Modified Oswestry Disability Index Research Articles

Comparison of Mckenzie approach versus Lumbar Stabilization Exercises in the treatment of chronic low back pain

Introduction: Lumbar stabilization and McKenzie exercises are becoming a popular trend for managing chronic low back pain though it is currently not known whether lumbar stabilization exercises produce better results in improving functional status compared to McKenzie approach. The purpose of this study was to determine the effectiveness of the McKenzie approach versus lumbar stabilization in the treatment of chronic low back pain. Material & Methods: This was a randomized controlled trial. Lottery method was used to randomly divide individuals who fulfilled inclusion criteria into 2 groups. Assessments of the patients were done in OPD. Baseline assessment was done on day 1 and post intervention assessment was done after 2 weeks. A total of 8 treatment sessions spread across 2 weeks were given (4 days per week). Data were assessed at baseline level and post intervention. Data was entered and analysed by SPSS version 21. Results: A total of 28 females and 02 males (mean age of 50.88 ±12.29) participated in the study. After 02 weeks of intervention, both treatment groups showed improvement in decreasing pain and improving functional status. The lumber stabilization group showed significant gains on Numeric Pain Rating Scale and (p=0.001) and Modified Oswestry Disability Index (p=0.001) compared to the Mckenzie group. Conclusion: Patients in both lumber stabilisation and McKenzie groups showed significant improvement, however, the patients in lumbar stabilization group were superior than the patients in McKenzie group on the selected outcomes.

Functional outcome of discectomy in lumbar disc prolapse

Background: Sciatica resulting from a lumbar intervertebral disc prolapse is the most common cause of radicular leg pain in adult working population. It can be treated with both conservative and operative methods. In our study, we have chosen open discectomy as an appropriate mode of surgical treatment for lumbar intervertebral disc prolapse. We assessed the surgical outcomes of patients treated with discectomy in lumbar disc prolapse. Objectives: To compare pre and post-operative back pain and leg pain using Visual Analogue Scale (VAS) and functional outcome using modified Oswestry Disability Index (ODI). Methods: 30 patients were included in this study and were followed up for up to 6 months postoperatively. We assessed the functional outcome of each patient with ODI and VAS post-operatively and at 6 months. Results: We found that males had higher incidence (60%) of disc prolapse. Majority of the patients presented with left sided radiculopathy (60%) and most commonly involving L4-L5 level (76.7%). The mean ODI and VAS score pre-operatively were 59.40±6.07 and 8 respectively, which improved to 15.12±5.15 and 1, respectively at 6 months post-operative follow-up. These were statistically highly significant. Conclusions: Our study established that open discectomy has a satisfactory functional outcome and leads to a significant improvement in the patients’ quality of life.

Outcome of low-grade degenerative spondylolisthesis treated with or without instrumentation

Spondylolisthesis is the anterior translation of cephalad vertebra, in relation to the adjacent caudal vertebra with an intact neural arch. The majority of low-grade listhesis be treated conservatively in the early stages of the disease. In the end, the problem is further compounded by the development of secondary spinal canal stenosis, which leads to the operating room. Therefore, it is necessary to conduct a study to compare the functional and effectiveness of a decompression, with or without instrumentation, for a low-grade, single-level degenerative spondylolisthesis with canal stenosis. Purpose: The study was carried out to compare the functional and clinical outcome of low-grade degenerative spondylolisthesis with a secondary canal stenosis, with or without the instrument. Methods: 40 patients were enrolled and assigned into instrumented or non-instrumented group, 20 patients in each group. The outcome measures were (1) The visual analogue scale to assess the clinical outcome and (2) the Modified Oswestry Disability Index to assess the functional outcome. Results: The improvement in VAS for low back ache was greater in the instrumented group than in the non-instrumented group (91.3% vs 90.5%) with no significant differences (p

Comparing the efficacy of two different temperature stimulation in warm acupuncture on acute low back pain: A randomized controlled trial

BackgroundWarm acupuncture, a combination of the mechanical stimulation of acupuncture and thermal stimulation of moxibustion, is commonly used in treating acute low back pain (LBP). This trial aimed to compare the efficacy of stronger (above 43°C) and weaker (above 40°C) heat stimulation in warm acupuncture on the function and pain in patients with acute LBP due to lumbosacral disc degeneration (LDD). MethodsOne hundred and fifty-nine adults were randomly assigned to receive warm acupuncture treatment with silver needle (SvN) or with stainless steel needle (SSN) (1:1). Both groups received a 3-week therapy with 3 sessions per week. The primary outcome was the modified Oswestry Disability Index at week 4. The secondary outcomes included average pain, three physical sign tests and adverse events. Participants were followed up at week 16 and week 28 after randomization. ResultsThe LBP related disability and pain intensity significantly relieved more in the SvN warm acupuncture group than in the SSN group, in both the short and long term (p<0.001). The between-groups difference in physical signs showed statistical significance only in the short term (p = 0.024), but not in long term (p = 0.081; p = 0.069). ConclusionCompared with warm acupuncture with stainless-steel needle at above 40°C, warm acupuncture with silver needle at above 43°C relieved more disability and pain in patients with acute LBP due to LDD. Study registrationChinese Clinical Trial Registry, ChiCTR1800019051.

English

BACKGROUND Operative treatment and fusion for isthmic spondylolisthesis can be achieved by various fusion techniques such as posterolateral fusion (PLF), anterior lumbar interbody fusion (ALIF), posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF) and circumferential fusion. The purpose of this study is to evaluate the clinical outcome and radiological correction achieved after TLIF and assess the correlation between them if any. METHODS This is a retrospective cohort study analysing 30 cases of adult isthmic spondylolisthesis who failed conservative treatment and were then treated with transforaminal lumbar interbody fusion between 2011 and 2013. The clinical follow-up was done with the modified Oswestry disability index (ODI) and visual pain analogue score (VPAS). For the radiological follow-up radiographs were taken and several radiographic parameters were noted and analysed. RESULTS The mean of the Oswestry disability index scores in all patients decreased from 67.73 to 13.1 at final follow up. Similarly, visual pain analogue score reduced from mean 8.43 to 1.76 at final follow up. The average anterolisthesis was significantly reduced from the preoperative 27.1 ± 14 % to 7.1 ± 5 % at final follow-up radiographs (P &lt; 0.001). Segmental lordosis increased from a mean of 11.5 degrees to 15.7 degrees. The difference in slip angle was significant from preoperative -4.87 ± 4.8 degrees and - 7.23 ± 4.63 degrees on the initial postoperative and - 7.2 ± 4.57 degrees at final follow-up radiographs (P = 0.14 and 0.13 respectively). CONCLUSIONS Thus, adult isthmic spondylolisthesis can be safely and effectively treated by TLIF with significant clinical relief and decrease in disability. TLIF procedure in isthmic spondylolisthesis is capable of reducing the sagittal translation and restoring disc height. Also, sagittal alignment and lordosis can be restored to a large extent. KEYWORDS Spondylolisthesis, Pelvic Incidence, Sagittal Balance, TLIF

Ergonomic Intervention on Physical Therapy Programs Decrease Pain and Disability Level on Subject with Myogenic Low Back Pain: A Case Report

Introduction: Myogenic Low Back Pain is an uncomfortable pain on the lower back, often caused by musculoskeletal disorders resulting in pain and disability. This case report aims to review ergonomic intervention on physical therapy program on myogenic low back pain.&#x0D; Case description: A 45-years-old man working as a roof tile craftsman complained of pain in the lower back area and already felt it for 1 month ago. The pain did not radiate to the leg. The patient has no neurological signs and symptoms. Patient-reported that he had experienced the same incident about 9 times in the last 3 years ago. The patient always performed bending motion and lifting the roof tile every day. The patient has been visited physical therapy and received ergonomic intervention and physical therapy programs such as core stability exercise, soft tissue mobilization and modalities for seven weeks. Following the ergonomic intervention and therapeutic exercise application, the Visual Analogue Scale score decreased from 6 to 0. The Modified Oswestry Disability Index score gradually decreased from 60% disability to 0% disability. The patient no longer complained of MLBP and was able to lift the roof tile well.&#x0D; Conclusion: After a seven-weeks physical therapy treatment session, the patient did not feel pain and can perform forward bending. Modified Oswestry Disability Index score improved and demonstrated improved lifting the roof tile without any complaints. We concluded that the ergonomic intervention combined with physical therapy programs effectively decreased pain and disability level on a subject with MLBP

Effects of McKenzie Approach and Kinesio Taping Technique in Individuals with Mechanical Low Back Pain: A Comparative Study

Objective of this study is to compare the effects of McKenzie approach and kinesio taping technique in individuals with mechanical low back pain. Materials and Methods used are, Quasi experimental study design in the study setting of Department of Physiotherapy, Kovai Medical Centre and Hospital, Coimbatore with the sample of the 20 Patients with Mechanical low back pain who met the inclusion criteria were selected for the study. They were Grouped in A and B with each of 10 Patients. Among the patients, Group A received McKenzie approach and Group B received Kinesio taping. Patients were measured for Pain status by Visual Analogue Scale, Functional ability by Modified Oswestry Disability Index Scale. Results of the data were analyzed using paired, and independent “t‟ tests at 5% level of significance. Even though, there was a significant improvement in both the groups, the McKenzie approach group showed a greater improvement when compared to Kinesio taping technique group. We conclude that McKenzie approach is more effective therapy for mechanical low back pain patients. KEY WORDS: Mechanical low back pain, McKenzie approach, Kinesio taping technique.

Prevalence of low back pain and related disability in patients with femoroacetabular impingement syndrome.

Low back pain (LBP) has been associated with worse hip function for persons with femoroacetabular impingement syndrome (FAIS). Reports are limited to surgical populations and based on the presence or absence of LBP, regardless of pain severity. To report the prevalence of clinically significant LBP for persons with FAIS; compare demographics, pain, and function between those with and without clinically significant LBP; and evaluate relationships between hip function and both LBP-related disability and LBP severity. We hypothesized that participants with LBP would be older, have higher body mass index (BMI), and report worse groin pain, longer symptom duration, and worse hip function. We hypothesized that worse LBP-related disability and LBP severity would be related to worse hip function. Observational cross-sectional study. Hip preservation clinic. 158 persons with FAIS. n/a MAIN OUTCOME MEASURE(S): Visual analog pain scales (VAS 0-100) were used to categorize participants with (≥30) and without (<30) clinically significant LBP. Age, sex, BMI, pain severity and duration, and hip function (33-item Hip Outcome Tool [iHOT33]) were compared between those with and without clinically significant LBP. Correlations were evaluated between the modified Oswestry Disability Index (ODI) and iHOT33, ODI and groin pain severity, LBP severity and iHOT33, and LBP and groin pain severity. Sixty percent of participants reported clinically significant LBP (n=95). These participants reported worse iHOT33 scores (mean difference: 10.1 points) than those without clinically significant LBP (p= .001). Worse ODI scores were associated with worse iHOT33 scores (P< .001; ρ=-0.74). Significant relationships were also observed between (1) ODI and groin pain, (2) LBP and iHOT33, and (3) LBP and groin pain, but the magnitudes of these correlations were weak (ρ ≤ 0.36). Clinically significant LBP is highly prevalent in persons with FAIS and is associated with worse hip function. Worse LBP-related disability, but not LBP severity, was strongly associated with worse hip function.

Percutaneous Vertebroplasty Versus Kyphoplasty for Thoracolumbar Osteoporotic Vertebral Compression Fractures in Patients with Distant Lumbosacral Pain

In clinical practice, we have found that the pain caused by thoracolumbar osteoporotic vertebral compression fracture (OVCF) is sometimes not limited to the level of the fractured vertebrae but instead occurs in areas far away from the injured vertebrae, such as the lower back, area surrounding the iliac crest, or buttocks, and this type of pain is known as distant lumbosacral pain. The pathogenesis of pain in distant regions caused by thoracolumbar OVCF remains unclear. To compare the clinical efficacy and imaging outcomes of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in the treatment of distant lumbosacral pain accompanied by thoracolumbar OVCF and to explore the possible pathogenesis of distant lumbosacral pain caused by thoracolumbar OVCF. Retrospective study. A university hospital spinal surgery departments. A total of 62 patients who underwent vertebral augmentation for thoracolumbar OVCF with lumbosacral pain were included and divided into the PVP group (28 cases) and the PKP group (34 cases). The Visual Analog Scale (VAS) was used to evaluate the severity of local and distant lumbosacral pain, and the Chinese modified Oswestry Disability Index (CMODI) was used for functional assessment. The anterior vertebral height (AVH) of the fractured vertebrae and local kyphotic angle were measured on plain radiographs. The average follow-up time was 28.62 ± 8.43 months in the PVP group and 29.22 ± 9.09 months in the PKP group. Within the 2 groups, the VAS score of local pain, VAS score of distant lumbosacral pain, and CMODI score at 3 days postoperatively and at the last follow-up improved significantly compared with the scores before surgery. However, there was no significant difference between the 2 groups. At 3 days postoperatively and at last follow-up, the AVH and Cobb angle in the 2 groups improved significantly compared with those before surgery, but the magnitudes of AVH improvement and Cobb angle correction were significantly larger in the PKP group than in the PVP group. First, this study is retrospective and may be prone to selection bias. Second, because of cultural and linguistic differences, the original version of the Oswestry Disability Index could not be properly understood and completed by people in mainland China. Therefore in this study, the CMODI was used, but the correlation coefficients of the CMODI within and between groups were 0.953 and 0.912, respectively. Third, a pain diagram was not used to accurately reflect the location of pain in the distant lumbosacral region. Both PVP and PKP can effectively alleviate pain in the distant lumbosacral region caused by thoracolumbar OVCF, and distant lumbosacral pain associated with thoracolumbar OVCF may be considered vertebrogenic referred pain.

Pre-operative Assessment of the Size of the Herniated Lumbar Disc on MRI as Apredictor of Surgical Outcome

Background: Lumbar intervertebral disc herniation (LDH) are the most common source of lumbar radiculopathy. Magnetic Resonance Imaging (MRI) is considered the diagnostic imaging procedure of choice for LDH as it can provide exquisite morphologic detail of the disc abnormality. The aim of this study was to determine if baseline MRI findings including disc herniation size is associated with differential surgical treatment effect. Method: This study was conducted on Benha university hospitals on 36 patients who underwent lumbar discectomy to estimate the role of MRI as a predictor of surgical outcome (by comparison between Preoperative and postoperative leg and back pain scores, as well as functional status measured using the modified oswestry disability index (MODI). Results: The age of patients was (21-51) years, mean 36 and 22 patients (61.1 %) were males and 14 patients (38.9 %) were female, all patients suffered from Back and leg pain, 69.44% of them with lower extremity pain , Sciatica with 77.78% of them hypoesthesia and/or leg weakness was reported in 36.11% of cases. Conclusion: It can be concluded that MRI finding espicially disc size and disc height can predict the surgcail outcome. Patients with larger disc herniations, on average, may have a higher likelihood of experiencing superior clinical outcomes following discectomy. Additional findings seem to support that a patient’s preoperative functional score has the strongest influence on postoperative clinical outcome.

Effect of pre-surgical factors against degenerative lumbal patient surgical actions: evaluation using modified oswestry disability index and rolland morris

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The Novel Technique of Uniportal Endoscopic Interlaminar Contralateral Approach for Coexisting L5-S1 Lateral Recess, Foraminal, and Extraforaminal Stenosis and Its Clinical Outcomes

Background: Multifocal intra-and-extraspinal lumbar stenotic lesions could be decompressed with one endoscopic surgical approach, which has the advantages of functional structure preservation, technical efficacy, and safety. Methods: A retrospective study was performed on 48 patients who underwent uniportal endoscopic contralateral approach due to coexisting lateral recess, foraminal, and extraforaminal stenosis at the L5-S1 level. Foraminal stenosis grade and postoperative dysesthesia (POD) were analyzed. Visual analog scale (VAS) pain scores, modified Oswestry Disability Index (ODI) scores, and MacNab criteria for evaluating pain disability and response were analyzed. Results: The foraminal stenosis grade of the treated spinal levels was grade 1 (n = 16, 33%), grade 2 (n = 20, 42%), and grade 3 (n = 12, 25%). The rate of occurrence of POD grade 2 and above, which may be related to intraoperative dorsal root ganglion (DRG) retraction injury, was revealed to be 4.2% (two with grade 2, none with grade 3). The patients showed favorable clinical outcomes. Conclusions: Uniportal endoscopic interlaminar contralateral approach is an effective procedure to resolve combined stenosis (lateral recess, foraminal, and extraforaminal region) with one surgical approach at the L5-S1 level. It may be a minimal DRG retracting and facet joint preserving procedure in foraminal and extraforaminal decompression.

Efficacy of Innovative Table for Traction, Myofascial Release Along with Medicated Steam (Swedan) in Non-Specific Low Back Pain Patients: A Research Protocol

Background: Low back pain (LBP) is a common condition associated with work absenteeism, disabilityand large health care costs with an annual prevalence range from 22% to 65%.Chronic low back pain is thecondition where the back pain lasts for more than three months. Lumbar traction is the process of applying astretching force to the lumbar vertebrae through body weight, weights, and/or pulleys to distract individualjoints of the lumbar spine. Myofascial release (MFR) is a form of manual medicine which involves theapplication of a low load, long duration stretch to the myofascial complex, intended to restore optimallength, decrease pain, and improve function. Medicated steam therapy is a method of giving medicatedsteam over the affected muscular area in order to provide local effect of pain relief. All the three methodswill be applied together to see the effect.Methods/Design: The study will be designed as a pilot study. A total of 30 samples will be taken withnonspecific low back pain. NPRS and Modified Oswestry Disability index was taken before treatment.Intervention including traction, myofascial release therapy and medicated steam will be given. . Two sessionswill be given once a week for 3 weeks and outcome will be recorded.Discussion: Various studies have been conducted over the effect of lumbar traction over low back pain.Traction distracts the muscles and the joint helps in relieving the pain. One of the therapeutic options istraction, which can be combined with other physical therapy modalities. Combining effect of traction withhot fermentation has been effective study have shown. It has been claimed that traction therapy results inlessening the muscle spasm

Simplicity Radiofrequency Ablation Demonstrates Greater Functional Improvement Than Analgesia: A Prospective Case Series

Pain originating from the posterior sacroiliac complex is notoriously difficult to effectively treat due to its complex anatomy and variable innervation. Data on radiofrequency ablation (RFA) is limited. The Abbott Simplicity probe creates 3 monopolar lesions along the medial aspect of the sacroiliac joint and 2 bipolar lesions between the active portions of the probe. This device has been studied previously with improvement of pain-associated disability and pain reduction, but insufficient data is present to determine its utility at this time. Using the most recent literature for the potential innervation of the posterior sacroiliac joint, it is reasonable to explore this novel device and its ability to treat sacroiliac joint pain. Identify the percentage of improved posterior sacroiliac complex pain and improved function in patients who completed posterior sacroiliac complex radiofrequency ablation using the Simplicity probe. Prospective case series. A single outpatient pain clinic. This prospective case-series occurred at an outpatient pain clinic. Data were analyzed after completion of follow-up appointments. Inclusion criteria included 2 successful lateral branch blocks. Fourteen patients with posterior sacroiliac complex pain were examined and completed sacroiliac ablation with the Simplicity probe. The numeric rating scale and the Modified Oswestry Disability Index were used as outcome measures for pain and function, respectively. The primary outcome measures were improvement in the numeric rating scale score by a reduction of 2.5 points and an improvement in Modified Oswestry Disability Index by 15% based upon previous studies demonstrating these values as the minimal clinical important difference . Patients were followed at a 3 to 6 month interval and 12 month interval (an average of 88 and 352 days, respectively). In total, 14 patients were examined. At the first follow-up, 29% of patients had analgesia and 38% functionally improved. At the second follow-up, 15% of patients had analgesia and 31% functionally improved. Considering data were collected retrospectively, this study relied on completed charts. Therefore, data points of interest were limited to what was previously documented, which included multiple answers or the absence of numerical data points. In addition, patients were disproportionately female (71.4%). Data were also affected by patients lost to follow-up. Also, this study examined a relatively small number of patients, therefore the results should be carefully considered. Radiofrequency ablation of the posterior sacroiliac complex with the Simplicity probe resulted in more functional improvement than analgesia. This study provides more data for clinicians to utilize in managing posterior sacroiliac complex pain. IRB: Protocol number 20170342HU. Not registered in clinical trials.

Myofascial release versus Mulligan sustained natural apophyseal glides' immediate and short-term effects on pain, function, and mobility in non-specific low back pain.

BackgroundMyofascial release (MFR) and Mulligan Sustained Natural Apophyseal Glides (SNAGs) are manual therapy techniques routinely practiced in the management of non-specific low back pain (NSLBP). As a solo intervention or along with other therapies, both methods have reported positive results for individuals with NSLBP. However, which technique improves NSLBP-related pain, restricted range of motion (ROM) and disability, warrants further research.ObjectiveTo study the comparative effects of MFR and SNAGs on pain, disability, functional ability, and lumbar ROM in NSLBP.MethodA parallel-group study was conducted at tertiary care hospitals. Sixty-five Sub-acute or chronic NSLBP patients were allocated to receive strengthening exercises along with either MFR (n = 33) or SNAGs (n = 32) for six treatment sessions over one week. An independent assessor evaluated outcome measures such as the Visual Analog Scale (VAS), Patient-Specific Function Scale (PSFS), and ROM at baseline, immediate (after 1st treatment), and short-term (post-sixth day of the intervention). The Modified Oswestry disability index (MODI) was assessed at baseline and short-term.ResultsWithin-group analysis found clinically and statistically significant (p < 0.05) changes for VAS and PSFS at immediate and short-term for both the groups. The lumbar extension also showed improvement immediately and in the short-term. Improvement in Lumbar flexion was seen only in the SNAGs group over the short-term. A statistically significant improvement was seen for MODI in both the groups but was not clinically significant in the MFR group. The analysis observed no statistically significant difference (p < 0.05) between the groups at both the immediate and short-term.ConclusionsPain and restricted function associated with NSLBP can be improved using SNAGs or MFR, along with strengthening exercises. For limited lumbar flexion ROM, Mulligan SNAGs have a better outcome than MFR over the short-term. Hence, both manual therapy techniques can be incorporated along with exercises for immediate and short-term management of sub-acute to chronic NSLBP.Clinical Trial Registration. CTRI/2018/12/016787 (http://ctri.nic.in/Clinicaltrials/).

A Prospective Comparative Study of Pulsed High-Intensity Laser Therapy and Pulsed Electromagnetic Field on Chronic Nonspecific Low Back Pain.

Objective: This study explored the different effects of pulsed high-intensity laser therapy (HILT) versus pulsed electromagnetic field (EMF) in the treatment of chronic nonspecific low back pain (ChNsLBP). Methods: Between August and December 2019, 51 ChNsLBP participants with a mean age of 35.2 ± 8.6 years were enrolled in this prospective comparative study. At random, they were divided into three groups, 17 in each; HILT, EMF, and controls. HILT group was recruited for Nd:YAG laser using the following parameters: a wavelength of 1064 nm, fluency of 610-810 mJ, frequency of 10-40 Hz, average power of 10.5 W, and 120 μs short pulse duration in scanning mode. All groups received the treatment twice a week for 8 consecutive weeks. They were assessed for the modified Oswestry disability index (MODI), pain disability index (PDI), visual analog scale (VAS), and lumbar flexion range of motion (flex ROM) before and after 8 weeks of study program. Results: The results showed greater improvement in the HILT group (VAS, PDI, MODI, and lumbar flex ROM, p = 0.001) than the EMF group (VAS, p = 0.002, PDI, p = 0.045, MODI, p = 0.002, and lumbar flex ROM, p = 0.042), with significant difference between the two groups in favor of the HILT group (p ˂ 0.05). Conclusions: Depending on the results of the study, both HILT and EMF are useful physiotherapy modalities in the treatment of ChNsLBP with HILT exhibiting better outcomes than EMF. Clinical recommendations should be highlighted to instigate the use of HILT in the management of musculoskeletal disorders, distinctively ChNsLBP.

Mid-term outcome of bilateral fragility fractures of the sacrum after bisegmental transsacral stabilization versus spinopelvic fixation.

Minimally invasive fixation of pelvic fragility fractures is recommended to reduce pain and allow early mobilization. The purpose of this study was to evaluate the outcome of two different stabilization techniques in bilateral fragility fractures of the sacrum (BFFS). A non-randomized, prospective study was carried out in a level 1 trauma centre. BFFS in 61 patients (mean age 80 years (SD 10); four male, 57 female) were treated surgically with bisegmental transsacral stablization (BTS; n = 41) versus spinopelvic fixation (SP; n = 20). Postoperative full weightbearing was allowed. The outcome was evaluated at two timepoints: discharge from inpatient treatment (TP1; Fitbit tracking, Zebris stance analysis), and ≥ six months (TP2; Fitbit tracking, Zebris analysis, based on modified Oswestry Disability Index (ODI), Majeed Score (MS), and the 12-Item Short Form Survey 12 (SF-12). Fracture healing was assessed by CT. The primary outcome parameter of functional recovery was the per-day step count; the secondary parameter was the subjective outcome assessed by questionnaires. Overall, no baseline differences were observed between the BTS and SP cohorts. In total, 58 (BTS = 19; SP = 39) and 37 patients (BTS = 14; SP = 23) could be recruited at TP1 and TP2, respectively. Mean steps per day at TP1 were median 308 (248 to 434) in the BTS group and 254 (196 to 446) in the SP group. At TP2, median steps per day were 3,759 (2,551 to 3,926) in the BTS group and 3,191 (2,872 to 3,679) in the SP group, each with no significant difference. A significant improvement was observed in each group (p < 0.001) between timepoints. BTS patients obtained better results than SP patients in ODI (p < 0.030), MS (p = 0.007), and SF-12 physical status (p = 0.006). In all cases, CT showed sufficient fracture healing of the posterior ring. Both groups showed significant outcome improvement and sufficient fracture healing. Both techniques can be recommended for BFFS, although BTS was superior with respect to subjective outcome. Step-count tracking represents a reliable method to evaluate the mobility level. Cite this article: Bone Joint J2021;103-B(3):462-468.

TREATMENT OF BACK PAIN AFTER HIP ARTHROPLASTY, USING DEEP OSCILLATION

Objective: Deep Oscillation® is an electromechanical procedure with deep therapy that allow to create a pulsed electrostatic field between the hand applicator and the processing better tissue nutrition, enhanced cellular metabolism, faster healing. The purpose of this work is to assessment of the outcome of the treatment of spinal pain after hip arthroplasty using Deep osсillation Methods: The study included 85 patients between the ages of 40 and 75 who were referred to the Arena 2 Rehabilitation Center for post hip joint arthroplasty spine pain, including 57 women and 28 men. Patients physical modalities: complex rehabilitation programme including deep oscillation (DO - fibromyalgia programme) and kinesitherapy - active analytic exercises (including isometric exercises) and soft tissue techniques (post-isometric relaxation, stretching of the lumbar fascia, manual massage). Spinal condition was assessed before treatment after treatment using the Modified Oswestry Disability Index (ODI). Results: Mean value of points before treatment - 3.35+1.1, after treatment - 1.36+0.79. p&lt;0.001 Oswestry Disability Index –67% and 27.2% respectively. Conclusion: After total endoprosthesis, there is a change in biomechanics and a shift in the center of gravity, which causes a change in the position of the spine and pain, so we definitely consider the spine examination and adequate rehabilitation and treatment in the post hip joint arthroplasty period. Involvement in the deep spine's treatment method reduces pain and improves the patient's quality of life, improve function and return-to-work status. Keywords: deep oscillation, hip arthroplasty, back pain.

Monkey See, Monkey Do—Using Graded Motor Imagery in the Management of Chronic Low Back Pain: A Case Report

Background The lifetime prevalence of low back pain (LBP) is high and recurrence is common. Graded motor imagery is a treatment method used in patients with chronic pain that has 3 stages: left/right discrimination or laterality recognition, explicit motor imagery, and mirror therapy. Case Presentation A 33-year-old man self-referred to physical therapy for chronic LBP. He demonstrated misconstrued beliefs regarding his LBP, impaired laterality recognition, and fear-avoidance behaviors. Outcome and Follow-Up This “monkey see, monkey do” approach, in conjunction with other interventions, resulted in a 10% improvement of modified Oswestry Disability Index score, greater than 90% laterality accuracy, and a reduction in pain levels. Discussion Graded motor imagery can facilitate sensory cortex reorganization. A unique approach to improving laterality recognition was demonstrated in this case: the patient could not improve his laterality scores to acceptable levels until he watched his wife successfully complete the task. JOSPT Cases 2021;1(1):61–67. doi:10.2519/josptcases.2021.9875

RELATIONSHIP BETWEEN DISABILITY AND RADIOGRAPHIC FINDINGS OF LUMBAR DISK DEGENERATION IN SAMPLE OF IRAQI PATIENTS WITH MECHANICAL LOW BACKACHE

Objectives: Disability related to chronic low back pain (LBP) is a complex and multidimensional phenomenon all over the world. The prevalence of backache in middle age and elderly is up to 84%. This study aims to evaluate the associations of X-ray features of lumbar disk degeneration with severity of disability among patients with mechanical LBP.&#x0D; Patients and Methods: A cross-sectional study was conducted on a total of 300 patients with chronic mechanical LBP. Severity of disability was measured using Modified Oswestry Disability Index and intensity of backache was assessed using numeric rating scale (0–10). X-ray features of lumbar disc degeneration according to Lane classification and spondylolisthesis were assessed in lateral recumbent lumbar X-rays.&#x0D; Results: The mean age of our sample was 52.45±7.87 and 71.7% of involved patients were women. Most patients were recorded as overweight or obese. The findings of disk space narrowing were mild in 65.7%, moderate in 28.7%, and severe in 5.6%, where the presence of osteophytes were small in 76.9%, moderate in 20.5%, and large in 2.6%. Regarding disability, two-third of cases were focused on minimal disability, followed by moderate, severe, and crippled as (26%), (6%), and (2%), respectively. There was highly significant association between women and pain radiation to legs (p=0.004). Obesity and overweight had meaningless effects on all markers.&#x0D; Conclusions: The severity of disability was significantly more in women, high intensity of lower back pain, presence of pain radiating to legs, moderate/severe disk space narrowing on X-ray, and disk degenerative disease score on X-ray, while age, presence of osteophytes and spondylolisthesis, body mass index, and pain duration were not associated with severity of disability.