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

Authors: Li, Zhuo | Guo, Jingwei | Ge, Ruidong | Liu, Chang

Article Type: Research Article

Abstract: BACKGROUND: Studies have shown that core muscle training can accelerate the recovery of motor function in stroke patients. However, there are no relevant reports to show the effect of core muscle training combined with functional electrical stimulation (FES) on the rehabilitation of stroke patients. OBJECTIVE: This study aimed to observe the efficacy of core muscle training combined with FES on motor and balance functions of lower limbs in stroke patients. METHODS: This study selected and divided 120 stroke patients with hemiplegia admitted to our hospital into the control and observation groups. Patients in …the control group just received core muscle training; while patients in the observation group were treated by core muscle training combined with FES. Both groups were treated for 8 weeks. Subsequently, the clinical data and information of all patients were collected and counted. Muscle strength changes were observed by detecting paralytic dorsiflexor (pDF), plantar flexor (pPF), knee extensor (pKE), and knee flexor (pKF) before and after treatment. Motor and balance abilities of both groups were scored through the 10-meter walking test (10 MWT), Berg balance scale (BBS), functional ambulation category (FAC) scale, timed up and go (TUG) test, and lower extremity motricity index (MI-Lower). RESULTS: No significant difference was found in clinical data between the two groups. The intensity of pDF, pPF, pKE, and pKF significantly increased in both groups after treatment, and the intensity of these parameters was higher in the observation group relative to the control group. Additionally, 10 MWT and TUG test scores of patients in the observation group were notably decreased while the BBS and MI-Lower scores were significantly increased after treatment compared with those in the control group. CONCLUSION: Core muscle training combined with FES can significantly improve the rehabilitation effect of lower limb motor and balance functions in stroke patients. Show more

Keywords: Stroke, rehabilitation effect, core muscle training, functional electrical stimulation

DOI: 10.3233/BMR-230074

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 347-354, 2024

Authors: Soufivand, Parviz | Gandomi, Farzaneh | Assar, Shirin | Abbasi, Homayoun | Salimi, Mehran | Ezati, Mozhgan | Pournazari, Mehran | Shahsavari, Soodeh

Article Type: Research Article

Abstract: BACKGROUND: There has been a dearth of research into the benefits of water-based workouts for ankylosing spondylitis (AS) patients. OBJECTIVE: This study aimed to compare the effect of Aqua Stretch and Aqua Pilates in improving quality of life (QOL), function, and pain in AS patients. METHODS: This study was conducted on 40 patients, who were randomly assigned to the Aqua Pilates, Aqua Stretch, and control groups. The experimental groups attended interventions for six-week. QOL, pain intensity, function, and fatigue were measured before and after treatments. RESULTS: Except for the chest …expanding, all variables in the Aqua Stretch group changed significantly after six weeks (p < 0.05). QOL (p = 0.002), 6MWT (p = 0.016), and Schober flexion (p = 0.011) showed changes, while BASDAI (p = 0.0001), VAS (p = 0.0001), fatigue (p = 0.0001), and Schober extension (p = 0.028) showed significant decreases. Except for chest expansion and Schober extension, which did not alter significantly after six-week of Aqua Pilates (p > 0.05), all other variables did. There was an increasing trend in 6MWT and Schober flexion (p = 0.021) and a decreasing trend in BASDAI (p = 0.002), VAS (p = 0.0001) and fatigue (p = 0.002). Except for QOL (p = 0.016), no statistically significant differences were found between the groups. CONCLUSION: All variables had a significant change after six-week Aqua Stretch, except for the chest expanding. Chest expanding and Schober extension were the variables which had no significant change after six-week Aqua Pilates. With the exception of QOL, no statistically significant differences were found between the groups. Aqua Stretch had the greatest effect on the VAS, as measured by the minimum clinically relevant differences (MCID). Moreover, in Aqua Stretch alone, there was a notable impact on fatigue, QOL, and the BASDAI. Show more

Keywords: Spine, rheumatoid srthritis, disability, fatigue, patient

DOI: 10.3233/BMR-230077

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 355-367, 2024

Authors: Ashida, Yuzo | Miki, Takahiro | Kondo, Yu | Takebayashi, Tsuneo

Article Type: Research Article

Abstract: BACKGROUND: No study to date has concurrently evaluated the impact of radiological factors, psychosocial factors, and central sensitization (CS) related symptoms in a single lumbar spinal canal stenosis (LSS) patient cohort. OBJECTIVE: To investigate the associations between these factors and clinical symptoms in LSS patients. METHODS: We recruited 154 patients with LSS scheduled for surgery. Patient-reported outcome measures and imaging evaluation including clinical symptoms, psychosocial factors, CS-related symptoms, and radiological classifications. Spearman’s rank correlation coefficient and multiple regression analyses were employed. RESULTS: Spearman’s correlation revealed CS-related symptoms positively correlated with …low back pain (r = 0.25, p < 0.01), leg pain (r = 0.26, p < 0.01), and disability (r = 0.32, p < 0.01). Pain catastrophizing positively correlated with leg pain (r = 0.23, p < 0.01) and disability (r = 0.36, p < 0.01). Regression analysis showed that pain catastrophizing was associated with disability (β = 0.24, 95%CI = 0.03–0.18), and CS-related symptoms with low back pain (β = 0.28, 95%CI = 0.01–0.09). Radiological classifications were not associated with clinical symptoms. CONCLUSION: Our findings suggest that psychosocial factors and CS-related symptoms, rather than radiological factors, seem to contribute to clinical symptoms in patients with LSS. Show more

Keywords: Lumbar spinal canal stenosis, radiological factors, psychosocial factors, central sensitization

DOI: 10.3233/BMR-230093

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 369-377, 2024

Authors: Zhang, Peng | Shen, Xiangyu | Zhang, Lin | Wang, Sheng | Wu, Qinfeng

Article Type: Research Article

Abstract: BACKGROUND: Adolescent idiopathic scoliosis (AIS) is the most common structural deformity of the spine during adolescence, which could cause varying degrees of physical and mental damage to patients. Schroth therapy and sling exercise are widely used in the treatment of patients with AIS currently, and have shown the significant therapeutic effect relatively. OBJECTIVE: To observe the efficacy of sling exercise combined with Schroth therapy on adolescents with mild idiopathic scoliosis (MIS). METHODS: Sixty patients with AIS were randomly divided into the Schroth+ sling group (n = …31) and the Schroth group (n = 29). Patients in both groups received Schroth therapy, and sling exercise was added in the Schroth+ sling group. Before and after 12 weeks of treatment, the Cobb angle, angle of trunk rotation (ATR), Scoliosis Research Society-22 (SRS-22) scale score and averaged electromyography (AEMG) of bilateral paraspinal muscles were evaluated. RESULTS: After the treatment, Cobb angle, ATR in both groups were decreased compared with those before (P < 0.001), and the decrease in the Schroth+ sling group was more obvious (P < 0.05). The AEMG of bilateral paraspinal muscles and the total score, posture, mental health of SRS-22 of the two groups improved compared with those before treatment (P < 0.05), and the Schroth+ sling group had a significant improvement than the Schroth group (P < 0.05). CONCLUSION: Schroth therapy improved the degree of scoliosis, torticollis, quality of life, and bilateral paraspinal strength on adolescents with mild idiopathic scoliosis. The effect was more pronounced when the sling exercise was included in the treatment regimens. Show more

Keywords: Adolescent, scoliosis, exercise therapy, electromyography

DOI: 10.3233/BMR-230102

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 379-388, 2024

Authors: Lim, Wootaek

Article Type: Research Article

Abstract: BACKGROUND: To measure hamstring flexibility, the active knee extension (AKE) test is preferred over the straight leg raise (SLR) test as it can be used to measure hamstring flexibility more selectively. However, hamstring stretching is primarily conducted in the SLR position (maximal hip flexion in the supine position) as it allows for maximal hip flexion in the supine position. OBJECTIVE: This study evaluates the effects of proprioceptive neuromuscular facilitation (PNF) stretching in the AKE position (maximal knee extension with 90∘ flexion of the hip in the supine position) on hip, knee, and ankle flexibility. …METHODS: SLR, AKE, and active dorsiflexion (ADF) tests were used to determine the range of motion (ROM) before (pre-ROM) and after (post-ROM) stretching. PNF stretching consisted of maximal isometric knee flexion at the end range with external resistance to prevent knee flexion. One set of PNF stretches (five trials of six seconds each) was conducted. RESULTS: The post-ROMs of hip, knee, and ankle measured via the SLR, AKE, and ADF tests, respectively, were significantly higher than the pre-ROMs. CONCLUSIONS: The improvement in knee flexibility was greater than the improvement in hip and ankle flexibility. The AKE position is recommended in clinical settings during PNF stretching for individuals with hamstring tightness. Furthermore, PNF stretching in the AKE position increases the ADF ROM. Show more

Keywords: Ankle flexibility, hip flexibility, knee flexibility, proprioceptive neuromuscular facilitation, stretching

DOI: 10.3233/BMR-230110

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 389-394, 2024

Authors: Harrison, Jeremy J. | Brismée, Jean-Michel | Sizer Jr, Phillip S. | Denny, Brent K. | Sobczak, Stéphane

Article Type: Research Article

Abstract: BACKGROUND: McKenzie standing trunk extension exercises have been used for the management of low back pain (LBP). However, no study to date has investigated the effect of standing trunk extension postures on spinal height and clinical outcomes. OBJECTIVE: To evaluate in subjects with LBP following a period of trunk loading how spinal height, pain, symptoms’ centralization and function outcome measures respond to two standing postures interventions: (1) repetitive trunk extension (RTE) and (2) sustained trunk extension (STE). METHODS: A consecutive sample of convenience of people with LBP were recruited to participate in 2-session …physical therapy using either RTE or STE in standing. RESULTS: Thirty participants (18 women) with a mean age of 53 ± 17.5 years completed the study. The first session resulted in spinal height increase (spinal growth) of 2.07 ± 1.32 mm for the RTE intervention and 4.54 ± 1.61 mm for the STE group (p < 0.001; ES = 1.67), while the second session (2-week following the first session) resulted in spinal growth of 2.39 ± 1.46 mm for the RTE group and 3.91 ± 2.06 mm for the STE group (p = 0.027; ES = 0.85). The STE group presented with the larger reduction in most pain from 6 to 2 as compared to the RTE group from 6 to 4 between Session 1 and Session 2 (p < 0.001). There was no difference between the groups in Modified Oswestry score and symptoms centralization (p = 0.88 and p = 0.77, respectively). CONCLUSION: People with LBP experienced greater spine growth and improvements of pain during standing STE as compared to RTE. People with LBP could use such postures and movements to alleviate their LBP and improve spine height while in a weight bearing position. Show more

Keywords: Intervertebral disc, manipulative therapy, rehabilitation, stadiometry, McKenzie, exercises, physical therapy

DOI: 10.3233/BMR-230118

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 395-405, 2024

Authors: Kim, Jin Seong | Hwang, Ui Jae | Chung, Kyu Sung | Yi, Chung Hwi | Choi, Woochol Joseph | Kwon, Oh Yun

Article Type: Research Article

Abstract: BACKGROUND: The restoration and management of the uninvolved side have been emphasized to prevent a second anterior cruciate ligament (ACL) injury and to ensure that athletes return to sports after ACL reconstruction. OBJECTIVE: To determine the factors influencing the single leg hop test (SLHT) and single leg vertical jump test (SLVJT) at 1 year postoperatively after ACL reconstruction in both the involved and uninvolved sides. METHODS: Ninety-four patients who underwent ACL reconstruction were assessed at 1 year postoperatively. Multiple regression models included eight independent variables with two dependent variables (SLHT and SLVJT.), each …on the involved and uninvolved side. RESULTS: On the involved side, the Y balance test (YBT), extensor peak torque per body weight (PT/BW), Biodex balance system anteroposterior index (BBS-API), and sex accounted for 53.9% of the variance in SLHT (P = 0.002), and extensor PT/BW and YBT accounted for 26.3% of the variance in SLVJT (P = 0.027). On the uninvolved side, YBT, sex, age, BBS-API, and flexor PT/BW accounted for 47.0% of the variance in SLHT (P = 0.046), and flexor PT/BW, YBT, and age accounted for 44.9% of the variance in SLVJT (P = 0.002). CONCLUSION: Knee extensor strength on the involved side and flexor strength on the uninvolved side influence the two functional performance tests. The YBT was an important factor in the two functional performance tests in both sides. Anteroposterior stability was the only factor that influenced the SLHT bilaterally. Show more

Keywords: Rehabilitation, posture control, torque

DOI: 10.3233/BMR-230121

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 407-417, 2024

Authors: Maeda, Noriaki | Tsutsumi, Shogo | Arima, Satoshi | Ikuta, Yasunari | Ushio, Kai | Komiya, Makoto | Tashiro, Tsubasa | Nishikawa, Yuichi | Kobayashi, Toshiki | Nakasa, Tomoyuki | Adachi, Nobuo | Urabe, Yukio

Article Type: Research Article

Abstract: BACKGROUND: Foot arch dynamics play an important role in dynamic postural control. Association between foot arch dynamics and postural control among adolescent athletes remains poorly explored. OBJECTIVE: To examine the relationship between foot arch dynamics, intrinsic foot muscle (IFM) morphology, and toe flexor strength and dynamic postural stability after jump landing and repetitive rebound jump performance in competitive adolescent athletes. METHODS: Based on foot arch dynamics, evaluated from relative change in the foot arch height in sitting and standing positions, 50 adolescent athletes were classified as stiff, normal, or flexible. IFM morphology was …evaluated by ultrasonography. Dynamic postural stability index (DPSI) was measured as participants jumped and landed with the right leg onto a force plate, whereas repetitive rebound jumping performance was assessed using the jump height and reactive jump index. RESULTS: The stiff group had a significantly worse DPSI and vertical stability index than the normal group (p = 0.26, p = 0.44, respectively), and worse anteroposterior stability index (APSI) values than the flexible group (p = 0.005). Multivariate regression models of the relationship between the APSI and foot arch dynamics showed adequate power (probability of error = 0.912). CONCLUSIONS: Increased foot arch stiffness negatively affects dynamic balance during jump-landing, which may deteriorate their performance. Show more

Keywords: Jump, postural balance, ultrasonography

DOI: 10.3233/BMR-230122

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 419-426, 2024

Authors: Igawa, Tatsuya | Ito, Riyaka | Takeuchi, Ayaka | Arai, Shiori | Kaga, Nanaka | Mashimo, Noa | Miyamae, Ruka | Urata, Ryunosuke | Kubo, Akira

Article Type: Research Article

Abstract: BACKGROUND: Elastic taping that applies shear force affects joint movement. However, it remains uncertain whether elastic taping or stretching is more effective in improving flexibility. OBJECTIVE: We investigated whether elastic taping for flexibility improvement is comparable to traditional stretching. METHODS: In this randomized controlled trial, 64 university students were randomly allocated to two groups: elastic taping on the sole or 30 s of static stretching. The primary outcome measures were the straight leg raising angle, tested with an equivalence margin (± 9.61∘ on changes), and the fingertip-to-floor distance. Secondary …outcomes were the hip flexor and knee extensor strength, two-step distance, adverse events, and pain intensity during the intervention, which were compared using conventional statistical methods. RESULTS: The mean differences in straight leg raising between the two groups after the interventions were not greater than the equivalence margin (mean [95% CI]: 1.4 [- 6.9, 9.5]; equivalence margin, - 9.61∘ to 9.61∘ ). There were no consistent differences between groups in terms of secondary outcomes except for pain intensity during the intervention (p > 0.05). Elastic taping did not induce pain. CONCLUSION: Elastic taping augments the flexibility-improving effect comparable to static stretching, based on an equivalence margin. Elastic taping of the sole appears to be an alternative method of improving flexibility. Show more

Keywords: Athletic tape, Muscle stretching exercises, Range of motion, articula, Randomized controlled trials as topic

DOI: 10.3233/BMR-230127

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 427-435, 2024

Authors: M, Kamalakannan | Josyula, Snigdha | S, Jenifer Augustina | M, Naveen | J, Hariharan | J, Vignesh | P, Karthikeyan | Alagesan, Jagatheesan

Article Type: Research Article

Abstract: BACKGROUND: Musculoskeletal injuries, such as strains, are prevalent across all age groups and have a substantial impact on daily functioning and quality of life. OBJECTIVE: To examine the effectiveness of high-intensity interval training (HIIT) with traditional rehabilitation programs on pain, range of motion (ROM), muscular strength, and functional changes in promoting accelerated recovery from musculoskeletal injuries. METHODS: A total of 80 participants (54 males, 26 females; mean age 35.6 years) with various musculoskeletal injuries were randomly assigned to either the HIIT group (n = 40) or the traditional …rehabilitation group (n = 40). The HIIT group underwent a six-week supervised program, with three sessions per week. The traditional rehabilitation group followed a similar six-week program emphasizing low to moderate intensity exercises and traditional rehabilitation techniques. Outcome measures, including pain levels, ROM, muscular strength, and functional outcomes, were assessed pre- and post-intervention. RESULTS: Significant improvements were observed in both the HIIT and traditional rehabilitation groups. However, the HIIT group demonstrated superior outcomes. Participants in the HIIT group experienced a greater reduction in pain levels compared to the traditional rehabilitation group (mean visual analog scale (VAS) score decrease of 5.2 vs. 3.8, respectively, p < 0.05). Functional outcomes significantly favored the HIIT group, with participants achieving faster completion times in the Timed Up and Go test (mean reduction of 2.1 seconds vs. 1.5 seconds, respectively, p < 0.01) and longer distances in the Single Leg Hop test (mean increase of 32 cm vs. 25 cm, respectively, p < 0.05). CONCLUSION: HIIT showed superior effectiveness over traditional rehabilitation in accelerating recovery from musculoskeletal injuries, with greater pain reduction and improved functional outcomes. Incorporating HIIT into rehabilitation protocols may offer an efficient approach for expedited recovery and enhanced functional capacity. Show more

Keywords: High-intensity interval training, traditional rehabilitation programs, musculoskeletal injuries, accelerated recovery, comparative analysis, HIIT protocols, rehabilitation effectiveness

DOI: 10.3233/BMR-230146

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 437-443, 2024