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

Authors: Chesterton, Paul | Payton, Stephen | McLaren, Shaun

Article Type: Research Article

Abstract: BACKGROUND: Lumbar mobilizations are used to clinically treat the lumbar and hamstring region. However, evidence is limited regarding the effectiveness of specific mobilization methods. OBJECTIVE: To compare central and unilateral posterior – anterior mobilizations (CPA, UPA) of the lumbar spine on lumbar and hamstring range of motion (ROM), and muscle activity (sEMG). METHODS: Twenty participants received CPA, UPA, or no mobilization (CON) on separate occasions (crossover design). Post-treatment outcome measures were ROM during active lumbar flexion (ALF) and active knee extension (AKE), as well as sEMG of the Erector Spinae (ES) and Biceps …Femoris (BF) during these movements. RESULTS: sEMG was possibly to very likely lower following CPA (mean difference range = - 5% to - 21%) and UPA (- 7% to - 36%), while ROM was most likely greater (- 12% to 25% and - 17% to 24%, respectively). Most sEMG measures were possibly to likely lower following UPA versus CPA (- 18% to - 11%), while AKE ROM was possibly greater (- 5.5%). Differences in ES sEMG (- 2.5%) and ROM (- 1.4%) during ALF were unclear and most likely trivial, respectively. CONCLUSIONS: CPA and UPA mobilizations increase lumbar and hamstring ROM whilst reducing local muscle activity. These effects appear to be greater for UPA mobilizations when compared with CPA. Show more

Keywords: Manipulation, spinal, lumbar vertebrae, hamstring muscles

DOI: 10.3233/BMR-171000

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2018

Authors: Zvekic-Svorcan, Jelena | Aleksic, Jelena | Jankovic, Tanja | Filipovic, Karmela | Cvetkovic, Milan | Vuksanovic, Miljanka | Filipov, Predrag

Article Type: Research Article

Abstract: OBJECTIVE: Vertebral fractures are the most common osteoporotic fractures occurring due to low bone mineral density, as well as other risk factors. The aim of the paper is to investigate risk factors for vertebral osteoporotic fracture occurrence in postmenopausal women. METHODS: Retrospective analysis of data pertaining to 651 postmenopausal women obtained from the National Osteoporosis Registry of Serbia was conducted. Further analyses were performed on 217 osteoporotic women identified from those records, whereby those in the experimental group (n = 110) had a vertebral fracture, while those assigned to the control …group (n = 107) did not. The two groups were comparable in terms of age (t = 0.450; p > 0.01). Risk factors that could serve as the best predictors of vertebral fracture occurrence were investigated. Multivariate logistic regression analysis was used for testing effect of several factors on vertebral fracture occurrence as the dependent variable. RESULTS: Patients that have never suffered a vertebral fracture had a significantly higher bone mineral density (t = 8.161; p < 0.01) in comparison to those with a verified vertebral fracture. Factors that significantly contributed to the risk of vertebral fracture were presence of kyphosis (OR 708.338; 95% CI 19.238–26.081.950), use of glucocorticoids (OR 87.618; 95% CI 9.175–836.707), and presence of comorbidities (OR 7.327; 95% CI 1.500–35.793). Moreover, a unit increase in body mass index (BMI) was found to lower the probability of vertebral fracture by a factor of 0.846. Women that entered menopause later have lower chance of suffering a vertebral fracture (OR = 0.539; 95% CI 0.400–0.726). CONCLUSION: Lower body mass index, presence of kyphosis, use of glucocorticoids, early menopause onset, and presence of comorbidities are the factors that contribute the most to vertebral osteoporotic fracture occurrence. Show more

Keywords: Risk factors, osteoporosis, postmenopausal, vertebral fractures

DOI: 10.3233/BMR-170898

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2018

Authors: Wang, Wentao | Duan, Kun | Ma, Minjie | Jiang, Yong | Liu, Tuanjiang | Liu, Jijun | Hao, Dingjun

Article Type: Research Article

Abstract: AIM: To compare outcomes of unipedicular versus bipedicular approach for percutaneous vertebroplasty for the treatment of thoracolumbar acute osteoporotic vertebral compression fracture (AOVCF). METHOD: From November 2014 to September 2015, 382 patients with AOVCF were randomly assigned to the unipedicular and bipedicular groups. Clinical outcomes and complications were compared. RESULTS: Both groups were comparable with respect to bone cement leakage and adjacent vertebral fractures (P > 0.05). Although the bipedicular approach was found to be superior in terms of reduction of kyphosis and loss of reduction, frequency of …x-ray fluoroscopy, VAS and ODI scores, the volume of cement injected and operating time, the between-group differences were not statistically significant (P > 0.05). Nerve root stimulation was more frequent in the unipedicular group (P < 0.05). CONCLUSIONS: The clinical and radiological outcomes of both procedures were comparable. The unipedicular approach was associated with more nerve root stimulation. Show more

Keywords: Percutaneous vertebroplasty, thoracolumbar, acute osteoporotic vertebral fracture, unipedicular, bipedicular

DOI: 10.3233/BMR-170870

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2018

Authors: Toprak, M. | Erden, M.

Article Type: Research Article

Abstract: BACKGROUND: Nocturnal shoulder pain could play an essential role in frozen shoulder (FS) and can lead to disturbed sleep, anxiety, depression and reduced quality of life (QoL). OBJECTIVE: The aim of this study was to examine anxiety, depression, sleep quality and quality of life in patients with FS and compare these to healthy controls. METHODS: We prospectively evaluated 148 participants (76 FS patients and 72 healthy controls). We obtained Visual Analogue Scale (VAS) pain score, Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI) and World Health Organization Quality of Life Scale …short form (WHOQoL-BREF). RESULTS: FS patients had significantly higher scores for VAS and BAI (p < 0.001) than the control group. There was no significant difference between the BDI scores of the groups (p = 0.067). The WHOQoL-BREF scale of the physical, mental and environmental fields were significantly lower in the FS group (p < 0.001). FS patients had significantly lower sleep efficiency, and sleep disorders in terms of PSQI section scores (p < 0.001). CONCLUSION: Our study demonstrated that there is a high prevalence and close relationships of pain, anxiety and sleep disturbance in patients with FS. Adding a psychiatric evaluation to the treatment of patients with FS may be beneficial. Show more

Keywords: Frozen shoulder, sleep quality, pain, anxiety, depression, quality of life

DOI: 10.3233/BMR-171010

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-5, 2018

Authors: Büyükavcı, Raikan | Aktürk, Semra | Sağ, Sinem

Article Type: Research Article

Abstract: PURPOSE: The aim of this study was to compare platelet distribution width (PDW) and neutrophil to lymphocyte ratio (NLR) values in mild-to-moderate and severe knee osteoarthritis (OA). METHODS: This was a retrospective study of patients with knee OA according to the Kellgren-Lawrence (KL) grading system. Of 465 patients, 231 were excluded (62 due to not meeting the inclusion criteria and 169 due to the lack of simultaneous haemogram and radiographic evaluations). Demographic characteristics and PDW and NLR values were recorded. The patients were then divided into two groups: KL grade 1–3 (mild-to-moderate OA) and KL grade 4 …(severe OA). RESULTS: In severe knee OA patients, blood PDW (13.44 ± 2.58, p = 0.01) and NLR values (2.16 ± 0.84, p = 0.04) were elevated as compared with those in mild-to-moderate knee OA patients. Blood PDW and NLR values of ⩾ 12.5 and ⩾ 2.1, respectively, were taken as cut-offs based on a receiver operating characteristics (ROC) curve analysis. In the ROC curve analysis, blood NLR ⩾ 2.1 had 60% sensitivity and 64.8% specificity, and PDW ⩾ 12.5 had 61% sensitivity and 58% specificity in predicting severe knee OA. In a univariate analysis, age (p < 0.001), PDW ⩾ 12.5 (p = 0.029) and blood NLR ⩾ 2.1 (p = 0.030) emerged as significant predictors of the severe knee OA. CONCLUSION: The results suggested that the blood PDW and NLR are novel inflammatory markers that can predict the radiographic severity of knee OA in clinical practice. Show more

Keywords: Knee osteoarthritis, platelet distribution width, neutrophil to lymphocyte ratio, inflammatory marker

DOI: 10.3233/BMR-171028

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-5, 2018

Authors: Mitchell, Ulrike H. | Hurrell, Jennifer

Article Type: Research Article

Abstract: BACKGROUND : Between 2005 and 2015 significant changes in the clinical decision making paradigm for the treatment of spinal instability occurred. This was largely motivated by a clinical prediction rule (CPR) derivation study that was developed to specifically identify patients with low back pain who are more likely to respond positively to lumbar stabilization exercises. OBJECTIVE : This is a narrative literature review on the recent advances physiotherapy has made in the treatment of clinical spinal instability. METHODS: Literature discussing the conservative treatment of lumbar spinal instability published from 2005–2015 was identified with electronic searches …of PubMed (MEDLINE) Advanced search, Web of Science, BIOSIS Previews, MEDLINE (EBSCO), SportDISCUS (EBSCO), CINAHL (EBSCO), PEDro, Scopus and Cochrane and reviewed. RESULTS : Five systematic reviews, 2 with meta-analyses, and 1 systematic review on the quality of systematic reviews were found. There seems to be some benefit from specific stabilization exercise programs in regards to pain reduction, but they might not be more effective than other forms of exercise. The currently existing CPR for stabilization exercises is not far enough developed to use in clinical practice and is not validated as of yet. CONCLUSION : Stabilization exercises seem to decrease chronic low back pain, although it is not clear that this pain has to be caused by clinical spinal instability. Caution should be exercised when using CPRs in the clinic; they are not meant to be strict treatment guidelines, but rather a tool that helps facilitate clinical decision-making. Show more

Keywords: Stability, CPR, spine, lumbar, systematic review

DOI: 10.3233/BMR-181239

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-6, 2018

Authors: Park, So Hyun | Lee, Yun-Seob | Cheon, Song Hee | Yong, Min-Sik | Lee, Daehwan | Lee, Eun-Ju

Article Type: Research Article

Abstract: BACKGROUND: Many practitioners recommend step-up and step-down exercises to increase muscle strength in the lower extremities. However, decreased stability of the hip joint and imbalanced muscle activities can alter limb biomechanics during these movements. OBJECTIVE: This study investigated muscle imbalance between the medial and lateral muscle components and between the proximal and distal muscle components by expressing the proportions of muscle activation in the step-up and step-down positions. METHODS: Nineteen subjects participated in the study. Activity of the vastus medialis oblique, vastus lateralis, semitendinosus, biceps femoris, adductor, gluteus medius, and gluteus maximus was …assessed. RESULTS: The semitendinosus-biceps femoris ratio was higher in the step-down position than in the step-up position. The adductor-gluteus medius, adductor-vastus lateralis, and adductor-biceps ratios were higher in the step-up position than in the step-down position. The gluteus maximus-biceps ratio was greater in the step-down position than in the step-up position. In the hip joint, internal rotation was significantly greater in the step-up position. CONCLUSIONS: The transverse angle of the hip joint has a greater effect on the medial-lateral balance of the muscles surrounding the hip joint. Muscle activation in the medial hamstring is greater in the step-down position; in the adductor, muscle activation is greater in the step-up position. The step-down position is more appropriate for those with proximal weakness, as it can promote muscle activation in the gluteus maximus while maintaining biceps femoris activation. Show more

Keywords: Hip joint, muscle activities, step-up, step-down

DOI: 10.3233/BMR-160779

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-5, 2018

Authors: Kim, Seon-Chil | Lee, Byoung-Kwon | Kim, Chang-Yong

Article Type: Research Article

Abstract: BACKGROUND: The Republic of Korea has become the most rapidly aging society and is anticipated to enter the post-aged society in 2026. As the population ages, demand for senior-friendly products has gradually increased. Under the demands for these circumstances, usability evaluation aimed to make these products more competitive in terms of quality has been perceived as a critical means. In particular, ergonomically wrong-designed products could prove fatal to elderly people. OBJECTIVE: The purpose of the study is to develop qualitative usability evaluation criteria of communication service robot, one of the senior-friendly products, for elderly people. …METHODS: To develop the usability testing criteria of a communication service robot for elderly people. The following was carried out: product selection, selection of target product, development of leading indicators, correction by experts, and preliminary evaluation according to the scenario and development of core indicators. For this, a draft questionnaire was developed for the elderly at around age 60. After small group tests and interviews, the experts modified the initial draft to the usability evaluation criteria of communication service robot for elderly people. RESULTS: Development indicators include four subscales: safety, controllability, efficiency, and satisfaction. All the subscales passed the reliability criteria by four groups of elderly people, divided by gender and the familiarity witth smart move devices. CONCLUSIONS: Development indicators cover a wider area of user experiences of the communication service robot and are a good measurement tool to help both the users and developers of the service robot for elderly people. Show more

Keywords: Communication service robot, elderly people, senior-friendly products, usability evaluation, user

DOI: 10.3233/BMR-169665

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-7, 2018

Authors: Em, Serda | Karakoc, Mehmet | Sariyildiz, Mustafa Akif | Bozkurt, Mehtap | Aydin, Abdulkadir | Cevik, Remzi | Nas, Kemal

Article Type: Research Article

Abstract: BACKGROUND: Diseases causing disabilities lead to sexual dysfunction. However, studies that evaluate sexual functions in patients with traumatic lower limb amputations (LLA) are limited and controversial. OBJECTIVE: The objective is to evaluate sexual functions in male patients with LLA and to identify factors that might contribute to sexual dysfunction. The hypothesis is that male patients with LLA would experience worse sexual and emotional functioning and consequently emotional impairment that consequently influenced the sexual function. METHODS: Sixty men with traumatic LLA and 60 healthy men were assessed according to the international index of erectile function …(IIEF) scoring system. Emotional state was assessed by the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI), and the quality of life by the Short Form-36 Health Survey (SF-36). RESULTS: Patients had significantly lower scores in the IIEF total score and subscores in comparison with the controls. Intercourse satisfaction scores were significantly higher (p < 0.05) in patients with trans-tibial amputation than in those with trans-femoral amputation. BDI and BAI scores negatively correlated with erectile function, sexual desire, intercourse satisfaction, overall satisfaction and total IIEF scores. The mental and physical scores of SF-36 significantly correlated with some of the sub scores and IIEF total scores. The power of statistical analysis for study population was 100% according to the given effect size (α = 0.01). CONCLUSION: The present study suggests that the LLA leads to impairments in the sexual function and quality of life in male patients. Also, sexual dysfunction in patients is strongly associated with emotional state, pain, level of amputation and quality of life. Show more

Keywords: Amputation, lower extremity, sexuality, emotional state, quality of life

DOI: 10.3233/BMR-170873

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2018

Authors: Saleh, Marwa Shafiek Mustafa | Botla, Afaf Mohamed Mahmoud | Elbehary, Noran Ahmed Mohammed

Article Type: Research Article

Abstract: BACKGROUND: Core stability exercises have been widely advocated for management of patients with different musculoskeletal conditions, even though its effect on postpartum lumbopelvic pain (LPP) has not been fully investigated. OBJECTIVE: This study was conducted to investigate the effect of core stability exercises on postpartum LPP. METHODS: Thirty four women suffering from postpartum LPP were randomly assigned to the study or control group. The control group (n = 17) received infrared radiation and continuous ultrasound on lumbosacral region (L1-S5), whereas the study group (n = …17) received core stability exercises in addition to infrared radiation and continuous ultrasound three sessions a week for six weeks. Pain Pressure Threshold (PPT), Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were assessed for all participants in both groups before and after the treatment program. RESULTS: There was a significant improvement in PPT, VAS and ODI post-treatment compared with the pre-treatment in both groups (p = 0.001). There was a significant improvement in participants who received core stability exercises as compared to participants treated with the traditional treatment in PPT (P = 0.001), VAS (P = 0.001) and ODI (P = 0.009). CONCLUSIONS: Core stability exercises in addition to conventional treatment significantly decreased pain and improved function for women with postpartum LPP. Show more

Keywords: Core stability exercises, low back pain, pelvic pain, postpartum lumbopelvic pain

DOI: 10.3233/BMR-181259

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2018