Musculoskeletal Diseases Commons^™

Biomechanical Effects Of Exercise-Based Interventions In Chronic Nonspecific Low Back Pain: A Systematic Review And Meta-Analysis, Lara De Vecchi Machado

Theses and Dissertations--Kinesiology and Health Promotion

Chronic nonspecific low back pain (CNLBP) is the leading cause of years lived with disability worldwide and represents a complex, multifactorial, and heterogeneous condition. It is characterized by substantial interindividual variability in muscle activation patterns, lumbo-pelvic coordination, and movement strategies. Although exercise is widely recommended as a first-line intervention and its clinical benefits are well established, the biomechanical mechanisms underlying functional improvement remain fragmented in the literature and are rarely synthesized quantitatively.

This dissertation conducted a systematic review with meta-analysis to investigate the biomechanical effects of exercise-based interventions in individuals with CNLBP. A total of 39 studies were included and …

Diagnosis And Management Of Cardiometabolic Disease After Spinal Cord Injury: Identifying Gaps In Physician Training And Practices, Chinenye Christa Nnoromele, Du Pham, Felicia Skelton, Ryan Solinsky

Faculty, Staff and Students Publications

CONTEXT: Cardiometabolic disease (CMD) frequently occurs in individuals with spinal cord injury (SCI), with growing awareness surrounding the expansive scope of this problem. As CMD has significant morbidity and mortality, early guidelines-based screening and management have been established. However, the extent to which these guidelines have been adopted are unclear.

OBJECTIVE: Describe physicians' screening and management pattern for CMD in patients with SCI, as compared to SCI-specific CMD screening guidelines, and elucidate variables linked to screening and management patterns.

METHODS: SCI medicine-boarded physicians were surveyed on screening timing for CMD following acute SCI, along with their practice pattern and comfort …

A Literature Review Of Pain Control In Osteoarthritis Patients Using Blood Flow Restriction Training, John Gericke, Dakota Pastore, Tyler Pigott

Rowan-Virtua Research Day

Background: Osteoarthritis (OA) is a degenerative disease that mainly affects articular cartilage of joints. OA most commonly affects the knees and causes pain and reduces quality of life in older adults. Blood flow restriction (BFR) occludes arterial and venous flow during exercise using a blood pressure cuff placed on the proximal lower limb. This creates an intramuscular hypoxic environment which promotes muscle hypertrophy. High load training can cause pain and inflammation in knee OA patients due to increased stress. BFR can allow patients with knee OA to use lower loads to achieve beneficial effects of rehabilitation.

Methods: Data was ascertained …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Identifying The Neural Correlates Of Anticipatory Postural Control: A Novel Fmri Paradigm, Jo Armour Smith, Rongwen Tain, Kelli G. Sharp, Laura M. Glynn, Linda R. Van Dillen, Korinne Henslee, Jesse V. Jacobs, Steven C. Cramer

Physical Therapy Faculty Articles and Research

Altered postural control in the trunk/hip musculature is a characteristic of multiple neurological and musculoskeletal conditions. Previously it was not possible to determine if altered cortical and subcortical sensorimotor brain activation underlies impairments in postural control. This study used a novel fMRI-compatible paradigm to identify the brain activation associated with postural control in the trunk and hip musculature. BOLD fMRI imaging was conducted as participants performed two versions of a lower limb task involving lifting the left leg to touch the foot to a target. For the supported leg raise (SLR) the leg is raised from the knee while the …

The Use Of Mobility And Medication On Patient’S Perception Of Pain In Hospitalized Patients With Chronic Back Pain Benchmark Study, Katherine E. Zaske Merenda Mrs., Katherine Merenda

MSN Capstone Projects

According to Boss & Huether, twenty-nine percent of Americans have been diagnosed with chronic low back pain (CLBP). This pain can affect every part of their lives leading to lost wages and decreased quality of life. CLBP is an issue experienced by many hospitalized patients. These patients may not be able to mitigate their pain as they normally would due to safety protocols in hospital settings. Exercise or mobility has been shown to decrease a person’s perception of pain. The importance of exercise and mobility in a hospital setting to help decrease a patient’s perception of pain needs further research. …

Physical Activity Interventions In Children With Juvenile Idiopathic Arthritis: A Systematic Review Of Randomized Controlled Trials, Maura D. Iversen, Marie Andre, Johan Von Heideken

Physical Therapy Faculty Publications

Introduction: Children with juvenile arthritis (JA) experience pain, stiffness, fatigue, and decreased motion leading to difficulties with daily activities and low physical activity (PA). PA is critical to improve health and function and mitigate JA-associated symptoms. This study evaluated the evidence for PA interventions in children with JA.

Materials and methods: A systematic review of randomized controlled trials (RCTs) of PA interventions in children with JA was conducted. Ovid (Medline), Cochrane Library, EMBASE, and CINAHL databases were searched for papers published in English between 1/1/1946 and 9/1/2021. Studies which concurrently assessed medical interventions were excluded. Participant and intervention characteristics and …

Minimizing Musculoskeletal Injury Risk In Health Care Professionals With Education On Safe Patient Handling, Aubrey Graves

Honors College Theses

Introduction: Nursing is a high-risk occupation for musculoskeletal injuries due to the strenuous activity of patient handling. These tasks include, assisting a patient in bed, moving a patient from the bed to a wheelchair, and assisting with walking. These work-related tasks can create a large amount of stress on the body, especially the back if proper technique is not utilized and/or if excessive loads are applied. The purpose of this study is to examine if teaching proper body mechanics and the dangers of not performing the tasks properly is an effective way of reducing musculoskeletal injuries.

Methods: The NUR 202 …

Conservative Management Of Low Back Pain, Se Won Lee, Dan Nguyen, Denny Mack, Eric Aguila, Mary Thomas, Karyn Doddy

HCA Healthcare Journal of Medicine

Low back pain (LBP) is frequently encountered in outpatient clinics and affects individual patients and society in general with decreased physical function, quality of life, disability, and/or economic burden. Although most acute LBP resolves on its own, recurrent and chronic LBP is a common reason for outpatient clinic visits. This review explores pragmatic approaches to LBP in the clinical setting, focusing on recognizing prognostic factors, initial approaches to evaluation, including selective imaging, and conservative management including patient education, therapeutic exercises and bracing.

Weight Reduction Motivation In Osteoarthritis Patients Through Nurse Practitioner Driven Education And Follow-Up: A Pilot Project, Caoilfhionn Mulvey, Martha Fuller Phd

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: The ultimate goal of this short-term pilot project is for

overweight or obese osteoarthritis patients to increase their knowledge on the benefits of

weight loss and physical activity. Research shows that for every kilogram of weight lost,

2.2–4.0 kilograms of weight is taken off of the joint and could reduce joint pain up to

thirty to fifty percent and improve quality of life. Following education from the provider,

patients will understand the correlation of osteoarthritis symptom management with

weight loss.

EBP Model/Frameworks: This project utilizes the Iowa Model of Evidence-Based

Practice to Promote Quality Care. This addresses …

Structural Remodeling Of The Lumbar Multifidus, Thoracolumbar Fascia And Lateral Abdominal Wall Perimuscular Connective Tissues: Medium-Term Test-Retest Reliability Of Ultrasound Measures, Christian Larivière, Dany H. Gagnon, Richard Preuss

Études primaires

Abstract

Introduction

Growing interest is being paid to the lumbar multifidus (LM) intramuscular fatty infiltrations and fibrosis that are secondary to low back pain as well to the remodeling of perimuscular connective tissues (fasciae) such as the thoracolumbar fascia and fascia sheets separating the abdominalwall muscles. Magnetic resonanceimaging and computed tomography have traditionally been used but rehabilitative ultrasound imaging (RUSI) is much more affordable and practical, which can accelerate research and clinical applications on this topic. The aim of this study was to test the medium-term (8 weeks) test-retest reliability of the corresponding RUSI measures.

Methods

Thirty-four participants …

The Effect Of Extensible And Non-Extensible Lumbosacral Orthoses On Anticipatory Postural Adjustments In Participants With Low Back Pain And Healthy Controls, Christian Larivière, Richard Preuss

Études primaires

Background

Wearing a lumbosacral orthosis (LSO) is known to influence spine mechanics, but less is known about how LSOs affect motor control. Whether the use of a LSO can negatively affect motor control of the lumbar spine is still under debate.

Objective

The current study examined the immediate effects of two flexible LSOs (extensible and non-extensible) on the anticipatory postural adjustments that prepare the spine for a predictable perturbation.

Design

A comparative study using a repeated measures design in a laboratory setting.

Methods

Healthy controls (n = 20) and participants with low back pain (n = 40) performed a rapid …

Comparison Of Pre- And Post-Operative Shoulder Muscle Emg Profiles In Reverse Total Shoulder Arthroplasty Patients, Emily Lau, Sreten Franovic, Noah Kuhlmann, Eric C. Makhni Md, Stephanie Muh Md

Medical Student Research Symposium

Background: Deltoid muscle function is central in reverse total shoulder arthroplasty (RTSA) function; however, there is limited information available regarding changes in deltoid activity before and after surgery. Few tests exist to evaluate specific muscle metrics pre and post operatively. Surface Electromyographic (EMG) is non-invasive and allows for observation of motions with multifaceted analysis of movement with minimal patient demand. Understanding the changes in shoulder muscle activation, namely in the deltoid, in patients pre and post-RTSA can further advance understanding of the procedure and rehabilitation efforts.

Methods: Nine individuals were recruited for this study: all patients underwent RTSA by a …

Oral Contraceptives As Possible Acl Injury Prevention Method, Haley Schweizer

Capstone Showcase

ABSTRACT

Introduction: Anterior Cruciate Ligament (ACL) injuries are an upsetting setback for many athletes that require a long and costly recovery process. The injury rates are four times greater in women than men. Preventative measures that help to prevent ACL injuries are limited to stretching and strengthening. Therefore, this review aims to investigate if oral contraceptive [I] usage provides a possible new avenue for prevention of ACL injury [O] in young female athletes (ages 18-30) [P] compared to those that do not take oral contraceptives [C].

Methods: A literature review was performed though PubMed, Google Scholar, SCOPUS Database, and ClinicalKey …

Structural Remodelling Of The Lumbar Multifidus, Thoracolumbar Fascia And Lateral Abdominal Wall Perimuscular Connective Tissues: A Cross-Sectional And Comparative Ultrasound Study, Christian Larivière, Richard Preuss, Dany H. Gagnon, Hakim Mecheri, Sharon M. Henry

Études primaires

Introduction

With low back pain (LBP), remodelling of the lumbar soft tissues involves both trunk muscles and neighbouring passive connective tissues. The aim of the present study was to compare three quantitative measures of these tissues, using ultrasound imaging (USI), among healthy controls and individuals with LBP.

Methods

USI measures from 30 healthy subjects and 34 patients with non-acute LBP were compared between groups and sexes. The measures employed were (1) lumbar multifidus echogenicity (fatty/fibrosis infiltration) at three vertebral levels; (2) posterior layer thickness of the thoracolumbar fascia, and (3) thickness of the perimuscular tissues surrounding the external oblique, internal …

Three-Month Efficacy Of Three Knee Braces In The Treatment Of Medial Knee Osteoarthritis In A Randomized Crossover Trial, Xavier Robert-Lachaine, Yoann Dessery, Étienne L. Belzile, Sylvie Turmel, Philippe Corbeil

Études primaires

Immediate biomechanical and functional effects of knee braces are often reported, however, the duration and type of knee brace treatment for knee osteoarthritis (KOA) remain unclear. The objective was to evaluate usage, comfort, pain, and knee adduction moment (KAM) of three knee braces each worn 3 months by patients. Twenty-four patients with KOA were assigned in a randomized crossover trial a valgus three-point bending system brace (V3P-brace), an unloader brace with valgus and external rotation functions (VER-brace) and a stabilizing brace used after ligament injuries (ACL-brace). Functional questionnaires and gait assessment were carried out before and after each brace wear …

Adherence To A Home Exercise Programme Following A Clinical Programme For Non-Acute Non-Specific Low Back Pain: An Exploratory Study, Judith L'Heureux, Marie-France Coutu, Djamal Berbiche, Christian Larivière

Études primaires

Purpose:Lack of adherence to home exercise programmes is hypothesised to partially explain the modest clinical effects seen in patients with low back pain. This study explored the association between the main biopsychosocial factors and adherence using a theory-driven approach including the fear-avoidance model, the common-sense model and the working alliance concept.

Methods: A repeated measures design was used. During and after an eight-week clinical exercise programme, 48 participants with non-acute and disabling low back pain followed a home exercise programme. Questionnaires assessed home exercise adherence and biopsychosocial factors at baseline, after the eight-week clinical programme and at the six-month follow-up. …

The Effects Of An 8-Week Stabilization Exercise Program On Lumbar Multifidus Muscle Thickness And Activation As Measured With Ultrasound Imaging In Patients With Low Back Pain: An Exploratory Study, Christian Larivière, Dany H. Gagnon, Sharon M. Henry, Richard Preuss, Jean-Pierre Dumas

Études primaires

Background

Lumbar stabilization exercise programs (LSEP) produce positive effects on clinical outcomes, but the underlying mechanisms remain relatively unexplored. Psychological and neuromuscular mechanisms can be involved, such as a better activation of the lumbar multifidus, which represents one possibility.

Objectives

To determine the following: (1) the effect of an LSEP on lumbar multifidus muscle thickness and activation, as measured with rehabilitative ultrasound imaging (RUSI), in patients with low back pain (LBP); (2) the correlation between RUSI measures and any change in clinical outcomes following the LSEP; and (3) the reliability of RUSI measures in control subjects over 8 weeks.

Design …

Trunk Postural Adjustments: Medium-Term Reliability And Correlation With Changes Of Clinical Outcomes Following An 8-Week Lumbar Stabilization Exercise Program, Jean-Alexandre Boucher, Richard Preuss, Sharon M. Henry, Marilee Nugent, Christian Larivière

Études primaires

Background

Low back pain (LBP) has been previously associated with delayed anticipatory postural adjustments (APAs) determined by trunk muscle activation. Lumbar stabilization exercise programs (LSEP) for patients with LBP may restore the trunk neuromuscular control of the lumbar spine, and normalize APAs. This exploratory study aimed at testing the reliability of EMG and kinematics-based postural adjustment measures over an 8-week interval, assessing their sensitivity to LBP status and treatment and examining their relationship with clinical outcomes.

Methods

Muscle activation of 10 trunk muscles, using surface electromyography (EMG), and lumbar angular kinematics were recorded during a rapid arm-raising/lowering task. Patients with …

Trunk Musculoskeletal Response In Maximum Voluntary Exertions: A Combined Measurement-Modeling Investigation, F. Ghezelbash, Z. El Ouaaid, A. Shirazi-Adl, A. Plamondon, N. Arjmand

Études primaires

Maximum voluntary exertion (MVE) tasks quantify trunk strength and maximal muscle electromyography (EMG) activities with both clinical and biomechanical implications. The aims here are to evaluate the performance of an existing trunk musculoskeletal model, estimate maximum muscle stresses and spinal forces, and explore likely differences between males and females in maximum voluntary exertions. We, therefore, measured trunk strength and EMG activities of 19 healthy right-handed subjects (9 females and 10 males) in flexion, extension, lateral and axial directions. MVEs for all subjects were then simulated in a subject-specific trunk musculoskeletal model, and estimated muscle activities were compared with EMGs. Analysis …

Muscle Synergy During A Single Leg Standing Test In Ambulatory Children With Cerebral Palsy, Brennan L. Smith

Theses and Dissertations--Kinesiology and Health Promotion

INTRODUCTION: Cerebral Palsy (CP) is a sensorimotor disorder characterized by dysfunctional motor coordination, balance problems, and loss of selective motor control. Motor coordination exhibited as co-contraction, has been subjectively quantified using gait analysis, but recent studies have begun to objectively analyze the amount of co-contraction by collecting electromyography (EMG) data. Center of pressure excursion (COPE) measurements collected during a single leg standing test (SLST) have shown to be more valid measurements of balance in populations with motor disabilities than a SLST alone. A recent study has correlated increased COPE velocity with a lower fall risk as determined by reported fall …

Motor Learning And Adaptation In People With Knee Osteoarthritis And Chronic Pain, Heather Turcotte, Katherine S. Rudolph

Osteopathic Medicine Student Research Posters

Osteoarthritis (OA) affects an estimated 50 million people in the US, and approximately 43% have limitations in daily function due to arthritis pain.3 Individuals with knee osteoarthritis (OA) have heightened sensitization to pain2,5 as well as reduced strength, diminished function and quality of life1 that prompts them to seek care from health care providers. Physical therapists commonly work with patients to improve function and quality of life by helping them learn to move without pain. Unfortunately, chronic pain causes changes to the nervous system that may impact the ability to learn new ways but the extent to which chronic pain …

Effect Of Monophasic Pulsed Current On Heel Pain And Functional Activities Caused By Plantar Fasciitis, Abdullah K. Alotaibi, Jerrold S. Petrofsky, Noha S. Daher, Everett Lohman, Michael S. Laymon, Hasan M. Syed

College of Health & Human Services (TUN) Publications and Research

Background: Plantar fasciitis (PF) is a soft tissue disorder considered to be one of the most common causes of inferior heel pain. The aim of this study was to investigate the effect of monophasic pulsed current (MPC) and MPC coupled with plantar fascia-specific stretching exercises (SE) on the treatment of PF.

Material and Methods: Forty-four participants (22 women and 22 men, with a mean age of 49 years) diagnosed with PF were randomly assigned to receive MPC (n=22) or MPC coupled with plantar fascia-specific SE (n=22). Prior to and after 4 weeks of treatment, participants underwent baseline evaluation; …

Quantitative Ultrasound: Measurement Considerations For The Assessment Of Muscular Dystrophy And Sarcopenia, Michael O. Harris-Love, Reza Monfaredi, Catheeja Ismail, Marc R. Blackman, Kevin Cleary

Exercise and Nutrition Sciences Faculty Publications

Diagnostic musculoskeletal ultrasound has potential clinical utility in characterizing pathological muscle tissue. Sonography has been long proposed as method of assessing muscle damage due to neuromuscular diseases such as muscular dystrophy, and more recently, changes in body and tissue composition associated with muscle wasting disorders such as sarcopenia. The use of quantitative ultrasound as an adjunct diagnostic procedure has different technical challenges than the traditional use of ultrasound in clinical medicine. Operator-dependent technique and variation are critical considerations when obtaining measures of echointensity (i.e., tissue composition estimates) and tissue dimensions (i.e., muscle thickness) – key elements of the ultrasound assessment …

Supervised Lower Extremity Strengthening Program To Improve Function In Women Over Fifty With Knee Osteoarthritis: A Time Series Design, Janelle Brooke Lemons, Diane Christine Sheesley, Pamela Reagan Sutton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Develop a simple, self-paced lower extremity strengthening program incorporating functional activities for women over the age of fifty to reduce limitations associated with knee OA.

Study Design: This was a pilot study utilizing a time series design with 8 women aged 55-65 (M + SD = 60 + 3) meeting the American College of Rheumatology's criteria for clinical diagnosis of knee OA.

Background: Lower extremity weakness in women with knee osteoarthritis is associated with pain and functional limitations.

Methods and Measures: Subjects began the 14-week program with 2 weeks of baseline treadmill walking. The following 12 weeks were divided …

The Effects Of A Short Course Of Muscle Energy Technique On Sacral Dysfunction In Patients With Acute Lumbosacral Pain, Regina O'Hara

Human Movement Studies & Special Education Theses & Dissertations

The purposes of this research study were to examine the effects of treating patients with suspected acute iliosacral rotational dysfunction with muscle energy techniques (MET) on (1) disability, (2) perceived pain during lumbar motion in neutral, flexion, and extension, (3) lumbar range of motion in flexion and extension, and (4) sagittal innominate rotation. Subjects were randomly assigned to the experimental and placebo groups. Experimental subjects received MET treatments, and placebo subjects received a stretching placebo treatinent. Subjects were treated four times over the course of one week. The initial examination and treatment occurred within 72 hours of the onset of …