Journal of Back and Musculoskeletal Rehabilitation - Volume 30, issue 6

Authors: Hidalgo, Benjamin | Hall, Toby | Bossert, Jean | Dugeny, Axel | Cagnie, Barbara | Pitance, Laurent

Article Type: Research Article

Abstract: OBJECTIVE: To review and update the evidence for different forms of manual therapy (MT) and exercise for patients with different stages of non-specific neck pain (NP). Data sources: MEDLINE, Cochrane-Register-of-Controlled-Trials, PEDro, EMBASE. METHOD: A qualitative systematic review covering a period from January 2000 to December 2015 was conducted according to updated-guidelines. Specific inclusion criteria only on RCTs were used; including differentiation according to stages of NP (acute – subacute [ASNP] or chronic [CNP]), as well as sub-classification based on type of MT interventions: MT1 (HVLA manipulation); MT2 (mobilization and/or soft-tissue-techniques); MT3 (MT1 + …MT2); and MT4 (Mobilization-with-Movement). In each sub-category, MT could be combined or not with exercise and/or usual medical care. RESULTS: Initially 121 studies were identified for potential inclusion. Based on qualitative and quantitative evaluation criteria, 23 RCTs were identified for review. Evidence for ASNP: MODERATE-evidence: In favour of (i) MT1 to the cervical spine (Cx) combined with exercises when compared to MT1 to the thoracic spine (Tx) combined with exercises; (ii) MT3 to the Cx and Tx combined with exercise compared to MT2 to the Cx with exercise or compared to usual medical care for pain and satisfaction with care from short to long-term. Evidence for CNP: STRONG-evidence: Of no difference of efficacy between MT2 at the symptomatic Cx level(s) in comparison to MT2 on asymptomatic Cx level(s) for pain and function. MODERATE to STRONG-evidence: In favour of MT1 and MT3 on Cx and Tx with exercise in comparison to exercise or MT alone for pain, function, satisfaction with care and general-health from short to moderate-terms. MODERATE-evidence: In favour (i) of MT1 as compared to MT2 and MT4, all applied to the Cx, for neck mobility, and pain in the very short term; (ii) of MT2 using sof-tissue-techniques to the Cx and Tx or MT3 to the Cx and Tx in comparison to no-treatment in the short-term for pain and disability. CONCLUSION: This systematic review updates the evidence for MT combined or not with exercise and/or usual medical care for different stages of NP and provides recommendations for future studies. Two majors points could be highlighted, the first one is that combining different forms of MT with exercise is better than MT or exercise alone, and the second one is that mobilization need not be applied at the symptomatic level(s) for improvements of NP patients. These both points may have clinical implications for reducing the risk involved with some MT techniques applied to the cervical spine. Show more

Keywords: Manual Therapy, musculoskeletal manipulation, exercise, neck pain, evidence based practice, systematic review

DOI: 10.3233/BMR-169615

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1149-1169, 2017

Authors: Szikszay, Tibor | Hall, Toby | von Piekartz, Harry

Article Type: Research Article

Abstract: BACKROUND: The mechanical behavior of the peripheral nervous system under elongation and tension has not been adequately established in vivo . OBJECTIVE: The purpose of this review is to investigate the mechanical behavior of the peripheral nervous system in vivo . METHODS : In vivo studies which evaluated the effects of limb movement and neurodynamic tests on peripheral nerve biomechanics were systematically searched in PubMed (Medline), the Cochrane Database, CINAHL, PEDro, Embase and Web of Science. Studies fulfilling the search criteria were assessed for methodological quality with a modified version of the Down …& Blacks scale by two reviewers. RESULTS: This review includes the results of 22 studies, of which 15 examined limb movement influencing the median nerve, four the sciatic nerve, two the tibial nerve; and one each the ulnar and peroneal nerves respectively. Substantial nerve longitudinal and transverse excursion and changes in diameter were reported. Despite this, increased nerve strain was not a major finding. CONCLUSION: The heterogeneity of included studies, including wide variety of nerves tested, measurement location and joint position prevented comparisons between studies and also amalgamation of data. Limb movement induces complex biomechanical effects of which nerve elongation plays only a minor role. Show more

Keywords: Neurodynamic, stretch, strain, in vivo, peripheral nerve, excursion

DOI: 10.3233/BMR-169720

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1171-1186, 2017

Authors: Wang, Yun-Ting | Qi, Yong | Tang, Fu-Yong | Li, Fei-Meng | Li, Qi-Huo | Xu, Chang-Peng | Xie, Guo-Ping | Sun, Hong-Tao

Article Type: Research Article

Abstract: BACKGROUND: LBP is one of the most common symptoms with high prevalence throughout the world. Conflicting conclusions exist in RCTs on cupping for LBP. OBJECTIVE: To assess the effects and safety of cupping for the patients with LBP. METHODS: Pubmed, Cochrane Library databases, and Embase database were electronically researched. RCTs reporting the cupping for the patients with LBP were included. The meta-analysis was conducted using Review Manager software (version 5.3, Nordic Cochrane Centre). The primary outcome was VAS scores. The secondary outcomes included ODI scores, MPPI scores and complications. RESULTS: …Six RCTs were included in this synthesized analysis. The results showed that cupping therapy was superior to the control management with respect to VAS scores (SMD: - 0.73, [95% CI: - 1.42 to - 0.04]; P = 0.04), and ODI scores (SMD: - 3.64, [95% CI: - 5.85 to - 1.42]; P = 0.001). There was no statistical significant difference as regard to MPPI scores. No serious adverse event was reported in the included studies. CONCLUSIONS: Cupping therapy can significantly decrease the VAS scores and ODI scores for patients with LBP compared to the control management. High heterogeneity and risk of bias existing in studies limit the authenticity of the findings. Show more

Keywords: Low back pain, cupping therapy, meta-analysis

DOI: 10.3233/BMR-169736

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1187-1195, 2017

Authors: Cieślik, Błażej | Podsiadły, Ireneusz | Kuczyński, Michał | Ostrowska, Bożena

Article Type: Research Article

Abstract: OBJECTIVE : The aim of this study was to investigate the effects of normalized muscle tension via tensegrity-based massage on postural stability in a sample of female young adults. METHODS : Nineteen females aged 21.8 ± 1.9 years were recruited presenting abnormal tension at muscles adhering to any of the following structural sites: superior iliac spine, lateral sacropelvic surface, linea aspera at 1/2 of femur length, and superior nuchal line of the occiput. Balance and postural control were assessed during bipedal stance using a force platform in multiple conditions: hard surface or soft foam surface with …the head in either a neutral posture or tilted backward. Baseline and 3-min and 15-min post-treatment measures were collected while barefoot and eyes closed. Main outcomes measures included center of pressure variability, range, radius, and velocity in the anteroposterior (AP) mediolateral (ML) dimensions. RESULTS : In the solid surface with neutral head posture condition only AP COP measures decreased significantly (p < 0.05). In the soft surface condition, significant differences were observed in the AP and ML dimensions among most measures (p < 0.05). CONCLUSIONS: A single application of tensegrity-based massage positively influenced postural control in young adult females, particularly in the AP direction. Show more

Keywords: Postural control, tensegrity, stability, COP, force platform, muscle chains

DOI: 10.3233/BMR-140206

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1197-1202, 2017

Authors: Lee, Jung Sub | Shin, Jong Ki | Goh, Tae Sik | Son, Seung Min | An, Sung Jin

Article Type: Research Article

Abstract: OBJECTIVE: To evaluate the reliability and validity of an adapted Korean version of the Spinal Appearance Questionnaire (SAQ). METHODS: Translation/retranslation of the English version of the SAQ was conducted, and all steps of the cross-cultural adaptation process were performed. The Korean version of the SAQ (K-SAQ) and the previously validated appearance domain of the Korean version of the Scoliosis Research Society-22 Outcomes questionnaire (K-SRS-22) were mailed to 160 patients with adolescent idiopathic scoliosis (AIS). Reliability assessments were conducted using kappa statistics to assess item agreements, and intraclass correlation coefficients (ICC) and Cronbach’s α …values were calculated. Convergent validity was evaluated by comparing K-SAQ and K-SRS-22 appearance domain scores and discriminant validity by analyzing relationships between K-SAQ scores and patient characteristics. RESULTS: All items of the K-SAQ had kappa values of agreement of > 0.6. The K-SAQ showed excellent test/re-test reliability with an intraclass correlation coefficient of 0.922. Internal consistency of the K-SAQ was found to be very good (α = 0.883). Convergent validity testing demonstrated a moderate correlation between the K-SAQ and K-SRS-22 (r = - 451). The correlation between the K-SAQ and major curve magnitude was significant (r = 0.812). Discriminant validity was confirmed by significant differences in K-SAQ scores and individual K-SAQ domain scores among patients requiring observation, bracing, or surgery. CONCLUSIONS: The adapted Korean version of the SAQ showed satisfactory reliability and validity, and thus, is considered suitable for the evaluation of spinal deformity appearance in Korean speaking patients with adolescent idiopathic scoliosis. Show more

Keywords: Adolescent idiopathic scoliosis, Spinal Appearance Questionnaire, Korean version

DOI: 10.3233/BMR-150480

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1203-1208, 2017

Authors: Li, Qiguang | Sun, Jianmin | Cui, Xingang | Jiang, Zhensong | Li, Tao

Article Type: Research Article

Abstract: BACKGROUND: A few studies have pointed that trunk extensors may affect the spinopelvic alignment; however, little is known about the exact association between degeneration of lower lumbar paraspinal muscles and spinopelvic parameters. OBJECTIVE: The study aimed to analyze the relationship between degeneration of lower lumbar paraspinal muscles and spinopelvic alignment in patients with osteoporotic vertebral compression fracture (OVCF). METHODS: Thirty-nine OVCF patients were involved in this study. All patients underwent a standing lateral radiographs of the entire spine and pelvis 6 months after kyphoplasty. Pelvic incidence, pelvic tilt, lower lumbar lordosis (LLL) were measured. …On the MRI images, the cross-sectional areas of the erector spinae (ES), multifidus (MF), vertebral body and the signal intensity of ES, MF, subcutaneous fat were measured. Pearson’s correlation coefficients was applied to analyze the correlation between the muscular degeneration degree (muscular atrophy and fatty infiltration) and spinopelvic parameters. RESULTS: The fatty change degree of ES at L4 inferior endplate level was positively correlated with pelvis retroversion (r = 0.480, p < 0.05). The grade of fat infiltration of ES plus MF at L5 level was negatively related to LLL (r = - 0.446, p < 0.05). The fatty change of ES at L5 level, atrophy of ES at L4 and L5 level did not correlate with pelvis back tilt. The fat infiltration of ES plus MF at L4 level, the atrophy degree of ES plus MF at L4 and L5 level had no correlation with LLL. CONCLUSIONS: With the increase of fatty infiltration of the erector spinae, the degree of pelvis retroversion increases; the lower lumbar lordosis decreases with the increase of intramuscular adipose tissue of the erector spinae plus multifidus. The atrophy degree of the erector spinae and multifidus is not correlated with pelvis back tilt and lower lumbar lordosis. Show more

Keywords: Lower lumbar paraspinal muscle, spinopelvic alignment, osteoporotic vertebral compression fracture, kyphoplasty

DOI: 10.3233/BMR-150506

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1209-1214, 2017

Authors: Lee, Sang-Yeol | Lee, Seung-Min | Jung, Jae-Min

Article Type: Research Article

Abstract: BACKGROUND: Ankle sprain are one of the most common injuries in sports and public health in general. Cross-slope may creat a risk for ankle sprain and are commonly found in both urban and rural environment. OBJECTIVE: The purpose of study was to clarify the environmental risk factor that can be easily occurred ankle sprain during walking (stance phase) and one leg standing at various ramp environment. METHODS: Participants was measured muscle activation on peroneus longus during both conditions (walk across the ramp and one leg stand in the transverse direction) of seven different …angle (0 ∘ , 2 ∘ , 5 ∘ , 10 ∘ , 15 ∘ , 20 ∘ , 25 ∘ ). The measured data were analyzed using one-way ANOVA to investigate the effect of muscle activation on the each condition. RESULTS: Ankle sprain can be easily occurred when cross walk and one-leg stand on a ramp from higher than 10 ∘ , and highest risk was angle of 25 ∘ or more. As a people with peroneus longus weakness walks a ramp, the ramp angle has a cross relationship with the sprain on the ankle. CONCLUSIONS: If people with peroneus longus weakness walk on the more than 10 ∘ of ramp angle, they will need a lot of attention for prevent ankle sprain. Show more

Keywords: Peroneus Longus, ankle sprain, cross ramp

DOI: 10.3233/BMR-150510

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1215-1219, 2017

Authors: Fay, Patricia | Edmond, Susan L. | Baron, Julia K. | Joshi, Michelle

Article Type: Research Article

Abstract: BACKGROUND: Depression, a common comorbidity encountered in physical therapy (PT) practice, negatively impacts outcomes. There is limited knowledge of PT practice patterns relative to screening for depression. OBJECTIVE: Objectives were to describe beliefs regarding depression, and identify practice patterns and perceived barriers regarding screening for depression among APTA Board Certified Orthopedic Clinical Specialist (OCS) PTs. METHODS: Surveys were distributed to all PT OCSs in the US; 416 responses were analyzed. Descriptive, univariate and multiple regression analyses were performed. RESULTS: Ninety-five percent of respondents believed that depression has a moderate to …high influence on PT outcomes, whereas 68% believed a pre-existing diagnosis of depression influences the plan of care. Most believed that 20% or more of their current patients presented with symptoms of depression. Nevertheless, only 18% formally screen for depression during the initial evaluation. Those with formal depression screening education were 2.3 times more likely to screen at initial examination. Common barriers to screening included lack of department policy, limited knowledge and lack of follow-up resources. CONCLUSIONS: Formal screening did not occur as frequently as expected, given the belief regarding depression’s impact on plan of care and outcomes. Addressing barriers may assist in greater compliance with recommended screening guidelines. Show more

Keywords: Physical therapy, physical therapists, depression screening, beliefs, barriers

DOI: 10.3233/BMR-169551

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1221-1229, 2017

Authors: Hayashi, Hiroyuki | Nakashima, Daiki | Matsuoka, Hiroka | Iwai, Midori | Nakamura, Shugo | Kubo, Ayumi | Tomiyama, Naoki

Article Type: Research Article

Abstract: BACKGROUND: Upper-limb function is important in patients with hip fracture so they can perform activities of daily living and participate in leisure activities. Upper-limb function of these patients, however, has not been thoroughly investigated. OBJECTIVE: The aim of this study was to evaluate the upper-limb motor and sensory functions in patients with hip fracture by comparing these functions with those of community-dwelling older adults (control group). METHODS: We compared the results of motor and sensory function tests of upper-limb function – range of motion, strength, sensibility, finger dexterity, comprehensive hand function – between …patients with hip fracture (n = 32) and the control group (n = 32). RESULTS: Patients with hip fracture had significantly reduced grip strength, pinch strength, finger dexterity, and comprehensive hand function compared with the control group. CONCLUSIONS: Most upper-limb functions are impaired in the patients with hip fracture. Thus, upper-limb function of patients with hip fracture should be considered during treatment. Show more

Keywords: Hip fracture, upper limb, hand, community-dwelling, comparative study

DOI: 10.3233/BMR-169560

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1231-1236, 2017

Authors: Muaidi, Qassim I.

Article Type: Research Article

Abstract: BACKGROUND: Knee proprioception is an integral component of neuromuscular control system that stabilizes the joints, reducing incidence of injury. Knee injuries’ incidences differ between genders. Knee rotation is a component of different knee injury mechanisms. Gender differences in knee proprioception in internal (IR) and external (ER) rotations are not sufficiently studied. OBJECTIVE: To check whether proprioceptive acuity in IR and ER directions of knee rotation is inherently lower in women compared to men. Moreover, to assess gender difference in ranges of knee rotation. METHODS: Thirty volunteers (15 women and 15 men) participated. Knee …proprioception acuity and ranges of knee rotation were assessed using the knee rotatory kinesthetic device (KRKD). Proprioception was tested using absolute judgment task, subject’s ability to discriminate different rotation movements (stimuli) randomly presented, then just notable difference (JND) was calculated; least difference accurately discriminated in 75% of trials. RESULTS: Women had lower proprioception acuity in IR than men (1.70 ∘ ± 0.79 ∘ and 1.12 ∘ ± 0.32 ∘ , p = 0.011) respectively. Active IR (women: 41.29 ∘ ± 7.46 ∘ , men 32.80 ∘ ± 3.64 ∘ , p = 0.000), and passive IR (women: 53.43 ∘ ± 11.67 ∘ , men: 37.94 ∘ ± 5.22 ∘ , p = 0.000) were higher in women compared to men. Active ER (women: 49.71 ∘ ± 11.37 ∘ , men: 39.16 ∘ ± 5.46 ∘ , p = 0.003), and passive ER (women: 62.29 ∘ ± 13.74 ∘ , men: 48.89 ∘ ± 7.09 ∘ , p = 0.002) were, also, higher in women. CONCLUSION: Gender difference in knee proprioception acuity was found in IR, which is the direction of rotation that anterior cruciate ligament (ACL) stabilize. Women’s ranges of knee rotation are greater than men in both IR and ER. Show more

Keywords: Proprioception, knee rotation, JND, joint position sense

DOI: 10.3233/BMR-169613

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1237-1243, 2017

Authors: Raya, Cristian Rodolfo | Plaza-Manzano, Gustavo | Pecos-Martín, Daniel | Ferragut-Garcías, Alejandro | Martín-Casas, Patricia | Gallego-Izquierdo, Tomás | Romero-Franco, Natalia

Article Type: Research Article

Abstract: BACKGROUND: Temporomandibular disorders (TMDs) are prevalent multifactorial pathologies in which the actual role of the cervical region position is controversial. OBJECTIVE: To analyze the relationship between the position of the upper cervical rachis and the symptoms of TMD. METHODS: Sixty women were recruited to this study. All of them completed a questionnaire and were subjected to a temporomadibular exploration to create two different groups: a TMD Group (n = 30) – women who suffered TMD symptoms according to the evaluation; and a control group (n = …30) – women who were free from TMD symptoms. Two X-ray examinations were performed in all the women: a lateral one and a frontal one with mouth open to assess the C1–C0 distance and the craniocervical angle. RESULTS: ANOVA showed that the TMD and control women had similar C1–C0 distances and craniocervical angles (p > 0.05). Pearson correlation did not indicate any relationship between the craniocervical position and the symptomatology of TMD (r = - 0.070). CONCLUSIONS: TMD symptomatology is unrelated to alterations in craniocervical position (C0–C1 distance and craniocervical angle). Women with and without TMD showed a similar prevalence of alteration in the craniocervical position. Show more

Keywords: Cervical vertebrae, temporomandibular joint disorders, upper cervical spine

DOI: 10.3233/BMR-169620

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1245-1250, 2017

Authors: Yıldırım, Azad | Nas, Kemal

Article Type: Research Article

Abstract: PURPOSE: There are limited studies related to the rehabilitation of neglected Monteggia fracture-dislocations. This study reports the results of the rehabilitation of neglected Monteggia fractures and dislocations and the best treatment options available. MATERIAL AND METHODS: Thirteen children were rehabilitated between 2009 and 2012. A retrospective chart review was conducted to record the following: age, gender, anatomic region of fractures, time delay from symptom onset to fracture, Bado classification, Mayo Elbow Performance Index (MEPI) which includes pain, range of motion and daily life comfort, surgeries, length of hospitalization, location and pattern of fracture, length of follow-up …and complications. RESULTS: The study group included thirteen children and adolescents; eleven males and two females with a mean age of 8.5 (range 2–15) years. According to the Bado classification, 11 patients had type 1, one had type 3 and one had type 4 fracture-dislocations. For Mayo Elbow Performance Index (MEPI) scales, patients that were less than ten years old had greater mean scores. Two patients had superficial infection, one had subluxation, one had osteoarthritis, one had delayed bone union and two had rigidity at the elbow. CONCLUSION: The goals of elbow rehabilitation following Neglected Monteggia cases include restoring function by restoring motion and muscle performance; influencing scar remodeling and preventing joint contracture; and restoring or maintaining joint stability. Patients aged younger than 10 years and intervals of less than one-year, between trauma and diagnosis, as well as early and effective rehabilitation were found as important parameters regarding favorable outcomes. Show more

Keywords: Monteggia, Bado, dislocation, rehabilitation

DOI: 10.3233/BMR-169621

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1251-1257, 2017

Authors: Dibai-Filho, Almir Vieira | de Jesus Guirro, Rinaldo Roberto | Rezende, Monique Silva | Rangon, Flávia Belavenuto | Ferreira, Vânia Tie Koga | de Oliveira Guirro, Elaine Caldeira

Article Type: Research Article

Abstract: BACKGROUND: Baropodometric evaluation has been used in research and clinical environments by professionals who are working on the physical rehabilitation of patients. However, to date, there is no published data on the use of baropodometry in patients with chronic neck pain. OBJECTIVE: To analyze peak plantar pressure and center of pressure oscillation in individuals with chronic neck pain compared to a control group. METHODS: This was a blind cross-sectional study. It included 44 participants of both genders, between 18 and 45 years old, distributed into a chronic neck pain group (n = …22) and a control group (n = 22). Participants were assessed by means of baropodometry, the Numeric Rating Scale, the Neck Disability Index, and the Pain-Related Self Statement Scale. The Mann-Whitney test was used for comparison of baropodometric variables between the two groups, and the Spearman correlation coefficient was used to check possible associations between the variables. RESULTS: No significant differences (p > 0.05) in peak plantar pressure or center of pressure oscillation were detected in the comparisons between the chronic neck pain and control groups. In addition, no significant correlation was observed (p > 0.05) between baropodometric variables and neck pain. CONCLUSION: Individuals with chronic neck pain with mild disability did not differ from a control group in terms of peak plantar pressure or center of pressure oscillation. Show more

Keywords: Chronic pain, postural balance, musculoskeletal equilibrium

DOI: 10.3233/BMR-169629

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1259-1264, 2017

Authors: Alahmari, Khalid A. | Reddy, Ravi Shankar | Silvian, Paul | Ahmad, Irshad | Nagaraj, Venkat | Mahtab, Mohammad

Article Type: Research Article

Abstract: BACKGROUND: Evaluation of cervical joint position sense in subjects with chronic neck pain has gained importance in recent times. Different authors have established increased joint position error (JPE) in subjects with acute neck pain. However, there is a paucity of studies to establish the influence of chronic neck pain on cervical JPE. OBJECTIVE: The objective of the study was to understand the influence of chronic neck pain on cervical JPE, and to examine the differences in cervical JPE between young and elderly subjects with chronic neck pain. METHODS: Forty-two chronic neck pain patients (mean age …47.4) were compared for cervical JPE with 42 age-matched healthy subjects (mean age 47.8), using a digital inclinometer. The cervical JPE were measured in flexion, extension, and rotation in right and left movement directions. RESULTS: The comparison of JPE showed significantly larger errors in subjects with chronic neck pain when compared to healthy subjects (p < 0.001). The errors were larger in all of the movement directions tested. Comparison between young and older subjects with chronic neck pain revealed no significant differences (P > 0.05) in cervical JPE. CONCLUSIONS: Cervical joint position sense is impaired in subjects with chronic neck pain. Show more

Keywords: Age, neck proprioception, neck pain

DOI: 10.3233/BMR-169630

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1265-1271, 2017

Authors: Oostendorp, Rob A.B. | Elvers, Hans | Mikolajewska, Emilia | Laekeman, Marjan | Roussel, Nathalie | van der Zanden, Olaf | Nijs, Jo | Samwel, Han

Article Type: Research Article

Abstract: BACKGROUND: Manual physical therapists (MPTs) working in primary care get limited information about patient’s courses of (chronic) low back pain (LBP). Identification of kinesiophobia is mostly based on clinical perception. OBJECTIVE: The aim of this study was to evaluate the association between the scores with which manual physical therapists in a primary care setting identify kinesiophobia in patients with low back pain, and the patients’ self-reported measures of kinesiophobia. METHODS: The cross-sectional study comprised 104 patients with LBP and 17 MPTs. Patients first independently completed the Tampa Scale for Kinesiophobia (TSK-17). The therapists, …blinded to the TSK-scores, rated their perception of a patient’s kinesiophobia using the Visual Analogue Scale-Estimation (VAS-est) and the accuracy of their ratings using the Visual Analogue Scale-Accuracy (VAS-ac). Kendall’s tau b was used to determine the level of correlation between scores on the TSK-17 and the VAS-est. Show more

DOI: 10.3233/BMR-169651

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1273-1284, 2017

Authors: Senthil, P. | Sudhakar, S. | Radhakrishnan, R. | Jeyakumar, S.

Article Type: Research Article

Abstract: BACKGROUND: Age-related hyperkyphosis causes deleterious effects on health, physical function, and quality of life. Recently, health care providers recognized it as a major health concern. OBJECTIVE: To identify the effect of corrective exercise strategy on hyperkyphosis and compare it with that of conventional exercise. METHODS: Subjects were randomly categorized into two groups. Each group comprised 30 subjects. Group A received the corrective exercise strategy, and group B received conventional exercises for 8 weeks of the study duration (15 repetitions of each exercise for three sessions/day for a total duration of 45 min and 4 …days/week. Pre- and post-interventional hyperkyphosis were analyzed according to posture number using the Posture Pro 8 postural analysis software. In addition, pectoralis minor flexibility was assessed using the ruler scale method in centimeters. RESULTS: Both groups showed highly significant postural alteration and changes in pectoralis minor muscle length (p < 0.001) CONCLUSIONS: The corrective exercise strategy seems to promote scapular stability and produce a more upright posture of the upper thoracic spine. Show more

Keywords: Hyperkyphosis, corrective exercise strategy, postural analysis, pectoralis minor muscle length test

DOI: 10.3233/BMR-169668

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1285-1289, 2017

Authors: Almhdawi, Khader A. | Mathiowetz, Virgil | Al-Hourani, Zeid | Khader, Yousef | Kanaan, Saddam F. | Alhasan, Mustafa

Article Type: Research Article

Abstract: BACKGROUND: Very few articles, comprehensively, investigated musculoskeletal pain symptoms (MPS) among wide variety of allied health professions (AHP) students. OBJECTIVES : This study aimed to investigate the prevalence of MPS and their associated factors among different AHP majors’ students. METHOD: A cross-sectional design was conducted. A sample of AHP students from nine majors (n = 838, Mean age = 21.3 years) completed a validated structured self-administrated questionnaires including Nordic Musculoskeletal Questionnaire, Depression Anxiety Stress Scale (DASS 21), and specific questions regarding demographics and life style. MPS prevalence …rate were compared between males and females and between majors. Logistic regression was conducted to identify predictors of MPS. RESULTS: MPS in neck, lower back, and shoulder 12-month were the most prevalent (67.1%, and 61.4%, 58.8% respectively). MPS prevalence was significantly higher in females and statistically different among majors. MPS were significantly associated with increased clinical training load, mental stress symptoms, and smartphone average use time. CONCLUSIONS: MPS in AHP students are prevalent and statistically higher among females. Students are advised to adhere to different conservative precautions and follow prevention programs. Future studies are needed to assess actual mechanisms causing MPS among AHP students and designing effective prevention programs specific to AHP students. Show more

Keywords: Occupational therapy, occupational safety, allied health, musculoskeletal pain, medical education

DOI: 10.3233/BMR-169669

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1291-1301, 2017

Authors: Ulger, Ozlem | Demirel, Aynur | Oz, Müzeyyen | Tamer, Seval

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVES: To determine the effects of spinal stabilization exercises (SSE) and manual therapy methods on pain, function and quality of life (QoL) levels in individuals with chronic low back pain (CLBP). METHODS: A total of one-hundred thirteen patients diagnosed as CLBP were enrolled to the study. The patients allocated into Spinal Stabilization group (SG) and manual therapy group (MG), randomly. While SSE performed in SG, soft tissue mobilizations, muscle-energy techniques, joint mobilizations and manipulations were performed in MG. While the severity of pain was assessed with Visual Analog Scale (VAS), Oswestry Disability Index (ODI) …and Short Form 36 (SF-36) assessments were performed to evaluate the functional status and QoL, respectively. All assessments were repeated before and after the treatment. Results: Intragroup analyses both treatments were effective in terms of sub parameters of pain, function and life quality (p < 0.05). Inter group analyses, there was more reduction in pain and improvement in functional status in favor of MG (p < 0.05). CONCLUSIONS: This study showed that SSE and manual therapy methods have the same effects on QoL, while the manual treatment is more effective on the pain and functional parameters in particular. Show more

Keywords: Low back pain, pain, rehabilitation, exercise, quality of life

DOI: 10.3233/BMR-169673

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1303-1309, 2017

Authors: Kapetanakis, S. | Giovannopoulou, E. | Charitoudis, G. | Kazakos, K.

Article Type: Research Article

Abstract: BACKGROUND: Lumbar discectomy is among the most frequently performed procedures in spinal surgery. Transforaminal percutaneous endoscopic discectomy (TPED) is a minimally invasive technique that gains ground among surgeons in the recent years. TPED has been studied in terms of effectiveness, however little is known about its overall impact on health-related quality of life (HRQoL) of the patients. OBJECTIVE: To investigate the progress of HRQoL following TPED. PATIENTS AND METHODS: Seventy-six (76) patients were enrolled in the study. Mean age was 56.5 ± 12.1 years with 38 (50%) males and 38 (50%) …females. All patients underwent TPED at L3-L4 (27.6%), L4-L5 (52.6%) and L5-S1 (19.7%). SF-36 was used for the assessment of HRQoL preoperatively and at 6 weeks, at 3, 6 and 12 months after the procedure. RESULTS: All aspects of SF-36 questionnaire showed statistically significant improvement one year after the procedure (p < 0.001). Role limitations due to physical problems, bodily pain and role limitations due emotional problems showed the highest improvement, followed by physical functioning, vitality, social functioning, mental health and general health. CONCLUSIONS: TPED for lumbar disc herniation is associated with significant improvement in all aspects of health-related quality of life within 6 weeks postoperatively and the improvement remains significant one year after surgery, as measured by the SF-36 questionnaire. Show more

Keywords: Lumbar hernia, discectomy, endoscopy, transforaminal, health-related quality of life

DOI: 10.3233/BMR-169702

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1311-1317, 2017

Authors: Muyor, José M. | Arrabal-Campos, Francisco M. | Martínez-Aparicio, Carmen | Sánchez-Crespo, Antonia | Villa-Pérez, Manuel

Article Type: Research Article

Abstract: OBJECTIVE: To evaluate the test-retest reliability and validity of the MOCAP system for measuring spinal sagittal thoracic and lumbar curvatures and sacral inclination in a standing posture. METHODS: Twenty-five male adults were evaluated on lateral standing radiographs. The thoracic and lumbar curvatures were calculated by Harrison’s posterior tangent method. The sacral inclination was defined as the angle between the tangent line of the sacral and vertical plane. In addition, MOCAP was used to calculate the spinal curvatures and sacral inclination. RESULTS: The thoracic and lumbar spine and sacral inclination demonstrated excellent reliability, with …mean ICCs levels greater than 0.980 and low CVs (mean: 2.15%). Systematic biases were not significant and were very near 0, and the mean standard errors were 0.257 ∘ . ANOVA of the radiographic and MOCAP measures did not report any statistically significant differences in the comparisons. The systematic biases and mean random errors were lower than 1 ∘ , with CVs lower than 5% and mean ICCs higher than 0.90 between sessions. CONCLUSION: The MOCAP system delivered consistently reliable and valid results for standing curvatures compared with a radiographic technique. This system could be used with confidence in research and clinical environments for sagittal spinal curvature measurements. Show more

Keywords: Optitrack, kyphosis, lordosis, spine, posture

DOI: 10.3233/BMR-169750

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1319-1325, 2017

Authors: Koura, Ghada Mohamed | Elimy, Doaa Ayoub | Hamada, Hamada Ahmed | Fawaz, Hossam Eddien | Elgendy, Mohamed Hussein | Saab, Ibtissam M.

Article Type: Research Article

Abstract: OBJECTIVE: To investigate the effect of foot pronation on the postural stability through measuring the dynamic balance including overall stability index (OAI), anteroposterior stability index (APSI) and mediolateral stability index (MLSI). METHODS: Forty participants from both sexes were selected from the Faculty of Physical Therapy, Cairo University, with a mean age of 23.55 ± 1.74 years. Subjects were divided into two groups: group A (8 males and 12 females) with foot pronation, and group B (9 males and 11 females) with normal feet. The Navicular Drop Test (NDT) was used to determine if …the feet were pronated and Biodex Balance System was used to assess dynamic balance at level 8 and level 4 for both groups. RESULTS: No significant difference was found in dynamic balance, including OAI, APSI and MLSI at stability level 8 (p > 0.05) but, there was a significant difference at stability level 4 (p < 0.05) between the two groups with lower stability in group A. CONCLUSION: Foot pronation affects the postural stability at stability level four and not affects stability level eight compared with those in the control group. Show more

Keywords: Flat feet, foot pronation, dynamic balance, biodex balance system

DOI: 10.3233/BMR-170886

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1327-1332, 2017

Authors: Callens, Christian | Nisand, Michaël | Isner-Horobeti, Marie-Eve

Article Type: Research Article

Abstract: BACKGROUND: Patellofemoral pain syndrome particularly impairs quality of life in young, physically active subjects. The exact etiology remains unknown, and so this syndrome is a challenging condition to treat. Some patients continue to experience pain and dysfunction after receiving one or more guidelines-compliant conservative treatments. Reducing the likelihood of patellofemoral pain syndrome is an important way of preventing the onset of debilitating anterior knee pain at all ages of life. CASE: A 24-year-old sportswoman with a 15-month history of anterior knee pain and failure of previous guidelines-compliant treatments. We treated this patient with techniques derived …from the paradigm of inductive physiotherapy, in which tone disorders with a central origin may contribute to musculoskeletal disorders. One distinctive feature of inductive physiotherapy relates to the fact that the painful area is not manipulated directly. RESULTS: The effects of physiotherapy were evaluated after ten weekly sessions and then 15 months later. The changes in the visual analogue pain scale score and the Knee Lequesne Index were clinically significant. We also observed an unexpected reduction in the static varus misalignment. CONCLUSION: This case could pave the way to an innovative neurological approach to the management of patellofemoral pain syndrome in the young adult. Show more

Keywords: Musculoskeletal disorders, patellofemoral pain syndrome, varus misalignment

DOI: 10.3233/BMR-150336

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 6, pp. 1333-1338, 2017