Journal of Back and Musculoskeletal Rehabilitation - Volume 33, issue 6

Authors: Carrasco-Uribarren, Andoni | Rodríguez-Sanz, Jacobo | Malo-Urriés, Miguel | Hidalgo-García, César | Tricás-Moreno, José Miguel | Balboa-López, David | Cabanillas-Barea, Sara

Article Type: Research Article

Abstract: BACKGROUND: Damage on the somatosensory system could cause sensation of dizziness, a condition known as cervicogenic dizziness (CD). Manual physical therapy has shown beneficial effects, relieving the symptoms of cervicogenic dizziness. However, the effect of upper cervical spine manipulation is unknown, as this is a technique that respects the International Federation of Orthopedic Manipulative Physical Therapists (IFOMPT) safety criteria. OBJECTIVE: To assess the effects of upper cervical spine traction-manipulation in subjects with cervicogenic dizziness. METHODS: This was a descriptive case series study. Treatment focused on the upper cervical spine manipulation procedure. Evaluation was …performed before and after the treatment. Variables recorded include upper and lower cervical range of motion, Cervical Flexion-Rotation Test (CFRT), dizziness intensity and cervical pain (VAS), self-perceived dizziness measured with Dizziness Handicap Inventory (DHI) and subjective perception of outcome (GROC-scale). RESULTS: Ten subjects were recruited. After the treatment protocol, there was an increased range of movement towards the most restricted side, as measured by the CFRT (p < 0.001), decreased intensity of dizziness (p < 0.001) and intensity of pain (p < 0.001). Functional capacity also improved after the intervention (p < 0.011). CONCLUSION: Upper cervical spine manipulation may decrease dizziness intensity and cervical pain and improve functional ability and upper cervical spine mobility in patients with cervicogenic dizziness. Show more

Keywords: Cervical spine, dizziness, manual therapy, range of movement, functional capacity

DOI: 10.3233/BMR-181479

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 6, pp. 961-967, 2020

Authors: Kurt, Vedat | Aras, Ozgen | Buker, Nihal

Article Type: Research Article

Abstract: BACKGROUND: Low back pain (LBP) is a common problem that causes pain, disability, and gait and balance problems. Neurodynamic techniques are used in the treatment of LBP. OBJECTIVE: The aim of this study was to compare the effects of electrotherapy and neural mobilization on pain, functionality, gait, and balance in patients with LBP. MATERIALS AND METHODS: A total of 41 patients were randomly assigned to either the neural mobilization group (NMG, n = 20) or electrotherapy group (ETG, n = 21). Assessment tools …used were Visual Analogue Scale (VAS) for pain, Oswestry Disability Index (ODI) for functionality, straight leg raise test (SLRT) for neural involvement, and baropedographic platform (Zebris FDM-2 TM ) for gait and static balance measurements. RESULTS: Both groups showed a significant decrease in pain and functional disability, while only the NMG group showed a significant increase in SLRT scores (p < 0.05). However, there were no statistically significant pre- to post-treatment changes in gait or static balance parameters in either group (p < 0.05). CONCLUSION: Neural mobilization was effective in reducing pain and improving functionality and SLRT performance in patients with LBP, but induced no change in gait and static balance parameters. Neural mobilization may be used as self-practice to supplement standard treatment programs. Show more

Keywords: Balance, disability, gait, low back pain, neurodynamics

DOI: 10.3233/BMR-181241

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 6, pp. 969-975, 2020

Authors: Yilmaz Tasdelen, Ozlem | Utkan, Ali | Ceritoglu, Kubilay Ugurcan | Ozalp Ates, Funda Seher | Bodur, Hatice

Article Type: Research Article

Abstract: BACKGROUND: Adaptation to Turkish language and validation studies of Knee Injury and Osteoarthritis Outcome Score – Physical Function Short Form (KOOS-PS) and Hip Disability and Osteoarthritis Outcome Score – Physical Function Short Form (HOOS-PS) were done previously but responsiveness to changes of these questionnaires could not be tested in these studies. OBJECTIVE: The aim of this study was to assess the responsiveness of the Turkish versions of the KOOS-PS and HOOS-PS in a patient group who underwent knee or hip joint arthroplasty operation. METHODS: Sixty-three patients who underwent total knee arthroplasties and sixteen …patients who underwent total hip arthroplasties for primary osteoarthritis were included in this study. The preoperative and 3-month postoperative KOOS-PS, HOOS-PS, and Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index hip and knee scores were collected from the hospital records, and the effect sizes (ESs) and standardized response means (SRMs) were calculated. RESULTS: The ESs and SRMs, respectively, were as follows: - 1.954 and - 2.156 for the KOOS-PS, - 1.833 and - 2.464 for the HOOS-PS, - 4.848 and - 4.210 for the WOMAC-knee, and - 3.835 and - 4.625 for the WOMAC-hip. CONCLUSIONS: The Turkish versions of the KOOS-PS and HOOS-PS exhibited strong responsiveness to change in the arthroplasty patients. Show more

Keywords: Responsiveness, Knee Injury and Osteoarthritis Outcome Score – Physical Function Short Form, Hip Disability and Osteoarthritis Outcome Score – Physical Function Short Form, KOOS-PS, HOOS-PS, arthroplasty

DOI: 10.3233/BMR-181420

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 6, pp. 977-981, 2020

Authors: Shahzad, Momena | Rafique, Nazish | Shakil-ur-Rehman, Syed | Ali Hussain, Syed

Article Type: Research Article

Abstract: BACKGROUND: Piriformis syndrome (PS) is a neuro-muscular condition, which is often underdiagnosed in clinical settings. This study will determine the effects of myofascial stretching Elongation Longitudinaux Avec Decoaption Osteo Articulaire (ELDOA) and post-facilitation stretching of the piriformis muscle in patients with PS. OBJECTIVE: We aimed to compare the effects of ELDOA and post-facilitation stretching of the piriformis muscle on pain, muscle length and functional performance in patients with PS. METHODS: A randomized clinical trial was conducted with 40 PS patients including both males and females, between the ages of 30–70. Patients were randomly assigned to the …ELDOA or post-facilitation group after assessments with the Numeric Pain Rating Scale (NPRS), Lower Extremity Functional Scale (LEFS), Piriformis Length Test and Straight Leg Raise (SLR). The assessments were done at baseline and at the end of the sixth week of treatment. RESULTS: The patients treated with ELDOA demonstrated significant improvement in pain (pre = 7.00 ± 2.75, post = 3.00 ± 1.75), piriformis length (pre = 27.6 ± 5.54, post = 36.8 ± 3.13), SLR (pre = 36.40 ± 7.24, post = 67.5 ± 8.36) and LEFS (pre = 26.90 ± 12.24, post = 58.10 ± 8.62), as compared with the group treated with post-facilitation stretching: pain: pre = 6.00 ± 1.00, post = 2.00 ± 1.50; piriformis length: pre = 28.55 ± 4.03, post = 38.8 ± 2.70; SLR: pre = 40.60 ± 7.48, post = 74.25 ± 5.19, and LEFS: pre = 25.20 ± 7.66, post = 66.30 ± 7.27). CONCLUSION: It can be concluded that the post-facilitation stretching technique shows more improvement in pain, muscle length, SLR, and LEFS in patients with PS as compared to ELDOA. Show more

Keywords: Muscle energy technique, myofascial stretching, piriformis syndrome, functional performance, post-facilitation stretching, Lower Extremity Functional Scale (LEFS)

DOI: 10.3233/BMR-181290

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 6, pp. 983-988, 2020

Authors: Duymaz, T. | Yagci, N. | Gayef, A. | Telatar, B.

Article Type: Research Article

Abstract: OBJECTIVE: The aim of this study was to investigate the incidence of low back pain in the postmenopausal period and the relationship between low back pain and emotional state, sleep and quality of life. METHODS: This cross-sectional study was conducted with 368 postmenopausal women between 40 and 65 years old. The frequency and severity of low back pain were recorded for all participants, as well as depressive symptoms and anxiety, quality of life and sleep quality. RESULTS: 90.2% of the participants reported low back pain. As low back pain severity increased, it was …found that depression, anxiety levels, NHP and PSQI total scores increased as well (p = 0.0001). Significant positive correlations were found between pain intensity and outcome measures, except for sleep duration and habitual sleep efficiency (p < 0.01). CONCLUSION: A great majority of women experience postmenopausal low back pain, which causes significant problems that negatively affect their quality of life, emotional state and sleep quality. Show more

Keywords: Postmenopause, women, low back pain

DOI: 10.3233/BMR-181381

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 6, pp. 989-994, 2020

Authors: Kılıç, Filiz | Demirgüç, Arzu | Arslan, Saniye Aydoğan | Keskin, Esra Dilek | Aras, Müyesser

Article Type: Research Article

Abstract: BACKGROUND: Knee osteoarthritis (OA) is a common musculoskeletal problem encountered in the postmenopausal period. OBJECTIVE: This study aimed to determine the impact of aerobic exercise on functional limitation, exercise tolerance, and performance tests in postmenopausal women with knee OA. METHODS: A total of 50 women (aged between 48–78) with grade 2–3 knee OA according to the Kellgren-Lawrence radiographic scale were enrolled. OA-specific physical performance tests (40 m Fast-Paced Walk Test (40mFPWT), 30 s Chair Stand Test (30sCST), Stair Climb Test (9-step SCT)), six-minute walk test (6MWT), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and …Visual Analogue Scale (VAS) were performed. Fifty patients were randomized to either the treatment or control groups. The treatment group received an additional aerobic exercise training along with a combined physiotherapy program for six weeks. The aerobic exercise program was carried out by the same physiotherapist every weekday (five days) for six weeks. The control group only received a combined physiotherapy program for six weeks. RESULTS: The post-treatment comparisons of the two groups yielded similar SCT results (p > 0.05), while VAS scores, the results of all performance tests, WOMAC scores, and the distance covered in 6MWT were significantly higher in the treatment group (p < 0.05). CONCLUSIONS: Consequently, this study provides an insight into the efficacy of the aerobic exercise program applied along with a combined physiotherapy program in postmenopausal women with knee OA. Show more

Keywords: Aerobic exercise, knee osteoarthritis, menopause, physical performance

DOI: 10.3233/BMR-191712

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 6, pp. 995-1002, 2020

Authors: Sainz de Baranda, Pilar | Andújar, Pilar | Collazo-Diéguez, Mónica | Pastor, Antonio | Santonja-Renedo, Fernando | Martínez-Romero, María Teresa | Aparicio-Sarmiento, Alba | Cejudo, Antonio | Rodríguez-Ferrán, Olga | Santonja-Medina, Fernando

Article Type: Research Article

Abstract: BACKGROUND: The child’s spine shows changes in posture and balance of its curvatures during growth and musculoskeletal spinal conditions are likely to develop, such as back pain (BP). OBJECTIVE: The purposes of this study were (a) to describe the sagittal spinal alignment in a relaxed standing position and (b) to analyze its association with BP among 8 to 12-year-old children. METHODS: This was a cross-sectional study. A total of 731 elementary schoolchildren (379 girls and 352 boys), from 16 Spanish schools, participated. An unilevel inclinometer was used to quantify the sagittal spinal curvatures (thoracic and lumbar) …in a relaxed standing position. Sagittal spinal morphotype was analyzed by sex, age, weight, height, and BMI. Children’s parents or legal guardians filled in a questionnaire according to the children’s responses about the BP suffered in the previous week and the preceding year. RESULTS: The mean angular value of thoracic kyphosis was 36.08 ± 8.99 ∘ and significantly higher in males than in females (p = 0.036). In contrast, the mean value of lumbar lordosis was 32.11 ± 7.46 ∘ , being higher in females than in men (p < 0.01). The thoracic curve tends to increase by age (p = 0.003). Children who had low back pain (LBP) in the previous week had a significantly greater lumbar curve (35.88 ± 8.20 ∘ ) than those who did not have LBP in the preceding week (32.24 ± 7.30 ∘ ). The angle for lumbar curvature was a small predictor of LBP occurrence in the assessed children (OR = 1.082 [small]; 95% CI = 1.009–1.160, p = 0.028). CONCLUSIONS: To conclude, almost 3/4 of the students were classified with normal thoracic kyphosis; however, 27.36% of the students had thoracic hyperkyphosis. Lumbar hyperlordosis was identified in 9.05% of the students, and was 2.5 times more frequent in girls. The lumbar curvature was a small predictor of LBP occurrence in the assessed children and the angle of lumbar curvature that most accurately identified individuals at risk of developing LBP was determined to be 33 ∘ . The results of this study indicate the need to assess sagittal spinal curvatures at school during development ages. Show more

Keywords: Kyphosis, lordosis, inclinometer, spine, spinal imbalance, children

DOI: 10.3233/BMR-191727

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 6, pp. 1003-1014, 2020