Journal of Back and Musculoskeletal Rehabilitation - Volume 35, issue 5

Authors: Ferenczi, Antoine | Ostertag, Agnès | Lasbleiz, Sandra | Lefèvre, Clémence | Petrover, David | Yelnik, Alain | Orcel, Philippe | Beaudreuil, Johann

Article Type: Research Article

Abstract: BACKGROUND: Dynamic humeral centering (DHC) is a physiotherapy modality that aims to prevent sub-acromial impingement of rotator cuff tendons. We recently developed a new clinical manoeuver – the Viggo-Cochin test – to enhance the ability of the Neer test to detect sub-acromial impingement. Here we hypothesised whether the DHC effect may differ between individuals with positive and negative Viggo-Cochin test results. OBJECTIVE: To assess the association between DHC and Viggo-Cochin test results. METHODS: Individuals with shoulder pain due to sub-acromial impingement underwent the Neer and Viggo-Cochin tests at baseline. They were assessed before …and after DHC by the Shoulder Pain and Disability Index (SPADI). A positive response to DHC was defined as a 20% reduction in the SPADI. RESULTS: We included 50 individuals (53 shoulders). The response to DHC did not differ by Neer test result at baseline: OR 0.73 [95% CI 0.22–2.38] (p = 0.601). By contrast, the response to DHC was 5-fold higher with a positive than negative Viggo-Cochin test result: OR 5.11 [95% CI 1.47–17.78] (p = 0.010). CONCLUSIONS: We found a higher clinical response to DHC with a positive than negative Viggo-Cochin test result at baseline in individuals with shoulder pain due to rotator cuff disease. Show more

Keywords: Shoulder pain, sub-acromial impingement, dynamic humeral centering, physiotherapy, clinical test

DOI: 10.3233/BMR-210214

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 5, pp. 1119-1124, 2022

Authors: Kataoka, Hideki | Hirase, Tatsuya | Goto, Kyo | Honda, Ayana | Nakagawa, Koichi | Yamashita, Junichiro | Morita, Kaoru | Honda, Yuichiro | Sakamoto, Junya | Okita, Minoru

Article Type: Research Article

Abstract: BACKGROUND: Research on the multi-faceted characteristics of persistent severe acute lower back pain (LBP) resulting from acute vertebral compression fractures (VCFs) is lacking. OBJECTIVE: To investigate the psychological and functional status of older patients with persistent severe acute LBP after conservative treatment of VCFs. METHODS: This prospective study included women aged 50 years and older who had acute VCFs and were admitted to the hospital. Pain intensity, depression, pain catastrophizing, activities of daily living (ADL), muscle strength, and vertebral deformity were assessed on admission. At 2 and 4 weeks post-admission, physical performance tests …were performed along with the above measures. RESULTS: We divided 131 participants into severe (n = 64) and mild (n = 67) groups according to their pain intensity at 4 weeks. Compared to the mild group, the severe group showed significantly higher levels of depression and catastrophizing, with significantly poorer muscle strength and endurance. There were no significant differences in ADL and vertebral deformities between the two groups. CONCLUSIONS: Our results suggest that older patients with persistent severe acute LBP resulting from VCFs tend to be depressed and pain catastrophizing. Furthermore, persistent severe acute LBP negatively impacts endurance and muscle strength but not ADL. Show more

Keywords: Catastrophizing, depression, physical performance, severe lower back pain, VCFs

DOI: 10.3233/BMR-210220

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 5, pp. 1125-1133, 2022

Authors: Sponbeck, J.K. | Moody, M.A. | Mitchell, U.H. | Neves, C.D. | Johnson, A.W.

Article Type: Research Article

Abstract: BACKGROUND: The multifidus muscle is important in spine stabilization. Atrophy of the multifidus muscle has been associated with low back pain. OBJECTIVE: To examine multifidus muscle cross-sectional area (CSA) adaptations over two volleyball seasons and one off-season in volleyball athletes experiencing low back pain or no low back pain. METHODS: Twelve female NCAA division 1 volleyball athletes participated. Athletes were placed into a low back pain or no low back pain group. Athlete’s multifidus was imaged and measured using ultrasound at four time points across seasons. Imaging time points were before season one, …following season one, following off-season, and following season two. A single level mixed-model analysis of variance was used for all analyses. A Tukey HSD post hoc test was used to determine differences between and within the low back pain and the no low back pain groups. RESULTS: Following off-season training the pain group had clinically significant smaller multifidus CSA at the L4 (- 2.36 cm 2 difference or 17.5%) and L5 (- 2.40 cm 2 or 12.5%) levels. Non-significant (p > 0.05) decreases in multifidus CSA were seen in both groups following season one and two. Athletes with pain had decreased multifidus CSA at the L4 and L5 vertebral levels at all time points which was non-significant (p > 0.05). CONCLUSIONS: Clinically significant decreases in multifidus CSA occurred in female volleyball athletes with low back pain at the L4 and L5 level following off-season training. Volleyball athletes with pain had smaller multifidus CSA averages at all time points measured of the two year period. Show more

Keywords: Ultrasonography, lumbar region, athletes, paraspinal muscles, low back pain

DOI: 10.3233/BMR-210234

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 5, pp. 1135-1142, 2022

Authors: Kohns, David J. | Scott, Ryan | Castellanos, Joel | Scribner, Darin | Hodges, Ryan | Clauw, Daniel J.

Article Type: Research Article

Abstract: BACKGROUND: Myofascial pain is a common, but poorly understood multifactorial condition. OBJECTIVE: This study analyzed how the degree of central sensitization (nociplastic pain) can impact the response to physical therapy for patients with myofascial pain. METHODS: This prospective, observational cohort study compared pain phenotyping and functional measures in 30 participants with non-acute neck/shoulder girdle primary myofascial pain following 3-months of physical therapy. The Fibromyalgia Survey Questionnaire Score served as a surrogate of central sensitization. RESULTS: All participants demonstrated some benefit from physical therapy; however, those with moderate levels of nociplastic …pain features were less likely to have clinically significant improvements on the Neck Disability Index, PEG score, or pain catastrophizing measures. Those with higher levels of nociplastic pain had a similar chance of showing improvement as those with lower levels, except regarding catastrophizing. Significant improvements were independent of the type or amount of therapy received. CONCLUSION: The degree of nociplastic pain in patients with myofascial pain appears to be inversely related to improvements from a peripherally based treatment. This is not to say that individuals with moderate to higher levels of nociplastic pain do not benefit from physical therapy, but they proportionally benefit less. Show more

Keywords: Myofascial pain, fibromyalgia, physical therapy, neck pain

DOI: 10.3233/BMR-210244

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 5, pp. 1143-1151, 2022

Authors: Xu, Huajun | Zhang, Yingchun | Wang, Caishan

Article Type: Research Article

Abstract: BACKGROUND: Frozen shoulder (FS), also known as shoulder adhesive capsulitis, is a musculoskeletal disorder associated with pain and functional disability. There is a lack of evidence on the optimal treatment strategy for FS. OBJECTIVE: The present study aimed to evaluate the effectiveness and safety of ultrasound-guided hydrodilatation of glenohumeral joint combined with acupotomy for treatment of FS. METHODS: In this prospective randomized, double-blind, controlled study, 63 FS patients were recruited, and equally allocated to treatment group and control group. The treatment group was treated with ultrasound-guided hydrodilatation of glenohumeral joint combined with acupotomy, …while the control group was only treated with ultrasound-guided hydrodilatation of glenohumeral joint. The pain and mobility of shoulder, overall efficacy and adverse reactions were evaluated 3 months after treatment. RESULTS: At baseline, no significant difference in all characteristic value was found between the treatment group (n = 33) and control group (n = 30). Three months after operation, the joint’s Active Range of Motion (AROM) and Constant-Murley Scale (CMS) scores in the experimental group were higher than those in the control group, and the coracohumeral ligament (CHL) thickness and the rate of hypoechoic thickening in rotator cuff space in the experimental group were lower than those in the control group (all P < 0.05). The amount of injection volume at the third hydrodilatation was significantly higher in the experimental group than that in the control group (15.8 ± 4.7 vs 12.2 ± 5.2, P = 0.03). After 2 times of treatment, the volume increment of glenohumeral joint Δ 2 in the experimental group was greater than that in the control group (3.5 ± 1.8 vs 1.2 ± 1.6, P < 0.001). There were significant differences in the effective rate between the two groups (93.94% vs. 76.67%, P = 0.04). CONCLUSION: The ultrasound-guided hydrodilatation of glenohumeral joint combined with acupotomy may benefit FS patients. Show more

Keywords: Ultrasound-guided, hydrodilatation, glenohumeral joint, acupotomy, frozen shoulder

DOI: 10.3233/BMR-210272

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 5, pp. 1153-1160, 2022

Authors: Fidelis, Obinna P.

Article Type: Research Article

Abstract: BACKGROUND: Orthopedic tractions can be employed in the rehabilitation of patients suffering from problems affecting the spine, as well as the upper and lower extremities but the high costs of using tractions due to prolonged hospital stays is a major disadvantage particularly in low-income economies. OBJECTIVE: The objective of this study was to design and develop a two-way adjustable traction system that accommodates both cervical and lower limb rehabilitation and improves limb and neck positioning. METHOD: The production process involved the use of computer-aided design (CAD) as well as other manufacturing procedures like …material selection, welding, and drilling. The system was tested for stability to be sure it does not fail under large loads. RESULT: A functional and easy-to-install two-way orthopedic traction system for both hospital and home use was developed, installed and tested. The dimensions and adjustability would ensure that it can be used for children and adults. CONCLUSION: This study describes a device that can be used in hospitals. When used at homes, it can reduce the cost of medical bills, and provide patients with the emotional/psychological benefits of being cared for in a familiar environment. Show more

Keywords: Bone fractures, design, forces, loads, pulleys

DOI: 10.3233/BMR-210302

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 5, pp. 1161-1167, 2022