Effect of total knee replacement surgery and postoperative 12 month home exercise program on gait parameters

Abstract Objective To evaluate the effects of surgery and a postoperative progressive home exercise program on gait parameters among individuals operated with total knee arthroplasty. Design Single blinded randomized controlled trial. Subjects 108 patients (84 females, 24 males, mean age 69 years). Interventions Patients were equally randomized into an exercise group (EG) and control group (CG). The 12-months progressive home exercise program starting two months postoperatively was compared to usual care. Methods Gait analysis was performed using the Gaitrite electronic walkway system. In addition, knee extension and flexion strength were measured by a dynamometer preoperatively, and pain o…

sj-docx-2-cre-10.1177_02692155231170687 - Supplemental material for Neck–Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial

Supplemental material, sj-docx-2-cre-10.1177_02692155231170687 for Neck–Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial by Marjo Rinne, Sanna Garam and Katriina Kukkonen-Harjula, Kari Tokola, Arja Häkkinen, Jari Ylinen, Riku Nikander in Clinical Rehabilitation

Effect of Isometric Upper-Extremity Exercises on the Activation of Core Stabilizing Muscles

Abstract Tarnanen SP, Ylinen JJ, Siekkinen KM, Malkia EA, Kautiainen HJ, Hakkinen AH. Effect of isometric upper-extremity exercises on the activation of core stabilizing muscles. Objective To evaluate whether isometric exercises for the upper extremities could sufficiently activate core stabilizing muscles to increase muscle strength. Design Cross-sectional study. Setting Department of physical medicine and rehabilitation at a Finnish hospital. Participants Healthy adult women (N=20). Interventions Not applicable. Main Outcome Measures Peak isometric strength of the back and abdominal muscles was measured and relative loading in 5 test exercises was evaluated by surface electromyography. Re…

Reliability and Validity of The Finnish Version of The Boston Carpal Tunnel Questionnaire among Surgically Treated Carpal Tunnel Syndrome Patients

Background and Aims: The Boston Carpal Tunnel Questionnaire is the most commonly used outcome measure in the assessment of carpal tunnel syndrome. The purpose of this study was to translate the original Boston Carpal Tunnel Questionnaire into Finnish and validate its psychometric properties. Materials and Methods: We translated and culturally adapted the Boston Carpal Tunnel Questionnaire into Finnish. Subsequently, 193 patients completed the Finnish version of the Boston Carpal Tunnel Questionnaire, 6-Item CTS Symptoms Scale, and EuroQol 5 Dimensions 12 months after carpal tunnel release. The Boston Carpal Tunnel Questionnaire was re-administered after a 2-week interval. We calculated cons…

Associations of neck muscle strength and cervical spine mobility with future neck pain and disability: a prospective 16-year study.

Abstract Background Neck pain has been associated with weaker neck muscle strength and decreased cervical spine range of motion. However, whether neck muscle strength or cervical spine mobility predict later neck disability has not been demonstrated. In this 16-year prospective study, we investigated whether neck muscle strength and cervical spine mobility are associated with future neck pain and related disability in women pain-free at baseline. Methods Maximal isometric neck muscle strength and passive range of motion (PROM) of the cervical spine of 220 women (mean age 40, standard deviation (SD) 12 years) were measured at baseline between 2000 and 2002. We conducted a postal survey 16 ye…

Stability of the upper neck during isometric neck exercises in rheumatoid arthritis patients with atlantoaxial disorders.

To study the effect of isometric neck strength exercises on upper cervical stability in patients with rheumatoid arthritis (RA).Twenty patients with a mean (SD) age of 58 (9) years and duration of RA of 27 (10) years volunteered for the study. Lateral radiographs of the cervical spine were taken to measure the current atlantoaxial distance (AAD) in flexion and extension. Maximal isometric neck flexion and extension strength values were measured by a dynamometer. Thereafter, AADs were measured from radiographs taken at 80-90% resistance of maximal strength.According to the full flexion radiographs at baseline, the patients were classified into three groups: eight patients without anterior at…

Validity and Reliability of the Finnish Version of the Locomotor Capabilities Index-5 in Patients Fitted with a Prosthesis after Major Lower Extremity Amputation

The early changes in trunk muscle strength and disability following lumbar spine fusion

To analyze trunk muscle function pre- and postoperatively in patients undergoing lumbar spine fusion. Associations between changes in trunk muscle strength and disability were also studied.A total of 114 patients undergoing lumbar spine fusion participated in the study. The flexion and extension strength of the trunk was measured preoperatively and 3 months after surgery using a strain-gauge dynamometer. Disability and pain during the past week was evaluated with the Oswestry disability index (ODI) and visual analog scale (VAS), respectively.Preoperative trunk extension and flexion strength levels were 319 N and 436 N in males, respectively, and 160 N and 214 N in females, respectively. In …

Does adding a 12-month exercise programme to usual care after a rotator cuff repair effect disability and quality of life at 12 months? A randomized controlled trial

Objective: To compare a 12-month home-based exercise programme with usual care for disability and health-related quality of life after rotator cuff repair. Design: Randomized controlled trial. Setting: Outpatient physical and rehabilitation medicine clinic. Subjects: Consecutive patients ( n = 67, mean age 54 years) who underwent rotator cuff repairs were randomized into an experimental group (EG) or a usual care group (UCG). Interventions: The UCG received ordinary postoperative instructions, while the EG were given advice and instructions on a shoulder muscle strengthening programme to be undertaken at home. Main measures: Disability was assessed with the American Shoulder and Elbow Surge…

sj-docx-2-cre-10.1177_02692155231170687 - Supplemental material for Neck–Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial

Supplemental material, sj-docx-2-cre-10.1177_02692155231170687 for Neck–Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial by Marjo Rinne, Sanna Garam and Katriina Kukkonen-Harjula, Kari Tokola, Arja Häkkinen, Jari Ylinen, Riku Nikander in Clinical Rehabilitation

Type of surgery is associated with pain and walking difficulties among older people with previous hip fracture

Aim The aim was to assess the level of lower body pain among people with previous femoral neck fracture, and whether the type of surgery was associated with pain and physical function a mean of 2 years after surgery. Methods The study included 115 community-dwelling older adults aged 60 years and older with previous femoral neck fracture, and 31 reference subjects without previous lower limb injuries. A total of 30 patients had internal fixation surgery, 70 had hemiarthroplasty and 15 had total hip replacement. All patients had surgery in the same hospital and received typical inpatient rehabilitation. From 1.6 months to 7.5 years after the fracture, the patients underwent examination inclu…

Psychometric Properties Of The Finnish Version Of The Locomotor Capabilities Index-5

Core muscle activation during dynamic upper limb exercises in women.

Although several everyday functions and sporting activities demand controlled use of the abdominal and back muscles while working with the upper limbs, the activity of core muscles during dynamic upper limb exercises in the standing position has not been studied extensively. The purpose of this cross-sectional study was to examine abdominal and back muscle activity during dynamic upper limb exercises while standing and to evaluate whether dynamic exercises are appropriate for strengthening muscles. The activation of the rectus abdominis, obliquus externus abdominis, longissimus, and multifidus muscles during dynamic bilateral or unilateral shoulder exercises with or without fixation of the …

DEPS-testin luotettavuus ja pätevyys aikuisilla selkäpotilailla

The Depression Scale (DEPS) is a patient-reported outcome instrument developed to recognize depressive symptoms. This study measured the psychometric properties of the DEPS among patients with degenerative spinal disease. Altogether 637 patients were included in the analysis. Main research question was whether the DEPS would meet pertinent psychometric criteria for reliability and validity. The results of analyses supported the DEPS instrument as a reliable and valid test to measure depressive symptoms among adult patients with spinal disease fulfilling the psychometric criteria. nonPeerReviewed

Scoliosis Research Society (SRS-30) kyselykaavakkeen pätevyys selkä- ja alaraajakipuisilla aikuispotilailla

Scoliosis Research Society questionnaire version 30 (SRS-30) has originally been developed to measure disability and health related quality of life in patients with adolescent idiopathic scoliosis but it has proven valid also in adults with degenerative spinal disease. Degenerative spine disease has many phases and manifestations including disc degeneration, spondylarthrosis, spondylolistheses and compromise to neural tissue. The aim of this study was to test whether the SRS-30 questionnaire is valid in adults with different sources of pain: local back pain, radicular pain or their combination. Structural analysis of the SRS-30 and comparison with RAND-36 and ODI was performed. The deformit…

Psychometric Properties of the Scoliosis Research Society Questionnaire (Version 22r) Domains Among Adults With Spinal Deformity : A Rasch Measurement Theory Analysis

Objective: Adults with degenerative spinal deformity (ASD) have lower health-related quality of life (HRQL) compared to the general population. Applying Rasch Measurement Theory (RMT), this study tested the revised Scoliosis Research Society-22 (SRS-22r) HRQL instrument among symptomatic adult patients with degenerative spinal disorders and varying degrees of ASD. Methods: SRS-22r data from 637 outpatient spine clinic patients with degenerative spine conditions were investigated for unidimensionality, item/scale fit, differential item functioning (DIF), scale coverage/targeting, and person separation index (PSI) using RMT. Results: Unidimensionality of the SRS-22r was not supported for eith…

Reduced Neck Muscle Strength and Altered Muscle Mechanical Properties in Cervical Dystonia Following Botulinum Neurotoxin Injections : A Prospective Study

Cervical dystonia (CD) is a focal dystonia causing involuntary activation of neck and shoulder muscles resulting in abnormal, sustained and painful posturing that may lead to physical disability and social withdrawal [1]. In recent years, botulinum neurotoxin (BoNT) has become the first line therapy for CD [2]. A subjective feeling of neck weakness has been reported as one of the most common localized adverse events of BoNT [2-7]. In clinical practice, this may sometimes be reported as having difficulty keeping the head upright. Although the effects of BoNT have been widely studied [2,5], there have been no prospective studies quantifying changes in maximal isometric neck muscle strength. O…

Maximal force, force/time and activation/coactivation characteristics of the neck muscles in extension and flexion in healthy men and women at different ages

This study examined the force production characteristics, activation/coactivation and endurance capacity of the neck extension and flexion muscles in healthy men (n=29) and women (n=28) divided into three age groups (18–26 years, 30–37 years and 45–55 years). Force and electromyography (EMG) measurements were performed during the maximal voluntary isometric extension and flexion actions. This was followed by an endurance test (ET; 60% force level of maximal voluntary contraction sustained until exhaustion), after which the force and EMG recordings were repeated. Men were both stronger and had higher values (P<0.001) for explosive force (rate of force development, RFD) than women in both act…

Structural validity of the Boston Carpal Tunnel Questionnaire and its short version, the 6-Item CTS symptoms scale : a Rasch analysis one year after surgery

Abstract Background: The Boston Carpal Tunnel Questionnaire (BCTQ) and its shorter version, the Six-Item Carpal Tunnel Symptoms Scale (CTS-6), are widely used for assessing function and/or symptoms in patients with carpal tunnel syndrome. This study examined the structural validity of the BCTQ and CTS-6 among patients who had undergone surgery for treatment of carpal tunnel syndrome. Methods: The data for this cross-sectional analysis were obtained from 217 adult patients who had undergone carpal tunnel release surgery one year earlier. All patients completed the CTS-6, Symptom Severity Scale (SSS) and Functional Status Scale (FSS) of the BCTQ at 12 months after surgery. The Rasch Measureme…

Efficacy of a 12-month, monitored home exercise programme compared with normal care commencing 2 months after total knee arthroplasty: A randomized controlled trial

Objective: To evaluate the efficacy of a delayed home exercise programme compared with normal care after primary total knee arthroplasty. Design: Single-blind, prospective, randomized, controlled trial. Participants: A total of 108 participants (61% females, mean age 69 years [standard deviation 8.7]), were randomized to a home-based exercise group (EG, n=53) or to a control group (CG, n=55). Methods: Two months post-operatively, the EG received a home exercise programme, while the CG received no additional guidance. The outcome measurements were: pain and disability, measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC); healthrelated quality of life (HR…

Enhanced rehabilitation guidance after arthroscopic capsulolabral repair of the shoulder : a randomized controlled trial

Objective: To compare the effects of a 12-month home-based exercise program to usual care in patients after arthroscopic capsulolabral repair of the shoulder. Design: Randomized controlled trial. Setting: Outpatient physical and rehabilitation medicine clinic. Subjects: Forty-five patients (mean age: 35 years; standard deviation (SD): 10 years) who underwent arthroscopic capsulolabral repair due to labral lesion were randomized into an exercise group (EG) or a control group (CG). Intervention: The EG received a 12-month home-based additional exercise program with four physiotherapy follow-up visits, while the CG received standard postoperative exercise instructions. Main measures: Self-repo…

Reproducibility of isometric strength: measurement of neck muscles

Abstract Objective. To evaluate the repeatability of an advanced method of measuring the strength of functionally different groups of neck muscles using an isometric apparatus. Design. A repeated measures design was used within and between sessions. Background. Chronic neck pain has been associated with poor isometric neck strength. In rehabilitation, strength measurements may thus help to evaluate the basic condition and show whether or not treatments and exercises have been beneficial for improving strength. Previous tests have concentrated on testing strength while trying to bend forwards and backwards, but no biomechanics device, able to test rotator muscles, has been presented. Method.…

Reliability and Validity Study of the Finnish Adaptation of Scoliosis Research Society Questionnaire Version SRS-30

Study design A prospective clinical study to test and adapt a Finnish version of the Scoliosis Research Society 30 (SRS-30) questionnaire. Objective The aim of this study was to perform cross-cultural adaptation and evaluate the validity of the adapted Finnish version of the SRS-30 questionnaire. Summary of background data The SRS-30 questionnaire has proved to be a valid instrument in evaluating health-related quality of life (HRQoL) in adolescent and adult population with spine deformities in the United States. Multinational availability requires cross-cultural and linguistic adaptation and validation of the instrument. Methods The SRS-30 was translated into Finnish using accepted methods…

sj-pdf-1-cre-10.1177_02692155231170687 - Supplemental material for Neck–Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial

Supplemental material, sj-pdf-1-cre-10.1177_02692155231170687 for Neck–Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial by Marjo Rinne, Sanna Garam and Katriina Kukkonen-Harjula, Kari Tokola, Arja Häkkinen, Jari Ylinen, Riku Nikander in Clinical Rehabilitation

Spinopelvic changes based on the simplified SRS-Schwab adult spinal deformity classification: relationships with disability and health-related quality of life in adult patients with prolonged degenerative spinal disorders

Study design Cross-sectional, observational study. Objective To study the occurrence of sagittal malalignment, the adaptability of a simplified sagittal modifiers grading of the Scoliosis Research Society (SRS)-Schwab adult spinal deformity (ASD) classification, and the deformity-specific SRS questionnaire version 30 (SRS-30) in an unselected adult cohort with symptomatic degenerative spinal disorders. Summary of background data The sagittal modifiers of the SRS-Schwab ASD classification correlate with health-related quality of life (HRQoL) measures in patients with ASD. The deformities and disabilities caused by sagittal malalignment in patients with common degenerative spinal disorders of…

Intra- and inter-rater reliability of thoracic spine mobility and posture assessments in subjects with thoracic spine pain

Abstract Background The thoracic spine (TS) has been neglected in the study of the spine despite its essential role in the stability and posture of the entire spinal complex. Therefore, there is an inevitable need to investigate the reproducibility of different thoracic spinal posture measures used in subjects with TS pain. Methods Thirty-two subjects (16 females and 16 males, mean age 39 years) were evaluated by two physiotherapists on the same day to gauge inter-rater reliability and on two consecutive days to gauge intra-rater reliability. TS posture was assessed by observation, and thoracic spine mobility was measured by manual assessment of segmental flexion and extension mobility in a…

Decreased neck muscle strength is highly associated with pain in cervical dystonia patients treated with botulinum toxin injections11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

Abstract Hakkinen A, Ylinen J, Rinta-Keturi M, Talvitie U, Kautiainen H, Rissanen A. Decreased neck muscle strength is highly associated with pain in cervical dystonia patients treated with botulinum toxin injections. Arch Phys Med Rehabil 2004;85:1684–8. Objectives To compare the isometric neck muscle strength of cervical dystonia patients treated with botulinum toxin injections with that of healthy control subjects and to evaluate the association between neck strength, neck pain, and disability in these patients. Design Clinical cross-sectional study. Setting Outpatient rehabilitation and neurology clinics in a Finnish hospital. Participants Twenty-three patients with cervical dystonia wi…

Reoperations after first lumbar disc herniation surgery; a special interest on residives during a 5-year follow-up

Abstract Background The overall rate of operations after recurrent lumbar disc herniation has been shown to be 3–11%. However, little is known about the rate of residives. Thus the aim of this study was to explore the cumulative rates of re-operations and especially residive disc herniations at the same side and level as the primary disc herniation after first lumbar disc herniation surgery and the factors that influence the risk of re-operations over a five year follow-up study. Methods 166 virgin lumbar disc herniation patients (mean age 42 years, 57% males) were studied. Data on patients' initial disc operations and type and timing of re-operations during the follow-up were collected fro…

Strength training and stretching versus stretching only in the treatment of patients with chronic neck pain: a randomized one-year follow-up study

Objective: To compare the effectiveness of a 12-month home-based combined strength training and stretching programme against stretching alone in the treatment of chronic neck pain. Design: A randomized follow-up study. Participants: One hundred and one patients with chronic non-specific neck pain were randomized in two groups. Intervention: The strength training and stretching group was supported by 10 group training sessions and the stretching group was instructed to perform stretching exercises only as instructed in one group session. Main outcome measurements: Neck pain, disability, neck muscle strength and mobility of cervical spine were measured before and after the intervention. Resu…

Muscle strength and range of movement deficits 1 year after hip resurfacing surgery using posterior approach.

The aim was to evaluate the effect of the posterior surgical approach on hip muscle strength and range of movement (ROM).Maximal isometric external and internal rotator strength of the hip muscles and bilateral leg extension strength were measured by dynamometers. Active (AROM) and passive (PROM) range of motion of the hip were measured by goniometers in 30 patients before and 3, 6 and 12 months after hip resurfacing. Postoperatively the patients were advised to return to their usual physical activities.Prior to the surgery internal rotation strength was on the same level on both sides, whereas external rotation strength of the operated hip was 26% (p0.001) lower compared with the unoperate…

Axial neck rotation strength in neutral and prerotated postures.

Abstract Objective. To characterize isometric rotation strength in the neutral and in different prerotated positions of the neck. Design. This was a descriptive study involving maximal isometric strength measurements of the cervical musculature. Background. The literature contains only a few studies pertaining to strength levels of the neck rotator muscles in the neutral position. None of these studies have dealt in detail with maximal neck strength in selected prerotation positions. Method. Twenty healthy men volunteered as subjects. Maximal axial rotation strength of the neck muscles was measured in a neutral position and bilaterally at 30° and 60° rotation using the isometric neck streng…

sj-pdf-1-cre-10.1177_02692155231170687 - Supplemental material for Neck–Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial

Supplemental material, sj-pdf-1-cre-10.1177_02692155231170687 for Neck–Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial by Marjo Rinne, Sanna Garam and Katriina Kukkonen-Harjula, Kari Tokola, Arja Häkkinen, Jari Ylinen, Riku Nikander in Clinical Rehabilitation

Acute effects of cold pack on mechanical properties of the quadriceps muscle in healthy subjects.

Purpose: To examine the effects of local cooling on mechanical properties of the quadriceps muscle in healthy subjects. Subjects: Thirty-nine healthy subjects (27 women, 12 men, mean age 39, range 20e62) volunteered. Methods: A cold gel pack was applied to the quadriceps muscle for 20 min. Properties were quantified by analyzing the frequency (tension), decrement (elasticity) and stiffness of damped oscillations and the compliance of the muscle before, immediately after and after 15-min after cooling. Results: The largest responses immediately after cooling were seen in the oscillation decrement parameter, 7.9 (3.7e12.1) %, and in the compliance parameter, � 7.5 (� 9.8 to � 5.3) %. Response…

Pulsed electromagnetic field therapy in the treatment of pain and other symptoms in fibromyalgia : a randomized controlled study

Low-energy pulsed electromagnetic field (PEMF) therapy has been suggested as a promising therapy to increase microcirculation, which is of great concern in patients with fibromyalgia. This study evaluated the effectiveness of PEMF therapy on the treatment of fibromyalgia. A group of 108 women with fibromyalgia were allocated to a 12-week treatment period with an active Bio-Electro-Magnetic-Energy-Regulation (BEMER) device and a similar treatment period with an inactive device. Each patient received active and sham treatments in a random order. Pain and stiffness were assessed on a visual analog scale (VAS, scale 0-100mm), and functional status was assessed by the Fibromyalgia Impact Questio…

Effect of biomechanical footwear on upper and lower leg muscle activity in comparison with knee brace and normal walking

Abstract Aim To evaluate the activity of knee stabilizing muscles while using custom-made biomechanical footwear (BF) and to compare it when walking barefoot and with a knee brace (Unloader®). Methods Seventeen healthy working-aged (mean age: 29 years; standard deviation: 8 years) individuals participated. The knee brace was worn on the right knee and BF in both legs. Surface electromyography (sEMG) data was recorded bilaterally from vastus medialis (VM), semitendinosus (ST), tibialis anterior (TA) and lateral gastrocnemius (LG) muscles during walking, and repeated-measures ANOVA with a post-hoc t-test was used to determine differences between the different walking modalities (barefoot, bra…

Reliability and validity of the Finnish version of the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, patient self-report section

Background The American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) is one of the most widely used shoulder outcome tools in clinical work and in scientific studies. However, it has not been validated in the Finnish language. The aims of this study were to cross-culturally adapt the ASES to the Finnish language and to study the psychometric properties of the self-report section of the ASES. Methods A total of 105 patients with shoulder symptoms answered the questionnaires of the ASES, a single disability question, the Simple Shoulder Test (SST), and the Short-Form 36 Health Survey (SF-36). The reliability of the ASES questionnaire was studied using a test-retest…

Neutral Spine Control Exercises in Rehabilitation After Lumbar Spine Fusion

Lumbar spine fusion (LSF) has been reported to change the biomechanics of the spine and therefore the rehabilitation after LSF is important. In this study, the effect of selected neutral spine control exercises on activation of trunk muscles after LSF was evaluated. Muscle activity was measured by surface electromyography of the rectus abdominis, external oblique, longissimus, and multifidus muscles during 6 exercises in 22 LSF patients (mean age = 59 years; age range = 25-84 years; 50% women). Muscle activity concurrent with trunk flexion and extension during maximal voluntary isometric contraction (MVIC) was used as a reference value. Pain during the effort was assessed with a visual anal…

Effectiveness of postoperative home-exercise compared with usual care on kinesiophobia and physical activity in spondylolisthesis:A randomized controlled trial

Objective: To study the effectiveness of a 12-month exercise therapy on kinesiophobia and physical activity in patients with spondylolisthesis after lumbar spine fusion. Design: Randomized controlled trial. Subjects: Patients (n = 98) with spondylolisthesis who had undergone lumbar spine fusion. Methods: All patients (mean age 59 years) had received lumbar spine fusion surgery and identical postoperative instructions. Three months postoperatively, they were randomized into an exercise group (n = 48) or usual care group (n = 50). The exercise group received 12-month progressive home-based training with regular booster sessions, and the usual care group a single session of physiotherapy instr…

External rotation strength deficit after hip resurfacing surgery.

The aim was to assess the effect of resurfacing hip arthroplasty on hip muscle function, when, in the posterior approach, the piriformis tendon and outer rotators of the hip joint were divided. The unoperated side was used as a control.Thirty-three consecutive patients (mean age 55 years, 73% males) were operated using the posterior approach. Main outcome measures were isometric muscle strength of external and internal rotators and extensors of the hip and hip pain.Hip external rotation strength (p0.001) and leg extension strength (p0.001) were significantly lower on the operated side compared with the un-operated side prior to the surgery. On the operated side external rotation strength de…

Effects of long-term home-based exercise on health-related quality of life in patients with chronic neck pain: A randomized study with a 1-year follow-up.

To evaluate whether long-term neck and upper body exercises conducted in economical community-based outpatient clinic and home-based settings could improve health-related quality of life (HRQoL)for individuals affected by chronic neck pain. The effect of baseline HRQoL and neck pain values on training adherence was also studied.Subjects (n = 101, 91 women/10 men, mean age 41.0 ± 9.5 years) with chronic non-specific neck pain were randomized to a combined strength-training and stretching-exercise group (CSSG, n = 49) or to a stretching exercise group (SG, n = 52). HRQoL was assessed at baseline and after 12 months using the RAND-36 questionnaire. Comparisons between groups were performed usi…

Muscle tone in different joint positions and at submaximal isometric torque levels

The aim was to evaluate the tone and electric activity of the quadriceps muscle at rest and different torque levels. The second aim was to study whether thickness of soft tissues and change in the joint position would affect muscle tone. Eighteen healthy subjects participated. Computerized muscle tonometer (CMT) and surface electromyography (sEMG) measurements were performed: seated, first at rest with leg straight and then with the knee at 60 degrees . Thereafter measurements were obtained at levels of 80, 60, 40 and 20% of the maximum isometric torque at the same knee angle. Thickness of skin, subcutis and muscle was measured by ultrasound. The CMT values taken were the depth the indenter…

The relationship between functional disability and health-related quality of life in patients with a rotator cuff tear

To determine the relationship between functional disability and health-related quality of life (HRQoL) in rotator cuff tear (RCT) patients.In 67 RCT patients (mean age, 54 years; 57% males), functional disability was self-reported with the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), HRQoL with the Short-Form 36 Health Survey (SF-36), and pain by visual analogue scale. ASES results were divided into tertiles (12-38, 39-51, and 52-82).Mean ASES score was 48 (range, 12-82). Patients with the highest functional disability and highest pain level had the lowest HRQoL. For the highest, middle, and lowest ASES categories, respectively, mean SF-36 Physical Comp…

Rasch validation of the Depression Scale among patients with low back pain.

BACKGROUND: The Depression Scale (DEPS) is a commonly used screening tool for major depression in studies investigating low back pain, yet it has not been validated for patients with back-specific problems. OBJECTIVE: To assess the psychometric properties of the DEPS in patients with degenerative spinal disease. METHODS: Six hundred and thirty-seven patients with a degenerative spinal disease completed the DEPS instrument. The Rasch Measurement Theory was applied to analyze the measurement properties of the DEPS. The main hypothesis-driven approach was whether the DEPS would meet relevant psychometric criteria for assessing depressive symptoms among patients with degenerative spinal disease…

Effect of neck strength training on health-related quality of life in females with chronic neck pain: a randomized controlled 1-year follow-up study

Abstract Background Chronic neck pain is a common condition associated not only with a decrease in neck muscle strength, but also with decrease in health-related quality of life (HRQoL). While neck strength training has been shown to be effective in improving neck muscle strength and reducing neck pain, HRQoL among patients with neck pain has been reported as an outcome in only two short-term exercise intervention studies. Thus, reports on the influence of a long-term neck strength training intervention on HRQoL among patients with chronic neck pain have been lacking. This study reports the effect of one-year neck strength training on HRQoL in females with chronic neck pain. Methods One hun…

Isometric endurance test of the cervical flexor muscles - Reliability and normative reference values.

Abstract Objective To obtain reference values for the isometric endurance test (IET) of the cervical flexor muscles, investigate its reproducibility, and compare the results with the maximal isometric strength test (MIST) of the cervical flexor muscles. Design Cross-sectional non-comparative study with single group repeated measurements. Methods Altogether 219 healthy females aged 20–59 years volunteered to participate in the study. The IET was performed in the supine position and MIST seated. The reproducibility was evaluated by the intraclass correlation coefficient (ICC) and an analysis described by Bland and Altman. The relationship between the two measuring methods was evaluated by Pea…

Neck–Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial

Objectives We investigated whether a specific exercise program for the neck–shoulder region reduces headache intensity, frequency, and duration, and how it influences neck disability among women with chronic headache compared to a control group. Design Two-center randomized controlled trial. Subjects 116 working-age women. Intervention The exercise group (n = 57) performed a home-based program with six progressive exercise modules, over 6 months. The control group (n = 59) underwent six placebo-dosed transcutaneous electrical nerve stimulation sessions. Both groups performed stretching exercises. Main measures The primary outcome was pain intensity of headache, assessed using the Numeric Pa…

Trunk Muscle Strength After Lumbar Spine Fusion: A 12-Month Follow-up.

Objective: The aim of this study was to investigate changes in trunk muscle strength 12 months after lumbar spine fusion (LSF) compared to preoperative strength. Methods: A total of 194 patients (mean ± standard deviation [SD] age, 61 ± 21 years) who underwent LSF participated in this prospective longitudinal study. Physical measurements of the participants were made before surgery and 12 months postoperatively. Isometric trunk extension and flexion strength was measured using a strain-gauge dynamometer in the standing position. Strength changes were calculated. Regression analysis was performed to explore which factors predicted strength levels at 12 months postoperatively. Results: The pr…

NEUROMUSCULAR PERFORMANCE CHARACTERISTICS OF OPEN-WHEEL AND RALLY DRIVERS

The purpose of the present study was to investigate neuromuscular performance characteristics in open-wheel and rally drivers using the cross-sectional study design. The subjects (N = 28) consisted of experienced international-level open-wheel drivers (n = 9), experienced international-level rally drivers (n = 9) and a physically active nondriving male control group (n = 10). In 3 separate test sessions, speed, muscle strength, and endurance tests were performed. The rally drivers had higher (p < 0.05) grip, shoulder flexion, and ankle plantar flexion strength, as compared to the control group. The open-wheel drivers showed higher strengths (p < 0.05) than the controls in neck forces, grip,…

Lower thoracic spine extension mobility is associated with higher intensity of thoracic spine pain

Objectives: To evaluate the association of thoracic spine (TS) posture and mobility with TS pain. Methods: Participants with TS pain reported maximum, average, and night pain in TS area, and pain summary score was calculated. Upright and sitting TS postures were evaluated by inspection. TS posture and mobility (flexion and extension) were recorded using an inclinometer and a tape measure, respectively. Correlations between posture and mobility assessments were calculated using Spearman rank correlation, the association of TS posture and mobility with TS pain by logistic regression analysis. Results: The participants’ (n = 73, 52 females, age range 22–56) TS pain duration was 12 weeks on ave…

Further validation of the Scoliosis Research Society (SRS-30) questionnaire among adult patients with degenerative spinal disorder.

Purpose The Scoliosis Research Society (SRS-30) questionnaire proved valid in measuring health-related quality of life (HRQoL) in adult patients with spinal deformity or degenerative disease. This study further assesses the validity of the SRS-30 by comparing its results with other HRQoL instruments, such as Oswestry disability index (ODI) and the RAND-36, among unselected adult patients with degenerative spinal disorder. Materials and methods 628 consecutive patients completed the SRS-30, the ODI, the pain visual analog scale (VAS), and RAND-36 questionnaires. Using a 9 mm minimal important difference threshold of the VAS, patients were divided into three groups of symptom location: back p…

Use of conservative therapy before and after surgery for carpal tunnel syndrome

Abstract Background Conservative therapies are typically offered to individuals who experience mild or intermittent symptoms of carpal tunnel syndrome (CTS) or postoperatively to subjects who have undergone carpal tunnel release. Although long-term studies report mostly positive results for carpal tunnel release, knowledge on the need for conservative treatments following surgery is scarce. The aim of this retrospective cohort study was to examine the use of conservative therapies before and after carpal tunnel releasing surgery. Methods Of 528 patients who underwent carpal tunnel release surgery in the study hospital during the study period, 259 provided sufficiently completed questionnair…

Pulsed electromagnetic field therapy in the treatment of pain and other symptoms in fibromyalgia: A randomized controlled study

Low-energy pulsed electromagnetic field (PEMF) therapy has been suggested as a promising therapy to increase microcirculation, which is of great concern in patients with fibromyalgia. This study evaluated the effectiveness of PEMF therapy on the treatment of fibromyalgia. A group of 108 women with fibromyalgia were allocated to a 12-week treatment period with an active Bio-Electro-Magnetic-Energy-Regulation (BEMER) device and a similar treatment period with an inactive device. Each patient received active and sham treatments in a random order. Pain and stiffness were assessed on a visual analog scale (VAS, scale 0-100 mm), and functional status was assessed by the Fibromyalgia Impact Questi…

Assessment of Construct Validity of the Oswestry Disability Index and the Scoliosis Research Society–30 Questionnaire (SRS-30) in Patients With Degenerative Spinal Disease

Observational cohort study.To measure and compare the structural validity of the Oswestry Disability Index (ODI) and the Scoliosis Research Society-30 (SRS-30) questionnaire in an adult population with prolonged degenerative thoracolumbar disease.The ODI and the SRS-30 are commonly used patient-reported outcome instruments to assess back-specific disability and symptoms related to scoliosis. Still, these instruments have not been validated for degenerative spinal disease with different stages of deformity.Altogether, 637 consecutive adult patients with degenerative spinal pathologies were included. The patients completed the ODI (version 2.0), the 23 preoperative items of the SRS-30, a gene…

The effect of thoracic spine manipulation on thoracic spine pain and mobility – Preliminary results of RCT