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

Authors: de Sire, Alessandro | Marotta, Nicola | Spanó, Riccardo | Fasano, Stefano | Sgro, Maria | Lippi, Lorenzo | Invernizzi, Marco | Ammendolia, Antonio

Article Type: Research Article

Abstract: BACKGROUND: Hip osteoarthritis (OA) is a chronic progressive disease that impresses a noticeable burden to society and healthcare systems. Physical exercise constitutes the first-line hip OA treatment approach, nevertheless, there is currently no gold standard method to treat this disease. OBJECTIVE: To evaluate the efficacy of proprioceptive neuromuscular facilitation (PNF) on functioning in patients with hip OA. METHOD: A pilot randomized controlled trial (RCT) was carried out on patients with painful bilateral hip OA with a body mass index (BMI) < 30 kg/m2 . After the randomization, the experimental group …was treated with PNF protocol and the control group with conventional physical therapy (10 sessions of manual therapy, 5 sessions/week for 2 weeks). The Harris Hip Score (HHS) was the primary outcome, whereas we assessed as secondary outcomes: pain, range of motion, and muscle strength of hip, physical performance, and quality of life. RESULTS: Twenty patients (40 hips) were enrolled and randomized into two groups: PNF group (mean age: 70.7 ± 8.07; BMI: 25.1 ± 3.07; 7 females and 3 males) and control group (mean age: 74.9 ± 10.72; BMI: 26.8 ± 3.78; 6 females and 4 males). The results showed a statistically significant improvement of HHS in the study group (T1: 90.6 ± 5.63) than in the control group (T1: 77.3 ± 10.9) (between-group p value < 0.001). Three months after the treatment we have statistically significant maintenance in the PNF group (T2:89.6± 6.32, within-group Δ T0-T2 p < 0.01) while the control group did not maintain the improvements recorded at T1 (T2: 71.4 ± 15.8). CONCLUSION: The results of this pilot RCT showed that incorporating PNF exercises into the rehabilitation program yielded notable enhancements in improving lower limb function, strength and ROM in hip OA patients. Nonetheless, further prospective studies including wider sample size are needed to implement scientific knowledge on this physical therapy approach, in patients with hip osteoarthritis. Show more

Keywords: Osteoarthritis, proprioceptive neuromuscular facilitation, physical therapy, rehabilitation, pain

DOI: 10.3233/BMR-230148

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 445-457, 2024

Authors: Li, Yameng | Mo, Pu-Chun | Peng, Fang | Guo, Jiaqi | Sheng, Zhongzhen | Lyu, Shaojun | Jan, Yih-Kuen

Article Type: Research Article

Abstract: BACKGROUND: The local hemodynamic response after cupping therapy has been considered as a contributing factor for improving muscle tissue health; however, the effects of cupping pressure and duration on the spatial hemodynamic response have not been investigated. OBJECTIVE: The objective of this study was to investigate the hemodynamic response inside and outside the cupping cup under various pressures and durations of cupping therapy. METHODS: A 3-way factorial design with repeated measures was used to investigate the main and interaction effects of the location (areas inside and outside the cup), pressure (- …225 and - 300 mmHg) and duration (5 and 10 min) on the hemodynamic response of the biceps muscle. A functional near-infrared spectroscopy was used to assess hemodynamic changes in 18 participants. RESULTS: A significant three-way interaction of the location, pressure, and duration factors was observed in oxyhemoglobin (p = 0.023), deoxy-hemoglobin (p = 0.013), and blood volume (p = 0.013). A significant increase was observed in oxyhemoglobin, blood volume, and oxygenation compared to pre-cupping (p < 0.05) in the area outside the cup. CONCLUSION: Our findings indicate that an appropriate combination of cupping pressure and duration can effectively affect the spatial hemodynamic response of the biceps. Show more

Keywords: Blood volume, dose response, hemoglobins, negative pressure, oxygen, oxyhemoglobins, skeletal muscle

DOI: 10.3233/BMR-230158

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 459-471, 2024

Authors: Petrosyan, Hayk | Leonardi, Christopher | Thakral, Aakash | Roth, Jason | Russoniello, Nicholas | Goldin, Yelena | Parikh, Sagar

Article Type: Research Article

Abstract: BACKGROUND: Home exercise programs (HEPs) are cost-effective and efficacious treatments for musculoskeletal pain conditions. Although HEPs are an important part of the continuum of care, non-adherence limits their effectiveness. OBJECTIVE: The objective of this study was to examine adherence and specific barriers to clinician-prescribed HEPs in adults with musculoskeletal pain. METHODS: A cross-sectional study was conducted with a total of 300 patients presenting to an outpatient pain clinic in an academic medical center. Participants’ self-reported information, including HEP completion frequency and barriers, was collected through a survey. RESULTS: The participants’ mean …age was 54.1 ± 15.8 years (females = 133 (65.5%)). Of 203 participants, 99 (48.8%) adhered to HEP, 56 (27.6%) partially adhered, and 48 (23.6%) did not adhere. One hundred eighty-seven (92.1%) participants reported receiving adequate instructions, and 175 (86.2%) reported receiving instructional materials. Age and “sufficient instructions” were found to be significant determinants of adherence (p < 0.05), while gender and handouts were not (p > 0.05). Pain in more than one body part was significantly (p < 0.05) associated with motivational barriers for non-adherence. CONCLUSION: Age and participants’ perception of sufficient instructions were significant factors for non-adherence. These results emphasize the importance of therapist-provided instructions to overcome barriers to adherence. Show more

Keywords: Pain management, musculoskeletal diseases, exercise therapy, home-based rehabilitation, treatment adherence

DOI: 10.3233/BMR-230178

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 473-485, 2024

Authors: Srivastava, Shalini | Karvir, Sagar | Girandola, Robert N.

Article Type: Research Article

Abstract: BACKGROUND: Low back pain (LBP) has emerged as a major public health concern leading to significant work productivity loss and deterioration in the quality of life. OBJECTIVE: A randomized, double-blind, placebo-controlled parallel-group clinical trial was conducted to investigate the effect of E-PR-01, a proprietary blend of Vitex negundo leaves and zingiber officinale rhizome, in individuals with LBP. METHODS: Seventy-two individuals aged 18 to 60 years with LBP were randomized in a 1:1 ratio in either the E-PR-01 or placebo group. The participants were instructed to take 2 capsules/day of the study products in …two divided doses for 30 days. The study outcomes were changes in functional activity, bending flexibility, pain intensity, work productivity, and sleep quality. The sustained effect of the study products was also evaluated on the pain and physical functioning for 7 days after stopping the product intake. The product’s safety was evaluated by adverse events reporting throughout the study. RESULTS: Compared to the placebo, the E-PR-01 demonstrated a statistically significant reduction in functional disability (mean RMQ score: - 5.47 vs. - 2.48), pain intensity (mean VAS score: - 31.29 vs. - 14.55) and improved bending flexibility (mean distance: - 5.60 vs. - 2.38 cm). In addition, a significant improvement in work productivity as well as sleep quality was also observed. In the E-PR-01 group, a statistically significant sustained effect was observed compared to the placebo for the pain intensity (p < 0.0005) and the functional activity (p < 0.0001) scores. No significant adverse event was reported in the study. CONCLUSION: E-PR-01 significantly improved low back pain and bending flexibility in adults without adverse effects. Moreover, the effect of E-PR-01 lasted 7 days after stopping the intervention. Show more

Keywords: Low back pain, Vitex negundo, Zingiber officinale, physical function, work productivity, sleep quality

DOI: 10.3233/BMR-230197

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 487-502, 2024

Authors: Yang, Sen | Chen, Can | Tang, Yong | Li, Kai | Yu, Xueke | Tan, Jiulin | Zhang, Chengmin | Rong, Zhigang | Xu, Jianzhong | Luo, Fei

Article Type: Research Article

Abstract: BACKGROUND: Degenerative spinal deformity (DSD) is believed to originate from degeneration of the discs and facet joints and vertebral wedging. Currently, the nosogeny of DSD is not yet fully clarified and there has been no systematic study on the impact of their lower back muscle strength on quality of life. OBJECTIVE: To determine the characteristics of back extensor strength (BES) in different body positions and examine their correlations with health-related quality of life (HQOL) in degenerative spinal deformity (DSD) patients. METHODS: Participants comprised 60 DSD patients and 40 healthy volunteers. Maximal isometric BES …was evaluated by dynamometers with the subject in three different positions (standing, prone, sitting). The visual analogue scale (VAS) score, Oswestry Disability Index (ODI), Roland–Morris Disability Questionnaire (RMQ), and 36-item Short Form Health Survey (SF-36) score were used to evaluate patient HQOL. Correlations between the BES in different body positions and HQOL were analysed. RESULTS: The BES values in three body positions were significantly smaller in DSD patients than healthy subjects (P < 0.05). The standing BES was found to be negatively associated with ODI and RMQ (R = 0.313, p < 0.05 and R = 0.422, p < 0.01, respectively). A negative relationship between sitting BES and RMQ was also seen (R = 0.271, p < 0.05). In addition, the standing and prone BES were positively correlated with the physical functioning score of the SF-36 (R = 0.471, p < 0.01 and R = 0.289, p < 0.05, respectively), and the sitting BES was positively correlated with the role-physical score of the SF-36 (R = 0.436, p < 0.01). CONCLUSION: The results indicate that the back extensor muscle is compromised in DSD patients and there are differences in predicting the severity of disability and physical HQOL scores with BES in different positions. Standing BES was the most reliable contributor to HQOL among three body positions. Show more

Keywords: Back muscles, spine, spinal diseases

DOI: 10.3233/BMR-230206

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 503-511, 2024

Authors: Lim, Wootaek

Article Type: Research Article

Abstract: BACKGROUND: Joint position reproduction measures the angle acuity of reference angle reproduction using an indicator angle. However, reference angles are often not available. OBJECTIVE: This study aimed to examine joint position sense at three different targeted joint angles, which were estimated from the maximum range of motion (maxROM) without a reference angle at each targeted joint angle. METHODS: The maxROM was measured in straight leg raise (SLR) and active knee extension (AKE) positions. In both positions, a targeted joint angle at 75% of the maxROM was assessed first, followed by that at 50% …and 25% of the maxROM. A one-sample t-test was used to analyze differences between the targeted and reproduced angles in both positions. RESULTS: All reproduced angles significantly differed from the targeted angle in both SLR and AKE positions except for the reproduced angle measured at 75% maxROM. Overall, position errors in the AKE position were higher than those in the SLR position. CONCLUSIONS: Estimating the angle based on the maxROM without a matched reference angle may lead to significant discrepancies in comparison with the targeted joint angle. In clinical settings, if accurate reproduction of motions is required to improve proprioception, providing a reference angle might be helpful. Show more

Keywords: Joint flexibility, lower extremity, proprioception, range of motion

DOI: 10.3233/BMR-230219

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 37, no. 2, pp. 513-519, 2024