Journal of Back and Musculoskeletal Rehabilitation - Volume 34, issue 1

Authors: Soer, Remko

Article Type: Editorial

DOI: 10.3233/BMR-205000

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 1, pp. 1-2, 2021

Authors: Mendez-Rebolledo, Guillermo | Morales-Verdugo, Juan | Orozco-Chavez, Ignacio | Habechian, Fernanda Assis Paes | Padilla, Eleazar Lara | de la Rosa, Francisco José Berral

Article Type: Review Article

Abstract: BACKGROUND: Muscle synergies contribute to scapular position during arm movement. The trapezius and serratus anterior (SA) muscles are the main stabilizers and are therefore the main target muscles of therapeutic exercises. OBJECTIVE: To systematically review the current literature investigating the optimal activation ratio of the scapular muscles during a range of closed kinetic chain exercises. METHODS: A systematic review search was conducted to identify studies reporting shoulder electromyography (EMG) activity during rehabilitation exercises in healthy participants. The search was conducted in PubMed, Cochrane Library, MEDLINE, CINAHL, Scopus, SPORTDiscus, and ScienceDirect. The included studies …reported closed kinetic chain exercises and the muscle activity as a percentage of maximum voluntary isometric contraction (%MVIC) or muscle ratios of the lower trapezius (LT), middle trapezius (MT), and SA with respect to the upper trapezius (UT). Muscle ratios were classified as optimal if they were equal to or lower than 0.6, and the adapted Newcastle-Ottawa Scale (NOS) was used to evaluate the methodological quality of the selected studies. RESULTS: Twenty-nine studies were included in this review; 7 main exercises and 30 variations of these were reported. The average electromyographic activity of the concentric and eccentric phase was considered. Half Push Up, Push Up Plus, and Scap Protraction exercises showed optimal SA activity (UT/SA < 0.6), while Press Up, Half Push Up, and One Hand Plank exercises showed optimal LT activity (UT/LT < 0.6). According to the NOS, 15 studies were classified as moderate methodological quality. CONCLUSIONS: The exercises in higher positions (e.g. exercises with the trunk closest to the vertical line) or unstable surfaces tend to favor UT activity over the MT, LT and SA. The exercises including scapular retraction showed optimal UT/MT and UT/LT ratios, while those including scapular protraction showed optimal UT/SA ratios. This will assist therapists in the correct selection of exercises for shoulder rehabilitation. Show more

Keywords: Kinetic chain, scapula, rehabilitation, physical therapy, exercise, electromyography

DOI: 10.3233/BMR-191771

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 1, pp. 3-16, 2021

Authors: Robinson, David M. | Eng, Christine | Makovitch, Steven | Rothenberg, Joshua B. | DeLuca, Stephanie | Douglas, Stephanie | Civitarese, David | Borg-Stein, Joanne

Article Type: Review Article

Abstract: BACKGROUND: Shoulder pain from rotator cuff pathology and glenohumeral osteoarthritis is a common entity encountered in musculoskeletal practices. Orthobiologic agents are being increasingly used as a treatment option and understanding their safety and efficacy is necessary. OBJECTIVE: To systematically evaluate the available evidence for orthobiologic use in rotator cuff and glenohumeral pathology. METHODS: A systematic review was undertaken following PRISMA guidelines. Randomized clinical trials (RCTs) and prospective cohort studies evaluating non-operative treatment with prolotherapy, platelet-rich plasma (PRP), or medicinal signaling cells (MSCs) for rotator cuff pathology and glenohumeral osteoarthritis were included. Bias risk …assessments used were the Cochrane tool and Newcastle-Ottawa score. RESULTS: The search yielded 852 potential articles, of which 20 met the inclusion criteria with a breakdown of 5 prolotherapy, 13 PRP, and 2 MSC. Sixteen studies were RCTs and 4 were cohort studies. Six studies were deemed “low risk of bias or good quality”. Efficacy results were mixed, and no serious adverse events were reported from orthobiologic treatment. CONCLUSIONS: Orthobiologics offer a relatively safe management option with inconclusive evidence for or against its use for rotator cuff pathology. No studies on glenohumeral osteoarthritis met the inclusion criteria. Adoption of standardized preparation reporting and consistent use of functional outcome measures is imperative for future studies to consider. Show more

Keywords: Musculoskeletal, orthobiologics, platelet-rich plasma, prolotherapy, medicinal signaling cells, sports medicine, rotator cuf

DOI: 10.3233/BMR-201844

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 1, pp. 17-32, 2021

Authors: Giray, Esra | Atalay, Kardelen Gencer | Şirazi, Serdar | Alp, Mehmet | Yagci, Ilker

Article Type: Case Report

Abstract: BACKGROUND AND OBJECTIVE: Jumping stump is an uncommon movement disorder characterized by involuntary movements and severe neuropathic pain in the stump. The pathophysiology and etiology of this phenomenon have not yet been clearly elucidated, and unfortunately, no proven treatment with successful recovery exists. This report aims to describe a severe painful jumping stump, possibly due to neuromas, in a traumatic transradial amputee. MATERIALS AND METHOD: We performed ultrasound examination of the painful stump depicted neuroma. Electromyographic evaluation of the stump revealed arrhythmic motor unit action potentials (MUAPs) with normal duration and amplitude; other movement disorders, such …as myokymia and fasciculations, were excluded. Ultrasound should be preferred to magnetic resonance imaging (MRI) for evaluation of stumps in patients with painful stump because MRI may not be helpful due to motion artefacts. The involuntary movements ceased after surgical excision of the neuroma following failure of conservative treatments. CONCLUSION: This report confirms that neuromas are clearly associated with jumping stump. Ultrasonographic and electromyographic assessments are necessary to reveal the features of this pathology for treatment planning. Show more

Keywords: Amputee, electromyography, jumping stump, movement disorder, pain, peripherally-induced movement disorder, stump, neuroma

DOI: 10.3233/BMR-191645

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 1, pp. 33-37, 2021

Authors: Tay, Matthew Rong Jie | Haw, Ong Joo

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVE: Morel-Lavallée Lesion (MLL) of the knee is an uncommon cause of knee swelling usually due to high-energy impact or in patients on anticoagulation. MLL of the knee due to low-energy non-athletic associated trauma in patients without antithrombotic therapy is rare. Early diagnosis can be achieved using point-of-care ultrasound. CASE REPORT: A 60-year-old female who was previously well was referred to our center for a persistently swollen left knee 2 months after a fall while on a flight of stairs. A point-of-care ultrasound identified a possible MLL of the knee. This was subsequently confirmed on magnetic …resonance imaging (MRI). The lesion resolved with ultrasound-guided therapeutic aspiration. CONCLUSION: MLL of the knee should be a differential diagnosis of traumatic knee swelling, even in low-energy trauma and in patients without bleeding diatheses. Ultrasound is a readily available and rapid modality that can aid both in the diagnosis and management of such lesions. Show more

Keywords: Morel-Lavallée Lesion, degloving injury, knee swelling, ultrasonography, magnetic resonance imaging

DOI: 10.3233/BMR-200041

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 1, pp. 39-42, 2021

Authors: Lippi, Lorenzo | de Sire, Alessandro | Desilvestri, Manuela | Baricich, Alessio | Barbanera, Andrea | Cattalani, Andrea | Invernizzi, Marco | Perrero, Luca

Article Type: Case Report

Abstract: INTRODUCTION: Scoliosis is frequently associated with pain and radiculopathy, but it is not considered a possible cause of acute spinal cord injury (SCI). Here we present a case report in which scoliosis was apparently linked to spinal cord ischaemia. CASE PRESENTATION: A 20-year-old woman with conservatively treated severe scoliosis presented with acute spinal cord infarction, which occurred during a spinal flexion while she was tidying up the bed. Other causes of SCI were excluded. Early rehabilitation was started and the patient progressively regained motor and sensory functions, with an AIS reduction from A to C. Bowel …and bladder disorders persisted and were autonomously managed with a trans-anal irrigation device and intermittent catheterisation after voluntary micturition. DISCUSSION: Early detection and management of spinal curvature disorders are essential in preventing long-term complications of scoliosis. Although the aetiology of spinal cord ischaemia in severe scoliosis should be better clarified, this rare case report suggests that scoliosis might be involved in its pathogenesis. Thus, we recommend early diagnosis of spinal curvature disorders and adequate rehabilitative treatment in order to prevent potential subsequent neurological complications. Show more

Keywords: Scoliosis, spinal cord injuries, spinal cord ischemia, spine, rehabilitation

DOI: 10.3233/BMR-200070

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 1, pp. 43-47, 2021

Authors: Nyawose, Zingisa Z. | Naidoo, Rowena

Article Type: Research Article

Abstract: BACKGROUND: Teachers present with shoulder musculoskeletal disorders, which result in pain and poor shoulder function. OBJECTIVE: To determine the effect of an eight-week shoulder rehabilitation intervention on pain and function, range of motion and muscle strength among teachers. METHODS: Thirty teachers presenting with shoulder pain were recruited and divided into equal control and experimental groups. The intervention group participated in an eight-week rehabilitation programme. Pre- and post-intervention measurements included the scapular position test, range of motion, muscle strength measurements as well as a shoulder rating questionnaire. RESULTS: There was a significant improvement …in the experimental group’s internal range of motion for the dominant (p = 0.006) and non-dominant arms (p = 0.003) post-intervention. Additionally, significant improvements were found in muscle strength in the experimental group in dominant and non-dominant flexion; abduction; external rotation (p < 0.001); dominant internal rotation (p < 0.001) and non-dominant internal rotation strength (p = 0.007). Post-intervention questionnaire data found a decrease in pain (p = 0.003); improved ability to perform daily activities (p = 0.006); improved overall score (p < 0.001) and satisfaction (p = 0.023) in the intervention group compared to the control group. CONCLUSION: The implementation of a rehabilitation programme in schools should be considered to manage the prevalence of shoulder musculoskeletal disorders among teachers. Show more

Keywords: Intervention, musculoskeletal disorders, prevalence, range of motion, muscle strength, teachers

DOI: 10.3233/BMR-200142

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 1, pp. 49-58, 2021

Authors: Kanaan, Saddam F. | Khraise, Hana’a | Almhdawi, Khader A. | Darlow, Ben | Oteir, Alaa O. | Mansour, Zaid M.

Article Type: Research Article

Abstract: BACKGROUND: The Back Pain Attitudes Questionnaire (Back-PAQ) is a tool developed for the assessment of attitudes about back pain. However, this tool is not available in the Arabic language. The availability of the Arabic version of the questionnaire will enable clinicians and researchers in Arabic-speaking countries to assess patients’ attitudes towards back pain. OBJECTIVE: We aimed to translate and cross-culturally adapt the English version of the Back-PAQ into Arabic and study its psychometric properties. METHODS: The translation and cross-cultural adaptation processes were performed according to published guidelines. The translated Arabic version was tested …for face and content validity on 40 participants. The psychometric properties of the final Arabic version were tested on 110 participants. Participants completed the Arabic version of the Back-PAQ and Fear-Avoidance Beliefs Questionnaire (FABQ). A subgroup of 50 participants completed the questionnaire twice in a week interval to determine the Back-PAQ test-retest reliability. RESULTS: The majority of participants found the questionnaire understandable and the questions relevant and appropriate for their back problem. There was a fair correlation between the Back-PAQ-Arabic and the FABQ physical activity scale (rho = 0.283, p = 0.001), and little to no correlation with total FABQ (rho = 0.186, p = 0.026) and education level (rho = - 0.162, p = 0.045). The Arabic Back-PAQ-Arabic showed moderate internal consistency with Cronbach’s α of 0.601, and excellent test-retest reliability (ICC 2 , 1 = 0.963). The Back-PAQ standard error of measurement was 3.57 and minimum detectable changes was 9.90. CONCLUSION: The Arabic version of the Back-PAQ has adequate validity and reliability properties. Show more

Keywords: Low back pain, Back Pain Attitudes Questionnaire, attitude, Arabic, translation, cross-cultural adaptation

DOI: 10.3233/BMR-191758

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 1, pp. 59-67, 2021

Authors: Sonmezer, Emel | Özköslü, Manolya Acar | Yosmaoğlu, Hayri Baran

Article Type: Research Article

Abstract: BACKGROUND: Although the Pilates method has been reported to be effective in women with low back pain (LBP), the efficacy of Pilates exercises in pregnant women with LBP has not been evaluated widely. OBJECTIVE: The purpose of this study was to determine the effects of clinical Pilates exercises on lumbopelvic stabilization, pain, disability and quality of life in pregnant women with LBP. METHODS: Fourty pregnant women were randomized into either a Pilates exercise group (n = 20) or control group (n = 20). …Subjects in the Pilates exercise group performed the exercises two times a week for eight weeks. Subjects in the control group followed regular prenatal care. Lumbopelvic stabilization was assessed with a pressure biofeedback unit, pain with the Visual Analog Scale, disability with the Oswestry Low Back Pain Questionnaire and quality of life with the Nottingham Health Profile (NHP). RESULTS: Pain and disability were significantly improved in the Pilates exercise group after intervention (p = 0.03, p < 0.001, respectively). There were also significant improvements in sleep, physical mobility sub-parameters of NHP and lumbopelvic stabilization after Pilates exercises (p = 0.048, p = 0.007, respectively). However, there were no statistically significant changes in all outcome measures in the control group (p > 0.05). CONCLUSIONS: Pilates exercises can be recommended as an effective and safe method for increasing lumbopelvic stabilization, reducing pain and disability, improving physical mobility and sleep problems in pregnant women with LBP. Show more

Keywords: Pilates exercises, disability, pain, quality of life, lumbopelvic stabilization, pregnancy, low back pain

DOI: 10.3233/BMR-191810

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 1, pp. 69-76, 2021

Authors: Suehiro, Tadanobu | Ishida, Hiroshi | Kobara, Kenichi | Osaka, Hiroshi | Kurozumi, Chiharu | Watanabe, Susumu

Article Type: Research Article

Abstract: BACKGROUND: The abdominal drawing-in exercise could help improve delayed transversus abdominis (TrA) activation during limb movement in subjects with recurrent low back pain (rLBP). However, little is known about whether the same effect is observed during lifting tasks in subjects with rLBP. OBJECTIVE: This study aimed to clarify whether a single session of abdominal drawing-in exercise could correct the altered trunk muscle activation patterns during a lifting task in subjects with rLBP. METHODS: Fifteen subjects with rLBP performed lifting tasks before and immediately after three sets of 10 repetitions of isolated TrA voluntary …contractions. The time of onset and activation amplitude during the lifting tasks were measured by surface electromyography (EMG) and compared between the trials before and immediately after exercise. RESULTS: During lifting, the onset of internal abdominal oblique/TrA (IO/TrA) and multifidus activation occurred earlier, the EMG amplitude of IO/TrA increased, and the EMG amplitude of erector spinae and multifidus decreased, compared with the pre-exercise data. CONCLUSIONS: These results suggest a possibility that the abdominal drawing-in exercise might be effective in improving the muscle recruitment pattern in people with rLBP. Show more

Keywords: Abdominal drawing-in exercise, trunk muscle activation pattern, lifting task, recurrent low back pain

DOI: 10.3233/BMR-191549

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 1, pp. 77-85, 2021