Journal of Back and Musculoskeletal Rehabilitation - Volume 26, issue 4

Authors: Tomkins-Lane, Christy C. | Battié, Michele C.

Article Type: Research Article

Abstract: Background: Identifying factors associated with walking capacity in people with lumbar spinal stenosis (LSS) may provide a better understanding of neurogenic claudication and inform future rehabilitation research. Objective: To examine factors associated with objectively measured walking capacity in a sample of people with LSS and self-reported walking limitations. Methods: Participants included 49 individuals (65.8 years ± 10) who were at least 45 years of age with clinically diagnosed lumbar spinal stenosis (LSS) confirmed on MRI or CT imaging. All participants completed a Self-Paced Walking Test with visual analog pain scales and body diagrams before and immediately …after walking. Questionnaires included the Physical Function and Symptom Severity Scales of the Swiss Spinal Stenosis Questionnaire, the Oswestry Disability Index (ODI) and the Health Utilities Index. Univariate linear relationships were examined, followed by development of a multivariate linear regression model with walking distance (m) as the dependent variable. A post-hoc analysis was also conducted including post-test symptom variables. Results: Variables retained from univariate analyses included years of leg pain, pre-test leg pain severity, the ODI, balance problems, and quality of life. When these variables were considered for a final model, only the ODI and balance problems were retained (R 2 = 0.33 ). Other than balance, none of the pre-test symptom variables entered into the final model. Post-hoc analysis including post-test symptom variables found the presence and severity of post-test leg pain to be most highly associated with walking distance. In an explanatory model considering the ODI, balance and these two post-walking factors, only presence of post-test leg pain added to the model (R 2 = 0.42 ). Conclusions: Factors found to be most highly associated with walking capacity in LSS were self-reported, pain-related function (ODI), balance problems, and presence of leg pain immediately following walking. Show more

Keywords: Spinal stenosis, walking, postural balance, pain

DOI: 10.3233/BMR-130390

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 26, no. 4, pp. 345-352, 2013

Authors: Masharawi, Youssef | Nadaf, Nedal

Article Type: Research Article

Abstract: Objective: The aim of this study was to investigate the effect of active non-weight-bearing (NWB) group exercising on women with non specific chronic low back pain (NSCLBP). Methods: Forty females with NSCLBP were assigned in a randomized control longitudinal single blinded pilot study. 20 of them were assigned to a NWB bi-weekly group exercise class and 20 females were included in the control group. The exercises involved the entire lumbo-pelvic spine aimed at improving lumbar mobility/flexibility and stability. Pain intensity (VAS), back specific disability (Rolland Morris questionnaire-RMQ), and lumbar flexion and extension ranges of motion measurements were taken …prior to intervention (t 0 ), immediately following 4 weeks of intervention (t 1 ) and 8 weeks later (t f u ). Reliability trials were conducted on 10 females. Non-parametric tests were used for statistical significance (p < 0.05 ). Results: The following significant changes in outcome measures were indicated at t 1 compared with t 0 and control group (p < 0.001 ): an increase in lumbar flexion and extension (mean difference=9.26° (+54%) for flexion and 5.95° for extension (+98%)); reduction in VAS score (mean difference=2.32 (+58%)) and RMQ score (mean difference=4.9 (−34%)). All changes remained significant at t f u . At t 0 , lumbar flexion was correlated with extension (r = 0.547 ) and VAS (r = − 0.581 ), whereas the RMQ score correlated with VAS score (r = 0.599 ) and negatively with lumbar extension (r = − 0.665 ). At t 1 , lumbar flexion correlated with extension (r = 0.664 ) and negatively with RMQ score (r = − 0.54 ). At t f u , changes in VAS score were negatively correlated with changes in lumbar flexion (r = − 0.522 ), while changes in lumbar flexion correlated with extension (r = 0.58 ). Conclusions: A functional program of NWB group exercising improves functional, painful status, lumbar flexion and extension ranges of motion in women suffering from NSCLBP. Show more

Keywords: Low back pain, NWB group exercising, Rolland Morris, VAS, lumbar flexion and extension

DOI: 10.3233/BMR-130391

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 26, no. 4, pp. 353-359, 2013

Authors: Ustun, N. | Erol, O. | Ozcakar, L. | Ceceli, E. | Ciner, O. Akar | Yorgancioglu, Z.R.

Article Type: Research Article

Abstract: Background: Sensitive muscle strength tests are needed to measure muscle strength in the diagnosis and management of sciatica patients. Objective: The aim of this study was to assess the isokinetic muscle strength in sciatica patients’ and control subjects’ ankles that exhibited normal ankle muscle strength when measured clinically. Methods: Forty-six patients with L5 and/or S1 nerve compression, and whose age, sex, weight, and height matched 36 healthy volunteers, were recruited to the study. Heel-walking, toe-walking, and manual muscle testing were used to perform ankle dorsiflexion and plantar flexion strengths in clinical examination. Patients with normal ankle …dorsiflexion and plantar flexion strengths assessed by manual muscle testing and heel-and toe-walking tests were included in the study. Bilateral isokinetic (concentric/concentric) ankle plantar-flexion-dorsiflexion measurements of the patients and controls were performed within the protocol of 30°/sec (5 repetitions). Peak torque and peak torque/body weight were obtained for each ankle motion of the involved limb at 30°/s speed. Results: L5 and/or S1 nerve compression was evident in 46 patients (76 injured limbs). Mean disease duration was two years. The plantar flexion muscle strength of the patients was found to be lower than that of the controls (p = 0.036 ). The dorsiflexion muscle strength of the patients was found to be the same as that of the controls (p = 0.211 ). Conclusions: Isokinetic testing is superior to clinical muscle testing when evaluating ankle plantar flexion torque in sciatica patients. Therefore, isokinetic muscle testing may be helpful when deciding whether to place a patient into a focused rehabilitation program. Show more

Keywords: Sciatica, manual muscle testing, isokinetic muscle testing

DOI: 10.3233/BMR-130392

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 26, no. 4, pp. 361-365, 2013

Authors: Baykara, Rabia Aydogan | Bozgeyik, Zulkif | Akgul, Ozgur | Ozgocmen, Salih

Article Type: Research Article

Abstract: Objectives: The aim of this study was to assess the point prevalence of low back pain (LBP) in patients with rheumatoid arthritis (RA); and to compare radiological and clinical aspects, as well as impact of LBP on health related quality of life (QoL), depression and disability in control patients with mechanical LBP (mLBP). Methods: Patients with RA and patients with mLBP of at least 3 months duration were consecutively recruited. All patients were examined and underwent lumbar X-ray and magnetic resonance (MR) imaging. Disc intensity, annulus fibrosis rupture, herniated nucleus pulposus (bulging, protrusion, extrusion or sequestration), stenosis, Schmorl …nodes, hemangiomas, Tarlov cysts, Type I or II degeneration, ligamentum flavum hypertrophy and loss of lordosis were assessed on MR. Assessments included QoL and disability scales like RAQoL, Short Form-36, Health Assessment Questionnaire (HAQ) and Oswestry Disability Index (ODI) and depression and anxiety scales as well. Results: Chronic LBP coexisted in 64.5% of patients with RA. Patients with LBP had higher scores on VAS-LBP compared to patients with RA+LBP. Additionally, patients with RA+LBP had the poorest scores on quality of life, functional disability and depression. Patients with mLBP had more frequent clinical manifestations and neurologic deficits. Patients with RA+LBP had more frequent Schmorl nodes compared to patients with mLBP. Conclusion: The association of RA with LBP leads to a significant decrease in the functional capacity and QoL as well as increase in depression risk. Appropriate diagnostic procedures and treatments should be administered to avoid further deterioration in functional disability and QoL. Show more

Keywords: Rheumatoid arthritis, low back pain, quality of life, magnetic resonance, disability

DOI: 10.3233/BMR-130393

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 26, no. 4, pp. 367-374, 2013

Authors: Otadi, Khadijeh | Hadian, Mohammad-Reza | Talebian, Saeed | Shadmehr, Azadeh | Emamdoost, Saeid | Shahriar, Gharibzadeh

Article Type: Research Article

Abstract: Background and Objectives: The aim of this study was to investigate the standing balance (with open and closed eyes) on rigid surface in women with myofascial neck pain syndromes. Material and Method: This study was carried out in single and double limbs stances, open versus closed eyes, and the results were compared with control group. Forty subjects (20 in each group) were tested on a force-platform, during 30 seconds. The mean velocity (cm/s), surface area (cm2), antero-posterior and medio-lateral displacements (cm) of center of foot pressure (COP) were determined. Results: There were significant differences between two …groups regarding the mean velocity and area of COP displacements. In addition, significant differences were observed in respect to eye and limb conditions (open versus closed; single versus double limbs stances; respectively) on mean velocity, area, antero-posterior (AP) and medio-lateral (ML) displacements of COP. Conclusion: Our results showed that myofascial neck pain syndrome might be one of the disturbing factors on standing balance. Show more

Keywords: Postural sway, myofascial neck pain syndrome, balance, vision

DOI: 10.3233/BMR-130395

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 26, no. 4, pp. 375-380, 2013

Authors: Hidalgo, Benjamin | Gobert, François | Bragard, Dominique | Detrembleur, Christine

Article Type: Research Article

Abstract: Background: Various inputs of proprioception have been identified and shown to influence low back proprioception sense. Objective: To investigate the effect of disrupting proprioception on lumbar spine repositioning error during forward bending. Method: Healthy-subjects (n = 28 ) and patients with non-specific chronic low-back pain (n = 10 ) aged between 20–50 years. Subjects performed 5 repetitions of a lumbar repositioning task targeting 30° of trunk-forward-bending from a seated-position with different proprioceptive disturbances administered to the low back. Video analysis of skin reflective markers measured lumbar spine range-of-motion. A control-task was performed without …any proprioceptive disturbance, while the remaining 4 tasks were electro-stimulation, vibration, taping and sitting on an unstable surface. Results: The healthy group showed significantly altered repositioning error when compared with the control task (p = 0.004 ): control-task vs. taping-task, vibration-task and unstable-sitting. In the NS-CLBP group, one motor-task showed significant difference in control-task vs. taping-task (p = 0.004 ). Comparison between the NS-CLBP and matched-healthy groups revealed that the NS-CLBP subjects had larger repositioning-error (p = 0.009 ) for control, taping and vibration tasks. Conclusions: Proprioceptive disturbances had the most significant effect in increasing repositioning-error among healthy subjects. The between-groups analysis confirmed evidence consistent with the literature of greater repositioning-error in people with NS-CLBP than healthy subjects. Show more

Keywords: Kinematics, low back pain, proprioception, repositioning error, spine

DOI: 10.3233/BMR-130396

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 26, no. 4, pp. 381-387, 2013

Authors: Obembe, Adebimpe Olayinka | Johnson, Olubusola Esther | Tanimowo, Tolulope Odunayo | Onigbinde, Ayodele Teslim | Emechete, Anne Anthonette

Article Type: Research Article

Abstract: Background and Objective: Musculoskeletal disorder is a significant health problem affecting adults and young people alike. The prevalence of musculoskeletal pain resulting from musculoskeletal disorders is on the increase especially with increased use of laptops. This study determined the prevalence of musculoskeletal pain among undergraduate students of Obafemi Awolowo University (OAU), Ile-Ife who use laptops. Material and Method: This was a cross-sectional study and participants were selected using the non-probability sampling technique. The Boston University Computer and Health Survey questionnaire was self-administered to 400 undergraduate laptop users. Data were analyzed using descriptive statistics of frequency and percentage. …Results: Three hundred and seventy six out of 400 copies of administered questionnaires were amenable to data analysis representing a response rate of 94%. Pain in the shoulder was the most reported musculoskeletal complaint from 268 (75.7%) participants. Elbow pain was the least common complaint from 132 (37.3%) participants. The prevalence of musculoskeletal pain was slightly higher among female students 93 (50.3%) of 185 and highest among students aged between 24 and 26 years: 60 (37.5%). In addition, the prevalence of musculoskeletal complaints was highest among those who used single-strap laptop bags 176 (94.1%). Conclusion: There is a high prevalence of musculoskeletal pain among undergraduate laptop users in OAU and shoulder pain was the most commonly reported. Show more

Keywords: Musculoskeletal, shoulder pain, laptop users

DOI: 10.3233/BMR-130397

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 26, no. 4, pp. 389-395, 2013

Authors: Chong, Timothy | Don, Darren W. | Kao, Ming-Chih | Wong, Dexter | Mitra, Raj

Article Type: Research Article

Abstract: Objective: To compare the sensitivity of physical examination (internal rotation of the hip) with radiographs (using the Kellgren-Lawrence grading scale) in the diagnosis of clinically significant hip osteoarthritis. Design: Case Series, Retrospective chart review of hip pain patients that underwent fluoroscopically guided hip steroid and anesthetic injections. Participants: 10 patients with hip pain patients seen at an academic outpatient center over a 2 year period were analyzed. Interventions: Fluoroscopically guided hip steroid and anesthetic injection. Main Outcome Measure: Pain relief and change in VAS pain score after intra-articular hip steroid and lidocaine …injection was the main outcome measure. Results: Based on Fisher’s exact test, there was no association between severity of radiographic hip arthritis and pain relief with intra-articular anesthetic/steroid injection (p = 0.45 ). Physical examination (provocative hip internal rotation) however was associated with a significant decrease in VAS pain score after intra-articular lidocaine and corticosteroid hip injection (p = 0.022 ). Conclusion: Simple hip radiographs alone are not sufficient to diagnose clinically significant hip osteoarthritis. Physical examination (hip internal rotation) was found to be more accurate than simple radiographs in the diagnosis of clinically significant hip osteoarthritis. Radiographs seem to best utilized when they are an extension of the physical examination and patient history. Show more

Keywords: Hip osteoarthritis, Kellgren-Lawrence, pain, radiographs

DOI: 10.3233/BMR-130398

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 26, no. 4, pp. 397-400, 2013

Authors: Ruhe, Alexander | Fejer, René | Walker, Bruce

Article Type: Research Article

Abstract: Introduction: Increased center of pressure excursions are well documented in patients with non-specific neck pain. While a linear relationship between pain intensity and postural sway has been described in low back pain patients, no such investigation has been conducted in adults with non-specific neck pain. Methods: Seventy patients with non-specific neck pain and a matching number of healthy controls were enrolled. Center of pressure parameters were measured by three static bipedal standing tasks of 90 sec duration each with eyes closed on a force platform. The pain intensity was assessed by a numeric rating scale (NRS), an equal …number of patients (n = 10 ) was enrolled per pain score. Results: The results confirmed an increased postural sway in pain sufferers compared to healthy controls. In addition, a significant and linear increase in postural sway was observed with higher pain ratings. Statistically significant changes in sway were reached with an incremental change in NRS scores of two to three points. Discussion and Conclusions: Mean velocity and sway area are closely related to self-reported pain scores in neck pain patients. This relationship has implications for clinical applications such as an objective monitoring tool for patients under treatment or rehabilitation. Show more

Keywords: Postural sway, center of pressure, force-plate, neck pain, pain intensity

DOI: 10.3233/BMR-130399

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 26, no. 4, pp. 401-409, 2013

Authors: Alipour, Akbar | Bodin, Lennart | Bergstrom, Gunnar | Jensen, Irene

Article Type: Research Article

Abstract: Objectives: To investigate the prospective value of the transitional and dynamic patterns of pain disability over time on sick leave in chronic recurrent back/neck pain cases. Methods: The material used was based on a longitudinal study with three repeated measurements. The graded Chronic Pain Scale was used to assess levels of pain disability. The relationship between the transitional patterns of the pain disability score (ten defined states of decrease, increase or no change, between two time points) and sick leave was analyzed for 909 chronic/recurrent cases in three different models using logistic regression. Results: Those with …high level of pain disability have a more transitional pattern and their pain level changed during the time period studied. When adjusting for age, gender, education and previous sick leave, the final model indicated that the current level of pain disability was a risk factor in taking sick leave. The likelihood of sick leave was highest in the transition of pain into the highest levels of disability, independent of past disability level of pain. Earlier sick leave remained as an important predictor of sick leave. Conclusions: From a clinical and prognostic perspective the probability of sick leave will be different and can be predicted based on previous sick leave but not from former history of pain disability level or its transitional pattern. Show more

Keywords: Back and neck pain, disability transition, sick leave

DOI: 10.3233/BMR-130400

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 26, no. 4, pp. 411-419, 2013

Authors: Linov, Lina | Klindukhov, Alexander | Li, Ling | Kalichman, Leonid

Article Type: Research Article

Abstract: Background and Objective: The association between facet orientation, tropism (asymmetry of the facet angles) and facet joint osteoarthritis (OA) has been previously reported, however, it is necessary to confirm the association in other samples. Our aim was to evaluate the association between facet orientation, tropism, and facet joint OA in an Israeli sample. Methods: One hundred and fifty low back and abdominal CTs of 82 males (mean age 61.74 ± 12.99) and 68 females (mean age 59.51 ± 11.74,) were evaluated in a cross-sectional study. Facet joint OA was evaluated at the L4–L5 spinal level using a 4-graded scale. …The association between facet joint OA, facet orientation and tropism was examined using multiple logistic regressions adjusted for age and sex. Results: Facet orientation showed a statistically significant association with facet joint OA on the right side (p = 0.009 ) and in a model where both sides were combined (p = 0.003 ). Facet joints with OA were more sagittally oriented. Tropism was not associated with facet joint OA on either side (p = 0.251 for right and 0.609 for the left side), or in a combination of both sides (p = 0.482 ). Conclusions: We confirm a significant association between sagittal orientation and OA of the lumbar facet joints at level L4–L5. Facet tropism was not associated with facet joint OA. Additional longitudinal studies are needed to understand the causal relationship between facet joint orientation and OA. Show more

Keywords: Lumbar spine, facet joints, osteoarthritis, facet orientation, facet tropism

DOI: 10.3233/BMR-130401

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 26, no. 4, pp. 421-426, 2013

Authors: Basat, Hande | Esmaeilzadeh, Sina | Eskiyurt, Nurten

Article Type: Research Article

Abstract: Background and Objective: The aim of this prospective, randomized controlled 6-month interventional trial was to investigate the effects of strengthening and high-impact exercise training on bone mineral density (BMD), bone turnover markers and health-related quality of life (HRQoL) in postmenopausal women. Material and Methods: Forty-two eligible postmenopausal women with osteopenia who referred to our outpatient clinics were included in the study and allocated equally to three groups receiving strengthening exercise, high-impact exercise or no exercise (control). The supervised training program consisted of a one-hour exercise session three times a week for six months. BMD at the L1–L4 and …femoral neck, serum bone turnover markers (osteocalcin, OC; N-telopeptides of type I collagen, NTx) and HRQoL were measured at the beginning and sixth months. Results: There was a significant increase in the BMD at the lumbar spine (p = 0.017 ) and femoral neck (p = 0.013 ) in the high-impact group compared to the strengthening and control groups. Serum OC (p = 0.033 ) increased, and NTx (p = 0.034 ) decreased significantly only in the high-impact group. HRQoL improved significantly in both training groups (p < 0.001 ). Conclusions: Our data suggest that 6-month supervised high-impact exercise training can be effective in prevention of bone loss at lumbar spine and femoral neck. These data also indicate that both supervised training programs improve HRQoL in postmenopausal women. Show more

Keywords: Postmenopausal women, exercise, bone metabolism, quality of life

DOI: 10.3233/BMR-130402

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 26, no. 4, pp. 427-435, 2013

Authors: Oncu, Julide | Iliser, Resat | Kuran, Banu

Article Type: Research Article

Abstract: Background and Objectives: It has been known that tender points detected by ACR 1990 criteria alone might not describe the essence of fibromyalgia, so preliminary diagnostic ACR 2010 criteria was developed. Since there has been no clear evidence exist examining the concordance rates and sensitivity to treatment of these two criteria comparatively, we aimed to shed light on this ambiguity. Matherial and Methods: One hundred patients with widespread pain were studied. Fulfillment of both criteria was determined at baseline, at 3th and 12th months. Sensitivity and specificity values were identified. The relationship between Fibromyalgia Impact Questionnaire and components …of two criteria was detected by pearson correlation. And the concordance rate was evaluated by kappa coefficient. Results: At the 1st visit (baseline), two criteria were concordant in 48.5% (n = 49 ) of cases (κ = 0.43 [ 95 % CI .0.22 , 0.58 ] ). However, the concordance was present in only 25(25%) of the subjects (κ = 0.29 [ 95 % CI : 0.12 , 0.36 ] ) at the end of the study. After 1 year of follow-up, the sensitivity of ACR 2010 was higher than that of ACR 1990 (0.88; 0.56 respectively) (p < 0.05 ). Conclusion: ACR 2010 criteria is more sensitive than ACR 1990 both at first diagnosis and after 1 year of follow-up. So; it enables to diagnose and may give oppurtunity to treat more underdiagnosed FM patients. Show more

Keywords: Fibromyalgia, diagnosis, criteria

DOI: 10.3233/BMR-130403

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 26, no. 4, pp. 437-443, 2013

Authors: Shenoy, S. | Balachander, H. | Sandhu, J.S.

Article Type: Research Article

Abstract: Background and Objectives: Incidence of Low Back Pain (LBP) in athletes is as high as 30%. Patients with LBP show altered postural and neuromuscular responses to various functional tasks. The objective of the study was to compare long latency reflex response (occurring between 40 to ∼ 100 ms duration) in athletes with chronic LBP with asymptomatic athletes. Methods: Surface electromyography (EMG) of superficial trunk muscles âĂŞ Rectus Abdominis (RA) and Erector Spinae (ES) were studied in athletes with chronic LBP (n = 24 ) and asymptomatic athletes (n = 25 ). Perturbations were introduced …in standing both expectedly and unexpectedly. The latency of onset and the Root Mean Square (RMS) amplitudes within the reaction duration were compared between the two groups. Results: The latency of onset was delayed in Unexpected perturbations but no change was observed in Expected tasks. The mean RMS amplitudes were significantly lower in both tasks for RA and in the Expected task for ES (p < 0.05 ). Conclusion: Chronic LBP athletes exhibit a delay in onset latency to Unexpected perturbations and reduced long latency response amplitudes to perturbation tasks compared to asymptomatic athletes. These changes could predispose athletes to recurrent low back pain and further injury. Show more

Keywords: Long latency reflex, low back pain, athletes, EMG, perturbation

DOI: 10.3233/BMR-130404

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 26, no. 4, pp. 445-450, 2013

Authors: Farasyn, Andre | Meeusen, Romain | Nijs, Jo | Cuesta-Vargas, Antonio

Article Type: Research Article

Abstract: Background and Objectives: In clinical examinations of a patient with non-specific low back pain (LBP), there is a need to dispose over a valid and quick to perform rating system. The “Backache Disability Index” for LBP or BADIX includes rating of 5 trunk movements in erect position and a “Morning Back Stiffness” score, whereof the sum gives the BADIX (max. 20 points). The objective of this study was to explore the reliability, responsiveness and concurrent validity of the BADIX. Patients with LBP (n = 100 ) were randomly assigned into a “control” group (n = 40 …) in function of validity studies, and a “treatment” group (n = 60 ) in function of responsiveness studies. The treatment group underwent two weekly sessions of in total 30 minutes of deep cross-friction on the thoraco-lumbar Erector spinae and gluteals. All patients completed the Oswestry Disability Questionnaire validated Dutch version (ODQ), the McGill Pain Questionnaire (MPQ). The impairment examination consists, besides current orthopaedic and neurologic examinations, of the new BADIX scoring system. Results: In our study the retest reliability after 3 days of the BADIX was perfect (n = 039 , r = 0.95 ). A good correlation (p < 0.001 ) was found between BADIX at baseline, and Oswestry Disability Index (ODI) (n = 93 , r = 0.76 ), and McGill-Quality of Life Index (r = 0.74 ). Similar discriminative ability and effect size of measures was found for BADIX and ODI (n = 54 ). It is proposed that the minimal detectable change should be equal or more than 2 points. Conclusions: The “Backache Disability Index” appears to be a reliable and a valid assessment tool of morning stiffness and restricted spinal movements, and discriminates between successful and unsuccessful treatment outcome. The BADIX will allow patients to take snapshots of their daily treatment evolution, save them on their computer or tablets (apps) and share the results with their doctors and/or therapists. Show more

Keywords: Low back pain, validity, reliability, disability index, impairment

DOI: 10.3233/BMR-130405

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 26, no. 4, pp. 451-459, 2013

Authors: Gul, Ebru Demir | Yilmaz, Ozlem | Bodur, Hatice

Article Type: Research Article

Abstract: Background: The Knee injury and Osteoarthritis Outcome Score-Physical function Short-form (KOOS-PS) is a disease-specific questionnaire that can be used to evaluate physical function in patients with knee problems and it has not been adapted to Turkish language. Objective: The purpose of the present study was to adapt the KOOS-PS to the Turkish language and to evaluate the psychometric properties of the Turkish version of the KOOS-PS in patients with primary knee osteoarthritis. Methods: The translation from the source language to the target language, synthesis, back-translation, revision and pre-test stages were performed. A total of eighty patients …participated in the study. Internal consistency was tested by Cronbach’s alpha, test-retest reliability was tested by the intra-class correlation coefficient (ICC). Construct validity was investigated with Spearmann’s rank correlation coefficient and correlations of the KOOS-PS with the WOMAC and Lequesne osteoarthritis indexes and with the duration of complaints, radiological grade and range of flexion were assessed for this purpose. Results: Internal consistency was good, with a Cronbach’s alpha of 0.904 and an ICC value of 0.839 certifying that the Turkish KOOS-PS is a reliable tool. Spearman’s rank correlation coefficients between the KOOS-PS and the overall WOMAC (r = 0.764 ), WOMAC-physical function (r = 0.754 ), WOMAC-pain (r = 0.706 ), overall Lequesne (r = 0.775 ), Lequesne-daily living activities (r = 0.737 ) and Lequesne-pain (r = 0.716 ) were high. Moderate correlations were found between the WOMAC-stiffness, Lequesne-walking distance and KOOS-PS (r = 0.599 and 0.528, respectively). Conclusions: The Turkish KOOS-PS was found to be reliable and valid for patients with primary knee osteoarthritis. Show more

Keywords: Reliability, validity, Turkish, KOOS-PS, knee osteoarthritis

DOI: 10.3233/BMR-130406

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 26, no. 4, pp. 461-466, 2013

Authors: Durmus, Dilek | Uzuner, Bora | Durmaz, Yunus | Bilgici, Ayhan | Kuru, Omer

Article Type: Research Article

Abstract: Background and Objectives: The aim of this study was to investigate the clinical relevance of Michigan Hand Outcomes Questionnaire (MHQ) in patients with rheumatoid arthritis (RA) and to evaluate the relationship between MHQ and disease activity, quality of life (QL), and handgrip strength separately. Material and Method: Eighty RA were included in the study. Disease activity is evaluated with Disease Activity Score 28 (DAS28), pain is evaluated with Visual Analog Scale (VAS). The Disabilities of Arm, Shoulder and Hand (DASH), MHQ, Short-Form 36 (SF-36), and Health Assessment Questionnaire (HAQ), Arthritis Impact Measurement Scales-hand and finger function scale-2 (AIMS-2) …were completed by all patients. Hand muscle strength (HMS) was measured with a hand-held dynamometer. Results: The MHQ moderately correlated with DAS28. When the patients were grouped according to three disease activity measurements, DASH scores were significantly higher with higher disease activity and MHQ scores were significantly lower with higher disease activity. A high correlation was found between MHQ total and HAQ, AIMS-2. The SF-36 scores were correlated with MHQ scores. Conclusions: The MHQ scores correlate with disease activity indices, functional disability, QL and DASH. The clinical relevance of MHQ, like DASH, is high and both questionnaires can be used effectively. Show more

Keywords: Rheumatoid Arthritis, MHQ, DASH, SF-36, HAQ, disease activity

DOI: 10.3233/BMR-130408

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 26, no. 4, pp. 467-473, 2013

Authors: Sansone, Valerio | McCleery, Jocelyn | Bonora, Cristina

Article Type: Case Report

Abstract: Low-back pain is a common complaint during pregnancy and the post-partum period, and it may be due to a variety of conditions. Among these, a frequently overlooked cause is a sacral fracture. We report the case of a 37 year old woman, suffering from post-partum low-back pain which had not responded to treatment. Though rare, a sacral stress fracture must be considered in cases of prolonged low-back or sacral pain in pregnant or post-partum women. Plain radiographs are frequently inconclusive and MRI is the imaging technique of choice. Capacitive coupling electric fields (CCEF) seemed to be effective in treating pain …and in reducing the patient's recovery time. Show more

Keywords: Low-back pain, stress fractures, sacrum, pregnancy, capacitive coupling electric field

DOI: 10.3233/BMR-130394

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 26, no. 4, pp. 475-477, 2013

Authors: Hasturk, Askin Esen | Coven, Ilker | Ozdemir, Ozgur | Erinanc, Hilal | Bal, Ajda

Article Type: Case Report

Abstract: Background and Objective: In this article, we describe a patient unusual presenting with both arachnoiditis ossificans and syringomyelia. We have reviewed the patient’s evaluation, surgery, and treatment. Case Description: This patient developed paraparesis following thoracolumbar spinal surgery to treat kyphosis secondary to ankylosing spondylitis. Results: We performed a T9-T11 total laminectomy, drained the cyst, dissected and removed the calcified plaques posterior to the cord, and decompressed the neural structures. Conclusion: Symptomatic arachnoiditis ossificans (AO) a rare clinical manifestation is characterized by the calcification or ossification of the spinal arachnoid. The occurrence of AO with …syringomyelia is rare. To date, a few cases with both AO and ankylosing spondylitis have been reported. Show more

Keywords: Arachnoiditis ossificans, ankylosing spondylitis, spinal surgery, syringomyelia

DOI: 10.3233/BMR-130407

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 26, no. 4, pp. 479-482, 2013

Article Type: Other

DOI: 10.3233/BMR-2013-26420

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 26, no. 4, pp. 483-487, 2013

Article Type: Other

DOI: 10.3233/BMR-2013-26421

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 26, no. 4, pp. 489-491, 2013