Journal of Back and Musculoskeletal Rehabilitation - Volume 27, issue 4

Authors: Civelek, Gul Mete | Ciftkaya, Pinar Oztop | Karatas, Metin

Article Type: Research Article

Abstract: Background and Objective: The aim of this study is to find prevalence and severity of restless legs syndrome (RLS) in patients with fibromyalgia syndrome (FMS) and detect effect of FMS and RLS coexistance on quality of sleep and life. Methods: In this study, presence and severity of RLS were detected in patients with FMS and Pitsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and Fibromyalgia Impact Questionnaire (FIQ) scores of all patients were measured. Results: One hundred and fifteenfemale patients with median age 49 (39.0–57.0)[median (25–75% interquartile range)] were included in the study. In 42.6% …of patients RLS coexisting with FMS was found. RLS was classified as moderate in 42.9% of patients and as severe in 49.0% of patients. In patients with FMS ans RLS sleep quality, daytime sleepiness and quality of life were more severely impaired (PSQI scores were 9.0 ± 4.4 vs 7.8 ± 4.3, p=0.003; ESS scores were 5.0(3.0–7.5) vs 3.0(1.0–4.3), p=0.036 and FIQ scores were 68.1 ± 9.8 vs 59.4 ± 16.9, p=0.027) compared to patients with only FMS. Prevalence of RLS was found higher in FMS than normal population and quality of sleep and quality of life were worse in patients with RLS. Conclusions: Presence of RLS should be investigated in every patient with FMS and treatment plans should also cover RLS in case of coexistance with FMS. Prospective cohort studies are needed for better explanation of FMS and RLS coexistance. Show more

Keywords: Fibromyalgia syndrome, restless legs syndrome, quality of sleep, quality of life

DOI: 10.3233/BMR-140478

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 27, no. 4, pp. 537-544, 2014

Authors: Davarian, Sanaz | Maroufi, Nader | Ebrahimi, Esmaeil | Parnianpour, Mohammad | Farahmand, Farzam

Article Type: Research Article

Abstract: Background and Objectives: It is suggested that activation of the transverse abdominis muscle has a stabilizing effect on the lumbar spine by raising intra-abdominal pressure without added disc compression. However, its feedforward activity has remained a controversial issue. In addition, research regarding bilateral activation of trunk muscles during a unilateral arm movement is limited. The aim of this study was to evaluate bilateral anticipatory activity of trunk muscles during unilateral arm flexion. Materials and Methods: Eighteen healthy subjects (aged 25 ± 3.96 years) participated in this study and performed 10 trials of rapid arm flexion in response to …a visual stimulus. The electromyographic activity of the right anterior deltoid (AD) and bilateral trunk muscles including the transverse abdominis/internal oblique (TA/IO), superficial lumbar multifidus (SLM) and lumbar erector spine (LES) was recorded. The onset latency and anticipatory activity of the recorded trunk muscles were calculated. Results: The first muscle activated in anticipation of the right arm flexion was the left TA/IO. The right TA/IO activated significantly later than all other trunk muscles (P< 0.0005). In addition, anticipatory activity of the right TA/IO was significantly lower than all other trunk muscles (P< 0.0005). There was no significant difference in either onset latency or anticipatory activity among other trunk muscles (P> 0.05). Conclusion: Healthy subjects showed no bilateral anticipatory co-activation of TA/IO in unilateral arm elevation. Further investigations are required to delineate normal muscle activation pattern in healthy subjects prior to prescribing bilateral activation training of transverse abdominis for subjects with chronic low back pain. Show more

Keywords: Anticipatory postural adjustments, motor control, low back, stability, self-induced perturbation

DOI: 10.3233/BMR-140480

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 27, no. 4, pp. 545-551, 2014

Authors: Durmus, Dilek | Unal, Mustafa | Kuru, Omer

Article Type: Research Article

Abstract: Background and Objectives: The aim of this trial is to search effectiveness of specifically adapted exercise programs on its own and with low back school on pain, disability, trunk and quadriceps muscle strength, walking performance, spinal mobility, quality of life (QOL), and depression in the patients with chronic low back pain (CLBP). Material and Method: A total of 121 patients with definite CLBP were included in this study. The patients were randomized into two groups. Group 1 (n=60) was given exercises only and accepted as the control group. Group 2 (n=61) received back school program and exercises. The …exercise treatment was performed 3 days a week, for 3 months. The pain (visual analog scale, VAS), disability (Oswestry Disability Questionnaire, ODQ), walking performance (6 minute walking test, 6MWT), depression (Beck Depression Inventory scores, BDI), and QOL (Short Form 36, SF-36) of all participants were evaluated. The trunk and knee muscle strength were measured with a handheld dynamometer. Patients were assessed at baseline (BT), at the end of treatment (AT), and at the six month follow-up (F). Results: Statistically significant improvements were found between groups regarding all of the clinical parameters over time. Pain, disability, muscle strength, endurance, 6MWT, mobility, QOL, and depression of both groups also showed improvements AT. These improvements persisted at 6-months follow-ups (P < 0.05). There were statistically significant differences between the groups for pain, disability, muscle strength, endurance, 6MWT, QOL, and depression regarding the change scores between AT–BT test and F–BT test (P < 0.05). Group 2 improved more than group 1 except for mobility. Conclusion: Exercise programs can be modified and used successfully in CLBP and this effect can be increased with addition of back school further. Level of Evidence: Diagnostic study Level-I-I (prospective study). Show more

Keywords: Chronic low back pain, exercise, back school, muscle strength, pain, disability, endurance, quality of life, depression

DOI: 10.3233/BMR-140481

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 27, no. 4, pp. 553-561, 2014

Authors: Linden, Michael | Scherbe, Sieghard | Cicholas, Burkhard

Article Type: Research Article

Abstract: Background: It is empirically well documented that psychotherapy is vital in the treatment of chronic back pain. Objective: To test in this randomized controlled clinical trial whether cognitive behavior group therapy is effective in respect to pain tolerance and disability apart from the effects on somatization in general and additional to the effects of a multimodal inpatient orthopedic rehabilitation programme. Methods: Fifty-three patients were randomly assigned to an intervention group, receiving six sessions of “cognitive behavior group therapy for back pain” (CBT-BP), and 50 to a control group who got unspecific occupational therapy sessions instead. Patients …were suffering from chronic back pain for at least six months. All patients were treated for 21 days in an orthopedic inpatient rehabilitation unit with a multimodal orthopedic treatment, including active physical therapy, patient education or motivation to exercise. Results: In both groups there is a significant improvement over time in the Symptom Checklist (SCL-90), the Rating of Health Locus of Control Attributions, the Fear Avoidance Beliefs Questionnaire (FABQS) and a Visual Analogue Pain Scale (VAS-pain). There are significant interactions between treatment group and VAS-pain and the FABQS, showing a superior improvement in the intervention group, while no significant superiority is found for the SCL. Conclusions: The experience of pain can be altered directly and not only through improvement of depression or general somatoform complaints. The study replicates other research and increases the evidence base for this mode of treatment. The treatment effect can be called specific as it is found additional to a multimodal inpatient care programme. Show more

Keywords: Cognitive behavior therapy, low back pain, rehabilitation, fear avoidance beliefs, pain, locus of control

DOI: 10.3233/BMR-140518

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 27, no. 4, pp. 563-568, 2014

Article Type: Other

DOI: 10.3233/BMR-2014-27425

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 27, no. 4, pp. 569-575, 2014

Article Type: Other

DOI: 10.3233/BMR-2014-27426

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 27, no. 4, pp. 577-579, 2014