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  1. Mehdikhani M, Behtash H, Ganjavian MS, Khalaj N
    J Back Musculoskelet Rehabil, 2016 Aug 10;29(3):515-9.
    PMID: 26836834 DOI: 10.3233/BMR-150651
    Hyperkyphosis with unknown reason is common in teenagers and can be corrected by orthotic management.
  2. Nagarajan M, Vijayakumar P
    J Back Musculoskelet Rehabil, 2013;26(3):227-42.
    PMID: 23893137 DOI: 10.3233/BMR-130373
    Recent evidences suggest functional thoracic hyperkyphosis (FTH) could be a different approach in the management of subacromial impingement syndrome (SIS). This case study aims firstly with the development of evidence informed FTH model for SIS. Secondly this study aimed to develop well defined multimodal physical therapy intervention for FTH and its related mechanical consequences in elderly patient with chronic SIS. As a result, Level IV positive evidence was found in both the short and long-term pain and disability of chronic SIS, using FTH model with 26 months of follow-up.
  3. Hejazi SM, Engkasan JP, Qomi MS
    J Back Musculoskelet Rehabil, 2012;25(4):231-4.
    PMID: 23220804 DOI: 10.3233/BMR-2012-0340
    BACKGROUND AND OBJECTIVE: Polymyositis (PM) is an idiopathic inflammatory myopathy manifested by proximal limb muscles weakness, elevated creatinin kinase, electromyography changes, and muscle inflammation in biopsy. We report an instance of intensive rehabilitation therapy in a patient with clinically active polymyositis.
    CASE REPORT: A 19-year-old female patient, diagnosed with 'electromyography and biopsy proven' polymyositis for 5 years, suffered from worsening limbs weakness and dysphagia. In her history, she had upper and lower limbs weakness accompanied by dysphagia which was further complicated by right bronchial aspiration 9 months ago. A four-week trial of intensive training and exercise rehabilitation, concurrently accompanied by medications was prescribed for this patient. At the end of therapy she achieved significant improvement in muscle strength, activities of daily living, and ambulation without any disease exacerbation.
    CONCLUSION: We concluded that short-term intensive training and exercise may lead to improvements in patients with PM, without causing a progress in the disease. Due to the rarity of PM and difficulty of conducting well-controlled studies to examine the risks and benefits of exercise in these patients, further research is necessary to investigate benefits of exercise training in active phase of disease.
  4. Vijayakumar P, Nagarajan M, Ramli A
    J Back Musculoskelet Rehabil, 2012;25(4):225-30.
    PMID: 23220803 DOI: 10.3233/BMR-2012-0337
    Osteitis pubis among soccer athletes is a disabling painful condition and it is difficult to manage without integrating a multimodal treatment approach. There is limited scientific evidence on the effectiveness of exercise in treating Osteitis pubis especially when it progress to a chronic painful condition. The purpose of this case report is to discuss the successful multimodal physiotherapeutic management for a 15-year old soccer athlete diagnosed with stage-IV Osteitis pubis. Land and water based active core muscle strengthening exercises, Proprioceptive neuromuscular facilitation techniques (PNF) and Manual Therapy are some of the essential components incorporated in multimodal intervention approach with emphasis to water based strength and endurance training exercises. The athlete was able to make progress to a successful recovery from his chronic painful condition and accomplished the clearly established clinical outcomes during each phase of rehabilitation.
  5. Shariat A, Lam ETC, Shaw BS, Shaw I, Kargarfard M, Sangelaji B
    J Back Musculoskelet Rehabil, 2017;30(3):641-647.
    PMID: 28372315 DOI: 10.3233/BMR-160526
    STUDY DESIGN: True experimental design.

    BACKGROUND: The back squat is an integral aspect of any resistance training program to improve athletic performance. It is also used for injury prevention of the lower limbs.

    OBJECTIVE: The purpose of this study was to examine the effect of back squat training at different intensities on strength and flexibility of the hamstring muscle group (HMG).

    METHODS: Twenty-two male recreational bodybuilders with at least two years of experience in resistance training were recruited to participate in a nine-week training program. They were randomly assigned to a heavy back squat group (90-95% of one repetition maximum) or a moderate-intensity back squat group (60-65% of one repetition maximum).

    RESULTS: The heavy back squat group resulted in a significantly (p < 0.001) increased in one repetition maximum strength but a significant (p < 0.001) reduction in HMG flexibility when compared to their counterparts. The results of the study indicate that while a heavy back squat training program is effective in improving strength, it has an adverse effect on the flexibility of the HMG.

    CONCLUSION: The implication of this study is that there is a tradeoff between strength and flexibility and trainers should select the appropriate training protocols for their athletes to maximize athletic performance.

  6. Lim E, Lim R, Suhaimi A, Chan BT, Wahab AKA
    J Back Musculoskelet Rehabil, 2018;31(6):1041-1047.
    PMID: 30149436 DOI: 10.3233/BMR-171042
    BACKGROUND: Low frequency sound wave stimulation therapy has become increasingly popular in the rehabilitation fields, due to its ease, less fatiguing and time efficient application.

    OBJECTIVE: This 12-week pilot study examines the efficacy of applying low frequency sound wave stimulation (between 16-160 Hz) through both hands and feet on relieving pain and improving functional ability in patients with chronic back pain.

    METHODS: Twenty-three participants with chronic shoulder (eleven participants) or low back pain (twelve participants) underwent a 12-week vibration therapy program of three sessions per week. A low frequency sound wave device comprising four piezoelectric vibration-type tactile tranducers enclosed in separate 5-cm diameter circular plates, which generate sinusoidal vibratory stimuli at a frequency of 16-160 Hz, was used in this study. Primary outcome measure was pain sensation measured using the Visual Analogue Scale (P-VAS). The secondary outcome measures were pain-related disability measured using the pain disability index (PDI) and quality of life measured using the SF-12.

    RESULTS: At week 12, significant reductions in pain sensation and pain-related disability were observed, with mean reductions of 3.5 points in P-VAS and 13.5 points in the PDI scores. Sixty-five percent of the participants had a reduction of at least 3 points on the P-VAS score, while 52% participants showed a decrease of at least 10 points in the PDI score. Significant improvement was observed in the SF-12 physical composite score but not the mental composite score.

    CONCLUSIONS: The preliminary findings showed that passive application of low frequency sound wave stimulation therapy through both hands and feet was effective in alleviating pain and improving functional ability in patients with chronic back pain.

  7. Rabbi MF, Ghazali KH, Mohd II, Alqahtani M, Altwijri O, Ahamed NU
    J Back Musculoskelet Rehabil, 2018;31(6):1097-1104.
    PMID: 29945343 DOI: 10.3233/BMR-170988
    This study aimed to investigate the electrical activity of two muscles located at the dorsal surface during Islamic prayer (Salat). Specifically, the electromyography (EMG) activity of the erector spinae and trapezius muscles during four positions observed while performing Salat, namely standing, bowing, sitting and prostration, were investigated. Seven adult subjects with an average age of 28.1 (± 3.8) years were included in the study. EMG data were obtained from their trapezius and erector spinae muscles while the subjects maintained the specific positions of Salat. The EMG signal was analysed using time and frequency domain features. The results indicate that the trapezius muscle remains relaxed during the standing and sitting positions while the erector spinae muscle remains contracted during these two positions. Additionally, during the bowing and prostration positions of Salat, these two muscles exhibit the opposite activities: the trapezius muscle remains contracted while the erector spinae muscle remains relaxed. Overall, both muscles maintain a balance in terms of contraction and relaxation during bowing and prostration position. The irregularity of the neuro-muscular signal might cause pain and prevent Muslims from performing their obligatory prayer. This study will aid the accurate understanding of how the back muscles respond in specific postures during Salat.
  8. Zahari Z, Ishak A, Justine M
    PMID: 31356191 DOI: 10.3233/BMR-181305
    OBJECTIVES: This study aimed to gain an overview of patient education and the effects of patient education for older people with low back pain (LBP).

    METHODS: The search strategies were performed via EBSCO MEDLINE, EBSCO CINAHL, Science Direct, PubMed, and PEDro databases from 2006 to 2016. The keywords "patient education", "low back pain", "elderly", "older adults", "older persons" and "older people" were used during the literature search. Boolean operators were used to expand or limit the searching scope and manual exclusion were performed to choose articles eligible for this study.

    RESULTS: A total of 2799 articles were retrieved but only five articles were related with patient education for older people with LBP. Findings suggest that patient education for older people may differ in terms of its contents such as health education, self-management, video education, and postural education. The high methodological quality of the studies revealed that patient education showed improvement in terms of pain, disability and quality of life among older people with LBP.

    CONCLUSIONS: Patient education improved pain and had positive effects on disability and quality of life among older people with LBP. However, due to the limited number of RCTs more studies are needed to provide evidence for its effectiveness.

  9. Dhondt E, Van Oosterwijck J, Cagnie B, Adnan R, Schouppe S, Van Akeleyen J, et al.
    PMID: 31356190 DOI: 10.3233/BMR-181125
    BACKGROUND: There is a growing need to identify patient pre-treatment characteristics that could predict adherence and outcome following specific interventions.

    OBJECTIVE: To identify predictors of adherence and outcome to outpatient multimodal rehabilitation in chronic low back pain (CLBP).

    METHODS: A total of 273 CLBP patients participated in an exercise-based rehabilitation program. Patients who completed ⩾ 70% of the treatment course were classified as adherent. Patients showing a post-treatment reduction of ⩾ 30% in Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) back pain intensity scores were assigned to the favorable outcome group.

    RESULTS: Multivariate logistic regression revealed that higher age, higher ability to perform low-load activities, and higher degrees of kinesiophobia increased the odds to complete the rehabilitation program. By contrast, lower levels of education and back pain unrelated to poor posture increased the odds for non-adherence. Furthermore, a favorable outcome was predicted in case the cause for LBP was known, shorter symptom duration, no pain in the lower legs, no difficulties falling asleep, and short-term work absenteeism.

    CONCLUSIONS: Assessment and consideration of patient pre-treatment characteristics is of great importance as they may enable therapists to identify patients with a good prognosis or at risk for non-responding to outpatient multimodal rehabilitation.

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