Journal of Back and Musculoskeletal Rehabilitation最新文献

Background: Cerebral palsy (CP) refers to a lasting motor impairment resulting from atypical brain development or injury. Aquatic exercise (AE) is frequently utilized as an approach for rehabilitating children with CP because of its appealing water properties.

Objective: The aim of this study was to examine how AE influences motor skills in children affected by CP.

Methods: Systematic searches of databases provided randomized controlled trials (RCTs) published from their inception up until May 22, 2024. The study compared the impacts of AE training with those of routine rehabilitation training (RRT). A random-effects model was employed to assess the aggregated data.

Results: In total, 491 articles were retrieved, and 15 studies (n = 595 patients) were included in this study. Compared with RRT, AE improved the gross motor function of children with CP (SMD = 7.63, 95% CI 5.79-9.47, P < 0.01), especially in the lying and turning over positions (SMD = 15.66, 95% CI 13.85-17.46, P < 0.01). AE also reduced muscle tension (SMD = -0.75, 95% CI -1.03--0.47, P < 0.01).

Conclusions: AE is expected to improve motor function in children with CP. Moreover, this study emphasizes the need for future high-quality related studies to supplement the results and improve the conclusions.

Background: Temporomandibular joint disorders (TMDs) are collective terms for a series of clinical diseases. However, due to the complexity of the temporomandibular joint (TMJ), TMDs are still unknown as to their pathogenesis.

Objective: This pilot randomized controlled trial aimed to evaluate the efficacy of extracorporeal shock wave therapy (ESWT) in conjunction with drug therapy for myogenic TMDs.

Methods: In accordance with the CONSORT (Consolidated Standards of Reporting Trials) guidelines, we conducted a randomized controlled trial involving 60 patients diagnosed with myogenic TMDs. Patients with myogenic TMDs (Class I) were randomly divided into ESWT group and Ultrashort Wave (UW) group. The UW group was given ultrashort wave combined with drug therapy, while the ESWT group was given extracorporeal shock wave combined with drug therapy. The primary outcome was pain intensity measured by the Visual Analog Scale (VAS), and secondary outcomes included maximum mouth opening (MMO) and temporomandibular joint function indices.

Results: Post-treatment assessments revealed significant improvements in VAS scores and MMO in both groups (p < 0.05). Besides, compared with the UW group, the VAS score, the degree of MMO and Friction indexes of the TMDs patients in the ESWT group were remarkably improved after treatment (p < 0.05).

Conclusion: For TMDs patients, extracorporeal shock wave combined with drug therapy can more quickly and effectively relieve the pain of the patient and improve the patient's dysfunction. However, due to the limitations of a small sample size and lack of prospective registration, these findings should be interpreted with caution. Future studies with larger sample sizes and proper registration are warranted.

Purpose: This study aimed to evaluate the reliability and quality of Turkish videos about frozen shoulder exercises published on the Youtube platform.

Material-method: 54 videos were included in the study as a result of searches and evaluations made on the YouTube platform using the keywords "frozen shoulder exercises" and "adhesive capsulitis exercises". The included videos were evaluated by two independent observers and a final independent 3rd observer, and the given modified DISCERN (mDISCERN), Global Quality Scale (GQS) and JAMA scores were compared with other video parameters. Differences between groups were examined.

Result: Exercises were detected in 10 different categories in the 54 videos included in the study. In the examination made according to GQS scoring, a statistically significant relationship was found between the viewing rate, mDISCERN and JAMA scores, the number of exercise types included in the video and the GQS quality grouping (p < 0.05). In the examination conducted in terms of reliability, a statistically significant relationship was found between mDISCERN scores and the number of exercise types included in the videos, JAMA and GQS scores (p < 0.05).

Conclusion: In our study, more than half of the frozen shoulder exercise videos on the Youtube platform were found to be low in reliability and quality. Due to the variety of content in the videos and the lack of individualized exercises, YouTube does not appear to be a suitable resource for frozen shoulder exercises. Considering all these, we believe that videos with informative content should be created by physicians or should be audited.

Background: Dry needling (DN) and Extracorporeal shock wave therapy (ESWT) are common in calcaneal epin treatment.

Objective: The aim of the study was to compare the effects of both treatments on proprioception, balance, pain, and functional status.

Methods: 90 patients which consist of 45 patients as DN + self stretching and 45 patients as ESWT + self stretching. Patients in each group were treated 1 session per week for 4 weeks. Assessments of 15° ankle dorsiflexion and plantar flexion proprioception, one leg standing test (OLST), foot function index (FFI), visual analog scale (VAS) (first step, resting, activity), quality of life scale (SF-36) were performed. The outcomes were recorded at pre-treatment, post-treatment, and 4 weeks after the post-treatment.

Results: Statistically significant differences were determined in VAS (resting, first step, activity) and FFI values in both treatment methods (p < 0.05). In OLST, SF-36, and FFI evaluations, DN was statistically more effective than the ESWT method (p < 0.001). In the 15° proprioception evaluations, a significant difference was observed in the patient's ankle in both methods, while the DN method is more effective in the indicated stages of evaluation.

Conclusions: Both methods applied to epin calcanei patients were effective, but the DN method is a more effective treatment method than the ESWT method in terms of balance, proprioception, foot function, and quality of life.

Background: The Scapular Dyskinesis Test (SDT) is typically conducted using either real-time visual observation or video analysis. However, factors such as restricted shoulder mobility, higher body mass index (BMI), patient-centred care, and cultural considerations may impact the reliability of SDT results. Palpation offers an alternative approach that addresses these limitations by providing additional tactile information on joint function and dysfunction.

Objective: This study aimed to evaluate the reliability and potential benefits of the palpation-based SDT.

Methods: Videotaped, real-time visual observation, and palpation-based SDTs were conducted on 55 patients to assess the reliability and potential advantages of the palpation technique.

Results: The inter-rater reliability of the palpation-based SDT was almost perfect (k = 0.82), while intra-rater reliability was similarly high (k = 0.97). Additionally, eight patients diagnosed with scapular dyskinesis (SD) were found to have Scapular Snapping Syndrome (SSS).

Conclusion: The palpation-based SDT demonstrated superior inter-rater reliability compared to video analysis and real-time visual observation, with almost perfect reliability (k = 0.82). This method is particularly beneficial for patients with high or low BMI, those unable to remove clothing, and may be useful for detecting SSS. The findings suggest that palpation SDT is an effective tool for assessing scapular dyskinesis in various clinical settings.

Background: Chronic neck pain (CNP) does not have a direct effect on breathing, but movements are restricted due to pain, and kyphotic posture may make movement of the diaphragm difficult.

Objective: This study aimed to determine the effects of neural mobilization (NM) on respiratory functionss in patients with chronic neck pain.

Methods: Overall, 26 patients with CNP were randomly assigned to two groups: NM (10 sessions) or control. In these participants, pain intensity was first assessed using a Visual Analog Scale (VAS). Next, the active range of motion (ROM) of the cervical joint was measured. Following this, respiratory function was evaluated using spirometry, which included parameters such as Forced Expiratory Volume in 1 s (FEV1), Forced Vital Capacity (FVC), and the FEV1/FVC ratio. Finally, neck awareness was assessed using the Fremantle Neck Awareness Questionnaire (FreNAQ).

Results: There was a significant difference in terms of pain intensity (p < 0.05) and range of motion of the neck joint in both groups after treatment (p < 0.05). In addition, there was a significant difference between the two groups in terms of respiratory function tests (p = 0.001) and neck awareness (p = 0.001).

Conclusion: The results of our study suggest that the use of NM treatment in addition to conventional physiotherapy in patients with chronic neck pain has beneficial effects on respiratory functions, joint range of motion, pain, and neck awareness.

Background: The fact that scapular asymmetry and cervical disc herniation share similar findings (e.g. forward head posture, neck pain) necessitates the assessment of scapular asymmetry in cervical disc herniation.

Objective: This comparative cross-sectional study sought to evaluate scapular asymmetry in cervical disc herniation.

Methods: The study involved 114 participants, split evenly between those diagnosed with cervical disc herniation and healthy individuals. Neck and interscapular pain were assessed using a numerical rating scale. Mechanosensitivity in the upper trapezius and suboccipital muscle insertion was measured bilaterally with an analog algometer. Forward head posture was assessed by determining the craniocervical angle. Cervical range of motion was evaluated using a goniometer, while scapular asymmetry was tested using the lateral scapular slide test. Upper trapezius tightness was visually evaluated, and pectoralis minor length was measured using a plastic angle ruler.

Results: Scapular asymmetry ratio was significantly higher in patients with cervical disc herniation (p < .05). The study group demonstrated significantly greater mechanosensitivity and limited cervical range of motion (p < .05). Neck and interscapular pain were more prominent in the study group. Pectoralis minor length, upper trapezius tightness, and craniocervical angle were similar in both groups (p > .05).

Conclusions: Scapular asymmetry is more prevalent in cervical disc herniation.

Background: Patients with chronic low back pain (CLBP) exhibit changes in paraspinal muscles fat infiltration and cross-sectional area (CSA). However, the relationship between lumbar disc herniation (LDH) and paraspinal muscles changes in CLBP patients remains unclear.

Objective: To analyze the relationship between LDH, fat infiltration in paraspinal muscles, and their CSA in patients with CLBP.

Methods: A total of 494 patients (201 males and 293 females) with an average age of 45.75 ± 12.93 years with CLBP were included in this study. Conventional magnetic resonance scanning sequences, inverted phase and Iterative Decomposition of water and fat with the Echo Asymmetry and Least-Square Estimation quantitation (IDEAL-IQ) sequences were used, and patients were assessed for pain on a visual analog scale (VAS). LDH was assessed based on T2 axial images at the L4-S1 level. Multifidus and erector spinae CSA and proton density fat fraction (PDFF) were measured bilaterally at the central level of the L4-S1 disc using the above-mentioned sequences and normalized by the square of height.

Results: Patients with LDH had a higher PDFF of the paraspinal muscles at the L4/5 level compared to those without LDH (p < 0.05). Additionally, the VAS score of patients with LDH was significantly higher than that of the control group (p < 0.05). However, there was no significant difference in the change of paraspinal muscles CSA between patients with CLBP with and without LDH.

Conclusion: In patients with LDH, there is increased fatty infiltration in the paraspinal muscles, with no significant changes in CSA. Different types of LDH are not related to paraspinal muscles fatty infiltration and CSA.

Background: Postoperative balance disorders in older adults after total knee arthroplasty (TKA) due to osteoarthritis are commonly attributed to proprioceptive joint deficits. Both Proprioceptive Neuromuscular Facilitation (PNF) and Focal Vibration (FV) can improve balance and proprioception.

Aim: To examine the combination of a PNF exercise program and quadriceps tendon FV in older adults after TKA due to osteoarthritis.

Methods: Ninety older adults who underwent TKA were randomly assigned to three groups of 30. The PNF Group followed a 6-week PNF exercise program starting four weeks post-surgery. The PNF + FV Group followed the same PNF program combined with FV applied to the rectus femoris and vastus medialis. The control group received instructions for a home-based exercise program. Pain (Numeric Pain Rating Scale; NPRS), knee range of motion (ROM), functional ability (Knee Injury and Osteoarthritis Outcome Score, KOOS), joint position sense (JPS), postural sway (force platform), and balance (Timed Up-and-Go; TUG test, Berg Balance Scale; BBS) were evaluated at baseline, six weeks, and six months post-intervention. A two-way repeated measures ANOVA analysis was applied with significance set at p < .05.

Results: The PNF + FV group showed significant improvements compared to the control group in NPRS, KOOS, TUG, BBS, displacement parameters, and absolute error scores (p < .05). The PNF + FV group showed earlier improvements compared to the PNF group, indicating faster adjustments due to the combined effect of PNF and FV. Additionally, the PNF + FV group showed greater improvement in TUG, BBS, KOOS sport, anterior-posterior displacement distance, and absolute error scores at 25° compared to the PNF group (p < .05). PNF exercises improved knee ROM (p < .05) with no additional effect from FV.

Conclusions: A 6-week protocol combining PNF exercises and FV significantly improved balance, knee joint position sense, knee functional ability, and pain intensity in older adults after TKA due to osteoarthritis. These findings suggest faster and more effective rehabilitation, potentially reducing postoperative disorders and future injury risks. Further research is needed to investigate the combination of FV and PNF.