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Price: EUR 130.00Authors: Berduszek, Redmar J. | Reneman, Michiel F. | Dekker, Rienk | van der Sluis, Corry K.
Article Type: Research Article
Abstract: BACKGROUND: The shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Patient Rated Wrist/Hand Evaluation (PRWHE) are commonly used questionnaires to assess patient-reported hand function. Information about the measurement properties of the Dutch versions is scarce. OBJECTIVE: To gain insight into the measurement properties of the Dutch language versions of the QuickDASH and the PRWHE in patients with (non)specific complaints of the hand, wrist, forearm and elbow. METHODS: Internal consistency, construct validity, test-retest reliability, responsiveness, and floor and ceiling effects were assessed according to COnsensus-based Standards for the selection …of health Measurement INstruments (COSMIN) recommendations. RESULTS: Questionnaires were filled out by 132 patients. Internal consistency of QuickDASH (Cronbach’s α = 0.92) and PRWHE (Cronbach’s α = 0.97) was high. Predefined hypotheses for construct validity were not confirmed for 75% for both QuickDASH and PRWHE (accordance with 62% of predefined hypotheses for both questionnaires). Test-retest reliability of QuickDASH (ICC = 0.90) and PRWHE (ICC = 0.87) was good. Both QuickDASH (AUC = 0.84) and PRWHE (AUC = 0.80) showed good responsiveness. No floor or ceiling effects were present. CONCLUSIONS: Measurement properties of the Dutch language versions of the QuickDASH and the PRWHE, applied to patients with (non)specific complaints of the hand, wrist, forearm and elbow, were very similar. Test-retest reliability and responsiveness were good for both QuickDASH and PRWHE. Construct validity could not be demonstrated sufficiently. Show more
Keywords: Hand, upper extremity, patient reported outcome measures, pain measurement, disability evaluation, psychometrics
DOI: 10.3233/BMR-230225
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Ylinen, Jari | Pasanen, Tero | Heinonen, Ari | Kivistö, Heikki | Kautiainen, Hannu | Multanen, Juhani
Article Type: Research Article
Abstract: BACKGROUND: Weakness and atrophy in trunk muscles have been associated with chronic low back pain (CLBP). OBJECTIVE: This study aimed to identify isometric exercises resulting the highest trunk muscle activity for individuals with and without CLBP. METHODS: Fourteen males with CLBP and 15 healthy age-matched healthy subjects were recruited for this study. Muscle activity during maximal voluntary isometric contraction (MVIC) was measured for a comparative reference with surface electromyography (sEMG) from six trunk muscles. Thereafter maximum EMG amplitude values were measured during eleven trunk stability exercises. The maximal EMG activity in each exercise …relative to the MVICs was analyzed using generalizing estimating equations (GEE) models with the unstructured correlation structure. RESULTS: The GEE models showed statistically significant differences in muscle activity between exercises within both groups (p < 0.001), with no significant differences between groups (p > 0.05). The highest muscle activity was achieved with the hip flexion machine for multifidus, side pull with a resistance band for lumbar extensors, side and single-arm cable pull exercises for thoracic extensors, rotary plank and the hip flexion machine for abdominal. CONCLUSION: This study found five isometric trunk exercises that exhibited highest muscle activity depending on muscle tested, with no significant difference between individuals with and without CLBP. Show more
Keywords: Electromyography, force measurement, isometric strength, resistance exercise, gym machine
DOI: 10.3233/BMR-230043
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Arias-Vázquez, Pedro Iván | Guzzardo, Mauro Nicolás | Guzzardo, Duilio Román | Castillo-Avila, Rosa Giannina | Tovilla-Zárate, Carlos Alfonso | Ake Montiel, Miguel Angel Nazul
Article Type: Research Article
Abstract: BACKGROUND: Corticosteroid injections are frequently used in the short-term treatment of musculoskeletal pain, but their use is controversial as repeated exposures to corticosteroids can lead to deleterious effects on musculoskeletal tissue. Ozone injections have been proposed as a possible treatment for musculoskeletal pain; however, their effectiveness has not been compared with corticosteroids. OBJECTIVE: To evaluate the effectiveness of ozone injections for reducing pain in individuals with musculoskeletal pain in comparison with corticosteroid injections through a meta-analysis. METHODS: An online systematic search was performed using electronic databases up to September 2023. We searched for studies …that compared corticosteroid injections with ozone injections in the treatment of musculoskeletal pain of diverse origins. RESULTS: Eleven studies were included comprising a total of 534 individuals. In the overall pooled analysis, a pain reduction in favor of corticosteroid injections was found in the short term (d = 0.31, 95% CI 0.01 to 0.60, p (z) 0.04, I2 = 32%). In the medium term, no significant differences were found in reducing pain between groups (d = - 0.17, 95% CI - 0.42 to 0.07, p (z) 0.15, I2 = 0%). CONCLUSIONS: Our results suggest that corticosteroids injections are more effective in reducing musculoskeletal pain in the short term, but equally effective in the medium term when compared with ozone injections. Nonetheless, better-quality clinical trials are necessary to corroborate these results. Show more
Keywords: Musculoskeletal diseases, osteoarthritis, tendinopathy, nerve compression syndromes
DOI: 10.3233/BMR-230173
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-17, 2023
Authors: Jellad, Anis | Kalai, Amine | Abbes, Ilef | Jguirim, Mahbouba | Boudokhane, Soumaya | Salah Frih, Zohra Ben | Bedoui, Mohamed Hedi
Article Type: Research Article
Abstract: BACKGROUND: Cervical traction is effective on pain and function in patients with cervical radiculopathy but its effectiveness on balance disorders has not yet been studied. OBJECTIVE: To evaluate the effect of mechanical intermittent cervical traction (MICT) on stabilometric parameters in patients with cervical radiculopathy. METHODS: This randomized crossover study assigned 20 patients with cervical radiculopathy to one of the two groups: Group effective traction (ET)/sham traction (ST) (n = 10) treated firstly with ET (traction force of 12 Kg) then with ST (traction force of 2 Kg) with one-week interval and …group ST/ET (n = 10) treated invertedly with a ST then ET. Each traction procedure was maintained for 10 minutes twice separated by 5 minutes of rest. Patients were assessed before and immediately after MICT procedure. Main outcome measures were stabilometric parameters: center of pressure, sway area and lateral and anteroposterior displacements using a force platform. Secondary outcome measures were pain intensity, grip strength and dizziness. RESULTS: ET has provided a significantly greater improvement in both groups and in the total population in terms of stabilometric parameters (p < 0.01), pain intensity, and grip strength (p < 0.05), compared to ST. CONCLUSION: MICT seems to have an immediate beneficial effect on stabilometric parameters, pain and grip strength in patients with cervical radiculopathy. Show more
Keywords: Cervical radiculopathy, postural balance, rehabilitation, clinical trial
DOI: 10.3233/BMR-230270
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Di Gesù, Marco | Alito, Angelo | Borzelli, Daniele | Romeo, Domenico | Bonomolo, Fabio | Calafiore, Dario | de Sire, Alessandro
Article Type: Research Article
Abstract: BACKGROUND: Ultrasound-guided galvanic electrolysis technique (USGET) is an innovative mini-invasive intervention with the potential to optimise outcomes in the treatment of Achille’s tendinopathy (AT). OBJECTIVE: The aim of this pilot study is to evaluate the efficacy of adding USGET to conventional eccentric exercise treatment in patients with chronic AT. METHODS: Inclusion criteria were patients with unilateral non-insertional AT, pain lasting > 3 months, aged 25–60 years. Patients were randomised in two groups receiving the same physiotherapy treatment (2 sessions per week for 8 weeks). In addition, the experimental group received three USGET stimulations, one …every 15 days. Outcome measures were assessment of Achilles tendinopathy severity using the Victorian Institute of Sport Assessment-Achilles (VISA-A) and pain intensity using the Visual Analogue Scale (VAS). Assessment points occurred at the onset of treatment (T0), its conclusion (T1), and subsequent follow-ups at one (T2) and two months (T3). RESULTS: Out of the 52 patients who met the study inclusion criteria, two participants withdrew from the study, resulting in a total of 50 subjects who completed the research. None of the parameters showed a different distribution at T1 (p > 0.337). At T2, there was a statistical difference in VISA-A (p = 0.010) and its subscales and VAS (p = 0.002) in the USGET group. At T3, both groups improved with a statistical difference observed in VISA-A (p < 0.001) and its subscales Pain (p = 0.004), Function (p = 0.003) and Sport (p = 0.002), but the EG patients showed a greater improvement. No adverse events were reported. CONCLUSION: The effect of USGET combined with eccentric exercise appears to be a safe and effective technique for achieving pain relief and functional recovery in the medium term, supporting the integrated use of USGET as a rehabilitative treatment option for patients with chronic AT. Show more
Keywords: Achilles tendon, exercise therapy, interventional ultrasound, physical and rehabilitation medicine, tendinopathies
DOI: 10.3233/BMR-230255
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Watanabe, Kota | Ashida, Yuzo | Hirota, Kento | Taniguchi, Tatsuya | Miyamoto, Hiroki | Teramoto, Atsushi
Article Type: Research Article
Abstract: BACKGROUND: Toe function is characterised by the strength and dexterity of toe motion. However, previous studies have mostly focused on the importance of toe strength. OBJECTIVE: This study aimed to investigate the relationships between flexion strength and dexterity of the toes and physical performance. METHODS: Twenty healthy participants were included in this study. The flexion force of each toe was measured using a digital force gauge, and the toe dexterity was evaluated using the marble pick-up and rock-paper-scissors tests. These parameters were statistically analysed in relation to physical performance, including repeated side step …and balance ability, which was evaluated using centre of pressure (COP) data during single-leg standing, tiptoe standing, and single-leg drop-jumping. RESULTS: A significant correlation was found between the first toe flexion force and the total trajectory length of the COP during one-leg standing and between the time required for marble pick-up and the rock-paper-scissors score and the COP during single-leg drop-jumping. CONCLUSION: The results underscore the importance of flexion strength and dexterity of the toes in human physical performance and the necessity for the evaluation and improvement of both functions. Show more
Keywords: Toe function, marble pick-up, rock-paper-scissors test, balance
DOI: 10.3233/BMR-230263
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-7, 2023
Authors: Ikwuanusi, Stephanie | Tella, Abidemi | Akinbo, Sunday | Nwaedozie, Obianuju | Adje, Mishael
Article Type: Research Article
Abstract: BACKGROUND: Specific stabilisation exercises (SSE) can combat the debilitating effects of chronic non-specific low back pain (CLBP), improve disability, pain and fear-avoidance beliefs (FAB). OBJECTIVE: To elicit the determinants of outcome in patients with CLBP with associated FABs after treatment with SSE. METHOD: Twenty-nine patients (20 females) with CLBP were classified using FAB questionnaire into high or low Work and Physical Activity (PA) subscales. After 4-week treatment, evaluations were done for pain, disability and lumbar spine active range of motion (AROM). Data was analysed exploratory-descriptively with a significance level set at p < …0.05. RESULTS: Participants were aged 55.24 ± 11.91 years. They scored 19 (65.5%) and 5 (17.2%) respectively on Work and PA subscales. The post-intervention evaluation showed significant differences in all outcomes, but no significant difference between patients with high or low FAB scores for both subscales. PA scores correlated significantly with pain while work scores correlated significantly with disability. Participants’ gender predicted disability, pain and AROM with moderate to large effect sizes. CONCLUSION: SSE can potentially improve disability, pain and range of motion for patients with chronic low back pain regardless of FABQ status. Gender and baseline patient status are potential determinants of outcome of treatment using SSE. Show more
Keywords: Disability, kinesiophobia, chronic pain, lumbar stabilisation exercises
DOI: 10.3233/BMR-230312
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2023
Authors: Ogrodzka-Ciechanowicz, Katarzyna | Kurzeja, Piotr | Sorysz, Tomasz
Article Type: Research Article
Abstract: BACKGROUND: Due to the systematically increasing number of shoulder replacement procedures among older people, the need to assess their quality of life is becoming more and more important. OBJECTIVE: The aim of the study was to functionally assess the shoulder joint and the quality of life of patients before and after reverse total shoulder arthroplasty (rTSA). METHODS: The observational study included 15 patients after the rTSA procedure (randomly selected). The quality of life and shoulder joint function before and after rTSA were assessed using the following scales: SF-36, Constant-Murley Score, Disabilities of the …Arm, Shoulder and Hand Scale (DASH) and the University of California-Los Angeles Shoulder Rating Scale (UCLA scale) and Simple Shoulder Test (SST). RESULTS: There were statistically significant differences (p < 0.001) between measurements in the overall scores of the SF-36 questionnaire. Statistically significant differences (p < 0.001) were found between measurements in terms of the Constant-Murley, DASH, UCLA and SST scales results. CONCLUSIONS: Reverse total shoulder arthroplasty significantly improved the patients’ quality of life and the functional condition of the operated limb. Show more
Keywords: Reverse total shoulder arthroplasty, quality of life, pain
DOI: 10.3233/BMR-230347
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2023
Authors: Ijiri, Tomohito | Suzuki, Toshiaki
Article Type: Research Article
Abstract: BACKGROUND: The normal value of the scapular muscle activity ratio during arm elevation is not clear. OBJECTIVE: To obtain normal values of the scapular muscle activity ratio during arm elevation in healthy individuals. METHODS: This cross-sectional study enrolled 47 healthy people. The participants performed shoulder flexion and lowered task with 90-degree movements every 2 seconds. Muscle activities of scapular muscles were measured. For normalization, the maximum isometric contraction of the shoulder flexion was measured at 90 ∘ (reference contraction). The integrated electromyographic value (IEMG) obtained during the task was …normalized by IEMG during the reference contraction and the relative IEMG value was calculated. Then, the scapular muscle activity ratio was computed. The relationship between muscle strength and other factors was also investigated. RESULTS: The median values for upper trapezius/serratus anterior and upper trapezius/lower trapezius were often approximately 1, and that for upper trapezius/middle trapezius was often between 1 and 2. The shoulder flexion isometric strength and scapular muscle activity ratio showed significant negative correlations in multiple phases. CONCLUSION: Normal values for upper trapezius/serratus anterior and upper trapezius/lower trapezius during arm elevation and lowering were generally 1. Low muscle strength may contribute to an abnormal scapular muscle activity balance. Show more
Keywords: Scapular muscle activity ratio, arm elevation, electromyography, muscle strength
DOI: 10.3233/BMR-230217
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2023
Authors: de Sire, Alessandro | Lippi, Lorenzo | Calafiore, Dario | Marotta, Nicola | Mezian, Kamal | Chiaramonte, Rita | Cisari, Carlo | Vecchio, Michele | Ammendolia, Antonio | Invernizzi, Marco
Article Type: Research Article
Abstract: BACKGROUND: Vertebral fragility fractures (VFFs) commonly result from low bone mass and microarchitecture deterioration of bone tissue. spinal orthoses are common non-pharmacological options for managing vertebral fracture pain. However, the effects of spinal orthoses on pain, physical functioning, and quality of life (QoL) are still debated. OBJECTIVE: This survey aimed to investigate the patients-reported outcomes of a dynamic spinal orthosis prescribed in the routine clinical practice of VFFs management. METHODS: This multi-center national-wide prospective cohort study assessed older patients (aged > 60 years) diagnosed with acute VFFs and prescribed with a …dynamic spinal orthosis (Spinfast ® ). A survey questionnaire was realized and included sections on patient characterization, osteoporosis characterization, spinal orthosis, clinical outcomes, pain medications, and osteoporosis medications. The questionnaire was administered at baseline and after three months. A total of 68 patients completed the questionnaire at three months. Most patients had one or two VFFs and were treated with pain medications and osteoporosis medications. Compliance and tolerability of the spinal orthosis were assessed, and clinical outcomes such as pain intensity, physical functioning, and QoL were measured. RESULTS: The results showed no significant differences in outcomes between age subgroups. Italian physical medicine and rehabilitation physicians were commonly involved in the management of VFFs patients. Sixty-six patients completed the questionnaire. The results showed that pain intensity, physical functioning and QoL improved after three months of spinal orthosis wearing (p < 0.0001). CONCLUSION: The correct management of VFFs is mandatory to improve pain and reduce disability, and our findings suggested a positive role of dynamic spinal orthosis to improve the comprehensive management of VFFs patients. However, high-quality research trials are warranted to provide clear recommendations for the correct clinical management of VFF. Show more
Keywords: Osteoporosis, rehabilitation, spinal orthoses, spine, vertebral fractures
DOI: 10.3233/BMR-230177
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-13, 2023
Authors: Yoon, Ji-Yeon | Shin, Sun-Shil
Article Type: Research Article
Abstract: BACKGROUND: Step width during walking can provide important information about aging and pathology. Although knee osteoarthritis (OA) is a common disease in elderly women, little is known about how different step widths influence gait parameters in patients with knee OA. OBJECTIVE: To address this, we investigated the differences between narrower and wider step width on the center of mass (CoM) and gait biomechanics of elderly women with knee OA. METHODS: Gait and CoM data were measured using a three-dimensional motion capture system and anthropometric data were acquired via standing full-limb radiography. Thirty elderly …women with knee OA were divided into two groups depending on the average step width value (0.16 m). Specifically, the narrower step width group included those with a below average step width (n = 15) and the wider step width group included those with an above average step width (n = 15). The differences between the two groups were analyzed using an independentt -test. RESULTS: Walking speed, step length, knee and ankle sagittal excursion, and medial-lateral CoM range were significantly greater in the narrower group. In contrast, the medial-lateral CoM velocity, medial-lateral ground reaction force (GRF), and foot progression angle were significantly higher in wider group. The external knee adduction moment, vertical GRF, and vertical CoM did not differ between the groups. CONCLUSIONS: Our data indicate that step width in women with knee OA is associated with trunk motion and gait patterns. People with a narrower step might improve their gait function by increasing trunk frontal control to maintain gait stability. In contrast, in those with a wider step, greater toe out angle and shorter step length might be a compensatory adaptation to reduce knee loading. Show more
Keywords: Knee osteoarthritis, step width, gait stability, center of mass, joint loading
DOI: 10.3233/BMR-230232
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Abujaber, Sumayeh | Altubasi, Ibrahim | Hamdan, Mohammad | Al-Zaben, Raed | Bani-Ahmad, Omar
Article Type: Research Article
Abstract: BACKGROUND: Knee osteoarthritis (OA) is a debilitating condition that leads to functional limitations. Self-reported questionnaires and performance-based tests are tools commonly used for measuring physical function. OBJECTIVES: (1) To evaluate the impact of end-stage knee OA on functional outcomes and examine the association between self-reported and performance-based measures of function in patients with end-stage knee osteoarthritis awaiting total knee arthroplasty (2) To explore the interrelationships among pain, strength, and overall physical function in this patient population. METHODS: In this cross-sectional analysis, 33 patients with end-stage knee OA were recruited and completed the knee …Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) and executed performance-based tests including the Timed Up and Go, the 30-second chair stand test, and the Stair Climbing Test. Knee pain, and isometric hip and knee strength were evaluated. RESULTS: Patients perceived deficits in their physical functionwith a score of 35/100 on the KOS-ADLS and demonstrated functional limitations in all performed tasks. KOS-ADLs was weakly associated with TUG and 30s-CST (r = - 0.301, p = 0.047, and r = 0.39, p = 0.014. respectively). Knee pain was linked with the KOS-ADL score and GRS score (r = - 0.406, p = 0.010; r = - 0.343, p = 0.027; respectively), while the strength of the affected side was correlated with the performed (p = < 0.001) and reported function outcomes (p = 0.007). CONCLUSION: Participants exhibit declines in both perceived and executed functional abilities. Self-reported and performance-based functional measures are weakly correlated within our study group, highlighting the importance of incorporating both measures in clinical practice for a comprehensive evaluation of physical function. Pain was linked to subjective aspect of physical function, while strength was connected to perceived and performed functional capacity. Implementing a tailored rehabilitation program targeting muscle weakness and pain holds the potential to mitigate functional decline in individuals awaiting total knee arthroplasty (TKA). Show more
Keywords: Patient reported outcome, functional performance, muscle strength, pain
DOI: 10.3233/BMR-230256
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Bertelè, Laura | Giorgi, Valeria | Bellavite, Paolo | Apostolo, Giovanni | Ortolani, Riccardo | Fila, Alice | Zanolin, Elisabetta
Article Type: Research Article
Abstract: BACKGROUND: Adolescent idiopathic scoliosis is a complex condition whose pathogenesis may include inflammation and signs of joint and bone degeneration. OBJECTIVE: The main objective of this study is to evaluate the relationship between the severity of adolescent idiopathic scoliosis and inflammatory blood parameters. METHODS: The study recruited patients with adolescent idiopathic scoliosis who attended the Rehabilitation Center of the Apostolo Foundation in Merate (LC). The scoliosis curve (Cobb’s angle) was used as a severity index to compare with inflammatory blood parameters (white blood cells subpopulations, immunoglobulins, protein electrophoresis). In addition, the study used …an overall severity grading called “Scoliosis Score” which includes all spine angles and Risser’s score (bone development index). RESULTS: Thirty-four subjects were recruited (mean age 14 years, 2 months), 30 females and 2 males. A significant correlation was found between Cobb’s angle and the percentage values of beta-2 globulins in a directly proportional manner (r = 0.42, p = 0.01), and gamma globulins in an inversely proportional manner (r = - 0.366, p = 0.04). However, no significant correlation between Cobb’s angle and the absolute values of white blood cells and percentage subpopulations was found (r = 0.0821 p = 0.655). A moderate, inverse correlation was found between the Scoliosis Score and the percentage of neutrophils (r = - 0.385, p = 0.02), a direct correlation was found between the Scoliosis Score and the percentage of lymphocytes (r = 0.404, p = 0.02). In addition, there was a strong correlation of the Scoliosis Score with alpha-2 globulin (r = 0.564, p = 0.0012), beta-1 globulin (r = 0.478, p = 0.0074), and beta-2 globulin (r = 0.370, p = 0.044) and an inverse relationship with gamma globulin (r = - 0.625, p = 0.0002). The main correlations were confirmed by regression analysis. CONCLUSION: The correlation between beta-2 globulins and gamma globulins with Cobb’s angle and the Scoliosis Score suggests a link between spinal curvature and inflammation in scoliosis patients, This link may indicate the significance of these parameters for diagnosing, staging the disease, and monitoring therapies. Show more
Keywords: Beta 2 globulins, cobb’s angle, electrophoresis, inflammation, plasma proteins, scoliosis
DOI: 10.3233/BMR-230186
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Hou, Xiaofei | Hu, Hailiang | Kong, Chao | Zhang, Sitao | Wang, Wei | Lu, Shibao
Article Type: Research Article
Abstract: BACKGROUND: The factors affecting lumbar spinal function in patients with degenerative lumbar spinal stenosis (DLSS) are still unclear. OBJECTIVE: This study explored psoas major muscle morphology in patients with DLSS and its association with their functional status. METHODS: A retrospective study was conducted on 288 patients with DLSS and 260 control subjects. Psoas major muscle evaluation included three morphometric parameters at the L3/4 disc level: psoas major index (PMI), muscle attenuation, and psoas major morphological changes (MPM). The association between psoas major morphology and functional status was assessed using the Oswestry disability index (ODI). …RESULTS: Both female and male patients with DLSS had a higher PMI and lower muscle attenuation. PMI and muscle attenuation were inversely correlated with age in the DLSS group. After multivariable analyses, the PMI and psoas major muscle attenuation were positively correlated with patients’ functional status. CONCLUSION: The PMI and muscle attenuation were positively correlated with functional status in patients with DLSS. These findings have important implications for physiotherapy programs of postoperative rehabilitation and conservative management of DLSS. Show more
Keywords: Degenerative lumbar spinal stenosis, psoas major muscle, morphology, functional status, oswestry disability index
DOI: 10.3233/BMR-230138
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Xu, Hanxiao | Liu, Heng
Article Type: Research Article
Abstract: BACKGROUND: Patients with Parkinson’s disease frequently experience problems with balance and gait. OBJECTIVE: This study examined the influences of regular ankle isokinetic muscle strength training on muscle strength and balance ability amongst elderly women with mild Parkinson’s disease. METHODS: A total of 55 elderly women with mild Parkinson’s disease were randomly divided into the experimental group (n = 28) and the control group (n = 27) for 16 weeks. The experimental group was trained for 16 weeks by using isokinetic muscle strength training. RESULTS: …After 16 weeks of training in the experimental group, the peak torque (PT) of ankle (average of the left and right sides) dorsiflexion, plantarflexion, eversion and inversion, and the standing balance index revealed that the left and right stability and overall stability indexes significantly increased by 25.9%, 43.5%, 62.7%, 82.8%, 37.1% and 32.2%, respectively (p < 0.05). The experimental group exhibited significantly increased PT of ankle dorsiflexion, plantarflexion, eversion and inversion. Moreover, the left and right stability and overall stability indexes were significantly improved compared with those of the control group (p < 0.05). This study found a linear regression relationship between the PT of ankle inversion and overall stability index. CONCLUSION: This study determined that ankle isokinetic muscle strength training improved ankle dorsiflexion, plantarflexion, eversion and inversion muscle strength, and balance ability amongst elderly women with mild Parkinson’s disease. However, it did not improve stability in the anterior and posterior directions. Ankle inversion muscle strength is more likely to affect overall balance. Show more
Keywords: Isokinetic training, muscle strength, mild Parkinson’s disease, balance
DOI: 10.3233/BMR-230259
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Demoulin, Christophe | Timmermans, Annick | Grosdent, Stéphanie | Danneels, Lieven
Article Type: Other
DOI: 10.3233/BMR-230401
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-2, 2023
Authors: Hirota, Kento | Watanabe, Kota | Miyamoto, Hiroki | Negishi, Keisuke | Watase, Mako | Teramoto, Atsushi
Article Type: Research Article
Abstract: BACKGROUND: The intrinsic foot muscles play an important role in medial longitudinal arch support, as well as several extrinsic foot muscles. While various strength training methods specific to intrinsic foot muscles have been conducted, these exercises are associated with certain concerns regarding their effectiveness and difficulty. We developed a new exercise for the intrinsic muscles (MTP flexion exercise). OBJECTIVE: The aim was to compare the shear modulus of the toe flexors as the muscle contraction activity during MTP flexion and short-foot exercises using ultrasound shear wave elastography. METHODS: Eleven healthy participants were included …in this study. The shear modulus of the toe flexor muscles was measured during MTP flexion and short-foot exercises using ultrasound shear wave elastography. The muscle shear modulus was statistically compared between the resting phase, and during the two exercises. RESULTS: The shear modulus during MTP flexion exercise was significantly greater than in the resting phase in the abductor hallucis, flexor hallucis brevis, flexor digitorum brevis, quadratus plantae, and flexor digitorum longus. The flexor digitorum longus showed greater shear modulus during MTP flexion exercise than during short-foot exercise. CONCLUSION: MTP flexion exercise showed equivalent or greater contraction activity in certain intrinsic and extrinsic foot muscles when compared with short-foot exercise. This exercise is considered one of the training options for strengthening the intrinsic muscles of the foot. Show more
Keywords: Toe flexor strength, intrinsic foot muscle, foot exercise, shear modulus
DOI: 10.3233/BMR-230282
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-7, 2024
Authors: Zheng, Patricia | Ewing, Susan | Tang, Angelina | Black, Dennis | Hue, Trisha | Lotz, Jeffrey | Peterson, Thomas | Torres-Espin, Abel | O’Neill, Conor
Article Type: Research Article
Abstract: BACKGROUND: Tools, such as the STarTBack Screening Tool (SBT), have been developed to identify risks of progressing to chronic disability in low back pain (LBP) patients in the primary care population. However, less is known about predictors of change in function after treatment in the specialty care population. OBJECTIVE: We pursued a retrospective observational cohort study involving LBP patients seen in a multidisciplinary specialty clinic to assess which features can predict change in function at follow-up. METHODS: The SBT was administered at initial visit, and a variety of patient characteristics were available in …the chart including the presence of chronic overlapping pain conditions (COPCs). Patient Reported Outcomes Measurement Information System-10 (PROMIS-10) global physical health (PH) and global mental health (MH) were measured at baseline and at pragmatic time points during follow-up. Linear regression was used to estimate adjusted associations between available features and changes in PROMIS scores. RESULTS: 241 patients were followed for a mean of 17.0 ± 7.5 months. Mean baseline pain was 6.7 (SD 2.1), PROMIS-10 global MH score was 44.8 (SD 9.3), and PH score was 39.4 (SD 8.6). 29.7% were low-risk on the SBT, 41.8% were medium-risk, and 28.5% were high-risk. Mean change in MH and PH scores from baseline to the follow-up questionnaire were 0.86 (SD 8.11) and 2.39 (SD 7.52), respectively. Compared to low-risk patients, high-risk patients had a mean 4.35 points greater improvement in their MH score (p = 0.004) and a mean 3.54 points greater improvement in PH score (p = 0.006). Fewer COPCs also predicted greater improvement in MH and PH. CONCLUSIONS: SBT and the presence of COPC, which can be assessed at initial presentation to a specialty clinic, can predict change in PROMIS following treatment. Effort is needed to identify other factors that can help predict change in function after treatment in the specialty care setting. Show more
Keywords: Non-surgical spine care, precision medicine, specialty clinic, low back pain
DOI: 10.3233/BMR-230067
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Miçooğulları, Mehmet | Yüksel, İnci | Angın, Salih
Article Type: Research Article
Abstract: BACKGROUND: Cranio-cervico-mandibular (CCM) malalignment is associated with forward head posture (FHP) and temporomandibular joint (TMJ) disorders and affects masticatory muscles. OBJECTIVE: This randomized, double-blind controlled trial aimed to compare the efficacy of scapula-thoracic (ST) exercises on temporomandibular and cervical joint position sense and postural stability in individuals with CCM malalignment. METHODS: Fourty-nine participants with CCM malalignment were randomly assigned to the ST exercise group (STEG, n = 24) or the control group (CG, n = 25). STEG included progressive strengthening, proprioceptive, and stabilization …exercises. All participants were assessed before treatment, at the end of the 8th week treatment period and at the 12th week post-treatment follow-up. Cranio-vertebral angle measurement, Fonseca’s Questionnaire, Helkimo Clinical Dysfunction Index, TMJ position test, cervical joint position error test and postural stability assessment were used. RESULTS: The TMJ and cervical joint position sense, total sway degree, area gap percentage, sway velocity and antero-posterior body sway results showed significant improvement in the STEG compared to the CG (p < 0.05), however medio-lateral body sway did not differ between groups (p > 0.05). CONCLUSIONS: Postural stability, TMJ and cervical joint position sense appear to be affected in individuals with CCM malalignment. Our results showed that an exercise program including ST stabilization, proprioception and strengthening of the scapular muscles may be effective in the management of CCM malalignment and will allow clinicians to plan holistic treatment. Show more
Keywords: Temporomandibular joint disorders, exercise therapy, proprioception, posture
DOI: 10.3233/BMR-230323
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-14, 2024
Authors: Hengsomboon, Ninwisan | Vongsirinavarat, Mantana | Bovonsunthonchai, Sunee | Thawalyawichachit, Laddawan | Hengsomboon, Pichaya
Article Type: Research Article
Abstract: BACKGROUND: The association between changes occurring in the spine and lower body parts is not well understood in adolescent idiopathic scoliosis (AIS). OBJECTIVES: The first aim of the study was to investigate the association of scoliosis with lower extremity (LE) alignments, foot characteristics, and muscle strengths in adolescents. Secondly, comparisons of the data among AIS with single and double curves and control groups were determined. METHODS: Thirty-one participants were recruited and classified into 3 groups; AIS with a single curve (n = 7), AIS with double curves (n …= 14), and controls (n = 10). Association of the presence of scoliosis with LE alignments (Q and TC angles), LE muscle strengths (hip, knee, and ankle), and foot characteristics (arch indexes) were examined using the point biserial correlation, and the data among three groups were compared using the ANOVA. RESULTS: Scoliosis was associated with Q angle, arch indexes, and all LE muscle strengths except for hip extensors and ankle plantar flexors strengths. Comparisons among the three groups showed significant increases in LE alignments and foot characteristics in AIS. Almost all LE muscle strengths decreased in AIS, especially for the single curve group. CONCLUSIONS: Apart from spinal deformity, the AIS has changed in LE alignments, muscle strengths, and foot characteristics. Therapists should consider these associations and alterations for designing proper management. Show more
Keywords: Scoliosis, spinal curvatures, lower extremity, muscle strength, flatfoot
DOI: 10.3233/BMR-230220
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Jiménez-Sánchez, Carolina | Cordova-Alegre, Paula | Carpallo-Porcar, Beatriz | Burgos-Bragado, Jose Manuel | Sanjuan-Sánchez, Daniel | Brandín-de la Cruz, Natalia
Article Type: Research Article
Abstract: BACKGROUND: Currently, the use of radiofrequency diathermy for the treatment of neck pain is booming. OBJECTIVE: This study aimed to evaluate the clinical efficacy of Digital Capacitive Diathermy (DCD® ) on stiffness, pain, cervical range of motion, and cervical disability and to compare it with ultrasound (US) in patients with latent myofascial trigger point (MTrP) in the upper trapezius. METHODS: Nineteen participants with latent MTrPs in the upper trapezius were included in the assessor-masked, randomized, clinical crossover trial. Subjects were exposed to both interventions: US and DCD® and treatment effectiveness was measured …by myotonometric variables, pressure pain threshold (PPT), visual analog scale (VAS), cervical side-bending flexion ranges, and the neck disability index scale (NDI). RESULTS: There were no significant differences between US and DCD® interventions regarding changes in outcome measures. The US group achieved a statistically significant difference of 2.16 to 1.13 points (p = 0.005; r = 0.646) for the VAS. The DCD® intervention showed a statistically significant improvement of 1.11 points for the NDI at 1-week following intervention (95% CI 0.14–2.07; p = 0.27; d = 0.217). CONCLUSION: Our findings suggest that DCD® and US can both be considered effective modalities for the treatment of latent MTrPs, having a longer duration of action with DCD® therapy. Show more
Keywords: Ultrasound therapy, diathermy, radiofrequency, myofascial trigger point, upper trapezius
DOI: 10.3233/BMR-230296
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Wu, Zhiming | Huang, Guoxin | Ai, Jinwei | Liu, Ying | Pei, Bin
Article Type: Research Article
Abstract: BACKGROUND: Low back pain is highly prevalent and the main cause of years lived with disability, but data on the burden and trends of low back pain (LBP) in adolescents and young adults (AYAs) are sparse. OBJECTIVE: To assess trends in the burden of LBP among AYAs aged 15–39 years at the global, regional and national levels from 1990 to 2019. METHODS: Data from the Global Burden of Disease (GBD) 2019 were used to analyze incidence, prevalence and Disability-adjusted life year (DALY) due to LBP at global, regional, and national levels. Joinpoint regression analysis …calculated the average annual percentage changes (AAPC). Then analyse the association between incidence, prevalence and DALYs and socioeconomic development using the GBD Socio-demographic Index (SDI). Finally, projections were made until 2030 and calculated in Nordpred. RESULTS: The incidence, prevalence and DALYs rates (95%UI) were 2252.78 (1809.47–2784.79), 5473.43 (4488.62–6528.15) and 627.66 (419.71–866.97) in 2019, respectively. From 1990 to 2019, the incidence, prevalence, and DALYs rates AAPC (95%CI) were - 0.49 (- 0.56 to - 0.42), - 0.58 (- 0.65 to - 0.51) and - 0.57 (- 0.64 to - 0.5), respectively. Incidence, prevalence, and DALYs rates in South Asia, East Asia, High-income North America, Western Europe, and Australasia decreased with SDI. Incidence, prevalence, and DALYs rates in Central Asia, Central Europe, and Eastern Europe decreased and then increased with SDI. At the national level, the incidence, prevalence, and DALYs rates are high in the United States and low in India and China. From the 2020 to 2030, most regions is predicted to decline. CONCLUSION: LBP in AYAs is a major global public problem with a high burden. There are large differences in incidence, prevalence and DALYs across SDIs, regions and countries. there is still a need to focus on LBP in AYAs and tailor interventions to reduce the future burden of this condition. Show more
Keywords: Low back pain, adolescent, young adult, global burden of disease
DOI: 10.3233/BMR-230215
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-12, 2024
Authors: Çalışkan, Zehra | Alaca, Nuray | Kablan, Nilüfer
Article Type: Research Article
Abstract: BACKGROUND: In individuals with transfemoral amputation (TFA), adaptations caused by prosthesis use may adversely affect contractile/noncontractile structures. OBJECTIVE: To investigate the immediate effect of the thoracolumbar fascia (TLF) kinesiology taping (KT) on the tone and stiffness of the fascia, low back pain (LBP) and standing balance in individuals with TFA. METHODS: Syrian male participants with TFA were enrolled in the prospective, single-blind, randomised controlled trial. Participants were divided into two groups: Experimental (EG with KT, n = 15) and Control (CG with sham KT, n = …14). A 6-minute walk test (6MWT) was performed, after which KT was applied. Measurements were taken at baseline, immediately after the 6MWT and 30 minutes after KT. RESULTS: Although pain decreased below baseline in both groups at 30 minutes post intervention (p < 0.001), the rate of pain reduction was significantly higher in the EG (p = 0.016). Anterior-posterior sway with eyes open improved significantly 30 minutes after KT application only in the EG (p = 0.010). In the eyes closed condition, anterior-posterior and medio-lateral sway decreased significantly compared to baseline 30 minutes after taping in the EG (p = 0.010- 0.032). CONCLUSION: KT can be used as an effective method to support standing balance and reduce LBP in individuals with TFA. Show more
Keywords: Amputation, fascia, low back ache, standing balance
DOI: 10.3233/BMR-230314
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Unuvar, Bayram Sonmez | Tufekci, Osman | Gercek, Hasan | Torlak, Mustafa Savas | Erbas, Onur
Article Type: Research Article
Abstract: BACKGROUND: Unilateral osteoarthritis (OA) affects single knees and presents a unique scenario where individuals experience varying degrees of symptoms between their affected and unaffected knees. OBJECTIVE: This study aims to investigate differences in muscle tightness between symptomatic and asymptomatic knees in individuals with unilateral knee OA while exploring the interplay among pain, functionality, and muscle tightness. METHODS: In this cross-sectional study, thirty knee OA patients underwent assessments for hamstring (Active Knee Extension, Straight Leg Raise), iliotibial band (Ober Test), and quadriceps tightness (Modified Thomas Test). Pain intensity was measured using the Visual Analog …Scale (VAS), and functional limitations were evaluated via the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). RESULTS: A negative correlation was observed between participants’ pain and AKE (p = 0.004, r = - 0.515), ASLR (p = 0.27, r = - 0.403), Ober (p = 0.010, r = - 0.461) values. However, no significant correlation was found with the Modified Thomas value (p = 0.204, r = - 0.239). There was also a negative correlation between participants’ WOMAC scores and AKE (p = 0.019, r = - 0.427), OBER (p = 0.004, r = - 0.510), and Modified Thomas (p = 0.022, r = - 0.416) values, while ASLR (p = 0.286, r = - 0.202) values showed no significant correlation. Comparisons between AKE, Ober, and Modified Thomas values showed higher values in asymptomatic extremities (AKE: p = 0.025, Ober: p = 0.021, Modified Thomas: p = 0.030). CONCLUSION: This study emphasizes the significance of muscle tightness in the symptomatic extremities of individuals with unilateral knee OA. The results indicate that increased muscle tightness makes pain worse and limits movement. It’s crucial for healthcare providers treating OA to focus on improving muscle flexibility, reducing pain, and enhancing overall function. Show more
Keywords: Hamstring muscles, knee, muscle tightness, osteoarthritis, quadriceps muscle
DOI: 10.3233/BMR-230373
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Cheng, Jinling | Han, Dongmiao | Qu, Jiayang | Liu, Zicai | Huang, Ying
Article Type: Review Article
Abstract: BACKGROUND: With lifestyle changes, the prevalence of flatfoot is increasing year by year, with a prevalence of 29%. Flatfoot will lead to an inevitable injury and reduce the quality of life. Short foot exercises can enhance the strength of the intrinsic muscles of the foot and improve the symptoms of flatfoot. However, there is controversy regarding its specific efficacy. OBJECTIVE: This meta-analysis quantitatively evaluates the effect of short foot training on patients with flatfeet and provides evidence to inform the clinical approach to short foot training in patients with flat feet. METHODS: A …total of eight databases were searched, including CNKI, WANFANG, VIP, and CBM in Chinese and PubMed, Cochrane, Web of Science, and Embase in English. The timeframe for searching the literature was March 2023 for each database build. English database search terms and search formulas were: (flat foot OR talipes valgus OR talipes calcaneovalgus) AND (short foot exercises OR physical therapy OR neurophysiotherapy). RESULTS: The current pooled results show no significant difference in the improvement of the navicular drop test and foot posture index with short foot exercises compared to controls; only short foot exercises greater than 6 w showed a significant improvement in the navicular drop test, and sensitivity analysis showed a significant improvement in the foot posture index with short foot exercises. CONCLUSION: This systematic review and meta-analysis showed that short foot exercises need a larger sample size to find their effect on improving flat feet; the duration of the intervention is a factor. As most studies are currently unclear whether the participants were patients with flat feet or asymptomatic individuals with flat feet the disease syndrome in patients with flatfoot may also be a factor. Show more
Keywords: Pes planus, flexible flatfoot, exercises
DOI: 10.3233/BMR-230226
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-13, 2024
Authors: Li, Lin | Li, Ju | He, Mu
Article Type: Research Article
Abstract: BACKGROUND: Acupuncture, traditional Chinese herb hot compress and rehabilitation training is useful in post-stroke shoulder–hand syndrome (SHS), but it is less commonly used in combination. OBJECTIVE: To analyse the therapeutic efficacy of a combination of acupuncture, traditional Chinese herb hot compress and rehabilitation training in SHS patients. METHOD: Patients diagnosed with post-stroke SHS and treated from January 2022 to March 2023 at Beijing Friendship Hospital and Beijing Pinggu Hospital were selected and randomly divided into three groups (A, B and C). Group A received conventional rehabilitative treatment (35 cases), Group B underwent conventional …rehabilitative treatment + acupuncture (35 cases), and Group C received conventional rehabilitative treatment + acupuncture + traditional Chinese herb hot compress treatment (35 cases). The post-treatment effectiveness rate, visual analogue scale (VAS) score, activities of daily living (ADL) score, Fugel–Meyer assessment (FMA) score, SHS assessment scale (SHSS) score and shoulder joint mobility were compared among the three groups. RESULTS: The post-treatment VAS score (F VAS score = 232.512, P < 0.001), FMA score (F FMA score = 239.412, P < 0.001), ADL score (F ADL score = 412.634, P < 0.001), SHSS score (F SHSS score = 212.542, P < 0.001) and shoulder joint mobility (F Shoulder Joint Mobility = 197.531, P < 0.001) all showed statistically significant differences. The VAS and SHSS scores decreased in the order of Group A > Group B > Group C, while the FMA, ADL and shoulder joint mobility scores increased in the order of Group C > Group B > Group A. The post-treatment effectiveness rates (χ 2 = 48.510, P < 0.001) also exhibited statistically significant differences, decreasing in the order of Group C (94.29%) > Group B (82.86%) > Group A (71.43%). CONCLUSION: The treatment efficacy of the combined acupuncture, traditional Chinese herb hot compress and rehabilitation training for SHS patients is significant, warranting its clinical promotion. Show more
Keywords: Acupuncture therapy, stroke rehabilitation, shoulder joint
DOI: 10.3233/BMR-230267
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Jung, Do Hun | Lee, Sang-Eok | Park, Dougho | Lee, Jang Woo
Article Type: Research Article
Abstract: BACKGROUND: An electrodiagnostic evaluation is conducted to diagnose carpal tunnel syndrome (CTS) and evaluate its severity. OBJECTIVE: This study proposes a revised approach for classifying the severity of electrophysiological findings for patients with CTS. METHODS: This retrospective cross-sectional study included patients with CTS confirmed through electrodiagnostic evaluations. Based on the Stevens’ classification, the patients were divided into three groups (mild/moderate/severe). A new intermediate group was defined to identify patients with normal motor nerve conduction studies and abnormal electromyographic results. CTS pain was evaluated using a numeric rate scale. Physical examinations and sonographic evaluation …were performed to detect anatomical abnormalities. RESULTS: Overall, 1,069 CTS hands of 850 CTS patients were included. The mean age was 57.9 ± 10.8 years, and 336 (39.5%) were men. There were 522 (48.8%) mild cases; 281 (26.3%) moderate cases; and 266 (24.9%) severe cases. In the severe group, 49 cases were reclassified into the intermediate group. The median cross-sectional area in the intermediate group significantly differed from that in the severe group. However, the pain score significantly differed from that of the moderate group. CONCLUSION: The intermediate CTS group showed clinical features that were intermediate to those of the moderate and severe CTS groups. Show more
Keywords: Nerve compression syndromes, classification, neurophysiology, ultrasonography
DOI: 10.3233/BMR-230275
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Lippi, Lorenzo | de Sire, Alessandro | Turco, Alessio | Santi, Roberto Mario | Polverelli, Marco | Ammendolia, Antonio | Follenzi, Antonia | Invernizzi, Marco
Article Type: Review Article
Abstract: BACKGROUND: Hemophilic arthropathy is a detrimental condition that crucially affects functional outcomes in hemophilic patients. In recent years, due to the advances in systemic therapies, growing attention has been raised in the rehabilitation field in order to improve functional outcomes of hemophilic patients. However, the optimal rehabilitation modalities in these patients are far from being fully characterized. OBJECTIVE: The present study aimed to assess the effects of different rehabilitation interventions on physical functioning and health-related quality of life of hemophilic arthropathic patients. METHODS: The review followed the Preferred Reporting Items for Systematic Reviews and …Meta-analyses (PRISMA) statement. Five databases were systematically searched for randomized controlled trials (RCTs) published until June 22nd, 2023. The selection criteria included adult patients with hemophilia A and B receiving rehabilitation interventions. The outcomes were muscle strength, physical function, pain intensity, physical performance, and health-related quality of life. RESULTS: Out of 1,743 identified records, 17 studies were included in the qualitative synthesis. Rehabilitation interventions were categorized into exercise intervention, fascial therapy, and multimodal intervention. The findings suggested positive outcomes in terms of muscle modifications, range of motion improvements, joint health enhancements, pain intensity reduction, and quality of life improvements. More in detail, meta-analyses showed significant improvements in pain intensity [ES: - 1.10 cm (- 1.37, - 0.82), p < 0.00001], joint health [ES: - 1.10 (- 1.38, - 0.82), p < 0.00001], In accordance, exercise interventions showed significant benefits in terms of joint health [ES: - 2.54 (- 3.25, - 1.83), p < 0.00001)] and quality of life [ES: 1.17 (0.48, 1.86), p < 0.0000)]. CONCLUSION: Rehabilitation interventions have a positive impact on functional outcomes and health-related quality of life of hemophilic arthropathic patients. Further studies are needed to better elucidate the role of a comprehensive intervention combining different rehabilitation approaches to treat hemophilic arthropathy. Show more
Keywords: Hemophilia, rehabilitation, fascial therapy, physical exercise, muscle, hemophilic arthropathy
DOI: 10.3233/BMR-230320
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-18, 2024
Authors: Cai, Congcong | Gazali, Nurul Adliah | Tan, Xin Ning | Soon, Benjamin | Lee, Adrian Thian Huat | Aw, Qian Wen Simone | Dana, Dharini D/O | Kwok, Joanne Ching Tung | Kwa, Mei Jun
Article Type: Research Article
Abstract: BACKGROUND: The psoas major (PM) has been identified as a potential contributor to chronic low back pain (LBP). However, few studies have investigated the effects of upright functional movement on PM activation in cLBP individuals. OBJECTIVE: This cross-sectional study aims to compare PM muscle activation characteristics in chronic LBP (cLBP) and healthy subjects during the transition from quiet double-leg standing to standing hip flexion. METHODS: Ultrasound Imaging was used to assess PM thickness at the lumbar vertebral level of L4–5 in 12 healthy and 12 cLBP participants. The changes in thickness between the test positions …were utilized as a proxy for PM activation. RESULTS: The cLBP group exhibited greater thickness changes on the non-dominant side PM during contralateral hip flexion but not ipsilateral hip flexion (p = 0.369) compared to their healthy counterparts (p = 0.011; cLBP: resting 27.85 mm, activated 34.63 mm; healthy: resting 29.51 mm, activated 29.00 mm). There were no significant differences in dominant side PM thickness changes between the two groups during either contralateral or ipsilateral hip flexion (p = 0.306 and p = 0.077). CONCLUSION: Our findings suggest a potential overactivation of the PM in the cLBP population. This insight may aid in the development of tailored rehabilitation programs. Show more
Keywords: Low back pain, psoas muscles, muscle contraction, ultrasonography
DOI: 10.3233/BMR-230384
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Zhoua, Xiao-Bin | Guan, Jian
Article Type: Case Report
Abstract: BACKGROUND: To effectively address severe deformities at the fracture site in patients, meticulous preoperative preparation is essential. This involves ensuring the restoration of the normal structural force line of the affected area and prevention of any residual deformities. By utilizing E3D technology prior to surgery, creating models based on individual patient image data and performing osteotomy, the required surgical parameters can be measured, thereby reducing surgical risks and enhancing precision. CASE PRESENTATION: This article documents a case involving a fractured femoral shaft resulting in femoral deformation. In this case, computer-aided design technology was employed for preoperative …planning and data measurement to guide the corrective osteotomy and fracture fixation procedures. CONCLUSION: The E3D software utilizes advanced techniques such as customized osteotomy, virtual reduction and internal fixation insertion technology. This enables the software to accurately pre-select the correction of femoral deformities and determine the appropriate specifications and types of internal implants. As a result, the software can create precise, rational, and personalized repair plans tailored to each patient’s needs. Show more
Keywords: Computer-aided technology, corrective osteotomy, digital modeling, fracture reduction
DOI: 10.3233/BMR-230235
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-6, 2024
Authors: Zhang, Nannan | Chen, Jianmin | Wang, Zhiyong | Ni, Jun
Article Type: Research Article
Abstract: BACKGROUND: After undergoing fibula-free flap harvest, patients may experience complications such as ankle instability. It remains unclear whether these patients have deficits of proprioception, and the recovery process is also uncertain. OBJECTIVE: This study aimed to objectively evaluate proprioception on the donor and normal side of surgical patients during long-term follow-up using the Pro-kin system. METHODS: This study enrolled 36 patients who underwent reconstruction of the head and neck using osseous free flaps harvested from the fibula. Each patient underwent pre-operative evaluations and was subsequently evaluated at postoperative months 1, 3, 6, and …12. The study assessed the proprioceptive evaluation of the lower limbs, muscle function, range of motion of the ankle, and donor side complications. RESULTS: On the donor side, the average trace error (ATE) at postoperative month 1 was significantly higher than pre-operation, postoperative months 6 and 12 (P < 0.05). The test execution time (TTE) at postoperative month 1 was significantly increased by 9.875s compared to the pre-operative levels (P = 0.012, 95% confidence interval [CI] 4: 1.877–17.873) and by 11.583s compared to postoperative month 12 (P = 0.007, 95% CI: 2.858–20.309). The reduction in range of motion of ankle dorsiflexion was most pronounced at postoperative month 1, exhibiting an 11.25∘ decrease compared to pre-operative levels (P < 0.001, 95% CI: 6.304–16.16). Although the range of motion of ankle dorsiflexion gradually improved over time at postoperative months 3, 6, and 12, it remained lower than pre-operative levels (P < 0.05). CONCLUSION: The study revealed that the patients exhibited proprioceptive disturbances in both lower limbs at postoperative month 1. The proprioceptive function gradually improved over time, with a gradual decrease in donor site complications. Show more
Keywords: Fibula-free flap harvest, proprioception, pro-kin system, ankle instability, rehabilitation
DOI: 10.3233/BMR-230436
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Koca, Tuba Tülay | Özer, Alev
Article Type: Research Article
Abstract: BACKGROUND: During pregnancy, many pregnant women experience lumbopelvic pain due to mechanical, systemic, and hormonal reasons and this pain and fear of movement (kinesiophobia) causes daily life limitations. OBJECTIVE: To examine low back pain (LBP), kinesiophobia, disability, and related conditions that develop together during pregnancy. METHODS: The was a cross-sectional and analytical study. The presence, severity, and duration of pain in the lumbopelvic region were questioned. Postpartum LBP was evaluated using a self-administered questionnaire, disability using the Oswestry Disability Index (ODI), pain intensity using a visual analog scale (VAS), physical activity levels using …the physical activity level during pregnancy questionnaire and the international physical activity questionnaire short form, and kinesiophobia was evaluated using the Tampa Scale for Kinesiophobia. RESULTS: The study comprised 120 pregnant women with a mean age of 27.4 ± 6.1 years. It was observed that 42.3% of the pregnant had LBP (n = 69). The mean body mass index (BMI) was 73.6 ± 16.2 kg/m2 , and the mean VAS score was 5.5 ± 2 cm. When we divided the group according to the presence of LBP, age (p = 0.49), gestational week (p = 0.75), and gravida (p = 0.81) were similar. BMI (p = 0.038) and ODI scores (p < 0.001) were higher in the group with LBP. CONCLUSION: LBP in pregnant women has a higher frequency than in the normal population, regardless of age, gestational week, and gravida. Obesity appears to be a risk factor for LBP and increases disability. Kinesiophobia in pregnant women is significantly associated with obesity and disability. Unless there are contraindications, a physically active pregnancy process and regular exercise should be recommend. Show more
Keywords: Lumbopelvic pain, disability, exercise, pregnancy
DOI: 10.3233/BMR-240006
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-8, 2024
Authors: Nakata, Akimi | Osuka, Satoshi | Ishida, Tomoya | Saito, Yuki | Koshino, Yuta | Samukawa, Mina | Kasahara, Satoshi | Tohyama, Harukazu
Article Type: Research Article
Abstract: BACKGROUND: Lumbopelvic movement patterns during prone hip extension has been proposed as a clinical screening method for trunk muscle dysfunction in patients with chronic low back pain (CLBP). However, correlations between trunk muscle onset and pelvic kinematics have not been investigated. OBJECTIVE: To examine the correlation between trunk muscle onset and pelvic kinematics during prone hip extension in participants with CLBP. METHODS: Fifteen patients with CLBP and 15 healthy individuals participated. We evaluated the muscle activities of the lumbar multifidus, the longissimus, and the semitendinosus via electromyogram and the displacement angles of the …pelvic tilt, oblique and rotation. RESULTS: The onset of the multifidus at the ipsilateral side of hip extension was significantly delayed in the patients with CLBP compared to the control group (P < 0.001). The onset of the ipsilateral multifidus in the control group was significantly correlated with increased anterior pelvic tilt angle (P = 0.019, r = 0.597), whereas no significant correlation was observed in the CLBP group (P = 0.810, r = - 0.068). CONCLUSION: The results suggest that pelvic kinematics during prone hip extension does not predict the delayed trunk muscle onset in patients with CLBP. Show more
Keywords: Biomechanics, electromyography, pelvis, paraspinal muscles, rehabilitation
DOI: 10.3233/BMR-240028
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-10, 2024
Authors: Ewertowska, Paulina | Formella, Oskar | Poniatowski, Łukasz | Zielińska, Afrodyta | Krzysztofik, Michał | Czaprowski, Dariusz
Article Type: Research Article
Abstract: BACKGROUND: Whole-body vibration (WBV) is being used in rehabilitation and sport. Studies confirm its positive impact on muscle strength and power or regulating muscle hypertension. However, there are some uncertainties regarding its influence on postural stability. This issue seems particularly interesting in the case of individuals with generalized joint hypermobility (GJH), for whom proprioceptive training and muscle strengthening exercises are recommended while techniques that decrease muscle tension are not advised. OBJECTIVE: The aim of the study was to evaluate the acute effect of WBV on postural stability in adults with GJH. METHODS: 60 …participants were categorized into the groups: 1) hypermobility with vibration (GJH+ WBV), 2) hypermobility without vibration (GJH–WBV), 3) control group with vibration (CTRL+ WBV), 4) control group without vibration (CTRL–WBV). The first and the third group completed WBV (frequency: 15 Hz and 30 Hz, amplitude 3 mm, 3 × 3 min). The second and fourth groups participated only in measurement sessions. GJH was assessed using the Beighton test. Postural stability was measured as the overall stability index (OSI) on the Biodex Balance System on the stable and unstable platform with open and closed eyes. Measurements were taken before and after WBV for two weeks. RESULTS: At a frequency of 15 Hz, a significant time effect was observed for measurements Before and After in CTRL–WBV on the stable platform with open eyes (p = 0.012) and on the unstable platform with closed eyes (p = 0.000) for the GJH+ WBV and CTRL+ WBV groups. There were no significant interactions (p > 0.05) between factors. At a frequency of 30 Hz, there was a significant time effect Before and After (p = 0.047) on the stable platform with open eyes, but no interaction was found between factors (p = 0.835). CONCLUSION: There is no positive acute effect of WBV on postural stability in adults with and without GJH. Show more
Keywords: Joint instability, vibration, postural control, balance
DOI: 10.3233/BMR-240004
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-9, 2024
Authors: Shi, Tao | Shou, Fenyong | Xia, Qun | Zhang, Tao | Teng, Donghui | Jing, Wanli | Zhou, Qiang
Article Type: Research Article
Abstract: BACKGROUND: The effect of anti-osteoporosis treatment in elderly patients with osteoporosis and lumbar discectomy and fusion (LIF) for lumbar degenerative diseases is not well known. OBJECTIVE: This study aimed to evaluate the effect of perioperative anti-osteoporosis treatment in the patients with osteoporosis and LIF. METHODS: From January to December 2022, patients were divided into three groups according to the inclusive criteria: the normal group (Group A), the osteopenia group (Group B) and the osteoporosis group (Group C). Quantitative computed tomography (QCT), height of the intervertebral space (HIS), segmental sagittal angle (SSA), visual analogue …scale (VAS) score and Oswestry Disability Index (ODI) were compared between the groups at the follow-up time. The serum Ca2 + , osteocalcin (OC), propeptide of type I procollagen (PINP) C-terminal cross-linking telopeptide of type I collagen (β -CTX) and 25-OH vitamin D (25-OH VD ) levels were compared between the groups at the time of follow-up. Interbody fusion was graded on the X-ray and CT images at the follow-up time. RESULTS: There were 165 patients in this study. There were significant differences in the mean age, mean score, HIS and SSA between the groups at the different follow-up times. There were significant differences in the concentrations of serum Ca2 + , OC, β -CTX, 25-OH VD and PINP at the sixth month after surgery between the groups. There were significant differences in the concentrations of serum Ca2 + , β -CTX and 25-OH VD between the pre-surgery and at six months after surgery in Group B and β -CTX and 25-OH VD in Group C. There was a significant difference in the degree of fusion between Group B and C (χ 2 = 5.6243, P < 0.05). CONCLUSION: In elderly patients with LIF and osteoporosis, anti-osteoporosis therapy could reduce bone resorption and thus facilitate fusion. Anti-osteoporosis medication tends to enhance radiological, functional, and fusion short-term outcomes. Show more
Keywords: Elderly patients, degenerative lumbar disease, lumbar discectomy and fusion, osteoporosis, anti-osteoporosis
DOI: 10.3233/BMR-230381
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Masoudi, Mona | Ehsani, Fatemeh | Hedayati, Rozita | Ramezani, Mona | Jaberzadeh, Shapour
Article Type: Research Article
Abstract: BACKGROUND: Impairment in both the motor and cognitive aspects of postural control is a critical issue in patients with chronic low back pain (CLBP) who experience high pain anxiety (HPA). OBJECTIVE: This study aimed to compare the effects of cathodal and anodal transcranial direct current stimulation (c-tDCS and a-tDCS) over the dorsolateral prefrontal cortex (DLPFC) on postural control during cognitive postural tasks in CLBP patients with HPA. METHODS: This study included 66 patients randomly assigned to three groups: DLPFC a-tDCS, DLPFC c-tDCS, and sham tDCS. All groups received 20 minutes of tDCS, but …the stimulation was gradually turned off in the sham group. Postural stability indices were assessed using the Biodex Balance System. RESULTS: Both the a-tDCS and c-tDCS groups showed a significant reduction in most postural stability indices at static and dynamic levels after the interventions (immediately, 24 hours, and one-week follow-up) during the cognitive postural task (P < 0.01). Additionally, there was a significant improvement in postural balance in the a-tDCS and c-tDCS groups compared to the sham tDCS group (P < 0.01). Furthermore, the a-tDCS group showed significantly greater improvement than the c-tDCS group (P < 0.01). CONCLUSION: Based on the results, both a-tDCS and c-tDCS over the DLPFC had positive effects on postural control during cognitive postural tasks in CLBP patients with HPA. Show more
Keywords: Chronic low back pain, pain-related anxiety, cathodal transcranial direct current stimulation, anodal transcranial direct current stimulation, dorsolateral prefrontal cortex, postural stability
DOI: 10.3233/BMR-230229
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2024
Authors: Hwang, Byeong-Hun | Jeon, In-Cheol
Article Type: Research Article
Abstract: BACKGROUND: Sufficient shoulder flexor strength is necessary for accurate movement of the shoulder joint because several factors can cause compensatory movements of the scapula. OBJECTIVE: We investigated the influence of external fixation on the isometric shoulder flexors strength (ISFS) in individuals with and without scapular elevation (SE) during shoulder flexion. METHODS: The healthy and SE groups included 29 individuals. The ISFS was measured using a tensiometer (kg) under conditions of with and without external fixation, in a random order. The change in the ISFS (the strength difference with and without external fixation) was …compared between the healthy and SE groups using an independent t -test. RESULTS: The change in the ISFS differed significantly between the healthy and SE groups (3.5% and 32.3%, respectively; p = 0.001). CONCLUSION: These findings suggest that external fixation should be considered during shoulder flexion to determine the ISFS accurately in individuals with compensated SE. Show more
Keywords: Compensation, scapular elevation, shoulder flexor, strength
DOI: 10.3233/BMR-230288
Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-7, 2024
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