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  • Author: Jacek Lewandowski x
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Marcin Grzes´kowiak, Zbigniew Krawiecki, Wojciech Łabe˛dz´, Jacek Kaczmarczyk, Jacek Lewandowski and Dawid Łochyn´ski

Context: Kinesio taping® (KT) is a therapeutic modality frequently used in the clinical practice for the treatment of various musculoskeletal disorders. It is often applied in patients with chronic low back pain to decrease pain and improve functional capacity. However, it is not known, whether thoracolumbar fascia KT technique can decrease back pain, restore normal activity of paraspinal muscles, and improve functional capacity in patients with lumbar disk herniation (LDH). Objective: To evaluate the impact of 7-day new KT stabilizing application on lumbar paraspinal muscles function, pain perception, and disability in patients with LDH. Design: A randomized controlled trial. Setting: Human Performance Laboratory. Patients: A number of 38 patients with LDH were randomized into KT (n = 19) and placebo taping (n = 19) groups. Interventions: Both groups received the same “x” type application running over the back along fibers of superficial lamina of the posterior layer of thoracolumbar fascia. Main Outcome Measures: The primary outcome measures were flexion-relaxation and extension-relaxation ratios calculated from electromyographic activity of lumbar multifidus and longissimus thoracic muscles. Pain intensity rating (Quadruple Visual Analogue Scale), pressure pain thresholds of the lower back, Roland-Morris Disability Questionnaire score, back extension force, and flexion range of motion (ROM) were among secondary outcomes. Results: KT application did not affect the lumbar multifidus and longissimus thoracic muscles flexion-relaxation and extension-relaxation ratios, lower back pressure pain thresholds, back flexion ROM, and back extension force (no group × time interaction [GTI]). KT and placebo taping comparably decreased disability level (time effect: F1,36 = 22.817, P < .001; GTI: F1,36 = 0.189, P = .67), average pain (time effect: F1,36 =39.648, P < .001; GTI: F1,36 = 2.553, P = .12), and the worst pain (time effect: F1,36 = 36.039, P < .001; GTI: F1,36 = 0.003, P = .96) intensity. Conclusion: Seven-day KT does not normalize lumbar paraspinal muscle function and is not superior to placebo in reducing disability and pain intensity in patients with LDH.

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Ewa Kaminska, Tomasz Piontek, Marzena Wiernicka, Grazyna Cywinska-Wasilewska, Jacek Lewandowski and Dawid Lochynski

Context:

The extent of knee extensor and flexor weakness after disruption of knee ligaments affects a rehabilitation output and functional recovery and may give prognostic information on a possible risk of development of knee osteoarthritis.

Objective:

The hypothesis tested was whether patients with a multiple-ligament tear would have larger abnormalities in strength of the knee extensors and flexors than patients with an isolated-ligament rupture.

Design:

Cross-sectional study, level III.

Setting:

Outpatient orthopedic clinic.

Participants:

3 groups of recreationally active men: noninjured control (CON, n = 12), with an anterior cruciate ligament injury (ACLI, n = 10), and with combined anterior and posterior cruciate ligament injury (APCLI, n = 9), matched according to age, body mass, and height.

Intervention:

All patients received conservative treatment and rehabilitation and awaited ligament reconstruction surgery.

Main Outcome Measures:

Isokinetic maximum-repetition peak torque per body mass (PT/BM) and total work (TW), PT and TW limb-symmetry index (LSI), and flexor-to-extensor PT ratio were evaluated during concentric knee extension-flexion movements at lower (60°/s) and higher (240°/s) isokinetic velocities.

Results:

The main finding was that compared with the individuals with ACLI, patients with APCLI produced in their injured limbs lower mean TW (extension: 30.3%, flexion: 28.2%) and had lower mean TW LSI (extension 74% in APCLI vs 91.6% in ACLI; flexion 61.3% in APCLI vs 90.8% in ACLI) at the higher but not lower speed of isokinetic testing. However, at the lower velocity the quantified size of reduction in PT/BM and TW was greater in subjects with APCLI than ACLI as compared with the CON individuals.

Conclusions:

After bi-cruciate-ligament injury the capacity to produce torque by concentric muscle contractions throughout knee-extension and-flexion movements performed with high speed is lower in injured limbs than after isolated anterior cruciate ligament tear.