Journal of Back and Musculoskeletal Rehabilitation最新文献

BackgroundOlder adults experience accelerated muscle loss due to decreased physical ability, inadequate nutrition, and chronic illnesses depletion, predisposing them to sarcopenia. While Baduanjin and acupuncture may be beneficial, their combined effectiveness remains unclear.ObjectivesTo evaluate the combined effects of acupuncture and Baduanjin on muscle mass, strength, and quality of life in older adults with sarcopenia.MethodsIn this randomized controlled trial, 105 adults aged 60-84 years with sarcopenia were randomly assigned to three groups: acupuncture combined with Baduanjin group (AC + BDJ), acupuncture group (AC), and Baduanjin group (BDJ). The 12-week intervention included acupuncture twice weekly for 30 min and Baduanjin exercises five times weekly for 20-30 min. Assessments were conducted at baseline, 12-week, and 20-week follow-up. The primary outcome was appendicular skeletal muscle mass index (ASMI). Secondary outcomes included body composition (weight, BMI, body fat percentage), physical function (handgrip strength, gait speed, calf circumference), and overall health status [short physical performance battery (SPPB), Mini-Nutritional Assessment (MNA), and Geriatric Depression Scale (GDS)]. Statistical analyses were performed using SPSS 26.0.ResultsAmong 93 completers, all groups showed significant within-group improvements (all P < 0.01). Crucially, AC + BDJ demonstrated superior improvements in ASMI (η²_p = 0.609) and SPPB (η²_p = 0.259) compared to individual groups (both P < 0.01). While AC + BDJ exhibited the largest percentage gains in other outcomes, Post-hoc differences were not statistically significant. Depressive symptom improvements were similar across groups.ConclusionCombining acupuncture with Baduanjin significantly enhances muscle mass and strength in older adults with sarcopenia, offering superior clinical efficacy and a low-risk, adaptable rehabilitation alternative.Trial registrationThis study was reviewed and approved by the Ethics Committee of Nanjing Hospital of Traditional Chinese Medicine (approval number KY2024017). The registration was completed in the International Traditional Medicine Clinical Trial Registration Platform with registration number ITMCTR2025000130.

BackgroundLumbar spondylolysis, a stress fracture, is frequently observed in adolescent athletes performing repetitive spinal extension and rotation. Early diagnosis and treatment are crucial to prevent progression and recurrence. However, the impact of the time from symptom onset to consultation on disease stage and recurrence remains unclear.ObjectiveThis study investigated whether delayed consultation influences the disease stage at diagnosis and recurrence in adolescent athletes with lumbar spondylolysis.MethodsA retrospective cohort study was conducted at Hospital A from April 2022 to April 2025. Data included age, sex, sport type, lesion location, disease stage (early, advanced, or terminal), consultation timing (<30 or >30 days), and recurrence. Fisher's exact test was used for univariate analysis, and variables with P < 0.20 were entered into a logistic regression model to identify independent predictors.ResultsEighty-three athletes (53 males, 30 females; mean age 14.9 ± 1.9 years) were analyzed. Univariate analysis revealed that delayed consultation and advanced disease stage were significantly associated with recurrence. Logistic regression identified disease stage as the only independent predictor (OR = 0.06, 95% CI: 0.01-0.32, P < 0.0011).ConclusionA delay in consultation was not an independent predictor of recurrence; however, it indirectly increased the risk of recurrence by contributing to disease stage advancement at the time of diagnosis. These findings highlight that timely consultation can prevent disease progression and lower recurrence risk. Educating athletes, parents, and coaches about early medical evaluation is essential to improve clinical outcomes and ensure a safe return to sports.

BackgroundCurrently, no studies have investigated the effectiveness of combining trunk stabilization exercises with lower extremity strength training in amateur golfers with low back pain.ObjectiveThis study aimed to evaluate the effects of a rehabilitation program incorporating trunk stabilization exercises and lower extremity strength training on pain, disability, balance, and golf performance in amateur golfers with nonspecific LBP (NSLBP).MethodsAmateur golfers with NSLBP (n = 30) were randomly assigned to either the experimental group (EG; n = 15) or the control group (CG; n = 15). The EG participated in a rehabilitation program that included trunk stabilization exercises and lower extremity strengthening exercises, while the CG performed golf swing exercises and stretching. Both groups trained for the same duration-40 min/day, four times per week, for 6 weeks.ResultsAn interaction effect was found in visual analog scale and Oswestry Disability Index scores (p < .05), and EG was significantly reduced more than CG. In balance ability, an interaction effect was found in total balance ability in the eyes-open condition, and left-right balance, pressure area, and total balance ability in the eyes-closed condition (p < .05), and balance ability improved more in EG than CG. In golf performance, an interaction effect was found in driver distance and ball speed (p < .05), and both EG and CG improved.ConclusionsThese findings indicate that a rehabilitation program combining trunk stabilization exercises and lower extremity strengthening exercises is more effective than general swing exercises and stretching in improving pain, disability, balance in amateur golfers with NSLBP.

BackgroundPain is the most common symptom in Thoracic Outlet Syndrome (TOS).ObjectiveThis study was conducted to determine the characteristics of pain in patients with TOS.Methods66 patients (59 female, 7 male) participated in this cross-sectional study. Pressure pain thresholds (PPT) and pain intensity were evaluated. Central Sensitization Inventory (CSI), Tampa Kinesiophobia Scale (TSK), Toronto Alexithymia Scale (TAS) and Pain Catastrophizing Scale (PCS) were used. Mann-Whitney U and Spearman tests were used for statistical analyzes.ResultsA significant positive correlation was observed between symptom duration (6.42 ± 5.33 years) and both CSI (r = 0.261,p = 0.034) and TSK (r = 0.271,p = 0.028). Centrally sensitized patients were found to have significantly worse kinesiophobia (p = 0.005), catastrophizing (p = 0.031) and alexithymia (p = 0.049). Patients with pain catastrophizing had higher kinesiophobia (p = 0.003). There was no difference in PPT in trapezius (p = 0.507) and infraspinatus (p = 0.690) muscles but there was a difference in the extensor carpi radialis (p = 0.009) and extensor indicis proprius (p = 0.002). Pain values were similar between patients who had undergone surgery and those who had not.ConclusionsThe findings of this investigation indicate that symptoms related to central sensitization in TOS are linked to chronic pain indicators, while catastrophizing is associated with kinesiophobia. Additionally, it was observed that a prolonged duration of symptoms in TOS intensifies the severity of central sensitization and kinesiophobia. The similarity in pain parameters between the surgical and non-surgical groups may reflect the effects of chronic pain due to prolonged symptom duration. These results suggest that TOS should not be perceived solely as a musculoskeletal issue.

BackgroundFibromyalgia is a chronic syndrome with widespread pain and multisystem symptoms. Hydrokinesitherapy, combining exercise and water immersion, may reduce pain, improve function, and enhance quality of life. It may be more effective than land-based therapy, though protocols remain unstandardized. This study evaluated its effectiveness in fibromyalgia.ObjectiveThis systematic review aimed to evaluate the effectiveness of hydrokinesitherapy compared to land-based exercise or placebo intervention in women with fibromyalgia, with particular focus on its impact on pain, physical function, well-being, and quality of life assessed through the fibromyalgia impact questionnaire (FIQ).MethodsA literature review was conducted using the following databases until may 28^th 2025: PubMed, Scopus, and Web of Science. Studies were deemed eligible based on the following PICO criteria: P) Participants: women diagnosed with fibromyalgia; I) Intervention: hydrotherapy; C) Control: land-based exercise or placebo/sham treatments; O) Outcome: Fibromyalgia Impact Questionnaire (FIQ). Only randomized controlled trials RCTs with two groups and full text in English were included.ResultsThis review included 10 RCTs with 469 participants, 238 treated with hydrokinesitherapy. Results showed significant improvements in pain, function, sleep, depression, and quality of life in women with fibromyalgia. Outcomes were better than land-based exercise, but benefits decline without continued therapy; long-term studies are needed to define optimal duration and structure.ConclusionHydrokinesitherapy combined with exercise benefits from warm-water immersion, reducing joint stress and improving movement tolerance in fibromyalgia. This review confirms its effectiveness in reducing pain, enhancing physical and psychological well-being, and improving quality of life.

BackgroundFalls are a leading cause of injury, loss of independence, and premature mortality among older adults, and they place a substantial burden on individuals, caregivers, and healthcare systems.ObjectiveThis cross-sectional study aimed to determine the contribution of vibration and proprioception sense, isometric muscle strength, static balance, reaction time and postural stability to falls in females aged 65 and over.MethodsIn this cross-sectional study, 92 females (aged ≥65 years) were evaluated for vibration sense, proprioception, isometric muscle strength, static balance, reaction time, and postural stability. The number of falls within the past year was recorded. Statistical analyses were performed using IBM SPSS v27.0, with non-normally distributed variables compared using the Mann-Whitney U test and independent contributors to falls identified by multiple linear regression with backward stepwise elimination.ResultsFallers demonstrated reduced vibration sense, larger ankle joint reposition errors, weaker dorsiflexor and plantarflexor strength, and slower dorsiflexion and plantarflexion reaction times (all p < 0.001); no group differences were seen for invertor/evertor strength, static balance duration, or postural sway (p > 0.05). In multivariable regression, greater plantarflexion joint reposition error (β = 0.454, p < 0.001), poorer vibration sense (β = -0.214, p = 0.005), reduced plantarflexor strength (β = -0.149, p = 0.040) and longer plantarflexion reaction time (β = 0.232, p = 0.003) independently predicted number of falls (VIF < 2.2).ConclusionImpaired vibration sense, greater plantar flexion proprioceptive error, reduced plantar flexor strength, and slower plantarflexion reaction time were independently associated with more falls. Targeted interventions to enhance proprioceptive function, muscle strength, and neuromuscular response may be essential for fall prevention and promoting safer, more independent aging.

Background: Unstable training surfaces and loads are often used to enhance neuromuscular activation, but their comparative effects on core and lower limb muscle activity during unilateral exercises remain unclear. Objective: To compare the effects of Bulgarian split squats performed under unstable surface conditions (USC) and unstable load conditions (ULC) on core and lower extremity muscle activation. Methods: Twenty-one physically active adults performed Bulgarian split squats under three conditions: stable condition (SC), USC using a balance pad, and ULC using a water-filled aqua bag. Surface electromyography (EMG) measured muscle activation during both descending and ascending phases. Data were normalized to %MVIC and analyzed using repeated measures ANOVA or non-parametric tests depending on data normality. Results: USC significantly increased core (rectus abdominis, external oblique, internal oblique, erector spinae) and selected lower limb muscle (gluteus maximus, gluteus medius, biceps femoris) activation compared to SC (p < .05). ULC elicited the greatest activation across both phases (p < .001). No significant differences were found in vastus lateralis and vastus medialis among conditions. Conclusions: Bulgarian split squats with unstable loads result in greater activation of core and selected lower limb muscles than unstable surfaces or stable conditions. Unstable load training may be an effective method to enhance muscular activation and stability in unilateral lower body exercises.Clinical trial registrationKCT0009349 (approval date: April 19, 2024).

BackgroundThe supraspinatus muscle and tendon are an integral part of shoulder joint function and stability. The supraspinatus tendon is one of the four tendons forming the rotator cuff in the shoulder. Supraspinatus tendon tear is a frequent lesion that occurs due to various causes like lifting heavy objects, falls onto the shoulder, a dislocation of the shoulder, swimming, trauma, sports injury, occupational activity and degenerative change. Smoking, hypercholesterolemia, and hereditary predisposition are all established risk factors for developing RC tears, which affect the age dependent tendon degeneration process. Only a few articles were found discussing the histological characteristics of degenerative change of the supraspinatus tendon in rotator cuff tears.ObjectiveTo evaluate the histological characteristics of degenerative changes in the supraspinatus tendon associated with rotator cuff tears.MethodsRotator cuff disease is a major cause of shoulder pain and shoulder dysfunction in adults; not every patient is symptomatic, though. We examined morphological features of human surgical specimens of the supraspinatus tendon in patients with full thickness tears of the rotator cuff.ResultsHistological analysis of the surgical specimen revealed significant degenerative changes, including disorganization and tearing of the collagen fiber bundles, sparingly distributed, rounded tenocytes, and increased vascularity (neovascularization) within the tendon matrix.ConclusionThese findings provide direct evidence of intrinsic tendon degeneration as a key pathological factor in full thickness rotator cuff tears, which may be helpful for future research on the pathophysiology of the condition.

BackgroundThe shoulder and elbow differ in their anatomical structure and physiological function, which can lead to differences in joint position sense (JPS) accuracy. However, most previous studies have assessed JPS in single-joint motions across multiple planes.ObjectiveThis study aimed to compare the joint position error (JPE) between single- and multi-joint motions and investigate how motion patterns and planes of motion influence proprioceptive accuracy.MethodsThe single-joint motion involved flexion of either the shoulder or elbow to a target angle of 45° without reference. The multi-joint motion included simultaneous shoulder and elbow flexion (SF-EF) and shoulder abduction with elbow flexion (SA-EF).ResultsIn the single-joint motion, the shoulder exhibited a lower JPE and higher reliability than those of the elbow. In multi-joint motions within the same plane (SF-EF), the shoulder JPE increased significantly, whereas in multi-joint motions across different planes (SA-EF), the JPE decreased.ConclusionIn single-joint motions, the shoulder has superior proprioceptive acuity compared to the elbow, which may be attributed to differences in peripheral sensory mechanisms and segment-based motor control within the central nervous system. In multi-joint motions, proprioceptive distortion owing to summation effects was observed in a single plane, but not in multiple planes.

BackgroundSpinal biomechanics interact with pelvic floor function. Since erectile dysfunction (ED) involves pelvic floor impairment, assessing the spine may inform ED pathophysiology and management.ObjectiveTo compare spinal posture, mobility, and stability between individuals with ED symptoms and healthy controls.MethodsThis case-control study included 66 participants (ED group, n = 33, age=45.18 ± 9.49 years; control group, n = 33, age=41.58 ± 7.71 years). The severity of ED was questioned with the International Index of Erectile Function (IIEF-5). Spine posture and mobility were assessed with the Spine Mouse device (IDIAG M360^®, Fehraltorf, Switzerland), and spine stability was assessed with the McGill trunk muscle endurance tests and Sahrmann test.ResultsThe ED group had a mean IIEF-5 score of 11.85 ± 4.40, indicating moderate ED. Sagittal spinal angles of the groups were similar (p > 0.05). Sagittal sacral mobility was less in the ED group (44.24°±20.67°) compared to the control group (52.58°±11.12°) (mean difference: -8.33°, 95% confidence interval (CI): -0.99 to -0.01, d = 0.50, p = 0.046). Trunk muscle flexor (mean difference: -8.85 s, 95% CI: -1.60 to -0.57, d = 1.09, p < 0.001), extensor (mean difference: -8.66 s, 95% CI: -1.22 to -0.22, d = 0.73, p = 0.004), left side lateral flexor muscle endurance test scores (mean difference: -5.52 s, 95% CI: -1.15 to -0.15, d = 0.65, p = 0.010) and Sahrmann test score (p = 0.021) were lower in the ED group compared to the control group.ConclusionsSacral mobility and spinal stability are impaired in men with ED, while spinal posture remains unchanged. Incorporating assessments and targeted interventions for spinal mobility and stability into ED management and physiotherapy programs may be beneficial.