Journal of Back and Musculoskeletal Rehabilitation - Volume 37, issue 1

Authors: Skvortsov, Dmitry | Altukhova, Alyona | Kaurkin, Sergey | Akhpashev, Alexander

Article Type: Research Article

Abstract: BACKGROUND: This study on gait biomechanics is based on a functional test (FT) performed at free and fast walking speeds. OBJECTIVE: We investigated the pattern of changes in gait biomechanical parameters and the knee function in patients after anterior cruciate ligament (ACL) injury or its reconstruction. METHODS: The study included 51 patients (33 males, 18 females) with a confirmed recent or old history of ACL tear, before or after reconstruction (26 patients). Mocap data was obtained using an inertial system. All patients were divided into three groups: 41 patients with physiological response (compensation), …6 patients with signs of decompensation, and 4 non-assessable patients. RESULTS: Increase in gait speed was associated with decrease in the walking cycle duration, stance and double support phases. In the compensation group, the physiological response of the knee was manifested in increased amplitudes. In the decompensation group, the amplitudes remained unchanged or decreased. In the compensation group, there were increases in the symmetrical muscle activity. The decompensation group was characterized by electromyography asymmetry. CONCLUSION: The observed universal physiological mechanism limiting the load on the damaged joint can be used for accurate assessment of the knee functional state in various periods of rehabilitation. Show more

Keywords: Knee joint, anterior cruciate ligament injuries, gait analysis, rehabilitation

DOI: 10.3233/BMR-220415

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 1, pp. 99-109, 2024

Authors: Kang, Jung Hoon | Im, Soo Bin | Kim, Ju Hyung | Jeong, Je Hoon

Article Type: Research Article

Abstract: BACKGROUND: The Subaxial Cervical Spine Injury Classification System (SLICS) is a commonly used algorithm for diagnosing and managing subaxial cervical spine trauma. A SLIC score 4 suggests either surgery or non-surgically treatment depending on the surgeon’s experience and patient’s conditions. OBJECTIVE: Prognosis and treatment results were analyzed in patients with SLIC score 4. METHODS: The patients with SLIC score 4 were retrospectively reviewed from 2012 to 2019. Forty-one patients were included and divided into two groups: non-surgically treated and surgically treated. Demographic data and radiographs were analyzed. Statistical analysis was performed to determine …the difference between the two clinical groups. RESULTS: Twenty-two patients were non-surgically treated, and nineteen patients were surgically treated. There was no neurological deterioration in both groups. However, there was no statistically significant difference in the last follow-up AISA and Nurick grade (p > 0.05). There was no significant difference in the number of patients who showed improvement when comparing the initial and the last follow-up neurological status (p > 0.05). CONCLUSION: Regardless of the treatment method, the spinal cord injury patients with SLICS point 4 showed a relatively good prognosis. Patients with SLIC score 4 could be treated non-surgically or surgically based on the surgeon’s experience and factors associated with the patient’s acute health status and chronic comorbidities. Show more

Keywords: Cervical spine, subaxial injury classification, spinal cord injury, cervical spine trauma

DOI: 10.3233/BMR-220428

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 1, pp. 111-117, 2024

Authors: Moriki, Kento | Ogihara, Hirofumi | Yoshikawa, Koji | Kikuchi, Kenta | Endo, Ryunosuke | Sato, Takaaki

Article Type: Research Article

Abstract: BACKGROUND: Sleep quality in patients with chronic low back pain (CLBP) may affect quality of life (QoL), possibly due to worsening pain, central sensitization (CS), and cognitive factors. However, causal relationship among the factors has not been confirmed yet. OBJECTIVE: The purpose of this study was to test the hypothesis that sleep quality in patients with CLBP is attributable to pain, cognitive factors, and CS, and influences QoL, by structural covariance analysis. METHODS: This is a cross-sectional study. Participants were recruited from six health care facilities and 101 patients with CLBP were included. …Structural covariance analysis assessed the fit of data to the model using goodness of fit index (GFI), adjusted goodness of fit index (AGFI), comparative fit index (CFI), and mean squared approximation error (RMSEA). RESULTS: The structural covariance analysis showed that the goodness-of-fit indices were high (GFI = 0.993, AGFI = 0.964, CFI = 1.00, RMSEA < 0.01). Sleep quality was not directly influenced by QoL but rather by CS and cognitive factors. CONCLUSION: This study suggests that sleep quality in patients with CLBP is indirectly mediated through multiple pathways, including cognitive factors and CS, which may influence QoL. Show more

Keywords: Sleep quality, cognitive factors, central sensitization, quality of life, chronic low back pain

DOI: 10.3233/BMR-220429

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 1, pp. 119-125, 2024

Authors: Preiss, Sandra | Beinert, Konstantin | Taube, Wolfgang

Article Type: Research Article

Abstract: BACKGROUND: Working in awkward and sustained postures is, besides psychosocial risk factors, the most reported physical risk factor for neck pain. Accurate proprioception is fundamental to correcting awkward head-to-trunk positions, but impaired proprioceptive performance has been found in patients with chronic neck pain. OBJECTIVE: The aim was to compare the effectiveness of two different interventions in a workplace set-up on sensorimotor performance and pain sensitivity in people with chronic neck pain. METHODS: A total of 25 patients with chronic neck pain participated in this double-blind study. Patients were randomly allocated to the visuomotor …tracking task group or the video group (watching a massage video, imagining themselves being massaged). The primary outcomes were cervical joint position sense acuity and pressure pain threshold of the cervical spine, evaluated by a blinded assessor. RESULTS: There were significant time by group interactions for cervical joint position sense acuity (F 1 ; 23 : 4.38; p = 0.048) and pressure pain threshold (F 1 ; 23 : 5.78; p = 0.025), with the tracking task group being more accurate in cervical joint position sense testing and less pain sensitive for pressure pain threshold. CONCLUSIONS: The visuomotor tracking task improves cervical joint position sense acuity and reduces pressure pain threshold immediately after intervention in people with chronic neck pain. Show more

Keywords: Neck muscles, exercise therapy, proprioception, posture, pain perception

DOI: 10.3233/BMR-220431

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 1, pp. 127-136, 2024

Authors: You, Xuanhe | Wu, Diwei | Chen, Anjing | Zhou, Xinran | Fan, Haiquan | Jiang, Yang

Article Type: Research Article

Abstract: BACKGROUND: Muscle imbalance has long been recognized as one of the possible pathogeneses for adolescent idiopathic scoliosis (AIS). PIEZO2, the susceptibility gene of AIS, has been identified to play an important role in neuromuscular activities. OBJECTIVE: This study aims to compare the mRNA expression of PIEZO2 between concave and convex paraspinal muscles of AIS patients and to identify the relationship between the ratio of PIEZO2 expression and curve magnitude. METHODS: Twenty female AIS patients (right thoracic curve) who underwent spinal correction surgery were divided into moderate (n = …12) and severe (⩾ 70 degrees) curve groups (n = 8). The morphology of the paraspinal muscles was assessed with spinal MRI. Multifidus specimens were collected during surgical operations from the concave and convex sides of the apical region, and mRNA expression of the PIEZO2 gene was compared between sides. The localization of PIEZO2 protein expression was confirmed with the markers PAX7 and PAX3, and the percentage of PIEZO2 + cells was also investigated. RESULTS: In the moderate curve group, fatty infiltration in the deep paraspinal muscle was significantly higher on the concave side than on the convex side. There were no differences in deep muscle area, superficial muscle area, or fatty infiltration of superficial paraspinal muscle. The mRNA expression of PIEZO2 was significantly increased on the concave side, and the asymmetric expression predominantly occurred in moderate curves rather than severe ones. PIEZO2 was expressed on satellite cells instead of fibers of the muscle spindle. The percent of PIEZO2 + PAX7 + cells in myofibers was significantly higher on the concave side in the moderate curve group, but not in the severe curve group. CONCLUSIONS: Asymmetric morphological changes occur in the deep paraspinal muscles of AIS. The PIEZO2 is asymmetrically expressed in the multifidus muscle and is preferentially expressed in satellite cells. Show more

Keywords: PIEZO2, adolescent idiopathic scoliosis, paraspinal muscle, satellite cells

DOI: 10.3233/BMR-220440

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 1, pp. 137-146, 2024

Authors: Daly, Emily | Prodoehl, Janey

Article Type: Research Article

Abstract: BACKGROUND: Deep neck flexor muscle atrophy and increased superficial neck muscle activation are associated with disability and pain intensity in individuals with neck pain. There is a lack of evidence to support direct assessment of deep neck flexor muscles in a non-invasive way during exercise performance to help determine the effectiveness of different neck strengthening exercises. OBJECTIVE: Compare longus colli (LC) and sternocleidomastoid (SCM) activation between individuals with and without neck pain using real time ultrasound (RTUS) during a series of craniocervical exercises. METHODS: This cross-sectional cohort study recruited 10 control and 10 …neck pain participants to complete four deep neck flexor activation activities involving varying levels of craniocervical flexion. Dimensions of the LC and SCM were measured using RTUS at rest and during exercise. Independent t-tests assessed baseline differences and analysis of variance examined activation changes. RESULTS: At rest, the neck pain group had significantly smaller cross-sectional area and thickness of the LC compared to the control group (p < 0.05). During exercise, the neck pain group showed significantly larger increases in LC thickness and cross-sectional area across exercise compared to the control group, with no differences in SCM activation between groups. CONCLUSIONS: Despite atrophy, individuals with neck pain can activate their deep neck flexor muscles appropriately without activating their superficial neck flexor muscles in a supine series of craniocervical flexion exercise as measured by non-invasive ultrasound imaging. Show more

Keywords: Cervicalgia, ultrasonography, longus colli, rehabilitation, exercise therapy

DOI: 10.3233/BMR-230002

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 1, pp. 147-156, 2024

Authors: Hagovská, Magdaléna | Buková, Alena | Takáč, Peter

Article Type: Research Article

Abstract: BACKGROUND: Currently there are not enough studies that compared frequent types of collective sports with regard to the prevalence of pain and disability of the lower limb. OBJECTIVE: To determine the prevalence of lower limb pain and disability in team sports players. METHODS: 388 athletes with average age 27.26 ± 4.69, from sports clubs at the national level were included in the study. The Oxford Hip Score was used to determine the prevalence of hip pain. The International Knee Documentation Committee was used to determine the prevalence of knee pain. …The Foot and Ankle Disability Index was used to determine the prevalence of ankle pain. RESULTS: Hockey players had a prevalence of hip pain of 97.2% and a 14.3 times higher risk of developing hip pain compared with football and floorball players. Floorball players had a 81.9% prevalence of knee pain, with a 3.8 times higher the risk of knee pain compared with football and hockey. Floorball players had a 62.3% prevalence of ankle pain and a 1.8 times higher the risk of developing ankle pain compared with football and hockey players. CONCLUSIONS: The highest percentage of knee 81.9% and ankle 62.3% pain, as well as the greatest risk of pain, was found among floorball players. Hockey players had the highest prevalence (97.2%) and risk of developing hip pain. Show more

Keywords: Disability, pain, sport injuries

DOI: 10.3233/BMR-230048

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 1, pp. 157-163, 2024

Authors: Vongsirinavarat, Mantana | Kao-ngampanich, Pattipon | Sinsurin, Komsak

Article Type: Research Article

Abstract: BACKGROUND: Self-corrective exercise is commonly used in the training protocol of patients with adolescent idiopathic scoliosis (AIS). The muscle activation pattern during symmetrical and overcorrection exercises is then explored to guide the treatment. OBJECTIVE: To compare the paraspinal muscle activity during three self-corrective positions and the habitual standing in AIS. METHODS: Thirty-three adolescents with double curved scoliosis were examined. The curve type and Cobb’s angle were determined from their whole spine X-ray. They adopted habitual standing, symmetrical correction and two overcorrected positions (O1 and O2). The surface electromyography (EMG) was monitored on both …sides of paraspinal muscles at the apex areas of scoliotic curves. The EMG ratio between sides was inferred as the corrective effect. RESULTS: All three self-correction positions produced greater EMG ratios compared with the habitual standing. The greatest EMG ratios were observed during the O1 position at the thoracic curve and the habitual standing at the lumbar curve. Participants with different subtypes of curves exhibited similar patterns of EMG ratios. CONCLUSION: From the biomechanical viewpoint, all three self-corrective positions possibly provided therapeutic effects for the scoliotic body regardless of the subtype of scoliosis curves. The O1 position seemed to be most effective for the adjusting activation of thoracic paraspinal muscles. The symmetrical corrective position is otherwise recommended for adjusting the lumbar muscle activation. Show more

Keywords: Scoliosis, therapeutic exercise, EMG, postural training

DOI: 10.3233/BMR-230055

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 1, pp. 165-173, 2024

Authors: Bi, Li-Na | Zheng, Xin | Qi, Yan-Yan | Hu, Su | Li, Chang | Zhang, Yan

Article Type: Research Article

Abstract: BACKGROUND: In adults with type 2 diabetes (T2DM), sarcopenia and obesity are two common body composition issues. OBJECTIVE: We investigated the associated influencing factors of muscle mass loss in obese adults with T2DM, to provide a theoretical basis for the prevention of sarcopenic obesity in patients with T2DM. METHODS: We recruited 315 participants in this study. The participants underwent body composition assessment and clinical information was collected. Dual-energy X-ray absorptiometry was used to verify the accuracy of the body composition data. Based on their body fat percentage, 189 patients with T2DM were classified …as obese. Patients with T2DM and obesity were grouped into the muscle mass loss group and non-muscle mass loss group based on gender. We collected demographic and clinical information about patients with T2DM who were obese, including their age, gender, body mass index (BMI), appendicular skeletal muscle index (ASMI), and body fat percentage (PBF). RESULTS: Among the participants who were obese and had T2DM, 56.61% (107/189) experienced muscle mass loss, with a detection rate of 43.42% (33/76) among females and 65.49% (74/113) among males. Body mass index, fat index, Android fat, Gynoid fat, limb fat, trunk fat, and total body bone mineral content were all lower in the muscle mass loss group compared to the non-muscle mass loss group, regardless of gender (all P < 0.001). Muscle mass loss in obese adults with T2DM was affected by BMI, body fat index, and limb fat. CONCLUSION: Muscle mass loss is more prevalent in adults with T2DM and a high PBF. Body mass index, body fat index, and limb fat are the protective factors of muscle mass loss in adult patients with T2DM and obesity. Show more

Keywords: Appendicular skeletal muscle index (ASMI), influencing factors, muscle mass loss, obesity, Type 2 diabetes mellitus (T2DM)

DOI: 10.3233/BMR-230065

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 1, pp. 175-181, 2024

Authors: Menek, M. Yilmaz | Menek, B.

Article Type: Research Article

Abstract: BACKGROUND: Percussion massage therapy is a popular approach in sport medicine for physical therapists, but few researchers have investigated the comparison with other intervention methods. OBJECTIVE: This study aimed to examine the comparison of the effects of dynamic stretching, static stretching and percussive massage therapy on balance and physical performance in individuals. METHODS: The participants who were 18–25 years of age, able to perform performance tests, did not have any orthopedic surgery, did not have problems during running and sudden turning, and did not have a professional sports history were included in the …study. Participants were assigned randomly to three groups as dynamic stretching (DS) (n = 16), static stretching (SS) (n = 16) and percussive massage therapy (PMT) (n = 16) groups. Horizontal jumping test, T drill test and balance measurements on a single leg with open and closed eyes of all participants were recorded before and after applications. RESULTS: When the values of the pre and post-treatment of all groups in the study were compared, significant improvements were observed in the t-test, horizontal jumping test and right/left foot balance with eyes open in DS group (p < 0.05). Significant improvements were observed in all values in the PMT group (p < 0.05). In the comparison of the differences between the groups, PMT group values were more significant than the SS group in all parameters. CONCLUSION: Percussive massage therapy would be an alternative that can be used to increase the performance and balance of individuals before exercise. Show more

Keywords: Exercise, massage therapy, postural balance, vibration, warm-up exercise

DOI: 10.3233/BMR-230069

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 1, pp. 183-193, 2024