Journal of Back and Musculoskeletal Rehabilitation - Volume 35, issue 3

Authors: Guo, Yu-Jie | Hu, Xiao-Yun | Li, Jia-Yu | Yang, Lei

Article Type: Research Article

Abstract: BACKGROUND: Exercise training after lumbar fusion surgery (LFS) is important for regaining the strength in the spinal muscles, pain management, and minimizing dysfunction. It may be prudent to evaluate technologies such as web-based chat and social media apps for increasing the efficacy of post-surgery interventions in LFS patients. OBJECTIVE: To explore the effectiveness of a WeChat-based individualized post-discharge rehabilitation program in patients with LFS. METHODS: Seventy-two eligible discharged LFS patients were enrolled from October 2018 to February 2019. The experimental group (36 cases) received a 10-week WeChat-based individualized rehabilitation program, while the control …group (36 cases) received routine follow-up guidance. The outcomes were measured using the Exercise Compliance Questionnaire, Numerical Rating Scale, Oswestry Disability Index and Chinese version of the self-efficacy for exercise scale. RESULTS: The analysis using generalized estimation equations method shows significant differences in the interaction effect of group*time in exercise compliance (Wald c 2 = 7.459, P < 0.05), group effect in pain (Wald c 2 = 5.811, P < 0.05) and self-efficacy (Wald c 2 = 16.383, P < 0.05). However, there was no significant difference between the experimental and control groups in the group effect in dysfunction improvement (Wald c 2 = 2.289, P > 0.05). CONCLUSIONS: The WeChat-based rehabilitation intervention can improve exercise compliance and self-efficacy, and help achieve greater pain relief compared to the routine intervention. However, the WeChat-based intervention did not offer better improvement in the self-dysfunction in the post-discharge LFS patients. Show more

Keywords: Lumbar fusion surgery, rehabilitation program, WeChat, post-discharge, nursing

DOI: 10.3233/BMR-200280

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 3, pp. 545-557, 2022

Authors: Castellanos, Ramon

Article Type: Research Article

Abstract: BACKGROUND: Facet joint syndrome (FJS) pain is a significant contributor to back pain and has a high rate of opioid prescription. Unfortunately, there are a limited number of therapeutic options for these patients. OBJECTIVE: To evaluate the safety and effectiveness of amniotic membrane/umbilical cord particulate (AM/UC) in managing FJS pain. METHODS: A single-center, investigator-initiated, retrospective study was performed on consecutive patients with FJS pain who received intra- or peri-articular injection of AM/UC between July 1, 2018 and July 26, 2019. Primary outcome was change in Patient Global Impression of Change (PGIC) at 6 …weeks, 3 months, 6 months, and 12 months to assess the self-reported percent improvement relative to baseline. Safety was assessed by AM/UC- and procedure-related complications. Paired t -tests were used to determine whether there is a statistically significant improvement of pain post-injection compared to baseline. RESULTS: There were a total of 54 patients (69.7 ± 13.4 years; 31 female) presenting baseline pain score of 9.2 ± 1.0 despite prior treatments of activity modification (66.7%), NSAIDs (61.1%), opioids (37.0%), and physical therapy (35.2%). Mean GPIC improvement was 65.3%, 67.5%, 56.9%, and 56.7% among responders 30 , respectively. There were no complications. CONCLUSION: This study supports the safety and effectiveness of AM/UC particulate injection in managing FJS pain. Show more

Keywords: Amniotic, chronic low back, facet, pain, umbilical cord

DOI: 10.3233/BMR-200330

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 3, pp. 559-564, 2022

Authors: Sabashi, Kento | Kasahara, Satoshi | Tohyama, Harukazu | Chiba, Takeshi | Koshino, Yuta | Ishida, Tomoya | Samukawa, Mina | Yamanaka, Masanori

Article Type: Research Article

Abstract: BACKGROUND: Knee osteoarthritis (OA) impairs postural control and may affect how the lower limb joints are used for postural control. OBJECTIVE: To investigate how individuals with knee OA use lower limb joints for static postural control. METHODS: Ten patients with knee OA and thirteen healthy controls performed quiet standing for 30 s. The standard deviation of the center of mass (COM) and lower limb joint motions in the anterior-posterior (AP) and medial-lateral (ML) planes were calculated from three-dimensional marker trajectories. Pearson’s correlation analysis and independent t -tests were conducted to investigate the relationship between …COM and lower limb joint motion and to compare group difference, respectively. RESULTS: The AP hip angular velocity alone in the knee OA group and the AP hip and knee angular velocity in the control group were significantly correlated with the AP COM velocity. The ML hip angular velocity was significantly correlated with the ML COM velocity in both groups. The knee OA group exhibited a significantly larger standard deviation of AP COM velocity than the control group. CONCLUSIONS: Individuals with knee OA depended solely on the contribution of the hip to the AP COM velocity, which could not be successfully controlled by the knee. Show more

Keywords: Knee osteoarthritis, quiet standing, postural control, center of mass, kinematics

DOI: 10.3233/BMR-200337

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 3, pp. 565-572, 2022

Authors: Radwan, Nadia L. | Ibrahim, Marwa M. | Mahmoud, Waleed S.

Article Type: Research Article

Abstract: BACKGROUND: Adolescents with idiopathic scoliosis present postural instability when compared with healthy subjects. Although Schroth exercises therapy (SET) is broadly utilized, its effect on postural stability is still not clear. OBJECTIVES: To compare the two treatment periods of the SET for improving the postural stability indices and Cobb angle, and to examine the correlation between the Cobb angle and stability indices in adolescent idiopathic scoliosis (AIS). METHODS: Twenty girls aged 10–16 years with AIS (study group) and 20 age-matched girls without AIS (control group) were examined. The Biodex Balance System was used to …evaluate the overall stability index (OSI), anteroposterior index (APSI), and mediolateral stability index (MLSI) in the study group before SET and one and three months after the therapy. A plain X-ray was used to measure the Cobb angle before and three months after SET. Stability indices and Cobb angle were measured only once for the control group. RESULTS: One-way repeated-measures ANOVA revealed that the three-month duration of SET was the most effective for improving OSI, APSI, and MLSI (p < 0.001). The significant proximities of OSI, APSI, and MLSI to the normal values post three months of SET were 29.65%, 24.07, and 20% respectively. The MLSI was robust and correlated with the Cobb angle (r = 0.85) three months post intervention. CONCLUSION: Stability indices and Cobb angles were highly improved after three months of SET compared to one month among AIS patients. The MLSI is the most substantial index correlated with the Cobb angle. Show more

Keywords: Adolescent idiopathic scoliosis, Biodex Balance System, postural balance, Schroth exercises

DOI: 10.3233/BMR-200342

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 3, pp. 573-582, 2022

Authors: Lee, Sang Hoon | Choi, Hyun Hee | Chang, Min Cheol

Article Type: Research Article

Abstract: BACKGROUND: Many patients complain of chronic cervical radicular pain, and pulsed radiofrequency (PRF) is known to have a positive effect for alleviating neuropathic pain. OBJECTIVES: In the present study, we used ultrasound (US) guidance and compared the effects of monopolar PRF with those of bipolar PRF in patients with chronic cervical radicular pain refractory to repeated transforaminal epidural steroid injections. METHODS: Sixty-six patients with chronic cervical radicular pain were included in this study. Patients were randomly assigned to one of the two groups: monopolar or bipolar PRF group (n = …33 per group). Pain intensity was evaluated using a numeric rating scale (NRS) at pretreatment, and at 1 and 3 months after the treatment. Target stimulation site was the extraforaminal nerve root. RESULTS: Compared to the pretreatment NRS scores, patients in both groups showed a significant decrease in NRS scores at 1 and 3 months after the treatment. Reductions in the NRS scores over time were significantly larger in the bipolar PRF group. Three months after the treatment, 18 patients (54.5%) in the monopolar PRF group and 27 (81.8%) in the bipolar PRF group reported successful pain relief (pain relief of ⩾ 50%). CONCLUSIONS: US-guided PRF can be an effective interventional technique for the management of chronic refractory cervical radiculopathy. Moreover, bipolar PRF has better treatment outcome than monopolar PRF. Show more

Keywords: Ultrasound, pulsed radiofrequency, monopolar, bipolar, cervical radicular pain, chronic pain

DOI: 10.3233/BMR-201842

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 3, pp. 583-588, 2022

Authors: Kurokawa, Yuki | Kato, Satoshi | Demura, Satoru | Shinmura, Kazuya | Yokogawa, Noriaki | Yonezawa, Noritaka | Shimizu, Takaki | Kitagawa, Ryo | Miaki, Hiroichi | Tsuchiya, Hiroyuki

Article Type: Research Article

Abstract: BACKGROUND: Abdominal bracing is effective in strengthening the trunk muscles; however, assessing performance can be challenging. We created a device for performing abdominal trunk muscle exercises. The effectiveness of this device has not yet been evaluated or compared OBJECTIVE: We aimed to quantify muscle activity levels during exercise using our innovative device and to compare them with muscle activation during abdominal bracing maneuvers. METHODS: This study included 10 men who performed abdominal bracing exercises and exercises using our device. We measured surface electromyogram (EMG) activities of the rectus abdominis (RA), external oblique, internal oblique …(IO), and erector spinae (ES) muscles in each of the exercises. The EMG data were normalized to those recorded during maximal voluntary contraction (%EMGmax). RESULTS: During the bracing exercise, the %EMGmax of IO was significantly higher than that of RA and ES (p < 0.05), whereas during the exercises using the device, the %EMGmax of IO was significantly higher than that of ES (p < 0.05). No significant difference was observed in the %EMGmax of any muscle between bracing exercises and the exercises using the device (p = 0.13–0.95). CONCLUSIONS: The use of our innovative device results in comparable activation to that observed during abdominal bracing. Show more

Keywords: Abdominal muscles, electromyography, exercise, stability

DOI: 10.3233/BMR-210001

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 3, pp. 589-596, 2022

Authors: Kashif, Muhammad | Manzoor, Nosheen | Safdar, Rimsha | Khan, Hafsa | Farooq, Maryam | Wassi, Ahmad

Article Type: Research Article

Abstract: BACKGROUND: Cervicogenic headache (CGH) is a common condition that results in significant disability. To treat this dysfunction, Mulligan described sustained natural apophyseal glides (SNAGs) as a manual therapy approach. However, only inconclusive short-term evidence exists for treating CGH with SNAGs. OBJECTIVE: The present study aims to investigate the effect of SNAGs in the treatment of CGH. METHODS: Fourty female patients ranging from 20 to 40 years with CGH were randomly assigned to two groups: 20 in a treatment group and 20 in a control group. SNAGs were applied to the treatment group while …the control group received placebo treatment. Both groups received their respective treatment for 20 minutes, alternately three times per week, for a total of 12 times in four weeks. The outcome measures were the Neck Disability Index (NDI) and the Visual Analogue Scale (VAS). Participants were assessed at baseline and at the end of each week. The data was analyzed using SPSS version 20. Independent t-testing was used to reveal changes between groups. One-way ANOVA was used to determine changes within groups. The level of significance was P < 0.05. RESULTS: Twenty participants (100%) in the treatment group and 17 (85%) in the control group had a history of headache aggravation with active movements or passive head positioning. There was no significant difference at baseline (p > 0.05), indicating that both groups were homogeneous at the time of recruitment. The p value (p < 0.05) showed a significant difference in pain and level of disability at three and four weeks (p < 0.05) in patients treated with SNAGs. However, the cervical range of motion (ROM) showed a statistically significant improvement in flexion and extension in the treatment group (p < 0.05) while there was no significant improvement in side flexion and rotation ROM in both groups (p > 0.05). CONCLUSION: This study found that SNAGs were effective in reducing pain and neck disability and improved ROM in females with CGH. Show more

Keywords: Cervicogenic headache, females, SNAGs

DOI: 10.3233/BMR-210018

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 3, pp. 597-603, 2022

Authors: Uebayashi, Kazuma | Okubo, Yu | Nishikawa, Takuya | Morikami, Taro | Hatanaka, Jindo

Article Type: Research Article

Abstract: BACKGROUND: Given the characteristics of the superficial trunk muscles that cross the chest and pelvis, their excessive contraction might limit chest mobility. OBJECTIVE: To examine the immediate effects of two types of trunk muscle exercises on chest mobility and trunk muscle activities. METHODS: Fourteen healthy men (age: 21.1 ± 1.0 years, height: 172.7 ± 5.6 cm, weight: 61.0 ± 7.1 kg, body mass index: 20.4 ± 1.7 kg/m 2 ; mean ± SD) randomly performed …trunk side flexion and draw-in exercises using a cross-over design. The chest kinematic data and trunk muscle activities were measured before and after each intervention during the following tasks: maximum inspiration/expiration and maximum pelvic anterior/posterior tilt while standing. Two-way repeated measures analysis of variance was used for statistical analysis (P < 0.05). RESULTS: After the side flexion, upper and lower chest mobility significantly decreased, and superficial trunk muscle activity significantly increased during the maximum pelvic anterior tilt (P < 0.05). Additionally, after the draw-in, upper chest mobility significantly increased during the maximum pelvic anterior tilt (P < 0.05). CONCLUSIONS: Increased activity of the superficial abdominal muscles might limit chest mobility during maximum pelvic anterior tilt. Conversely, the facilitation of deep trunk muscles might increase upper chest mobility during the maximum pelvic anterior tilt. Show more

Keywords: Electromyography, thorax, thoracic wall, rib cage, torso, kinematics

DOI: 10.3233/BMR-210019

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 3, pp. 605-614, 2022

Authors: Salbaş, Ender | Ketenci, Sertaç

Article Type: Research Article

Abstract: BACKGROUND: Although there are a few studies on the seasonality of facial paralysis, no studies have utilized internet data for this purpose. The use of internet data to investigate diseases and user-contributed health-related content is increasingly prevalent, and has earned the name “infodemiology”. OBJECTIVE: This study aims to use Google Trends data to investigate whether there is a seasonal variation in facial paralysis. METHODS: In this observational study, the search volume for the terms “facial paralysis” and “Bell’s palsy” for a total of 19 countries was queried from Google Trends, selecting the time …interval between January 2004 and October 2020. RESULTS: In the Cosinor analysis of data from a total of 19 countries, from both northern and southern hemisphere, a statistically significant seasonality was found in the search volume of facial paralysis. It was observed that facial paralysis searches peaked in spring in the northern hemisphere and in winter in the southern hemisphere. CONCLUSION: Internet search query data showed that facial paralysis has a seasonal variation, with peaks in spring for the northern hemisphere and winter for the southern hemisphere. Further studies are needed to understand the deviation between hemispheres and the cause of the peak in winter-spring season. Show more

Keywords: Facial paralysis, Bell’s palsy, infodemiology, internet search, seasonality

DOI: 10.3233/BMR-210021

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 3, pp. 615-623, 2022

Authors: Yotnuengnit, Pattarapol | Boonyapaisancharoen, Pongrin | Jamin, Nastasja | Schulte-Goecking, Heike | Azad, Shahnaz-Christina | Kraft, Eduard | Piravej, Krisna | Leukert, Johannes

Article Type: Research Article

Abstract: BACKGROUND: Worldwide, chronic low back pain (CLBP) is one of the most common causes of physical and psychological disabilities. The factors that affect low back pain (LBP) between Western and Eastern countries are different. OBJECTIVE: We assessed the factors associated with LBP and their impact in German and Thai CLBP participants. METHODS: This cross-sectional study was conducted in 100 Thai and 100 German CLBP participants. Data were collected before the participants received treatment in the outpatient rehabilitation clinic. We used standardized questionnaires to assess the demographic and socioeconomic data, clinical features of the …pain, the impact of pain during daily activities, and psychological consequences. RESULTS: We found a statistically significant difference between the two groups for minimal pain intensity (NRS German = 3.01, Thai = 1.83), and the participants’ acceptable pain intensity (NRS German = 1.97, Thai = 3.88). The German participants had a higher negative impact score in their daily living compared to the Thai participants (German = 23.5, Thai = 10). Also, the German participants suffered more often from depression (CES-D score; German = 17, Thai = 4). However, the average back pain intensity was the same for both groups. CONCLUSION: German CLBP participants had significantly more depressive symptoms and pain-related impairments compared to the Thai participants. On the other hand, there were no differences in maximum and average pain severities. Show more

Keywords: Chronic low back pain, socioeconomic status, psychological effect, Thailand, Germany

DOI: 10.3233/BMR-210029

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 3, pp. 625-632, 2022