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

Authors: Dernek, Bahar | Ulusoy, İbrahim | Aydoğmuş, Suavi | Duymuş, Tahir Mutlu | Kesiktaş, Fatma Nur | Dıraçoğlu, Demirhan

Article Type: Research Article

Abstract: BACKGROUND: Cervical radiculopathy is characterized by pain, numbness, tingling, and weakness, mostly in an affected extremity, reflecting compression of a nerve in the neck is compressed or irritated where it emerges from the spinal cord. Diagnosis requires a detailed anamnesis, physical examination, and imaging. Physical therapy, exercise, medical therapy, and injections are the preferred treatments, but injections into the cervical region are only indicated if conservative treatment is ineffective. OBJECTIVE: This study explored the utility of selective cervical nerve root blocks (SNRBs) performed at various levels under ultrasound guidance (USG). METHODS: We evaluated …patients diagnosed with cervical radiculopathy via physical examination and magnetic resonance imaging from November 2019 to March 2020. We included those who did not respond to conservative treatment and therefore received SNRBs at various levels. Sixty-three patients were evaluated over 6 months in terms of pain, functional status, and complications. RESULTS: We retrospectively evaluated patients with cervical herniated discs who received SNRBs at various levels between C4–7 under USG. Pain and functional status improved in month 1 and was maintained until at least month 6. CONCLUSION: SNRB injections performed under USG effectively treated pain and poor functional status in selected patients. The procedure is safe (especially) for patients who do not respond to conservative treatment. Show more

Keywords: Ultrasound, injection, cervical radiculopathy, treatment, nerve block

DOI: 10.3233/BMR-210076

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 5, pp. 1013-1019, 2022

Authors: Algarni, Fahad Saad Homed

Article Type: Research Article

Abstract: BACKGROUND: Musculoskeletal (MSK) pain can negatively affect work life and quality of life (QoL). OBJECTIVE: This study characterizes the QoL of workers in Saudi Arabia and compares it between adults of working age with and without MSK pain. METHODS: This is a descriptive cross-sectional study. The Short Form-36 (SF-36) instrument was used to measure eight domains that describe QoL among workers with and without MSK pain. Descriptive statistics and parametric tests enabled comparisons between the two sets of workers. RESULTS: A total of 2042 workers participated in the study. The …majority of them had experienced MSK pain during the last 12 months. In addition, the results for most SF-36 domains varied significantly across age and gender groups. Workers who lacked MSK pain over the last 12 months reported higher means for all SF-36 domains, with the exception of the physical function domains. CONCLUSION: This study found that the majority of workers experience MSK pain. In all bodily regions, neck and back pain are the most frequently reported areas of discomfort for these employees. Workers without MSK pain experience better QoL. This observation suggests the need for managers to pay closer attention to workers with MSK pain, as these employees experience significantly lower QoL. To prevent or reduce MSK pain, workers should undergo routine medical examination and early intervention for MSK pain. These preventative measures can help to increase workers’ QoL. Show more

Keywords: Quality of life, musculoskeletal, pain, workers

DOI: 10.3233/BMR-210122

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 5, pp. 1021-1033, 2022

Authors: Ogon, Izaya | Teramoto, Atsushi | Takashima, Hiroyuki | Terashima, Yoshinori | Yoshimoto, Mitsunori | Emori, Makoto | Iba, Kousuke | Takebayashi, Tsuneo | Yamashita, Toshihiko

Article Type: Research Article

Abstract: BACKGROUND: Pain sensitization may be one of the mechanisms contributing to chronic low back pain (CLBP). OBJECTIVE: To evaluate the association between visceral fat, CLBP, and central sensitization (CS); describe the relationship between low back pain (LBP) intensity and CS; and identify possible correlation between visceral fat and LBP intensity. METHODS: Patients with CLBP were divided using their CS inventory (CSI) scores into low- (CSI < 40) and high-CSI (CSI ⩾ 40) subgroups. We compared computed tomography (CT) measurements and scores for association with pain according to …the visual analogue scale (VAS) between the two groups. RESULTS: The low-CSI and the high-CSI groups had 47 patients (67.1%; 21 men, 26 women) and 23 patients (32.9%; 11 men and 12 women), respectively. The high-CSI group had a significantly higher mean VAS score (p < 0.01) and estimated mean visceral fat area (p < 0.05) than the low-CSI group. There was a moderate positive correlation between VAS score and visceral fat (standardised partial regression coefficient: 0.659, p < 0.01) in the high-CSI group according to multiple linear regression analysis adjusted for age and sex. CONCLUSIONS: Visceral fat is associated with CLBP, regardless of sex or age, and may be a potential therapeutic target for CLBP with CS. Show more

Keywords: Chronic pain, low back pain, central sensitization, central sensitization inventory, visceral fat

DOI: 10.3233/BMR-210124

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 5, pp. 1035-1041, 2022

Authors: Tütüncüler, Erman | Ök, Nusret | Güngör, Harun Reşit | Bayrak, Gökhan | Şavkın, Raziye | Büker, Nihal

Article Type: Research Article

Abstract: BACKGROUND: Static or dynamic postural control cannot be fully restored in patients with knee osteoarthritis, even after total knee arthroplasty (TKA), which may contribute to an increased risk of falls in the elderly. OBJECTIVE: To evaluate balance and the fall risk before and after TKA in patients with bilateral knee osteoarthritis. Secondary outcomes were patient-reported and performance-based activity limitations. METHODS: A total of 45 patients were separated into two groups as unilateral TKA (UTKA, n = 24) and bilateral TKA (BTKA, n = …21) groups. All the patients received standard postoperative physical therapy for 3 months. Balance and fall risk (Biodex Balance System SD), patient-reported and performance-based functionality (WOMAC, 30-second chair-stand test, 9-step stair climbing test and 40-meter fast-paced walk test) and Short Form-12 (SF-12) were evaluated at preoperatively, and at 3 months postoperatively. RESULTS: There was no difference between the groups in postoperative fall risk and balance (p > 0.05). The BTKA group obtained better results in the sit-to-stand test and SF-12 physical dimension (p < 0.05). CONCLUSIONS: UTKA and BTKA interventions and the standard postoperative rehabilitation were seen to improve balance and quality of life, and reduce the fall risk, patient-reported and performance-based activity limitations. However, despite improvements in balance, the risk of falling persists. Show more

Keywords: Total knee arthroplasty, fall risk, balance, knee function, quality of life

DOI: 10.3233/BMR-210127

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 5, pp. 1043-1051, 2022

Authors: Ezema, Charles Ikechukwu | Onyeso, Ogochukwu Kelechi | Nna, Emmanuel Okechukwu | Awosoga, Oluwagbohunmi A. | Odole, Adesola Christiana | Kalu, Michael Ebe | Okoye, Goddy Chuba

Article Type: Research Article

Abstract: BACKGROUND: Transcutaneous electrical nerve stimulation (TENS) is a promising non-pharmacological modality for the management of chronic low back pain (CLBP), but its efficacy and mode of action have not been clearly established. OBJECTIVE: To evaluate the responses of plasma beta-endorphin (β E), met-enkephalin (ME), and pain intensity (PI) among patients with CLBP exposed to TENS or sham-TENS. METHODS: This double-blind trial involved 62 participants (aged 53.29 ± 5.07 years) randomised into TENS group (frequency 100 Hz, burst-rate 2 Hz, burst-width 150 μ s, intensity 40 mA, …duration 30 min), and sham-TENS group. The PI and plasma concentrations of β E and ME were measured at baseline, immediately (0 hr), 1 hr, 24 hrs, and 48 hrs post-intervention. Data were analysed using general linear model repeated measures, ordinal regression, one-way analysis of variance, Kruskal-Wallis test, independent and paired samples t -tests, Mann-Whitney U test, Wilcoxon signed-rank test, and Kendall’s tau coefficient. RESULTS: There was a significant temporal difference in PI between groups, F (1, 58) = 18.83, p < 0.001; the TENS group had better pain relief. The relative analgesic effect of TENS started immediately after the intervention (median difference [M ⁢ D ] = - 3, p < 0.001), peaked at 1 hr (M ⁢ D = - 4, p < 0.001), and worn out by 24 hrs (M ⁢ D = - 1, p = 0.029). However, there was no significant difference in β E and ME between the groups from 0 hr to 24 hrs post interventions, and no significant correlation between the PI, and β E, or ME. CONCLUSION: TENS significantly reduced PI up to 24 hrs after treatment. Show more

Keywords: Beta-endorphin, met-enkephalin, physiotherapy, spondylosis, TENS analgesic

DOI: 10.3233/BMR-210146

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 5, pp. 1053-1064, 2022

Authors: Kuo, Ying-Chen | Hsu, Wei-Chun | Lin, Yi-Jia | Lin, Yu-Ting | Chen, Yann-Rong | Hsieh, Lin-Fen

Article Type: Research Article

Abstract: BACKGROUND: Calcific tendinitis of the shoulder is a common disorder resulting in restricted motion and pain. OBJECTIVE: This study compared the effects of ultrasound-guided fine-needle puncture (USNP), radial shock wave therapy (RSWT), and the combination of both treatments (COMB) on calcific tendinitis of the shoulder. METHODS: We enrolled 62 patients who had unilateral shoulder pain for more than 3 months. The patients were randomly divided into three groups: USNP, RSWT, and COMB. All USNP needle punctures were guided with ultrasound (US), and RSWT was delivered at 2 Hz (2000 shock waves; 0.26 mJ/mm …2 ) once a week for 3 weeks. The COMB group received three weekly rounds of RSWT after a single US-guided needle puncture. The primary outcome was the pain visual analog scale (VAS), and secondary outcomes were the Constant scores, 36-Item Short-Form Health Survey, and range of motion. RESULTS: A within-group comparison at 3 months revealed significant improvements in the pain VAS (p < 0.05, during activity) and Constant (p < 0.05) scores, but between-group comparisons revealed no statistically significant differences in the pain VAS (p > 0.05) or Constant (p = 0.089) scores. Only improvement differences in role-emotional (SF-36; p = 0.01) and active external rotation (p = 0.035) were determined over time, which favored the USNP and COMB groups. CONCLUSIONS: Although no significant differences were observed among the groups in the treatment of calcific tendinitis of the shoulder, more satisfactory outcomes were noted in the USNP and COMB groups than in the RSWT group. Larger samples, longer follow-up times, and other treatment protocols are suggested for future studies. Show more

Keywords: Shoulder pain, tendinitis, extracorporeal shockwave therapy, ultrasonography

DOI: 10.3233/BMR-210166

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 5, pp. 1065-1074, 2022

Authors: Reichardt, Amber | Passmore, Steven R. | Toth, Audrey | Olin, Gerald

Article Type: Research Article

Abstract: BACKGROUND: Osteoarthritis (OA) is one of the most prevalent and disabling musculoskeletal diseases worldwide. There is preliminary evidence from experimental studies and consensus documents that chiropractic management may alleviate spine and/or extremity OA related pain in the short term. OBJECTIVE: This research explores the potential relationship of a pragmatic course of care, including soft tissue therapy, spinal manipulation, and other treatments commonly delivered by chiropractors, to spine and extremity pain in patients with OA. METHODS: A retrospective analysis of prospectively collected data from the chiropractic program at a publicly funded healthcare facility was …conducted. The primary outcome measures for patients diagnosed with spine and/or extremity OA (n = 76) were numeric pain scores of each spinal and extremity region at baseline and discharge, and a change score was determined. RESULTS: Statistically significant improvements that exceed a clinically meaningful difference in pain numeric rating scale scores were demonstrated by point change reductions from baseline to discharge visits. Change scores exceeding a minimally clinically important difference of “2-points” were present in the sacroiliac (- 2.91), extremity (- 2.84), cervical (- 2.73), thoracic (- 2.61), and lumbar (- 2.59) regions. CONCLUSION: Patients diagnosed with OA in a socioeconomically disadvantaged community demonstrated reductions in mean pain scores in both a clinically meaningful and statistically significant manner concurrent with a course of chiropractic care. Show more

Keywords: Osteoarthritis, chiropractic, pain, spine, extremity, vulnerable populations, musculoskeletal disease, retrospective studies, delivery of healthcare

DOI: 10.3233/BMR-210192

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 5, pp. 1075-1084, 2022

Authors: Jiang, Lisi | Zhang, Lei | Huang, Wenhan | Zeng, Qing | Huang, Guozhi

Article Type: Research Article

Abstract: BACKGROUND: Proprioception is essential for the normal movement of knee joints. How proprioception training affects the postoperative knee functional recovery after anterior cruciate ligament (ACL) reconstruction remains unknown. OBJECTIVE: This study investigated the effect of proprioception training on the knee joint kinematics of patients after ACL reconstruction (ACLR). METHODS: The randomized controlled study was performed at the Department of Orthopaedics and Traumatology of Guangdong Provincial People’s Hospital between December 2019 and April 2021. Forty-five patients who underwent ACLR were randomly divided into a proprioception group (n = 23) …and a control group (n = 22). The patients were randomly divided into an experimental group and a control group according to whether the final digits of their ID numbers were odd or even. All patients followed a common postoperative rehabilitation program. The outcome measures included the patients Lysholm scores, hop distances, and knee kinematics during unanticipated jump-cut maneuvering measured at different follow-up times. Knee joint kinematics were described as the positional and orientational changes of the femur relative to the tibia. RESULTS: After surgery, the proprioception group did not exhibit significantly higher hop distances than the control group at the 6-month (114.8 ± 19.0 vs. 105.9 ± 20.7 cm, p = 0.137, 95% CI: - 3.13 to 22.03 cm) and 1-year follow-ups (143.1 ± 19.3 vs. 133.9 ± 26.2 cm, p = 0.216, 95% CI: - 5.57 to 23.87 cm). For knee joint kinematics, the members of the proprioception training group exhibited significantly reduced knee abduction (valgus) angles and external rotation and significantly increased knee flexion compared to those in the common training group. CONCLUSIONS: The results suggested that proprioceptive rehabilitation training enhances knee joint functional performance and shows altered knee joint kinematics in ACL-reconstructed populations during unanticipated jump-cut maneuvering compared with the common rehabilitation training. Show more

Keywords: Anterior cruciate ligament reconstruction, proprioception training, rehabilitation, kinematics

DOI: 10.3233/BMR-210201

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 5, pp. 1085-1095, 2022

Authors: Qi, Jing | Yue, Haiquan | Liu, E. | Chen, Guang | Liu, Yuting | Chen, Jiahui

Article Type: Review Article

Abstract: BACKGROUND: Kinesio tape (KT) has been in extensive use for the rehabilitation of injuries related to sports, however, only a handful of studies have focused on the efficacy of KT following extraction of a third molar tooth. OBJECTIVE: The study aims to assess whether pain and edema following surgical extraction of the third molar can be reduced by KT. METHOD: This research was carried out following the principles of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Web of Science, Embase, PubMed, The Cochrane Library, CNKI, VIP, and WanFang Data databases …were searched for trials published from their inception to eighth October 2021. They included published randomized controlled trials in Chinese or English languages. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database scale. Mean differences (MDs) with 95% confidence intervals (CIs) were used for the analysis of continuous data. The heterogeneity was measured using the I 2 statistics. Then, Revman 5.4 software was employed for performing the meta-analysis. RESULTS: Eight studies comprising 453 participants in total were included. In comparison to the no kinesio tape group, KT did not furnish improved results on mouth opening ([MD = 0.36, 95% CI (- 0.67, 1.40), p = 0.49]), and swelling ([MD = - 1.24, 95% CI (- 3.43, 0.95), p = 0.79]). However, KT manifested a reduction in operation time ([MD = - 1.00, 95% CI (- 1.93, - 0.07), P = 0.04]), edema ([MD = - 0.53, 95% CI (- 0.88, - 0.19), P = 0.003]), and pain intensity ([MD = - 1.29, 95% CI (- 1.86, - 0.73), P < 0.00001]), favouring the kinesio tape group. Overall, the size of the effect was found in the small to moderate range. CONCLUSION: Despite the fact that KT can reduce pain and has been shown to have positive effects in several studies, there is no convincing evidence that it can reduce the swelling after surgical extraction of the third molar. Show more

Keywords: Kinesio tape, pain, edema, taping, third molar extraction surgery

DOI: 10.3233/BMR-210209

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 5, pp. 1097-1107, 2022

Authors: Kim, Nackhwan | Yoon, Soo Hoon | Kim, Minhee | Lee, Sang-Heon | Kim, Dong Hee | Kim, Ki Hoon

Article Type: Research Article

Abstract: BACKGROUND: Vibration training is an adjuvant to muscle-strengthening exercises. OBJECTIVE: To investigate the short-term effects of direct vibration on the deep trunk muscles of patients with non-specific chronic low back pain (CLBP). METHODS: Participants with non-specific CLBP were randomly placed into two groups: the vibration-plus stabilization exercise (VSE) group (n = 31) and the conventional stabilization exercise (CSE) group (n = 31). The groups underwent 12 sessions of an exercise program. The thickness and activity of the trunk muscles were measured using ultrasonography …and surface electromyography. RESULTS: Ultrasonography revealed that the ratio of muscle thickness to contraction and relaxation was statistically increased after exercise in the bilateral transversus abdominis (TrA) and lumbar multifidus (LM) muscles in the CSE group (p = 0.031), and in the bilateral TrA, LM, and internal oblique (IO) muscles in the VSE group (p < 0.001). The LM/lumbar erector spinae (LES) ratio in the CSE group (p = 0.037), and the IO/rectus abdominis (RA), TrA/RA, and LM/LES ratios in the VSE group (p = 0.019) were statistically increased. Multiple regression analysis showed that symptom improvement was related to increased activity of the deep trunk muscles in the VSE group (p < 0.001). CONCLUSION: Direct vibration can increase the selective activity of contracting deep trunk muscles. Show more

Keywords: Low back pain, vibration, exercise therapy, muscle activity, surface electromyography, ultrasonography

DOI: 10.3233/BMR-210211

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 35, no. 5, pp. 1109-1118, 2022