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Atallah AA, Althuwaybi SE, Faydh JA, Alsherbi RK, Alsufyani ME, Aljuaid HM. Prevalence of Lower Back Pain and its Relationship with Driving Postures among Drivers in Taif, Saudi Arabia. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:S433-S438. [PMID: 36110777 PMCID: PMC9469425 DOI: 10.4103/jpbs.jpbs_882_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/15/2022] [Accepted: 01/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background Lower back pain (LBP) is well-known as the most common musculoskeletal condition with 80% of lifetime prevalence. The effects of LBP on cultural, social, and public health continue to increase. It brings in billions of dollars of medical costs. This study assessed the prevalence of LBP among car drivers with the wrong driving position in Taif. Methodology A cross-sectional study using an electronic questionnaire in English translated to Arabic, which included questions about driving with wrong postures, lower back pain, and its correlation. Results 91.1% of participants satisfied our inclusion criteria for the data analysis. The prevalence of lower back pain in this study was about 44.1% (n = 659). It was more among those aged >40 years (50.9%) compared to other age groups, which showed a statistically significant association (P < 0.001). It was found that 54.4% (n = 813) had been driving in a wrong posture, and there was a strong association observed between this wrong posture and LBP (51.8%) (P < 0.001). Conclusion The prevalence of LBP was high among drivers. This study calls for implanting health education and awareness programs about LBP and its risk factors.
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Affiliation(s)
- Ayman A. Atallah
- Department of Family and Community Medicine, College of Medicine, Taif University, Taif, Saudi Arabia
| | | | - Jamal Amin Faydh
- Medical Intern, College of Medicine, Taif University, Taif, Saudi Arabia
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Mechanical Hyperalgesia but Not Forward Shoulder Posture Is Associated with Shoulder Pain in Volleyball Players: A Cross-Sectional Study. J Clin Med 2022; 11:jcm11061472. [PMID: 35329798 PMCID: PMC8950069 DOI: 10.3390/jcm11061472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/22/2022] [Accepted: 03/05/2022] [Indexed: 02/04/2023] Open
Abstract
Shoulder antepulsion, altered scapular kinematics and imbalance of muscle activity are commonly associated with shoulder pain. This study aimed to observe if there is an association between the forward shoulder angle (FSA) and the pectoralis minor length index (PMI) in volleyball players with and without shoulder pain. Furthermore, this study observed if there is an association between shoulder posture and upper limb mechanical hyperalgesia in volleyball players with and without shoulder pain. Methods: a cross-sectional study was conducted in the Physiotherapy and Pain Research Center in Alcalá de Henares (Spain). A total of 56 volleyball players met the inclusion criteria and agreed to enter the study. Subjects were divided into two groups: shoulder pain group (SPG) and control group (without pain). The following measurements of the dominant sides of the players were collected: FSA, PMI, and pressure pain threshold (PPT) in serratus anterior, lower trapezius, infraspinatus, teres minor, upper trapezius, levator scapulae, pectoralis major, radial nerve, cubital nerve, and median nerve. Results: The Spearman’s Rho revealed no significant correlations were found between FSA and PMI. Moreover, Spearman’s Rho test revealed in the SPG a negative moderate correlation between FSA and Infraspinatus-PPT (Rho = −0.43; p = 0.02); FSA and levator scapulae-PPT (Rho = −0.55; p < 0.01); FSA and pectoralis major-PPT (Rho = −0.41; p = 0.02); PMI and cubital nerve-PPT (Rho = −0.44; p = 0.01). Conclusions: No association was found between the forward shoulder angle and the pectoralis minor index in volleyball players with and without shoulder pain. There is a moderate negative association between shoulder forward angle and muscle mechanical hyperalgesia in volleyball players with shoulder pain, but no such associations were found in volleyball players without shoulder pain. Treatment of the infraspinatus, levator scapulae, pectoralis major, and pectoralis minor muscles could improve shoulder pain and ulnar nerve mechanosensitivity.
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Ellis R, Richards N, Archer L, Whittington C, Mawston G. Assessing Sciatic Nerve Excursion and Strain with Ultrasound Imaging during Forward Bending. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:2560-2569. [PMID: 34218969 DOI: 10.1016/j.ultrasmedbio.2021.05.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 04/27/2021] [Accepted: 05/18/2021] [Indexed: 06/13/2023]
Abstract
Entrapment neuropathies affecting the sciatic nerve tract may adversely affect neural biomechanical features such as excursion and strain. There is a paucity of in vivo evidence examining the effects of forward bending upon sciatic nerve excursion and strain. The purpose of this study was to assess the reliability of ultrasound imaging in measuring sciatic nerve excursion and strain during forward bending movements. Secondary aims were to quantify sciatic nerve excursion and strain during forward bending movements and to assess the relationship between sciatic nerve excursion and movements of the hip and lumbar spine. The reliability of measuring sciatic nerve excursion was high to excellent whilst measurement of sciatic nerve strain was moderate. The amount of hip flexion, during forward bending, was a strong predictor of sciatic nerve excursion. These findings will support clinicians in the assessment and treatment of entrapment neuropathies, in addition to providing a foundation for future research.
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Affiliation(s)
- Richard Ellis
- Department of Physiotherapy, School of Clinical Sciences, Auckland University of Technology, Northcote, Auckland, New Zealand; Active Living and Rehabilitation: Aotearoa New Zealand, Health and Rehabilitation Research Institute, School of Clinical Sciences, Auckland University of Technology, Northcote, Auckland, New Zealand.
| | - Nathan Richards
- Department of Physiotherapy, School of Clinical Sciences, Auckland University of Technology, Northcote, Auckland, New Zealand
| | - Logan Archer
- Department of Physiotherapy, School of Clinical Sciences, Auckland University of Technology, Northcote, Auckland, New Zealand
| | - Chris Whittington
- BioDesign Lab, School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Grant Mawston
- Department of Physiotherapy, School of Clinical Sciences, Auckland University of Technology, Northcote, Auckland, New Zealand; Health and Rehabilitation Research Institute, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
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Jengojan S, Schellen C, Dovjak G, Schmidhammer R, Weber M, Kasprian G, Bodner G. High-resolution ultrasound demonstrates in vivo effects of wrist movement on the median nerve along the forearm. Muscle Nerve 2021; 64:585-589. [PMID: 34423460 DOI: 10.1002/mus.27403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 11/10/2022]
Abstract
INTRODUCTION/AIMS High-resolution ultrasound (HRUS) is the imaging method of choice to visualize peripheral nerve size, structure, and biomechanical performance. The purpose of this study was to show and quantify the effects of active and passive wrist alignment on median nerve (MN) cross-sectional area (CSA) along the forearm in a healthy population. METHODS Sixteen healthy volunteers underwent HRUS of their dominant forearm (n = 16, 10 males, 6 females, 18-55 y of age). Median nerve's CSA was assessed at four defined areas on the forearm in relation to active and passive wrist alignment. RESULTS Changes in wrist alignment were significantly associated with MN CSA (P < .001), regardless if the wrist was moved actively or passively. MN CSA was lowest during passive extension of the wrist joint and highest during passive flexion of the wrist joint (range: 4.5-23.2 mm2 ). DISCUSSION The elasticity of nerve tissue, the loose connective tissue between the fascicles, and the paraneurium allow peripheral nerves to adapt to longitudinal strain. HRUS enables the demonstration of significant median nerve CSA changes along the forearm during active and passive wrist movement in healthy volunteers.
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Affiliation(s)
- Suren Jengojan
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Christoph Schellen
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.,Department of Radiology, Klinik Landstraße, Vienna, Austria
| | - Gregor Dovjak
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | | | - Michael Weber
- Division of General Radiology and Pediatric Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Gregor Kasprian
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Gerd Bodner
- Neuromuscular Imaging and High-Resolution Sonography, Neuromuscular Imaging Vienna, Vienna, Austria
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Tanoue H, Mitsuhashi T, Sako S, Inaba R. An exploratory study on the impact of static and dynamic sitting postures on lumbar and pelvic mobility during visual display terminal work. J Phys Ther Sci 2021; 33:406-412. [PMID: 34083879 PMCID: PMC8165355 DOI: 10.1589/jpts.33.406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 02/06/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Limited studies exist on the impact of sustained work at a visual display
terminal (VDT) on the position and motion of the pelvis and lumbar spine. We evaluated the
changes in movement of the lumbar column and pelvis during VDT work. [Participants and
Methods] We evaluated the sitting posture of 20 healthy adults while they performed VDT
work. The effects of the sitting posture on lumbo-pelvic position and motion were captured
using a three-dimensional accelerometer. Between-posture effects of VDT work were
evaluated using an analysis of variance (ANOVA). A two-way ANOVA was used to assess the
root mean square (RMS) values of the 80-min VDT work period for each posture. A one-way
ANOVA was used to evaluate pre- and post-work changes in RMS values during the finger
floor distance test (FFD). [Results] People in the dynamic sitting balance chair
(DSBC)-based posture demonstrated significantly higher pelvic RMS values than those in
reclining and upright sitting postures. The DSBC-based posture was also associated with
significantly higher pre- and post-work lumbar and pelvic RMS values during the FFD than
in the reclining and upright sitting postures. [Conclusion] The dynamic balance chair may
be an effective method of establishing a pattern of spinal exercise during prolonged
sitting.
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Affiliation(s)
- Hironori Tanoue
- Department of Rehabilitation, Aichi Koseiren Asuke Hospital: 20 Nakata, Yagami-cho, Toyota-shi, Aichi-ken 444-2351, Japan
| | | | - Shunji Sako
- Department of Physical Therapy, Nagoya Isen School Corporation Vocational College, Japan
| | - Ryoichi Inaba
- Department of Occupational Health, Graduate School of Medicine, Gifu University, Japan
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Thoomes E, Ellis R, Dilley A, Falla D, Thoomes-de Graaf M. Excursion of the median nerve during a contra-lateral cervical lateral glide movement in people with and without cervical radiculopathy. Musculoskelet Sci Pract 2021; 52:102349. [PMID: 33618231 DOI: 10.1016/j.msksp.2021.102349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 02/03/2021] [Accepted: 02/06/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND A segmental, contra-lateral cervical lateral glide (CCLG) mobilization technique is effective for patients with cervical radiculopathy (CR). The CCLG technique induces median nerve sliding in healthy individuals, but this has not been assessed in patients with CR. OBJECTIVE This study aimed to 1) assess longitudinal excursion of the median nerve in patients with CR and asymptomatic participants during a CCLG movement, 2) reassess nerve excursions following an intervention at a 3-month follow-up in patients with CR and 3) correlate changes in nerve excursions with changes in clinical signs and symptoms. DESIGN Case-control study. METHODS During a computer-controlled mechanically induced CCLG, executed by the Occiflex™, longitudinal median nerve excursion was assessed at the wrist and elbow with ultrasound imaging (T0) in 20 patients with CR and 20 matched controls. Patients were re-assessed at a 3-month follow-up (T1), following conservative treatment including neurodynamic mobilization. RESULTS There was a significant difference between patients and controls in the excursion of the median nerve at both the wrist (Mdn = 0.50 mm; IQR = 0.13-1.30; 2.10 mm (IQR = 1.42-2.80, p < 0.05)) and elbow (Mdn = 1.21 mm (IQR = 0.85-1.94); 3.49 mm (IQR = 2.45-4.24, p < 0.05)) respectively at T0. There was also a significant increase in median nerve excursion at both sites between T0 and T1 in those with CR (Mdn = 1.96, 2.63 respectively). Wilcoxon Signed-Ranks Test indicated median pre-test ranks (Mdn = 0.5, 1.21; Z = - 3.82, p < 0.01; Z = -3.78, p < 0.01 respectively) and median post-test ranks. There was a strong correlation between improvement in median nerve excursion at the elbow at T1 and improvement in pain intensity (r = 0.7, p < 0.001) and functional limitations (r = 0.6, p < 0.01). CONCLUSION Longitudinal median nerve excursion differs significantly between patients with CR and asymptomatic volunteers at baseline, but this difference is no longer present after 3 months of conservative physiotherapy management. Improvement in nerve excursion correlates with improvement in clinical signs and symptoms.
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Affiliation(s)
- Erik Thoomes
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, United Kingdom; Fysio-Experts, Research Department, Hazerswoude, the Netherlands.
| | - Richard Ellis
- Department of Physiotherapy, School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand; Active Living and Rehabilitation: Aotearoa New Zealand, Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Andrew Dilley
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, United Kingdom
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Martínez-Merinero P, Aneiros Tarancón F, Montañez-Aguilera J, Nuñez-Nagy S, Pecos-Martín D, Fernández-Matías R, Achalandabaso-Ochoa A, Fernández-Carnero S, Gallego-Izquierdo T. Interaction between Pain, Disability, Mechanosensitivity and Cranio-Cervical Angle in Subjects with Cervicogenic Headache: A Cross-Sectional Study. J Clin Med 2021; 10:jcm10010159. [PMID: 33466533 PMCID: PMC7796513 DOI: 10.3390/jcm10010159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/21/2020] [Accepted: 01/02/2021] [Indexed: 12/25/2022] Open
Abstract
The relationship between the forward head posture and mechanosensitivity in subjects with a cervicogenic headache (CGH) remains uncertain. The aim of the study was to evaluate if there was a relationship between the tissue mechanosensitivity and cranio-cervical angle (CCA) that was moderated by pain intensity and/or disability in subjects with CGH. A convenience sample of 102 subjects was recruited. The CCA was measured with photographs, using a postural assessment software. The pain intensity was measured with a visual analogue scale (VAS), and the disability was measured with the Northwick Park Questionnaire. The pressure pain threshold (PPT) was measured at the spinous process of C2, the upper trapezius and splenius capitis muscles, and the median nerve. Simple moderation multiple regression analyses were constructed. There was a positive relationship between PPT at C2 and CCA, but a nonsignificant relationship for the PPT measured at the muscles and median nerve. The effect of PPT at C2 over CCA was moderated by pain intensity (R2 = 0.17; R2 change = 0.06; p < 0.05) but not disability. The Johnson–Neyman analysis revealed a cut-off point for the statistical significance of 4.66 cm in VAS. There seems to be a positive relationship between PPT at C2 and CCA, which is positively moderated by pain intensity in subjects with CGH.
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Affiliation(s)
- Patricia Martínez-Merinero
- Physiotherapy Department, Faculty of Health, Exercise and Sport, European University, Villaviciosa de Odón, 28660 Madrid, Spain;
| | | | - Javier Montañez-Aguilera
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, 46115 Alfara del Patriarca, Spain;
| | - Susana Nuñez-Nagy
- Department of Physiotherapy and Nursing, Alcalá University, 28871 Alcalá de Henares, Spain; (S.N.-N.); (D.P.-M.); (S.F.-C.); (T.G.-I.)
| | - Daniel Pecos-Martín
- Department of Physiotherapy and Nursing, Alcalá University, 28871 Alcalá de Henares, Spain; (S.N.-N.); (D.P.-M.); (S.F.-C.); (T.G.-I.)
- Research Institute of Physical Therapy and Pain, Alcalá University, 28871 Alcalá de Henares, Spain;
| | - Rubén Fernández-Matías
- Research Institute of Physical Therapy and Pain, Alcalá University, 28871 Alcalá de Henares, Spain;
| | - Alexander Achalandabaso-Ochoa
- Research Institute of Physical Therapy and Pain, Alcalá University, 28871 Alcalá de Henares, Spain;
- Department of Health Sciences, Universidad de Jaén, 23071 Jaén, Spain
- Correspondence:
| | - Samuel Fernández-Carnero
- Department of Physiotherapy and Nursing, Alcalá University, 28871 Alcalá de Henares, Spain; (S.N.-N.); (D.P.-M.); (S.F.-C.); (T.G.-I.)
- Research Institute of Physical Therapy and Pain, Alcalá University, 28871 Alcalá de Henares, Spain;
| | - Tomás Gallego-Izquierdo
- Department of Physiotherapy and Nursing, Alcalá University, 28871 Alcalá de Henares, Spain; (S.N.-N.); (D.P.-M.); (S.F.-C.); (T.G.-I.)
- Research Institute of Physical Therapy and Pain, Alcalá University, 28871 Alcalá de Henares, Spain;
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Szikszay T, Hall T, von Piekartz H. In vivo effects of limb movement on nerve stretch, strain, and tension: A systematic review. J Back Musculoskelet Rehabil 2017; 30:1171-1186. [PMID: 28869435 DOI: 10.3233/bmr-169720] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKROUND The mechanical behavior of the peripheral nervous system under elongation and tension has not been adequately established in vivo. OBJECTIVE The purpose of this review is to investigate the mechanical behavior of the peripheral nervous system in vivo. METHODS In vivo studies which evaluated the effects of limb movement and neurodynamic tests on peripheral nerve biomechanics were systematically searched in PubMed (Medline), the Cochrane Database, CINAHL, PEDro, Embase and Web of Science. Studies fulfilling the search criteria were assessed for methodological quality with a modified version of the Down & Blacks scale by two reviewers. RESULTS This review includes the results of 22 studies, of which 15 examined limb movement influencing the median nerve, four the sciatic nerve, two the tibial nerve; and one each the ulnar and peroneal nerves respectively. Substantial nerve longitudinal and transverse excursion and changes in diameter were reported. Despite this, increased nerve strain was not a major finding. CONCLUSION The heterogeneity of included studies, including wide variety of nerves tested, measurement location and joint position prevented comparisons between studies and also amalgamation of data. Limb movement induces complex biomechanical effects of which nerve elongation plays only a minor role.
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Affiliation(s)
- Tibor Szikszay
- Department of Physiotherapy and Rehabilitation, University of Applied Science, Osnabrück, Germany
| | - Toby Hall
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Harry von Piekartz
- Department of Physiotherapy and Rehabilitation, University of Applied Science, Osnabrück, Germany
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Singla D, Veqar Z. Association Between Forward Head, Rounded Shoulders, and Increased Thoracic Kyphosis: A Review of the Literature. J Chiropr Med 2017; 16:220-229. [PMID: 29097952 DOI: 10.1016/j.jcm.2017.03.004] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 03/29/2017] [Accepted: 03/29/2017] [Indexed: 11/25/2022] Open
Abstract
Objective The purpose of this review was to explore the association between forward head posture, rounded shoulders, and increased thoracic kyphosis. Methods The PubMed, ERIC, and Cochrane databases were searched using the key words posture, head, shoulder, forward scapular posture, and thoracic kyphosis through December 2016. Results Our initial search yielded 6840 research studies, 6769 of which were excluded because they either were duplicates or did not satisfy the inclusion criteria. After the abstracts of the remaining studies were read, 15 were assessed for eligibility, and only 4 papers were included in the present review. Cervical lordosis values were found to be significantly associated with thoracic kyphosis values. Also, there were significant correlations between rounded shoulders and increased thoracic kyphosis. Conclusion Forward head posture, rounded shoulders, and increased thoracic kyphosis can exist alone or in any combination.
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Affiliation(s)
- Deepika Singla
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, Jamia Nagar, Okhla, Delhi, India
| | - Zubia Veqar
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, Jamia Nagar, Okhla, Delhi, India
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Liu S, Hemming D, Luo RB, Reynolds J, Delong JC, Sandler BJ, Jacobsen GR, Horgan S. Solving the surgeon ergonomic crisis with surgical exosuit. Surg Endosc 2017. [DOI: 10.1007/s00464-017-5667-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Krause F, Wilke J, Niederer D, Vogt L, Banzer W. Acute effects of foam rolling on passive tissue stiffness and fascial sliding: study protocol for a randomized controlled trial. Trials 2017; 18:114. [PMID: 28274273 PMCID: PMC5343315 DOI: 10.1186/s13063-017-1866-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 02/24/2017] [Indexed: 12/02/2022] Open
Abstract
Background Self-myofascial release (SMR) aims to mimic the effects of manual therapy and tackle dysfunctions of the skeletal muscle and connective tissue. It has been shown to induce improvements in flexibility, but the underlying mechanisms are still poorly understood. In addition to neuronal mechanisms, improved flexibility may be driven by acute morphological adaptations, such as a reduction in passive tissue stiffness or improved movement between fascial layers. The aim of the intended study is to evaluate the acute effects of SMR on the passive tissue stiffness of the anterior thigh muscles and the sliding properties of the associated fasciae. Methods In a crossover study design, 16 participants will receive all of the following interventions in a permutated random order: (1) one session of 2 × 60 s of SMR at the anterior thigh, (2) one session of 2 × 60 s of passive static stretching of the anterior thigh and (3) no intervention. Passive tissue stiffness, connective tissue sliding, angle of first stretch sensation, as well as maximal active and passive knee flexion angle, will be evaluated before and directly after each intervention. Discussion The results of the intended study will allow a better understanding of, and provide further evidence on, the local effects of SMR techniques and the underlying mechanisms for flexibility improvements. Trial registration ClinicalTrials.gov, identifier: NCT02919527. Registered on 27 September 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1866-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Frieder Krause
- Department of Sports Medicine, Institute of Sport Science, Goethe University Frankfurt, Ginnheimer Landstraße 39, 60487, Frankfurt am Main, Germany.
| | - Jan Wilke
- Department of Sports Medicine, Institute of Sport Science, Goethe University Frankfurt, Ginnheimer Landstraße 39, 60487, Frankfurt am Main, Germany
| | - Daniel Niederer
- Department of Sports Medicine, Institute of Sport Science, Goethe University Frankfurt, Ginnheimer Landstraße 39, 60487, Frankfurt am Main, Germany
| | - Lutz Vogt
- Department of Sports Medicine, Institute of Sport Science, Goethe University Frankfurt, Ginnheimer Landstraße 39, 60487, Frankfurt am Main, Germany
| | - Winfried Banzer
- Department of Sports Medicine, Institute of Sport Science, Goethe University Frankfurt, Ginnheimer Landstraße 39, 60487, Frankfurt am Main, Germany
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Meng S, Reissig LF, Beikircher R, Tzou CHJ, Grisold W, Weninger WJ. Longitudinal Gliding of the Median Nerve in the Carpal Tunnel: Ultrasound Cadaveric Evaluation of Conventional and Novel Concepts of Nerve Mobilization. Arch Phys Med Rehabil 2015; 96:2207-13. [DOI: 10.1016/j.apmr.2015.08.415] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 08/12/2015] [Accepted: 08/12/2015] [Indexed: 10/23/2022]
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13
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Outcomes following the conservative management of patients with non-radicular peripheral neuropathic pain. J Hand Ther 2015; 27:192-9; quiz 200. [PMID: 24685569 DOI: 10.1016/j.jht.2014.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 02/04/2014] [Accepted: 02/17/2014] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Prospective cohort. INTRODUCTION There is limited evidence for conservative management of patients with non-radicular peripheral neuropathic pain (PNP). PURPOSE To investigate the effectiveness of a comprehensive treatment approach on pain and disability in patients with non-radicular PNP and to determine if improvements are maintained following the discontinuation of therapy. METHODS Patients received a multi-modal therapeutic intervention. Outcome measures were the shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QDASH), Numeric Pain Rating Scale (NPRS), and grip strength. Follow-up data were collected 5 ± 2 months post-discharge. RESULTS There was a significant improvement in the QDASH and mean pain (p < .001). There was no significant change in grip strength (p > .13). Follow-up data suggest that pain and disability scores are maintained (p < .001). CONCLUSION A comprehensive, conservative treatment program has a positive and lasting effect on pain and disability scores in patients with non-radicular PNP. LEVEL OF EVIDENCE IIIa.
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Silva A, Manso A, Andrade R, Domingues V, Brandão MP, Silva AG. Quantitative in vivo longitudinal nerve excursion and strain in response to joint movement: A systematic literature review. Clin Biomech (Bristol, Avon) 2014; 29:839-47. [PMID: 25168082 DOI: 10.1016/j.clinbiomech.2014.07.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 07/30/2014] [Accepted: 07/30/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Neural system mobilization is widely used in the treatment of several painful conditions. Data on nerve biomechanics is crucial to inform the design of mobilization exercises. Therefore, the aim of this review is to characterize normal nervous system biomechanics in terms of excursion and strain. METHODS Studies were sought from Pubmed, Physiotherapy Evidence Database, Cochrane Library, Web of Science and Scielo. Two reviewers' screened titles and abstracts, assessed full reports for potentially eligible studies, extracted information on studies' characteristics and assessed its methodological quality. FINDINGS Twelve studies were included in this review that assessed the median nerve (n=8), the ulnar nerve (n=1), the tibial nerve (n=1), the sciatic nerve (n=1) and both the tibial and the sciatic nerves (n=1). All included studies assessed longitudinal nerve excursion and one assessed nerve strain. Absolute values varied between 0.1mm and 12.5mm for median nerve excursion, between 0.1mm and 4.0mm for ulnar nerve excursion, between 0.7 mm and 5.2mm for tibial nerve excursion and between 0.1mm and 3.5mm for sciatic nerve excursion. Maximum reported median nerve strain was 2.0%. INTERPRETATION Range of motion for the moving joint, distance from the moving joint to the site of the lesion, position of adjacent joints, number of moving joints and whether joint movement stretches or shortens the nerve bed need to be considered when designing neural mobilization exercises as all of these factors seem to have an impact on nerve excursion.
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Affiliation(s)
- Ana Silva
- School of Health Sciences, University of Aveiro, Escola Superior de Saúde da Universidade de Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - André Manso
- School of Health Sciences, University of Aveiro, Escola Superior de Saúde da Universidade de Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - Ricardo Andrade
- School of Health Sciences, University of Aveiro, Escola Superior de Saúde da Universidade de Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - Vanessa Domingues
- School of Health Sciences, University of Aveiro, Escola Superior de Saúde da Universidade de Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - Maria Piedade Brandão
- School of Health Sciences, University of Aveiro, Escola Superior de Saúde da Universidade de Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; Center for Health Technology and Services Research (CINTESIS), Piso 2, Edifício Nascente, Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal
| | - Anabela G Silva
- School of Health Sciences, University of Aveiro, Escola Superior de Saúde da Universidade de Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; Center for Health Technology and Services Research (CINTESIS), Piso 2, Edifício Nascente, Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal.
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The pattern of tibial nerve excursion with active ankle dorsiflexion is different in older people with diabetes mellitus. Clin Biomech (Bristol, Avon) 2012; 27:967-71. [PMID: 22809735 PMCID: PMC3772678 DOI: 10.1016/j.clinbiomech.2012.06.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Revised: 06/27/2012] [Accepted: 06/28/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND The peripheral nervous system has an inherent capability to tolerate the gliding (excursion), stretching (increased strain), and compression associated with limb motions necessary for functional activities. The biomechanical properties during joint movements are well studied but the influence of other factors such as limb pre-positioning, age and the effects of diabetes mellitus are not well established for the lower extremity. The purposes of this pilot study were to compare the impact of two different hip positions on lower extremity nerve biomechanics during an active ankle dorsiflexion motion in healthy individuals and to determine whether nerve biomechanics are altered in older individuals with diabetes mellitus. METHODS Ultrasound imaging was used to quantify longitudinal motion of the tibial nerve and transverse plane motion of the tibial and common fibular nerves in the popliteal fossa during active ankle movements. FINDINGS In healthy individuals, ankle dorsiflexion created mean tibial nerve movement of 2.18 mm distally, 1.36 mm medially and 3.98 mm superficially. When the hip was in a flexed position there was a mean three-fold reduction in distal movement. In people with diabetes mellitus there was significantly less distal movement of the tibial nerve in the neutral hip position and less superficial movement of the nerve in both hip positions compared to healthy individuals. INTERPRETATION We have documented reductions in tibial nerve excursion due to limb pre-positioning thought to pre-load the nervous system using a non-invasive methodology. Thus, lower limb pre-positioning impacts nerve biomechanics during ankle motions common in functional activities. Additionally, our findings indicate that nerve biomechanics have the potential to be altered in older individuals with diabetes mellitus compared to younger healthy individuals.
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Abstract
The validity of upper-limb neurodynamic tests (ULNTs) for detecting peripheral neuropathic pain (PNP) was assessed by reviewing the evidence on plausibility, the definition of a positive test, reliability, and concurrent validity. Evidence was identified by a structured search for peer-reviewed articles published in English before May 2011. The quality of concurrent validity studies was assessed with the Quality Assessment of Diagnostic Accuracy Studies tool, where appropriate. Biomechanical and experimental pain data support the plausibility of ULNTs. Evidence suggests that a positive ULNT should at least partially reproduce the patient's symptoms and that structural differentiation should change these symptoms. Data indicate that this definition of a positive ULNT is reliable when used clinically. Limited evidence suggests that the median nerve test, but not the radial nerve test, helps determine whether a patient has cervical radiculopathy. The median nerve test does not help diagnose carpal tunnel syndrome. These findings should be interpreted cautiously, because diagnostic accuracy might have been distorted by the investigators' definitions of a positive ULNT. Furthermore, patients with PNP who presented with increased nerve mechanosensitivity rather than conduction loss might have been incorrectly classified by electrophysiological reference standards as not having PNP. The only evidence for concurrent validity of the ulnar nerve test was a case study on cubital tunnel syndrome. We recommend that researchers develop more comprehensive reference standards for PNP to accurately assess the concurrent validity of ULNTs and continue investigating the predictive validity of ULNTs for prognosis or treatment response.
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Manualtherapie bei chronischem Spannungskopfschmerz. MANUELLE MEDIZIN 2012. [DOI: 10.1007/s00337-012-0904-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Carroll M, Yau J, Rome K, Hing W. Measurement of tibial nerve excursion during ankle joint dorsiflexion in a weight-bearing position with ultrasound imaging. J Foot Ankle Res 2012; 5:5. [PMID: 22397397 PMCID: PMC3315758 DOI: 10.1186/1757-1146-5-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Accepted: 03/08/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The ability of peripheral nerves to stretch and slide is thought to be of paramount importance to maintain ideal neural function. Excursion in peripheral nerves such as the tibial can be measured by analysis of ultrasound images. The aim of this study was to assess the degree of longitudinal tibial nerve excursion as the ankle moved from plantar flexion to dorsiflexion in a standardised weight-bearing position. The reliability of ultrasound imaging to measure tibial nerve excursion was also quantified. METHODS The tibial nerve was imaged over two separate sessions in sixteen asymptomatic participants in a weight-bearing position. Longitudinal nerve excursion was calculated from a three-second video loop captured by ultrasound imaging using frame-by-frame cross-correlation analysis. Intraclass correlation coefficients (ICC) with 95% confidence intervals (CI) were used to assess the intra-rater reliability. Standard error of the measurement (SEM) and smallest real difference (SRD) were calculated to assess measurement error. RESULTS Mean nerve excursion was 2.99 mm SEM ± 0.22 mm. The SRD was 0.84 mm for session 1 and 0.66 mm for session 2. Intra-rater reliability was excellent with an ICC = 0.93. CONCLUSIONS Assessment of real-time ultrasound images of the tibial nerve via frame-by-frame cross-correlation analysis is a reliable non-invasive technique to assess longitudinal nerve excursion. The relationship between foot posture and nerve excursion can be further investigated.
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Affiliation(s)
- Matthew Carroll
- School of Rehabilitation & Occupation Studies, Health & Rehabilitation Research Institute, Department of Podiatry, AUT University, Private Bag 92006, Auckland 1142, New Zealand.
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Nicoud F, Castellazzi G, Lesniewski PJ, Thomas JC. Fast template tracking in video sequences. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2011; 82:105110. [PMID: 22047332 DOI: 10.1063/1.3650711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Tracking of poorly defined, rotating and/or distorted objects in a video sequence poses significant problems especially in medical diagnostics including ultrasound (sonographic) video used for examination and diagnosis of internal movement of tissue or muscle and nerve action. Cross-correlation techniques have been successful in retrieving dynamic information directly from ultrasound video data. We outline a fast implementation of tracking based on normalized cross-correlation using an adaptive template and present results from our application, developed in MATLAB™, which successfully tracks arbitrarily selected objects in deformed or severely compromised images. Common ultrasound image evaluation is qualitative but there is need to retrieve quantitative dynamic information such as the trajectory or velocity of selected areas. Our approach uses normalized two-dimensional cross-correlation to find the position of an initially selected template enclosing the feature of interest and map its trajectory frame-by-frame to produce displacement and velocity plots. We illustrate operation of the application using routine ultrasound data and demonstrate its performance using test video of objects rotating full circle and rolling down a ramp. We analyse errors associated with sampling to compare performance of our implementation with a more rigorous but tedious and computationally expensive correlation of a resampled, rotated, and shifted template.
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Affiliation(s)
- Florent Nicoud
- Applied Physics, School of Electrical and Information Engineering, University of South Australia, Adelaide, SA 5095, Australia
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Altered Alignment of the Shoulder Girdle and Cervical Spine in Patients With Insidious Onset Neck Pain and Whiplash-Associated Disorder. J Appl Biomech 2011; 27:181-91. [DOI: 10.1123/jab.27.3.181] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Clinical theory suggests that altered alignment of the shoulder girdle has the potential to create or sustain symptomatic mechanical dysfunction in the cervical and thoracic spine. The alignment of the shoulder girdle is described by two clavicle rotations, i.e, elevation and retraction, and by three scapular rotations, i.e., upward rotation, internal rotation, and anterior tilt. Elevation and retraction have until now been assessed only in patients with neck pain. The aim of the study was to determine whether there is a pattern of altered alignment of the shoulder girdle and the cervical and thoracic spine in patients with neck pain. A three-dimensional device measured clavicle and scapular orientation, and cervical and thoracic alignment in patients with insidious onset neck pain (IONP) and whiplash-associated disorder (WAD). An asymptomatic control group was selected for baseline measurements. The symptomatic groups revealed a significantly reduced clavicle retraction and scapular upward rotation as well as decreased cranial angle. A difference was found between the symptomatic groups on the left side, whereas the WAD group revealed an increased scapular anterior tilt and the IONP group a decreased clavicle elevation. These changes may be an important mechanism for maintenance and recurrence or exacerbation of symptoms in patients with neck pain.
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Kim MH, Yoo WG. Effects of a Visual Feedback Device for Hip Adduction on Trunk Muscles and Sitting Posture in Visual Display Terminal Workers. Asia Pac J Public Health 2011; 23:378-85. [DOI: 10.1177/1010539511403729] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study was designed to identify the effects of a visual feedback device for hip adduction on trunk muscles and sitting posture when working at a visual display terminal. The forward head and trunk flexion angles of 20 workers were analyzed using a motion analysis system, and the activities of the lower trapezius, external abdominal oblique, internal abdominal oblique, and L5 paraspinal muscles were analyzed using a electromyography system. The statistical significance of differences between using and not using a visual feedback device was assessed by paired t tests. Using the visual feedback device during Visual Display Terminal work significantly decreased the forward head and trunk flexion angles, and significantly increased the activities of the external abdominal oblique, internal abdominal oblique, and L5 paraspinal muscles. The authors suggest that the visual feedback device for hip adduction promotes the adoption of standard spine and pelvic postures, which might be effective in preventing poor sitting postures.
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Affiliation(s)
| | - Won-gyu Yoo
- Inje University, Gyeongsangnam-do, Republic of Korea,
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Yasui H, Takamoto K, Hori E, Urakawa S, Nagashima Y, Yada Y, Ono T, Nishijo H. Significant correlation between autonomic nervous activity and cerebral hemodynamics during thermotherapy on the neck. Auton Neurosci 2010; 156:96-103. [PMID: 20400380 DOI: 10.1016/j.autneu.2010.03.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Revised: 02/02/2010] [Accepted: 03/15/2010] [Indexed: 12/30/2022]
Abstract
Although local thermotherapy reduces mental stress and neck stiffness, its physiological mechanisms are still not fully understood. We speculated that local thermotherapy exerts its effect, in addition to its direct peripheral effects, through the central nervous system that is involved in controlling stress responses. In the present study, we investigated the effects of a heat- and steam-generating (HSG) sheet on cerebral hemodynamics and autonomic nervous activity using near-infrared spectroscopy (NIRS) and the electrocardiograms (ECGs). Thirteen healthy young female subjects participated in this study. HSG or simple (control) sheets were repeatedly applied to the neck for 120 s with 180 s intervals of rest between applications. During the experiment, brain hemodynamic responses (changes in Oxy-Hb, Deoxy-Hb, and Total-Hb) and autonomic nervous activity based on heart rate variability (HRV) were monitored. Subjective perception of neck stiffness and fatigue was significantly improved after application of the HSG sheet. NIRS findings indicated that the application of HSG sheets decreased Oxy-Hb concentration in the anterior-dorsal region of the medial prefrontal cortex (adMPFC), while increasing parasympathetic nervous activity and decreasing sympathetic nervous activity. Furthermore, changes in Oxy-Hb in the adMPFC were significantly and negatively correlated with those in parasympathetic nervous activity during application of the HSG sheet. These findings suggest that application of the HSG sheet to the neck region induced mental relaxation and ameliorated neck stiffness by modifying activity of the adMPFC.
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Affiliation(s)
- Hiroshi Yasui
- System Emotional Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Sugitani 2630, Toyama 930-0194, Japan
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Erel E, Dilley A, Turner S, Kumar P, Bhatti WA, Lees VC. Sonographic measurements of longitudinal median nerve sliding in patients following nerve repair. Muscle Nerve 2009; 41:350-4. [DOI: 10.1002/mus.21501] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Dilley A, Odeyinde S, Greening J, Lynn B. Longitudinal sliding of the median nerve in patients with non-specific arm pain. ACTA ACUST UNITED AC 2008; 13:536-43. [PMID: 17913563 DOI: 10.1016/j.math.2007.07.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2006] [Revised: 06/08/2007] [Accepted: 07/15/2007] [Indexed: 11/21/2022]
Abstract
In patients with non-specific arm pain (NSAP; also known as repetitive strain injury), there are clinical signs of altered median nerve sliding. It is possible that a restriction along the nerve course will lead to abnormal increases in local strain during limb movements, possibly contributing to symptoms. The present study uses ultrasound imaging to examine median nerve sliding through the proximal and distal nerve segments in 18 NSAP patients. Longitudinal nerve sliding was measured during metacarpophalangeal, wrist and elbow movements. During elbow movements, the angle of elbow extension at which the nerve begins to move was determined, since this was expected to decrease with a restriction through the shoulder. The results from this study were compared with previously reported data. Nerve movements ranged from 1.26 to 4.73 mm in patients compared with 1.43-5.57 mm in controls. There was no significant difference in nerve sliding (p>0.05) or in the angle of elbow extension at which the nerve began to move (mean=53.4 degrees in patients, 52.0 degrees in controls; p>0.05). In summary, restriction of median nerve sliding is unlikely to play a major role in NSAP. Therefore, painful responses during limb movements which tension the nerve are unlikely to result from abnormal increases in nerve strain.
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Affiliation(s)
- Andrew Dilley
- Department of Physiology, University College London, Gower Street, London, UK.
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Van Hoof T, Gomes GT, Audenaert E, Verstraete K, Kerckaert I, D'herde K. 3D Computerized Model for Measuring Strain and Displacement of the Brachial Plexus Following Placement of Reverse Shoulder Prosthesis. Anat Rec (Hoboken) 2008; 291:1173-85. [DOI: 10.1002/ar.20735] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Yoo WG, Yi CH, Cho SH, Jeon HS, Cynn HS, Choi HS. Effects of the height of ball-backrest on head and shoulder posture and trunk muscle activity in VDT workers. INDUSTRIAL HEALTH 2008; 46:289-297. [PMID: 18544890 DOI: 10.2486/indhealth.46.289] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This study was designed to elucidate the effects of a ball-backrest at different heights on the head and shoulder posture and neck and trunk muscles of visual display terminal (VDT) workers who adopted a forward head posture when working at a VDT. Twenty-three VDT workers with forward head posture performed the keyboard typing work at a VDT without and with a ball-backrest at the L3, T10, and T4 levels. Surface electromyograms were recorded from the neck, shoulder, and trunk muscles, and the forward head angle and forward shoulder angle were analyzed using a 3-D motion analysis system. The significance of differences for the ball-backrest at different heights was tested by repeated one-way ANOVA, with the significance cutoff set at p=0.05. The mean forward head angle and forward shoulder angle decreased in the order of no backrest, T10-level ball-backrest, T4-level ball-backrest. Compared with not using a backrest, the activity of midcervical muscles was significantly lower and that of the lower trapezius was significantly higher when using a T4-level ball-backrest, and the activity of the internal oblique abdominal muscle was significantly higher when using a T10-level ball-backrest. We suggested that using T4 and T10-level ball-backrests would produce similar effects to active exercise, such as ball exercise for trunk stabilization, and that a ball-backrest would prevent kinematics changes. Therefore, the height of the backrest must be determined on the basis of the characteristics of work-related musculoskeletal disorders when applying a ball-backrest to VDT workers with such disorders.
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Affiliation(s)
- Won-gyu Yoo
- Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, 607 Obangdong, Gimhae, Gyeongsangnam-do, 621-749 Republic of Korea
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Lowe W. Suggested variations on standard carpal tunnel syndrome assessment tests. J Bodyw Mov Ther 2008; 12:151-7. [DOI: 10.1016/j.jbmt.2007.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2007] [Revised: 04/07/2007] [Accepted: 04/10/2007] [Indexed: 11/16/2022]
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Smith TM, Sawyer SF, Sizer PS, Brismée JM. The double crush syndrome: a common occurrence in cyclists with ulnar nerve neuropathy-a case-control study. Clin J Sport Med 2008; 18:55-61. [PMID: 18185040 DOI: 10.1097/jsm.0b013e31815c1d7a] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the incidence of double crush syndrome in the upper limbs of cyclists with clinical diagnosis of ulnar nerve neuropathy. DESIGN Case-control study. SETTING Outpatient clinics and university setting. PARTICIPANTS Consecutive sampling of 70 cyclists (140 upper limbs) with a mean age of 36 years (+/-11.3). Seventy-two upper limbs were excluded, leaving 40 upper limbs with a clinical diagnosis of ulnar nerve neuropathy [ULNN (+)] and 28 without symptoms of ulnar nerve neuropathy [ULNN (-)]. ASSESSMENT Cyclists were examined clinically for the presence of proximal dysfunction using the following testing (independent variables): (1) thoracic outlet syndrome provocation testing: elevated arm stress test and modified Cyriax release test; (2) presence of an elevated first rib: cervical rotation lateral flexion test; and (3) presence of proximal symptoms: reports of neck pain and shoulder pain. MAIN OUTCOME MEASUREMENTS The upper limbs of cyclists were categorized into 2 groups (dependent variable)-ULNN (+) and ULNN (-)-based on history, symptoms, motor, sensory, and provocative clinical testing. RESULTS A significantly greater number of upper limbs of cyclists with ULNN (+) presented with positive provocative testing for thoracic outlet syndrome (elevated arm stress test P = 0.005; modified Cyriax release test P = 0.002) than did the upper limbs of cyclists with ULNN (-). The likelihood for the presence of neck pain, shoulder pain, and an elevated first rib was 3, 5, and 12 times greater, respectively, in the ULNN (+) than the ULNN (-) group. CONCLUSION A statistically significant greater number of the upper limbs of cyclists with clinical diagnosis of ulnar nerve neuropathy presented with proximal dysfunctions suggestive of double crush syndrome.
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Affiliation(s)
- Tanya M Smith
- Center of Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, Texas 79430, USA
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Yoo WG, Yi CH, Kim MH. Effects of a proximity-sensing feedback chair on head, shoulder, and trunk postures when working at a visual display terminal. JOURNAL OF OCCUPATIONAL REHABILITATION 2006; 16:631-7. [PMID: 17086500 DOI: 10.1007/s10926-006-9059-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
INTRODUCTION This study was designed to identify the effects of feedback from a proximity-sensing chair on head, shoulder, and trunk postures when working at a visual display terminal (VDT). METHODS Twenty healthy adults were asked to perform VDT work, and their forward head, forward shoulder, and trunk flexion angles were analyzed using a 3-D motion analysis system. The statistical significance of differences between without and with an auditory feedback device was tested by paired t-tests, with the significance cutoff set at alpha=0.05. RESULTS The forward head, forward shoulder, and trunk flexion angles significantly decreased during VDT work when using the proximity sensor with auditory feedback. CONCLUSION We suggest that a feedback device promotes the adoption of beneficial postures, which may be effective in preventing VDT-work-related neck and upper-limb disorders.
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Affiliation(s)
- Won-gyu Yoo
- Department of Rehabilitation Therapy, The Graduate School, Yonsei University, 134 Shinchon-dong, Seodaemun-gu, Seoul, 120-752 Republic of Korea.
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. AA, . RG. Prevalence of Shoulder Postural Impairments in 10-12 Years Old Primary Students of Zahedan. JOURNAL OF MEDICAL SCIENCES 2006. [DOI: 10.3923/jms.2006.332.337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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