Journal of Back and Musculoskeletal Rehabilitation - Volume 34, issue 2

Authors: Kyrölä, Kati | Häkkinen, Arja H. | Ylinen, Jari | Repo, Jussi P.

Article Type: Research Article

Abstract: BACKGROUND: The Depression Scale (DEPS) is a commonly used screening tool for major depression in studies investigating low back pain, yet it has not been validated for patients with back-specific problems. OBJECTIVE: To assess the psychometric properties of the DEPS in patients with degenerative spinal disease. METHODS: Six hundred and thirty-seven patients with a degenerative spinal disease completed the DEPS instrument. The Rasch Measurement Theory was applied to analyze the measurement properties of the DEPS. The main hypothesis-driven approach was whether the DEPS would meet relevant psychometric criteria for assessing depressive symptoms among …patients with degenerative spinal disease. RESULTS: The Mean (SD) DEPS score was 9.2 (6.6). Scale minimum or maximum points among participants were 2.4% and 0.8%, respectively. Cronbach’s alpha for internal consistency was 0.92. Person Separation Index for reliability was 0.88. All items had ordered thresholds and seven of the 10 items had good item fit. Unidimensionality of the DEPS was supported (proportion of significant t -tests, 4.5%). CONCLUSIONS: This study supports the validity of the DEPS for screening depressive symptoms in patients with degenerative spinal disease. Show more

Keywords: The Depression Scale, DEPS, degenerative spinal deformity, back pain, outcome

DOI: 10.3233/BMR-191638

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 2, pp. 261-267, 2021

Authors: Nambi, Gopal | Abdelbasset, Walid Kamal | Alqahatani, Bader A.

Article Type: Research Article

Abstract: BACKGROUND: Virtual reality training is commonly used for balance problems in neurological conditions with the use of visual and auditory biofeedback. The knowledge about the effective implementation of this training in chronic low back pain is lacking. OBJECTIVE: The objective of this study is to find the radiological and biochemical effects of virtual reality training in football players with chronic low back pain. METHODS: A randomized, single-blinded controlled study was conducted on 36 participants. The first group received virtual reality training (VRT; n = 12), the second group …received combined physical rehabilitation (CPR; n = 12), and the third group (control group; n = 12) received conventional training exercises for four weeks. Radiological (muscle cross-sectional area and muscle thickness) and biochemical (CRP, TNF-α , IL-2, IL-4, IL-6) values were measured at baseline and after four weeks. RESULTS: Four weeks following training, the VRT group showed more significant changes in the muscle cross-sectional area than the CPR and control groups (p ⩽ 0.001). Biochemical measures such as CRP, TNF-α , IL-2, IL-4, and IL-6 also showed significant improvement in the VRT group compared to the other two groups (p ⩽ 0.001). CONCLUSION: The results show that virtual reality training has positive effects on the radiological and biochemical aspects in university football players with chronic low back pain. Show more

Keywords: Virtual reality training, cross-sectional area, muscle thickness, chronic low back pain, sports

DOI: 10.3233/BMR-191657

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 2, pp. 269-277, 2021

Authors: Król, Piotr | Franek, Andrzej | Król, Tomasz | Stanula, Arkadiusz | Dolibog, Paweł | Durmała, Jacek | Polak, Anna | Kuszewski, Michał | Stania, Magdalena

Article Type: Research Article

Abstract: BACKGROUND: Extracorporeal shock wave therapy is among the conservative treatments for symptomatic heel spur. OBJECTIVE: The purpose of this trial is to evaluate and compare the therapeutic effects of radial shock wave (RSWT) and focused shock wave (FSWT) applied in the treatment of symptomatic heel spur. METHODS: Fifty-five participants were randomly divided into two comparative groups that were administered FSWT and RSWT, respectively. The severity of dysfunction (Foot Function Index, FFI), ground reaction forces (GRF) and walking temporal parameters were measured in all patients at baseline and at weeks 1, 3, 6, 12 …and 24 after treatment. RESULTS: In both groups, a gradual decrease in the FFI values occurred after treatment. The percentage reduction in the FFI was comparable for both groups. Statistically significant changes were only noted between some measurements of GRF and walking temporal parameters. The percentage changes in the values of the force and temporal parameters were similar between the groups. CONCLUSIONS: Both FSWT and RSWT are efficacious in the treatment of symptomatic heel spur and their therapeutic effects are comparable. Objective data registered by force platforms during walking are not useful for tracing the progress of treatment applied to patients with symptomatic heel spur between consecutive procedures. Show more

Keywords: Gait, symptomatic heel spur, physical therapy modalities

DOI: 10.3233/BMR-191739

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 2, pp. 279-287, 2021

Authors: Reddy, Ravi Shankar | Alahmari, Khalid A. | Samuel, Paul Silvian | Tedla, Jaya Shanker | Kakaraparthi, Venkata Nagaraj | Rengaramanujam, Kanagaraj

Article Type: Research Article

Abstract: BACKGROUND: Proprioception, one’s sense of movement and position, is a common term used in back rehabilitation. Kinesthetic rehabilitation may be useful in managing lower back pain; however, reliable measures are required to quantify lumbar proprioception sense. OBJECTIVE: To investigate intrarater and interrater reliability of neutral lumbar positioning (NLP) and target lumbar positioning (TLP) tests and compare the position sense errors in subjects with non-specific low back pain and healthy controls. METHODS: Intrarater (between-day) and interrater (within-day) reliability of NLP and TLP tests were assessed in 30 subjects with low back pain and 30 …healthy subjects using a digital inclinometer. NLP is evaluated when the subject is repositioned to neutral from flexion, while TLP is evaluated in lumbar flexion, by bending laterally left and right. RESULTS: Intrarater reliability for NLP tests had ICC values of 0.85 and 0.89 and TLP tests had 0.78 and 0.92. Likewise, interrater reliability for NLP had ICC values of 0.75 and 0.85, and for the TLP test, the interrater reliability had 0.78 and 0.93. Subjects with back pain had significantly larger neutral and target lumbar proprioceptive errors compared to healthy controls (p < 0.001). CONCLUSIONS: Intrarater and interrater reliability showed good agreement for both NLP and TLP tests of lumbar proprioception. Subjects with nonspecific low back pain have impaired lumbar proprioceptive sense. Show more

Keywords: Lower back, proprioception, assessment tools, reliability, position sense, motion detection

DOI: 10.3233/BMR-200010

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 2, pp. 289-299, 2021

Authors: Scaturro, Dalila | de Sire, Alessandro | Terrana, Pietro | Costantino, Claudio | Lauricella, Lorenza | Sannasardo, Claudia Emilia | Vitale, Francesco | Mauro, Giulia Letizia

Article Type: Research Article

Abstract: BACKGROUND: Adolescent idiopathic scoliosis screening still needs a considerable implementation, particularly throughout a school-based assessment protocol. OBJECTIVE: This study aims to evaluate the effectiveness of clinical examinations currently in use for the diagnosis of adolescent idiopathic scoliosis, through a survey carried out in secondary schools to standardize a screening protocol that could be generalized. METHODS: In their classrooms, the adolescents underwent an idiopathic scoliosis screening through three examinations: Adam’s test, axial trunk rotation (ATR) and plumb line. In case of single positivity to one of the three examinations, a column X-ray examination was …recommended. RESULTS: The sensitivity and diagnostic specificity of Adam’s test or ATR were 56.3% and 92.7%, respectively. The positivity to at least one between ATR or plumb line showed that sensitivity was higher than specificity: 91.3% versus 80.8%; the positivity to at least one between Adams’s test or plumb line showed a sensitivity of 95.2% and a specificity of 81.5%. Finally, the positivity to all three examinations showed an increase in specificity (99.7%). CONCLUSIONS: Taken together, our findings show that this school-based screening protocol had a very high specificity in early diagnosis of adolescent idiopathic scoliosis. Show more

Keywords: Scoliosis, spine deformities, Adam’s test, axial trunk rotation, plumb line

DOI: 10.3233/BMR-200215

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 2, pp. 301-306, 2021

Authors: Han, Ji Won | Kim, Young Mi | Kim, Kyoung

Article Type: Research Article

Abstract: BACKGROUND: Respiratory-muscle weakness is an important clinical problem. The respiratory system’s health is a decisive factor in the physical and social life of the elderly. Changes in respiratory muscular strength and function activate the torso’s adjustment ability, which affects daily activities. OBJECTIVE: This study aimed to investigate the effects of resistance exercises combined with breathing exercises on the respiratory-muscle strength of elderly women. METHOD: This study included 26 elderly woman, who were randomly divided into two sub-groups of 13 participants each. The experimental group performed breathing exercises and dynamic upper- and lower-extremity exercises, …and the control group practiced only dynamic upper- and lower-extremity exercises. The maximum expiratory pressure (MEP) and maximum inspiratory pressure (MIP) were measured both before and at the end of the six-week study. RESULTS: In both groups, both the post-test MIPs and MEPs were significantly higher than the pre-intervention ones (p < 0.05). For MIPs, the between-group difference was not statistically significant, either before the intervention or post-test (p > 0.05). For MEPs, the between-group difference was statistically significant at post-intervention points (p < 0.05). CONCLUSION: The results showed that resistance exercises applying maximum expiration improved the respiratory-muscle strength of elderly women. These findings indicate that resistance exercises applying maximum expiration as described here in should be considered in patients who require breathing therapy, because the combination seems to significantly increase the strength of the respiratory muscles. Show more

Keywords: Resistance exercise, maximum expiration, respiratory muscle strength

DOI: 10.3233/BMR-181166

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 2, pp. 307-312, 2021

Authors: Andrade, Alexandro | de Azevedo Klumb Steffens, Ricardo | Sieczkowska, Sofia Mendes | Coimbra, Danilo Reis | Vilarino, Guilherme Torres

Article Type: Brief Report

Abstract: OBJECTIVE: The aim was to analyze the effect of one session and three sessions of strength training (ST) on pain in women with fibromyalgia (FM). METHOD: Twenty-three women with FM performed three sessions of ST for a week. Each training session worked the main muscle groups and lasted 60 min. Three sets of 12 repetitions were performed with 1 min intervals in between. The load was increased based on the perception of subjective effort of each patient. Pain intensity was evaluated immediately after the first and third sessions using a Fischer digital algometer. RESULTS: After …the first ST session, pain reduction was observed. No significant differences were found in pain thresholds on the baseline versus the third session. The analysis of MBI demonstrated that the ST does not worsen patients’ pain, indicating a 52.2% trivial effect and a 39.1% beneficial effect. CONCLUSION: Our results suggest that there is no harmful effect on the pain of women with FM after an acute session of ST. We emphasize that despite the promising results, more studies on the subject are needed to help understand pain in patients with FM. Show more

Keywords: Fibromyalgia, rheumatic diseases, resistance training, exercise, pain

DOI: 10.3233/BMR-181254

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 2, pp. 313-318, 2021

Authors: Shukla, Varsha | Das, Siddharth Kumar | Mahdi, Abbas Ali | Agarwal, Shweta | Alok, Ragini | Ansari, Jamal Akhtar | Khandpur, Sukhanshi

Article Type: Research Article

Abstract: BACKGROUND: Fibromyalgia syndrome (FMS) is an extra-articular rheumatological disease characterised by widespread chronic musculoskeletal pain. Metal-induced oxidative stress contributes to the severity of FMS. AIMS: First, this study evaluated the association between plasma levels of toxic heavy metals and essential metals with oxidative stress (OS) markers. Second, the OS markers and metal contents were correlated with the disease severity by assessing the Fibromyalgia Impact Questioner Revised (FIQR) and tender points (TP). METHOD: A total of 105 FMS patients and 105 healthy controls of similar age and sex were recruited. OS parameter such as …lipid peroxidation (LPO), protein carbonyl group (PCG), nitric oxide (NO) and essential metals such as zinc (Zn), magnesium (Mg), manganese (Mn), copper (Cu) and toxic heavy metals such as aluminium (Al), arsenic (As), lead (Pb) were estimated. RESULTS: Levels of LPO, PCG, NO (p < 0.001) and Cu, Mn, and Al (p < 0.001), were significantly higher, and Mg (p < 0.001) and Zn (p < 0.001) were significantly lower in patients compared to controls. A positive association was observed between OS parameters, FIQR and TP with Cu, Al and Mn. A significant negative association was observed between Zn and Mg with FIQR, TP and OS parameters. CONCLUSION: Heavy metals such as Al induce OS parameters and decrease the levels of essential trace elements such as Mg and Zn, which may be responsible for the severity of FMS. Show more

Keywords: Lipid peroxidation, oxidants, essential trace elements

DOI: 10.3233/BMR-200102

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 2, pp. 319-326, 2021

Authors: He, Xiangfeng | Zhang, Xueyan | Liao, Fuyuan | He, Li | Xu, Xin | Jan, Yih-Kuen

Article Type: Research Article

Abstract: BACKGROUND: Various cupping sizes of cupping therapy have been used in managing musculoskeletal conditions; however, the effect of cupping sizes on skin blood flow (SBF) responses is largely unknown. OBJECTIVE: The objective of this study was to compare the effect of three cupping sizes of cupping therapy on SBF responses. METHODS: Laser Doppler flowmetry (LDF) was used to measure SBF on the triceps in 12 healthy participants in this repeated measures study. Three cup sizes (35, 40 and 45 mm in diameter) were blinded to the participants and were tested at - …300 mmHg for 5 minutes. Reactive hyperemic response to cupping therapy was expressed as a ratio of baseline SBF. RESULTS: All three sizes of cupping cups resulted in a significant increase in peak SBF (p < 0.001). Peak SBF of the 45 mm cup (9.41 ± 1.32 times) was significantly higher than the 35 mm cup (5.62 ± 1.42 times, p < 0.05). Total SBF of the 45 mm cup ((24.33 ± 8.72) × 10 3 times) was significantly higher than the 35 mm cup ((8.05 ± 1.63) × 10 3 times, p < 0.05). Recovery time of the 45 mm cup (287.46 ± 39.54 seconds) was significantly longer than the 35 mm cup (180.12 ± 1.42 seconds, p < 0.05). CONCLUSIONS: Our results show that all three cup sizes can significantly increase SBF. The 45 mm cup is more effective in increasing SBF compared to the 35 mm cup. Show more

Keywords: Cupping size, cupping therapy, dose response, laser Doppler, negative pressure, skin blood flow

DOI: 10.3233/BMR-200120

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 2, pp. 327-333, 2021