Journal of Back and Musculoskeletal Rehabilitation - Volume 28, issue 1

Authors: Truszczyńska, Aleksandra | Drzał-Grabiec, Justyna | Płszewski, Maciej | Rapała, Kazimierz | Tarnowski, Adam

Article Type: Research Article

Abstract: BACKGROUND: The available literature is lacking in reports on the quantitative analysis of posture in patients with lumbar stenosis. OBJECTIVE: The aim of this study was to analyze body posture in patients with lumbar spinal canal stenosis. METHODS: The study involved 100 people: 49 persons with severe lumbar spine stenosis and 51 control subjects without any history of back pain. All participatants were evaluated by a photogrammetric method. RESULTS: Photogrammetric measurements showed statistically significant differences in the shape of the anterior-posterior curvatures of the spine. In the study group thoracic kyphosis was significantly greater …(p = 0.043 ), and the depth of lumbar lordosis was significantly smaller (p = 0.038 ). The inclination of the thoracolumbar segment was also significantly lower (p = 0.013 ). CONCLUSIONS: 1. Measurements of body posture indicate a deepening of thoracic kyphosis and flattening of lumbar lordosis in lumbar stenosis patients. 2. Flattening of physiological lordosis seems to be caused by enlargment of the space of the spinal canal and dural sac in this position. Show more

Keywords: Spinal stenosis, lumbar spine, posture

DOI: 10.3233/BMR-140493

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 1, pp. 75-79, 2015

Authors: Ishida, Hiroshi | Watanabe, Susumu

Article Type: Research Article

Abstract: BACKGROUND: Recent studies have indicated that maximum expiration could be a useful way of performing challenging exercises that include coactivation of the deep and superficial abdominal muscles. However, little is known about the effect of maximum expiration on the activity of the abdominal muscles during lumbar stabilizing exercise. OBJECTIVES: The purpose of our study was to quantify changes in the activities of the abdominal muscles during side bridge exercise in combination with maximum expiration. DESIGN: Experimental laboratory study. METHODS: The activities of the rectus abdominis (RA), external oblique (EO), and internal oblique (IO) muscles …were measured using electromyography in 12 healthy men performing 3 tasks: holding the breath after maximum expiration in the supine position, holding the breath after resting expiration during side bridge exercise, and holding the breath after maximum expiration during side bridge exercise. RESULTS: Significant increases in the activities of the abdominal muscles (RA, EO, and IO) occurred with maximum expiration when compared with resting expiration during side bridge exercise (P < 0.05 ). CONCLUSION: This is the first study to demonstrate the effect of maximum expiration on abdominal muscle activities during a stabilizing exercise, thus contributing to existing knowledge about therapeutic exercise for alternative core training. Show more

Keywords: Electromyography, abdominal muscles, stabilizing exercise

DOI: 10.3233/BMR-140494

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 1, pp. 81-84, 2015

Authors: Jentzsch, Thorsten | Geiger, James | Slankamenac, Ksenija | Werner, Clément M.L.

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVES: There is a lack of studies on obesity measured by outer abdominal fat (OAF), which describes abdominal subcutaneous adipose tissue thickness with regard to spino-pelvic parameters. We investigated OAF and its physiologic values on computed tomography (CT) scans with regard to age, gender, facet joint (FJ) arthritis, FJ orientation, lumbar lordosis (LL) and pelvic incidence (PI). MATERIAL AND METHOD: OAF, lumbar FJs, LL and PI were evaluated on CT scans. RESULTS: CT scans of 620 individuals with a mean age of 42.5 years were reviewed. OAF showed a mean value of 19.7 millimeters …(mm). It significantly increased with age until 70 years and decreased thereafter (p ≤ 0.0001 ). There was no significant gender difference. OAF was significantly increased with FJ arthritis (p = 0.01 ), but not with FJ orientation, LL or PI. CONCLUSION: OAF on CT scans seems to have a mean value of 19.7 mm. It is higher in the older age groups until 70 years. As a novelty finding, OAF significantly increases with higher degrees of FJ arthritis, but is notrelated to gender or other spino-pelvic parameters such as FJ orientation, LL or PI. Differences in fat distributionmay be found at other anatomic sites, such as visceral fat. Obese patientsmay benefit from weight loss by decreasing their FJ arthritis, which maypotentially decrease associated back pain, which may be worth further investigations. Show more

Keywords: Outer abdominal fat, obesity, facet joint arthritis, facet joint orientation, lumbar lordosis, pelvic incidence

DOI: 10.3233/BMR-140495

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 1, pp. 85-91, 2015

Authors: Espejo-Antúnez, L. | López-Miñarro, P.A. | Garrido-Ardila, E.M. | Castillo-Lozano, R. | Domínguez-Vera, P. | Maya-Martín, J. | Albornoz-Cabello, M.

Article Type: Research Article

Abstract: BACKGROUND: To improve hamstring extensibility some methods have been analyzed and compared for determining their acute and chronic effectiveness. OBJECTIVE: To compare the immediate effect of electrical muscle elongation (EME) versus Kinesio tape (KT) in hamstring muscle extensibility. METHODS: One hundred and twenty adult amateur athletes with hamstring shortness (straight leg raise test angle < 80 °) were randomly assigned to a group: group 1 (EME session of 4 KHz interferential current, bipolar technique and AMF=100 Hz, n = 40 ), group 2 (KT, n = 40 ) or group …3 (control group, no intervention, n = 40 ). Hamstring extensibility was assessed before and after the intervention through the active knee extension test. Results: Significant improvements were found in both EME and KT groups whereas no changes were detected in the control group. However, no significant differences between both techniques were detected. The EME group showed large effect size (d = 0.843 ) while the KT group reached medium effect size (d = 0.431 ). CONCLUSIONS: Both electrical muscle elongation and Kinesio tape are effective techniques in the short-term in amateur athletes with decreased hamstring extensibility. The higher increase of hamstring extensibility, with a better clinical effect was achieved with the application of electrical muscle elongation. However, no significant differences were found when comparing the effectiveness of both techniques. Show more

Keywords: Muscle stretching, electric current, technique, range of movement, sport

DOI: 10.3233/BMR-140496

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 1, pp. 93-100, 2015

Authors: Paolucci, Teresa | Vetrano, Mario | Zangrando, Federico | Vulpiani, Maria Chiara | Grasso, Maria Rosaria | Trifoglio, Domenica | Di Franco, Manuela | Iannuccelli, Cristina | Sorgi, Maria Laura | Reis, Victor | Saraceni, Vincenzo Maria | Guidetti, Laura

Article Type: Research Article

Abstract: BACKGROUND: Control of pain management is an important up-stream process in fibromyalgia (FM) mechanisms. OBJECTIVE: To investigate whether adapted physical activity (APA) could change the illness perception in relation to the FM personality profile. METHODS: Thirty-seven women with FM allocated randomly: 19 treatment group (TG) and 18 control group (CG). Interventions: exercises program included ten sessions, two times for week for one hour each and observation for CG. Scales: Illness Perception Questionnaire-revisited (IPQ-r) for the mental representation of the disease, Minnesota Multiphasic Personality Inventory profiles (MMPI-2) for personality tool and Fibromyalgia Impact Questionnaire (FIQ) for function, …impact and symptoms. Outcome assessments were performed before rehabilitation treatment (T0) than at the end (T1), and a follow-up 12 weeks after treatment (T2). RESULTS: APA was efficacy to improve FIQ values in TG at T1 and T2 test days (P = 0.014 ). Changes in IPQ-R values in T2 were not significant. All patients presented a baseline T-score ≥ 65 in at least one of the basic and content MMPI-2 scales (Hy, D, Hs and Hea and Anx). CONCLUSION: APA was efficacy in FM, but further research to differentiate between illness experience rather than focus on a strict personality profile are necessary. Show more

Keywords: Fibromyalgia, rehabilitation, physical exercise, personality assessment, pain perception, MMPI-2\vspace{-0.4cm}

DOI: 10.3233/BMR-140497

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 1, pp. 101-109, 2015

Authors: Ota, Susumu | Goto, Hiroshi | Noda, Yukari | Fujita, Remi | Matsui, Yasumoto

Article Type: Research Article

Abstract: BACKGROUND: Posture and physical function have been quantified in mature adults, but not in elderly females. OBJECTIVE: To quantify standing posture and measures of physical function in community-dwelling women over the age of 65 years, and to examine relationships between these variables. METHODS: Fifty-three women were recruited from day care service users (average age: 83.7 ± 6.3 years old). Standing postural alignments were assessed using 2-dimensional analyses with a digital video camera. The time up and go test (TUG) and other physical function tests were conducted. RESULTS: Decreased lower cervical angle (increased forward head …position) was significantly correlated with increased upper cervical angle (increased chin-up, r = − 0.45 ), increased thoracic spine angle (increased kyphosis, r = − 0.38 ), and decreased lumbar spine angle (thoracolumbar segments backward relative to the pelvis, r = 0.48 ). The decreased lumbar spine angle was significantly correlated with increased thoracic angle (increased kyphosis, r = − 0.37 ), increased pelvic plane angle (increased anterior pelvic tilt, r = − 0.49 ), and decreased knee flexion angle (r = 0.46 ). Increased TUG time (slower walking speed) was correlated to increased forward head position (r = 0.30 ) and thoracolumbar segments forward relative to the pelvis (r = 0.34 ). CONCLUSIONS: Posture and physical function measures were provided for community-dwelling females who were >65 years of age. They did not demonstrate any correlation between measured knee strength, back strength or single leg standing with measures of postural alignment, but TUG showed a moderate correlation with the lower cervical and lumbar spine posture measures. Show more

Keywords: Posture, frail elderly women, physical function

DOI: 10.3233/BMR-140498

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 1, pp. 111-117, 2015

Authors: Roberts, Andrew J. | Dew, Angela | Bridger, Robert | Etherington, John | Kilminster, Shaun

Article Type: Research Article

Abstract: BACKGROUND: Psychosocial factors are known to play a key role in determining the progress of back pain patients. However, it is not known whether these factors are applicable to military personnel, who tend to be fitter than the general population. OBJECTIVE: The aim was to identify physical and psychological predictors in a prospective study of the outcome of back pain rehabilitation over 6 months and a longer follow-up time of between 15 and 32 months. METHODS: Two hundred and fifty military personnel reporting for a residential rehabilitation programme completed a battery of physical and psychological tests. …The physical tests included 800 m run time and the Biering-Sorensen test. The psychological/psychosocial measures included items on fear avoidance, self efficacy, anxiety and depression and occupational psychosocial factors such as job satisfaction. RESULTS: Self efficacy and 800 m run time predicted self-reported functional ability at 6 months and medical discharge/return to full fitness at 15–32 months. Patients with 800 m run times of more than 3 minutes 31 seconds had a four times greater chance of medical discharge from the Armed forces. CONCLUSIONS: Eight hundred metre run time and self-efficacy were independent predictors of both self-reported functional ability at 6 months and return to full fitness/medical discharge at 15–32 months. Self-efficacy also predicted 40% of the variance in the intensity of back pain and 10% of other non-back pain. Rehabilitation should include greater emphasis on physical fitness and on improving self-efficacy. Show more

Keywords: Low back pain, self-efficacy, 800 m run time, military, rehabilitation

DOI: 10.3233/BMR-140499

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 1, pp. 119-128, 2015

Authors: Eyigor, Can | Eyigor, Sibel | Akdeniz, Sedef | Uyar, Meltem

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVE: The number of studies and evidences is inadequate especially with regard to the efficacy of pulsed radiofrequency (PRF) application in non-spinal indications. The purpose of this study was to investigate the effect of PRF on pain, functioning and quality of life in patients with advanced knee OA. METHODS: The study included 21 patients with complaints of knee pain. Intra-articular PRF was applied for 10 minutes at 42°C. Pain severity was assessed using the 10 cm standard visual analogue scale (VAS). Outcome measures also included a 20-meter walk test, a 6-minute walk test, WOMAC, Lequesne index, …and the Short Form-36 (SF-36). All measurements were assessed before treatment and 4 and 12 weeks after the treatment. RESULTS: A statistically significant improvement was found in VAS scores at rest and after walking, subscores of SF36-pain and SF36-social functioning, and Lequesne score at week four (p < 0.05 ). This improvement was maintained for the scores of VAS-walking at week 12 (p < 0.05 ). CONCLUSION: It is possible to state that intra-articular PRF application is effective and safe for the pain treatment of patients with advanced knee OA. Therefore, we think that PRF application will be included in chronic pain treatment guidelines in the future with the increase in the number of future studies. Show more

Keywords: Knee, osteoarthritis, pain, quality of life, radiofrequency

DOI: 10.3233/BMR-140500

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 1, pp. 129-134, 2015

Authors: Çelenay, Şeyda Toprak | Kaya, Derya Özer | Özüdogbreve;ru, Anıl

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVE: Spinal posture and mobility are significant for protecting spine. The aim was to compare effects of different postural training interventions on spinal posture and mobility. MATERIAL AND METHOD: Ninety-six university students (ages: 18–25 years) were allocated into Electrical Stimulation (ES) (n = 24 ), Exercise (n = 24 ), Biofeedback Posture Trainer (Backtone) (n = 24 ), and Postural Education (n = 24 , Controls) groups. All the groups got postural education. The interventions were carried out 3 days a week for 8 weeks. Spinal Mouse® device …(Idiag, Fehraltorf, Switzerland) was used to detect thoracic and lumbar curvatures and mobility (degrees) in standing and sitting positions. Paired Student’s t-test, one-way ANOVA, and pairwise post-hoc tests were used. RESULTS: ES decreased thoracic curvature, the exercise decreased thoracic and lumbar curvature and increased thoracic mobility in standing position between pre-post training (p < 0.05 ). Exercise and Backtone improved thoracic curvature in sitting (p < 0.05 ). In Exercise Group, thoracic curvature decreased compared to Backtone and Education Groups, and thoracic mobility increased compared to all groups (p < 0.05 ). CONCLUSIONS: The exercise was effective and superior in improving thoracic and lumbar curves, and mobility among university students. ES decreased thoracic curve. Biofeedback posture trainer improved sitting posture. LEVEL OF EVIDENCE: A prospective randomized controlled trial, Level 1. Show more

Keywords: Back posture, posture education, electrical stimulation, exercise, orthotic device

DOI: 10.3233/BMR-140501

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 1, pp. 135-144, 2015

Authors: Choi, Bongsam

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVES: Relative precision is to denote the ratio of the error variance of two sample designs. The aim of the present study was to compare measurement precisions of the Oswestry Back Pain Disability Questionnaire and a computer adaptive testing (CAT) method for measuring disability resulting from back pain. MATERIAL AND METHOD: A cross-sectional study was carried out with two independent convenient samples from two out-patient rehabilitation clinics for back pain (N = 42 ) and non-back pain groups (N = 42 ). Participants were asked to fill out the ODQ and CAT …of International Classification of Functioning, Disability and Health – Activity Measure (ICF-AM). A series of Rasch analyses were performed to calculate person ability measures. RESULTS: The CAT measures had greater precision in discriminating the groups than did the ODQ measure in comparisons of the relative precision. CONCLUSIONS: The CAT measure appears to be more effective than the ODQ measure in terms of measurement precision. By administering test items calibrated in a way, CAT measures using item response theory may promise a means with measurement precision as well as efficiency. Show more

Keywords: Back pain, item response theory, Rasch model, computer adaptive testing, relative precision

DOI: 10.3233/BMR-140502

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 1, pp. 145-152, 2015

Authors: Sumen, Ahmet | Sarsan, Ayse | Alkan, Hakan | Yildiz, Necmettin | Ardic, Fusun

Article Type: Research Article

Abstract: BACKGROUND: Myofascial pain syndrome (MPS) which is an important cause of musculoskeletal pain has shown a dramatic increase in recent years. OBJECTIVES: We aimed to evaluate the efficacy of intramuscular electrical stimulation therapy (IMS) and low-level-laser-therapy (LLLT) in patients with MPS. METHODS: Patients were randomly divided into three groups. First group were treated with LLLT and stretching exercise. Second group were treated with IMS and stretching exercise. Third group were treated with only streching exercise. The patients were evaluated through the pain intensity, pain threshold, cervical joint movement range and the neck disability index parameters. …RESULTS: An improvement was found in all parameters for all groups, except for the pain threshold within the control group at the end of the treatment and one month after the treatment. It was found that pain score was significantly lower in Group 1 and 2 at one month after the treatment compared to Group 3. Similarly, it was found that pain threshold score was significantly higher in Group 2 at one month after the treatment compared to Group 3. CONCLUSIONS: In this study we observed that both LLLT and IMS treatments added on to stretching are effective in improving pain parameters in patients with MPS. Show more

Keywords: Myofascial pain syndrome, low level laser therapy, electrotherapy

DOI: 10.3233/BMR-140503

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 1, pp. 153-158, 2015

Authors: Novais-Shimano, Suraya Gomes | Shimano, Marcos Massao | Marcolino, Alexandre Marcio | Fonseca, Marisa de Cássia Registro

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVES: The physical injuries caused by +Gz include skeletal-muscle overloads. This study has aimed at demonstrating ergonomic conditions of the pilots from the Brazilian Air Force’s Aerial Demonstration Squadron (BAFADS) during flight. METHODS: All the 13 pilots from the BAFADS were evaluated through an interview. Surface electromyography (SEMG) was employed during the flight manoeuvre simulation (under normal and overload conditions). RESULTS: The report analyses showed perception of discomfort in the right shoulder related to +Gz. The SEMG showed moderate levels of shoulder muscles activation for normal contractions (± 25%). During vigorous contraction, levels of …recruitment were high: upper trapezius fibres (± 105%), middle trapezius fibres (± 90%) and posterior deltoid fibres (± 95%). The great demand from the deltoid muscles (posterior fibres) infers a very high level of recruitment from the rotator cuff muscle, which may explain the discomfort in the pilots’ shoulder during the flight manoeuvre. CONCLUSION: The mutual analysis of both methods not only does it demonstrate a correlation between symptoms and muscle recruitment, but also provides data to implement intervention measures for pilots’ physical training in order to minimise the discomfort symptoms during flights. Show more

Keywords: Ergonomics, pilots, electromyography, prevention, shoulder

DOI: 10.3233/BMR-140504

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 1, pp. 159-166, 2015

Authors: Muyor, José M.

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVE: Systematic repetition or prolonged posture in specific postures adopted during training could generate modifications on the sagittal spinal curvatures. Spinal alteration in its physiologic curvatures in the sagittal plane has been associated with predisposition to spinal disorders. The objective was to evaluate and compare the changes produced on the sagittal thoracic and lumbar spinal curvatures, and pelvic tilt from standing posture on the floor to upper, middle, lower and aerodynamic handlebars postures adopted on their own road bicycles. MATERIAL AND METHOD: A total of twenty-eight male professional cyclists (179.92 ± 5.78 cm; 67.18 ± 5.74 …kg) participated in the study. Cyclists had an experience of 17.22 ± 6.16 years in cycling, and spent 6.52 ± 0.51 days per week and 3.78 ± 0.61 hours per day training on their bicycles. Sagittal spinal curvatures (thoracic and lumbar) and pelvic tilt were measured in the standing position on the floor and while sitting on a bicycle with different handlebar-hand positions (high, middle, low and aerodynamic) using a Spinal Mouse system. RESULTS: The thoracic spine showed significantly greater angular values while in a standing posture than on the bicycle in all handlebar-hands postures evaluated. The lumbar curvature changed from lordosis (negative values – anterior convexity) in standing posture to kyphosis (positive values – posterior convexity) in all handlebar-hands positions on the bicycle. The aerodynamic handlebar positions showed the greatest lumbar flexion (lumbar kyphosis) and anterior pelvic tilt. CONCLUSIONS: Professional cyclists passively maintain their thoracic spine straighter on the bicycle due to handlebar-hands support than in standing posture. However, the lumbar spine is flexed on the bicycle in all handlebar-hands evaluated. The pelvis is modified to greater anterior pelvic tilt when the handlebar-hands position is farther and lower regarding the saddle of the bicycle. Show more

Keywords: Thoracic, lumbar, pelvis, posture, cycling, bike-fitting

DOI: 10.3233/BMR-140506

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 1, pp. 167-172, 2015

Authors: Fogelman, Yacov | Kent, John

Article Type: Research Article

Abstract: Myofascial pain is a major cause of musculoskeletal regional pain. Myofascial pain, which is a high-prevalence but eminently treatable condition, is almost universally underdiagnosed by physicians and undertreated by physical therapy modalities. Large numbers of patients can be left suffering in chronic pain for years. Dry needling, also referred to as Intramuscular Stimulation, is a method in the arsenal of pain management which has been known for almost 200 years in Western medicine, yet has been almost completely ignored. With the increase in research in this field over the past two decades, there are many high-quality studies that demonstrate dry …needling to be an effective and safe method for the treatment of myofascial pain when diagnosed and treated by adequately-trained physicians or physical therapists. This article provides an overview of recent literature regarding the treatment of myofascial pain syndrome, evidence for the efficacy of dry needling as a central component of its management, and a glimpse at developments in recent imaging methods to aid in the treatment of these problems. Show more

Keywords: Myofascial pain syndrome, dry needling, intramuscular stimulation, trigger point

DOI: 10.3233/BMR-140547

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 1, pp. 173-179, 2015

Authors: Valentin, Stephanie | Yeates, Tobey DeMott | Licka, Theresia | Elliott, James

Article Type: Research Article

Abstract: BACKGROUND: Inter-rater reliability of generalised lumbar extensor muscle CSA has been identified, however, more detailed reliability metrics of individual trunk muscles are lacking. OBJECTIVE: To report muscle volume and muscle fatty infiltrate (MFI) inter-rater reliability of individual trunk muscles between two novice assessors. METHODS: Lumbar axial MRI scans from 10 healthy male participants were analysed. The muscles erector spinae (ES), multifidus (M), rectus abdominis (RA), and psoas (PS) were manually traced, region of interest quantified and muscle volume and MFI determined by both assessors. Agreement between the assessors was determined using intraclass correlation coefficients (3,1), Bland-Altman …plots and Lin’s concordance coefficient. RESULTS: Good to excellent agreement was found for volume (ICC 0.77–0.96) and MFI (0.84–0.96) for all muscles on first evaluation, except for M volume, which required a second evaluation. Best agreement for muscle volume and MFI was found for ES (ICC 0.96). CONCLUSIONS: First evaluation of muscle volume and MFI yields high to excellent inter-rater agreement, except for M, where further training and/or experience is required to achieve acceptable reliability outcomes. This may have clinical implications due to the relevance of M atrophy reported in patients with low back pain. Show more

Keywords: Inter-rater reliability, agreement, MRI, lumbar spine, muscle

DOI: 10.3233/BMR-140552

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 1, pp. 181-190, 2015

Authors: Kim, Yushin | Kim, Jungjin | Yoon, BumChul

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVES: It is possible to increase multi-directional trunk stability using co-activation. However, it is unclear whether there is a preference for left or right trunk rotation after intensive unilateral stability training. The aim of this study was to examine the directional preference in trunk rotational stability after unilateral core training. MATERIAL AND METHOD: This study was conducted on 16 female basketball players. For eight weeks, eight participants performed unilateral core training that focused on one side of the trunk. The remaining eight participants were not provided any additional training. To determine rotational trunk stability, all participants …were requested to maintain an upright sitting posture against sudden, external, left or right rotational perturbations of the trunk. Angular displacement of the trunk was measured using a motion analyzer. RESULTS: At the end of the training period, the angular displacement in response to the perturbation was reduced for both rotational directions (left: − 26 % , right: − 24 % ) in the trained group (p < 0.05 ). CONCLUSION: This study showed that trunk stability improved without particular directional preference in response to unilateral core training. This result adds to our understanding of the nature of trunk stability and multi-directional improvement. LEVEL OF EVIDENCE: Intervention study, Level 1b. Show more

Keywords: Postural control, trunk stability, core training, direction, perturbation

DOI: 10.3233/BMR-140569

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 1, pp. 191-196, 2015

Authors: Ozkan, Aslihan Kusvuran | Doruk, Pinar | Adam, Mehmet | Celik, Zerrin Yilmaz | Leblebici, Berrin

Article Type: Case Report

Abstract: Osteopetrosis is a rare genetic disorder caused by osteoclast failure. Dominant negative mutations of the ClCN7 gene cause the so-called, autosomal dominant osteopetrosis type II, which represents the most frequent and heterogeneous form of osteopetrosis, ranging from asymptomatic to intermediate-severe, thus suggesting additional genetic and environmental determinants affecting penetrance. Here, we present a case a 46 year-old woman complained low back pain for 15 years. The patient lacked any history of direct trauma and her pain was radiating to her left leg, increasing with physical activity, she had no pain at nights. The patient was diagnosed with autosomal dominant osteopetrosis …on the basis of the presence of typical radiological appearance. Were present a case report of osteopetrosis type II (an autosomal dominantly inherited disease) as a cause for low back pain without any familial penetrance of the disease. Show more

Keywords: Autosomal dominant osteopetrosis, low back pain

DOI: 10.3233/BMR-140486

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 1, pp. 197-200, 2015