Journal of back and musculoskeletal rehabilitation
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J Back Musculoskelet Rehabil · Jan 2010
Three-dimensional gait analysis of patients with weakness of ankle dorsiflexor as a result of unilateral L5 radiculopathy.
L5 radiculopathy leads to weakness in ankle dorsiflexor, which can further affect ambulation status. The purpose of this study was to investigate the characteristics of gait patterns associated with L5 radiculopathy. ⋯ The pelvis of intact side was tilted downward due to hip abductor weakness of involved side in the stance phase whereas the pelvis of involved side was tilted upward for foot clearance in the swing phase. This contributed to increase in hip adduction of the involved side through the gait cycle. Eccentric contraction of ankle dorsiflexion that normally occurred in the loading response and the early swing phase was not sufficient and, therefore, ankle dorsiflexion was decreased in these gait cycles.
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J Back Musculoskelet Rehabil · Jan 2010
Case ReportsImportance of fear-avoidance behavior in chronic non-specific low back pain.
International classification of Functioning, Disability and Health has adapted a biopsychosocial model for management of chronic low back pain patient (CLBP). The influence of psychological factors seems to be important in the transition from acute to chronic low back pain (> 3 months). In particular, pain-related fear and pain catastrophizing are believed to be important factors for disability. ⋯ After a few weekly therapeutic sessions of CBT, significant changes were seen in all outcome measures. It has been concluded that probably, by using specific biopsychosocial training, positive results in fear avoidance behavior can be achieved. Hence the psychotherapeutic management approach is considered as a useful economical tool in low back pain.
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J Back Musculoskelet Rehabil · Jan 2010
Case ReportsChanges in a patient with neck pain after application of ischemic compression as a trigger point therapy.
To describe the immediate effects of ischemic compression (IC) as a trigger point therapy in a case of a patient with neck pain. The application of IC is a safe and effective method to successfully treat elicited myofascial trigger points. The purpose of this method is to deliberate the blockage of blood in a trigger point area in order to increase local blood flow. This washes away waste products, supplies necessary oxygen and helps the affected tissue to heal. In this case study, we treated a 27-year-old female patient with a medical report of neck pain for at least four months. The physical examination revealed a neck pain and stiffness at the left side and pain increases when moving the neck. An active myofascial trigger point was found in the left trapezius muscle. The following data were recorded: active range of motion of cervical rachis measured with a cervical range of motion instrument, basal electrical activity of the left trapezius measured with electromyography, and pressure tolerance of the myofascial trigger point measured with visual analogue scale, assessing local pain evoked by the application of 2.5 kg/cm2 pressure with an analogue algometer. ⋯ In this case of a patient with neck pain, active range of motion of cervical rachis, basal electrical activity of the trapezius muscle and myofascial trigger point sensitivity gaining short-term positive effects with the application of one single ischemic compression session. Nevertheless, randomized controlled double-blinded studies should be conducted in future to examine the effectiveness of this ischemic compression technique in case of the presence of myofascial trigger points in the neck.
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J Back Musculoskelet Rehabil · Jan 2010
Patient guided Piezo-electric Extracorporeal Shockwave Therapy as treatment for chronic severe patellar tendinopathy: A pilot study.
Patellar tendinopathy is a common overuse injury for which no evidence-based treatment guidelines exist. Extracorporeal Shock Wave Therapy (ESWT) seems to be an effective treatment for patellar tendinopathy but the most beneficial treatment strategies still need to be ascertained. Aim of this pilot study was to investigate if patient guided Piezo-electric, focused ESWT, without local anesthesia is a safe and well tolerated treatment which improves pain and function in patients with patellar tendinopathy. ⋯ Patient guided Piezo-electric ESWT without local anesthesia is a safe and well tolerated treatment which should be considered as a treatment for patients with patellar tendinopathy.