Journal of Back and Musculoskeletal Rehabilitation - Volume 34, issue 5

Authors: Sencan, Savas | Erdem, Didem | Gunduz, Osman Hakan | Bilim, Serhad | Duruoz, Mehmet Tuncay

Article Type: Research Article

Abstract: BACKGROUND: Lumbosacral radiculopathy is associated with a broad range of complaints; therefore, specific disability measurements should be validated for this condition. OBJECTIVES: The aim of this study was to investigate the validity and reliability of the Istanbul Low Back Pain Disability Index (ILBPDI) in lumbosacral radiculopathy. METHODS: Patients diagnosed with radiculopathy caused by a disc herniation were included. Disability and quality of life were evaluated with the Oswestry Disability Index (ODI) and Short Form-36 (SF-36), respectively. The severity of low back pain and leg pain were evaluated using a Numeric Rating Scale (NRS). …The reliability of the ILBPDI was assessed using the Cronbach’s alpha coefficient. The relation of ILBPDI with SF-36, ODI, NRS-back and NRS-leg scores were analyzed for convergent validity. The relation of the ILBPDI with age, body mass index (BMI), and disease duration was analyzed for divergent validity. Factor analysis was used to establish the internal construct validity. RESULTS: One hundred patients (55% female) were included in this study. The Cronbach’s alpha coefficient was 0.92. The ILBPDI was found to be correlated with the ODI (rho : 0.619, p < 0.005) and NRS-leg score (rho : 0.597, p < 0.005), but not with NRS-back score (rho : 0.164, p > 0.05). The ILBPDI was significantly correlated with physical functioning (rho : - 0.638, p < 0.005), bodily pain (rho : - 0.488, p < 0.005), general health (rho : - 0.264, p = 0.008) and social function (rho : - 0.372, p < 0.005) subscales of SF-36 (convergent validity). The ILBPDI was not correlated with age, BMI, or disease duration (divergent validity). Factor analysis showed that the scale had three-factors which were correlated to bending forward, standing, and sitting activities. CONCLUSION: The ILBPDI is a valid and reliable instrument in patients with lumbosacral radiculopathy. Show more

Keywords: Reliability and validity, low back pain, radiculopathy, disability evaluation, quality of life

DOI: 10.3233/BMR-200339

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 5, pp. 813-820, 2021

Authors: Barsotti, Carlos Eduardo Gonçales | Junior, Carlos Augusto Belchior B. | Andrade, Rodrigo Mantelatto | Torini, Alexandre Penna | Ribeiro, Ana Paula

Article Type: Research Article

Abstract: BACKGROUND: Idiopathic scoliosis is accompanied by postural alterations, instability of gait, and functional disabilities. The objective was to verify radiographic parameters (coronal and sagittal) of adolescents with idiopathic scoliosis (AIS) pre- and post-surgery with direct vertebral rotation (DVR), associated with type 1 osteotomies in all segments (except the most proximal) and type 2 in the periapical vertebrae of the curves. METHODS: A prospective study design was employed in which 41 AIS were evaluated and compared pre- and post-surgery. Scoliosis was confirmed by a spine X-ray exam (Cobb angle). Eight radiographic parameters were measured: Cobb angles (thoracic …proximal and distal), segmental kyphosis, total kyphosis, lumbar lordosis, pelvic incidence, sacral slope, and pelvic tilt. RESULTS: The Cobb angle averaged 51.3 ∘ ± 14.9 ∘ . Post-surgery, there were significant reductions for the following spine measurement parameters: Cobb angle thoracic proximal (p = 0.003); Cobb angle thoracic distal (p = 0.001); Cobb angle lumbar (p = 0.001); kyphosis (T5-T12, p = 0.012); and kyphosis (T1-T12, p = 0.002). These reductions showed the effectiveness of surgical correction to reduce Cobb angles and improve thoracic kyphosis. The values obtained for lumbar lordosis, pelvic incidence, sacral slope, and pelvic tilt were not significantly different pre- and post-surgery. CONCLUSION: The surgical technique of DVR in AIS proved to be effective in the coronal and sagittal parameters directed at Cobb angles and thoracic kyphosis in order to favor the rehabilitation process. Show more

Keywords: Idiopathic scoliosis, adolescents, surgery, spine

DOI: 10.3233/BMR-200320

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 5, pp. 821-828, 2021

Authors: Tobinaga, Takashi | Obayashi, Shigeru | Miyazaki, Chieko | Yazawa, Makoto | Saito, Takamichi | Hashimoto, Kumiko | Ogawa, Masato | Tochigi, Yuki | Oka, Koichiro | Ozeki, Satoru

Article Type: Research Article

Abstract: BACKGROUND: Some patients with end-stage osteoarthritis of the knee remain unsatisfied after total knee arthroplasty (TKA). We postulated that to increase satisfaction, self-efficacy (SE) for physical activity should receive more attention in rehabilitative intervention, alongside the management of patient expectations, pain, and function. OBJECTIVE: We examined the relative impact of Physical Activity SE on Health-Related Quality of Life (HRQOL) alongside other factors such as pain and physical function which are well-addressed by current interventions. METHODS: One hundred and six first-TKA recipients (15 Male/91 Female, age 73.6 ± 7.2) were evaluated …at 3 and 6 months post-operatively using the Medical Outcomes Study 36-Item Health Survey (SF-36v2) for HRQOL, knee extension strength measurement, Timed Up and Go test (TUG), One Leg Standing time test (OLS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for pain and function, and an instrument for measuring Physical Activity SE among the frail elderly in Japan. RESULTS: Significant improvement over pre-operative values was found at 3 and 6 months in TUG, OLS, WOMAC Pain and Function, and the 8 subscales of the SF-36v2. Factors found to significantly impact SF-36v2 subscale scores at 6 months post-operatively were found to be knee pain, knee function, and SE for physical activity. CONCLUSION: These results support our postulation that interventions to improve SE for physical activity could have comparable impact alongside interventions for knee pain and knee function, on the advancement of HRQOL among TKA recipients. Show more

Keywords: Total knee arthroplasty, Health-Related Quality of Life, self-efficacy, physical function, rehabilitation

DOI: 10.3233/BMR-200017

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 5, pp. 829-835, 2021

Authors: An, Da-In | Park, Jung-Eun | Lee, Chang-Hyung | Kim, Soo-Yong

Article Type: Research Article

Abstract: BACKGROUD: Reliable scapular upward rotation and anterior-posterior tilt data are required for patients with subacromial impingement syndrome (SIS). Only a few studies have explored the reliability of such measurements derived using a modified inclinometer. OBJECTIVES: To determine the relative and absolute reliability of scapular upward rotation and anterior-posterior tilt measurements derived using a modified digital inclinometer in patients with SIS. METHOD: Seventeen SIS patients were assessed twice within 1 week. We determined the relative and absolute measurement reliability by calculating the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal clinically …important difference (MCID). Both intra- and interrater reliability were determined. RESULTS: The intra-rater reliability (both measurements) was high (0.72–0.88), and the interrater ICC was high to excellent (0.72–0.98). Clinically acceptable SEM and MCID values were obtained for scapular upward rotation (SEM: 4.28–9.33 ∘ , MCID: 5.1–11.3 ∘ ) and anterior-posterior tilt (SEM: 3.72–7.55 ∘ , MCID: 2.5–10.8 ∘ ). CONCLUSIONS: Measurements of scapular upward rotation and anterior-posterior tilt using a modified digital inclinometer reliably reveal scapular position and kinematics in patients with SIS. Show more

Keywords: Modified digital inclinometer, scapular anterior-posterior tilt, scapular upward rotation, subacromial impingement syndrome

DOI: 10.3233/BMR-200080

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 5, pp. 837-843, 2021

Authors: Shimo, Kazuhiro | Hasegawa, Mami | Mizutani, Seiko | Hasegawa, Tomomi | Ushida, Takahiro

Article Type: Research Article

Abstract: BACKGROUND: Physical activity (PA) is essential in the management and rehabilitation of low back pain (LBP). However, it is not clear that PA interventions in the workplace can improve LBP. OBJECTIVE: This study aimed to investigate the effects of workplace counseling on PA and LBP among workers. METHODS: We recruited 37 people with 12 weeks of LBP who worked in a manufacturing company in Aichi, Japan. Participants were randomly assigned to the intervention (n = 20) or control group (n = 17). All …participants of both groups were affixed with waist-worn accelerometers to monitor PA. The intervention group also received a program of face-to-face counseling with a physical therapist or nurse once a week for 12 weeks to reassure and encourage participants to maintain a high level of PA. PA and LBP severity were assessed at baseline, 3 and 6 months. RESULTS: PA was significantly higher in the intervention group than in the control group at 3 and 6 months. In the intervention group, PA significantly increased at 3 and 6 months from baseline, and LBP severity at 6 months improved significantly from baseline. CONCLUSIONS: Our data suggest that workplace PA intervention can increase PA and improve LBP among workers. Show more

Keywords: Workplace intervention, physical activity counseling, workers

DOI: 10.3233/BMR-200178

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 5, pp. 845-852, 2021

Authors: Senturk, Yazgi | Kirmizigil, Berkiye | Tuzun, Emine Handan

Article Type: Research Article

Abstract: OBJECTIVE: Our objective was to investigate the effects of clinical Pilates exercises (CPE), applied to the primary caregivers of special needs children, on cardiovascular endurance (CVE) and psychosomatic parameters in comparison to a control group. METHODS: Fifty-five primary caregivers of special needs children, divided into two groups as the CPE and control groups, were included in the study. The six-minute walk test, the Fatigue Severity Scale, the Coping Orientation for Problems Experienced (COPE) Inventory, the Beck Depression Inventory and the State-Trait Anxiety Inventory were used to measure CVE, fatigue severity, attitudes toward coping with problems, depression …levels and anxiety levels, respectively. RESULTS: Statistically significant differences between the groups in favor of the CPE group were found concerning the denial parameter of COPE, fatigue (which was the primary outcome), depression and anxiety (all p values < 0.05). Statistically significant intragroup comparison differences were only detected in the CPE group in the fatigue, depression, anxiety and COPE (use of instrumental and emotional social support and focus on and venting of emotions) questionnaire results (all p values < 0.05). CONCLUSIONS: CPE are an applicable and effective method for the primary caregivers of special needs children in improving psychosomatic parameters, albeit not effective for CVE. It is recommended to investigate the long-term effects of clinical Pilates exercises on a similar group. Show more

Keywords: Special needs child, primary caregiver, psychosomatic questionnaire, clinical pilates, exercise

DOI: 10.3233/BMR-191649

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 5, pp. 853-864, 2021

Authors: Lin, Wujian | Wang, Weiming | Wu, Lishan | Andersen, Lars Louis | Wang, Yuling

Article Type: Research Article

Abstract: BACKGROUND: Vibration exercise has been investigated to enhance muscle activation, however, the effect of different amplitude vibratory exercises on cardiovascular stress is less understood. OBJECTIVE: Our study aims to explore the acute effect of shoulder vibratory exercises with different postures and amplitudes on the cardiovascular response in healthy adults. METHODS: Using a repeated measures randomized design, 36 subjects performed three different sessions with FLEXI-BAR exercise (FBE): (1) zero-amplitude, (2) small-amplitude, (3) large-amplitude. Each session included three different shoulder positions: 45-, 90- and 180-degree flexion. Heart rate variability (HRV), heart rate (HR) and rating …of perceived exertion (RPE) were monitored continuously, while systolic blood pressure (SBP), diastolic blood pressure (DBP) and rate-pressure product (RPP) were measured before and after each exercise session. RESULTS: Compared with zero-amplitude, both small- and large-amplitude FBE protocols induced higher SBP. By contrast, DBP decreased with small- and large-amplitude. The RPP immediately after the exercise session were higher than at baseline. For high frequency, low frequency of HRV and HR there was a main effect of amplitude. CONCLUSION: Small- and large-amplitude FBE increased significantly SBP, RPE, HRV, HR and induced lower DBP, but the changes were modest, suggesting that FBE impose no extra threats to cardiovascular stress. Show more

Keywords: FLEXI-BAR, vibration, exercise, heart rate, blood pressure

DOI: 10.3233/BMR-200044

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 5, pp. 865-875, 2021

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

Article Type: Research Article

Abstract: OBJECTIVE: The purpose of this study was to investigate differences in regional lumbar lordosis (RLL) and global lumbar lordosis (GLL) angle during slumped sitting and upright sitting among three global subgroups. METHODS: A total of 48 young asymptomatic volunteers stood in a comfortable posture, sat upright, and sat in a slumped position for 5 seconds, with inertial measurement units attached to the T10, L3, and S2 vertebrae. According to standing measurement, the participants were categorized into flat-back (GLL < 20 ∘ ), normal lordosis (20 ∘ ⩽ …GLL < 30 ∘ ), and hyper-lordosis (30 ∘ ⩽ GLL < 40 ∘ ) groups. RESULTS: Both the GLL and RLL in the flat-back group were reduced lumbar lordosis in the upright sitting posture and increased lumbar kyphosis in the slumped sitting postures compared to the other groups (p < 0.05), but the range of motion during the transition from upright sitting to slumped sitting was lower than that of the normal and hyper-lordosis groups (p < 0.05). GLL in standing was a moderate correlation with GLL and RLL during upright sitting (p < 0.05). However, there was a strong correlation between GLL and RLL kinematics during upright and slumped sitting (p < 0.05). CONCLUSIONS: Flat-back posture is a potential source of low back pain during both upright and slumped sitting compared to the normal and hyper-lordosis groups. Posture measurements in a standing and sitting position conducted to assess lordosis should consider the relationship between GLL and RLL. Show more

Keywords: Flat-back posture, global lumbar lordosis, regional lumbar lordosis, slumped sitting posture

DOI: 10.3233/BMR-200087

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 5, pp. 877-885, 2021

Authors: Yurt, Yasin | Yatar, İlker | Malkoç, Mehtap | Yakut, Yavuz | Mıhçıoğlu, Serpil | Koltak, Cansu

Article Type: Research Article

Abstract: BACKGROUND: The instant effect of a brace on pulmonary functions of patients with adolescent idiopathic scoliosis (AIS) is known. However, the permanent effects of its regular use are still unclear. OBJECTIVE: This study aimed to determine whether a brace in patients with AIS had a permanent effect on respiratory functions. METHODS: Fifteen patients with a mean age of 13.2 ± 1.6 years, and a major Cobb angle of 25.8 ∘ ± 7.7 ∘ participated in this study. Lung volumes and …respiratory muscle strength were measured with and without thoracolumbosacral brace, at the end of first month and follow-up period after the patients started using the brace for 23 hours daily. RESULTS: When the brace was on, the forced vital capacity (FVC), forced expiratory volume in 1 second (FEV 1 ), ratio of FEV 1 /FVC, peak expiratory flow, and forced expiratory flow between 25% and 75% of vital capacity values were found to be lower at both first month and follow-up. After the follow-up, the measurement results did not differ from the results of the first month. CONCLUSIONS: The brace had a momentary restrictive effect on patients with AIS. However, it did not cause a permanent change in pulmonary functions after the 8-month follow-up. Show more

Keywords: Scoliosis, braces, pulmonary function test, respiratory muscle

DOI: 10.3233/BMR-200195

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 5, pp. 887-893, 2021

Authors: Kim, Young Kyun | Cho, Sung Yeon | Lee, Kun Ho

Article Type: Research Article

Abstract: BACKGROUND: Transcutaneous electrical nerve stimulation (TENS) for chronic low back pain (CLBP) requires a treatment period of ⩾ 6 weeks to decrease pain and disability and is ineffective as sole treatment. Instrument-assisted soft tissue mobilization (IASTM) has rapid effects in musculoskeletal disorders. OBJECTIVE: This study aimed to investigate the effects of a 3-week combined TENS and IASTM treatment (TICT) on CLBP. METHODS: Thirty-two young men with CLBP were randomly divided into the TICT and control groups (n = 16 each). Patients were evaluated with the …visual analog (VAS) and face pain-rating scales (FPRS) for pain, the Oswestry Disability Index (ODI) and passive straight leg raise (PSLR) test for flexibility, and the supine bridge test (SBT) for endurance before and after the treatment course. The TICT group received TICT on the lower back, glutes, and hamstrings, six times in 3 weeks. RESULTS: Group, time, and group × time interaction effects on pain were significant (VAS and FPRS, all p < 0.001). Group × time interaction (ODI, p < 0.001; PSLR, p < 0.05; SBT, p < 0.01) and group (ODI, p < 0.05) and time main effects (ODI, p < 0.001; PSLR, p < 0.01; SBT, p < 0.001) on motor function were significant. CONCLUSION: Thus, short-term TICT decreased pain level and increased motor function in CLBP patients, yet further investigation is needed on different age and gender groups. Show more

Keywords: Chronic low back pain, instrument-assisted soft tissue mobilization, motor function, transcutaneous electrical nerve stimulation, TENS, IASTM

DOI: 10.3233/BMR-200369

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 5, pp. 895-902, 2021