Journal of Back and Musculoskeletal Rehabilitation - Volume 34, issue 3

Authors: Soer, Remko

Article Type: Editorial

DOI: 10.3233/BMR-215002

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 3, pp. 335-336, 2021

Authors: Gao, Shuai-Shuai | Wang, Yan-Jun | Zhang, Guo-Xun | Zhang, Wen-Ting

Article Type: Research Article

Abstract: BACKGROUND: Hip fractures are serious fractures for the elderly. The rehabilitation of patients with hip fractures has been greatly affected by the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVE: We have piloted a new model for tracking patients and providing rehabilitation guidance that uses WeChat. The purpose of this study is to explore the role of chat software in rehabilitation guidance for hip fracture patients during COVID-19. METHODS: Patients treated for hip fractures from February 1 to April 30, 2020 were randomly divided into a control group and an observation group. The control group …was given conventional discharge guidance, while the observation group also followed up the patients using WeChat to guide the exercise. Satisfaction, the Harris Hip Score, complications and the mortality of the two groups after discharge were compared. RESULTS: The incidence of complications and mortality in the observation group were significantly lower than in the control group: p = 0.022 and p = 0.048, respectively. The Harris Hip Score and satisfaction were significantly better than the control group’s: p = 0.000 and p = 0.007, respectively. CONCLUSION: During the COVID-19 pandemic, it is very helpful to use WeChat software or other social software with similar functions (such as WhatsApp and Facebook) to guide the rehabilitation of hip fractures. Show more

Keywords: COVID-19, hip fracture, rehabilitation, mortality

DOI: 10.3233/BMR-200324

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 3, pp. 337-342, 2021

Authors: Sun, Weige | Zhang, Haijiao | Tang, Limei | He, Ying | Tian, Suzhai

Article Type: Review Article

Abstract: BACKGROUND: Numerous studies have investigated factors for non-specific chronic low back pain (NSCLBP) in nurses, and have reached different conclusions. Evidence-based recommendations are required for the prevention and treatment of NSCLBP in nurses. OBJECTIVE: This meta-analysis aimed to systematically review and quantify the factors of NSCLBP in nurses. METHODS: Eleven databases were searched. The odds ratios (OR) with 95% confidence intervals (CIs) were pooled using meta-analysis, and either a fixed-effect or random-effect model was used based on heterogeneity across included studies. RESULTS: Eighteen publications including 11,752 nursing staff were included. …Being female (pooled estimate [95% CI], 1.56 [1.24–1.96]; P < 0.001), married (1.89 [1.38–2.60]; P < 0.001), overweight (0.63 [0.43–0.93]; P = 0.02), working at least 10 years (0.65 [0.48–0.89]; P = 0.007), and working night shifts (2.19 [1.16–4.21]; P = 0.02) were positively related to NSCLBP. Junior college education (0.60 [0.47–0.77]; P < 0.001) and job satisfaction (0.58 [0.47–0.73]; P < 0.001) were negatively related. Age (0.80 [0.50–1.27]; P = 0.34) and physical exercise (0.99 [0.39–2.49]; P = 0.98) were not related. CONCLUSIONS: This is the first meta-analysis to quantify the risk factors for NSCLBP in nurses. Being female, married, working night shifts, overweight, working at least 10 years and dissatisfied with work are risk factors. High-quality prospective studies are required to validate the findings of this study. Show more

Keywords: Nurse, factors, non-specific chronic low back pain, meta-analysis, review

DOI: 10.3233/BMR-200161

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 3, pp. 343-353, 2021

Authors: Gergelé, Eloi | Parent, Eric | Gross, Douglas P.

Article Type: Research Article

Abstract: BACKGROUND: Accurate clinical decision support tools may help clinicians select appropriate interventions for patients with spinal conditions. The Örebro Musculoskeletal Pain Questionnaire (ÖMPQ) is a screening questionnaire extensively studied as a predictive tool. The Work Assessment Triage Tool (WATT) is a clinical decision support tool developed to help select interventions for injured workers. OBJECTIVE: To compare the classification accuracy of the ÖMPQ and WATT to clinician recommendations for selecting interventions leading to a successful return to work in patients with spinal conditions. METHODS: A secondary analysis was undertaken of data from injured workers …with spinal conditions assessed between 2013 and 2016. We considered it a success if the workers did not receive wage replacement benefits 30 days after assessment. Analysis included positive likelihood ratio (LR+ ) as an indicator of predictive accuracy. RESULTS: Within the database, 2,872 patients had complete data on the ÖMPQ, WATT, and clinician recommendations. At 30 days, the ÖMPQ was most accurate for identifying treatments that lead to successful outcomes with a LR+ = 1.51 (95% Confidence Interval 1.26–1.82) compared to 1.05 (95% Confidence Interval 1.02–1.09) for clinicians, and 0.85 (95% Confidence Interval 0.79–0.91) for the WATT. CONCLUSIONS: All tool recommendations had poor accuracy, however the ÖMPQ demonstrated significantly better results. Show more

Keywords: Spine, decision making, return to work, occupational health, rehabilitation

DOI: 10.3233/BMR-200169

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 3, pp. 355-362, 2021

Authors: Zicarelli, Carlos A.M. | Santos, João Paulo M. | Poli-Frederico, Regina Célia | Silva, Rubens A. | Barrilec, Fabrice | Barrette, Gilles | Iida, Ligia M. | Russo, Priscilla P. | Larangeira, Lino L.S. | Fernandes, Marcos T.P. | Fernandes, Karen B.P.

Article Type: Research Article

Abstract: BACKGROUND: Pressure pain threshold (PPT) is decreased in several musculoskeletal disorders, giving indirect evidence regarding pain status. Despite the fact that PPT has been already proven to be reliable in patients with acute conditions, there is great variability of methods and results observed within studies, and only a few evidences confirming its reliability in chronic conditions. OBJECTIVE: The objective of this study was to determine the test-retest reliability of PPT in the neck and low back regions to discriminate individuals with neck or low back pain from healthy individuals. Additionally, one secondary aim was to establish the minimum …detectable change (MDC) and the standard error of measurement for future clinical studies and interventions. METHODS: In this reliability study, 74 individuals (15 individuals from the neck pain and 17 from the neck control group; 21 individuals from the low back pain and 21 from the low back control group). PPT was measured in the neck region (suboccipital, trapezius and supraspinal muscles) and in the lower back region (paraspinal muscles in the levels of L1, L3 and L5). Intrarater reliability was assessed using intraclass correlation coeficient and Bland-Altman. RESULTS: Excellent intra-rater reliability was observed for both (ICC of 0.874 for the neck pain versus ICC of 0.895 in neck control group; ICC of 0.932 for the low back pain group versus ICC of 0.839 for the control group). A small bias was observed for all groups (- 0.08 for the neck pain group versus 0.10 in the control group; and 0.32 in low back pain group versus 0.44 in the control group). Minimum detectable change of 0.63 kgf of neck pain and 1.21 kgf of low back pain was calculated. It was found difference in PPT between pain and control groups (p < 0.05). CONCLUSION: It may be suggested that the protocol with PPT is reliable and able to discriminate individuals with and without neck and low back pain with a minor measurement error. Therefore, this method may be used to detect possible progress after interventions in patients with neck or low back pain. Show more

Keywords: Chronic pain, neck pain, low back pain, pressure pain threshold, test reproducibility, pain measurement

DOI: 10.3233/BMR-181208

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 3, pp. 363-370, 2021

Authors: Johnston, Heather | Wanninayake, Susari | Drake, Janessa D.M.

Article Type: Research Article

Abstract: BACKGROUND: Chest size is a known factor in the development of back pain for women. However, the neuromuscular mechanisms associated with chest size and back pain are poorly understood. OBJECTIVE: The purpose of this study was to investigate chest size and its association with back pain development and muscle activity patterns during prolonged standing. METHODS: Twenty university-aged women were divided into two groups: small chest size (n = 10, ∼ A/C cup) and large chest size (n = 10, ∼ …D/E cup). Participants completed a 2-hr standing protocol, where eight channels of bilateral trunk electromyography were collected. Muscle activity, specifically co-contraction, was compared between chest size groups, pain developers, and time. RESULTS: The large chest size group reported higher amounts of pain at the upper, middle, and low back. Women in the large chest group sustained higher levels of co-contraction for muscles involving the thoracic and lumbar erector spinae compared to those in the small chest size group during prolonged standing. CONCLUSIONS: Thoracolumbar co-contraction determined in this study may be a potential mechanism contributing to increased back pain development for women with large chest sizes during prolonged standing. This pain mechanism could be targeted and addressed in future non-invasive musculoskeletal rehabilitation to improve back pain for women. Show more

Keywords: Anthropometry, low back pain, occupational standing, muscle co-contraction

DOI: 10.3233/BMR-200090

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 3, pp. 371-380, 2021

Authors: Vanhauter, N. | Van Erck, A. | Anciaux, M. | Pollefliet, A. | Joos, E.

Article Type: Research Article

Abstract: BACKGROUND: The World Health Organization states that low back pain is the leading cause for disability worldwide. Patients with chronic low back pain (CLBP) show important decreases in lumbar strength and can now be assessed by using the new isokinetic dynamometer BioniX Sim3 Pro which offers very detailed measurements. OBJECTIVE: To compare lumbar flexion and extension strength values, as well as extension-flexion ratio (EFR) based on isokinetic velocity and gender, for patients with CLBP on the BioniX Sim3 Pro. METHODS: A retrospective analysis was performed on data from 20 men and 22 women …with CLBP. Maximum torque in flexion and extension was measured isometrically and isokinetically. Statistical analysis was performed on these parameters. RESULTS: EFR shows a downward trend with increasing speed of measurement (isometric to isokinetic 30 ∘ /s and isokinetic 30 ∘ /s to isokinetic 90 ∘ /s, respectively): in men from 1.21 to 1.04 (p < 0.001) and from 1.04 to 0.93 (p = 0.207). In women, EFR decreased from 1.41 to 1.13 (p < 0.001) and from 1.13 to 1.00 (p = 0.144). CONCLUSIONS: Patients with CLBP have a decreased strength in lumbar extension and flexion compared to the age-corrected normal values of Bionix Sim3 Pro. With increasing speed of testing protocol, a decrease in EFR is observed in this population. Show more

Keywords: Isokinetic, low back pain, bionix, lumbar, torque values

DOI: 10.3233/BMR-200225

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 3, pp. 381-388, 2021

Authors: Pino-Ortega, José | Oliva-Lozano, José M. | Gómez-Carmona, Carlos D. | Rojas-Valverde, Daniel | Bastida-Castillo, Alejandro | Moreno-Pérez, Victor | Nakamura, Fabio Y.

Article Type: Research Article

Abstract: BACKGROUND: Previous studies have analysed the effect of wearing high-heeled shoes (HHS) on gait analysis, balance and its relation to health. However, further research is needed to study its effect on the difference of chain reactions in the transfer of body impacts from the lower to the upper limbs. OBJECTIVES: The aims of the present research were: (a) to compare the effects of wearing HHS on impacts across body joints during walking with sport shoes (SS) as a reference, and (b) to examine such effects at different speeds. METHODS: Seven well-trained women completed …this study. Incremental treadmill walking test were performed with two different footwear: SS and HHS. Inertial devices were used to quantify the chain reactions at selected anatomical lower limbs and trunk locations. Statistical analysis included the Wilcoxon test with ranges and Cohen’s d effect size with percentage of differences. RESULTS: The highest values were found at the heel in both footwear and in both legs (SS: right = 0.76 ± 0.27, left = 0.79 ± 0.27; HHS: right = 1.07 ± 0.38, left = 1.11 ± 0.41), while the lowest values were registered at lower and upper back. Furthermore, significant differences were found with the HHS load being higher at all locations (p < 0.05; %= 𝑑𝑖𝑓𝑓 12.20–36.36%), influenced by the walking speed. In addition, a strong influence of footwear in the change of the laterality profile was found (p < 0.05). CONCLUSIONS: These findings suggest that the use of HHS increase the load on the lower limb and the trunk. Until reaching 5 km/h during walking, no significant differences were found between wearing HHS or SS in accelerometer load, producing exponential differences from this speed. The great between-subject variability implies that within-subject analysis is recommended, as it is more related to real clinical practice. Show more

Keywords: Footwear, accelerometry, assessment, health, gait biomechanics

DOI: 10.3233/BMR-191591

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 3, pp. 389-398, 2021

Authors: Igwesi-Chidobe, Chinonso N. | Sorinola, Isaac O. | Godfrey, Emma L.

Article Type: Research Article

Abstract: BACKGROUND: Illness perceptions predict chronic low back pain (CLBP) disability. This study cross-culturally adapted and validated the Igbo Brief Illness Perceptions Questionnaire (Igbo-BIPQ) in people with CLBP in rural/urban Nigeria. METHODS: A cross-cultural adaptation and validation of the Igbo-BIPQ was undertaken. The BIPQ was forward/back-translated by clinical/non-clinical translators. An expert review committee appraised the translations. The questionnaire was pre-tested on twelve rural Nigerian dwellers with CLBP. Internal consistency using Cronbach’s alpha; test-retest reliability using intra-class correlation coefficient and Bland-Altman plot; and minimal detectable change were investigated amongst 50 people with CLBP in rural and urban Nigeria. …Construct validity was determined by correlating the Igbo-BIPQ score with those of eleven-point box scale and Igbo Roland Morris Disability Questionnaire (Igbo-RMDQ) using Pearson’s correlation analyses in 200 adults with CLBP in rural Nigeria. Ceiling and floor effects were investigated in both samples. RESULTS: Good face/content validity, internal consistency (α = 0.76) and intraclass correlation coefficient (ICC = 0.78); standard error of measurement and minimal detectable change of 5.44 and 15.08 respectively; moderate correlations with pain intensity and self-reported disability (r ⩾ 0.4); no ceiling/floor effects were observed for Igbo-BIPQ. CONCLUSION: This study provides evidence of some aspects of validity and reliability of the Igbo-BIPQ. Show more

Keywords: Illness perceptions, Africa, cross-cultural, psychometric, low back pain

DOI: 10.3233/BMR-191687

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 3, pp. 399-411, 2021

Authors: Moreno-Pérez, Victor | Hernández-Davó, Jose Luis | Nakamura, Fabio | López-Samanes, Álvaro | Jiménez-Reyes, Pedro | Fernández-Fernández, Jaime | Behm, David G.

Article Type: Research Article

Abstract: OBJECTIVE: The aim of this study was to compare the potential post-activation performance enhancement (PAPE) effects of two different warm-up strategies, involving dynamic stretching (DS) or heavy load leg press (HL) on several key physical qualities in tennis players. METHODS: Twenty-six elite male tennis players (age: 19.22 ± 4.20 years; body mass: 67.37 ± 8.19 kg; height: 1.77 ± 0.07 m) performed both warm-ups, with 48-hours between protocols (DS and HL), performed in a randomized order. Pre- and post-tests included: countermovement jump, 5-m and 10-m sprint, 5-0-5 …agility test, and hip extension and flexion range-of-motion which were performed before and after DS and HL warm-up protocols. RESULTS: The DS warm-up led to substantial improvements in 5-m and 10-m sprint, 5-0-5 agility test, countermovement jump, and also to higher hip flexion range-of-motion. The HL warm-up caused impairments in 5-m and 10-m sprints, but improvements in 5-0-5 agility test, countermovement jump and hip extension range-of-motion. Compared to HL, DS warm-up induced possibly to likely positive effects on 5-m and 10-m linear sprint performance, as well as in hip flexion range-of-motion. Nevertheless, no differences in performance improvements in 5-0-5 agility test, countermovement jump and hip extension range-of-motion were found when comparing DS and HL warm-up protocols. CONCLUSION: DS seems to be more effective than HL when performing a short warm-up protocol in elite tennis players. Show more

Keywords: Racquet sport, vertical jump, sprint, range of motion

DOI: 10.3233/BMR-191710

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 3, pp. 413-423, 2021

Authors: Szczygieł, Elżbieta | Gigoń, Agata | Chudyba, Izabela Cebula | Joanna, Golec | Edward, Golec

Article Type: Research Article

Abstract: BACKGROUND: Adolescent idiopathic scoliosis (AIS) is a common structural spine deformity affecting 2%–4% of adolescents. Due to the unknown cause of idiopathic scoliosis, its therapy is a long-term and often unsatisfactory process. In the literature, it is often suggested that problems related to the feeling of one’s own body are caused by AIS. OBJECTIVE: The aim of this study was to assess the feeling of one’s own body among children with and without scoliosis on the example of feeling the head position, pelvis shape and balance. METHOD: The research included 62 children: 30 …with scoliosis and 25 without diagnosed scoliosis with an age range between 11 to 19 years. The minimum scoliosis value was 7 ∘ and the maximum was 53 ∘ . The average value was 25 ∘ . During the study, three functional tests were used: Cervical Joint Position Error Test (CJPET), Clinical Test of Sensory Integration on Balance (CTSIB) and Body proportion demonstration test (BPDT). RESULTS: The results of the tests showed statistically significant differences (CJPET p = 3.54 * 10 - 14 , CTSIB p = 0.0376, BPDT p = 0.0127). However, none of the studies showed a correlation between the results of people with scoliosis and the value of their Cobb angles. Show more

Keywords: Scoliosis, children, spine deformity, body, therapy

DOI: 10.3233/BMR-191761

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 3, pp. 425-430, 2021

Authors: Kiatkulanusorn, Sirirat | Suato, Bhornluck Paepetch | Werasirirat, Phurichaya

Article Type: Research Article

Abstract: BACKGROUND: There are currently no reports of biomechanical changes in patients with forward head posture (FHP) that result in altered muscle activation throughout various functions with muscle activation response during diverse sleep postures. OBJECTIVE: This study investigated neck and back muscle activity in individuals with and without FHP during a maintained side-sleeping position by incorporating various pillow designs. METHODS: Thirty-four participants (i.e., 17 in each group) were enrolled. The muscle activity was investigated via surface electromyography during the use of three trial pillows: orthopedic pillow, hollow pillow, and Thai neck support pillow. …RESULTS: With the application of all three trial pillow, the FHP group demonstrated significantly greater middle-lower trapezius muscle activity than the normal head posture group (p < 0.05). Sternocleidomastoid and upper trapezius (UT) muscle activity were similar between the two groups (p > 0.05). Only UT muscle activity was affected by variations in pillow design. In the normal group, no difference was observed in the muscle activity between all three pillows (p > 0.05). CONCLUSIONS: Feasibly, the ability to appropriately modify a pillow configuration without creating undesired muscle activation was limited to those exhibiting FHP. Therefore, specially designed pillows or mattresses should be investigated in terms of their relevance to muscle fatigue and potential musculoskeletal pain in FHP patients. Show more

Keywords: Pillow, sleep, electromyography, forward head posture, muscle activity

DOI: 10.3233/BMR-200038

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 3, pp. 431-439, 2021

Authors: de Alegria, Samantha Gomes | Kasuki, Leandro | Gadelha, Monica | Lopes, Agnaldo José

Article Type: Research Article

Abstract: BACKGROUND: Musculoskeletal disorders in acromegaly compromise upper and lower limb activity. Corresponding changes can be better assessed by a functional capacity test incorporating multitasking, such as the Glittre Activities of Daily Living Test (GA-T). OBJECTIVES: To evaluate functional capacity in adults with acromegaly using the GA-T and to correlate functional capacity with hand function and health-related quality of life. METHODS: The GA-T was applied to 36 patients with acromegaly and an equal number of healthy individuals. Additionally, participants completed the Acromegaly Quality of Life (AcroQoL) questionnaire and underwent a chronic pain assessment using …a map of the human body, a hand function evaluation using the Cochin Hand Functional Scale (CHFS), and a handgrip strength test. RESULTS: Relative to the comparison group, patients with acromegaly required more time to perform the GA-T, showed worse hand function, and reported that squatting to accomplish shelving tasks was the major difficulty. GA-T time was correlated with the AcroQoL global score, handgrip strength, and the CHFS (r s = - 0.487, p = 0.002; r s = - 0.369, p = 0.026; r s = 0.538, p = 0.0007, respectively). CONCLUSIONS: Patients with acromegaly exhibited a reduced functional capacity as assessed by the GA-T. Additionally, an association was identified between the total GA-T time and both hand function and quality of life. Show more

Keywords: Acromegaly, exercise, functional capacity, activity of daily living, quality of life

DOI: 10.3233/BMR-200089

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 3, pp. 441-451, 2021

Authors: Shin, Sun-Shil | Yoo, Won-Gyu

Article Type: Research Article

Abstract: BACKGROUND AND OBJECTIVE: Lumbar spinal stenosis (LSS) is a common spinal disorder that causes patients to assume a forward-trunk posture. Spinal alignment affects swing limb angles and stance limb muscle activities. Therefore, we investigated the effects of differences in step up (SU) and step down (SD) tasks on the kinematics of the trunk and swing limb as well as stance limb muscle coordination in patients with LSS. METHODS: Nine elderly female patients diagnosed with LSS were recruited for this study. The sagittal kinematics of the trunk and swing limb and isolated contraction ratio of the gluteus …medius (GMed) and vastus lateralis (VL) during SU and SD tasks were measured using a motion analysis system and surface electromyography system. RESULTS: Thoracic (17.71 ∘ ± 7.77 ∘ ) and spine angles (13.64 ∘ ± 11.34 ∘ ) as well as swing hip (48.48 ∘ ± 12.76 ∘ ) and pelvic angles (7.52 ∘ ± 10.33 ∘ ) were significantly greater during SU than SD (10.14 ∘ ± 8.41 ∘ , 10.03 ∘ ± 11.03 ∘ , 29.42 ∘ ± 10.57 ∘ , 3.21 ∘ ± 10.11 ∘ , all P < 0.05, respectively). The isolated contraction ratio of the GMed of the stance limb (34.12% ± 13.28%) was significantly higher during SU than during SD (26.65% ± 10.02%), whereas that of the VL of the stance limb (65.88% ± 13.28%) was significantly lower during SU than during SD (73.35% ± 10.02%, P = 0.011 for both comparisons). CONCLUSIONS: Patients with LSS demonstrated trunk compensatory mechanisms to address swing hip and knee angles. Trunk position affected pelvic limb muscle coordination in the standing support limb. These findings demonstrate that SD are more challenging than SU for patients with LSS, possibly due to reduced ability to generate adequate leg extensor muscular output to safely control the motion of the body’s center of mass. Therefore, trunk positions must be considered when patients with LSS undergo rehabilitation programs, particularly those involving SD or descending stairs, so that healthcare professionals can better assist patients with LSS. In addition, this study provides a background for further studies. Show more

Keywords: Isolated contraction ratio, lumbar spinal stenosis, sagittal alignment, step down, step up

DOI: 10.3233/BMR-200118

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 3, pp. 453-459, 2021

Authors: Shamsi, Hasan | Khademi-Kalantari, Khosro | Akbarzadeh-Baghban, Alireza | Izadi, Neda | Okhovatian, Farshad

Article Type: Research Article

Abstract: BACKGROUND: The cervical flexion relaxation phenomenon (FRP) is a myoelectric silence of neck extensor muscles which occurs after a certain degree of flexion. Impaired flexion relaxation can impose the vertebral structures to excessive loading resulting from the persistence of muscular contraction. OBJECTIVE: This study aimed to investigate the incidence or absence of FRP in cervical erector spinae (CES) and upper trapezius muscles in patients with chronic neck pain (CNP). METHODS: Twenty-five patients with CNP and 25 healthy volunteers were recruited. They accomplished cervical flexion and extension from a neutral position in four phases …in the sitting position. The surface electromyography activity of both CES and upper trapezius muscles was recorded in each phase. Cervical flexion and extension movements were simultaneously measured using an electrogoniometer. RESULTS: FRP in CES was observed in 84% and 36% of healthy subjects and CNP patients, respectively. Flexion relaxation ratio (FRR) in CES was lower in CNP patients than in healthy subjects (mean diff = 1.33; 95% CI: 0.75–1.91) (P < 0.001). Only in CNP patients, FRR in right erector spinea was significantly higher than that in the left erector spinea (P = 0.04). CONCLUSIONS: FRP incidence in CNP patients was less than in healthy subjects. Moreover, this phenomenon begins later in CNP patients than in healthy subjects indicating prolonged activity of CES muscles during flexion in the CNP group. The difference between FRR in the right and left sides of erector spinea muscles can result in CNP. Show more

Keywords: Flexion relaxation phenomenon, chronic neck pain, cervical erector spinea

DOI: 10.3233/BMR-200137

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 3, pp. 461-468, 2021

Authors: Li, Hao | Li, Jun | Ma, Yaojing | Li, Fangcai | Xu, Zhengkuan | Chen, Qixin

Article Type: Research Article

Abstract: BACKGROUND: Sarcopenia has been found to affect the postoperative outcomes of lumbar surgery. The effect of sarcopenia on the clinical outcomes in patients who underwent stand-alone lateral lumbar interbody fusion (LLIF) has not yet been examined. OBJECTIVE: To investigate whether sarcopenia affects the Oswestry Disability Index (ODI) and visual analog scale (VAS) score for back pain following single-level stand-alone LLIF. METHODS: Patients who underwent a single level stand-alone LLIF for lumbar diseases were retrospectively investigated. Sarcopenia was defined according to the diagnostic algorithm recommended by the Asian Working Group for Sarcopenia. Patients were …divided into the sarcopenia (SP) and non-sarcopenia (NSP) group. Univariate analysis was used to compare with regards to demographics and clinical outcomes. Multivariate logistic regression was performed to elucidate factors predicting poor clinically improvement. RESULTS: Sixty-nine patients were enrolled, with 16 and 53 patients in the SP and NSP group respectively. In the SP group, patients were much older (P = 0.002), their body mass index was significantly lower (P < 0.001), the percent of women was higher (P = 0.042), and the skeletal muscle mass index (SMI) (P < 0.001) and gait speed were much lower (P = 0.005). The postoperative ODI scores were much higher and the improvement rate was much lower (both P < 0.001) in the SP group, whereas VAS scores for back pain showed no difference between the two groups. SMI and gait speed had a moderate and weak correlation with the final ODI score, respectively. Low SMI and low gait speed were independently associated with poor clinical outcomes at the final follow-up. CONCLUSIONS: Sarcopenia impacts the final clinical outcomes of stand-alone LLIF for lumbar diseases. Low SMI and low gait speed were negative impact factors for the clinical improvement after stand-alone LLIF. Show more

Keywords: Sarcopenia, lateral lumbar interbody fusion, stand-alone, outcome

DOI: 10.3233/BMR-200138

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 3, pp. 469-476, 2021

Authors: Arsenis, S. | Gioftsidou, A. | Smilios, I. | Malliou, P. | Chatzinikolaou, A. | Ispyrlidis, I. | Beneka, A.

Article Type: Research Article

Abstract: BACKROUND: New training methods are constantly used to improve the ability of skeletal muscles to develop strength. OBJECTIVE: The aim of the present study was to investigate the effect of half-squat training with free weights and flywheel device on isokinetic knee muscle strength for well-trained amateur soccer players. METHODS: Forty eight players were randomly divided into three groups (n = 16 each): Desmotech Training group (DT), Free Weight Training group (WT) and one Control Group (CON). DT and WT performed an eight-week half-squat training program, with two sessions …per week. The DT group performed training with a flywheel device. Isokinetic concentric-eccentric strength assessments of the knee extensors-flexors muscle groups were performed at different angular velocities (60, 180 and 240 ∘ /s). RESULTS: The eight-week training program improved all the isokinetic joint moment indicators examined in the DT and WT groups (p < 0.01). The DT group achieved higher performances at all the isokinetic parameters examined, however, without statistically significant differences to the WT group. CONCLUSIONS: Flywheel-based exercise is an effective training method and is suggested to be used to strengthen the lower limbs of soccer players. Show more

Keywords: Isoinertial, eccentric load, soccer, sports

DOI: 10.3233/BMR-200151

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 3, pp. 477-483, 2021

Authors: Sugawara, André Tadeu | Lima, Moises da Cunha | Dias, Cristiane Bitencourt

Article Type: Research Article

Abstract: BACKGROUND: Myofascial Pain Syndrome causes disability in daily life activities and despite all efforts, it continues to be a challenge, perpetuating suffering, overloading services and costs. New treatment options need to be tested. OBJECTIVE: We aimed to quantify the rESWT short-term analgesic effect and identify the predictors of success through comparing results achieved in MPS and Articular Pain (AP). METHOD: Retrospective cohort study of 1,580 patients with Myofascial Pain Syndrome or Articular Pain underwent two weekly radial Extracorporeal Shock-wave Therapy sessions. The pain intensity was measured by Visual Analog Scale before and one …week after the end of the treatment (3 weeks). RESULTS: The therapy decreases pain by 62.50% (p < 0.0001), with a high success rate (91.59%) and a low worsening of baseline conditions rate (2.1%). The best recommendation is for patients with intense myofascial pain (Visual Analog Scale ⩾ 70 mm), using high shock-wave frequency (⩾ 15 Hz). CONCLUSIONS: Two rESWT sessions promote pain relief, with a high success rate and low rates of treatment abandonment and worsening. The best results are obtained in myofascial pain patients with high pain intensity, treated with high-frequency dosage. Show more

Keywords: Myofascial Pain Syndrome, musculoskeletal pain, pain management, rehabilitation, Extracorporeal Shock-wave Therapy

DOI: 10.3233/BMR-200152

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 3, pp. 485-490, 2021

Authors: Truszczyńska-Baszak, Aleksandra | Drzał-Grabiec, Justyna | Tarnowski, Adam

Article Type: Research Article

Abstract: BACKGROUND: One of the most difficult complications of total hip arthroplasty is an infection in the area of the implant with an incidence of 0.5% to 2.5% resulting in the most severe situation in prosthesis removal. OBJECTIVE: The aim of the study was to assess postural stability and functional disorders in patients after hip prosthesis removal. METHODS: A group of 15 patients after hip prosthesis removal was compared to a control group of 15 healthy persons who were age-matched without any symptoms of degenerative disorders in the lower spine and lower extremities. The …static balance test was conducted on a bi-modular stabilometric platform, registering the movement of the centre of foot pressure. The functional state of the patients was assessed on the basis of the Harris Hip Score (HHS). RESULTS: Patients had poor functional result (HSS mean 62.29 ± 12.92 points). Obtained results of postural stability of patients showed huge difficulties maintaining stability and showed statistically significant differences in a majority of the analysed parameters. CONCLUSIONS: Several stability parameters showed significantly worse results in patients after hip prosthesis removal. Special attention should be paid and focused physiotherapy should be undertaken for patients with a stability disorder and functional status to prevent falls and improve functioning. Show more

Keywords: Postural stability, hip, Girdlestone procedure, hanging hip

DOI: 10.3233/BMR-200204

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 3, pp. 491-496, 2021