Journal of Back and Musculoskeletal Rehabilitation最新文献

BackgroundLow back pain (LBP) is a leading cause of disability worldwide, particularly among professional drivers due to prolonged sitting and whole-body vibrations. Auto rickshaw drivers in India represent a vulnerable occupational group lacking ergonomic support and healthcare.ObjectiveThis study aimed to determine the prevalence of persistent LBP and its associated ergonomic, demographic, and lifestyle factors among auto rickshaw drivers in an urban setting.MethodsA cross-sectional study was conducted during March-April 2024 among 353 auto rickshaw drivers aged 20-55 years. Data were collected via questionnaires on sociodemographic, occupational, and lifestyle factors and health status. Pain severity was measured on a 10-point scale. Statistical analyses, including chi-square, t-tests, and regression, were done using JASP (p < 0.05).ResultsThe prevalence of persistent LBP was 48.16%. Key predictors included male sex (OR = 10.659, p = 0.002), longer driving hours (OR = 1.152, p = 0.042), and family history of musculoskeletal disorders (OR = 7.667, p < 0.001). Ergonomic factors like lumbar support and vehicle vibration increased LBP prevalence. Smoking and physical inactivity showed significant associations, though no single factor predicted LBP severity.ConclusionNearly half of urban auto rickshaw drivers experience persistent LBP, influenced by occupational and ergonomic factors. The findings highlight the need for targeted interventions, including improved seating, rest breaks, and posture education. Public health strategies promoting physical activity and addressing smoking may reduce LBP risk. Future studies should explore unmeasured psychosocial factors affecting LBP severity.

BackgroundDegenerative meniscal tears are common, causing knee pain, functional limitations, and reduced quality of life. Effective treatment is essential to restore daily functionality. This study evaluated the impact of a neuromuscular exercise program on individuals with degenerative meniscal tears.Materials and MethodsFifty patients (ages 20-65) with degenerative meniscal tears were randomly divided into two groups. Group 1 participated in a physiotherapist-guided neuromuscular exercise program, while Group 2 performed a home exercise program. Both groups underwent treatment three times a week for six weeks. Effectiveness was assessed using the Tegner Activity Level Scale, Knee Injury and Osteoarthritis Outcome Score - Physical Function Short Form (KOOS-PS), Western Ontario Meniscal Evaluation Tool (WOMET), pain assessment, and jump performance before and after treatment.ResultsBoth groups showed significant improvements. However, Group 1 improved WOMET General Calculation, Night Pain, and KOOS-PS Symptoms (p < 0.001). Neuromuscular exercises with physiotherapist support yielded superior outcomes compared to the home program. Significant changes were observed in parameters such as "Pain Activity" and "Pain Rest" (p < 0.001) in both groups, with notable improvements in Group 1. WOMET tests also showed significant gains for Group 1 (p < 0.001) and Group 2 (p < 0.001).ConclusionPhysiotherapist-supervised neuromuscular exercise programs significantly improved pain, knee function, and quality of life in individuals with degenerative meniscal tears. The findings underscore the added value of professional supervision in maximizing clinical outcomes.

BackgroundPhysiotherapy guidelines for managing low back pain (LBP) recommend the use of validated measures such as trunk mobility, pain intensity, and questionnaires to evaluate function. However, the relationship between these clinical parameters remains insufficiently understood.ObjectiveTo investigate associations between trunk mobility, mobility-dependent pain, and quality of life (QOL) as potential clinical parameters in individuals with nonspecific chronic low back pain (NSCLBP).MethodsA secondary analysis was conducted on data from 51 individuals with NSCLBP enrolled in a randomized trial comparing the 4xT method and physiotherapeutic-guided exercise. Both groups completed a six-week rehabilitation program with two sessions per week, followed by a six-week therapy-free period. Trunk range of motion, mobility-dependent pain, and perceived health were analyzed as predictors of QOL using correlation and linear regression.ResultsIncreased trunk mobility and elevated perceived health are positively associated with QOL in individuals with NSCLBP. Higher levels of mobility-dependent pain are negatively associated with QOL. The interaction between trunk mobility and changes in mobility-dependent pain intensity did not have an additional impact on QOL. Overall, our findings indicate that these associations were moderate or occasionally weak.ConclusionsTrunk mobility, mobility-dependent pain, and perceived health are relevant clinical predictors of QOL in individuals with NSCLBP. These findings highlight the importance of assessing both objective physical function and subjective pain perception when evaluating rehabilitation outcomes. Targeting trunk mobility and mobility-dependent pain in LBP treatment may lead to more personalized care and improved QOL. Including these measures should be standard practice when assessing rehabilitation effectiveness.Clinical Trial Registration Number: NCT03309540.

BackgroundCervical stenosis is an important problem in patients with cervical pain, which may cause proprioception problems.ObjectiveThis study aims to evaluate the effect of the degree of cervical stenosis on cervical proprioception and cervical range of motion (ROM).MethodA total of 111 patients presenting with cervical pain and undergoing cervical magnetic resonance imaging were included in the study. The ROM of the patients was measured with the Pa Cervical Range of Motion (CROM) device. Proprioception was evaluated with measurement of joint position error (JPE). JPE was assessed with neutral head position and target head position tests. The severity of stenosis was detected according to the Kang grading system. The Kruskal-Wallis test is used to compare joint position error in patients with different cervical stenosis stages.ResultsTwenty nine(%26) patients had no stenosis, 31 (28%) had mild stenosis, 31 (28%) had moderate stenosis, and 20 (18%) had severe stenosis. According to the neutral head positioning test, there was a significant difference in right lateral flexion between patients with different degrees of stenosis (grade 0: 1.67[0.67-4.67] vs. grade 2: 4.67[2.3-10.0], p = 0.009) and in flexion (grade 0: 8.0[2.67-10.0] vs. grade 3: 12.66[8.33-17.67], p = 0.011). There was also a significant difference in head-to-target JPEs in all motion planes(p < 0.05).ConclusionDegree of cervical stenosis significantly affects cervical proprioception and cervical ROM. The study's findings may guide clinicians in developing effective rehabilitation programs for proprioception in cervical stenosis and encourage further research on intervention effects at different stages of the disease.

ObjectPreload is known to improve spinal stability; however, its effect on the voluntary contraction of lumbar muscles needs investigation. This study aimed to investigate the role of preload in enhancing the voluntary contraction of lumbar muscles in a group of young men.MethodsTwenty healthy participants successively participated in experiments with the following preload conditions arranged in random order: no preload, forward preload, backward preload, or right-hand-pull preload. Preload intensity was set to 20% and 40% of the maximum load forces, and the participants voluntarily co-activated their trunk muscles while seated. Surface electromyography signals were recorded for analysis.ResultsForward preload was able to increase the maximal voluntary contraction strength of lumbar muscles, an effect enhanced with greater preload intensity. Backward preload reduced the maximal voluntary contraction strength of lumbar muscles as preload intensity increased. Right-hand-pull preload exhibited some asymmetrical characteristics.DiscussionDuring co-activation of the trunk muscles, preload demonstrated different effects on the voluntary contraction strength of lumbar muscles in a group of young men. As forward preload enhanced the voluntary contraction of lumbar muscles, it may play a significant role in stabilising the spine. Backward preload may also have a stabilising effect on the spine, but more research is required.

ObjectiveThis study compared the effects of resistance and stretching exercises on menstrual symptoms, quality of life, and functional and emotional status in young women with primary dysmenorrhea.MethodsIn this randomized controlled trial, 54 women (18-25 years) with primary dysmenorrhea were assigned to stretching (n = 17), resistance (n = 19), or control (n = 18) groups. Outcomes were assessed using the Visual Analog Scale (VAS), Menstrual Symptoms Questionnaire (MSQ), Pittsburgh Sleep Quality Index (PSQI), Health-Related Quality of Life (SF-36), and Functional and Emotional Measure of Dysmenorrhea (FEMD). Assessments were conducted before the intervention and over two menstrual cycles. Exercise groups trained three times weekly for eight weeks.ResultsVAS, MSQ, PSQI, and FEMD scores significantly decreased in both exercise groups compared to the control group (p < 0.05). SF-36 scores were significantly higher in both exercise groups (p < 0.05). Post-treatment, medication use decreased significantly. Subdimension analyses revealed improvements in SF-36 and reductions in MSQ and FEMD subdimensions. No significant differences were found between the resistance and stretching groups in the primary outcomes (p > 0.05).ConclusionBoth resistance and stretching exercises reduce menstrual symptoms and improve quality of life. No significant difference was found; women may choose stretching or strengthening exercises based on personal preference.

IntroductionRadiofrequency thermocoagulation(RFT), intra-articular steroid-injection(IAI) and PENG block application to the articular branches of the femoral and obturator nerves are the methods used in the treatment of pain in patients with chronic hip pain. We aimed to investigate the effectiveness of these methods.MethodsRandomization was performed as conventional RFT applied to the articular branches of the femoral and obturator nerves with fluoroscopy(Group1), IAI of corticosteroids with ultrasonography(Group2) and PENG block with ultrasonography Group3).Pain intensity was evaluated with the (NRS) or Verbal Pain Scale(VPS) before the procedure and 2 h, 1 and 3 months after the procedure, and functional capacity was evaluated with the (WOMAC) scale before the procedure, 1 and 3 months after the procedure.ResultsIn Group1, NRS/VPS and WOMAC scores were significantly higher before the procedure. NRS/VPS before the procedure and at the 3rd month were significantly higher in Group2 and Group3.In Group3, 1st month scores were significantly higher than 2nd hour scores. In Group2, pre-procedure WOMAC scores were significantly higher than 1st and 3rd Months, and 3rd Month scores were significantly higher than 1st Month.The 1st month WOMAC scores of Group 3 were significantly higher than the other groups and the 3rd month scores of Group 1 were significantly lower than the other groups.ConclusionIn our study, PENG Block, RFT and IAI applications were effective on short-time pain in patients with chronic hip pain.IAI and RFT were effective on chronic pain until the 1st month, and only RFT was effective at the 3rd month follow-up.

BackgroundAcupuncture, a traditional oriental therapy, is increasingly being adopted globally as a method of complementary intervention for pain relief in patients with fibromyalgia (FM). The aim of this study was to evaluate the effectiveness of acupuncture compared to placebo, pharmacotherapy, or physiotherapy in reducing pain and improving function in patients with FM.MethodsAn electronic search was performed in the MEDLINE, Web of Science, CENTRAL, EMBASE, LILACS, CINAHL, PEDro, and SPORTDiscus databases. The eligibility criteria were systematic reviews of clinical trials that compared acupuncture versus control interventions for pain intensity and other clinical outcomes in women with FM.ResultsA total of 10 systematic reviews met the eligibility criteria for the quantitative synthesis. For pain intensity, the mean difference (MD) was -1.30 cm (95% CI = -1.85 to 0.76, p < 0.001). For functional status, the MD was -10.18 points (95% CI = -13.56 to -6.79, p < 0.001). For sleep quality, the MD was 0.46 points 95% CI = -1.85 to 0.76, p < 0.001). For fatigue, the standard mean difference (SMD) was -0.18 (95% CI = -0.86 to 0.51, p = 0.55). For depression, the MD was -6.28 points (95% CI = -9.80 to -2.76, p = 0.0005). Most of the differences were in favor of acupuncture, except for sleep quality.ConclusionCompared to pharmacotherapy and physiotherapy interventions, acupuncture showed statistically significant differences in pain intensity, functional status, and depression symptoms; however, all differences did not reach the minimum threshold to be considered clinically important in patients with FM. The quality of evidence was low to very low according to GRADE ratings.

BackgroundThe factors and thresholds associated with falls in patients with hip osteoarthritis (HOA) have not been clarified. This study aimed to clarify the internal factors associated with falls in patients with HOA and their thresholds using a decision tree analysis.MethodsThe study participants were 203 patients with HOA scheduled to undergo total hip arthroplasty at multiple facilities in Japan. The study evaluated various potential predictors, including sociodemographic factors, medical information, and assessments of motor function. Classification and regression tree techniques were used to develop clinical prediction rules.ResultsIn total, 24.1% of the participants had experienced a fall. Age was selected as the first factor for falls in patients with HOA, with age > 79 years found to be highly associated with falls (57.1%). Pain scores on the Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ) were selected as the second factor. The findings indicated that even among those aged ≤ 69 years, those with a JHEQ pain score ≤ 9 (severe pain) were more likely to experience a fall (40.7%). The model demonstrated a fair level of predictive performance, as indicated by the area under the receiver operating characteristic curve (AUROC) of 0.738.ConclusionBeing older and having severe pain even at a young age were identified as significant predictors of falls among patients with HOA. These findings could help health-care providers develop more effective interventions to prevent falls in patients with HOA.