Journal of Back and Musculoskeletal Rehabilitation - Volume 17, issue 3-4

Authors: Cakmak, Aysegul | Muslumanoglu, Lutfiye | Ozcan, Emel | Disci, Rian | Ekmekci, Ozlem | Arikan, Firdevs | Berker, Ender

Article Type: Research Article

Abstract: Education is the most prominent among conservative treatment methods for chronic mechanical low back pain; the organized application of education has been conducted under the title "Back School". Our study was designed in order to demonstrate the long term outcomes of the Back School by evaluating the patients' application of what is taught in the education program to their daily life, the regularity of their exercises and the subsequent improvement in pain severity, disability and number of attacks. 133 patients with chronic mechanical low back pain were evaluated according to the criteria before, and at least …one year after the Back School treatment with a mailed questionnaire. Statistical analysis revealed that exercises were generally not taken regularly during the long term follow up, but especially higher education graduates applied what they had learned at the Back School to their daily life. Although this application did not reduce the number of attacks, it significantly decreased pain severity and reduced the disability by enabling the patient to cope with the pain. It is emphasized at the conclusion of the study that the patients should be followed after their attendance in Back School and encouraged to follow what they have learned and continue with their exercises. Show more

Keywords: Back pain, Back School, chronic mechanical low back pain, conservative, education, nonoperative, outcome, pain, treatment

DOI: 10.3233/BMR-2004-173-401

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 17, no. 3-4, pp. 83-89, 2004

Authors: Löfvander, Monica B. | Engström, Alf W.

Article Type: Research Article

Abstract: Background: Perceived inability to work predicts a negative outcome of rehabilitation. Objectives: To analyse self-rated inability to work, (SIW), before and after a rehabilitation programme in the primary care, and the risk factors for persistent SIW. Patients: Immigrant patients aged 20–45 years. Methods: Somatic status, ratings of psychosocial stressors and interviews about concepts of pain were performed. Anxiety about pain, depression, and SIW were evaluated before (SIW1) and after (SIW2) the programme consisting of conversations about pain, and daily exercise. Correlation statistics was done by non-parametric methods. The odds ratios (OR) with 95 …Results: 49 men and 100 women with service-jobs, on the average 38 years, participated. All had pain from muscular structures in the shoulder, back and/or hip regions, 62 Conclusion: The frequency of SIW remained high despite a significant decrease. Preceding long sick leave, anxiety about the pain and psychosocial stress increased the risk of persistent SIW, implying the necessity of further improving the methods of reducing anxiety and the use of only short periods of sick leave in this category of patients. Show more

Keywords: disability, chronic pain, sick leave, primary care, rehabilitation, immigrants, psychosocial stress

DOI: 10.3233/BMR-2004-173-402

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 17, no. 3-4, pp. 91-100, 2004

Authors: Malliou, P. | Gioftsidou, A. | Pafis, G. | Beneka, A. | Godolias, G.

Article Type: Research Article

Abstract: The aim of the study was to investigate the effect of balance training on proprioception and on lower limb injuries. The sample consisted of 100 young soccer players, from four different soccer teams. Two teams were the experimental group, (N = 50), and two the control group (N = 50). During the competition period, the experimental group followed a proprioception training program, 2 times per week, with 20 minute sessions. The frequency and the characteristics of injuries occurred were also recorded. Balance tests on the stability system (Biodex) were performed before and after the competition period. For the balance tests …repeated measures Anova was used and the results revealed significant differences between the pre and post training measures for the experimental group. Also, the results revealed an important difference between the experimental and control group in the incidence rate of the injuries. Finally, an important difference was found between the experimental and control group in moderate severity injuries. The application of a specific balance training program on healthy young soccer players can improve their proprioception and prevent low limb injuries. Show more

Keywords: proprioception training, soccer, balance boards, lower limb injuries

DOI: 10.3233/BMR-2004-173-403

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 17, no. 3-4, pp. 101-104, 2004

Authors: Lee, Tzu-Hsien

Article Type: Research Article

Abstract: The objective of this study was to examine the effects of different squat postures on maximum static lifting strengths. Ten experienced healthy male lifters were examined on their maximum static two-handed lifting strengths and associated elbow, shoulder, trunk, knee and ankle postural angles at three exertion heights (25 cm, 34 cm and 43 cm) and five lifting postures (stoop posture and light, medium, deep, and full squat postures). A two-factor factorial repeated measures design was used for analyzing the strength data. The results indicated lifting strength decreased with the extent of squat posture. All five investigated postural angles were highly …correlated with lifting strength. Overall stepwise regression revealed that knee angle had most influence on lifting strength. Additionally, The regression equations for lifting strength developed on the knee angle demonstrated satisfactory linear relationship between lifting strength and knee angle for individuals. This paper clearly shows that lifting posture needs to be standardized in lifting strength tests. Show more

Keywords: static strength, squat lifting, postural angle

DOI: 10.3233/BMR-2004-173-404

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 17, no. 3-4, pp. 105-109, 2004

Authors: Cimbiz, Ali | Bayazit, Vahdettin

Article Type: Research Article

Abstract: The main aim was to evaluate effects of lower limb injuries on balance and muscle strength in university physical education students. Sixty voluntary students of both sexes from the Dumlupinar University School of Physical Education, Kutahya, Turkey were divided into two groups: Thirty students had lower limb injuries and recovered without physical therapy program as Recovered Group (RG), mean age 21.7 ± 1.5 (19–26); and thirty students a non-injured control group (CG), mean age 20.7 ± 1.8 (18–29) years. RG were injured 56.7% ankle, 43.3% knee injuries and were recovered since 3.6 ± 1.7 (2.5–6) months. Both groups are training …sports (basketball, volleyball, soccer and judo) twenty hours a week. The CG was selected in order to match the RG characteristics, such as: age, mass and sex. Standing on dominant and non-dominant leg, functional reach and manual muscle tests were used for assessment. Static and dynamic standing one leg test on non-injured leg, eyes open, and injured leg, eyes closed, were significantly lower in RG (p < 0.05). The results showed no significant differences between the groups in muscular strength and functional reach test values (p > 0.05). This study show that unreported lower limb injuries impairs propriception sense and balance which may increase risk of re-injury. Although after recovered injury muscle strength can gain in short time but balance is still decreased. In this situation players are opened for severe injuries. One leg standing balance a simple test that could be used clinically to monitor lower extremity injury, and also to identify athletes with decreased functional stability, who may be more at risk of sustaining injury. Show more

Keywords: lower limb injuries, proprioception one leg standing test, physical education students

DOI: 10.3233/BMR-2004-173-405

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 17, no. 3-4, pp. 111-116, 2004

Authors: Kee, William G. | Smith, Arthur R. | Folk, Jeffrey W.

Article Type: Research Article

Abstract: 22 subjects were screened for either mild or moderate depression on the Beck Depression Inventory II (BDI) and primary idiopathic fibromyalgia out of a pool of 136. Subjects had one week of washout from medications. Subjects then were treated for 6 weeks with citalopram 20–40 mg. Measures taken at baseline, end of washout week and end of study included: BDI, Visual Analog Scale for pain, McGill Pain Questionnaire (MPQ), Sleep Questionnaire, Fibromyalgia Impact Questionnaire (FIQ), Pressure Threshold Gauge for Tender Points and Activity Diary. No consistent differences on independent variables were seen between subjects who completed the study and …those who dropped out or between depressed and non-depressed patients. Regression analyses did not indicate any consistent relationship between subject variables and measures used in the study. Subject change during the 6 week medication trial showed significant improvement on: VAS scores, MPQ, FIQ, sleep, 4 tender points, 2 control points and pooled tender point score. Depressed subjects showed greater improvement than non-depressed. A maximum of 41.9% of the change in pain was attributable to depression leaving over 50% attributable to other factors. The study indicates that citalopram is effective in making changes in the symptoms of fibromyalgia beyond changes seen in mood. Show more

Keywords: fibromyalgia, chronic pain, citalopram, outpatient pain treatment

DOI: 10.3233/BMR-2004-173-406

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 17, no. 3-4, pp. 117-125, 2004

Authors: Topuz, Oya | Özfidan, Erhan | Ozgen, Merih | Ardic, Füsun

Article Type: Research Article

Abstract: The study was designed to compare the efficacy of two different modalities of transcutaneous electrical nerve stimulation (conventional and low-frequency TENS) (C-TENS and Low-TENS) and percutaneous neuromodulation therapy (PNT) in the treatment of chronic low back pain. Sixty patients with chronic low back pain were randomly divided into four groups as placebo-TENS, C-TENS, Low-TENS, and PNT. Therapeutic modalities were administered for 2 weeks. The pre-treatment and post-treatment assessments were done by using the Visual Analog Scale for pain; Low Back Pain Outcome Scale and Oswestry Disability Index for functional disability; and Health Status Survey Short Form (SF-36) for quality of …life. In placebo-TENS group only emotional role limitation score of SF-36 significantly decreased after the treatment. All measurements except emotional role limitation score of SF-36 significantly improved in C-TENS group after the treatment. In both of Low-TENS and PNT groups, all parameters were significantly improved by the treatment. TENS modalities and PNT were significantly more effective than the placebo-TENS. No significant difference was found between C-TENS and Low-TENS. PNT was significantly more effective than TENS in providing relief of activity pain and in improving general health, vitality and emotional role limitation scores of health quality. Show more

DOI: 10.3233/BMR-2004-173-407

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 17, no. 3-4, pp. 127-133, 2004

Authors: Cubukcu, Sibel | Karsli, Bilge | Alimoglu, M. Kemal

Article Type: Research Article

Abstract: Purpose: To determine the ratio of MP or non MP cases among patients with anterolateral thigh pain and/or disesthesia simulating MP. Material-methods: Forty patients with MP symptoms were included in the study. Demographic data, possible etiologic factors for MP, and symptom changes due to hip position were noted. Electroneuromyography (ENMG) and radiologic studies of lumbosacral and pelvic region were performed in all patients. The patients were divided in to two groups regarding ENMG results: The patients with no sensorial response at the distribution area of lateral femoral cutaneous nerve (LFCN) (group A, 22 patients) and those with normal …LFCN responses (group B, 18 patients). Mann Whitney U and chi-square tests were used for statistical analyses. Results: Female/male ratio was 0.9 and the mean age was 55.4 ± 12.5 (27–75) years. Six patients were police-men, 6 were obese, 3 had story of pelvic laparascopy, 3 had carpal tunnel syndrome and 4 were diabetic. The remaining patients had no history of risk factors or disorders that may be related to MP like symptoms. Symptoms were aggravated by hip extension in 77.3% of real MP patients. The prevalence of low back pathologies including disc hernia, spinal stenosis and degenerative changes in group A and B was 54.5% and 94.4% respectively. Conclusion: The patients with MP like symptoms and findings may have low-back pathologies without any evidence of abnormal LFCN responses in ENMG. Symptom aggravation as a result of hip extension may be considered in favor of MP. But, we recommend applying ENMG to confirm or rule out the MP diagnosis. Show more

Keywords: meralgia paresthetica, low-back, pain, electroneuromyography

DOI: 10.3233/BMR-2004-173-408

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 17, no. 3-4, pp. 135-139, 2004