Journal of Back and Musculoskeletal Rehabilitation - Volume 36, issue 6

Authors: Farì, Giacomo

Article Type: Editorial

DOI: 10.3233/BMR-235004

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 6, pp. 1217-1218, 2023

Authors: Lippi, Lorenzo | Folli, Arianna | Turco, Alessio | Moalli, Stefano | Curci, Claudio | Ammendolia, Antonio | de Sire, Alessandro | Invernizzi, Marco

Article Type: Review Article

Abstract: BACKGROUND: Spinal cord injury (SCI) is a disabling condition characterized by multilevel skeletal muscle impairment and rapid cortical and trabecular bone loss. Rehabilitation is a cornerstone of the long-term management of patients with SCI; however, the optimal rehabilitation strategy for improving bone health has not been fully characterized. OBJECTIVE: To characterize the current evidence supporting different rehabilitation interventions improving bone health in patients with SCI. METHODS: On November 17 th , 2022, five databases (PubMed, Scopus, Web of Science, Cochrane, and PEDro) were systematically searched for randomized controlled trials (RCTs) …assessing SCI patients undergoing rehabilitation interventions. The primary outcomes were bone macroscopical effects. Secondary outcomes were changes in bone metabolisms and functional outcomes. RESULTS: Out of 499 records, 11 RCTs met the eligibility criteria and were included. Electrical stimulation combined with physical exercise was assessed by 5 studies, standing intervention was assessed by 3 studies, vibration was assessed by 1 study, ultrasound therapy was assessed by 1 study, and electroacupuncture combined with a pulsed magnetic field was assessed by 1 study. The rehabilitation intervention was administered combined with pharmacological treatment (3 studies) or alone (8 studies). Positive effects in terms of BMD were reported by 3 studies. The quality assessment revealed some concerns in 9 out of 11 studies, in accordance with the Cochrane Risk of Bias assessment – version 2. CONCLUSION: Our data suggest that multicomponent interventions including rehabilitation might be considered a suitable option to improve bone health management in SCI patients. Further studies are mandatory to characterize the optimal combination of non-pharmacological interventions reducing bone loss and improving the risk of fractures in patients with SCI. Show more

Keywords: Osteoporosis, spinal cord injury, rehabilitation, bone health, physiotherapy

DOI: 10.3233/BMR-230006

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 6, pp. 1219-1235, 2023

Authors: Reyes-Ferrada, W. | Chirosa-Rios, L. | Martinez-Garcia, D. | Rodríguez-Perea, A. | Jerez-Mayorga, D.

Article Type: Research Article

Abstract: BACKGROUND: Low back pain is one of the leading causes of disability globally, with a high economic and social burden. A decrease or imbalance in trunk strength has been associated with the occurrence of low back pain and its severity. Trunk strength training is helpful in the treatment of Non-specific low back pain (NSLBP) patients. However, we do not know the effects of trunk isokinetic training (IKT) on pain intensity, disability, and trunk strength. OBJECTIVE: This systematic review aimed to determine the effects of trunk IKT in NSLBP patients on pain intensity, disability, and trunk flexor …and extensor isokinetic strength. METHODS: We searched PubMed, Web of Science, Scopus, CENTRAL, and PEDro, from January 2001 until March 2021 and updated to November 2022. Randomized controlled trials (RCTs) that investigated the effect of IKT in adult participants with NSLBP on pain intensity, disability, or isokinetic trunk strength were included. Mean difference (MD) and 95% confidence intervals (95% CI) were calculated for pain. Bias was assessed using the Cochrane risk of bias (RoB) tool and evidence certainty via Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS: Among 1750 retrieved articles, eight were included in this review. Meta-analysis comparing IKT (trunk isokinetic training, n = 134) with control groups (conventional exercises, n = 133) revealed that IKT decreases pain intensity (MD - 1.50 (95% CI: - 2.60; - 0.39)) immediately post-intervention, and one month (MD - 1.97 (95% CI: - 2.92; - 1.03)) and at six months follow-up (MD - 2.48 (95% CI: - 2.77; - 2.19)), although with a very low to low quality according to the GRADE rating. Besides, IKT decreases disability and increases isokinetic trunk strength, but with scant evidence. CONCLUSIONS: Trunk IKT could be a novel clinical tool for pain management in patients with NSLBP, although evidence is scarce. In addition, few RCTs exist for IKT on disability or trunk isokinetic strength in patients with NSLBP. Therefore, further research on this topic is needed. Show more

Keywords: Rehabilitation, exercises, strengthening, dynamometer, core muscles, chronic pain

DOI: 10.3233/BMR-220301

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 6, pp. 1237-1250, 2023

Authors: Kulshreshtha, Poorvi | Deepak, Kishore Kumar

Article Type: Review Article

Abstract: BACKGROUND: The heterogeneity of symptoms and ineffective treatment raise questions about the current diagnostic criteria of fibromyalgia (FM). Misdiagnosis of FM often leads to less than efficacious treatment and poor quality of life. OBJECTIVE: This article reviews relevant evidence-based literature on personality traits in FM patients with an autonomic dysfunction perspective based on a hierarchical model to explain the utility of considering the personality trait in FM diagnosis. METHODS: A narrative review of articles concerning chronic pain, FM, and personality traits with respect to autonomic dysfunction in FM was conducted after extensive relevant …literature searches. RESULTS: Reports discussing the predisposing factors, including coping styles, anger, suicide risk, a lack of physical activity and social support, in maintaining persistent pain in FM exist. Relationships between pain duration and severity and personality traits like neuroticism and extraversion have been reported. Coexisting clinical manifestations of FM like sleep disorders, anxiety, and intestinal irritability indicate autonomic dysfunction. CONCLUSIONS: This article lays out a constructive framework for individualized and personalized medicine for the effective rehabilitation of FM patients. The quest to find a definitive diagnosis of FM should include personality biomarkers that might translate into personalized medicine. An individualistic approach may bank upon artificial intelligence algorithms for both diagnostic as well as prognostic purposes in FM. Show more

Keywords: Artificial intelligence, autonomic nervous system, biomarkers, chronic pain, diagnosis, personality

DOI: 10.3233/BMR-220353

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 6, pp. 1251-1260, 2023

Authors: Baik, Seung-Min | Kim, Seok-Hyun | Lee, Ji-Hyun

Article Type: Review Article

Abstract: BACKGROUND: Adolescent idiopathic scoliosis (AIS), which is the most common type of scoliosis, is a progressive disease that occurs in children aged 10–16 years. Abnormal curvature in AIS provokes spinal asymmetry of the upper body alignment and might deteriorate postural balancing and control ability. OBJECTIVE: To evaluate the effect of exercise interventions on balance and postural stability in patients with adolescent idiopathic scoliosis. METHODS: Embase, Scopus, Pubmed (Medline) and Web of Science databases were searched using the terms idiopathic scoliosis, physiotherapy, and balance. The articles selected were published in English in peer-reviewed journals …from 2012 to July 2022. RESULTS: Ten studies met the inclusion criteria. The PEDro scale values ranged from 2 to 6 (mean, 3.6), indicating a low level of scientific rigor. In the sample studies, spinal stabilization exercises were most often trialed (n = 3), followed by Schroth’s exercise (n = 2), stretching and self-elongation exercise (n = 2), the exercise protocol of Blount and Moe, physiotherapeutic scoliosis-specific exercise, and proprioceptive neuromuscular facilitation exercise (all n = 1). CONCLUSIONS: Physical therapists will be able to apply hippotherapy, Schroth exercise, physiotherapy scoliosis-specific exercise, trunk stabilization, proprioceptive neuromuscular facilitation exercise, spinal stabilization exercise, core stabilization exercise, and body awareness therapy to manage balance impairments in patients with adolescent idiopathic scoliosis, and further studies are needed to provide stronger evidence. Show more

Keywords: Equine-assisted therapy, proprioception, sensory processing

DOI: 10.3233/BMR-220391

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 6, pp. 1261-1272, 2023

Authors: Aydin, Abdulkadir | Atiç, Ramazan

Article Type: Research Article

Abstract: BACKGROUND: During the COVID-19 pandemic, it is thought that healthcare workers are most exposed to musculoskeletal disorders. However, there are limited studies in the literature examining the musculoskeletal disorders among healthcare workers during the COVID-19 pandemic. OBJECTIVE: The aim of this study was to examine musculoskeletal problems and psychological disorders in healthcare personnel working at Dicle University Faculty of Medicine and Research Hospitals during the COVID-19 pandemic and to come up with solutions for rehabilitation. METHODS: The Cornell Musculoskeletal Disorder Questionnaire (CMDQ) was used to assess musculoskeletal problems in the past week. Additionally, …Beck depression inventory (BDI) was used to evaluate the psychological state of the participants. Questions on demographic characteristics, habits, the presence and localisation of musculoskeletal system (MSS) diseases, severity and duration of pain, chronic diseases, trauma history and working conditions were included in the questionnaire prepared by the researchers. RESULTS: The study included 74 nurses, 42 residents, 26 specialists, 24 technicians, 16 dentists, 12 physiotherapists, and 26 other allied health personnel. Dentists had the highest total CMDQ score (160.73) whereas resident doctors had the lowest total CMDQ score (98.33). Low back, neck and back pain were the most common MSS problems. BDI was highest in nurses and 70.27% of the nurses were women. The total workplace ergonomics score was found to be 25.91%, and the visual analogue scale (VAS) was highest in nurses (6.72). CONCLUSIONS: While MSS pain is concentrated on the waist, neck and back regions in all healthcare workers. We concluded that the uncertainty associated with the pandemic, delay in preventive measures such as vaccination and medication, rapid and strong transmission of the disease and increasing number of deaths have led to an increase in stress, depression and burnout among healthcare workers. Show more

Keywords: Health worker, ergonomics, burnout, anxiety, psychosocial impacts

DOI: 10.3233/BMR-220229

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 6, pp. 1273-1283, 2023

Authors: Abass, Mohamed Yassen | Shendy, Wael | Samir, Hatem | Sweif, Radwa E. | Ahmed, Mai A. | Awad, Amina

Article Type: Research Article

Abstract: BACKGROUND: Chronic mechanical cervical pain (CMCP) is a common disabling problem worldwide, interfering with upper extremities function. However studying the impact of CMCP on shoulder proprioception is still lacking. OBJECTIVE: To investigate the impact of CMCP on shoulder proprioception in young adults compared with normal control (NC) individuals. METHODS: A comparative study was conducted between two groups; 40 patients with CMCP (mean age 32.28 ± 6.586) and 40 age and sex matched NC (mean age 33.43 ± 9.021). The Biodex isokinetic dynamometer was used to assess shoulder …active sense of position at 30 ∘ external and internal rotations. The absolute angular error was calculated for the dominant and non-dominant shoulders. RESULTS: The absolute angular error was significantly increased only in the CMCP at both rotation angles for both shoulders, showing a remarkable increase on the dominant shoulder and in the external rotation range compared with NC. CONCLUSIONS: CMCP can significantly impair shoulder proprioception, particularly on the dominant side and in external rotation range. This could emphasize the careful examination of shoulder proprioception for the early detection of shoulders at risk, to eliminate the possibility of shoulder instability and/or injury in young adults with CMCP. Show more

Keywords: Chronic mechanical cervical pain, shoulder proprioception, shoulder stability, isokinetic dynamometer

DOI: 10.3233/BMR-220173

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 6, pp. 1285-1293, 2023

Authors: Lin, Wujian | Wang, Weiming | Sun, Yiping | You, Longfei | Li, Yilin | Wu, Shaoping | Liao, Lingxiao | Andersen, Lars Louis | Wang, Yuling

Article Type: Research Article

Abstract: BACKGROUND: Based on electromyography measurements, shoulder vibratory exercises efficiently stimulate shoulder muscles activity. Yet very few studies have supported that shoulder vibratory exercises increased shoulder muscles strength and function, and the noninferiority compared with conventional elastic resistance exercises remains unknown. OBJECTIVE: This study investigated the effect of vibratory exercises versus conventional elastic resistance exercises with elastic bands on shoulder external rotation muscles strength and functional performance in young adults. METHODS: 26 young adults (7 males and 19 females, with age 23.89 ± 3.02) were recruited and randomly allocated to shoulder …vibratory exercises with FLEXI-BAR (FLEXI-BAR group) or conventional resistance exercises with elastic band (TheraBand group) for 3 times/week, 4 weeks totally. Shoulder external rotator muscles strength test and Underkofler softball distance throw test (USDTT) were performed before and after the training period. RESULTS: After 4 weeks training, shoulder external rotator muscles strength increased 22.25 ± 15.06 N (P = 0.004, effect size = 1.48) within FLEXI-BAR group and 22.81 ± 14.94 N (P = 0.007, effect size = 1.53) within TheraBand group. There were no statistically significant differences between groups in the three muscle strength tests (P > 0.65). Regarding shoulder function, FLEXI-BAR exercises increased the throw distance 0.81 ± 0.92 meters in USDTT (P = 0.041, effect size = 0.88) while TheraBand exercise did not (P = 0.284), yet there was no statistically significant between group effects (P = 0.608). CONCLUSIONS: These findings suggest that shoulder vibratory exercises can improve shoulder muscles strength in young adults and can be a useful alternative to the conventional elastic resistance exercises to improve the shoulder muscles strength and function. This provides therapists with more options in terms of choosing training equipment for rehabilitation programs. Show more

Keywords: Vibration, FLEXI-BAR, TheraBand, resistance training, rehabilitation

DOI: 10.3233/BMR-220190

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 6, pp. 1295-1305, 2023

Authors: Yoon, Sam-Won | Son, Ho-Hee

Article Type: Research Article

Abstract: BACKGROUND: Studies regarding effects of therapeutic tapings when patients with patellofemoral pain syndrome (PFPS) descend stairs are limited. OBJECTIVE: The purpose of this study was to investigate the effect of McConnell taping (MT) and Kinesio taping (KT) on kinematic variables when patients with PFPS descend stairs. METHODS: Fifty PFPS patients were randomly assigned to either the MT group or the KT group. Pain and lower extremities joint angles were measured while descending stairs before and after the intervention. All outcomes measured were analyzed using either paired t tests or independent t tests to …compare the difference within or between groups, respectively. RESULTS: There was a statistically significant difference in both groups in anterior knee pain scale score (p < 0.05). As a result of analysis of lower extremities joint angles at initial contact, loading response, and terminal stance, there were statistically significant within-group differences in hip, knee flexion, abduction and lateral rotation angles in both groups (p < 0.05). There were statistically significant within-group differences in hip flexion, knee flexion, and dorsiflexion angles in pre-swing (p < 0.05). There was a statistically significant difference between the groups in the following events: (1) knee lateral rotation angle at initial contact; (2) hip flexion angle at loading response; (3) and hip flexion at terminal stance angle (p < 0.05). CONCLUSION: MT and KT were effective in lowering knee pain and improving lower extremities joint angle when patients with PFPS descend stairs. In the comparison between the groups, the MT group showed significantly reduced anterior knee pain and increased range of motion of the lower extremities joint compared to the KT group. Show more

Keywords: Knee injury, alignment, lower extremity, gait analysis, initial contact

DOI: 10.3233/BMR-220244

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 6, pp. 1307-1316, 2023

Authors: Liu, Yingmin | Feng, Chengbao | Li, Yuyuan | Qie, Dandan | Xu, Bin | Wen, Yafei | Ma, Su | Yu, Wanglin | Xie, Zhanqing

Article Type: Research Article

Abstract: BACKGROUND: Long-round needle usage can treat muscular pain, but there is little research on cervical spondylotic radiculopathy (CSR). OBJECTIVE: To explore the efficacy and safety of long-round needle usage in treating CSR. METHODS: Ninety-eight patients with CSR were randomly divided into control and observation groups. They were treated with filiform needles and long-round needles, respectively. The therapeutic effect, safety, inflammatory factors and neck dysfunction index (NDI), McGill pain questionnaire (MPQ) and Generic Quality of Life Inventory-74 (GQOL-74) scores were compared between the two groups. RESULTS: After treatment, the effective rate …and safety of the observation group were better than those of the control group. The NDI and MPQ scores in the observation group were significantly lower than those in the control group, and the GQOL-74 score was higher than that in the control group. The level of interleukin-8 in the observation group was significantly lower than that in the control group, and the level of interleukin-10 was significantly higher than that in the control group. CONCLUSIONS: Long-round needle therapy has a good effect on patients with CSR, which can safely improve the quality of life of patients with mild local inflammatory damage. Show more

Keywords: Treatment outcome, inflammation, quality of life

DOI: 10.3233/BMR-220295

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 6, pp. 1317-1323, 2023