{"title":"Trajectory-based analysis of spinal kinematics during forward bending in non-specific chronic low back pain subgroups: A smartphone 2D video tracking.","authors":"Hwa-Ik Yoo, Il-Kyu Ahn, Oh-Yun Kwon","doi":"10.1177/10538127251372010","DOIUrl":"https://doi.org/10.1177/10538127251372010","url":null,"abstract":"<p><p>BackgroundSimple range of motion measurements in individuals with non-specific chronic low back pain (NSCLBP) during forward bending provide limited information about the directional characteristics of spinal movements.PurposeTo examine the horizontal and vertical displacement trajectories of thoracolumbar regions (T12 and L2 levels) during forward bending using smartphone-based 2-dimensional video analysis, and to compare kinematics among NSCLBP subgroups classified as the flexion pattern (FP) and extension pattern (EP), and healthy controls.MethodsA total of 185 participants were recruited (58 healthy, 87 FP, 40 EP). Two markers were positioned over the spinous processes of T12 and L2. Marker trajectories were tracked using Kinovea software, and displacements along the <i>x</i>- (anterior-posterior) and <i>y</i>-axes (superior-inferior) were measured.ResultsThe EP group showed significantly greater anterior displacement at the T12 and L2 levels than the FP group, and at the L2 level than healthy controls. No significant differences were found between FP and healthy groups or in vertical displacement of the two markers.ConclusionsHorizontal displacement trajectories effectively differentiated NSCLBP subgroups, particularly identifying a distinct movement strategy in the EP group. Smartphone-based video analysis may offer a clinically useful and accessible tool for subgroup-specific assessment.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127251372010"},"PeriodicalIF":1.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The relationship between rotator cuff disorders and abdominal muscles: Biomechanical and clinical findings.","authors":"Gizem Sarıçimen, Merih Özgen, Cüneyt Çalışır, Fezan Mutlu","doi":"10.1177/10538127251370048","DOIUrl":"https://doi.org/10.1177/10538127251370048","url":null,"abstract":"<p><p>BackgroundRotator cuff (RC) disorders are common musculoskeletal conditions causing shoulder pain and functional loss. While abdominal muscles aid in core stabilization and force transmission, their strength, endurance, and thickness in RC disorders remain underexplored.ObjectivesThis study aimed to examine the differences in abdominal muscle performance between individuals with RC pathology and healthy controls and to evaluate the relationship of these parameters with pain, disability and quality of life.Materials and MethodThis cross-sectional study evaluated 128 individuals (RC group: 64; control group: 64). The strength of the abdominal muscles was evaluated, and the McGill endurance test was performed. Muscle thickness was measured using ultrasound imaging. Shoulder-related pain, symptoms and functionality were assessed with Shoulder Pain and Disability Index and Western Ontario Rotator Cuff Index.ResultsThe RC group exhibited significantly lower abdominal muscle strength and endurance compared to controls (<i>p</i> < 0.001). A moderate negative correlation was observed between abdominal muscle performance and clinical scores. According to ultrasound evaluations, patients with right-sided shoulder pathology (RSSP) had thinner EO (<i>p</i> < 0.001) and TrA (<i>p</i> = 0.016) muscles on the affected side, while left-sided shoulder pathology (LSSP) showed similar reductions in RA (<i>p</i> = 0.001), EO (<i>p</i> = 0.012), and TrA (<i>p</i> = 0.006) thickness. The RC group showed significantly greater percentage asymmetry in RA muscle thickness compared with controls (<i>p</i> = 0.02), while no statistically significant differences were found for EO, IO, or TrA muscles.ConclusionThis study demonstrates that decreased abdominal muscle function and thickness are associated with RC disorders. We emphasize that core stability exercises should be included in rotator cuff rehabilitation.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127251370048"},"PeriodicalIF":1.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hamad S Al Amer, Shahul Hameed Pakkir Mohamed, Sharon L Olson
{"title":"Effects of sitting posture and duration on lumbosacral nerve root function: A case-control study.","authors":"Hamad S Al Amer, Shahul Hameed Pakkir Mohamed, Sharon L Olson","doi":"10.1177/10538127251371635","DOIUrl":"https://doi.org/10.1177/10538127251371635","url":null,"abstract":"<p><p>PurposeThis study aimed to investigate the effects of different sitting postures and prolonged sitting on lumbosacral nerve root function by measuring the amplitude of the soleus (SOL) Hoffmann reflex (H-reflex).MethodsThis study included 30 healthy individuals who were selected through convenience sampling and divided according to daily sitting duration over the past year into a prolonged sitting group (≥6 h/day) and a control group (≤4 h/day). The SOL H-reflex amplitude was recorded in erect, slumped, slouched, and supine positions. Ischial pressure was evaluated in all sitting postures to assess spinal loading.ResultsSlouched sitting significantly lowered ischial pressure (<i>p</i> <i><</i> <i>0.0005</i>) and produced higher H-reflex amplitudes (<i>p</i> <i><</i> <i>0.0005</i>), which were not significantly different from those in the supine position (<i>p</i> <i>=</i> <i>0.362</i>). In contrast, (<i>p</i> <i><</i> <i>0.0005</i>) erect and slumped (<i>p < 0.0005</i>) postures showed increased ischial pressure and significantly reduced H-reflex amplitudes (<i>p</i> <i><</i> <i>0.0005</i> for both postures). Participants in the prolonged sitting group demonstrated significantly lower SOL H-reflex amplitudes than those in the control group (<i>p</i> <i>=</i> <i>0.008, ηp²</i> <i>=</i> <i>0.23</i>).ConclusionVarious sitting postures and durations exert different effects on the lumbosacral spine and nerve roots. Slouched sitting reduces spinal stress and lower nerve root compression compared to erect and slumped seated positions. Extended sitting duration may partially compress the lumbosacral nerve root, thereby potentially contributing to postural low back pain over time.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127251371635"},"PeriodicalIF":1.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kaiwen Xiong, Shan Cheng, Lin Cong, Taihui Zhang, Duoduo Hui, Yao Wang
{"title":"Effect of preload on lumbar muscle contraction during co-activation of trunk muscles in young males simulating anti-G straining maneuver.","authors":"Kaiwen Xiong, Shan Cheng, Lin Cong, Taihui Zhang, Duoduo Hui, Yao Wang","doi":"10.1177/10538127251370574","DOIUrl":"https://doi.org/10.1177/10538127251370574","url":null,"abstract":"<p><p>ObjectPreload is known to improve spinal stability; however, its effect on the voluntary contraction of lumbar muscles needs investigation. This study aimed to investigate the role of preload in enhancing the voluntary contraction of lumbar muscles in a group of young men.MethodsTwenty healthy participants successively participated in experiments with the following preload conditions arranged in random order: no preload, forward preload, backward preload, or right-hand-pull preload. Preload intensity was set to 20% and 40% of the maximum load forces, and the participants voluntarily co-activated their trunk muscles while seated. Surface electromyography signals were recorded for analysis.ResultsForward preload was able to increase the maximal voluntary contraction strength of lumbar muscles, an effect enhanced with greater preload intensity. Backward preload reduced the maximal voluntary contraction strength of lumbar muscles as preload intensity increased. Right-hand-pull preload exhibited some asymmetrical characteristics.DiscussionDuring co-activation of the trunk muscles, preload demonstrated different effects on the voluntary contraction strength of lumbar muscles in a group of young men. As forward preload enhanced the voluntary contraction of lumbar muscles, it may play a significant role in stabilising the spine. Backward preload may also have a stabilising effect on the spine, but more research is required.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127251370574"},"PeriodicalIF":1.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Postoperative rehabilitation of spaghetti wrist : A case report.","authors":"Xin-Nan Tang, Xin Yu, Qian Pei, Wen-Qian Zhi, Qiang Huang","doi":"10.1177/10538127251370040","DOIUrl":"https://doi.org/10.1177/10538127251370040","url":null,"abstract":"<p><p>ObjectiveThis case report presents a comprehensive rehabilitation protocol and outcomes for zone 5 forearm injuries involving tendons and neurovascular structures. Phase-specific rehabilitation strategies were used to maximize functional recovery. The findings provide clinical guidance for managing this rare injury, offering insights into rehabilitation approaches and expected outcomes.DesignCase Report.ParticipationA 46-year-old right-handed male sustained a severe glass-induced open forearm injury during badminton. Emergency surgery revealed complete ruptures of: vascular structures (radial artery, ulnar artery and vein), nerves (ulnar, median, and little finger digital nerves), and tendons (flexor pollicis longus, flexor digitorum profundus and superficialis of digits 2-5, flexor carpi radialis, flexor carpi ulnaris, and palmaris longus)Rehabilitation ProgramA 7-month progressive rehabilitation protocol was implemented for zone 5 flexor tendon injuries with ulnar/median nerve damage, with adjustments based on recovery progress.Outcome MeasuresPostoperative rehabilitation progress was assessed through clinical and functional measures.ConclusionEarly surgery combined with a structured rehabilitation protocol achieved excellent functional recovery, with 70-90% wrist and digit range of motion restoration, improved grip strength and activities of daily living by 12 weeks, progressive sensorimotor recovery between 20-28 weeks, and successful work return by 10 weeks, demonstrating this protocol's efficacy for complex neurotendinous injuries.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127251370040"},"PeriodicalIF":1.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brian Swanson, John McCarthy, Elizabeth Clark, Olivia Norman, Olivia Wilson
{"title":"The influence of spine position on measures of lower extremity neural sensitivity.","authors":"Brian Swanson, John McCarthy, Elizabeth Clark, Olivia Norman, Olivia Wilson","doi":"10.1177/10538127251370575","DOIUrl":"https://doi.org/10.1177/10538127251370575","url":null,"abstract":"<p><p>BackgroundThe Slump Test evaluates neural tissue mechanosensitivity in individuals with lower extremity symptoms. However, there has been little research assessing the role of altering lumbar spine positioning on sensory response. Therefore, this study compared differences in subjective and objective findings observed in different lumbar spine positions during neurodynamic testing.MethodsHealthy participants were assessed using the 90/90 knee extension (KEA) to determine available ROM, followed by lumbar spine flexed slump (FS), and lumbar spine extended slump (ES). Outcomes included knee extension angle, hamstring EMG activity (%MVIC), distal extent of sensory response, and qualitative mechanosensory response.ResultsForty participants (23.95 ± 2.64 years; 14 male/26 female) completed the study. Significantly less knee extension ROM was found for ES vs. FS (p < .001) and ES vs. KEA (p = .037). A greater proportion of distal symptoms were observed during ES vs. FS (p < .05). FS and ES showed higher EMG values than KEA (p < .001), with no difference between the two slump conditions.ConclusionIn this healthy population, ES produced the greatest distal sensory responses, highest EMG activity, and lowest knee extension ROM. Incorporating lumbar extension during slump testing may be useful to determine mechanosensitive behavior, but further research is needed in clinical populations.The trial was prospectively registered at clinical trials.gov. NCT05313217.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127251370575"},"PeriodicalIF":1.4,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluating the efficacy of cranio-mandibular stabilization exercises on pain, jaw mobility, mouth function, and oral health-related quality of life in patients with temporomandibular disorder management: A randomized controlled trial.","authors":"Ramesh Chandra Patra, A Yashudas","doi":"10.1177/10538127251361631","DOIUrl":"https://doi.org/10.1177/10538127251361631","url":null,"abstract":"<p><p>AimThe purpose of this study is to evaluate the effects of a manual therapy program and cranio-mandibular stabilization exercises on orofacial pain levels, jaw mobility, functional performance, and oral health-related quality of life (OHRQoL) in patients with Temporomandibular Disorders (TMD) in comparison to manual therapy and placebo interventions.Materials and MethodsIn this randomized controlled study, 87 participant (63.5% women and 36.5% men) aged 18 to 50 years with myofascial or mixed TMD were randomly assigned into three groups: Manual Therapy Group (MT), Cranio-Mandibular Stabilization Exercises (CMSE), or Control Group (CG). Pre-Intervention assessment was done at baseline, following post- treatment (after 8 weeks), three months, and twelve months. The outcome evaluation were done by the Visual Analog Scale, Mandibular Function Impairment Questionnaire, Oral Health Impact Profile-14, and jaw range of motion (ROM).ResultsBonferroni post hoc tests and mixed-model ANOVA with repeated measures were used to analyze all results. At baseline, 8 weeks, 3 month, and 12 months, the CMSE group's improvements in jaw function and discomfort were noticeably larger than those of the Control Group (ES > 0.7). At the conclusion of therapy and three months later, CMSE performed better for OHRQoL than both the Manual Therapy and Control groups (ES > 0.7).ConclusionThe results indicate that a structured manual therapy plan combined with cranio-mandibular stabilization exercises provides significant therapeutic advantages in lowering pain and disability in patients with temporomandibular disorders (TMD).</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127251361631"},"PeriodicalIF":1.4,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The baseline bubble inclinometer measurement of sagittal thoracic spinal range of motion is reliable: Validated by optoelectronic motion capture system.","authors":"Ziang Jiang, Jiling Ye, Rongshan Cheng, Qiang Zhang, Lili Xu, Tsung-Yuan Tsai","doi":"10.1177/10538127251357101","DOIUrl":"https://doi.org/10.1177/10538127251357101","url":null,"abstract":"<p><p>BackgroundThe thoracic spinal range of motion (ROM) is a commonly used in pathological and functional assessment. Baseline bubble inclinometers are one of the most frequently employed thoracic ROM measurement methods. However, there is currently no consensus on the accuracy and standardized procedure of their utilization.ObjectiveThe purpose of this study is to validate the accuracy of baseline bubble inclinometers in measuring the sagittal thoracic spinal ROM and to propose the standard guideline for their utilization.Method28 participants were recruited for this study. The maximum thoracic spinal ROM during flexion and extension was measured using inclinometers, with the optoelectronic motion capture system (Vicon) serving as the control group.ResultThe thoracic spinal ROM during flexion was 14.5 ± 10.5°; during extension was 19.0 ± 9.2°, and the total ROM was 33.5 ± 14.0°. The inclinometers showed moderate to high correlations with the Vicon results, particularly in measuring flexion ROM, which exhibited the highest effectiveness (r = 0.84∼0.89). The accuracy of the inclinometers was enhanced by ensuring a cervical nodding and fixation position. Additionally, it was observed that females were more suitable candidates for thoracic spinal ROM measurement using inclinometers, as they exhibited higher correlations with the Vicon results.ConclusionThis study successfully validated the accuracy of the inclinometer as a convenient thoracic spinal ROM measurement method, that can save significant time for physiotherapists in clinical settings. The measurements obtained in this study may serve as a preliminary reference for the thoracic spinal ROM in healthy individuals and standardized protocols for using the baseline bubble inclinometer.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127251357101"},"PeriodicalIF":1.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hazel Celık Guzel, Sule Kecelıoglu, Ebru Kaya Mutlu, Mert Durukan, Tulay Satı Kırkan
{"title":"Masseter muscle hyperactivity and pain sensitization during smartphone use: A cross-sectional study of thenar-trigeminal interaction.","authors":"Hazel Celık Guzel, Sule Kecelıoglu, Ebru Kaya Mutlu, Mert Durukan, Tulay Satı Kırkan","doi":"10.1177/10538127251360869","DOIUrl":"https://doi.org/10.1177/10538127251360869","url":null,"abstract":"<p><p>BackgroundWhile it is known that smartphone use (SU) affects the musculoskeletal system, the effect of repetitive thumb movements on the masseter muscle has not been systematically investigated.ObjectiveTo investigate the effects of repetitive thumb movements due to SU on the masseter muscle through thenar muscle activity.MethodsThe students' pressure pain thresholds of the thenar and masseter muscles were assessed with an algometer, and bilateral masseter muscle activation was assessed with Electromyography (EMG). Students were asked to perform repetitive thumb taps with their dominant hand for 5 min using the \"Fast-Tap\" smartphone application.ResultsThis cross- sectional observational study included 105 students aged 20.96 (2.44) years. Post-SU, right thenar (p < .001), right masseter (p < .001), and left masseter (p = .040) pressure pain threshold decreased, and right masseter muscle activation was higher in terms of %MVC values (p < .001). The right and left thenar and masseter muscle pressure pain thresholds were moderately to highly correlated (p < 0.001). Additionally, the number of thumb taps was moderately correlated with right masseter muscle activation (p < 0.001) and weakly correlated with left masseter muscle activation (p = .005).ConclusionRepetitive thumb movements due to SU may affect the masseter muscle, and the thenar-masseter relationship may lead to innovative treatment approaches in the future.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127251360869"},"PeriodicalIF":1.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alessandro de Sire, Andrea Parente, Emanuele Prestifilippo, Martina Cocco, Stefano Fasano, Andrea Racinelli, Andrea Reggiani, Ambrogio Vimercati, Nicola Marotta, Antonio Ammendolia
{"title":"Efficacy of oxygen-ozone therapy and proprioceptive neuromuscular facilitation on pain and disability in patients affected by acute or subacute low back pain: A randomized controlled trial.","authors":"Alessandro de Sire, Andrea Parente, Emanuele Prestifilippo, Martina Cocco, Stefano Fasano, Andrea Racinelli, Andrea Reggiani, Ambrogio Vimercati, Nicola Marotta, Antonio Ammendolia","doi":"10.1177/10538127251360867","DOIUrl":"https://doi.org/10.1177/10538127251360867","url":null,"abstract":"<p><p>BackgroundLow back pain (LBP) is one of the most common causes of disability worldwide. Although the etiology of LBP is varied, mechanical and inflammatory stimuli might involve the lumbar region, determining neurological symptoms and even radicular pain, often varying with posture.ObjectivesThis randomized controlled trial (RCT) aimed to evaluate the efficacy of Oxygen-Ozone (O<sub>2</sub>O<sub>3</sub>) injections and Proprioceptive Neuromuscular Facilitation (PNF) in pain relief and functioning in LBP, in comparison with a Control Group treated with O<sub>2</sub>O<sub>3</sub> and Back School program.MethodsWe included 86 patients randomly assigned to two groups affected by LBP, with a Numerical Rating Scale (NRS) scale >4. There were 8 dropouts, for a total of 78 patients enrolled. All the patients underwent 8 injections of O<sub>2</sub>O<sub>3</sub>, once a week, with a concentration of 20 μg/mL, administered into the paravertebral musculature at L4-L5 and L5-S1 bilaterally. Subsequently, the experimental group underwent PNF treatment, while the control group received Back School techniques, 3 times/week for 4 weeks. Outcome measures included NRS, Oswestry Disability Index (ODI), EuroQol-5-Dimensions-3-Levels (EQ5D3L). We used: Independent t-test for between-group analysis, paired t-test for within-group analysis; ANOVA for repeated-measures analysis along the different time-points.ResultsBoth groups showed significant improvements in NRS, ODI after O<sub>2</sub>O<sub>3</sub> injections (T1, p < 0.005). Physical therapy with O<sub>2</sub>O<sub>3</sub> demonstrated improvements in all outcomes (p < 0.005), with greater efficacy in the PNF-group, particularly in NRS and ODI (ΔT0-T2, p < 0.005).ConclusionThis RCT demonstrated the efficacy of a combined treatment, based on O<sub>2</sub>O<sub>3</sub> injections and PNF or Back-School, in improving pain, and functioning in LBP, with major findings in PNF management.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127251360867"},"PeriodicalIF":1.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}