Journal of Back and Musculoskeletal Rehabilitation - Volume 31, issue 4

Authors: Senington, Billy | Lee, Raymond Y. | Williams, Jonathan Mark

Article Type: Review Article

Abstract: BACKGROUND: Fast bowlers display a high risk of lower back injury and pain. Studies report factors that may increase this risk, however exact mechanisms remain unclear. OBJECTIVE : To provide a contemporary analysis of literature, up to April 2016, regarding fast bowling, spinal kinematics, ground reaction force (GRF), lower back pain (LBP) and pathology. METHOD: Key terms including biomechanics, bowling, spine and injury were searched within MEDLINE, Google Scholar, SPORTDiscuss, Science Citation Index, OAIster, CINAHL, Academic Search Complete, Science Direct and Scopus. Following application of inclusion criteria, 56 studies (reduced from 140) were appraised …for quality and pooled for further analysis. RESULTS: Twelve times greater risk of lumbar injury was reported in bowlers displaying excessive shoulder counter-rotation (SCR), however SCR is a surrogate measure which may not describe actual spinal movement. Little is known about LBP specifically. Weighted averages of 5.8 ± 1.3 times body weight (BW) vertically and 3.2 ± 1.1 BW horizontally were calculated for peak GRF during fast bowling. No quantitative synthesis of kinematic data was possible due to heterogeneity of reported results. CONCLUSIONS: Fast bowling is highly injurious especially with excessive SCR. Studies adopted similar methodologies, constrained to laboratory settings. Future studies should focus on methods to determine biomechanics during live play. Show more

Keywords: Biomechanics, cricket fast bowling, injury, lower back pain

DOI: 10.3233/BMR-170851

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 31, no. 4, pp. 671-683, 2018

Authors: Park, Taejune | Lee, Ho Jun | Kim, Jae Seong | Nam, Kiyeun

Article Type: Review Article

Abstract: BACKGROUND: Posterior epidural lumbar disc fragment is infrequent because of anatomical barriers, and it is difficult to diagnose posterior epidural lumbar disc fragment because of its rare incidence and the ambiguity of radiologic evaluations. And it is difficult to differentiate it from other diseases such as spinal tumors. OBJECTIVE: Differential diagnosis of posterior epidural lumbar disc fragment is clinically important because its diagnosis can affect treatment and prognosis. To investigate the incidence, anatomical concern, etiology, symptom, diagnostic tool, management and prognosis of posterior epidural lumbar disc fragment, we reviewed articles including case report. METHODS: …We performed a search of all clinical studies of posterior epidural lumbar disc fragment published to date. The following keywords were searched: Posterior epidural lumbar disc fragment, disc migration, posterior epidural disc, extradural migration, dorsal epidural migration, sequestrated disc, and disc fragment. RESULTS: We identified 40 patients of posterior epidural lumbar disc fragment from 28 studies. The most common presentation of posterior epidural lumbar disc fragment was sudden onset radiculopathy (70.0%), followed by cauda equina syndrome (27.5%). The most frequently used diagnostic modality was magnetic resonance imaging (MRI), conducted in 36 cases (90.0%), and followed by computed tomography in 14 cases (35.0%). After the imaging studies, the preoperative diagnoses were 45.0% masses, 20.0% lesions, and 12.5% tumors. Characteristic MRI findings in posterior epidural lumbar disc fragment are helpful for diagnosis; it typically displays low signals on T1-weighted images and high signals on T2-weighted images with respect to the parent disc. In addition, most of the disc fragments show peripheral rim enhancement on MRI with gadolinium administration. Electrodiagnostic testing is useful for verifying nerve damage. Surgical treatment was performed in all cases, and neurologic complications were observed in 12.5%. CONCLUSIONS: As posterior epidural lumbar disc fragment could be masqueraded as spinal tumor, if rim enhancement is observed in MRI scans with sudden symptoms of radiculopathy or cauda equina syndrome, it should be taken into consideration. Early diagnosis can lead to early surgery, which can reduce complications. Show more

Keywords: Posterior epidural migration of lumbar disc fragment, cauda equina syndrome, electromyography, magnetic resonance imaging

DOI: 10.3233/BMR-170866

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 31, no. 4, pp. 685-691, 2018

Authors: Yagci, Gozde | Ayhan, Cigdem | Yakut, Yavuz

Article Type: Research Article

Abstract: BACKGROUND: In scoliosis, curve progresses due to muscle imbalance and poor posture. Basic body awareness therapy (BBAT) aims to improve posture, coordination, and balance by increasing body awareness, which may help decrease deformities. OBJECTIVE: This study aimed to investigate effects of Basic body awareness therapy (BBAT) on curve magnitude, trunk asymmetry, cosmetic deformity, and quality of life in adolescent idiopathic scoliosis (AIS) patients. METHODS: Twenty female AIS patients were randomly assigned to BBAT and traditional exercises (TEs) groups. The BBAT group received BBAT and traditional exercises (TEs), while the TEs group received …only TEs. The following assessments were included: Cobb angles using X-ray, angle of trunk rotation (ATR) using scoliometer, trunk asymmetry using the Posterior Trunk Symmetry Index (POTSI), cosmetic deformity using the Walter Reed Visual Assessment Scale (WRVAS), and quality of life using the SRS-22 test. Measurements were conducted at baseline examination and ten weeks later. Patients were instructed to wear their brace 23 h daily. Results were analyzed using the Wilcoxon rank-sum test to compare repeated measurements and Mann-Whitney U test to compare the groups. RESULTS: The BBAT group had greater improvement in the thoracic Cobb angle than the TEs group. Cosmetic deformity improved in both groups, whereas body asymmetry improved in only the BBAT group. SRS-22 scores were unchanged in both groups. CONCLUSIONS: BBAT as an additive to bracing and TEs improve curve magnitude, body symmetry and trunk deformity. Show more

Keywords: Idiopathic scoliosis, basic body awareness therapy, curve progression, body symmetry

DOI: 10.3233/BMR-170868

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 31, no. 4, pp. 693-701, 2018

Authors: Sağ, S. | Sağ, M.S. | Tekeoğlu, I. | Kamanlı, A. | Nas, K. | Acar, B.A.

Article Type: Research Article

Abstract: OBJECTIVES: In this study, we aimed to investigate the relationship of NLR (Neutrophil lymphocyte ratio), MPV (mean platelet volume), PDW (distribution width) rates in rheumatoid arthritis (RA) patients with IL-17 and IL-1 beta which are within the cytokines playing an important role in etiopathogenesis and activity of the disease. PATIENTS AND METHODS: Fifty-seven RA patients diagnosed according to RA classification criteria of ACR/EULAR 2010 and 37 controls were included into the study. WBC (white blood cell), NEU (neutrophil), PLT (platelet), LYM (lymphocyte) values in complete blood count received from routine blood examination of patients were recorded, …and NLR, PLR (platelet lymphocyte ratio) rates were recorded. IL-17 and IL-1 beta were studies in serum samples. Disease activity of RA patients was evaluated with Disease Activity Score (DAS28). Age, gender, disease age, BMI (body mass index), medications used, co-morbid diseases, smoking of the patients were recorded. RESULTS: Fifty-seven RA patients (46 (80.7%) females, 11 (19.3%) males), and 34 patients (24 (70.6% females and 10 (29.4) males) as a control group were involved. Demographic characteristics were similar between two groups, and statistically significant difference was not detected between patient and control groups in terms of gender, age, and BMI (p > 0.05). We found higher NLR, MPV, PDW, IL-17 values in RA patients compared to control group (p < 0.05). There was a positive correlation of NLR with DAS28, CRP. While erythrocyte sedimentation rate (ESR) had negative correlation with MPV and PDW, it had positive correlation with PLT. We found positive correlation of C-reactive protein (CRP) with NLR and PLT. We could not find correlation of IL-1 beta and IL-17 with hematologic markers. CONCLUSION: In this study, we investigated the relationship of IL-17 and IL-1 beta which play an important role in pathogenesis of RA patients with the parameters analyzed in routine complete blood count, providing information about disease activity such as DAS 28, CRP, and ESR. We illuminated on an issue which has not discussed before by looking from a different angle. More extensive, follow-up studies are needed to emphasize the importance of these parameters and to reveal the relationship between cytokines during the follow-up of the disease activity. Show more

Keywords: Rheumatoid arthritis, IL-17, neutrophil lymphocyte ratio

DOI: 10.3233/BMR-170903

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 31, no. 4, pp. 703-707, 2018

Authors: Tuan, Shenghui | Liou, Ihsiu | Su, Hungtzu | Tsai, Yunjeng | Chen, Guanbo | Sun, Shufen

Article Type: Research Article

Abstract: BACKGROUND: Most studies used hyaluronic acid (HA) requiring 3–5 intra-articular injections (IAJ) for knee osteoarthritis (KOA). OBJECTIVE: We evaluated the efficacy of a single IAJ of a novel HA by measuring the thickness of quadriceps and femoral intercondylar cartilage (FIC) under ultrasonography (US) in addition to subjective self-reported measures. METHODS: Forty-nine patients with KOA (Kellgren-Lawrence grades 2–3) received unilateral IAJ of HYAJOINT Plus to the worse knee and were assessed at baseline and 1, 3 and 6-months after IAJ. Outcome measures were the (1) Visual Analog Scale for pain (VAS), (2) Western Ontario …and McMaster Universities Osteoarthritis Index (WOMAC), (3) Lequesne’s Index, (4) single-leg-stance duration (5) thigh circumference, and (6) thickness of quadriceps and FIC under US. RESULTS: Forty-six patients completed the 6-month-follow-up study. All outcome measures improved significantly after HA injection (p < 0.001). Both VAS and WOMAC-pain subscale scores improved significantly at 1, 3, and 6 months (p < 0.01). The US thickness of the quadriceps and FIC improved significantly at both 3 and 6 months (p < 0.05). The Lequesne’s index, single-leg-stance and thigh circumference improved significantly at 6 months (p < 0.01). CONCLUSIONS : HYAJOINT Plus is effective both subjectively and objectively for 6 months and is safe as a treatment for KOA. Show more

Keywords: Knee pain, osteoarthritis, hyaluronic acid, ultrasonography

DOI: 10.3233/BMR-170950

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 31, no. 4, pp. 709-718, 2018

Authors: Cokorilo, Nebojsa | Mikalacki, Milena | Satara, Goran | Cvetkovic, Milan | Marinkovic, Dragan | Zvekic-Svorcan, Jelena | Obradovic, Borislav

Article Type: Research Article

Abstract: BACKGROUND: Aerobic exercises to music can have a positive effect on functional and motor skills of an exerciser, their health, as well as an aesthetic and socio-psychological component. OBJECTIVE: The objective of this study was to determine the effects of reactive exercising in a group on functional capabilities in physically active and physically inactive women. METHODS: A prospective study included 64 healthy women aged 40–60 years. The sample was divided into the experimental group (N = 36), i.e. physically active women who have been engaged in recreational group …exercises at the Faculty of Sport and Physical Education, University of Novi Sad, Serbia, and the control group (N = 28), which consisted of physically inactive women. All the participants were monitored using the same protocol before and after the implementation of the research. All women had their height, weight and body mass index measured as well as their spiroergometric parameters determined according to the Bruce protocol. RESULTS: A univariate analysis of variance has shown that there is a statistically significant difference between the experimental group and the control group in maximum speed, the total duration of the test, relative oxygen consumption, absolute oxygen consumption and ventilation during the final measurement. After the training intervention, the experimental group showed improvements in all the parameters analyzed compared with pretest values. CONCLUSION: The recreational group exercise model significantly improves aerobic capacity and functioning of the cardiovascular system. Therefore, it is essential for women to be involved more in any form of recreational group exercising in order to improve functional capacity and health. Show more

Keywords: Spirometry, ergometry, exercise, cardiorespiratory fitness

DOI: 10.3233/BMR-170952

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 31, no. 4, pp. 719-725, 2018

Authors: Areerak, Kantheera | van der Beek, Allard J. | Janwantanakul, Prawit

Article Type: Research Article

Abstract: BACKGROUND: Neck pain has an episodic course with varying time for recovery and identification of individuals likely to recover is important. OBJECTIVE: The aim of this study was twofold: 1a) to explore the duration of recovery from nonspecific neck pain, and 1b) to investigate the relation between recovery duration and age, and 2) to evaluate whether the NHBOW can predict duration of recovery from non-specific neck pain. METHODS: One hundred and three from 342 office workers reported non-specific neck pain, with information collected on pain intensity and disability every month for 12 months. The …time to recovery was measured from the onset of neck pain to full recovery. The 103 office workers were divided into two groups using the NHBOW score. Kaplan-Meier survival curves were used to describe the median time to recovery. The survival curves of the two NHBOW groups were compared using Cox regression analysis. RESULTS: The median time to recovery from neck pain was 2 months. The duration of recovery was not significantly related with age of participants. There was no significant difference in time to recovery from neck pain between the NHBOW low-score group and the high-score group. CONCLUSION: This study showed that the NHBOW was unable to predict duration of recovery from nonspecific neck pain in office workers. Show more

Keywords: Health literacy, office worker, recovery, prognosis

DOI: 10.3233/BMR-170958

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 31, no. 4, pp. 727-734, 2018

Authors: Truszczyńska-Baszak, Aleksandra | Wysocka, Edyta | Starzec, Małgorzata | Drzał-Grabiec, Justyna | Tarnowski, Adam

Article Type: Research Article

Abstract: OBJECTIVES: Lumbar spinal stenosis may lead to urinary inconsistence and can have a negative impact on the quality of life. The aim of the study was to assess the incidence of urinary incontinence and quality of life in female patients with spinal canal stenosis comparing to control group. METHODS: The study population consisted of 50 women diagnosed with severe lumbar spinal canal stenosis. Their mean age was 55.32 ± 12.97 years. The clinical control group consisted of 30 women who did not suffer from any spine disorders. Their mean age was 54.87 ± …12.01 years. There was no difference between both groups regarding age, weight, BMI and number of parity. The women diagnosed with clinical and radiographic symptoms of spinal canal stenosis filled out an anonymous questionnaire, ODI, ICIQ-UI-SF, and ICIQ-LUTSqol questionnaires. RESULTS: We found urinary incontinence in 56% of women with lumbar spinal canal stenosis and in 43% of clinical control group. We also found a statistically significant correlation between duration of lumbar stenotic symptoms, the SLR sign, number of deliveries and the intensity of urinary incontinence. CONCLUSIONS: Urinary incontinence in women with lumbar spinal canal stenosis is significantly different from the control group. Leakage of urine happened more frequently, the amount of urine leaked was greater, and the general impact on everyday life is harsher, as compared to the clinical control group. Show more

Keywords: Spinal canal stenosis, urinary incontinence, quality of life

DOI: 10.3233/BMR-170976

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 31, no. 4, pp. 735-741, 2018

Authors: Duray, M. | Yagci, N. | Ok, N.

Article Type: Research Article

Abstract: BACKGROUND: Self-efficacy that is associated with various pain-related disabilities such as chronic low back pain (LBP), should be questioned besides physical assessments. OBJECTIVES: To investigate the physical factors associated with self-efficacy in patients with chronic mechanic LBP. METHODS: One hundred nine patients diagnosed as chronic mechanic LBP (65 females, 44 males) between 20–50 years old were included to this study. The intensity of LBP was assessed by using a 10-cm Visual Analogue Scale. For musculoskeletal fitness measurement; muscle strength, muscle endurance, and flexibility tests were applied. Functional Reach Test for balance evaluation, Self-Efficacy …Scale for self-efficacy measurement, Roland-Morris Disability Questionnaire for disability level evaluation were used. RESULTS: We found a moderate negative correlation between self-efficacy and pain intensity (r = - 0.506); a negative and strong correlation between self-efficacy and disability level (r = - 0.654) (p < 0.05). Self efficacy had a significant association with right (r = 0.265) and left (r = 0.290) lateral side bending flexibility (p < 0.05). According to multiple regression analysis results, it was found that disability level had a significant effect on self-efficacy (β = - 2.014; p < 0.01). CONCLUSIONS: Poor musculoskeletal fitness and pain intensity may cause decreasing self-efficacy but the major determinant of decreased self-efficacy was low-back related disability scores. Show more

Keywords: Low back pain, self-efficacy, physical fitness

DOI: 10.3233/BMR-170993

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 31, no. 4, pp. 743-748, 2018

Authors: Raţă, Bogdan Constantin | Raţă, Marinela | Antohe, Bogdan

Article Type: Case Report

Abstract: BACKGROUND: Most lesions of the soft tissues, especially those at the muscle level, are due to the lack of elasticity of the connective tissue and fascia. Stretching is one of the most commonly used methods of treatment for such musculoskeletal issues. OBJECTIVE: This study tracks the effects of stretching on the electromyographic activity of muscle chains, applied to a 24-year-old athlete diagnosed with the Haglund’s disease. METHOD: For the evaluation, we used visual examination and surface electromyography (maximum volumetric isometric contraction). The therapeutic intervention consisted in the application of the static stretching positions, …which intended the elongation of the shortened muscle chains. The treatment program had a duration of 2 months, with a frequency of 2 sessions per week and an average duration of 60 minutes. RESULTS: The posterior muscle chains recorded an increase in the EMG activity, while the anterior muscle chains tended to diminish their EMG activity. As a result of the applied treatment, all the evaluated muscle chains recorded a rebalancing of the electromyographic activity, demonstrating the efficiency of stretching as a method of global treatment of muscle chains. CONCLUSIONS: By analysing all the data, we have come to the conclusion that static stretching is an effective treatment method for shortened muscle chains. Show more

Keywords: Stretching, muscle chains, athletics

DOI: 10.3233/BMR-170998

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 31, no. 4, pp. 749-758, 2018