The biomechanics of the lumbosacral region in acute and chronic low back pain patients.

BACKGROUND: A previous study examined the relationship between the sacral inclination angle (SIA), lumbosacral angle (LSA) and sacral horizontal angle (SHA) and spinal mobility in acute low back pain and chronic low back pain patients. We chose to investigate the lumbar lordosis angle, segmental lumbar lordosis angle, SIA, LSA and SHA in acute and chronic low back pain (LBP) patients as well as the correlation between spinal stability and these angles. OBJECTIVES: To investigate the biomechanics of the lumbosacral spine region in acute and chronic LBP patients, as well as to examine the correlation between spinal stability and lumbosacral angles. STUDY DESIGN: Randomized controlled evaluation SETTING: Physical Medicine and Rehabilitation outpatient clinic METHODS: Sixty participants with LBP were recruited and categorized as either acute LBP (pain < 3 months) or chronic LBP (pain > 6 months), with 30 subjects in each group. All subjects underwent standing, lateral lumbosacral x-rays, which were analyzed for lumbar stability, SIA, LSA, SHA, lumbar lordosis angle and segmental lumbar lordosis angles. RESULTS: The mean age of the ALBP subjects was 41.00 +/- 11.63 (18 - 66) and that of the chronic LBP subjects 49.26 +/- 15.6 (22-74), with females comprising 50% of the acute LBP group and 73.3% of the chronic LBP group. Lumbar stability was observed in 62.1% of acute LBP patients and 36.8% of chronic LBP patients. A statistically significant difference was found between the 2 groups in terms of age, gender, and lumbar stability. There was no statistical difference regarding SIA, LSA, SHA, total and segmental lordosis angles between acute and chronic LBP patients (p>0.05). CONCLUSION: We were unable to find a difference between the radiological values for the shape of the SIA, LSA, SHA, and total and segmental lordosis as noted on screening x-ray techniques regarding the occurrence of acute or chronic LBP, but a statistically significant difference was found for lumbar stability. Further extensive studies are needed to examine lumbar stability and its relationship between angles of lumbosacral region.

Evaluation of upper extremity rehabilitation in hemiplegic patients with and without complex regional pain syndrome type 1.

We investigated the effects of the complex regional pain syndrome (CRPS) type 1 on upper extremity rehabilitation in hemiplegic patients. Eighty patients were enrolled and were randomly assigned to either study (40 hemiplegic patients with CRPS) or control (40 hemiplegic patients without CRPS) groups. All patients participated in a hemiplegia rehabilitation program consisting of neurodevelopmental techniques, stretching and strengthening exercises, and conventional methods. Additionally, participants in the study group received analgesic and calcitonin therapy, elevation, range of movement therapy for the affected joints, and contrast baths. Clinical findings were assessed before and after rehabilitation using the upper-limb function (ULF), hand movements (HM), and advanced hand activities (AHA) subscales of the Motor Assessment Scale (MAS) and the Ashworth scale for upper extremities. A statistically significant difference in MAS ULF was apparent at admission and upon discharge in both groups. In the control group, a significant difference was found between MAS HM and MAS AHA on admission and at discharge, no difference was found in the study group for these parameters. No difference was found for either group with regard to the Ashworth scale. No between-group differences were found regarding MAS ULF, MAS HM, and MAS AHA at admission and at discharge. Our data showed no influence of CRPS on MAS ULF, MAS HM, and MAS AHA and the Ashworth scale for upper extremities.