Journal of Back and Musculoskeletal Rehabilitation - Volume 33, issue 5

Authors: Löfvander, Monica | Rosenblad, Andreas

Article Type: Research Article

Abstract: BACKGROUND: Mortality rates among immigrant patients undergoing rehabilitation for musculoskeletal backache are unknown. OBJECTIVE: To study the association between marital status, severe psychosocial strain, receiving long-term time-limited sickness allowance (TLSA) and all-cause mortality (ACM) in a cohort of immigrants aged 20–45 years with long-standing backache in Sweden. METHODS: We studied 318 patients (92% foreign-born, 76% non-European) of known marital status on sick-leave for musculoskeletal backache. They were followed up for ACM until 2015. Socio-demographic data, TLSA and psychosocial strain, including major depression, severe psychosocial stressors and pessimistic thoughts, were analysed using multiple-imputation Cox …regression. RESULTS: Over a mean (standard deviation) follow-up time of 15 (5.0) years, 11 (3.5%) participants died. At baseline, 34% were unmarried, 19% were receiving TLSA, and 71% had ⩾ 1 psychosocial strain component (38% depression; 47% severe stressors; 35% pessimistic thoughts). After concomitant risk factors were adjusted for, being unmarried and receiving TLSA were associated with higher mortality by factors of 6.2 (p = 0.005) and 5.8 (p = 0.006), respectively. Psychosocial strain was only significantly associated with higher mortality in the unadjusted analyses. CONCLUSIONS: Being unmarried and receiving TLSA were associated with significantly higher ACM in this highly marginalized group of immigrant patients. Show more

Keywords: Chronic pain, sickness allowance, psychosocial stressors, depression, illness attitudes, immigrants, rehabilitation, all-cause mortality, primary care

DOI: 10.3233/BMR-181273

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 5, pp. 801-809, 2020

Authors: Safari, Maedeh | Shojaei, Shahrokh | Tehrani, Pedram | Karimi, Alireza

Article Type: Research Article

Abstract: BACKGROUND: The main responsibility of the anterior cruciate ligament (ACL) is to restore normal knee kinematics and kinetics. Although so far different research has been carried out to measure or quantify the stresses and strains in the ACL experimentally or numerically, there is still a paucity of knowledge in this regard under different flexion angles of the tibiofemoral knee joint. OBJECTIVE: Understanding the stresses and strains within the ACL under various loading and boundary conditions may have a key asset for the development of an optimal surgical treatment of ACL injury that can better restore normal …knee function. This study aimed to calculate the stresses and strains within the ACL under different flexion angles using a patient-specific finite element (FE) model of the human tibiofemoral knee joint. METHODS: A patient-specific FE model of the human tibiofemoral knee joint was established using computed tomography/magnetic resonance imaging data to calculate the stresses and strains in the ACL under different flexion angles of 0, 10, 20, 30, and 45 ∘ . RESULTS: Although the role of the flexion angle in the induced stresses and strains of the ACL was insignificant, the highest stress and strain were observed at the flexion angle of 0 ∘ . The concentration of the stresses and strains regardless of the flexion angles were also located at the proximal end of the ACL, where the clinical reports indicated that most ACL tearing occurs there at the femoral insertion site. CONCLUSIONS: The results have implications not only for understanding the stresses and strains within the ACL under different flexion angles, but also for providing preliminary data for the biomechanical and medical experts in regard of the injuries which may occur to the ACL at relatively higher flexion angles. Show more

Keywords: Anterior cruciate ligament, tibiofemoral, flexion angle, von Mises stress, finite element analysis

DOI: 10.3233/BMR-191505

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 5, pp. 811-815, 2020

Authors: Pawłowska, Katarzyna Maria | Bochyński, Rafał | Pawłowski, Jakub | Jerzak, Leszek | Grochulska, Agnieszka

Article Type: Research Article

Abstract: BACKGROUND: Osteoarthritis is one of the most common joint disorders. It causes pain, stiffness and a decreased range of motion which have a significant impact on daily activities and gait, consequently leading to disability. OBJECTIVE : The aim of this study is to compare hip mobilization with non-weight bearing exercises. METHODS: A total of 57 females aged between 55–65 were divided into 2 groups. In the control group non-weight bearing exercises were conducted, whereas the research group received hip mobilization. RESULTS: The Lequesne index significantly improved in the research group as …compared with the control group. Hip function improved both in the control and research groups. Active hip extension increased by 0.54, while active abduction rose by 2.14 after non-weight bearing exercises. In the control group after mobilization both passive and active hip extension increased significantly by 3.53, active abduction by 5 and passive by 4.41, while active and passive internal rotation by 3.82 and 4.56, respectively. In both groups pain decreased. CONCLUSIONS: Mobilization increases hip range of motion, decreases pain and improves hip function more than non-weight bearing exercises. Show more

Keywords: Hip osteoarthritis, mobilization, manual therapy, therapeutic exercises

DOI: 10.3233/BMR-181118

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 5, pp. 817-822, 2020

Authors: Cavalcanti, Isabela Franco | Antonino, Gabriel Barreto | Monte-Silva, Katia Karina do | Guerino, Marcelo Renato | Ferreira, Ana Paula de Lima | das Graças Rodrigues de Araújo, Maria

Article Type: Research Article

Abstract: BACKGROUND: Spinal pain is an important public health issue that brings biopsychosocial problems. Global Postural Re-education (GPR) is one of its treatments. OBJECTIVE: Evaluate the effects of GPR on pain, flexibility, and posture of individuals with non-specific low back pain and/or neck pain for more than six weeks. METHODS: The study enrolled 18 individuals, which were randomized into two groups: GPR group (GPRG; n = 09), submitted to 10 sessions of GPR and control group (CG; n = 09), not submitted to any …technique. The evaluations were done before and after the GPRG sessions, for pain perception (Visual Analogue Scale – VAS), flexibility (finger-floor test) and posture (SAPO). The re-evaluation was done in the GPRG after the end of 10 treatment sessions and, in the GC, after the time equivalent to 10 sessions. The level of significance was set at p < 0.05. RESULTS: This pilot study has no homogeneity between groups. GPRG presented improvement in pain and flexibility, but showed no changes in posture. In the CG, there was no difference in the variables evaluated in this study. CONCLUSION: GPR had positive effects on pain and flexibility, but did not present a significant effect on posture. Show more

Keywords: Low back pain, neck pain, flexibility, posture, Global Postural Re-education

DOI: 10.3233/BMR-181371

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 5, pp. 823-828, 2020

Authors: Denteneer, Lenie | Van Daele, Ulrike | De Hertogh, Willem | Truijen, Steven | Deckers, Kristiaan | Stassijns, Gaetane

Article Type: Research Article

Abstract: BACKGROUND: For patients with nonspecific chronic low back pain (CLBP), exercise therapy is stated to be the most effective intervention strategy but it is unclear which kind of exercise therapy is most beneficial. OBJECTIVE: To identify preliminary prognostic indicators that predict outcome for exercise therapy in patients with nonspecific CLBP. METHODS: Patients were recruited in two hospitals and received 18 intervention sessions: stabilization therapy, isometric training therapy or a combination therapy. The primary outcome measure was the change in the Modified Low Back Pain Disability Questionnaire after nine weeks. RESULTS: …A total of 59 patients completed the study which represents a statistical power of 90%. In total, 30 patients were categorized as having treatment success and 29 as treatment failure. After using regression analyses to determine the association between standardized examination variables and treatment response status, prognostic indicators were identified for predicting therapy success (positive likelihood ratio [LR], 3.8) and failure (negative LR, 0.19). CONCLUSIONS: The most important variables were the prone instability test, pelvic tilt test, straight leg raise, body weight, visual analogue scale and the short form 36 health survey. Show more

Keywords: Classification, prognosis, prediction, clinical examination, exercise therapy, nonspecific, chronic, low back pain, rehabilitation, physical therapy

DOI: 10.3233/BMR-181370

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 5, pp. 829-839, 2020

Authors: Park, Sun Ja | Kim, Young Mi | Yang, Sung Rae

Article Type: Research Article

Abstract: BACKGROUND: Trunk stabilization contributes to the efficient control of body movements in daily life, and it plays an important role in maintaining the proper alignment of the body and preventing low back pain. OBJECTIVE: This study aimed to identify the effectiveness of breathing exercises and lumbar segmental exercises on the vital capacity of lumbar instability patients. METHOD: Fifty-nine patients suffering from chronic low back pain participated in this study. They were randomly divided into three groups: experiment group 1 performed breathing and segmental stabilization exercises (n = 20), …experiment group 2 performed segmental stabilization exercises (n = 20), and the control group performed the modality treatment (n = 19). The measurements were assessed on vital capacity. RESULTS: The difference in the forced vital capacity, maximal expiratory pressure, and maximal inspiratory pressure at pre- and post-intervention was significant in the RE+ LSSE and LSSE groups (p < 0.05) and among all groups (p < 0.05). The difference in the forced expiratory volume at one second of each group was significant (p < 0.05) but was not significant among groups (p > 0.05). CONCLUSION: In conclusion, the lumbar segmental stabilization exercise activates the deep muscle and improves the respiratory function and respiratory pressure, when used for chronic low back pain patients with segmental instability. Show more

Keywords: Lumbar segmental stabilization exercise, breathing exercises, vital capacity, chronic low back pain

DOI: 10.3233/BMR-181202

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 5, pp. 841-848, 2020

Authors: Zwierzchowska, Anna | Tuz, Jacek | Grabara, Małgorzata

Article Type: Research Article

Abstract: BACKGROUND: One of the complications of obesity is low back pain, frequently associated with postural disorders. Body adiposity index (BAI) can be calculated without weighing, which may be rendered useful in settings where measuring accurate body weight is problematic. OBJECTIVE: The aim of this study was to compare two indices of somatic structure, i.e., BAI and BMI regarding their accuracy (specific and sensitive) in predicting postural aberrations. METHODS: The study group comprised of 1281 participants aged 20–22 years, who were students from universities in southern Poland. Anteroposterior spinal curvatures were measured using the Rippstein …plurimeter. All subjects were measured for body height (BH) and mass, waist and hip circumference (WC and HC, respectively). RESULTS: In both male and female groups classified according to BAI cut-off points, a significant linear relationship was noted for the lumbar lordosis angle, i.e., the latter increased along with the BAI increase. The analysis of variance confirmed statistically significant differences in lordosis angles in both groups (women f = 19.6, p < 0.001; men f = 21.18, p < 0.001). These data evidenced a weak relationship between LL and the BAI. Pearson correlation coefficient (r) between LL and BAI was 0.2 and 0.21 for men and women, respectively. CONCLUSIONS: We concluded that, contrary to BAI, BMI value did not indicate a significant difference in lumbar lordosis angle between normal weight and obese participants (women and men). Show more

Keywords: Body adiposity index, Rippstein plurimeter, thoracic kyphosis, increments of angles spine

DOI: 10.3233/BMR-170982

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 5, pp. 849-855, 2020

Authors: Ha, Sun-Young | Shin, DooChul

Article Type: Research Article

Abstract: BACKGROUND: The curl-up exercise is widely used in clinical practice for strengthening abdominal muscles, but has been applied without a systematic method. OBJECTIVE: The purpose of this study was to determine the most effective method considering the angle and muscle contraction direction during the curl-up exercise. METHODS: Fourteen healthy males performed the curl-up exercise according to contraction direction (concentric and eccentric) and angle (30 ∘ , 60 ∘ , and 90 ∘ ). The muscle activity of the rectus abdominis (RA), external oblique (EO), …internal oblique (IO), and iliopsoas (IP) was measured using electromyography (EMG), and the muscle thickness of transversus abdominis (TrA) was measured using ultrasonography. RESULTS: The activities of the abdominal muscles (RA, EO, and IO) decreased with increasing angles (30 ∘ , 60 ∘ , and 90 ∘ ) (p < 0.05). There was no significant difference between eccentric and concentric contractions. The thickness ratio of TrA was the largest at an eccentric curl-up at 30 ∘ , and the smallest at a concentric curl-up at 30 ∘ (p < 0.05). CONCLUSIONS: The most effective angle for curl-up was 30 ∘ . Although there is no difference in the direction of muscle contraction, eccentric curl-up at 30 ∘ could be considered the most effective posture for abdominal strengthening considering the importance of TrA. Show more

Keywords: Abdominal muscles, electromyography, ultrasonography

DOI: 10.3233/BMR-191558

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 5, pp. 857-863, 2020

Authors: Burelo-Peregrino, Elena Guadalupe | Salas-Magaña, Marisol | Arias-Vázquez, Pedro Iván | Tovilla-Zarate, Carlos Alfonso | Bermudez-Ocaña, Deysi Yadira | López-Narváez, María Lilia | Guzmán-Priego, Crystell Guadalupe | González-Castro, Thelma Beatriz | Juárez-Rojop, Isela Esther

Article Type: Review Article

Abstract: BACKGROUND: Up to now there is not enough evidence that supports the use of electrotherapy in the treatment of Bell’s palsy. OBJECTIVE: Through a systematic review, we aimed to verify whether the use of electrotherapy is effective for treating Bell’s palsy or peripheral paralysis. METHODS: Publications were searched in PubMed, EBSCO and Web of Science. The present systematic review included studies that analyzed the electrotherapy as a therapeutic method for treating individuals with Bell’s palsy, in order to recover the function of facial muscles. RESULTS: Seven studies involving a total …of 131 cases and 113 controls were included in this systematic review. In the studies analyzed, patients received electrotherapy combined with other treatments such as hot-wet facial napkins, massages and muscle reeducation. Although the effect of electrotherapy alone was not evaluated, the use of electrotherapy combined with other treatments produced a significant improvement in the individuals evaluated. CONCLUSIONS: Due to the diverse methodologies used and the small number of individuals included in the studies, we could not fully prove the efficacy of electrotherapy for treating Bell’s Palsy. Future studies with larger samples and homogenous populations should be performed to obtain conclusive results. Show more

Keywords: Bell’s palsy, peripheral paralysis, electrotherapy

DOI: 10.3233/BMR-171031

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 5, pp. 865-874, 2020