Back Muscle Function in Older Women With Age-Related Hyperkyphosis: A Comparative Study

ObjectiveThe purpose of this study was to compare static maximal back extensor muscle force, endurance, and characteristics of flexion relaxation phenomenon (FRP) in older women with and without age-related hyperkyphosis.MethodsMaximum back extensor force and endurance measured in a sitting position with a designed load cell setup; appearance, onset, and offset angles of FRP; and extension relaxation ratio (ERR) during a dynamic flexion-extension task were compared between 24 older women with hyperkyphosis (thoracic kyphosis angle ≥50°), mean age 65 ± 4.4 years, and 24 older women without hyperkyphosis (thoracic kyphosis angle ?50°), mean age 63 ± 4.3 years. Variables of force, endurance, angles of FRP, and ERR were analyzed using an independent sample t test. A χ² test was used to identify differences between groups in FRP appearance.ResultsStatic back extensor force and endurance were significantly lower among those with versus those without hyperkyphosis (P ? .001). Although the 2 groups did not differ in FRP appearance and ERR in the superficial erector spinal muscles (P ? .05), FRP in the hyperkyphosis group started sooner and ended later than in the group without hyperkyphosis (P ? .05).ConclusionOur study indicates that women with age-related hyperkyphosis had decreased static maximal force and endurance of the back extensor muscles and prolonged myoelectrical silence of the superficial erector spinal muscles. Reduced endurance of the superficial erector spinal muscles may trigger early onset of FRP and prolonged relaxation of these muscles.     

Kinesio Taping reduces pain and improves disability in low back pain patients: a randomised controlled trial

Objective

To investigate the effects of Kinesio Taping^® (KT) on chronic non-specific low back pain (LBP).

Transitional cell carcinoma of the urethra [correction of ureter] in a patient with buttock pain: a case report

Murphy DR, Morris NJ. Transitional cell carcinoma of the ureter in a patient with buttock pain: a case report.This case reports on a patient with an unusual presentation of a rare tumor: urethral transitional cell carcinoma (TCC). Urethral TCC occurs in approximately 0.7% to 4.0% of patients who have had primary bladder cancer. The initial symptoms usually involve hematuria, with approximately a third of patients reporting flank area pain. Buttock pain and the absence of hematuria are uncommon with this disorder. The patient was initially suspected to have piriformis syndrome, but when he did not respond as expected to treatment, and because of his history of primary bladder cancer, further evaluation was undertaken and the diagnosis was made. The patient responded well to radiation and chemotherapy. Musculoskeletal physicians should be particularly suspicious of the presence of urethral TCC in a patient with a history of primary bladder cancer who reports low back or buttock pain, particularly if the patient does not respond quickly to treatment.     

Outcomes after a prone lumbar traction protocol for patients with activity-limiting low back pain: a prospective case series study

Beattie PF, Nelson RM, Michener LA, Cammarata J, Donley J. Outcomes after a prone lumbar traction protocol for patients with activity-limiting low back pain: a prospective, case series study.

Objective

To determine outcomes after administration of a prone lumbar traction protocol.

Design

Prospective, longitudinal, case series.

Setting

Suburban, chiropractic practice.

Participants

A total of 296 subjects with low back pain (LBP) and evidence of a degenerative and/or herniated intervertebral disk at 1 or more levels of the lumbar spine. We excluded patients involved in litigation and those receiving workers’ compensation.

Intervention

An 8-week course of prone lumbar traction, using the vertebral axial decompression (VAX-D) system, consisting of five 30-minute sessions a week for 4 weeks, followed by one 30-minute session a week for 4 additional weeks.

Main Outcome Measures

The numeric pain rating scale and the Roland-Morris Disability Questionnaire (RMDQ) were completed at preintervention, discharge (within 2 weeks of the last visit), and at 30 days and 180 days after discharge. Intention-to-treat strategies were used to account for those subjects lost to follow-up.

Results

A total of 250 (84.4%) subjects completed the treatment protocol. On the 30-day follow-up, 247 (83.4%) subjects were available; on the 180-day follow-up, data were available for 241 (81.4%) subjects. We noted significant improvements for all postintervention outcome scores when compared with preintervention scores (P<.01).

Conclusions

Traction applied in the prone position using the VAX-D for 8 weeks was associated with improvements in pain intensity and RMDQ scores at discharge, and at 30 and 180 days after discharge in a sample of patients with activity-limiting LBP. Causal relationships between these outcomes and the intervention should not be made until further study is performed using randomized comparison groups.     

Quantification of lumbar stability by using 2 different abdominal activation strategies

OBJECTIVE: To determine whether the abdominal hollowing technique is more effective for lumbar spine stabilization than a full abdominal muscle cocontraction. DESIGN: Within-subject, repeated-measures analysis of variance was used to examine the effect of combining each of 4 loading conditions with either the hollow or brace condition on the dependent variables of stability and compression. A simulation was also conducted to assess the outcome of a person activating just the transversus abdominis during the hollow. SETTING: Laboratory. PARTICIPANTS: Eight healthy men (age range, 20-33y). INTERVENTIONS: Electromyography and spine kinematics were recorded during an abdominal brace and a hollow while supporting either a bilateral or asymmetric weight in the hands. MAIN OUTCOME MEASURES: Spine stability index and lumbar compression were calculated. RESULTS: In the simulation "ideal case," the brace technique improved stability by 32%, with a 15% increase in lumbar compression. The transversus abdominis contributed .14% of stability to the brace pattern with a less than 0.1% decrease in compression. CONCLUSIONS: Whatever the benefit underlying low-load transversus abdominis activation training, it is unlikely to be mechanical. There seems to be no mechanical rationale for using an abdominal hollow, or the transversus abdominis, to enhance stability. Bracing creates patterns that better enhance stability.     

艾灸结合中药熏蒸干预对慢性腰肌劳损患者疼痛及腰背功能恢复的影响

目的探究艾灸结合中药熏蒸干预对慢性腰肌劳损患者疼痛及腰背功能恢复的影响.方法选取某院2016年7月至2018年5月诊治的慢性腰肌劳损患者90例,采用随机数表法分为两组,各45例.对照组给予功能康复锻炼干预,观察组在对照组基础上采用艾灸联合中药熏蒸,对比两组临床疗效、治疗前后疼痛评分及腰背功能恢复情况.结果观察组治疗总有效率91.11%,高于对照组的66.67%,差异有统计学意义(P<0.05);观察组治疗后视觉模拟评分法(VAS)评分低于对照组,背肌力高于对照组,腰肌耐力时间长于对照组,差异有统计学意义(P<0.05).结论艾灸结合中药熏蒸干预可有效改善慢性腰肌劳损患者的临床症状,降低其腰痛评分,利于促进腰背功能的恢复,改善预后.     

The Association Among Overweight,Obesity, and Low Back Pain in U.S. Adults: A Cross-Sectional Study of the 2015 National Health Interview Survey

Objective

The purpose of this study was to explore the association between obesity (via body mass index [BMI]) and presence of low back pain (LBP) in a representative sample of US adults, aged ≥18 years.

Development of a Multivariate Prognostic Model for Pain and Activity Limitation in People With Low Back Disorders Receiving Physiotherapy

Objective

To identify predictors for back pain, leg pain, and activity limitation in patients with early persistent low back disorders (LBDs).

Intertester Agreement and Validity of Identifying Lumbar Pain Provocative Movement Patterns Using Active and Passive Accessory Movement Tests

Objective

The purpose of this study was to evaluate the interexaminer agreement and validity of active and passive pain provocation tests in the lumbar spine.

Methods

Two blinded raters examined 36 participants, 18 of whom were asymptomatic and 18 reported subacute nonspecific low back pain (LBP). Two types of pain provocation tests were performed: (1) physiological movements in single (flexion/extension) and, when necessary, combined planes and (2) passive accessory intervertebral movement tests of each lumbar vertebra in prone with the lumbar spine in neutral, flexion, and extension position.

Results

The interobserver agreement in both groups was good to excellent for the identification of flexion (κ = 0.87-1) or extension (κ = 0.65-0.74) as the most painful pattern of spinal movement. In healthy participants, 0% was identified as having a flexion provocative pattern and 8.8% were identified as having an extension provocative pattern. In the LBP group, 20% were identified as having a flexion provocative pattern vs 60% with an extension provocative pattern. The average interexaminer agreement for passive accessory intervertebral movement tests in both groups was moderate to excellent (κ = 0.42-0.83). The examiners showed good sensitivity (0.67-0.87) and specificity (0.82-0.85) to distinguish participants with LBP using this combined examination procedure.

Conclusion

The use of a combination of pain provocative tests was found to have acceptable interexaminer reliability and good validity in identifying the main pain provocative movement pattern and the lumbar segmental level of involvement. These pain provocation tests were able to distinguish participants with LBP from asymptomatic participants and may help clinicians in directing manual therapy treatment.