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

Authors: Öztürk, Gökhan Tuna | Erden, Ender | Erden, Ebru | Ulašlı, Alper Murat

Article Type: Research Article

Abstract: BACKGROUND: Piriformis syndrome (PS) is the common entrapment neuropathy causing buttock pain. Patients are conventionally treated with lifestyle modification, exercise, non-steroidal anti-inflammatory drugs, corticosteroid or botulinum toxin injections. However, some patients may not respond to these conventional treatment methods. Platelet rich plasma (PRP) injection has been shown to be beneficial in various muscular injuries, but its effects have not yet been investigated in PS. OBJECTIVE: The aim of this study was to explore the effect of PRP on pain and functional status in patients with PS, and to identify any correlations between clinical changes and demographic …features. METHODS: A total of 60 patients with PS were randomly separated into two groups (PRP and control groups). All patients received one session of either PRP or saline injection performed under ultrasound guidance. The pain was measured with a visual analog scale (VAS) and Oswestry Disability Index (ODI) scores were noted at three intervals in both groups: before treatment, 1 week after treatment and 1 month after treatment. RESULTS: The VAS and ODI scores were improved in both groups. The improvement was more obvious in the PRP group in the first week, and the results were similar for both groups when measured 1 month after the treatment. CONCLUSION: Ultrasound-guided PRP injection provided greater improvements in both pain and functional status in patients with PS, starting in the early period after treatment. A repeat injection might be needed for a long-term effect. Show more

Keywords: Platelet rich plasma, PS, ultrasound, injection

DOI: 10.3233/BMR-210032

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 3, pp. 633-639, 2022

Authors: Nechvátal, Pavol | Hitrík, Tomáš | Kendrová, Lucia Demjanovič | Macej, Michal

Article Type: Research Article

Abstract: BACKGROUND: Low back pain (LBP) causes disability in daily life, and presents not only a health but also a socio-economic problem. New treatment options need to be tested and confirmed. OBJECTIVE: Compare the effect of the McKenzie method and spiral stabilization in patients with LBP. METHODS: Sixty patients with an average age of 47 years, which were included in our prospective, comparative study were randomly divided into two 30-member groups. One group exercised according to the McKenzie method (MDT), the other one according to the Spiral Stabilization Method (SPS). During the initial examination the …Aberdeen Back Pain Scale was used to determine the degree of managing with daily activities and functionality, and the Roland-Morris Disability Questionnaire was used to determine the degree of disability. Check- up was performed after 2 and 6 weeks of treatment. RESULTS: In both groups, there was a significant improvement in results after 2 and 6 weeks of treatment (p < 0.05). When comparing the effect of 2 and 6 weeks of treatment of both therapeutic procedures (MDT and SPS), the difference was insignificant (p > 0.05). CONCLUSIONS: None of these two treatment methods achieved better results, as they both have a comparable effect on reducing disability and improving the management of daily activities and physical functions. Therefore, both are equally effective in patients with LBP. Show more

Keywords: Disability, low back pain, McKenzie method, spine

DOI: 10.3233/BMR-210055

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 3, pp. 641-647, 2022

Authors: Kirmizi, Muge | Sengul, Yesim Salik | Angin, Salih

Article Type: Research Article

Abstract: BACKGROUND: Flexible flatfoot is associated with altered plantar pressure distribution, but it is not clear how muscle fatigue affects plantar pressure characteristics in flexible flatfoot and normal foot. OBJECTIVE: To investigate the effects of calf muscles fatigue on plantar pressure variables in flexible flatfoot and normal foot. METHODS: Twenty-five people with flexible flatfoot and twenty-five people with normal foot were included. The unilateral heel-rise test was used to induce calf muscles fatigue. Plantar pressure variables were collected during preferred walking immediately before and after fatigue. The two-way mixed-design ANOVA was used to determine …the main effect of fatigue and the interaction between foot posture and fatigue. RESULTS: Fatigue caused medialization of the contact area under the forefoot and the maximum force under the heel and forefoot (p < 0.05). When examining the differences in the effects of fatigue between groups, the contact area under the medial heel increased with fatigue in flexible flatfoot but decreased in normal foot; moreover, the contact area and maximum force under the midfoot and the maximum force under the third metatarsal decreased with fatigue in flexible flatfoot but increased in normal foot (p < 0.05). CONCLUSIONS: Calf muscles fatigue caused medialization of the maximum force and contact area. Especially the midfoot was affected differently by fatigue in flexible flatfoot and normal foot. Show more

Keywords: Pes planus, plantar pressure analysis, heel rise, foot biomechanics, fatigue

DOI: 10.3233/BMR-210069

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 3, pp. 649-657, 2022

Authors: Almalki, Husam | Herrington, Lee | Jones, Richard

Article Type: Research Article

Abstract: BACKGROUND: In order to administer the International Knee Documentation Committee Subjective Knee Form (IKDC) questionnaire to Arabic speakers, a rigorous process of cross-cultural adaptation and validation is required in order to reach equivalence between the original publication and target version of the questionnaire. OBJECTIVES: The main aim of this study is to translate and culturally adapt the IKDC into Arabic to suit the Arabic population. The secondary aim is to assess the Arabic version of the IKDC in order to test the psychometric characteristics (reliability, validity and dimensionality). METHODS: The translation process has …been carried out according to cross-cultural adaptation guidelines in accordance with the American Orthopaedic Society for Sports Medicine guidelines with forward/backward translations and pre-testing. The Arabic IKDC, Knee injury and Osteoarthritis Outcome Score (KOOS), RAND-36-Item Health Survey (RAND-36) questionnaire, and visual analogue scales (VAS) of pain were tested in 105 ACLR patients. Test-retest reliability, internal consistency, construct validity and content validity were evaluated. RESULTS: The test-retest reliability proved excellent with a high value for the intraclass correlation coefficient (r = 0.95). The internal consistency was strong (Cronbach’s α = 0.91). Good construct validity by the strong correlations between similar component of the KOOS subscales, Rand-36 subscales and VAS, and good content validity with absence of floor and ceiling effects. CONCLUSIONS: The Arabic version of the IKDC is a valid and reliable instrument for Arabic patients with ACLR. However, further research is required with a more varied knee sample in order to enable generalisation to a wider population. Show more

Keywords: International Knee Documentation Committee (IKDC), cross-cultural adaptation, translation, knee outcome

DOI: 10.3233/BMR-210136

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 3, pp. 659-665, 2022

Authors: Kurzeja, Piotr | Ogrodzka-Ciechanowicz, Katarzyna | Prusak, Jarosław | Szurmik, Tomasz

Article Type: Research Article

Abstract: BACKGROUND: The gold standard in the clinical assessment of the extent of scoliosis is the Cobb method but the analysis also covers the changes that occur within the spine and trunk in relation to the transverse and sagittal planes. OBJECTIVE: The study aimed to estimate changes in the sagittal plane of the spine in girls with right-sided thoracic adolescent idiopathic scoliosis. METHODS: The study involved 29 girls with scoliosis (13.6 ± 0.6 years) and 36 healthy girls as the comparison group. The tests included an interview, clinical examination (with the …use of Adam’s test and the Cobb angle), and examination of shape of the spine surface with the use of the photogrammetric method and the projection moire effect. RESULTS: Lower values of the thoracic kyphosis parameters were found in the scoliosis group. Significant differences were noted for the parameters of the lumbosacral section α (p = 0.02), thoracolumbar section β (p < 0.001), the upper thoracic section γ (p < 0.001), thoracolumbar and upper thoracic section β + γ (p < 0.001) and the total size of α + β + γ (p < 0.001) curvatures. CONCLUSIONS: The study showed that with an increase in the angular value of the thoracic curvature, the thoracic kyphosis decreased. Show more

Keywords: Idiopathic scoliosis, moire topography, spine

DOI: 10.3233/BMR-210206

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 3, pp. 667-676, 2022

Authors: Wang, Yonggang | Wang, Dongmin | Kang, Xuewen | Ma, Zhanjun | Ma, Ying’ping | Hu, Xuchang | Ma, Bing | He, Xuegang | Wang, Shixiong | Gao, Bingren

Article Type: Research Article

Abstract: BACKGROUND: Scoliosis causes changes in the thorax, but it is unclear what type of changes occur in the thoracic profile after scoliosis surgery. OBJECTIVE: To investigate changes in rib cage deviation in the postoperative period after adolescent idiopathic scoliosis (AIS) surgery. METHODS: Forty-four patients with AIS with a main right thoracic curvature underwent posterior surgical fusion (PSF), and radiological parameters of the spine and thorax were evaluated. RESULTS: The correction rates of main thoracic curve (MT)-Cobb angle at immediate after surgery and postoperative follow-up (2 years) were 64% and 66%, …respectively. At these two postoperative time points, the correction rates of height of thoracic vertebrae 1 to 12 (T1T12) were 10% and 12%; the correction rates of Rib-vertebra angle difference (RVAD) were 59% and 52%; the correction rates of Apical rib hump prominence (RH) were 58% and 76%; while the correction rates of Apical vertebral body-rib ratio (AVB-R) were 23% and 25%, respectively. Statistical analysis showed that all these radiological parameters at the two postoperative time points were significantly different from the preoperative values (p < 0.001). There were significant correlations between MT-Cobb angle and T1-T12 height (p < 0.001), RVAD (p < 0.001), RH (p < 0.001), and AVB-R (p < 0.001). CONCLUSIONS: Posterior spinal fusion appears to be effective at correcting scoliosis, and the correction of rib cage deviation also plays an important role. Show more

Keywords: Adolescent idiopathic scoliosis, AIS, posterior surgical fusion, PSF, thoracic

DOI: 10.3233/BMR-210258

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 3, pp. 677-686, 2022