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Pizol GZ, Miyamoto GC, Cabral CMN. Hip biomechanics in patients with low back pain, what do we know? A systematic review. BMC Musculoskelet Disord 2024; 25:415. [PMID: 38807086 PMCID: PMC11131240 DOI: 10.1186/s12891-024-07463-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/19/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Biomechanical alterations in patients with low back pain (LBP), as reduced range of motion or strength, do not appear to be exclusively related to the trunk. Thus, studies have investigated biomechanical changes in the hip, due to the proximity of this joint to the low back region. However, the relationship between hip biomechanical changes in patients with LBP is still controversial and needs to be summarized. Therefore, the aim of this study was to systematically review observational studies that used biomechanical assessments in patients with non-specific LBP. METHODS The search for observational studies that evaluated hip biomechanical variables (i.e., range of motion, kinematic, strength, and electromyography) in adults with non-specific acute, subacute, and chronic LBP was performed in the PubMed, Embase, Cinahl and Sportdiscus databases on February 22nd, 2024. Four blocks of descriptors were used: 1) type of study, 2) LBP, 3) hip and 4) biomechanical assessment. Two independent assessors selected eligible studies and extracted the following data: author, year of publication, country, study objective, participant characteristics, outcomes, and results. The methodological quality of the studies was assessed using the Epidemiological Appraisal Instrument and classified as low, moderate, and high. Due to the heterogeneity of the biomechanical assessment and, consequently, of the results among eligible studies, a descriptive analysis was performed. RESULTS The search strategy returned 338 articles of which 54 were included: nine articles evaluating range of motion, 16 evaluating kinematic, four strength, seven electromyography and 18 evaluating more than one outcome. The studies presented moderate and high methodological quality. Patients with LBP, regardless of symptoms, showed a significant reduction in hip range of motion, especially hip internal rotation, reduction in the time to perform functional activities such as sit-to-stance-to-sit, sit-to-stand or walking, greater activation of the hamstrings and gluteus maximus muscles and weakness of the hip abductor and extensor muscles during specific tests and functional activities compared to healthy individuals. CONCLUSION Patients with LBP present changes in range of motion, task execution, activation, and hip muscle strength when compared to healthy individuals. Therefore, clinicians must pay greater attention to the assessment and management of the hip during the treatment of these patients. SYSTEMATIC REVIEW REGISTRATION International Prospective Register of Systematic Reviews (PROSPERO) (CRD42020213599).
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Affiliation(s)
- Gustavo Zanotti Pizol
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno 475, Tatuapé, Sao Paulo, SP, CEP: 03071-000, Brazil.
| | - Gisela Cristiane Miyamoto
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno 475, Tatuapé, Sao Paulo, SP, CEP: 03071-000, Brazil
| | - Cristina Maria Nunes Cabral
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno 475, Tatuapé, Sao Paulo, SP, CEP: 03071-000, Brazil
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Kendell M, Smith A, O'Sullivan P, Beales D, Chan J, Li KM, McMullan M, Smith K, Rabey M. How do people with chronic low back pain pick a pencil off the floor? Physiother Theory Pract 2024; 40:576-593. [PMID: 36066194 DOI: 10.1080/09593985.2022.2120374] [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: 05/10/2022] [Revised: 08/29/2022] [Accepted: 08/29/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Picking objects off the floor is provocative for people with chronic low back pain (CLBP). There are no clinically applicable methods evaluating movement strategies for this task. The relationship between strategy and multidimensional profiles is unknown. OBJECTIVE Develop a movement evaluation tool (MET) to examine movement strategies in people with CLBP (n = 289) picking a pencil off the floor. Describe those movement strategies, and determine reliability of the MET. Explore differences across multidimensional profiles and movement strategies. METHODS An MET was developed using literature and iterative processes, and its inter-rater agreement determined. Latent class analysis (LCA) derived classes demonstrating different strategies using six movement parameters as indicator variables. Differences between classes across multidimensional profiles were investigated using analysis of variance, Kruskal-Wallis, or chi-squared tests. RESULTS Six movement parameters were evaluated. There was substantial inter-rater agreement (Cohen's Kappa = 0.39-0.79) across parameters. LCA derived three classes with different strategies: Class 1 (71.8%) intermediate trunk inclination/knee flexion; Class 2 (24.5%) greater forward trunk inclination, lower knee flexion; Class 3 (3.7%) lower forward trunk inclination, greater knee flexion. Pain duration differed across all classes (p ≤ .001). Time taken to complete forward bends differed between Class 3 and other classes (p = .024). CONCLUSIONS Movement strategies can be reliably assessed using the MET. Three strategies for picking lightweight objects off the floor were derived, which differed across pain duration and speed of movement.
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Affiliation(s)
- Michelle Kendell
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Anne Smith
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Peter O'Sullivan
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Darren Beales
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Jonathan Chan
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Kun Man Li
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Matthew McMullan
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Kelby Smith
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Martin Rabey
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
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Ludwig O, Dindorf C, Kelm S, Kelm J, Fröhlich M. Muscular Strategies for Correcting the Pelvic Position to Improve Posture-An Exploratory Study. J Funct Morphol Kinesiol 2024; 9:25. [PMID: 38390925 PMCID: PMC10885056 DOI: 10.3390/jfmk9010025] [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: 12/18/2023] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
The correction of postural weaknesses through the better positioning of the pelvis is an important approach in sports therapy and physiotherapy. The pelvic position in the sagittal plane is largely dependent on the muscular balance of the ventral and dorsal muscle groups. The aim of this exploratory study was to examine whether healthy persons use similar muscular activation patterns to correct their pelvic position or whether there are different motor strategies. The following muscles were recorded in 41 persons using surface electromyography (EMG): M. trapezius pars ascendens, M. erector spinae pars lumbalis, M. gluteus maximus, M. biceps femoris, M. rectus abdominis, and M. obliquus externus. The participants performed 10 voluntary pelvic movements (retroversion of the pelvis). The anterior pelvic tilt was measured videographically via marker points on the anterior and posterior superior iliac spine. The EMG data were further processed and normalized to the maximum voluntary contraction. A linear regression analysis was conducted to assess the relationship between changes in the pelvic tilt and muscle activities. Subsequently, a Ward clustering analysis was applied to detect potential muscle activation patterns. The differences between the clusters and the pelvic tilt were examined using ANOVA. Cluster analysis revealed the presence of four clusters with different muscle activation patterns in which the abdominal muscles and dorsal muscle groups were differently involved. However, the gluteus maximus muscle was involved in every activation pattern. It also had the strongest correlation with the changes in pelvic tilt. Different individual muscle patterns are used by different persons to correct pelvic posture, with the gluteus maximus muscle apparently playing the most important role. This can be important for therapy, as different muscle strategies should be trained depending on the individually preferred motor patterns.
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Affiliation(s)
- Oliver Ludwig
- Department of Sport Science, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau (RPTU), 67663 Kaiserslautern, Germany
| | - Carlo Dindorf
- Department of Sport Science, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau (RPTU), 67663 Kaiserslautern, Germany
| | - Sebastian Kelm
- Department of Sport Science, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau (RPTU), 67663 Kaiserslautern, Germany
| | - Jens Kelm
- Orthopädisch-Chirurgisches Zentrum, 66557 Illingen, Germany
| | - Michael Fröhlich
- Department of Sport Science, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau (RPTU), 67663 Kaiserslautern, Germany
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Thomaz de Aquino Nava G, Mendes Tozim B, Hebling Spinoso D, Baldini Prudencio C, Tavella Navega M. Chronic low back pain and muscle activity in women during the sit-to-stand task: A cross-sectional study. J Bodyw Mov Ther 2024; 37:366-371. [PMID: 38432830 DOI: 10.1016/j.jbmt.2023.11.040] [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: 01/25/2022] [Revised: 07/07/2023] [Accepted: 11/24/2023] [Indexed: 03/05/2024]
Abstract
INTRODUCTION The ability to stand up and sit down is important. Due to the large number of repetitions of these activities during the day and the demand that the task requires, it is cited as painful in the presence of low back pain (LBP). Individuals with LBP present alterations in muscle activation, however, this statement needs to be verified during everyday situations like the sit-to-stand task (STST). Therefore, the objective was to evaluate the muscle recruitment of women with and without LBP during the STST. METHODS 35 women were evaluated, and allocated into the control group (CG n = 15) and the low back pain group (LBPG n = 20). The protocol consisted of clinical evaluation and the sit-to-stand task (STST). Electromyographic signals of the lumbar multifidus (LM), internal oblique (IO) and external oblique (EO), rectus abdominis (RA), and lumbar iliocostalis (LI) were carried out concomitantly with the STST. To verify normality, the Shapiro-Wilk test was used. For the characterization of the sample, the MANOVA test was chosen and the MANCOVA test was also chosen to compare the characteristics of the participants. RESULTS Regarding the data analysis of the electromyographic signals, higher values were seen in the RA (moments 2 and 3) in the LBPG in the STST. CONCLUSION The present study showed that women with chronic LBP present higher muscle activation of the rectus abdominis in the sit-to-stand task.
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Affiliation(s)
- Guilherme Thomaz de Aquino Nava
- Department of Physical Education, Institute of Biosciences, São Paulo State University (UNESP), Rio Claro, São Paulo, Brazil.
| | - Beatriz Mendes Tozim
- Department of Physiotherapy and Occupational Therapy, School of Philosophy and Sciences, São Paulo State University (UNESP), Marília, São Paulo, Brazil
| | - Deborah Hebling Spinoso
- Department of Physiotherapy and Occupational Therapy, School of Philosophy and Sciences, São Paulo State University (UNESP), Marília, São Paulo, Brazil
| | - Caroline Baldini Prudencio
- Department of Tocogynecology, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Marcelo Tavella Navega
- Department of Physical Education, Institute of Biosciences, São Paulo State University (UNESP), Rio Claro, São Paulo, Brazil; Department of Physiotherapy and Occupational Therapy, School of Philosophy and Sciences, São Paulo State University (UNESP), Marília, São Paulo, Brazil
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Kearney JW, Weyden MNSVD, Cortes N, Fernandes O, Martin JR. Effect of the Law Enforcement Duty Belt on Muscle Activation during Hip Hinging Movements in Young, Healthy Adults. J Funct Morphol Kinesiol 2023; 8:99. [PMID: 37489312 PMCID: PMC10366834 DOI: 10.3390/jfmk8030099] [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: 06/17/2023] [Revised: 07/07/2023] [Accepted: 07/14/2023] [Indexed: 07/26/2023] Open
Abstract
Sixty percent of all law enforcement officers (LEOs) experience low back pain (LBP), with the LEO duty belt (LEODB) commonly reported to be a contributing factor. The primary purpose of the study was to investigate the LEODB's effect on muscular activity and compare it to a tactical vest, which is a commonly used alternative to an LEODB. In total, 24 participants (13 male, 11 female; mass, 73.0 ± 11.1 kg; height, 169.0 ± 10.0 cm; age, 24.0 ± 5.8 years) completed a progressive series of hip hinge tasks in a single testing session. All participants completed four conditions (no belt, leather belt, nylon belt, and weight VEST) in a randomized order. Surface electromyography (sEMG) sensors were placed bilaterally on the rectus abdominus, multifidus, biceps femoris, and rectus femoris. Across all tasks, no significant effects of load on muscle activity were found for any of the muscles. Participants rated the VEST condition as more comfortable (p < 0.05) and less restrictive (p < 0.05) than either LEODB. The findings suggest an LEODB does not alter muscle activity during bodyweight hip hinging or lifting objects from the ground. Future research should examine whether changes in muscle activity occur with durations of LEODB wear more similar to an actual work shift duration for LEOs (≥8 h).
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Affiliation(s)
- James W Kearney
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA 20110, USA
| | - Megan N Sax van der Weyden
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA 20110, USA
| | - Nelson Cortes
- School of Sport, Rehabilitation, and Exercise Science, University of Essex, Colchester CO4 3WA, UK
- Department of Bioengineering, George Mason University, Fairfax, VA 22030, USA
| | - Orlando Fernandes
- Sport and Health Department, School of Science and Technology, University of Évora, 7004-516 Évora, Portugal
| | - Joel R Martin
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA 20110, USA
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Rum L, Russo Y, Vannozzi G, Macaluso A. "Posture first": Interaction between posture and locomotion in people with low back pain during unexpectedly cued modification of gait initiation motor command. Hum Mov Sci 2023; 89:103094. [PMID: 37148816 DOI: 10.1016/j.humov.2023.103094] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/14/2023] [Accepted: 04/21/2023] [Indexed: 05/08/2023]
Abstract
The ability to adapt anticipatory postural adjustments (APAs) in response to perturbations during single-joint movements is altered in people with chronic low back pain (LBP), but a comprehensive analysis during functional motor tasks is still missing. This study aimed to compare APAs and stepping characteristics during gait initiation between people with LBP and healthy controls, both in normal (without cue occurrence) condition and when an unexpected visual cue required to switch the stepping limb. Fourteen individuals with LPB and 10 healthy controls performed gait initiation in normal and switch conditions. The postural responses were evaluated through the analysis of center of pressure, propulsive ground reaction forces, trunk and whole-body kinematics, and activation onsets of leg and back muscles. During normal gait initiation, participants with LBP exhibited similar APAs and stepping characteristics to healthy controls. In the switch condition, individuals with LBP were characterized by greater mediolateral postural stability but decreased forward body motion and propulsion before stepping. The thorax motion was associated with forward propulsion parameters in both task conditions in people with LBP but not healthy controls. No between-group differences were found in muscle activation onsets. The results suggest that postural stability is prioritized over forward locomotion in individuals with LBP. Furthermore, the condition-invariant coupling between thorax and whole-body forward propulsion in LBP suggests an adaptation in the functional use of the thorax within the postural strategy, even in poor balance conditions.
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Affiliation(s)
- Lorenzo Rum
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro De Bosis 6, 00135 Rome, Italy.
| | - Yuri Russo
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro De Bosis 6, 00135 Rome, Italy; Department of Sport and Health Sciences, University of Exeter, St Luke's Campus, Magdalen Road, Exeter EX1 2LU, UK
| | - Giuseppe Vannozzi
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro De Bosis 6, 00135 Rome, Italy
| | - Andrea Macaluso
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro De Bosis 6, 00135 Rome, Italy
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Lunkes LC, Dias Neto MA, Barra LF, de Castro LR, Ferreira AS, Meziat-Filho N. Education to keep the abdomen relaxed versus contracted during pilates in patients with chronic low back pain: study protocol for a randomised controlled trial. BMC Musculoskelet Disord 2023; 24:49. [PMID: 36670384 PMCID: PMC9854226 DOI: 10.1186/s12891-023-06160-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/11/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Low back pain is a very common symptom frequently characterized as a biopsychosocial problem. This study aims to investigate the effectiveness of education to keep the abdomen relaxed versus contracted during Pilates exercises in patients with primary chronic low back pain. METHODS Two-group randomised controlled trial with allocation of parallel groups and intention-to-treat-analysis. This study will be conducted in Lavras, MG, Brazil. A total of 152 participants will be randomised into two groups that will be treated with Pilates exercises for 12 weeks (twice a week for 60 minutes). Recruitment began in May 2022. The control group will receive guidance on the specific activation of the center of strength (the powerhouse), while the experimental group will receive guidance to perform the exercises in a relaxed and smooth way. Primary outcomes will be pain intensity (Numeric Pain Rating Scale) and disability (Rolland-Morris Questionnaire) 12 weeks post randomisation. Secondary outcomes will be global improvement (Perception of Global Effect Scale) and specific functionality (Patient-specific Functional Scale). The outcomes will be analyzed using repeated-measure linear mixed models. The assessors were not considered blinded because the participants were not blinded, and outcomes were self-reported. DISCUSSION The findings of this study will help in clinical decision-making concerning the need to demand abdominal contraction during the exercises, understanding if it's a fundamental component for the effectiveness of the Pilates method for this population. TRIAL REGISTRATION This trial was prospectively registered in the Clinical Trials (NCT05336500) in April 2022.
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Affiliation(s)
- Luciana Crepaldi Lunkes
- Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, RJ, Brazil. .,Physiotherapy Department, Centro Universitário de Lavras (UNILAVRAS), Rua Padre José Poggel, 506, Padre Dehon, Lavras, MG, 37203-593, Brazil.
| | - Milton Apolinário Dias Neto
- grid.441664.50000 0004 0508 9542Physiotherapy Department, Centro Universitário de Lavras (UNILAVRAS), Rua Padre José Poggel, 506, Padre Dehon, Lavras, MG 37203-593 Brazil
| | - Lavínia Fernandes Barra
- grid.441664.50000 0004 0508 9542Physiotherapy Department, Centro Universitário de Lavras (UNILAVRAS), Rua Padre José Poggel, 506, Padre Dehon, Lavras, MG 37203-593 Brazil
| | - Lívia Resende de Castro
- grid.441664.50000 0004 0508 9542Physiotherapy Department, Centro Universitário de Lavras (UNILAVRAS), Rua Padre José Poggel, 506, Padre Dehon, Lavras, MG 37203-593 Brazil
| | - Arthur Sá Ferreira
- grid.441993.20000 0004 0466 2861Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, RJ Brazil
| | - Ney Meziat-Filho
- grid.441993.20000 0004 0466 2861Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, RJ Brazil
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Alamrani S, Gardner A, Falla D, Russell E, Rushton AB, Heneghan NR. Content validity of the Scoliosis Research Society questionnaire (SRS-22r): A qualitative concept elicitation study. PLoS One 2023; 18:e0285538. [PMID: 37146069 PMCID: PMC10162511 DOI: 10.1371/journal.pone.0285538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 04/25/2023] [Indexed: 05/07/2023] Open
Abstract
INTRODUCTION Scoliosis Research Society-22 revised (SRS-22r) is the common questionnaire used to evaluate health related quality of life (HRQOL) for young people with adolescent idiopathic scoliosis (AIS). The aim of this study is to evaluate its content validity for this population. METHODS In-depth semi-structured interviews were conducted with a purposive sample of young people with AIS (Cobb angle ≥25˚, aged 10-18 years). Concept elicitation was used to evaluate the influence of AIS on participants' HRQOL. Participant information sheets and consent/assent forms were age relevant. Topic guide was informed by the SRS-22r and existing evidence. Interviews were audio and video recorded, transcribed verbatim, coded, and analysed using thematic analysis. Derived themes/codes were compared with SRS-22r contents (domains/items). RESULTS Eleven participants (mean age 14.9 years [SD = 1.8]; 8 female) were recruited. The mean curve size was 47.5° [SD = 18°] and participants had been managed via different approaches. Four main themes emerged with associated subthemes: 1) Physical effects related to physical symptoms (back hurt, stiffness) and body asymmetry (uneven shoulders), 2) Activity-related effects showed impact on mobility (sitting for long periods), self-care (dressing), and school activities (focus during lessons), 3) Psychological effects revealed emotional (feel worried), mental (sleep quality), and body image effects (hide back from others), 4) Social effects (participation in school and leisure activities), and school, friends and mental health support. A weak association was found between items of the SRS-22r and the identified codes. CONCLUSION The SRS-22r does not adequately capture important concepts that relate to HRQOL of adolescents with AIS. These findings support revision of the SRS-22r, or the development of a new patient reported outcome measure to evaluate HRQOL of adolescents with AIS.
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Affiliation(s)
- Samia Alamrani
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
- Physical Therapy Department, College of Applied Medical Science, University of Tabuk, Tabuk, Saudi Arabia
| | - Adrian Gardner
- Spine Unit, The Royal Orthopaedic Hospital, Northfield, Birmingham, United Kingdom
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Emily Russell
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Alison B Rushton
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Nicola R Heneghan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
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Telles GF, Ferreira ADS, Junior PMP, Lemos T, Bittencourt JV, Nogueira LAC. Concurrent validity of the inertial sensors for assessment of balance control during quiet standing in patients with chronic low back pain and asymptomatic individuals. J Med Eng Technol 2022; 46:354-362. [PMID: 35243965 DOI: 10.1080/03091902.2022.2043947] [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: 01/11/2023]
Abstract
The objective was to investigate the concurrent validity of inertial sensors for measuring balance control in patients with chronic low back pain and asymptomatic individuals. Thirty-nine patients with chronic low back and 39 age- and sex-matched asymptomatic individuals were included. Balance control analysis was performed in quiet standing with two inertial sensors positioned at the lumbar region and the sternum and compared to the results of a force plate. The variables analysed with either device were Root Mean Square (RMS), index of smoothness (JERK), trajectory length (PATH) and area (AREA). Spearman's correlation coefficient investigated the correlation. Patients with chronic low back pain showed moderate correlation with the inertial sensor positioned on the lumbar for RMS (rs = 0.59; p < 0.01), PATH (rs = 0.42, p = 0.01) and AREA (rs = 0.59; p < 0.01) and weak correlation with the inertial sensor positioned on the sternum for PATH (rs = 0.36, p = 0.04). The asymptomatic group showed statistically significant correlations for RMS for the lumbar (rs = 0.38; p = 0.03) and sternum inertial sensor (rs = 0.42; p = 0.02). Inertial sensors showed weak to moderate correlations compared to data obtained from a force plate.
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Affiliation(s)
- Gustavo Felicio Telles
- Rehabilitation Science Postgraduation Progam - Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil
| | - Arthur de Sá Ferreira
- Rehabilitation Science Postgraduation Progam - Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil
| | - Pedro Manoel Pena Junior
- Rehabilitation Science Postgraduation Progam - Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil
| | - Thiago Lemos
- Rehabilitation Science Postgraduation Progam - Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil
| | - Juliana Valentim Bittencourt
- Rehabilitation Science Postgraduation Progam - Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil
| | - Leandro Alberto Calazans Nogueira
- Rehabilitation Science Postgraduation Progam - Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil.,Physiotherapy Department - Federal Institute of Rio de Janeiro (IFRJ), Rio de Janeiro, Brazil
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Zurek G, Kasper-Jędrzejewska M, Dobrowolska I, Mroczek A, Delaunay G, Ptaszkowski K, Halski T. Vibrating Exercise Equipment in Middle-Age and Older Women with Chronic Low Back Pain and Effects on Bioelectrical Activity, Range of Motion and Pain Intensity: A Randomized, Single-Blinded Sham Intervention Study. BIOLOGY 2022; 11:268. [PMID: 35205134 PMCID: PMC8869153 DOI: 10.3390/biology11020268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 11/24/2022]
Abstract
Background: Chronic low back pain (CLBP) is one of the most common musculoskeletal disorders. Physical activity (PA) is often recommended as part of the management of CLBP, but to date, no one particular exercise has been shown to be superior. Vibrating exercise equipment (VEE) is widely available and used despite little scientific evidence to support its effectiveness in the prevention and treatment of musculoskeletal problems. The aim of this study was to evaluate the efficiency of using VEE compared with sham-VEE in women with CLBP. Methods: A randomized (1:1 randomization scheme) single-blinded sham-controlled intervention study was conducted. Through simple randomization, 92 women aged 49-80 years were assigned to one of two groups: VEE (the experimental group) and sham-VEE (the control group). The VEE and sham-VEE intervention consisted of aerobic exercises with specific handheld equipment. Both groups performed physical activity twice weekly for 10 weeks. The erector spinae muscles' bioelectrical activity (using an eight-channel electromyograph MyoSystem 1400L), lumbar range of motion (Schober's test) and pain intensity (visual analog scale) were measured in all participants at baseline and after 10 weeks. Results: There was a significant decrease in the bioelectrical activity of the erector spinae muscles during flexion movement (left: Me = 18.2 before; Me = 14.1 after; p = 0.045; right: Me = 15.4 before; Me = 12.6 after; p = 0.010), rest at maximum flexion (left: Me = 18.1 before; Me = 12.5 after; p = 0.038), extension movement (right: Me = 21.8 before; Me = 20.2 after; p = 0.031) and rest in a prone position (right: Me = 3.5 before; Me = 3.2 after; 0.049); an increase in lumbar range of motion (Me = 17.0 before; Me = 18.0 after; p = 0.0017) and a decrease in pain intensity (Me = 4.0 before; Me = 1.0 after; p = 0.001) following a program of PA in the VEE group. Conclusions: No significant changes were found in intergroup comparisons. The beneficial changes regarding decreased subjective pain sensation in the VEE and sham-VEE groups may be due to participation in systematic physical activity. However, PA with vibrating exercise equipment could be a prospective strategy for increasing lumbar range of motion and for decreasing pain and erector spinae muscle activity in people with CLBP.
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Affiliation(s)
- Grzegorz Zurek
- Department of Biostructure, University School of Physical Education, I.J. Paderewskiego 35, 51-612 Wroclaw, Poland; (G.Z.); (G.D.)
| | - Martyna Kasper-Jędrzejewska
- Institute of Health Sciences, University of Opole, Katowicka 68, 45-060 Opole, Poland; (I.D.); (A.M.); (T.H.)
| | - Iwona Dobrowolska
- Institute of Health Sciences, University of Opole, Katowicka 68, 45-060 Opole, Poland; (I.D.); (A.M.); (T.H.)
| | - Agata Mroczek
- Institute of Health Sciences, University of Opole, Katowicka 68, 45-060 Opole, Poland; (I.D.); (A.M.); (T.H.)
| | - Gerda Delaunay
- Department of Biostructure, University School of Physical Education, I.J. Paderewskiego 35, 51-612 Wroclaw, Poland; (G.Z.); (G.D.)
| | - Kuba Ptaszkowski
- Department of Clinical Biomechanics and Physiotherapy in Motor System Disorders, Faculty of Health Science, Wroclaw Medical University, Grunwaldzka 2, 50-355 Wroclaw, Poland;
| | - Tomasz Halski
- Institute of Health Sciences, University of Opole, Katowicka 68, 45-060 Opole, Poland; (I.D.); (A.M.); (T.H.)
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11
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Ippersiel P, Teoli A, Wideman TH, Preuss RA, Robbins SM. The Relationship Between Pain-Related Threat and Motor Behavior in Nonspecific Low Back Pain: A Systematic Review and Meta-Analysis. Phys Ther 2022; 102:6478879. [PMID: 34939120 DOI: 10.1093/ptj/pzab274] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 06/30/2021] [Accepted: 11/07/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Although pain-related fear and catastrophizing are predictors of disability in low back pain (LBP), their relationship with guarded motor behavior is unclear. The aim of this meta-analysis was to determine the relationship between pain-related threat (via pain-related fear and catastrophizing) and motor behavior during functional tasks in adults with LBP. METHODS This review followed PRISMA guidelines. MEDLINE, Embase, PsychINFO, and CINAHL databases were searched to April 2021. Included studies measured the association between pain-related fear or pain catastrophizing and motor behavior (spinal range of motion, trunk coordination and variability, muscle activity) during movement in adults with nonspecific LBP. Studies were excluded if participants were postsurgery or diagnosed with specific LBP. Two independent reviewers extracted all data. The Newcastle-Ottawa Scale was used to assess for risk of bias. Correlation coefficients were pooled using the random-effects model. RESULTS Reduced spinal range of motion during flexion tasks was weakly related to pain-related fear (15 studies, r = -0.21, 95% CI = -0.31 to -0.11) and pain catastrophizing (7 studies, r = -0.24, 95% CI = -0.38 to -0.087). Pain-related fear was unrelated to spinal extension (3 studies, r = -0.16, 95% CI = -0.33 to 0.026). Greater trunk extensor muscle activity during bending was moderately related to pain-related fear (2 studies, r = -0.40, 95% CI = -0.55 to -0.23). Pain catastrophizing, but not fear, was related to higher trunk activity during gait (2 studies, r = 0.25, 95% CI = 0.063 to 0.42). Methodological differences and missing data limited robust syntheses of studies examining muscle activity, so these findings should be interpreted carefully. CONCLUSION This study found a weak to moderate relationship between pain-related threat and guarded motor behavior during flexion-based tasks, but not consistently during other movements. IMPACT These findings provide a jumping-off point for future clinical research to explore the advantages of integrated treatment strategies that target both psychological and motor behavior processes compared with traditional approaches.
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Affiliation(s)
- Patrick Ippersiel
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Lethbridge-Layton-Mackay Rehabilitation Centre, Montreal, Québec, Canada
| | - Anthony Teoli
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Lethbridge-Layton-Mackay Rehabilitation Centre, Montreal, Québec, Canada
| | - Timothy H Wideman
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Lethbridge-Layton-Mackay Rehabilitation Centre, Montreal, Québec, Canada
| | - Richard A Preuss
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Lethbridge-Layton-Mackay Rehabilitation Centre, Montreal, Québec, Canada
| | - Shawn M Robbins
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Lethbridge-Layton-Mackay Rehabilitation Centre, Montreal, Québec, Canada
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12
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STANCIU LE, PETCU LC, APOSTOL Sterian, IONESCU EV, OPREA D, OPREA C, ȚUCMEANU ER, ILIESCU MG, POPESCU MN, OBADA Bogdan. The influence of low back pain on health – related quality of life and the impact of balneal treatment. BALNEO AND PRM RESEARCH JOURNAL 2021. [DOI: 10.12680/balneo.2021.475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction. Low back pain has a direct and proportional impact on function and a general one on the quality of life. The present study aims to evaluate the functional impact of low back pain using specific self-assessment tools as indexes of appreciation and epidemiological correlations of potential risk factors involved. The conceptual model of our research is based on the importance of correlating symptoms with clinical assessment, using scales of pain, disability, quality of life, and determination of epidemiological correlations of these areas and the determined factors of the pathology.
Material and method. The study group is made up of 106 cases with clinical diagnostic of low back pain, admitted from 28 September 2020 to 28 March 2021, at Balneal and Rehabilitation Sanatorium of Techirghiol. After performing anamnesis, general clinical examination, specific neuro-musculo-skeletal examination, the patients filled the surveys highlighting the impact of their low back pain on functionality and disability deriving from it. The survey included the Oswestry Disability Index, the Functional Independence Measure (FIM) instrument and the Visual analog scale (VAS) score evaluated at the moment of hospitalization and at discharge. Statistical analysis of data was carried out and correlations between variables resulting from study were highlighted. The study was conducted according to the norms of deontology and medical ethics. The authors declare no conflict of interest.
Results and discussions. Lumbar pathology is common in patients who are hospitalized for a complex balneary-physical-kinetic treatment at Balneal and Rehabilitation Sanatorium of Techirghiol. About 80% of patients who have addressed to our unit in which the study was conducted, have presented low back pain. The majority of patients were females, representing 57,55% of the total number. Regarding the patients’ age, 58,5% of them were in the 50-70 years interval. The study reveals a major positive impact of our treatment on spinal symptomatology, an effect pointed out by the relevant statistical differences between the admittance and discharge VAS scores(p<0.001). Reporting the investigated disability with the Oswestry questionnaire of painful lumbar syndrome, and functional evaluation scale (FIM) demonstrates the impact of this pathology on the patient's social life, once again emphasizing the special attention to be paid to axial pathology, both as curative treatment and the importance of prophylactic treatment. Statistical analysis of identified risk factors, reveals the importance of prophylaxis and patient’s education in this area. A strong and important statistical correlation was found between the Oswestry total score and the walking and standing items, and a moderate, but strong correlation with the other items. Regarding the sex life item, the correlation is existent, but at a modest level.
Conclusions. The study reveals the importance of correlation of the data obtained from anamnesis, the general clinical examination and the specific examination neuromioarthrokinetic with assessment tools that determine the level of functional independence, the functional impact on social life in high-frequency pathologies treated in medical facilities that provide healthcare in the field of medical recovery. It is necessary to quantify the therapeutic results obtained, in order to assess the level of improvement in quality of life.
Keywords: low back pain, balneal, functional indicators, quality of life,
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Affiliation(s)
- Liliana-Elena STANCIU
- Faculty of Medicine, „Ovidius” University of Constanta, Romania ² Department of Rehabilitation, Balneal and Rehabilitation Sanatorium of Techirghiol, Constanta, Romania
| | - Lucian Cristian PETCU
- Department of Rehabilitation, Balneal and Rehabilitation Sanatorium of Techirghiol, Constanta, Romania
| | - APOSTOL Sterian
- Faculty of Medicine, „Ovidius” University of Constanta, Romania ² Department of Rehabilitation, Balneal and Rehabilitation Sanatorium of Techirghiol, Constanta, Romania
| | - Elena-Valentina IONESCU
- Faculty of Medicine, „Ovidius” University of Constanta, Romania ² Department of Rehabilitation, Balneal and Rehabilitation Sanatorium of Techirghiol, Constanta, Romania
| | - Doinița OPREA
- Faculty of Medicine, „Ovidius” University of Constanta, Romania ² Department of Rehabilitation, Balneal and Rehabilitation Sanatorium of Techirghiol, Constanta, Romania
| | - Carmen OPREA
- Faculty of Medicine, „Ovidius” University of Constanta, Romania ² Department of Rehabilitation, Balneal and Rehabilitation Sanatorium of Techirghiol, Constanta, Romania
| | - Elena-Roxana ȚUCMEANU
- Faculty of Medicine, „Ovidius” University of Constanta, Romania ² Department of Rehabilitation, Balneal and Rehabilitation Sanatorium of Techirghiol, Constanta, Romania
| | - Mădălina-Gabriela ILIESCU
- Faculty of Medicine, „Ovidius” University of Constanta, Romania ² Department of Rehabilitation, Balneal and Rehabilitation Sanatorium of Techirghiol, Constanta, Romania
| | | | - OBADA Bogdan
- Faculty of Medicine, „Ovidius” University of Constanta, Romania
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13
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Reducing the Weight of Spinal Pain in Children and Adolescents. CHILDREN 2021; 8:children8121139. [PMID: 34943335 PMCID: PMC8700484 DOI: 10.3390/children8121139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/10/2021] [Accepted: 11/26/2021] [Indexed: 11/30/2022]
Abstract
Spinal pain in adults is a significant burden, from an individual and societal perspective. According to epidemiologic data, spinal pain is commonly found in children and adolescents, where evidence emerging over the past decade has demonstrated that spinal pain in adults can, in many cases, be traced back to childhood or adolescence. Nevertheless, very little focus has been on how to best manage spinal pain in younger age groups. The purpose of this article is to put the focus on spinal pain in children and adolescents and highlight how and where these problems emerge and how they are commonly dealt with. We will draw on findings from the relevant literature from adults to highlight potential common pathways that can be used in the management of spinal pain in children and adolescents. The overall focus is on how healthcare professionals can best support children and adolescents and their caregivers in making sense of spinal pain (when present) and support them in the self-management of the condition.
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14
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The influence of hip extensor and lumbar spine extensor strength on lumbar spine loading during a squat lift. J Electromyogr Kinesiol 2021; 62:102620. [PMID: 34844059 DOI: 10.1016/j.jelekin.2021.102620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 10/26/2021] [Accepted: 11/13/2021] [Indexed: 11/20/2022] Open
Abstract
Weakness of the hip extensors and lumbar spine extensors has been proposed to contribute to greater demands on the lumbar spine during lifting. The purpose of the current study was to examine the associations among strength of the hip and lumbar spine extensors, lumbar spine extensor moments and lumbar paraspinal muscle activation during a squat lift task. Twenty-seven healthy females participated. Strength of the hip and lumbar spine extensors was measured using a dynamometer. Lumbar spine moments and lumbar paraspinal muscle activity were quantified during the concentric phase of the squat lifting task. There was a significant positive association between lumbar extensor strength and average lumbar extensor moment during lifting (r = 0.498, p = 0.008). Similarly, hip extensor strength was positively associated with the average lumbar extension moment (r = 0.382, p = 0.049). Hip extensor strength was negatively associated with activation of the lumbar paraspinal muscles during lifting (ρ = -0.382, p = 0.049). Stronger individuals are more likely to use their hip extensors and lumbar spine extensors to perform a squat lift task. In contrast, those with lower strength employ subtle biomechanical changes to reduce lumbar spine demand.
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15
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Christe G, Aussems C, Jolles BM, Favre J. Patients With Chronic Low Back Pain Have an Individual Movement Signature: A Comparison of Angular Amplitude, Angular Velocity and Muscle Activity Across Multiple Functional Tasks. Front Bioeng Biotechnol 2021; 9:767974. [PMID: 34869281 PMCID: PMC8634715 DOI: 10.3389/fbioe.2021.767974] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/26/2021] [Indexed: 11/28/2022] Open
Abstract
Despite a large body of evidence demonstrating spinal movement alterations in individuals with chronic low back pain (CLBP), there is still a lack of understanding of the role of spinal movement behavior on LBP symptoms development or recovery. One reason for this may be that spinal movement has been studied during various functional tasks without knowing if the tasks are interchangeable, limiting data consolidation steps. The first objective of this cross-sectional study was to analyze the influence of the functional tasks on the information carried by spinal movement measures. To this end, we first analyzed the relationships in spinal movement between various functional tasks in patients with CLBP using Pearson correlations. Second, we compared the performance of spinal movement measures to differentiate patients with CLBP from asymptomatic controls among tasks. The second objective of the study was to develop task-independent measures of spinal movement and determine the construct validity of the approach. Five functional tasks primarily involving sagittal-plane movement were recorded for 52 patients with CLBP and 20 asymptomatic controls. Twelve measures were used to describe the sagittal-plane angular amplitude and velocity at the lower and upper lumbar spine as well as the activity of the erector spinae. Correlations between tasks were statistically significant in 91 out of 99 cases (0.31 ≤ r ≤ 0.96, all p < 0.05). The area under the curve (AUC) to differentiate groups did not differ substantially between tasks in most of the comparisons (82% had a difference in AUC of ≤0.1). The task-independent measures of spinal movement demonstrated equivalent or higher performance to differentiate groups than functional tasks alone. In conclusion, these findings support the existence of an individual spinal movement signature in patients with CLBP, and a limited influence of the tasks on the information carried by the movement measures, at least for the twelve common sagittal-plane measures analysed in this study. Therefore, this work brought critical insight for the interpretation of data in literature reporting differing tasks and for the design of future studies. The results also supported the construct validity of task-independent measures of spinal movement and encouraged its consideration in the future.
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Affiliation(s)
- Guillaume Christe
- Department of Physiotherapy, HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Camille Aussems
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Brigitte M. Jolles
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Institute of Microengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Julien Favre
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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16
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Falla D, Devecchi V, Jiménez-Grande D, Rügamer D, Liew BXW. Machine learning approaches applied in spinal pain research. J Electromyogr Kinesiol 2021; 61:102599. [PMID: 34624604 DOI: 10.1016/j.jelekin.2021.102599] [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: 06/08/2021] [Revised: 07/26/2021] [Accepted: 08/01/2021] [Indexed: 01/13/2023] Open
Abstract
The purpose of this narrative review is to provide a critical reflection of how analytical machine learning approaches could provide the platform to harness variability of patient presentation to enhance clinical prediction. The review includes a summary of current knowledge on the physiological adaptations present in people with spinal pain. We discuss how contemporary evidence highlights the importance of not relying on single features when characterizing patients given the variability of physiological adaptations present in people with spinal pain. The advantages and disadvantages of current analytical strategies in contemporary basic science and epidemiological research are reviewed and we consider how analytical machine learning approaches could provide the platform to harness the variability of patient presentations to enhance clinical prediction of pain persistence or recurrence. We propose that machine learning techniques can be leveraged to translate a potentially heterogeneous set of variables into clinically useful information with the potential to enhance patient management.
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Affiliation(s)
- Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK.
| | - Valter Devecchi
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | - David Jiménez-Grande
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | - David Rügamer
- Department of Statistics, Ludwig-Maximilians-Universität München, Germany
| | - Bernard X W Liew
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex, UK
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17
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Balasch-Bernat M, Willems T, Danneels L, Meeus M, Goubert D. Differences in myoelectric activity of the lumbar muscles between recurrent and chronic low back pain: a cross-sectional study. BMC Musculoskelet Disord 2021; 22:756. [PMID: 34479536 PMCID: PMC8417959 DOI: 10.1186/s12891-021-04623-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 08/20/2021] [Indexed: 11/23/2022] Open
Abstract
Background Altered lower back muscle activity is proposed as a contributing factor to the reoccurrence and chronicity of low back pain (LBP). This study compared lumbar muscle activity during trunk extension in patients with continuous chronic LBP (CLBP), non-continuous CLBP, recurrent LBP (RLBP) and healthy subjects. Methods In 75 subjects (16 continuous CLBP, 15 non-continuous CLBP, 23 RLBP, 21 healthy controls), surface electromyographic (EMG) activity of the lumbar erector spinae (ES), multifidus (MF), latissimus dorsi (LD) and gluteus maximus (GM) was recorded during the concentric, holding and eccentric phase of a modified Biering Sorenson exercise. Results Continuous CLBP patients showed higher EMG activity in the ES and MF muscles compared to healthy controls in the concentric (p = 0.011; p = 0.009 respectively) and the holding phase (p = 0.015; p = 0.013). Higher EMG activity was observed in continuous CLBP compared to RLBP in the ES and MF muscles in the holding phase (p = 0.035; p = 0.037), and in the MF in the concentric phase (p = 0.046), but not in the ES (p = 0.062). No differences in muscle activity were established in either the concentric, holding, and eccentric phase for the LD and GM muscles. No differences were found between non-continuous CLBP and the other groups. Conclusions An enhanced muscle activity of the lumbar muscles during the concentric and holding phase was observed during trunk extension in patients with continuous CLBP compared to patients with RLBP and healthy subjects. No differences between groups are present in the GM and LD muscles during concentric and holding phases and for any muscle in the eccentric phase.
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Affiliation(s)
- Mercè Balasch-Bernat
- Department of Physiotherapy, University of Valencia, Valencia, Spain.,Physiotherapy in Motion, MultiSpeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain
| | - Tine Willems
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. .,Department of Rehabilitation Sciences, Campus Heymans (UZ) 3 B3, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
| | - Lieven Danneels
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Mira Meeus
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Pain in Motion Research Group, Valencia, Spain.,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Dorien Goubert
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Pain in Motion Research Group, Valencia, Spain
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18
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Sa-Ngiamsak T, Thetkathuek A. Short-distance versus long-distance deep-seaport container truck drivers' prevalence and perceived discomfort of musculoskeletal symptoms in the Thailand Eastern Economic Corridor. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:1779-1786. [PMID: 34011248 DOI: 10.1080/10803548.2021.1932313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives. This research aimed to study the prevalence and perceived discomfort of musculoskeletal (MSK) symptoms among short-distance and long-distance deep-seaport truck drivers. Methods. Cross-sectional analysis using a standardized modified version of the Nordic musculoskeletal questionnaire (NMQ) was carried out using direct interviews with 25 male participants: 15 short-distance and 10 long-distance truck drivers. Results. As much as 88% was reported for the existence of MSK symptoms in the past 12 months. Considering all truck groups, regardless of short or long distance, the lower back was found with the highest prevalence (72%) followed by the neck (32%). The χ2 test showed long-distance truck drivers had statistically significantly more prevalence in the neck (p = 0.028) than short-distance drivers. Perceived discomfort by the Borg CR10 scale confirmed the lower back had the highest score (2.4) followed by the neck (1.44). The Kruskal-Wallis test revealed that long-distance truck drivers had significantly higher scores on the lower back and neck (p = 0.039 and p = 0.009, respectively). Conclusion. Longer exposure to prolonged non-natural working postures, vibration, traffic conditions and working stress could be the judicial causes. To minimize this problem, integrated interventions need to be implemented with particular measures among short-distance and long-distance truck drivers.
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19
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Deane JA, Lim AKP, McGregor AH, Strutton PH. Understanding the impact of lumbar disc degeneration and chronic low back pain: A cross-sectional electromyographic analysis of postural strategy during predicted and unpredicted postural perturbations. PLoS One 2021; 16:e0249308. [PMID: 33793605 PMCID: PMC8016216 DOI: 10.1371/journal.pone.0249308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 03/16/2021] [Indexed: 11/17/2022] Open
Abstract
People with chronic low back pain (LBP) exhibit changes in postural control. Stereotypical muscle activations resulting from external perturbations include anticipatory (APAs) and compensatory (CPAs) postural adjustments. The aim and objective of this study was to determine differences in postural control strategies (peak amplitude, APAs and CPAs) between symptomatic and asymptomatic adults with and without Lumbar Disc Degeneration (LDD) using surface electromyography during forward postural perturbation. Ninety-seven subjects participated in the study (mean age 50 years (SD 12)). 3T MRI was used to acquire T2 weighted images (L1-S1). LDD was determined using Pfirrmann grading. A bespoke translational platform was designed to deliver horizontal perturbations in sagittal and frontal planes. Electromyographic activity was analysed bilaterally from 8 trunk and lower limb muscles during four established APA and CPA epochs. A Kruskal-Wallis H test with Bonferroni correction for multiple comparisons was conducted. Four groups were identified: no LDD no pain (n = 19), LDD no pain (n = 38), LDD pain (n = 35) and no LDD pain (n = 5). There were no significant differences in age or gender between groups. The most significant difference between groups was observed during forward perturbation. In the APA and CPA phases of predictable forward perturbation there were significant differences ankle strategy between groups (p = 0.007–0.008); lateral gastrocnemius and tibialis anterior activity was higher in the LDD pain than the LDD no pain group. There were no significant differences in the unpredictable condition (p>0.05). These findings were different from the remaining groups, where significant differences in hip strategy were observed during both perturbation conditions (p = 0.004–0.006). Symptomatic LDD patients exhibit different electromyographic strategies to asymptomatic LDD controls. Future LBP electromyographic research should benefit from considering assessment of both lower limbs in addition to the spine. This approach could prevent underestimation of postural control deficits and guide targeted rehabilitation.
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Affiliation(s)
- Janet A Deane
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom.,Department of Health Sciences, The University of Manchester and Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Adrian K P Lim
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom.,Department of Imaging, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Alison H McGregor
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Paul H Strutton
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
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20
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Investigation of physiological stress shielding within lumbar spinal tissue as a contributor to unilateral low back pain: A finite element study. Comput Biol Med 2021; 133:104351. [PMID: 33812314 DOI: 10.1016/j.compbiomed.2021.104351] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/17/2021] [Accepted: 03/17/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The pathomechanism of low back pain (LBP) remains unknown. Unilateral LBP patients have demonstrated ipsilateral morphological and material property changes within the lumbar soft tissues, potentially leading to asymmetric tissue loading. Through the comparison of healthy and unilateral LBP validated finite element models (FEMs), this study investigates potential stress shielding consequential of spinal tissue property augmentation. METHODS Two FEMs of the musculoskeletal system - one demonstrating healthy and unilateral LBP conditions - were developed undergoing 30-degree flexion. FEMs included the vertebrae, intervertebral discs, and soft tissues from L1-S1. Material properties selected for the soft tissues were retrieved from published literature. To reflect unilateral LBP, the paraspinal morphology was atrophied, while the tissue moduli were increased. The symptomatic thoracolumbar fascia (TLF) was uniformly increased. Validation of the models preceded testing. RESULTS Model validation in spinal flexion was accomplished through comparison to literature. Compared to the healthy model, the unilateral LBP multifidus (MF), longissimus thoracis (LT), and TLF exhibited average tension changes of +7.9, -5.1, and +9.3%, respectively. Likewise, the symptomatic MF, LT, and TLF exhibited tension changes of +19.0, -10.4, and +16.1% respectively, whereas the asymptomatic MF, LT, and TLF exhibited -4.0, -2.0, and +0.4% changes in tension, respectively. CONCLUSION Relative to the healthy tissues, the symptomatic LBP soft tissues demonstrated a 19.5 kPa increase in stress, with 99.8% of this increase distributed towards the TLF, suggesting a load allocation bias within the symptomatic unilateral LBP tissues. Consequentially, symptomatic paraspinal muscles may be unable to withstand loading, leading to stress shielding.
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21
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Christe G, Crombez G, Edd S, Opsommer E, Jolles BM, Favre J. Relationship between psychological factors and spinal motor behaviour in low back pain: a systematic review and meta-analysis. Pain 2021; 162:672-686. [PMID: 33591109 DOI: 10.1097/j.pain.0000000000002065] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/24/2020] [Indexed: 12/11/2022]
Abstract
ABSTRACT This meta-analysis investigated whether more negative psychological factors are associated with less spinal amplitude of movement and higher trunk muscle activity in individuals with low back pain. Furthermore, it examined whether pain intensity was a confounding factor in this relationship. We included studies that provided at least 1 correlation coefficient between psychological (pain-related fear, catastrophizing, depression, anxiety, and self-efficacy) and spinal motor behaviour (spinal amplitude and trunk muscle activity) measures. In total, 52 studies (3949 participants) were included. The pooled correlation coefficients (95% confidence interval; number of participants) were -0.13 (-0.18 to -0.09; 2832) for pain-related fear, -0.16 (-0.23 to -0.09; 756) for catastrophizing, -0.08 (-0.13 to -0.03; 1570) for depression, -0.08 (-0.30 to 0.14; 336) for anxiety, and -0.06 (-0.46 to 0.36; 66) for self-efficacy. The results indicated that higher levels of pain-related fear, catastrophizing, and depression are significantly associated with reduced amplitudes of movement and larger muscle activity and were consistent across subgroup and moderation analyses. Pain intensity did not significantly affect the association between these psychological factors and spinal motor behaviour and had a very small independent association with spinal motor behaviour. In conclusion, the very small effect sizes found in the meta-analyses question the role of psychological factors as major causes of spinal movement avoidance in low back pain. Experimental studies with more specific and individualized measures of psychological factors, pain intensity, and spinal motor behaviour are recommended.
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Affiliation(s)
- Guillaume Christe
- Department of Physiotherapy, HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Geert Crombez
- Department of Experimental Clinical and Health Psychology, Ghent University, Gent, Belgium
| | - Shannon Edd
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Emmanuelle Opsommer
- Department of Physiotherapy, HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Brigitte M Jolles
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- Institute of Microengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Julien Favre
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
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Non-specific chronic low back pain elicits kinematic and neuromuscular changes in walking and gait termination. Gait Posture 2021; 84:238-244. [PMID: 33383534 DOI: 10.1016/j.gaitpost.2020.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/24/2020] [Accepted: 12/07/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Chronic low back pain (CLBP) is associated with an increased trunk stiffness and muscle coactivation during walking. However, it is still unclear whether CLBP individuals are unable to control neuromechanically their upper body motion during a sudden termination of gait (GT), which involves a challenging balance transition from walking to standing. RESEARCH QUESTION Does CLBP elicit neuromuscular and kinematic changes which are specific to walking and GT?. METHODS Eleven individuals with non-specific CLBP and 11 healthy controls performed walking and sudden GT in response to an external visual cue. 3D kinematic characteristics of thorax, lumbar and pelvis were obtained, with measures of range of motion (ROM) and intra-subject variability of segmental movement being calculated. Electromyographic activity of lumbar and abdominal muscles was recorded to calculate bilateral as well as dorsoventral muscle coactivation. RESULTS CLBP group reported greater transverse ROM of the lumbar segment during walking and GT compared to healthy controls. Thorax sagittal ROM was higher in CLBP than healthy participants during GT. Greater overall movement variability in the transverse plane was observed in the CLBP group while walking, whereas GT produced greater variability of lumbar frontal motion. CLBP participants showed higher bilateral lumbar coactivation compared to healthy participants after the stopping stimulus delivery during GT. SIGNIFICANCE These results suggest that CLBP can elicit a wider and more variable movement of the upper body during walking and GT, especially in the transverse plane and at lumbar level. Alterations in upper body motor control appeared to depend on task, plane of motion and segmental level. Therefore, these findings should be considered by practitioners when screening before planning specific training interventions for recovery of motor control patterns in CLBP population.
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Cho JH, Lee KH, Lim ST. Aged Lumbar Extension Strength of Chronic Low Back Pain in Korean Population of 10-80 Years. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:1894-1901. [PMID: 33346210 PMCID: PMC7719641 DOI: 10.18502/ijph.v49i10.4692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: The purpose of this study was to find the basic data of medical and exercise therapy by indexing lumbar extension muscle strength of low back pain (LBP) patients. Methods: In this cross-sectional study, 3078 chronic LBP participants from The J hospital, Seoul, Republic of Korea, from 2003 to 2010 were enrolled. Maximum muscle strength was measured at maximum flexion angle and maximum extension angle according to range of motion (ROM) results. For each isometric test, participants were seated and secured in the MEDX (medx lumbar extension machine, Ocala, FL, USA) machine. Results: The relative ROM (P=0.012) differed significantly among the aged groups in all participants. In addition, mean of strength (P<0.001), maximal of strength (P<0.001), mean of strength %BW (P<0.001) and maximal of strength %BW (P<0.001) are significant differences in all participants. The results of multiple regression analysis was the ‘model A’, maximal of strength for 32.1% of the variance in weigh, body mass index and range of motion. In addition, ‘model B’ was 30.4%, ‘model C’ was 28.8%, ‘model D’ was 28.5%, ‘model E’ was 21.7%, and ‘model F’ was 23.5% of the variance in weigh, body mass index and range of motion. Conclusion: We found the three predictor (weight, BMI, and ROM) variables accounted for 32.1% of the variance in maximal of strength %BW, the highest in < 29 yr groups. Our data indicate the basic data of medical and exercise therapy by indexing lumbar extension muscle strength of LBP patients.
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Affiliation(s)
- Ji-Hoon Cho
- Department of Sport and Leisure Studies, Shingyeong University, Hwaseong, Republic of Korea
| | - Ki-Hyuk Lee
- Department of Sport Culture, Dongguk University, Seoul, Republic of Korea
| | - Seung-Taek Lim
- Institute of Sport Science, Kangwon National University, Gangwon-do, Republic of Korea.,Nasaret International Hospital, Incheon, Republic of Korea.,Waseda Institute for Sport Sciences, Waseda University, Saitama, Japan
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Ataei G, Abedi R, Mohammadi Y, Fatouraee N. Analysing the effect of wearable lift-assist vest in squat lifting task using back muscle EMG data and musculoskeletal model. Phys Eng Sci Med 2020; 43:651-658. [PMID: 32524453 DOI: 10.1007/s13246-020-00872-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 04/17/2020] [Indexed: 12/17/2022]
Abstract
The most common disorders of the musculoskeletal system are low back disorders. They cause significant direct and indirect costs to different societies especially in lifting occupations. To reduce the risk of low back disorders, mechanical lifting aids have been used to decrease low back muscle forces. But there are very few direct ways to calculate muscle forces and examine the effect of personal lift-assist devices, so biomechanical models ought to be used to examine the quality of these devices for assisting back muscles in lifting tasks. The purpose of this study is to examine the effect of a designed wearable lift-assist vest (WLAV) in the reduction of erector spinae muscle forces during symmetric squat lifting tasks. Two techniques of muscle calculation were used, the electromyography-based method and the optimization-based model. The first uses electromyography data of erector spinae muscles and its linear relationship with muscle force to estimate their forces, and the second uses a developed musculoskeletal model to calculate back muscle forces using an optimization-based method. The results show that these techniques reduce the average value of erector spinae muscle forces by 45.38 (± 4.80) % and 42.03 (± 8.24) % respectively. Also, both methods indicated approximately the same behaviour in changing muscle forces during 10 to 60 degrees of trunk flexion using WLAV. The use of WLAV can help to reduce the activity of low back muscles in lifting tasks by transferring the external load effect to the assistive spring system utilized in it, so this device may help people lift for longer.
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Affiliation(s)
- Gholamreza Ataei
- Department of Radiology Technology, Faculty of Paramedical Sciences, Babol University of Medical Sciences, Babol, Iran
| | - Rasoul Abedi
- Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Yousef Mohammadi
- Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Nasser Fatouraee
- Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran.
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ELIAS JULIANAPEREIRA, LONGEN WILLIANSCASSIANO. CLASSIFICATION OF LOW BACK PAIN INTO SUBGROUPS FOR DIAGNOSTIC AND THERAPEUTIC CLARITY. COLUNA/COLUMNA 2020. [DOI: 10.1590/s1808-185120201901206442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective To establish a classification in subgroups with symptoms and functionality involving volunteers with nonspecific chronic low back pain for better clarity of functional and therapeutic diagnostic definitions. Methods Observational, quantitative, cross-sectional study with population of 62 university students between 18 and 30 years of age, with a mean age of 21.40 (± 2.40) years, presenting nonspecific lumbar pain for more than three months. Three questionnaires were used for the division into subgroups: STarT Back Screening, the Oswestry Disability Index, and FABQ-Brasil, the VAS evaluation, orthopedic tests: Lasègue’s, Slump test, de Sèze test, Valsalva maneuver, and evaluation of the pain threshold of the right and left iliocostal lumbar muscles. Results All the volunteers included in the study had chronic back pain. Most of them (50%) had normal body mass index, 54.8% were sedentary, and of those who were physically active, 14.5% did body building. The Slump test (35.5%) proved to be more reliable than Lasègue’s test (21%). In the evaluation, the volunteers reported moderate pain intensity (72.6%) and the mean pressure pain threshold was 6.37 kgf and 6.14 kgf for the right and left iliocostal muscles, respectively. In the questionnaires, 85.5% had a low-risk score, that is, a good prognosis for pain treatment, and 91.9% had minimum disability. The largest treatment hypothesis group was stabilization (29.0%). Conclusion The method of treatment subgroup classification is a guide towards better semiological perspectives and the definition of the clinically preferred physiotherapeutic treatment for each case. Level of Evidence III; Diagnostic study.
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Affiliation(s)
- JULIANA PEREIRA ELIAS
- Universidade do Extremo Sul Catarinense, Brazil; Núcleo de Promoção e Atenção Clínica à Saúde do Trabalhador, Brazil; Universidade do Extremo Sul Catarinense, Brazil
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Pfluegler G, Kasper J, Luedtke K. The immediate effects of passive joint mobilisation on local muscle function. A systematic review of the literature. Musculoskelet Sci Pract 2020; 45:102106. [PMID: 32056830 DOI: 10.1016/j.msksp.2019.102106] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 11/20/2019] [Accepted: 12/22/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Passive joint mobilisation is popular among healthcare providers and their patients; however, its effectiveness for improving muscle function is not well researched and the mechanisms of action involved are unclear. OBJECTIVES To assess the effect of passive joint mobilisations on the function of muscles surrounding the targeted joints in symptomatic as well as asymptomatic individuals. SELECTION CRITERIA Controlled experimental trials assessing the immediate effect of passive joint mobilisation on outcomes associated with local muscle function. DATA COLLECTION Two authors independently assessed trial quality and extracted data. MAIN RESULTS A total of seventeen studies were included, of which ten studies reported data on asymptomatic individuals and seven studies reported data on symptomatic individuals with various conditions. There is a moderate level of evidence that joint mobilisation immediately decreases the activation of superficial muscles during low load conditions in symptomatic individuals. For asymptomatic individuals, there is a low level of evidence that passive joint mobilisation improves maximum muscle strength when compared to sham mobilisation, opposed to a very low level of evidence suggesting no effect in symptomatic individuals. The five studies reporting data on both, changes in muscle function as well as changes in pain, suggest that other, not pain-related mechanisms may play an important role regarding the reported improvement in muscle function. CONCLUSION Current best evidence suggests that passive joint mobilisation has the ability to immediately alter muscle function. The specific mechanisms of action involved require further basic science investigations. Registration number (PROSPERO): CRD42018117033.
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Affiliation(s)
- Georg Pfluegler
- Faculty of Health and Well Being, Sheffield Hallam University, Broomhall Road, Sheffield, S10 2BP, United Kingdom
| | - Johanna Kasper
- Private Physiotherapy Practice "teamphysios", Kreuzgasse 37, 1180, Vienna, Austria
| | - Kerstin Luedtke
- Academic Physiotherapy, Pain and Exercise Research, University of Luebeck, Ratzeburger Allee 160, 23562, Luebeck, Germany.
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Palsson TS, Travers MJ, Rafn T, Ingemann-Molden S, Caneiro JP, Christensen SW. The use of posture-correcting shirts for managing musculoskeletal pain is not supported by current evidence - a scoping review of the literature. Scand J Pain 2019; 19:659-670. [PMID: 31075089 DOI: 10.1515/sjpain-2019-0005] [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: 12/20/2018] [Accepted: 03/13/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS The concept of bad posture being a dominant driver of pain is commonly held belief in the society. This may explain the significant attention supportive clothing such as posture-correcting shirts has recently gained in Scandinavia and the USA. The aim of this scoping review was to present an overview and synthesis of the available evidence for the use of posture-correcting shirts aimed at reducing pain or postural discomfort and optimising function/posture. METHODS A systematic search was conducted for literature investigating the effect of posture-correcting shirts on musculoskeletal pain or function. PubMed, Embase, CINAHL, PEDro and the Cochrane Library were searched for relevant literature. Results of the searches were evaluated by two independent reviewers in three separate steps based on title, abstract and full text. For data synthesis, the population, intervention, comparator and outcome were extracted. The quality of the literature was evaluated using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and the risk of bias was assessed using the Risk Of Bias In Non-randomized Studies - of Interventions (ROBINS-I) assessment tool or the RoB 2.0 tool for individually randomized, parallel group trials. The overall confidence in the literature was determined using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS A total of 136 articles were identified and six of these were included in the review. These studies were heterogeneous with regards to aims, outcomes and methods, presenting contrasting results. The overall findings were that posture-correcting shirts change posture and subjectively have a positive effect on discomfort, energy levels and productivity. The quality of the included literature was poor to fair with only one study being of good quality. The risk of bias was serious or critical for the included studies. Overall, this resulted in very low confidence in available evidence. An important limitation of all studies was that they were conducted in pain-free individuals. CONCLUSIONS The contrasting findings and the low quality of current literature, questions the intended effect of posture-correcting shirts and whether the changes it creates are in fact useful for clinical practice. Moreover, the findings are contrasted by the available evidence regarding posture and pain with a particular focus on whether this management strategy may have a detrimental effect on people living with musculoskeletal pain. A major limitation to the existing literature on the effect of posture-correcting shirts is that no studies have investigated their effect in clinical populations. IMPLICATIONS Based on the available literature and the major limitation of no studies investigating clinical populations, there is no good quality evidence to support recommendation of posture-correcting shirts as a management strategy for musculoskeletal pain. Promotion of this product may reinforce the inaccurate and unhelpful message that poor posture leads to pain. The efficacy of such garments should be tested in clinical populations and not only in pain-free individuals, to assess whether there is any meaningful benefit of this management approach. Until then, the use of posture-correcting shirts for musculoskeletal pain is not supported by current evidence.
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Affiliation(s)
- Thorvaldur Skuli Palsson
- Associate Professor, Department of Health Science and Technology, SMI® Aalborg University, Frederik Bajers Vej 7A-205, Aalborg, Denmark, Phone: +4530220937
| | - Mervyn J Travers
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Australia.,School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Trine Rafn
- Department of Physiotherapy, University College of Northern Denmark (UCN), Aalborg, Denmark
| | - Stian Ingemann-Molden
- Department of Physiotherapy, University College of Northern Denmark (UCN), Aalborg, Denmark
| | - J P Caneiro
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.,Body Logic Physiotherapy Clinic, Perth, Australia
| | - Steffan Wittrup Christensen
- Department of Physiotherapy, University College of Northern Denmark (UCN), Aalborg, Denmark.,Department of Health Science and Technology, SMI® Aalborg University, Aalborg, Denmark
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28
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Piancino MG, Dalmasso P, Borello F, Cinnella P, Crincoli V, Garagiola U, de Biase C, Tonni I, Matacena G, Deregibus A. Thoracic-lumbar-sacral spine sagittal alignment and cranio-mandibular morphology in adolescents. J Electromyogr Kinesiol 2019; 48:169-175. [PMID: 31398597 DOI: 10.1016/j.jelekin.2019.07.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 04/30/2019] [Accepted: 07/30/2019] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The relationship between thoracic-lumbar-sacral spine sagittal alignment and craniofacial morphology is still controversial. Evidence-based results are difficult to obtain and scientific studies are inhomogeneous. The aim of this study was to investigate the difference of thoracic-lumbar-sacral spine posture and cephalometric values comparing two groups of subjects with different cranial structure in the sagittal plane. METHODS Eighty-one subjects were consecutively selected and divided into two groups, according to the orientation of the condyle-orbital plane (CoOr) with respect to the superior maxilla (SpP): Group1: 49 subjects 11.6 (2.1) years showing posterior-rotation of CoOr: SpP^CoOr ≤ -2°, -4.1°(2.1°); Group2: 32 subjects 12.9 (2.3)years showing anterior-rotation of CoOr: SpP^CoOr ≥ 2°, 3.7°(1.9°). Each patient underwent in blinding, Spinal Mouse recording and cephalometry of the skull. RESULTS Group1 showed a significant forward tilting of the spine 4.4°(1.8°) with respect to Group2 2.4°(1.3°) (p < 0.0001) and higher values related to the vertical dimension of the skull: higher maxillary divergency (p < 0.0001), steep occlusal plane (p < 0.0007), higher gonial angle (p < 0.001). DISCUSSION The results of this study showed a difference in the thoracic-lumbar-sacral spine inclination between groups with different craniofacial morphology. The achievement of this outcome is important to improve our multidisciplinary evaluation and treatment planning.
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Affiliation(s)
- Maria Grazia Piancino
- Department of Surgical Sciences, Dental School C.I.R., Division of Orthodontics, University of Turin, via Nizza 230, 10126 Turin, Italy.
| | - Paola Dalmasso
- Department of Public Health and Pediatrics, School of Medicine, University of Turin, Italy
| | - Fabio Borello
- I.N.Ri.M. (National Institute of Metrologic Research), Str. Delle Cacce 91, 10135 Turin, Italy
| | - Pasquale Cinnella
- Spine Surgery Department, CTO Hospital, University Hospital Company "Città della Salute e della Scienza di Torino", Corso Bramante 88, 10126 Turin, Italy
| | - Vito Crincoli
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Division of Complex Operating Unit of Dentistry, "Aldo Moro" University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy
| | - Umberto Garagiola
- Department of Biomedical Surgical and Dental Sciences Maxillo-Facial and Odontostomatology Unit, Fondazione Cà Granda IRCCS Ospedale Maggiore Policlinico University of Milan, Milan, Italy
| | - Corrado de Biase
- Department of Surgical Sciences, Dental School C.I.R., Division of Orthodontics, University of Turin, via Nizza 230, 10126 Turin, Italy
| | - Ingrid Tonni
- Medical and Surgical Specialties, Radiological Sciences and Public Health, Dental School, Division of Orthodontics, University of Brescia, Piazza del Mercato 15, 25121 Brescia, Italy
| | - Giada Matacena
- Department of Surgical Sciences, Dental School C.I.R., Division of Orthodontics, University of Turin, via Nizza 230, 10126 Turin, Italy
| | - Andrea Deregibus
- Department of Surgical Sciences, Dental School C.I.R., Division of Orthodontics, University of Turin, via Nizza 230, 10126 Turin, Italy
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Biały M, Adamczyk WM, Marczykowski P, Majchrzak R, Gnat R. Deformations of abdominal muscles under experimentally induced low back pain. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2019; 28:2444-2451. [PMID: 31127387 DOI: 10.1007/s00586-019-06016-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 04/02/2019] [Accepted: 05/16/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Low back pain (LBP) is associated with altered motor control and muscle activity; however, it remains unknown whether these changes predispose humans to injury and pain or are the consequence of ongoing nociceptive processes. In this experimental study, we aimed to use a novel ultrasound imaging technique for the measurement of lateral abdominal wall muscle activity: the tissue deformation index (TDI). METHODS Forty-two healthy subjects (22.30 ± 1.49 years of age) were exposed to postural perturbation induced by rapid arm movement. Activity of three muscles, the transversus abdominis (TrA) and the internal and external oblique (EO), was recorded by ultrasound imaging (M-mode) with and without induction of LBP. Pain was induced by electrical stimulation applied bilaterally to the lumbar spine. RESULTS No significant differences in the TDI between right and left sides of the body (p > 0.05) were found. Generally, muscles deformed slower with pain compared to non-painful conditions; however, only EO muscle displayed a statistically significant reduction in deformation velocity (p ≤ 0.00001). TDI for EO decreased from 0.065% per ms ( ± 0.038, 95% CI 0.057-0.074) to 0.053% per ms ( ± 0.035, 95% CI 0.046-0.061). Furthermore, characteristic inter-muscular TDI gradients were observed, directed from inner towards outer muscular layers, with TrA showing the lowest TDI and EO the highest. CONCLUSION Experimentally induced LBP suppresses deformation of the superficial abdominal muscles and increases the variability of local/deep muscles. Further research is required to confirm these observations. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Maciej Biały
- Motion Analysis Laboratory, Faculty of Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland. .,Functional Diagnosis Laboratory, Sport-Klinika, Endoscopy Surgery Clinic, Żory, Poland.
| | - Wacław M Adamczyk
- Medical Section, Orthopaedic and Trauma Surgery, Academic Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L), University of Luebeck, Luebeck, Germany.,Laboratory of Pain Research, Faculty of Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Patryk Marczykowski
- Faculty of Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Rafał Majchrzak
- Faculty of Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Rafał Gnat
- Motion Analysis Laboratory, Faculty of Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
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30
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Matheve T, De Baets L, Bogaerts K, Timmermans A. Lumbar range of motion in chronic low back pain is predicted by task-specific, but not by general measures of pain-related fear. Eur J Pain 2019; 23:1171-1184. [PMID: 30793429 DOI: 10.1002/ejp.1384] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/30/2019] [Accepted: 02/17/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Most studies fail to show an association between higher levels of pain-related fear and protective movement behaviour in patients with chronic low back pain (CLBP). This may be explained by the fact that only general measures of pain-related fear have been used to examine the association with movement patterns. This study explored whether task-specific, instead of general measures of pain-related fear can predict movement behaviour. METHODS Fifty-five patients with CLBP and 54 healthy persons performed a lifting task while kinematic measurements were obtained to assess lumbar range of motion (ROM). Scores on the Photograph Daily Activities Series-Short Electronic Version (PHODA-SeV), Tampa Scale for Kinesiophobia and its Activity Avoidance and Somatic Focus subscales were used as general measures of pain-related fear. The score on a picture of the PHODA-SeV, showing a person lifting a heavy object with a bent back, was used as task-specific measure of pain-related fear. RESULTS Lumbar ROM was predicted by task-specific, but not by general measures of pain-related fear. Only the scores on one other picture of the PHODA-SeV, similar to the task-specific picture regarding threat value and movement characteristics, predicted the lumbar ROM. Compared to healthy persons, patients with CLBP used significantly less ROM, except the subgroup with a low score on the task-specific measure of pain-related fear, who used a similar ROM. CONCLUSIONS Our results suggest to use task-specific measures of pain-related fear when assessing the relationship with movement. It would be of interest to investigate whether reducing task-specific fear changes protective movement behaviour. SIGNIFICANCE This study shows that lumbar range of motion in CLBP is predicted by task-specific, but not by general measures of pain-related fear. This suggests that both in clinical practice and for research purposes, it might be recommended to use task-specific measures of pain-related fear when assessing the relationship with movement behaviour. This may help to disentangle the complex interactions between pain-related fear, movement and disability in patients with CLBP.
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Affiliation(s)
- Thomas Matheve
- REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Liesbet De Baets
- REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Katleen Bogaerts
- REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.,Health Psychology, University of Leuven, Leuven, Belgium
| | - Annick Timmermans
- REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
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The relationship between functionality and erector spinae activity in patients with specific low back pain during dynamic and static movements. Gait Posture 2018; 66:208-213. [PMID: 30205316 DOI: 10.1016/j.gaitpost.2018.08.042] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 08/15/2018] [Accepted: 08/31/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Alterations in the activity of the lumbar erector spinae (LES) muscles on both sides of the spine have been inconsistently reported in patients with specific low back pain (sLBP) after measuring the muscular activity with surface electromyography (sEMG). It also remains unclear whether these alterations in LES activity can be related to the functional level of patients with sLBP. RESEARCH QUESTION This study investigated the LES activity in patients with sLBP during activities of daily living (ADL) which included dynamic and static movement tasks. Moreover, the alterations in LES activity were correlated with the first seven questions of the Zurich Claudication Questionnaire (ZCQ-SS). METHODS Thirty patients with specific LBP and twenty healthy subjects were recruited to perform five ADLs including 'static waist flexion', 'sit to stand',' 30-seconds standing', '6-minutes walking' and 'climbing stairs'. sEMG sensors were mounted on the left and right LES muscles. The integrated EMG (IEMG) was calculated from the preprocessed sEMG data as statistical comparison criteria. RESULTS LES activity was significantly higher in patients during 'sit to stand',' 30-seconds standing' and 'climbing stairs' and significantly lower during 'static waist flexion' compared to healthy controls. All tasks showed a significant correlation with the ZCQ-SS score except for '6-minutes walking', whereby LES activity and ZCQ-SS score correspondingly increased during 'sit to stand' and 'climbing stairs' and the LES activity decreased with an increasing ZCQ-SS score during 'static waist flexion' and' 30-seconds standing'. SIGNIFICANCE There was a high correlation between alterations in LES activity and the level of functionality in LBP patients. However, the LES activity showed an opposite behavior during static and dynamic movement tasks. The methodology presented can be a useful tool for quantifying improvements in functionality after rehabilitation processes.
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Babelyuk DV, Polihas YM. Kinesiotaping as one of the methods of treatment of low back pain syndrome. PAIN MEDICINE 2018. [DOI: 10.31636/pmjua.v3i1.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
About 80 % of adults feel pain in their backs at a definite moment of life. That’s also the most frequent reason why people lose their efficiency. It’s also the key factor due to which workable people miss their working days. Recently, the frequency of sickness rate of low back pain syndrome is getting higher and higher. For examples, according to the data of the organization, which aims at analyzing pathological conditions and diseases, which cause death or looseness of efficiency, in 1990 in the USA, low back pain syndrome took the sixth place, but in 2010 back pain went up to the third place, giving the way only to ischemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD). So, we can imagine how common, widespread and serious for modern world became the problem of back pain. That’s why, only now doctors throughout the world are starting to form their separate individual researches into one qualitative and useful list of recommendations to begin an effective fight with this serious medical and social problem. Kinesiotaping (“kinesio” – movement + “tape”) – is an effective treatment and rehabilitation method of muscle and joints injuries with the help of special elastic tapes – namely kinesio tapes. The article focuses on the method of kinesiotaping and the ways of its usage for treating low back pain syndrome. The research also highlights the history of appearance and development of kinesiotaping as a method of treatment, physiological features of kinesio tape and ways of its usage in everyday medical practice. Besides analyzing recent researches in this field we provide descriptions of three clinical cases from our own medical practice which proves the effectiveness of kinesiotaping in the complex treatment of low back pain syndrome. After deep analysis of the patients’ condition we can state that due to kinesiotaping which is used together with other physiotherapeutic methods and exercises, they recover quickly than those who do not undergo kinesiotaping procedures.
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