Journal of Back and Musculoskeletal Rehabilitation - Volume 34, issue 6

Authors: Cho, Sung Hak

Article Type: Research Article

Abstract: BACKGROUND: Compared with healthy people, patients with chronic tension-type headache (CTTH) are likely to have forward head postures (FHP) and a higher number of active trigger points (aTrP) on the suboccipital muscle. OBJECTIVE: This study aims to verify how the suboccipital muscle inhibition (SMI) on aTrPs and the FHP correction exercise can effectively reduce symptoms of the CTTH patients. METHOD: The subjects of this study were 45 individuals with CTTH, divided into three groups of 15 patients each: a) the SMI group using the myofascial release technique; b) the SMIEx group subject to …both the SMI therapy and FHP correction exercises; and c) the control group. Group A and B were given the relevant interventions twice a week for four consecutive weeks, and went through the headache impact test (HIT-6) and examinations on the pressure pain threshold (PPT) of the headache areas, the type and number of myofascial trigger points (TrP), the soft tissue PPT, and the posture before and after the intervention. RESULTS: There was a significant improvement in the HIT-6, the headache PPT, the soft tissue PPT, the TrP, and the posture in Group A and B patients to whom the SMI technique and SMIEx interventions were applied. The biggest reduction and increase in the HIT-6 and the headache PPT respectively were seen in the SMIEx group. CONCLUSION: According to this study, the SMIEx can be an effective intervention for patients with CTTH. Show more

Keywords: Chronic tension-type headache (CTTH), suboccipital muscle inhibition(SMI) technique, FHP correction exercise

DOI: 10.3233/BMR-191667

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 6, pp. 989-996, 2021

Authors: Brück, Katrin | Jacobi, Kirsten | Schmidt, Tobias

Article Type: Research Article

Abstract: BACKGROUND: Chronic neck pain (CNP) is a common health problem in western industrialized nations. In recent years, the fascial tissue has attracted the attention of therapists, and a treatment of the fasciae promises to be a meaningful approach in the therapy of patients with CNP. OBJECTIVE: The aim of this study was to investigate the effectiveness of a fascial treatment (FT) compared to manual therapy (MT) and to no intervention (control group, CG) in patients with CNP. METHODS: Sixty participants with CNP were randomized into three groups. Primary outcome parameters were pain intensity …as measured by the visual analogue scale (VAS), and severity of illness as measured by the Neck Pain and Disability Scale (NPAD). Secondary outcome parameter was the range of motion (ROM) of the cervical spine. RESULTS: Repeated measures t -tests demonstrated significant decreases with medium to large effect sizes for the FT (VAS: d R ⁢ M = 1.14; NPAD: d R ⁢ M = 0.51) and for the MT (VAS: d R ⁢ M = 1.15; NPAD: d R ⁢ M = 0.72). CONCLUSION: Our results confirmed the effectiveness of MT on pain and severity of illness in the treatment of patients suffering from CNP. Furthermore, the results demonstrated the effectiveness and clinical relevance of FT for this population. Show more

Keywords: Chronic neck pain, fascial treatment, HVLA, manual therapy, myofascial tissue, osteopathy

DOI: 10.3233/BMR-191731

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 6, pp. 997-1006, 2021

Authors: Fung, Kerry W.Y. | Chow, Daniel H.K. | Shae, W.C.

Article Type: Research Article

Abstract: BACKGROUND: Active exercise is the only proven effective intervention for knee osteoarthritis (OA). The addition of manual therapy has shown to improve outcome of exercises. Passive mobilization with submaximal bilateral passive ankle dorsiflexion was examined in a double-blinded randomized controlled clinical trial. A passive ankle dorsiflexion apparatus was used to standardize the frequency, range of motion, and duration parameters. OBJECTIVES: The purpose of the study was to determine whether a simple standardised mobilization technique could be incorporated as a safe and unsupervised conservative treatment for knee OA. METHODS: In total, 73 participants were randomly …assigned to the experimental (n = 37) or control group (n = 36). All participants performed active exercises and received six sessions of 10-minute dorsiflexion intervention, either real or sham, for two weeks. Pre- and post-experimental assessments for the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) for pain, and range of motion of the knee were conducted. RESULTS: Results were analyzed using two-way repeated measures analysis of variance and Independent-Samples Mann-Whitney U Test. The mean score of WOMAC for the experimental and control groups changed from 31.84 to 18.19 and 34.74 to 21.06, respectively, after the intervention. The VAS also showed significant improvements. Significant improvements were observed in WOMAC in both groups after the intervention; however, differences between the groups were not statistically significant. CONCLUSIONS: Exercise with either 30 ∘ or 5 ∘ of passive dorsiflexion yielded favorable clinical effects. Although submaximal bilateral ankle dorsiflexion was proven to be safe for elderly participants with osteoarthritis of the knee, whether it provided extra benefits to exercises alone was unclear. Further research is required to determine the effectiveness of dorsiflexion and optimal range of mobilization. Show more

Keywords: Knee, osteoarthritis, mobilization, WOMAC

DOI: 10.3233/BMR-191799

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 6, pp. 1007-1014, 2021

Authors: Ojukwu, Chidiebele Petronilla | Ezeukwu, Obinna Antoninius | Anih, Chinagozim Faith | Okemuo, Adaora Justina | Ezugwu, Uchechukwu Anthonia | Ikele, Chioma Nneka | Igweagu, Chukwuma Paulinus | Ezugwu, Lazarus Eneje

Article Type: Research Article

Abstract: BACKGROUND: High prevalence of breastfeeding (BF)-related musculoskeletal disorders (MSDs) in nursing mothers have been reported in previous studies. Studies are scarce on the biomechanical effects of the commonly utilized BF positions. OBJECTIVE: This study evaluated the electromyographic (EMG) activities of the trunk muscles in response to three BF positions commonly utilized by mothers globally. METHODS: 20 non-pregnant nulliparous females participated in this experimental study. EMG activities from erector spinae (ES) and external oblique (EO) muscles were recorded bilaterally in three BF conditions: cradle (C1); cross-cradle (C2); football (FB). Data were analyzed using descriptive …statistics and inferential statistics of one-way analysis of variance with alpha level set at 0.05. RESULTS: The activity levels of right EO and ES muscles significantly increased during the C2 hold, while the left EO and ES muscles revealed significantly higher EMG levels in the C1 trial. Asymmetrical activity between the right and the left parts of the EO muscle was significantly higher during the C2 hold. CONCLUSION: These findings suggest that compared to C2 and C1 holds, FB hold may be more biomechanically efficient relative to its decreased muscular demands. The physical stresses associated with BF may be higher with the adoption of C2 and C1 holds, especially for prolonged periods. Show more

Keywords: Breastfeeding positions, electromyography, trunk muscle activities

DOI: 10.3233/BMR-200018

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 6, pp. 1015-1021, 2021

Authors: Lim, Wootaek

Article Type: Research Article

Abstract: BACKGROUND: In clinical practice, knee flexion at the prone position for manual muscle testing of hamstrings and hip extension at the supine position for stretching of hamstring muscles are typically proposed. OBJECTIVE: Although different positions have been proposed for different purposes in hamstrings, the understanding of the changing the functional role of hamstrings with position changes is poorly understood. METHODS: The electromyographic (EMG) activity and hip extension force were compared among different postures; hip neutral, internal, and external rotation. EMG and force were measured in prone position during knee flexion and those were …additionally measured in supine position during hip extension. In supine position, additional measurements were made in hip neutral, internal and external rotation. RESULTS: Hamstrings showed high EMG activity during knee flexion. Knee flexion force in prone position was significantly decreased at hip extension force in supine position. In supine position, EMG activity was significantly higher in semitendinosus (ST) than biceps femoris (BF) during internal rotation. CONCLUSIONS: It should be noted that bi-articular muscles may have different functional dependencies on the corresponding muscles for each joint. In addition, because the altered alignment of the hamstring muscles that was affected by hip rotation had a significant effect on muscle activity, and hip rotation may be helpful for selective training of medial or lateral hamstrings. Show more

Keywords: Electromyography, force, hamstrings, hip rotation

DOI: 10.3233/BMR-200064

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 6, pp. 1023-1029, 2021

Authors: Nitayarak, Haifah | Charntaraviroj, Pornpimol

Article Type: Research Article

Abstract: BACKGROUND: Scapular stabilization exercises can improve forward shoulder posture in young women. However, the effects of optimal exercise protocols on neck and shoulder postures, scapular muscle imbalance and thoracic kyphosis are still unclear. OBJECTIVES: To investigate the effects of scapular stabilization exercises on neck and shoulder postures, scapular muscle imbalance and thoracic kyphosis in young women with upper crossed syndrome. METHODS: Thirty-nine women aged 18–25 years with upper crossed syndrome were recruited. Participants were randomly allocated intotwo groups. The exercise group performed scapular stabilization exercises using elastic bands at 10 repetitions/set, 3 sets/day, …and 3 days/week for 4 weeks. The control group did not perform any exercises during the experimental period. The cervical and shoulder angles were evaluated using the Kinovea program. A caliper, handheld dynamometer and flexi ruler were used to evaluate the length of the pectoralis minor, strength of the scapular stabilizer muscles and degree of the mid-thoracic curve, respectively. RESULTS: The exercise group showed significant differences (p < 0.05) in the increase in cervical and shoulder angle, length of the pectoralis minor, and strength of the scapular muscles, except in the degree of mid-thoracic curve compared to the control group. CONCLUSION: This study indicated that scapular stabilization exercises can improve forward head and shoulder posture, increase the flexibility of the pectoralis minor and strengthen the scapular muscles. Show more

Keywords: Upper crossed syndrome, posture, muscle imbalance, scapular stabilization exercise

DOI: 10.3233/BMR-200088

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 6, pp. 1031-1040, 2021

Authors: Petit, Audrey | Le Borgne, Margaux | Albert, Valérie | Durand, Marie-José

Article Type: Research Article

Abstract: BACKGROUND: Addressing chronic low back pain (cLBP) from the point of view of representation allows better understanding the behaviors associated with it and thus improve its medical and socio-occupational management. The Quebec Questionnaire of Representations related to Work Disability (QRWoD) proposes an evaluation of 9 dimensions of the cLBP-related representation. OBJECTIVE: To translate and adapt the QRoWD to French language and assess its validity and reliability in French cLBP workers on prolonged sick leave. METHODS: A prospective study was conducted from March 2017 to April 2018 in the Department of occupational health of …the University Hospital of Angers, France. The QRWoD is a self-administered questionnaire (87 items) which assesses Identity, Acute/Chronic duration, Consequences, Personal Control, Treatment Control, Cyclical Timeline, Coherence, Emotional Representation and Causes dimensions. The Internal consistency (Cronbach’s α ) and the convergent validity (Pearson correlations) in comparison to validated instruments for each dimension were assed. RESULTS: Fifty French workers (29 men, 43 ± 9.1 years, 293.6 ± 173.0 days of work absence) were included. The internal consistency (all α > 0.7) and the convergent validity (all r 2 > 0.25, p < 0.01) of each dimension were very satisfactory except for the Cyclical Timeline dimension. CONCLUSIONS: The French version of the QRoWD seems to be valid and relevant among the target population. Show more

Keywords: Chronic low back pain, cross-cultural adaptation, dimensions, representation, validity, work disability

DOI: 10.3233/BMR-200093

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 6, pp. 1041-1048, 2021

Authors: Arslan, Serdar | Dinç, Engin

Article Type: Research Article

Abstract: BACKGROUND: The Functional Movement Screen (FMS) is a clinical assessment tool used to determine musculoskeletal dysfunctions and asymmetries in athletes. OBJECTIVE: The aim of this study was to investigate whether FMS scores differed between elite youth male soccer players with low body fat percentage and those with normal body fat percentage and between those with and without a history of soccer injury. METHODS: Fifty-three elite youth male soccer players were included in the study. The participants’ injury histories were recorded, followed by body composition assessment and FMS tests. The participants were grouped according …to body fat percentage and injury history for data analysis. RESULTS: The mean age, weight and height of the participants were 17.11 ± 0.91 years, 68.78 ± 7.41 kg and 1.77 ± 0.57 meters, respectively. Comparisons of the groups according to body fat percentage and injury history revealed no differences in FMS scores (p > 0.05). CONCLUSION: Lower body fat percentage did not confer an advantage or disadvantage to elite youth male soccer players in terms of FMS scores FMS scores provide limited information to predict injuries in elite youth male players. Show more

Keywords: Football, body fat, injuries, sports, body composition, athletes

DOI: 10.3233/BMR-200100

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 6, pp. 1049-1056, 2021

Authors: Nam, Soo-Jin | Oh, Duck-Won

Article Type: Research Article

Abstract: BACKGROUND: Side-lying hip abduction exercise could be beneficial to improve the neuromuscular control of the hip abductor; however, there has been limited information available to determine the exercise load during the exercise. OBJECTIVE: This study aimed to demonstrate the effects of using external loads on the hip abductor muscles during side-lying hip abduction exercises in females with gluteus medius (GM) weakness. METHODS: This study enrolled 24 females with weakness in the GM. Electromyographic (EMG) data of the quadratus lumborum (QL) and GM muscles were recorded during the exercise under three load conditions: no-load, …external load-1 (3% of body weight), and external load-2 (5% of body weight). RESULTS: During the exercise, the EMG activities of the QL were significantly different under all three conditions (p < 0.05), with greater activity observed in the external load-2 condition (92.05 ± 65.93% maximal voluntary isometric contraction [MVIC]) as compared to the others, and in the external load-1 condition (82.47 ± 57.36% MVIC) as compared to the no-load condition (48.94 ± 45.09% MVIC). Furthermore, the GM/QL ratios showed significant differences between no-load (1.78 ± 1.47) and external load-1 conditions (0.93 ± 0.60), and between no-load and external load-2 (0.85 ± 0.45) conditions (p < 0.05). CONCLUSION: These findings suggest that greater load could be a factor to increase the QL activity during the exercise in females with weakened GM. Show more

Keywords: Hip abduction, load, exercise

DOI: 10.3233/BMR-200108

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 6, pp. 1057-1062, 2021

Authors: Soer, Remko | Six Dijkstra, Marianne W.M.C. | Bieleman, Hendrik J. | Oosterveld, Frits G.J. | Rijken, Noortje H.M.

Article Type: Research Article

Abstract: BACKGROUND: Many patients visiting physiotherapists for musculoskeletal disorders face psychosocial challenges which may form a large barrier to recover. There are only a limited number of evidence based psychosocial therapies, but they are mainly based on breathing exercises. OBJECTIVE: to study which respiration frequency would lead to the highest relaxation, reflected in vagal tone derived from the heart rate variability (HRV) in healthy subjects. METHODS: A randomized controlled cross sectional study was performed. Respiration cycles of four, five, six, seven and eight breaths per minute (BPM) were delivered in randomized order for two minutes …each. HRV metrics were measured during the sessions with electrocardiogram (ECG). Repeated Measures ANOVA’s were performed to analyze differences between breathing frequencies. RESULTS: 100 healthy volunteers were included (40 male). Standard Deviation of inter beat intervals (SDNN) values were significantly highest at 5 BPM, whereas the Root Mean Square of Successive Differences (RMSSD) values appeared highest at 7 breaths per minute (p < 0.01). High Frequency (HF) power was lowest at 4 BPM, whereas Low Frequency (LF) power was not significantly influenced by respiration frequency. CONCLUSIONS: Breathing at a frequency of 5 to 7 breaths per minute leads to highest HRV values, but there is no single respiration ratio that maximizes all metrics. Physiotherapists may use five to seven BPM as guidance to determine ideal breathing frequencies. Show more

Keywords: Heart rate variability, breathing frequencies, relaxation, stress, physiotherapy

DOI: 10.3233/BMR-200190

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 34, no. 6, pp. 1063-1068, 2021