Journal of Back and Musculoskeletal Rehabilitation最新文献

BackgroundChronic low back pain (CLBP) is a major burden. The Pain and Disability Drivers Management (PDDM) model is a framework developed to analyse factors contributing to disability and pain in CLBP patients.ObjectiveThe primary objective was to explore the prognostic value of the PDDM model using real-life data. The secondary objective was to explore its analytical value.MethodsA monocentric retrospective cohort study included CLBP patients who underwent a multidisciplinary rehabilitation program between January 2014 and December 2020. Regression analyses were performed using the five domains of the PDDM as explanatory variables. To assess its prognostic value, the main outcome was the change in disability over the course of the program. Secondary outcomes were change in pain and return to work. To assess its analytical value, the outcome was baseline disability.ResultsCognitive-emotional domain of the PDDM predicted change in disability. Nociceptive, Nervous System Dysfunction and Cognitive-Emotional domains of the PDDM were associated with baseline disability.ConclusionsThe PDDM model showed limited prognostic value in our context but provided valuable insights into the bio-psycho-social dimensions contributing to disability in CLBP patients.

BackgroundIdentifying determinants of pain-related disability in chronic spinal pain (CSP) remains a major research focus, but the role of interoceptive sensibility is underexplored.ObjectiveTo determine whether adaptive interoceptive sensibility uniquely predicts pain-related disability and to compare its dimensions and cognitive factors across disability severity in people with CSP.MethodsThis cross-sectional study included 108 people with CSP. Pain intensity over the previous week and during activity, pain duration, and coexisting extremity pain were recorded. The Pain Disability Index, Pain Catastrophizing Scale, Pain Beliefs Questionnaire, and Multidimensional Assessment of Interoceptive Awareness (MAIA-2) were administered. A linear regression identified disability-related factors. Demographic-adjusted outcomes were compared across mild, moderate, and severe disability groups.ResultsInteroceptive sensibility explained an additional 17.70% of the variance in pain-related disability after adjusting for demographics, and among the eight dimensions measured by MAIA-2, not-distracting (B = -2.66, 95% CI = -5.13 to -0.18) and not-worrying (B = -6, 95% CI = -9.08 to -2.94) predicted pain-related disability (p < 0.05). Not-distracting remained a unique predictor when pain characteristics and catastrophizing were included in the model (B = -2.62, 95% CI = -4.41 to -0.83, p < 0.05). The mild disability group showed less catastrophizing and more not-worrying, and the severe disability group showed less not-distracting (p < 0.05, η²_p=0.06 to 0.19).ConclusionAdaptive interoceptive sensibility, especially not-worrying and not-distracting dimensions, were associated with spinal pain-related disability.

BackgroundPlay-to-earn (P2E) games are a growing category of smartphone games that require repetitive tapping and prolonged gaming in poor postures, increasing the risk of musculoskeletal disorders (MSDs).ObjectiveThis study aimed to assess the prevalence of MSDs among smartphone P2E gamers and compare it with non-P2E gamers among students and staff at Zanjan University of Medical Sciences.MethodsA cross-sectional study was conducted in 2024 on 938 students and staff. Data were collected using a demographic questionnaire and the standardized Nordic Musculoskeletal Questionnaire. Descriptive statistics, independent sample t-tests, and Chi-square tests were used for data analysis.ResultsThe one-year and seven-day prevalence of MSDs among P2E gamers were 80% and 70.3%, respectively, both higher than those observed in non-P2E gamers. The upper back had the highest prevalence of pain, followed by the neck and lower back. The seven-day prevalence of MSDs in the wrists/hands and upper back was significantly higher in P2E gamers. A history of gaming and the frequency of unlocking the smartphone touchscreen were associated with increased MSD prevalence.ConclusionAs P2E games may increase the probability of MSDs, developing guidelines for smartphone P2E gamers may help raise awareness and prevent MSDs.

BackgroundPrehabilitation aims to optimize patients' physical and psychological status before spine surgery to enhance recovery. However, its effectiveness on postoperative outcomes remains remains to be controversial. This meta-analysis aims to evaluate Prehabilitation impact on pain, functional recovery, psychological status, and perioperative outcomes.MethodsA systematic search of MEDLINE/PubMed, Web of Science, Scopus, and Embase was conducted through January 2025 using PRISMA guidelines. A total of 5738 records were initially identified through database searches, of which 3765 remained after duplicate removal. Studies comparing postoperative outcomes in patients undergoing spine surgery with and without prehabilitation were included. Meta-analysis was performed using a random-effects model, with subgroup analyses based on exercise inclusion.ResultsAccording to our inclusion criteria, twenty-seven studies (2449 participants) were deemed appropriate to be included in our study. Our meta-analysis showed prehabilitation significantly reduced postoperative back pain (SMD = -0.4028, p = 0.0269) and improved trunk muscle strength (SMD = 0.1472, p = 0.0142). However, no significant differences were observed for disability (SMD = -0.3772, p-value = 0.5705), quality of life (SMD = 0.0657, p-value = 0.5372), and leg pain (SMD = -0.1921, p-value = 0.3920). In addition, depression, operation time, blood loss, or length of stay were shown to be comparable between the two groups of patients.ConclusionsPrehabilitation may reduce postoperative back pain and improve muscle function, but does not significantly impact disability, quality of life, or perioperative outcomes. Future research should refine protocols and identify patient subgroups that benefit most from prehabilitation.

BackgroundThe Slump Test evaluates neural tissue mechanosensitivity in individuals with lower extremity symptoms. However, there has been little research assessing the role of altering lumbar spine positioning on sensory response. Therefore, this study compared differences in subjective and objective findings observed in different lumbar spine positions during neurodynamic testing.MethodsHealthy participants were assessed using the 90/90 knee extension (KEA) to determine available ROM, followed by lumbar spine flexed slump (FS), and lumbar spine extended slump (ES). Outcomes included knee extension angle, hamstring EMG activity (%MVIC), distal extent of sensory response, and qualitative mechanosensory response.ResultsForty participants (23.95 ± 2.64 years; 14 male/26 female) completed the study. Significantly less knee extension ROM was found for ES vs. FS (p < .001) and ES vs. KEA (p = .037). A greater proportion of distal symptoms were observed during ES vs. FS (p < .05). FS and ES showed higher EMG values than KEA (p < .001), with no difference between the two slump conditions.ConclusionIn this healthy population, ES produced the greatest distal sensory responses, highest EMG activity, and lowest knee extension ROM. Incorporating lumbar extension during slump testing may be useful to determine mechanosensitive behavior, but further research is needed in clinical populations.The trial was prospectively registered at clinical trials.gov. NCT05313217.

ObjectivesNo previous studies have investigated the relationship between body perception disturbance (BPD) and functional outcomes in patients who underwent lumbar spinal surgery. This study prospectively investigated temporal changes in BPD and its relationship with postoperative pain and disability in patients who underwent surgery for lumbar spinal stenosis.MethodsIn this prospective observational study, a total of ninety patients who underwent lumbar spinal surgery at our institution between September 2023 and July 2024 were included. BPD, pain intensity, and disability were assessed by using Fremantle Back Awareness Questionnaire, Visual Analog Scale, and Oswestry Disabilty Index at three time points: preoperatively, at discharge, and 3 months postoperatively.ResultsThe results showed a significant decrease in BPD from the preoperative period to 3 months postoperatively (p < 0.05). However, no significant association was observed between BPD and the postoperative pain intensity or disability. Furthermore, high preoperative BPD levels had no significant impact on postoperative outcomes at 3 months.ConclusionsThe results of this study suggest that BPD significantly improves postoperatively, and that the effects of preoperative BPD on pain and disability are limited. Further studies with extended follow-up periods and the consideration of psychosocial factors are needed to fully understand the long-term effects of BPD on postoperative outcomes.

BackgroundBlood flow restriction (BFR) is considered an alternative method for increasing muscle activity and thickness to reduce Nonspecific Chronic Low back pain (NSCLBP).ObjectivesThis study aimed to evaluate the effects of BFR with core stabilization exercise (CSE) on muscle activity, muscle thickness, and disability in individuals with NSCLBP.MethodsA total of 38 individuals with NSCLBP aged 18-45 years were included in this study. The participants were randomly divided into the BFR + CSE and CSE groups (n = 19 each). All participants underwent supervised rehabilitation sessions three times per week over a period of four consecutive weeks. Muscle activity, muscle thickness, and disability were assessed before and after the four-week intervention.ResultsThe BFR + CSE group showed significant within-group improvement in muscle activity of the transversus abdominis (TrA), multifidus (MF), and gluteus maximus (Gmax), muscle thickness at rest and during contraction, and disability (p < 0.05). The CSE group showed a significant increase in electromyography activity of the MF muscle (p < 0.05), a significant increase in muscle thickness at rest for the TrA, MF, and Gmax muscles (p < 0.05), and only a significant increase in muscle thickness during contraction for the TrA muscle (p < 0.05). Additionally, the BFR + CSE group exhibited superior benefits compared to the CSE group across all variables.ConclusionBFR combined with CSE over four weeks is more effective in improving TrA, MF, and Gmax muscle strength, muscle thickness, and disability.

BackgroundLower Extremity Functional Scale (LEFS) is a useful tool for evaluating lower extremity (LE) disability, but it has not been adapted for use with Kannada or other regional languages in India.ObjectiveThis study aimed to perform cross-cultural adaptation and Kannada translation of the LEFS (LEFS-K) and examine its psychometric properties.MethodsA Longitudinal study on 150 patients with hip and knee injuries. Numeric Rating Scales for Pain (NRS-P) and disability (NRS-D), and Sit-to-stand (5STS) was administered at the initial visit. LEFS-K and NRS again 2 days later and at discharge. Intraclass correlation coefficient (ICC) and Cronbach's alpha (CA) assessed test-retest reliability and internal consistency. Pearson correlation coefficients (r) examined concurrent relations. Effects size was calculated for responsiveness. Clinically important (MCID) and statistically true (MDC) were assessed for the LEFS-K.ResultsLEFS-K demonstrated excellent test-retest reliability (ICC = 0.98) and internal consistency (CA = 0.88). Low to moderate correlations (r < 0.70) were observed between the LEFS-K and other measures (NRS-P, NRS-D, and 5STS). The LEFS-K was deemed responsive to assess change for LE disability (ES = 0.84).ConclusionThe Kannada LEFS is proved to be a reliable, valid and responsive tool for evaluating LE MSK disability in Kannada speaking individuals with hip and knee disorders.

IntroductionThis study examined the effect of a single treatment of Active Release Techniques (ART^®) on resting stiffness of the medial gastrocnemius (MG), resting tension of the triceps surae unit, plantar-flexion strength, and active ankle range of motion (ROM).MethodsTwenty-four healthy participants (14 females, mean (SD) age: 24.8 (4.6) years) were randomised to 4 min of ART^® applied to one leg. With the foot fixed in 5° plantar-flexion, shear wave velocity (SWV) was measured using ultrasound elastography and resting tension was measured using a dynamometer, acquired before, immediately, and 5 min post intervention. Active ankle ROM and plantar-flexion maximal voluntary isometric strength (MVIC) were measured before and after ART^®. Repeated measures ANOVAs with factors of limb and time were used.ResultsMG SWV of the intervention limb decreased immediately following ART^® (mean % change = -5.65% [95%CI: -2.05 to -9.26], p = 0.003) and at 5 min (mean % change = -5.50% [95%CI: -1.22 to -9.78], p = 0.017). There was no difference post ART^® for resting tension of the triceps surae unit, plantar-flexion MVIC, or active ankle ROM for either the intervention or control limb.ConclusionFour minutes of ART^® applied to the MG induces a significant reduction in resting MG SWV, which persisted for 5 min, but was not coupled with a change in resting tension of the triceps surae unit, plantar-flexion MVIC, or ROM.