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

Authors: Schwertner, Debora Soccal | da Silva Oliveira, Raul Alexandre Nunes | Swarowsky, Alessandra | Felden, Érico Pereira Gomes | Beltrame, Thais Silva | da Luz Koerich, Micheline Henrique Araújo

Article Type: Research Article

Abstract: BACKGROUND: Young people tend to spend most of their time in activities involving inappropriate positions, which can promote musculoskeletal alterations and disorders. OBJECTIVE: To investigate the prevalence of low back pain (LBP) in young people and analyse its associations with daily postural habits. METHODS: Cross-sectional and retrospective study evaluating 679 Brazilian young people (15 to 18 years old), using questionnaires about LBP and awareness of postural habits. The prevalence values were calculated for the present moment, the last three months and throughout life. The Mann-Whitney U test and the Chi-square test were applied. …RESULTS: The prevalence of LBP at the present moment was 27.2%, 57.7% over the last three months and 73.9% throughout life. Boys and girls presented significantly different values, a larger number of girls manifesting pain for the three moments. The associated postural habits were: turning the body, reduction of lumbar lordosis when seated, not placing the feet on the floor, crossing the legs when sitting in the classroom and at home, sitting or lying in an inappropriate position, and distributing the body asymmetrically on the legs when standing. CONCLUSIONS: Young people from 15 to 18 years of age show a high prevalence of low back pain. Inadequate postural habits adopted during everyday activities are associated with this complaint. These findings could contribute to the implementation of prevention and rehabilitation strategies. Show more

Keywords: Adolescent, risk factors, low back pain, habits, prevalence

DOI: 10.3233/BMR-200356

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2022

Authors: Ezema, Charles Ikechukwu | Onyeso, Ogochukwu Kelechi | Nna, Emmanuel Okechukwu | Awosoga, Oluwagbohunmi A. | Odole, Adesola Christiana | Kalu, Michael Ebe | Okoye, Goddy Chuba

Article Type: Research Article

Abstract: BACKGROUND: Transcutaneous electrical nerve stimulation (TENS) is a promising non-pharmacological modality for the management of chronic low back pain (CLBP), but its efficacy and mode of action have not been clearly established. OBJECTIVE: To evaluate the responses of plasma beta-endorphin (β E), met-enkephalin (ME), and pain intensity (PI) among patients with CLBP exposed to TENS or sham-TENS. METHODS: This double-blind trial involved 62 participants (aged 53.29 ± 5.07 years) randomised into TENS group (frequency 100 Hz, burst-rate 2 Hz, burst-width 150 μ s, intensity 40 mA, …duration 30 min), and sham-TENS group. The PI and plasma concentrations of β E and ME were measured at baseline, immediately (0 hr), 1 hr, 24 hrs, and 48 hrs post-intervention. Data were analysed using general linear model repeated measures, ordinal regression, one-way analysis of variance, Kruskal-Wallis test, independent and paired samples t -tests, Mann-Whitney U test, Wilcoxon signed-rank test, and Kendall’s tau coefficient. RESULTS: There was a significant temporal difference in PI between groups, F (1, 58) = 18.83, p < 0.001; the TENS group had better pain relief. The relative analgesic effect of TENS started immediately after the intervention (median difference [M ⁢ D ] = - 3, p < 0.001), peaked at 1 hr (M ⁢ D = - 4, p < 0.001), and worn out by 24 hrs (M ⁢ D = - 1, p = 0.029). However, there was no significant difference in β E and ME between the groups from 0 hr to 24 hrs post interventions, and no significant correlation between the PI, and β E, or ME. CONCLUSION: TENS significantly reduced PI up to 24 hrs after treatment. Show more

Keywords: Beta-endorphin, met-enkephalin, physiotherapy, spondylosis, TENS analgesic

DOI: 10.3233/BMR-210146

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-12, 2022

Authors: Reichardt, Amber | Passmore, Steven R. | Toth, Audrey | Olin, Gerald

Article Type: Research Article

Abstract: BACKGROUND: Osteoarthritis (OA) is one of the most prevalent and disabling musculoskeletal diseases worldwide. There is preliminary evidence from experimental studies and consensus documents that chiropractic management may alleviate spine and/or extremity OA related pain in the short term. OBJECTIVE: This research explores the potential relationship of a pragmatic course of care, including soft tissue therapy, spinal manipulation, and other treatments commonly delivered by chiropractors, to spine and extremity pain in patients with OA. METHODS: A retrospective analysis of prospectively collected data from the chiropractic program at a publicly funded healthcare facility was …conducted. The primary outcome measures for patients diagnosed with spine and/or extremity OA (n = 76) were numeric pain scores of each spinal and extremity region at baseline and discharge, and a change score was determined. RESULTS: Statistically significant improvements that exceed a clinically meaningful difference in pain numeric rating scale scores were demonstrated by point change reductions from baseline to discharge visits. Change scores exceeding a minimally clinically important difference of “2-points” were present in the sacroiliac (- 2.91), extremity (- 2.84), cervical (- 2.73), thoracic (- 2.61), and lumbar (- 2.59) regions. CONCLUSION: Patients diagnosed with OA in a socioeconomically disadvantaged community demonstrated reductions in mean pain scores in both a clinically meaningful and statistically significant manner concurrent with a course of chiropractic care. Show more

Keywords: Osteoarthritis, chiropractic, pain, spine, extremity, vulnerable populations, musculoskeletal disease, retrospective studies, delivery of healthcare

DOI: 10.3233/BMR-210192

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2022

Authors: Dernek, Bahar | Ulusoy, İbrahim | Aydoğmuş, Suavi | Duymuş, Tahir Mutlu | Kesiktaş, Fatma Nur | Dıraçoğlu, Demirhan

Article Type: Research Article

Abstract: BACKGROUND: Cervical radiculopathy is characterized by pain, numbness, tingling, and weakness, mostly in an affected extremity, reflecting compression of a nerve in the neck is compressed or irritated where it emerges from the spinal cord. Diagnosis requires a detailed anamnesis, physical examination, and imaging. Physical therapy, exercise, medical therapy, and injections are the preferred treatments, but injections into the cervical region are only indicated if conservative treatment is ineffective. OBJECTIVE: This study explored the utility of selective cervical nerve root blocks (SNRBs) performed at various levels under ultrasound guidance (USG). METHODS: We evaluated …patients diagnosed with cervical radiculopathy via physical examination and magnetic resonance imaging from November 2019 to March 2020. We included those who did not respond to conservative treatment and therefore received SNRBs at various levels. Sixty-three patients were evaluated over 6 months in terms of pain, functional status, and complications. RESULTS: We retrospectively evaluated patients with cervical herniated discs who received SNRBs at various levels between C4–7 under USG. Pain and functional status improved in month 1 and was maintained until at least month 6. CONCLUSION: SNRB injections performed under USG effectively treated pain and poor functional status in selected patients. The procedure is safe (especially) for patients who do not respond to conservative treatment. Show more

Keywords: Ultrasound, injection, cervical radiculopathy, treatment, nerve block

DOI: 10.3233/BMR-210076

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-7, 2022

Authors: Kataoka, Hideki | Hirase, Tatsuya | Goto, Kyo | Honda, Ayana | Nakagawa, Koichi | Yamashita, Junichiro | Morita, Kaoru | Honda, Yuichiro | Sakamoto, Junya | Okita, Minoru

Article Type: Research Article

Abstract: BACKGROUND: Research on the multi-faceted characteristics of persistent severe acute lower back pain (LBP) resulting from acute vertebral compression fractures (VCFs) is lacking. OBJECTIVE: To investigate the psychological and functional status of older patients with persistent severe acute LBP after conservative treatment of VCFs. METHODS: This prospective study included women aged 50 years and older who had acute VCFs and were admitted to the hospital. Pain intensity, depression, pain catastrophizing, activities of daily living (ADL), muscle strength, and vertebral deformity were assessed on admission. At 2 and 4 weeks post-admission, physical performance tests …were performed along with the above measures. RESULTS: We divided 131 participants into severe (n = 64) and mild (n = 67) groups according to their pain intensity at 4 weeks. Compared to the mild group, the severe group showed significantly higher levels of depression and catastrophizing, with significantly poorer muscle strength and endurance. There were no significant differences in ADL and vertebral deformities between the two groups. CONCLUSIONS: Our results suggest that older patients with persistent severe acute LBP resulting from VCFs tend to be depressed and pain catastrophizing. Furthermore, persistent severe acute LBP negatively impacts endurance and muscle strength but not ADL. Show more

Keywords: Catastrophizing, depression, physical performance, severe lower back pain, VCFs

DOI: 10.3233/BMR-210220

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2022

Authors: Ferrillo, Martina | Ammendolia, Antonio | Paduano, Sergio | Calafiore, Dario | Marotta, Nicola | Migliario, Mario | Fortunato, Leonzio | Giudice, Amerigo | Michelotti, Ambra | de Sire, Alessandro

Article Type: Review Article

Abstract: BACKGROUND: Patients with temporomandibular disorders (TMD) mostly suffer from muscle-related pain. Several conservative interventions have been suggested as treatments for TMD in the last years. OBJECTIVE: The aim of this systematic review with meta-analysis was to assess the efficacy of rehabilitative approaches in reducing pain in patients with muscle-related TMD. METHODS: PubMed, Scopus, and Web of Science were systematically searched from inception until April 28 th , 2021 to identify randomized controlled trials (RCTs) presenting: patients with painful muscle-related TMD; rehabilitative approaches as interventions; placebo or sham treatment as …comparisons; pain intensity, using visual analogue scale as outcome. A meta-analysis was performed to evaluate the overall effect on painful muscle-related TMD patients. PROSPERO registration number of this systematic review is CRD42021251904. RESULTS: Out of 1997 papers suitable for title/abstract screening, 189 articles were assessed for eligibility. Sixteen RCTs were included and most of them (n = 6, 37.5%) investigated the effects of the laser therapy. The meta-analysis revealed that rehabilitative interventions had a significant overall effect size (ES) of 1.44 (p < 0.0001) in decreasing pain in patients with muscle-related disorders. CONCLUSION: Findings of this systematic review with meta-analysis suggested that rehabilitative approaches might be effective in reducing pain in muscle-related TMD patients. However, the low number of RCTs evaluating conservative approaches might impair the synthesis of evidence regarding the different techniques, calling for caution in the interpretation of these results. Show more

Keywords: Temporomandibular disorders, myofascial pain, pain, physical therapy, rehabilitation

DOI: 10.3233/BMR-210236

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-16, 2022

Authors: Xu, Huajun | Zhang, Yingchun | Wang, Caishan

Article Type: Research Article

Abstract: BACKGROUND: Frozen shoulder (FS), also known as shoulder adhesive capsulitis, is a musculoskeletal disorder associated with pain and functional disability. There is a lack of evidence on the optimal treatment strategy for FS. OBJECTIVE: The present study aimed to evaluate the effectiveness and safety of ultrasound-guided hydrodilatation of glenohumeral joint combined with acupotomy for treatment of FS. METHODS: In this prospective randomized, double-blind, controlled study, 63 FS patients were recruited, and equally allocated to treatment group and control group. The treatment group was treated with ultrasound-guided hydrodilatation of glenohumeral joint combined with acupotomy, …while the control group was only treated with ultrasound-guided hydrodilatation of glenohumeral joint. The pain and mobility of shoulder, overall efficacy and adverse reactions were evaluated 3 months after treatment. RESULTS: At baseline, no significant difference in all characteristic value was found between the treatment group (n = 33) and control group (n = 30). Three months after operation, the joint’s Active Range of Motion (AROM) and Constant-Murley Scale (CMS) scores in the experimental group were higher than those in the control group, and the coracohumeral ligament (CHL) thickness and the rate of hypoechoic thickening in rotator cuff space in the experimental group were lower than those in the control group (all P < 0.05). The amount of injection volume at the third hydrodilatation was significantly higher in the experimental group than that in the control group (15.8 ± 4.7 vs 12.2 ± 5.2, P = 0.03). After 2 times of treatment, the volume increment of glenohumeral joint Δ 2 in the experimental group was greater than that in the control group (3.5 ± 1.8 vs 1.2 ± 1.6, P < 0.001). There were significant differences in the effective rate between the two groups (93.94% vs. 76.67%, P = 0.04). CONCLUSION: The ultrasound-guided hydrodilatation of glenohumeral joint combined with acupotomy may benefit for FS patients. Show more

Keywords: Ultrasound-guided, hydrodilatation, glenohumeral joint, acupotomy, frozen shoulder

DOI: 10.3233/BMR-210272

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2022

Authors: Jiang, Lisi | Zhang, Lei | Huang, Wenhan | Zeng, Qing | Huang, Guozhi

Article Type: Research Article

Abstract: BACKGROUND: Proprioception is essential for the normal movement of knee joints. How proprioception training affects the postoperative knee functional recovery after anterior cruciate ligament (ACL) reconstruction remains unknown. OBJECTIVE: This study investigated the effect of proprioception training on the knee joint kinematics of patients after ACL reconstruction (ACLR). METHODS: The randomized controlled study was performed at the Department of Orthopaedics and Traumatology of Guangdong Provincial People’s Hospital between December 2019 and April 2021. Forty-five patients who underwent ACLR were randomly divided into a proprioception group (n = 23) …and a control group (n = 22). The patients were randomly divided into an experimental group and a control group according to whether the final digits of their ID numbers were odd or even. All patients followed a common postoperative rehabilitation program. The outcome measures included the patients Lysholm scores, hop distances, and knee kinematics during unanticipated jump-cut maneuvering measured at different follow-up times. Knee joint kinematics were described as the positional and orientational changes of the femur relative to the tibia. RESULTS: After surgery, the proprioception group did not exhibit significantly higher hop distances than the control group at the 6-month (114.8 ± 19.0 vs. 105.9 ± 20.7 cm, p = 0.137, 95% CI: - 3.13 to 22.03 cm) and 1-year follow-ups (143.1 ± 19.3 vs. 133.9 ± 26.2 cm, p = 0.216, 95% CI: - 5.57 to 23.87 cm). For knee joint kinematics, the members of the proprioception training group exhibited significantly reduced knee abduction (valgus) angles and external rotation and significantly increased knee flexion compared to those in the common training group. CONCLUSIONS: The results suggested that proprioceptive rehabilitation training enhances knee joint functional performance and shows altered knee joint kinematics in ACL-reconstructed populations during unanticipated jump-cut maneuvering compared with the common rehabilitation training. Show more

Keywords: Anterior cruciate ligament reconstruction, proprioception training, rehabilitation, kinematics

DOI: 10.3233/BMR-210201

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2022

Authors: Kuo, Ying-Chen | Hsu, Wei-Chun | Lin, Yi-Jia | Lin, Yu-Ting | Chen, Yann-Rong | Hsieh, Lin-Fen

Article Type: Research Article

Abstract: BACKGROUND: Calcific tendinitis of the shoulder is a common disorder resulting in restricted motion and pain. OBJECTIVE: This study compared the effects of ultrasound-guided fine-needle puncture (USNP), radial shock wave therapy (RSWT), and the combination of both treatments (COMB) on calcific tendinitis of the shoulder. METHODS: We enrolled 62 patients who had unilateral shoulder pain for more than 3 months. The patients were randomly divided into three groups: USNP, RSWT, and COMB. All USNP needle punctures were guided with ultrasound (US), and RSWT was delivered at 2 Hz (2000 shock waves; 0.26 mJ/mm …2 ) once a week for 3 weeks. The COMB group received three weekly rounds of RSWT after a single US-guided needle puncture. The primary outcome was the pain visual analog scale (VAS), and secondary outcomes were the Constant scores, 36-Item Short-Form Health Survey, and range of motion. RESULTS: A within-group comparison at 3 months revealed significant improvements in the pain VAS (p < 0.05, during activity) and Constant (p < 0.05) scores, but between-group comparisons revealed no statistically significant differences in the pain VAS (p > 0.05) or Constant (p = 0.089) scores. Only improvement differences in role-emotional (SF-36; p = 0.01) and active external rotation (p = 0.035) were determined over time, which favored the USNP and COMB groups. CONCLUSIONS: Although no significant differences were observed among the groups in the treatment of calcific tendinitis of the shoulder, more satisfactory outcomes were noted in the USNP and COMB groups than in the RSWT group. Larger samples, longer follow-up times, and other treatment protocols are suggested for future studies. Show more

Keywords: Shoulder pain, tendinitis, extracorporeal shockwave therapy, ultrasonography

DOI: 10.3233/BMR-210166

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2022

Authors: Tuan, Sheng-Hui | Sun, Shu-Fen | Huang, Wan-Yun | Chen, Guan-Bo | Li, Min-Hui | Liou, I-Hsiu

Article Type: Case Report

Abstract: BACKGROUND: Sudden onset of acute torticollis in children is rare and is usually diagnosed as atlantoaxial rotatory subluxation (AARS). The common treatment for acute AARS without neurological symptoms is halter traction in conjunction with muscle relaxant and sedative agents, followed by cervicothoracic orthotic immobilization. To the best of our knowledge, a case of acute AARS treatment with high-intensity laser therapy (HILT) has not yet been reported so far. OBJECTIVE: We aimed to report a case of acute AARS treatment with HILT successfully and to discuss about the clinical effect of HILT in AARS. METHODS: …We reported a 9-year-old girl with acute onset of torticollis visiting the rehabilitation outpatient department. RESULS: The physical examination revealed a typical cock robin position without neurological symptoms. A series of evaluations, including open-mouth odontoid radiograph and soft tissue sonography, confirmed the diagnosis of acute AARS. The patient received HILT over the left suboccipital and upper back muscle groups, which started on the day of the first rehabilitation clinic visit, once a week, for four weeks. Torticollis and neck pain improved gradually with each session of HILT, and the symptoms resolved completely after the fourth session. Dynamic computed tomography (CT) of the cervical spine showed no evidence of obvious AARS after the treatment. CONCLUSIONS: The patient had no complaints after HILT in a case of acute AARS resulting from a mechanical factor. Due to its pain-relief and muscle-release characteristics, HILT indicates the probable benefit of relaxation of spastic muscles for patients with AARS. Show more

Keywords: Torticollis, atlantoaxial rotatory subluxation, high intensity laser, cock robin position, posture, children

DOI: 10.3233/BMR-210133

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-7, 2022

Authors: Tütüncüler, Erman | Ök, Nusret | Güngör, Harun Reşit | Bayrak, Gökhan | Şavkın, Raziye | Büker, Nihal

Article Type: Research Article

Abstract: BACKGROUND: Static or dynamic postural control cannot be fully restored in patients with knee osteoarthritis, even after total knee arthroplasty (TKA), which may contribute to an increased risk of falls in the elderly. OBJECTIVE: To evaluate balance and the fall risk before and after TKA in patients with bilateral knee osteoarthritis. Secondary outcomes were patient-reported and performance-based activity limitations. METHODS: A total of 45 patients were separated into two groups as unilateral TKA (UTKA, n = 24) and bilateral TKA (BTKA, n = …21) groups. All the patients received standard postoperative physical therapy for 3 months. Balance and fall risk (Biodex Balance System SD), patient-reported and performance-based functionality (WOMAC, 30-second chair-stand test, 9-step stair climbing test and 40-meter fast-paced walk test) and Short Form-12 (SF-12) were evaluated at preoperatively, and at 3 months postoperatively. RESULTS: There was no difference between the groups in postoperative fall risk and balance (p > 0.05). The BTKA group obtained better results in the sit-to-stand test and SF-12 physical dimension (p < 0.05). CONCLUSIONS: UTKA and BTKA interventions and the standard postoperative rehabilitation were seen to improve balance and quality of life, and reduce the fall risk, patient-reported and performance-based activity limitations. However, despite improvements in balance, the risk of falling persists. Show more

Keywords: Total knee arthroplasty, fall risk, balance, knee function, quality of life

DOI: 10.3233/BMR-210127

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

Authors: Ogon, Izaya | Teramoto, Atsushi | Takashima, Hiroyuki | Terashima, Yoshinori | Yoshimoto, Mitsunori | Emori, Makoto | Iba, Kousuke | Takebayashi, Tsuneo | Yamashita, Toshihiko

Article Type: Research Article

Abstract: BACKGROUND: Pain sensitization may be one of the mechanisms contributing to chronic low back pain (CLBP). OBJECTIVE: To evaluate the association between visceral fat, CLBP, and central sensitization (CS); describe the relationship between low back pain (LBP) intensity and CS; and identify possible correlation between visceral fat and LBP intensity. METHODS: Patients with CLBP were divided using their CS inventory (CSI) scores into low- (CSI < 40) and high-CSI (CSI ⩾ 40) subgroups. We compared computed tomography (CT) measurements and scores for association with pain according to …the visual analogue scale (VAS) between the two groups. RESULTS: The low-CSI and the high-CSI groups had 47 patients (67.1%; 21 men, 26 women) and 23 patients (32.9%; 11 men and 12 women), respectively. The high-CSI group had a significantly higher mean VAS score (p < 0.01) and estimated mean visceral fat area (p < 0.05) than the low-CSI group. There was a moderate positive correlation between VAS score and visceral fat (standardised partial regression coefficient: 0.659, p < 0.01) in the high-CSI group according to multiple linear regression analysis adjusted for age and sex. CONCLUSIONS: Visceral fat is associated with CLBP, regardless of sex or age, and may be a potential therapeutic target for CLBP with CS. Show more

Keywords: Chronic pain, low back pain, central sensitization, central sensitization inventory, visceral fat

DOI: 10.3233/BMR-210124

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