Journal of Back and Musculoskeletal Rehabilitation - Volume 36, issue 4

Authors: Haddas, Ram

Article Type: Editorial

DOI: 10.3233/BMR-235002

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 4, pp. 779-782, 2023

Authors: Xu, Anle | Huang, Qiangmin | Rong, Jifeng | Wu, Xuejiao | Deng, Meikui | Ji, Lijuan

Article Type: Review Article

Abstract: BACKGROUND: Ischemic compression is widely used to clinically treat neck pain. However, no meta-analysis has been conducted to evaluate the effects of this process on neck pain. OBJECTIVE: This study aimed to evaluate the effects of ischemic compression on the myofascial trigger points for improving neck pain-related symptoms (mainly pain, joint mobility limitation and function limitation) and to compare ischemic compression with other therapies. METHODS: Electronic searches were conducted in PubMed, OVID, Web of Science, EBSCO, SCOUPS, Cochrane Library, PEDro, Wanfang, CNKI and Chinese VIP Database in June 2021. Only randomised controlled trials …on the effects of ischemic compression on neck pain were included. The major outcomes were pain intensity, pressure pain threshold, pain-related disability and range of motion. RESULTS: Fifteen studies involving 725 participants were included. Significant differences were observed between ischemic compression and sham/no treatment group in pain intensity, pressure pain threshold and range of motion immediately and in the short term. Significant effect sizes of dry needling were observed over ischemic compression in terms of improving pain intensity (SMD = 0.62; 95% CI: 0.08 to 1.16; P = 0.02), pain-related disability (SMD = 0.68; 95% CI: 0.19 to 1.17; P = 0.007) and range of motion (MD = - 2.12; 95% CI: - 2.59 to - 1.65; P < 0.001) immediately after treatment. Dry needling also showed a significant small effect size for the short-term reduction of pain (SMD = 0.44; 95% CI: 0.04 to 0.85; P = 0.03). CONCLUSION: Ischemic compression can be recommended in the immediate and short-term pain relief and increase in the pressure pain threshold and range of motion. Dry needling is superior to ischemic compression in relieving pain and improving pain-related disability and range of motion immediately after treatment. Show more

Keywords: Pressure release, dry needling, myofascial pain syndromes, cervical pain, meta-analysis

DOI: 10.3233/BMR-220045

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 4, pp. 783-798, 2023

Authors: Urata, Ryunosuke | Igawa, Tatsuya | Ito, Shomaru | Suzuki, Akifumi

Article Type: Review Article

Abstract: BACKGROUND: The benefits of combining supervised exercise in the non-surgical treatment of lumbar spinal stenosis (LSS) is unclear. OBJECTIVE: To compare the effectiveness of non-surgical treatments with and without supervised exercise for pain intensity, symptom severity, functional impairment/disability, walking distance, and quality of life (QOL) in LSS patients. METHODS: Randomized controlled trials (RCTs) evaluating combinations of supervised exercises were searched using four electronic databases up to August 13, 2020. Meta-analysis was conducted for immediate and long-term results. RESULTS: Three studies were identified, including 244 participants. Immediate-term results showed that leg …pain intensity (mean distance [MD]: - 0.94, 95% confidence intervals [95% CI]: - 1.60 to - 0.29, p < 0.01) and symptom severity (MD: - 0.29, 95% CI: - 0.50 to - 0.08, p < 0.01) were lower in the study group than in the control group, and walking distance (MD: 415.83, 95% CI: 298.15 to 533.50, p < 0.001) and QOL were higher in the study group. Long-term results showed that functional disability/impairment (MD: - 0.27, 95% CI: - 0.49 to - 0.04, p < 0.05) was lower in the study group than in the control group, and walking distance and QOL were higher in the study group. CONCLUSION: The number of studies on this topic was small and limited. Combinations of non-surgical treatment and supervised exercise may not provide significant benefits. Show more

Keywords: Spinal stenosis, exercise therapy, systematic review as topic, meta-analysis as topic

DOI: 10.3233/BMR-220220

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 4, pp. 799-813, 2023

Authors: Lin, Yeyan | Wu, Yongqin | Zhou, Xuelai | Shen, Bin | Lv, Cunxian

Article Type: Research Article

Abstract: BACKGROUND: In the treatment of knee osteoarthritis (KOA), there is a need for the long-term use of therapeutic drugs that reduce joint pain and have fewer adverse effects. OBJECTIVE: This study aimed to investigate the therapeutic effect of bean pressing on ear points on early KOA pain. METHODS: One hundred patients with KOA recruited at the Wenzhou Hospital of Traditional Chinese Medicine between February 2019 and May 2022 were divided randomly into a treatment group (n = 50) and control group (n = …50). Patients in the treatment group received regular rehabilitation combined with auricular bean-pressing treatment, while patients in the control group only received conventional rehabilitation treatment. The measurement indicators – knee swelling, tenderness, range of motion sign score, C-reactive protein, and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) indexes – were recorded before and after treatment. RESULTS: On day 5 following the start of treatment, the visual analog scale (VAS) and WOMAC scores of the treatment group were significantly lower than those of the control group (P < 0.05), and the VAS and WOMAC scores in the treatment group after treatment were significantly lower than those before treatment (P < 0.05). At week 4 after the start of treatment, the dosage of nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment group was significantly lower than that in the control group (P < 0.05). No adverse events were observed during the treatment. CONCLUSIONS: Auricular bean-pressing therapy had an analgesic effect and could also alleviate mild to moderate KOA swelling, joint stiffness, and other symptoms, effectively reducing the demand for NSAIDs and improving both knee function and quality of life. The results suggested that auricular bean-pressing therapy has promising prospects in the treatment of early KOA pain. Show more

Keywords: Auricular bean pressing, knee osteoarthritis, pain, curative effect

DOI: 10.3233/BMR-220271

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 4, pp. 815-822, 2023

Authors: Gomes, Maryanne Martins | dos Santos Silva, Sandra Raquel | Padula, Rosimeire Simprini

Article Type: Research Article

Abstract: BACKGROUND: Low back pain is a highly prevalent musculoskeletal disorder that leads to functional incapacity and absence from work. OBJECTIVE: To analyze warehouse workers’ prevalence and factors associated with low back pain. METHODS: Cross-sectional study design with 204 male warehouse workers (stocker, separator, checker, and packer) from motor parts companies. Age, body mass, marital status, education, the practice of physical exercise, presence of pain, low back pain intensity, comorbidities, time away from work, handgrip strength, flexibility, and trunk muscle strength were collected and analyzed. Data are presented as mean, standard deviation, absolute and …relative frequency. A binary logistic regression was performed, with low back pain (yes or no) as the dependent variable. RESULTS: 24.0% of the workers reported low back pain with an average intensity of 4.7 (± 2.4) points. The participants were young, had completed high school education, were single and married, and had normal body weight. There was a more likely low back pain presence in separator tasks. Greater handgrip strength in the dominant (right) hand and trunk muscle is associated with no low back pain. CONCLUSION: Low back pain prevalence was 24% among young warehouse workers, more likely in separation tasks. A greater handgrip and trunk strength can be a protective factor to no low back pain. Show more

Keywords: Low back, work-related musculoskeletal disorders, occupational health, ergonomics

DOI: 10.3233/BMR-220035

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 4, pp. 823-829, 2023

Authors: Hwang, Ui-Jae | Kwon, Oh-Yun

Article Type: Research Article

Abstract: BACKGROUND: Electrical muscle stimulation (EMS) has been applied in many rehabilitation settings for muscle strengthening, facilitation of muscle contraction, re-education of muscle action, and maintenance of muscle strength and size during prolonged immobilization. OBJECTIVE: The purpose of this study was to investigate effect of 8 weeks of EMS training on abdominal muscle function and to determine whether the training effect could be maintained after 4 weeks of EMS detraining. METHODS: Twenty-five subjects performed EMS training for 8 weeks. Before and after 8 weeks of EMS training, and after 4 weeks of EMS detraining, …muscle size (cross-sectional area [CSA] of the rectus abdominals [RA] and lateral abdominal wall [LAW]), strength, endurance, and lumbopelvic control (LC) were measured. RESULTS: There were significant increases in CSA [RA (p < 0.001); LAW (p < 0.001)], strength [trunk flexor (p = 0.005); side-bridge (p < 0.05)], endurance [trunk flexor (p = 0.010); side-bridge (p < 0.05)], and LC (p < 0.05) after 8 weeks of EMS training. The CSA of the RA (p < 0.05) and the LAW (p < 0.001) were measured after 4 weeks of detraining and they were greater than that of the baseline. There were no significant differences in abdominal strength, endurance, and LC between baseline measurements and post-detraining. CONCLUSION: The study indicates that there is less of a detraining effect on muscle size than on muscle strength, endurance, and LC. Show more

Keywords: Abdomen, electric-stimulation, endurance, strength, hypertrophy

DOI: 10.3233/BMR-210335

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 4, pp. 831-843, 2023

Authors: Proskura, Patrycja | Rutkowska-Kucharska, Alicja | Sobera, Małgorzata

Article Type: Research Article

Abstract: BACKGROUND: Low back pain (LBP) in sedentary workers is an increasing problem. Hyperlordosis or hypolordosis of the lumbar spine may be one of the causes of LBP. Various exercise programs are used in the prevention of LBP, but they do not consider individualization for diagnosed hyperlordosis or hypolordosis of the lumbar spine. OBJECTIVE: The purpose of this study was to evaluate the effect of the authors’ original exercise program aimed at reducing hyperlordosis or increasing hypolordosis. METHODS: Sixty women aged 26 to 40 working in a sedentary position participated in the study. The …sagittal curvature and the range of motion of the lumbar spine flexion were measured with the Saunders inclinometer, and the level of LBP was evaluated using the VAS scale. Subjects were randomly divided into two groups that participated in a 3-month exercise program developed by the authors. The first group performed exercises adjusted to the diagnosed hyperlordosis or hypolordosis, and the second group performed the same exercises regardless of the lumbar lordosis angle. The study was conducted again after completing the exercises. RESULTS: There was a statistically significant difference between the groups (p < 0.0001) in the level of pain, with better results in the group where individualized exercise was used – 60% of the participants reported complete absence of LBP. The lumbar lordosis angle was within normal limits in 97% of the subjects in the first group, and in 47% of the subjects in the second group. CONCLUSION: The results of this study confirm the validity of using individualized exercises with regard to diagnosed hyperlordosis or hypolordosis of the lumbar spine in order to achieve better analgesic and postural correction effects. Show more

Keywords: Spinal disease, lordosis, kyphosis, flexibility, exercise therapy

DOI: 10.3233/BMR-210349

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 4, pp. 845-859, 2023

Authors: Subbarayalu, Arun Vijay | Idhris, Mohamed | Prabaharan, Sivasankar | Sakthivel, Muhil | Mohamed, Shahul Hameed Pakkir | Peter, Manuelraj | Anandraj, Spurgeon | Pandiyarajan, Anand | Farook, Mohammed Barkath Ali Mohammed | Pattukuthu, Abdurahiman

Article Type: Research Article

Abstract: BACKGROUND: Low back pain (LBP) is a common musculoskeletal condition that necessitates public health concerns. It also attracts considerable research interest among physiotherapists. OBJECTIVE: This study conducted a bibliometric analysis to reveal the affinity of Indian physiotherapists toward research on LBP using the Scopus database. METHODS: An electronic search was performed on December 23, 2020, using specific keywords. The data was downloaded in a Scopus plain text file (.txt) format and were analyzed using R studio (biblioshiny) software. RESULTS: Two hundred and thirteen articles concerning LBP published from 2003 to …2020 were retrieved from the Scopus database. Among those articles (N = 213), 85.45% (n = 182) were published between 2011 and 2020. An article published by “James SL (2018)” in the Lancet had the highest citation of 1439. The highest collaboration was between India and the United Kingdom, and India and the United States of America jointly accounted for 12.2% (n = 26) of the entire articles (N = 213). CONCLUSION: Indian physiotherapists have shown an interest through gradually increasing their research output on LBP since 2015. They contributed effectively to various journals and international collaboration. Nevertheless, there is room to improve the quality and quantity of LBP articles in high-quality journals, thereby enhancing the citation count. This study recommends improving the scientific output of Indian physiotherapists on LBP by expanding their international networks. Show more

Keywords: Bibliometrics, India, Low Back Pain, Physical therapists

DOI: 10.3233/BMR-210363

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 4, pp. 861-869, 2023

Authors: Chokphukiao, Pakwipa | Poncumhak, Puttipong | Thaweewannakij, Thiwabhorn | Intaruk, Roongnapa | Amatachaya, Sugalya

Article Type: Research Article

Abstract: BACKGROUND: Body composition decline, lower limb impairments, and mobility deficits affect independence of older people. The exploration for a practical measure involving upper extremities may offer an alternative tool to be used by primary healthcare (PHC) providers for these individuals. OBJECTIVE: To explore reliability and validity of seated push-up tests (SPUTs) among older participants when used by PHC providers. METHODS: Older participants (n = 146) with an average age of > 70 years were cross-sectionally assessed using various demanding forms of SPUTs and standard measures …to assess validity of the SPUTs. Reliability of the SPUTs were assessed in nine PHC raters, including an expert, health professionals, village health volunteers, and care givers. RESULTS: The SPUTs demonstrated very good agreement, with excellent rater and test-retest reliability (kappa values > 0.87 and ICCs > 0.93, p < 0.001). Moreover, the SPUT outcomes significantly correlated with lean body mass, bone mineral contents, muscle strength and mobility of older participants (r , r p ⁢ b = - 0.270 to 0.758, p < 0.05). CONCLUSION: SPUTs are reliable and valid for older adults when used by PHC members. The incorporation of such practical measures is particularly important during this COVID-19 pandemic with limited people’s hospital access. Show more

Keywords: Clinical measure, community service, caregiver, primary healthcare, mobility

DOI: 10.3233/BMR-220040

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 4, pp. 871-882, 2023

Authors: Melo, Ana S.C. | Vilas-Boas, J. Paulo | Cruz, Eduardo B. | Macedo, Rui M. | e Ferreira, Sílvia B. | Sousa, Andreia S.

Article Type: Research Article

Abstract: BACKGROUND: Scapular muscles changes, as increased upper trapezius activity and decreased middle and lower trapezius and serratus anterior muscle activity, have been demonstrated in shoulder pain specific or non-specific conditions. Shoulder external rotation exercises have been recommended to improve scapular activity in shoulder pain. OBJECTIVE: To evaluate the relative scapular muscles activity during multi-joint exercises combining shoulder external rotation, trunk rotation and scapular squeeze. METHODS: Forty-one participants with and without shoulder pain were assessed in a cross-sectional study. They performed isometric multi-joint exercises at 0 ∘ and 90 ∘ …of shoulder abduction with and without support. The relative activity of upper, middle, and lower trapezius and serratus anterior (upper/middle and lower portions) was measured through electromyography. The scapular muscular balance was assessed by the ratio between relative activity of the upper trapezius and the other muscles. RESULTS: Both groups presented similar results. The exercise at 90 ∘ abduction led to increased relative muscle activity against maximal voluntary contraction in both groups for upper trapezius (with support: 4% MVIC, p = 0.001 or 15% MVIC, p < 0.0001; and without support: 11% MVIC, p < 0.0001 or 13%, p < 0.0001, for asymptomatic and symptomatic group, respectively) and lower trapezius (with support: 66% MVIC, p < 0.0001 or 62% MVIC, p < 0.0001, for asymptomatic and symptomatic group, Show more

DOI: 10.3233/BMR-220056

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 4, pp. 883-893, 2023