Journal of Back and Musculoskeletal Rehabilitation - Volume 33, issue 2

Authors: Yang, Kuang | Li, Haiyin | Li, Changqing

Article Type: Research Article

Abstract: BACKGROUND: IVD degeneration is a widespread problem all over the world, which a variety of inflammatory cytokines have been implicated in, while Sphingosine 1-phosphate (S1P) is an important lipid mediator that may play a role in IVD degeneration. OBJECTIVE: To study the expression and role of S1PRs in the intervertebal disc (IVD) degeneration to enhance understanding of disc degeneration. METHODS: Degenerated and normal IVD were harvested from patients through surgery. Expression of S1P receptor subtypes was evaluated using real-time PCR, immunohistochemistry, and western blotting. The effect of S1PR on inflammation induced by interleukin-1β …in nucleus pulposus (NP) cells was also assessed by real time PCR and western blotting. RESULTS: The nucleus pulposus mainly expressed the S1PR1/2/3, and the expression decreased in the severe degenerated nucleus pulposus cells. The ligand, S1P, inhibited the up-regulation of matrix metallopeptidase-3 (MMP-3) and ADAM metallopeptidase with thrombospondin type 1 motif 4 (ADAMTS4) induced by IL-1β . CONCLUSIONS: The results show that an the expression of S1PRs in degenerative discs is down-regulated as degeneration, and S1P can inhibit the inflammation response induced by IL-1β in NP cells, implicating that S1P/S1PR may contribute to IVD degeneration. Show more

Keywords: Sphingosine 1-phosphate receptors, nucleus pulposus cells, intervertebral disc degeneration, IL-1β

DOI: 10.3233/BMR-181488

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 2, pp. 255-262, 2020

Authors: Kudo, Daisuke | Miyakoshi, Naohisa | Hongo, Michio | Kasukawa, Yuji | Ishikawa, Yoshinori | Shimada, Yoichi

Article Type: Research Article

Abstract: BACKGROUND: Lower limb compensation for spinal sagittal malalignment and its impact on quality of life (QOL) and low back pain (LBP) have not been well studied. OBJECTIVE: To clarify postural compensation and the impact of spinal and lower limb sagittal alignment and muscle strength on QOL and LBP in persons > 50 years old. METHODS: In this cross-sectional study, 122 rural community-dwelling, healthy adults (56 males, 66 females; average age 71.1 years; age range, 52–88 years) underwent assessments of QOL (36-Item Short-Form Health Survey; SF-36), LBP (Roland-Morris Disability Questionnaire; RDQ), …thoracic kyphosis (TK), lumbar lordosis (LL), sacral inclination (SI), grip strength, lower limb strength, and back extensor strength (BES). On univariate and multivariate analyses, variables that correlated with QOL and the RDQ were identified. RESULTS: LL was moderately correlated with SI and weakly correlated with the knee flexion angle (KFA). LL, KFA, C7-L5D, and BES were correlated with SF-36 subscales and the RDQ. KFA contributed to the physical component summary of the SF-36. Female sex and BES contributed to the RDQ. CONCLUSIONS: Knee flexion compensated for lumbar kyphosis, but affected physical QOL scores negatively; BES was the most reliable contributor to QOL and the RDQ. Show more

Keywords: Spinal sagittal malalignment, lumbar lordosis, thoracic kyphosis, SF-36, Roland-Morris Disability Questionnaire, knee flexion angle, back extensor strength

DOI: 10.3233/BMR-160618

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 2, pp. 263-268, 2020

Authors: Saraiva, Bruna Thamyres Ciccotti | Pinto, Rafael Z. | Oliveira, Crystian Bitencourt | Zanuto, Edner Fernando | Scarabottolo, Catarina Covolo | Delfino, Leandro Dragueta | Suetake, Vinícius Yukio Botelho | Gil, Fernanda Caroline Staquencini | Christofaro, Diego Giulliano Destro

Article Type: Research Article

Abstract: BACKGROUND: The literature on physical activity practice through sports as a protective factor for back pain in adolescents is conflicting. However, few studies have aimed to verify if continuity of the practice of physical activity from childhood to adolescence may be related to lower chances of back pain in adolescents. OBJECTIVES: The objective of this study was to analyze the association between physical activity practice from childhood to adolescence and back pain in adolescents. METHODS: The random sample was composed of 870 adolescents with a mean age of 13.7 ± …2.0 years. The continuity of physical activity practice was assessed through the continuity of sports practice from childhood to adolescence. Pain in the neck and low back were evaluated through a questionnaire. RESULTS: The prevalence of neck pain and low back pain in boys was 17.5% and in girls was 20.9% for neck pain and 21.9% for low back pain. Physical activity practice during childhood to adolescence was a protective factor for neck pain (OR = 0.57 [CI = 0.35–0.94]) and low back pain (OR = 0.53 [CI = 0.33–0.86]) in girls and neck pain in boys (OR = 0.52 [CI = 0.30–0.90]), even after adjusting for confounding factors. CONCLUSION: Girls with physical activity practice during childhood to adolescence were less likely to develop neck pain and back pain when compared to girls who did not maintain practice of physical activity. Similar results were observed in boys considering neck pain. Show more

Keywords: Physical activity, sports, back pain, musculoskeletal disorders, adolescents

DOI: 10.3233/BMR-181136

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 2, pp. 269-275, 2020

Authors: Dhondt, Evy | Van Oosterwijck, Jessica | Cagnie, Barbara | Adnan, Rahmat | Schouppe, Stijn | Van Akeleyen, Jens | Logghe, Tine | Danneels, Lieven

Article Type: Research Article

Abstract: BACKGROUND: There is a growing need to identify patient pre-treatment characteristics that could predict adherence and outcome following specific interventions. OBJECTIVE: To identify predictors of adherence and outcome to outpatient multimodal rehabilitation in chronic low back pain (CLBP). METHODS: A total of 273 CLBP patients participated in an exercise-based rehabilitation program. Patients who completed ⩾ 70% of the treatment course were classified as adherent. Patients showing a post-treatment reduction of ⩾ 30% in Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) back pain intensity scores were …assigned to the favorable outcome group. RESULTS: Multivariate logistic regression revealed that higher age, higher ability to perform low-load activities, and higher degrees of kinesiophobia increased the odds to complete the rehabilitation program. By contrast, lower levels of education and back pain unrelated to poor posture increased the odds for non-adherence. Furthermore, a favorable outcome was predicted in case the cause for LBP was known, shorter symptom duration, no pain in the lower legs, no difficulties falling asleep, and short-term work absenteeism. CONCLUSIONS: Assessment and consideration of patient pre-treatment characteristics is of great importance as they may enable therapists to identify patients with a good prognosis or at risk for non-responding to outpatient multimodal rehabilitation. Show more

Keywords: Kinesiophobia, disability, logistic models, logistic regression, low back pain, predictors, prognosis, rehabilitation, clinical outcome, therapy

DOI: 10.3233/BMR-181125

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 2, pp. 277-293, 2020

Authors: Hannink, Erin | Shannon, Thomas | Barker, Karen L. | Dawes, Helen

Article Type: Research Article

Abstract: BACKGROUND: Abnormal sagittal spinal curvature is associated with pain, decreased mobility, respiratory problems and increased mortality. Time-of-flight technology of the Microsoft Kinect sensor can reconstruct a three-dimensional image of the back quickly and inexpensively. OBJECTIVE: To estimate the extent of the reproducibility of sagittal spine curvature measurement using the Microsoft Kinect sensor. METHODS: Simultaneous measurement of thoracic and lumbar spine using the Microsoft Kinect sensor in 37 participants. Two investigators gave standardised instructions and each captured 3 images. Thoracic kyphosis and lumbar lordosis angle indexes were calculated using maximum height divided by the …length. RESULTS: Adult participants (mean age in years (SD) = 51.7 (20.6); 57% female; BMI in kg/m 2 (SD) = 24.9 (3.3)) kyphosis and lordosis indexes showed high intra-rater and inter-rater ICC values (0.960–0.973). The means of the first images from both raters had significantly larger kyphosis indexes compared to the second and third images, yet no difference between means in lordosis data. CONCLUSIONS: The results indicate that the Microsoft Kinect sensor has a reproducible method with high intra-rater and inter-rater reliability. The difference between the means over repeated measures suggest the second image capture is more consistent. It is a reproducible and quick method in clinical and research settings. Show more

Keywords: Kyphosis, lordosis, postural topography, sagittal plane

DOI: 10.3233/BMR-191554

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 2, pp. 295-301, 2020

Authors: Huijnen, Ivan P.J. | Schasfoort, Fabienne C. | Smeets, Rob J.E.M. | Sneekes, Emiel | Verbunt, Jeanine A. | Bussmann, Johannes B.J.

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVE: The purpose of this study is to determine whether patients, classified by their treating consultant in rehabilitation medicine as avoider or persister, show differences in a large set of detailed outcomes of actual, objectively measured daily physical behaviour. METHODS: In this explorative cross-sectional study, 16 patients were included; 9 patients were categorized as avoider and 7 patients as persister. Subjects wore the VitaMove activity monitor, a high-end accelerometry-based device that allowed automatic detection of a large set of body postures and motions. Physical behaviour was assessed in detail by total duration of body …postures and motions as percentages of 24 hours, as well as by the number of sit-to-stand transfers, overall activity level, walking speed, and the distribution of bouts of physical activity and sedentary behaviour. Differences between groups were tested with the Mann Whitney U test. RESULTS: There were no significant differences between groups in any of the physical behaviour outcomes. CONCLUSIONS: Our study showed that activity-related behavioural style categorization by consultants in rehabilitation medicine is not expressed in objectively measured detailed outcomes of daily physical behaviour. Show more

Keywords: Activity monitoring, activity-related behaviour, chronic low back pain, excessive persistence, avoidance

DOI: 10.3233/BMR-171048

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 2, pp. 303-311, 2020

Authors: Denteneer, Lenie | van Daele, Ulrike | Truijen, Steven | de Hertogh, Willem | Maldoy, Marjan | Leysen, Marijke | Stassijns, Gaetane

Article Type: Research Article

Abstract: BACKGROUND: Up until now, assessment of physical functioning in patients with low back pain is mostly completed with the use of patient reported outcome measurements (PROMs). There are however limitations to the use of these measurements such as inaccuracies due to recall bias, social desirability bias and errors in self-observation. A recent review indicated seven clinical tests as having good test retest reliability. These tests can now be further investigated for their validity. OBJECTIVES: To investigate the convergent validity of seven clinical tests (extensor endurance, flexor endurance, 5 minute walking, 50 foot walking, shuttle walk, sit …to stand and the loaded forward reach test) in patients with nonspecific chronic low back pain (CLBP). METHODS: Patients filled in a series of PROMs and performed all included clinical tests during a specific test moment. Convergent validity was firstly investigated by assessing Pearson correlations between the seven included clinical tests and secondly by assessing the correlations between the predefined PROMs and the clinical tests. RESULTS: Twenty-five patients were included in this study representing a power of 84%. The best overall evidence for convergent validity could be identified for the extensor endurance, sit to stand and the loaded forward reach test. However, when all study results were combined, evidence for convergent validity was found for all included clinical tests except for the shuttle walk test. CONCLUSION: The current study was able to provide evidence that multimethod and multidimensional approaches should be used as a more comprehensive assessment of physical function in patients with nonspecific CLBP. Show more

Keywords: Clinical testing, physical functioning, activities, participation, clinimetric, low back pain

DOI: 10.3233/BMR-181318

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 2, pp. 313-322, 2020

Authors: Millere, Anna | Kalnberza-Ribule, Zaiga | Mezals, Matiss | Nulle, Anda | Millere, Inga | Deklava, Liana

Article Type: Research Article

Abstract: BACKGROUND: It is known that pain has emotional and behavioral consequences that influence the development of problems and outcome of treatment. Patients’ attitudes and coping mechanisms seem to play a causal role in the chronification of low back pain (LBP) and augment a cycle of chronic pain and disability. OBJECTIVE: To examine pain catastrophizing, stress coping strategies and disability among patients with low back pain in rehabilitation practice in Latvia. METHODS: Seventy-four patients participated in the study. We used the Demographic questionnaire, Visual Analogue Scale, The Oswestry Low Back Disability Questionnaire, Pain Catastrophizing …Scale and “The Ways of Coping scale”. RESULTS: According to our data there is a strong interrelationship of disability and pain catastrophizing. The research data shows significantly higher scores of pain catastrophizing in patients with a more severe disability. CONCLUSIONS: Achieved research highlights the importance of a multifactorial approach to pain management and the enormous significance of pain catastrophizing in patients with low back pain. Show more

Keywords: Disability, low back pain, rehabilitation, pain catastrophizing

DOI: 10.3233/BMR-170945

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 2, pp. 323-328, 2020

Authors: Brindisino, Fabrizio | Giovannico, Giuseppe | Maselli, Filippo

Article Type: Case Report

Abstract: BACKGROUND: Shoulder pain is one of the most common problems affecting people older than 60 years. Among the shoulder pathologies, the disorders of the periarticular soft tissue (e.g. rotator cuff) are considered to be the most common; moreover, these disorders are found in approximately 75% of patients with seropositive rheumatoid arthritis. The incidence of structural rotator cuff tendon pathology, including full-thickness rotator cuff tendon tears, increases with age. Recent researchers suggested that non-operative treatment of full-thickness rotator cuff tears could be successful in some patients; furthermore, in rheumatoid arthritis patients, there was a greater possibility of developing surgical complications …compared with non-rheumatoid arthritis patients. MATERIALS AND METHODS: A case report of a woman, 72 years old, with rheumatoid arthritis, shoulder pain and pseudo-paralytic arm presented with a massive tear of Supraspinatus and Infraspinatus tendon. In accordance with evidence, the case was managed using pain education and exercise therapy for 2.5 months. The shoulder pain, the function and the range of motion improved following a physiotherapy program. CONCLUSION: Pain education in combination with exercise therapy was effective for improving pain and function in a full-thickness tear of Supraspinatus and Infraspinatus tendon in a patient also suffering from rheumatoid arthritis. Show more

Keywords: Pain neurological education, exercise therapy, shoulder pain, full-thickness rotator cuff tear, rheumatoid arthritis

DOI: 10.3233/BMR-171069

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 2, pp. 329-337, 2020

Authors: Koseki, Kazunori | Yozu, Arito | Takano, Hanako | Abe, Atsushi | Yoshikawa, Kenichi | Maezawa, Takayuki | Kohno, Yutaka | Mutsuzaki, Hirotaka

Article Type: Case Report

Abstract: BACKGROUND: Independent walking is important for individuals who have undergone lower limb amputation. Recently, robot-assisted gait training has been widely used for individuals with abnormal gait. However, no study has evaluated the effect of the Honda Walking Assist Device ® (HWA) on the gait of patients who have undergone transfemoral (TF) amputation. OBJECTIVE: This study aimed to investigate the safety, feasibility, and effect of gait training using the HWA for individuals who underwent lower limb amputation. METHODS: This study included two elderly patients who underwent TF amputation due to …a nontraumatic reason. Gait training interventions using the HWA were performed for a week (5 training sessions). Self-selected walking speed (SWS), step length, cadence, hip kinematic parameters, and symmetricity of single support time ratios during SWS were measured before and after the HWA interventions. RESULTS: SWS, step length, cadence, and hip angle range improved after the HWA interventions in both patients. Symmetricity of single support time ratios and maximum hip extension angle improved in patient 1, but not in patient 2. There were no adverse events in either patient. CONCLUSIONS: Gait training using the HWA was safe and effective for improving the gait of two TF amputees. Show more

Keywords: Lower limb amputation, gait training, Honda Walking Assist Device, transfemoral amputation

DOI: 10.3233/BMR-191726

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 2, pp. 339-344, 2020