Journal of Back and Musculoskeletal Rehabilitation - Volume 37, issue 2

Authors: Osama, Muhammad

Article Type: Research Article

DOI: 10.3233/BMR-245001

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 249-251, 2024

Authors: Jiang, Xiaoyu | Zhou, Jianpeng | Chen, Qiang | Xu, Qiling | Wang, Shuting | Yuan, Lin | Zhang, Deqi | Bi, Hongyan | Li, Haixia

Article Type: Review Article

Abstract: BACKGROUND: Robot-assisted gait training (RAGT) has been reported to treat motor dysfunction in patients with Parkinson’s disease (PD) in the last few years. However, the benefits of RAGT for treating motor dysfunction in PD are still unclear. OBJECTIVES: To investigate the efficacy of RAGT for motor dysfunction in PD patients. METHODS: We searched PubMed, Web of Science, Cochrane Library, Embase, CNKI, Wanfang, Chinese Biomedical Literature Database (CBM), and Chinese VIP Database for randomized controlled trials investigating RAGT to improve motor dysfunction in PD from the databases’ inception dates until September 1, 2022. The …following outcome indexes were employed to evaluate motor dysfunction: the Berg Balance Scale (BBS), Activities-specific Balance Confidence Scale (ABC), 10-Meter Walk Test gait speed (10-MWT), gait speed, stride length, cadence Unified Parkinson Disease Rating Scale Part III (UPDRS III), 6-Minute Walk Test (6MWT), and the Timed Up and Go test (TUG). The meta-analysis was performed using the proper randomeffect model or fixed-effect model to evaluate the difference in efficacy between the RAGT and the control groups. The Cochrane Risk of Bias Tool was used for the included studies and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) was used to interpret the certainty of the results. RESULTS: The results consisted of 17 studies comprising a total of 670 participants. Six hundred and seven PD patients with motor dysfunction were included: 335 in the RAGT group and 335 in the control group. This meta-analysis results established that when compared with the control group, robot-assisted gait training improved the BBS results of PD patients (MD: 2.80, 95%CI: 2.11–3.49, P < 0.00001), ABC score (MD: 7.30, 95%CI: 5.08–9.52, P < 0.00001), 10-MWT (MD: 0.06, 95%CI: 0.03–0.10, P = 0.0009), gait speed (MD: 3.67, 95%CI: 2.58–4.76, P < 0.00001), stride length (MD: 5.53, 95%CI: 3.64–7.42, P < 0.00001), cadence (MD: 4.52, 95%CI: 0.94–8.10, P = 0.01), UPDRS III (MD: - 2.16, 95%CI: - 2.48–- 1.83, P < 0.00001), 6MWT (MD: 13.87, 95%CI: 11.92–15.82, P < 0.00001). However, RAGT did not significantly improve the TUG test result of patients with PD (MD = - 0.56, 95% CI: - 1.12–0.00, P = 0.05). No safety concerns or adverse reactions among robot-assisted gait training patients were observed. CONCLUSION: Even though RAGT can improve balance function, walking function, and gait performance and has demonstrated positive results in several studies, there is currently insufficient compelling evidence to suggest that it can improve all aspects of lower motor function. Show more

Keywords: Rehabilitation robot, exercise, movement disorders, Gait Disorders, balance function

DOI: 10.3233/BMR-220395

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 253-268, 2024

Authors: Liu, Yaoyao | Kim, Minhee

Article Type: Research Article

Abstract: BACKGROUND: In the working environment of modern society, a poor sitting posture for a prolonged time may lead to abnormal spinal alignment such as thoracic kyphosis (TK). OBJECTIVE: This study aimed to evaluate the efficacy of taping for posture correction of patients with TK, providing theoretical and empirical guidance for clinicians attempting to rectify TK posture. METHODS: The study included 15 subjects aged 30–60 years, all with a TK angle of ⩾ 40∘ . Subjects were required to ascend and descend a set of three steps (a low step, high step, …and second low step) under three different conditions: without tape assistance, with taping assistance using 20% elongation, and with taping assistance using 40% elongation. A triaxial accelerometer was employed to measure and compare the anterior-posterior (AP), vertical (VT), and medial-lateral (MIL) movements of the thoracic vertebrae in the different conditions. RESULTS: There were no significant differences in the MIL (P = 0.903) or AP (P = 0.114) movements between the no tape assistance and 20% elongation taping conditions. However, a significant difference was found in the VT movement (P = 0.017). Comparing the no assistance condition to the 40% elongation taping condition, no significant changes were noted in the MIL movement (P = 0.650), but significant differences were detected in both the VT (P = 0.003) and AP movements (P = 0.016). No significant differences were found in any of the three measurements between 20% and 40% elongation taping. CONCLUSION: Taping serves as an effective method for immediately improving kyphotic posture. It corrects the position of the scapula and cervicothoracic line and exerts passive retraction on the relevant muscles, thus mitigating trunk imbalance. Show more

Keywords: Alignment, athletic tape, musculoskeletal pain, postural balance

DOI: 10.3233/BMR-230027

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 269-276, 2024

Authors: Zhong, Zhinian | Jin, Kang | Qin, Fengling | Nie, Rongrong

Article Type: Research Article

Abstract: BACKGROUND: Lumbar disc herniation (LDH) is a common clinical disease of the skeletal system, and its prevalence has been on a rise. OBJECTIVE: To evaluate the efficacy of Huoxue Tongluo decoction plus acupuncture in the treatment of lumbar disc herniation and its effectiveness in improving the functional recovery of the patients’ affected joints and mitigating their pain. METHODS: In this prospective study, 110 patients with lumbar disc herniation enrolled in our Hospital from June 2019 to June 2021 were collected and randomized to receive either conventional treatment (control group) or Huoxue Tongluo Decoction …plus acupuncture (study group). RESULTS: Huoxue Tongluo Decoction plus acupuncture resulted in more rapid mitigation of lower extremity symptoms and lumbar symptoms versus conventional treatment (P < 0.05). Patients receiving traditional Chinese medicine (TCM) showed milder inflammatory responses than those with conventional medication, as evidenced by the lower serum concentrations of tumor necrosis factor-α (TNF-α ), interleukin (IL)-6, and high-sensitivity C-reactive protein (hs-CRP) (P < 0.05). After treatment, the study group had higher Japanese Orthopedic Association (JOA) scores and lower visual analogue scale (VAS) scores than the control group (P < 0.05), suggesting that the combination of the herbal decoction and acupuncture provided better functional recovery of the affected joints and pain mitigation for the patients. Furthermore, the lower Pittsburgh sleep quality index (PSQI) scores in patients in the study group indicated better sleep quality of patients after TCM intervention than after conventional treatment (P < 0.05). Huoxue Tongluo Decoction plus acupuncture was associated with a significantly higher efficacy (94.55%) versus conventional treatment (80%) (P < 0.05). CONCLUSIONS: Huoxue Tongluo Decoction combined with acupuncture significantly offers a viable treatment alternative for lumbar disc herniation with promising treatment outcomes, mitigates patients’ limb pain, and improves their lumbar function and sleep quality. Further trials are, however, required prior to general application in clinical practice. Show more

Keywords: Clinical disease, effectiveness, functional recovery

DOI: 10.3233/BMR-220347

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 277-283, 2024

Authors: Ege, Ferhat

Article Type: Research Article

Abstract: BACKGROUND: Low back pain is an important widespread health problem that can occur at any age, causing serious socioeconomic losses. OBJECTIVE: The objective of this study is to investigate the relationship between kinesiophobia severity and pain severity, depression, and quality of life in patients with mechanical low back pain. METHODS: The study sample consisted of 155 patients, of whom 72 were female and 83 were male, aged between 18 and 75 years with mechanical low back pain. Quality of life was assessed with the 36-Item Short Form Health Survey (SF-36), pain intensity with the …Visual Analogue Scale (VAS), kinesiophobia with the Tampa Kinesiophobia Scale (TKS), and depression with the Beck Depression Inventory (BDI). Patients were divided into the low (TKS ⩽ 37) and high kinesiophobia (TKS > 37) groups according to the scores they obtained from TKS. RESULTS: VAS-pain severity and BDI scores were significantly higher in the high kinesiophobia group than in the low kinesiophobia group (p < 0.001). On the other hand, the SF-36 subscale scores were significantly higher in the low kinesiophobia group than in the high kinesiophobia group (p < 0.001). The TKS scores were moderately correlated with VAS-pain severity (r = 0.470; p < 0.001) and BDI scores (r = 0.584; p < 0.001) in the positive direction, and strongly correlated with all sub-parameters of quality of life in the negative direction (p < 0.001). CONCLUSION: The results indicated that the severity of kinesiophobia in patients with non-inflammatory low back pain is associated with pain severity, depression, and poor quality of life. Show more

Keywords: Kinesiophobia, pain, quality of life, depression

DOI: 10.3233/BMR-220365

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 285-294, 2024

Authors: Sun, Zhenhui | Li, Nan | Yang, Zhi | Zhang, Wenhui | Liu, Jie

Article Type: Research Article

Abstract: BACKGROUND: Anatomical cup implantation is a promising approach in primary total hip arthroplasty (THA) and improves functional outcomes. OBJECTIVE: We aimed to evaluate the cup position and functional outcomes in primary THA with preoperative dynamic 3D planning. METHODS: We retrospectively reviewed 54 hips in 48 patients who underwent primary THA with anatomical cup implantation (mean follow-up time: 52 months). Cup positions were evaluated based on patient-specific morphology, the acetabular fossa and the combined anteversion test. Functional outcomes were assessed after THA. The paired-sample t -test was performed for surgical and contralateral native …hips among 42 patients who underwent unilateral THA. RESULTS: Two hips suffered intraoperative trochanteric fracture, but no hip dislocations occurred. No patients reported groin or thigh pain, and all patients were capable of deep squatting and one-leg standing. The mean Harris hip score, WOMAC score, and physical SF-36 score were 94.46 ± 6.16, 10.41 ± 3.62, and 95.19 ± 8.74, respectively. Except for acetabular offset, THA restored biomechanics to those of contralateral native hip, including cup anteversion, abduction, femoral offset and acetabular height (P > 0.05). CONCLUSION: This study provided evidence for the application of anatomical cup implantation assisted with dynamic 3D planning in primary THA, which restored morphology and improved functional outcomes. Show more

Keywords: Total hip arthroplasty, acetabular cup implantation, 3D planning, retrospective study

DOI: 10.3233/BMR-230004

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 295-304, 2024

Authors: ALJawaee, Madawi | Williams, Jonathan M. | Jones, Michael D.

Article Type: Research Article

Abstract: BACKGROUND: Despite wobble board use being common in physiotherapy the effect of certain factors, essential to clinical reasoning, have not been investigated. OBJECTIVE: To determine the effect of biological sex, anthropometrics, footwear and dual tasking (DT) on wobble board balance performance. METHODS: Eighty-six healthy participants (44 females) had their wobble board performance measured during double-leg-stance (DLS) with eyes open (DLSEO), closed (DLSEC) and single-leg-stance (SLS) tasks, with and without footwear and a DT added. Anthropometrics were also measured. RESULTS: Females outperformed males during most tasks, with some large effect sizes …(ES). Performance was moderately related to weight and shoulder, waist and hip circumference. Overall, there were no differences between footwear and no footwear, except for males during SLS. DT made little difference, except during DLSEO and SLS, where single task was better than DT, though only females had a large ES. CONCLUSION: During wobble board tasks, biological sex differences were observed and a modest correlation between anthropometrics and performance noted. DT and footwear had minimal effect. Show more

Keywords: Wobble board, dual task, footwear, gender, correlation

DOI: 10.3233/BMR-230020

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 305-315, 2024

Authors: Cha, Kyoung Hyeon | Yeo, Seung Mi | Son, Ju-Hyun | Kim, Young-Joon | Lee, Chang-Hyung

Article Type: Research Article

Abstract: BACKGROUND: Chronic low back pain (LBP) can lead to muscle spasms, limited range of motion, and abnormal posture, resulting in trunk muscle asymmetry. OBJECTIVE: This study aimed to assess the intra- and inter-rater reliability of a quantitative measurement of trunk coronal asymmetry in patients with chronic LBP, minimizing unnecessary gravity and friction force using a manual table in the prone position. METHODS: This prospective study was conducted at a single center, targeting patients with chronic LBP to measure trunk coronal asymmetry on a manual table in the prone position. The intra-class correlation coefficient …(ICC) was calculated using one-way random-effects and two-way mixed-effects models. RESULTS: Fifty-eight patients who had LBP for more than three months were enrolled from May 1, 2021, to December 31, 2021. The intra- and inter-rater reliabilities of the two examiners’ measurements were 0.872 and 0.899, and 0.852, respectively. Based on pain severity, the participants were classified into mild and severe groups, with ICCs of 0.823 and 0.889, and 0.936 and 0.918, respectively. CONCLUSION: Measurement of trunk coronal asymmetry in the prone position using a manual table demonstrates high intra- and inter-rater reliability. In addition, the reliability increases with greater pain severity. Show more

Keywords: Low back pain, prone position, visual analogue scale, spasm

DOI: 10.3233/BMR-230042

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 317-325, 2024

Authors: Sariyildiz, Mustafa Akif | Batmaz, Ibrahim | Hattapoğlu, Salih

Article Type: Research Article

Abstract: BACKGROUND: Epidural steroid injections are common procedures used to treat lumbosacral radicular pain due to lumbar disc herniation (LDH). It is crucial for the clinician to anticipate which patients can benefit from interventional treatment options. OBJECTIVE: This study aimed to examine the effect of radiological and clinical parameters on lumbar transforaminal epidural steroid injections (TFESI)/local anesthetic injection outcomes in patients with LDH. METHODS: This study included 286 patients with LDH (146 males and 140 females). All patients received a fluoroscopically guided TFESI (triamcinolone acetonide 40 mg, lidocaine 2%, and 2.5 ml of physiological …saline). Patients were evaluated according to radicular pain, the Oswestry Disability Index (ODI) and the Hospital Anxiety and Depression Scale at baseline and 3 months after the injections. Demographic, clinical and magnetic resonance imaging (MRI) findings were recorded to assess the predictive factors for TFESI outcomes. Pfirrmann Grades 1 and 2 were classified as low-grade nerve root compression and Grade 3 was classified as highgrade nerve root compression. RESULTS: Compared to baseline measurements there were significant improvements in radicular pain, ODI score, Laseque angle, and Schober test scores 3 months after injection. Improvements of at least 50% in radicular pain relief and the ODI functionality index were (n = 214) 82%, (n = 182) 70% respectively at 3 months. Correlation analyses revealed that a shorter duration of symptoms, lowgrade nerve root compression and foraminal/extraforaminal location on MRI findings were associated with a favorable response. CONCLUSIONS: Lowgrade nerve root compression was a predictor of a favorable response to TFESI. Show more

Keywords: Epidural injection, lumbar disc herniation, MRI imaging, treatment response, nerve root compression

DOI: 10.3233/BMR-230051

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 327-335, 2024

Authors: Zhang, Yafei | Chai, Tingting | Weng, Hao | Liu, Yang

Article Type: Research Article

Abstract: BACKGROUND: Previous studies have suggested an association between pelvic rotation (PR) and scoliotic deformity in severe adolescent idiopathic scoliosis (AIS), but none have investigated this relationship in mild to moderate AIS. OBJECTIVE: To investigate the relationship between PR and trunk rotation in mild to moderate AIS. METHODS: This was a case-control study. The cases were 32 AIS patients with PR in the opposite direction to the thoracic curve, and the controls were 32 AIS patients with PR in the same direction as the thoracic curve. All patients were assessed with the Adams forwards …bend test. Type II trunk rotation was selected as exposure. Logistic regression was used to estimate the association between PR direction and types of trunk rotation while accounting for confounders. Multiple linear regression was used to analyse the relationships between PR magnitude and the angle of trunk rotation (ATR). RESULTS: Logistic regression showed an unadjusted OR of 9.13 (95% CI 2.92–28.50, P < 0.001), and adjustment for sex and Cobb angle only slightly changed the OR (adjusted OR, 8.23; 95% CI, 2.51–27.01; P = 0.001). The concave/convex ratio was associated with ATR measurements in both cases (β = - 0.379; P = 0.030) and controls (β = - 0.468, P = 0.008). CONCLUSION: An association was found between PR and trunk rotation, which may help achieve more effective physiotherapy in mild to moderate AIS. Show more

Keywords: Anthropometry, pelvis, rotation, scoliosis

DOI: 10.3233/BMR-230070

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 337-346, 2024