scholarly journals Reliability of Diaphragmatic Mobility Assessment Using a Real Time Ultrasound Among Non-Specific Low Back Pain.

2017 ◽  
Vol 16 (3) ◽  
pp. 443-447 ◽  
Author(s):  
Vikram Mohan ◽  
Ummi Farhana Hashim ◽  
Sulaiman Md Dom ◽  
Patraporn Sitilerpisan ◽  
Aatit Paungmali
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Real Time ◽  
Medical Science ◽  
Ultrasound Measurement ◽  
Measurement Tool ◽  
Low Back ◽  
Rater Reliability ◽  
Mobility Assessment ◽  
The Right

Background and Objective: Ultrasound measurement of Diaphragmatic Mobility (DM) has been shown to be a reliable measurement tool among healthy subjects. However, the measures of reliability are needed prior to clinical use of this device among Non-Specific Low Back Pain (NS-LBP). Therefore, the aim of the study was to investigate the relative and absolute reliability of DM using Real Time Ultrasound (RTUS) among subjects with NS-LBP.Materials and Methods: Nine subjects with NS-LBP (23.33 ± 1.58) years old were recruited. A qualified examiner performed measurement of DM using RTUS by placing transducer on the right subcostal region in semi-fowler’s position with 30 degree elevation of the trunk. The test-retest measures were re-assessed with 24 hour interval between sessions.Results: There was no systematic errors between the test-retest measures (p>0.05). Intra rater reliability showed ICC value of 0.92, which indicates an excellent reliability. The SEMs of the measurement was 2.56 mm and the MDC of 7.09mm.Conclusion:The RTUS for assessing DM provides an excellent intra-rater reliability which may be used as an assessment technique for clinical evaluation of DM in adults with NS-LBP. The SEMs and MDC reported may also allow for accurate interpretation of DM assessments in NS-LBP.Bangladesh Journal of Medical Science Vol.16(3) 2017 p.443-447

scholarly journals Low Back Pain in Hidradenitis Suppurativa: A Diagnosis Not to Miss!

2018 ◽  
Vol 10 (2) ◽  
pp. 187-189
Author(s):  
Benjamin Schnebert ◽  
Véronique del Marmol ◽  
Farida Benhadou
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Hidradenitis Suppurativa ◽  
Combined Therapy ◽  
Skin Lesions ◽  
Skin Area ◽  
Low Back ◽  
Inflammatory Drugs ◽  
The Right ◽  
Altered Sensitivity

We report the case of a patient suffering from hidradenitis suppurativa since puberty and complaining of chronic low back pain associated to altered sensitivity and muscular weakness in the right leg. A diagnosis of lumbosciatica was confirmed. Symptoms were not relieved after the use of nonsteroidal anti-inflammatory drugs and analgesics. A surgical decompression was then indicated but heavily debated. Indeed, extended inflammatory and fibrotic hidradenitis suppurativa lesions were located regarding the skin area eligible for the proposed surgery. A combined therapy with clindamycine/rifampicin was started and the surgery was postponed. A complete remission of the articular symptoms was observed 1 month after the start of the antibiotherapy and the inflammatory skin lesions were greatly improved. With the presentation of this clinical case, we would like to discuss the spectrum of rheumatic disorders associated to hidradenitis suppurativa that needs to be correctly diagnosed and taken into consideration in the therapeutic management of the patient.

scholarly journals Movement Control Impairment and Low Back Pain: State of the Art of Diagnostic Framing

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 548 ◽  
Author(s):  
Salvioli ◽  
Pozzi ◽  
Testa
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
State Of The Art ◽  
Movement Control ◽  
Knee Extension ◽  
Cochrane Library ◽  
Low Back ◽  
Validity And Reliability ◽  
Property A ◽  
Rater Reliability

Background and objectives: Low back pain is one of the most common health problems. In 85% of cases, it is not possible to identify a specific cause, and it is therefore called Non-Specific Low Back Pain (NSLBP). Among the various attempted classifications, the subgroup of patients with impairment of motor control of the lower back (MCI) is between the most studied. The objective of this systematic review is to summarize the results from trials about validity and reliability of clinical tests aimed to identify MCI in the NSLBP population. Materials and Methods: The MEDLINE, Cochrane Library, and MedNar databases have been searched until May 2018. The criteria for inclusion were clinical trials about evaluation methods that are affordable and applicable in a usual clinical setting and conducted on populations aged > 18 years. A single author summarized data in synoptic tables relating to the clinical property; a second reviewer intervened in case of doubts about the relevance of the studies. Results: 13 primary studies met the inclusion criteria: 10 investigated inter-rater reliability, 4 investigated intra-rater reliability, and 6 investigated validity for a total of 23 tests (including one cluster of tests). Inter-rater reliability is widely studied, and there are tests with good, consistent, and substantial values (waiter’s bow, prone hip extension, sitting knee extension, and one leg stance). Intra-rater reliability has been less investigated, and no test have been studied for more than one author. The results of the few studies about validity aim to discriminate only the presence or absence of LBP in the samples. Conclusions: At the state of the art, results related to reliability support the clinical use of the identified tests. No conclusions can be drawn about validity.

scholarly journals The Anatomy of the Lateral Branches of the Sacral Dorsal Rami: Implications for Radiofrequency Ablation

2014 ◽  
Vol 5;17 (5;9) ◽  
pp. 459-464
Author(s):  
Joseph Fortin
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Radiofrequency Ablation ◽  
Sacroiliac Joint ◽  
Low Back ◽  
Sacral Foramina ◽  
Dorsal Rami ◽  
Lateral Branches ◽  
The Right ◽  
Segmental Innervation

Background: The sacroiliac joint (SIJ) is a major source of pain in patients with chronic low back pain. Radiofrequency ablation (RFA) of the lateral branches of the dorsal sacral rami that supply the joint is a treatment option gaining considerable attention. However, the position of the lateral branches (commonly targeted with RFA) is variable and the segmental innervation to the SIJ is not well understood. Objectives: Our objective was to clarify the lateral branches’ innervation of the SIJ and their specific locations in relation to the dorsal sacral foramina, which are the standard RFA landmark. Methods: Dissections and photography of the L5 to S4 sacral dorsal rami were performed on 12 hemipelves from 9 donated cadaveric specimens. Results: There was a broad range of exit points from the dorsal sacral foramina: ranging from 12:00 – 6:00 position on the right side and 6:00 – 12:00 on the left positions. Nine of 12 of the hemipelves showed anastomosing branches from L5 dorsal rami to the S1 lateral plexus. Limitations: The limitations of this study include the use of a posterior approach to the pelvic dissection only, thus discounting any possible nerve contribution to the anterior aspect of the SIJ, as well as the possible destruction of some L5 or sacral dorsal rami branches with the removal of the ligaments and muscles of the low back. Conclusion: Widespread variability of lateral branch exit points from the dorsal sacral foramen and possible contributions from L5 dorsal rami and superior gluteal nerve were disclosed by the current study. Hence, SIJ RFA treatment approaches need to incorporate techniques which address the diverse SIJ innervation. Key words: Sacroiliac joint pain, radiofrequency ablation, dorsal sacral rami, low back pain

scholarly journals Deficits in the Star Excursion Balance Test and Golf Performance in Elite Golfers with Chronic Low Back Pain

2021 ◽  
pp. 229-236
Author(s):  
Yi-Chien Peng ◽  
Chung-Yuan Hsu ◽  
Wen-Tzu Tang
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Golf Swing ◽  
Control Group ◽  
Low Back ◽  
Balance Test ◽  
Star Excursion Balance Test ◽  
Pain Symptoms ◽  
The Right

The purpose of this study was to investigate whether low-handicap elite golfers with chronic low back pain (CLBP) exhibit deficits in dynamic postural control and whether CLBP affects golfers in terms of their golf swing parameters. A total of fifteen Division 1 college golfers were recruited as participants. Of these, six of whom experienced CLBP, while the remaining participants were healthy. In this study, CLBP was defined as experiencing chronic pain symptoms for more than six months. The Star Excursion Balance Test (SEBT) was administered to examine dynamic posture control in both groups. The TrackMan Golf Launch Monitor Simulator was used to collect data on the performance parameters of the swing of the participants. The results for both feet in the medial, lateral, posterior, posteromedial, and posterolateral directions indicated that the CLBP group scored lower than the control group. However, the CLBP group scored higher for the right foot in the anterolateral direction. The parameters for the club speed and ball carry of the CLBP group were lower than those of the control group. Further, the CLBP group exhibited a more upright swing plane relative to the control group. Taken together, our findings suggest that SEBT may be feasible and highly accessible to assess golf swing performance of elite players with CLBP.

scholarly journals An Intramuscular Epidermal Cyst of Erector Spinae Muscles: A Case Report

2020 ◽  
pp. 1-3
Author(s):  
Seung Won Park ◽  
Jong Han Gill ◽  
Myeong Jin Ko ◽  
Seong Hyun Wui ◽  
Seung Won Park
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Subcutaneous Tissue ◽  
Erector Spinae ◽  
Epidermal Cyst ◽  
Low Back ◽  
Palpable Mass ◽  
Spinal Magnetic Resonance Imaging ◽  
Local Tenderness ◽  
The Right

An intramuscular epidermal cyst without subcutaneous involvement is extremely rare. The patient presented with low back pain. Spinal magnetic resonance imaging indicated spindle-shaped mass in the right erector spinae muscles located at L3 to L5 level without any connection with subcutaneous tissue. The patient underwent operation for removal of intramuscular cystic lesion. The tumor was totally removed and pathologically confirmed with epidermal cyst. Unlike typical epidermal cyst, the patient had a characteristic clinical manifestation of mild low back pain without palpable mass and local tenderness.

scholarly journals Gluteus medius muscle function in people with and without low back pain: a systematic review

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Sean Sadler ◽  
Samuel Cassidy ◽  
Benjamin Peterson ◽  
Martin Spink ◽  
Vivienne Chuter
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Muscle Function ◽  
Weight Bearing ◽  
Gluteus Medius ◽  
Measurement Tool ◽  
Low Back ◽  
Case Control Studies ◽  
Gluteus Medius Muscle

Abstract Introduction Globally, low back pain (LBP) is one of the greatest causes of disability. In people with LBP, dysfunction of muscles such as the gluteus medius have been demonstrated to increase spinal loading and reduce spinal stability. Differences in gluteus medius function have been reported in those with LBP compared to those without, although this has only been reported in individual studies. The aim of this systematic review was to determine if adults with a history, or current LBP, demonstrate differences in measures of gluteus medius function when compared to adults without LBP. Methods MEDLINE, EMBASE, AMED, PsycINFO, PubMED, Pro Quest Database, CINAHL and SPORTDiscus were searched from inception until December 2018 for published journal articles and conference abstracts. No language restrictions were applied. Only case-control studies with participants 18 years and over were included. Participants could have had any type and duration of LBP. Studies could have assessed gluteus medius function with any quantifiable clinical assessment or measurement tool, with the participant non-weight bearing or weight bearing, and during static or dynamic activity. Quality appraisal and data extraction were independently performed by two authors. Results The 24 included articles involved 1088 participants with LBP and 998 without LBP. The gluteus medius muscle in participants with LBP tended to demonstrate reduced strength and more trigger points compared to the gluteus medius muscle of those without LBP. The level of activity, fatigability, time to activate, time to peak activation, cross sectional area, and muscle thickness showed unclear results. Meta-analysis was not performed due to the heterogeneity of included studies. Conclusion Clinically, the findings from this systematic review should be considered when assessing and managing patients with LBP. Future studies that clearly define the type and duration of LBP, and prospectively assess gluteus medius muscle function in those with and without LBP are needed. Trial registration PROSPERO (CRD42017076773).

scholarly journals Transversus abdominis and multifidus asymmetry in runners measured by MRI: a cross-sectional study

2019 ◽  
Vol 5 (1) ◽  
pp. e000556
Author(s):  
Ulrike H Mitchell ◽  
A Wayne Johnson ◽  
Patrick J Owen ◽  
Timo Rantalainen ◽  
Daniel Belavy
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Muscle Activation ◽  
Cross Sectional Study ◽  
Transversus Abdominis ◽  
Low Back ◽  
Sectional Study ◽  
Multifidus Muscle ◽  
Cross Sectional ◽  
The Right

ObjectiveThe transversus abdominis muscle (TrA) is active during running as a secondary respiratory muscle and acts, together with the multifidus, as trunk stabiliser. The purpose of this study was to determine size and symmetry of TrA and multifidus muscles at rest and with contraction in endurance runners without low back pain.DesignCross-sectional study.SettingA medical imaging centre in Melbourne, Australia.ParticipantsThirty middle-aged (43years±7) endurance-trained male (n=18) and female (n=12) runners without current or history of low back pain.Outcome measuresMRI at rest and with the core engaged. The TrA and multifidus muscles were measured for thickness and length (TrA) and anteroposterior and mediolateral thickness (multifidus). Muscle activation was extrapolated from rest to contraction and compared with the same and contralateral side. Paired t-tests were performed to compare sides and contraction status.ResultsLeft and right TrA and multifidus demonstrated similar parameters at rest (p>0.05). However, with contraction, the right TrA and multifidus (in mediolateral direction) were 9.2% (p=0.038) and 42% (p<0.001) thicker, respectively, than their counterparts on the left. There was no TrA thickness side difference with contraction in left-handed participants (p=0.985). When stratified by sex, the contracted TrA on the right side remained 8.4% thicker, but it was no longer statistically significant (p=0.134). The side difference with contraction of the TrA became less with increasing training age.ConclusionsRight-handed long-term runners without low back pain exhibit a greater right side core muscle activation when performing an isometric contraction. This activation preference diminishes with increasing training age.

scholarly journals P.001 Transient neurapraxic radiculopathy

2017 ◽  
Vol 44 (S2) ◽  
pp. S14-S14
Author(s):  
SK Baker
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Peak Torque ◽  
Strength Testing ◽  
Low Back ◽  
Neurologic Examination ◽  
Prone Positioning ◽  
History Of ◽  
The Right ◽  
Reversible Reduction

Background: Neurapraxia is considered to be a temporary disorder of peripheral nerve conduction due to trauma that does not cause axonopathy. However, patients with radiculopathy, confirmed by MRI, who may not have active axonal damage with evidence of spontaneous activity may still report transient give-way weaknesss. In the absence of active changes on intramuscular recording a neurophysiologic consultation may fail to substantiate any significant neurologic concern. This report documents and objectifies prone positioning-induced radicular neurapraxic weakness in an elderly man. Methods: An 83-year-old gentleman was referred for neuromuscular evaluation with regards to peripheral neuropathy. He had a history of low back pain and MRI evidence of multilevel DDD and discogenic neuroforaminal narrowing. Strength testing was performed by Biodex evaluation. Routine electrophysiologic assessments were performed. Results: On neurologic examination proximal strength iwas normal with grade 4 dorsiflexion strength. Stocking-glove loss to pinprick was absent. Preliminary objective testing of the right quadriceps revealed a peak torque of 87.1 Nm. Immediately after lying prone for 3 minutes (for paraspinal EMG), his power dropped to 33.7 Nm. Strength fully recovered by 36 hrs. Conclusions: This case documents evidence of a 61% reversible reduction in torque in the right quadriceps after prone lying. Electromyographers need to be cautious with radiculopathy patients during paraspinal testing.

Sign in / Sign up

Export Citation Format

Share Document