Journal of Back and Musculoskeletal Rehabilitation - Volume 34, issue 6

Authors: Soer, Remko

Article Type: Editorial

DOI: 10.3233/BMR-215005

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 6, pp. 903-904, 2021

Authors: Huang, Liyi | Zhang, Qing | Fu, Chenying | Liang, Zejun | Xiong, Feng | He, Chengqi | Wei, Quan

Article Type: Research Article

Abstract: BACKGROUND: The effects of hyperbaric oxygen therapy (HBO) for spinal cord injury (SCI) are controversial. OBJECTIVE: The purpose of this study was to evaluate the effects of HBO therapy on motor function, sensory function, and psychology after SCI. METHOD: We searched the following databases: Medline, Embase, PubMed, Ovid, Cochrane library, China National Knowledge Infrastructure (CNKI), Wan Fang, and VIP up to May 2020. We included Randomized Controlled Trials (RCTs) which investigated patients with SCI received HBO during hospitalization. Motor function, sensory function, and psychology status were measured by commonly used scales including American …Spinal Injury Association (ASIA) motor score, Modified Barthel Index (MBI), ASIA sensory score, Hamilton Depression Scale (HAMD), and Hamilton Anxiety Scale (HAMA). We performed a meta-analysis by calculating mean difference (MD) to determine the effect of HBO on three levels of function on patients with SCI. We evaluated heterogeneity by I 2 test, and I 2 > 50% was significant. RESULTS : A total of 1746 studies were identified initially, and 11 studies were included, involving 875 participants. HBO therapy significantly improved the ASIA motor score (MD 15.84, 95% CI 9.04 to 22.64, I 2 = 87%). Six trails suggested that HBO therapy statistically promoted ASIA sensory score (MD 66.30, 95% CI 53.44 to 79.16, I 2 = 95%). The other four trails suggested that HBO therapy statistically increased the light touch score (MD 9.27, 95% CI 3.89 to 14.65, I 2 = 91%) and needling score (MD 10.01, 95% CI 8.60 to 11.43, I 2 = 95%), respectively. HBO therapy was implicated in the significant improvement of MBI (MD 13.80, 95% CI 10.65 to 16.94, I 2 = 0%). HBO therapy also decreased the HAMA (MD - 2.37, 95% CI - 2.72 to - 2.02, I 2 = 0%) and HAMD (MD - 3.74, 95% CI - 5.82 to - 1.65, I 2 = 90%). CONCLUSIONS: HBO therapy may improve motor function, sensory function and psychology after SCI compared to conventional treatments. More high-quality, large sample size RCTs are needed to support these perspectives. Show more

Keywords: Spinal cord injury (SCI), hyperbaric oxygen (HBO), ASIA, motor function, sensory function, psychology, depression, anxiety, activities of daily living, meta-analysis

DOI: 10.3233/BMR-200157

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 6, pp. 905-913, 2021

Authors: Negrini, Francesco | de Sire, Alessandro | Lazzarini, Stefano Giuseppe | Pennestrì, Federico | Sorce, Salvatore | Arienti, Chiara | Vitale, Jacopo Antonino

Article Type: Review Article

Abstract: BACKGROUND: Activity monitors have been introduced in the last years to objectively measure physical activity to help physicians in the management of musculoskeletal patients. OBJECTIVE: This systematic review aimed at describing the assessment of physical activity by commercially available portable activity monitors in patients with musculoskeletal disorders. METHODS: PubMed, Embase, PEDro, Web of Science, Scopus and CENTRAL databases were systematically searched from inception to June 11 th , 2020. We considered as eligible observational studies with: musculoskeletal patients; physical activity measured by wearable sensors based on inertial measurement units; comparisons …performed with other tools; outcomes consisting of number of steps/day, activity/inactivity time, or activity counts/day. RESULTS: Out of 595 records, after removing duplicates, title/abstract and full text screening, 10 articles were included. We noticed a wide heterogeneity in the wearable devices, that resulted to be 10 different types. Patients included suffered from rheumatoid arthritis, osteoarthritis, juvenile idiopathic arthritis, polymyalgia rheumatica, and fibromyalgia. Only 3 studies compared portable activity trackers with objective measurement tools. CONCLUSIONS: Taken together, this systematic review showed that activity monitors might be considered as useful to assess physical activity in patients with musculoskeletal disorders, albeit, to date, the high device heterogeneity and the different algorithms still prevent their standardization. Show more

Keywords: Fitness trackers, activity monitors, physical activity, exercise, musculoskeletal diseases

DOI: 10.3233/BMR-200348

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 6, pp. 915-923, 2021

Authors: Ferrillo, Martina | Curci, Claudio | Roccuzzo, Andrea | Migliario, Mario | Invernizzi, Marco | de Sire, Alessandro

Article Type: Review Article

Abstract: BACKGROUND: Radiographic methods to assess skeletal maturity (SM) have a key role in adolescent idiopathic scoliosis (AIS) management, allowing to predict risk of spinal curve progression. Cervical vertebral maturation (CVM) has been recently introduced as an alternative tool to assess skeletal maturity; however, its clinical role is still debated. OBJECTIVE: This systematic review aimed to investigate the reliability of CVM in the SM assessment of growing subjects, comparing it to hand wrist maturation (HVM). METHODS: PubMed, Scopus, and Web of Science databases were systematically searched from inception until 31 st …December 2020 to identify observational studies presenting: growing subjects as participants; CVM methods as intervention; HVM methods as comparator; reliability for SM assessment as outcome. A 10-item quality tool has been used to assess study quality. RESULTS: Out of 205 papers, 12 papers were included in the data synthesis. We classified 10 studies (83.3%) as medium-quality studies and 2 studies (16.7%) as high-quality studies. Eight studies reported a significant correlation between CVM Baccetti and different HWM methods. CONCLUSION: Taken together, these findings suggested that CVM might be considered as reliable SM assessment method compared to HWM in growing subjects. However, further studies are warranted to confirm these findings. Show more

Keywords: Growth and development, scoliosis, age determination by skeleton, spine, radiology

DOI: 10.3233/BMR-210003

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 6, pp. 925-936, 2021

Authors: Forbes, A. | Cantin, V. | Develle, Y. | Dubé, Y. | Bertrand-Grenier, A. | Ménard-Lebel, C. | Sobczak, S.

Article Type: Brief Report

Abstract: BACKGROUND: There is no non-invasive in vivo method to assess intervertebral kinematics. Current kinematics models are based on in vitro bone reconstructions from computed tomography (CT)-scan imaging, fluoroscopy and MRIs, which are either expensive or deleterious for human tissues. Musculoskeletal ultrasound is an accessible, easy to use and cost-effective device that allows high-resolution, real-time imaging of bone structure. OBJECTIVE: The aim of this preliminary study was to compare the concordance of 3D bone modeling of lumbar vertebrae between CT-scan and ultrasound imaging and to study the intra and inter-reliability of distances measured on 3D …ultrasound bone models. METHODS: CT-scan, ultrasound, and in situ data of five lumbar vertebrae from the same human specimen were used. All vertebrae were scanned by tomography and a new musculoskeletal ultrasound procedure. Then, 3D bone modeling was created from both CT-scan and ultrasound image data set. Distances between anatomical bones landmarks were measured on the 3D models and compared to in situ measurements. Show more

DOI: 10.3233/BMR-200259

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 6, pp. 937-950, 2021

Authors: Kim, Da-Sol | Jo, Nam-Gyu | Kim, Gi-Wook

Article Type: Case Report

Abstract: BACKGROUND: Paralabral cysts are a rare cause of shoulder pain. Linear ultrasound transducers are often used for musculoskeletal evaluation and intervention. However, the use of linear transducer is limited when the target structure is located deep and blocked by bony barriers, as is the case of paralabral ganglion cysts. OBJECTIVE: This case report aims to describe a beneficial role of using a convex transducer on the evaluation and ultrasonography-guided intervention of paralabral cysts below the acromion. CASE DESCRIPTION: Two patients visiting the outpatient clinic of Physical Medicine and Rehabilitation complained of severe pain …during shoulder movement. Ultrasound scans with linear transducer detected rotator cuff lesions. Shoulder magnetic resonance imaging was done because of the persistent pain despite therapeutic interventions for the rotator cuff lesion, and confirmed paralabral cysts. Although a linear array transducer could not visualize the cystic lesion but could only perform suprascapular nerve block and intra-articular injection, the use of a convex array transducer improved the visualization of the cystic lesion which we treated using ultrasound-guided aspiration and intra-cystic injection. Visual analog scale and Shoulder Pain and Disability Index were checked to assess the treatment effect of each intervention. The intra-cystic injection with aspiration and intra-articular injection showed minimal to moderate improvement of pain score. CONCLUSION: In pain related to shoulder movement, especially pain that continues despite appropriate treatment for rotator cuff lesions, ultrasound diagnosis of paralabral ganglion cysts using convex transducers will improve the diagnostic value and accuracy of intervention. Show more

Keywords: Shoulder pain, ultrasonography, ganglion cysts, transducers

DOI: 10.3233/BMR-200281

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 6, pp. 951-956, 2021

Authors: Du, Shenxing | Wei, Lihong | He, Bangjian | Fang, Zhen | Zhou, Eryuan | Ma, Xiaoxiao | Li, Ju

Article Type: Research Article

Abstract: OBJECTIVE: The aim of the study was to identify the efficacy of dynamic fixation using rigid tape (RT) in rehabilitation after surgery of terrible triad injury of the elbow (TTIE). METHODS: Sixty patients who underwent surgery of TTIE were equally randomly divided into RT group and hinged external fixation brace (HEFB) group. Dynamic fixations were applied for 8 weeks. General rehabilitation programs were performed for 3 months, 5 times a week. Follow-up (FU) was at six months. Main outcomes included pain (Visual Analogue Scale, VAS), muscle strength, range of motion (ROM), Elbow Function (Mayo Elbow Performance Index, …MEPI), Quality of Life (QOL) (Short Form 36 Questionnaire, SF-36). RESULTS: There were significant time x group interactions for pain, ROM, MEPI, SF-36 (all p = 0.000), which demonstrated positive efficacy of both the two interventions. Difference at each time-point (except for baseline) of pain and ROM between the two groups was statistically significant (all p < 0.05). Some differences between the two groups were not statistically significant which at 14d on MEPI (p = 0.108) and at 21d (p = 0.259) and FU (p = 0.402) on QOL. Moreover, the increased muscle strength at each time-point had no statistically significant difference between the two groups (all p > 0.05). CONCLUSIONS: Both RT and HEFB could significantly improve the postoperative functional outcomes of the TTIE. However, early rehabilitation intervention could increase pain, which affected the corresponding function (MEPI) and QOL. Note that this kind of impact was short-term and reversible. The muscle strength and ROM were not affected by the increased severe pain, maintaining a trend of improvement. In addition, the subjects in the RT group improved faster and more efficiently and had better results with pain, ROM, MEPI, and QOL compared to the subjects in the HEFB group. Show more

Keywords: Orthopedic fixation devices, athletic tape, braces, rehabilitation, elbow

DOI: 10.3233/BMR-200279

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 6, pp. 957-964, 2021

Authors: You, Dokyoung S. | Ziadni, Maisa S. | Cooley, Corinne E. | Talavera, David C. | Mackey, Sean C. | Poupore-King, Heather

Article Type: Brief Report

Abstract: BACKGROUND : Randomized clinical trials (RCT) suggest a multidisciplinary approach to pain rehabilitation is superior to other active treatments in improving pain intensity, function, disability, and pain interference for patients with chronic pain, with small effect size (ds = 0.20–0.36) but its effectiveness remains unknown in real-world practice. OBJECTIVE: The current study examined the effectiveness of a multidisciplinary program to a cognitive and behavioral therapy (pain-CBT) in real-world patients with chronic back pain. METHODS: Twenty-eight patients (M 𝑎𝑔𝑒 = 57.6, 82.1% Female) completed a multidisciplinary …program that included pain psychology and physical therapy. Eighteen patients (M 𝑎𝑔𝑒 = 58.9, 77.8% Female) completed a CBT-alone program. Using a learning healthcare system, the Pain Catastrophizing Scale, 0–10 Numerical Pain Rating Scale, and Patient-Reported Outcomes Measurement Information System ® measures were administered before and after the programs. RESULTS: We found significant improvement in mobility and pain behavior only after a multidisciplinary program (p ’s < 0.031; d = 0.69 and 0.55). We also found significant improvement in pain interference, fatigue, depression, anxiety, social role satisfaction, and pain catastrophizing after pain-CBT or multidisciplinary programs (p ’s < 0.037; d s = 0.29–0.73). Pain ratings were not significantly changed by either program (p ’s > 0.207). CONCLUSIONS: The effect of a multidisciplinary rehabilitation program observed in RCT would be generalizable to real-world practice. Show more

Keywords: Chronic back pain, multidisciplinary program, cognitive and behavioral therapy, acceptance and commitment therapy, physical therapy, a learning health system

DOI: 10.3233/BMR-200305

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 6, pp. 965-973, 2021

Authors: Tamura, Akihiro | Akasaka, Kiyokazu | Otsudo, Takahiro | Igarashi, Hitomi | Yoshida, Saori

Article Type: Research Article

Abstract: BACKGROUND: Low back pain (LBP) is a common complaint and preventive measures should be considered immediately. In addition, asymmetrical trunk motion, which occurs due to repetitive motion upon performing daily activities, may be one of the biomechanical factors to cause LBP. OBJECTIVE: To investigate the characteristics of asymmetrical trunk motion in women with a history of LBP. METHODS: Thirty-four women were dichotomously categorized into either the LBP or non-LBP group. Trunk active range of motion (RoM) upon sitting and standing were measured via a three-dimensional motion analysis system. Each RoM and rotation and …side-flexion asymmetries were calculated and an unpaired t -tests were used to identify differences between each group. RESULTS: Trunk rotation asymmetry upon sitting and standing position in LBP group was significantly greater than that in non-LBP group. Furthermore, trunk rotation angle upon sitting in LBP group was significantly larger than that in non-LBP group. CONCLUSIONS: The limited RoM and asymmetry of trunk rotation may be due to imposed repetitive mechanical stress on habitual excessive motion, including most asymmetrical movements. Our findings indicated that a small trunk rotation angle and asymmetrical trunk rotation may be useful parameters to predict LBP onset or other musculoskeletal conditions of the trunk. Show more

Keywords: Trunk, kinematic, range of motion, symmetric motion, prevention

DOI: 10.3233/BMR-181353

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 6, pp. 975-981, 2021

Authors: D’Elia, Giovanni | Meoni, Barbara | Paci, Matteo | Parretti, Filippo | Roselli, Giuliana | Bartolini, Marco | Miele, Vittorio

Article Type: Research Article

Abstract: BACKGROUND: Rotator cuff calcific tendinopathy (RCCT) is a very frequent and debilitating disease often treated with Ultrasound-guided percutaneous irrigation (UGPI) followed by physiotherapy. OBJECTIVE: A multicenter observational clinical study was designed to assess the effects of physiotherapy after UGPI on the functional recovery of the shoulders of patients suffering from RCCT. METHOD: One hundred sixty-six patients (mean age 50.7± 7.6 years), 121 women, with painful RCCT were treated with UGPI and assessed at the day of UGPI (T0), and at one (T1), 3 (T2) and 6 (T3) months after treatment by …the Constant- Murley Score (CMS), Oxford Shoulder Scale (OSS) and Numerical Rating Scale (NRS). Patients were divided into 2 groups, Physiotherapy (PT+) and not Physiotherapy (PT-) according to the performance of the rehabilitation program based on personal decision. RESULTS: A significant improvement at T1 in all outcomes in both groups and between T1 and T3 for NRS during movement and OSS was found, but not for NRS at rest and CMS. There was no difference between groups for all outcome measures. In 27,1% of patients symptoms recurred in an average of 13 ± 8 weeks. CONCLUSIONS: Results suggest that post-UGPI not-standardized physiotherapy might not provide additional clinical benefits in short and medium term. Further studies could assess the effectiveness of physiotherapy performed after three months in patients with recurrence of pain. Show more

Keywords: Tendinopathy, shoulder, ultrasound, interventional, physiotherapy

DOI: 10.3233/BMR-191637

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 6, pp. 983-988, 2021