pain Evaluation Questionnaire walking ability dysfunction score, and Roland-Morris Disability Questionnaire score. CONCLUSIONS: The characteristics of patients who dropped out were older age, walking ability dysfunction, and low quality of life associated with low back pain. Show more

Keywords: Chronic musculoskeletal pain, multidisciplinary treatment, inpatient pain management program, drop out

DOI: 10.3233/BMR-200292

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2021

Authors: Başar, Betül | Başar, Hakan

Article Type: Research Article

Abstract: BACKGROUND: Early full weight-bearing mobilization is controversial in osteoporotic patients who have undergone uncemented hemiarthroplasty (UCH). OBJECTIVES: The aim of the study was to compare the results of early full weight-bearing mobilization in CH and uncemented hemiarthroplasty (UCH). The effect of subsidence on the results was also evaluated. METHODS: Fifty-nine patients who underwent CH and UCH were evaluated. The mean age was 79.8 years (10 females, 15 males) for CH and 75.5 years (10 females, 24 males) for UCH. All patients started immediate full weight-bearing mobilization and weight-bearing exercises. RESULTS: There was no …difference between the groups according to the Harris Hip Score. Both groups were evaluated in subgroups according to whether there is varus in the femoral stem. There was no difference between subgroups according to the Harris Hip Score. The femoral subsidence was not determined in CH group. In the UCH group, the subsidence was 1.13 ± 1.03 mm in varus femoral stem subgroup and 0.81 ± 0.85 mm in without femoral stem varus subgroup. There was no difference in subsidence between femoral stem with varus and without varus. The subsidence did not affect the Harris Hip Score. CONCLUSION: Full weight-bearing mobilization could be safely preferred in UCH, as in CH. Femoral stem varus below 5 degrees does not affect the results and subsidence. Show more

Keywords: Hemiarthroplasty rehabilitation, full-weight bearing mobilization, weight bearing exercises, subsidence

DOI: 10.3233/BMR-210024

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2021

Authors: Baik, Seung-Min | Cynn, Heon-Seock | Yi, Chung-Hwi | Lee, Ji-Hyun | Choi, Jung-Hoon | Lee, Kyung-Eun

Article Type: Research Article

Abstract: BACKGROUND: The effectiveness of side-sling plank (SSP) exercises on trunk and hip muscle activation in subjects with gluteus medius (Gmed) weakness is unclear. OBJECTIVE: To quantify muscle activation of the rectus abdominis (RA), external oblique (EO), erector spinae (ES), lumbar multifidus (LM), Gmed, gluteus maximus (Gmax), and tensor fasciae latae (TFL) during SSP with three different hip rotations compared to side-lying hip abduction (SHA) exercise in subjects with Gmed weakness. METHODS: Twenty-two subjects with Gmed weakness were recruited. SHA and three types of SSP exercises were performed: SSP with neutral hip (SSP-N), hip …lateral rotation (SSP-L), and hip medial rotation (SSP-M). Surface electromyography was used to measure the activation of the trunk and hip muscles. RESULTS: The trunk and hip muscles activations were generally significantly higher level during three SSP than SHA. SSP-M showed significantly lower EO activation while significantly higher ES and LM activation than SSP-L. Gmed activation was significantly higher during SSP-M than during SSP-L. TFL activation was significantly lower during SSP-M than during SSP-N and SSP-L. CONCLUSIONS: SSP could be prescribed for patients who have reduced Gmed strength after injuries. Especially, SSP-M could be applied for patients who have Gmed weakness with dominant TFL. Show more

Keywords: Gluteus medius weakness, side-lying hip abduction, side-sling plank, surface electromyography

DOI: 10.3233/BMR-210061

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2021

Authors: Dudoniene, Vilma | Kuisma, Raija | Juodzbaliene, Vilma

Article Type: Research Article

Abstract: BACKGROUND: Juvenile spinal osteochondrosis (JSO) affects vertebral endplates and may cause intervertebral discs alterations. The condition is typically related to pain, and weakness and shortening of trunk muscles. Sling suspension therapy (SST) has been shown to reduce lumbar pain effectively. It is, however, unclear whether SST is superior to other treatment methods in reducing pain, correcting posture, and activating trunk stabilizers in JSO. OBJECTIVE: In this study, we intended to compare the effectiveness of two different exercise modalities; Sling Suspension Therapy and Gym Ball Exercise in the treatment of JSO in adolescent girls. METHODS: …A randomised controlled single centre clinical trial was carried out in an inpatient rehabilitation unit at a sanatorium. Forty adolescent girls (age 16.3 ± 0.47 yrs.), who were diagnosed with JSO (according to ICD-10 Version: 2016 – M 42.0) were randomly assigned into two groups: Group 1 – Sling suspension therapy (SST), Group 2 – Gym ball exercises (GBE). Both groups received interventions for 3 weeks, 15 sessions, and 30 minutes a day for 5 consecutive days a week. Back pain, endurance of trunk muscles and standing posture were evaluated pre- and post-interventions. RESULTS: Both groups demonstrated significant improvement in all measured outcomes. SST was more effective in reducing pain (p < 0.05), increasing the endurance of trunk muscles (p < 0.05) and improving the standing posture (p < 0.05) compared to GBE (p < 0.05). CONCLUSIONS: Sling suspension therapy is more effective compared with Gym ball exercises in the treatment of juvenile spinal osteochondrosis in adolescent girls in terms of back pain, posture and endurance of trunk muscles. Show more

Keywords: Spinal osteochondrosis, back pain, suspension therapy, Gym ball, standing posture, endurance

DOI: 10.3233/BMR-210099

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-7, 2021

Authors: Kim, Kun Yung | Kim, Gi-Wook

Article Type: Case Report

Abstract: BACKGROUND: Knee osteoarthritis (OA) is accompanied by inflammation and angiogenesis. Modifying angiogenesis through transcatheter arterial embolization (TAE) can be a potential treatment for knee OA. OBJECTIVE: We subjected five OA knees in three patients to TAE and report the results of our post-treatment observations. CASE DESCRIPTION: Three patients that had experienced knee pain for a minimum of one year prior to the study, and whose pain had persisted despite conservative treatment, were included in this study. Patients more often chose conservative treatment over surgical treatment. Pain and functional scales were evaluated before, immediately, …and 1 month after TAE using the Numeric Rating Scale (NRS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). TAE was performed by an experienced interventional radiologist. The average values of NRS evaluated before and after 5 TAEs were 5.2 before TAE, 3 immediately after TAE, and 3.6 after 1 month of TAE, and the average values of WOMAC were 52, 38.4, and 36.4, respectively. There were no major adverse effects. CONCLUSION: The examined cases support the conclusion that TAE is an effective treatment for patients with knee OA. Substantial pain relief and WOMAC improvement were observed both immediately and one month after TAE. Show more

Keywords: Knee, osteoarthritis, pain, embolization

DOI: 10.3233/BMR-210043

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-6, 2021

Authors: Surmeli, Mahmut | Cinar Ozdemir, Ozlem

Article Type: Research Article

Abstract: BACKGROUND: Upper limb lymphedema is one of the complications following breast cancer-related surgery. It is a fact that there are alterations in posture of the trunk following surgery, however, there is not much data on whether upper limb lymphedema has any effect on body posture. OBJECTIVES: The main purpose of the study was to investigate the effect of upper limb lymphedema in the trunk posture and spine mobility of patients following breast cancer surgery. METHODS: Twenty-seven women with lymphedema and 29 women without lymphedema with mastectomy or breast-conserving surgery participated in the study. …Posture was evaluated by the New York Posture Rating Chart and spinal stability and thoracic mobility were evaluated by the Spinal Mouse device. RESULTS: Posture and spine posture scores were significantly higher in the without lymphedema group (p = 0.004; 0.041; respectively). There was a significant difference between the groups in terms of lateral (p < 0.001) and posterior (p < 0.001) view of shoulders, spine (p = 0.027), upper (p < 0.001) and lower back (p = 0.009), and trunk postures (p = 0.001). CONCLUSIONS: Body posture and spine are more affected due to upper limb lymphedema following breast cancer surgery. Alterations of posture mainly occur on shoulders, spine, upper and lower back, and trunk, but not on head and neck postures. Show more

Keywords: Lymphedema, posture, spine, mastectomy, breast

DOI: 10.3233/BMR-210049

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2021

Authors: Boutellier, Angela | Nüesch, Corina | Suter, Peter | Perrot, Guido | Mündermann, Annegret

Article Type: Research Article

Abstract: BACKGROUND: The function of trunk muscles in chronic nonspecific low back pain (CNLBP) is controversially discussed, and trunk muscle function in sedentary occupation workers is poorly understood. OBJECTIVE: To investigate whether muscle function differs between sedentary occupation workers with and without CNLBP and to determine the association between functional limitations and muscle function. METHODS: This study included 32 sedentary occupation workers (16 workers with CNLBP and 16 age- and sex-matched workers without CNLBP). Group differences in isokinetic trunk flexion-extension strength, muscle cocontraction, endurance time (Biering-Sorensen test) and electromyographic muscle fatigue were assessed. The …association of these parameters and Oswestry Disability Index (ODI) score were examined in the CNLBP group. RESULTS: Participants with CNLBP had lower trunk extensor (- 20%) and flexor (- 18%) strength and less cocontraction (- 22%) than participants without CNLBP, but due to large variability in both groups these differences were not statistically significant. Trunk muscle endurance and fatigue were comparable between groups. Variance in endurance time explained 28% of variance in the ODI-score in the CNLBP group (R 2 = 0.277). CONCLUSIONS: In patients with CNLBP, greater functional disability was associated with lower endurance. Further evidence is necessary to elucidate whether specifically training endurance performance may be beneficial for sedentary occupation workers. Show more

Keywords: Low back pain, muscle function, muscle fatigue, muscle strength, electromyography

DOI: 10.3233/BMR-200269

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2021

Authors: Yagci, Gozde | Ozcan, Damlagul Aydin | Kuru, Cigdem Ayhan | Yakut, Yavuz

Article Type: Research Article

Abstract: BACKGROUND: Previous studies have reported increased kinesiophobia in adults with degenerative scoliosis or adolescents who have undergone spinal surgery. However, little is known about the phenomenon of kinesiophobia among adolescents with idiopathic scoliosis (IS). OBJECTIVES: The aim of this study was to investigate levels of kinesiophobia and its association with treatment choice in IS. METHODS: The study included 98 IS patients with a mean age of 14 years and 20 healthy controls. Participants with IS were divided into groups based on treatment conditions, as follows: (1) untreated (n = …33); (2) treated with exercise (n = 32); and (3) treated with a brace (n = 33). Kinesiophobia was measured using the Tampa Scale for Kinesiophobia (TSK). Comparisons were made between four groups. RESULTS: Untreated participants with IS were found to have greater kinesiophobia than healthy controls (p < 0.001). Participants treated with a brace (p = 0.046) and exercise (p = 0.064) had similar kinesiophobia levels as the healthy control group. CONCLUSIONS: Kinesiophobia was found to be higher in adolescents with IS compared to healthy peers. Brace or exercise treatment both had a positive impact on kinesiophobia. These findings should be considered when organizing rehabilitation programs to achieve the best results for adolescents with IS. Show more

Keywords: Scoliosis, fear, movement, exercise therapy, brace

DOI: 10.3233/BMR-210111

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2021

Authors: Karadağ, Ahmet | Canbaş, Muhammed

Article Type: Research Article

Abstract: BACKGROUND: Low back pain is an important health problem that may cause functional loss. Several back pain disability scales have been developed in different languages. OBJECTIVE: The present study evaluates the correlation between the Istanbul Low Back Pain Disability Index (ILBPDI) the Back Pain Functional Scale (BPFS) and other back pain disability scales in patients with mechanical low back pain. METHODS: Included in the study were 105 patients who presented to our outpatient clinics and who were diagnosed with mechanical low back pain. The ILBPDI, BPFS, Quebec back pain disability scale (QBPDS) and …Oswestry low back pain disability questionnaire (ODI) were administered to all participants, and Visual analogue scale (VAS) scores were recorded. RESULTS: A strongly negative correlation was identified between ILBPDI and BPFS (p < 0.05), and a strongly positive correlation was noted between ILBPDI and QBPDS, ODI and VAS. CONCLUSION: A strong correlation exists between ILBPDI and BPFS, and a further strong correlation between ILBPDI ODI and QBPDS. These questionnaires can be used interchangeably to evaluate disability associated with chronic mechanical low back pain. Show more

Keywords: LBP, disability, ILBPDI, BPFS, Turkey

DOI: 10.3233/BMR-191824

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-5, 2021