In which direction does skin move during joint movement?

Fascia Tissue Manipulations in Chronic Low Back Pain: A Pragmatic Comparative Randomized Clinical Trial of the 4xT Method® and Exercise Therapy

BACKGROUND

The 4xT method is a protocolized practice in treating musculoskeletal disorders. The 4xT method consists of four components: Test (functional diagnostic test), Trigger (fascia tissue manipulations), Tape (elastic taping), and Train (exercise). There is a lack of clinical studies evaluating the treatment effects of the use of the 4xT method.

METHODS

A randomized controlled trial was conducted to compare the effectiveness of the 4xT method and exercise therapy-only in patients with chronic nonspecific low back pain. Based on a priori sample size calculation, fifty-one individuals with chronic nonspecific low back pain were randomly assigned to either the 4xT or exercise group. Both groups underwent a six-week rehabilitation program with two treatments per week. The primary outcomes were trunk flexion and extension mobility, trunk flexion, and extension mobility-dependent pain, and quality of life evaluated during a 6-week therapy period and after a 6-week therapy-off period.

RESULTS

Interaction effects were noted in all outcomes. The 4xT group showed significant improvements over time for trunk flexion and extension mobility, trunk flexion and extension mobility-dependent pain, and quality of life (p < 0.05), with no significant relapse post-therapy (except for extension mobility). The exercise group exhibited significant within-time changes in the quality of life, as measured with the VAS (p < 0.05), but not for EQ-5D-3L.

CONCLUSIONS

The results of this study demonstrate that the 4xT method stands out as a promising and impactful treatment option for chronic nonspecific low back pain individuals, as it demonstrated significant reductions in mobility-dependent pain, increased trunk mobility, and improved quality of life compared to exercise-only treatments.

A study on skin mobility according to joint movement: Variations in mobility according to joint motion range and correlation and influence with hydrica composition

BACKGROUND

Skin structures arranged in an advantageous structure for skin stretching to facilitate movement of the human body, and have structural functions to help the movement of the joints by changing the position of the skin, such as the stretch that occurs incidentally. Proper movement of the skin is required to be efficient owing to the nature of the skin that covers the entire human body with a single connected tissue layer.

AIMS

The purpose of this study was to quantify the skin mobility that occurs during joint motion and to identify the correlation and influence with hydrica composition.

MATERIALS & METHODS

The subjects of this study were healthy people in their 20s-50s (20 male, 20 female), The movement of the skin marker attached to the skin was measured using X-ray, and the hydrica composition was measured using Inbody S10.

RESULTS

Experiments showed that the skin on the side at which the joint bends and wrinkles form moved away from the moving joint, while the skin on the side where the wrinkles spread out moved toward the moving joint. As the range of joint motion increases, the skin became more mobile (OR: 18.95 ± 5.91 mm, MR: 34.09 ± 7.87 mm, IR: 51.14 ± 8.73 mm, FF: 78.76 ± 12.24) (p < 0.05). As a result of regression analysis between the total amount of skin mobility and the factors of hydrica composition, it was found that the ABW (arm body water) affected skin mobility as B = 7.430 (p < 0.05, adjusted R2  = 0.119).

CONCLUSION

Based on the results of this study, it was revealed that directional movement of the skin appeared according to joint movement, and it was affected by body water.

Systematic Review of Lumbar Elastic Tape on Trunk Mobility: A Debatable Issue

Objectives

To systematically review the literature to analyze the effect of lumbar elastic tape application on trunk mobility, surpassing the minimal detectable change of the used outcome measurement tool, and to analyze the additional effect of applied tension and direction of elastic tape application in low back pain and participants without low back pain.

Data Sources

Four databases were used: PubMed, Web of Science, Physiotherapy Evidence Database (PEDro), and Google Scholar.

Study Selection

The inclusion criteria were randomized and clinical controlled trials evaluating the effectiveness of lumbar elastic tape application on trunk mobility.

Data Extraction

Two researchers executed the search and a third author was consulted to resolve disagreements. The methodological quality was scored using the PEDro scale, with studies scoring ≤5 being excluded.

Data Synthesis

Eight out of 6799 studies were included; 5 studied individuals with low back pain, and 3 studied participants without low back pain. Two studies scored low on the PEDro scale and were excluded. None of the reported significant changes in trunk mobility due to elastic tape application exceeded the indicated minimal detectable change. No conclusions can be drawn from the direction and applied tension of elastic tape application.

Conclusions

Based on the results of this systematic review, there is no evidence supporting the effect of lumbar elastic tape application. We recommend consensus in the use of more reliable and valid instruments in future studies.

Shadow pitching deviates ball release position: kinematic analysis in high school baseball pitchers

Background

Although shadow pitching, commonly called “towel drill,” is recommended to improve the throwing motion for the rehabilitation of pitching disorders before the initiation of a throwing program aimed at returning to throwing using a ball, the motion differs from that of normal throwing. Learning improper motion during ball release (BR) may increase shoulder joint forces. Abnormal throwing biomechanics leads to injures. However, there has been no study of shadow pitching focusing on the BR position. The purpose of the present study was to evaluate the BR position and kinematic differences between shadow pitching and normal throwing. In addition, the effect of setting a target guide for BR position on throwing motion was examined in shadow pitching.

Methods

The participants included in this study were 20 healthy male students who were overhand right-handed pitchers with no pain induced by a throwing motion. Participants performed normal throwing (task 1), shadow pitching using a hand towel (task 2), and shadow pitching by setting a target of the BR position (task 3). A motion capture system was used to evaluate kinematic differences in throwing motions, respectively. Examination items comprised joint angles and the differences in BR position.

Results

BR position of task 2 shifted significantly toward the anterior, leftward, and downward directions compared with task 1. The distance of BR position between tasks 1 and 2 was 24 ± 10%. However, task 3 had decreased BR deviation compared with task 2 (the distance between 3 and 1 was 14 ± 7%). Kinematic differences were observed among groups at BR. For shoulder joint, task 2 showed the highest value in abduction and horizontal adduction among groups. In spine flexion, left rotation and thorax flexion, task 2 was significantly higher than task 1. Task 3 showed small differences compared with task 1.

Conclusions

The BR position of shadow pitching deviated significantly in the anterior, leftward, and downward directions compared with normal throwing. Furthermore, we demonstrated that the setting of BR target reduces this deviation. Thus, the target of BR position should be set accurately during shadow pitching exercises in the process of rehabilitation.

Effects of soft tissue artefacts on computed segmental and stifle kinematics in canine motion analysis

Skin marker-based motion analysis has been widely used to evaluate the functional performance of canine gait and posture. However, the interference of soft tissues between markers and the underlying bones (soft tissue artefacts, STAs) may lead to errors in kinematics measurements. Currently, no optimal marker attachment sites and cluster compositions are recommended for canine gait analysis. The current study aims to evaluate cluster-level STAs and the effects of cluster compositions on the computed stifle kinematics. Ten mixed-breed healthy dogs affixed with 19 retroreflective markers on the thigh and shank were enrolled. During isolated stifle passive extension, the marker trajectories were acquired with a motion capture system, and the skeletal poses were determined by integrating fluoroscopic and CT images of the bones. The cluster-level STAs were assessed, and clusters were paired to calculate the stifle kinematics. A selection of cluster compositions was useful for deriving accurate sagittal and frontal plane stifle kinematics with flexion angles below 50 per cent of the range of motion. The findings contribute to improved knowledge of canine STAs and their influence on motion measurements. The marker composition with the smallest error in describing joint kinematics is recommended for future applications and study in dogs during dynamic gait assessment.

Current Concepts Burn Rehabilitation, Part I: Care During Hospitalization

This article summarizes current interventions for several of the most common challenges faced by patients during their rehabilitation from burn injury. These include preservation of range of motion through scar contracture management, and achieving maximal independence through exercise, and training in activities of daily living.

The effects of new taping methods designed to increase muscle strength

[Purpose] Although there are several studies on the use of elastic tape to influence muscle strength, results are contradictory and controversial. Our previous studies based on the sliding mechanism between superficial fascia and subcutaneous tissue may help the muscle strength. The purpose of this study was to confirm the effects of new taping methods on muscle strength. [Subjects and Methods] Sixteen healthy male participants took part in this study. Tape was applied on the right gluteus maximus and hip extension strength was determined by an isokinetic evaluation (30°/sec, concentric mode, four conditions). Condition 1: Tape was applied from the muscle insertion to origin; Condition 2: Tape was applied from the origin to insertion; Condition 3: Dummy tape with no direction; Condition 4: No tape was applied. [Results] The mean value of conditions 1–4 were 398.2 ± 24.3 Newton (N), 343.7 ± 25.9 N, 363.7 ± 26.4 N, and 371.3 ± 26.3 N, respectively (mean ± SE). The result of condition 1 was significantly greater compared with the other conditions. [Conclusion] This new method corresponded to a tape direction of insertion-rigin may help to increase the muscle strength.

Functional difference between the proximal and distal compartments of the semitendinosus muscle

[Purpose] The tendinous inscription divides the semitendinosus muscle into the proximal and distal compartments. It was hypothesized that there are functional differences between those compartments. [Subjects and Methods] Seven adult males performed knee flexion and hip extension in the prone position. An ultrasound device measured the decrease in the length of muscle fibers in the two compartments during these movements. The knee and hip joint angles were concurrently measured using a video camera. Pearson's correlation coefficients were calculated between the decrease in muscle fiber length in each compartment and joint angle. [Results] During knee flexion, decreased muscle fiber length was significantly correlated with increased knee flexion angle. During hip extension, there were no significant correlations for either compartment. Only the decrease in muscle fiber length in the distal compartment during hip extension tended to be negative; the other decreases in muscle fiber length tended to be positive. [Conclusion] Correlations did not reveal any functional differences. However, only the distal compartment elongated during hip extension. This result might show a functional difference and could be applied in clinical contexts during hip extension.