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Ikwuanusi S, Tella A, Akinbo S, Nwaedozie O, Adje M. Determinants of outcomes for patients with chronic low back pain and fear-avoidance beliefs following treatment with specific stabilisation exercises. J Back Musculoskelet Rehabil 2023:BMR230312. [PMID: 38217583 DOI: 10.3233/bmr-230312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2024]
Abstract
BACKGROUND Specific stabilisation exercises (SSE) can combat the debilitating effects of chronic non-specific low back pain (CLBP), improve disability, pain and fear-avoidance beliefs (FAB). OBJECTIVE To elicit the determinants of outcome in patients with CLBP with associated FABs after treatment with SSE. METHOD Twenty-nine patients (20 females) with CLBP were classified using FAB questionnaire into high or low Work and Physical Activity (PA) subscales. After 4-week treatment, evaluations were done for pain, disability and lumbar spine active range of motion (AROM). Data was analysed exploratory-descriptively with a significance level set at p< 0.05. RESULTS Participants were aged 55.24 ± 11.91 years. They scored 19 (65.5%) and 5 (17.2%) respectively on Work and PA subscales. The post-intervention evaluation showed significant differences in all outcomes, but no significant difference between patients with high or low FAB scores for both subscales. PA scores correlated significantly with pain while work scores correlated significantly with disability. Participants' gender predicted disability, pain and AROM with moderate to large effect sizes. CONCLUSION SSE can potentially improve disability, pain and range of motion for patients with chronic low back pain regardless of FABQ status. Gender and baseline patient status are potential determinants of outcome of treatment using SSE.
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Affiliation(s)
- Stephanie Ikwuanusi
- Department of Physiotherapy College of Medicine, University of Lagos, Lagos, Nigeria
| | - Abidemi Tella
- Department of Physiotherapy College of Medicine, University of Lagos, Lagos, Nigeria
| | - Sunday Akinbo
- Department of Physiotherapy College of Medicine, University of Lagos, Lagos, Nigeria
| | - Obianuju Nwaedozie
- Department of Physiotherapy College of Medicine, University of Lagos, Lagos, Nigeria
| | - Mishael Adje
- LUNEX International University of Health, Exercise & Sports, Differdange, Luxembourg
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Masroor S, Tanwar T, Aldabbas M, Iram I, Veqar Z. Effect of Adding Diaphragmatic Breathing Exercises to Core Stabilization Exercises on Pain, Muscle Activity, Disability, and Sleep Quality in Patients With Chronic Low Back Pain: A Randomized Control Trial. J Chiropr Med 2023; 22:275-283. [PMID: 38205226 PMCID: PMC10774616 DOI: 10.1016/j.jcm.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/12/2023] [Accepted: 07/22/2023] [Indexed: 01/12/2024] Open
Abstract
Objective The purpose of this study was to test the effect of adding diaphragmatic breathing exercises (DBEs) to core stabilization exercises (CSEs) for patients with chronic low back pain (CLPB). Methods Twenty-two patients with CLPB were randomly allocated to the experimental (DBE + CSE) or control group (CSE only). They were given 12 treatment sessions 3 times a week for 4 weeks. Patients were evaluated before and after the 12 sessions. Surface electromyography of transverse abdominis, Oswestry Disability Index, Fear Avoidance Belief Questionnaire, Pittsburgh Sleep Quality Index, Numeric Pain Rating Scale, and chest expansion were used as outcome measures for pain, muscle activity, disability, and sleep quality. Results The outcome measure scores showed statistical significance of (P = .01) in time effect on muscle activity, sleep quality, disability score, pain score, fear-avoidance belief of patients and chest expansion; and group effect on Fear Avoidance Belief Questionnaire and physical activity parameter (P = .05). An interaction effect (time x group) on muscle activity for right transverse abdominus during tuck in (P = .01) and chest expansion (P = .01) was also found; however, no significant difference was found related to other parameters. Conclusion The combination of DBE and CSE interventions compared to CSE alone showed improvement in the measured parameters for patients with CLBP. Incorporating DBE with CSE also improved muscle activation and chest expansion.
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Affiliation(s)
- Sana Masroor
- Centre of Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - Tarushi Tanwar
- Centre of Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - Mosab Aldabbas
- Centre of Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - Iram Iram
- Centre of Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - Zubia Veqar
- Centre of Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
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Puranik S, Shenoy S. Surface electromyography analysis of core stabilizing muscles during isometric shoulder contractions in athletes with low back pain. J Bodyw Mov Ther 2023; 36:364-369. [PMID: 37949585 DOI: 10.1016/j.jbmt.2023.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/14/2022] [Accepted: 04/11/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND The study was carried out in the athletes with and without Low Back Pain (LBP) to determine the surface electromyography activity of core stabilizing muscles while performing isometric shoulder and trunk contractions. STUDY DESIGN Cross-sectional study. METHODS This study enlisted the participation of 40 athletes. Group A included 20 athletes (18 males and 2 females) without LBP, and Group B included 20 athletes (12 males and 8 females) with LBP. Athletes with LBP were assessed using the Modified Oswestry Disability Questionnaire (MODQ) and Visual Analog Scale (VAS) to determine their level of disability and pain severity, respectively. EMG activity of the rectus abdominis, external oblique, longissimus, and multifidus was recorded in both groups as they performed bilateral isometric shoulder and trunk contractions. RESULTS In the LBP group, EMG activity of the rectus abdominis and external oblique muscles was significantly lower (P < 0.05). The LBP group had significantly more multifidus activity (P = 0.03) than the NLBP group. Among all the exercises, bilateral isometric shoulder extension contraction activated the rectus abdominis, right external oblique, and longissimus group of muscles significantly more (P < 0.05) in both groups. In both groups, bilateral isometric shoulder flexion contraction resulted in significantly higher multifidus muscle activation (P = 0.002). CONCLUSION The activation of core stabilizing muscles was altered in athletes with LBP. When athletes are unable to contract and activate trunk muscles owing to pain, upper extremity exercises can be used to activate these muscles.
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Affiliation(s)
- Surabhi Puranik
- MYAS-GNDU Department of Sports Sciences and Medicine, Guru Nanak Dev University, Amritsar, India.
| | - Shweta Shenoy
- MYAS-GNDU Department of Sports Sciences and Medicine, Guru Nanak Dev University, Amritsar, India
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Song BH, Kim J. Effects of Pilates on Pain, Physical Function, Sleep Quality, and Psychological Factors in Young Women with Dysmenorrhea: A Preliminary Randomized Controlled Study. Healthcare (Basel) 2023; 11:2076. [PMID: 37510517 PMCID: PMC10379070 DOI: 10.3390/healthcare11142076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/15/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
The effect of Pilates on dysmenorrhea has been little studied. The purpose of this study was to evaluate the effect of Pilates on menstrual pain and symptoms, premenstrual syndrome, and risk factors of dysmenorrhea. Thirty young women with primary dysmenorrhea were randomly assigned into a Pilates group (PG; n = 15) and a waitlist control group (CG; n = 15). The Pilates was performed twice a week for 12 weeks. Menstrual pain and symptoms were measured by visual analogue scale (VAS) and the Cox menstrual symptom scale (CMSS), respectively. Premenstrual syndrome was assessed using the premenstrual symptoms screening tool (PSST). Additionally, back flexibility, hip muscle strength, sleep duration and quality, perceived stress, state-trait anxiety, and depression were evaluated. The VAS, CMSS severity and frequency, and PSST symptoms and functional impairments decreased in the PG compared to the CG (p < 0.001 or p < 0.01) with large effect sizes. Back flexibility and the strength of hip flexors, hip extensors, and hip abductors significantly increased in the PG compared to the CG (all p < 0.01) with large effect sizes. Sleep quality (p < 0.01) and stress (p < 0.05) improved in the PG. Sleep duration, anxiety, and depression did not change in either group. In conclusion, the 12-week Pilates intervention ameliorates dysmenorrhea, partly mediated by improved physical function and sleep quality.
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Affiliation(s)
- Bo-Hwa Song
- Graduate School of Alternative Medicine, Kyonggi University (Seoul Campus), 24, Kyonggidae-ro 9-gil, Seodaemun-gu, Seoul 03746, Republic of Korea
| | - Jaehee Kim
- Graduate School of Alternative Medicine, Kyonggi University (Seoul Campus), 24, Kyonggidae-ro 9-gil, Seodaemun-gu, Seoul 03746, Republic of Korea
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Bates NA, Huffman A, Goodyear E, Nagai T, Rigamonti L, Breuer L, Holmes BD, Schilaty ND. Physical clinical care and artificial-intelligence-guided core resistance training improve endurance and patient-reported outcomes in subjects with lower back pain. Clin Biomech (Bristol, Avon) 2023; 103:105902. [PMID: 36805199 DOI: 10.1016/j.clinbiomech.2023.105902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 01/19/2023] [Accepted: 01/30/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Low back pain is an extremely prevalent issue with an extensive impact, ranging from decreased quality of life to lost years of productivity. Many interventions have been developed to alleviate chronic lower back pain, yet it remains a widespread problem. The objective of this study was to examine the role of artificial intelligence guided resistance training relative to clinical variables in subjects experiencing lower back pain. METHODS 69 out of 108 enrolled and 92 accrued subjects completed the 8-week intervention. Subjects were randomized into four groups (Control, Training, Clinical, or Combined). The Training cohort received supervised artificial-intelligence-guided core-focused resistance training while the Clinical group received clinical care. The Combined group received both clinical care and artificial-intelligence-guided training and the Control group received no treatment. Participants were evaluated using functional testing and patient-reported outcomes at baseline, 4 weeks, and 8 weeks. FINDINGS In the clinical tests, the Clinical and Combined cohorts showed increased total time for isometric extensor endurance and the Clinical cohort increased total distance traveled in the 6-min walk test at 8 weeks. The Training, Clinical, and Combined groups showed improvements in Patient-reported outcomes after 8 weeks. Most of the significant improvements were only seen at the 8-week evaluation for both the clinical evaluations and Patient-reported outcomes. The Control group did not show significant improvements in any outcome measures. INTERPRETATION The present data indicate that core-focused interventions, including artificial-intelligence-guided moderate-resistance exercise, can increase objective functional outcomes and patient satisfaction using Patient-reported outcomes in individuals with lower back pain.
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Affiliation(s)
- Nathaniel A Bates
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Division of Sports Medicine, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
| | - Allison Huffman
- The Ohio State University School of Medicine, Columbus, OH, USA
| | - Evelyn Goodyear
- The Ohio State University School of Medicine, Columbus, OH, USA
| | - Takashi Nagai
- Division of Sports Medicine, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; United States Army Research Institute of Environmental Medicine, Natick, MA, United States of America
| | - Luca Rigamonti
- Division of Sports Medicine, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Policlinico San Pietro, Ponte San Pietro, Italy
| | - Logan Breuer
- Division of Sports Medicine, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Nathan D Schilaty
- Division of Sports Medicine, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Department of Neurosurgery & Brain Repair, University of South Florida, Tampa, FL, USA; Center for Neuromusculoskeletal Research, University of South Florida, Tampa, FL, USA
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Proskura P, Rutkowska-Kucharska A, Sobera M. Evaluation of the effects of a novel exercise program in the treatment of low back pain in women working in a seated position: A randomized trial. J Back Musculoskelet Rehabil 2023:BMR210349. [PMID: 36872766 DOI: 10.3233/bmr-210349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
BACKGROUND Low back pain (LBP) in sedentary workers is an increasing problem. Hyperlordosis or hypolordosis of the lumbar spine may be one of the causes of LBP. Various exercise programs are used in the prevention of LBP, but they do not consider individualization for diagnosed hyperlordosis or hypolordosis of the lumbar spine. OBJECTIVE The purpose of this study was to evaluate the effect of the authors' original exercise program aimed at reducing hyperlordosis or increasing hypolordosis. METHODS Sixty women aged 26 to 40 working in a sedentary position participated in the study. The sagittal curvature and the range of motion of the lumbar spine flexion were measured with the Saunders inclinometer, and the level of LBP was evaluated using the VAS scale. Subjects were randomly divided into two groups that participated in a 3-month exercise program developed by the authors. The first group performed exercises adjusted to the diagnosed hyperlordosis or hypolordosis, and the second group performed the same exercises regardless of the lumbar lordosis angle. The study was conducted again after completing the exercises. RESULTS There was a statistically significant difference between the groups (p< 0.0001) in the level of pain, with better results in the group where individualized exercise was used - 60% of the participants reported complete absence of LBP. The lumbar lordosis angle was within normal limits in 97% of the subjects in the first group, and in 47% of the subjects in the second group. CONCLUSION The results of this study confirm the validity of using individualized exercises with regard to diagnosed hyperlordosis or hypolordosis of the lumbar spine in order to achieve better analgesic and postural correction effects.
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Calibration of Hernia-Specific Patient-Reported Outcome Measures. J Surg Res 2022; 276:182-188. [DOI: 10.1016/j.jss.2022.02.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 01/27/2022] [Accepted: 02/14/2022] [Indexed: 11/20/2022]
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Ramalingam V, Cheong SK, Lee PF. Preliminary study on changes of brainwaves for musculoskeletal pain among collegiate athletes. Technol Health Care 2022; 30:993-1003. [PMID: 35275584 DOI: 10.3233/thc-213633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Brainwaves studies on pain are gaining more attention in recent years. However, the target group in a similar study on collegiate athletes with musculoskeletal pain is still under explore. OBJECTIVE The objective is to investigate the differences of the brainwaves response and its association with pain interference of the collegiate athletes with and without musculoskeletal pain. METHODS Collegiate athletes (n= 49) were recruited and categorized into pain group (PG) (n= 25) and no-pain group (NPG) (n= 24). Brainwaves were recorded for 2 minutes with eyes closed in a resting state using EEG. Pain intensity and pain interference were documented using visual analogue scale and brief pain inventory, respectively. Independent t-test was used to compare brainwaves of PG and NPG, and Spearman's correlation was used to find the association between brain waves and pain interference. RESULTS Findings showed a significant decrease (p< 0.05) in brain waves in PG on left temporal regions as compared to NPG. Frontal beta, theta, and gamma waves were found to be negatively correlated with participants' pain interference. CONCLUSION This outcome potentially contributes EEG as an alternative non-invasive tool for an objective pain assessment method in health care technology to aid in the rehabilitation process.
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Affiliation(s)
| | - Soon Keng Cheong
- Faculty of Medicine and Health Sciences, University Tunku Abdul Rahman, Bandar Sungai Long, Kajang, Selangor, Malaysia
| | - Poh Foong Lee
- Lee Kong Chian Faculty of Engineering and Science, University Tunku Abdul Rahman, Bandar Sungai Long, Kajang, Selangor, Malaysia
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Gohil D, Kothari D, Baxi G, Palekar T. Comparison of matrix rhythm therapy versus pilates on pain, lumbar flexibility, functional impairments, and pelvic inclination in chronic low back pain. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_526_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Sarac DC, Bayram S, Tore NG, Sari F, Guler AA, Tufan A, Oskay D. Association of Core Muscle Endurance Times With Balance, Fatigue, Physical Activity Level, and Kyphosis Angle in Patients With Ankylosing Spondylitis. J Clin Rheumatol 2022; 28:e135-e140. [PMID: 33252392 DOI: 10.1097/rhu.0000000000001641] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND/OBJECTIVE Core muscle endurance (CME), which is the ability of sustaining the activity of trunk muscles, has been shown to be lower in patients with ankylosing spondylitis (AS). The aim was to investigate the possible relationship between CME times and balance, fatigue, physical activity (PA) level, and thoracic kyphosis angle. METHODS Fifty-one patients with AS with a mean age of 41.0 years (interquartile range, 25/75 years; 29.0/51.0 years) were included in the study. Core muscle endurance times were assessed by using trunk extension, trunk flexion, and side bridge tests. Overall stability index, anteroposterior stability index, mediolateral stability index, and limits of stability were evaluated with the Biodex Balance System. Fatigue and PA levels were surveyed using Fatigue Severity Scale and International Physical Activity Questionnaire, respectively. Thoracic kyphosis angle was measured by using a digital inclinometer. Additionally, CME times were compared for "high-fatigue" versus "low-fatigue" and as "low PA" versus "moderate/high PA" groups. Spearman correlation coefficients and Mann-Whitney U test were used for statistical analysis. RESULTS Significant correlations were detected between overall stability index, anteroposterior stability index, Fatigue Severity Scale, International Physical Activity Questionnaire, and all CME tests (p < 0.05) and between mediolateral stability index and side bridge test (p < 0.05). Limits of stability correlated only with side bridge test (p < 0.05). Core muscle endurance significantly differed between high-fatigue and low-fatigue groups (p < 0.05), except trunk flexor test (p > 0.05). No significant differences were observed between low PA and moderate/high PA groups (p > 0.05), except side bridge test (p < 0.05). CONCLUSIONS Core muscle endurance times seem to be related to PA level, fatigue, and balance but not with thoracic kyphosis angle. Assessing CME in patients with AS might help in planning individualized exercise programs.
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Affiliation(s)
- Devrim Can Sarac
- From the Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences
| | - Selin Bayram
- From the Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences
| | - Nurten Gizem Tore
- From the Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences
| | - Fulden Sari
- From the Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences
| | - Aslihan Avanoglu Guler
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Abdurrahman Tufan
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Deran Oskay
- From the Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences
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Kim SK, Kim HS, Chung SS. Effects of an Individualized Educational Program for Korean Patients With Chronic Low Back Pain: A Randomized Controlled Trial. J Nurs Res 2021; 29:e177. [PMID: 34593721 DOI: 10.1097/jnr.0000000000000455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Most patients with low back pain prefer to ignore symptoms and avoid medical management because of incorrect perceptions about this condition. However, over 90% of patients with chronic low back pain are hardly unable to perform daily activities, with 50% reporting that their daily activities have been severely impeded. PURPOSE In this study, an individualized educational program was developed and implemented in a sample of Korean patients with chronic low back pain, and the effectiveness of this program was evaluated. METHODS This study was conducted as a randomized controlled trial with outpatients (n = 43) in an orthopedic clinic. The Analysis, Design, Development, Implementation, and Evaluation model was applied to develop the educational program. The experimental group was provided with an educational booklet and contacted via biweekly personalized telephone and face-to-face counseling sessions. The control group was provided the educational booklet only. SAS Version 9.4 was used to analyze collected data using the χ2 test, t test, Fisher's exact test, Wilcoxon test, linear regression analysis, and Spearman partial correlation analysis. RESULTS After 8 weeks, the experimental group demonstrated a significantly greater reduction in maximum, average, and current low back pain experienced within the immediately preceding 24 hours than the control group (p = .001, p = .002, and p = .014, respectively). In addition, daily living disability showed a greater reduction, and average back muscle strength showed a more significant improvement in the experimental group than in the control group (p = .001 and p = .035). The difference in medication adherence between the groups was not statistically significant (p = .089). The experimental group rated an average of 4.3 out of 5.0 points on the program satisfaction scale, indicating an 86% rate of satisfaction. CONCLUSIONS/IMPLICATIONS FOR PRACTICE In this study, the individualized educational program was shown to be effective in helping alleviate symptoms in patients with chronic low back pain, decrease daily living disability, and improve average back muscle strength. It was further demonstrated that following up with expert medical staffs can motivate patients to incorporate the recommendations of the program into their daily routine, leading to higher patient satisfaction.
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Affiliation(s)
- Seong-Kyong Kim
- PhD, RN, General Manager, Department of Orthopedic Surgery, Samsung Medical Center, Seoul, Republic of Korea
| | - Hee-Seung Kim
- PhD, RN, Emeritus Professor, College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Soo Chung
- PhD, MD, Orthopedist, Department of Orthopedic Surgery, Bumin Hospital, Busan, Republic of Korea
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Arcanjo FL, Martins JVP, Moté P, Leporace G, Oliveira DAD, Sousa CSD, Saquetto MB, Gomes-Neto M. Proprioceptive neuromuscular facilitation training reduces pain and disability in individuals with chronic low back pain: A systematic review and meta-analysis. Complement Ther Clin Pract 2021; 46:101505. [PMID: 34852989 DOI: 10.1016/j.ctcp.2021.101505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND and purpose: Although proprioceptive neuromuscular facilitation (PNF) exercises are used in rehabilitation practice, their effects in patients with low back pain (LBP) remain unclear. This study aimed to investigate the efficacy of PNF training for pain and disability in patients with LBP. METHODS In this systematic review, we searched five databases from the earliest date available to October 2020. Three comparisons were performed: PNF versus control, PNF versus core strengthening, and PNF versus conventional physical therapy. RESULTS Sixteen studies met the eligibility criteria (722 patients). PNF training improved pain (standardized mean difference [SMD]: -2.6; 95% confidence interval [CI]: -4.2 to -0.9, n = 174) and disability (SMD: -3.29; 95% CI: -5.3 to -1.3, n = 144) compared to the control. PNF training also yielded a greater benefit for pain reduction (mean difference [MD]: -1.8, 95% CI: -2.2 to -0.3, n = 177) and disability improvement (MD: -6.6, 95% CI: -9.3 to -3.8, n = 113) than did core strengthening. CONCLUSION PNF training seems to be a useful strategy for decreasing pain and improving disability in patients with LBP. However, the quality of evidence for the outcomes of both pain and disability was low to moderate.
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Affiliation(s)
- Fabio Luciano Arcanjo
- Postgraduate Program in Medicine and Health, Federal University of Bahia (UFBA) Salvador, Bahia, Brazil; Physiotherapy Research Group, UFBA, Brazil; AF-Physioteherapy, Brazil
| | - José Vicente Pereira Martins
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; International Proprioceptive Neuromuscular Facilitation Association (IPNFA), Brazil; Integrated Aquatic Therapy and Rehabilitation Center, Rio de Janeiro, Brazil
| | - Paulo Moté
- International Proprioceptive Neuromuscular Facilitation Association (IPNFA), Brazil; Integrated Aquatic Therapy and Rehabilitation Center, Rio de Janeiro, Brazil
| | - Gustavo Leporace
- Department of Research in Biomechanics, Institute Brazil of Technologies in Health, Rio de Janeiro, Brazil
| | | | | | - Micheli Bernardone Saquetto
- Postgraduate Program in Medicine and Health, Federal University of Bahia (UFBA) Salvador, Bahia, Brazil; Physiotherapy Research Group, UFBA, Brazil; Physical Therapy Department, UFBA, Salvador, Bahia, Brazil
| | - Mansueto Gomes-Neto
- Postgraduate Program in Medicine and Health, Federal University of Bahia (UFBA) Salvador, Bahia, Brazil; Physiotherapy Research Group, UFBA, Brazil; Physical Therapy Department, UFBA, Salvador, Bahia, Brazil.
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Manipulative therapy of sacral torsion versus myofascial release in patients clinically diagnosed posterior pelvic pain: a consort compliant randomized controlled trial. Spine J 2021; 21:1890-1899. [PMID: 33991702 DOI: 10.1016/j.spinee.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 04/29/2021] [Accepted: 05/01/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Chronic low back pain represents a health care problem with substantial costs. It is generally accepted that approximately 10% to 25% of patients with persistent chronic low back pain may have pain arising from the sacroiliac joints. PURPOSE This study aimed to analyze the effects of manipulative therapy of sacral torsion versus myofascial release on disability, pain intensity, and mobility in patients with chronic low back pain and sacroiliac joints. STUDY DESIGN/SETTING A prospective, single-blinded randomized clinical trial. PATIENT SAMPLE Sixty-four patients (mean±SD age: 51±9; 60% female) with chronic low back pain and sacroiliac joints comprised the patient sample. No participant withdrew because of adverse effects. OUTCOME MEASURES Self-reported disability (primary), pain intensity, scale of kinesiophobia, quality of life, isometric endurance of trunk flexor muscles, and lumbar mobility in flexion were assessed at baseline, pos-treatment, and one month follow-up. METHODS Participants were randomly assigned to a sacral torsion manipulation group or myofascial release group, receiving a total of 12 sessions (once weekly). RESULTS ANCOVA did not showed a statistically significant difference between groups for disability (95% CI -2.40-1.90, p=.177). Effect sizes were large in both groups at both follow-up periods. Similar results were achieved for all secondary outcomes (p˂. 05). The linear model longitudinal analyses showed significant improvements in both groups over time for all outcomes with the exception of fear of movement (manipulative: Minimum within-groups change score 1.91, p˂.001; myofascial: 1.66, p˂.001). CONCLUSION Manipulative and myofascial release therapy in patients with clinically diagnosed sacroiliac joints syndrome resulted in a similar short-term benefits on patient reported disability. Both groups experienced similar decrease in the intensity of pain over time, although no clinically meaningful effects were demonstrated in either group.
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Moon BJ, Han MS, Kim JY, Lee JK. Thoracolumbar Slope Is Useful Parameter for Evaluating HealthRelated Quality of Life and Sagittal Imbalance Aggravation in Adult Spinal Deformity: A Prospective Observational Cohort Study. Neurospine 2021; 18:467-474. [PMID: 34610676 PMCID: PMC8497235 DOI: 10.14245/ns.2142408.204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/07/2021] [Indexed: 01/18/2023] Open
Abstract
Objective The purpose of the present study was to evaluate the natural course of primary degenerative sagittal imbalance (PDSI), its aggravating factors, and health-related quality of life (HRQoL) associated with various spinal alignment parameters (SAPs) in patients with PDSI who have not undergone surgery.
Methods One hundred three participants volunteered to participate. The SAPs, including T1 pelvic angle (T1PA), thoracolumbar tilt, and thoracolumbar slope (TLS), were measured on whole-spine standing radiographs. The back and lumbar muscle volumes were measured. To determine HRQoL at baseline and at 2-year follow-up, face-to-face questionnaires were administered, which included visual analogue scale of the back and leg, physical component summary/mental component summary of 36-item Short Form Health Survey, Oswestry Disability Index (ODI), and Mini-Mental State Examination.
Results Overall HRQoL measures had improved after 2 years of follow-up compared to baseline. PDSI aggravation was observed in 18 participants (26.1%). TLS, sagittal vertical axis (SVA), and T1PA were strongly correlated with each other. TLS, SVA, and T1PA were correlated with ODI score. Among them, TLS was most highly correlated with ODI score. TLS greater than -3.5° was a predicting factor for PDSI aggravation (p=0.034; 95% confidence interval, 1.173–63.61; odds ratio, 8.636).
Conclusion The present study implied that PDSI does not necessarily worsen with aging. TLS is an appropriate parameter for assessing the clinical situation in patients with PDSI. Furthermore, a TLS greater than -3.5° predicts PDSI aggravation; thus, TLS may be a useful parameter for predicting prognosis in PDSI.
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Affiliation(s)
- Bong Ju Moon
- Department of Neurosurgery, Chonnam National University Medical School & Research Institute of Medical Sciences, Gwangju, Korea
| | - Moon-Soo Han
- Department of Neurosurgery, Chonnam National University Medical School & Research Institute of Medical Sciences, Gwangju, Korea
| | - Jae-Young Kim
- Department of Neurosurgery, Chonnam National University Medical School & Research Institute of Medical Sciences, Gwangju, Korea
| | - Jung-Kil Lee
- Department of Neurosurgery, Chonnam National University Medical School & Research Institute of Medical Sciences, Gwangju, Korea
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Dairywala MI, Gupta S, Salna M, Nguyen TC. Surgeon Strength: Ergonomics and Strength Training in Cardiothoracic Surgery. Semin Thorac Cardiovasc Surg 2021; 34:1220-1229. [PMID: 34597795 DOI: 10.1053/j.semtcvs.2021.09.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 09/22/2021] [Indexed: 01/09/2023]
Abstract
With the high prevalence of musculoskeletal pain in surgeons and interventionalists, it is critical to analyze the impact of ergonomics on cardiothoracic surgeon health. Here, we review the existing literature and propose recommendations to improve physical preparedness for surgery both in and outside the operating room. For decades, cardiothoracic surgeons have suffered from musculoskeletal pain, most commonly in the neck, and back due to a lack of proper ergonomics during surgery. A lack of dedicated ergonomics curriculum during training may leave surgeons at a high predisposition for work-related musculoskeletal disorders. We searched PubMed, Google Scholar, and other sources for studies relevant to surgical ergonomics and prevalence of musculoskeletal disease among surgeons and interventionalists. Whenever possible, data from quantitative studies, and meta-analyses are presented. We also contacted experts and propose an exercise routine to improve physical preparedness for demands of surgery. To date, many studies have reported astonishingly high rates of work-related pain in surgeons with rates as high as 87% in minimally-invasive surgeons. Several optimizations regarding correct table height, monitor positioning, and loupe angles have been discussed. Lastly, implementation of ergonomics training at some programs have been effective at reducing the rates of musculoskeletal pain among surgeons. Surgical work-related stress injuries are more common than we think. Many factors including smaller incisions and technological advancements have led to this plight. Ultimately, work-related injuries are underreported and understudied and the field of surgical ergonomics remains open for investigative study.
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Affiliation(s)
- Mohammed I Dairywala
- Department of Cardiothoracic and Vascular Surgery, University of Texas Health Science Center Houston, McGovern Medical School, Houston, Texas
| | - Saurabh Gupta
- Division of Cardiac Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Michael Salna
- Division of Cardiac, Thoracic, and Vascular Surgery, Department of Surgery, Columbia University Irving Medical Center, New York, New York
| | - Tom C Nguyen
- Division of Adult Cardiothoracic Surgery, Department of Surgery, UCSF Health, San Francisco, California.
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17
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Gun BK, Banaag A, Khan M, Koehlmoos TP. Prevalence and Risk Factors for Musculoskeletal Back Injury Among U.S. Army Personnel. Mil Med 2021; 187:e814-e820. [PMID: 34159385 DOI: 10.1093/milmed/usab217] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/16/2021] [Accepted: 05/20/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Physical and medical readiness have emerged as a top priority in the army over the last decade. With this emphasis on deployment readiness, it is important to understand key risk factors attributed to common medical problems that arise in our soldiers, including low back pain. The purpose of this study is to elucidate demographic and lifestyle risk factors which would result in seeking medical care for musculoskeletal low back pain among active duty army personnel. MATERIALS AND METHODS A cross-sectional retrospective study investigating all active duty soldiers between October 1, 2016 and September 30, 2018 was performed using the existing Military Health System Data Repository to retrospectively review administrative claims data. Our study queried 39 unique International Classification of Disease codes, 10th Revision codes for low back pain to determine a positive case. We compared those with and without back pain across all variables using a chi-square analysis in SAS. Multivariate logistic analysis was performed to adjust for confounding within any single proposed risk factor and the six other proposed risk factors. RESULTS Six hundred fifty seven thousand and six thirty soldiers met inclusion criteria; 228,184 of whom had a medical encounter for low back pain (34.7%). All of the proposed risk factors included statistically significant unadjusted and adjusted odds ratios (ORs) with age conferring the greatest risk in soldiers aged 50-59 with an OR of 2.89 (2.73-3.05) compared to those aged 20-29. Obesity-adjusted OR was 1.77 (1.74-1.80) compared to those who were normal weight. Senior Enlisted status-adjusted OR was 1.34 (1.32-1.36). Females were 66% more likely to have low back pain compared to males with an OR of 1.66 (1.63-1.68). CONCLUSION Disease burden for low back pain tends to be high in the U.S. Army with 34.7% of service members experiencing low back pain. Older age, obesity, and being an enlisted, female service member are risk factors for these musculoskeletal injuries, which is in agreement with previously reported literature on the topic. To mitigate the burden of low back pain, policies and incentives to encourage healthy body mass index and lifestyle are needed. The results of this work inform future studies aimed at further delineating the risk factors found in this study.
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Affiliation(s)
- Baris K Gun
- Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Amanda Banaag
- Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD 20817, USA
| | - Munziba Khan
- Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD 20817, USA
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18
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Lehecka BJ, Stoffregen S, May A, Thomas J, Mettling A, Hoover J, Hafenstine R, Hakansson NA. Gluteal Muscle Activation During Common Yoga Poses. Int J Sports Phys Ther 2021; 16:662-670. [PMID: 34123518 PMCID: PMC8168988 DOI: 10.26603/001c.22499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/29/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Approximately 24% of physical therapists report regularly using yoga to strengthen major muscle groups. Although clinicians and athletes often use yoga as a form of strength training, little is known about the activation of specific muscle groups during yoga poses, including the gluteus maximus and medius. HYPOTHESIS/PURPOSE The purpose of this study was to measure gluteus maximimus and gluteus medius activation via electromyography (EMG) during five common yoga poses. A secondary purpose of the current study was to examine differences in muscle activation between sexes and experience levels. STUDY DESIGN Cross-Sectional. METHODS Thirty-one healthy males and females aged 18-35 years were tested during five yoga poses performed in a randomized order. Surface EMG electrodes were placed on subjects' right gluteus maximus and gluteus medius. Subjects performed the poses on both sides following a maximal voluntary isometric contraction (MVIC) test for each muscle. All yoga pose EMG data were normalized to the corresponding muscle MVIC data. RESULTS Highest gluteus maximus activation occurred during Half Moon Pose on the lifted/back leg (63.3% MVIC), followed by the stance/front leg during Half Moon Pose (61.7%), then the lifted/back leg during Warrior Three Pose (46.1%). Highest gluteus medius activation occurred during Half Moon Pose on the lifted/back leg (41.9%), followed by the lifted/back leg during the Warrior Three Pose (41.6%). A significant difference was found in %MVIC of gluteus medius activity between male and female subjects (p = 0.026), and between experienced and inexperienced subjects (p = 0.050), indicating higher activation among males and inexperienced subjects, respectively. CONCLUSION Half Moon Pose and Warrior Three Pose elicited the highest activation for both the gluteus maximus and the gluteus medius. Higher gluteus medius activation was seen in males and inexperienced subjects compared to their female and experienced counterparts. LEVEL OF EVIDENCE 3.
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19
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Frizziero A, Pellizzon G, Vittadini F, Bigliardi D, Costantino C. Efficacy of Core Stability in Non-Specific Chronic Low Back Pain. J Funct Morphol Kinesiol 2021; 6:jfmk6020037. [PMID: 33922389 PMCID: PMC8167732 DOI: 10.3390/jfmk6020037] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/12/2021] [Accepted: 04/20/2021] [Indexed: 11/29/2022] Open
Abstract
(1) Background: Management of chronic low back pain (cLBP) is often multidisciplinary, involving a combination of treatments, including therapeutic exercises. Core stability exercises aim to improve pain and disability in cLBP increasing spinal stability, neuromuscular control, and preventing shear force that causes injury to the lumbar spine. The purpose of this study was to review the available evidence about the effectiveness in reducing pain and improving disability of core stability exercises for non-specific cLBP. (2) Methods: We perform a systematic research on common Medline databases: PubMed, Pedro, and Cochrane Library. Search results were limited to articles written in English and published between January 2005 and November 2020.The search provided a total of 420 articles. Forty-nine articles met the inclusion criteria and 371 articles were excluded. (3) Results: Core stability provides great therapeutic effects in patients with non-specific chronic low back pain reducing pain intensity, functional disability, and improving quality of life, core muscle activation, and thickness. Evidences suggest that core stability is more effective than rest or no/minimal intervention and combination with other types of exercise for cLBP have shown grater efficacy. (4) Conclusion: Core stability could be proposed in a comprehensive approach in cLBP, the combination with other modalities of therapeutic exercise should be promoted. Patient compliance is crucial to determine the efficacy of the intervention.
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Affiliation(s)
- Antonio Frizziero
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (D.B.); (C.C.)
- Correspondence:
| | | | - Filippo Vittadini
- Department of Physical and Rehabilitation Medicine, Casa di Cura Policlinico S. Marco, 30100 Venice, Italy;
| | - Davide Bigliardi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (D.B.); (C.C.)
| | - Cosimo Costantino
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (D.B.); (C.C.)
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Sung WS, Hong Y, Jeon SR, Yoon J, Chung EK, Jo HG, Kim TH, Shin S, Lee HJ, Kim EJ, Seo BK, Choi J, Nam D. Efficacy and safety of thread embedding acupuncture combined with acupuncture for chronic low back pain: A randomized, controlled, assessor-blinded, multicenter clinical trial. Medicine (Baltimore) 2020; 99:e22526. [PMID: 33285673 PMCID: PMC7717797 DOI: 10.1097/md.0000000000022526] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Low back pain is a very common disease. Many patients with chronic low back pain (CLBP) have been treated by complementary and alternative medicine such as acupuncture (AT) treatment. A type of AT, thread embedding acupuncture (TEA), consists of a thread that can continually stimulate at the AT points and has mechanical and chemical effects. Although TEA was widely used in clinical practice, there was little evidence of its efficacy and safety for CLBP. METHODS This clinical trial was randomized, controlled, assessor-blinded, two-armed, parallel, and conducted in multiple centers. Four Korean medical institutions recruited 38 outpatients with CLBP. The participants were randomly allocated to a treatment group (TEA combined with AT) or a control group (only AT) in a 1:1 ratio. All participants received conventional AT twice a week for 8 weeks (16 sessions) at 15 AT points (GV3 and bilateral BL23, BL24, BL25, BL26, BL40, BL60, and EX-B5) and the treatment group participants additionally received TEA once a week for 8 weeks (8 sessions) on 10 AT points in the multifidus, spinal erector, and lumbar quadrate muscles. The primary outcome measure of this study was the change of visual analog scale (VAS) from baseline (0 week) to the end of intervention (8 weeks). Secondary outcome measures included clinically relevant improvement (minimal clinically important difference) and 3% to 50% decrease on VAS, disability level (Korean version of Roland and Morris disability questionnaire), quality of life (Korean version of European quality of life 5dimension), global assessment (patient global impression of change), economic analysis, credibility test, and safety assessment. RESULTS The treatment group showed a significant reduction in VAS scores when compared with the control group (-33.7 ± 25.1 vs -15.6 ± 17.0, P = .013). As for the secondary outcome measures, the treatment group showed significant difference in 50% decrease on VAS and patient global impression of change. There was no serious adverse event associated with TEA and AT. CONCLUSION This clinical trial documents the efficacy and safety of TEA combined with AT for the management of CLBP.
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Affiliation(s)
- Won-Suk Sung
- Department of Acupuncture & Moxibustion, Dongguk University Bundang Oriental Hospital, Seongnam-si, Gyeonggi-do
| | - Yejin Hong
- Department of Clinical Korean Medicine, Graduate School
| | - Sae-Rom Jeon
- Department of Clinical Korean Medicine, Graduate School
| | - Jimin Yoon
- Department of Pharmacy, College of Pharmacy
| | | | | | - Tae-Hun Kim
- Clinical Trial Center, Korean Medicine Hospital, Department of Korean Medicine
| | - Seungwon Shin
- Clinical Trial Center, Korean Medicine Hospital, Department of Korean Medicine
| | - Hyun-Jong Lee
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Daegu Haany University, Gyeongsan-si, Gyeongsangbuk-do
| | - Eun-Jung Kim
- Department of Acupuncture & Moxibustion, Dongguk University Bundang Oriental Hospital, Seongnam-si, Gyeonggi-do
| | - Byung-Kwan Seo
- Department of Acupuncture & Moxibustion, Kyung Hee University Hospital at Gangdong
| | - Jieun Choi
- Department of Clinical Korean Medicine, Graduate School
| | - Dongwoo Nam
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
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21
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Trampe D, Gouteron A, Naaim A, Laroche D, Grelat M, Casillas JM. A tool to improve functional outcome assessment of a multimodal program for patients with chronic low back pain: A study on walk tests (at comfortable and fast speed). J Back Musculoskelet Rehabil 2020; 33:485-494. [PMID: 31561323 DOI: 10.3233/bmr-171019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Tools for functional assessment of chronic low back pain (LBP) are lacking. OBJECTIVE To determine the correlations and the responsiveness of the 400 m comfortable walk test (400 mCWT) and the 200 m fast-walk test (200 mFWT) in the functional assessment of a multimodal program. METHODS One hundred and twenty-seven participants (68 females) with LBP and with or without radicular pain completed a Quebec Back Pain Disability Scale, a Sorensen test, a Shirado test, a 400 mCWT and a 200 mFWT, at baseline and at the end of the program. RESULTS No significant side effect was reported during walk tests. Walking speed was significantly increased after the program (0.18 ± 0.15 m.s-1 for the 400 mCWT and 0.17 ± 0.17 m.s-1 for the 200 mFWT). Clinical parameters were also significantly improved (82.02 ± 83.1 seconds for the Shirado, 92.1 ± 100.1 seconds for the Sorensen, -14.0 ± 12.9 for the Quebec scale). A significant relationship was found between the increase in walking speed for the two walk tests and the improvement of the Quebec scale. The gait speed improvement was close to the minimal clinically important change (95% confidence interval: 0.14-0.22) determined from the Quebec scale threshold (minimum detectable change). CONCLUSIONS Both 400 mCWT and 200 mFWT are correlated with functional parameters and are responsive for the functional assessment of LBP.
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Affiliation(s)
- Delphine Trampe
- Department of Rehabilitation, University Hospital of Dijon, Dijon, France
| | - Anaïs Gouteron
- Department of Rehabilitation, University Hospital of Dijon, Dijon, France
| | - Alexandre Naaim
- CIC INSERM 1432, Plateforme d'Investigation Technologique, University Hospital of Dijon, Dijon, France
| | - Davy Laroche
- CIC INSERM 1432, Plateforme d'Investigation Technologique, University Hospital of Dijon, Dijon, France.,INSERM U1093, Dijon, France
| | - Mickael Grelat
- Department of Neurological Surgery, University Hospital of Dijon, Dijon, France
| | - Jean-Marie Casillas
- Department of Rehabilitation, University Hospital of Dijon, Dijon, France.,CIC INSERM 1432, Plateforme d'Investigation Technologique, University Hospital of Dijon, Dijon, France.,INSERM U1093, Dijon, France
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22
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Twelve Weeks of Strengthening Exercise for Patients with Rheumatoid Arthritis: A Prospective Intervention Study. J Clin Med 2020; 9:jcm9092792. [PMID: 32872481 PMCID: PMC7564491 DOI: 10.3390/jcm9092792] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/22/2020] [Accepted: 08/26/2020] [Indexed: 12/25/2022] Open
Abstract
Rheumatoid arthritis (RA) patients may benefit from exercise for several reasons. However, whole-limb strengthening exercises for such patients remain poorly studied. We hypothesized that systemic strength training that includes the upper and lower extremities would improve strength per se and enhance the quality of life. Here, we investigated the effects of 12 weeks of upper- and lower-limb strengthening exercise on the strength and quality of life of RA patients using the International Classification of Functioning, Disability, and Health model. This was a prospective, interventional controlled trial. Forty female RA patients were recruited and assigned to two groups not based on willingness to exercise, with 20 patients in the exercise group and 20 in the control group. All patients in the exercise group received once-weekly training sessions of 60 min over 12 weeks. All participants were assessed before and after the 12-week intervention period. We measured the hand grip strength and isometric quadriceps contraction, the cross-sectional area of the rectus femoris (CSA-RF) (via ultrasonography), and performed the 30 s sit-to-stand test and the 6 min walk test (6MWT). We derived the Borg scale score after the 6MWT and assessed the extent of social participation and quality of life using a Korean version of the 36-Item Short Form Health Survey (SF-36). A total of 35 subjects completed the experiment (18 in the exercise group, 17 in the control group). After the 12-week intervention period, the lower-limb strength and the CSA-RF were significantly increased in the exercise group. The activity level did not change significantly in either group. The exercise group exhibited significant improvements in the SF-36 mental health domain scores. Thus, strengthening exercise is useful for patients with RA.
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Abstract
The spine is an anchoring structure that is the base for mechanical motion of the body and a protector of neuroelements. Spinal disorders continue to plague generations with issues. Management options continue to evolve, allowing for operative and nonoperative pathways to treat underlying causes. Positive patient outcomes and long-term relief are achieved through evidence-based practice and innovative trends. The future of spine care will continue to push boundaries, allowing patients to return to activity at a much faster rate, with decreased restrictions and lower rates of future complications.
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Affiliation(s)
- Dorothy Pietrowski
- Department of Orthopaedic Surgery and Rehabilitative Services, University of Chicago, 5841 South Maryland MC3079, Chicago, IL 60637, USA.
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24
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Lee JH, Choi KH, Kang S, Kim DH, Kim DH, Kim BR, Kim W, Kim JH, Do KH, Do JG, Ryu JS, Min K, Bahk SG, Park YH, Bang HJ, Shin KH, Yang S, Yang HS, Yoo SD, Yoo JS, Yoon KJ, Yoon SJ, Lee GJ, Lee SY, Lee SC, Lee SY, Lee IS, Lee JS, Lee CH, Lim JY, Han JY, Han SH, Sung DH, Cho KH, Kim SY, Kim HJ, Ju W. Nonsurgical treatments for patients with radicular pain from lumbosacral disc herniation. Spine J 2019; 19:1478-1489. [PMID: 31201860 DOI: 10.1016/j.spinee.2019.06.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 06/02/2019] [Accepted: 06/04/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Lumbosacral disc herniation (LDH) is one of the most frequent musculoskeletal diseases causative of sick leave in the workplace and morbidity in daily activities. Nonsurgical managements are considered as first line treatment before surgical treatment. PURPOSE This clinical practice guideline (CPG) is intended to provide physicians who treat patients diagnosed with LDH with a guideline supported by scientific evidence to assist in decision-making for appropriate and reasonable treatments. STUDY DESIGN/SETTING A systematic review. PATIENT SAMPLE Studies of human subjects written in Korean or English that met the following criteria were selected: patients aged ≥18 years, clinical presentation of low back and radicular leg pain, diagnosis of LDH on radiological evaluation including computed tomography or magnetic resonance imaging. OUTCOMES MEASURES Pain and functional evaluation scales such as visual analogue scale, numeric rating scale, and Oswestry disability index METHODS: The MEDLINE (PubMed), EMBASE, Cochrane Review, and KoreaMed databases were searched for articles regarding non-surgical treatments for LDH published up to July 2017. Of the studies fulfilling these criteria, those investigating clinical results after non-surgical treatment including physical and behavioral therapy, medication, and interventional treatment in terms of pain control and functional improvements were chosen for this study. RESULTS Nonsurgical treatments were determined to be clinically effective with regards to pain reduction and functional improvement in patients with LDH. Nevertheless, the evidence level was generally not evaluated as high degree, which might be attributed to the paucity of well-designed randomized controlled trials. Exercise and traction were strongly recommended despite moderate level of evidence. Epidural injection was strongly recommended with high degree of evidence and transforaminal approach was more strongly recommended than caudal approach. CONCLUSIONS This CPG provides new and updated evidence-based recommendations for treatment of the patients with LDH, which suggested that, despite an absence of high degrees of evidence level, non-surgical treatments were clinically effective.
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Affiliation(s)
- Jung Hwan Lee
- Namdarun Rehabilitation Clinic, Yongin-si, Gyeongg-do, South korea
| | - Kyoung Hyo Choi
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
| | - Seok Kang
- Department of Physical Medicine and Rehabilitation, Korea University Guro Hospital, Seoul, South Korea
| | - Dong Hwan Kim
- Department of Physical and Rehabilitation Medicine, College of Medicine, Kyung Hee University Hospital, South Korea
| | - Du Hwan Kim
- Department of Physical and Rehabilitation Medicine, Dongsan Medical Center, School of Medicine, Keimyung University, Daegu, South Korea
| | - Bo Ryun Kim
- Department of Rehabilitation Medicine, School of Medicine, Jeju National University, Jeju, South Korea
| | - Won Kim
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jung Hwan Kim
- Rehabilitation Hospital and Research Institute, National Rehabilitation Center, Seoul, South Korea
| | - Kyung Hee Do
- Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center, Seoul, South Korea
| | - Jong Geol Do
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ju Seok Ryu
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundnang Hospital, Seoul, South Korea
| | - Kyunghoon Min
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Sung Gin Bahk
- Department of Physical Medicine & Rehabilitation, Seocho Se Barun Hospital, Seoul, South Korea
| | - Yun Hee Park
- Department of Physical Medicine and Rehabilitation, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Heui Je Bang
- Department of Rehabilitation Medicine, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Kyoung-Ho Shin
- Heal & Tun Rehabilitation Medicine Clinic, Seongnam-si, Gyeonggi-do, South Korea
| | - Seoyon Yang
- Department of Physical and Rehabilitation Medicine, Seoul Hyundai Hospital, Seoul, South Korea
| | - Hee Seung Yang
- Department of Physical and Rehabilitation Medicine, Veterans medical center, Seoul, South Korea
| | - Seung Don Yoo
- Department of Physical and Rehabilitation Medicine, Kyung Hee university, College of Medicine, Seoul, South Korea
| | - Ji Sung Yoo
- Department of Rehabilitation Medicine, Research Institute and Hospital, National Cancer Center, South Korea
| | - Kyung Jae Yoon
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Se Jin Yoon
- Department of Physical and Rehabilitation Medicine, Danam Rehabilitation Hospital, South Korea
| | - Goo Joo Lee
- Department of Rehabilitation Medicine, Chungbuk National University Hospital, Cheongju, South Korea
| | - Sang Yoon Lee
- Department of Rehabilitation Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Sang Chul Lee
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung Yeol Lee
- Department of Physical Medicine and Rehabilitation, College of Medicine, Soonchunhyang University Hospital, Seoul, South Korea
| | - In-Sik Lee
- Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, South Korea
| | - Jung-Soo Lee
- Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Chang-Hyung Lee
- Department of Physical and Rehabilitation Medicine, Pusan National University Yangsan Hospital, School of Medicine, Pusan National University, Busan, South Korea
| | - Jae-Young Lim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jae-Young Han
- Department of Physical and Rehabilitation Medicine, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Seung Hoon Han
- Department of Rehabilitation Medicine, Hanyang University Guri Hospital, Seoul, South Korea
| | - Duk Hyun Sung
- Department of Physical Medicine and Rehabilitation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kang Hee Cho
- Department of Physical and Rehabilitation Medicine, Chungnam National University, Daejeon, South Korea
| | - Soo Young Kim
- Department of Family Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Hyun Jung Kim
- Department of Preventive Medicine, Institute for Evidence-based Medicine, Cochrane Korea, College of Medicine, Korea University, Seoul, South Korea
| | - Woong Ju
- Department of Obstetrics and Gynecology, Ewha Womans University, Seoul, South Korea
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Wasser JG, Vincent KR, Herman DC, Vincent HK. Potential lower extremity amputation-induced mechanisms of chronic low back pain: role for focused resistance exercise. Disabil Rehabil 2019; 42:3713-3721. [DOI: 10.1080/09638288.2019.1610507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Joseph G. Wasser
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, USA
| | - Kevin R. Vincent
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, USA
| | - Daniel C. Herman
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, USA
| | - Heather K. Vincent
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, USA
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The paraspinal muscle-tendon system: Its paradoxical anatomy. PLoS One 2019; 14:e0214812. [PMID: 30958835 PMCID: PMC6453460 DOI: 10.1371/journal.pone.0214812] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 03/20/2019] [Indexed: 12/19/2022] Open
Abstract
Anatomy of the muscle-tendon system is an important component to musculoskeletal models. In particular, the cross-sectional area of belly (mCSA) and tendon (tCSA) provides information about the maximum force that a muscle may exert. The ratio of mCSA to tCSA (rCSA) demonstrates how muscle force is related to the ability to resist/transmit the force to bone. Previous anatomical studies of the lumbar paraspinal muscles (LPM) showed that their bellies have large mCSA suggesting that they are powerful muscles. Surprisingly, surgical experience shows that the tendons of the LPM are among the thinnest tendons of the body. We therefore hypothesized that traditional biomechanics of the LPM and the rCSA do not correspond for LPM. In 10 fresh-frozen old cadavers, we measured the mCSA, tCSA and rCSA of the LPM (multifidus and the erector spinae, i.e. the longissimus and the iliocostalis); then, we compared these data with those of one of the weakest muscles in the body, i.e. the extensor digitorum communis (EDC) chosen because it shares some common anatomical features with the LPM, in particular with the erector spinae. For instance, the EDC has a polyarticular course and presents long and thin effector tendons. Among the LPM, the longissimus has the greatest mean ACSA with 10.42 cm2 compared with 9.16 cm2 for the iliocostalis and 0.24 cm2 for the multifidus. Mean ACSA of the EDC was almost ten times smaller than those of erector spinae. Regarding the mean tCSA, the EDC was the largest one with 11.48 mm2 compared with 2.69 mm2 and 1.43 mm2 for the longissimus, 5.74 mm2 and 2.38 mm2for the iliocostalis and 5.28 mm2 and 4.96 mm2 for the multifidus. Mean rCSAs of the erector spinae were extremely small, ranged from 1/156 for the spinal attachment of the iliocostalis to 1/739 for the rib attachment of the longissimus that suggests that tendons are an unsuitable size to transmit the force to bone. Mean rCSA of the multifidus and the EDC were in the same range with rCSA = 1/5 and rCSA = 1/9 respectively. The rCSA of the multifidus was substantial, but its ACSA (1cm2) corresponds to low-power muscles. This paradoxical anatomy compels us to consider the biomechanics of the LPM in a different way from that of the classical “chord-like model”, i.e. the muscle belly creates a force that is applied to a bone piece through a tendon. The LPM have large contractile mass in a semi-rigid compartment inside which the pressure may increase. This result strengthens the hypothesis that high pressure and intrinsic stiffness of the LPM create two stiff bodies, closely attached to the spine thus ensuring its stabilization.
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Maddalozzo GF, Aikenhead K, Sheth V, Perisic MN. A Novel Treatment Combination for Failed Back Surgery Syndrome, With a 41-Month Follow-Up: A Retrospective Case Report. J Chiropr Med 2019; 17:256-263. [PMID: 30846918 DOI: 10.1016/j.jcm.2018.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 01/02/2018] [Accepted: 03/21/2018] [Indexed: 01/20/2023] Open
Abstract
Objective The purpose of this retrospective case report was to describe chiropractic management of a patient with failed back surgery syndrome. Clinical Features A 45-year-old woman presented 2 years after L4-L5 and L5-S1 fusion surgery with low back and sciatic pain. Her physical exam included a positive straight leg raise and diminished lower-extremity reflexes and muscle strength. The patient's magnetic resonance imaging showed right disc bulging and annular tearing at L2-L3 and L3-L4 disc bulging with foraminal impingement. Intervention and Outcome A total of 52 treatments were provided over 28 weeks consisting of multidirectional functional decompression (FD) unweighted gait training, core exercises while in FD, strengthening exercises on a vibration platform, and supine spinal FD with vibration and chiropractic spinal manipulative therapy. Over the course of treatment, the patient noted gradual improvement in function (Oswestry Disability Index) and pain (Numeric Rating Scale), with a reduction in pain medications. Follow-up of 41 months posttreatment revealed an Oswestry Disability Index score of 0 and Numeric Rating Scale score of 0, and the patient no longer was using any pain medication. Conclusion After a course of care, the patient in this study reported resolution of symptoms, decrease in pain medications, and improvement of function.
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Affiliation(s)
- Gianni F Maddalozzo
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, Oregon.,Illinois Back Institute, Wheaton, Illinois
| | - Kristine Aikenhead
- Clinical Sciences, National University of Health Sciences, Lombard, Illinois
| | - Vani Sheth
- Illinois Back Institute, Wheaton, Illinois
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[Inpatient multimodal pain therapy : Additive value of neuromuscular core stability exercises for chronic back pain]. Schmerz 2018; 31:115-122. [PMID: 27913929 DOI: 10.1007/s00482-016-0178-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The medical and healthcare economic burden caused by chronic lumbar back pain (CLBP) requires the use of interdisciplinary treatment approaches. The present study aimed to evaluate whether the effectiveness of inpatient multimodal pain therapy (MPT, operations and procedures (OPS) coding 8-918.02), can be increased by implementing additional neuromuscular core stability exercises (NCSE). MATERIAL AND METHODS As part of a prospective controlled study, subjects with CLBP (n = 48, 17 males, 58.2 ± 11.7 years) were allocated to one of two groups. One group received standard care (SC, n =23) encompassing manual, pharmacological and psychological therapy in addition to passive physiotherapeutic applications. The intervention group (IG, n =25) additionally completed NCSE. On the day of admission and on discharge as well as 1 and 6 weeks after inpatient care, pain intensity (numeric rating scale), pain-related routine daily functions (Oswestry disability index), well-being (SF-12 Health Survey) and motor function parameters (trunk strength, endurance and postural control) were assessed. Data analysis was performed using statistical inference methods. In addition, effect sizes (Cohen's d) of intergroup differences were calculated. RESULTS Both groups showed significant reductions in pain intensity (p < 0.05, d > 0.6) at all measurement points (MP). Physical well-being and disability (p < 0.05, d > 0.6) were improved 1 week after discharge in the intervention group only. Overall, no systematic differences between groups were detected (p > 0.05). In relation to the motor outcomes, no significant changes over time nor between groups were verified (p > 0.05). DISCUSSION Despite the use of an additional NCSE, no significant added value in individuals with CLBP could be detected, although a systematic pre-post effect in daily functions and physical well-being (one week after discharge) was observed for the IG only. Therefore, on the basis of the study results, the implementation of additional NCSE into the inpatient MPT cannot be clearly recommended. To further delineate the therapeutic relevance, studies with larger sample sizes are needed.
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Joyce AA, Kotler DH. Core Training in Low Back Disorders: Role of the Pilates Method. Curr Sports Med Rep 2018; 16:156-161. [PMID: 28498224 DOI: 10.1249/jsr.0000000000000365] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The Pilates method is a system of exercises developed by Joseph Pilates, which emphasizes recruitment and strengthening of the core muscles, flexibility, and breathing, to promote stability and control of movement. Its focus bears similarity to current evidence-based exercise programs for low back disorders. Spinal stability is a function of three interdependent systems, osseoligamentous, muscular, and neural control; exercise addresses both the muscular and neural function. The "core" typically refers to the muscular control required to maintain functional stability. Prior research has highlighted the importance of muscular strength and recruitment, with debate over the importance of individual muscles in the wider context of core control. Though developed long before the current evidence, the Pilates method is relevant in this setting and clearly relates to current evidence-based exercise interventions. Current literature supports the Pilates method as a treatment for low back disorders, but its benefit when compared with other exercise is less clear.
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Affiliation(s)
- Andrew A Joyce
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA
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Wasser JG, Herman DC, Horodyski M, Zaremski JL, Tripp B, Page P, Vincent KR, Vincent HK. Exercise intervention for unilateral amputees with low back pain: study protocol for a randomised, controlled trial. Trials 2017; 18:630. [PMID: 29284521 PMCID: PMC5747115 DOI: 10.1186/s13063-017-2362-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 11/30/2017] [Indexed: 11/10/2022] Open
Abstract
Background Atraumatic lower limb amputation is a life-changing event for approximately 185,000 persons in the United States each year. A unilateral amputation is associated with rapid changes to the musculoskeletal system including leg and back muscle atrophy, strength loss, gait asymmetries, differential mechanical joint loading and leg length discrepancies. Even with high-quality medical care and prostheses, amputees still develop secondary musculoskeletal conditions such as chronic low back pain (LBP). Resistance training interventions that focus on core stabilization, lumbar strength and dynamic stability during loading have strong potential to reduce LBP and address amputation-related changes to the musculoskeletal system. Home-based resistance exercise programs may be attractive to patients to minimize travel and financial burdens. Methods/design This study will be a single-assessor-blinded, pre-post-test randomised controlled trial involving 40 men and women aged 18–60 years with traumatic, unilateral transtibial amputation. Participants will be randomised to a home-based, resistance exercise group (HBRX) or a wait-list control group (CON). The HBRX will consist of 12 weeks of elastic resistance band and bodyweight training to improve core and lumbopelvic strength. Participants will be monitored via Skype or Facetime on a weekly basis. The primary outcome will be pain severity (11-point Numerical Pain Rating Scale; NRSpain). Secondary outcomes will include pain impact on quality of life (Medical Outcomes Short Form 36, Oswestry Disability Index and Roland Morris Disability Questionnaire), kinematics and kinetics of walking gait on an instrumented treadmill, muscle morphology (muscle thickness of multifidus, transversus abdominis, internal oblique), maximal muscle strength of key lumbar and core muscles, and daily step count. Discussion The study findings will determine whether a HBRX program can decrease pain severity and positively impact several physiological and mechanical factors that contribute to back pain in unilateral transtibial amputees with chronic LBP. We will determine the relative contribution of the exercise-induced changes in these factors on pain responsiveness in this population. Trial registration ClinicalTrials.gov, ID: NCT03300375. Registered on 2 October 2017. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2362-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Joseph G Wasser
- Department of Orthopaedics and Rehabilitation, UF Health Orthopaedics and Sports Medicine Institute (OSMI), University of Florida, Gainesville, FL, 32611, USA.
| | - Daniel C Herman
- Department of Orthopaedics and Rehabilitation, UF Health Orthopaedics and Sports Medicine Institute (OSMI), University of Florida, Gainesville, FL, 32611, USA
| | - MaryBeth Horodyski
- Department of Orthopaedics and Rehabilitation, UF Health Orthopaedics and Sports Medicine Institute (OSMI), University of Florida, Gainesville, FL, 32611, USA
| | - Jason L Zaremski
- Department of Orthopaedics and Rehabilitation, UF Health Orthopaedics and Sports Medicine Institute (OSMI), University of Florida, Gainesville, FL, 32611, USA
| | - Brady Tripp
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32608, USA
| | | | - Kevin R Vincent
- Department of Orthopaedics and Rehabilitation, UF Health Orthopaedics and Sports Medicine Institute (OSMI), University of Florida, Gainesville, FL, 32611, USA
| | - Heather K Vincent
- Department of Orthopaedics and Rehabilitation, UF Health Orthopaedics and Sports Medicine Institute (OSMI), University of Florida, Gainesville, FL, 32611, USA
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Feng Q, Jiang C, Zhou Y, Huang Y, Zhang M. Relationship between spinal morphology and function and adolescent non-specific back pain: A cross-sectional study. J Back Musculoskelet Rehabil 2017; 30:625-633. [PMID: 28234252 DOI: 10.3233/bmr-160544] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
CONTEXT Non-specific back pain has become a public health problem affecting adolescent health. OBJECTIVE To examine the relationships between abnormalities in spinal morphology and non-specific back pain among adolescents. DESIGN Cross-sectional study. SETTING Junior and senior high schools. PATIENTS Participants were screened using a questionnaire regarding back pain. Students in the pain group (n= 273, 121 boys and 152 girls) reported experiencing upper and/or lower back pain within the previous month, and those who did not report pain were assigned to the group without pain (n= 127, 63 boys and 64 girls). Participants who had experienced acute upper and/or lower back injuries within the previous month or received a definitive diagnose of disease were excluded. METHODS The SpinalMouse® was used to measure the thoracic kyphosis angle (TKA), lumbar lordosis angle (LLA), sacrum/hip angle (SA), and incline angle (INA) in both the standing position and sitting position. The SpinalMouse® also was used to measure the sacral, thoracic, and lumbar range of motion (ROM) in the fully flexed position and fully extended position in the sagittal plane. The thoracic and lumbar ROM in left/right lateral flexion was recorded. The Matthiass test was used to assess changes in the measured angles upon loading. RESULTS Among junior high school students, 47.0% of boys and 53% of girls had an abnormal TKA. Among senior high school students, 52.6% of boys and 46.99% of girls had an abnormal TKA. The incidence of LLA abnormality was significantly higher among junior high boys than girls (p< 0.05), as was the incidence of hypolordosis (p< 0.05). Significantly fewer senior high boys than girls had a normal LLA value (p< 0.05). An excessive TKA (p< 0.05, odds ratio = 1.236) and limited lumbar ROM (p< 0.01, odds ratio = 0.975) were correlated with back pain in adolescents. CONCLUSIONS The incidences of TKA and LLA abnormality are high among Chinese adolescents, and an excessive TKA and insufficient total lumbar ROM may be risk factors for non-specific back pain in adolescents.
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Affiliation(s)
- Qiang Feng
- China Institute of Sport Science, Beijing, China
| | | | - Yu Zhou
- National Institute of Education Sciences, Beijing, China
| | - Yun Huang
- Guangxi College of Sports and Physical Education, Guangxi, China
| | - Ming Zhang
- China Institute of Sport Science, Beijing, China
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Lee K, Kim M, Ha H, Lee W. Comparison of lateral abdominal muscle thickness during bridge exercises with different support surfaces in healthy individuals. ISOKINET EXERC SCI 2017. [DOI: 10.3233/ies-171172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Kyeongbong Lee
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Seoul, Korea
| | - Minkyu Kim
- Department of Physical Therapy, The Graduate School of Sahmyook University, Seoul, Korea
| | - Hyungeun Ha
- Department of Physical Therapy, Namseoul University, Cheonan, Korea
| | - Wanhee Lee
- Department of Physical Therapy, College of Health and Welfare, Sahmyook University, Seoul, Korea
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Risk Factors of Postoperative Low Back Pain for Low-Grade Degenerative Spondylolisthesis: An At Least 2-Year Follow-Up Retrospective Study. World Neurosurg 2017; 107:789-794. [DOI: 10.1016/j.wneu.2017.08.109] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 08/14/2017] [Accepted: 08/16/2017] [Indexed: 11/20/2022]
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Abdominal Wall Reconstruction for Incisional Hernia Optimizes Truncal Function and Quality of Life: A Prospective Controlled Study. Ann Surg 2017; 265:1235-1240. [PMID: 27280505 DOI: 10.1097/sla.0000000000001827] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The aim of the study was to examine abdominal wall function in patients undergoing abdominal wall reconstruction (AWR) for incisional hernia. BACKGROUND The literature on abdominal wall function in patients with incisional hernia is sparse. It has been suggested that AWR leads to improvement in function, but it is unknown whether this is specific to the abdominal wall or due to an improvement in overall physical fitness. METHODS We performed a prospective case-control study of 18 consecutive patients with large incisional hernia undergoing AWR with linea alba restoration. Truncal flexion and extension strength, hand grip strength, leg extension power, and quality of life (SF-36 and Carolinas Comfort Scale) were assessed preoperatively and 1 year postoperatively. Patients were compared with a control group of patients with an intact abdominal wall undergoing colorectal resection (n = 18). The study was registered at ClinicalTrials.gov (NCT02011048). RESULTS Compared with preoperative measurements, 1-year follow-up after AWR demonstrated an increase of both truncal flexion strength (from mean 505.6 N to 572.3 N, P < 0.001) and truncal extension strength (from 556.7 to 606.0 N, P = 0.005). There was no significant change of either hand grip strength or leg extension power. After AWR, the physical component of overall quality of life improved, whereas the mental component score remained unchanged. In the control group, surgery resulted in a decrease in both truncal flexion and truncal extension. CONCLUSIONS AWR for incisional hernia specifically improved long-term abdominal wall muscular function and quality of life.
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Maddalozzo GF, Kuo B, Maddalozzo WA, Maddalozzo CD, Galver JW. Comparison of 2 Multimodal Interventions With and Without Whole Body Vibration Therapy Plus Traction on Pain and Disability in Patients With Nonspecific Chronic Low Back Pain. J Chiropr Med 2016; 15:243-251. [PMID: 27857632 PMCID: PMC5106425 DOI: 10.1016/j.jcm.2016.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 07/06/2016] [Accepted: 07/07/2016] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE The purpose of this secondary data analysis was to compare the effect of 2 multimodal exercise-based physical therapy interventions (one with and one without whole-body vibration [WBV] therapy plus traction) on pain and disability in patients with nonspecific chronic low back pain (NSCLBP). METHODS We conducted a secondary analysis of data from 2 distinct samples. One sample was from the Focus on Therapeutic Outcomes Inc. (FOTO) group (n = 55, age 55.1 ± 19.0 years), and the other was the Illinois Back Institute (IBI) (n = 70, age 47.5 ± 13.4 years). Both groups of patients had NSCLBP for more than 3 months and a pain numeric rating scale (NRS) score of ≥7. Both groups received treatment consisting of flexibility or stretching exercises, core stability training, functional training, and postural exercises and strengthening exercises. However, the IBI group also received WBV plus traction. NSCLBP was measured before and after therapeutic trials using the NRS for pain and Oswestry Disability Index (ODI). RESULTS The NRS scores were significantly improved in both groups, decreasing by 2 points in the FOTO group and by 5 points in the IBI group. The ODI scores were significantly improved in both groups; the FOTO group score improved by 9 points and the IBI group improved by 22 points. CONCLUSIONS The results of this preliminary study suggest that NPS and ODI scores statistically improved for both NSCLBP groups receiving multimodal care. However, the group that included WBV therapy plus traction in combination with multimodal care had greater clinical results. This study had several limitations making it difficult to generalize the results from this study sample to the entire population.
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Affiliation(s)
| | - Brian Kuo
- School of Biological and Population Health Sciences, Corvallis, OR
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