Physiotherapy Practice and Research - Volume 44, issue 2

Authors: Collins, Shane | McDevitt-Petrovic, Orla | Henderson, Ellen

Article Type: Research Article

Abstract: INTRODUCTION: Low back pain (LBP) is a leading cause of disability worldwide. A spectrum of psychological conditions such as anxiety, fear, stress and low mood are often reported to co-occur in individuals with persistent back pain and are cited as reasons for the continued experience of pain. However, any potential causal effect of emotional distress on new onset LBP is understudied. Therefore, the aim of this review is to examine the impact of emotional distress as a risk factor for new presentations of acute low back pain. METHODS: A systematic review was performed in accordance with the PRISMA …guidelines. The Medline, Embase and APA databases were searched for primary research articles exploring emotional distress and low back pain. Prospective studies that investigated subjects initially free from back pain, who also undertook some form of psychometric testing at baseline, were included in the review. In total, 6 studies were identified with a broad geographical spread and diverse population cohorts including pregnant women, forestry workers, nursing students, adolescents, individuals with medical comorbidities and adult population studies. RESULTS: The results from all six studies found a significant relationship between an initial presence of emotional distress and subsequent onset of acute low back pain. CONCLUSION: This review encourages the acknowledgement of underlying emotional distress as a risk factor in acute low back pain, and to address it as part of the overall management plan. Show more

Keywords: Emotional distress, stress, low back pain, prospective

DOI: 10.3233/PPR-230737

Citation: Physiotherapy Practice and Research, vol. 44, no. 2, pp. 177-186, 2023

Authors: Okudan, Begum | Çelik, Derya | Koban, Orkun

Article Type: Research Article

Abstract: OBJECTIVE: The study aimed to determine the clinical and functional status of patients with chronic low back pain (CLBP) due to facet joint arthrosis (FJA) and to examine the relationship, if any, between pain beliefs and clinical and functional status. METHODS: This descriptive, cross-sectional study involved patients who had been diagnosed with CLBP due to mild to moderate FJA. The participants were evaluated using the Numeric Pain Rating Scale (NPRS rest and activity), the Oswestry Disability Index (ODI), the Short-Form Quality of Life Index 12 version 2 (SF-12v2; PCS and MCS) and the Pain Beliefs Questionnaire (PBQ). Statistical …analyses were performed using SPSS. RESULTS: This study involved 58 patients (28 females and 30 males) with a mean age of 52.12±4.64 years. The reported pain intensity was 1.93±1.52 at rest and 5.10±1.10 during activity, while the ODI was 24.59±6.61. The MCS was higher than the PCS, with mean scores of 43.52±5.86 and 38.97±5.01, respectively. The participants had higher scores for organic pain beliefs (3.81±0.51) than for psychological pain beliefs (3.35±0.69). A weak positive correlation was found between psychological pain beliefs and functional status (r  = 0.336; p  = 0.010). CONCLUSIONS: Patients with CLBP due to FJA experienced mild pain at rest, moderate pain during activity, and moderate functional disability. Participants with stronger psychological pain beliefs exhibited a higher level of functional disability. Addressing pain beliefs may help to improve functional outcomes. Show more

Keywords: Low back pain, function, cross-sectional study, facet joint

DOI: 10.3233/PPR-220694

Citation: Physiotherapy Practice and Research, vol. 44, no. 2, pp. 187-194, 2023

Authors: Matsui, Kazuhisa | Suzuki, Risako | Nakai, Keiko | Kuwashima, Runa | Tachibana, Takashi

Article Type: Research Article

Abstract: BACKGOURND: The pathophysiology of adhesive capsulitis may be associated with increased neural mechanosensitivity in upper limb neurodynamic test. OBJECTIVE: To investigate the findings of neurodynamic assessment in patients with more than four month history of adhesive capsulitis. METHODS: Thirty-five patients with more than four month history of adhesive capsulitis were participated in this study. A physiotherapist performed the Upper Limb Neurodynamic test 1 procedure on the participant’s upper limb. Elbow extension range of motion at the end of the Upper Limb Neurodynamic test 1 was compared with the participant’s elbow extension at the end of Upper …Limb Neurodynamic test 1 performed on the opposite upper limb and to elbow extension on the symptomatic side performed with the arm by the side. RESULTS: The intensity of pain in Upper Limb Neurodynamic test 1 increased with lateral flexion of the neck to the unaffected side and eased with lateral flexion to the affected side in all participants. A marked restriction of the elbow passive extension range of motion in Upper Limb Neurodynamic test 1 on the affected side (–54.6±17.8°) compared to the unaffected side was found (–7.3±10.7°) (p  < 0.001). CONCLUSIONS: Restriction of elbow passive extension range of motion at the end of the Upper Limb Neurodynamic 1 test reproduced patients’ familiar adhesive capsulitis associated pain and the pain changed with structural differentiation using cervical lateral flexion. Neurodynamic assessment may need to be considered to assess neural mechanosensitivity in patients with adhesive capsulitis. Show more

Keywords: Adhesive capsulitis, upper limb neurodynamic test 1, mechanosensitivity of peripheral nerve

DOI: 10.3233/PPR-230762

Citation: Physiotherapy Practice and Research, vol. 44, no. 2, pp. 195-201, 2023

Authors: Sakulsriprasert, Prasert | Bunprajun, Tipwadee | Soonthonsawat, Subkamon

Article Type: Research Article

Abstract: PURPOSE: To investigate the test-retest reliability, side-to-side difference, responsiveness, and concurrent validity of skin blood flow (SkBF) measured by laser Doppler flowmetry (LDF) in individuals with acute or subacute lateral elbow tendinopathy (LET). METHODS: Eighteen individuals with acute or subacute LET were recruited for this study. SkBF was measured over the lateral epicondyle and common extensor origin on both ipsilateral and contralateral sides. The intraclass correlation coefficient (ICC3,1 ) was used to evaluate test-retest reliability. A paired t -test was used for comparing the side-to-side difference. Responsiveness was reported with a change score, paired t -test, effect size …(ES), and standardized response mean (SRM). The concurrent validity of SkBF was investigated by correlating with a visual analog scale (VAS) pain intensity during resisted wrist extension isometric contraction using the Spearman correlation coefficient. RESULTS: Test-retest reliability was good at lateral epicondyle (ICC3,1  = 0.899), and at common extensor origin (ICC3,1  = 0.803). A side-to-side difference was found between the two sides (p  < 0.001). For responsiveness, the change score for SkBF at the lateral epicondyle was – 8.04, and the common extensor origin was – 3.54. The ES and SRM ranged from – 0.71 to – 0.78. Concurrent validity was reported with a strong correlation with pain intensity (r  = – 0.637). DISCUSSION: SkBF is a reliable and responsive variable for investigating the elbows with acute or subacute LET providing clinical information according to its inflammatory responses. However, the concurrent validity can be found only for SkBF at common extensor origin, which correlates with pain during resisted wrist extension isometric contraction. Show more

Keywords: Tennis elbow, inflammation, microcirculation, perfusion, capillary

DOI: 10.3233/PPR-220706

Citation: Physiotherapy Practice and Research, vol. 44, no. 2, pp. 203-209, 2023

Authors: Waqar, Aleena | Saif, Mahnoor | Osama, Muhammad | Nasir, Rida | Fayyaz, Amman

Article Type: Research Article

Abstract: PURPOSE: Knee Osteoarthritis is a common degenerative joint disease associated with significant walking-related disability. Impaired gait mechanics can lead to an increase in energy expenditure and impaired energy recovery, causing an increase in perceived fatigue resulting in functional decline. However, despite the association of performance fatigability with negative health outcomes and walking-related disability, it is still not well understood in patients with knee osteoarthritis. METHODS: The study conducted a cross-sectional comparison between 20 participants with knee osteoarthritis (OA) classified as grade III or less on the Kellgren classification, and a control group of 20 healthy individuals matched in …age, weight, height, body mass index (BMI) and gender. A six-minute walk test (6MWT) was used as an outcome measurement tool, and distance, gait velocity, and walking-related performance fatigability were calculated. SPSS version 21 was used to analyze the data, and the normality of the data was determined using the Shapiro-Wilk test. For normally distributed data, the independent t-test was employed, while the non-normally distributed data was analyzed using the Mann-Whitney U test. RESULTS: No significant differences (p  > 0.05) were observed between healthy controls and participants with knee OA in terms of age, weight, height, and BMI. However, significant differences (p  < 0.05) were observed in total distance covered in 6 minutes, distance covered in each minute, gait velocity and walking-related performance fatigability. Persons with knee OA demonstrated greater fatigability and lesser gait velocity and distance covered during the 6MWT. CONCLUSION: Individuals with knee OA exhibited greater fatigability and lower gait velocity and distance covered during the 6MWT. Show more

Keywords: Fatigue, knee osteoarthritis, osteoarthritis

DOI: 10.3233/PPR-220655

Citation: Physiotherapy Practice and Research, vol. 44, no. 2, pp. 211-215, 2023

Authors: Ullucci Jr., Paul A. | Gibson, Sandra

Article Type: Research Article

Abstract: BACKGROUND: Cervical spine dysfunction has been shown to cause symptoms of dizziness and vertigo in patients, due to its connection to the vestibular system. There is a sparsity of prospective studies describing the prevalence of cervical involvement in these patients. OBJECTIVE: To identify the prevalence of cervical mobility restrictions in patients with symptoms of dizziness and vertigo prospectively. METHODS: Eighty-two subjects referred to physical therapy were assessed for mobility restrictions from the Atlanto-occipital joint to the level of C5 using evidenced-based manual techniques. These techniques included the seated and supine cervical flexion rotation tests and posterior …to anterior joint mobility assessments. RESULTS: The prevalence of cervical mobility restrictions was 72% overall. Restrictions were found in 70% of those referred for dizziness/vertigo, 64% with benign paroxysmal positional vertigo (BPPV) and 90% of those referred for concussion. None of the referring providers had considered cervical involvement prior to making the referral. CONCLUSIONS: Afferent input from the muscles, joint and connective tissues in the cervical spine can cause the symptoms associated with dizziness, vertigo and concussion. This prospective study demonstrates the high prevalence of cervical mobility restrictions in these patients. This study provides much needed evidence for the need for early manual assessment of the cervical spine and surrounding structures if an appropriate rehabilitation program is to be designed. Physical therapists, athletic trainers and those who care for patients with complaints of dizziness, vertigo, BPPV or concussion should assess their patient for mobility restrictions early on in the evaluation process and treat accordingly. Show more

Keywords: Prevalence, cervicogenic dizziness, cervicogenic concussion, evidence based, cervicogenic vertigo

DOI: 10.3233/PPR-230760

Citation: Physiotherapy Practice and Research, vol. 44, no. 2, pp. 217-221, 2023