Journal of Back and Musculoskeletal Rehabilitation最新文献

Introduction: Return to school (RTS) after adolescent idiopathic (AIS) scoliosis surgery is a critical outcome measure signifying a return to everyday life. Prior studies in Western populations report an average RTS of 42.3 days for AIS surgery. This study aims to estimate RTS and identify factors affecting it in Saudi Arabia.

Method: This retrospective cross-sectional study included 48 AIS patients who underwent posterior spinal fusion (PSF). Data collected included demographics, surgical details, and recovery timelines. After identifying the average time to return to school, patients were categorized based on RTS duration, with a 42-day cutoff. Factors that could delay the time to return to school were analyzed.

Result: Among the 48 patients, 41 (85.4%) were female, with a mean age of 14.47 years (SD 2.7). The average RTS was 60.1 days (SD 24). Significant associations were found between RTS and age at surgery (12.92 years for RTS ≤ 42 days vs 14.84 years for RTS > 42 days, p = 0.04) and levels fused (15.40 for RTS ≤ 42 days vs 13.38 for RTS > 42 days, p = 0.036). Other factors showed no significant associations.

Conclusion: The average RTS after scoliosis correction in Saudi Arabia is two weeks longer than the average in other countries. Further studies are needed to develop solutions to reduce the delayed RTS in Saudi Arabia.

Background and purpose: This study aimed to explore the biomechanical characteristics of patients with stroke and neuromuscular action control mechanisms in single-dual-task walking-conversion training.

Materials and methods: Patients with stroke from four centers were enrolled and randomly divided into the cognitive combined treadmill-walking and exercise combined treadmill-walking groups (n = 30 per group). The gait spatiotemporal parameters, walking function, and fall risk of the two experimental groups were compared before and after 4 and 6 weeks of training. Surface electromyography (sEMG) and functional near-infrared spectroscopy (fNIRS) were performed to analyze neuromuscular action control mechanisms in different task phases.

Results: After 6 weeks of training, the gait spatiotemporal parameters, walking function, integral electromyogram (iEMG) values, and root mean square (RMS) of the affected lower limb muscles of the two experimental groups significantly improved (P < 0.01), while the fall risk was reduced (P < 0.01). fNIRS analysis showed that in both the single- and dual-task phases, HbO signal concentrations in the brain functional regions of the two experimental groups significantly increased after training (P < 0.01). These indicators were not significantly different between the two experimental groups after 6 weeks of training (P > 0.05). In addition, during the dual-task phase, the blood oxygen signal concentrations and functional connectivity in the functional brain regions of the two experimental groups were lower than those of healthy controls.

Conclusion: Cognitive or motor tasks combined with treadmill-walking training can promote the recovery of physical function in patients with stroke.Clinical trial registration: This study was registered in the Chinese Clinical Trial Registry (ChiCTR; registration number: ChiCTR2200060864).

Background: Posture during smartphone use is an important factor that affects musculoskeletal pain.

Objective: To investigate the prevalence and characteristics of musculoskeletal pain in the neck, trunk, and upper extremities during smartphone use.

Methods: A total of 326 Chinese and Korean smartphone users participated in an online survey on smartphone posture, addiction, and musculoskeletal pain.

Results: The neck, shoulder, and lower back were most frequently affected, whereas the elbow, lower back, and forearm showed the highest level of discomfort. Stiffness was the predominant type of discomfort in most body parts. Numbness surpassed stiffness in the elbow and hand, whereas throbbing surpassed stiffness in the wrist. Body posture influenced upper arm and lower back discomfort, with a right-sided lying posture resulting in the highest level of lower back pain (p < 0.05). Using a smartphone with a more flexed neck posture increased neck discomfort (p < 0.05). Holding a smartphone with one hand, while controlling the screen with the opposite finger, increased hand pain (p < 0.05).

Conclusion: The inferences obtained from this study indicate that smartphone usage posture significantly affects musculoskeletal discomfort. The suggested posture for minimizing musculoskeletal discomfort is to use the smartphone in a left-side-lying position, hold it vertically with both hands, and utilize both thumbs for texting and scrolling.

Background: Assessment, diagnosis, and treatment of motor control impairments are among the most widely implemented management strategies for chronic low back pain (CLBP). Low back movement control tests described by Luomajoki et al. are reliable and valid for assessing the presence and severity of motor control impairment. However, very little is known about the importance of demographic and well-established CLBP contributing factors in explaining the presence and severity of any type of motor control impairment.

Objective: The study objectives were to evaluate the associations of the presence and the severity of movement control impairment with age, gender, BMI, CLBP and its intensity and duration, postural stability, self-reported central sensitization, kinesiophobia, and CLBP-related disability with logistic and ordinal regressions and Wald chi-squared tests.

Methods: This cross-sectional study included 161 subjects with CLBP and 42 pain-free controls. The study was carried out in single private chiropractic clinic.

Results: Higher age and BMI were distinctly greater associated with a higher presence and severity of movement control impairment compared to the pain-related factors, namely the CLBP or its intensity or duration, central sensitization, kinesiophobia, and CLBP-related disability.

Conclusions: Results highlight the importance of considering demographic factors, such as age and BMI, when interpreting motor control impairment findings. Accordingly, the findings challenge the validity of testing motor control impairment in the management of CLBP.

Background: Low back pain is the third most reported complaint after headache and chronic fatigue, and more than 80% of the population will experience low back pain at some point in their lives.

Objective: We conducted this study to investigate the effects of instrument-assisted manipulation (IAM) and mobilization with movement (MWM) on joint range of motion (ROM), pain, proprioception, endurance, back awareness, and disability in individuals with chronic nonspecific low back pain (CNSLBP).

Methods: 51 participants with CNSLBP were randomized to one of three groups: (1) MWM; (2) IAM; or (3) core exercise. Joint ROM, pain, proprioception, endurance, back awareness, and disability were assessed at baseline, week 2 and 6.

Results: Joint ROM and activity pain scores increased in all groups (p < 0.05). Both activity and resting pain improved in the MWM group (p < 0.001; p = 0.004). Most measures related to proprioception improved in the MWM group (p = 0.005; p = 0.016; p = 0.016). Endurance increased in all groups, but the flexor endurance increase was higher in the MWM group (p < 0.05). Back awareness and disability increased in all groups (p < 0.05), but disability increased most in MWM group (p = 0.022).

Conclusions: MWM could effectively improve pain, proprioception, endurance, and disability.

Background: Ankle osteoarthritis (AOA) is a prevalent condition that affects joint function, often leading to pain, inflammation, and impaired mobility, significantly impacting patients' quality of life.

Objective: This study explores the effects of electroacupuncture treatment on clinical outcomes and gait characteristics in patients with ankle osteoarthritis (AOA).

Methods: A total of 78 patients with AOA were randomly divided into a experiment group and a control group. The control group was treated with strength training, and the experiment group was additionally treated with electroacupuncture. The Ankle Osteoarthritis Scale (AOS), American Foot and Ankle Society's Ankle and Hindfoot Scale (AOFAS-AHS), and the 3D Motion Analysis System were used before and after the intervention to assess the clinical outcomes and changes in kinematic parameters in the AOA patients before and after therapy.

Results: After treatment, the differences in intra-group comparisons and inter-group comparisons of AOS scores, AOFAS-AHS scores, stride length, stride length, single-support phase, and gait variable scores (GVS) of ankle dorsiflexion-plantarflexion of the patients in the experiment group were statistically significant; the differences in inter-group comparisons of GVS scores of hip rotation of the patients in the experiment group were statistically significant; and the differences in the gait profile scores (GPS) and gait deviation indices of the patients in the experiment group were statistically significant. The differences in the intra-group comparisons were statistically significant. The within-group comparisons of AOS score, AOFAS-AHS score, GPS score and GVS score of ankle dorsiflexion-plantarflexion were statistically significant in the control group patients.

Conclusions: Electroacupuncture has shown promise as an adjunctive therapy for patients with AOA, offering a more holistic rehabilitation strategy. By improving joint mobility and optimizing gait mechanics, electroacupuncture can effectively reduce pain, facilitate the restoration of normal gait patterns, and enhance patients' overall quality of life.

Background: The Low Back Activity Confidence Scale (LoBACS) was developed to evaluate self-efficacy in individuals with low back pain (LBP).

Objective: This study aimed to assess the psychometric properties of Turkish version of LoBACS in individuals with non-specific LBP.

Methods: The study included 105 participants (66 female, 39 male) with a mean age of 40.94 ± 14.65 years. The cultural adaptation and psychometric evaluation of LoBACS followed international standards and COSMIN guidelines. Reliability was assessed using the Cronbach's α and Intraclass Correlation Coefficient (ICC). Structural validity was tested with Confirmatory Factor Analysis (CFA). Pearson correlation analysis examined the relationships between LoBACS and the Waddell Disability Index (WDI), Modified Oswestry Disability Index (MODI), Roland Morris Disability Questionnaire (RMDQ), International Physical Activity Questionnaire (IPAQ), Short Form-36 (SF-36), Fear Avoidance Beliefs Questionnaire (FABQ), and Visual Analog Scale (VAS).

Results: The Turkish version of LoBACS showed high reliability (ICC = 0.850, Cronbach's α = 0.919). CFA and fit indices supported its validity. Correlations between LoBACS and other measures ranged from -0.192 to 0.542. No floor or ceiling effects were noted.

Conclusion: The Turkish version of LoBACS is a reliable and valid tool for assessing self-efficacy in individuals with non-specific LBP, suitable for both research and clinical settings.

Background: Engineers in the semiconductor industry frequently experience recurrent low back pain (LBP) due to prolonged, repetitive work postures. The operation of machinery in this industry requires a high level of muscle endurance. Dynamic taping can help reduce stress on joints and soft tissues during movement.

Objectives: This study investigated the effect of dynamic taping in workers with recurrent LBP, focusing on pain levels, muscle strength, work-related endurance, and fear avoidance behaviors.

Methods: This crossover study recruited 28 engineers with repetitive LBP from the semiconductor industry. Each participant underwent two interventions: dynamic taping and no taping. Participants completed a maximal isometric back extensor strength test, three muscle endurance tests (Biering-Sorensen, kneeling forward lean, and repetitive lifting), and two LBP questionnaires (visual analog scale [VAS] and Fear Avoidance Belief Questionnaire 2 [FABQ2]) in each scenario. MicroFET2 was used to assess back extensor strength. Electromyography (EMG) was performed to determine peak or mean values and median frequencies of the erector spinae muscle before and after endurance tests. Total endurance test durations and posttest VAS scores were recorded. FABQ2 scores were evaluated again 3 days after taping.

Results: The results of the paired t test revealed that dynamic taping significantly improved performance in the kneeling forward lean test (p < 0.01) and increased maximum isometric strength (p < 0.01). Furthermore, dynamic taping reduced VAS scores after three endurance tests (all p < 0.01) and FABQ2 score (p = 0.03). Two-way repeated measures analysis of variance revealed significant time effects in the Biering-Sorensen on average EMG activation (p < 0.01) and median frequencies during fatigue monitoring (p < 0.01). Significant time effects were also found in the kneeling forward lean test on median frequencies (p < 0.01). In addition, significant interaction effects were found in the Biering-Sorensen test on average EMG activation (p < 0.01) and in the kneeling forward lean test on median frequencies (p < 0.01). Compared with the no-taping group, the taping group exhibited a more significant decrease in erector spinae muscle activity and maintained median frequencies during fatigue tests.

Conclusion: The use of dynamic tape significantly enhanced maximum isometric strength, improved performance in work-related endurance tests without increasing muscle activity, and reduced FABQ2 scores among semiconductor engineers with recurrent LBP.

Background: Chronic non-specific neck pain (CNSNP) is a highly prevalent musculoskeletal disorder associated with significant disability, resulting in growing recourse to healthcare providers, huge cost for society and a great number of workdays lost.

Objective: By this systematic review and metanalysis we aimed to assess the effects of different physical therapy techniques in patients with CNSNP.

Methods: PubMed, Scopus, and Web of Science databases were regularly used to search for articles published from 1^st January 2010 until 31^st January 2024. All RCTs were assessed for eligibility, including studies on: patients with diagnosis of CNSNP; physical therapy approaches such as manual therapy (MT) and therapeutic exercise (TE); waiting list, sham treatments, as comparison; Visual Analogue Scale, Numerical Rating Scale, Numerical Pain Rating Scale, and Numerical Pain Scale, as outcomes.

Results: At the end of the search, 14025 studies were identified. After the removal of duplicates, 10,852 were considered eligible according to title and abstract screening, while 10,557 papers were excluded after this process. Therefore; a total of 11 RCTs were included in this systematic review. A decrease of pain intensity was observed in all groups, albeit in patients being treated with TE and MT. Besides this, the combination of TE and MT demonstrated a 91% of probability to be the best choice in patients with CNSNP at the first visit. Only the combination of TE plus MT/cognitive behavioral therapy and MT as a single treatment showed a reduction in pain score. Overall, 3 studies (27.2%) showed a low risk of bias, 6 (54.5%) showed some concerns in bias assessment, and 2 (19%) a high risk of bias.

Conclusion: Collectively, the findings of this systematic review showed that MT and TE might be considered as effective rehabilitation approaches for treatment of pain in patients with CNSNP.

Background: Lumbar multifidus (LM) and transverse abdominis (TrA) muscle activation deficits have been reported in patients with chronic low back pain (CLBP). These activation deficits could be related to poor functional capacity and self-reported clinical outcomes.

Objective: To determine the associations between lumbopelvic muscle activation and functional capacity, as well as self-reported clinical outcomes in individuals with CLBP.

Methods: Thirty individuals with CLBP were recruited. Ultrasound imaging was used to measure muscle activation. Participants performed a functional reach test (FRT), 5-time sit-to-stand test (5STS), 2-min step test (2MST), prone trunk extension test (PTET), and abdominal curl test (ACT). Self-reported clinical outcomes including visual analog scale (VAS), duration of low back pain (DLBP), modified Oswestry disability questionnaire (MODQ), and short-form health survey (SF-36) were also collected.

Results: LM activation was significant associated (P < 0.05) with functional capacity (5STS and PTET) and self-reported clinical outcome (SF-36) were observed. Results also demonstrated TrA activation was significant associated (P < 0.05) with ACT, VAS, and DLBP.

Conclusion: Our findings suggest that clinicians should focus on LM activation to potentially improve functional capacity and quality of life, as well as minimize the chronicity. In addition, pain duration can influence TrA activation, while TrA activation training may be able to modulate pain.