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

Authors: Farì, Giacomo | Santagati, Dario | Macchiarola, Dario | Ricci, Vincenzo | Di Paolo, Stefano | Caforio, Laura | Invernizzi, Marco | Notarnicola, Angela | Megna, Marisa | Ranieri, Maurizio

Article Type: Research Article

Abstract: BACKGROUND: Surf practice contributes to overuse injuries and musculoskeletal pain. Relationship between the type of surfing practiced and the onset of pain is not fully understood as well as the potential role of rehabilitation in preventing it. OBJECTIVE: To investigate musculoskeletal pain and to deepen whether the age and the anatomical region involved influenced the pain appearance in relation to four surfing disciplines. METHODS: A cross-sectional study was carried out. An online survey was addressed to a group of Italian surfers (practicing surf, kitesurf, windsurf and stand up paddle since at least 1 …year), collecting demographic data, discipline practiced, location of musculoskeletal pain. RESULTS: One hundred and twenty-six surfers were involved in the study. Spine and upper limbs pain was more frequent compared to lower limbs one in the surf (p < 0.001) and in the windsurf groups (p = 0.007). In the kitesurf group a greater prevalence of pain was observed in spine and lower limbs compared to upper limbs (p = 0.017). Low back pain is the most represented among the spine pain subgroups (p < 0.001). Pain was lower in younger athletes (p = 0.007). CONCLUSIONS: Understanding risk factors and biomechanics of musculoskeletal pain is essential to realize prevention training strategies. Rehabilitation in sinergy with specific training allows pain-free activity, optimizing its overall health benefits. Show more

Keywords: Surf, water board sports, epidemiology, injury

DOI: 10.3233/BMR-210191

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-7, 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: Kurzeja, Piotr | Ogrodzka-Ciechanowicz, Katarzyna | Prusak, Jarosław | Szurmik, Tomasz

Article Type: Research Article

Abstract: BACKGROUND: The gold standard in the clinical assessment of the extent of scoliosis is the Cobb method but the analysis also covers the changes that occur within the spine and trunk in relation to the transverse and sagittal planes. OBJECTIVE: The study aimed to estimate changes in the sagittal plane of the spine in girls with right-sided thoracic adolescent idiopathic scoliosis. METHODS: The study involved 29 girls with scoliosis (13.6 ± 0.6 years) and 36 healthy girls as the comparison group. The tests included an interview, clinical examination (with the …use of Adam’s test and the Cobb angle), and examination of shape of the spine surface with the use of the photogrammetric method and the projection moire effect. RESULTS: Lower values of the thoracic kyphosis parameters were found in the scoliosis group. Significant differences were noted for the parameters of the lumbosacral section α (p = 0.02), thoracolumbar section β (p < 0.001), the upper thoracic section γ (p < 0.001), thoracolumbar and upper thoracic section β + γ (p < 0.001) and the total size of α + β + γ (p < 0.001) curvatures. CONCLUSIONS: The study showed that with an increase in the angular value of the thoracic curvature, the thoracic kyphosis decreased. Show more

Keywords: Idiopathic scoliosis, moire topography, spine

DOI: 10.3233/BMR-210206

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 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: Schmalzl, Jonas | Walter, Helen | Rothfischer, Wolfram | Blaich, Sören | Gerhardt, Christian | Lehmann, Lars-Johannes

Article Type: Research Article

Abstract: BACKGROUND: Adaptations in glenohumeral range of motion may affect overhead athletes and lead to shoulder pathologies. OBJECTIVE: The purpose of this study was to evaluate glenohumeral internal rotation deficit (GIRD) and postero-superior impingement among male handball and volleyball players and the relationship between these pathologies and training level (amateur vs. professional), position (attack vs. no attack), experience (> 5 years vs. < 5 years) and sports. METHODS: Sixty-seven handball players and 67 volleyball players with a mean age of 25 [± 5] years were …included. The range of motion including external and internal rotation in 90 ∘ abduction of the dominant and non-dominant shoulder was measured of each examined athlete. Visual analogue scale, disabilities of the shoulder and hand score, constant score and subjective shoulder value were recorded. The athletes were examined for postero-superior impingement and abduction force was measured with an isokinetic dynamometer. RESULTS: Internal rotation was significantly lower and external rotation was significantly greater in the dominant arm for both sports. 72% presented with GIRD. GIRD was more prevalent in athletes active for > 5 years (odds ratio (OR) 3), in those training > 3 times per week (OR 1.4) and in handball players (OR 2.7). 24% presented with postero-superior impingement. Players active for > 5 years (OR 1.22), professionals (OR 1.14), volleyball players (OR 1.19), offensive players (OR 2.2) and athletes with GIRD > 10 ∘ (OR 1.5) showed a higher prevalence of postero-superior impingement. CONCLUSION: GIRD is a common phenomenon in handball and volleyball players. Offensive players are frequently suffering from postero-superior impingement. GIRD > 10 ∘ leads in nearly 75% of the athletes to a decrease of total range of motion and a high rate of postero-superior impingement. Thus, a decreased range of motion seems to be the turning point from adaptation to pathology. Therefore, regular controls of range of motion and countermeasures by means of stretching the posterior shoulder joint should be integrated in the training content. Show more

Keywords: GIRD syndrome, internal impingement, handball, volleyball, glenohumeral internal rotation deficit, SLAP lesion

DOI: 10.3233/BMR-191767

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

Authors: Solmaz, Ilker | Orscelik, Aydan | Koroglu, Ozlem

Article Type: Research Article

Abstract: BACKGROUND: Prolotherapy (PrT) is an increasingly popular regenerative injection treatment for the management of musculoskeletal injuries. The diagnostic injection is a method for selecting suitable patients to apply PrT using subcutaneous 5% dextrose solution. OBJECTIVE: The study aims to assess the PrT usage and modifications in the treatment of chronic low back pain and lumbar disc herniation and to define diagnostic injection procedure for PrT. METHOD: Two thousand three hundred and eighty-two patients with low back pain or lumbar disc herniation were evaluated at the Traditional and Complementary Medicine Practice Center in Ankara, …Turkey. Six hundred fifty-four patients were included in the study. Diagnostic injections were performed on all patients who were thought to be eligible candidates for PrT indications. A 4-or-6 week interval was allowed between treatment sessions. RESULTS: Xix hundred and fifty-four patient treatments were completed. The Visual Analogue Scale (VAS) scores decreased to 5.1 ± 1.4 while 7.2 ± 1.1 before the diagnostic injection (p < 000.1). The VAS scores decreased from 7.2 ± 1.1 before the treatment to 0.9 ± 0.9 after 52 weeks of the treatment (p < 000.1). Thirty-four patients’ treatments resulted in poor clinical results (5.2%), and 620 of the patients’ pain improved (94.8%). CONCLUSION: PrT can be regarded as a safe way of providing a meaningful improvement in pain and musculoskeletal function compared to the initial status. Diagnostic injection is an easy way to eliminate patients and may become a favorite treatment modality. 5% dextrose is a more simple and painless solution for PrT and also has a high success. Show more

Keywords: Prolotherapy, chronic musculoskeletal pain, injection

DOI: 10.3233/BMR-191745

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

Authors: Pieri, Emanuela | Bonetti, Francesca | Pellicciari, Leonardo | Scipioni, Fabio

Article Type: Review Article

Abstract: BACKGROUND: Therapeutic exercise (TE) is recommended in multimodal treatment for patients with non-specific chronic back pain (cLBP). OBJECTIVE: The aim of this study is to identify an exercise or a spectrum of exercises, well described and reproducible by the clinician, for cLBP patients. METHODS: Systematic review by researching in the databases MEDLINE, EMBASE, PEDro, CINAHL, and Scopus. Evidence from Randomized Controlled Trials (RCTs) supported the TE in patients with non-specific cLBP, provided that it was well described and could be repeated by another therapist. Methodological evaluation was performed using the PEDro scale and …only studies with a score of ⩾ 6 were included. The assessment of the intervention description was carried out with the TIDieR checklist. The risk of bias was examined. RESULTS: Twenty-one articles were included in this systematic review. The defective description and the poorly reporting of the intervention makes it more difficult for the clinician to include the TE into clinical practice. CONCLUSIONS: The findings of this study showed that the reporting of the intervention in high quality RCT on chronic low back pain is low, threatening the external validity of the results. Show more

Keywords: Randomized controlled trial, physical therapy modalities, exercise therapy, rehabilitation, low back pain

DOI: 10.3233/BMR-210179

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-14, 2021

Authors: Park, Ki Deok | Ryu, Jeong Won | Cho, Kyoung Rai | Park, Yongbum | Chung, Wook-Jin

Article Type: Research Article

Abstract: BACKGROUND: Ultrasound is increasingly being utilized in the diagnosis and treatment of adhesive capsulitis. OBJECTIVE: To compare the therapeutic effects and advantages of combined handheld ultrasound and fluoroscopy-guided intra-articular corticosteroid injection with those of conventional ultrasound-guided corticosteroid injection in adhesive capsulitis of the shoulder. METHODS: A total of 39 patients diagnosed with adhesive capsulitis of the shoulder were randomly assigned into two groups. Group A patients (n = 19) underwent combined handheld ultrasound and fluoroscopy-guided corticosteroid injection and group B patients (n = …20) underwent conventional ultrasound-guided corticosteroid injection to the intra-articular space of the shoulder twice. Treatment efficacy was assessed at 2 and 6 weeks after the final injection, based on the verbal numeric pain scale, Shoulder Pain and Disability Index, and range of motion. Secondary outcome measures were the accuracy and procedure time. RESULTS: Both injection methods were effective in the treatment of adhesive capsulitis. No significant differences in treatment efficacy and injection accuracy were observed between the two groups (p > 0.05). CONCLUSIONS: This study showed no statistical differences in treatment efficacy between 2 groups. However, the combined use of ultrasound and fluoroscopy can increase the accuracy of injection compared with conventional ultrasound alone. Show more

Keywords: Interventional ultrasound, frozen shoulder, intraarticular injection, fluoroscopy

DOI: 10.3233/BMR-210170

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

Authors: Naye, Florian | Décary, Simon | Tousignant-Laflamme, Yannick

Article Type: Research Article

Abstract: BACKGROUND: A framework to establish the biopsychosocial patient profile for persons with low back pain has been recently proposed and validated: The Pain and Disability Drivers Management model (PDDM). In order to facilitate its clinical integration, we developed the PDDM rating scale. OBJECTIVES: To determine the inter-rater agreement of the PDDM rating scale. A second objective was to determine if this inter-rater agreement varies according to the complexity of patients’ clinical presentation. METHODS: We recruited physiotherapists during workshops on the PDDM. We asked each participant to assess two clinical vignettes using the rating …scale. One vignette presented a typical clinical presentation (moderate level of difficulty) and one presented an atypical presentation (complex level of difficulty). We determined inter-rater agreement with the proportion of participants who gave the same answer for each PDDM domain. RESULTS: For the typical vignette, the inter-rater agreement per domain was moderate to good (between 0.54 and 0.97). For the complex vignette, the inter-rater agreement per domain was poor to good (between 0.49 and 0.81). The comparison between the two vignettes showed a significant difference (p < 0.01) for nociceptive and cognitive-emotional domains. CONCLUSION: Overall performance indicates that the rating scale present adequate agreement for clinical use, but specific domains require further development. Show more

Keywords: Low back pain, phenotype, rehabilitation, scale development, biopsychosocial, patient-centered care

DOI: 10.3233/BMR-210125

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