Journal of Back and Musculoskeletal Rehabilitation最新文献

ObjectiveThe purpose of this paper was to evaluate the efficacy of intra-articular (AI) injections of Hyaluronic Acid (HA) versus Oxygen-Ozone (O₂O₃) in relieving pain and reducing disability in patients affected by knee osteoarthritis (KOA).MethodsPeople with painful KOA for at least three months were randomly allocated to receive three IA injections, once a week, of HA (Group A) vs O₂O₃ (Group B). They were evaluated at baseline (T0), at 1 (T1), 3 (T2), 6 (T3), and 12 months (T4) after the treatment, using as outcomes: WOMAC pain score, WOMAC LK 3.1, Numeric Rating Scale (NRS), and KOOS.ResultsOf the 122 patients assessed for eligibility, 112 participants were enrolled. Both groups A and B showed significant improvements in all outcomes measures from 1 month after the treatment (HA Group: 6.77 ± 2.53 vs 3.66 ± 2.57; O2O3 Group: 6.50 ± 2.24 vs 3.45 ± 2.30). In contrast, at T2 and T3, the HA-treated group showed significant pain and functional improvement compared to O₂O₃ group.ConclusionBoth HA and O₂O₃ might be considered safe and potential effective treatments for KOA, due to their anti-inflammatory effects. O₂O₃ seems to have a faster effect; rather, HA showed superior efficacy at 3 months onwards from the end of the treatment.

BackgroundSpinal cord injury is a complex condition affecting millions globally, often requiring extensive rehabilitation. YouTube is increasingly utilized by spinal cord injury-patients and caregivers for rehabilitation information, despite potential misinformation risks. However, few studies have assessed the quality of spinal cord injury -related content on this platform.AimThis study evaluates the quality, reliability, and effectiveness of YouTube videos on spinal cord rehabilitation to identify credible resources and improve patient education.MethodsA systematic search was conducted on YouTube using keywords related to spinal cord injury rehabilitation, yielding 74 videos that met inclusion criteria. These were assessed independently by two reviewers for quality indicators using DISCERN, JAMA, and Global Quality Score criteria. Viewer engagement metrics such as views, likes, and comments were also analyzed.ResultsMost videos were of low to moderate quality, with only 24% rated as high quality. Videos uploaded by physicians received significantly higher quality ratings compared to those from other sources (p < 0.01), although their view counts were generally lower. Viewer engagement was positively correlated with likes and comments but inversely correlated with quality metrics, indicating that popular videos often lacked reliable information. Among the included videos, 28.4% were uploaded by physicians, 52.7% by physiotherapists, and 18.9% by others, providing insight into the source reliability.ConclusionThe overall quality of spinal cord injury rehabilitation videos on YouTube is low, posing risks for misinformation among patients. Efforts are needed to enhance the accessibility of scientifically accurate information. Healthcare professionals and digital platforms should collaborate to improve the quality of health-related videos, supporting informed decision-making for spinal cord injury patients.

BackgroundThe closed kinetic chain upper extremity stability test (CKCUEST) is widely used to assess shoulder stability. The modified CKCUEST (mCKCUEST) incorporates height-normalized hand spacing (50%) to account for individual anthropometric variations and improve biomechanical validity.ObjectiveTo establish normative reference values for mCKCUEST performance in healthy Indian adults and to define diagnostic thresholds and performance phenotypes using percentile classification, ROC analysis, and clustering techniques.MethodsA cross-sectional study was conducted among 517 physically active participants (53.6% females) aged 18-28 years. Each participant completed three mCKCUEST trials. Mean, relative (touches/meter), and power scores were calculated. Percentile ranks were stratified by sex. ROC analysis assessed discriminatory cut-offs, while k-means clustering was used to identify phenotypic subgroups. An adaptation index (Trial 3-Trial 1) was computed to evaluate neuromuscular responsiveness.ResultsThe mean mCKCUEST score was 17.6 ± 2.3 repetitions with a relative score of 10.5 ± 1.5 touches/meter and a power score of 56.2 ± 11.9. Males performed better than females in Trials 2 and 3 (p < 0.001). No significant correlations were observed between anthropometric variables and performance outcomes. K-means clustering revealed three distinct performance phenotypes, including one with low baseline scores but high neuromuscular adaptability. BMI-based stratification showed most participants were in the normal range (72.5%).ConclusionThis study provides normative benchmarks for mCKCUEST in healthy Indian adults. The integration of percentile norms, BMI stratification, and adaptation-based phenotypes enhances individualized interpretation in clinical and performance assessment settings.

BackgroundLow back pain (LBP) has emerged as a critical public health concern whose associated disability burden and healthcare expenditures have been persistently escalating among aging populations worldwide.ObjectiveThis global study analyzed the disability burden of LBP among the older population for over three decades and identified interventions specifically targeting older adults.MethodsRepeated cross-sectional data on LBP among individuals aged ≥65 years from the Global Burden of Disease Study 2021 were extracted and compared to age-standardized rates of LBP incidence and disability adjusted life years (DALYs) across various demographic and geographic categories.ResultsCountries with a high sociodemographic index (SDI), advanced health systems, and high incomes, including North America and the Latin America and Caribbean region, exhibited the highest incidence rates and DALYs of LBP. Occupational ergonomics is still the primary factor for LBP in countries with low SDI, and minimal health level countries. Body mass index (BMI) was substantially increased in all global subgroups, especially in countries with low-middle SDI, limited health systems, world bank low-income level groups.ConclusionAdvanced economic development and healthcare showed a non-linear correlation with LBP. High BMI is projected to become a predominant modifiable risk factor for LBP progression, highlighting the urgent need for the implementation of lifestyle strategies.

BackgroundThe thoracic spinal range of motion (ROM) is a commonly used in pathological and functional assessment. Baseline bubble inclinometers are one of the most frequently employed thoracic ROM measurement methods. However, there is currently no consensus on the accuracy and standardized procedure of their utilization.ObjectiveThe purpose of this study is to validate the accuracy of baseline bubble inclinometers in measuring the sagittal thoracic spinal ROM and to propose the standard guideline for their utilization.Method28 participants were recruited for this study. The maximum thoracic spinal ROM during flexion and extension was measured using inclinometers, with the optoelectronic motion capture system (Vicon) serving as the control group.Result: The thoracic spinal ROM during flexion was 14.5 ± 10.5°; during extension was 19.0 ± 9.2°, and the total ROM was 33.5 ± 14.0°. The inclinometers showed moderate to high correlations with the Vicon results, particularly in measuring flexion ROM, which exhibited the highest effectiveness (r = 0.84∼0.89). The accuracy of the inclinometers was enhanced by ensuring a cervical nodding and fixation position. Additionally, it was observed that females were more suitable candidates for thoracic spinal ROM measurement using inclinometers, as they exhibited higher correlations with the Vicon results.ConclusionThis study successfully validated the accuracy of the inclinometer as a convenient thoracic spinal ROM measurement method, that can save significant time for physiotherapists in clinical settings. The measurements obtained in this study may serve as a preliminary reference for the thoracic spinal ROM in healthy individuals and standardized protocols for using the baseline bubble inclinometer.

BackgroundOrthopedic patients often present with significant pain symptoms, which can impact both the physical and mental well-being of patients, emerging as a significant concern. Given its safety, effectiveness, and absence of side effects, acupoint therapy is being increasingly utilized in the pain management of orthopedic patients. This study conducted a network meta-analysis to compare analgesic efficacy, safety, and effectiveness of acupuncture (AP), electroacupuncture (EA), moxibustion, and acupressure, so as to provide a reference for the clinical application of acupoint therapies in managing orthopedic pain.MethodsEight databases, including PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, and VIP, were searched for clinical randomized controlled trials (RCTs) investigating the effects of AP, EA, moxibustion, and acupressure on orthopedic pain. The quality of the included documents was evaluated using the Cochrane Risk of Bias Tool, and graphs regarding the risk of bias and network meta-analysis were drawn by Revman 5.2, Stata 18.0 and R software (v4.3.2). Intervention ranking probabilities were quantified using SUCRA values derived from a Bayesian random-effects model.Results1) For decreasing Visual Analogue Scale (VAS) scores in patients with orthopedic pain, moxibustion therapy was identified as the optimal intervention (SUCRA=94.84%); 2) For decreasing VAS scores in patients with orthopedic pain undergoing surgical intervention, AP therapy was identified as the optimal intervention (SUCRA=76.99%); 3) For decreasing VAS scores in patients with orthopedic pain not undergoing surgical intervention, moxibustion therapy was identified as the optimal intervention (SUCRA=90.26%); 4) AP therapy (SUCRA=83.73%) demonstrated the most favorable safety profile; 5) Acupressure therapy (SUCRA=77.93%) was identified as the most effective therapeutic method.ConclusionIt is recommended to select differentiated acupoint therapies tailored to the type of orthopedic pain. Specifically, post-operative patients with orthopedic pain should prioritize AP, while moxibustion is advised for non-surgical patients.

IntroductionAssessing balance is critical in clinical and research settings, assisting to identify impairments and guiding interventions. Numerous medical conditions can affect balance, including many spinal pathologies. Though there is consensus on the importance of evaluating balance for patients with spinal pathologies, current research lacks an analysis of current methods and conditions under which standing balance is assessed. This review aims to investigate trends and level of standardization in standing balance evaluation methodologies in current research on spinal pathologies.MethodsOvid (MedLine), PubMed, and Google Scholar, were used to locate literature from January 2019 to December 2024. Extracted data included spinal pathology and methods used to assess standing balance. Assessments were stratified into two groups: Qualitative and Instrumented. Qualitative includes assessments scored by a person via predetermined criteria. Instrumented includes assessments measured via instrumented platform. Bilateral Quiet Standing (BQS) is a term referring to otherwise unnamed and non-standardized assessments conducted on an instrumented platform under conditions specified by the individual study.ResultsThe search located 4237 studies, where 154 were included after title and abstract review. Full text review isolated 45 included studies. This review located 15 distinct assessment types consisting of 7 qualitative and 8 instrumented assessment types. The most common tests were the Single Leg Stance (SLS) and BQS assessment.ConclusionA lack of standardization exists across clinical and research settings. This emphasizes the need for enhanced comparability of balance assessments in patients with spinal pathologies. Standardization is crucial for effective interventions and improving quality of life.

PurposeThis study aimed to investigate the effects of different sitting postures and prolonged sitting on lumbosacral nerve root function by measuring the amplitude of the soleus (SOL) Hoffmann reflex (H-reflex).MethodsThis study included 30 healthy individuals who were selected through convenience sampling and divided according to daily sitting duration over the past year into a prolonged sitting group (≥6 h/day) and a control group (≤4 h/day). The SOL H-reflex amplitude was recorded in erect, slumped, slouched, and supine positions. Ischial pressure was evaluated in all sitting postures to assess spinal loading.ResultsSlouched sitting significantly lowered ischial pressure (p < 0.0005) and produced higher H-reflex amplitudes (p < 0.0005), which were not significantly different from those in the supine position (p = 0.362). In contrast, (p < 0.0005) erect and slumped (p < 0.0005) postures showed increased ischial pressure and significantly reduced H-reflex amplitudes (p < 0.0005 for both postures). Participants in the prolonged sitting group demonstrated significantly lower SOL H-reflex amplitudes than those in the control group (p = 0.008, ηp² = 0.23).ConclusionVarious sitting postures and durations exert different effects on the lumbosacral spine and nerve roots. Slouched sitting reduces spinal stress and lower nerve root compression compared to erect and slumped seated positions. Extended sitting duration may partially compress the lumbosacral nerve root, thereby potentially contributing to postural low back pain over time.

BackgroundSimple range of motion measurements in individuals with non-specific chronic low back pain (NSCLBP) during forward bending provide limited information about the directional characteristics of spinal movements.PurposeTo examine the horizontal and vertical displacement trajectories of thoracolumbar regions (T12 and L2 levels) during forward bending using smartphone-based 2-dimensional video analysis, and to compare kinematics among NSCLBP subgroups classified as the flexion pattern (FP) and extension pattern (EP), and healthy controls.MethodsA total of 185 participants were recruited (58 healthy, 87 FP, 40 EP). Two markers were positioned over the spinous processes of T12 and L2. Marker trajectories were tracked using Kinovea software, and displacements along the x- (anterior-posterior) and y-axes (superior-inferior) were measured.ResultsThe EP group showed significantly greater anterior displacement at the T12 and L2 levels than the FP group, and at the L2 level than healthy controls. No significant differences were found between FP and healthy groups or in vertical displacement of the two markers.ConclusionsHorizontal displacement trajectories effectively differentiated NSCLBP subgroups, particularly identifying a distinct movement strategy in the EP group. Smartphone-based video analysis may offer a clinically useful and accessible tool for subgroup-specific assessment.

BackgroundRotator cuff (RC) disorders are common musculoskeletal conditions causing shoulder pain and functional loss. While abdominal muscles aid in core stabilization and force transmission, their strength, endurance, and thickness in RC disorders remain underexplored.ObjectivesThis study aimed to examine the differences in abdominal muscle performance between individuals with RC pathology and healthy controls and to evaluate the relationship of these parameters with pain, disability and quality of life.Materials and MethodThis cross-sectional study evaluated 128 individuals (RC group: 64; control group: 64). The strength of the abdominal muscles was evaluated, and the McGill endurance test was performed. Muscle thickness was measured using ultrasound imaging. Shoulder-related pain, symptoms and functionality were assessed with Shoulder Pain and Disability Index and Western Ontario Rotator Cuff Index.ResultsThe RC group exhibited significantly lower abdominal muscle strength and endurance compared to controls (p < 0.001). A moderate negative correlation was observed between abdominal muscle performance and clinical scores. According to ultrasound evaluations, patients with right-sided shoulder pathology (RSSP) had thinner EO (p < 0.001) and TrA (p = 0.016) muscles on the affected side, while left-sided shoulder pathology (LSSP) showed similar reductions in RA (p = 0.001), EO (p = 0.012), and TrA (p = 0.006) thickness. The RC group showed significantly greater percentage asymmetry in RA muscle thickness compared with controls (p = 0.02), while no statistically significant differences were found for EO, IO, or TrA muscles.ConclusionThis study demonstrates that decreased abdominal muscle function and thickness are associated with RC disorders. We emphasize that core stability exercises should be included in rotator cuff rehabilitation.