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Tomschi F, Brühl M, Schmidt A, Ransmann P, Strauss AC, Hilberg T. Functional clinical motor performance tests to assess potential fall risks in patients with haemophilia: A case-control study. Haemophilia 2024; 30:1032-1042. [PMID: 38837595 DOI: 10.1111/hae.15060] [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: 03/26/2024] [Revised: 05/07/2024] [Accepted: 05/21/2024] [Indexed: 06/07/2024]
Abstract
INTRODUCTION Patients with haemophilia (PwH) are at increased risk of falls due to haemophilic arthropathy. Yet, studies on clinical tests associated with the risk of falling are scarce in PwH. AIMS (1) To evaluate the feasibility of different clinical motor performance tests associated with the risk of falling in PwH; (2) to evaluate PwH's performance of these tests compared to a control group; (3) to identify possible influencing factors that affect performance. METHODS Twenty-nine severe and moderate PwH (57.0 years, IQR: 48.0-61.5) and 29 healthy age- and BMI-matched control participants (CG) performed 13 different clinical tests (SPPB, timed up and go, push and release, functional reach, single-leg stance, knee and grip strength). Haemophilia joint health score (HJHS), kinesiophobia (TSK-11), subjective physical performance (HEP-Test-Q), falls efficiency (FES-I) and falls were assessed. RESULTS No adverse events occurred. PwH showed impaired performance in all clinical tests, a lower falls efficiency and a higher HJHS than CG. PwH with higher HJHS, lower HEP-Test-Q and higher TSK-11 scores showed higher deficits. Largest discrepancies were observed in the single-leg stance with eyes open and knee extensor strength, where orthopaedically majorly affected PwH showed worse performance compared to minorly affected PwH and the CG, respectively. The prevalence of ≥1 fall in the last year was 27.6% (PwH) and 10.3% (CG). CONCLUSION These clinical tests are feasible in PwH. Impaired joint status, a high kinesiophobia and low physical performance impair performance. These tests can be used by clinicians for gaining specific information on functional motor abilities of patients.
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Affiliation(s)
- Fabian Tomschi
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | - Marius Brühl
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
- Department of Orthopaedics and Trauma Surgery, University of Bonn, Bonn, Germany
| | - Alexander Schmidt
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | - Pia Ransmann
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | - Andreas C Strauss
- Department of Orthopaedics and Trauma Surgery, University of Bonn, Bonn, Germany
| | - Thomas Hilberg
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
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Masroor S, Tanwar T, Aldabbas M, Iram I, Veqar Z. Effect of Adding Diaphragmatic Breathing Exercises to Core Stabilization Exercises on Pain, Muscle Activity, Disability, and Sleep Quality in Patients With Chronic Low Back Pain: A Randomized Control Trial. J Chiropr Med 2023; 22:275-283. [PMID: 38205226 PMCID: PMC10774616 DOI: 10.1016/j.jcm.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/12/2023] [Accepted: 07/22/2023] [Indexed: 01/12/2024] Open
Abstract
Objective The purpose of this study was to test the effect of adding diaphragmatic breathing exercises (DBEs) to core stabilization exercises (CSEs) for patients with chronic low back pain (CLPB). Methods Twenty-two patients with CLPB were randomly allocated to the experimental (DBE + CSE) or control group (CSE only). They were given 12 treatment sessions 3 times a week for 4 weeks. Patients were evaluated before and after the 12 sessions. Surface electromyography of transverse abdominis, Oswestry Disability Index, Fear Avoidance Belief Questionnaire, Pittsburgh Sleep Quality Index, Numeric Pain Rating Scale, and chest expansion were used as outcome measures for pain, muscle activity, disability, and sleep quality. Results The outcome measure scores showed statistical significance of (P = .01) in time effect on muscle activity, sleep quality, disability score, pain score, fear-avoidance belief of patients and chest expansion; and group effect on Fear Avoidance Belief Questionnaire and physical activity parameter (P = .05). An interaction effect (time x group) on muscle activity for right transverse abdominus during tuck in (P = .01) and chest expansion (P = .01) was also found; however, no significant difference was found related to other parameters. Conclusion The combination of DBE and CSE interventions compared to CSE alone showed improvement in the measured parameters for patients with CLBP. Incorporating DBE with CSE also improved muscle activation and chest expansion.
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Affiliation(s)
- Sana Masroor
- Centre of Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - Tarushi Tanwar
- Centre of Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - Mosab Aldabbas
- Centre of Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - Iram Iram
- Centre of Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - Zubia Veqar
- Centre of Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
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Deguchi N, Tanaka R, Hirakawa Y, Sasai H. Preliminary effectiveness of pain management programme on physical activity for patients with chronic musculoskeletal pain: Non-randomized controlled trial. Musculoskeletal Care 2023; 21:947-952. [PMID: 37060209 DOI: 10.1002/msc.1768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 03/25/2023] [Indexed: 04/16/2023]
Affiliation(s)
- Naoki Deguchi
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
- Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan
| | - Ryo Tanaka
- Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan
| | - Yoshiyuki Hirakawa
- Department of Rehabilitation, Fukuoka Rehabilitation Hospital, Fukuoka, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
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Zheng X, Reneman MF, Preuper RHS, Otten E, Lamoth CJ. Relationship between physical activity and central sensitization in chronic low back pain: Insights from machine learning. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 232:107432. [PMID: 36868164 DOI: 10.1016/j.cmpb.2023.107432] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND AND OBJECTIVES Chronic low back pain (CLBP) is a leading cause of disability. The management guidelines for the management of CLBP often recommend optimizing physical activity (PA). Among a subsample of patients with CLBP, central sensitization (CS) is present. However, knowledge about the association between PA intensity patterns, CLBP, and CS is limited. The objective PA computed by conventional approaches (e.g. cut-points) may not be sensitive enough to explore this association. This study aimed to investigate PA intensity patterns in patients with CLBP and low or high CS (CLBP-, CLBP+, respectively) by using advanced unsupervised machine learning approach, Hidden semi-Markov model (HSMM). METHODS Forty-two patients were included (23 CLBP-, 19 CLBP+). CS-related symptoms (e.g. fatigue, sensitivity to light, psychological features) were assessed by a CS Inventory. Patients wore a standard 3D-accelerometer for one week and PA was recorded. The conventional cut-points approach was used to compute the time accumulation and distribution of PA intensity levels in a day. For the two groups, two HSMMs were developed to measure the temporal organization of and transition between hidden states (PA intensity levels), based on the accelerometer vector magnitude. RESULTS Based on the conventional cut-points approach, no significant differences were found between CLBP- and CLBP+ groups (p = 0.87). In contrast, HSMMs revealed significant differences between the two groups. For the 5 identified hidden states (rest, sedentary, light PA, light locomotion, and moderate-vigorous PA), the CLBP- group had a higher transition probability from rest, light PA, and moderate-vigorous PA states to the sedentary state (p < 0.001). In addition, the CBLP- group had a significantly shorter bout duration of the sedentary state (p < 0.001). The CLBP+ group exhibited longer durations of active (p < 0.001) and inactive states (p = 0.037) and had higher transition probabilities between active states (p < 0.001). CONCLUSIONS HSMM discloses the temporal organization and transitions of PA intensity levels based on accelerometer data, yielding valuable and detailed clinical information. The results imply that patients with CLBP- and CLBP+ have different PA intensity patterns. CLBP+ patients may adopt the distress-endurance response pattern with a prolonged bout duration of activity engagement.
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Affiliation(s)
- Xiaoping Zheng
- Department of Human Movement Sciences, University of Groningen,University Medical Center Groningen, Groningen 9713 AV, The Netherlands.
| | - Michiel F Reneman
- Department of Rehabilitation Medicine, University of Groningen,University Medical Center Groningen, Groningen 9751 ND, The Netherlands
| | - Rita Hr Schiphorst Preuper
- Department of Rehabilitation Medicine, University of Groningen,University Medical Center Groningen, Groningen 9751 ND, The Netherlands
| | - Egbert Otten
- Department of Human Movement Sciences, University of Groningen,University Medical Center Groningen, Groningen 9713 AV, The Netherlands
| | - Claudine Jc Lamoth
- Department of Human Movement Sciences, University of Groningen,University Medical Center Groningen, Groningen 9713 AV, The Netherlands
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Beauchamp T, Arbeeva L, Cleveland RJ, Golightly YM, Hales DP, Hu DG, Allen KD. Accelerometer-Based Physical Activity Patterns and Associations With Outcomes Among Individuals With Osteoarthritis. J Clin Rheumatol 2022; 28:e415-e421. [PMID: 33902099 PMCID: PMC8542057 DOI: 10.1097/rhu.0000000000001750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study examined patterns of physical activity and associations with pain, function, fatigue, and sleep disturbance among individuals with knee or hip osteoarthritis. METHODS Participants (n = 54) were enrolled in a telephone-based physical activity coaching intervention trial; all data were collected at baseline. Self-reported measures of pain and function (WOMAC [Western Ontario and McMaster Universities Osteoarthritis Index] subscales), fatigue (10-point numeric rating scale), and PROMIS (Patient-Reported Outcomes Information System) Sleep Disturbance were collected via telephone. Accelerometers were mailed to participants and were worn for at least 3 days. Proportion of time participants spent in sedentary behavior during the morning (from wake until 12:00 pm), afternoon (12:00 pm until 5:59 pm) and evening (6:00 pm until sleep) each day was averaged across all days of wear. Pearson correlations assessed associations between activity and self-reported measures. RESULTS Participants spent a large proportion of time in sedentary behavior: 65.6% of mornings, 70.0% of afternoons, and 76.6% of evenings. Associations between proportion of time spent in sedentary behavior and reported outcomes were generally strongest in the afternoon, strongest for WOMAC function, and lowest for PROMIS Sleep Disturbance. In the evening hours, sedentary time was most strongly associated with fatigue. CONCLUSIONS Overall, findings stress the importance of reducing sedentary behavior among adults with osteoarthritis and suggest behavioral interventions may be strengthened by considering patients' within-day variation in symptoms and activity.
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Affiliation(s)
- Tyler Beauchamp
- From the Medical College of Georgia at Augusta University, Augusta, GA
| | - Liubov Arbeeva
- Department of Medicine and Thurston Arthritis Research Center
| | | | - Yvonne M Golightly
- Division of Physical Therapy and Thurston Arthritis Research Center, Injury Prevention Research Center, Department of Epidemiology
| | - Derek P Hales
- Department of Nutrition Gillings School of Global Public Health and Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC
| | - David G Hu
- Department of Medicine and Thurston Arthritis Research Center
| | - Kelli D Allen
- Department of Medicine and Thurston Arthritis Research Center
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Asiri F, Reddy RS, Tedla JS, ALMohiza MA, Alshahrani MS, Govindappa SC, Sangadala DR. Kinesiophobia and its correlations with pain, proprioception, and functional performance among individuals with chronic neck pain. PLoS One 2021; 16:e0254262. [PMID: 34237105 PMCID: PMC8266083 DOI: 10.1371/journal.pone.0254262] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/23/2021] [Indexed: 01/16/2023] Open
Abstract
Chronic neck pain (CNP) incidence in the general population is high and contributes to a significant health problem. Kinesiophobia (fear of pain to movement or re-injury) combined with emotions and physical variables may play a vital role in assessing and managing individuals with CNP. The study’s objectives are 1) to evaluate the relationship between kinesiophobia, neck pain intensity, proprioception, and functional performance; 2) to determine if kinesiophobia predicts pain intensity, proprioception, and functional performance among CNP individuals. Sixty-four participants with CNP (mean age 54.31 ± 9.41) were recruited for this cross-sectional study. The following outcome measures were evaluated: Kinesiophobia using the Tampa Scale of Kinesiophobia (TSK), neck pain intensity using the visual analog scale (VAS), cervical proprioceptive joint position errors (in flexion, extension, and rotation directions) using cervical range of motion (CROM) device and handgrip strength as a measure of functional performance using the Baseline® hydraulic hand dynamometer. Kinesiophobia showed a strong positive correlation with neck pain intensity (r = 0.81, p<0.001), a mild to a moderate positive correlation with proprioception joint position errors (JPE) in extension, rotation left and right directions (p<0.05), but no correlation in flexion direction (p = 0.127). Also, there was a moderate negative correlation with handgrip strength (r = -0.65, p<0.001). Regression analysis proved that kinesiophobia was a significant predictor of pain intensity, proprioception, and functional performance (p<0.05). This study infers that kinesiophobia in individuals with CNP predicts pain, proprioception, and functional performance. Kinesiophobia assessment should be considered in regular clinical practice to understand the barriers that can influence rehabilitation outcomes in CNP individuals.
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Affiliation(s)
- Faisal Asiri
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
- * E-mail:
| | - Jaya Shanker Tedla
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Mohammad A. ALMohiza
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mastour Saeed Alshahrani
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | | | - Devika Rani Sangadala
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
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Kamonseki DH, Christenson P, Rezvanifar SC, Calixtre LB. Effects of manual therapy on fear avoidance, kinesiophobia and pain catastrophizing in individuals with chronic musculoskeletal pain: Systematic review and meta-analysis. Musculoskelet Sci Pract 2021; 51:102311. [PMID: 33302214 DOI: 10.1016/j.msksp.2020.102311] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/21/2020] [Accepted: 11/24/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To systematically review the effectiveness of manual therapy on fear-avoidance, kinesiophobia, and pain catastrophizing in patients with chronic musculoskeletal pain. LITERATURE SEARCH Databases (Medline, EMBASE, CINAHL, PEDro, CENTRAL, Web of Science, and SCOPUS) were searched from inception up to March 2020. STUDY SELECTION CRITERIA Two reviewers independently selected randomized controlled trials that investigated the effects of manual therapy associated or not with other interventions on fear-avoidance, kinesiophobia and pain catastrophizing in patients with chronic musculoskeletal pain. DATA SYNTHESIS Standardized Mean Differences (SMD) and 95% confidence interval (CI) were calculated using a random-effects inverse variance model for meta-analysis according to the outcome of interest, comparison group and follow-up period. The level of evidence was synthesized using GRADE. RESULTS Eleven studies were included with a total sample of 717 individuals. Manual therapy was not superior to no treatment on reducing fear-avoidance at short-term (low quality of evidence; SMD = -0.45, 95% CI -0.99 to 0.09), and intermediate-term (low quality of evidence; SMD = -0.48, 95% CI -1.0 to 0.04). Based on very-low quality of evidence, manual therapy was not better than other treatments (SMD = 0.10, 95% CI -0.56 to 0.77) on reducing fear-avoidance, kinesiophobia (SMD = -0.12, 95% CI -0.87 to 0.63) and pain catastrophizing (SMD = -0.16, 95% CI -0.48 to 0.17) at short-term. CONCLUSION Manual therapy may not be superior to no treatment or other treatments on improving fear-avoidance, kinesiophobia and pain catastrophizing, based on very low or low quality of evidence. More studies are necessary to strengthen the evidence of effects of manual therapy on pain-related fear outcomes.
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Affiliation(s)
- Danilo Harudy Kamonseki
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil.
| | - Peter Christenson
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | - S Cyrus Rezvanifar
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Letícia Bojikian Calixtre
- Department of Dental Materials and Prosthodontics, Araraquara Dental School, Universidade Estadual Paulista (UNESP), Araraquara, SP, Brazil
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Health, Physical Activity and Musculoskeletal Symptoms among Stone, Sand, and Gravel Mine Workers: Implications for Enhancing and Sustaining Worker Health and Safety. SAFETY 2020. [DOI: 10.3390/safety6040052] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
There is little data delineating relationships between health and worker musculoskeletal symptoms (MSS), particularly among stone, sand, and gravel mine (SSGM) workers. There is also little data detailing the relationships between physical activity and MSS among these workers. A cross-sectional study using data from 459 SSGM workers was completed. Logistic regression analyses assessed relationships between health factors, physical activity, and low back, neck, shoulder, and knee MSS. Those who reported their health as very good/excellent were less likely to suffer low back and knee MSS. Those who indicated their health was poor/fair were more likely to suffer shoulder, neck, and knee MSS. Obese workers were more likely to experience knee MSS and those who smoked in the past had higher odds of neck MSS. Vigorous physical activity was mostly protective, but those performing more than 5 h of moderate physical activity each week had greater odds of shoulder and neck MSS. Given these results, workers in SSGM may benefit from targeted interventions that bolster vigorous physical activity and improve health. Further, health protection efforts need to be initiated by SSGM operations to address work issues and to sustain health as job roles and work hours impacted MSS as well.
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