Journal of Back and Musculoskeletal Rehabilitation - Volume 32, issue 3

Authors: Kiss, Gabriella | Kovácsné, Viktória B. | Tóth, Ákos L. | Jeges, Sára | Makai, Alexandra | Szilágyi, Brigitta | Ács, Pongrác | Járomi, Melinda

Article Type: Research Article

Abstract: BACKGROUND: Trunk prevention training, which provides the basis of several conditioning training programs, is used in sports at professional and amateur levels, taking the specifications of the given sport and the age-related characteristics of the athletes into consideration. OBJECTIVE: Our aim was to examine the strength and flexibility of muscles responsible for correct posture, the lumbar motor control ability and the posture of recruitment kayak-canoe athletes. METHODS: Controlled, randomized examination with 103 persons (age: 15.1 ± 3.5 years), who were divided into two groups. Fifty were in the intervention group, who …took part in the 6-month trunk prevention training program (height: 162.30 cm, body weight: 49.70 ± 10.32 kg), 53 in the control group (not performing trunk prevention training) (height: 158.24 cm, body weight: 51.45 ± 11.71 kg). The strength of core muscles was measured with Kraus-Weber test, muscle flexibility with Kempf-test, lumbar motor control ability with Sitting Forward Lean and Leg Lowering test and posture with photogrammetry test before and after the program. RESULTS: Static strength of abdominal muscles (p < 0.001), superficial and deep dorsal muscles (p < 0.001), flexibility of knee extensors (p < 0.001), chest muscles (p < 0.001), the lumbar motor control ability (p < 0.001) and habitual posture (p < 0.001) significantly improved in the intervention group. The post-measurements in the intervention group were significantly (p < 0.001) better than in the control group. CONCLUSIONS: As a result of the trunk prevention training the strength of core stabilization muscles, the lumbar motor control ability and the posture also improved in case of recruitment athletes. Show more

Keywords: Trunk prevention training, sports physiotherapy, lumbar motor control, kayak-canoe, recruitment

DOI: 10.3233/BMR-181297

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 3, pp. 367-378, 2019

Authors: Mueller, Steffen | Stoll, Josefine | Cassel, Michael | Engel, Tilman | Mueller, Juliane | Mayer, Frank

Article Type: Research Article

Abstract: OBJECTIVE: To evaluate trunk peak torque and muscle activation pattern during isokinetic and sudden trunk loading (STL) between adolescent athletes with/without back pain. METHODS: Nine adolescent athletes with back pain (BP) (m/f 2/7; 15.6 ± 1.2 y; 177 ± 9 cm; 67 ± 13 kg; 22.5 ± 9.8 h/week) and nine matched controls (m/f 2/7; 15.7 ± 1.4 y; 177 ± 12 cm; 65 ± 9 kg; 16.5 ± 8.0 h/week training) were included. Trunk strength in rotation and flexion/extension …was assessed. Sudden trunk loading was measured during eccentric extension and rotation (30 ∘ /s) with additional perturbation. Trunk muscle activity was measured using a 12 lead-EMG (electromyography). Main outcome measures were peak torque [Nm] and MVC normalized EMG-amplitudes (RMS [%]) for each muscle. Additionally, the mean EMG-RMS for four areas of the trunk was calculated (right/left ventral, right/left dorsal). RESULTS: Back pain showed lower trunk peak torque for all conditions in extension/flexion, but not for rotation. EMG amplitudes were increased for BP athletes with statistical significant differences for dorsal muscles in rotation and extension (p < 0.0042), not for ventral muscles in flexion. CONCLUSIONS: The evaluation of strength and muscle activity in isokinetic and sudden trunk loading presents altered trunk function in adolescent back pain athletes. Training interventions focusing on trunk strength and muscular activation pattern appears reasonable. Show more

Keywords: EMG, elite athlete, trunk rotation, extension/flexion, novel perturbation, isokinetic

DOI: 10.3233/BMR-181215

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 3, pp. 379-388, 2019

Authors: Takasaki, Hiroshi | May, Stephen

Article Type: Research Article

Abstract: BACKGROUND: Mechanical Diagnosis and Therapy (MDT) manages low back pain (LBP) with subgroup classifications. For a subgroup of the posterior derangement syndrome, postural education limiting lumbar flexion is included. However, it is not known if habitual posture in this subgroup actually changes through MDT management because of technical difficulties in monitoring habitual lumbopelvic posture. However, a wearable device, “LUMOback”, which can evaluate the proportion of time with a neutral lumbopelvic posture (posture score), has now become available. OBJECTIVE: To preliminarily investigate whether the posture score changes through the course of MDT management. METHODS: …Primary inclusion criterion was LBP with the posterior derangement syndrome. Primary outcome measure was the posture score during one week. The posture score was assessed one week before and six weeks after the initial MDT management, which included extension exercises and postural education. RESULTS: All participants (n = 8) reported a successful treatment effect after the 6-week MDT intervention; however, there was no specific trend in the posture score (Friedman test: p = 0.277). CONCLUSIONS: This study found evidence that the proportion of time with a neutral lumbopelvic posture during daily living, the posture score, which was measured with the LUMOback, did not systematically change with MDT management. Show more

Keywords: Exercise therapy, low back pain, physical therapy modalities, posture, wearable electronic devices

DOI: 10.3233/BMR-181263

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 3, pp. 389-398, 2019

Authors: Kim, Min-Hee | Yoo, Won-Gyu

Article Type: Research Article

Abstract: BACKGROUND: In clinics, training of the lower trapezius muscle for the rehabilitation of the shoulder is often applied. The narrow-base push-up exercise is considered suitable training of the proximal shoulder complex, but the effect on the lower trapezius muscle has not yet been investigated. OBJECTIVE: The purpose of this study was to investigate the effect of push-up, push-up plus, and support surfaces on the lower trapezius muscle during the narrow-base push-up exercise. METHODS: A total of 11 males participated in this study. Surface electromyographic response of the lower trapezius muscle was examined during …the narrow-base push-up exercise. RESULTS: The lower trapezius muscle activity increased significantly in both the stable and the unstable conditions during the narrow-base push-up phase compared with both conditions during the narrow-base push-up plus phase. CONCLUSIONS: The narrow-base push-up is considered a suitable exercise for strengthening the lower trapezius muscle regardless of support surfaces. Show more

Keywords: Electromyography, narrow-base push-up exercise, trapezius muscle

DOI: 10.3233/BMR-170942

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 3, pp. 399-402, 2019

Authors: Park, Du-Jin | Park, Se-Yeon

Article Type: Research Article

Abstract: BACKGROUND: A high prevalence and incidence of neck and shoulder pain are common problems that require more attention from health service providers and researchers. Recent findings have indicated that the neck stretching is the one of the most effective physical therapy interventions. Although the recovery of the pain through the stretching exercise has been described in a previous study, functional advantages and changes of the neuromuscular control has not been suggested. Additionally, there was a lack of studies that considered methods of stretching. OBJECTIVE: The purpose of the present study was to examine the long-term effects …of stretching methods for cervical neuromuscular dysfunction, disability and pain in a sample of sedentary workers with neck pain. METHODS: Twenty-four sedentary workers with neck pain participated in this study and were assigned to the following two groups: static stretching (SS), and diagonal active stretching (DS). Active cervical range of motion (ROM), pressure pain threshold (PPT), self reported questionnaire (Neck Disability Index, NDI), and the flexion – relaxation ratio (FRR) from the cervical erector spinae muscles were measured at pre-treatment, post-treatment (after 4 weeks) and follow-up (after 6 and 8 weeks). RESULTS: In both groups, the values obtained for the cervical ROM as flexion, extension, lateral flexion, were significantly increased in comparison to pre-treatment (p < 0.05). Significant increases of the left and right neck rotation, left and right FRR were only observed in the DS group (p < 0.05). The NDI score of the SS group was significantly lower than that of the DS group (p < 0.05). CONCLUSIONS: Our findings suggest that both static and diagonal stretching exercises were effective for reducing disability of the neck and increasing cervical range of motion. Compared to the SS, in addition, present results suggest that changes of the activation patterns as FRR, and cervical rotational movement could be accomplished with the DS. Show more

Keywords: Stretching, computer workers, PIR

DOI: 10.3233/BMR-171107

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 3, pp. 403-410, 2019

Authors: Uysal, Sümeyye Cildan | Tüzün, Emine Handan | Eker, Levent | Angın, Ender

Article Type: Research Article

Abstract: BACKGROUND: Fibromyalgia is characterized by a chronic and common musculoskeletal system pain that affects cervical mobility and inspiration. This may cause changes in thoracic mechanics. OBJECTIVE: To investigate the effectiveness of the muscle energy technique applied to cervical accessory respiratory muscles on respiratory muscle strength and endurance in patients with fibromyalgia. METHODS: The participants were 37 women diagnosed with fibromyalgia. They were assessed for their respiratory muscle strength, respiratory muscle endurance, pain and fatigue severity, flexibility and disability. The muscle energy technique was applied to the scalene, upper trapezius, and sternocleidomastoid muscles after …a superficial heat application. The treatment was continued for 3 weeks with 3 sessions per week. RESULTS: After the treatment, expiratory muscle strength and respiratory muscle endurance increased significantly. Severity of pain and fatigue and disability were reduced, cervical flexibility increased significantly (p < 0.05). The effect size was r ⩾ 0.4 for all the variables. CONCLUSION: The muscle energy technique applied to cervical accessory respiratory muscles in patients with fibromyalgia who had complaints in the neck and back region positively increased respiratory muscle strength and endurance, cervical flexibility, and decrease pain intensity, fatigue and disability. It is recommended that subsequent randomized studies are carried out with a placebo control group. Show more

Keywords: Respiratory muscle strength, respiratory muscle endurance, pain intensity, cervical flexibility, fatigue, disability

DOI: 10.3233/BMR-181287

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 3, pp. 411-419, 2019

Authors: Lim, Jong-Min | Cho, Jae-Jin | Kim, Tae-Yeong | Yoon, Bum-Chul

Article Type: Research Article

Abstract: BACKGROUND: Rehabilitation after anterior cruciate ligament (ACL) reconstruction focuses on restoring knee deficiencies and function. However, the extent of the clinician’s direct supervision that is required to recover knee function is unknown. OBJECTIVE: To investigate differences in isokinetic knee strength improvement, endurance, and proprioception between home-based (HBR) and supervised rehabilitation (SR). METHODS: Thirty participants were randomly allocated to each group after reconstruction. Isokinetic knee strength and proprioception were measured using the Biodex multi-joint and stability systems, respectively, before and after intervention. RESULTS: The SR group showed a significant improvement from …baseline, but not the HBR group (SR group, from 1.94 ± 1.44 to 1.02 ± 0.92, p < 0.05; HBR group, from 1.69 ± 0.88 to 1.61 ± 0.90, p > 0.05). There was a significant effect of exercise type on proprioception scores after controlling for pretest values (p < 0.05). No significant difference in isokinetic knee strength was observed between the groups. CONCLUSIONS: HBR recovered knee strength as effectively as the SR, but SR was more effective than HBR for the recovery of proprioception and functional knee movement. This result indicates that guidance from health professionals play an important role in enhancing proprioception for patients following ACL reconstruction. Show more

Keywords: Anterior cruciate ligament reconstruction, rehabilitation, supervision, isokinetic knee strength, proprioception

DOI: 10.3233/BMR-181237

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 3, pp. 421-429, 2019

Authors: Cho, Sung-Hak | Park, Se-Yeon

Article Type: Research Article

Abstract: BACKGROUND: Recent clinical research has supported the use of suspension devices in rehabilitation procedures both in practice and in theory. Although a longitudinal study has reported on the use of suspension devices among asymptomatic subjects, it is necessary to investigate the immediate effects of suspension exercises in patients with CLBP. OBJECTIVE: The present study aims to investigate changes in neuromuscular activation after the prescription of suspension exercises in patients with CLBP. A secondary aim was to determine whether practical flexion and extension strength can be effectively enhanced. METHODS: Before and after suspension exercise, …flexion extension (FE) ratio and trunk strength of flexion and extension were measured. Patients performed two types of suspension exercises: supine bridge and forward leaning exercises. The paired t-test was used to compare the FE ratio and strength data. Pearson correlation coefficient was performed to study the correlation between measured variables. RESULTS: Compared to the pre-exercise measurements, the flexion-extension ratio and trunk extension strength was significantly increased at the post-exercise measurement (p < 0.05). The FE ratio in the right lumbar erector spine muscle was significantly correlated with post-exercise trunk extension strength (p < 0.05). CONCLUSIONS: For patients with chronic lower back pain, stimulation of the lumbar extensor muscle and of proprioception is effective both for strengthening lumbar extensors and for improving the flexion-extension ratio. Consequently, forward leaning and supine bridge exercises with a suspension device are beneficial for normalising neuromuscular control of the erector spinae muscles. Show more

Keywords: Electromyography, extensor strengthening, forward leaning, sling

DOI: 10.3233/BMR-181298

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 3, pp. 431-436, 2019

Authors: Kim, Taeyeong | Kim, Minhee | Lee, Minyoung | Yoon, Bumchul

Article Type: Research Article

Abstract: BACKGROUND: The prevalence of degenerative shoulder disease is increasing, and most shoulder diseases are accompanied by changed activation of the scapular muscles. However, the characteristics of scapular muscle activation in older adults have not yet been reported. OBJECTIVE: The aim of this study was to investigate the effect of age and load on scapular muscle activation during shoulder abduction and flexion. METHODS: Eleven older adults (5 men, 6 women; 71.1 ± 5.3 years) and ten young adults (5 men, 5 women; 25.0 ± 2.7 years) performed shoulder …elevation (abduction and flexion) with and without a dumbbell. Electromyography were recorded from the upper, middle and lower trapezius, and serratus anterior muscles in the dominant side. Muscle activation was normalized by reference voluntary contractions. RESULTS: During shoulder elevation with a dumbbell load, the activation of the middle trapezius (p = 0.036) in older adults was significantly higher than that in young adults during abduction. The activation of the upper trapezius (p = 0.001) in older adults was significantly higher than that in young adults during flexion. CONCLUSION: The older adults have a higher activation of the upper and middle trapezius during shoulder elevation with a weighted load. Show more

Keywords: Older adults, aging, scapular muscle, upper trapezius, EMG

DOI: 10.3233/BMR-181293

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 3, pp. 437-443, 2019

Authors: Yörükoğlu, Ali Çağdaş | Şavkın, Raziye | Büker, Nihal | Alsayani, Khaled Yahya Abdullah

Article Type: Research Article

Abstract: BACKGROUND: Strong core stabilization not only minimizes the load on the vertebral column, but also improves strength and endurance of peripheral joints, and enables the energy transfer to distal segments. Despite the current interest surrounding core stability, none of the studies investigated the effect of core stability on the formation of rotator cuff tear or healing after repair. OBJECTIVE: To determine the relationship between core stability and upper extremity functional performance in patients who underwent rotator cuff repair surgery and to compare those with healthy subjects of similar age. METHODS: Patients who underwent …rotator cuff repair (RC repair group, n = 58 patient) and healthy subjects of the similar age group (control group, n = 114) were included in the study. The mean age was 55.03 ± 9.84 years in the RC repair group and 52.71 ± 6.31 years in the control group. The RC repair group took standardized rehabilitation. The rehabilitation program did not include core strength and stability exercise. Core endurance was assessed with Flexor Endurance, Prone Bridge and Supine bridge test. Disabilities of the Arm, Shoulder and Hand (DASH), Short Form-36 (SF-36) and the Close Kinetic Chain Upper Extremity Stability (CKCUES) test were used to evaluate the upper extremity functional performance. RESULTS: The core endurance (prone and supine bridge test) of the control group was statistically significantly better than the RC repair group (p ⩽ 0.005). The DASH-T, SF-36 and CKCUES scores of the control group were also statistically significantly better. CONCLUSION: The neuromuscular system should be considered as a whole, and addition of the core stabilization exercises to an effective rehabilitation program after RC repair surgery may be beneficial. Show more

Keywords: Rotator cuff, core stability, upper extremity, quality of life

DOI: 10.3233/BMR-170962

Citation: Journal of Back and Musculoskeletal Rehabilitation, vol. 32, no. 3, pp. 445-452, 2019